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Cuthbertson C, Rivas-Koehl D, Codamon A, Billington A, Rivas-Koehl M. Mental Health Among LGBTQ+ Farmers in the United States. J Agromedicine 2024; 29:583-593. [PMID: 38879886 DOI: 10.1080/1059924x.2024.2368185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
OBJECTIVES The objective of the current study is to describe mental health among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people who work in agriculture in the U.S. METHODS This study uses a survey of LGBTQ+ adults who work in agriculture in the U.S. (N = 148), including questions about LGBTQ+ identity, farming background, depression symptoms (PHQ-8) and diagnosis, anxiety symptoms (GAD-7) and diagnosis, suicide risk, and stress. Data were analyzed using SPSS, including descriptive statistics, chi-square tests, and Mann-Whitney U tests. RESULTS Over one-third (36.1%) had probable depression (PHQ-8 ≥ 10), and 71.9% were experiencing mild to severe depression symptoms. Nearly half (46.2%) had probable anxiety disorder (GAD-7 ≥ 8), and 69.7% experienced mild to severe anxiety symptoms. Over half (51.7%) were at significant risk for suicide. Greater proportions of men had probable anxiety disorder, probable depression, and suicide risk compared to non-men. Greater proportions gay participants had probable depression, as did beef producers. Perceived stress was higher for men, lesbian and gay participants, transgender participants, and those in beef production. Resilient coping was highest among participants who were genderqueer or genderfluid, bisexual, and those in field crop production. CONCLUSION LGBTQ+ farmers in the current sample experienced depression and anxiety at higher rates than general farming or general LGBTQ+ samples, although suicide risk was lower than for general LGBTQ+ samples. Future research should explore how working in agriculture may be protective against suicide risk for LGBTQ+ farmers, as well as how specific farm stressors are related to LGBTQ+ farmer mental health.
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Affiliation(s)
- Courtney Cuthbertson
- Department of Human Development and Family Studies, University of Illinois, Urbana, USA
| | - Dane Rivas-Koehl
- Department of Human Development and Family Studies, University of Illinois, Urbana, USA
| | - Anisa Codamon
- Department of Human Development and Family Studies, University of Illinois, Urbana, USA
| | - Alyssa Billington
- Department of Human Development and Family Studies, University of Illinois, Urbana, USA
| | - Matthew Rivas-Koehl
- Department of Human Development and Family Studies, University of Illinois, Urbana, USA
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Lee HK, Bonilha HS, Hong I. Relationship Between Voice Problems and Depression Among American Adults. Otolaryngol Head Neck Surg 2024. [PMID: 39342505 DOI: 10.1002/ohn.946] [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: 05/22/2024] [Revised: 07/01/2024] [Accepted: 08/03/2024] [Indexed: 10/01/2024]
Abstract
OBJECTIVE Voice problems have a large impact on quality-of-life and societal participation. It has been previously reported that persons with voice problems have a higher likelihood of depression than those without voice problems. Despite this knowledge, little has changed in clinical practice related to screening for depression or incorporating the presence of depression in treatment planning. This study aims to provide an updated analysis of the prevalence of depressive symptoms in persons with voice disorders to elucidate the current magnitude of the relationship in hopes that this will provoke greater awareness of the co-occurrence of voice problems and depression and improve clinical care. STUDY DESIGN Cross-sectional design with a national survey. SETTING None. METHODS The study examined the 23,706 adults from the 2022 National Health Interview Survey database. A series of logistic regression models with propensity score matching approaches were used to examine the association between voice problems and depression by accounting for demographics and health conditions. RESULTS When comparing persons with and without voice problems, there were statistical differences in demographics and health conditions (all P < .05); however, those differences were balanced by propensity score matching methods (all P > .05). The balanced samples revealed that those with voice problems were approximately twice as likely to experience depressive symptoms (odds ratios ranged from 1.532 to 2.024, all P < .05) compared to those without voice problems. Depressive symptoms increased with the severity (P < .0001) and duration of the voice problem (P = .0328). CONCLUSION The study found robust associations between voice problems and depression within the current American adult population in 2022. To achieve optimal treatment outcomes, it is critical that the co-occurrence of voice problems and depression is understood, and that treatment planning addressed both conditions, when applicable.
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Affiliation(s)
- Ho Kyung Lee
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju, Republic of Korea
| | - Heather Shaw Bonilha
- Communication Sciences and Disorders, University of South Carolina, Columbia, South Carolina, USA
| | - Ickpyo Hong
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
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Feldman EL, Slavish DC. Initial development of a sleep health literacy scale. Sleep Health 2024:S2352-7218(24)00177-3. [PMID: 39332924 DOI: 10.1016/j.sleh.2024.08.001] [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: 08/15/2023] [Revised: 07/22/2024] [Accepted: 08/02/2024] [Indexed: 09/29/2024]
Abstract
OBJECTIVES Health literacy includes the skills necessary for effective communication with health professionals, understanding health instructions, and recognizing health needs. Our study aimed to create a novel measure of sleep health literacy-an individual's capacity to comprehend sleep-related information and navigate sleep-related healthcare services. METHODS The Sleep Health Literacy scale consists of two subscales: "Sleep Health Communication" (11 Likert-scale items assessing access to resources and communication with healthcare providers) and "Sleep Health Knowledge" (46 true/false items assessing specific knowledge of sleep health). The Sleep Health Literacy scale was completed by 154 undergraduate students (mean age=20.96years; 79.87% female) in study 1. In study 2, an additional sample of 251 participants (mean age=20.23years; 79.87% female) completed the Sleep Health Literacy scale, along with measures of convergent and discriminant validity. RESULTS Exploratory factor analysis results in study 1 revealed a two-factor structure for the "Sleep Health Communication" subscale ("comprehension" and "critical application"). The subscale demonstrated good internal consistency (α = 0.81) and inter-item and item-total correlations. On the "Sleep Health Knowledge" subscale, participants answered 76.36% of items correctly. In study 2, the Sleep Health Literacy had good convergent validity with Sleep Beliefs Scale and the All Aspect of Health Literacy Scale. CONCLUSIONS The Sleep Health Literacy scale offers a standardized measure to assess sleep health literacy, an understudied domain that has important links to health. This measure may allow researchers and clinicians to better understand how to improve sleep health. Further validation of the Sleep Health Literacy scale is warranted in more diverse samples.
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Affiliation(s)
- Emily L Feldman
- Department of Psychology, University of North Texas, Denton, Texas, United States
| | - Danica C Slavish
- Department of Psychology, University of North Texas, Denton, Texas, United States.
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Heumann E, Helmer SM, Busse H, Negash S, Horn J, Pischke CR, Niephaus Y, Stock C. Depressive and anxiety symptoms among university students during the later stages of the COVID-19 pandemic in Germany - Results from the COVID 19 German Student Well-being Study (C19 GSWS). Front Public Health 2024; 12:1459501. [PMID: 39371201 PMCID: PMC11451415 DOI: 10.3389/fpubh.2024.1459501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 09/02/2024] [Indexed: 10/08/2024] Open
Abstract
Introduction Data on the mental health of university students in Germany during the later stages of the pandemic is still limited. This study aimed to determine (1) the prevalence of anxiety and depressive symptoms among university students 1.5 years after the first COVID-19 restrictions and (2) which factors were associated with these outcomes. Methods The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) collected data of 6,996 students at five German universities. Associations between anxiety and depressive symptoms with sociodemographic and other factors were analyzed using multivariable logistic regression models. Results The mean age of the participants was 23.9 years (SD = 4.8), 67% were female and 31% male. The prevalence for depressive symptoms was 29 and 32% for anxiety. The lack of a trusted person and financial difficulties were associated with anxiety and depressive symptoms. Being worried that someone in one's personal network had become severely ill with COVID-19 and concern about (re)infection with COVID-19 were associated with anxiety symptoms. Those with pre-existing health conditions had an up to 1.98-times higher chance for reporting depressive symptoms (OR, 95% CI: 1.01-3.88) and an up to 2.27-times higher chance for anxiety symptoms, respectively (OR, 95% CI: 1.15-4.46). Conclusion Concepts for prevention and counseling to tackle mental health problems in students are needed and programs should take specific stressors in times of crises into account.
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Affiliation(s)
- Eileen Heumann
- Institute of Health and Nursing Science, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Stefanie M. Helmer
- Human and Health Sciences, Institute of Public Health and Nursing Science (IPP), University of Bremen, Bremen, Germany
| | - Heide Busse
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Sarah Negash
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Johannes Horn
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Claudia R. Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Yasemin Niephaus
- Department of Social Sciences, University of Siegen, Siegen, Germany
| | - Christiane Stock
- Institute of Health and Nursing Science, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
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Hlynsson JI, Sjöberg A, Ström L, Carlbring P. Evaluating the reliability and validity of the Questionnaire on Well-Being: a validation study for a clinically informed measurement of subjective well-being. Cogn Behav Ther 2024:1-23. [PMID: 39263846 DOI: 10.1080/16506073.2024.2402992] [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: 05/14/2024] [Accepted: 09/05/2024] [Indexed: 09/13/2024]
Abstract
Researchers and clinicians are becoming increasingly aware of the importance of assessing positive functioning to inform clinical outcomes. This paper evaluates the Questionnaire on Well-Being (QWB, available for free https://doi.org/10.17605/OSF.IO/GSC3R), a clinically informed instrument that assesses subjective well-being, across two studies. Study One, consisting of treatment-seeking individuals in an assertiveness training sample (n = 495), explored the factorial structure of the QWB, assessed the four-week test-retest reliability, criterion-related validity, and identified a preliminary cutoff point for the QWB with clinical significance. Study Two, including participants from the general public (n = 1561), confirmed the factorial structure of the QWB and further evaluated criterion-related validity. The results provided support for a unidimensional structure for the QWB. Furthermore, the QWB exhibited excellent internal reliability (Cronbach's alpha = 0.93 and 0.94 in Study One and Two, respectively), high test-retest reliability (ICC3 = .50 at a four-week follow-up in Study One), and appropriate criterion-related validity demonstrating positive correlations with positive affect and negative correlations with psychopathology. Finally, a cutoff point on the QWB below 50 was associated with marked psychopathology. These findings provide preliminary support for the usage of the QWB in clinical and non-clinical settings, establishing the QWB as a reliable indicator of subjective well-being.
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Affiliation(s)
- Jón Ingi Hlynsson
- Department of Psychology, University of Iceland, Reykjavík, Iceland
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Anders Sjöberg
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | | | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
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Liu GY, Yan MD, Mai YY, Fu FJ, Pan L, Zhu JM, Ji WJ, Hu J, Li WP, Xie W. Frontiers and hotspots in anxiety disorders: A bibliometric analysis from 2004 to 2024. Heliyon 2024; 10:e35701. [PMID: 39220967 PMCID: PMC11365340 DOI: 10.1016/j.heliyon.2024.e35701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 06/05/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
Objective This study aimed to analyze research on anxiety disorders using VOSviewer and CiteSpace to identify research hotspots and future directions. Methods We conduct ed a comprehensive search on the Web of Science Core Collection (WoSCC) for relevant studies about anxiety disorders published within the past two decades (from 2004 to 2024). VOSviewer and CiteSpace were mainly used to analyze the authors, institutions, countries, publishing journals, reference co-citation patterns, keyword co-occurrence, keyword clustering, and other aspects to construct a knowledge atlas. Results A total of 22,267 publications related to anxiety disorders were retrieved. The number of publications about anxiety disorders has generally increased over time, with some fluctuations. The United States emerged as the most productive country, with Harvard University identified as the most prolific institution and Brenda W. J. H. Penninx as the most prolific author in the field. Conclusion This research identified the most influential publications, authors, journals, institutions, and countries in the field of anxiety research. Future research directions are involved advanced treatments based on pharmacotherapy, psychotherapy and digital interventions, mechanism exploration to anxiety disorders based on neurobiological and genetic basis, influence of social and environmental factors on the onset of anxiety disorders.
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Affiliation(s)
- Gui-Yu Liu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Ming-De Yan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Yi-Yin Mai
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Fan-Jia Fu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Lei Pan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Jun-Ming Zhu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Wen-Juan Ji
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Jiao Hu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
| | - Wei-Peng Li
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
- Department of Neurology, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Wei Xie
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510515, PR China, China
- Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Yu L, Wang J, Hu Z, Xu T, Zhou W. A novel nomogram for predicting optimal weight loss response following diet and exercise intervention in patients with obesity. Sci Rep 2024; 14:18168. [PMID: 39107586 PMCID: PMC11303791 DOI: 10.1038/s41598-024-69295-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 08/02/2024] [Indexed: 08/10/2024] Open
Abstract
This study aimed to identify factors associated with optimal weight loss response by analyzing pre-weight loss data from a cohort of 2577 patients with obesity who visited weight management clinics between 2013 and 2022. Out of these, 1276 patients had follow-up data available. Following dietary and exercise interventions, 580 participants achieved optimal weight loss outcomes. Participants were subsequently divided into two groups based on their weight loss outcomes: those who achieved optimal weight loss response and those who did not. Statistical analysis, conducted using RStudio, identified thirteen predictor variables through LASSO and logistic regression, with age emerging as the most influential predictor. A nomogram was developed to predict optimal weight loss response, showing good predictive performance (AUC = 0.807) and clinical applicability, validated by internal validation methods. Decision curve analysis (DCA) further illustrated the nomogram's clinical utility. The developed nomogram prediction model for optimal weight loss response is user-friendly, highly accurate, and demonstrates excellent discriminative and calibration capabilities.
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Affiliation(s)
- Lei Yu
- Department of Health Management Centre, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China
| | - Jing Wang
- Department of Health Management Centre, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China
| | - Zhendong Hu
- Department of Esophageal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China
| | - Tiancheng Xu
- Department of Esophageal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China.
| | - Weihong Zhou
- Department of Health Management Centre, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, China.
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Amanvermez Y, Karyotaki E, Cuijpers P, Ciharova M, Bruffaerts R, Kessler RC, Klein AM, Wiers RW, de Wit LM. Sources of stress among domestic and international students: a cross-sectional study of university students in Amsterdam, The Netherlands. ANXIETY, STRESS, AND COPING 2024; 37:428-445. [PMID: 38047318 DOI: 10.1080/10615806.2023.2280701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 11/02/2023] [Indexed: 12/05/2023]
Abstract
High perceived stress is associated with psychological and academic difficulties among college students. In this study, we aimed to investigate associations of student status (international vs domestic student in the Netherlands) with eight common sources of stress (i.e., financial, health, love life, relationship with family, relationship with people at work/ school, the health of loved ones, other problems of loved ones, and life in general). Participants were 2,196 college students (domestic: n = 1,642, international: n = 554) from two universities in Amsterdam, the Netherlands. Hierarchical linear regression analyses were used to estimate associations of student status with all eight sources of stress. Student status was significantly associated with higher levels of perceived stress in almost all life domains. International student status was significantly associated with higher perceived stress in the domains of financial situation and health of loved ones after adjusting for sociodemographic characteristics, depressive and anxiety symptoms, and other sources of stress. Findings highlight that several differences exist in the magnitude of perceived stress in certain areas between international and domestic students in the Netherlands. Consequently, it is essential to uncover the different needs of college students and develop specific strategies to deliver the most suitable services.
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Affiliation(s)
- Yagmur Amanvermez
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marketa Ciharova
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Anke M Klein
- Developmental and Educational Psychology of the Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Reinout W Wiers
- Addiction, Development, and Psychopathology (ADAPT) Lab, Department of Psychology, and Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Leonore M de Wit
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Riddle M, Blalock DV, Robertson L, Duffy A, Le Grange D, Mehler PS, Rienecke RD, Joiner T. Comparing eating disorder treatment outcomes of transgender and gender diverse adolescents with those of cisgender adolescents. Int J Eat Disord 2024; 57:1555-1565. [PMID: 38483005 DOI: 10.1002/eat.24195] [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: 11/10/2023] [Revised: 02/11/2024] [Accepted: 03/01/2024] [Indexed: 07/23/2024]
Abstract
OBJECTIVE Eating disorder (ED), depression, and anxiety symptoms at admission and discharge were compared, as were admission-to-discharge changes, for transgender and gender diverse (TGD), and cisgender adolescents receiving intensive treatment for EDs. METHOD Participants were 44 TGD and 573 cisgender adolescents admitted to a treatment facility. Participants completed the Eating Disorder Examination Questionnaire (EDE-Q), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) at admission and discharge. RESULTS Both groups had elevated EDE-Q scores at admission (TGD: M = 3.78, standard deviation [SD] = 1.70; cisgender: M = 3.33, SD = 1.74) that improved by discharge (TGD: M = 2.27, SD = 1.83, Cohen's d = .98; cisgender: M = 2.10, SD = 1.54, Cohen's d = .79); there were no differences in EDE-Q between groups at admission (p = .09; odds ratio [OR] = 1.18, 95% confidence interval [CI] [.98, 1.44]) or discharge (p = .48; OR = 1.07, 95% CI [.88, 1.30]). On admission, TGD adolescents had higher suicidality, measured by PHQ-9, item 9 (p < .001; OR = 1.94, 95% CI [1.51, 2.52]), and depression (p < .001; OR = 1.10, 95% CI [1.05, 1.16]) than cisgender participants. Severity decreased over treatment for all measures. Both groups showed similar improvement on suicidality (p = .93; OR = .98, 95% CI [.70,1.36]), depression (p = .42; OR = 1.02, 95% CI [.97, 1.07]), and anxiety (p = .14; OR = 1.05, 95% CI [.99, 1.12]). However, at discharge, suicidality (p = .02; OR = 1.40, 95% CI [1.04, 1.85]), depression (p < .01; OR = 1.06, 95% CI [1.02, 1.11]), and anxiety (p = .02; OR = 1.06, 95% CI [1.01, 1.12]) were higher for TGD adolescents than their cisgender peers. DISCUSSION All participants had similar ED symptom severity and improvement. Depression, anxiety, and suicidality remained elevated for TGD adolescents compared to their cisgender peers at discharge, suggesting the need for targeted treatment. PUBLIC SIGNIFICANCE Transgender and gender diverse (TGD) adolescents have increased risk of eating disorders (EDs); few studies examine how they respond to ED treatment. We examine treatment outcomes of TGD adolescents receiving ED treatment compared to their cisgender peers. We measured ED symptoms along with depression, anxiety, and suicidality at the beginning and end of treatment. While TGD adolescents showed similar improvement in ED symptoms, measures of depression, anxiety, and suicidality remained elevated at the time of discharge.
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Affiliation(s)
- Megan Riddle
- Eating Recovery Center and Pathlight Mood and Anxiety Center, Bellevue, Washington, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Dan V Blalock
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Lee Robertson
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Alan Duffy
- Eating Recovery Center and Pathlight Mood and Anxiety Center, Denver, Colorado, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco School of Medicine, San Francisco, California, USA
- Emeritus, Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, IL, USA
| | - Philip S Mehler
- Eating Recovery Center and Pathlight Mood and Anxiety Center, Denver, Colorado, USA
- ACUTE at Denver Health, Denver, Colorado, USA
- Department of Internal Medicine, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Renee D Rienecke
- Eating Recovery Center and Pathlight Mood and Anxiety Center, Denver, Colorado, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois, USA
| | - Thomas Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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Jackson DB, Testa A, Fix RL, Semenza DC, Nagata JM, Ganson KT. Police Contact, Non-Suicidal Self-Injury, and Suicidal Ideation: Findings From a National Sample of Canadian Adolescents and Young Adults. FAMILY & COMMUNITY HEALTH 2024; 47:202-208. [PMID: 38758023 DOI: 10.1097/fch.0000000000000408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND AND OBJECTIVES The purpose of this research is to investigate associations between police contact, non-suicidal self-injury (NSSI), and suicidal ideation (SI) among a national sample of Canadian adolescents and young adults (ages 16-30). METHODS Data used in this study were obtained from the Canadian Study of Adolescent Health Behaviors (N = 940), a national survey of Canadians ages 16-30. RESULTS Police contact was associated with higher odds of NSSI (OR = 1.98, 95% CI = 1.37, 2.86). Those who reported police contact with intrusion (OR = 2.39, 95% CI = 1.49, 3.38) and police contact with harassment (OR = 3.98, 95% CI = 2.30, 6.88) had higher odds of NSSI relative to respondents with no contact. Finally, any police contact was associated with higher odds of SI (OR = 1.56, 95% CI = 1.04, 2.34) and respondents experiencing police stops with harassment had higher odds of SI compared to those who had never been stopped (OR = 2.48, 95% CI = 1.45, 4.24). CONCLUSIONS Distressing police contact heightens the risk of NSSI and SI among young people. Rigorous evaluation of trauma-informed, developmentally appropriate strategies for identifying and intervening on NSSI and SI following adverse police encounters should be prioritized.
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Affiliation(s)
- Dylan B Jackson
- Author Affiliations: Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Jackson); Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas (Dr Testa); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Fix); Department of Sociology, Anthropology, and Criminal Justice, Department of Urban-Global Health, School of Public Health, Rutgers University, Piscataway, New Jersey (Dr Semenza); Department of Pediatrics, University of California, San Francisco, San Francisco, California (Dr Nagata); and Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada (Dr Ganson)
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Tang H, Zhang Z, Chen H, Chen H, Chen X, Li S, Ye Y, Zhou J. Core items selection and psychometric properties of the adult attention-deficit hyperactivity disorder self-report scale-chinese short version (ASRS-CSV). Asian J Psychiatr 2024; 99:104136. [PMID: 38986316 DOI: 10.1016/j.ajp.2024.104136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/16/2024] [Accepted: 05/25/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVE This study aimed to develop and validate the Chinese Short Version of the Adult ADHD Self-Report Scale (ASRS-CSV), addressing the need for culturally appropriate diagnostic tools for Attention-Deficit Hyperactivity Disorder (ADHD) in the Chinese adult population. METHODS Utilizing a combination of intergroup difference analysis, factor analysis, and network analysis, we identified core ADHD symptoms pertinent to the Chinese cultural context. The study involved two samples: a vocational and technical school sample (N=1144) and an internet sample (N=1654), comprising adults aged 16-25 years. Reliability, validity, and diagnostic efficacy of the ASRS-CSV were assessed through psychometric testing. RESULTS The ASRS-CSV demonstrated high internal consistency (Cronbach's alpha > 0.9) and robust convergent validity (AVE > 0.7). The scale's diagnostic cutoff points were optimized, revealing high sensitivity and specificity for ADHD screening. Cross-cultural analysis highlighted differences in core ADHD symptoms between Chinese and Western populations, underscoring the scale's cultural sensitivity. CONCLUSION The ASRS-CSV is a reliable, valid, and efficient tool for screening ADHD in Chinese adults, reflecting the socio-cultural nuances of ADHD symptomatology. Its development marks a significant advancement in the field of psychiatry, offering a tailored approach for ADHD assessment in China and contributing to the global discourse on cross-cultural psychiatric diagnosis.
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Affiliation(s)
- Huajia Tang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
| | - Zheng Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
| | - Honghui Chen
- Medical Psychological Center, the Second Xiangya Hospital of Central South University, Medical Psychological Institute, Central South University, National Clinical Research Center for Mental Disorders, Changsha, Hunan, China
| | - Hui Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Xianliang Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Sihong Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Yanyue Ye
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
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Negash S, Horn J, Heumann E, Stock C, Zeeb H, Pischke CR, Matos Fialho PM, Helmer SM, Niephaus Y, Mikolajczyk R. University Students' Financial Situation During COVID-19 and Anxiety and Depressive Symptoms: Results of the COVID-19 German Student Well-Being Study (C19 GSWS). Psychol Res Behav Manag 2024; 17:2271-2285. [PMID: 38860194 PMCID: PMC11162964 DOI: 10.2147/prbm.s453694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/17/2024] [Indexed: 06/12/2024] Open
Abstract
Background The COVID-19 pandemic has had a major impact on students' financial situation as well as on their mental health. Aim To examine the reported change in the financial situation of German university students before and across two time points of the COVID-19 pandemic and to evaluate its associations with anxiety and depressive symptoms. Methods We used data from the cross-sectional COVID-19 German Student Well-being Study conducted at five German universities (N = 7203). Linear regression models were used to analyze associations between a reported change in financial situation and anxiety and depressive symptoms. Results Twenty-eight percent of the participants reported to have a worsened financial situation at the time of the survey compared to the time prior to the pandemic. A worsened financial situation at the time of the survey as compared to prior to the pandemic was associated with higher levels of anxiety and depressive symptoms reported in all three depression and anxiety scales [a 1.46 point increase on the CES-D 8 scale (95% confidence interval (CI): 1.19; 1.73), a 0.37-point increase in PHQ-2 (95% CI: 0.28; 0.46), and a 0.45-point increase in GAD-2 (95% CI: 0.35; 0.55)]. An improved financial situation, on the other hand, was associated with lower levels of anxiety and depressive symptoms. As for the second change, comparing the current financial situation with the situation during the first wave of the pandemic, the associations with anxiety and depressive symptoms were broadly similar. Conclusion Our findings suggest that students are a vulnerable population in need of mental and financial support during times of crisis. Future research is needed to obtain insights into potential long-term effects of the pandemic on students' mental health.
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Affiliation(s)
- Sarah Negash
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Johannes Horn
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Eileen Heumann
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
| | - Christiane Stock
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Paula M Matos Fialho
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Stefanie M Helmer
- Institute of Public Health and Nursing Research, Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Yasemin Niephaus
- Department of Social Sciences, University of Siegen, Siegen, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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13
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Hlynsson JI, Carlbring P. Diagnostic accuracy and clinical utility of the PHQ-2 and GAD-2: a comparison with long-format measures for depression and anxiety. Front Psychol 2024; 15:1259997. [PMID: 38800678 PMCID: PMC11123884 DOI: 10.3389/fpsyg.2024.1259997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Background Anxiety and depression are highly prevalent and often comorbid mental disorders that are encompassed within the broad category of emotional disorders. The frequent comorbidity of anxiety and depression can pose challenges for accurate diagnosis and treatment which, in turn, highlights the need for reliable measurements that are simultaneously responsive to change and prevent non-response bias. Brief measures of anxiety and depression can potentially increase response rates due to their brevity and ease of administration. This study evaluates the psychometric characteristics, discriminative accuracy, and sensitivity to change of the Generalized Anxiety Disorder 2-item scale (GAD-2) and the Patient Health Questionnaire 2-item scale (PHQ-2) within a clinical population. Method The sample comprised treatment-seeking participants (n = 3,411), screened (n = 2,477) to receive an internet-based psychotherapeutic intervention (cognitive-behavioral, psychodynamic, or waitlist). Results Brief measures can effectively detect individuals who may be eligible for a diagnosis of depression and anxiety, not only prior to but also during and following the completion of psychological treatment. The discriminative ability of the GAD-2 was significantly greater during active treatment and at post-assessment compared with pre-treatment screening, although no such differences were found for the PHQ-2. Finally, endorsing the most severe response option on the GAD-2 and PHQ-2 was associated with a high probability of presenting with clinically relevant anxiety and depressive symptoms. Conclusion Brief measures of anxiety and depression are viable instruments to screen for and monitor anxiety and depressive symptoms. Clinical trial registration ClinicalTrials.gov, identifier NCT05016843.
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Affiliation(s)
- Jón Ingi Hlynsson
- Department of Psychology, University of Iceland, Reykjavík, Iceland
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
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14
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Bernusky HCR, Tibbo PG, Conrod PJ, Yunus FM, Keough MT, Thompson KD, Krank MD, Hadwin AF, Stewart SH. Do anxiety symptoms and coping motives serially mediate the association between psychotic-like experiences and cannabis-related problems in undergraduate recent cannabis users? Addict Behav 2024; 151:107937. [PMID: 38113687 DOI: 10.1016/j.addbeh.2023.107937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/01/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
Many Canadian emerging adults (ages 18-25 years) use cannabis, with 60 % of past-three-month users experiencing one or more cannabis-related problems (i.e., adverse consequences of use). While psychotic-like experiences (PLEs) and cannabis problems overlap, little is known about the mechanisms explaining this link. One hypothesis is that PLEs are distressing and give rise to anxiety, with which emerging adults attempt to cope through increased cannabis use, in turn increasing their risk for cannabis-related problems. We tested a chained-mediational model to determine if anxiety and coping-with-anxiety motives for cannabis use sequentially mediated the link between PLEs and cannabis problems in emerging adult undergraduates; a conditional process model tested for moderation by sex. Emerging adult cannabis users (N = 413; mean [SD] age = 19.1 [1.5] years; 71.9 % female) from five Canadian universities provided cross-sectional, self-report survey data in fall 2021. Validated measures of PLEs, anxiety, cannabis coping-with-anxiety motives, and cannabis-related problems were administered. Path analyses supported the hypothesized chained mediational indirect effect (b = 0.027, 95 % bootstrap CI [0.012, 0.050]). No direct effect was found (p =.698), suggesting that the PLEs-to-cannabis problems association is fully explained by anxiety and cannabis coping-with-anxiety motives. Inconsistent with hypotheses, mediation did not depend on sex (95 % CIs crossed zero); therefore, anxiety and cannabis coping-with-anxiety motives explain the link between PLEs and cannabis problems in emerging adults regardless of their sex. Results highlight anxiety and cannabis coping-with-anxiety motives as potentially important intervention targets in cannabis-using emerging adults with PLEs, possibly preventing the development/worsening of cannabis-related problems.
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Affiliation(s)
- Haley C R Bernusky
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada
| | - Patricia J Conrod
- Département de psychiatrie et d'addictologie, Université de Montréal, 2900, boulevard Édouard-Montpetit, bureau S-750, Pavillon Roger-Gaudry, Montréal, Québec H3T 1J4, Canada
| | - Fakir M Yunus
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Life Sciences Centre (Psychology Wing), Halifax, Nova Scotia B3H 4R2, Canada
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele Street, 225 Behavioural Science Building, North York, Ontario M3J 1P3, Canada
| | - Kara D Thompson
- Department of Psychology, St. Francis Xavier University, 2323 Notre Dame Avenue, 125 Annex, Antigonish, Nova Scotia B2G 2W5, Canada
| | - Marvin D Krank
- Department of Psychology, University of British Columbia, 1147 Research Road, ART 334, Kelowna, British Columbia V1V 1V7, Canada
| | - Allyson F Hadwin
- Department of Educational Psychology and Leadership Studies, University of Victoria, 3800 Finnerty Road, Victoria, British Columbia V8P 5C2, Canada
| | - Sherry H Stewart
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Life Sciences Centre (Psychology Wing), Halifax, Nova Scotia B3H 4R2, Canada.
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15
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Robeson M, Brasil KM, Adams HC, Zlomke KR. Measuring depression and anxiety in autistic college students: A psychometric evaluation of the PHQ-9 and GAD-7. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241240183. [PMID: 38514920 DOI: 10.1177/13623613241240183] [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: 03/23/2024]
Abstract
LAY ABSTRACT Anxiety, depression, and suicidality are major concerns among college students, though less is known about these constructs in autistic college students. Given the rising number of autistic individuals entering college, adequate screening and diagnosis of mental health difficulties is necessary to provide care to this population. For example, despite widespread usage of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), it is unknown if the two instruments accurately measure depression and anxiety the same way between non-autistic and autistic individuals. Thus, the current study was the first to examine how these instruments measure depression and anxiety symptoms in autistic versus non-autistic college students. Utilizing tests of construct measurement in a sample of autistic (n = 477) and non-autistic (n = 429) university students aged 18-29, results showed that while the GAD-7 and PHQ-9 appear to be accurately capturing anxiety and depression in autistic college students, the PHQ-9 item assessing suicidality was found to be measuring different things. This indicates that autistic college students are not interpreting this question the way non-autistic students are, and thus, the measure is failing to capture suicidality in autistic people. Future investigators should continue to assess the appropriateness of using common screening measures, originally created by non-autistic people, in autistic populations.
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16
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Niwenahisemo LC, Hong S, Kuang L. Assessing anxiety symptom severity in Rwandese adolescents: cross-gender measurement invariance of GAD-7. Front Psychiatry 2024; 15:1346267. [PMID: 38528981 PMCID: PMC10962260 DOI: 10.3389/fpsyt.2024.1346267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/15/2024] [Indexed: 03/27/2024] Open
Abstract
Background Anxiety disorders are among the most common mental health problems experienced by adolescents worldwide because of their evident significant impact on their quality of life and functioning. The generalized anxiety disorder item (GAD-7) was manufactured to identify the severity of self-reported anxiety symptoms. Efforts to address and screen for mental health problems in Rwanda have been limited, and the importance of screening for anxiety disorders is high. The primary aim of this study was to analyze the psychometric properties of the Kinyarwanda version of the Generalized Anxiety Disorder GAD-7, and then test the measurement invariance of the GAD-7 by gender. Methods We used the Rwandese version of GAD-7 among secondary school students in Kigali city (n=1813). Measurement invariance of the GAD-7 across gender and report on anxiety symptom severity prevalence. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine measurement invariance. Results Our findings demonstrated that in the sample of 1813 adolescents aged between 12 and 17 years, generalized anxiety symptoms prevalence rates were higher in females (46.4%) than males (n= 29.8%) GAD-7 demonstrated good reliability and validity coefficients with a Cronbach's α of .077 and KMO and Bartlett test of Sphericity = 0.835. In addition to these psychometric properties, the GAD-7 screening scale had equivalence for configural and metric invariance across groups with excellent fit indices, and we confirmed partial scalar invariance across groups. Conclusion The GAD-7 can be used in cross-group comparison of generalized anxiety disorder prevalence, and we acknowledge that full scalar invariance is generally difficult to confirm, especially due to gender differences. We recommend that future studies further investigate populations living in rural areas and conduct trials that will focus on anxiety-specific treatment in Rwandan Clinical health care centers to determine the diagnostic accuracy of this screening tool.
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Affiliation(s)
| | - Su Hong
- *Correspondence: Su Hong, ; Li Kuang,
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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17
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Wang F, Wu Y, Wang S, Du Z, Wu Y. Development of an optimal short form of the GAD-7 scale with cross-cultural generalizability based on Riskslim. Gen Hosp Psychiatry 2024; 87:33-40. [PMID: 38301522 DOI: 10.1016/j.genhosppsych.2024.01.010] [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: 12/29/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 02/03/2024]
Abstract
Despite the relatively small number of items in the GAD-7, fewer items are increasingly sought to shorten testing time in large-scale mental health screenings. As a result, short forms based on the GAD-7, the GAD-2, and GAD-mini, have become popular. However, the GAD-2 and GAD-mini have reported lower diagnostic accuracy in some cultural contexts, implying that a validated short-form version of the GAD-7 may be lacking in large-scale cross-cultural anxiety screening. Based on this, to develop an optimal short form of the GAD-7 with cross-cultural stability, we utilized seven GAD-7 datasets from six different countries, totaling 47,484 participants. Five 2 to 6 item short forms of the GAD were constructed using the Riskslim machine learning algorithm. We evaluated the diagnostic accuracy of the GAD-7 short forms in the training and test sets based on the coefficient of determination(R2) and area under the curve(AUC) metrics, and the results showed that GAD-R2 performed poorly in some cultures, and all of the 3 to 6 item short forms of the GAD performed good in cross-cultural diagnostic rates, with the GAD-R6 showing the highest diagnostic accuracy in all cultures; GAD-R3 outperformed GAD-R2, GAD-2, and GAD-mini in all cultures; GAD-R3 had higher generalizability across cultures and special populations; Given that the GAD-R3 was shorter and nearly as accurate as the GAD-R6, we recommend the use of the GAD-R3 in clinical studies and epidemiologic investigations. And we recommend the optimal actual cutoff value of 15 for GAD-R3. Overall, we recommend GAD-R3 as the short-form version of GAD-7 in cross-cultural studies. However, the 2-item GAD scale is also optimal for the short-form version in clinical practice.
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Affiliation(s)
- Fei Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Yunchou Wu
- School of Psychology, Southwest University,Chongqing, China
| | - Suqi Wang
- School of Philosophy, Anhui University, Hefei, China
| | - Zhuoran Du
- School of Philosophy, Anhui University, Hefei, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China.
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18
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Hlynsson JI, Gustafsson O, Carlbring P. Uncertainty Breeds Anxiety and Depression: The Impact of the Russian Invasion in Ukraine on a Swedish Clinical Population Receiving Internet-Based Psychotherapy. CLINICAL PSYCHOLOGY IN EUROPE 2024; 6:e12083. [PMID: 39119223 PMCID: PMC11303911 DOI: 10.32872/cpe.12083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 01/15/2024] [Indexed: 08/10/2024] Open
Abstract
Background Recent global crises, such as the COVID-19 pandemic and the 2022 Russian invasion of Ukraine, have contributed to a rise in the global prevalence of anxiety and depressive disorders. This study examines the indirect impact of the Ukraine war on emotional disorders within a Swedish clinical population. Method The sample comprised participants (n = 1,222) actively engaged in an internet-based psychotherapeutic intervention (cognitive-behavioral, psychodynamic, and waitlist) when the war broke out. The Patient Health Questionnaire-9 scale and the Generalized Anxiety Disorder-7 scale were used to measure depression and anxiety. Results Anxiety and depressive symptom severity increased following the war's onset, with an average weekly increase of 0.77-points for anxiety (p = .001, Cohen's d = 0.08) and 0.09-points for depression (p = .70, Cohen's d = 0.01); however, the increase was negligible for depression. Furthermore, higher socioeconomic status (SES) predicted declines in depression and anxiety during the study period, with a 0.69-point average weekly decrease in anxiety (p < .001, Cohen's d = 0.32) and a 1.09-point decrease in depression (p < .001, Cohen's d = 0.48) per one unit increase in SES, suggesting that SES may serve as a protective factor that buffers against psychopathological development during crises. Conclusions These findings have implications for mitigating the development of psychopathology during crises and interpreting treatment efficacy estimates during such events. Our findings also emphasize the potential of internet-based psychotherapy in addressing emotional disorders during crises. This study presents up-to-date information about the reaction of treatment-seeking individuals to abrupt uncertainty.
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Affiliation(s)
| | - Oskar Gustafsson
- Department of Statistics, Stockholm University, Stockholm, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
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Wang X, Han S, Jia C, Yang X, Hu Y, Zhang Y, Yang Z, Zhang L, Wang Z. Psychometric and Circumplex Properties Evaluation of the International Personality Item Pool-Interpersonal Circumplex (IPIP-IPC) in Chinese People Living with HIV (PLWH). Psychol Res Behav Manag 2024; 17:705-724. [PMID: 38410379 PMCID: PMC10896111 DOI: 10.2147/prbm.s446547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/10/2024] [Indexed: 02/28/2024] Open
Abstract
Background and Purpose With the improved life expectancy of people living with HIV (PLWH) due to widespread use of antiretroviral therapy (ART), there is a greater emphasis on enhancing long-term well-being and overall quality of life for PLWH. Understanding interpersonal personalities of PLWH can gain further insight into how to improve the overall quality of life in this population. The International Personality Item Pool-Interpersonal Circumplex (IPIP-IPC) scale has been developed to assess interpersonal personalities of individuals, and this scale has been translated into Chinese. However, the Chinese version of IPIP-IPC has not been tested among PLWH in China. In this study, we aimed to test the psychometric properties and circumplex structure of this scale. Methods This study was based on cross-sectional, multi-center, large sample data. We employed the Chinese version of IPIP-IPC scale on 3040 PLWH from April 2022 to April 2023 in China to test its psychometric as well as circumplex properties. The structural summary method (SSM) was employed to analyze the circumplex structure of the scale. Results The total scale exhibited a Cronbach's alpha of 0.85 and McDonald's omega of 0.91. Out of the 288 possible relationships, 275 relationships satisfy the circular properties hypothesis. The scale demonstrates good reliability and validity, meeting the requirements of psychometrics. Conclusion Our findings demonstrate that the Chinese version of the IPIP-IPC scale is a reliable tool for evaluating interpersonal personalities in this population. These results highlight the validity and applicability of the IPIP-IPC scale specifically in the Chinese context, providing valuable insights into the intricacies of interpersonal traits among PLWH.
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Affiliation(s)
- Xiaomeng Wang
- School of Nursing, Peking University, Beijing, 100191, People’s Republic of China
| | - Shuyu Han
- School of Nursing, Peking University, Beijing, 100191, People’s Republic of China
| | - Changli Jia
- School of Medical and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People’s Republic of China
| | - Xianxia Yang
- School of Public Health, Wuhan University, Wuhan, Hubei, 430071, People’s Republic of China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Yukun Zhang
- School of Nursing, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Zhongfang Yang
- School of Nursing, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Lili Zhang
- Department of Nursing, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, 100069, People’s Republic of China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, 100191, People’s Republic of China
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Wagner F, Wagner RG, Makuapane LP, Masango M, Kolanisi U, Gómez-Olivé FX. Mental distress, food insecurity and university student dropout during the COVID-19 pandemic in 2020: evidence from South Africa. Front Psychiatry 2024; 15:1336538. [PMID: 38380123 PMCID: PMC10876832 DOI: 10.3389/fpsyt.2024.1336538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/19/2024] [Indexed: 02/22/2024] Open
Abstract
Background Student dropout has been a key issue facing universities for many years. The COVID-19 pandemic was expected to exacerbate these trends; however, international literature has produced conflicting findings. Limited literature from Africa has investigated the impact of COVID-19 on student dropout trends, despite the documented devastation, including increased risk of food insecurity and mental distress, caused by the pandemic. Objective This work seeks to understand the impact of food insecurity and mental distress on student dropout during the COVID-19 pandemic. Methods Using a cross-sectional research design, first-year undergraduate students from a large South African university were recruited via email to participate in a survey between September and October 2020. The Household Food Insecurity Access Scale (HFIAS) was used to measure food insecurity and the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) was used to measure mental distress. Multivariate regression was used to investigate factors associated with student dropout. Results The student dropout rate was 10.5% (95% CI: 8.2-13.2). The prevalence of severe food insecurity was 25.7% (95% CI: 22.3-29.4) and the prevalence of severe mental distress symptoms was 26.7% (95% CI: 23.3-30.4). Dropout rates and levels of food insecurity were highest among students residing in remote areas during the lockdown at 19.2% and 43.6%, respectively. The multivariate logistic regression revealed that being male increased the probability of dropout almost three-fold (odds ratio (OR) = 2.70; 95% CI: 1.48-4.89, p =0.001)). Being moderately food insecure increased the odds of dropout more than two-fold (OR=2.50; 95% CI:1.12-5.55, p=0.025), and experiencing severe mental distress symptoms increased the odds of dropout seven-fold (OR=7.08; 95% CI:2.67-18.81, p<0.001). Conclusion While acknowledging that various factors and complexities contribute to student dropout, the increased vulnerability to food insecurity and mental distress, stemming from issues such as widespread job losses and isolation experienced during the pandemic, may have also had an impact on dropout. This work reiterates the importance of directing additional support to students who are food insecure and those who are experiencing mental distress in order to mitigate university student dropout.
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Affiliation(s)
- Fezile Wagner
- Analytics and Institutional Research Unit (AIRU), University of the Witwatersrand, Johannesburg, South Africa
| | - Ryan G. Wagner
- 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
| | - Lerato P. Makuapane
- Analytics and Institutional Research Unit (AIRU), University of the Witwatersrand, Johannesburg, South Africa
| | - Mxolisi Masango
- Department of Institutional Planning (DIP), University of Pretoria, Pretoria, South Africa
| | - Unathi Kolanisi
- Department of Consumer Sciences, Faculty of Science, Agriculture and Engineering, University of Zululand, KwaDlangezwa, South Africa
| | - Francesc 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
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21
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Hlynsson JI, Lindner P, Barri B, Carlbring P. Exploring cutoff points and measurement invariance of the Brunnsviken brief quality of life inventory. Front Psychol 2024; 14:1305682. [PMID: 38259555 PMCID: PMC10801901 DOI: 10.3389/fpsyg.2023.1305682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/23/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Quality of life (QoL) can be defined as the goodness of life, beyond simply absence of disease or functional impairments, self-rating scales of which capture valuable information beyond change in primary outcomes. This study (n = 3,384) validated the Brunnsviken Brief Quality of Life Inventory (BBQ) across divergent groups by evaluating its measurement invariance (MI). We hypothesized measurement invariance for the BBQ across age groups, genders, depression, and anxiety severity. Potential cutoff points for the BBQ were also explored. Method Confirmatory factor analysis (CFA) models were fit to sample data obtained from an ongoing study on transdiagnostic internet-based treatment modules. Parameters were successively constrained to assess configural, metric, scalar, and residual invariance factor structures across different groups. Results The BBQ demonstrated MI at the metric level and partial MI at the scalar level across all these groups, which remained stable at the strict-residual level for all groups except for genders. These results remained stable after correcting for unbalanced group sizes for gender, clinical-subclinical levels of depression, and clinical-subclinical levels of anxiety. A cutoff point analysis revealed that a BBQ total scores below 39 was associated with notable psychopathology. Discussion The BBQ is a reliable measure of QoL that is applicable for various divergent groups (e.g., vulnerable persons), and thus a viable instrument for use in healthcare and research with minimal aversive impact.Clinical trial registration: NCT05016843.
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Affiliation(s)
| | - Philip Lindner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - Bushra Barri
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
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22
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Xiong NN, Fan TT, Liu Q, Fritzsche K, Leonhart R, Stein B, Waller C, Müller MM. Burnout, emotional distress and sleep quality among Chinese psychiatric healthcare workers during the COVID-19 pandemic: a follow-up study. Front Public Health 2023; 11:1272074. [PMID: 38179557 PMCID: PMC10764523 DOI: 10.3389/fpubh.2023.1272074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/08/2023] [Indexed: 01/06/2024] Open
Abstract
Background Different from the very early stages of the COVID-19 pandemic, burnout and chronic mental health problems among health care workers (HCWs) has become a challenge. Research is lacking on the relationship between burnout, stress, emotional distress and sleep quality. Methods The Chinese center has been involved in the Cope-Corona project since the second survey (T2). Named after the project, a total of three cross-sectional surveys were distributed: T2 (February 16-20, 2021), T3 (May 10-14, 2022), and T4 (December 20-24, 2022). Burnout, depression, anxiety, sleep quality, workplace factors and individual resources were measured. Using the T4 data, we conducted structural equation model (SEM) to examine the mediating role of burnout in predicting emotional distress and sleep quality. Results 96, 124, and 270 HCWs were enrolled at T2, T3, and T4, respectively. In line with the epidemic trends, the level of perceived COVID-19 related risks was significantly higher at T4, while the feeling of health and safety decreased significantly. At T4, the percentages of participants with clinically significant levels of depression and anxiety symptoms were 18.9% (51/270) and 9.3% (25/270), respectively, while 30.4% (82/270) of them reported poor or very poor sleep quality. According to the SEM, individual resources and workplace factors mainly had an indirect effect in predicting depression and anxiety via burnout. However, neither burnout nor stress was a mediator or predictor of sleep quality. Instead, individual resources, positive workplace factors, and younger age had a direct effect in predicting good sleep quality. Conclusion Measures designed to enhance workplace factors and individual resources should be implemented to improve psychosomatic wellbeing of HCWs.
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Affiliation(s)
- Na-na Xiong
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing, China
| | - Teng-teng Fan
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing, China
| | - Qi Liu
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing, China
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Center for Mental Health, Medical Centre - University of Freiburg, Freiburg, Germany
| | - Rainer Leonhart
- Department for Social Psychology and Methodology, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Christiane Waller
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
| | - Markus M. Müller
- Department of Psychosomatic Medicine and Psychotherapy, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
- Social and Organizational Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
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23
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Levinson A, Lobel M, Preis H, Mahaffey B. Coping with subjective and objective stress during a pandemic pregnancy: implications for maternal mental health. Arch Womens Ment Health 2023; 26:819-829. [PMID: 37555873 PMCID: PMC10842317 DOI: 10.1007/s00737-023-01357-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/25/2023] [Indexed: 08/10/2023]
Abstract
The COVID-19 pandemic heightened prenatal maternal stress, a risk factor for poorer maternal and infant health. There was substantial variability, however, in the extent to which the stress of pandemic pregnancy influenced maternal mental health. Some of this variability may have been due to the different coping strategies used to manage pandemic stress. In this cross-sectional study of 7,383 pregnant women in the U.S. (M = 25.69 ± 8.71 weeks gestational age) recruited during the first and second U.S. waves of the COVID-19 pandemic, we examined associations of objective stressors, the subjective experience of stress, and the use of four coping strategies with anxiety and depressive symptoms. Spiritual coping, planning/preparation, and avoidant coping were associated with increased subjective and objective stress and with greater mood and anxiety symptoms, whereas coping by positive appraisal was associated with modestly lower subjective stress and with lower mood and anxiety symptoms. We also found small interactions of stress and coping in predicting mood and anxiety symptoms, suggesting that fit between coping strategy and type of stress influences coping outcomes. Specific coping strategy used as well as the fit between coping strategy and stress type may determine whether coping buffers or exacerbates mood and anxiety symptoms. The small magnitude of these associations suggests that individual-level coping may be insufficient in the face of the overwhelming nature of the stress accompanying a global pandemic. This work adds to our understanding of coping with pregnancy stress in the context of population-level stressors (i.e., a pandemic or large-scale disaster).
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Affiliation(s)
- Amanda Levinson
- School of Medicine, Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Brittain Mahaffey
- School of Medicine, Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA.
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24
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Wu J, Long D, Hafez N, Maloney J, Lim Y, Samji H. Development and validation of a youth climate anxiety scale for the Youth Development Instrument survey. Int J Ment Health Nurs 2023; 32:1473-1483. [PMID: 37605318 DOI: 10.1111/inm.13201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/23/2023]
Abstract
Emerging terms in the literature such as climate anxiety describe heightened concern, fear, and anxiety related to the climate crisis. Recent efforts have attempted to develop and validate scales to measure climate anxiety; however, extant research is largely focused on adults. Consequently, it is unclear whether developed measures are appropriate for adolescent populations, despite disproportionate impacts of the climate crisis experienced by this age group. The purpose of this study was two-fold; first, we aimed to assess levels of climate concern among Canadian adolescents using the Youth Development Instrument (YDI), a population-level youth well-being survey administered in schools with students (ages 15-18). Secondly, we collaborated with adolescents to adapt an existing climate anxiety scale to be included in the YDI survey. We used survey results to validate the adapted scale for use with adolescents and assessed levels of climate anxiety within our sample. In consultation with adolescents, the 13-item Climate Change Anxiety Scale (CCAS) was adapted to create the Climate Change Anxiety Scale - Short-form (CCAS-S) which consists of four-items adapted from the original CCAS. A total of 2306 respondents were included in analyses. Most adolescents reported feeling climate change concern (75.8%). A smaller proportion reported experiences of climate anxiety (48.7%). Confirmatory factor analysis supported a one-factor structure for the CCAS-S, with high internal consistency (Cronbach's alpha = 0.95) and good model fit with error co-variance. Findings from this study provide construct validity evidence and reliability for the use of the CCAS-S in adolescent populations.
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Affiliation(s)
- Judy Wu
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - David Long
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nada Hafez
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Jacqueline Maloney
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Yan Lim
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Hasina Samji
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- British Columbia Center for Disease Control (BCCDC), Vancouver, British Columbia, Canada
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25
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Andersson N, Abdiweli H, Boman J, Nylander E. Self-compassion, perfectionism, impostor phenomenon, stress and anxiety in patients with localized provoked vulvodynia. J Psychosom Obstet Gynaecol 2023; 44:2229008. [PMID: 37402237 DOI: 10.1080/0167482x.2023.2229008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/09/2023] [Accepted: 06/19/2023] [Indexed: 07/06/2023] Open
Abstract
Studies have shown that psychological distress has a role in the symptomology of localized provoked vulvodynia. Therefore, psychosocial support has been presented as a valuable part of the treatment. However, little is known about which psychological variables that coincide with localized provoked vulvodynia. The purpose of this study was to identify qualities of psychological distress in patients with localized provoked vulvodynia. Patients with localized provoked vulvodynia were consecutively recruited to participate in this cross-sectional questionnaire-based study. Participants completed a self-report questionnaire measuring perfectionism, impostor phenomenon, self-compassion, anxiety and perceived stress. A sample of 30 patients were included. Questionnaire results suggestive of perfectionism was seen in 63%, impostor phenomenon in 80%, low self-compassion in 27%, anxiety in 43% and perceived stress in 23% of the participants. The level of self-compassion was higher in patients in a committed relationship. The investigated qualities appear to be more common in patients with localized provoked vulvodynia than in comparable groups. Impostor phenomenon and perfectionism were particularly common, with more than half of the study population scoring above the cutoff for clinical significance. This motivates research to investigate if interventions targeting impostor phenomenon and perfectionism, may aid in the treatment of localized provoked vulvodynia.
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Affiliation(s)
- Nirina Andersson
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Hamdi Abdiweli
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Jens Boman
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Elisabet Nylander
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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26
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Wenig V, Heumann E, Stock C, Busse H, Negash S, Pischke CR, Heinrichs K. Associations of loneliness with mental health and with social and physical activity among university students in Germany: results of the COVID-19 German student well-being study (C19 GSWS). Front Public Health 2023; 11:1284460. [PMID: 38026349 PMCID: PMC10668152 DOI: 10.3389/fpubh.2023.1284460] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction University students are at high risk for loneliness with a potential negative impact on health. The COVID-19 measures disrupted students' academic routine and social life, which might have affected their perception of loneliness. This study investigated the prevalence of perceived loneliness among university students in Germany during the COVID-19 pandemic and its associations with mental health, behavioral outcomes, and sociodemographic characteristics. Methods COVID-19 German student well-being study (C19 GSWS) collected data from five German universities from October 27th to November 14th, 2021, resulting in a sample of 7,203 respondents. Associations of loneliness with depressive symptoms, anxiety, social and physical activity, as well as sociodemographic characteristics, were analyzed using multivariable logistic regressions. Results A total of 20.6% of students reported loneliness. Students with depressive or anxiety symptoms had more than eight- or sixfold odds, respectively, for reporting loneliness (depressive symptoms: OR = 8.29; 95% CI: 7.21-9.52; anxiety: OR = 6.48; 95% CI: 5.65-7.43) compared with students who did not report any symptoms. Students who were less physically active were more likely to experience loneliness compared with students who were more physically active (no moderate physical activity: OR = 1.39; 95% CI: 1.21-1.59; no vigorous physical activity: OR = 1.19; 95% CI: 1.04-1.36). We found no association between loneliness and social activity. However, loneliness was associated with being single (OR = 2.93; 95% CI: 2.55-3.36), living alone (OR = 1.31; 95% CI: 1.13-1.52), or having a temporary residency status in Germany (OR = 2.24; 95% CI: 1.65-3.04). Conclusion Our findings highlight the importance of loneliness as a relevant factor associated with health. Further research is needed to determine potential protective factors to tackle loneliness and to investigate how study conditions at higher education institutions may affect students' perceived loneliness.
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Affiliation(s)
- Vanessa Wenig
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
| | - Eileen Heumann
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
| | - Christiane Stock
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
- Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
| | - Heide Busse
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Sarah Negash
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Claudia R. Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Katherina Heinrichs
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
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27
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Wang SX, Goodman J, Laurenceau JP. Was the 2020 Presidential Election Nerve-Wracking?: Changes in Mental Health Among College Dreamers. Dela J Public Health 2023; 9:68-76. [PMID: 38173957 PMCID: PMC10759975 DOI: 10.32481/djph.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
U.S. presidential elections can be stressful for many Americans; however, there is little research as to how elections might influence mental health of undocumented immigrants specifically. The 2020 U.S. Presidential Election had the potential to dramatically influence immigration policies with the Democratic candidate promising a pathway toward citizenship for undocumented immigrants who arrived in the U.S. as minors (i.e., dreamers), and the incumbent Republican candidate threatening to terminate the DACA program. Using an online survey method, this exploratory longitudinal study examined whether dreamers' mental health changed following the U.S. presidential election, while also examining risk factors associated with their mental health. We employed GAD-7 and PHQ-9 questionnaires as preclinical screens for anxiety and depression. We found that the mean anxiety and depression scores decreased significantly following the election, i.e., when the democratic candidate was declared the winner. Risk factors for mental health problems also differed before and after the election. Risk factors for depression before the election included being female, Hispanic white, having a low self-reported status on the subjective social ladder, and having high perceived discrimination; risk factors for depression after the election included coming to the U.S. at an older age and high perceived discrimination. Risk factors for anxiety before the election included being female, having more siblings, both parents working, and high perceived discrimination. Risk factors for anxiety after the election included low self-reported status on the subjective social ladder, being a freshman, and high perceived discrimination. Preliminary results suggest that mental health of dreamers improved after the election. In addition, while risk factors differed before and after the election, perceived everyday discrimination remained a consistent risk factor for mental health issues.
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28
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Trub L, Stewart JL, Oberndorf M, Parker V, Starks TJ. The compounding effects of income loss and change in living arrangement on emerging adult women's mental health during COVID's onset. Women Health 2023; 63:713-726. [PMID: 37794625 DOI: 10.1080/03630242.2023.2262620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/17/2023] [Indexed: 10/06/2023]
Abstract
Research suggests that young adult women were among those more susceptible to mental health declines in the initial months of COVID-19. Unfortunately, longitudinal data examining mental health before and after the pandemic's onset are extremely limited. In a sample of 240 women ages 18-29 who were surveyed online first in November-December 2019 and then again between May and July 2020, this study aimed to examine how major life changes associated with the pandemic (i.e. loss of income, loss of employment, change in relationship status, and change in living arrangement) impacted mental health (i.e. depression, anxiety, stress). Multivariate regression analyses were conducted on three models predicting stress, anxiety, and depression from the four life changes, controlling for the effects of mental health before the COVID-19 pandemic. Results showed that a change in living arrangement was uniformly associated with increased mental health problems among women who also experienced a decrease in income. Likewise, loss of income was uniformly related to increased mental health problems among women who also experienced a change in living arrangement. In contrast, job loss was associated with a decrease in stress, and changes in relationship status were not associated with mental health outcomes. These findings highlight the potential for COVID-19 to produce co-occurring and synergistic stressors. Meanwhile, the impact of job loss on mental health may have been attenuated by enhanced unemployment benefits. Mental health interventions that aim to support young women as the pandemic abates should be tailored to address the impact of multiple psychosocial stressors.
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Affiliation(s)
- Leora Trub
- Psychology, Pace University, New York, New York, USA
| | - J L Stewart
- Psychology, Hunter College of the City University of New York, New York, New York, USA
- Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, USA
| | - M Oberndorf
- Psychology, Pace University, New York, New York, USA
| | - V Parker
- Psychology, Pace University, New York, New York, USA
| | - Tyrel J Starks
- Psychology, Hunter College of the City University of New York, New York, New York, USA
- Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York, New York, New York, USA
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Hinz A, Esser P, Friedrich M, Glaesmer H, Mehnert-Theuerkauf A, Schroeter ML, Petrowski K, Toussaint A. Changes in anxiety in the general population over a six-year period. PLoS One 2023; 18:e0291206. [PMID: 37699040 PMCID: PMC10497144 DOI: 10.1371/journal.pone.0291206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 08/24/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Anxiety is a frequent condition in patients and in the general population. The aim of this study was to investigate changes in anxiety over time and to test several psychometric properties of the Generalized Anxiety Disorder Screener (GAD-7) from a longitudinal perspective. METHODS The GAD-7 was included in an examination with two waves, six years apart. The study sample (n = 5355) was comprised of representatively selected adults from the general population with a mean age of 57.3 (SD = 12.3) years. RESULTS During the 6-year time interval, anxiety increased significantly from 3.28 ± 3.16 (t1) to 3.66 ± 3.46 (t2). Confirmatory factor analyses proved the longitudinal measurement invariance of the GAD-7. Reliability of the GAD-7 was established both for the cross-sectional and the longitudinal perspective. The test-retest correlation was r = 0.53, and there were no substantial sex or age differences in these coefficients of temporal stability. The mean changes in anxiety were similar for males and females, and there was no linear age trend in the changes measured by the GAD-7. Changes in anxiety over the 6-year period were correlated with changes in satisfaction with life (r = -0.30), bodily complaints (r = 0.31), and the mental component of quality of life (r = -0.48). CONCLUSION The GAD-7 is a suitable instrument for measuring changes in anxiety. Age and gender have only minor significance when interpreting change scores.
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Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Matthias L. Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig & Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Katja Petrowski
- Medical Psychology & Medical Sociology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Department of Internal Medicine III, Dresden University of Technology, Dresden, Germany
| | - Anne Toussaint
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Niileksela CR, Jones NB. Measurement Equality of Frequency and Severity Item Response Options on Depression and Generalized Anxiety Scales. Assessment 2023; 30:2016-2028. [PMID: 36341537 DOI: 10.1177/10731911221134599] [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: 07/22/2023]
Abstract
Rating scales are commonly used in psychological research and practice. It is important to consider how different item response options used on rating scales, such as those based on frequency or severity, may affect how they measure psychological constructs. In this study, participants were randomly assigned to conditions where they completed two depression and two generalized anxiety rating scales that used either frequency or severity item response options. Descriptive statistics and reliability estimates across depression and generalized anxiety scales using different item response options were similar. Measurement invariance tests indicated that depression and generalized anxiety scales with different item response options could be considered practically invariant. Finally, depression and generalized anxiety scales with different item response options had similar correlations with measures of impairment and other psychological constructs. There were essentially no differences in psychometric and measurement properties of these depression and generalized anxiety scales when using different item response options, suggesting this may not substantially affect the measurement of these constructs.
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Kaiser H, Grice T, Walker B, Kaiser J. Barriers to help-seeking in medical students with anxiety at the University of South Carolina School of Medicine Greenville. BMC MEDICAL EDUCATION 2023; 23:463. [PMID: 37344832 PMCID: PMC10286385 DOI: 10.1186/s12909-023-04460-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/16/2023] [Indexed: 06/23/2023]
Abstract
Anxiety levels in medical students have been reported as higher than the aged-matched general population, yet medical students are less likely to seek care for mental health issues. Medical students carry high levels of self-stigma about their own mental health and fear the negative consequences of seeking care. The purpose of this study was to examine the student population at the University of South Carolina School of Medicine Greenville (UofSC SOMG) for anxiety levels and determine the self-stigma attitudes this population carries. UofSC SOMG students were surveyed using the GAD7, questions about mental health stigma, and open-ended questions on barriers to mental health care in medical students. Anxiety levels were compared to student responses. 31% of students reported moderate-severe anxiety levels. Stigma was the most frequently listed barrier to care, however, students with moderate-severe anxiety were more likely to report cost as a barrier to care than students with minimal anxiety levels. Despite free and accessible mental health care, medical students at UofSC SOMG still have anxiety at rates higher than the general population. Future work should help to provide interventions to the barriers of care, so medical students can better utilize mental health care resources.
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Affiliation(s)
- Helen Kaiser
- University of South Carolina School of Medicine Greenville, Greenville, SC, 29605, USA.
| | - Tori Grice
- University of South Carolina School of Medicine Greenville, Greenville, SC, 29605, USA
| | - Brittany Walker
- Prisma Health Upstate, 701 Grove Road Balcony Suite 5, Greenville, SC, 29605, USA
| | - Jacob Kaiser
- Prisma Center for Psychiatry, 109 Physicians Dr. Ste B, Greer, SC, 29650, USA
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32
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Andersson MJ, Kenttä G, Moesch K, Borg E, Claesdotter-Knutsson E, Håkansson A. Symptoms of depression and anxiety among elite high school student-athletes in Sweden during the COVID-19 pandemic: A repeated cross-sectional study. J Sports Sci 2023; 41:874-883. [PMID: 37527354 DOI: 10.1080/02640414.2023.2241783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 07/20/2023] [Indexed: 08/03/2023]
Abstract
The COVID-19 pandemic precipitated numerous changes in daily life, including the cancellation and restriction of sports globally. Because sports participation contributes positively to the development of student-athletes, restricting these activities may have led to long-term mental health changes in this population. Using a repeated cross-sectional study design, we measured rates of depression using the Patient Health Questionnaire-2 and anxiety using the Generalized Anxiety Disorder-2 scale in student-athletes attending elite sport high schools in Sweden during the second wave of the pandemic (February 2021; n = 7021) and after all restrictions were lifted (February 2022; n = 6228). Depression among student-athletes decreased from 19.8% in 2021 to 17.8% in 2022 (p = .008, V = .026), while anxiety screening did not change significantly (17.4% to 18.4%, p > .05). Comparisons between classes across years revealed older students exhibited decreases in depressive symptoms, while younger cohorts experienced increases in symptoms of anxiety from 2021 to 2022. Logistic regressions revealed that being female, reporting poorer mental health due to COVID-19, and excessive worry over one's career in sports were significant predictors of both depression and anxiety screenings in 2022. Compared to times when sports participation was limited, the lifting of restrictions was associated with overall reduced levels of depression, but not anxiety.
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Affiliation(s)
- Mitchell J Andersson
- Malmö Addiction Center, Region Skåne, Clinical Sports and Mental Health Unit, Malmö, Sweden
- Faculty of Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Göran Kenttä
- Swedish Sports Confederation, Stockholm, Sweden
- Department of Physiology, Nutrition and Biomechanics, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Karin Moesch
- Swedish Sports Confederation, Stockholm, Sweden
- Department of Sports Science, Malmö University, Malmö, Sweden
| | - Elisabet Borg
- Faculty of Social Sciences, Department of Psychology - Perception and Psychophysics, Stockholm University, Stockholm, Sweden
| | | | - Anders Håkansson
- Malmö Addiction Center, Region Skåne, Clinical Sports and Mental Health Unit, Malmö, Sweden
- Faculty of Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
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Heumann E, Trümmler J, Stock C, Helmer SM, Busse H, Negash S, Pischke CR. Study Conditions and University Students' Mental Health during the Pandemic: Results of the COVID-19 German Student Well-Being Study (C19 GSWS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5286. [PMID: 37047902 PMCID: PMC10094523 DOI: 10.3390/ijerph20075286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 06/19/2023]
Abstract
University students are generally vulnerable to mental health problems. This was exacerbated during the COVID-19 pandemic, when students experienced decisive changes and restrictions in their academic lives. Our study aimed at (a) analysing associations between study conditions and symptoms of depression and anxiety and (b) determining the extent of use and motivation to use student counselling services. The C19 GSWS is a cross-sectional study conducted at five universities in Germany (N = 7203). Descriptive analyses and linear regression models were performed to estimate the associations between study conditions and mental health outcomes. A total of 42.4% of the students felt down, depressed, or hopeless on several days over the past 14 days. Between a third and 44.1% of the students felt burdened by their study conditions. Worse perceived study conditions were associated with higher levels of depressive symptoms and anxiety. Only 7.1% indicated that they had utilised student counselling services, and female gender, enrolment in a bachelor's programme, and having more than 1 reason for utilisation were factors associated with use. The results of our research underline the need for universities to review their study conditions and to provide targeted intervention strategies and counselling services to promote students' mental well-being.
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Affiliation(s)
- Eileen Heumann
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Jannis Trümmler
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University Duesseldorf, 40225 Duesseldorf, Germany
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Unit for Health Promotion Research, University of Southern Denmark, Degnevej 14, 6705 Esbjerg, Denmark
| | - Stefanie M. Helmer
- Institute for Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
| | - Heide Busse
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany
| | - Sarah Negash
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Claudia R. Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University Duesseldorf, 40225 Duesseldorf, Germany
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Russell MA, Reavley N, Williams I, Li W, Tarzia L, Chondros P, Sanci L. Changes in mental health across the COVID-19 pandemic for local and international university students in Australia: a cohort study. BMC Psychol 2023; 11:55. [PMID: 36855196 PMCID: PMC9973240 DOI: 10.1186/s40359-023-01075-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 02/03/2023] [Indexed: 03/02/2023] Open
Abstract
PURPOSE Previous research has indicated that university students experienced substantial mental health issues during the global COVID-19 pandemic, but few studies have considered changes relative to pre-pandemic levels across population groups. Hence, the aim of this study was to compare changes in mental health and associated stressors across the pandemic for international and local university students studying in Australia. METHODS In a cohort of 4407 university students, we assessed depression (Patient Health Questionnaire 2), anxiety (Generalized Anxiety Disorder-2), social support (Medical Outcomes Study-Social Support Survey), inability to afford food, fear of partner, and experiences of discrimination, both pre-pandemic (April-May 2019) and during the pandemic (September-October 2020). Change in prevalence between local and international students were estimated with logistic regression, adjusting for baseline factors. RESULTS Compared to local students, international students experienced an increase in probable major depression (odds ratio (OR) 1.43, 95% Confidence Interval (CI) 1.23, 1.66), low social support (OR 2.63, 95% CI 2.23, 3.11), inability to afford food (OR 5.21, 95% CI 3.97, 6.83) race-based discrimination (OR 2.21, 95% CI 1.82, 2.68) and fear of partner (OR 3.46, 95% CI 2.26, 5.13). Interaction analyses indicated that these issues were more likely to be experienced by students living outside their country of origin, inclusive of international students based in Australia (depression p value interaction term 0.02). CONCLUSION The pandemic had a substantial negative impact on international students, particularly those living outside of their country of origin during the pandemic. The inequalities exacerbated by the pandemic were present prior to the pandemic and are likely to continue post-pandemic without action. Interventions to build the supports for international students need to be urgently explored.
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Affiliation(s)
- Melissa A. Russell
- grid.1008.90000 0001 2179 088XCentre of Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Nicola Reavley
- grid.1008.90000 0001 2179 088XCentre of Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Ian Williams
- grid.1008.90000 0001 2179 088XDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Wenjing Li
- grid.1008.90000 0001 2179 088XCentre of Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Laura Tarzia
- grid.1008.90000 0001 2179 088XDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Patty Chondros
- grid.1008.90000 0001 2179 088XDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Lena Sanci
- grid.1008.90000 0001 2179 088XDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia
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Vitagliano LA, Wester KL, Jones CT, Wyrick DL, Vermeesch AL. Group Nature-Based Mindfulness Interventions: Nature-Based Mindfulness Training for College Students with Anxiety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1451. [PMID: 36674206 PMCID: PMC9860632 DOI: 10.3390/ijerph20021451] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
The mental health crisis across college campuses is accelerating, with anxiety listed as the top mental health issue for undergraduate college students. Although evidence suggests the COVID-19 pandemic escalated the mental health crisis on college campuses, pre-COVID-19 anxiety among college students was on the rise. Research supports Mindfulness Based Interventions (MBIs) to reduce anxiety among college students. Additionally, exposure to natural environments, which are accessible to students on college campuses, is effective in reducing anxiety. While brief nature-based mindfulness interventions appear effective in reducing anxiety among college students, these interventions are often offered in isolation without social interaction among group members and lack intentional integration of mindfulness and nature-related theories. The purpose of this work is to describe a framework for integrating the use of Mindfulness and Attention Restoration Theory (ART) in an innovative psychoeducational group intervention, Nature-Based Mindfulness Training © (NBMT), for college students with anxiety. In conclusion, we argue for the need to intentionally integrate mindfulness and nature into nature-based mindfulness interventions as an effective and sustainable means to reduce anxiety. Limitations and areas for future research are described.
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Affiliation(s)
- Luke A. Vitagliano
- Department of Counseling and Educational Development, University of North Carolina Greensboro, 1400 Spring Garden Street, Greensboro, NC 27412, USA
| | - Kelly L. Wester
- Department of Counseling and Educational Development, University of North Carolina Greensboro, 1400 Spring Garden Street, Greensboro, NC 27412, USA
| | - Connie T. Jones
- Department of Counseling and Educational Development, University of North Carolina Greensboro, 1400 Spring Garden Street, Greensboro, NC 27412, USA
| | - David L. Wyrick
- Department of Public Health Education, University of North Carolina Greensboro, 1400 Spring Garden Street, Greensboro, NC 27412, USA
| | - Amber L. Vermeesch
- Department of Family and Community Nursing, School of Nursing, University of North Carolina Greensboro, 1007 Walker Avenue, Greensboro, NC 27402, USA
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Heumann E, Helmer SM, Busse H, Negash S, Horn J, Pischke CR, Niephaus Y, Stock C. Anxiety and depressive symptoms of German university students 20 months after the COVID-19 outbreak - A cross-sectional study. J Affect Disord 2023; 320:568-575. [PMID: 36220498 PMCID: PMC9547656 DOI: 10.1016/j.jad.2022.09.158] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/24/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Given the long duration of the COVID-19 pandemic, monitoring mental health remains important. This study aimed to determine (1) the prevalence of anxiety and depressive symptoms among university students 20 months after the first COVID-19 restrictions and (2) which factors were associated with these outcomes. METHODS The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) collected data of 7025 students at five German universities. Associations between anxiety and depressive symptoms with sociodemographic and other factors were analysed using multivariable logistic regression models. RESULTS The mean age of the participants was 23.9 years (SD = 4.9), 67 % were female and 31 % male. The prevalence for depressive symptoms was 29 % (PHQ-2) and 12 % (CES-D 8) and 32 % for anxiety. A complicated relationship status, the lack of a trusted person, and financial difficulties were associated with anxiety and depressive symptoms. University students who were worried about (re-) infection with COVID-19 had a 1.37-times higher chance for reporting anxiety (GAD-2: OR, 95 % CI: 1.09-1.71). Those with pre-existing cardiovascular health conditions had an up to 3.21-times higher chance for reporting depressive symptoms (OR, CESD-D 8, 95 % CI: 1.44-7.14). LIMITATIONS The study design is cross-sectional and uses self-reported outcomes. CONCLUSIONS Concepts for prevention and counselling to tackle mental health problems in students are needed and programmes should take specific stressors related to the pandemic into account.
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Affiliation(s)
- Eileen Heumann
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | | | - Heide Busse
- Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Sarah Negash
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Johannes Horn
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Claudia R Pischke
- Institute of Medical, Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Yasemin Niephaus
- Department of Social Sciences, University of Siegen, Siegen, Germany
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, Berlin, Germany; Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
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Lambe LJ, Yunus FM, Moore M, Keough MT, Thompson K, Krank M, Conrod P, Stewart SH. Inhibited personality traits, internalizing symptoms, and drinking to cope during the COVID-19 pandemic among emerging adults. Cogn Behav Ther 2022; 52:198-212. [PMID: 36519887 DOI: 10.1080/16506073.2022.2152726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Emerging adults with high levels of inhibited personality traits may be at-risk for drinking to cope during the COVID-19 pandemic. The current research explored mediational pathways between two inhibited personality traits (anxiety sensitivity (AS) and hopelessness (HOP)), internalizing symptoms (anxiety, depression, and COVID-19 distress), and coping drinking motives (drinking to cope with anxiety and drinking to cope with depression) during the pandemic. Cross-sectional data were collected from 879 undergraduate drinkers (79% female, 83% White, 18-25 years old) at five Canadian universities from January-April 2021. Participants self-reported on their personality, anxiety (GAD-7), depressive symptoms (PHQ-9), COVID-19 distress, and coping drinking motives. Mediational path analyses provided evidence of both specific and non-specific pathways between personality and coping motives via internalizing symptoms. Depressive symptoms partially mediated the link between HOP and drinking to cope with depression motives. While anxiety symptoms did not significantly mediate links between AS and coping with anxiety motives in the full model, evidence of mediation was found in a post-hoc sensitivity analysis. COVID-19 distress served as a non-specific mediator. AS and HOP are critical transdiagnostic risk factors that increase vulnerability for internalizing psychopathology and, in turn, risky drinking motives, in the context of the COVID-19 pandemic.
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Affiliation(s)
- Laura J. Lambe
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Fakir Md Yunus
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mackenzie Moore
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Kara Thompson
- Department of Psychology, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Marvin Krank
- Department of Psychology, University of British Columbia- Okanagan Campus, Kelowna, British Columbia, Canada
| | - Patricia Conrod
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Sherry H. Stewart
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
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Artyukhov A, Pritchard M, Brasil K. Relationships between body image and mental health in white, cisgender college students. Eat Weight Disord 2022; 27:3579-3586. [PMID: 36344745 DOI: 10.1007/s40519-022-01495-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Previous studies have suggested that drive for leanness (DL) may be less maladaptive than drive for thinness (DT) or drive for muscularity (DM). However, no studies have examined whether there might be gender differences in the relationships between these three drives and mental health variables. The purpose of this study was twofold. First, we wanted to examine DL in the context of mental health and to see if it is less maladaptive than DT and DM. Second, we wanted to examine gender differences in the relationships between body dissatisfaction (DT, DM, DL) and mental health in a sample of college students. METHODS A sample of 988 White, heterosexual, cisgender college students (76.8% female) completed an omnibus survey measuring body image (DL, DT, DM) and mental health (generalized anxiety, social physique anxiety, self-esteem) variables. Regression analyses evaluated associations between these drives and mental health variables. RESULTS DT predicted all three mental health outcomes in both men and women. DM predicted generalized and social physique anxiety in women but only generalized anxiety in men. DL predicted social physique anxiety only in women. CONCLUSION Because we found gender differences in body image and relationships between body image and mental health, future studies should take gender into account when exploring body image and related variables. LEVEL OF EVIDENCE V Cross-sectional descriptive study.
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Affiliation(s)
| | - Mary Pritchard
- Department of Psychological Science, Boise State University, Boise, ID, USA.
| | - Kyle Brasil
- Combined-Integrated Clinical & Counseling, Psychology Program, University of South Alabama, Mobile, AL, USA
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Du SH, Guo W, Yang C, Chen S, Guo SN, Du S, Du ZM, Fei YT, Zhao JP. Filiform needle acupuncture for allergic rhinitis: A systematic review and meta-analysis. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:497-513. [PMID: 36068161 DOI: 10.1016/j.joim.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 05/07/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Filiform needle acupuncture (FNA), the most classical and widely applied acupuncture method based on traditional Chinese medicine theory, has shown a promising effect in the treatment of allergic rhinitis (AR). OBJECTIVE To evaluate the efficacy, safety, cost-effectiveness, and patient preference of FNA in the treatment of AR by comparing FNA with sham acupuncture, no treatment, and conventional medication. SEARCH STRATEGY Eight electronic databases were systematically searched from inception to October 14, 2021. Additional studies were acquired from clinical trial registration platforms and reference lists. INCLUSION CRITERIA Randomized controlled trials were included if they compared FNA with either sham acupuncture, no treatment or conventional medication for AR. DATA EXTRACTION AND ANALYSIS Two researchers extracted data independently of each other using a predesigned data acquisition form, and results were cross-checked after completion. The primary outcome was symptom score (Total Nasal Symptom Score or Visual Analogue Scale), and the secondary outcomes were the AR control questionnaire, quality of life (QoL) score (Different versions of Rhinoconjunctivitis Quality of Life Questionnaire), medication score (use of rescue medication), mental health score, total IgE, adverse event rate, clinical economic indicators, and patient satisfaction score. Standardized mean difference (SMD) or mean difference (MD) with 95% confidence interval was used to calculate the effect size for continuous data, while risk ratio with 95% CI was used for dichotomous data. RESULTS Thirty studies were included in this review. Compared with sham acupuncture, FNA significantly reduced the symptom score (SMD: -0.29 [-0.43, -0.15]), AR's impact on QoL (SMD: -0.23 [-0.37, -0.08]) and medication score (SMD: -0.3 [-0.49, -0.11]). Compared with no treatment, FNA dramatically reduced the symptom score (SMD: -0.8 [-1.2, -0.39]) and AR's impact on QoL (SMD: -0.82 [-1.13, -0.52]). There were no increased rates of adverse events with FNA compared to sham acupuncture and no treatment. FNA increased patient satisfaction and may be cost-effective. Most pieces of evidence from the above two comparisons were of high confidence. Moreover, FNA significantly outperformed conventional medication in reducing the symptom score (SMD: -0.48 [-0.85, -0.1]) and displayed a lower rate of adverse events, but the quality of evidence was very low. CONCLUSION FNA is an effective and safe intervention for AR and can help with symptom relief, QoL improvement, reducing medication usage, and increasing patient satisfaction. Further studies are needed to verify its cost-effectiveness and superiority over conventional medication and the best therapeutic strategies.
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Affiliation(s)
- Shi-Hao Du
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Wei Guo
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Chao Yang
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Sheng Chen
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Sheng-Nan Guo
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Shuo Du
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Zhong-Ming Du
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Yu-Tong Fei
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Ji-Ping Zhao
- Department of Acupuncture and Moxibustion, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China.
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Martínez-Vázquez S, Martínez-Galiano JM, Peinado-Molina RA, Gutiérrez-Sánchez B, Hernández-Martínez A. Validation of General Anxiety Disorder (GAD-7) questionnaire in Spanish nursing students. PeerJ 2022; 10:e14296. [PMID: 36340193 PMCID: PMC9635356 DOI: 10.7717/peerj.14296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022] Open
Abstract
Background Nursing students are at risk of anxiety during their university education. Objective To determine the psychometric characteristics of the General Anxiety Disorder (GAD-7) questionnaire in a population of university nursing students. Methods A cross-sectional study was carried out with 170 students at the University of Jaen (Spain) in 2022. An online questionnaire was administered that included sociodemographic and student profile variables, the GAD-7 questionnaire, and the Goldberg anxiety subscale. An exploratory factor analysis (EFA), validation with convergence, and reliability analysis using Cronbach's α were performed. Results The EFA identified a single component that explained 63.50% of the variance. It was positively correlated with the Goldberg anxiety subscale (r = 0.653; p < 0.001). A statistically significant association was observed with academic year, gender, and having experienced an anxiety crisis (p < 0.005). Internal consistency with Cronbach's α was 0.903. Conclusion The GAD-7 presents appropriate psychometric characteristics for use in a university population of nursing students. It is capable of detecting symptoms and generalized anxiety disorder, making it a useful and simple tool for detecting anxiety-related problems in this population.
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Xi S, Gu Y, Guo H, Jin B, Guo F, Miao W, Zhang L. Sleep quality status, anxiety, and depression status of nurses in infectious disease department. Front Psychol 2022; 13:947948. [PMID: 36312085 PMCID: PMC9615549 DOI: 10.3389/fpsyg.2022.947948] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/01/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To investigate the current status of sleep quality and influencing factors of clinical nurses in infectious disease hospitals, and to provide basis and reference for improving their sleep status and providing psychological support. Methods Using convenience sampling method, clinical nurses from a tertiary hospital for infectious diseases were selected as the survey subjects in September 2021. General information questionnaire, Pittsburgh Sleep Quality Questionnaire (PSQI), Generalized Anxiety Disorder Scale (GAD-7), Depression Screening Scale (PHQ-9) were used for questionnaire surveys, and multiple linear regression was used to analyze the impact of decreased sleep quality in clinical nurses factor. Results A total of 460 questionnaires were returned, of which 442 were valid, effective rate is 96.09%. The Pittsburgh sleep quality index (PSQI) score of 442 clinical nurses was 7.07 ± 2.14, of which 60 (13.57%) had sleep disorders; the Generalized Anxiety Disorder Scale (GAD-7) score was 4.77 ± 3.50, of which 182 (41.18%) had varying degrees of anxiety; The score of PHQ-9 was 5.95 ± 3.79, of which 187 (42.31%) had different degrees of depressive symptoms. The stepwise multiple linear regression analysis which involved PHQ-9 and GAD-7 scores showed that: both the PHQ-9 score and the GAD-7 score were positively correlated with the sleep quality score, and the PHQ-9 score increased every time 1 point, sleep quality score increased by 0.239 points; GAD-7 score increased by 1 point, sleep quality score increased by 0.150 points. The overall model test (F = 109.760, P < 0.001) regression model is meaningful. Conclusion Decreased sleep quality is common among clinical nurses in infectious disease hospitals, and the sleep status of nurses is positively correlated with anxiety and depression. Nursing managers pay attention to sleep quality of clinical nurses in infectious disease hospitals and carry out effective interventions to improve the sleep quality of nurses.
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Affiliation(s)
- Shuangmei Xi
- Department of Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yanmei Gu
- Department of Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Huimin Guo
- Department of Nursing, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Boxun Jin
- Department of Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Fengjuan Guo
- Transplant Center, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wenjing Miao
- Department of Emergency, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Lili Zhang
- Department of Nursing, Beijing Youan Hospital, Capital Medical University, Beijing, China
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Blake H, Carlisle S, Fothergill L, Hassard J, Favier A, Corner J, Ball JK, Denning C. Mixed-methods process evaluation of a residence-based SARS-CoV-2 testing participation pilot on a UK university campus during the COVID-19 pandemic. BMC Public Health 2022; 22:1470. [PMID: 35915479 PMCID: PMC9343222 DOI: 10.1186/s12889-022-13792-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 06/10/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Regular testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is an important strategy for controlling virus outbreaks on university campuses during the COVID-19 pandemic but testing participation rates can be low. The Residence-Based Testing Participation Pilot (RB-TPP) was a novel intervention implemented at two student residences on a large UK university campus over 4 weeks. The aim of the pilot was to increase the frequency of asymptomatic SARS-CoV-2 saliva testing onsite. This process evaluation aimed to determine whether RB-TPP was implemented as planned and identify implementation barriers and facilitators. METHODS A mixed-methods process evaluation was conducted alongside the RB-TPP. Evaluation participants were students (opting in, or out of RB-TPP) and staff with a role in service provision or student support. Monitoring data were collected from the intervention delivery team and meeting records. Data were collected from students via online survey (n = 152) and seven focus groups (n = 30), and from staff via individual interviews (n = 13). Quantitative data were analysed descriptively and qualitative data thematically. Barriers and facilitators to implementation were mapped to the 'Capability, Opportunity, Motivation-Behaviour' (COM-B) behaviour change framework. RESULTS Four hundred sixty-four students opted to participate in RB-TPP (98% of students living onsite). RB-TPP was implemented broadly as planned but relaxed social distancing was terminated early due to concerns relating to national escalation of the COVID-19 Delta variant, albeit testing continued. Most students (97.9%) perceived the period of relaxed social distancing within residences positively. The majority engaged in asymptomatic testing (88%); 46% (52% of testers) were fully compliant with pre-determined testing frequency. Implementation was facilitated by convenience and efficiency of testing, and reduction in the negative impacts of isolation through opportunities for students to socialise. Main barriers to implementation were perceived mixed-messages about the rules, ambivalent attitudes, and lack of adherence to COVID-19 protective measures in the minority. CONCLUSIONS This process evaluation identifies factors that help or hinder the success of university residence-based outbreak prevention and management strategies. RB-TPP led to increased rates of SARS-CoV-2 testing participation among students in university residences. Perceived normalisation of university life significantly enhanced student mental wellbeing. The complexity and challenge generated by multiple lines of communication and rapid adaptions to a changing pandemic context was evident. TRIAL REGISTRATION NUMBER UKAS 307727-02-01; Pre-results. CLINICALTRIALS gov Identifier: NCT05045989 ; post-results (first posted, 16/09/21). ETHICAL APPROVAL Faculty of Medicine & Health Sciences Research Ethics Committee, University of Nottingham (Ref: FMHS 96-0920).
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Affiliation(s)
- H Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK.
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.
| | - S Carlisle
- School of Medicine, University of Nottingham, Nottingham, UK
| | - L Fothergill
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - J Hassard
- School of Medicine, University of Nottingham, Nottingham, UK
| | - A Favier
- Faculty of Registrars, University of Nottingham, Nottingham, UK
| | - J Corner
- Faculty of Registrars, University of Nottingham, Nottingham, UK
| | - J K Ball
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - C Denning
- School of Medicine, University of Nottingham, Nottingham, UK
- Biodiscovery Institute, University of Nottingham, Nottingham, UK
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43
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Boness CL, Gatten N, Treece M, Miller MB. A mixed-methods approach to improve the measurement of alcohol-induced blackouts: ABOM-2. Alcohol Clin Exp Res 2022; 46:1497-1514. [PMID: 35702924 PMCID: PMC9427728 DOI: 10.1111/acer.14882] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/16/2022] [Accepted: 06/07/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Alcohol-induced blackouts describe memory loss resulting from alcohol consumption. Approximately half of college students report experiencing a blackout in their lifetime. Blackouts are associated with an increased risk for negative consequences, including serious injury. Research has documented two types of blackouts, en bloc (EB) and fragmentary (FB). However, research is limited by the lack of a validated measure that differentiates between these two forms of blackout. This study used a mixed-methods approach to improve the assessment of FB and EB among young adults. Specifically, we sought to improve the existing Alcohol-Induced Blackout Measure (ABOM), which was derived from a relatively small pool of items that did not distinguish FB from EB. METHODS Study 1 used three rounds of cognitive interviewing with U.S. college students (N = 31) to refine existing assessment items. Nineteen refined blackout items were retained for Study 2. Study 2 used face validity, factor analysis, item response theory, and external validation analyses to test the two-factor blackout model among U.S. heavy-drinking college students (N = 474) and to develop and validate a new blackout measure (ABOM-2). RESULTS Iterative factor analyses demonstrated that the items were well represented by correlated EB and FB factors, consistent with our hypothesis. External validation analyses demonstrated convergent and discriminant validity. These analyses also provided preliminary evidence for the two factors having differential predictive validity (e.g., FB correlated with enhancement drinking motives, while EB correlated with coping and conformity motives). CONCLUSIONS The Alcohol-Induced Blackout Measure-2 (ABOM-2) improves the measurement of blackout experiences among college students. Its use could facilitate the examination of EB and FB as differential predictors of alcohol-related outcomes in future studies.
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Affiliation(s)
- Cassandra L. Boness
- Center on Alcohol, Substance use, And Addictions, University of New Mexico,Department of Psychological Science, University of Missouri
| | - Natalie Gatten
- Department of Psychological Science, University of Missouri
| | - McKenna Treece
- Department of Psychological Science, University of Missouri,Department of Counseling and Counseling Psychology, University of Missouri Kansas City
| | - Mary Beth Miller
- Department of Psychological Science, University of Missouri,Department of Psychiatry, University of Missouri
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44
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Ganson KT, Mitchison D, Rodgers RF, Cunningham ML, Murray SB, Nagata JM. Compulsive exercise among college students: 5-year time trends in prevalence and demographic, substance use, and mental health correlates. Eat Weight Disord 2022; 27:717-728. [PMID: 34024038 DOI: 10.1007/s40519-021-01210-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/08/2021] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To provide 5-year time trends in prevalence and demographic, substance use, and mental health correlates of compulsive exercise among a national sample of college men and women. METHODS We analyzed 4 academic survey years (2016-2020; N = 8251) of the national (USA) Healthy Minds Study. Compulsive exercise was measured by self-report of any occurrence of "compulsive" exercise in the past 4 weeks. Unadjusted prevalence of compulsive exercise in the past 4 weeks was estimated across the 4 survey years by sex. Multiple logistic regression analyses were conducted among the pooled sample and stratified by sex to estimate the associations between compulsive exercise in the past 4 weeks and demographic, substance use, and mental health correlates. RESULTS Among the pooled sample, 11% (95% confidence interval [CI] 9.60-12.42%) of men and 17% (95% CI 15.86-18.24%) of women reported compulsive exercise in the past 4 weeks. Prevalence across the 4 survey years remained stable among men and women. Higher body mass index was associated with greater odds of any compulsive exercise in the past 4 weeks among men, while any sports participation was associated with greater odds of any compulsive exercise in the past 4 weeks among women. Compulsive exercise in the past 4 weeks was associated with greater odds of all mental health symptoms and illicit drug use among men and women, and higher odds of alcohol use among women. CONCLUSION Compulsive exercise is relatively common among college men and women and is associated with substance use behaviors and poor mental health symptoms. LEVEL OF EVIDENCE V, cross-sectional descriptive study.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON, M5S 1V4, Canada.
| | - Deborah Mitchison
- School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, Australia
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU, Montpellier, France
| | | | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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45
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Zhang A, Weaver A, Walling E, Zebrack B, Levin NJ, Stuchell B, Himle J. Evaluating an engaging and coach-assisted online cognitive behavioral therapy for depression among adolescent and young adult cancer survivors: A pilot feasibility trial. J Psychosoc Oncol 2022; 41:20-42. [PMID: 35040368 PMCID: PMC10599691 DOI: 10.1080/07347332.2021.2011530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Technology-assisted Cognitive Behavioral Therapy (tCBT) has significant potentials to provide engaging and accessible depression treatment for adolescents and young adults (AYAs) coping with cancer. This study evaluated the feasibility and preliminary efficacy of an engaging and tailorable tCBT - Mind Your Total Health (MYTH) - for AYA cancer survivors' depression. METHODS Seventeen AYAs diagnosed with cancer were randomly assigned to either the intervention (MYTH) or control group. The intervention group (n = 10) received eight weekly 30-35 minutes coach-assisted tCBT (MYTH), while the control group (n = 7) received active control, BeatingtheBlues (BtB). RESULTS Eight out of ten participants in the MYTH group completed at least six out of eight sessions, suggesting strong feasibility (80% completion rate) among AYAs with cancer. Efficacy outcomes indicated that participants in the MYTH group reported significant pre- and post-treatment reduction in depression, t(9) = 5.25, p < 0.001, and anxiety, t(9)=5.07, p < 0.001. Notably, participants in the MYTH group reported significantly lower post-treatment depression than participants in the BtB group, t(15) = 2.40, p < 0.05. The between-group difference reflected a significant between-group treatment effect size, d = 1.12, p < 0.05. DISCUSSION This engaging, tailorable, and coach-assisted tCBT intervention is promising in alleviating depression and anxiety among AYA cancer survivors. Future research needs to include larger sample size and a more diverse patient population.
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Affiliation(s)
- Anao Zhang
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Addie Weaver
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily Walling
- Department of Pediatrics, University of Michigan, Medical School, Ann Arbor, Michigan, USA
| | - Brad Zebrack
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Nina Jackson Levin
- School of Social Work & Department of Anthropology, University of Michigan, Ann Arbor, Michigan, USA
| | - Beth Stuchell
- Department of Pediatrics, University of Michigan, Medical School, Ann Arbor, Michigan, USA
| | - Joseph Himle
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
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46
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Hussenoeder FS, Pabst A, Conrad I, Löbner M, Engel C, Zeynalova S, Reyes N, Glaesmer H, Hinz A, Witte V, Schroeter ML, Wirkner K, Kirsten T, Löffler M, Villringer A, Riedel-Heller SG. Anxiety and Food Addiction in Men and Women: Results From the Longitudinal LIFE-Adult-Study. Front Psychiatry 2022; 13:914358. [PMID: 35774094 PMCID: PMC9239341 DOI: 10.3389/fpsyt.2022.914358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/25/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Anxiety is a widespread phenomenon, and it is connected to disordered eating and obesity. We want to analyze the connection between anxiety and food addiction (FA) over two points in time to better understand the directionality of the association. Since there are gender differences with regard to anxiety and eating, we are also interested in differences between men and women. METHODS We used data from the population-based LIFE-Adult-Study (N = 1,474) at time 1 (baseline) and time 2 (first follow-up) to analyze the connections between anxiety (GAD-7) and FA (YFAS) using a multiple group latent cross-lagged panel model with female and male participants as groups. We controlled for age, marital status, socioeconomic status and social support. RESULTS Anxiety (women: β = 0.50, p ≤ 0.001; men: β = 0.59, p ≤ 0.001) as well as FA (women: β = 0.37, p ≤ 0.001; men: β = 0.58, p ≤ 0.001) exhibited stability over time for both genders. We found a significant association between anxiety at time 1 and FA at time 2 for women (β = 0.25, p ≤ 0.001) but not for men (β = 0.04, p = 0.10), and significant associations between FA at time 1 and anxiety at time 2 for women (β = 0.23, p ≤ 0.001) as well as men (β = 0.21, p ≤ 0.001). CONCLUSION Food addiction longitudinally affects anxiety, independent of gender and other sociodemographic variables. In addition, anxiety affects subsequent FA as well, but only in women. Interventions that address FA could reduce anxiety in men and women, while interventions that mitigate anxiety could help prevent FA in women.
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Affiliation(s)
- Felix S Hussenoeder
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Ines Conrad
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany.,Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Samira Zeynalova
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Nigar Reyes
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Veronica Witte
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Kerstin Wirkner
- Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Toralf Kirsten
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany.,Department for Medical Data Science, University Hospital Leipzig, Leipzig, Germany
| | - Markus Löffler
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - Arno Villringer
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
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47
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Xu S, Chen Y, Li Y, Yang S, Lu Y, Li L, Huang M, Ma M, Ou W, Lv G, Zhao X, Qin Y, Ju Y, Zhang Y, Li L. Factor structure and psychometric properties of the affective lability scale-short form in Chinese adolescents. Front Psychiatry 2022; 13:881541. [PMID: 36465311 PMCID: PMC9713808 DOI: 10.3389/fpsyt.2022.881541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 10/27/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Previous studies on the reliability and validity of the Affective Lability Scale short-form (ALS-SF) have only been evaluated in adults, which may not be able to generalize to the adolescent population. We aimed to examine the factor structure, the reliability and validity of ALS-SF among Chinese adolescents and construct an adolescent form of ALS (ALS-AF). METHODS A total of 1,439 middle school students were investigated with a broad survey including ALS-SF, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), Connor-Davidson Resilience Scale 10-item (CD-RISC-10) and non-suicidal self-injury (NSSI) behavior self-report. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to investigate the structural validity of ALS-SF and construct ALS-AF. Cronbach's α was used to assess the internal consistency and reliability of the scale. Factor loading, Average Variance Extracted (AVE) and Composite Reliability (CR) were applied to measure the convergent validity and divergent validity. Besides, Correlation and regression analyses were used to explore the relationship between affective lability and depression, anxiety, NSSI and resilience. RESULTS Factor analysis failed to support the original three-factor model of 18-item ALS-SF and confirmed the three-factor model of 15-item ALS-AF. The ALS-AF showed good internal consistency as well as strong convergent and discriminative validity. Besides, ALS-AF was positively correlated with PHQ-9, GAD-7 and self-harm, and was negatively associated with resilience. CONCLUSION Our study shows that the ALS-AF has good reliability and validity for testing affective lability in Chinese adolescents.
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Affiliation(s)
- Shuyin Xu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yafei Chen
- Xiangya Medical School, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yunjing Li
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Siqi Yang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yimei Lu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Liang Li
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Mei Huang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Mohan Ma
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Wenwen Ou
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Guanyi Lv
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaotian Zhao
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yaqi Qin
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yumeng Ju
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yan Zhang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Lingjiang Li
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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48
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Sun J, Liang K, Chi X, Chen S. Psychometric Properties of the Generalized Anxiety Disorder Scale-7 Item (GAD-7) in a Large Sample of Chinese Adolescents. Healthcare (Basel) 2021; 9:healthcare9121709. [PMID: 34946435 PMCID: PMC8701121 DOI: 10.3390/healthcare9121709] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022] Open
Abstract
Anxiety symptoms are common among adolescents. A well-validated and easy-to-use tool is indispensable to measure and detect anxiety for timely interventions. The Generalized Anxiety Disorder Scale-7 item (GAD-7) is a self-report scale used to measure the severity of anxiety and has been validated in adult populations, but psychometric properties of the GAD-7 remained rarely tested in adolescents. The study aimed to investigate the reliability and validity of the GAD-7 in Chinese adolescents. Sex- and age-specific analyses were conducted in a large sample of adolescents (n = 67,281, aged 10-17 years). Our results showed that the GAD-7 scores were higher in female and older adolescents. The GAD-7 presented good internal consistency and a unidimensional structure across sex- and age-specific groups. The GAD-7 scores were significantly correlated with the scores of the Patient Health Questionnaire-9 item (PHQ-9, a self-reported scale to measure depression symptoms) in all subgroups, indicating acceptable criterion validity. In conclusion, the GAD-7 is a scale with good psychometrics and can serve as a tool for anxiety screening in Chinese adolescents at the populational level.
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Affiliation(s)
- Jiangang Sun
- College of Physical Education, West Anhui University, Lu’An 237012, China;
| | - Kaixin Liang
- School of Psychology, Shenzhen University, Shenzhen 518060, China; (K.L.); (X.C.)
| | - Xinli Chi
- School of Psychology, Shenzhen University, Shenzhen 518060, China; (K.L.); (X.C.)
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia
- Correspondence:
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49
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Pritchard M, Brasil K, McDermott R, Holdiman A. Untangling the associations between generalized anxiety and body dissatisfaction: The mediating effects of social physique anxiety among collegiate men and women. Body Image 2021; 39:266-275. [PMID: 34695680 DOI: 10.1016/j.bodyim.2021.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 09/29/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
Researchers disagree on which types of anxiety influence body dissatisfaction and how gender (cisgender men vs. cisgender women) may impact these associations. Specifically, little is known about how generalized anxiety and social physique anxiety combine to predict body dissatisfaction in men and women. The purpose of the present study was to explore a moderated mediation model in which the relationships between generalized anxiety and body dissatisfaction (drive for thinness and drive for muscularity) were mediated by social physique anxiety and moderated by gender. Data from 423 U.S. college students (n = 259 women) were analyzed using multigroup structural equation modeling. Generalized anxiety was positively associated with social physique anxiety, and this association was significantly stronger for men than for women. Neither social physique anxiety nor generalized anxiety were associated with drive for muscularity. Social physique anxiety was positively and significantly associated with drive for thinness equally for men and women and emerged as a significant mediator. These results highlight gender differences/similarities in body image and suggest drive for thinness and social physique anxiety may have a common factor of generalized anxiety. When helping clients who suffer with body dissatisfaction, clinicians and researchers may wish to focus on generalized anxiety (and not just social physique anxiety).
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Affiliation(s)
- Mary Pritchard
- Boise State University, Department of Psychological Science, 1910 University Dr. Boise, ID83725-1715, USA.
| | - Kyle Brasil
- University of South Alabama, Department of Counseling and Instructional Sciences, University Commons 3600, Mobile, AL 36688, USA
| | - Ryon McDermott
- University of South Alabama, Department of Counseling and Instructional Sciences, University Commons 3600, Mobile, AL 36688, USA
| | - Anna Holdiman
- Boise State University, Department of Psychological Science, 1910 University Dr. Boise, ID83725-1715, USA
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50
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Chrisman SPD, Whelan BM, Zatzick DF, Hilt RJ, Wang J, Marcynyszyn LA, Rivara FP, McCarty CA. Prevalence and risk factors for depression, anxiety and suicidal ideation in youth with persistent post-concussive symptoms (PPCS). Brain Inj 2021; 35:1637-1644. [PMID: 34841998 PMCID: PMC10460267 DOI: 10.1080/02699052.2021.2008490] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 08/05/2021] [Accepted: 11/16/2021] [Indexed: 12/23/2022]
Abstract
Objectives: To assess the prevalence and risk factors for emotional distress in youth with persistent post-concussive symptoms (PPCS) greater than one month.Methods: We used baseline data from an intervention study for youth with PPCS, utilizing Poisson regression to examine factors associated with exceeding clinical cut-points on measures of depression, anxiety, self-harm and suicidal ideation. Predictors included: age, sex, socioeconomic status, mental health history, duration of concussion symptoms, history of prior concussion, trauma history and sleep quality.Results: The sample included 200 youth with PPCS, (mean 14.7 SD 1.7 years, 82% white, 62% female). Forty percent reported clinically significant depressive symptoms, 25% anxiety, 14% thoughts of self-harm and 8% thoughts of suicide. History of depression was associated with 3-fold higher risk for thoughts of self-harm (95% CI:1.82-6.99) and 6-fold higher risk for suicidal ideation (95% CI:1.74-24.46). Better sleep quality was associated with lower risk for all outcomes. History of prior concussion and duration of PPCS were not significantly associated with any outcomes.Conclusions: Suicidal thoughts are common post-concussion, and history of depression is a strong risk factor. Tailored interventions may be needed to address mental health in this population.
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Affiliation(s)
- Sara P. D. Chrisman
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle WA, USA
- Department of Pediatrics, University of Washington Seattle, Washington, USA
| | - Bridget M Whelan
- Department of Pediatrics, University of Washington Seattle, Washington, USA
| | - Douglas F Zatzick
- Department of Psychiatry, University of Washington Seattle, Washington, USA
| | - Robert J Hilt
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle WA, USA
- Department of Psychiatry, University of Washington Seattle, Washington, USA
| | - Jin Wang
- Harborview Injury Prevention and Research Center, University of Washington, Seattle WA, USA
| | - Lyscha A Marcynyszyn
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle WA, USA
| | - Frederick P Rivara
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle WA, USA
- Department of Pediatrics, University of Washington Seattle, Washington, USA
- Harborview Injury Prevention and Research Center, University of Washington, Seattle WA, USA
| | - Carolyn A McCarty
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle WA, USA
- Department of Pediatrics, University of Washington Seattle, Washington, USA
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