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Neelakantan L, Fry D, Florian L, Silion D, Filip M, Thabeng M, Te K, Sunglao JA, Lu M, Ward CL, Baban A, Jocson RM, Peña Alampay L, Meinck F. "We don't know how to talk": Adolescent meaning making and experiences of participating in research on violence in Romania, South Africa, and the Philippines. CHILD ABUSE & NEGLECT 2024:106931. [PMID: 38972820 DOI: 10.1016/j.chiabu.2024.106931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 06/02/2024] [Accepted: 06/28/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Current evidence on adolescent participation in violence research has primarily measured distress, harm or upset using quantitative methods. There are relatively few studies which have employed qualitative methods to understand adolescent emotional experiences, and to articulate the experiences of participation from their own perspective. OBJECTIVE This study aimed to assess adolescents' experiences of participating in research on violence in different contexts, namely Romania, South Africa, and the Philippines. METHODS A purposive sample of adolescents (N = 53, 51 % female) were recruited from rural, urban, and peri-urban areas in Romania, the Eastern Cape Province of South Africa, and Metro Manila, Philippines. Semi-structured one-on-one in-depth interviews and drawings sought adolescent perspectives on their experiences of participation, including the emotions they felt, and their perceptions of research on violence. RESULTS Drawing on analysis of interviews and drawings, adolescents reported a layered emotional experience, ranging from sadness, anger, apprehension, and upset, to joy, relief, and laughter. Their emotional experiences were driven by participation as a relational encounter, both with the researchers involved, as well as with other children and young people they encountered. Adolescents emphasized participation as enabling disclosure of difficult experiences, and the creation of awareness of violence. CONCLUSIONS Adolescent perspectives of participation in research on violence are nuanced and encompass their lived experience as well as the fundamentally relational nature of participation. Adolescents experienced increased awareness of topics in violence and perceived research participation as enabling disclosure and possible help-seeking. Measures of participation impact developed along with adolescents, which reflect this complexity, are needed.
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Affiliation(s)
- Lakshmi Neelakantan
- Population Mental Health Unit, Centre for Mental Health and Community Wellbeing, School of Population and Global Health, University of Melbourne, Australia.
| | - Deborah Fry
- Childlight - Global Child Safety Institute, Moray House School of Education and Sport, University of Edinburgh, UK.
| | - Lani Florian
- Moray House School of Education and Sport, University of Edinburgh, UK.
| | - Doriana Silion
- Department of Psychology, Babes-Bolyai University, Romania
| | - Madalina Filip
- Department of Psychology, Babes-Bolyai University, Romania
| | | | - Kathlyn Te
- Department of Psychology, Ateneo de Manila University, Philippines
| | | | - Mengyao Lu
- Childlight - Global Child Safety Institute, Moray House School of Education and Sport, University of Edinburgh, UK.
| | - Catherine L Ward
- Department of Psychology & Safety and Violence Initiative, University of Cape Town, South Africa.
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Romania
| | - Rosanne M Jocson
- National Institute of Education, Nanyang Technological University, Singapore.
| | | | - Franziska Meinck
- School of Social and Political Science, University of Edinburgh, UK; OPTENTIA, Faculty of Health Sciences, North-West University, Vanderbijlpark, South Africa; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
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Peters S, Cook L, Littlewood D, Awenat Y, Drake R, Gill J, Gorton A, Haddock G, Harris K, Hozhabrafkan K, Huggett C, Kirby L, Pratt D, Gooding P. A systematic investigation of the short and long term experiences of taking part in research about suicidal thoughts and acts in the context of a randomised controlled trial. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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3
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Lannen P, Bombach C, Sticca F, Simoni H, Jenni OG. The LifeStories project: Empowering voices and avoiding harm—Ethics protocol of a long-term follow-up study of individuals placed in infant care institutions in Switzerland. Front Psychol 2022; 13:1032388. [DOI: 10.3389/fpsyg.2022.1032388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/04/2022] [Indexed: 11/19/2022] Open
Abstract
Little empirical data exist to guide ethical decisions when conducting research with vulnerable populations. The current study assesses a protocol designed to mitigate risks in a population-based cohort of 246 individuals placed in care institutions as infants in a non-selective 60-year follow-up. In total, 116 (47%) individuals chose to participate, of whom 53 (55%) reported positive effects of participation such as the opportunity to fill some gaps in their life stories, to better deal with their past, and to understand previous family dynamics. Only three individuals (2.5%) explicitly reported negative short-term consequences such as feeling upset as a result of thinking about stressful times, but they nonetheless rated the usefulness of the study as high. For six participants (5%), psychological counseling sessions were initiated as a support measure. Our findings suggest that risk of harm can be managed with a rigorous ethics protocol when conducting research with a vulnerable cohort and therefore enable the voices of survivors to be heard. A step wise approach in which increasing amounts of information were presented at each step, clearly operationalized passive decline, and direct and consistent contact with highly trained staff were considered key to mitigating distress.
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4
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Siller L, Edwards KM, Herrington R, Bordeaux S, Charge LL, Charge DL. Reactions to Participating in Sexual and Dating Violence Research Among Native American Youth. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP19188-NP19204. [PMID: 34355981 DOI: 10.1177/08862605211035884] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The purpose of the current study was to explore the reactions of Native American adolescents to participating in survey research on sexual and dating violence. Participants were 149 Native American adolescents who completed a survey in school. Survey items included sexual assault, dating violence, sexual harassment, and demographic questions. At the end of the survey, participants were asked if they were upset by the survey. Results showed that almost a quarter of youth were upset by the survey (24.2%), victims were more likely than non-victims to be upset by the survey, perpetrators were more likely than non-perpetrators to be upset by the survey, and sexual minorities were more likely than non-sexual minorities to be upset by the survey. Sex and age did not emerge as significantly associated with being upset. Participants were asked to describe why they were upset, and a content analysis revealed four categories of responses (i.e., feeling awkward or weird, topic of the survey, reminders, and "other"). Overall, although the research was well tolerated by most of the participants, researchers should consider adding information about what might increase feelings of upset in parental consent and youth assent forms, such as being reminded of a past upsetting experience and/or feeling awkward or weird because of some of the questions.
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Affiliation(s)
- Laura Siller
- University of Nebraska-Lincoln, Lincoln, NE, USA
| | | | - Ramona Herrington
- University of Nebraska-Lincoln, Lincoln, NE, USA
- Oglala Sioux Tribe, Pine Ridge, SD, USA
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Ibrahim H, Goessmann K, Neuner F. Sharing for relief: associations of trauma-focused interviews and well-being among war-affected displaced populations in the Middle East. ETHICS & BEHAVIOR 2022. [DOI: 10.1080/10508422.2022.2122466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Hawkar Ibrahim
- Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University
| | - Katharina Goessmann
- Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University
| | - Frank Neuner
- Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University
- Vivo International, Konstanz, Germany
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6
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Zhu L, Soletchi Seya MK, Villaveces A, Conkling M, Trika BJ, Myriam Kamagate MF, Annor FB, Massetti GM. Experiences of participation in a population-based survey on violence: Emotional discomfort, disclosure concerns, and the perceived value of participation among adolescents and young adults. J Trauma Stress 2022; 35:1226-1239. [PMID: 35384077 PMCID: PMC10658816 DOI: 10.1002/jts.22824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 11/08/2022]
Abstract
The accurate measurement of violence depends on high-quality data collected using methods that ensure participant confidentiality, privacy, and safety. To assess survey participants' emotional distress, discomfort, and self-perceived value of participating in the Honduras (2017), El Salvador (2017), Cote d'Ivoire (2018), and Lesotho (2018) Violence Against Children and Youth Surveys, which include sensitive topics such as sexual, physical, and emotional violence, we investigated individual self-reported distress and perceived value of participation by age, sex, and other demographic factors. We also examined the associations between past experiences of violence and both self-reported distress and perceived value of survey participation. Few individuals reported distress or concerns about disclosure. Across countries, 82.9% (Cote d'Ivoire) to 96.1% (Honduras) of participants indicated they were not afraid that someone might overhear their answers, 82.5% (Cote d'Ivoire) to 98.0% (El Salvador) said participation was not upsetting or stressful, and 93.3% (Cote d'Ivoire) to 98.6% (Honduras) said participation was worthwhile. The value of these interviews may exceed the negative feelings that some questions potentially elicit and can contribute to improved responses to victims.
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Affiliation(s)
- Liping Zhu
- Division of Violence Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marie Kaye Soletchi Seya
- Division of Violence Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Andrés Villaveces
- Division of Violence Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Martha Conkling
- Division of Global HIV & TB, U.S. Centers for Disease Control and Prevention, Maseru, Lesotho
| | - Beugre Joseph Trika
- Division of Global HIV & TB, U.S. Centers for Disease Control and Prevention, Abidjan, Côte d’Ivoire
| | | | - Francis B. Annor
- Division of Violence Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Greta M. Massetti
- Division of Violence Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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7
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Zhan Q, Xia T. Difference and Analysis of Evaluating Psychological Monitors' Interview and Classmates' Being Interviewed About Suicide. Front Psychol 2022; 13:858903. [PMID: 35795422 PMCID: PMC9251424 DOI: 10.3389/fpsyg.2022.858903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
In recent years, suicide has become the leading cause of unnatural death among college students in China. Psychological monitors, as class cadres who manage affairs related to mental health within their classes, are critical in identifying and intervening in psychological crises among their classmates. In China, however, talking about death is a cultural taboo, and many mental health workers have expressed concern about their implementation of interviews about suicide with others. Generally speaking, interviews with suicidal classmates are usually conducted by professional psychological experts and psychological monitors (psychological monitors are non-professional peer counselors in China). Such classmates that have undergone both the aforementioned types of interviews were investigated in this paper. However, this paper focuses on two issues. Firstly, what are the perceptions of classmates who have been interviewed toward the experience of being interviewed by psychological monitors? Secondly, what are the psychological monitors' perceptions of their implementation of interviews about suicide with classmates? In this study, 1,664 classmates who had been interviewed and 1,320 psychological monitors were surveyed by means of an online questionnaire. The results showed that classmates who have been interviewed perceived their experience of being interviewed by a psychological monitor about suicide more positively than the psychological monitors who viewed their implementation of interviews about suicide with classmates. Among the classmates who have been interviewed, three categories of classmates have more positive perceptions of their experience of being interviewed by a psychological monitor about suicide. Category one is males. Category two is those who were willing to seek help from the psychological monitors. Category three is those who had a more correct attitude toward mental illness. Among the psychological monitors, three categories of psychological monitors have more positive perceptions of their implementation of interviews about suicide with classmates. Category one is those who have the experience of implementing interviews with their classmates. Category two is those who have received training. Category three is those who had a more correct attitude toward mental illness. Psychological monitors can interview classmates confidently, and the training of psychological monitors on mental health knowledge should be strengthened in universities.
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Affiliation(s)
- Qisheng Zhan
- School of Education, Tianjin University, Tianjin, China
- Institute of Psychology, Tianjin University, Tianjin, China
- *Correspondence: Qisheng Zhan
| | - Tianyu Xia
- School of Education, Tianjin University, Tianjin, China
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Dehn LB, Driessen M, Steinhart I, Beblo T. Participating in Longitudinal Observational Research on Psychiatric Rehabilitation: Quantitative Results From a Patient Perspective Study. Front Psychiatry 2022; 13:834389. [PMID: 35185660 PMCID: PMC8854761 DOI: 10.3389/fpsyt.2022.834389] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Longitudinal observational studies play on an important role for evidence-based research on health services and psychiatric rehabilitation. However, information is missing about the reasons, why patients participate in such studies, and how they evaluate their participation experience. METHODS Subsequently to their final assessment in a 2-year follow-up study on supported housing for persons with severe mental illness, n = 182 patients answered a short questionnaire on their study participation experience (prior experiences, participation reasons, burden due to study assessments, intention to participate in studies again). Basic respondent characteristics as well as symptom severity (SCL-K9) were also included in the descriptive and analytical statistics. RESULTS To help other people and curiosity were cited as the main initial reasons for study participation (>85%). Further motives were significantly associated with demographic and/or clinical variables. For instance, "relieve from boredom" was more frequently reported by men and patients with substance use disorders (compared to mood disorders), and participants 'motive" to talk about illness" was associated with higher symptom severity at study entry. Furthermore, only a small proportion of respondents indicated significant burdens by study participation and about 87% would also participate in future studies. CONCLUSIONS The respondents gave an overall positive evaluation regarding their participation experience in an observational study on psychiatric rehabilitation. The results additionally suggest that health and social care professionals should be responsive to the expectations and needs of patients with mental illness regarding participation in research.
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Affiliation(s)
- Lorenz B Dehn
- Department of Psychiatry and Psychotherapy, Evangelische Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Evangelische Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, University of Bielefeld, Bielefeld, Germany
| | - Ingmar Steinhart
- von Bodelschwinghsche Stiftungen Bethel, Bielefeld, Germany.,Institut für Sozialpsychiatrie Mecklenburg-Vorpommern e. V., University of Greifswald, Greifswald, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Evangelische Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, University of Bielefeld, Bielefeld, Germany
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Andriessen K, Krysinska K, Rickwood D, Pirkis J. The Reactions of Adolescents, Parents and Clinicians to Participating in Qualitative Research Interviews Regarding Adolescents Bereaved by Suicide and Other Traumatic Death. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010452. [PMID: 35010712 PMCID: PMC8744783 DOI: 10.3390/ijerph19010452] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022]
Abstract
There are concerns that involving adolescents bereaved by suicide and other traumatic death in research may cause distress and harm. However, no study has investigated such bereaved adolescents’ research experiences. In addition, no study has looked at the experiences of parents and clinicians as participants in adolescent suicide and traumatic death bereavement research. This study aimed to explore the short-term impact of research participation experienced by adolescents, parents, and clinicians. A total of 61 participants (adolescents, n = 17; parents, n = 12; clinicians, n = 32) filled out a short survey within two weeks of having taken part in a qualitative interview study. Data were analyzed descriptively. Most participants had experienced no distress while participating and no negative effects of participating; rather, participation was experienced as helpful for them and they would highly recommend participating in a study like this to others. A few adolescents and parents reported some distress, related to anxiety about participation and the unpleasantness of grief memories. The study clearly indicates that bereaved adolescents, parents and clinicians can safely participate in research interviews regarding their experiences of grief and help after suicide, generally valuing the opportunity to share their experience. To prevent and mitigate potential distress, training of research staff and implementation of appropriate participant distress protocols are imperative. Future studies could include longitudinal follow-up of participants to assess any longer-term consequences.
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Affiliation(s)
- Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia; (K.K.); (J.P.)
- Correspondence:
| | - Karolina Krysinska
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia; (K.K.); (J.P.)
| | - Debra Rickwood
- Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia;
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia; (K.K.); (J.P.)
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Mathews B, MacMillan HL, Meinck F, Finkelhor D, Haslam D, Tonmyr L, Gonzalez A, Afifi TO, Scott JG, Pacella RE, Higgins DJ, Thomas H, Collin-Vézina D, Walsh K. The ethics of child maltreatment surveys in relation to participant distress: Implications of social science evidence, ethical guidelines, and law. CHILD ABUSE & NEGLECT 2022; 123:105424. [PMID: 34883421 DOI: 10.1016/j.chiabu.2021.105424] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/10/2021] [Accepted: 11/29/2021] [Indexed: 06/13/2023]
Abstract
Epidemiological surveys measuring the prevalence of child maltreatment generate essential knowledge that is required to enhance human rights, promote gender equality, and reduce child abuse and neglect and its effects. Yet, evidence suggests Institutional Review Boards (IRBs) may assess the risk of these studies using higher than normal thresholds, based on a perception they may cause high distress to participants. It is essential for IRBs and researchers to have an accurate understanding of the nature and extent of participant distress associated with these studies, and of the duties of researchers towards survey participants, so that meritorious research is endorsed and duties to participants discharged. Assessment by IRBs of the ethics of such research must be appropriately informed by scientific evidence, ethical principles, and legal requirements. This article adds to knowledge by considering participant distress in child maltreatment surveys and its appropriate ethical and operational treatment. We provide an updated overview of scientific evidence of the frequency and severity of distress in studies of child maltreatment, a review of ethical requirements including a focus on beneficence and participant welfare, and a new analysis of researchers' legal duties towards participants. Our analyses demonstrate that participant distress is infrequent and transitory, that researchers can satisfy ethical requirements towards participants, and that legal liability does not extend to emotional distress. Informed by these bodies of knowledge, we distil key principles of good epidemiological practice to provide solutions to operational requirements in these surveys, which both fulfil ethical requirements to participants, and demonstrate trauma-informed practice.
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Affiliation(s)
- Ben Mathews
- Australian Centre for Health Law Research, School of Law, Queensland University of Technology (QUT), Australia; Bloomberg School of Public Health, Johns Hopkins University, USA.
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada; Department of Pediatrics, McMaster University, Canada
| | - Franziska Meinck
- School of Social and Political Science, University of Edinburgh, UK; School of Health Sciences, North-West University, South Africa
| | - David Finkelhor
- Crimes Against Children Research Center, Family Research Laboratory, Department of Sociology, University of New Hampshire, USA
| | - Divna Haslam
- Australian Centre for Health Law Research, School of Law, Queensland University of Technology (QUT), Australia; Parenting and Family Support Centre, The University of Queensland, Australia
| | - Lil Tonmyr
- Family Violence Surveillance, Public Health Agency of Canada, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Canada
| | - Tracie O Afifi
- Department of Community Health Sciences, University of Manitoba, Canada; Department of Psychiatry, University of Manitoba, Canada
| | - James G Scott
- Mental Health Programme, QIMR Berghofer Medical Research Institute, Australia; Queensland Centre for Mental Health Research, Australia
| | - Rosana E Pacella
- Institute for Lifecourse Development, Faculty of Education, Health & Human Sciences, University of Greenwich, UK
| | - Daryl J Higgins
- Institute of Child Protection Studies, Australian Catholic University, Australia
| | - Hannah Thomas
- Mental Health Programme, QIMR Berghofer Medical Research Institute, Australia; Queensland Centre for Mental Health Research, Australia
| | | | - Kerryann Walsh
- School of Early Childhood and Inclusive Education, Queensland University of Technology (QUT), Australia
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11
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Lasrado R, Bielsten T, Hann M, Schumm J, Reilly ST, Davies L, Swarbrick C, Dowlen R, Keady J, Hellström I. Developing a Management Guide (the DemPower App) for Couples Where One Partner Has Dementia: Nonrandomized Feasibility Study. JMIR Aging 2021; 4:e16824. [PMID: 34783666 PMCID: PMC8663680 DOI: 10.2196/16824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/31/2021] [Accepted: 06/02/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Promoting the health and well-being of couples where one partner has dementia is an overlooked area of care practice. Most postdiagnostic services currently lack a couple-centered approach and have a limited focus on the couple relationship. To help address this situation, we developed a tablet-based self-management guide (DemPower) focused on helping couples enhance their well-being and relationship quality. OBJECTIVE The aim of this study is to investigate the feasibility and acceptability of the DemPower app. METHODS A nonrandomized feasibility design was used to evaluate the DemPower intervention over 3 months among couples where a partner had a diagnosis of dementia. The study recruited 25 couples in the United Kingdom and 19 couples in Sweden. Outcome measures were obtained at baseline and postintervention. The study process and interventions were evaluated at various stages. RESULTS The study was completed by 48% (21/44) of couples where one partner had dementia, of whom 86% (18/21) of couples accessed all parts of the DemPower app. Each couple spent an average of 8 hours (SD 3.35 hours) using the app during the study period. In total, 90% (19/21) of couples reported that all sections of DemPower were useful in addressing various aspects of daily life and helped to focus on how they interacted in their relationship. Of the 4 core subjects on which the DemPower app was structured, home and neighborhood received the highest number of visits. Couples used activity sections more often than the core subject pages. The perception of DemPower's utility varied with each couple's lived experience of dementia, geographic location, relationship dynamics, and opportunities for social interaction. A 5.2-point increase in the dementia quality of life score for people with dementia and a marginal increase in the Mutuality scale (+1.23 points) for caregiver spouses were found. Design and navigational challenges were reported in the DemPower app. CONCLUSIONS The findings suggest that the DemPower app is a useful resource for couples where one partner has dementia and that the implementation of the app requires the support of memory clinics to reach couples at early diagnosis. TRIAL REGISTRATION ISRCTN Registry ISRCTN10122979; http://www.isrctn.com/ISRCTN10122979.
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Affiliation(s)
- Reena Lasrado
- Social Care & Society, The University of Manchester, Manchester, United Kingdom
| | - Therese Bielsten
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Mark Hann
- Division of Population Health, The University of Manchester, Manchester, United Kingdom
| | | | | | - Linda Davies
- Division of Population Health, The University of Manchester, Manchester, United Kingdom
| | - Caroline Swarbrick
- Faculty of Health and Medicine, University of Lancaster, Lancaster, United Kingdom
| | - Robyn Dowlen
- Centre for Cultural Value, School of Performance and Cultural Industries, University of Leeds, Leeds, United Kingdom
| | - John Keady
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, United Kingdom
| | - Ingrid Hellström
- Department of Health Care Sciences & Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
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12
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Schatten HT, Allen KJD, Carl EC, Miller IW, Armey MF. Evaluating Potential Iatrogenic Effects of a Suicide-Focused Research Protocol. CRISIS 2021; 43:508-515. [PMID: 34547918 DOI: 10.1027/0227-5910/a000823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Concerns regarding the potential iatrogenic effects of suicide assessment have long impeded suicide research. Aims: We sought to examine the effects of an intensive, suicide-focused assessment protocol on mood, suicidality, and urges to harm oneself or others. Method: Participants were adults admitted to a psychiatric inpatient unit for recent suicidal ideation or behavior, or reasons unrelated to suicide. Our study protocol included clinical interviews evaluating suicide history and laboratory tasks with suicide-related stimuli. We modified an existing measure to create a brief, 6-item interview, the Assessment Session Check-In, which was administered before and after research procedures. Results: These indicated overall reductions in distress, suicidal intent, and urges to harm oneself or others from preassessment to postassessment. Postassessment reductions in stress predicted lower likelihood of a suicide attempt at follow-up. Limitations: Although beneficial to examine a high-risk sample, it is possible that an intensive suicide-focused protocol could prove more problematic for those with lower baseline levels of negative affect and suicidal thoughts. Conclusions: Results challenge the belief that assessing suicide elevates distress or suicidality, even among a high-risk sample of adults admitted to a psychiatric inpatient unit.
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Affiliation(s)
- Heather T Schatten
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Psychosocial Research Program, Butler Hospital, Providence, RI, USA
| | | | - Emily C Carl
- Department of Psychology, University of Texas at Austin, TX, USA
| | - Ivan W Miller
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Psychosocial Research Program, Butler Hospital, Providence, RI, USA
| | - Michael F Armey
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Psychosocial Research Program, Butler Hospital, Providence, RI, USA
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13
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Greene MC, Kane JC, Bolton P, Murray LK, Wainberg ML, Yi G, Sim A, Puffer E, Ismael A, Hall BJ. Assessing trauma and related distress in refugee youth and their caregivers: should we be concerned about iatrogenic effects? Eur Child Adolesc Psychiatry 2021; 30:1437-1447. [PMID: 32880725 PMCID: PMC9135458 DOI: 10.1007/s00787-020-01635-z] [Citation(s) in RCA: 3] [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: 01/17/2020] [Accepted: 08/26/2020] [Indexed: 11/26/2022]
Abstract
Assessment of potentially traumatic events and related psychological symptoms in refugee youth is common in epidemiological and intervention research. The objective of this study is to characterize reactions to assessments of trauma exposure and psychological symptoms, including traumatic stress, in refugee youth and their caregivers. Eighty-eight Somali youth and their caregivers participated in a screening and baseline interview for a psychological intervention in three refugee camps in Ethiopia. Participants were asked about their levels of distress prior to, immediately after, and approximately two weeks after completing the interview. Other quantitative and qualitative questions inquired about specific reactions to interview questions and procedures. Children and caregivers became increasingly relaxed over the course of the interview, on average. Few children (5.3%) or caregivers (6.5%) who reported being relaxed at the beginning of the interview became upset by the end of the interview. Some children and caregivers reported that certain assessment questions were upsetting and that feeling upset interfered with their activities. Despite some participants reporting persistent negative reactions, most reported liking and benefitting from the interview. While the majority of refugee youth and their caregivers reported positive experiences associated with completing trauma-related assessments, some reported negative reactions. Researchers and practitioners must consider the necessity, risks, and benefits of including questions about potentially traumatic events and related symptoms that are particularly upsetting in screening, survey research, and clinical assessment. When included, it is important that researchers and practitioners monitor negative reactions to these assessments and connect participants who become distressed with appropriate services.
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Affiliation(s)
- M Claire Greene
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute, 40 Haven Avenue, New York, NY, USA
| | - Jeremy C Kane
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Paul Bolton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Laura K Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Milton L Wainberg
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute, 40 Haven Avenue, New York, NY, USA
| | - Grace Yi
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Amanda Sim
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - Eve Puffer
- Department of Psychology and Neuroscience, Duke Global Health Institute, Duke University, Durham, NC, USA
| | | | - Brian J Hall
- Global and Community Mental Health Research Group, New York University (Shanghai), 1555 Century Avenue, Pudong New District, Shanghai, 200122, People's Republic of China.
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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14
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Jefferson K, Stanhope KK, Jones-Harrell C, Vester A, Tyano E, Hall CDX. A scoping review of recommendations in the English language on conducting research with trauma-exposed populations since publication of the Belmont report; thematic review of existing recommendations on research with trauma-exposed populations. PLoS One 2021; 16:e0254003. [PMID: 34324528 PMCID: PMC8321367 DOI: 10.1371/journal.pone.0254003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 06/17/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To identify recommendations for conducting public health research with trauma-exposed populations. METHODS Researchers searched Embase, PubMed, Scopus, Web of Science, Open Grey, and Google Scholar for recommendations. Trauma that causes psychological impact was our exposure of interest and we excluded clinical articles on treating physical trauma. We reviewed titles and abstracts of 8,070 articles and full text of 300 articles. We analyzed recommendations with thematic analysis, generated questions from the existing pool of recommendations, and then summarized select gaps. RESULTS We abstracted recommendations from 145 articles in five categories: community benefit, participant benefit, safety, researcher well-being, and recommendations for conduct of trauma research. CONCLUSIONS Gold standards to guide the conduct of trauma-informed public health research do not yet exist. The literature suggests participation in trauma research is not inherently harmful, and current recommendations concern using research to benefit communities and participants, protecting participants and researchers from harm, and improving professional practice. As public health researchers increasingly analyze trauma as a determinant of health, gold standards for the conduct of trauma-informed public health research would be appropriate and timely.
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Affiliation(s)
- Kevin Jefferson
- Independent Researcher, Atlanta, Georgia, United States of America
| | - Kaitlyn K. Stanhope
- Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Carla Jones-Harrell
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Aimée Vester
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Emma Tyano
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, United States of America
| | - Casey D. Xavier Hall
- Institute for Sexual and Gender Minority Health and Well-being, Northwestern University, Evanston, Illinois, United States of America
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois, United States of America
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15
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Sollis K, Biddle N, Edwards B, Herz D. COVID-19 Survey Participation and Wellbeing: A Survey Experiment. J Empir Res Hum Res Ethics 2021; 16:179-187. [PMID: 34057369 DOI: 10.1177/15562646211019659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Individuals throughout the world are being recruited into studies to examine the social impacts of coronavirus disease 2019 (COVID-19). While previous literature has illustrated how research participation can impact distress and wellbeing, to the authors' best knowledge no study has examined this in the COVID-19 context. Using an innovative approach, this study analyses the impacts of participation in a COVID-19 survey in Australia on subjective wellbeing through a survey experiment. At a population level, we find no evidence that participation impacts subjective wellbeing. However, this may not hold for those with mental health concerns and those living in financial insecurity. These findings provide the research community with a deeper understanding of the potential wellbeing impacts from COVID-19-related research participation.
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Affiliation(s)
- Kate Sollis
- Centre for Social Research and Methods, 2219Australian National University, Canberra, ACT, Australia
| | - Nicholas Biddle
- Centre for Social Research and Methods, 2219Australian National University, Canberra, ACT, Australia
| | - Ben Edwards
- Centre for Social Research and Methods, 2219Australian National University, Canberra, ACT, Australia
| | - Diane Herz
- Social Research Centre, Melbourne, Vic, Australia
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16
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Hesse CA, Strauss C, Shorey RC, Stuart GL, Cornelius TL. Examination of the Transient Changes in Affect Resulting From Participation in Research Addressing Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP5014-NP5032. [PMID: 30160601 DOI: 10.1177/0886260518795172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
As a result of the proliferation of data examining intimate partner violence (IPV), there has been an emerging interest in how this research emotionally affects participants, particularly those with a history of personal experience with IPV. While a large body of IPV research suggests that only a small proportion of individuals experience transient emotional distress as the result of participation, this research is limited by examining only the emotional responses at the conclusion of the research, rather than examining changes in affect during the research. Therefore, this research sought to examine negative affect among participants throughout the research to better examine the trajectory of affect during participation in research on IPV. We recruited a sample of 914 college students who completed a measure of negative affect at the beginning, after being exposed to violence questionnaires, and at the conclusion of the research. The findings suggested that among the total sample, negative affect generally declined over the course of the research, although there was a significant interaction for victims of both psychological and physical IPV, such that their negative affect remained stable over participation in the research. Negative affect was significantly correlated with measures of reactions to the research globally, and not significantly related to perceptions of the overall benefits of the research. These data suggest that participation in research on IPV does not increase negative affect, even among those with a history of IPV. Implications of these data for future research on IPV are discussed.
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17
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Sikweyiya Y, Mahlangu P, Dartnall E, Suich H. Examining the Risks of Engaging in Population-based Surveys on Violence: Follow-up Study of the Individual Deprivation Measure in South Africa. J Empir Res Hum Res Ethics 2021; 16:212-224. [PMID: 33890813 DOI: 10.1177/15562646211010641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the South African Individual Deprivation Measure, the individual survey, included questions about two potentially highly sensitive topics-individuals' experience of violence and their control over personal decision making. In-depth follow-up interviews were conducted with 105 consenting survey participants to determine whether participating in the survey resulted in negative impacts for individuals, particularly in relation to these two topics. Several participants found that being asked about their experiences resurfaced painful memories, but we did not find any evidence that the approach of surveying every eligible individual in the dwelling resulted in any form of harm for the survey participants.
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Affiliation(s)
- Yandisa Sikweyiya
- 59097Gender & Health Research Unit, South African Medical Research Council, Pretoria, South Africa.,School of Public Health, 37708University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - Pinky Mahlangu
- Gender & Health Research Unit, 59097South African Medical Research Council, Pretoria, South Africa.,School of Public Health, 37707University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
| | | | - Helen Suich
- 2219Australian National University, Canberra, Australia
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18
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Fortier J, Stewart-Tufescu A, Salmon S, Garces Davila I, MacMillan HL, Gonzalez A, Mathews B, Struck S, Taillieu T, Afifi TO. What type of survey research questions are identified by adults as upsetting? A focus on child maltreatment. CHILD ABUSE & NEGLECT 2020; 109:104764. [PMID: 33038722 DOI: 10.1016/j.chiabu.2020.104764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/18/2020] [Accepted: 09/24/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND Research on child maltreatment is imperative to inform evidence-based prevention and intervention efforts. Nonetheless, researchers continue to face barriers due to the perceived sensitivity and possibility of harm when asking about these experiences. While studies have started to explore reactions to participating in research on sensitive topics, there are notable limitations and fewer have focused on child maltreatment. OBJECTIVE The objective of this study was to better understand adult respondents' identification of, and reactions to, potentially upsetting questions in the context of a well-being and experiences survey, with a focus on child maltreatment. METHODS Data were from the first wave of the Well-Being and Experiences Study in Manitoba, Canada: a computerized self-reported community-based survey of adolescents and their parents/caregivers administered individually at a research facility. The current study focused on parents/caregivers' responses (N = 1000). The study utilized a mixed methods approach with descriptive statistics and qualitative thematic analyses of open-ended responses of their perceptions of upsetting questions. RESULTS Overall, few respondents (15.1 %) identified any questions as upsetting. Ten themes emerged in respondents' recall of upsetting questions, including maltreatment and other themes often perceived as less sensitive. Only 4% identified maltreatment-related questions as upsetting. Among those who identified any questions or maltreatment-specific questions as upsetting, most felt they were important to ask and should not be removed (92.7 %-97.5 %). These findings suggest that retrospective survey questions about experiences of child maltreatment involving adult samples are not associated with major upset and should be included in future health and social surveys.
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Affiliation(s)
- Janique Fortier
- Department of Community Health Sciences, University of Manitoba, Canada
| | | | - Samantha Salmon
- Department of Community Health Sciences, University of Manitoba, Canada
| | | | - Harriet L MacMillan
- Departments of Psychiatry and Behavioural Neurosciences, and of Pediatrics, McMaster University, Canada
| | - Andrea Gonzalez
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Canada
| | - Ben Mathews
- Faculty of Law, Queensland University of Technology, Australia
| | - Shannon Struck
- Department of Community Health Sciences, University of Manitoba, Canada
| | - Tamara Taillieu
- Department of Community Health Sciences, University of Manitoba, Canada
| | - Tracie O Afifi
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Canada.
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19
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Canet-Juric L, Andrés ML, del Valle M, López-Morales H, Poó F, Galli JI, Yerro M, Urquijo S. A Longitudinal Study on the Emotional Impact Cause by the COVID-19 Pandemic Quarantine on General Population. Front Psychol 2020; 11:565688. [PMID: 33071893 PMCID: PMC7531077 DOI: 10.3389/fpsyg.2020.565688] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 08/26/2020] [Indexed: 01/19/2023] Open
Abstract
COVID-19 pandemic represents, not only a public physical health emergency, but a mental health serious problem as well. However, little is known about the psychological impact of the quarantine during this pandemic. The aim of this study is to assess the emotional impact of the lockdown measures imposed by the Argentinian government to fight the virus. For this, a survey was distributed on social network. We surveyed the Argentinian general population twice: 2 days after the mandatory quarantine started (time 1), and 2 weeks later (time 2). Anxiety levels were assessed using the State-Trait Anxiety Inventory; depressive symptoms were assessed using the Beck Depression Inventory-II; and affect was assessed using the Positive and Negative Affect Scale. A total of 6057 people answered both surveys. In addition, different socio-demographic factors were considered, such as risk factors for COVID-19, age, gender, educational level, variation in family income due to quarantine, number of children, whether they have older adults in charge or not and the number of hours viewing information about COVID-19. Statistically significant variations were observed between the two time points. The effect size, however, was very small. Depression tends to increase slightly, while levels of anxiety and affect (positive and negative) tend to decrease. Also, some slight differences related to the socio-demographic factors were found. Findings suggests that sustaining the lockdown measures could have a larger effect on mental health in the long term. It is necessary to continue monitoring emotional distress and other related mental health problems on the general population. It is also necessary to create programs aimed at promoting mental health, and to distribute information about it.
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Affiliation(s)
- Lorena Canet-Juric
- Institute of Basic and Applied Psychology and Technology (IPSIBAT), National University of Mar del Plata (UNMDP), Mar del Plata, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - María Laura Andrés
- Institute of Basic and Applied Psychology and Technology (IPSIBAT), National University of Mar del Plata (UNMDP), Mar del Plata, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Macarena del Valle
- Institute of Basic and Applied Psychology and Technology (IPSIBAT), National University of Mar del Plata (UNMDP), Mar del Plata, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Hernán López-Morales
- Institute of Basic and Applied Psychology and Technology (IPSIBAT), National University of Mar del Plata (UNMDP), Mar del Plata, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Fernando Poó
- Institute of Basic and Applied Psychology and Technology (IPSIBAT), National University of Mar del Plata (UNMDP), Mar del Plata, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Juan Ignacio Galli
- Institute of Basic and Applied Psychology and Technology (IPSIBAT), National University of Mar del Plata (UNMDP), Mar del Plata, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Matías Yerro
- Institute of Basic and Applied Psychology and Technology (IPSIBAT), National University of Mar del Plata (UNMDP), Mar del Plata, Argentina
| | - Sebastián Urquijo
- Institute of Basic and Applied Psychology and Technology (IPSIBAT), National University of Mar del Plata (UNMDP), Mar del Plata, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
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20
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Damiano SR, McLean SA, Nguyen L, Yager Z, Paxton SJ. Do we cause harm? Understanding the impact of research with young children about their body image. Body Image 2020; 34:59-66. [PMID: 32521428 DOI: 10.1016/j.bodyim.2020.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
Abstract
Although research into the early development of body image and eating behaviors is essential, concerns have been raised about whether their assessment might precipitate body or eating concerns in children. We aimed to identify how parents perceived their young children (under 9 years) had been impacted from involvement in the longitudinal Children's Body Image Development Study (CBIDS) that assessed body image and eating behaviors. Participants were 218 parents (99 % mothers) who completed an online questionnaire assessing whether and why their child discontinued participation in CBIDS, and the perceived impact of participation on children's body image, weight attitudes, language about bodies, internalisation of appearance ideals, peer appearance conversations, dietary restraint, muscle building activities, and physical activity. Impact and reasons for cessation of participation were assessed retrospectively. Almost all parents were positive or neutral about their child's involvement, 0.5%-3.2% of parents perceived a negative impact in an area, and 0.9 % of parents moderately agreed that they regretted participating in CBIDS. Themes for positive and negative aspects of CBIDS involvement were explored using thematic analysis. Although research is essential to guide development of prevention strategies, this study highlights the need to implement safeguards to ensure a positive experience for all children.
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Affiliation(s)
- Stephanie R Damiano
- Department of Psychology & Counselling, School of Psychology and Public Health, La Trobe University, Melbourne 3086, Australia.
| | - Siân A McLean
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Melbourne 3086, Australia
| | - Lilly Nguyen
- Department of Psychology & Counselling, School of Psychology and Public Health, La Trobe University, Melbourne 3086, Australia
| | - Zali Yager
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia
| | - Susan J Paxton
- Department of Psychology & Counselling, School of Psychology and Public Health, La Trobe University, Melbourne 3086, Australia
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21
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Hart LM, Cropper P, Morgan AJ, Kelly CM, Jorm AF. teen Mental Health First Aid as a school-based intervention for improving peer support of adolescents at risk of suicide: Outcomes from a cluster randomised crossover trial. Aust N Z J Psychiatry 2020; 54:382-392. [PMID: 31707787 DOI: 10.1177/0004867419885450] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aims of this study were to assess evidence for a novel, universal mental health literacy programme in the school setting (teen Mental Health First Aid) as an intervention to improve peer support towards adolescents at risk of suicide and to examine whether participation in a school-based programme dealing with suicide was distressing to participants. METHOD In a cluster randomised crossover trial, Australian high school students aged 15-17 years (N = 1605, 44.74% female, Mage = 15.87) received either teen Mental Health First Aid or a matched control physical first aid course. Data were collected before, immediately after and 12 months after training through online surveys assessing correct recognition of suicidality and intentions to help a fictional peer (John) who was depicted as experiencing depressive symptoms and suicidal thoughts in a vignette. Students were also asked whether any information in the training or surveys was found distressing and completed a validated measure of psychological distress (the Kessler Psychological Distress Scale). RESULTS Students receiving teen Mental Health First Aid training were much more likely to report an increase from pre- to post-training in recognition of suicidality (OR = 1.97, 95% CI = [1.14, 3.39], p = 0.02) and appropriate first aid intentions towards a peer at risk of suicide than students receiving physical first aid (OR = 35.40, 95% CI = [19.86, 63.14], p < 0.001). Twelve months after training, most effects were still significant. Although a greater proportion of teen Mental Health First Aid participants self-reported feeling briefly distressed after the training, there was no evidence of greater distress at 12 months on the Kessler Psychological Distress Scale. CONCLUSION teen Mental Health First Aid is effective in increasing recognition of and intentions to assist a suicidal peer. Although the open discussion of mental health first aid for a suicidal peer was distressing for some students, results suggest this was transient and not associated with harm. Future studies are required to ascertain whether these increases are indeed associated with better provision of support and prevention of youth suicide.
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Affiliation(s)
- Laura M Hart
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Penny Cropper
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Amy J Morgan
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Melbourne, VIC, Australia
| | - Anthony F Jorm
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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22
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Ward-Ciesielski EF, Wilks CR. Conducting Research with Individuals at Risk for Suicide: Protocol for Assessment and Risk Management. Suicide Life Threat Behav 2020; 50:461-471. [PMID: 31702077 PMCID: PMC7148174 DOI: 10.1111/sltb.12602] [Citation(s) in RCA: 4] [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: 06/17/2019] [Accepted: 08/27/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Suicide prediction, prevention, and intervention are urgent research areas. One barrier for research with high-risk populations is limited resources to manage risk in a research setting. We describe using the University of Washington Risk Assessment Protocol (UWRAP) to assess and manage suicide risk during phone-administered eligibility assessments in two clinical trials. METHOD Study 1 (N = 151) recruited suicidal adults who were not engaged in mental health treatment and Study 2 (N = 135) recruited suicidal adults who used alcohol to regulate emotions. Pre- and postassessment ratings of stress, urge to harm self, urge to use drugs/alcohol, and intent to harm self were compared and strategies to manage increased suicide risk following screening interviews were implemented, as indicated. RESULTS In both studies, average postassessment ratings were significantly lower than pre-assessment. A minority of participants reported higher ratings on one or more domains; however, following more thorough suicide risk assessment, risk was appropriately managed by providing low-level interventions (e.g., validation). CONCLUSIONS Suicide risk in research involving community participants can be managed by using appropriate risk protocols.
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23
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Carers' Motivations for, and Experiences of, Participating in Suicide Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051733. [PMID: 32155819 PMCID: PMC7084311 DOI: 10.3390/ijerph17051733] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/26/2020] [Accepted: 03/03/2020] [Indexed: 11/17/2022]
Abstract
(1) Background: First-hand accounts of lived experience of suicide remain rare in the research literature. Increasing interest in the lived experience of suicide is resulting in more opportunities for people to participate in research based on their personal experience. How individuals choose to participate in research, and their experience of doing so, are important considerations in the ethical conduct of research. (2) Methods: To understand the experience of providing care for someone who has previously attempted suicide, a cross-sectional online community survey was conducted. This survey concluded with questions regarding motivation to participate and the experience of doing so. Of the 758 individuals who participated in the survey, 545 provided open-ended text responses to questions regarding motivation and 523 did so for questions regarding the experience of participating. It is these responses that are the focus of this paper. Data were analysed thematically. (3) Results: Motivations to participate were expressed as primarily altruistic in nature, with a future focus on improving the experience of the person who had attempted suicide alongside carers to ease distress. The experience of participating was difficult yet manageable, for all but a few participants. (4) Conclusions: With the increasing interest in first-hand accounts of suicide, how individuals experience participation in research is an important focus that requires further attention.
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24
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Carter SP, Ammerman BA, Gebhardt HM, Buchholz J, Reger MA. Participant Reactions to Suicide-Focused Research. CRISIS 2020; 41:367-374. [PMID: 32036704 DOI: 10.1027/0227-5910/a000650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background: Concerns exist regarding the perceived risks of conducting suicide-focused research among an acutely distressed population. Aims: The current study assessed changes in participant distress before and after participation in a suicide-focused research study conducted on a psychiatric inpatient unit. Method: Participants included 37 veterans who were receiving treatment on a psychiatric inpatient unit and completed a survey-based research study focused on suicide-related behaviors and experiences. Results: Participants reported no significant changes in self-reported distress. The majority of participants reported unchanged or decreased distress. Reviews of electronic medical records revealed no behavioral dysregulation and minimal use of as-needed medications or changes in mood following participation. Limitations: The study's small sample size and veteran population may limit generalizability. Conclusion: Findings add to research conducted across a variety of settings (i.e., outpatient, online, laboratory), indicating that participating in suicide-focused research is not significantly associated with increased distress or suicide risk.
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Affiliation(s)
- Sarah P Carter
- Seattle-Denver Center of Innovation for Veteran-Centered Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA.,Department of Health Services, University of Washington, Seattle, WA, USA
| | - Brooke A Ammerman
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | | | - Jonathan Buchholz
- VA Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Mark A Reger
- VA Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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25
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Wolford-Clevenger C, Hugley MJ, McNulty J, Elledge LC, Cropsey K, Stuart GL. The risk-benefit ratio of studying psychiatric symptoms via daily diary methods. Account Res 2019; 26:498-511. [PMID: 31738573 DOI: 10.1080/08989621.2019.1694913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Ethics committee members and researchers have deliberated about the risk-benefit ratio of researching sensitive issues such as psychiatric symptoms. Although research has suggested that inquiring about psychiatric symptoms in research generally does not cause harm, these findings have primarily arisen from cross-sectional studies. We examined whether this generalized to repeated, daily assessments of psychiatric symptoms. We collected daily survey data on psychiatric symptoms over 90 days from a sample of 206 college students. A subset of the sample (n = 80) provided reactions to study participation administered on the 90th day. Individuals who did not complete the 90th day survey reported higher levels of suicidal ideation and hopelessness than those who did. For individuals who completed the 90th, final assessment, reactions primarily fell within the neutral to positive range, with variation depending on their baseline levels of psychiatric symptoms and identification as religious. This study adds to past work by demonstrating that individuals who remained in the study had neutral to positive experiences. However, participants with greater suicidal ideation and hopelessness were likely to attrit, warranting caution in assuming a low risk-benefit ratio of these studies. Management of risks involved in repeated assessment studies may be informed by this work.
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Affiliation(s)
| | - Mickeah J Hugley
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James McNulty
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | | | - Karen Cropsey
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gregory L Stuart
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
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Verhofstadt M, Chambaere K, Leontjevas R, Peters GJY. Towards an assessment instrument for suffering in patients with psychiatric conditions: assessing cognitive validity. BJPsych Open 2019; 5:e35. [PMID: 31530306 PMCID: PMC6469232 DOI: 10.1192/bjo.2019.25] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Unbearable suffering is a key criterion in legally granting patients' euthanasia requests in Belgium yet a generally accepted definition of unbearable suffering remains elusive. The ability to understand and assess unbearable suffering is essential, particularly in patients with psychiatric conditions, as the underlying causes of these conditions are not always apparent. To enable research into when and why suffering experiences incite patients with psychiatric conditions to request euthanasia, and to help explore preventive and curative perspectives, the development of an assessment instrument is needed. AIMS To improve the cognitive validity of a large initial item pool used to assess the nature and extent of suffering in patients with psychiatric conditions. METHOD Cognitive validity was established via two rounds of cognitive interviews with patients with psychiatric conditions with (n = 9) and without (n = 5) euthanasia requests. RESULTS During the first round of cognitive interviews, a variety of issues relating to content, form and language were reported and aspects that were missing were identified. During the second round, the items that had been amended were perceived as sufficiently easily to understand, sensitive to delicate nuances, comprehensive and easy to answer accurately. Neither research topic nor method were perceived as emotionally strenuous, but instead as positive, relevant, comforting and valuable. CONCLUSIONS This research resulted in an item pool that covers the concept of suffering more adequately and comprehensively. Further research endeavours should examine potential differences in suffering experiences over time and in patients with psychiatric conditions with and without euthanasia requests. The appreciation patients demonstrated regarding their ability to speak extensively and openly about their suffering and wish to die further supports the need to allow patients to speak freely and honestly during consultations. DECLARATION OF INTERESTS None.
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Affiliation(s)
- Monica Verhofstadt
- Junior Researcher, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Belgium
| | - Kenneth Chambaere
- Senior Researcher and Assistant Professor, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Belgium
| | - Roeslan Leontjevas
- Senior Researcher and Professor, Department of Methodology and Statistics, Faculty of Psychology and Education Science, Open University; and Department of Primary and Community Care, Radboud University, Medical Centre Nijmegen, the Netherlands
| | - Gjalt-Jorn Ygram Peters
- Senior Researcher and Assistant Professor, Department of Methodology and Statistics, Faculty of Psychology and Education Science, Open University; and Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands
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Adolescent and young adult cancer survivors' perceptions of participating in a survey – Ethical and methodological considerations. Eur J Oncol Nurs 2019; 39:55-61. [DOI: 10.1016/j.ejon.2019.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/30/2019] [Accepted: 02/01/2019] [Indexed: 11/20/2022]
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28
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Tan DPW, Morgan AJ, Jorm AF, Reavley NJ. Emotional impacts of participation in an Australian national survey on mental health-related discrimination. ETHICS & BEHAVIOR 2019. [DOI: 10.1080/10508422.2019.1593844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Denise P. W. Tan
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University
| | - Amy J. Morgan
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne
| | - Anthony F. Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne
| | - Nicola J. Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne
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Hasking PA, Lewis SP, Robinson K, Heath NL, Wilson MS. Conducting research on nonsuicidal self-injury in schools: Ethical considerations and recommendations. SCHOOL PSYCHOLOGY INTERNATIONAL 2019. [DOI: 10.1177/0143034319827056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research on nonsuicidal self-injury (NSSI) has grown significantly over the last 15 years, with much of this work focused on factors that initiate and maintain NSSI among school-aged youth. Although this work is important, it does raise several ethical concerns. In this article we outline key ethical issues underlying NSSI research in schools and offer recommendations for conducting ethically sound and productive research in this area. Ethical concerns addressed include: 1) recruitment of minors to research; 2) disclosure and confidentiality; 3) the risk of iatrogenic effects; 4) duty of care; 5) engaging schools in research; and 6) safety of the researchers. In each area, we offer recommendations to assist researchers, ethics committees, and schools in working together to conduct ethical NSSI research, further our understanding of NSSI, and address and respond to these behaviors in schools.
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Murdoch M, Partin MR, Vang D, Kehle-Forbes SM. The Psychological Risk of Minimal Risk Activities: A Pre- and Posttest Study Using the Self-Assessment Manikin. J Empir Res Hum Res Ethics 2018; 14:15-22. [PMID: 30406711 DOI: 10.1177/1556264618810302] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It is difficult to apply U.S. Federal Code of Regulation's criterion for "minimal risk," because benchmarks of minimal risk have not been quantified. Our goal was to examine the psychological risks of several day-to-day activities. Using the Self-Assessment Manikin (SAM), we assessed the state valence and arousal of 432 patients and employees at a large Midwestern Department of Veterans Affairs medical facility before and after they had their blood drawn, saw their primary care physician or mental health provider, or took part in an exercise class. Exercise was associated with near-large to large salutary effects (Cohen's d = 0.76-1.17); other effects were small or moderate in positive directions (Cohen's d = 0.02-0.51). Our findings are a promising start toward establishing benchmarks and quantifying the psychological harms of minimal risk activities. Estimates such as these may help researchers determine whether their own research exceeds minimal risk.
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Affiliation(s)
- Maureen Murdoch
- 1 Minneapolis VA Health Care System, MN, USA.,2 University of Minnesota Medical School, Minneapolis, USA
| | - Melissa Ruth Partin
- 1 Minneapolis VA Health Care System, MN, USA.,2 University of Minnesota Medical School, Minneapolis, USA
| | - Derek Vang
- 1 Minneapolis VA Health Care System, MN, USA
| | - Shannon Marie Kehle-Forbes
- 1 Minneapolis VA Health Care System, MN, USA.,2 University of Minnesota Medical School, Minneapolis, USA.,3 VA Boston Healthcare System, MA, USA
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31
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Shaw T, Runions KC, Johnston RS, Cross D. Does the Risk Outweigh the Benefits? Adolescent Responses to Completing Health Surveys. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2018; 28:412-426. [PMID: 29024181 DOI: 10.1111/jora.12343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The aim of this study is to describe the self-reported experiences of adolescents in population-based samples when completing health-related surveys on topics with varying potential for evoking distress. Survey data were collected in three school-based studies of bullying behaviors (N = 1,771, 12-14 years), alcohol use (N = 823, 12, 15, and 17 years), and electronic image sharing (N = 274, 13 years). Between 5% and 15% of respondents reported being upset at survey completion, but at most 1.4% were entirely negative in their evaluation. Age was not associated with being upset, but younger adolescents were more likely to see benefit in participation. Although concurrent mental health symptoms increased the risk of being upset, this was mostly mitigated by perceived benefits from participation.
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Affiliation(s)
- Thérèse Shaw
- Telethon Kids Institute
- The University of Western Australia
| | - Kevin C Runions
- Telethon Kids Institute
- The University of Western Australia
- Department of Health, Western Australia
| | | | - Donna Cross
- Telethon Kids Institute
- The University of Western Australia
- Edith Cowan University
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32
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Hall J, Rus-Calafell M, Omari-Asor L, Ward T, Emsley R, Garety P, Craig TKJ. Assessing the subjective experience of participating in a clinical trial (AVATAR). Psychiatry Res 2018; 263:82-87. [PMID: 29502043 DOI: 10.1016/j.psychres.2018.02.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 02/12/2018] [Accepted: 02/12/2018] [Indexed: 11/25/2022]
Abstract
This study assessed the subjective experience of participating in a clinical trial, specifically positive and negative experiences and the experience of audio recording assessment sessions. The study was cross-sectional from a single blinded randomised controlled trial. Forty participants with a primary diagnosis of non-organic psychosis completed baseline and 12-week follow-up questionnaires assessing their experiences. Participants rated research interviews as moderately helpful in facilitating their therapy and talking to the interviewer as moderately helpful at baseline and 12-week follow-up. Self-report ratings of the degree of self-realisation promoted by the research questionnaires were significantly higher at 12-week follow-up compared to baseline. Participants adjusted quickly to being audio recorded and rated interviews as not at all disruptive and not at all to slightly intrusive. On average there were neutral emotional reactions, positive gains and minimal inconveniences as a result of participation. The main reasons for taking part were: 'To help myself', 'I was curious' and 'To help others'. The findings offer support to previous research reporting that individuals with mental health problems find participating in clinical trials a beneficial experience. This may alleviate concerns that participation in similar studies may be personally intrusive or harmful.
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Affiliation(s)
- Jheanell Hall
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Mar Rus-Calafell
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lorraine Omari-Asor
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Thomas Ward
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Richard Emsley
- Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Philippa Garety
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tom K J Craig
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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33
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Batterham PJ, Calear AL, Carragher N, Sunderland M. Prevalence and predictors of distress associated with completion of an online survey assessing mental health and suicidality in the community. Psychiatry Res 2018; 262:348-350. [PMID: 28843625 DOI: 10.1016/j.psychres.2017.08.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 07/07/2017] [Accepted: 08/20/2017] [Indexed: 11/18/2022]
Abstract
While there is evidence that mental health surveys do not typically increase distress, limited research has examined distress in online surveys. The study investigated whether completion of a 60-min online community-based mental health survey (n = 3620) was associated with reliable increases in psychological distress. 2.5% of respondents had a reliable increase in distress, compared to 5.0% with a reliable decrease, and decreased distress overall across the sample (Cohen's d = -0.22, p < 0.001). Initial depression/anxiety symptoms were associated with increased distress, but suicidality was not. Online mental health surveys are associated with low prevalence of increased distress.
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Affiliation(s)
- Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Road, Canberra, Australia.
| | - Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Road, Canberra, Australia
| | - Natacha Carragher
- Office of Medical Education, University of New South Wales, Sydney, Australia
| | - Matthew Sunderland
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, Sydney, Australia
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34
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Procter NG, Kenny MA, Eaton H, Grech C. Lethal hopelessness: Understanding and responding to asylum seeker distress and mental deterioration. Int J Ment Health Nurs 2018; 27:448-454. [PMID: 28322492 DOI: 10.1111/inm.12325] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2017] [Indexed: 11/28/2022]
Abstract
The mental deterioration of the so called 'legacy caseload' (asylum seekers who arrived in Australia by boat between August 2012-December 2013) has become a national concern and is garnering international attention. Prolonged uncertainty is contributing to mental deterioration and despair. There have been at least 11 deaths by suicide since June 2014. Social support services have been limited and legal assistance in short supply; this is associated with lengthy delays with visa applications. Thwarted belongingness, purpose and identity, a shortage of available services, and barriers to legal support for processes attendant upon Refugee Status Determination increase the likelihood that the mental health of asylum seekers will deteriorate further, potentially developing into worsening decline, which will lead to increased self-harm and suicide. This article summarises recent suicide deaths in Australia, positing practical assistance and support for asylum seekers living in the community. Therapeutic engagement should be trauma-informed wherever possible, helping asylum seekers to reframe their sense of lethal hopelessness.
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Affiliation(s)
- Nicholas G Procter
- School of Nursing and Midwifery, University of South Australia, Perth, Western Australia, Australia.,Mental Health and Substance Use Research Group, Adelaide, South Australia, Australia
| | - Mary Anne Kenny
- School of Law, Murdoch University, Perth, Western Australia, Australia
| | - Heather Eaton
- School of Nursing and Midwifery, University of South Australia, Perth, Western Australia, Australia.,Mental Health and Substance Use Research Group, Adelaide, South Australia, Australia
| | - Carol Grech
- School of Nursing and Midwifery, University of South Australia, Perth, Western Australia, Australia
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Smith KV, Thew GR, Graham B. Conducting ethical internet-based research with vulnerable populations: a qualitative study of bereaved participants' experiences of online questionnaires. Eur J Psychotraumatol 2018; 9:1506231. [PMID: 30151076 PMCID: PMC6104613 DOI: 10.1080/20008198.2018.1506231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 06/29/2018] [Accepted: 07/08/2018] [Indexed: 10/31/2022] Open
Abstract
Background: Bereavement can be considered a potentially traumatic experience, and concerns have been raised about conducting grief research responsibly online. Objective: Given that online research introduces new methodological opportunities and challenges, we aimed to develop a greater understanding of how bereaved individuals experience participation in online research. Method: One day after participation in an online grief study, 876 participants, bereaved on average for 40 months, received a 'check-in' email to support well-being and offer further contact if needed. Although not explicitly asked to respond if no help was needed, 300 participants sent email replies, with only six requesting support. These responses were analysed qualitatively using content analysis. Results: Results suggested that participants found it acceptable to be asked about their grief and while difficult emotions were frequently described in response to the questionnaires, these reactions were temporary. A range of positive reactions was also reported, including new realizations arising from completing the research and changes in thinking related to grief. Participants also wrote about their appreciation for the study and how it was carried out, as well as a desire to contribute more to the study and to help others in a similar position. Conclusions: We suggest that the use of the check-in email to support well-being following study completion, along with advice on preparing to take part, contributed to positive experiences of participation and we recommend these strategies for future studies. These findings could allay clinical concerns about conducting online research with vulnerable populations, as well as raising questions about the possible therapeutic impact of measurement.
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Affiliation(s)
- Kirsten V Smith
- Oxford Centre for Anxiety Disorders and Trauma, University of Oxford, Oxford, UK.,The Loss Foundation [Registered Charity 1147362], London, UK
| | - Graham R Thew
- Oxford Centre for Anxiety Disorders and Trauma, University of Oxford, Oxford, UK
| | - Belinda Graham
- Oxford Centre for Anxiety Disorders and Trauma, University of Oxford, Oxford, UK.,The Loss Foundation [Registered Charity 1147362], London, UK
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36
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Edwards KM, Neal AM, Dardis CM, Kelley EL, Gidycz CA, Ellis G. College Students' Reactions to Participating in Relational Trauma Research: A Mixed Methodological Study. JOURNAL OF INTERPERSONAL VIOLENCE 2017; 32:3346-3369. [PMID: 26303939 DOI: 10.1177/0886260515599158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Using a mixed methodology, the present study compared men's and women's perceived benefits and emotional reactions with participating in research that inquired about child maltreatment and intimate partner violence (IPV) victimization and perpetration. Participants consisted of 703 college students (357 women, 346 men), ages 18 to 25 who reported on their childhood maltreatment, adolescent and adult IPV victimization and perpetration, and their reactions (perceived benefits and emotional effects) to participating. Participants' reactions to participating were assessed using quantitative scales, as well as open-ended written responses that were content coded by researchers. Women reported more personal benefits from research, whereas men and women reported similar levels of emotional reactions to research participation. Furthermore, greater frequencies of child maltreatment and IPV victimization were related to higher levels of emotional reactions. Common self-identified reasons for emotional reactions (e.g., not liking to think about abuse in general, personal victimization experiences) and benefits (e.g., reflection and awareness about oneself, learning about IPV) were also presented and analyzed. These data underscore the importance of future research that examines the behavioral impact of research participation utilizing longitudinal and in-depth qualitative methodologies. Findings also highlight the potential psychoeducational value of research on understanding the reasons underlying participants' benefits and emotional effects.
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37
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Murdoch M, Kehle-Forbes SM, Partin MR. Changes in affect after completing a mailed survey about trauma: two pre- and post-test studies in former disability applicants for posttraumatic stress disorder. BMC Med Res Methodol 2017; 17:81. [PMID: 28486955 PMCID: PMC5424391 DOI: 10.1186/s12874-017-0357-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 05/03/2017] [Indexed: 11/29/2022] Open
Abstract
Background One potential concern with using mailed surveys containing trauma-related content is the possibility of re-traumatizing survivors without a trained mental health professional present. Prior research provides insufficient guidance regarding the prevalence and magnitude of this risk because the psychological harms of trauma-related surveys have typically been estimated using single post-test observations. Post-test observations cannot quantify magnitude of change in participants’ emotional states and may over or under estimate associations between participants’ characteristics (risk factors) and post-survey upset. Methods We conducted two pre- and post-test studies in samples of former applicants for posttraumatic stress disorder disability benefits: 191 males who served during Gulf War I plus 639 male and 921 female Veterans who served sometime between 1955 and 1998. We used two 9-point items from the Self-Assessment Manikins to measure participants’ valence (sadness/happiness) and arousal (tenseness/calmness) before and after they completed mailed surveys asking about trauma-related symptoms or experiences. We examined the following potential predictors for post-survey sadness and tenseness: screening positive for posttraumatic stress disorder, having a serious mental illness, and history of military sexual assault or combat. Results After the survey, across the groups, 29.3–41.8% were sadder, 45.3–52.2% had no change in valence, and 12.9–22.5% were happier; 31.7–40.2% were tenser, 40.6–48.2% had no change in arousal, and 17.3–24.0% were calmer. The mean increase in sadness or tenseness post-survey was less than one point in all groups (SD’s < 1.7). Cohen’s d ranged from 0.07 to 0.30. Most hypothesized predictors were associated with greater baseline sadness or tenseness, but not necessarily with larger post-survey changes. Women with a history of military sexual assault had the largest net post-survey changes in sadness (mean = 0.7, SD = 1.4) and tenseness (mean = 0.6, SD = 1.6). Conclusion While a substantial minority of Veterans reported more sadness or tenseness post-survey, the net change in affect was small. Most hypothesized risk factors were actually associated with higher baseline sadness or tenseness scores. When receiving unsolicited, trauma-related surveys by mail, separate protections for Veterans with the risk factors studied here do not seem necessary. Electronic supplementary material The online version of this article (doi:10.1186/s12874-017-0357-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maureen Murdoch
- Section of General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA. .,Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA. .,Department of Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA. .,Center for Chronic Disease Outcomes Research (111-0), Minneapolis VA Medical Center, One Veterans Drive, Minneapolis, MN, 55417, USA.
| | - Shannon Marie Kehle-Forbes
- Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA.,Department of Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.,National Center for PTSD Women's Health Sciences Division at VA Boston Healthcare System, Boston, MA, USA
| | - Melissa Ruth Partin
- Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA.,Department of Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
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The PULSAR Specialist Care protocol: a stepped-wedge cluster randomized control trial of a training intervention for community mental health teams in recovery-oriented practice. BMC Psychiatry 2017; 17:172. [PMID: 28482829 PMCID: PMC5423029 DOI: 10.1186/s12888-017-1321-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 04/21/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Recovery features strongly in Australian mental health policy; however, evidence is limited for the efficacy of recovery-oriented practice at the service level. This paper describes the Principles Unite Local Services Assisting Recovery (PULSAR) Specialist Care trial protocol for a recovery-oriented practice training intervention delivered to specialist mental health services staff. The primary aim is to evaluate whether adult consumers accessing services where staff have received the intervention report superior recovery outcomes compared to adult consumers accessing services where staff have not yet received the intervention. A qualitative sub-study aims to examine staff and consumer views on implementing recovery-oriented practice. A process evaluation sub-study aims to articulate important explanatory variables affecting the interventions rollout and outcomes. METHODS The mixed methods design incorporates a two-step stepped-wedge cluster randomized controlled trial (cRCT) examining cross-sectional data from three phases, and nested qualitative and process evaluation sub-studies. Participating specialist mental health care services in Melbourne, Victoria are divided into 14 clusters with half randomly allocated to receive the staff training in year one and half in year two. Research participants are consumers aged 18-75 years who attended the cluster within a previous three-month period either at baseline, 12 (step 1) or 24 months (step 2). In the two nested sub-studies, participation extends to cluster staff. The primary outcome is the Questionnaire about the Process of Recovery collected from 756 consumers (252 each at baseline, step 1, step 2). Secondary and other outcomes measuring well-being, service satisfaction and health economic impact are collected from a subset of 252 consumers (63 at baseline; 126 at step 1; 63 at step 2) via interviews. Interview-based longitudinal data are also collected 12 months apart from 88 consumers with a psychotic disorder diagnosis (44 at baseline, step 1; 44 at step 1, step 2). cRCT data will be analyzed using multilevel mixed-effects modelling to account for clustering and some repeated measures, supplemented by thematic analysis of qualitative interview data. The process evaluation will draw on qualitative, quantitative and documentary data. DISCUSSION Findings will provide an evidence-base for the continued transformation of Australian mental health service frameworks toward recovery. TRIAL REGISTRATION Australian and New Zealand Clinical Trial Registry: ACTRN12614000957695 . Date registered: 8 September 2014.
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39
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Harris KM, Goh MTT. Is suicide assessment harmful to participants? Findings from a randomized controlled trial. Int J Ment Health Nurs 2017; 26:181-190. [PMID: 27083774 DOI: 10.1111/inm.12223] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 01/14/2016] [Accepted: 01/25/2016] [Indexed: 11/27/2022]
Abstract
There is considerable debate on whether suicide assessment carries an iatrogenic risk for participants/patients. A double-blind randomized controlled trial (registration: R000022314) tested the emotional impact of suicide assessment on participants (n = 259) randomly assigned to experimental (n = 122) or control conditions (n = 137). The experimental condition included the Suicidal Affect-Behavior-Cognition Scale and intensive death-related questions, the control condition a quality of life scale. Both included measures of depression, social support and loneliness. Affective states were assessed immediately before and after testing, and research biases minimized. Post-test debriefing interviews collected qualitative reactions. Experimental participants ranged from nonsuicidal to highly suicidal. Between-groups ANCOVAs and repeated measures ANOVAs showed no differences by study condition, and no pre-post-test affect changes for either condition or suicidal participants (P > 0.10), supporting the null hypothesis of no iatrogenic effects. However, depressive participants in both conditions showed significant decreases in positive affect (P < 0.05). Smallest real difference (SRD) scores approximated clinically meaningful differences and showed 20% of participants had a significant positive survey reaction, 24% a negative reaction, with the rest neutral. Linear regressions revealed depressive symptoms and perceived family support, but not suicidality or other factors, predicted negative affect changes, which was supported by qualitative findings. Social desirability bias was also found in qualitative survey responses. No evidence of iatrogenic effects of suicide assessment were found. Recommendations are made to counter possible negative assessment effects on depressive participants/patients, and nurses and other caregivers are encouraged to talk to patients about suicidal symptoms.
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Affiliation(s)
- Keith M Harris
- School of Psychology, University of Queensland, St Lucia, Australia
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40
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Rinehart JK, Nason EE, Yeater EA, Miller G. Do Some Students Need Special Protection From Research on Sex and Trauma? New Evidence for Young Adult Resilience in "Sensitive Topics" Research. JOURNAL OF SEX RESEARCH 2017; 54:273-283. [PMID: 27093242 PMCID: PMC6563918 DOI: 10.1080/00224499.2016.1156047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Institutional review boards (IRBs) have expressed concerns that certain individuals or groups, such as participants who are younger, ethnic minorities, or who have certain psychological or personality traits, may be particularly distressed when participating in "sensitive topics" research. This study examined the effects of several demographic and individual difference factors (i.e., age, sex, ethnicity, religiosity, Big Five personality traits, and baseline psychological distress levels) on reactions to participation in sensitive topics research. Participants were 504 undergraduates who completed an extensive battery of either trauma/sex questionnaires or cognitive tests and rated their positive and negative emotional reactions and the perceived benefits and mental costs of participating. They also compared research participation to normal life stressors. Our findings indicated that individual difference and demographic risk factors do not increase participant distress after participating in sex/trauma research over and above that experienced after participating in traditionally minimal-risk cognitive tasks. Participants generally found research participation less distressing than normal life stressors and even enjoyable.
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Affiliation(s)
| | - Erica E. Nason
- University of Texas Health Science Center at San Antonio
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41
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Cunningham JL, Zanzi M, Willebrand M, Ekselius L, Ramklint M. No regrets: Young adult patients in psychiatry report positive reactions to biobank participation. BMC Psychiatry 2017; 17:21. [PMID: 28095825 PMCID: PMC5240261 DOI: 10.1186/s12888-017-1199-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 01/09/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Research in vulnerable individuals must insure voluntariness and minimize negative reactions caused by participation. This study aimed to describe consent and completion rate in young psychiatric patients in relation to study components, degree of disability and to compare response to research participation in patients and controls. METHODS Between 2012 and 2015, 463 patients with psychiatric disorders between the ages of 18-25 from the Dept. of General Psychiatry at Uppsala University Hospital and 105 controls were recruited to donate data and samples to a biobank. Consent and completion in relation to questionnaires, biological sampling of blood, saliva or feces, were monitored. Both groups were also asked about their perceived disability and how research participation affected them. RESULTS Most patients who participated consented to and completed questionnaires and blood sampling. The majority also consented to saliva sampling, while less than half consented to collect feces. Of those who gave consent to saliva and feces only half completed the sampling. Both patients and controls reported high voluntariness and were positive to research participation. Within the patient group, those with greater perceived disability reported greater distress while participating in research, but there was no difference in consent or completion rates or level of regret. CONCLUSIONS With the described information procedures, psychiatric patients, regardless of perceived disability, reported high voluntariness and did not regret participation in biobanking. Compared to questionnaires and blood sampling, given consent was reduced for feces and completion was lower for both saliva and feces sampling.
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Affiliation(s)
- Janet L. Cunningham
- Department of Neuroscience, Psychiatry, Uppsala University Hospital, Entrance 10, Floor 3B, 751 85, Uppsala, Sweden
| | - Manuel Zanzi
- Department of Neuroscience, Psychiatry, Uppsala University Hospital, Entrance 10, Floor 3B, 751 85, Uppsala, Sweden
| | - Mimmie Willebrand
- Department of Neuroscience, Psychiatry, Uppsala University Hospital, Entrance 10, Floor 3B, 751 85, Uppsala, Sweden
| | - Lisa Ekselius
- Department of Neuroscience, Psychiatry, Uppsala University Hospital, Entrance 10, Floor 3B, 751 85, Uppsala, Sweden
| | - Mia Ramklint
- Department of Neuroscience, Psychiatry, Uppsala University Hospital, Entrance 10, Floor 3B, 751 85, Uppsala, Sweden
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Enticott JC, Shawyer F, Brophy L, Russell G, Fossey E, Inder B, Mazza D, Vasi S, Weller PJ, Wilson-Evered E, Edan V, Meadows G. The PULSAR primary care protocol: a stepped-wedge cluster randomized controlled trial to test a training intervention for general practitioners in recovery-oriented practice to optimize personal recovery in adult patients. BMC Psychiatry 2016; 16:451. [PMID: 27998277 PMCID: PMC5168875 DOI: 10.1186/s12888-016-1153-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 12/01/2016] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND General practitioners (GPs) in Australia play a central role in the delivery of mental health care. This article describes the PULSAR (Principles Unite Local Services Assisting Recovery) Primary Care protocol, a novel mixed methods evaluation of a training intervention for GPs in recovery-oriented practice. The aim of the intervention is to optimize personal recovery in patients consulting study GPs for mental health issues. METHODS The intervention mixed methods design involves a stepped-wedge cluster randomized controlled trial testing the outcomes of training in recovery-oriented practice, together with an embedded qualitative study to identify the contextual enablers and challenges to implementing recovery-oriented practice. The project is conducted in Victoria, Australia between 2013 and 2017. Eighteen general practices and community health centers are randomly allocated to one of two steps (nine months apart) to start an intervention comprising GP training in the delivery of recovery-oriented practice. Data collection consists of cross-sectional surveys collected from patients of participating GPs at baseline, and again at the end of Steps 1 and 2. The primary outcome is improvement in personal recovery using responses to the Questionnaire about the Process of Recovery. Secondary outcomes are improvements in patient-rated measures of personal recovery and wellbeing, and of the recovery-oriented practice they have received, using the INSPIRE questionnaire, the Warwick-Edinburgh Mental Well-being Scale, and the Kessler Psychological Distress Scale. Participant data will be analyzed in the group that the cluster was assigned to at each study time point. Another per-protocol dataset will contain all data time-stamped according to the date of intervention received at each cluster site. Qualitative interviews with GPs and patients at three and nine months post-training will investigate experiences and challenges related to implementing recovery-oriented practice in primary care. DISCUSSION Recovery-oriented practice is gaining increasing prominence in mental health service delivery and the outcomes of such an approach within the primary care sector for the first time will be evaluated in this project. If findings are positive, the intervention has the potential to extend recovery-oriented practice to GPs throughout the community. TRIAL REGISTRATION Australian and New Zealand Clinical Trial Registry ( ACTRN12614001312639 ). Registered: 8 August 2014.
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Affiliation(s)
- Joanne C. Enticott
- Southern Synergy, Department of Psychiatry, Monash University, 126 Cleeland St, Dandenong, VIC Australia ,Royal District Nursing Service Institute, 31 Alma Rd, St Kilda, VIC Australia
| | - Frances Shawyer
- Southern Synergy, Department of Psychiatry, Monash University, 126 Cleeland St, Dandenong, VIC Australia
| | - Lisa Brophy
- Mind Australia, Heidelberg, VIC Australia ,Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC Australia
| | - Grant Russell
- School of Primary Health Care, Monash University, Notting Hill Campus, Victoria, Australia ,Southern Academic Primary Care Research Unit, Monash University, Notting Hill, Victoria, Australia
| | - Ellie Fossey
- School of Primary Health Care, Monash University Peninsula Campus, Frankston, VIC Australia
| | - Brett Inder
- Department of Econometrics and Business Statistics, Monash University, Melbourne, VIC Australia
| | - Danielle Mazza
- School of Primary Health Care, Monash University, Notting Hill Campus, Victoria, Australia
| | - Shiva Vasi
- School of Primary Health Care, Monash University, Notting Hill Campus, Victoria, Australia ,Southern Academic Primary Care Research Unit, Monash University, Notting Hill, Victoria, Australia
| | | | | | - Vrinda Edan
- Southern Synergy, Department of Psychiatry, Monash University, 126 Cleeland St, Dandenong, VIC Australia
| | - Graham Meadows
- Southern Synergy, Department of Psychiatry, Monash University, 126 Cleeland St, Dandenong, VIC, Australia. .,Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia. .,Monash Health, Melbourne, VIC, Australia.
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Goossens I, Nicholls TL, Torchalla I, Brink J, de Ruiter C. The Perceived Impact of Trauma-Focused Research on Forensic Psychiatric Patients With Lifetime Victimization Histories. J Empir Res Hum Res Ethics 2016; 11:334-345. [PMID: 27887006 DOI: 10.1177/1556264616670769] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the perceived costs, benefits, and motivations for participating in individual trauma-focused interviews among forensic psychiatric patients ( N = 74). The majority of our participants were male, and 100% endorsed adverse childhood experiences (e.g., abuse, neglect) or exposure to potentially traumatic events (e.g., assault). Levels of posttraumatic avoidance (41.9%), reexperiencing (59.5%), and increased arousal (51.3%) were high. In line with previous studies, our findings suggest an overall positive research experience in this sample. In spite of extensive histories of lifetime victimization we did not find an association between victimization, posttraumatic symptomatology, and a negative research experience. Our findings suggest that participation in trauma-focused research is not only possible with, but also potentially beneficial for forensic patients.
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Affiliation(s)
- Ilvy Goossens
- 1 The University of British Columbia, Vancouver, Canada.,2 BC Mental Health and Substance Use Services, Coquitlam, Canada
| | - Tonia L Nicholls
- 1 The University of British Columbia, Vancouver, Canada.,2 BC Mental Health and Substance Use Services, Coquitlam, Canada
| | - Iris Torchalla
- 3 Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada
| | - Johann Brink
- 1 The University of British Columbia, Vancouver, Canada.,2 BC Mental Health and Substance Use Services, Coquitlam, Canada
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The Experience of Participation in Suicide Research From the Perspective of Individuals With Bipolar Disorder. J Nerv Ment Dis 2016; 204:840-844. [PMID: 26915014 DOI: 10.1097/nmd.0000000000000487] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Reasons underlying the elevated prevalence of suicide in bipolar disorder remain underresearched and poorly understood. Participation in suicide-focused research may pose a risk to vulnerable groups, such as those with bipolar disorder. Participants were asked to provide feedback about their experience of participating in a suicide-focused qualitative research interview. The data set was analyzed using inductive thematic analysis. Qualitative themes were (1) talking about suicide was not distressing, (2) negative interview expectations, (3) personal benefits, (4) value of suicide research, (5) interview advice, and (6) talking about suicide was difficult. Suicide-focused research can be conducted with minimal participant distress. Sufficient procedures must be in place, both to identify those at risk of experiencing distress and to efficiently deal with any distress that might occur.
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Oliveira RMD, Duarte AF, Alves D, Furegato ARF. Development of the TabacoQuest app for computerization of data collection on smoking in psychiatric nursing. Rev Lat Am Enfermagem 2016; 24:e2726. [PMID: 27579930 PMCID: PMC5016051 DOI: 10.1590/1518-8345.0661.2726] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 10/31/2015] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE to develop a mobile app for research on the use of tobacco among psychiatric patients and the general population. METHOD applied research with the technological development of an app for data collection on an Android tablet. For its development, we considered three criteria: data security, benefits for participants and optimization of the time of researchers. We performed tests with twenty fictitious participants and a final test with six pilots. RESULTS the app collects data, stores them in the database of the tablet and export then to an Excel spreadsheet. RESOURCES calculator, stopwatch, offline operation, branching logic, field validation and automatic tabulation. CONCLUSION the app prevents human error, increases the quality of the data by validating them during the interview, allows the performing of automatic tabulation and makes the interviews less tiring. Its success may encourage the use of this and other computational resources by nurses as a research tool.
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Affiliation(s)
- Renata Marques de Oliveira
- Doctoral Student, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Alexandre Freitas Duarte
- BSc in Biomedical Informatics, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Domingos Alves
- PhD, Assistant Professor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP. Brazil
| | - Antonia Regina Ferreira Furegato
- PhD, Retired Full Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Edwards KM, Sylaska KM. Reactions to Participating in Intimate Partner Violence and Minority Stress Research: A Mixed Methodological Study of Self-Identified Lesbian and Gay Emerging Adults. JOURNAL OF SEX RESEARCH 2016; 53:655-665. [PMID: 26421906 DOI: 10.1080/00224499.2015.1035428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to examine lesbian and gay (LG) young adults' reactions to participating in intimate partner violence (IPV) and minority stress research using a mixed methodological design. Participants were 277 U.S. college students currently involved in same-sex relationships and self-identified cisgender LG who completed an online questionnaire that included closed- and open-ended questions. Results suggested that IPV research was well tolerated by the vast majority of participants; close to one in 10 participants reported being upset by the study questions, yet 75% of upset individuals reported some level of personal benefit. Reasons for upset as identified in the open-ended responses included thinking about personal experiences with IPV, as the perpetrator or friend of a victim, as well as thinking about the uncertainty of their future with their current partner. The correlates of emotional reactions and personal benefits to research participation were also examined, and these varied among gay men and lesbian women. Implications of these findings underscore the importance of accurate reflection of risk and benefits in informed consent documents as well as systematic evaluation of sexual minority participants' reactions to research participation in an effort to conduct ethically sound sexual science research.
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Affiliation(s)
- Katie M Edwards
- a Department of Psychology and Women's Studies , Prevention Innovations Research Center, and the Carsey School of Public Policy, University of New Hampshire
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Edwards KM, Haynes EE, Rodenhizer-Stämpfli KA. High School Youth's Reactions to Participating in Mixed-Methodological Dating Violence Research. J Empir Res Hum Res Ethics 2016; 11:220-30. [PMID: 27307419 DOI: 10.1177/1556264616651783] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study used a sample of high school youth (N = 218) and a mixed-methodological research design to examine high school students' reactions to participating in focus groups and completing surveys that inquired about dating violence (DV). Results showed that showed that 1.5% (n = 3) of the youth regretted participating in the study and 6% (n = 12) were upset by the study questions; being upset was attributed to personal experiences with DV and being disturbed by peers' responses during the focus group. Furthermore, 49% (n = 99) of the youth reported feeling that they personally benefited from participating in the study for reasons such as learning ways to help friends in situations of DV. Results have implications for conducting mixed-methodological DV research with youth.
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Sexual Assault Victims Participating in Research: Causing Harm When Trying to Help? Arch Psychiatr Nurs 2016; 30:412-7. [PMID: 27256950 DOI: 10.1016/j.apnu.2016.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/26/2015] [Accepted: 01/17/2016] [Indexed: 11/22/2022]
Abstract
For fear of causing unnecessary distress, ethical concerns have been raised in regard to asking vulnerable persons e.g. sexually traumatized victims to participate in scientific research studies. The current study investigates how victims of sexual assault perceived participating in scientific research in regard to victims' psychological and/or physiological distress and potential beneficial outcomes from participation (N=51). Results from interviews with victims indicated that the majority of victims of sexual assault who had taken part in the study considered their participation in research a positive experience causing little short- or long-term psychological or physiological distress. In addition, over half of the respondents reported some benefits from participation.
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Morrison AP, Law H, Barrowclough C, Bentall RP, Haddock G, Jones SH, Kilbride M, Pitt E, Shryane N, Tarrier N, Welford M, Dunn G. Psychological approaches to understanding and promoting recovery in psychosis and bipolar disorder: a mixed-methods approach. PROGRAMME GRANTS FOR APPLIED RESEARCH 2016. [DOI: 10.3310/pgfar04050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BackgroundRecovery in mental health is a relatively new concept, but it is becoming more accepted that people can recover from psychosis. Recovery-orientated services are recommended for adult mental health, but with little evidence base to support this.ObjectivesTo facilitate understanding and promotion of recovery in psychosis and bipolar disorder (BD), in a manner that is empowering and acceptable to service users.MethodThere were six linked projects using qualitative and quantitative methodologies: (1) developing and piloting a service user-defined measure of recovery; (2) a Delphi study to determine levels of consensus around the concept of recovery; (3) examination of the psychological factors associated with recovery and how these fluctuate over time; (4) development and evaluation of cognitive–behavioural approaches to guided self-help including a patient preference trial (PPT); (5) development and evaluation of cognitive–behavioural therapy (CBT) for understanding and preventing suicide in psychosis including a randomised controlled trial (RCT); and (6) development and evaluation of a cognitive–behavioural approach to recovery in recent onset BD, including a RCT of recovery-focused cognitive–behavioural therapy (RfCBT). Service user involvement was central to the programme.ResultsMeasurement of service user-defined recovery from psychosis (using the Subjective Experience of Psychosis Scale) and BD (using the Bipolar Recovery Questionnaire) was shown to be feasible and valid. The consensus study revealed a high level of agreement among service users for defining recovery, factors that help or hinder recovery and items which demonstrate recovery. Negative emotions, self-esteem and hope predicted recovery judgements, both cross-sectionally and longitudinally, whereas positive symptoms had an indirect effect. In the PPT, 89 participants entered the study, three were randomised, 57 were retained in the trial until 15-month follow-up (64%). At follow-up there was no overall treatment effect on the primary outcome (Questionnaire about the Process of Recovery total;p = 0.82). In the suicide prevention RCT, 49 were randomised and 35 were retained at 6-month follow-up (71%). There were significant improvements in suicidal ideation [Adult Suicidal Ideation Questionnaire; treatment effect = –12.3, 95% confidence interval (CI) –24.3 to –0.14], Suicide Probability Scale (SPS; treatment effect = –7.0, 95% CI –15.5 to 0) and hopelessness (subscale of the SPS; treatment effect = –3.8, 95% CI –7.3 to –0.5) at follow-up. In the RCT for BD, 67 participants were randomised and 45 were retained at the 12-month follow-up (67%). Recovery score significantly improved in comparison with treatment as usual (TAU) at follow-up (310.87, 95% CI 75.00 to 546.74). At 15-month follow-up, 32 participants had experienced a relapse of either depression or mania (20 TAU vs. 12 RfCBT). The difference in time to recurrence was significant (estimated hazard ratio 0.38, 95% CI 0.18 to 0.78;p < 0.006).ConclusionsThis research programme has improved our understanding of recovery in psychosis and BD. Key findings indicate that measurement of recovery is feasible and valid. It would be feasible to scale up the RCTs to assess effectiveness of our therapeutic approaches in larger full trials, and two of the studies (CBT for suicide prevention in psychosis and recovery in BD) found significant benefits on their primary outcomes despite limited statistical power, suggesting definitive trials are warranted.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
- Anthony P Morrison
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Heather Law
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | | | - Richard P Bentall
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Gillian Haddock
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Steven H Jones
- The Spectrum Centre for Mental Health Research, University of Lancaster, Lancaster, UK
| | - Martina Kilbride
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK
| | - Elizabeth Pitt
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK
| | - Nicholas Shryane
- School of Social Sciences, University of Manchester, Manchester, UK
| | - Nicholas Tarrier
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Mary Welford
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK
| | - Graham Dunn
- Centre for Biostatistics, University of Manchester, Manchester, UK
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Lévesque S, Rodrigue C, Beaulieu-Prévost D, Blais M, Boislard MA, Lévy JJ. Intimate partner violence, sexual assault, and reproductive health among university women. CANADIAN JOURNAL OF HUMAN SEXUALITY 2016. [DOI: 10.3138/cjhs.251-a5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Relationships between victimization, termination of pregnancy (ToP), diagnosis of sexually transmitted infection (STI), and emergency contraceptive use were examined using data from a survey of university students in Montreal, Canada. Female students who had been sexually active in the past two years with at least one male partner were included (n=1,812). Victimization experiences were assessed, and logistic regressions were performed to predict the correlates of lifetime use of emergency contraception, ToP, and ever having been diagnosed with an STI. In this sample, 36.1% reported intimate partner violence (IPV), 8.5% reported sexual assault (SA) and 18.9% reported both SA and IPV. Factors statistically associated with emergency contraceptive use, ToP and STI diagnosis were older age, financial hardship, migratory trajectory, early sexual initiation, and dual victimization. These data indicate that the reproductive health needs of female university students experiencing victimization are unmet. Interventions should focus on victimization screening and enhancing reproductive autonomy.
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Affiliation(s)
- Sylvie Lévesque
- Sexology Department, Université du Québec à Montréal, Montréal, QC
| | - Carl Rodrigue
- Sexology Department, Université du Québec à Montréal, Montréal, QC
| | | | - Martin Blais
- Sexology Department, Université du Québec à Montréal, Montréal, QC
| | | | - Joseph J. Lévy
- Sexology Department, Université du Québec à Montréal, Montréal, QC
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