Category: Mental Health

Should Service Users be Involved in Co-Designing Surveys they will Use?

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Research Paper Title

Validation of a Comprehensive Patient Experience Survey for Addiction and Mental Health that was Co-designed with Service Users.

Background

A rigorous survey development process was undertaken to design and test a novel, comprehensive patient experience measure that can be used across the full continuum of addiction and mental health programs.

Service users were involved in all aspects of the measure’s development, including the selection of items, pre-testing, naming of the scales, and interpretation of the results.

Methods

Survey data was collected from 1222 patients in treatment in a variety of service settings across Alberta, Canada (89% outpatients; 60% female).

Results

An exploratory factor analysis identified five subscales-patient-centred care, treatment effectiveness, staff behaviour, availability and coordination of care, and communication.

The subscales had high internal reliability (Cronbach’s alpha = 0.77 to 0.85) and test-retest reliability ranged from 0.53 to 0.82 across the five scales.

Conclusions

Scores on the new instrument were correlated with treatment outcomes.

The assessment of patient experience should be integrated into a continuous, sustainable quality improvement process to be truly effective.

Reference

Currie, S.R., Liu, P., Adamyk-Simpson, J. & Stanich, J. (2020) Validation of a Comprehensive Patient Experience Survey for Addiction and Mental Health that was Co-designed with Service Users. Community Mental Health Journal. 56(4), pp.735-743. doi: 10.1007/s10597-019-00534-1. Epub 2020 Jan 1.

Are Pre-service Military-related & Mental Disorder Factors Associated with Leaving the UK Armed Forces?

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Research Paper Title

Pre-service Military-related and Mental Disorder Factors Associated with Leaving the UK Armed Forces.

Background

The UK Armed Forces (UKAF) have a substantial manning deficit as more personnel leave than join.

This article identified pre-service, military, and mental health factors giving rise to leaving the UKAF and estimated the contributions to leaving of those factors which are potentially amenable to modification.

Methods

This study utilised data from a three-phase cohort study (2004-2006, 2007-2009 and 2014-2016), commencing while respondents were serving in the UKAF (n = 10,836; 6,046 (55.8%) had left service).

Associations between leaving the services and socio-demographics, military career and experiences, and mental health were determined using Cox regression.

Contribution to leaving was based on population attributable fractions (PAF) from Cox regression.

Analyses were stratified by rank due to the different career structures of Commissioned Officers and enlisted personnel.

Results

Leaving the UKAF was associated with joining when older, being a woman with a child/children, Army service, combat role, lower education level, and poor mental health.

Factors contributing a significant proportion of leaving among enlisted personnel were joining over the age of 17, history of externalising behaviour, being female, common mental disorders, and alcohol misuse.

Among Commissioned Officers only age at joining and sex contributed significant proportions to leaving.

Conclusions

The key factors for leaving are education and higher age at recruitment.

These are not amenable to intervention, for policy, equity, and legal reasons.

Heavy drinking and common mental disorder symptoms may be more amenable to modification and hence reduce rates of leaving the UKAF.

Women are more likely to leave due to childbearing.

Reference

Burdett, H., Stevelink, S.A.M., Jones, N., Hull, L., Wessely, S. & Rona, R. (2020) Pre-service Military-related and Mental Disorder Factors Associated with Leaving the UK Armed Forces. Psychiatry. 1-16. doi: 10.1080/00332747.2020.1729063. [Epub ahead of print].

Can We Link Financial Worries & Poor Mental Health?

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Research Paper Title

Sociodemographic Characteristics, Financial Worries and Serious Psychological Distress in U.S. Adults.

Background

Economic recessions have been well studied in relationship to poor mental health.

However, subjective financial worries have not been examined relative to serious psychological distress (SPD), a measure of poor mental health.

Methods

Adults 18 to 64 years in the cross-sectional 2016 National Health Interview Survey (n = 24,126) were examined for worries about paying for bills, serious medical events, expected medical costs, retirement, children’s college tuition and maintaining a standard of living; by sociodemographic such as sex and race/ethnicity. Over 50% of adults reported two or more financial worries.

Results

In multivariate models, financial worries were associated with SPD.

White adults at the lowest education level had the greatest proportion with SPD compared with all other race/ethnic groups.

Conclusions

Women had greater risk for SPD and for each financial worry compared with men.

Financial worries were prevalent in US adults, were associated with increased risk for SPD, and varied by sex.

Reference

Weissman, J., Russell, D. & Mann, J.J. (2020) Sociodemographic Characteristics, Financial Worries and Serious Psychological Distress in U.S. Adults. Community Mental Health Journal. 56(4), pp.606-613. doi: 10.1007/s10597-019-00519-0. Epub 2020 Jan 1.

Is there a Link between Exercise Addiction & Eating Disorders?

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Research Paper Title

A comparative meta-analysis of the prevalence of exercise addiction in adults with and without indicated eating disorders.

Background

Exercise addiction is associated with multiple adverse outcomes and can be classified as co-occurring with an eating disorder, or a primary condition with no indication of eating disorders.

The researchers conducted a meta-analysis exploring the prevalence of exercise addiction in adults with and without indicated eating disorders.

Methods

A systematic review of major databases and grey literature was undertaken from inception to 30/04/2019.

Studies reporting prevalence of exercise addiction with and without indicated eating disorders in adults were identified.

A random effect meta-analysis was undertaken, calculating odds ratios for exercise addiction with versus without indicated eating disorders.

Results

Nine studies with a total sample of 2140 participants (mean age = 25.06; 70.6% female) were included.

Within these, 1732 participants did not show indicated eating disorders (mean age = 26.4; 63.0% female) and 408 had indicated eating disorders (mean age = 23.46; 79.2% female).

The odds ratio for exercise addiction in populations with versus without indicated eating disorders was 3.71 (95% CI 2.00-6.89; I2 = 81; p  ≤ 0.001).

Exercise addiction prevalence in both populations differed according to the measurement instrument used.

Conclusions

Exercise addiction occurs more than three and a half times as often as a comorbidity to an eating disorder than in people without an indicated eating disorder.

The creation of a measurement tool able to identify exercise addiction risk in both populations would benefit researchers and practitioners by easily classifying samples.

Reference

Trott, M., Jackson, S.E., Firth, J., Jacob, L., Grabovac, I., Mistry, A., Stubbs, B. & Smith, L. (2020) A comparative meta-analysis of the prevalence of exercise addiction in adults with and without indicated eating disorders. Eating and Weight Disorders: EWD. doi: 10.1007/s40519-019-00842-1. [Epub ahead of print].

Intellectual Disabilities & Coexisting Mental Health Conditions

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Research Paper Title

Developmental stages and estimated prevalence of coexisting mental health and neurodevelopmental conditions and service use in youth with intellectual disabilities, 2011-2012.

Background

Few studies exist on mental health and neurodevelopmental conditions and service use among youth with intellectual disabilities (IDs), which makes it difficult to develop interventions for this population.

The objective of the study is to

  1. Estimate and compare the prevalence of mental health and neurodevelopmental conditions in youth with and without ID across three developmental stages; and
  2. Estimate and compare mental health service use in youth with and without ID across three developmental stages.

Methods

The researchers conducted secondary data analysis using cross-sectional data collected from caregivers completing the 2011-2012 National Survey of Children’s Health.

The data set represents a nationally representative sample of youth (0-17 years) in the USA with one child from each household being randomly selected.

Data were collected from caregivers in 50 states, Washington D.C. and the US Virgin Islands.

The researchers restricted the sample to parents of youth between 3-17 years (N = 81 510).

Results

Compared with youth without ID, youth ages 3-17 with ID had a statistically significantly higher prevalence of (1) mental health and neurodevelopmental conditions and (2) mental health care use and medication use for mental health and neurodevelopmental issues (other than attention deficit disorder/attention deficit hyperactivity disorder).

Clinically significant differences in coexisting conditions and service use were also found across developmental stages.

Conclusions

Youth with ID are at greater risk of having coexisting mental health and neurodevelopmental conditions than youth without ID and are more likely to receive treatment.

Therefore, clinicians should consider mental health and neurodevelopmental conditions and the unique needs of youth by developmental stage when tailoring interventions for youth with ID.

Reference

Comer-HaGans, D., Weller, B.E., Story, C. & Holton, J. (2020) Developmental stages and estimated prevalence of coexisting mental health and neurodevelopmental conditions and service use in youth with intellectual disabilities, 2011-2012. Journal of Intellectual Disability Research. 64(3), pp.185-196. doi: 10.1111/jir.12708. Epub 2020 Jan 1.

Postpartum: Linking Poor Body Image & Depressive Symptoms

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Research Paper Title

A qualitative insight into the relationship between postpartum depression and body image.

Background

This study qualitatively explored the experience of depression and body image concerns in women diagnosed with depression in the postpartum period.

Women’s bodies undergo substantial changes during the perinatal period which can impact their body image and mood post-birth.

However, it remains unknown how women diagnosed with depression experience their body image in the postpartum period.

Methods

Seventeen women in their first postpartum year completed qualitative telephone interviews: seven women diagnosed with depression and ten without depression.

Thematic content analysis identified the main themes of the women’s narratives:

  • Expectations and adjustments to motherhood;
  • Mood in response to changing postpartum body;
  • The context of feeling bad about my body; and
  • Body letting me down and relationship to mood.

Results

Differences in the relationship between body image and mood for postpartum women with depression compared to women without depression were revealed.

Other themes seemed to be experienced in the same way by women with and without depression.

Conclusions

Poor body image and depressive symptoms appear linked during postpartum.

An improved understanding of this association may assist postpartum women to manage negative body image post-birthand prevent the exacerbation of negative emotional health in this period.

Reference

Hartley, E., Fuller-Tyszkiewicz, M., Skouteris, H. & Hill, B. (2020) A qualitative insight into the relationship between postpartum depression and body image. Journal of Reproductive and Infant Psychology. 1-13. doi: 10.1080/02646838.2019.1710119. [Epub ahead of print].

Linking Attitudes towards Mental Illness & the Media

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Research Paper Title

Turkish newspaper articles mentioning people with mental illness: A retrospective study.

Background

Because a great majority of the public knows about mental disorders primarily through printed or visual media, the attitudes exhibited in mass media might be predictive in stigmatizing individuals with mental disorders.

The aim of this study was to retrospectively assess the articles in Turkish newspapers that mention individuals with mental disorders.

Methods

This study was designed to retrospectively investigate and analyze newspaper content in Turkey; the newspapers’ circulation information was collected by examining the websites of the four newspapers with above 1% of the total circulation.

The News Evaluation Form was used to evaluate a sampling of articles that met the inclusion criteria of having appeared in the lifestyle and agenda pages of newspapers, and of using neutral or negative labelling keywords about psychiatric patients.

Results

Almost all the articles reviewed were negative toward individuals with mental disorders.

Three quarters of the reports were forensic, among which two thirds of the individuals with mental disorders were criminalised, and one third were victims of crime.

In approximately half of the news reports, most images were related to the news and were not protected.

Although not all the articles contain stigmatising elements directed toward people with mental disorders, two thirds of the subjects’ images in the news were found to have stigmatising elements.

Conclusions

Media has an impact on attitudes toward people with mental disorders mostly negatively along with individual experiences and peer interactions.

Reference

Aci, O.S., Ciydem, E., Bilgin, H., Ozaslan, Z. & Tek, S. (2020) Turkish newspaper articles mentioning people with mental illness: A retrospective study. The International Journal of Social Psychiatry. doi: 10.1177/0020764019894609. [Epub ahead of print].

Could an Elevated Spindle Oscillatory Frequency in PTSD Indicate a Deficient Sensory-gating Mechanism is Responsible For Preserving Sleep Continuity?

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Research Paper Title

Increased Oscillatory Frequency of Sleep Spindles in Combat-Exposed Veteran Men with Post-Traumatic Stress Disorder.

Background

Sleep disturbances are core symptoms of post-traumatic stress disorder (PTSD), but reliable sleep markers of PTSD have yet to be identified.

Sleep spindles are important brain waves associated with sleep protection and sleep-dependent memory consolidation.

The present study tested whether sleep spindles are altered in individuals with PTSD and whether the findings are reproducible across nights and sub-samples of the study.

Methods

Seventy-eight combat-exposed veteran men with (n = 31) and without (n = 47) PTSD completed two consecutive nights of high-density EEG recordings in a laboratory.

The researchers identified slow (10-13 Hz) and fast (13-16 Hz) sleep spindles during N2 and N3 sleep stages and performed topographical analyses of spindle parameters (amplitude, duration, oscillatory frequency, and density) on both nights.

To assess reproducibility, they used the first 47 consecutive participants (18 with PTSD) for initial discovery and the remaining 31 participants (13 with PTSD) for replication assessment.

Results

In the discovery analysis, compared to non-PTSD participants, PTSD participants exhibited 1) higher slow-spindle oscillatory frequency over the antero-frontal regions on both nights and 2) higher fast-spindle oscillatory frequency over the centro-parietal regions on the second night.

The first finding was preserved in the replication analysis.

The researchers found no significant group differences in the amplitude, duration, or density of slow or fast spindles.

Conclusions

The elevated spindle oscillatory frequency in PTSD may indicate a deficient sensory-gating mechanism responsible for preserving sleep continuity.

The findings, if independently validated, may assist in the development of sleep-focused PTSD diagnostics and interventions.

Reference

Wang, C., Laxminarayan, S., Ramakrishnan, S., Dovzhenok, A., Cashmere, J.D., Germain, A. & Reifman, J. (2020) Increased Oscillatory Frequency of Sleep Spindles in Combat-Exposed Veteran Men with Post-Traumatic Stress Disorder. Sleep. pii: zsaa064. doi: 10.1093/sleep/zsaa064. [Epub ahead of print].

Examining Bicultural Stress & Well-being Processes among Adolescents

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Research Paper Title

Disentangling relationships between bicultural stress and mental well-being among Latinx immigrant adolescents.

Background

The Acculturative Process and Context Framework (Ward & Geeraert, 2016) proposes that acculturative stressors influence psychological well-being over time.

In fact, extant literature has linked bicultural stress with psychological functioning; yet, no studies have explored the causal dominance of bicultural stress.

The purpose of the present study was to evaluate the directionality of prospective relations among bicultural stress and psychosocial functioning (i.e., depressive symptoms, hopefulness, and self-esteem) in Latinx immigrant adolescents across 5 waves.

Methods

There were 303 Latinx adolescents who were recruited for this study from Los Angeles and Miami and were assessed across 5 waves at 6-month intervals.

Adolescents were 14.50 years old on average (SD = .88) and 53.16% were male.

Adolescents reported living in the United States for 2.07 years on average (SD = 1.87). A Random-Intercept Cross-Lagged Panel Model (RI-CLPM) was used to examine the between- and within-person relations among bicultural stress, depressive symptoms, hopefulness, and self-esteem in a comprehensive model.

Results

The comprehensive RI-CLPM including bicultural stress, depressive symptoms, hopefulness, and self-esteem exhibited excellent model fit.

Between-person, trait-like relations among constructs ranged from small to large, as expected.

Within-person, cross-lagged estimates among constructs were overall inconsistent, with some evidence that, within individuals, self-esteem influences later hopefulness.

Conclusions

Findings from this study indicate that the RI-CLPM is an effective strategy to examine bicultural stress and well-being processes among adolescents.

There is a need for further research examining bicultural stress among Latinx immigrant youth, particularly within prevention and intervention studies.

Reference

Romero, A., Piña-Watson, B., Stevens, A.K., Schwartz, S.J., Unger, J.B., Zamboanga, B.L., Szapocznik, J., Lorenzo-Blanco, E., Cano, M,Á., Meca, A., Baezconde-Garbanati, L., Córdova, D., Villamar, J.A., Soto, D.W., Lizzi, K.M., Des Rosiers, S.E., Pattarroyo, M. & Oshri, A. (2020) Disentangling relationships between bicultural stress and mental well-being among Latinx immigrant adolescents. Journal of Consulting and Clinical Psychology. 88(2), pp.149-159. doi: 10.1037/ccp0000466.

Need a Mental Health Buddy?

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A former gunner has set up an initiative to help veterans with mental health issues in his hometown of Barrow-in-Furness.

Tony McNally has introduced a buddy system whereby ex-Service personnel give up their time to talk to others.

Working closely with local authorities and healthcare professionals, the volunteers are on standby to provide extra support to those who find themselves in a dark place.

McNally also contacted the town’s sports teams for free tickets for veterans, with rugby league outfit Barrow Raiders the first to get on board.

“I have found that when I attend a sporting event, I forget all about my own PTSD and other worries,” he said.

McNally has set up a Facebook page – Furness and South Lakes Buddy Buddy Mental Health Group.

For more info email: fslmhg@yahoo.com.