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Scarlett H, Wiernik E, van der Waerden J. Longitudinal trajectories and associated risk factors of paternal mental illness in the nine years surrounding the transition to fatherhood. J Affect Disord 2024; 362:363-374. [PMID: 38986876 DOI: 10.1016/j.jad.2024.07.008] [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: 01/09/2024] [Revised: 06/07/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND The arrival of one's first child is a known risk factor for mental illness, yet investigations on fathers' mental health are limited. We conducted a longitudinal investigation on paternal depression and anxiety in the nine years surrounding the transition to fatherhood. METHODS Using a national cohort of French men (CONSTANCES, n = 6299), we investigated the prevalence and associated risk factors of mental illness amongst first-time fathers. Responses to the Center for Epidemiological Studies Depression (CES-D) and 12-item General Health Questionnaire (GHQ-12) scales were used to identify clinically significant symptom scores. Self-declared mental illness was also reported by participants. Group-based modelling was used to identify latent trajectory groups for both measures. RESULTS Levels of self-declared anxiety (averaging 4.9 % pre-fatherhood, 7.8 % post) exceeded that of depression (1.9 % pre- fatherhood, 3.3 % post) or other disorders. However, rates of clinically significant symptom scores (17-27 %) were consistently higher. Participants' mental health appeared to worsen from two-years prior to their child's arrival and improve from two-years after. We identified three trajectory groups for fathers' self-declared mental illness: Low stable (90.3 %); Low risk with high temporary increase (5.6 %); and Consistent high risk (4.1 %). Risk factors associated with worsening mental health trajectories were unemployment, not living with one's partner, having had adverse childhood experiences and foregoing healthcare due to financial reasons. LIMITATIONS All measures of mental illness relied on participant self-reports and are thus subject to bias. CONCLUSIONS This study reveals an important period of heightened psychological vulnerability amongst first-time fathers, emphasising the need for increased and better adapted paternal mental health screening.
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Affiliation(s)
- Honor Scarlett
- UMR-S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne University, INSERM, Paris, France.
| | - Emmanuel Wiernik
- UMS 011 Population-based Cohorts Unit, Paris Cité University, Paris Saclay University, Versailles Saint-Quentin-en-Yvelines University, INSERM, Paris, France
| | - Judith van der Waerden
- UMR-S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne University, INSERM, Paris, France
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Bisby MA, Barrett V, Staples LG, Nielssen O, Dear BF, Titov N. Things You Do: A randomized controlled trial of an unguided ultra-brief intervention to reduce symptoms of depression and anxiety. J Anxiety Disord 2024; 105:102882. [PMID: 38850775 DOI: 10.1016/j.janxdis.2024.102882] [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: 01/03/2024] [Revised: 05/05/2024] [Accepted: 05/22/2024] [Indexed: 06/10/2024]
Abstract
The 'Things You Do' encompass five types of actions that are strongly associated with good mental health: Healthy Thinking, Meaningful Activities, Goals and Plans, Healthy Habits, and Social Connections. Ultra-brief interventions which increase how often people perform these actions may decrease depression and anxiety. A two-arm randomized controlled trial (N = 349) compared an unguided ultra-brief intervention based on the 'Things You Do' against a waitlist control. The intervention included one online module, two practice guides, and four weeks of daily text messages. The primary timepoint was 5-weeks post-baseline. The intervention resulted in moderate reductions in depression (d = 0.51) and anxiety (d = 0.55) alongside moderate increases in the frequency of Things You Do actions (d = 0.54), compared to controls. No significant change in number of days out of role or life satisfaction were observed. Treatment completion was high (92 %), most participants reported being satisfied with the treatment (66 %), and improvements were maintained at 3-month follow-up. This study demonstrated that an automated ultra-brief 'Things You Do' intervention resulted in clinically significant reductions in depression and anxiety. Ultra-brief interventions may provide a scalable solution to support individuals who are unlikely to engage in longer forms of psychological treatment.
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Affiliation(s)
- Madelyne A Bisby
- eCentreClinic, School of Psychological Sciences, Macquarie University, Australia; MindSpot Clinic, MQ Health, Macquarie University, Australia.
| | | | | | - Olav Nielssen
- MindSpot Clinic, MQ Health, Macquarie University, Australia
| | - Blake F Dear
- eCentreClinic, School of Psychological Sciences, Macquarie University, Australia; MindSpot Clinic, MQ Health, Macquarie University, Australia
| | - Nickolai Titov
- eCentreClinic, School of Psychological Sciences, Macquarie University, Australia; MindSpot Clinic, MQ Health, Macquarie University, Australia
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Ilkevič E, Hausmann M, Grikšienė R. Emotion recognition and regulation in males: Role of sex and stress steroids. Front Neuroendocrinol 2024; 74:101145. [PMID: 38862092 DOI: 10.1016/j.yfrne.2024.101145] [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: 11/23/2023] [Revised: 06/04/2024] [Accepted: 06/07/2024] [Indexed: 06/13/2024]
Abstract
Understanding emotions in males is crucial given their higher susceptibility to substance use, interpersonal violence, and suicide compared to females. Steroid hormones are assumed to be critical biological factors that affect and modulate emotion-related behaviors, together with psychological and social factors. This review explores whether males' abilities to recognize emotions of others and regulate their own emotions are associated with testosterone, cortisol, and their interaction. Higher levels of testosterone were associated with improved recognition and heightened sensitivity to threatening faces. In contrast, higher cortisol levels positively impacted emotion regulation ability. Indirect evidence from neuroimaging research suggested a link between higher testosterone levels and difficulties in cognitive emotion regulation. However, this notion must be investigated in future studies using different emotion regulation strategies and considering social status. The present review contributes to the understanding of how testosterone and cortisol affect psychological well-being and emotional behavior in males.
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Affiliation(s)
- Erik Ilkevič
- Department of Neurobiology and Biophysics, Life Science Center, Vilnius University, Lithuania
| | | | - Ramunė Grikšienė
- Department of Neurobiology and Biophysics, Life Science Center, Vilnius University, Lithuania.
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Seidler ZE, Benakovic R, Wilson MJ, McGee MA, Fisher K, Smith JA, Oliffe JL, Sheldrake M. Approaches to Engaging Men During Primary Healthcare Encounters: A scoping review. Am J Mens Health 2024; 18:15579883241241090. [PMID: 38606788 PMCID: PMC11010769 DOI: 10.1177/15579883241241090] [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: 09/04/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 04/13/2024] Open
Abstract
Gender-responsive healthcare is critical to advancing men's health given that masculinities intersect with other social determinants to impact help-seeking, engagement with primary healthcare, and patient outcomes. A scoping review was undertaken with the aim to synthesize gender-responsive approaches used by healthcare providers (HCPs) to engage men with primary healthcare. MEDLINE, PubMed, CINAHL, and PsycINFO databases were searched for articles published between 2000 and February 2024. Titles and abstracts for 15,659 citations were reviewed, and 97 articles met the inclusion criteria. Data were extracted and analyzed thematically. Thirty-three approaches were synthesized from across counseling/psychology, general practice, social work, nursing, psychiatry, pharmacy, and unspecified primary healthcare settings. These were organized into three interrelated themes: (a) tailoring communication to reach men; (b) purposefully structuring treatment to meet men's health needs, and (c) centering the therapeutic alliance to retain men in care. Strength-based and asset-building approaches focused on reading and responding to a diversity of masculinities was reinforced across the three findings. While these approaches are recommended for the judicious integration into health practitioner education and practice, this review highlighted that the evidence remains underdeveloped, particularly for men who experience health inequities. Critical priorities for further research include intersectional considerations and operationalizing gender-responsive healthcare approaches for men and its outcomes, particularly at first point-of-contact encounters.
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Affiliation(s)
- Zac E. Seidler
- Movember, Melbourne, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ruben Benakovic
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael J. Wilson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Krista Fisher
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - James A. Smith
- Rural and Remote Health, College of Medicine and Public Health, Flinders University, Darwin, Northern Territory, Australia
| | - John L. Oliffe
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
- Department of Nursing, The University of Melbourne, Parkville, Victoria, Australia
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Opozda MJ, Oxlad M, Turnbull D, Gupta H, Smith JA, Ziesing S, Nankivell ME, Wittert G. Facilitators of, barriers to, and preferences for e-mental health interventions for depression and anxiety in men: Metasynthesis and recommendations. J Affect Disord 2024; 346:75-87. [PMID: 37949238 DOI: 10.1016/j.jad.2023.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Little is known about men's use of online mental health (eMH) interventions and factors that promote their engagement or attrition. We aimed to synthesise the qualitative literature on men's preferences for, attitudes towards, and experiences of using eMH interventions for depression and anxiety, and develop recommendations from the findings. METHOD Systematic searches were conducted (Jan 2000-Oct 2020) in six databases; study quality was assessed using Qualsyst with a minimum total of 0.55 required for inclusion. Extracted data were synthesised using meta-aggregation. RESULTS Eight studies met inclusion criteria and three synthesised findings were generated. (1) Facilitators of men's eMH use: finding apps and technology motivating and convenient, support and encouragement from important others, and interventions allowing men to take action, gain control over their mental health, and resulting in positive outcomes; (2) Barriers to men's eMH use: lack of free time, predicted or experienced lack of benefit from use, and technical difficulties; (3) What men want in eMH: personalised, tailored, relevant interventions that are bright and easy to use, with information presented in multiple formats, psychoeducation, exercises, self-monitoring, information on further resources, and the option of clinician involvement, without any repetitive questioning, boring tools, or negative feedback. LIMITATIONS All included studies were conducted in high income, 'Western' countries; most data related to experiences of using an existing eMH intervention within a trial, rather than in 'real world' settings where eMH acceptability is generally lower and experiences may differ. CONCLUSIONS Practice, research, and policy recommendations are presented.
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Affiliation(s)
- Melissa J Opozda
- Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia.
| | - Melissa Oxlad
- Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia; School of Psychology, University of Adelaide, Adelaide, Australia
| | - Deborah Turnbull
- Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia; School of Psychology, University of Adelaide, Adelaide, Australia
| | - Himanshu Gupta
- Rural and Remote Health, College of Medicine and Public Health, Flinders University, Darwin, Australia
| | - James A Smith
- Rural and Remote Health, College of Medicine and Public Health, Flinders University, Darwin, Australia
| | - Samuel Ziesing
- Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Murray E Nankivell
- Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Gary Wittert
- Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
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Carrier JD, Gallagher F, Vanasse A, Roberge P. Demand management processes to improve access to cognitive-behavioral therapies for anxiety disorders: a grounded theory study. FRONTIERS IN HEALTH SERVICES 2024; 3:1266987. [PMID: 38274712 PMCID: PMC10808741 DOI: 10.3389/frhs.2023.1266987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024]
Abstract
Introduction Anxiety disorders are impactful mental health conditions for which evidence-based treatments are available, notably cognitive-behavioral therapies (CBTs). Even when CBTs are available, demand-side factors limit their access, and actors in a position to perform demand management activities lack a framework to identify context-appropriate actions. Methods We conducted a constructivist grounded theory study in Quebec, Canada, to model demand management targets to improve access to CBTs for anxiety disorders. We recruited key informants with diverse experiences using purposeful, then theoretical sampling. We analyzed data from 18 semi-directed interviews and 20 documents through an iterative coding process centered around constant comparison. Results The resulting model illustrates how actors can target clinical-administrative processes fulfilling the demand management functions of detection, evaluation, preparation, and referral to help patients progress on the path of access to CBTs. Discussion Modeling clinical-administrative processes is a promising approach to facilitate leveraging the competency of actors involved in demand management at the local level to benefit public mental health.
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Affiliation(s)
- Jean-Daniel Carrier
- PRIMUS Research Group, Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Psychiatry, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Frances Gallagher
- School of Nursing, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du CHUS, Sherbrooke, QC, Canada
| | - Alain Vanasse
- PRIMUS Research Group, Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du CHUS, Sherbrooke, QC, Canada
| | - Pasquale Roberge
- PRIMUS Research Group, Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Psychiatry, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du CHUS, Sherbrooke, QC, Canada
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7
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Montiel C, Bedrossian N, Kramer A, Myre A, Piché A, McDonough MH, Sabiston CM, Petrella A, Gauvin L, Doré I. Barriers and facilitators of supportive care access and use among men with cancer: a qualitative study. J Cancer Surviv 2023:10.1007/s11764-023-01467-1. [PMID: 37853270 DOI: 10.1007/s11764-023-01467-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/13/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE Men diagnosed with cancer are underrepresented in existing supportive care programming and related research, with preliminary indications that men face unique challenges in accessing and engaging with such services. This study aims to identify barriers and facilitators related to the supportive care service access and use among men diagnosed with cancer. METHODS From March to May 2021, thirty-one Quebec men (Mage = 52.7, range:(26-82 years) diagnosed with various cancer types were recruited to take part in individual telephone interviews (n = 14) or online focus groups (n = 17) addressing experiences of cancer supportive care services. Content analysis of qualitative data was performed. RESULTS Barriers and facilitators to men's supportive care access and use were grouped into four categories: (1) alignment between services and men's needs and preferences; (2) delivery of services in an accessible, inclusive, and responsive way; (3) communication and promotion of services in ways that are acceptable, appealing, and attractive to men; and (4) social norms and perceptions of gender and masculinity affecting men's perceptions of and engagement with services. CONCLUSIONS Barriers and facilitators influencing access and use of supportive care services in men are numerous and diverse. These findings may inform the development of new and the adaptation of current supportive care strategies to better address men's needs and preferences after a cancer diagnosis. IMPLICATIONS FOR CANCER SURVIVORS Increased adequacy of services tailored to men's needs and preferences, with an emphasis on supporting men to take an active role in their recovery, could improve access and adherence to care. Services adopting a more integrated, patient-centered, and holistic approach to service delivery could positively impact the cancer care trajectory and health outcomes of men. Larger systemic changes may be needed to support men in engaging in currently existing activities and services.
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Affiliation(s)
| | | | | | | | - Alexia Piché
- Centre de Recherche du CHUM, Montréal, QC, Canada
- Université de Montréal, QC, Montréal, Canada
| | | | | | - Anika Petrella
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Lise Gauvin
- Centre de Recherche du CHUM, Montréal, QC, Canada
- Université de Montréal, QC, Montréal, Canada
| | - Isabelle Doré
- Centre de Recherche du CHUM, Montréal, QC, Canada.
- Université de Montréal, QC, Montréal, Canada.
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Kagan M, Mahat-Shamir M. The mediating role of self-compassion and the moderating role of restrictive emotionality in gender role discrepancy and depression. Heliyon 2023; 9:e19606. [PMID: 37681183 PMCID: PMC10480626 DOI: 10.1016/j.heliyon.2023.e19606] [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: 09/29/2022] [Revised: 07/24/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023] Open
Abstract
Masculine gender role discrepancy is men's perception of themselves as people who fail to conform to traditional masculine norms. There is solid scientific evidence that gender role discrepancy is related to grave mental health outcomes such as depression. Yet, the mechanisms that explicate the relationship between masculine gender role discrepancy and masculine depression remain unclear. As individual differences in men are suggested to be associated with depression, the current study aimed to examine the mediating role of self-compassion and the moderating role of restrictive emotionality in the association between masculine gender role discrepancy and masculine depression. For the purpose of the current study, a structured questionnaire was distributed through online means, resulting in a sample of 954 men aged 18 and older. The results revealed that self-compassion partially mediates the relationship between gender role discrepancy and masculine depression. Moreover, a positive effect of gender role discrepancy on masculine depression was found to be more pronounced at higher levels of restrictive emotionality. The contemporary empirical evidence underscores the significance of individual variances in adhering to conventional masculine gender norms concerning the nexus between gender role discrepancy and masculine depression. Moreover, this research accentuates the salience of gender role matters in shaping the mental well-being of men.
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Affiliation(s)
- Maya Kagan
- School of Social Work, Ariel University, Kiryat Hamada, Ariel, Israel
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9
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Sharp P, Zhu P, Ogrodniczuk JS, Seidler ZE, Wilson MJ, Fisher K, Oliffe JL. "Hey Amir, How Are You REALLY Doing?": Participant Perspectives of a Peer-Based Suicide Prevention Campaign for Men. Am J Mens Health 2023; 17:15579883231209189. [PMID: 37904538 PMCID: PMC10619351 DOI: 10.1177/15579883231209189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 11/01/2023] Open
Abstract
Suicide is a major public health concern and leading cause of death among men in Canada. This study reports the feasibility and acceptability of Buddy Up, a peer-based suicide prevention campaign for men. A mixed-methods approach was used to analyze respondent survey questionnaires (n = 48) and individual participant interviews (n = 19) collected from campaign users. Survey respondents reported that they enjoyed their involvement in the campaign (92%), were more confident to talk with men about mental health and suicide (95%), and would recommend Buddy Up to others (95%). Qualitative interviews were thematically analyzed to develop three inductively derived themes: (a) Engaging men with relatable masculine content and design: "Buddy Up really spoke to them in their language," highlighting the importance of understanding and working with gendered practices and motivations to legitimize and motivate involvement in suicide prevention; (b) Leveraging campaign participation to initiate conversations and promote mental health: "It gives men language and license to start asking questions," revealing ways in which participants utilized Buddy Up to negotiate and norm checking-in to promote men's mental health; and (c) Driving new masculine cultures: "We start every meeting with a mental health moment," identifying how participants fostered healthy milieus for disclosing mental health challenges with teamwork and preventive action under the banner of Buddy Up. The study findings support the feasibility of Buddy Up and highlight the acceptability of peer-based approaches to mental health promotion. The findings can also empirically guide future efforts for systematically building men's peer-based suicide prevention programs.
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Affiliation(s)
- Paul Sharp
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | - Patricia Zhu
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada
| | - John S. Ogrodniczuk
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | - Zac E. Seidler
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Movember, Melbourne, VIC, Australia
| | - Michael J. Wilson
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Krista Fisher
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - John L. Oliffe
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada
- Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia
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10
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Fisher K, Rice SM, Oliffe JL, King K, Seidler ZE. Young men and anxiety: Resisting, reckoning and responding. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:1462-1482. [PMID: 37032499 DOI: 10.1111/1467-9566.13641] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
Anxiety is the most prevalent mental disorder experienced by young men, and when untreated, is predictive of co-morbid mental health challenges and suicide. Despite the rising prevalence, there is a conspicuous absence of qualitative research to distil and theorise young men's anxiety. Twenty-five young Australian men (15-25 years), who had been diagnosed with an anxiety disorder or self-reported anxiety symptoms, took part in individual semi-structured interviews. Interviews were transcribed verbatim and analysed using a constructivist grounded theory approach. A three-process grounded theory (Resisting-Reckoning-Responding; Triple R Anxiety Model) depicted young men's experiences of anxiety, gilded and guided by their masculine socialisation. Initially, young men noticed somatic symptoms (i.e., headaches, nausea and myalgia) but did not connect these symptoms to anxiety. Avoiding anxiety (e.g., denying, distracting) proved unhelpful in the longer term and as symptoms diffused, a subsequent process of reckoning anxiety (i.e., meaning making) ensued. As young men gained insight to the life limiting bounds of their anxiety, some were prompted towards actions of acceptance, seeking help proactively and employing strength-based adaptive coping strategies. This theoretical conceptualisation of young men's anxiety has the capacity to enhance identification and treatment efforts, improving young men's mental health outcomes across the lifespan.
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Affiliation(s)
- Krista Fisher
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Simon M Rice
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - John L Oliffe
- University of British Columbia, Vancouver, British Columbia, Canada
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kylie King
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Zac E Seidler
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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11
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Papadopoulos N, Prokopakis EP, Karatzanis AD, Linardakis M, Mourellou E, Symvoulakis EK. Features of ENT Cases in the Emergency Department of a Tertiary Hospital in Greece: A Prospectively Driven Data Collection Study. Healthcare (Basel) 2023; 11:1943. [PMID: 37444776 DOI: 10.3390/healthcare11131943] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
Primary healthcare is the pillar of a well-functioning healthcare system. General practitioners (GPs) should have a broad skillset to cope with the various conditions they encounter in everyday practice. Ear, nose, and throat (ENT) cases are some of the most common reasons for seeking care. The study aimed to define the frequency and type of ENT disorders seen in the emergency department of a tertiary hospital in Greece. All patients examined by an ENT specialist in the emergency department setting, within a year, were recorded, as well as all referrals from private practice or primary care facilities. From September to December 2021, data were collected from patients who agreed to complete a two-minute survey, namely, the Generalized Anxiety Disorder Scale (GAD-2) questionnaire. During the study year, 4542 cases were documented, from which the most common conditions listed were external otitis (6.9%/314), epistaxis (6.7%/305), and impacted earwax (5.7%/261). The diagnoses that led to hospitalization were 336 and the most common were peritonsillar abscess (16.4%/55), epistaxis (8.0%/27), and facial nerve paralysis (7.4%/25). Referrals from GPs working in the public sector represented more than the half of the total. There was a significant correlation between an increased number of hospital visits and an increased GAD-2 score, in the semester before the current visit (p < 0.001). Referrals to ENT specialists represent around 5% of all cases examined, and about 8% of all visits required hospitalization. Interdisciplinary clinical and research investment into GP training is compulsory to regulate ENT referrals by GPs.
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Affiliation(s)
- Nikolaos Papadopoulos
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Voutes, 71003 Heraklion, Greece
| | - Emmanuel P Prokopakis
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Alexander D Karatzanis
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Manolis Linardakis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Voutes, 71003 Heraklion, Greece
| | - Evangelia Mourellou
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Voutes, 71003 Heraklion, Greece
| | - Emmanouil K Symvoulakis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Voutes, 71003 Heraklion, Greece
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12
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Syakiylla Sayed Daud SN, Sudirman R, Wee Shing T. Safe-level SMOTE method for handling the class imbalanced problem in electroencephalography dataset of adult anxious state. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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13
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Lundgren J, Thiblin E, Lutvica N, Reuther C, Farrand P, Woodford J, von Essen L. Concerns experienced by parents of children treated for cancer: A qualitative study to inform adaptations to an internet-administered, low-intensity cognitive behavioral therapy intervention. Psychooncology 2023; 32:237-246. [PMID: 36447354 PMCID: PMC10107313 DOI: 10.1002/pon.6074] [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: 06/22/2022] [Revised: 10/25/2022] [Accepted: 11/22/2022] [Indexed: 12/02/2022]
Abstract
OBJECTIVE Childhood cancer treatment completion is associated with mental health difficulties and negative socioeconomic consequences for parents. However, psychological support needs are often unmet. We developed an internet-administered, guided, low-intensity cognitive behavioral therapy-based self-help intervention (EJDeR) and examined feasibility and acceptability with a single-arm feasibility trial (ENGAGE). Results suggest EJDeR is acceptable, however, adherence, especially for fathers, could be improved. Following the Medical Research Council complex interventions framework, this study explores concerns experienced by parents actively seeking support related to their child's cancer who were recruited into ENGAGE to inform further adaptation of EJDeR. METHOD Seventy-three semi-structured interviews (26 fathers, 47 mothers) were conducted, with data analyzed using manifest content analysis. RESULTS Analysis resulted in seven categories: (1) Feeling lost and lonely in life; (2) Low mood; (3) Parenting difficulties; (4) Productivity difficulties; (5) Relationship challenges; (6) Stress reactions; and (7) Worry. With the exception of subcategories Afraid of not being a good parent, Cancer recurrence, and Child's development and future a somewhat higher percentage of mothers than fathers mentioned all identified concerns. CONCLUSION Parents described experiencing a range of concerns after their child had completed cancer treatment. EJDeR will be adapted to address these concerns and include indirect intervention modules targeting concerns such as stress. Information to support parenting, relationships, finance, and employment difficulties, alongside signposting to inform help-seeking, will be included. Findings also suggest a need to improve the gender-sensitivity of EJDeR.
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Affiliation(s)
- Johan Lundgren
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Ella Thiblin
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Nina Lutvica
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Christina Reuther
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Paul Farrand
- Clinical Education, Development, and Research (CEDAR), Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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14
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Men’s anxiety, why it matters, and what is needed to limit its risk for male suicide. DISCOVER PSYCHOLOGY 2022. [PMCID: PMC8895358 DOI: 10.1007/s44202-022-00035-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractAnxiety disorders are the most prevalent mental health disorder experienced by men. If left untreated, anxiety is predictive of psychiatric disorders including depression and associated suicide risk. Despite the prevalence and impact of men’s anxiety, it remains largely overlooked in the field of men’s mental health. Globally, men are reported to have lower rates of anxiety disorders compared to women; however, these sex-differences do not reflect the complexity and nuance of men’s experiences. There is early evidence to suggest a male-type anxiety phenotype which may go undetected with generic diagnostic classifications. Masculine norms (i.e., stoicism, toughness, invulnerability) appear to be central to men’s experiences and expressions of anxiety as well as men’s help-seeking and coping behaviours. This is particularly concerning given anxiety increases men’s risk of physical and psychological comorbidities and suicide risk. The effective assessment, detection and treatment of men’s anxiety is therefore critical to improve mental health outcomes across the male lifespan. We propose three key recommendations for the field of men’s anxiety: (i) to develop a theoretical model surrounding men’s experiences of anxiety, (ii) broaden mental health resources, interventions and suicide prevention strategies to encompass men’s gendered experiences of anxiety (e.g., sentiments of shame, physical symptom manifestation), and (iii) utilise informal supports (i.e., friends and family) as an avenue of intervention to improve men’s anxiety outcomes. Without a substantial research agenda in men’s anxiety, we will fail to recognise and respond to men’s gendered experiences of anxiety and ultimately fail to reduce male suicides.
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15
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Bell E, Pooley A, Tam P, Boyce P, Bryant R, Porter R, Malhi GS. A novel exploration of irritability in adolescent males: A preliminary study. Australas Psychiatry 2022:10398562221141362. [PMID: 36421033 DOI: 10.1177/10398562221141362] [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] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Irritability is a key symptom of mood disorders and is common in adolescence; nevertheless, it is poorly understood and assessed. Research examining irritability and its relationship to mood and anxiety disorders risk factors in adolescent males is lacking. Therefore, the current study aimed to address this gap. METHOD An online survey designed to interrogate the relationship between irritability and other risk factor variables was administered to 627 adolescent males (ages 12-17). Findings were analysed statistically using MANOVAs. RESULTS When divided into high and low irritability groups, higher irritability scores were significantly correlated with higher scores on all risk factor variables. Further, higher irritability scores were associated with higher scores on all variables that indicate an increased risk for development of psychological disorders, such as depression and anxiety. CONCLUSION This study is the first to focus on subjective irritability. In adolescent males, it identifies a potentially novel model of irritability's involvement in maladaptive processes relating to emotional dysregulation, behavioural difficulties and anxiety.
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Affiliation(s)
- Erica Bell
- Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, 4334The University of Sydney, Sydney, NSW, Australia.,CADE Clinic and Mood-T, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Amanda Pooley
- Research Institute for Children and Adolescents, Wahroonga, NSW, Australia
| | - Philip Tam
- Child and adolescent psychiatrist and researcher in private practice.,Co-founder of Network for Internet Investigation and Research in Australia (NIIRA)
| | - Philip Boyce
- Discipline of Psychiatry, Sydney Medical School, Faculty of Medicine and Health, 4334University of Sydney, Sydney, NSW, Australia
| | - Richard Bryant
- School of Psychology, 7800University of New South Wales, Sydney, NSW, Australia
| | - Richard Porter
- Department of Psychological Medicine, 2495University of Otago, New Zealand
| | - Gin S Malhi
- Academic Department of Psychiatry, Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, 4334The University of Sydney, Sydney, NSW, Australia.,CADE Clinic and Mood-T, Royal North Shore Hospital, Sydney, NSW, Australia.,Visiting Professor, Department of Psychiatry, 6396University of Oxford, UK
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16
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Farhane-Medina NZ, Luque B, Tabernero C, Castillo-Mayén R. Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review. Sci Prog 2022; 105:368504221135469. [PMID: 36373774 PMCID: PMC10450496 DOI: 10.1177/00368504221135469] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
Background: The prevalence and comorbidity of anxiety disorders are significantly different between women and men, with research showing a greater impact on women. The aim of this review was to identify the psychosocial and biological factors that have been considered to explain this gender and sex difference in prevalence and determine whether these factors are related to any anxiety comorbidity differences between men and women. Methods: Following the PRISMA guidelines, we carried out a systematic review of studies published between 2008 and 2021 in PsycINFO and PubMed databases. Empirical and review studies evaluating psychosocial and biological factors that could influence the difference in prevalence and comorbidity between men and women were included. A qualitative narrative synthesis was performed to describe the results. Results: From 1012 studies, 44 studies were included. Retrieved articles were categorized depending on their object of study: psychosocial factors (n = 21), biological factors (n = 16), or comorbidity (n = 7). Results showed that differences in anxiety between women and men have been analyzed by psychosocial and biological factors but rarely together. Among the psychosocial factors analyzed, masculinity may be a protective factor for anxiety development, while femininity can be a risk factor. In the studies that took biological factors into account, the potential influence of brain structures, genetic factors, and fluctuations in sexual hormones are pointed out as causes of greater anxiety in women. Concerning comorbidity, the results noted that women tend to develop other internalizing disorders (e.g. depression), while men tend to develop externalizing disorders (e.g. substance abuse). Conclusions: For an accurate understanding of differences between women and men in anxiety, both biological and psychosocial factors should be considered. This review highlights the need to apply the biopsychosocial model of health and the gender perspective to address differences in anxiety between sexes.
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Affiliation(s)
- Naima Z. Farhane-Medina
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
- Department of Psychology, University of Cordoba, Cordoba, Spain
| | - Bárbara Luque
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
- Department of Psychology, University of Cordoba, Cordoba, Spain
| | - Carmen Tabernero
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
- Institute of Neuroscience of Castilla y León (INCYL), University of Salamanca, Salamanca, Spain
| | - Rosario Castillo-Mayén
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
- Department of Psychology, University of Cordoba, Cordoba, Spain
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17
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Trail K, Wilson MJ, Rice SM, Hunt T, Pirkis J, Seidler ZE. "I Called When I Was at My Lowest": Australian Men's Experiences of Crisis Helplines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159143. [PMID: 35897513 PMCID: PMC9332851 DOI: 10.3390/ijerph19159143] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 01/09/2023]
Abstract
Background: Helplines are an accessible form of support for people struggling with difficulties in their lives and are key services in suicide prevention and intervention. Men’s experiences of telephone helplines are not well understood, despite high male suicide rates. Methods: We conducted an online cross-sectional survey with N = 684 Australian men (aged 17–83 years, M = 50.13) using open- and closed-ended questions about their experiences of helplines during the COVID-19 pandemic. Descriptive statistics were analysed to investigate differences between men using and not using helplines. Qualitative responses were analysed using thematic analysis. Results: Within the sample, 100 men (14.6%) had used a helpline service. Men using helplines were more likely to be unemployed and in younger age brackets than those not using helplines. They were also more likely to report experiencing stressors related to COVID-19, including financial stress and job loss, perceived impact on mental health and relationship breakdown. Qualitative analysis indicated varied experiences of helplines, with men shedding light on how their interaction with a counsellor, the structure of services and their expectations of the service impacted their experience. Conclusions: Further in-depth qualitative enquiry in this space is required, with the objective of understanding how helpline services may seek to better engage with male callers.
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Affiliation(s)
- Katherine Trail
- Orygen, Parkville, VIC 3052, Australia; (M.J.W.); (S.M.R.); (Z.E.S.)
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC 3010, Australia
- Correspondence:
| | - Michael J. Wilson
- Orygen, Parkville, VIC 3052, Australia; (M.J.W.); (S.M.R.); (Z.E.S.)
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Simon M. Rice
- Orygen, Parkville, VIC 3052, Australia; (M.J.W.); (S.M.R.); (Z.E.S.)
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Tara Hunt
- Lifeline Research Foundation, Lifeline Australia, Sydney, NSW 2000, Australia;
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Zac E. Seidler
- Orygen, Parkville, VIC 3052, Australia; (M.J.W.); (S.M.R.); (Z.E.S.)
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC 3010, Australia
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18
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Jenkins CR, Boulet LP, Lavoie KL, Raherison-Semjen C, Singh D. Personalized Treatment of Asthma: The Importance of Sex and Gender Differences. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:963-971.e3. [PMID: 35150902 DOI: 10.1016/j.jaip.2022.02.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/18/2022] [Accepted: 02/03/2022] [Indexed: 12/19/2022]
Abstract
An individual's sex (nominally male or female, based on biological attributes) and gender (a complex term referring to socially constructed roles, behaviors, and expressions of identity) influence the clinical course of asthma in several ways. The physiologic development of the lungs and effects of sex hormones may explain why more boys than girls have asthma, and after puberty, more women than men have asthma. Female sex hormones have an impact throughout the life span and are associated with poor asthma control. Gender may influence exposure to asthma triggers, and sex and gender can influence the prevalence of comorbidities and interactions with health care professionals. Despite widely reported sex- and gender-based differences in asthma and asthma management, these issues frequently are not considered by health care professionals. There is also inconsistency regarding the use of "sex" and "gender" in scientific discourse; research is needed to define sex- and gender-based differences better and how they might interact to influence asthma outcomes. This review outlines the impact an individual's sex and gender can have on the pathogenesis, clinical course, diagnosis, treatment, and management of asthma.
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Affiliation(s)
| | | | - Kim L Lavoie
- Department of Psychology, University of Québec at Montreal and Montreal Behavioural Medicine Centre, CIUSSS-NIM, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
| | - Chantal Raherison-Semjen
- Centre Hospitalier Universitaire de Guadeloupe, Guadeloupe, France; INSERM U1219, EpiCene Team, University of Bordeaux, Bordeaux, France
| | - Dave Singh
- University of Manchester, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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