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Cruz-Gonzalez M, Shrout PE, Alvarez K, Hostetter I, Alegría M. Measurement Invariance of Screening Measures of Anxiety, Depression, and Level of Functioning in a US Sample of Minority Older Adults Assessed in Four Languages. Front Psychiatry 2021; 12:579173. [PMID: 33658950 PMCID: PMC7917233 DOI: 10.3389/fpsyt.2021.579173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/25/2021] [Indexed: 01/21/2023] Open
Abstract
Population aging in the US and its increase in racial/ethnic diversity has resulted in a growing body of literature aimed at measuring health disparities among minority older adults. Disparities in health outcomes are often evaluated using self-reported measures and, to attend to linguistic diversity, these measures are increasingly being used in languages for which they were not originally developed and validated. However, observed differences in self-reported measures cannot be used to infer disparities in theoretical attributes, such as late-life depression, unless there is evidence that individuals from different groups responded similarly to the measures-a property known as measurement invariance. Using data from the Positive Minds-Strong Bodies randomized controlled trial, which delivered evidence-based mental health and disability prevention services to a racially/ethnically diverse sample of minority older adults, we applied invariance tests to two common measures of anxiety and depression (the GAD-7 and the HSCL-25) and two measures of level of functioning (the Late-Life FDI and the WHODAS 2.0) comparing four different languages: English, Spanish, Mandarin, and Cantonese. We found that these measures were conceptualized similarly across languages. However, at the item-level symptom burden, we identified a non-negligible number of symptoms with some degree of differential item functioning. Spanish speakers reported more worry symptoms and less somatic symptoms for reasons unrelated to their psychological distress. Mandarin speakers reported more feelings of restlessness, and both Mandarin and Cantonese speakers reported no interest in things more often for reasons unrelated to their psychological distress. Mandarin and Cantonese speakers were also found to consistently report more difficulties performing physical activities for reasons unrelated to their level of functioning. In general, invariance tests have been insufficiently applied within psychological research, but they are particularly relevant as a prerequisite to accurately measure health disparities. Our results highlight the importance of conducting invariance testing, as we singled out several items that may require careful examination before considering their use to compare symptoms of psychological distress and level of functioning among ethnically and linguistically diverse older adult populations.
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Affiliation(s)
- Mario Cruz-Gonzalez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States.,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Patrick E Shrout
- Department of Psychology, New York University, New York, NY, United States
| | - Kiara Alvarez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States.,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Isaure Hostetter
- Department of Health Policy, Harvard School of Public Health, Boston, MA, United States
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States.,Department of Medicine, Harvard Medical School, Boston, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Macdonald JA, Greenwood CJ, Francis LM, Harrison TR, Graeme LG, Youssef GJ, Di Manno L, Skouteris H, Fletcher R, Knight T, Williams J, Milgrom J, Olsson CA. Profiles of Depressive Symptoms and Anger in Men: Associations With Postpartum Family Functioning. Front Psychiatry 2020; 11:578114. [PMID: 33329118 PMCID: PMC7719778 DOI: 10.3389/fpsyt.2020.578114] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/27/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Evidence suggests that men commonly experience depression as feelings of anger; yet, research has not investigated what this means for the manifestation of depressive symptoms in the early years of fatherhood and for key indicators of family functioning. Methods: Using data from a longitudinal cohort study of men at the normative age for entering fatherhood (28-32 years), we conducted latent class analyses to identify patterns of depressive symptoms and 3 sub-types of state anger (feeling; verbal; physical). We then assessed whether class membership was associated with paternity status (n = 535). In a subsample of fathers of infants aged up to 18 months (n = 162), we prospectively assessed associations with paternal-infant bonding, co-parenting, perceived social support, paternal involvement in childcare and alcohol use up to 2 years later. Results: Five classes emerged that differentiated men by anger and depressive symptom severity and by the degree to which men endorsed the feeling of wanting to express anger physically. Compared to the reference class with minimal symptoms, fathers had a higher probability of being in either the mild or most severe symptom classes. Men in symptomatic classes were at higher risk of lower levels of social support, co-parenting problems, and paternal-infant bonds. Class membership was not associated with alcohol use or paternal involvement in childcare. Conclusions: Our results reveal patterns of co-existing symptoms of depression and anger in fathers of infants that will be relevant to men's own need for support, their family safety, partner mental health and child developmental outcomes.
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Affiliation(s)
- Jacqui A. Macdonald
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Christopher J. Greenwood
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Lauren M. Francis
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Tessa R. Harrison
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Liam G. Graeme
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - George J. Youssef
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Laura Di Manno
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
- Warwick Business School, University of Warwick, Coventry, United Kingdom
| | - Richard Fletcher
- Faculty of Health and Medicine, Family Action Centre, University of Newcastle, Callaghan, NSW, Australia
| | - Tess Knight
- Cairnmillar Institute, Hawthorn East, VIC, Australia
| | - Joanne Williams
- Department of Health Sciences and Biostatistics, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Craig A. Olsson
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
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Romans SE, Clarkson RF, Einstein G, Kreindler D, Laredo S, Petrovic MJ, Stanley J. Crying, oral contraceptive use and the menstrual cycle. J Affect Disord 2017; 208:272-277. [PMID: 27794250 DOI: 10.1016/j.jad.2016.08.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 08/04/2016] [Accepted: 08/24/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Crying, a complex neurobiological behavior with psychosocial and communication features, has been little studied in relationship to the menstrual cycle. METHODS In the Mood and Daily Life study (MiDL), a community sample of Canadian women aged 18-43 years, n=76, recorded crying proneness and crying frequency daily for six months along with menstrual cycle phase information. RESULTS Crying proneness was most likely during the premenstruum, a little less likely during menses and least likely during the mid-cycle phase, with statistically significant differences although the magnitude of these differences were small. By contrast, actual crying did not differ between the three menstrual cycle phases. Oral contraceptive use did not alter the relationship between menstrual cycle phase and either crying variable. A wide range of menstrual cycle phase - crying proneness patterns were seen with visual inspection of the individual women's line graphs. LIMITATIONS timing of ovulation was not ascertained. Using a three phase menstrual cycle division precluded separate late follicular and early luteal data analysis. The sample size was inadequate for a robust statistical test of actual crying. CONCLUSIONS reproductive aged women as a group report feeling more like crying premenstrually but may not actually cry more during this menstrual cycle phase. Individual patterns vary substantially. Oral contraceptive use did not affect these relationships. Suggestions for future research are included.
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Affiliation(s)
- Sarah E Romans
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand.
| | - Rose F Clarkson
- Austin Hospital, Department of Psychiatry, University of Melbourne, Australia
| | - Gillian Einstein
- Dalla Lana School of Public Health, Department of Psychology, University of Toronto, Canada
| | - David Kreindler
- Centre for Mobile Computing in Mental Health, Sunnybrook Health Sciences Centre, Canada; Department of Psychiatry, University of Toronto, Canada
| | - Sheila Laredo
- Department of Medicine, Women's College Hospital, University of Toronto, Canada
| | - Michele J Petrovic
- Cancer Research, Princess Margaret Hospital, University Health Network, Canada
| | - James Stanley
- Department of Public Health, University of Otago, Wellington, New Zealand
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How to support patients who are crying in palliative home care: an interview study from the nurses’ perspective. Prim Health Care Res Dev 2016; 17:479-88. [DOI: 10.1017/s1463423616000037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AimThe aim of this study was to explore how nurses can support patients who are crying in a palliative home care context.BackgroundIn palliative care the nurse has a central role in the team whose duty it is to create a sense of security and trust, as well as to give comfort and support the patients. The nurse’s responsibility is to identify different needs of the patients for support and develop a relationship with them. Patients may express their pain, anxiety, fear and suffering by crying. No studies have been found which focus on how nurses can support patients who are crying in different ways and crying for different reasons.MethodsA qualitative explorative study was performed. Semi-structured interviews were held with eight nurses aged 32–63 years (Median 40) working in Swedish palliative home care. The data were analysed using Qualitative Content analysis.FindingsIt was reported that the nurse should meet and confirm the patient during different types of crying episodes and should also be able to alternate between being close and physically touching the in such close contact with the patients, the nurse can provide emotional support by showing empathy, merely being present and letting the patients cry as much as they want. When the crying finally stops, the nurse can support the person by speaking with them, showing sensitivity, humility and respect for the patient’s wishes. A few examples of the patients’ need for information or practical support emerged. The nurse can emotionally support the person who is crying by just being present, confirming, showing empathy, offering a chance to talk and showing respect for their individual needs and the different ways they may cry.
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Stults CD, Elston Lafata J, Diamond L, MacLean L, Stone AL, Wunderlich T, Frankel RM, Tai-Seale M. How do primary care physicians respond when patients cry during routine ambulatory visits? ACTA ACUST UNITED AC 2014. [DOI: 10.1179/1753807614y.0000000044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Steer RA. Self-reported inability to cry as a symptom of anhedonic depression in outpatients with a major depressive disorder. Psychol Rep 2011; 108:874-82. [PMID: 21879634 DOI: 10.2466/02.09.13.15.pr0.108.3.874-882] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To ascertain whether self-reported inability to cry would be associated with symptoms of anhedonic depression, the 21-item Beck Depression Inventory-II was administered to 1,050 outpatients diagnosed with a DSM-IV-TR major depressive disorder. 219 (21%) patients reported on the BDI-II Crying item that they were unable to cry, and 831 (79%) patients reported they were able to cry. Only BDI-II Loss of Interest was significantly associated with the inability to cry after the other BDI-II symptoms were controlled for using a multiple logistic-regression analysis. The inability to cry was discussed as an indicator of anhedonic depression.
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Affiliation(s)
- Robert A Steer
- Department of Psychiatry, School of Osteopathic Medicine, University of Medicine and Dentistry of New Jersey, Stratford, NJ 08084-1391, USA.
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Measuring depression and PTSD after trauma: common scales and checklists. Injury 2011; 42:288-300. [PMID: 21216400 PMCID: PMC3295610 DOI: 10.1016/j.injury.2010.11.045] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 11/12/2010] [Indexed: 02/02/2023]
Abstract
Traumatic injury is an important public health problem secondary to high levels of morbidity and mortality. Injured survivors face several physical, emotional, and financial repercussions that can significantly impact their lives as well as their family. Depression and posttraumatic stress disorder (PTSD) are the most common psychiatric sequelae associated with traumatic injury. Factors affecting the prevalence of these psychiatric symptoms include: concomitant TBI, the timing of assessment of depression and PTSD, the type of injury, premorbid, sociodemographic, and cultural factors, and co-morbid medical conditions and medication side effects. The appropriate assessment of depression and PTSD is critical to an understanding of the potential consequences of these disorders as well as the development of appropriate behavioural and pharmacological treatments. The reliability and validity of screening instruments and structured clinical interviews used to assess depression and PTSD must be considered. Common self-report instruments and structured clinical interviews used to assess depression and PTSD and their reliability and validity are described. Future changes in diagnostic criteria for depression and PTSD and recent initiatives by the National Institute of Health regarding patient-reported outcomes may result in new methods of assessing these psychiatric sequelae of traumatic injury.
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Carlson K, Hall JM. Exploring the concept of manliness in relation to the phenomenon of crying: a Bourdieusian approach. J Holist Nurs 2011; 29:189-97; quiz 198-200. [PMID: 21262775 DOI: 10.1177/0898010110393354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The concept of manliness related to the phenomenon of crying can be better understood by tracing the roots of the language of manliness through history. A Bourdieusian theoretical approach is used, incorporating the analytics of habitus, bodily hexis, and symbolic violence. This less-studied phenomenon of crying is investigated from a holistic, biopsychosocial framework. Manliness is a social construct that has remained surprisingly consistent throughout history. The importance of this concept to physical, psychological, and social health and well-being is addressed from a holistic nursing perspective. This is a timely issue for men's mental health, for example, that of returning combat veterans experiencing loss, grief, and posttraumatic stress. This exploration provides insight for nursing by analyzing the concept of manliness, which stems largely from militaristic roots, and might present obstacles to emotional release.
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Affiliation(s)
- Kelly Carlson
- College of Nursing, University of Tennessee, Knoxville, 1800 Volunteer Boulevard, Knoxville, TN 37996, USA.
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Academic psychiatry's responsibility for increasing the recognition of mood disorders and risk for suicide in primary care. Curr Opin Psychiatry 2010; 23:157-66. [PMID: 19926995 DOI: 10.1097/yco.0b013e328333e195] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The authors seek solutions to better meet the healthcare needs of depressed patients in primary care by improving the recognition of depression, other mood disorders and of a risk for suicide. RECENT FINDINGS For 25 years academic psychiatry and primary care have known that only 10-50% of depressed patients are adequately treated, primarily because of the failure to recognize depression. There are substantial negative consequences including suicide. Suicide occurs during depression so the recognition of depression is the critical first step to preventing suicide. Recently noted is that one barrier to recognition is the traditional, comprehensive, psychiatric interview taught in academic departments of psychiatry that is impractical in primary care settings because it takes too much time. Some brief, initial psychiatric techniques have been developed but these typically have been introduced in primary care training programs and not by departments of psychiatry. SUMMARY A verbal four-question, 90 s screen for depression may be acceptable for routine use in primary care because it typically requires only seconds to a few minutes. Introduction of such a screening instrument to medical students on psychiatry and primary care clerkships could increase the recognition of depression and reduce death by suicide.
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