Category: Mental Health

Specialist Mental Health Nurse Practitioner Candidate Roles & the Benefits these Roles can have in Reducing the Significant Morbidity & Mortality of Mental Health Consumers

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Research Paper Title

Improving physical health outcomes for people with severe mental illness: A proof-of-concept study of nurse practitioner candidate practice.

Background

People with severe mental illness have significantly reduced life expectancy and higher risk of cardiovascular diseases than the general population.

There is a critical need for quality physical health care to improve consumers’ health outcomes.

There is minimal knowledge, however, on the impact of mental health nurse practitioner candidate (NPC) practices on consumers’ health outcomes.

The aim of this proof-of-concept study was to describe the impacts of NPC practices on the quality of physical healthcare provision and physical health outcomes (cardiovascular and cardiometabolic) of consumers in community mental health service settings.

Methods

Using a mixed methods design, quantitative data were collected for 12 months prior to (Period 1), and 12 months during (Period 2), the candidacy period.

Qualitative interviews were conducted with a purposive sample of n = 10 consumers to explore their perspectives on physical healthcare provision by the NPCs.

During the 12-month candidacy period, the number of metabolic monitoring assessments rose from n = 55 in Period 1 to n = 146 in Period 2 (P < 0.01, χ2 = 41.20).

Advanced practices provided by NPCs included taking an extensive holistic history and clinical examination, ordering diagnostic pathology, and clinical simulation of physical health medication prescription (under medical supervision).

Results

Analysis of consumer interviews resulted in two themes:

  • Positive and helpful NPC health care; and
  • Improvements in physical and mental health.

Conclusions

The findings add new knowledge on specialist mental health nurse practitioner candidate roles and demonstrate the benefits these roles can have in reducing the significant morbidity and mortality of mental health consumers.

Reference

Furness, T., Giandinoto, J.A., Wordie-Thompson, E., Woolley, S., Dempster, V. & Foster, K. (2019) Improving physical health outcomes for people with severe mental illness: A proof-of-concept study of nurse practitioner candidate practice. International Journal of Mental health Nursing. doi: 10.1111/inm.12680. [Epub ahead of print].

Teachers’ Perceptions of their Learners’ Mental Health Problems

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Research Paper Title

A qualitative study on teachers’ perceptions of their learners’ mental health problems in a disadvantaged community in South Africa.

Background

The combination of extensive poverty, violence and HIV has potential mental health impacts on children in Southern Africa.

This article is nested in a broader study to evaluate the strength and difficulties questionnaire (SDQ) among Sotho speakers, and assess the mental health status of children made orphans by AIDS.

The aim of this study was to describe the mental health problems that the teachers perceive among learners in their classrooms, to understand what the teachers saw as causing these problems and to identify potential approaches to address these problems within the school setting.

Methods

As part of the larger study, 10 teachers were purposively selected to write a report describing the mental health problems among learners in their class.

These findings were discussed at two later meetings with a larger grouping of teachers to validate the findings and obtain additional input.

Results

The teachers were concerned about the emotional state of their pupils, especially in relation to depression, anxiety, substance abuse, scholastic problems and aggression.

These problems were felt to arise from the children’s lived context; factors such as poverty, death of parents and caregivers from AIDS and trauma, parental substance abuse and child abuse.

The teachers expressed a desire to assist the affected learners, but complained that they did not get support from the state services.

Conclusions

Many learners were evaluated by teachers as struggling with mental health issues, arising from their social context.

The teachers felt that with support, schools could provide assistance to these learners.

Reference

Skinner, D., Sharp, C., Marais, L., Serekoane, M. & Lenka, M. (2019) A qualitative study on teachers’ perceptions of their learners’ mental health problems in a disadvantaged community in South Africa. Curationis. 42(1), pp.e1-e7. doi: 10.4102/curationis.v42i1.1903.

Resilience Training: Guided Self-reflection as an Alternative to Coping Skills in Military Officer Cadets

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Research Paper Title

Strengthening resilience in military officer cadets: A group-randomized controlled trial of coping and emotion regulatory self-reflection training.

Background

This group-randomised control trial examined the efficacy of guided coping and emotion regulatory self-reflection as a means to strengthen resilience by testing the effects of the training on anxiety and depression symptoms and perceived stressor frequency after an intensive stressor period.

Methods

The sample was 226 officer cadets training at the Royal Military College, Australia. Cadets were randomised by platoon to the self-reflection (n = 130) or coping skills training (n = 96). Surveys occurred at 3 time points: baseline, immediately following the final reflective session (4-weeks post-baseline), and longer-term follow-up (3-months post-initial follow-up).

Results

There were no significant baseline differences in demographic or outcome variables between the intervention groups. On average, cadets commenced the resilience training with mild depression and anxiety symptoms. Analyses were conducted at the individual-level after exploring group-level effects.

No between-groups differences were observed at initial follow-up. At longer-term follow-up, improvements in mental health outcomes were observed for the self-reflection group, compared with the coping skills group, on depression (Cohen’s d = 0.55; 95% CI [0.24, 0.86]), anxiety symptoms (Cohen’s d = 0.69; 95% CI [0.37, 1.00]), and perceived stressor frequency (Cohen’s d = 0.46; 95% CI [0.15, 0.77]).

Longitudinal models demonstrated a time by condition interaction for depression and anxiety, but there was only an effect of condition for perceived stressor frequency. Mediation analyses supported an indirect effect of the intervention on both anxiety and depression via perceived stressor frequency.

Conclusions

Findings provide initial support for the use of guided self-reflection as an alternative to coping skills approaches to resilience training.

Reference

Crane, M.F., Boga, D., Karin, E., Gucciardi, D.F., Rapport, F., Callen, J. & Sinclair, L. (2019) Strengthening resilience in military officer cadets: A group-randomized controlled trial of coping and emotion regulatory self-reflection training. Journal of Consulting and Clinical Psychology. 87(2), pp.125-140. doi: 10.1037/ccp0000356. Epub 2018 Nov 29.

What are the Factors Associated with Anxiety Disorders among Patients with Substance Use Disorders

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Research Paper Title

Factors associated with anxiety disorders among patients with substance use disorders in Lebanon: Results of a cross-sectional study.

Background

Estimate the rate of anxiety disorders (AD) and associated factors among patients with substance use disorder (SUD) in Lebanon.

Methods

A cross-sectional study, conducted between April and September 2017, enrolled 57 inpatients with SUD.

Results

The rate of AD in patients with SUD was 61.4%. The university level of education compared to the primary level of education (ORa = 0.221) was significantly associated with lower anxiety among patients with SUD. Being sexually abused and having a family history of depression tended to significance.

Conclusions

AD is widespread in Lebanon and high rates of anxiety in patients with SUD were found, warranting the implementation of strategic interventions and establishing national policies and legislation for mental health services to provide optimal care.

Reference

Haddad, C., Darwich, M.J., Obeid, S., Sacre, H., Zakhour, M., Kazour, F., Nabout, R., Hallit, S. & Tahan, F.E. (2019) Factors associated with anxiety disorders among patients with substance use disorders in Lebanon: Results of a cross-sectional study. Perspectives in Psychiatric Care. doi: 10.1111/ppc.12462. [Epub ahead of print].

Can Emotional Responses to Stressors in Everyday Life Predict Long-Term Trajectories of Depressive Symptoms?

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Research Paper Title

Emotional Responses to Stressors in Everyday Life Predict Long-Term Trajectories of Depressive Symptoms.

Background

Individuals’ emotional responses to stressors in everyday life are associated with long-term physical and mental health. Among many possible risk factors, the stressor-related emotional responses may play an important role in future development of depressive symptoms.

The current study examined how individuals’ positive and negative emotional responses to everyday stressors predicted their subsequent changes in depressive symptoms over 18 months.

Methods

Using an ecological momentary assessment approach, participants (n = 176) reported stressor exposure, positive affect (PA), and negative affect (NA) five times a day for 1 week (n = 5,483 observations) and provided longitudinal reports of depressive symptoms over the subsequent 18 months.

A multivariate multilevel latent growth curve model was used to directly link the fluctuations in emotions in response to momentary stressors in everyday life with the long-term trajectory of depressive symptoms.

Results

Adults who demonstrated a greater difference in stressor-related PA (i.e., relatively lower PA on stressor vs. nonstressor moments) reported larger increases in depressive symptoms over 18 months.

Those with greater NA responses to everyday stressors (i.e., relatively higher NA on stressor vs. nonstressor moments), however, did not exhibit differential long-term changes in depressive symptoms.

Conclusions

Adults showed a pattern consistent with both PA and NA responses to stressors in everyday life, but only the stressor-related changes in PA (but not in NA) predicted the growth of depressive symptoms over time.

These findings highlight the important-but often overlooked-role of positive emotional responses to everyday stressors in long-term mental health.

Reference

Zhaoyang, R., Scott, S.B., Smyth, J.M., Kang, J.E. & Sliwinski, M.J. (2019) Emotional Responses to Stressors in Everyday Life Predict Long-Term Trajectories of Depressive Symptoms. Annals of Behavioral Medicine. pii: kaz057. doi: 10.1093/abm/kaz057. [Epub ahead of print].

Mental Health Conditions: Medication & Standing Trial

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In this article (below), Laura Spinney weaves through the ethical grey area of forcing people with mental health conditions to take medication so they can stand trial.

It is an interesting that attempts to look at both sides of the argument.

Read the article:

Trial by Medication (Spinney, 2019)Download

Reference

Spinney, L. (2019) Comment: Trial by Medication. New Scientist. 28 September 2019, pp.24.

Happiness: Linking Temperament, Perspective, & Misfortune

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I really like this reply by a reader to an article (in the New Scientist) about happiness (2019, p.26):

“Apparently, the search for happiness is now a well-funded industry.

Surely this calls into question whether spending so much time, money and, quite possibly, anxiety in its pursuit is counter-productive.

Instead, wouldn’t it be better to question what exactly happiness is?

To me, it is experienced in response to a joyous event or achievement.

It is fleeting, before a return to the baseline.

Maintain this state for too long and it will lose its magic.

More superlative events will be needed to maintain this level of happiness, inflating everyday irritations to trauma.

Surely the answer lies in contentment?

A neutral level of default temperament offers a greater ability to enjoy genuine happiness at all levels, to keep minor annoyances in perspective and to promote greater strength in dealing with misfortune.”

Reference

Groves, R. (2019) Money Can’t Buy You Happiness or Contentment. New Scientist. 21 September 2019, pp.26.

Feeling Sad: Have Kids, then Move Them Out!

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When it comes to who is happier, people with kids or those without, most research points to the latter.

Now it seems that parents are happier than their peers later in life – when their children move out.

Most surveys of parental happiness have focused on those whose children still live at home. These tend to show that people with kids are less happy than their child-free peers because they have less free time, sleep and money.

Christoph Becker at Heidelberg University in Germany and his colleagues wondered if the story might be different for parents whose kids have left home.

To find out, they analysed data from a European survey that asked 55,000 people aged 50 and older about their emotional well-being.

They found that those with children had greater life satisfaction and fewer symptoms of depression than people without children, but only if their kids had left home (Becker, Kirchmaier & Trautmann, 2019).

This may be because when children grow up and move out they provide social enrichment to their parents minus the day-to-day stress of looking after them (Becker, Kirchmaier & Trautmann, 2019). The researchers also believe they may also give something back by providing care and financial support to their parents.

The picture is similar in the US, says Nicholas Wolfinger at the University of Utah. He recently analysed 40 years of data and found that empty-nest parents aged 50 to 70 were 5-6% more likely to report being very happy than those with kids still at home.

If parents baulk at the idea of waiting for their kids to move out to maximise their potential happiness, they could move to a country with better childcare support, says Wolfinger.

A 2016 study found that parents with children at home were slightly happier than their child-free peers if they lived in places that have paid parental leave, generous childcare subsidies and holiday and sick leave, like Norway, Portugal and Sweden.

Reference

Becker, C., Kirchmaier, I. & Trautmann, S.T. (2019) Marriage, parenthood and social network: Subjective well-being and mental health in old age. PLOS One. https://doi.org/10.1371/journal.pone.0218704.

The Ill Effect of Problematic Neighbourhood Environments on Spousal/Partner Relationships & Mental Health and Psychological Well-being

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Research Paper Title

Perceived neighbourhood disorder and psychological distress among Latino adults in the United States: Considering spousal/partner relationship.

Background

It has been well-established that neighbourhood disorder and disadvantage are detrimental to mental health and psychological well-being.

There has been growing research interest in minority stress issues, however, less is known about how perceived neighbourhood disorder matters for psychological well-being among Latino adults in the United States.

Methods

Analysing data from National Latino Asian American Study, 2002-2003, the present study investigates the relationships among perceived neighbourhood disorder, spousal/partner relationships (i.e., spousal/partner strain and support), and psychological distress.

Results

The findings indicated that perceived neighbourhood disorder and spousal/partner strain were positively associated with increased psychological distress, whereas spousal/partner support had no protective effect against psychological distress.

Moreover, mediation analysis showed that the association between perceived neighbourhood disorder and psychological distress was partially mediated by spousal/partner strain (i.e., 15.13%), not spousal support.

Finally, moderation analysis revealed that the presence of spousal/partner strain exacerbated the relationship between perceived neighbourhood disorder and psychological distress. Conversely, the absence of spousal/partner strain appeared to buffer the adverse impact of neighbourhood disorder on psychological distress.

Conclusions

These findings highlighted the ill effect of problematic neighbourhood environments on the quality of the spousal/partner relationship and subsequently Latino’s psychological well-being.

Reference

Kwon, S. (2019) Perceived neighborhood disorder and psychological distress among Latino adults in the United States: Considering spousal/partner relationship. Journal of Community Psychology. doi: 10.1002/jcop.22288. [Epub ahead of print].