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Wang SB, Fox KR, Boccagno C, Hooley JM, Mair P, Nock MK, Haynos AF. Functional assessment of restrictive eating: A three-study clinically heterogeneous and transdiagnostic investigation. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:761-774. [PMID: 34780230 PMCID: PMC8597895 DOI: 10.1037/abn0000700] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Restrictive eating is common and associated with negative psychological outcomes across the life span and eating disorder (ED) severity levels. Little is known about functional processes that maintain restriction, especially outside of narrow diagnostic categories (e.g., anorexia nervosa). Here, we extend research on operant four-function models (identifying automatic negative, automatic positive, social negative, and social positive reinforcement functions) that have previously been applied to nonsuicidal self-injury (NSSI), binge eating, and purging to restricting. We assessed restrictive eating functions in three samples: clinically heterogeneous adolescents (Study 1: N = 457), transdiagnostic adults (Study 2: N = 145), and adults with acute or recently weight-restored anorexia nervosa (Study 3: N = 45). Study 1 indicated the four-function model was a good fit for restricting (root mean square error of approximation [RMSEA] = .06, Tucker-Lewis index [TLI] = .88). This factor structure replicated in Study 2 (comparative fit index [CFI] = .97, RMSEA = .07, TLI = .97, standardized root mean square residual [SRMR] = .09). Unlike NSSI, binge eating, and purging, which have been found to primarily serve automatic negative reinforcement functions, all three present studies found automatic positive reinforcement was most highly endorsed (by up to 85% of participants). In Studies 1 and 3, automatic functions were associated with poorer emotion regulation (ps < .05). In Study 1, social functions were associated with less social support (ps < .001). Across studies, automatic functions were associated with greater restriction ps < .05). Functions varied slightly by ED diagnosis. Across ED presentation, severity, and developmental stage, restrictive eating may be largely maintained by automatic positive reinforcement, with some variability across presentations. Continued examination of restrictive eating functions will establish processes that maintain restriction, allowing more precise treatment targeting for these problematic behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Kathryn R. Fox
- Department of Psychology, University of Denver, Denver, CO
| | | | - Jill M. Hooley
- Department of Psychology, Harvard University, Cambridge, MA
| | - Patrick Mair
- Department of Psychology, Harvard University, Cambridge, MA
| | | | - Ann F. Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
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Zhang G, Yue X, Ye Y, Peng MYP. Understanding the Impact of the Psychological Cognitive Process on Student Learning Satisfaction: Combination of the Social Cognitive Career Theory and SOR Model. Front Psychol 2021; 12:712323. [PMID: 34512469 PMCID: PMC8427433 DOI: 10.3389/fpsyg.2021.712323] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Abstract
In higher education, student learning satisfaction is a significant predictor of learning that indicates the commitment students have to their learning and future academic achievement. The study combines the social cognitive career theory (SCCT) and the stimulus-organism-response (SOR) model to explore the psychological cognition and attitudes derived from students during their learning, discusses the pattern of student learning satisfaction enhancement from the aspect of process, and further understands the relationships among social support systems, interaction relationships, self-efficacy, generic skills, and learning satisfaction. In this study, 800 valid copies of questionnaires were collected from 12 universities through purposive sampling, and the structural model was analyzed by partial least squares structural equation modeling (PLS-SEM). The results showed that the relationships among all the constructs were positive and showed a significant effect; furthermore, the research results showed that self-efficacy and student generic skills had a significantly indirect effect in the model-specifically, a mediating effect. Finally, corresponding theoretical and practical implications were put forward based on the research results.
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Affiliation(s)
- Guihua Zhang
- Department of Business, Yeungnam University, Gyeongsan, South Korea
| | - Xiaoyao Yue
- Graduate School of Human Sciences, Assumption Universtiy, Bangkok, Thailand
| | - Yan Ye
- Graduate School of Education, Stamford International University, Bangkok, Thailand
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Groves AK, Gebrekristos LT, McNaughton Reyes L, Moodley D, Raziano V, Maman S. A mixed-methods study of resilience and return to school among adolescent mothers in South Africa. Glob Public Health 2021; 17:2111-2124. [PMID: 34432605 DOI: 10.1080/17441692.2021.1970208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ABSTRACTUp to two-thirds of South African adolescent mothers drop out of school, which increases their HIV risk and other poor health outcomes. Despite variability in adolescent mothers' schooling trajectories, we have a limited understanding of their re-enrollment in school following the life-changing circumstance of childbirth. In this paper, we draw on qualitative interviews (n = 16) and quantitative surveys (n = 109) with adolescent mothers (aged 14-19) who had recently given birth to describe how access to individual and social resources contributes to their resilience following childbirth and thus affects their ability to re-enroll in school. Nearly all the adolescent mothers in our study expressed a desire to return to school, and most of their families also emotionally supported adolescent mothers in these goals. Despite mothers' high hopes and familial emotional support, only half of the adolescent mothers re-enrolled in the first six months following childbirth. Adolescent mothers' re-entry trajectories were strongly affected by institutional support and by family members' provision of instrumental support. To a lesser extent, support from partners and peers also played a role in re-enrollment. Multilevel interventions to maximise resilience following the onset of early motherhood may facilitate return to school and positively influence adolescent mothers' health and well-being.
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Affiliation(s)
- Allison K Groves
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Luwam T Gebrekristos
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Luz McNaughton Reyes
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Dhayendre Moodley
- Department of Obstetrics and Gynaecology, University of KwaZulu-Natal Nelson R. Mandela School of Medicine, Congella, South Africa
| | - Valerie Raziano
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Suzanne Maman
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
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Filiatreau LM, Pettifor A, Edwards JK, Masilela N, Twine R, Xavier Gómez-Olivé F, Haberland N, Kabudula CW, Lippman SA, Kahn K. Associations Between Key Psychosocial Stressors and Viral Suppression and Retention in Care Among Youth with HIV in Rural South Africa. AIDS Behav 2021; 25:2358-2368. [PMID: 33624194 PMCID: PMC8222008 DOI: 10.1007/s10461-021-03198-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 12/20/2022]
Abstract
Despite improvements in access to antiretroviral treatment over the past decade, sub-optimal HIV care outcomes persist among youth with HIV (YWH) in rural South Africa. Psychosocial stressors could impede improved HIV treatment outcomes within this population. We linked self-reported psychosocial health and demographic data from a cross-sectional survey conducted among YWH aged 12-24 in rural South Africa to individual medical record data, including facility visit history and viral load measurements. Poisson regression with robust standard errors was used to estimate the associations between five psychosocial stressors- heightened depressive symptoms (Center for Epidemiological Studies-Depression scale scores ≥ 16), lower social support (Medical Outcomes Social Support Scale scores ≤ 38), lower resilience (Conner-Davidson Resilience Scale scores ≤ 73), lower self-esteem (Rosenberg Self-Esteem Scale scores ≤ 21), and higher perceived stress (Sheldon Cohen Perceived Stress Scale scores ≥ 10)- and viral non-suppression (viral load ≥ 400 copies/mL) and loss to care (no documented clinic visits within the 90 days prior to survey), separately. A total of 359 YWH were included in this analysis. The median age of study participants was 21 (interquartile range: 16-23), and most were female (70.2%), single (82.4%), and attending school (54.7%). Over a quarter of participants (28.1%) had heightened depressive symptoms. Just 16.2% of all participants (n = 58) were lost to care at the time of survey, while 32.4% (n = 73) of the 225 participants with viral load data were non-suppressed. The prevalence of non-suppression in individuals with lower self-esteem was 1.71 (95% confidence interval: 1.12, 2.61) times the prevalence of non-suppression in those with higher self-esteem after adjustment. No meaningful association was observed between heightened depressive symptoms, lower social support, lower resilience, and higher perceived stress and viral non-suppression or loss to care in adjusted analyses. Retention in care and viral suppression among YWH in rural South Africa are below global targets. Interventions aimed at improving viral suppression among YWH should incorporate modules to improve participant's self-esteem as low self-esteem is associated with viral non-suppression in this setting. Future studies should longitudinally explore the joint effects of co-occurring psychosocial stressors on HIV care outcomes in YWH and assess meaningful differences in these effects by age, gender, and route of transmission.
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Affiliation(s)
- Lindsey M Filiatreau
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 170 Rosenau Hall, CB #7400, 135 Dauer Drive, Chapel Hill, NC, 27599-7400, USA.
| | - Audrey Pettifor
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 170 Rosenau Hall, CB #7400, 135 Dauer Drive, Chapel Hill, NC, 27599-7400, USA
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jessie K Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 170 Rosenau Hall, CB #7400, 135 Dauer Drive, Chapel Hill, NC, 27599-7400, USA
| | - Nkosinathi Masilela
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rhian Twine
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - F Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Chodziwadziwa Whiteson Kabudula
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sheri A Lippman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Marshburn CK, Campos B. Seeking Just Us: A Mixed Methods Investigation of Racism-Specific Support Among Black College Students. JOURNAL OF BLACK PSYCHOLOGY 2021. [DOI: 10.1177/00957984211034961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Social support is theorized to protect health against the negative effects of stress. However, findings are mixed regarding whether social support protects Black people’s psychological well-being against racism. The current mixed methods study examined racism-specific support (RSS)—social support in response to racism—in same- (Black/Black) and cross-race (Black/non-Black) friendships. We investigated whether 31 Black college students ( M age = 19.7, SD = 1.70; 74% women) had (1) racial preferences (same-vs. cross-race) for whom they sought RSS, and (2) whether perceptions of RSS’s helpfulness differed when provided by cross-race friends. Participants completed measures of emotional closeness to same- and cross-race friends and participated in focus group interviews discussing racism and RSS. Results found participants reported more emotional closeness to Black friends and non-Black friends of color relative to White friends. As predicted, 65% of participants preferred RSS from Black (vs. non-Black) friends. Participants’ qualitative responses ( n = 21–24) revealed Black (vs. non-Black) friends were perceived to better understand racism. These findings suggest RSS from Black friends, specifically, might benefit Black college students’ psychological well-being.
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Affiliation(s)
| | - Belinda Campos
- Department of Chicano/Latino Studies, University of California, Irvine, CA, USA
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Medina-Marino A, Bezuidenhout D, Hosek S, Barnabas RV, Atujuna M, Bezuidenhout C, Ngwepe P, Peters RPH, Little F, Celum CL, Daniels J, Bekker LG. The Community PrEP Study: a randomized control trial leveraging community-based platforms to improve access and adherence to pre-exposure prophylaxis to prevent HIV among adolescent girls and young women in South Africa-study protocol. Trials 2021; 22:489. [PMID: 34311754 PMCID: PMC8314507 DOI: 10.1186/s13063-021-05402-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/26/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND HIV incidence among South African adolescent girls and young women (AGYW) remains high, but could be reduced by highly effective pre-exposure prophylaxis (PrEP). Unfortunately, AGYW report significant barriers to clinic-based sexual and reproductive health services. Even when AGYW access PrEP as an HIV prevention method, poor prevention-effective use was a serious barrier to achieving its optimal HIV prevention benefits. Determining the acceptability and feasibility of community-based platforms to increase AGYW's access to PrEP, and evaluating behavioural interventions to improve prevention-effective use of PrEP are needed. METHODS We propose a mixed-methods study among AGYW aged 16-25 years in Eastern Cape Province, South Africa. In the first component, a cross-sectional study will assess the acceptability and feasibility of leveraging community-based HIV counselling and testing (CBCT) platforms to refer HIV-negative, at-risk AGYW to non-clinic-based, same-day PrEP initiation services. In the second component, we will enrol 480 AGYW initiating PrEP via our CBCT platforms into a three-armed (1:1:1) randomized control trial (RCT) that will evaluate the effectiveness of adherence support interventions to improve the prevention-effective use of PrEP. Adherence will be measured over 24 months via tenofovir-diphosphate blood concentration levels. Qualitative investigations will explore participant, staff, and community experiences associated with community-based PrEP services, adherence support activities, study implementation, and community awareness. Costs and scalability of service platforms and interventions will be evaluated. DISCUSSION This will be the first study to assess the acceptability and feasibility of leveraging CBCT platforms to identify and refer at-risk AGYW to community-based, same-day PrEP initiation services. It will also provide quantitative and qualitative results to inform adherence support activities and services that promote the prevention-effective use of PrEP among AGYW. By applying principles of implementation science, behavioural science, and health economics research, we aim to inform strategies to improve access to and prevention-effective use of PrEP by AGYW. TRIAL REGISTRATION ClinicalTrials.gov NCT03977181 . Registered on 6 June 2019-retrospectively registered.
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Affiliation(s)
- Andrew Medina-Marino
- Research Unit, Foundation for Professional Development, 10 Rochester Rd, Vincent, East London, Buffalo City Metro, Eastern Cape Province, South Africa.
- The Desmond Tutu HIV Centre, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Dana Bezuidenhout
- Research Unit, Foundation for Professional Development, 10 Rochester Rd, Vincent, East London, Buffalo City Metro, Eastern Cape Province, South Africa
| | - Sybil Hosek
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Stroger Hospital of Cook County, Chicago, IL, USA
| | - Ruanne V Barnabas
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Millicent Atujuna
- The Desmond Tutu HIV Centre, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa
| | - Charl Bezuidenhout
- Research Unit, Foundation for Professional Development, 10 Rochester Rd, Vincent, East London, Buffalo City Metro, Eastern Cape Province, South Africa
| | - Phuti Ngwepe
- Research Unit, Foundation for Professional Development, 10 Rochester Rd, Vincent, East London, Buffalo City Metro, Eastern Cape Province, South Africa
| | - Remco P H Peters
- Research Unit, Foundation for Professional Development, 10 Rochester Rd, Vincent, East London, Buffalo City Metro, Eastern Cape Province, South Africa
| | - Francesca Little
- Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa
| | - Connie L Celum
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Joseph Daniels
- Department of Psychiatry and Human Behaviors, Charles R. Drew University of Medicine and Science, Los Angeles, USA
| | - Linda-Gail Bekker
- The Desmond Tutu HIV Centre, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.
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Nemati H, Mohammadpoorasl A, Ebrahimi H, Atri SB, Sahebihagh MH. Transition in Smoking Stages and Its Relationship with Family Psychological Function and Perceived Social Support in Adolescents of Tabriz, Iran. Int J Prev Med 2021; 12:67. [PMID: 34447509 PMCID: PMC8356960 DOI: 10.4103/ijpvm.ijpvm_289_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 04/22/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND There is limited information on the relationship between family psychological functions and perceived social support with progress in cigarette smoking stages in adolescents. This study was aimed to determine the relationship between family psychological function and perceived social support through a transition in different stages of cigarette smoking in adolescents of Tabriz, Iran. METHODS In this study, 4,216 students (14-19 years old) from high schools were selected by multistage cluster sampling method. Initially, we used valid and reliable questionnaires for demographic characteristics, risk factors, Iranian family psychological function, and perceived social support. The smoking status questionnaire was administered twice, with an interval of 6 months. Data were analyzed using univariate and multivariate logistic regression analysis. RESULTS Overall, 3,968 students with the mean (standard deviation) age of 15.96 (0.75) years completed the questionnaire in the first phase of the study. The results showed that lower levels of family psychosocial function (P < 0.001) and perceived social support (P < 0.001) in the univariate state were significantly associated with progress in cigarette smoking stages. By controlling the potential confounding factors, the weak and moderate family psychological function compared to the strong function increased the chance of progress in the cigarette smoking stages by almost 11 and 4 times, respectively (P < 0.001). The low and moderate level of perceived social support compared to the high level increased the chance of progress in cigarette smoking stages by almost 7 and 2 times, respectively (P < 0.001). CONCLUSIONS It is suggested to perform an organized, precise, and operational planning for strengthening the family psychological functions and providing an appropriate social support condition among adolescents to prevent the tendency toward cigarette smoking and its more advanced phases.
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Affiliation(s)
- Hossein Nemati
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- M. Sc. Student of Community Health Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asghar Mohammadpoorasl
- Tabriz Health Services Management Research Center, Tabriz, Iran
- Epidemiology and Biostatistics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Ebrahimi
- Psychiatric Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shirin B. Atri
- Department of Community Health Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad H. Sahebihagh
- Tabriz Health Services Management Research Center, Tabriz, Iran
- Department of Community Health Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
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Borg D, Rae K, Fiveash C, Schagen J, James-McAlpine J, Friedlander F, Thurston C, Oliveri M, Harmey T, Cavanagh E, Edwards C, Fontanarosa D, Perkins T, de Zubicaray G, Moritz K, Kumar S, Clifton V. Queensland Family Cohort: a study protocol. BMJ Open 2021; 11:e044463. [PMID: 34168023 PMCID: PMC8231060 DOI: 10.1136/bmjopen-2020-044463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The perinatal-postnatal family environment is associated with childhood outcomes including impacts on physical and mental health and educational attainment. Family longitudinal cohort studies collect in-depth data that can capture the influence of an era on family lifestyle, mental health, chronic disease, education and financial stability to enable identification of gaps in society and provide the evidence for changes in government in policy and practice. METHODS AND ANALYSIS The Queensland Family Cohort (QFC) is a prospective, observational, longitudinal study that will recruit 12 500 pregnant families across the state of Queensland (QLD), Australia and intends to follow-up families and children for three decades. To identify the immediate and future health requirements of the QLD population; pregnant participants and their partners will be enrolled by 24 weeks of gestation and followed up at 24, 28 and 36 weeks of gestation, during delivery, on-ward, 6 weeks postpartum and then every 12 months where questionnaires, biological samples and physical measures will be collected from parents and children. To examine the impact of environmental exposures on families, data related to environmental pollution, household pollution and employment exposures will be linked to pregnancy and health outcomes. Where feasible, data linkage of state and federal government databases will be used to follow the participants long term. Biological samples will be stored long term for future discoveries of biomarkers of health and disease. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Mater Research Ethics (HREC/16/MHS/113). Findings will be reported to (1) QFC participating families; (2) funding bodies, institutes and hospitals supporting the QFC; (3) federal, state and local governments to inform policy; (4) presented at local, national and international conferences and (5) disseminated by peer-review publications.
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Affiliation(s)
- Danielle Borg
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Kym Rae
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Corrine Fiveash
- Gallipoli Medical Research Foundation, Greenslopes, Queensland, Australia
| | - Johanna Schagen
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Janelle James-McAlpine
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Frances Friedlander
- Maternity Unit, Greenslopes Private Hospital, Greenslopes, Queensland, Australia
| | - Claire Thurston
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Maria Oliveri
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Theresa Harmey
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Erika Cavanagh
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Centre for Maternal Fetal Medicine, Mater Hospital Brisbane, Brisbane, Queensland, Australia
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Christopher Edwards
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Davide Fontanarosa
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Tony Perkins
- School of Medical Science, Griffith University - Gold Coast Campus, Southport, Queensland, Australia
| | - Greig de Zubicaray
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Karen Moritz
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
- The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Sailesh Kumar
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Vicki Clifton
- Mother and Baby, Mater Medical Research Institute, South Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
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Omari F, Chrysanthopoulou SA, Embleton LE, Atwoli L, Ayuku DO, Sang E, Braitstein P. The impact of care environment on the mental health of orphaned, separated and street-connected children and adolescents in western Kenya: a prospective cohort analysis. BMJ Glob Health 2021; 6:bmjgh-2020-003644. [PMID: 33789867 PMCID: PMC8016077 DOI: 10.1136/bmjgh-2020-003644] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 02/09/2021] [Accepted: 03/04/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction The effect of care environment on orphaned and separated children and adolescents’ (OSCA) mental health is not well characterised in sub-Saharan Africa. We compared the risk of incident post-traumatic stress disorder (PTSD), depression, anxiety and suicidality among OSCA living in Charitable Children’s Institutions (CCIs), family-based care (FBC) and street-connected children and youth (SCY). Methods This prospective cohort followed up OSCA from 300 randomly selected households (FBC), 19 CCIs and 100 SCY in western Kenya from 2009 to 2019. Annual data were collected through standardised assessments. We fit survival regression models to investigate the association between care environment and mental health diagnoses. Results The analysis included 1931 participants: 1069 in FBC, 783 in CCIs and 79 SCY. At baseline, 1004 participants (52%) were male with a mean age (SD) of 13 years (2.37); 54% were double orphans. In adjusted analysis (adjusted HR, AHR), OSCA in CCIs were significantly less likely to be diagnosed with PTSD (AHR 0.69, 95% CI 0.49 to 0.97), depression (AHR 0.48 95% CI 0.24 to 0.97), anxiety (AHR 0.56, 95% CI 0.45 to 0.68) and suicidality (AHR 0.73, 95% CI 0.56 to 0.95) compared with those in FBC. SCY were significantly more likely to be diagnosed with PTSD (AHR 4.52, 95% CI 4.10 to 4.97), depression (AHR 4.72, 95% CI 3.12 to 7.15), anxiety (AHR 4.71, 95% CI 1.56 to 14.26) and suicidality (AHR 3.10, 95% CI 2.14 to 4.48) compared with those in FBC. Conclusion OSCA living in CCIs in this setting were significantly less likely to have incident mental illness, while SCY were significantly more, compared with OSCA in FBC.
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Affiliation(s)
- Felicita Omari
- Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Lonnie E Embleton
- Epidemiology, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Lukoye Atwoli
- Mental Health, Moi University College of Health Sciences, Eldoret, Kenya
| | - David O Ayuku
- Behavioral Sciences, Moi University College of Health Sciences, Eldoret, Kenya
| | - Edwin Sang
- Data Management and Biostatistics, Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Paula Braitstein
- Epidemiology, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
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Gabriel I, Creedy D, Coyne E. Feasibility of a socio-spiritual intervention to improve quality of life of adult Nigerians with cancer and their family caregivers: Protocol for a randomised controlled trial. Contemp Clin Trials Commun 2021; 22:100802. [PMID: 34195469 PMCID: PMC8233201 DOI: 10.1016/j.conctc.2021.100802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 06/08/2021] [Accepted: 06/12/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Despite high psychosocial needs that negatively affect the quality of life of adults living with cancer and their family caregivers, there is a lack of interventions that are culturally sensitive to low-income countries. This protocol tests the feasibility of a randomised controlled trial on the efficacy of a socio-spiritual intervention to improve the quality of life of adult Nigerians living with cancer and their family caregivers. METHODS/DESIGN This two-arm trial will recruit 152 adults with cancer and their family caregivers (76 dyads). Participants will be recruited from a clinical facility in Zaria, Kaduna State, Nigeria. Eligible participants will be randomly assigned to either the intervention or control group at a 1:1 ratio. The intervention consists of four weekly face-to-face sessions with a focus on spirituality, social support, and information needs. Control participants will receive usual care. Outcome measures include feasibility, spiritual need, social need, information, cancer health literacy, and quality of life collected at baseline and immediate post-intervention. DISCUSSION Nigeria has the highest rate of extreme poverty globally with high rates of cancer mortality. Testing the feasibility of social-spiritual interventions in resource poor settings is important to establish preliminary efficacy and sustainability. Family-centred interventions for adults living with cancer and their family caregivers can strengthen their coping capabilities. If this intervention is feasible and effective, it could be implemented both in clinical practice and communities in other low and middle income countries.
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Affiliation(s)
- Israel Gabriel
- Griffith University, Logan Campus, 68 University Dr, Meadowbrook, QLD 4131, Australia
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Debra Creedy
- Griffith University, Logan Campus, 68 University Dr, Meadowbrook, QLD 4131, Australia
| | - Elisabeth Coyne
- Griffith University, Logan Campus, 68 University Dr, Meadowbrook, QLD 4131, Australia
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Gomez-Baya D, Santos T, Gaspar de Matos M. Developmental assets and positive youth development: an examination of gender differences in Spain. APPLIED DEVELOPMENTAL SCIENCE 2021. [DOI: 10.1080/10888691.2021.1906676] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Santiago PHR, Quintero A, Haag D, Roberts R, Smithers L, Jamieson L. Drop-the- p: Bayesian CFA of the Multidimensional Scale of Perceived Social Support in Australia. Front Psychol 2021; 12:542257. [PMID: 33716843 PMCID: PMC7953044 DOI: 10.3389/fpsyg.2021.542257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 01/22/2021] [Indexed: 11/16/2022] Open
Abstract
AIM We aimed to investigate whether the 12-item Multidimensional Scale of Perceived Social Support (MSPSS) constitutes a valid and reliable measure of social support for the general adult Australian population. METHODS Data were from Australia's National Survey of Adult Oral Health 2004-2006 and included 3899 participants aged 18 years old and over. The psychometric properties were evaluated with Bayesian confirmatory factor analysis. One-, two-, and three-factor (Significant Other, Family and Friends) structures were tested. Model fit was assessed with the posterior predictive p-value (PPPχ2), Bayesian root mean square error of approximation (BRMSEA), and Bayesian comparative fit index (BCFI). Dimensionality was tested by comparing competing factorial structures with the Bayes factor (BF). Reliability was evaluated with the Bayesian Ω H . Convergent validity was investigated with the Perceived Stress Scale (PSS) and discriminant validity with the Perceived Dental Control scale (PDC-3). RESULTS The theoretical three-factor model (Significant Other, Family, and Friends) provided a good fit to the data [PPPχ2 < 0.001, BRMSEA = 0.089-95% credible interval (CrI) (0.088, 0.089); BCFI = 0.963-95% CrI (0.963, 0.964)]. The BF provided decisive support for the three-factor structure in relation to the other structures. The SO [BΩ H = 0.95 - 95% CrI (0.90, 0.99)], FA (BΩ H = 0.92 - 95% CrI (0.87, 0.97), and FR (BΩ H = 0.92 - 95% CrI (0.88, 0.97)] subscales displayed excellent reliability. The MSPSS displayed initial evidence of convergent and discriminant validity. CONCLUSION The MSPSS demonstrated good psychometric properties and excellent reliability in a large Australian sample. This instrument can be applied in national surveys and provide evidence of the role of social support in the Australian population.
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Affiliation(s)
- Pedro Henrique Ribeiro Santiago
- Australia Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Adrian Quintero
- Icfes – Colombian Institute for Educational Evaluation, Bogotá, Colombia
| | - Dandara Haag
- Australia Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Rachel Roberts
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Lisa Smithers
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Lisa Jamieson
- Australia Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
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Saber M, Rashedi V, FadakarDavarani MM, Borhaninejad V. Social Support, Happiness, and Self-Rated Health among Older Adults: A Population-Based Study. ADVANCES IN GERONTOLOGY 2021; 11:22-28. [DOI: 10.1134/s2079057021010471] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/09/2020] [Accepted: 06/15/2020] [Indexed: 10/10/2024]
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Breazeale S, Dorsey SG, Kearney J, Conley S, Jeon S, Yoo B, Redeker NS. Symptom cluster profiles following traumatic orthopedic injuries: A protocol. Res Nurs Health 2020; 44:268-278. [PMID: 33368378 DOI: 10.1002/nur.22102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/27/2020] [Accepted: 12/13/2020] [Indexed: 11/09/2022]
Abstract
Traumatic injuries affect millions of Americans annually, resulting in $671 billion in healthcare costs and lost productivity. Postinjury symptoms, like pain, sleep disturbance, anxiety, depression, and stressor-related disorders are highly prevalent following traumatic orthopedic injuries (TOI) and may contribute to negative long-term outcomes. Symptoms rarely present in isolation, but in clusters of two or more symptoms that co-occur to affect health in aggregate. Identifying symptom cluster profiles following TOI may identify those at highest risk for negative outcomes. Dysregulation of brain-derived neurotrophic factor (BDNF) is a potential biological mechanism responsible for symptom cluster profile membership after TOI and may be targeted in future precision-health applications. The purpose of this paper is to present the protocol of a cross-sectional study designed to identify symptom cluster profiles and measure the extent to which the BDNF val66met mutation and serum concentration of BDNF are associated with membership in symptom cluster profiles. We plan to recruit 150 TOI survivors within the first 72 h of injury. The study aims are to (1) describe TOI survivors' membership in symptom cluster profiles, indicated by pain, sleep disturbance, and symptoms of anxiety, depression, and stressor-related disorders, immediately following a TOI; (2) examine associations between demographic and clinical factors and symptom cluster profile membership among TOI survivors; (3) test the hypothesis that low serum concentrations of BDNF are associated with membership among symptom cluster profiles following TOI; and (4) test the hypothesis that the presence of the val66met mutation on one or both alleles of the BDNF gene is associated with membership among symptom cluster profiles following TOI.
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Affiliation(s)
| | - Susan G Dorsey
- University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Joan Kearney
- Yale School of Nursing, West Haven, Connecticut, USA
| | | | | | - Brad Yoo
- Yale School of Medicine, New Haven, Connecticut, USA
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Sutherland SC, Shannon HS, Ayuku D, Streiner DL, Saarela O, Atwoli L, Braitstein P. Reliability and validity of the RS14 in orphaned and separated adolescents and youths in western Kenya. PLoS One 2020; 15:e0241699. [PMID: 33232345 PMCID: PMC7685429 DOI: 10.1371/journal.pone.0241699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 10/20/2020] [Indexed: 12/02/2022] Open
Abstract
PURPOSE The 14-item Resilience Scale (RS14) is a tool designed to measure psychological resilience. It has been used effectively in diverse populations. However, its applicability is largely unknown for Sub-Saharan adolescent populations and completely unknown for orphaned and separated adolescents and youths (OSAY), a highly vulnerable population for whom resilience may be critical. This study assesses the RS14's psychometric properties for OSAY in Uasin Gishu County, Kenya. METHODS Survey responses from a representative sample of 1016 OSAY (51.3% female) aged 10-25 (mean = 16; SD = 3.5) living in institutional and home-based environments in Uasin Gishu County were analyzed. The RS14's psychometric properties were assessed by examining internal consistency reliability, confirmatory factor analyses, and convergent validity using correlations between resilience and each of social support and depression. Sub-analyses were conducted by age and sex. RESULTS Resilience scores ranged from 14-98 (mean = 66; SD = 19) with no sex-based significant difference. Resilience was higher for those aged ≥18 (mean = 69; range = 14-98) versus age <18 (mean = 65; range = 14-98). Internal consistency was good (Cronbach's α = .90). Confirmatory factor analysis indicated a 1-factor solution, though the model fit was only moderate. Resilience was positively correlated with social support in all ages (.22; p < .001) and negatively correlated with depression in individuals age <18 (-.22; p < .001). The relationship between resilience and depression in individuals age ≥18 was statistically significant only in females (-.17; p = .026). CONCLUSION This study demonstrates reasonable evidence that the RS14 is both valid and reliable for measuring psychological resilience in the population of OSAY in western Kenya.
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Affiliation(s)
- Sarah C. Sutherland
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Harry S. Shannon
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Science, McMaster University, Hamilton, Canada
- Institute for Work & Health, Toronto, Canada
| | - David Ayuku
- Department of Behavioral Sciences, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - David L. Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Olli Saarela
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Lukoye Atwoli
- Department of Mental Health, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - Paula Braitstein
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Epidemiology and Medical Statistics, School of Public Health, College of Health Sciences, Moi University, Eldoret, Kenya
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
- Regenstrief Institute, Inc, Indianapolis, Indiana, United States of America
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Patient expectations and perceived social support related to return to sport after anterior cruciate ligament reconstruction in adolescent athletes. Phys Ther Sport 2020; 47:72-77. [PMID: 33197876 DOI: 10.1016/j.ptsp.2020.10.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/28/2020] [Accepted: 10/30/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Examine the relationship between pre-operative competitive status and return to sport expectations post-operatively among adolescents undergoing ACL reconstruction. Assess the association between perceived levels of social support and doubts in returning to sport after ACL reconstruction. DESIGN Cross-sectional. SETTING Outpatient sports medicine clinic at a single institution. PARTICIPANTS 12-18 years old with an ACL tear who were planning to undergo ACL reconstruction. MAIN OUTCOME MEASURES Psychovitality questionnaire responses and Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire scores. RESULTS 86% of participants expected to return to sports in six months or less after surgery; there was no significant difference in expected time to return to sport between competitive vs. recreational athletes. Competitive athletes were less likely to be content returning to a lower activity level after surgery compared to recreational athletes. There were no significant differences in MSPSS scores between those who did and did not report doubts in their ability to return to their previous sports. CONCLUSION Most of our adolescent athlete population expected to return to sport after ACL reconstruction within six months of surgery. Those with and without doubts in their ability to return to sports did not significantly differ in levels of perceived social support.
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Mariani R, Renzi A, Di Trani M, Trabucchi G, Danskin K, Tambelli R. The Impact of Coping Strategies and Perceived Family Support on Depressive and Anxious Symptomatology During the Coronavirus Pandemic (COVID-19) Lockdown. Front Psychiatry 2020; 11:587724. [PMID: 33281647 PMCID: PMC7691226 DOI: 10.3389/fpsyt.2020.587724] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/12/2020] [Indexed: 12/28/2022] Open
Abstract
The coronavirus pandemic represents a severe global crisis, affecting physical, and psychological health. Lockdown rules imposed to counteract the rapid growth of COVID-19, mainly social restrictions, have represented a risk factor for developing depressive and anxious symptoms. The research aims are to explore the effect of coping strategies and perceived social support on depressive and anxious symptomatology during the COVID-19 pandemic. Ninety-six healthy people (46 males, mean age = 39.3; SD = 16.6) completed through on-line platform: Socio-demographic questionnaire, Coping Inventory for Stressful Situations (CISS), Multidimensional Scale of Perceived Social Support (MSPSS) and Symptom Checklist-90-Revised (SCL-90-R), 3 weeks after the imposition of lockdown restrictions. SCL-90-R Depression scores showed significant positive correlation with CISS Emotion (r = 0.85; p = 0.001) and Avoidant (r = 0.34; p = 0.018), a significant negative correlation with MSPSS Family support (r = -0.43; p = 0.003). SCL-90-R Anxiety scores showed a significant positive correlation with CISS Emotion (r = 0.72; p = 0.001) and Avoidant (r = 0.35; p = 0.016). No significant correlations between both CISS Emotion and Avoidant scales with social support emerged. Two Multiple Linear Regression analysis were performed using, respectively, SCL-90-R Depression and Anxiety scores as dependent variables, and the CISS and MSPSS scales, age, and gender as predictors. The first regression model (R 2 = 0.78; adjusted R 2 = 0.75) revealed CISS Emotion (β = 0.83; p = 0.001) and MSPSS Family support (β = -0.24; p = 0.004) had a predictive effect on SCL-90-R Depression scores. The second regression model (R 2 = 0.52; adjusted R 2 = 0.472) revealed that only CISS Emotion (β = 0.71; p = 0.001) predicted the SCL-90-R Anxiety scores. In conclusion, during the COVID-19 pandemic lockdowns, coping focus on emotions seemed to increase anxious and depressive symptoms, probably due to the uncontrollable nature of the stressful event and the high emotional response. Family support which reduces the sense of loneliness had an exclusive role in mitigating depressive symptoms. These results highlight the importance of promoting psychological strategies to improve emotional regulation skills, reducing isolation from family, to prevent mood symptomatology in healthy citizens during large-scale health crises.
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Affiliation(s)
- Rachele Mariani
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Alessia Renzi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Kerri Danskin
- Princeton Psychological Services, Princeton, NJ, United States
| | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
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Bresenham D, Kipp AM, Medina-Marino A. Quantification and correlates of tuberculosis stigma along the tuberculosis testing and treatment cascades in South Africa: a cross-sectional study. Infect Dis Poverty 2020; 9:145. [PMID: 33092636 PMCID: PMC7579945 DOI: 10.1186/s40249-020-00762-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 10/12/2020] [Indexed: 11/14/2022] Open
Abstract
Background South Africa has one of the world’s worst tuberculosis (TB) (520 per 100 000 population) and TB-human immunodeficiency virus (HIV) epidemics (~ 56% TB/HIV co-infected). While individual- and system-level factors influencing progression along the TB cascade have been identified, the impact of stigma is underexplored and underappreciated. We conducted an exploratory study to 1) describe differences in perceived community-level TB stigma among community members, TB presumptives, and TB patients, and 2) identify factors associated with TB stigma levels among these groups. Methods A cross sectional study was conducted in November 2017 at public health care facilities in Buffalo City Metro (BCM) and Zululand health districts, South Africa. Community members, TB presumptives, and TB patients were recruited. Data were collected on sociodemographic characteristics, TB knowledge, health and clinical history, social support, and both HIV and TB stigma. A validated scale assessing perceived community TB stigma was used. Univariate and multivariate linear regression models were used to describe differences in perceived community TB stigma by participant type and to identify factors associated with TB stigma. Results We enrolled 397 participants. On a scale of zero to 24, the mean stigma score for TB presumptives (14.7 ± 4.4) was statistically higher than community members (13.6 ± 4.8) and TB patients (13.3 ± 5.1). Community members from Zululand (β = 5.73; 95% CI 2.19, 9.72) had higher TB stigma compared to those from BCM. Previously having TB (β = − 2.19; 95% CI − 4.37, 0.0064) was associated with reduced TB stigma among community members. Understanding the relationship between HIV and TB disease (β = 2.48; 95% CI 0.020, 4.94), and having low social support (β = − 0.077; 95% CI − 0.14, 0.010) were associated with increased TB stigma among TB presumptives. Among TB Patients, identifying as Black African (β = − 2.90; 95% CI − 4.74, − 1.04) and knowing the correct causes of TB (β = − 2.93; 95% CI − 4.92, − 0.94) were associated with decreased TB stigma, while understanding the relationship between HIV and TB disease (β = 2.48; 95% CI 1.05, 3.90) and higher HIV stigma (β = 0.32; 95% CI 0.21, 0.42) were associated with increased TB stigma. Conclusions TB stigma interventions should be developed for TB presumptives, as stigma may increase initial-loss-to-follow up. Given that stigma may be driven by numerous factors throughout the TB cascade, adaptive stigma reduction interventions may be required.
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Affiliation(s)
- Dana Bresenham
- Research Unit, Foundation for Professional Development, 10 Rochester Rd, Vincent, East London, South Africa
| | - Aaron M Kipp
- Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA. .,Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA. .,Department of Public Health, East Carolina University, 115 Heart Drive, Ste #2219, Greenville, NC, 27858-4353, USA.
| | - Andrew Medina-Marino
- Research Unit, Foundation for Professional Development, 10 Rochester Rd, Vincent, East London, South Africa. .,Desmond Tutu HIV Centre, Men's Health Division, University of Cape Town, Cape Town, South Africa.
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Huang Y, Wu R, Wu J, Yang Q, Zheng S, Wu K. Psychological resilience, self-acceptance, perceived social support and their associations with mental health of incarcerated offenders in China. Asian J Psychiatr 2020; 52:102166. [PMID: 32447270 DOI: 10.1016/j.ajp.2020.102166] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES We aimed to analyze the mental health status of incarcerated offenders in the detention centers and related factors; and introduce psychological resilience, self-acceptance and perceived social support for further analyses, to explore the relationships between them and mental health in these special populations. METHODS Incarcerated offenders in two detention centers of Guangdong province were recruited. General demographic questionnaire, Self-acceptance Questionnaire (SAQ), Perceived Social Support Scale (PSSS), Connor and Davidson Resilience Scale (CD-RISC) and General Health Questionnaire (GHQ-20) were addressed to the participants for investigation. Pearson correlation analysis, multiple linear regression and Structural Equation Modeling (SEM) were used to identify the associations and related factors. RESULTS Scores for GHQ-20, CD-RISC, SAQ and PSSS were 7.72 ± 4.49, 57.85 ± 17.30, 40.94 ± 5.40 and 42.99 ± 9.90, respectively. Some socio-demographic factors influenced significantly to the mental health status. After adjusting for socio-demographic factors, the scores of self-acceptance (B = -0.23, P < 0.001), perceived social support (B = -0.10, P < 0.001) and psychological resilience (B = -0.06, P < 0.001) were negatively associated with scores of mental health. Further SEM analyses suggested self-acceptance and resilience had not only mediating effects respectively, but also multiple mediating effects between perceived social support and mental health (r = -0.11, P < 0.01; r = -0.12, P < 0.01; r = -0.04, P < 0.01). CONCLUSION The levels of mental health, psychological resilience, self-acceptance and perceived social support among incarcerated offenders are generally low, and influenced by socio-demographic factors. In addition, self-acceptance, perceived social support and resilience are protective factors for mental health status of offenders; and self-acceptance and resilience mediate the association between perceived social support and mental health.
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Affiliation(s)
- Yuanni Huang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China; Shenzhen Pingle Orthopedics Hospital (Shenzhen Pingshan Hospital of Traditional Chinese Medicine), Shenzhen, 518122, Guangdong Province, China
| | - Ruibin Wu
- Chaozhou People's Hospital, Chaozhou, 521000, Guangdong Province, China
| | - Junkai Wu
- Chaozhou Detention Center, Chaozhou, 521011, Guangdong Province, China
| | - Qingwen Yang
- Xingning Detention Center, Xingning, 514526, Guangdong Province, China
| | - Shukai Zheng
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China
| | - Kusheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China.
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Correlation Anxiety, Stress, and Depression with Perceived Social Support Among the Elderly: A Cross-Sectional Study in Iran. AGEING INTERNATIONAL 2020. [DOI: 10.1007/s12126-020-09376-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractOne of the common psychological problems of the elderly is depression, anxiety and stress, and dementia. Social support is one of the variables associated with the elderly lifestyle that can be considered as a product of the social dimension of lifestyle. The present study was conducted to investigate the association of anxiety, stress, and depression with perceived social support among elderly people in Jahrom city. This is an analytical cross-sectional study that was conducted on elderly people in Jahrom city in Iran. The sample size in this study was 210 people and was selected through cluster sampling and random selection of clinics located in Jahrom. Data were collected from two questionnaires: Depression Anxiety Stress Scales (DASS) and perceived social support. After completing the questionnaires, the data were analyzed using SPSS software version 21 with descriptive statistics, Pearson correlation. The results of Spearman’s correlation coefficient showed significant relationships between social support for the elderly and depression (r = −0.627, p < 0.001), also observed between social support for the elderly and stress (r = −0.535, p < 0.001). However, no significant relationship was determined between social support for the elderly and anxiety (r = −0909, p > 0.05). Depression and stress can be reduced by improving social support in the elderly. More attention should also be given to social support for oldermen.
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Ringdal R, Bjørnsen HN, Espnes GA, Bradley Eilertsen ME, Moksnes UK. Bullying, social support and adolescents' mental health: Results from a follow-up study. Scand J Public Health 2020; 49:309-316. [PMID: 32456594 PMCID: PMC8056700 DOI: 10.1177/1403494820921666] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims: The aim of this study was to examine the predictive roles of being bullied and perceived social support in association with adolescents’ mental health. Methods: At two time points, September 2016 and April–June 2017, questionnaires were distributed to students between 15 and 21 years of age in four upper-secondary schools in Norway, with a total sample size of 351. Random- and fixed-effects regression models were used to estimate the effects of being bullied and social support on adolescents’ mental health. Results: In the random-effects models, being bullied was associated with lower scores on mental well-being and higher scores on anxiety and depression symptoms. Social support from family and friends was associated with higher scores on mental well-being, as well as fewer anxiety and depression symptoms. However, the results from the fixed-effects model, with more realistic assumptions, indicated that being bullied was only associated with more anxiety and depression symptoms, while support from friends was associated with higher scores on mental well-being and fewer anxiety and depression symptoms. Conclusions: Based on the fixed-effects models, being bullied was associated with more anxiety and depression symptoms. However, being bullied was not significantly associated with mental well-being. Social support from family was not significantly associated with either aspects of mental health. Moreover, social support from friends was associated with higher scores on mental well-being and fewer anxiety and depression symptoms. The two sources of social support did not buffer the negative effects of being bullied on either aspect of mental health.
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Affiliation(s)
- Regine Ringdal
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway.,NTNU Center for Health Promotion Research, Norway
| | - Hanne Nissen Bjørnsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway.,NTNU Center for Health Promotion Research, Norway
| | - Geir Arild Espnes
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway.,NTNU Center for Health Promotion Research, Norway
| | - Mary-Elizabeth Bradley Eilertsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway.,NTNU Center for Health Promotion Research, Norway
| | - Unni Karin Moksnes
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway.,NTNU Center for Health Promotion Research, Norway
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Laksmita OD, Chung MH, Liao YM, Haase JE, Chang PC. Predictors of resilience among adolescent disaster survivors: A path analysis. J Adv Nurs 2020. [PMID: 32301129 DOI: 10.1111/jan.14396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/19/2020] [Accepted: 04/08/2020] [Indexed: 12/26/2022]
Abstract
AIMS To investigate a theoretical model of risk and protective factors to predict resilience among adolescent disaster survivors. DESIGN A cross-sectional study. METHODS Parent's consent and student's informed consent forms were distributed at seven schools in a postdisaster setting (Yogyakarta, Indonesia) between July-October 2017; those who agreed to participate had to complete the self-reported questionnaires. Demographic data were evaluated using descriptive statistical analyses and relationships among study variables were determined using a path analysis. RESULTS Results of the model test analysis indicated that six of the seven the hypothesized paths were supported by data from our samples and demonstrated significance on the path coefficients (p < .01). One path coefficient on the association between posttraumatic stress disorder (PTSD) symptoms and resilience was found to be insignificant (β = -0.002, p > .05). However, overall, our hypothesized model was retained, indicating empirical support and adequate model's fit indices for the theoretical model. CONCLUSIONS Overall, the findings demonstrated the predictive roles of risk and protective factors in adolescent disaster survivors' resilience. IMPACT Resilience is known to be an important concept in recovering from long-term impacts following a disaster in adolescent populations, but its risk and protective factors have not been adequately explored. We found that PTSD symptoms influenced how adolescent disaster survivors developed defensive coping, social support had an indirect effect on resilience through courageous coping and defensive coping acted as a mediator between PTSD symptoms and courageous coping. These findings can help mental health professionals (i.e., community mental health nurses) promote intervention strategies to enhance resilience through improving coping skills in adolescent populations exposed to a disaster.
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Affiliation(s)
- Okki D Laksmita
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Yuan-Mei Liao
- School of Nursing, College of Nursing, Yang-Ming University, Taipei, Taiwan
| | - Joan E Haase
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Pi-Chen Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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73
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Zhianfar L, Nadrian H, Asghari Jafarabadi M, Espahbodi F, Shaghaghi A. Effectiveness of a Multifaceted Educational Intervention to Enhance Therapeutic Regimen Adherence and Quality of Life Amongst Iranian Hemodialysis Patients: A Randomized Controlled Trial (MEITRA Study). J Multidiscip Healthc 2020; 13:361-372. [PMID: 32341649 PMCID: PMC7166073 DOI: 10.2147/jmdh.s247128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 03/31/2020] [Indexed: 01/30/2023] Open
Abstract
Purpose A multimodal intervention designed and executed to improve therapeutic regimen adherence and quality of life in a sample of Iranian hemodialysis patients. Its feasibility and impact was assessed post intervention. Patients and Methods This randomized controlled trial (RCT) study was conducted at two hemodialysis wards of the Shahrvand hospital located in Sari, the capital city of the Mazandaran province, north of Iran. The study sample included patients with end-stage renal disease (ESRD) receiving outpatient hemodialysis treatment. Considering 10% attrition, 70 registered patients were randomly categorized into intervention and control groups. The proposed intervention included playing of relevant educational video tracks, conducting eight cognitive behavioral therapy (CBT) group sessions, and telephone-based peer support. Data were collected applying a set of questionnaires including sociodemographic, Beck Depression Inventory (BDI-SF), Multidimensional Scale of Perceived Social Support (MSPSS), Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) and the World Health Organization Quality of Life (WHOQOL-SF) scale. Sociodemographic and clinical data were collected at baseline in both groups and the postintervention assessment was performed in the intervention and nonintervention groups after one month and three months. Results A significant change in the self-reported depression symptoms (P=0.001), mean social support score (P=0.001), nursing care satisfaction score (P=0.001), quality of life score (P=0.001) and interdialytic weight gain (IDWG) (P=0.001) was observed among the participants in the intervention group compared to the baseline measures. The highest rise in the ESRD-AQ scores within the intervention group was observed after one month of intervention (mean difference=131.88) compared to the baseline values. Same pattern of statistically significant changes in mean scores of the intervention group’s attendants in all subscales of the ESRD-AQ were also ascertained. Conclusion This interventional study revealed that inaugurating of a feasible low-cost intervention without need to add major logistic or financial inputs into existing health-care systems, especially in resource limited contexts, is achievable. Findings of this study could provide insights into scientific basis of evidence-informed interventions applicable in the realm of health-care delivery.
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Affiliation(s)
- Leila Zhianfar
- Health Education & Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Haidar Nadrian
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Epidemiology and Biostatistics Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Espahbodi
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdolreza Shaghaghi
- Health Education & Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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74
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Wittenborn AK, Natamba BK, Rainey M, Zlotnick C, Johnson J. Suitability of the multidimensional scale of perceived social support as a measure of functional social support among incarcerated adults with major depressive disorder. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:960-976. [PMID: 31951288 PMCID: PMC9365427 DOI: 10.1002/jcop.22315] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 05/30/2023]
Abstract
The multidimensional scale of perceived social support (MSPSS) is a 12-item measure of functional social support (SS); however, the psychometric properties of the MSPSS have not been evaluated in prisoners. We used measures of known-groups validity, convergent and discriminant validity, internal consistency reliability and factor structure to assess the suitability of the MSPSS for measuring SS among 184 individuals in prison in the U.S., who were diagnosed with depression. The MSPSS was correlated with scores on scales measuring related constructs (i.e., loneliness), and uncorrelated with unrelated constructs (i.e., verbal ability). Correlations among items of the MSPSS on the same subscale were large, and small to moderate among items of different subscales. The overall Cronbach's α for the scale was 0.93. Confirmatory factor analysis showed that the theorized three-factor solution for the MSPSS (i.e., significant other, family, and friends) provided a good fit for the data. We recommend using the MSPSS to measure perceived SS among incarcerated individuals.
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Affiliation(s)
- Andrea K. Wittenborn
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, Michigan
| | - Barnabas K. Natamba
- Division of Public Health, Michigan State University College of Human Medicine, Flint, Michigan
| | - Melinda Rainey
- Division of Public Health, Michigan State University College of Human Medicine, Flint, Michigan
| | - Caron Zlotnick
- Department of Psychiatry and Human Behavior, Butler Hospital and Brown University, Providence, Rhode Island
| | - Jennifer Johnson
- Division of Public Health, Michigan State University College of Human Medicine, Flint, Michigan
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Humphreys KL, LeMoult J, Wear JG, Piersiak HA, Lee A, Gotlib IH. Child maltreatment and depression: A meta-analysis of studies using the Childhood Trauma Questionnaire. CHILD ABUSE & NEGLECT 2020; 102:104361. [PMID: 32062423 PMCID: PMC7081433 DOI: 10.1016/j.chiabu.2020.104361] [Citation(s) in RCA: 237] [Impact Index Per Article: 59.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/03/2020] [Accepted: 01/08/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND Researchers have documented that child maltreatment is associated with adverse long-term consequences for mental health, including increased risk for depression. Attempts to conduct meta-analyses of the association between different forms of child maltreatment and depressive symptomatology in adulthood, however, have been limited by the wide range of definitions of child maltreatment in the literature. OBJECTIVE We sought to meta-analyze a single, widely-used dimensional measure of child maltreatment, the Childhood Trauma Questionnaire, with respect to depression diagnosis and symptom scores. PARTICIPANTS AND SETTING 192 unique samples consisting of 68,830 individuals. METHODS We explored the association between total scores and scores from specific forms of child maltreatment (i.e., emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and depression using a random-effects meta-analysis. RESULTS We found that higher child maltreatment scores were associated with a diagnosis of depression (g = 1.07; 95 % CI, 0.95-1.19) and with higher depression symptom scores (Z = .35; 95 % CI, .32-.38). Moreover, although each type of child maltreatment was positively associated with depression diagnosis and scores, there was variability in the size of the effects, with emotional abuse and emotional neglect demonstrating the strongest associations. CONCLUSIONS These analyses provide important evidence of the link between child maltreatment and depression, and highlight the particularly larger association with emotional maltreatment in childhood.
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Affiliation(s)
| | | | - John G Wear
- Western University of Health Sciences, United States
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Laksmita OD, Chung MH, Liao YM, Chang PC. Multidimensional Scale of Perceived Social Support in Indonesian adolescent disaster survivors: A psychometric evaluation. PLoS One 2020; 15:e0229958. [PMID: 32168332 PMCID: PMC7069614 DOI: 10.1371/journal.pone.0229958] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 02/17/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Social support plays an important role in adolescents' mental health and well-being, and even more so for disaster survivors. To measure the level of social support, one needs an appropriate tool to produce valid and reliable results; therefore, we aimed to measure the invariance across gender groups, and analyze the construct validity and reliability of the Indonesian version of the Multidimensional Scale of Perceived Social Support (MSPSS), a social support measurement tool which was theoretically constructed and has been well validated in many countries with various cultures and backgrounds. METHODS A school-based assessment was conducted in junior and senior high schools in a post-disaster setting in Yogyakarta Province, Indonesia. We analyzed 299 adolescent survivors of a volcanic eruption, aged 12~18 years who completed a 12-item Indonesian version of the MSPSS. RESULTS The factorial validity confirmed the three-factor structure of the scale (Family, Friends, and Significant Others) which met all of the criteria of parameter indices and provided evidence of high internal consistency reliability. The three-level measurement of invariance, which consisted of configural, metric, and scalar invariance, also performed very well across gender groups with our data and corresponded to the recommended parameters. Our composite reliability values were all fine (>0.7) and indicated that the items in the same construct were strongly correlated and reliable. CONCLUSIONS The Indonesian version of the MSPSS was shown to be a valid, reliable, theoretically constructed, and applicable instrument for adolescent disaster survivors.
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Affiliation(s)
- Okki Dhona Laksmita
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Yuan-Mei Liao
- Institute of Clinical Nursing, College of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Pi-Chen Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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77
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Ringdal R, Espnes GA, Eilertsen MEB, BjØrnsen HN, Moksnes UK. Social support, bullying, school-related stress and mental health in adolescence. NORDIC PSYCHOLOGY 2020. [DOI: 10.1080/19012276.2019.1710240] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Regine Ringdal
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- NTNU Center for Health Promotion Research, Trondheim, Norway
| | - Geir Arild Espnes
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- NTNU Center for Health Promotion Research, Trondheim, Norway
| | - Mary-Elizabeth Bradley Eilertsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- NTNU Center for Health Promotion Research, Trondheim, Norway
| | - Hanne Nissen BjØrnsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- NTNU Center for Health Promotion Research, Trondheim, Norway
| | - Unni Karin Moksnes
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- NTNU Center for Health Promotion Research, Trondheim, Norway
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Abstract
This article explores the potential of Artificial Intelligence (AI) chatbots for creating positive change by supporting customers in the digital realm. Our study, which focuses on the customer and his/her declarative psychological responses to an interaction with a virtual assistant, will fill a gap in the digital marketing research, where little attention has been paid to the impact of Error and Gender, as well as the extent to which Social Presence and Perceived Competence mediate the relationships between Anthropomorphic design cues and Trust. We provide consistent evidence of the significant negative effect of erroneous conversational interfaces on several constructs considered in our conceptual model, such as: perceived competence, trust, as well as positive consumer responses. We also provide support to previous research findings and confirm that people employ a biased thinking across gender and this categorization also influences their acceptance of chatbots taking social roles. The results of an empirical study demonstrated that highly anthropomorphized female chatbots that engage in social behaviors are significantly shaping positive consumer responses, even in the error condition. Moreover, female virtual assistants are much more commonly forgiven when committing errors compared to male chatbots.
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79
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Mo PKH, Xin M, Lau JTF. Testing the vulnerability and scar model of the relationship between self-concept, social support and anxiety symptoms among children of HIV-infected parents in China: A 3-year longitudinal study. J Affect Disord 2019; 259:441-450. [PMID: 31611002 DOI: 10.1016/j.jad.2019.08.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 06/18/2019] [Accepted: 08/17/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Mental illness is a great concern among children of HIV-infected parents (COHIP), who are at their crucial stage of psychosocial development. It has been shown that self-concept (SC) and social support (SS) are important correlates of anxiety symptoms (AS), however, nature of the causality remained unclear. METHODS A 3-year longitudinal study was conducted in rural Central China, where many people were infected with HIV through unhygienic blood donation. A total of 195 COHIP (mean age: 12.6 years, 49.2% male) completed the baseline assessment and were followed for three years. Cross-lagged structural equation modeling analyses were used to test competing theoretical models: vulnerability model (low SC/SS contributes to AS), scar model (AS erodes SC/SS) and reciprocity model (low SC/SS and AS predict each other). RESULTS At each wave, 104 (53.3%) and 67 (41.6%) participants presented with anxiety disorders respectively. Nested-model comparison supported the superiority of scar models wherein AS significantly predicted subsequent low SC (β=-0.24, p=0.013) and SS (β=-0.31, p= 0.033), controlling for synchronous and autoregressive effects of all measures. The most parsimonious multivariate model that included significant relations was finally identified with a good model fit. LIMITATIONS Findings might be subject to reporting bias; and could not inform the temporal relationship between SC and SS. CONCLUSION Prevalence of anxiety was high among Chinese COHIP. The present study provides empirical evidence for scarring effects of AS; thus, highlighted the importance of identifying and treating COHIP's anxiety to mitigate long-term negative impacts on their psychosocial development.
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Affiliation(s)
- Phoenix K H Mo
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Meiqi Xin
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Joseph T F Lau
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China.
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Spence SH, March S, Donovan CL. Social support as a predictor of treatment adherence and response in an open-access, self-help, internet-delivered cognitive behavior therapy program for child and adolescent anxiety. Internet Interv 2019; 18:100268. [PMID: 31890621 PMCID: PMC6926273 DOI: 10.1016/j.invent.2019.100268] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Although self-help, internet-based cognitive behaviour therapy (ICBT) can produce significant reductions in anxiety for many young people, a sizable proportion show low program adherence and continue to show anxiety problems after treatment. It is important that we identify factors that predict those most likely to complete program sessions and benefit from self-help ICBT so that we can better match interventions to individual needs, and inform program design and development. OBJECTIVE This study examined the role of social support in predicting treatment adherence and outcome among youth enrolled in an open-access, internet-delivered, CBT intervention targeting anxiety. METHODS Participants were 3684 young people (aged 7 to 17 years) who reported elevated levels of anxiety symptoms when registering for the program. Treatment adherence was assessed as number of treatment sessions completed. Treatment response was evaluated as change in self-reported anxiety symptoms. Youth-reported social support (from friends, family and a special person) at pre-treatment was examined as a hypothesized predictor of adherence and outcome after controlling for baseline anxiety, gender, and age, with age being examined as a moderator. RESULTS Linear regression analyses showed that participants with greater social support, from all sources, tended to show greater program adherence, although the proportion of explained variance was small. Age moderated the effect of family support upon adherence, such that greater family support was associated with greater number of sessions completed only for older youth. Greater family and total support were associated with greater reductions in anxiety, irrespective of participant age, but again the percent of variance explained was small. Younger participants were more likely to complete more sessions and to show greater reductions in anxiety. Those with higher pre-treatment anxiety tended to complete fewer sessions but demonstrated greater reductions in anxiety. CONCLUSIONS The findings highlight the need to consider ways to enhance treatment adherence and outcome of those engaging in self-help ICBT for youth anxiety problems, particularly when social support is low.
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Affiliation(s)
| | - Sonja March
- The University of Southern Queensland, School of Psychology and Counselling, Australia
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81
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Psychometric evaluation of the Multi-Dimensional Scale of Perceived Social Support in young adults with chronic health conditions. Ir J Psychol Med 2019; 39:386-390. [PMID: 31762425 DOI: 10.1017/ipm.2019.54] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Introduction.
The Multi-Dimensional Scale of Perceived Social Support (MSPSS) is one of the most widely employed tools for measuring perceived social support from three sources: family, friends and a significant other. This study aimed to establish the factor structure of the MSPSS in young adults living with chronic health conditions (CHCs). It also aimed to examine the reliability and convergent validity of the tool.
Methods.
A cross-sectional quantitative design was applied. Participants (n = 123, 90 females) were students aged 18–25 years recruited from Colleges of Further Education in Ireland (mean age of 20.1 years, s.d. = 2.43). Participants completed the MSPSS and two subscales of the Medical Outcomes Study 36-item Short Form Health Survey that assessed social functioning and emotional well-being.
Results.
Exploratory factor analysis yielded a three-factor solution of the MSPSS in young adults living with CHCs. The three factors together explained 83% of the variance in MSPSS scores. All the items had high loadings on the factors (0.72–0.94). The MSPSS showed satisfactory reliability and convergent validity.
Conclusions.
These findings suggest that the MSPSS is a valid and reliable tool for measuring perceived social support from three sources in young adults living with CHCs. Social support has been associated with positive outcomes in young adults living with CHCs, thus it is imperative for researchers and clinicians to have access to psychometrically sound instruments to evaluate the construct.
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82
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Stockbridge MD, Newman R. Enduring Cognitive and Linguistic Deficits in Individuals With a History of Concussion. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:1554-1570. [PMID: 31487473 DOI: 10.1044/2019_ajslp-18-0196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The purpose of this research is to determine whether individuals with a history of concussion retain enduring differences in narrative writing tasks, which necessitate rapid and complex integration of both cognitive and linguistic faculties. Method Participants aged 12-40 years old, who did or did not have a remote history of concussion, were recruited to take an online survey that included writing both a familiar and a novel narrative. They also were asked to complete multiple tasks targeting word-level and domain general cognitive skills, so that their performance could be interpreted across these dimensions. Results Participants with a concussion history were largely similar to participants with no history of brain injury across tasks that targeted a single skill in isolation. However, participants with prior concussions demonstrated difficulty in providing both key content and details when presented with a novel video and asked to provide a summary of what they had just seen. Number of lifetime concussions predicted the inclusion of key content when summarizing the video. Thus, differences in cognitive and linguistic skills required for written narrative language may continue to be present far after concussion, despite average normative levels of performance on tasks targeting these skills in isolation. Conclusions These findings suggest that individuals with a concussion history, particularly a history of multiple concussions, may continue to experience difficulties for a long period after injury and are likely to benefit from more complex and ecologically valid assessment prior to discharge. Individuals with a concussion history who return to full participation in work, school, and recreational activities may continue to benefit from assistance when asked to rapidly acquire and distill novel information, as is often required in academic and professional environments.
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Affiliation(s)
| | - Rochelle Newman
- Department of Hearing and Speech Sciences, University of Maryland, College Park
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83
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Gomez-Baya D, Reis M, Gaspar de Matos M. Positive youth development, thriving and social engagement: An analysis of gender differences in Spanish youth. Scand J Psychol 2019; 60:559-568. [PMID: 31535399 DOI: 10.1111/sjop.12577] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 08/12/2019] [Indexed: 11/29/2022]
Abstract
The framework of Positive Youth Development (PYD) arose from a strength-based conception of the transition to adulthood. Although previous literature has provided evidence for some PYD correlates, little is known about gender differences in PYD and its outcomes in thriving and social engagement, which could improve interventions" effectiveness. Thus, this study aimed to examine gender differences in PYD dimensions (i.e., competence, confidence, connection, caring, and character), individual thriving (i.e., psychological adjustment, academic adjustment, and healthy lifestyles) and social engagement, and to examine the associations between them. Data from the 'PYD in a Cross-National Perspective Project" in Spain were collected by administering a paper-based self-report to students from high school and university. Results showed greater scores in connection, caring, and character in women, as well as greater social engagement and academic adjustment. Men presented higher competence and confidence, more frequent physical activity and better psychological adjustment. In addition, more PYD was related to greater social engagement, better psychological and academic adjustment, and healthier lifestyles. Some practical implications for program design may be derived, which underscore the need to promote the five PYD dimensions equally in female and male youths in order to improve their individual thriving and social engagement.
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Affiliation(s)
- Diego Gomez-Baya
- Department of Social, Developmental and Educational Psychology, Universidad de Huelva, Huelva, Spain.,Faculty of Human Kinetics and Institute of Environmental Health, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Marta Reis
- Faculty of Human Kinetics and Institute of Environmental Health, Universidade de Lisboa, Cruz Quebrada, Portugal.,Post-doctoral fellow of the Foundation for Science and Technology -SFRH/BPD/110905/2015, Lisboa, Portugal
| | - Margarida Gaspar de Matos
- Faculty of Human Kinetics and Institute of Environmental Health, Universidade de Lisboa, Cruz Quebrada, Portugal
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Poudel-Tandukar K, Chandler GE, Jacelon CS, Gautam B, Bertone-Johnson ER, Hollon SD. Resilience and anxiety or depression among resettled Bhutanese adults in the United States. Int J Soc Psychiatry 2019; 65:496-506. [PMID: 31288604 DOI: 10.1177/0020764019862312] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Resilience, or an individual's positive response in managing life's adversities, is of increasing interest in addressing the mental health disparities in refugees. Although the link between stressful life events and poor mental health is established, research on the role of resilience on the mental health of refugees is limited. AIMS This study assessed the association between resilience and anxiety or depression in resettled Bhutanese adults in Western Massachusetts. METHODS A cross-sectional survey was conducted among 225 Bhutanese (men: 113, women: 112) refugees aged 20-65 residing in Massachusetts. Resilience was measured with the 25-item Wagnild and Young's Resilience Scale including two constructs as follows: a 17-item 'personal competence' that measures self-reliance, independence, determination, resourcefulness, mastery and perseverance and an 8-item 'acceptance of self and life' that measures adaptability, flexibility and a balanced perspective of life. Higher total scores indicate greater resilience. The Hopkins Symptom Checklist-25 was used to measure anxiety (10-item) and depression (15-item) with a cutoff mean score of ⩾1.75 for moderate to severe symptoms. Associations of resilience with anxiety or depression scores were assessed using multiple-linear and logistic regression analyses. RESULTS The proportion of participants with above threshold anxiety and depression were 34.2% and 24%, respectively. Resilience was inversely associated with both anxiety (beta for 1 unit change in resilience scores: β = -0.026; p = .037) and depression (β = -0.036, p = .041). 'Personal competence' resilience was inversely associated with both anxiety (β = -0.041 p = .017) and depression (β = -0.058, p = .019), but 'acceptance of self and life' resilience was not. Participants with the highest tertile of resilience scores had a significantly decreased risk of anxiety (ORs (95% CI): 0.13 (0.04-0.40)) and depression (0.16 (0.04-0.60)). CONCLUSION Higher resilience was associated with reduced anxiety and depression among Bhutanese with personal competence resilience accounting for most of the effects. These findings suggest the potential targets for mental-health intervention to improve resilience in refugees.
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Affiliation(s)
| | | | - Cynthia S Jacelon
- 1 College of Nursing, University of Massachusetts Amherst, Amherst, MA, USA
| | - Bhuwan Gautam
- 2 Bhutanese Society of Western Massachusetts, Springfield, MA, USA
| | | | - Steven D Hollon
- 4 Department of Psychology, Vanderbilt University, Nashville, TN, USA
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Alinejad-Naeini M, Razavi N, Sohrabi S, Heidari-Beni F. The association between health literacy, social support and self-efficacy in mothers of preterm neonates. J Matern Fetal Neonatal Med 2019; 34:1703-1710. [PMID: 31307262 DOI: 10.1080/14767058.2019.1644620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Health literacy, social support and self-efficacy are important concepts in mothers of preterm neonates. The purpose of study was to determine the association between health literacy, social support and self-efficacy of mothers of preterm neonates admitted to the neonatal intensive care unit. METHODS This descriptive correlational study was conducted from November 2017 to January 2019 on 200 mothers of preterm neonates admitted to the neonatal intensive care unit of selected hospitals affiliated with Iran University of Medical Sciences, Tehran, Iran. Data were collected using demographic, maternal health literacy, maternal self-efficacy and multidimensional scale of perceived social support questionnaires. Data were analyzed by descriptive statistics (mean and standard deviation) and inferential tests (Pearson correlation coefficient) using SPSS-PC (v.23) and R software. RESULTS The data showed 23.5% of mothers had high likelihood of low health literacy, 45.5% had possibility of low health literacy and 31% had adequate with mean score 2.57 ± 1.28. Also, 9.5% of participants had low perceived social support, 62.5% moderate perceived social support and 28% high perceived social support. Maternal self-efficacy score was 52.54 ± 8.06. Pearson's correlation coefficient analyses revealed a statistically significant positive correlation between maternal health literacy and social support (r = 0.304, p < .001). Also maternal health literacy was positively correlated with the self-efficacy (r = 0.292, p < .001) and self-efficacy was positively correlated with social support (r = 0.440, p < .001). CONCLUSION Health literacy, social support and self-efficacy of mothers of preterm neonates admitted to the neonatal intensive care unit in Iran are related together. Therefore, neonatal care nurses need to note this in care of this clients and adopt strategies to enhance them.
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Affiliation(s)
- Mona Alinejad-Naeini
- Department of Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Narjes Razavi
- Department of Health, Education and Health Promotion, Tehran University of Medical Sciences, Tehran, Iran
| | - Soroor Sohrabi
- Hazrat Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Heidari-Beni
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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86
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Garman EC, Schneider M, Lund C. Perinatal depressive symptoms among low-income South African women at risk of depression: trajectories and predictors. BMC Pregnancy Childbirth 2019; 19:202. [PMID: 31200665 PMCID: PMC6570971 DOI: 10.1186/s12884-019-2355-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/09/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The aim of the study was to identify trajectories of perinatal depressive symptoms and their predictors among women living in a low-resource setting in South Africa, and who present with a risk of depression during pregnancy. METHODS This is a secondary analysis of a randomised controlled trial among 384 women living in Khayelitsha, a low income setting in South Africa, recruited at their first antenatal visit if they scored 13 or above on the Edinburgh Postnatal Depression Scale, were at least 18 years of age, less than 29 weeks pregnant and spoke isiXhosa. Participants were followed up at 8 months gestation, 3 and 12 months postpartum. Latent trajectories of depressive symptoms were identified using growth mixture modelling, based on the Hamilton Depression Rating Scale (HDRS). There were no differences in HDRS scores between the control and intervention arms, so all participants were assessed together. Health, social and economic predictors of trajectories were investigated to identify high-risk groups with greater or more chronic depressive symptoms, using univariate logistic regression. RESULTS Two trajectories were identified: antenatal only (91.4%), with moderate to severe symptoms at baseline which later subside; and antenatal and postnatal (8.6%), with severe depressive symptoms during pregnancy and later in the postpartum period, which subside temporarily to moderate levels at 3 months postpartum. Predictors for the antenatal and postnatal trajectory include severe food insecurity, intimate partner violence, lower social support, greater functional impairment, problematic drinking and suicide risk. CONCLUSIONS A small proportion of women who are at risk for depression antenatally remain at risk throughout the perinatal period, and can be differentiated from those who show a natural remission. Identification and referral strategies should be developed with these findings in mind, especially given the limited mental health resources in low-income settings.
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Affiliation(s)
- Emily C. Garman
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Marguerite Schneider
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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87
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Faghani Aghoozi M, Karimi Khoshal M, Faiazi S, Tork Zahrani S, Amerian M. On the Relationship between Social Support and Early Breastfeeding Termination. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2019. [DOI: 10.29252/pcnm.9.1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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88
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Mendoza AN, Fruhauf CA, MacPhee D. Grandparent Caregivers' Resilience: Stress, Support, and Coping Predict Life Satisfaction. Int J Aging Hum Dev 2019; 91:3-20. [PMID: 31006249 DOI: 10.1177/0091415019843459] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Do support and coping strategies moderate the link between stress and life satisfaction among grandparent caregivers? BACKGROUND Grandparents raising grandchildren often experience stress, which may compromise their subjective well-being. Thus, it is important to understand the role of support and coping as protective or promotive factors in relation to grandparent caregivers' resilience (i.e., life satisfaction). METHODS Grandparent caregivers (N = 74) reported their daily hassles, life satisfaction, social support, and coping. RESULTS These grandparent caregivers are a vulnerable population in terms of stress and limited social support and coping. Structural equation modeling supported direct, promotive effects of social support and coping on life satisfaction, but not moderation. CONCLUSION Despite high levels of stress, half of the grandparent caregivers were satisfied with their lives, which was explained by their social support and coping skills. Some grandparents who assume this role likely would benefit from interventions that promote social support and coping skills.
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Affiliation(s)
| | | | - David MacPhee
- 3447 Colorado State University, Fort Collins, CO, USA
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89
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Taylor RM, Fern LA, Barber J, Alvarez-Galvez J, Feltbower R, Morris S, Hooker L, McCabe MG, Gibson F, Raine R, Stark DP, Whelan JS. Description of the BRIGHTLIGHT cohort: the evaluation of teenage and young adult cancer services in England. BMJ Open 2019; 9:e027797. [PMID: 31005941 PMCID: PMC6500338 DOI: 10.1136/bmjopen-2018-027797] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE International recognition of the unique needs of young people with cancer is growing. Many countries have developed specialist age-appropriate cancer services believing them to be of value. In England, 13 specialist principal treatment centres (PTCs) deliver cancer care to young people. Despite this expansion of specialist care, systematic investigation of associated outcomes and costs has, to date, been lacking. The aim of this paper is to describe recruitment and baseline characteristics of the BRIGHTLIGHT cohort and the development of the bespoke measures of levels of care and disease severity, which will inform the evaluation of cancer services in England. DESIGN Prospective, longitudinal, observational study. SETTING Ninety-seven National Health Service hospitals in England. PARTICIPANTS A total of 1114 participants were recruited and diagnosed between July 2012 and December 2014: 55% (n=618) were men, mean age was 20.1 years (SD=3.3), most (86%) were white and most common diagnoses were lymphoma (31%), germ cell tumour (19%) and leukaemia (13%). RESULTS At diagnosis, median quality of life score was significantly lower than a published control threshold (69.7 points); 40% had borderline to severe anxiety, and 21% had borderline to severe depression. There was minimal variation in other patient-reported outcomes according to age, diagnosis or severity of illness. Survival was lower in the cohort than for young people diagnosed during the same period who were not recruited (cumulative survival probability 4 years after diagnosis: 88% vs 92%). CONCLUSIONS Data collection was completed in March 2018. Longitudinal comparisons will determine outcomes and costs associated with access/exposure to PTCs. Findings will inform international intervention and policy initiatives to improve outcomes for young people with cancer.
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Affiliation(s)
- Rachel M Taylor
- Cancer Clinical Trials, University College Hospitals NHS Foundation Trust, London, UK
| | - Lorna A Fern
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Julie Barber
- Department of Statistical Science, University College London, London, UK
| | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cádiz, Spain
| | | | - Stephen Morris
- Department of Applied Health Research, University College London, London, UK
| | - Louise Hooker
- Wessex Teenage and Young Adult Cancer Service, University Hospital Southhamptom, Southampton, UK
| | - Martin G McCabe
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Faith Gibson
- ORCHID, Great Ormond Street Hospital For Children NHS Trust, London, UK
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Rosalind Raine
- Institute of Epidemiology & Health, University College London, London, UK
| | - Dan P Stark
- Leeds Insitute of Molecular Medicine, University of Leeds, Leeds, UK
| | - Jeremy S Whelan
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
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90
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Simon N, Roberts NP, Lewis CE, van Gelderen MJ, Bisson JI. Associations between perceived social support, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD): implications for treatment. Eur J Psychotraumatol 2019; 10:1573129. [PMID: 30788064 PMCID: PMC6374963 DOI: 10.1080/20008198.2019.1573129] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/28/2018] [Accepted: 01/10/2019] [Indexed: 11/18/2022] Open
Abstract
Background: Perceived social support (PSS) is one of the most important risk factors for the onset and maintenance of posttraumatic stress disorder (PTSD) symptoms, however the relationship between PSS and Complex PTSD (CPTSD) is unknown. The evidence-base for CPTSD treatment is currently lacking, though increasingly important given the recent publication of the ICD-11, which now allows for a formal diagnosis of CPTSD. Objective: This research aims to develop understanding of the relationship between PSS and CPTSD with a view to informing the development of new and existing treatments. Method: A cross-sectional study was undertaken with 246 individuals recruited to the National Centre for Mental Health (NCMH) cohort. Measures of PSS and PTSD/CPTSD were undertaken with this clinical sample and linear and logistic regression were conducted to assess for associations between PSS and the PTSD symptom clusters of DSM-5 and ICD-11, and to explore the predictive utility of any PSS association on the likelihood of a CPTSD presentation. Results: It was found that individuals with a presentation of CPTSD tend to exhibit lower levels of PSS, compared with individuals not presenting with CPTSD, and lower PSS had a statistically significant unique association with the likelihood of presenting with CPTSD. Conclusions: Intervention aiming to improve PSS could be particularly helpful for some individuals with CPTSD, especially those with disturbances in relationships, and there is opportunity to develop skills training within a phase-based approach to treatment that targets factors related to PSS.
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Affiliation(s)
- Natalie Simon
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Neil P. Roberts
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
- Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, UK
| | - Catrin E. Lewis
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Marieke J. van Gelderen
- Foundation Centrum ’45, partner in Arq Psychotrauma Expert Group, Leiden University Medical Center, Leiden, the Netherlands
- Foundation Centrum ’45, Leiden University Medical Center, Oegstgeest, the Netherlands
| | - Jonathan I. Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
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91
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Hall BJ, Yip PSY, Garabiles MR, Lao CK, Chan EWW, Marx BP. Psychometric validation of the PTSD Checklist-5 among female Filipino migrant workers. Eur J Psychotraumatol 2019; 10:1571378. [PMID: 30774783 PMCID: PMC6366408 DOI: 10.1080/20008198.2019.1571378] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/20/2018] [Accepted: 01/04/2019] [Indexed: 01/08/2023] Open
Abstract
Migrant populations are at increased risk for exposure to traumatic life events. Presently, there are no reliable and valid screening instruments for posttraumatic stress disorder (PTSD) among Filipino migrant workers, a population that numbers over 2.3 million worldwide. This study evaluated the psychometric properties of the PTSD Checklist for DSM-5 (PCL-5) in a sample of female Filipino migrant workers in Macao (SAR), China, in two studies. The first examined the reliability (internal and test-retest), convergent validity (with depression, anxiety, and rumination), and discriminant validity (with pain and social support) in a sample of 131 participants. The second study established criterion validity of the PCL-5 using the PTSD module of the Mini-International Neuropsychiatric Interview (MINI), delivered by a female Filipino psychologist as the criterion, in a sample of 100 participants. Results indicated excellent internal consistency (Cronbach's alpha = 0.95) and moderate 10-day test-retest reliability (ρ = 0.58, p < .001). PCL-5 scores correlated strongly with scores on measures of depression (ρ = 0.71, p < .001), anxiety (ρ = 0.61, p < .001), and rumination (ρ = 0.68, p < .001), supporting convergent validity. Discriminant validity was demonstrated by a weaker association with scores on measures of pain (ρ = 0.33, p < .001) and social support (ρ = -0.11, p = .22). The diagnostic accuracy of the scale was good (AUC = 0.87). The optimal cutoff score of 25 optimized sensitivity (0.89) while maintaining adequate specificity (0.73), with a weighted Kappa of κ[1]) = 0.82. Our results demonstrated that the PCL-5 is a reliable and valid screening instrument for use among female Filipino migrant workers.
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Affiliation(s)
- Brian J. Hall
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macau, Macau (SAR), People’s Republic of China
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Paul S. Y. Yip
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macau, Macau (SAR), People’s Republic of China
| | - Melissa R. Garabiles
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macau, Macau (SAR), People’s Republic of China
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
| | - Chao Kei Lao
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macau, Macau (SAR), People’s Republic of China
| | - Edward W. W. Chan
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macau, Macau (SAR), People’s Republic of China
| | - Brian P. Marx
- Department of Veteran Affairs, National Center for PTSD, Boston, USA
- Department of Psychiatry, Boston University, Boston, USA
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92
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Psychometric characteristics and measurement invariance across genders of the Multidimensional Scale of Perceived Social Support (MSPSS) among Nigerian adolescents. HEALTH PSYCHOLOGY REPORT 2019. [DOI: 10.5114/hpr.2019.82629] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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93
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Rabiei L, Lotfizadeh M, Abbasi M, Babaei Heydarabadi A, Masoudi R. Psychosocial Factors and Their Relationship With Self-management in People With Type 2 Diabetes Mellitus: A Conceptual Framework Based on Socio-Cognitive Theory. INTERNATIONAL JOURNAL OF EPIDEMIOLOGIC RESEARCH 2018. [DOI: 10.15171/ijer.2018.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and aims: Maintaining the health of diabetic people depends on the self-management of the disease. This study aimed to evaluate the relationship of distress, self-efficacy, perceived social support, and self-care with self-management behaviors in the patients with type 2 diabetes. Methods: The present analytical-descriptive study was conducted on 228 diabetic patients, during 2016-2017. Most of the participants were male (60.6%) and the mean age of them was 51.95±15.04. The participants were selected based on a simple random sampling method after completing the consent form. The required data were collected through questionnaires of distress, self-efficacy, perceived social support, self-care, and self-management. The data were statistically analyzed using SPSS software version 22.0. Results: Out of 228 participants, 77.3% were married and the highest frequency in terms of educational attainment was related to those with a high school diploma. The results indicated that the duration of affliction with diabetes was less than 10-15 years in 88.9% of the participants. Pearson correlation test demonstrated that the total score of self-management had a significant relationship with the total scores of distress, perceived social support, self-efficacy, and self-care (P<0.005). The results of regression analysis also indicated that distress, perceived social support, self-efficacy, and self-care had a predictive power of 0.43% for self-management. Among these variables, the predictive powers of self-efficacy and self-care were statistically significant, and the prediction rate of self-efficacy was more than that of other ones (β =0.17). Conclusion: The study findings showed that the researchers who want to perform interventions based on cognitive-social theory should mainly focus on self-care and self-efficacy.
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Affiliation(s)
- Leili Rabiei
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Masoud Lotfizadeh
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mohammad Abbasi
- Department of Nursing, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
| | - Akbar Babaei Heydarabadi
- Social Determinants of Health Research Center, Department of Health Education and Health Promotion, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Masoudi
- Community-oriented Nursing and Midwifery Research Center, Nursing and Midwifery School, Shahrekord University of Medical Sciences, Shahrekord, Iran
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94
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Cuadrado I, García-Ael C, Molero F, Recio P, Pérez-Garín D. Acculturation process in Romanian immigrants in Spain: The role of social support and perceived discrimination. CURRENT PSYCHOLOGY 2018. [DOI: 10.1007/s12144-018-0072-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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95
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Humm A, Kaminer D, Hardy A. Social support, violence exposure and mental health among young South African adolescents. J Child Adolesc Ment Health 2018; 30:41-50. [PMID: 29911956 DOI: 10.2989/17280583.2018.1476358] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Cumulative violence exposure has been associated with both internalising and externalising difficulties in youth. Therefore, it is important to identify protective factors that may ameliorate both exposure to and the impact of cumulative violence. This study aimed to identify sources of perceived social support amongst early adolescents in a low-income, high-violence community in South Africa, and to examine the association of perceived support with exposure to violence and with the severity of depression, aggression and conduct disorder symptoms. METHOD A sample of 615 Grade 7 learners completed measures of perceived social support, different types of violence exposure and symptoms of depression, aggression and conduct disorder. RESULTS Maternal, paternal and overall family support were weakly associated with a reduced risk of domestic violence, but not with other forms of violence exposure, and were also weakly associated with a reduced risk of mental health difficulties. Peer support was associated with higher symptomatology across all mental health outcomes while teacher support was associated with greater severity of depression. CONCLUSIONS The stress-buffering effects of social support may not be maintained in contexts of high exposure to violence. Implications for interventions to enhance youth safety and resilience in high-violence contexts are considered.
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Affiliation(s)
- Annette Humm
- a Department of Psychology , University of Cape Town , Cape Town , South Africa.,b Department of Psychology , University of Tübingen , Tübingen , Germany
| | - Debra Kaminer
- a Department of Psychology , University of Cape Town , Cape Town , South Africa
| | - Anneli Hardy
- a Department of Psychology , University of Cape Town , Cape Town , South Africa
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96
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Alizadeh S, Khanahmadi S, Vedadhir A, Barjasteh S. The Relationship between Resilience with Self- Compassion, Social Support and Sense of Belonging in Women with Breast
Cancer. Asian Pac J Cancer Prev 2018; 19:2469-2474. [PMID: 30255701 PMCID: PMC6249445 DOI: 10.22034/apjcp.2018.19.9.2469] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 07/17/2018] [Indexed: 11/27/2022] Open
Abstract
Background: The purpose of this study was to investigate the associations among Resilience, self- compassion, social support and Sense of belonging in Iranian women with breast cancer. Materials and methods: This study was a descriptive-analytical cross-sectional study .The data of 150 patients with breast cancer were collected by convenience sampling using Demographic characteristics questionnaire, Connor-Davidson resilience scale, self-compassion scale and the multidimensional scale of perceived social support in Urmia, Iran in 2016. Results: The most age of the patients were in the range of 41-49 years, and most of them were married. The self- compassion, social support and Sense of belonging (r = all correlated significantly with resilience). Significant positive correlation was identified among self-compassion, social support, sense of belonging and resilience (P < 0.01). Conclusions: The results of this study clarified the self-compassion, social support and Sense of belonging are effective on the resilience among Iranian women with breast cancer. It is recommended to design some interventional programs to increase the aspect of resilience in these patients.
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Affiliation(s)
- Saeedeh Alizadeh
- Department of Anthropology, Faculty of Social Sciences, University of Tehran, Tehran, Iran.
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97
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Rossouw J, Yadin E, Alexander D, Seedat S. Prolonged exposure therapy and supportive counselling for posttraumatic stress disorder in adolescents in a community-based sample, including experiences of stakeholders: study protocol for a comparative randomized controlled trial using task-shifting. BMC Psychiatry 2018; 18:288. [PMID: 30189857 PMCID: PMC6127988 DOI: 10.1186/s12888-018-1873-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 08/31/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a dearth of empirical evidence on the effectiveness of pharmacological and non-pharmacological treatments for adolescents with posttraumatic stress disorder (PTSD) in developing countries. The primary aim of the study is to examine the effects of prolonged exposure therapy compared with supportive counseling for adolescents with PTSD delivered by nurses trained as counselors. METHODS/DESIGN A single-blind randomized clinical trial comprising 90 adolescents with PTSD using a permuted block design will be utilized. Nurses previously naïve to prolonged exposure and supportive counselling will be trained to provide these treatments at the adolescents' high schools. Data collection will last from March 2014 to December 2017 and annually thereafter, dependent on the availability of funding. Participants will receive seven to fourteen 60 min sessions of prolonged exposure treatment (n = 45) or supportive counselling (n = 45). All assessments will be conducted before treatment, at mid-treatment, immediately after treatment completion, at 3-, 6-, and 12-month follow-up, and annually thereafter. It is hypothesized that PE-A will be superior to SC in reducing PTSD symptoms at post-treatment as measured by the CPSS-I administered by an independent evaluator. It is further hypothesized that PE-A treatment gains will be maintained at 3-, 6- and 12-month follow-ups and annually thereafter. DISCUSSION While early indications are that PE-A is an effective treatment for PTSD in adolescents, this study will help determine the effectiveness of PE-A in a South African, community setting (school-based) when task-shifted to nurses, as compared to SC. TRIAL REGISTRATION Pan African Clinical Trials Registry: PACTR201511001345372 , retrospectively registered 11 November 2015.
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Affiliation(s)
- Jaco Rossouw
- Stellenbosch University, Stellenbosch, Western Cape South Africa
- Centre for Cognitive-Behaviour Therapy, 67 Visagie Street, Monte Vista, Cape Town, Western Cape 7460 South Africa
| | - Elna Yadin
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA USA
| | - Debra Alexander
- Stellenbosch University, Stellenbosch, Western Cape South Africa
| | - Soraya Seedat
- Stellenbosch University, Stellenbosch, Western Cape South Africa
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98
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Wongpakaran T, Wongpakaran N, Sirirak T, Arunpongpaisal S, Zimet G. Confirmatory factor analysis of the revised version of the Thai multidimensional scale of perceived social support among the elderly with depression. Aging Ment Health 2018. [PMID: 28621147 DOI: 10.1080/13607863.2017.1339778] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Difficulties in modeling the Multidimensional Scale of Perceived Social Support (MSPSS) have occurred, and these were corrected in the revised version of the Thai MSPSS. However, the revised version has not been tested in elderly populations. The present study aimed at confirming the factor structure of the revised version of the MSPSS among the elderly with depressive disorders, in populations with or without depressive disorders. METHODS Eight hundred and three elderly patients were recruited from four tertiary hospitals; 190 (23.7%) had depressive disorders. All completed the revised Thai MSPSS consisting of 12 items, using a 7-point Likert scale. Confirmatory factor analysis (CFA) of the MSPSS was conducted in both groups. RESULTS The mean age was 69.24 years (SD 6.88), and 70% of the sample was female. There were no significant difference in demographic data between two groups. The revised version of the Thai MSPSS provided excellent internal consistency. The three-factor model was clearly superior to other alternative models in both depressed and non-depressed groups. CFA for the whole group revealed an acceptable model fit: χ2 = 147.44, df = 45, p < 0.001; Tucker-Lewis Index 0.975; Comparative Fit Index 0.982; Good Fit Index 0.966; and root-mean-square error of approximation 0.056. The fit statistics in the depressed group was better than in the non-depressed group across all models. CONCLUSIONS Due to its robust factor structure, these data support the use of the revised MSPSS as a brief instrument for assessing perceived social support in the elderly with or without depressive disorders.
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Affiliation(s)
| | | | - Thanitha Sirirak
- c Faculty of Medicine, Prince of Songkla University , Hat Yai , Thailand
| | | | - Gregory Zimet
- e Department of Pediatrics , Indiana University , Indianapolis , IN , USA
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Ermis-Demirtas H, Watson JC, Karaman MA, Freeman P, Kumaran A, Haktanir A, Streeter AM. Psychometric Properties of the Multidimensional Scale of Perceived Social Support Within Hispanic College Students. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2018. [DOI: 10.1177/0739986318790733] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of the current study was to investigate the psychometric properties of the Multidimensional Scale of Perceived Social Support (MSPSS) within a sample of Hispanic college students. The sample of 223 Hispanic or Latino/a college students consisting of 142 women (65%) and 79 men (35%) was recruited from a Hispanic serving institution in the southern United States. The results of factor analysis confirmed the three-subscale structure of the MSPSS: family, friend, and a significant other.
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Field S, Onah M, van Heyningen T, Honikman S. Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed methods study. BMC Womens Health 2018; 18:119. [PMID: 29973182 PMCID: PMC6030741 DOI: 10.1186/s12905-018-0612-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 06/22/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Rates of violence against women are reported to be highest in Africa compared to other continents. We aimed to determine associations between mental illness, demographic, psychosocial and economic factors with experience of intimate partner violence (IPV) among pregnant women in a low resource setting in Cape Town and to explore the contextual elements pertaining to domestic violence. METHODS We recruited adult women attending antenatal services at a primary-level maternity facility. Demographic, socioeconomic and psychosocial data were collected by questionnaire. The Expanded Mini- International Neuropsychiatric Interview (MINI) Version 5.0.0 was used to assess mental health status and the Revised Conflict Tactic Scale (CTS2) used to assess IPV in the six months prior to the study. Non-parametric tests, Wilcoxon sum of rank test, Fisher Exact and two sample T test and multicollinearity tests were performed. Descriptive, bivariate and logistic regression analyses were conducted to identify associations between the outcome of interest and key predictors. A probability value of p ≤ 0.05 was selected. From counselling case notes, a thematic content analysis was conducted to describe contextual factors pertaining to forms of domestic violence (DV). RESULTS The prevalence of IPV was 15% of a sample of 376 women. Women who were food insecure, unemployed, in stable but unmarried relationships, had experienced any form of past abuse and were not pleased about the current pregnancy were more likely to experience IPV. MINI-defined mental health problems and a history of mental illness were significantly associated with IPV. Qualitative analysis of 95 counselling case notes revealed that DV within the household was not limited to intimate partners and, DV in this context was often perceived as 'normal' behaviour by the participants. CONCLUSIONS This study contributes towards a greater understanding of the risk profile for IPV amongst pregnant women in low-income settings. Adversity, including food insecurity and mental ill-health are closely associated with IPV during the antenatal period. Advocates against violence against pregnant women are advised to consider that violence in the home may be perpetrated by non-intimate partners and may by enabled by a pervasive belief in the acceptability of the violence.
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Affiliation(s)
- Sally Field
- Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, 7700 South Africa
| | - Michael Onah
- Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, 7700 South Africa
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Thandi van Heyningen
- Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, 7700 South Africa
| | - Simone Honikman
- Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, 7700 South Africa
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