Parental divorce is associated with an increased risk to develop mental disorders in women

The role of parental divorce in the later vulnerability to perinatal depression and early parenting stress

OBJECTIVE

This study will examine the role of childhood experience of parental divorce on later perinatal depression and parenting stress.

METHODS

546 women were recruited at less than 20 weeks pregnancy into an ongoing pregnancy cohort study and followed up in pregnancy and the postpartum. Depression at recruitment was measured using the Structured Clinical Interview for the DSM and the Edinburgh Postnatal Depression Scale repeated in pregnancy and the postpartum. Parenting stress was measured at 12 months postpartum using Parenting Stress Index.

RESULTS

This study found 33% of women had experienced parental divorce. While we did not find a statistically significant relationship between the experience of parental divorce and perinatal depression, there was a higher rate of perinatal depression when parental divorce occured at a younger age. There was no association with parental divorce and parenting stress. Childhood divorce was significantly associated with other adverse childhood experiences.

CONCLUSIONS

Our findings did not support an impact of parental divorce on either maternal perinatal depression or on parenting stress, suggesting the experience of parental divorce for children may not inevitably impact their later experiences as parents. Further research on the association with age of parental divorce and later perinatal mental health is warranted.

Pathways Linking Parental Care and Control to Loneliness in Breast Cancer Patients with A History of Childhood Maltreatment: Exploring the Mediating Roles of Ambivalence Over Emotional Expression and Self-Discrepancy

Childhood maltreatment is a risk factor for loneliness and is linked to breast cancer. Parental bonding experienced during one's childhood also plays a significant role in increasing or decreasing the risk of loneliness later in life. Previous research has highlighted the significance of ambivalence over emotional expression (AEE) and self-discrepancy in the psychological adaptation of breast cancer patients, particularly concerning the impact of parental care and control experienced by patients in their relationship with their parents during childhood. Nevertheless, previous studies have not examined the mediating effects of AEE and self-discrepancy on parental care and control, as well as loneliness, in breast cancer patients. This study aimed to investigate whether AEE and self-discrepancy mediate the association of childhood parental care and control with loneliness in breast cancer patients with a history of childhood maltreatment. One hundred and thirty-three breast cancer patients who were receiving chemotherapy within the first 3 months post-diagnosis were recruited from one private and three public hospitals in Tabriz, Iran, to complete questionnaires. Parental bonding, loneliness, AEE, and self-discrepancy were assessed using the Parental Bonding Instrument (PBI), University of California Los Angeles (UCLA) Loneliness Scale, Ambivalence over the Expression of Emotion Questionnaire (AEQ), and Self-Discrepancies Scale (S-DS). Mediation models were tested using structural equation modeling. Effects of parental care (β = -.17, p < .05) and control (β = .21, p < .001) on loneliness were significant. Furthermore, both AEE (β = .19, p < .05) and self-discrepancy (β = .23, p < .01) significantly predicted loneliness. The pathway between parental care and AEE was significant (β = -.21, p < .001), as was the direct effect of parental control on self-discrepancy (β = .19, p < .05). Bootstrapping results showed that AEE significantly mediated the relationship between parental care and loneliness (95% confidence interval [CI] [-0.09, -0.01]). In addition, there was a significant indirect effect from parental control to loneliness via self-discrepancy (95% CI [0.11, 0.01]). These findings suggest that AEE and self-discrepancy could potentially be utilized in preventing or addressing loneliness in breast cancer patients who have a history of childhood maltreatment. Future research could, for example, assess whether integrating psychosocial interventions focusing on these variables as part of medical care can improve the mental health status of this subgroup of breast cancer patients who have experienced childhood maltreatment.

The Association Between Child Maltreatment and Loneliness Across the Lifespan: A Systematic Review and Multilevel Meta-Analysis

While there is evidence that child maltreatment is positively associated with loneliness, the strength of this association is not yet clear. It is also unclear whether the magnitude and statistical significance of this association varies across groups of individuals. Therefore, this meta-analysis examines whether there are differences in loneliness between individuals with and without maltreatment histories, and which factors may influence the association between child maltreatment and loneliness. A three-level meta-analysis was conducted on 52 studies reporting 116 effect sizes (N = 1,705,493; Mage = 30.93; 49.6% females). Results showed a medium overall effect (g = 0.45, p < .001, 95% CI [0.36, 0.53]), indicating that individuals with maltreatment histories, on average, feel lonelier than individuals without maltreatment histories. Moderator analyses showed that effect sizes were larger for emotional abuse and emotional neglect as compared to other types of child maltreatment and decreased when participants were older at the time of loneliness assessment. These findings suggest that individuals with maltreatment histories, especially those who have been emotionally abused and/or emotionally neglected, are vulnerable to experiencing loneliness across the lifespan. The results also suggest that feelings of loneliness warrant attention in prevention and intervention programs for individuals with maltreatment histories.

Patterns of Adverse Childhood Experiences and Problematic Health Outcomes Among US Young Adults: A Latent Class Analysis

INTRODUCTION

Adverse childhood experiences (ACEs) predict problematic health outcomes (eg, substance use, mental health) among young adults; whether specific ACEs are differentially associated with specific substance use and mental health symptoms is understudied.

METHODS

Latent class analysis (LCA) identified classes of ACEs among 2209 US young adults (Mage = 24.69, range: 18-34; 57.4% female; 30.9% sexual minority; 35.8% racial/ethnic minority) in a 2-year study (2018-2020). Multivariable logistic regressions examined ACEs (reported in 2019) in relation to 2020 reports of current (past 30-day) substance use (ie, tobacco use; cannabis use and hazardous use; alcohol use and binge drinking) and mental health (ie, ≥moderate depression and anxiety symptoms), controlling for sociodemographics (ie, age, gender, race, ethnicity, sexual orientation, education).

RESULTS

Overall, 65.4% reported ≥1 ACE (M = 2.09, SD = 2.30); 34.8%, 39.1%, and 71.1% current tobacco, cannabis, and alcohol use; 39.1% and 15.3% hazardous cannabis use and binge drinking; and 24.2% and 34.5% ≥moderate depression and anxiety symptoms, respectively. LCA yielded 4 classes: Low ACEs (referent; 55.6%), Poor family health and divorce (16.3%), Parental abuse (16.0%), and High ACEs (12.1%). High ACEs (vs Low ACEs) was associated with each adverse substance use and mental health outcome except alcohol use. Poor family health and divorce was associated with tobacco use, cannabis use, and both mental health outcomes. Parental abuse was associated with tobacco use, cannabis use, hazardous cannabis use, and both mental health outcomes.

CONCLUSIONS

Health promotion interventions for young adults must assess ACEs, given that certain types of ACEs may be associated with distinct substance use and mental health outcomes.

Association between parental separation, childhood trauma, neuroticism, and depression: a case control study

Background

Parental separation has been suggested to be associated with depression development in offspring. The new family constellation subsequent to separation could be associated with elevated scores of childhood trauma, shaping more emotionally instable personalities. This could ultimately be a risk factor for mood disorders and particularly the development of depression in life.

Methods

To test this hypothesis, we investigated the associations between parental separation, childhood trauma (CTQ) and personality (NEO-FFI) in a sample of N = 119 patients diagnosed with depression and N = 119 age and sex matched healthy controls.

Results

While parental separation was associated with elevated scores of childhood trauma, there was no association between parental separation and Neuroticism. Furthermore, in a logistic regression analysis, Neuroticism and childhood trauma were found to be significant predictors for depression diagnosis (yes/no), but not parental separation (yes/no).

Conclusion

Parental separation might be associated with depression only indirectly via childhood trauma. Childhood trauma or Neuroticism seem more directly related to the development of depression. However, it is worthwhile to install prevention programs helping parents and children to cope with parental separation in order to minimize the impact of separation and associated stressors.

Adverse childhood experiences and pre-pregnancy body mass index in the HUNT study: A population-based cohort study

OBJECTIVE

Investigate the association between adverse childhood experiences and pre-pregnancy body mass index (BMI) in a population-based cohort in Trøndelag county, Norway.

MATERIALS AND METHODS

We linked data from the third (2006-2008) or fourth (2017-2019) survey of the Trøndelag Health Study (HUNT) and the Medical Birth Registry of Norway for 6679 women. Multiple logistic regression models were used to examine the association between adverse childhood experiences and pre-pregnancy BMI. Adverse childhood experiences were self-reported in adulthood and included perceiving childhood as difficult, parental divorce, parental death, dysfunctional family environment, bad childhood memories and lack of support from a trusted adult. Pre-pregnancy BMI was derived from the Medical Birth Registry of Norway or BMI measurement from the HUNT survey conducted within 2 years prior to the woman's pregnancy.

RESULTS

Perceiving childhood as difficult was associated with higher odds of pre-pregnancy underweight (OR 1.78, 95%CI 0.99-3.22) and obesity (OR 1.58, 95%CI 1.14-2.2). A difficult childhood was positively associated with obesity with an adjusted OR of 1.19, 95%CI 0.79-1.81 (class I obesity), 2.32, 95%CI 1.35-4.01 (class II obesity) and 4.62, 95%CI 2.0-10.65 (class III obesity). Parental divorce was positively associated obesity (OR 1.34, 95%CI 1.10-1.63). Bad childhood memories were associated with both overweight (OR 1.34, 95%CI 1.01-1.79) and obesity (OR 1.63, 95%CI 1.13-2.34). Parental death was not associated with pre-pregnancy BMI.

CONCLUSIONS

Childhood adversities were associated with pre-pregnancy BMI. Our results suggest that the positive associations between childhood adversities and pre-pregnancy obesity increased with increasing obesity level.

Social anxiety disorder and childhood adversities in Portugal: Findings from the WHO world mental health survey initiative

Social anxiety disorder (SAD) is one of the most underrecognized and undertreated common mental disorders. This study aimed to describe its epidemiology and to understand the association between childhood adversities and SAD in the context of Portugal's collectivist culture. Data about SAD, childhood adversities, socio-demographic variables were collected from a nationally representative sample using well-validated scales employed for the World Mental Health Survey. Logistic and linear regression models were carried out to explore the association between childhood adversities and SAD prevalence and age of onset. The estimated lifetime prevalence of SAD was 4.68% and the 12-month prevalence was 3.14%. The mean age of onset was 13.6 ± 8.79. People with a college education had 3.42 higher odds of having SAD compared to people with no education or a primary school education. Most childhood adversities significantly increased the odds of a lifetime prevalence of SAD. Parental Maladjustment increased the odds of SAD when gender, age, and education were adjusted. The study findings show a relatively high prevalence of SAD in Portugal and confirms that females, younger people, students, and single people are more likely to have SAD. The study highlights the need to address experiences of parental maladjustment in interventions for people with SAD in Portugal.

Peer Power! Secure Peer Attachment Mediates the Effect of Parental Attachment on Depressive Withdrawal of Teenagers

Adolescents' depressive social withdrawal is a relevant concern for mental health professionals, and it is widespread among community teenagers in form of subclinical symptoms. Different studies suggest that insecure attachment representations increase the adolescents' likelihood to show symptoms of withdrawal (e.g., loneliness). This study explored the effect of the general attachment internal working model (IWM) and the independent and cumulative effects of the specific attachment representations of parents-in terms of secure base/safe haven-and peers on adolescents' withdrawal. Additionally, the mediation of peer attachment on the effect of parental attachment on symptoms was explored. All analyses were conducted controlling for the difference between teenagers living with parents together or divorced/separated, as children of divorcees are considered more exposed to stressors. Ninety-one adolescents aged 12-17 years old were assessed online during the COVID pandemic period, employing the Youth Self-Report to assess withdrawal and the Friends and Family Interview to assess attachment-general IWM and attachment-specific representations. Results show no influence of parents together/separated or of the general IWM on withdrawal, but higher parent secure base/safe haven and peer attachment cumulatively predicted 10-21% less withdrawal. Moreover, more positive peer attachment mediated 61% of the effect of the parental secure attachment on withdrawal, revealing an indirect effect of parental attachment on withdrawal through peer attachment. In conclusion, both parents and peers are influential on adolescent mental health, and fostering positive peer relationships can buffer the effect of dysfunctional family relationships on teenagers' withdrawal.

A Scoping Review of the Factors That Influence Families' Ability or Capacity to Provide Young People With Emotional Support Over the Transition to Adulthood

The transition to adulthood is typically marked by changes in relationships with family members, peers, and romantic partners. Despite this, the family often maintains a prominent role in young adults' lives. A scoping review was conducted to identify the factors that influence families' ability or capacity to provide young people with emotional support during the transition to adulthood, and to understand the gaps in this research area. Title and abstract searches were conducted from January 2007 to February 2021 in multiple databases, including PsycINFO, MEDLINE, and Sociological Abstracts. Fifteen semi-structured interviews were also conducted with stakeholders (professionals from relevant sectors/working within this field). In total, 277 articles were eligible for inclusion in the review. Following data extraction, 19 factors were identified. Factors with the most research (more than 20 articles) included: family proximity or co-residence; mental health; sex or gender differences; and family communication. Factors with less research included: societal context; young person's sexual orientation or gender identity; social networks; and adverse life events. Gaps in the research area were also identified, including methodological issues (e.g., lack of mixed methods and longitudinal study designs), a disproportionate focus on the parent-child relationship, and a lack of contextually situated research. Our findings indicate that future research in this area could benefit from taking an intersectional, multi-method approach, with a focus on the whole family and diverse samples.

Mother-Child and Father-Child Relationships in Emerging Adults from Divorced and Non-Divorced Families

The main aim of this study was to analyze the associations between parental divorce and interparental conflict with the quality of parent-child relationships. Specifically, we analyzed trust, communication and alienation in both father-child and mother-child relationships in a sample of 1078 Spanish emerging adults from divorced and non-divorced families. The interaction between parental divorce and conflict was also analyzed. In support of our expectations, parental divorce was associated with lower trust and communication, along with higher alienation in father-child and mother-child relationships. When interparental conflict was included, parental conflict was more strongly associated with lower trust and communication in mother-child relationships, and higher alienation in both mother-child and father-child relationships. However, parental divorce was still associated with low trust and communication with fathers, when interparental conflict and the interaction between parental divorce and conflict were added. In summation, our results suggest that both parental divorce and conflict should be taken into account in the study of the consequences of family-related stress variables on adult children’s wellbeing. These findings add to the current literature and contribute to better comprehend the effects of parental divorce and conflict on both mother-child and father-child affective relationships in an understudied cultural context. The implications, limitations and future research recommendations are discussed.

Effectiveness of acceptance and commitment therapy (ACT) on emotional regulation and loneliness of divorced women in Iran

Ineffective emotional regulation and loneliness both play a key role in the development of mental disorders. Divorced individuals are particularly predisposed to loneliness in cultures where post-divorce relationships are uncommon or stigmatized. The aim of the present study was to determine the effectiveness of Acceptance and Commitment Therapy (ACT) on the emotional regulation and loneliness of divorced women in Iran, a culture with strong honor values that condemn post-divorce relationships for women leading to increased levels of loneliness and social exclusion in divorced Iranian women. The present study was carried out using a pretest-posttest control group study design. The research sample consisted of 30 divorced women who were randomly assigned to experimental (vs. control) groups. In order to evaluate the variables of interest, the emotional regulation Questionnaire (ERQ) and UCLA Loneliness Scale were used. Divorced women in the experimental group were treated using ACT techniques in eight sessions, each lasting 90 minutes. Results of analysis of covariance showed a significant increase in the adaptive emotional regulation of divorced women in the experimental group after the intervention. In addition, there was a significant reduction in the loneliness of divorced women who received the ACT intervention. We find that the ACT intervention improves emotional regulation and reduces loneliness in divorced women in Iran.

The Mediating Role of Loneliness Between Social Support and Depressive Symptoms Among Chinese Rural Adolescents During COVID-19 Outbreak: A Comparative Study Between Left-Behind and Non-left-behind Students

Introduction: The COVID-19 pandemic has greatly impacted people's life across the globe. In a public health crisis, rural adolescents are more prone to mental health problems. The current study aimed to investigate the prevalence of depressive symptoms among Chinese rural adolescents during the COVID-19 outbreak, and examine the association between perceived social support and depressive symptoms and its underlying mechanisms. Method: Perceived Social Support Scale, UCLA Loneliness Scale, Patient Health Questionnaire-9 were administrated to 826 rural adolescents from Anhui Province, China, amid the COVID-19 crisis. Mackinnon's four-step procedure was employed to examine the mediating effect, while Hayes PROCESS macro was utilized to test the moderated mediation model. Results: The results showed the rate of depressive symptoms among rural adolescents in China was 77.6% during the outbreak of COVID-19. Female left-behind students and non-left-behind students from disrupted families experienced more depressive symptoms (all P < 0.05). Loneliness mediated the association between perceive social support and depressive symptoms and the indirect effect was stronger in left-behind adolescents in comparison to non-left-behind adolescents during the COVID-19 pandemic. Conclusion: Depressive symptoms are extremely prevalent among Chinese rural adolescents during the COVID-19 outbreak, and perceived social support plays a protective role against depressive symptoms. Chinese rural adolescents, especially left-behind students, could benefit from the interventions aimed at enhancing the perceived social support and reducing loneliness during the COVID-19 pandemic.

Parental Separation and Divorce and Adulthood Attachment: The Mediating Role of the Abandonment Schema

This study investigated whether the Abandonment schema mediates the relationship between a history of parental separation or divorce and attachment styles in adulthood. Participants (N = 426; M^age = 30.78 years) completed online measures, using Qualtrics. Results demonstrated that a history of parental separation or divorce was positively associated with anxious and avoidant attachment styles in adulthood. Mediation analyses revealed that the Abandonment schema mediated these relationships (p <.001). This suggests that adults with a history of parental divorce or separation are more likely to report anxious and avoidant attachment styles, and this is partially accounted for by an expectation that they will be abandoned by others. These findings have implications for case formulation and can be used to inform treatment. Schema therapy focused on healing the Abandonment schema could promote attachment security in individuals with a history of parental separation or divorce. For example, limited reparenting (i.e., the therapist seeking to meet the client's unmet emotional needs, within the professional boundaries of the relationship), could be tailored to address the individual's underlying unmet need for security and stability. Further research is needed to advance our understanding of the implications of these findings for treatment.

"It is a matter of life or death": Spotlighting Children in the Context of HIPD as Perceived by Frontline Practitioners

It is a wide consensus that high-intensity parental disputes (HIPD) might result in negative ramifications for children. The current study wishes to advance the knowledge regarding what children undergo during the acute time of the dispute, as portrayed by experienced frontline social workers mandated by the court to intervene with parents and their children in the context of HIPD. Ninety-four social workers participated in ten focus groups and five in-depth interviews. A thorough analysis of the narratives revealed three main themes. The first relates to their tremendous fear for the children's wellbeing, often displayed by the words "burn" and "death." The second theme addresses the practitioners' reflections with respect to the various experiences the children undergo during the acute time of HIPD and their risk assessments. The third theme addresses the practitioners' struggle in identifying how to protect the children during these times. The discussion spotlights the exposure of children to HIPD as a prolonged and chronic risk, with potentially adverse emotional and physical impacts. Key conclusions address the need to advance children's rights and the protection of children in the context of HIPD.

The Relationship between Differentiation of Self and Psychological Adjustment to Separation

Many individuals suffer negative mental health consequences such as anxiety and depression following separation from a romantic partner and/or co-parenting conflict due to divorce. Consequently, treating the psychological aftermath of divorce and partner separation remains a predominant concern for mental health practitioners. According to family systems theory, high interdependence and low differentiation of self are associated with a lessened capacity for managing anxiety or adapting to stressful events since intense emotions may inhibit the ability to cope. To assess the relationship between differentiation of self and psychological adjustment to separation, 84 divorced adults completed an online survey. Multiple regression analysis demonstrated that a model based on fusion with others, I-position, and emotional cutoff was a statistically significant predictor of lonely/negativity. Bivariate correlation analyses confirmed significant linear relationships between fusion with others, lonely/negativity, and co-parenting conflict. No differences between genders were found. There is a continuing need to develop interventions to address the negative consequences of divorce, help reduce emotional suffering, and encourage healthy co-parenting. Individuals struggling with psychological adjustment post-divorce, or those seeking education for managing the psychological effects of divorce and co-parenting, may benefit from counseling strategies that incorporate an assessment of differentiation of self and psychological adjustment to separation.

Adaptation of the Young Adults' Cigarette Dependence (YACD) Scale for the development and validation of the Adolescent Cigarette Dependence Scale (ACDS)

Vulnerable adolescents may lose control over cigarette use within a day or two after smoking their first cigarette, as nicotine dependence (ND) symptoms may appear before actual daily smoking and usually occur at low levels of daily smoking. Moreover, smoking can cause illnesses and promote other types of substance abuse. Therefore, it was deemed essential to adapt the Young Adults' Cigarette Dependence (YACD) Scale to develop and validate the Adolescent Cigarette Dependence Scale (ACDS) in Lebanese adolescents and evaluate whether cumulative cigarette smoking is associated with nicotine dependence and symptoms of dependence. A cross-sectional study was carried out between August and September 2020, during the partial sanitary lockdown imposed by the government to limit COVID-19, coinciding with the summer holidays for most Lebanese. The total sample consisted of 564 community-dwelling adolescents aged 13 to 18. A factor analysis was performed using a varimax rotation. The Kaiser-Meyer-Olkin (KMO) measurement of sampling adequacy and Bartlett's sphericity test were appropriate. The factors retained corresponded to Eigenvalues > 1. Cronbach's alpha value represented the internal consistency of the scale. The Hooked on Nicotine Checklist (HONC) was used to screen for dependence symptoms. All items of the YACD were extracted, except for items 4 (smoking to concentrate at work) and 18 (smoking as a habit), which yielded a three-factor solution (factor 1 = smoking patterns; factor 2 = positive and negative reinforcements; factor 3 = smoking cessation) with Eigenvalues > 1 (variance explained = 56.18%; KMO = 0.784; Bartlett's sphericity test p < 0.001; α_Cronbach = 0.875). The newly generated scale was termed Adolescent Cigarette Dependence Scale (ACDS) and consisted of 19 items. Higher ACDS scores (higher cigarette dependence) were significantly associated with higher HONC scores (higher symptoms of dependence) (rho = 0.647; p < 0.001). Having deceased (B = 8.54) or divorced (B = 4.26) parents and higher cumulative cigarette smoking (B = 0.29) were significantly associated with higher ACDS scores. Higher cumulative cigarette smoking (B = 0.05) was significantly associated with higher HONC scores due to cigarettes. This study could validate a new tool to evaluate nicotine dependence among Lebanese adolescents, the Adolescent Cigarette Dependence Scale (ACDS). This version adapted from the Young Adults' Cigarette Dependence (YACD) Scale is reliable and valuable and correlates well with other scales, such as the HONC. However, further studies are necessary to improve this instrument, adding new questions useful for the diagnosis and evaluation of cigarette dependence.

Negative life events and self-harm among the elderly: Result from a survey of 7070 people aged≥60 in China

PURPOSES

Negative life events have been reported as a risk factor for elderly self-harm. The aim of this study was to examine the relationship between negative life events and self-harm in a large sample of people aged 60 and older, and explore the role of some previously identified influential factors in this relationship.

METHODS

Multi-stage stratified sampling method was used to select the elderly people over 60 years old in Shandong, China. Information were collected through face-to-face interviews. Univariate and multivariable logistic regression were used for initial analysis. Karlson-Holm-Breen (KHB) method was used for mediating effect analysis.

RESULTS

A total of 7070 participants were included in the study, 160 reported they had a history of self-harm (2.3%), 756 reported they had negative life event experience (10.7%). After model adjustment, the association between negative life events, loneliness, economic status and self-harm was still statistically significant. Mediation analysis showed that the association is explained by loneliness (proportion of mediation 48.86%), self-rated economic status (16.13%).

CONCLUSIONS

Negative life events, loneliness and economic status were associated with self-harm among the older adults. Loneliness and economic status may play an intermediary role in the relationship between negative life events and self-harm, especially loneliness. More psychological and social functions intervention strategies and prevention measures on the self-harm of the elderly should be provided for the elderly who have experienced negative life events.

Community Action Package in Iran's Comprehensive Mental and Social Health Services (the SERAJ Program)

Objective: The social component of health plays a significant role in improving the mental health of the people of a district. A national program on providing comprehensive social and mental health services, entitled ‎‎"SERAJ", was developed and piloted in three districts of Iran. The present study aims to determine its model for improving the indicators of the social component of mental health. Method : This study is a system design for which a literature review, interviews with experts, and focused group discussions with stakeholders were used. Results: Community action in promoting the mental health of the districts has three main components: strengthening intersectoral collaboration through the memorandum of understandings (MoU), increasing people's participation by establishing People's Participation House (PPH) with the presence of the representative of current People's network, and social protection of people suffering from mental disorders by establishing the Social Support Unit (SSU) for self-reliance activity. All three components are controlled by the governor and with supervision and technical consult of the health network of the district and stakeholder participation. Conclusion: The model uses the inner capacities of the city instead of creating new structures. The prerequisites for the effective function of the main three components are educating departments, educating members of the PPH, and hiring a social worker at the SSU. The effective measures taken by the departments to reduce the risk factors for mental disorders are dependent on the technical and financial support of relevant organizations at the provincial and national levels.

Subjective social status is an important determinant of perceived stress among adolescents: a cross-sectional study

BACKGROUND

Stress is an increasing public health problem, and the association between stress and subjective social status (SSS) among adolescents has received little attention. SSS in society have shown to be associated with perceived stress, but the association between SSS in school and stress has never been examined. The aim of this study was to explore the association between SSS and perceived stress in Danish adolescent boys and girls.

METHODS

Data was collected in 2017 in frame of The Danish Occupation of Children and Adolescents Cohort (FOCA cohort), where Danish 9th graders (age 15/16) from 1746 schools participated in a survey (4527 girls, 3654 boys, aged 15 to 16 years). SSS in society and SSS in school were the exposure variables, and the level of perceived stress was the outcome variable. Associations between SSS in school and in society separately with perceived stress was analysed using linear regression models stratified by gender and adjusted to social and health-related factors (e.g. neighbourhood safety, home characteristics, grade meaning, homework load, self-rated health, smoking, alcohol consumption).

RESULTS

The mean overall PSS score was 14.7; for girls the score was 16.3, and for boys it was 12.6. The analyses revealed a strong linear association between SSS, in both society and school, and perceived stress. The lower the SSS, the higher perceived stress. The associations were the same for both genders, but girls reported a higher level of stress than did boys.

CONCLUSION

We found that girls reported a higher level of perceived stress than boys. Furthermore, we found a strong association between low SSS in society and especially SSS in school and a high level of perceived stress among Danish adolescents.

Perceived parental support in childhood and adolescence as a tool for mental health screening in students: A longitudinal study in the i-Share cohort

BACKGROUND

Negative events in childhood are associated with increased risk of mental health problems, and evaluation could help identify students at high risk of mental health disorder. However, childhood adversity measures are difficult to implement in routine care. Perceived parental support in childhood and adolescence may be more easily assessed, as it is a rather neutral and non-intrusive question.

METHODS

We retrieved students' health data collected from the French i-Share cohort, in a longitudinal population-based study including 4463 students of 18-24 years of age. Students in this cohort completed a self-reported questionnaire about major psychiatric problems at one-year follow-up.

RESULTS

Among 4463 participants, 26% reported a major mental health problem-including suicidal behavior (17%), major depression (7%), and severe generalized anxiety disorder (15%). Adjusted logistic regression revealed that a lower level of perceived parental support was significantly associated with higher risk of any mental health problem. Compared to students who reported extremely strong perceived parental support, students who perceived no support had a nearly 4-fold higher risk of mental health problems (aOR 3.80, CI 2.81-5.13). Lower levels of perceived parental support were dose-dependently associated with higher incidences of suicidal behavior, major depression, and severe generalized anxiety disorder.

LIMITATIONS

Study limitations included a moderate follow-up response rate, and retrospective self-report questionnaires.

CONCLUSION

Perceived parental support was strongly associated with the incidence of mental health problems among college students. If validated, these results suggest that health professionals should consider using this simple marker to improve mental health risk assessment and screening.