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Religion/Spirituality, Mental Health, and the Lifespan: Findings from a Representative Sample of Canadian Adults. Can J Aging 2023; 42:115-125. [PMID: 35909323 DOI: 10.1017/s0714980822000162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Theories of adult development and aging suggest that older adults turn towards religion and spirituality (R/S) to increase meaning and purpose in life, and to assist in coping with adverse experience. We sought to examine the relationship between R/S and positive mental health and mental illness (i.e., psychological distress) in adulthood, and to determine the potential moderating role of age. Data from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH), a national population health study, were used. A multivariable linear regression model revealed a significant R/S by age interaction for positive mental health (p = 0.001). Although R/S was associated with positive mental health among all participants, there was a stronger relationship between R/S and positive mental health for older adults. No statistically significant relationship between R/S and psychological distress was observed. Findings highlight the importance of R/S to positive mental health across the adult lifespan. The differential relationships among R/S, positive mental health, and mental illness underscore the utility of using the dual-continua of mental health and mental illness in order to understand their respective determinants.
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Zhang L, Li Z. Factor structure and longitudinal measurement invariance of the K6 among a national representative elder sample of China. BMC Public Health 2022; 22:1789. [PMID: 36131316 PMCID: PMC9491003 DOI: 10.1186/s12889-022-14193-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background As the number of older people is rapidly growing, prevention, screening, and treatment of mental health problems (including anxiety and depression) in this population increasingly become a heavy burden to individuals, families, and even the whole society. The Kessler-6 screening measure (K6) is an efficient and effective instrument for general mental health problems. However, few studies have examined its measurement invariance across time, which is particularly important in longitudinal studies, such as exploring developmental trajectories of non-specific psychological distress and evaluating the effects of certain interventions. Methods The current study investigated the factor structure and the longitudinal measurement invariance of the K6 among a national representative elder sample of China. Longitudinal data in two survey waves (the year 2010, and the year 2014) from the China Family Panel Studies were drawn for secondary data analysis. A total of 3845 participants aged 60 years old and above (52.2% male, mean age = 66.99 years, SD = 5.93 years) responded to both waves of the survey. Results A comparison of four existing models with confirmatory factor analysis supported a two-factor solution of the K6. A series of multi-group confirmatory factor analyses further indicated that the K6 held strict longitudinal measurement invariance across time. Additionally, the internal consistency indices across time and the stability coefficients over time were acceptable. Conclusions The findings further confirmed the psychometric defensibility of the K6 when used in the old Chinese population. The longitudinal measurement invariance justified comparisons of psychological distress scores among different measurement time points.
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Affiliation(s)
- Lisong Zhang
- School of Sociology and Population, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Zhongquan Li
- School of Social and Behavioral Sciences, Nanjing University, 163 Xianlin Avenue, Qixia District, Nanjing, 210023, Jiangsu, China.
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Higbee M, Wright ER, Roemerman RM. Conversion Therapy in the Southern United States: Prevalence and Experiences of the Survivors. JOURNAL OF HOMOSEXUALITY 2022; 69:612-631. [PMID: 33206024 DOI: 10.1080/00918369.2020.1840213] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Numerous studies have determined that conversion therapy, a practice meant to change one's sexual orientation to heterosexual or gender identity to cisgender, can be ineffective and severely harmful. However, few studies have documented the prevalence or characteristics of its survivors. This study is a quantitative analysis of the LGBTQ Institute Southern Survey that estimates the prevalence of conversion therapy (specifically SOCE) in the Southern United States and documents its significant association with negative mental health outcomes. Conversion therapy survivors comprised 7.6% of the sample (11.6% after listwise deletion). Respondents who were younger and reported being a gender minority; lesbian, gay, or some other sexual orientation; Hispanic; less educated; and less religious were more likely to have experienced it. Findings support previous studies which report a strong correlation between conversion therapy and poor mental health outcomes. Results regarding the prevalence and demographics of survivors offer new insights for further research.
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Affiliation(s)
- Madison Higbee
- Sociology, Georgia State University, Atlanta, Georgia, USA
| | - Eric R Wright
- Sociology, Georgia State University, Atlanta, Georgia, USA
| | - Ryan M Roemerman
- Communication Studies, University of Iowa, LGBTQ Institute, National Center for Civil and Human Rights, Atlanta, Georgia, USA
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Rivers AS, Sanford K. A special kind of stress: Assessing feelings of decisional distress for breast cancer treatment decisions. PATIENT EDUCATION AND COUNSELING 2021; 104:3038-3044. [PMID: 33941423 DOI: 10.1016/j.pec.2021.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/19/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Women with breast cancer need to make difficult treatment decisions and may experience decisional distress (worry, anxiety, and thought intrusion) associated with these decisions. This study investigated ways that decisional distress was both associated with and distinct from other variables regarding decisional process and life functioning, and it investigated the validity of a decisional distress scale. METHODS A total of 263 women previously or currently diagnosed with breast cancer reported on initial treatment decisions regarding surgery, chemotherapy, or radiation, or decisions involving oral endocrine therapy (either currently or retrospectively). Participants completed online measures of decisional distress, alliance and confusion in patient-practitioner relationships, positive and negative interactions in close relationships, financial and general distress, and decision satisfaction. RESULTS Decisional distress demonstrated a unidimensional factor structure invariant across treatment context groups, a wide range of meaningful variation, significant correlations with all hypothesized variables (especially patient confusion), but also key distinctions from other variables. CONCLUSION Decisional distress is a meaningful construct that can be assessed with precision, and important for understanding medical decision-making processes and patient quality of life. PRACTICE IMPLICATIONS Assessing decisional distress is crucial for evaluating treatment decision outcomes. One key to reducing decisional distress may involve reducing patient confusion.
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Affiliation(s)
| | - Keith Sanford
- Department of Psychology and Neuroscience, Baylor University, Waco, USA
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Cotton SM, Menssink J, Filia K, Rickwood D, Hickie IB, Hamilton M, Hetrick S, Parker A, Herrman H, McGorry PD, Gao C. The psychometric characteristics of the Kessler Psychological Distress Scale (K6) in help-seeking youth: What do you miss when using it as an outcome measure? Psychiatry Res 2021; 305:114182. [PMID: 34455216 DOI: 10.1016/j.psychres.2021.114182] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/10/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
This is the first study to describe psychometric properties of the Kessler Psychological Distress Scale (K6) in a large cohort of help-seeking young people presenting to primary mental health care services. The aim was to determine whether the K6 was appropriate for monitoring outcomes in such settings. 1067 young people were recruited from Australian headspace services. We examined dimensionality of the K6, measurement invariance, and how the K6 correlated with the the Patient Health Questionnaire-9 (PHQ-9)and the Generalised Anxiety Disorder-7 Scale (GAD-7). Standardised Response Mean (SRM) and Cohen's d effect size (ES) were used to examine 3-month stability of the K6. The best-fitting model was a two-factor model: (i) nervous and restlessness; and (ii) hopeless, worthless, depressed and effort. Measurement non-invariance was observed for sex and age groups. K6 strongly correlated with the PHQ-9 and GAD-7. The K6 was less sensitive to change compared to these other two measures. There was some support for the K6 being a screener for young people presenting to primary care; however, there issues arise with its use as an outcome measure. These issues include measurement non-invariance, concern about the dimensionality and focus of items, and its sensitivity to change.
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Affiliation(s)
- S M Cotton
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia.
| | - J Menssink
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia
| | - K Filia
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia
| | - D Rickwood
- headspace National Youth Mental Health Foundation Ltd, Melbourne VIC, Australia; Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - I B Hickie
- Brain and Mind, University of Sydney, Camperdown, NSW, Australia
| | - M Hamilton
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia
| | - S Hetrick
- Department of Psychological Medicine, The University of Auckland, Auckland, Australia
| | - A Parker
- Orygen, Parkville, Melbourne VIC, Australia; Victoria University, Institute of Health and Sport, Melbourne VIC, Australia
| | - H Herrman
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia
| | - P D McGorry
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia
| | - C Gao
- Orygen, Parkville, Melbourne VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne VIC, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne VIC, Australia
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6
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Zhang L, Li Z. A Mokken scale analysis of the Kessler-6 screening measure among Chinese older population: findings from a national survey. BMC Geriatr 2020; 20:361. [PMID: 32962656 PMCID: PMC7507816 DOI: 10.1186/s12877-020-01771-w] [Citation(s) in RCA: 5] [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] [Received: 04/15/2020] [Accepted: 09/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aging population increases rapidly across the world. Timely and effective screening of their mental-health problems is important to individuals, families, and the whole society. The Kessler-6 screening measure (K6) is a very popular instrument for non-specific psychological distress. However, few studies have focused on the psychometric properties of this instrument in the older population. METHODS The present study employed Mokken scale analysis to evaluate its dimensionality and structure. This study also used differential item functioning (DIF) to examine whether the same structure existed across sex in a national representative sample of old Chinese people. Data were drawn from a public data set, the 2010 China Family Panel Studies (CFPS2010), and responses from a total of 6450 participants aged 60 years old and above (3136 males and 3314 females) were included in the final analysis. RESULTS Mokken scale analysis supported the unidimensional structure of the K6. Differential item functioning (DIF) analysis revealed that two of the six items ("Hopeless" and "Everything was an effort") were marked for DIF based on the Chi-square. However, their impacts were negligible in terms of McFadden's pseudo R2. CONCLUSIONS The K6 demonstrates adequate psychometric properties in the old Chinese population. The sum of all six items can be used as an indicator of non-specific psychological distress. Differences in the indicator across sex should be considered as a real difference in psychological distress between the female and the male.
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Affiliation(s)
- Lisong Zhang
- School of Sociology and Population, Nanjing University of Posts and Telecommunications, 9 Wenyuan Road, Qixia District, Nanjing, 210023, Jiangsu, China
| | - Zhongquan Li
- School of Social and Behavioral Sciences, Nanjing University, 163 Xianlin Avenue, Qixia District, Nanjing, 210023, Jiangsu, China.
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Sexton JD, Crawford MS, Sweat NW, Varley A, Green EE, Hendricks PS. Prevalence and epidemiological associates of novel psychedelic use in the United States adult population. J Psychopharmacol 2019; 33:1058-1067. [PMID: 30816808 DOI: 10.1177/0269881119827796] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Novel psychedelics approximate classic psychedelics, but unlike classic psychedelics, novel psychedelics have been used by humans for a shorter period of time, with fewer data available on these substances. AIMS The purpose of this study was to determine the prevalence of novel psychedelic use and the associations of novel psychedelic use with mental health outcomes. METHODS We estimated the prevalence of self-reported, write-in lifetime novel psychedelic use and evaluated the associations of novel psychedelic use with psychosocial characteristics, past month psychological distress, and past year suicidality among adult respondents pooled from years 2008-2016 of the National Survey on Drug Use and Health (weighted n=234,914,788). RESULTS A fraction (weighted n=273,720; 0.12%) reported lifetime novel psychedelic use. This cohort tended to be younger, male, and White, have greater educational attainment but less income, be more likely to have never been married, engage in self-reported risky behavior, and report lifetime illicit use of other drugs, particularly classic psychedelics (96.9%). (2-(4-Bromo-2,5-dimethoxyphenyl)ethanamine) (2C-B) (30.01%), (2,5-dimethoxy-4-iodophenethylamine) (2C-I) (23.9%), and (1-(2,5-dimethoxy-4-ethylphenyl)-2-aminoethane) (2C-E) (14.8%) accounted for the majority of lifetime novel psychedelic use. Although lifetime novel psychedelic use was not associated with psychological distress or suicidality compared to no lifetime novel psychedelic use or classic psychedelic use, relative to lifetime use of classic psychedelics but not novel psychedelics, lifetime novel psychedelic use was associated with a greater likelihood of past year suicidal thinking (adjusted Odds Ratio (aOR)=1.4 (1.1-1.9)) and past year suicidal planning (aOR=1.6 (1.1-2.4)). CONCLUSION Novel psychedelics may differ from classic psychedelics in meaningful ways, though additional, directed research is needed.
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Affiliation(s)
- James D Sexton
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael S Crawford
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Noah W Sweat
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allyson Varley
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emma E Green
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Peter S Hendricks
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
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Gómez‐Benito J, Berrío ÁI, Guilera G, Rojo E, Purdon S, Pino O. The Screen for Cognitive Impairment in Psychiatry: Proposal for a polytomous scoring system. Int J Methods Psychiatr Res 2018; 27:e1598. [PMID: 29110352 PMCID: PMC6877218 DOI: 10.1002/mpr.1598] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 01/02/2023] Open
Abstract
The Screen for Cognitive Impairment in Psychiatry is a simple, fast, and easy to administer scale that has been validated in clinical and community samples. The aim of this study was to propose a polytomous scoring system for the Screen for Cognitive Impairment in Psychiatry and to demonstrate its functioning, thus providing new and complementary information regarding the utility and precision of this screening tool. Three hundred seventy-six Spanish patients diagnosed with schizophrenia spectrum disorder were evaluated. A polytomous scoring system was generated and analyzed by means of the partial credit model. Category assessment revealed optimal functioning after collapsing the 7-category system to 1 with either 5 or 4 categories, depending on the item. The proposed polytomous scoring system shows good psychometric properties and an adequate fit to the partial credit model. These results provide further confirmation of the test's utility in clinical settings and of its suitability for detecting cognitive impairment.
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Affiliation(s)
- Juana Gómez‐Benito
- Quantitative Psychology Unit, Faculty of PsychologyUniversity of BarcelonaBarcelonaSpain
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences (NeuroUB)University of BarcelonaBarcelonaSpain
| | - Ángela I. Berrío
- Quantitative Psychology Unit, Faculty of PsychologyUniversity of BarcelonaBarcelonaSpain
| | - Georgina Guilera
- Quantitative Psychology Unit, Faculty of PsychologyUniversity of BarcelonaBarcelonaSpain
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences (NeuroUB)University of BarcelonaBarcelonaSpain
| | - Emilio Rojo
- Benito Menni CASMGermanes HospitalàriesBarcelonaSpain
- Department of PsychiatryInternational University of CataloniaBarcelonaSpain
| | - Scot Purdon
- Department of PsychiatryUniversity of AlbertaEdmontonAlbertaCanada
| | - Oscar Pino
- Quantitative Psychology Unit, Faculty of PsychologyUniversity of BarcelonaBarcelonaSpain
- Benito Menni CASMHospital General de GranollersGranollersSpain
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Morrone E, Sguazzin C, Bertolotti G, Giordano A, Braghiroli A, Balestroni GL, Manni R, Ferini Strambi L, Castronovo V, Zucconi M, De Carli F, Pinna E, Ottonello M, Giorgi I, Terzaghi M, Marelli S, Fanfulla F. Development and validation of the Maugeri Sleep Quality and Distress Inventory (MaSQuDI-17). PLoS One 2017; 12:e0180743. [PMID: 28700701 PMCID: PMC5507265 DOI: 10.1371/journal.pone.0180743] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/20/2017] [Indexed: 11/18/2022] Open
Abstract
Objectives The aim of this study was to develop and validate a questionnaire designed to measure the impact of sleep impairment on emotional distress in patients with various sleep disorders. Methods Five experts created an item data-bank pertaining to sleep-related psychological symptoms and somatic perceptions. Fifty patients in two focus groups examined each item for: a) word clarity (indicating any ambiguity of interpretation) and b) appropriateness for the target population. This process permitted to identify 36 appropriate items. Classical Test Theory and Rasch Analysis were used to further refine the questionnaire, yielding the final 17-item set. Concurrent validation of the new scale was tested with the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and the Anxiety and Depression questionnaires. Results Starting from the initial item data-bank, a 17-item questionnaire, the Maugeri Sleep Quality and Distress Inventory (MaSQuDI–17), was produced. Parallel Analysis on the MaSQuDI–17 confirmed the presence of a single dimension; exploratory factor analysis showed salient loading for each item, explaining 58.7% of total variance. Item-remainder correlation ranged from 0.72 to 0.39 and Cronbach alpha was 0.896. Rasch analysis revealed satisfactory psychometric properties of the new scale: the rating structure performed according to expectations, model fit was good and no item dependencies emerged. The scale presented good convergent validity and scores significantly distinguished healthy subjects from OSAS or Insomnia or BSD (p < 0.001). Conclusions MaSQuDI –17 shows good psychometric qualities, and can be used to assess the impact of sleep disorders such as Insomnia, OSAS, Central Hypersomnia and BSD on emotional stress.
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Affiliation(s)
- Elisa Morrone
- Sleep Medicine Unit, Istituti Clinici Scientifici Maugeri, Scientific Istitute of Pavia IRCCS, Pavia, Italy
| | - Cinzia Sguazzin
- Psychology Unit, Istituti Clinici Scientifici Maugeri, Scientific Istitute of Pavia IRCCS, Pavia Italy
| | - Giorgio Bertolotti
- Psychology Unit, ICS Maugeri, Istituti Clinici Scientifici Maugeri, Scientific Istitute of Tradate IRCCS, Tradate, Italy
| | - Andrea Giordano
- Unit of Bioengineering, Istituti Clinici Scientifici Maugeri, Scientific Istitute of Veruno IRCCS, Veruno, Italy
| | - Alberto Braghiroli
- Division of Respiratory Disease, Istituti Clinici Scientifici Maugeri, Scientific Istitute of Veruno IRCCS, Veruno, Italy
| | - Gian Luigi Balestroni
- Psychology Unit, Istituti Clinici Scientifici Maugeri, Scientific Istitute of Veruno IRCCS, Veruno, Italy
| | - Raffaele Manni
- Unit of Sleep Medicine and Epilepsy, C. Mondino National Neurological Institute, Pavia, Italy
| | - Luigi Ferini Strambi
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Sleep Disorders Center, Università Vita-Salute San Raffaele, Milano, Italy
| | - Vincenza Castronovo
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Sleep Disorders Center, Università Vita-Salute San Raffaele, Milano, Italy
| | - Marco Zucconi
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Sleep Disorders Center, Università Vita-Salute San Raffaele, Milano, Italy
| | - Fabrizio De Carli
- Institute of Bioimaging and Molecular Physiology, National Research Council (CNR) Genova, Italy
| | - Eleonora Pinna
- Psychology Unit, Istituti Clinici Scientifici Maugeri, Scientific Istitute of Pavia IRCCS, Pavia Italy
| | - Marcella Ottonello
- Psychology Unit, Istituti Clinici Scientifici Maugeri, Scientific Istitute of Genova Nervi, Genova,Italy
| | - Ines Giorgi
- Psychology Unit, Istituti Clinici Scientifici Maugeri, Scientific Istitute of Pavia IRCCS, Pavia, Italy
| | - Michele Terzaghi
- Unit of Sleep Medicine and Epilepsy, C. Mondino National Neurological Institute, Pavia, Italy
| | - Sara Marelli
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Sleep Disorders Center, Università Vita-Salute San Raffaele, Milano, Italy
| | - Francesco Fanfulla
- Sleep Medicine Unit, Istituti Clinici Scientifici Maugeri, Scientific Istitute of Pavia IRCCS, Pavia, Italy
- * E-mail:
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Singhal A, Borrelli B. Dental Disparities and Psychological Distress Among Mobility-Impaired Adults. Am J Prev Med 2017; 52:645-652. [PMID: 27989449 DOI: 10.1016/j.amepre.2016.10.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 10/03/2016] [Accepted: 10/14/2016] [Indexed: 12/01/2022]
Abstract
INTRODUCTION More than one in five American adults has a disability, the most common being mobility impairment (MI). People with MI face significant barriers to healthcare access and are more likely to experience psychological distress. This study examined disparities in access to medical and dental care among people with MI and examine the mediational role of psychological distress on this relationship. METHODS Analyses were conducted on 36,697 adults (aged ≥18 years) responding to the 2014 National Health Interview Survey (analyzed in 2015). MI was defined as needing special equipment and having difficulty walking a quarter mile without equipment. Outcomes included having lost all natural teeth (edentulous), unmet dental needs, annual dental visit, and annual medical visit. Psychological distress was measured using the Kessler psychological distress (K6) scale. RESULTS Compared with adults without MI, adults with MI had greater odds of being edentulous (OR=2.10, 95% CI=1.82, 2.43), having unmet dental needs (OR=1.99, 95% CI=1.66, 2.40), and lower odds of having annual dental visits (OR=0.62, 95% CI=0.54, 0.71). However, adults with MI were significantly more likely to have annual medical visits (OR=2.31, 95% CI=1.90, 2.81) than adults without MI. Psychological distress partially, yet significantly, mediated the relationship between MI and outcomes. CONCLUSIONS People with MI have significant oral health needs and poor access to dental care, which are partially mediated by psychological distress. Results suggest that mental health services should be considered for inclusion in interventions and medical visits can be leveraged to improve oral health outcomes in this population.
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Affiliation(s)
- Astha Singhal
- Health Policy and Health Services Research, Boston University, Henry M. Goldman School of Dental Medicine, Boston, Massachusetts;.
| | - Belinda Borrelli
- Division of Behavioral Science Research, Health Policy and Health Services Research, Boston University, Henry M. Goldman School of Dental Medicine, Boston, Massachusetts
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Rasch analysis supported the construct validity of self-report measures of activity and participation derived from patient ratings of the ICF low back pain core set. J Clin Epidemiol 2017; 84:161-172. [PMID: 28108353 DOI: 10.1016/j.jclinepi.2016.12.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 12/05/2016] [Accepted: 12/16/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate whether measures of activity limitations and participation restrictions with sound internal construct validity could be derived from patient ratings of the International Classification of Functioning, Disability and Health Low Back Pain Core Set (LBP-CS). STUDY DESIGN AND SETTING The LBP-CS Self-Report Checklist (LBP-CS-SRC) was developed to permit patients to self-rate their functioning according to an extended set of activity and participation categories from the LBP-CS. Rasch analysis was used to examine the validity of the LBP-CS-SRC with a sample of 308 adults with chronic low back pain attending two tertiary-referral outpatient services in Brisbane, Australia. RESULTS The activity limitations and participation restrictions qualifier scales functioned satisfactorily, and the LBP-CS-SRC person response validity was good. After deletion of six misfitting items, the dimensionality results supported using the instrument as distinct measures of activity limitations (17 items) and participation restrictions (10 items). The activity and participation measures both had good person separation reliability, and no component items exhibited meaningful differential item functioning. CONCLUSION The results demonstrate that measures of activity and participation with sound internal construct validity can be derived from patient ratings of LBP-CS categories. The LBP-CS-SRC can be used in clinical practice and epidemiologic research to support understanding of patients' perspectives on functioning.
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12
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Hendricks PS, Thorne CB, Clark CB, Coombs DW, Johnson MW. Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population. J Psychopharmacol 2015; 29:280-8. [PMID: 25586402 DOI: 10.1177/0269881114565653] [Citation(s) in RCA: 220] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Mental health problems are endemic across the globe, and suicide, a strong corollary of poor mental health, is a leading cause of death. Classic psychedelic use may occasion lasting improvements in mental health, but the effects of classic psychedelic use on suicidality are unknown. We evaluated the relationships of classic psychedelic use with psychological distress and suicidality among over 190,000 USA adult respondents pooled from the last five available years of the National Survey on Drug Use and Health (2008-2012) while controlling for a range of covariates. Lifetime classic psychedelic use was associated with a significantly reduced odds of past month psychological distress (weighted odds ratio (OR)=0.81 (0.72-0.91)), past year suicidal thinking (weighted OR=0.86 (0.78-0.94)), past year suicidal planning (weighted OR=0.71 (0.54-0.94)), and past year suicide attempt (weighted OR=0.64 (0.46-0.89)), whereas lifetime illicit use of other drugs was largely associated with an increased likelihood of these outcomes. These findings indicate that classic psychedelics may hold promise in the prevention of suicide, supporting the view that classic psychedelics' most highly restricted legal status should be reconsidered to facilitate scientific study, and suggesting that more extensive clinical research with classic psychedelics is warranted.
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Affiliation(s)
- Peter S Hendricks
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christopher B Thorne
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - C Brendan Clark
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David W Coombs
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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