Education, sense of mastery and mental health: results from a nation wide health monitoring study in Norway

Religious Involvement, Vegetarian Diet, and Mental Well-Being Among Seventh-day Adventists in Peru

Mental well-being is conditioned by several factors, including religious involvement and diet. However, this evidence does not exist among members of the Seventh-day Adventist Church (SDA) in Latin America, particularly Peru. This study evaluated the association between religious involvement and vegetarian diet with mental well-being in members of the SDA Church in Peru. In this cross-sectional study, the sample included 767 participants, aged 18 to 59 years. A face-to-face and online survey was administered that included information on the dietary regimen and sociodemographic characteristics. Religious involvement and mental well-being were measured using the 12-item version of the General Health Questionnaire (GHQ-12) and the Duke University Religion Index (DUREL), respectively. A multivariate analysis was conducted to investigate the factors associated with mental well-being. Being female (β = 1.80, p < 0.001), coming from the highland region (β = 1.98, p < 0.001), having a basic educational degree (β = 1.85, p < 0.001), a higher level of religious involvement (β = 0.34, p < 0.001), and being vegetarian (β = 1.21, p < 0.001) were associated with greater mental well-being. This evidence highlights the implication of religious participation and a vegetarian diet in mental health, not only among SDA church members but also in a broader context. However, it should be recognized that direct transfer of church-based health promotion interventions and strategies to the general population can present challenges; therefore, it is suggested that these strategies should be adapted and adjusted to consider differences in the community context.

Correlation of Positive Psychological Health among US Adults (Aged ≥ 50 Years) with Pain and Documented Opioid Treatment

In this study, we aimed to identify the factors correlated with positive psychological health among United States older adults (≥50 years) with pain and documented opioid treatment. This retrospective cross-sectional study utilized a nationally representative dataset (Medical Expenditure Panel Survey). A multivariable logistic regression model was developed to assess the correlation of positive psychological health in the eligible population. The logistic regression model showed having excellent/very good/good (versus fair/poor) perceived health (adjusted odds ratio [AOR] = 9.062; 95% confidence interval [CI] = 5.383, 15.254) had a statistically significant correlation with positive psychological health among the eligible population. This finding offers important insights for clinicians and policymakers to consider when formulating approaches to better manage the psychological health of United States older adults with pain and documented opioid treatment.

Multidimensional employment precariousness mediates the association between low educational attainment and poor subjective well-being: results from a nationwide cross-sectional study in South Korea

OBJECTIVE

This paper explored how multidimensional employment precariousness (MEP) mediates the relationship between educational attainment and subjective well-being.

METHODS

A nationwide sample of 46 919 Korean workers participated in surveys between 2017 and 2020. Educational attainment was divided into four categories: elementary school, middle school, high school, and college. Subjective well-being was assessed using the 5-item World Health Organization Well-Being Index, and MEP was evaluated using a modified version of the Employment Precariousness Scale (ERPES-E), with scores ranging from 0 to 100 and higher scores indicating worse employment precariousness. A counterfactual-based logistic mediation analyses were used to estimation.

RESULTS

The mean MEP score was 36.0 [standard deviation (SD) 12.1] for college education, 44.3 (SD 11.5) for high school, 49.5 (SD 10.1) for middle school, and 51.1 (SD 10.0) for elementary school. The prevalence of poor subjective well-being was 24.0% for college education, 31.3% for high school, 40.6% for middle school, and 44.8% for elementary school. Odds ratios (OR) for the total effect of education on the poor subjective well-being were 1.44 [95% confidence interval (CI) 1.37-1.53] for high school, 2.19 (95% CI 1.98-2.24) for middle school, and 2.40 (95% CI 2.04-2.82) for elementary school when compared to college education. The OR for the indirect effect mediated through MEP were 1.27 (95% CI 1.25-1.29) for high school, 1.46 (95% CI 1.42-1.51) for middle school, and 1.53 (95% CI 1.48-1.59) for elementary school, accounting for 63.9%, 48.5%, and 48.6% of the total effect, respectively.

CONCLUSION

Our study suggests that MEP is an important contributor to the disparities in subjective well-being resulting from educational gradients.

Predictors of treatment attrition of cognitive health interventions in first episode psychosis

AIM

Dropping out of psychological interventions is estimated to occur in up to a third of individuals with psychosis. Given the high degree of attrition in this population, identifying predictors of attrition is important to develop strategies to retain individuals in treatment. We observed a particularly high degree of attrition (48%) in a recent randomized controlled study assessing cognitive health interventions for first-episode psychosis participants with comorbid social anxiety. Due to the importance of developing interventions for social anxiety in first episode psychosis, the aim of the present study was to identify putative predictors of attrition through a secondary analysis of data.

METHODS

Participants (n = 96) with first episode psychosis and comorbid social anxiety were randomized to receive cognitive behavioural therapy for social anxiety or cognitive remediation. Differences between completers and non-completers (<50% intervention completed) were compared using t-tests or chi-square analyses; statistically significant variables were entered into a multivariate logistic regression model.

RESULTS

Non-completers tended to be younger, had fewer years of education and had lower levels of social anxiety compared to completers. Lower baseline social anxiety and younger age were statistically significant predictors of non-completion in the logistic regression model.

CONCLUSIONS

Age and social anxiety were predictors of attrition in cognitive health interventions in first episode psychosis populations with comorbid social anxiety. In the ongoing development of social anxiety interventions for this population, future studies should investigate specific engagement strategies, intervention formats and outcome monitoring to improve participant retention in treatment.

Sense of mastery in first-episode psychosis-a one-year follow-up study

Introduction

A sense of mastery refers to beliefs about having control over one's life and has been found to protect health and buffer the effect of stressful experiences.

Methods

We investigated sense of mastery in first-episode psychosis (FEP) patients and population controls at baseline and at one-year follow-up. Pearlin and Schooler's Sense of Mastery scale was completed by 322 participants at baseline and by 184 participants at follow-up.

Results

People having experienced FEP reported lower mastery than controls at both time points, but a modest increase was seen in patients at follow-up. The strongest correlates of high baseline mastery in FEP were lower depressive symptoms and higher perceived social support, whereas positive or negative psychotic symptoms did not associate with mastery. Current depressive symptoms also correlated with mastery at the follow-up point, and change in depressive symptoms correlated with change in mastery. Higher mastery at treatment entry predicted remission of psychotic symptoms one year later. Sense of mastery was also found to mediate the association of perceived social support with depressive symptoms.

Discussion

The usefulness of mastery measures should be further tested for estimations of patient prognosis in early psychosis.

Construct validity of the General Health Questionnaire (GHQ-12) in patients with COVID-19 and its demographic and medical correlates

Introduction

The present cross sectional study aimed to evaluate the construct and criterion validity, reliability, and gender and age differences of the 12-item General Health Questionnaire (GHQ-12) among hospitalized patients with COVID-19 in 2020. The criterion validity was assessed via its link with perceived stress, sleep quality, daily life activities, and demographic and medical characteristics.

Methods

A total of 328 COVID-19 patients (55.8% men; Mage = 50.49, SD = 14.96) completed the GHQ-12, the Perceived Stress Scale (PSS), the Pittsburgh Sleep Quality Index (PSQI), the Activities of Daily Life (ADL)-Katz Scale, and the Lawton Instrumental Activities of Daily Living Scale (IADL).

Results

Among 13 factorial models, the three-factor model (successful coping, self-esteem, and stress) was shown to have the best fit. GHQ-12 was positively associated with PSQI, PSS, Hyperlipidemia, psychiatry disorders, hospitalization duration, the change in sleep time, and use of sleeping pills, and negatively correlated with educational level, and the number of family members. The GHQ-12 also had a negative correlation with ADL and IADL in over 60 years of age group. Females scored higher on total GHQ-12 scores, compared to males. Finally, the hospitalization duration was longer for patients over 60 (mean = 8.8 days, SD = 5.9) than patients under 60 (mean = 6.35 days, SD = 5.87).

Discussion

Overall, the findings provided evidence that mental distress in patients with COVID-19 is correlated with high perceived stress, low sleep quality, low ADL and IADL, and a range of demographic features and medical conditions. Designing psychological interventions for these patients that target the aforementioned correlates of mental distress is warranted.

Dietary Intake of Flavonoids Associated with Sleep Problems: An Analysis of Data from the National Health and Nutrition Examination Survey, 2007-2010

Flavonoids possess the latent ability to protect against sleep disorders. We examined the correlation between daily flavonoid intake and sleep duration, and sleep disorders. We enrolled 8216 participants aged ≥ 20 from the National Health and Nutrition Examination Survey (NHANES, 2007-2010), carrying out a cross-sectional study. Flavonoid intake was collected by dietary intake interview recalls. Logistic regression was utilized to evaluate the association between flavonoid intake sleep duration, and sleep disorders. We used subgroup and interaction analysis to explore differences between subgroups. When adjusting covariates in model 2, anthocyanidins, flavan-3-ols, flavones, flavonols, and the sum of flavonoids were considerably related to insufficient sleep duration (odds ratio (OR) (95% confidence interval (CI)); 0.83 (0.72, 0.95); 0.91 (0.83, 0.98); 0.63 (0.41, 0.98); 0.78 (0.64, 0.94); 0.85 (0.76, 0.95), respectively); the converse association was observed between flavanones, and flavones and the risk of sleep disorders (OR (95% CI); 0.85 (0.77, 0.95); 0.61 (0.41, 0.90), respectively). In relation to insufficient sleep, there were statistically significant interactions between flavonoid consumption and race/ethnicity, and education level. In relation to insufficient sleep, there were statistically significant interactions between flavonoid consumption and working status. In this study, we found that certain flavonoids were linked to increased sleep duration and a lower risk of sleep problems. Our research indicated that flavonoids might be a preventive factor for sleep disorders.

Client predictors of therapy dropout in a primary care setting: a prospective cohort study

BACKGROUND

Therapy dropout poses a major challenge. Considerable research has been conducted on predictors of dropout, however none in the context of primary mental health services in Norway. The purpose of this study was to investigate which client characteristics can predict dropout from the service Prompt Mental Health Care (PMHC).

METHODS

We performed a secondary analysis of a Randomized Controlled Trial (RCT). Our sample consisted of 526 adult participants receiving PMHC-treatment in the municipalities of Sandnes and Kristiansand, between November 2015 to August 2017. Using logistic regression, we investigated the association between nine client characteristics and dropout.

RESULTS

The dropout rate was 25.3%. The adjusted analysis indicated that older clients had a lower odds ratio (OR) of dropping out compared to younger clients (OR = 0.43, [95% CI = 0.26, 0.71]). Moreover, clients with higher education had a lower odds ratio of dropping out compared to clients with lower levels of education (OR = 00.55, 95% CI [0.34, 0.88]), while clients who were unemployed were more likely to drop-out as compared the regularly employed (OR = 2.30, [95% CI = 1.18, 4.48]). Finally, clients experiencing poor social support had a higher odds ratio of dropping out compared to clients who reported good social support (OR = 1.81, [95% CI = 1.14, 2.87]). Sex, immigrant background, daily functioning, symptom severity and duration of problems did not predict dropout.

CONCLUSION

The predictors found in this prospective study might help PMHC-therapists identify clients at risk of dropout. Strategies for preventing dropout are discussed.

Physical activity mediates the effect of education on mental health trajectories in older age

OBJECTIVE

Why people with lower levels of educational attainment have poorer mental health than people with higher levels can partly be explained by financial circumstances. However, whether behavioral factors can further explain this association remains unclear. Here, we examined the extent to which physical activity mediates the effect of education on mental health trajectories in later life.

METHODS

Data from 54,818 adults 50 years of age or older (55 % women) included in the Survey of Health, Aging and Retirement in Europe (SHARE) were analyzed using longitudinal mediation and growth curve models to estimate the mediating role of physical activity (baseline and change) in the association between education and mental health trajectories. Education and physical activity were self-reported. Mental health was derived from depressive symptoms and well-being, which were measured by validated scales.

RESULTS

Lower education was associated with lower levels and steeper declines in physical activity over time, which predicted greater increases in depressive symptoms and greater decreases in well-being. In other words, education affected mental health through both levels and trajectories of physical activity. Physical activity explained 26.8 % of the variance in depressive symptoms and 24.4 % in well-being, controlling for the socioeconomic path (i.e., wealth and occupation).

CONCLUSIONS

These results suggest that physical activity is an important factor in explaining the association between low educational attainment and poor mental health trajectories in adults aged 50 years and older.

Measurement invariance of the CD-RISC-10 across gender, age, and education: A study with Slovenian adults

The study aimed to investigate measurement invariance of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) across gender, age, and education. Adults from a general population of Slovenia (N = 431; 58% female; age 18 to 59 years) filled in the CD-RISC-10, the short form of the Mental Health Continuum and the Depression, Anxiety and Stress Scale. Measurement invariance of the proposed one-factor model of CD-RISC-10 by gender, age, and level of education was examined using multiple-group confirmatory factor analysis. The results showed configural, metric, and scalar invariance of the CD-RISC-10 across gender, age, and educational groups. The measure showed satisfactory reliability, positive associations with emotional, psychological, and social well-being, and negative links with negative emotional states. Group differences in latent means suggested higher resilience in men than women, early adults as compared to emerging adults, and people with higher as compared to those with lower level of education. The Slovenian version of the CD-RISC-10 is an acceptably reliable and valid measure of resilience, suitable to detect possible differences between gender, age, and educational groups. Resilience shows favorable associations with enhanced positive mental health and diminished symptoms of mental problems.

Health differences by entry stream among Canadian Armed Forces officer cadets

LAY SUMMARY

This study compared the baseline physical and mental health of officer candidates attending military college and officer training programs (i.e., non-direct-entry officer or non-DEO stream) with those of officers entering through a direct stream (direct-entry officer or DEO stream). Overall, DEO candidates had better health than non-DEO candidates. Female DEO and non-DEO candidates also reported more physical activity than male DEO and non-DEO candidates, and female non-DEO candidates had more symptoms of mental illness than male non-DEO candidates. A better understanding of these groups may lead to opportunities to customize health screening and supports depending on officer entry stream and sex; however, more research is needed to inform policy.

Cyberharassment Victimization on Three Continents: An Integrative Approach

This article introduces and applies an integrative model of cyberharassment victimization. The model combines routine activity theory (RAT), the general theory of crime (GTC), and the personal resources approach to analyze risk factors for victimization while acknowledging the protective role of a sense of mastery. Survey respondents were aged 15 to 25 years (N = 4816) from the U.S., Finland, Spain, and South Korea. Logistic regression models were used to analyze cyberharassment victimization. RAT-related factors were positively associated with cyberharassment victimization. Low self-control was positively associated with cyberharassment victimization in the U.S., Finland, and Spain but not in South Korea. The sense of mastery was negatively associated with cyberharassment victimization in the U.S., Finland, and South Korea but not in Spain. Protective factors against cyberharassment victimization should be utilized in future studies as adequate knowledge of protective factors could assist policymakers in generating preventative measures against cyberharassment. Our study demonstrates the benefits of integrating criminological theories and protective factors in studies using cross-national data to gain a better understanding of the dynamics of cyberharassment.

Predictors of repeated adolescent self-harm: The display of multiple variables and mediators in a 2-year study

BACKGROUND

Data on self-harm (SH) repetition in non-Western adolescents are limited; this study is to survey the predictors.

METHODS

A total of 5879 adolescents (mean age 16.02 years) in Northern Taiwan were recruited. The participants filled in online questionnaires about their sociodemographic data, suicidality, depressive symptoms, self-esteem, social support, family discord, impulsivity, and alcohol and tobacco use at baseline (T1) and at the 1 year follow-up (T2). We used logistic regression analysis to examine the predictors of SH continuation. Generalized structural equation modeling (GSEM) was then estimated to analyze the treatable variables for both years and to investigate their relationships and mediating effects.

RESULTS

A total of 125 students were identified as being in the SH continuation group; while 470 students were identified as being in the SH stop group. The SH continuation rate was 21%; no significant gender difference was found. Logistic regression analysis showed that the predictors of SH continuation were low school ranking, poor quality of listening from relatives, use of the cutting method for SH, and a suicide plan in the past year at T1, and more depressed mood, use of the cutting method for SH, more suicide ideation and plans at T2. Similar predictors were found by GSEM; self-esteem at T1 and depressed mood at T2 were found to be mediators in the pathways.

CONCLUSION

The continuation rate of SH was similar to that reported in Western countries. These predictors should be included in the treatment plan to prevent SH continuation.

Influence of college education on happiness: A quasi-experimental study based on higher education expansion in China

Previous studies have documented a positive association between college education and happiness. However, the endogeneity of college education attainment is rarely examined, and a more robust link between college education and happiness needs to be built. Based on the Chinese General Social Survey data of 2017, the present study used the quasi-experiment of China's higher education expansion started in 1999 to construct a fuzzy regression discontinuity design to examine the causal association between college education and happiness. It is observed that college education indeed improved Chinese happiness, but this positive association was stronger in males than in females. Further, college education was observed to improve happiness by improving individual political status, perceived personal status, health and family social status, but not by increasing personal income. Accordingly, the government should continue to promote the development of higher education, and the fairness of higher education development deserves more attention to reduce population disparities in happiness.

Identifying long-term and imminent suicide predictors in a general population and a clinical sample with machine learning

BACKGROUND

Machine learning (ML) is increasingly used to predict suicide deaths but their value for suicide prevention has not been established. Our first objective was to identify risk and protective factors in a general population. Our second objective was to identify factors indicating imminent suicide risk.

METHODS

We used survival and ML models to identify lifetime predictors using the Cohort of Norway (n=173,275) and hospital diagnoses in a Saskatoon clinical sample (n=12,614). The mean follow-up times were 17 years and 3 years for the Cohort of Norway and Saskatoon respectively. People in the clinical sample had a longitudinal record of hospital visits grouped in six-month intervals. We developed models in a training set and these models predicted survival probabilities in held-out test data.

RESULTS

In the general population, we found that a higher proportion of low-income residents in a county, mood symptoms, and daily smoking increased the risk of dying from suicide in both genders. In the clinical sample, the only predictors identified were male gender and older age.

CONCLUSION

Suicide prevention probably requires individual actions with governmental incentives. The prediction of imminent suicide remains highly challenging, but machine learning can identify early prevention targets.

Strategic Assessment of Neighbourhood Environmental Impacts on Mental Health in the Lisbon Region (Portugal): A Strategic Focus and Assessment Framework at the Local Level

Scientific evidence shows that each place/environment generates specific conditions with associated impacts on the mental health and well-being of the population. A holistic, multilevel and integrated environmental approach to mental health enhances the understanding of this phenomena, supporting the local decision-making processes to improve spatial planning of neighbourhood environments. The aim of this study is to develop a strategic assessment framework, based on four municipalities in the Lisbon Region (Portugal), that explores policy and planning initiatives capable of generating favourable neighbourhood environmental conditions for mental health while also detecting risks. Using baseline results of significant statistical associations between individuals’ perceptions of their neighbourhood environment and their mental health in the Lisbon Region, a Strategic Focus on Environmental and Mental Health Assessment framework (SEmHA) was built, by applying the methodology “Strategic Thinking for Sustainability” in Strategic Environmental Assessment, developed by Partidário in 2012. Taking into account the promotion of the population’s mental health, four critical decision factors of neighbourhood environments were identified: (1) public space quality (e.g., improving sense of place), (2) physical environment quality (e.g., low levels of noise exposure), (3) professional qualification and creation of economic activities (e.g., attracting new economic activities), and (4) services and facilities (e.g., improving access to health and education services). The proposed strategic focus and assessment framework contributes to ensuring that interventions in neighbourhood environments truly achieve community mental health benefits and reduce inequalities, thus helping policy makers to assess impacts at the local level.

Socio-economic and demographic patterns of mental health complaints among the employed adults in Estonia

Background

Mental health problems follow a distinct socio-economic gradient and contribute to the health inequalities. The study aims to analyse the socio-economic and demographic factors of self-reported mental health complaints (stress, depressiveness, overtiredness, suicidal thoughts) among employed adult population in Estonia.

Methods

Data on 4041 employed respondents (2064 men and 1977 women) aged 20–64 years from nationally representative health surveys from years 2016 and 2018 in Estonia were used for the study. Dependent variables included self-reported stress, depressiveness, overtiredness, and suicidal thoughts. Descriptive statistics and both log-binomial and Poisson regression analysis were used to describe the socio-economic and demographic variations in these mental health complaints.

Results

More than half of the respondents had either stress, depressiveness, overtiredness or suicidal thoughts with 25% reporting two or more of mental health complaints. Lower personal income was associated with higher rates of all mental health complaints (stress, depressiveness, overtiredness, and suicidal thoughts) among employed adults in Estonia. Additionally, lower education was associated with higher prevalence of depressiveness and lower job skills predicted higher prevalence of suicidal thoughts. Higher prevalence ratios for depressiveness and overtiredness were found for women compared to men whereas Estonians had higher prevalence ratios for stress and suicidal thoughts compared to non-Estonians. All mental health complaints were more frequently reported at younger ages (compared to 50-64-year olds) and by not married or cohabiting respondents.

Conclusion

High prevalence of mental health complaints and their socio-economic and demographic patterning refer to considerable inequalities in mental health among employed adults. Policy actions targeting especially younger adults and those with financial difficulties are needed to address these early manifestations of mental health problems.

Perceived Racial Discrimination and Mental Health in Diverse Groups of Asian Americans: The Differing Impacts by Age, Education, and Ethnicity

The aim of this study was to examine how perceived racial discrimination is associated with mental distress among diverse Asian Americans and to explore the potential moderators in the relationship. Based on the 2015 Asian American Quality of Life (AAQoL) survey (n = 2609), direct influences were tested of the contextual (demographic, health-related, and immigration-related) variables and perceived racial discrimination on mental distress, as well as their interactions. About 30% of the sample reported perceived racial discrimination, and 44% fell into the category of having mental distress. Perceived racial discrimination was associated with 1.90 times higher odds of mental distress and had significant interactions with age, education, and ethnicity. The association of mental distress with perceived racial discrimination was higher among those who were 60 or older, less educated, and Vietnamese than among their respective counterparts. Findings can guide strategic and targeted interventions for high-risk groups.

Low education and mental health among older adults: the mediating role of employment and income

PURPOSE

Transition from work to retirement may be associated with poor mental health outcomes in older-age groups, especially among those of lower socio-economic position (SEP). This study investigates the association between low educational achievement and mental health status, and the mediating role of employment status and income level among older-age Australians.

METHODS

This study was based on the '45 and Up Study', a prospective cohort study of participants from New South Wales (Australia) aged 45 years and older (N = 267,153), followed-up over the period 2006-2018. A causal mediation analysis was used to assess the total causal effect (TCE) of educational achievement level on psychological distress, and the extent of mediation by employment status and income level.

RESULTS

Lower educational achievement was associated with subsequent psychological distress, with a stronger TCE among those with low educational achievement (OR = 1.46, 95% CI 1.25-1.72), followed by those with intermediate educational achievement (OR = 1.26, 95% CI 1.07-1.48), compared to those with high educational achievement. In models investigating mediation by employment status and income level, 44.7%, (95% CI 34.2-55.3) of the association was mediated by employment status and income level, with a stronger mediating effect evident for income level.

CONCLUSION

Findings suggest that employment status and income level changes at older age are more strongly associated with poorer mental health among those of lower SEP. Poor mental health associated with lower SEP may be ameliorated particularly by changes to income level, but also how people transition from employment to retirement.

The Mediating Role of Psychological Distress in Excessive Gambling among Young People: A Four-Country Study

Background and aims: Loneliness and a low sense of mastery are associated with excessive gambling, but the underlying processes of these relationships remain unstudied. Because psychological distress can increase vulnerability to excessive gambling, we investigated its mediating role in these relationships among young people. To meet the need for cross-country research, we also observed how these relationships occur in four countries with different cultures. Design, setting, and participants: Demographically balanced cross-sectional survey data were collected from 15–25-year-olds in Finland (n = 1200; 50% male), the United States (n = 1212; 49.8% male), South Korea (n = 1192; 49.6% male), and Spain (n = 1212; 51.2% male). Measurements: Excessive gambling was measured with the South Oaks Gambling Screen, psychological distress was assessed with the 12-item General Health Questionnaire, loneliness was measured with the three-item Loneliness Scale, and low sense of mastery was assessed with the Pearlin Mastery Scale. Associations were examined first using zero-inflated negative binomial regression analyses with excessive gambling as the outcome. In addition, path analyses were performed to study how loneliness and low sense of mastery relate to excessive gambling, with psychological distress as the mediating variable. Findings: Loneliness and low sense of mastery were associated indirectly with excessive gambling via psychological distress in all country samples. Low sense of mastery was also directly associated with excessive gambling. There was a direct association between loneliness and excessive gambling only in samples from South Korea and Spain. Conclusions: Psychological distress is an important factor in understanding how loneliness and sense of mastery relate to gambling.

Predictors and consequences of non-suicidal self-injury in relation to life, peer, and school factors

INTRODUCTION

Numerous life, peer, and school-related factors have been found to be associated with non-suicidal self-injury (NSSI) among adolescents; however, most studies have not explored the possible reciprocal nature of these associations. The aim of the current study was to examine bidirectional and longitudinal associations between NSSI and several life, peer, and school-related factors (i.e., stressful life events, peer relationships, academic achievement, and attitudes towards school).

METHOD

Community-based adolescents completed questionnaires assessing the variables of interest at three time points; age 12 (T1; 55.09% girls), age 13 (T2; 56.95% girls), and ages 14-15 (T3; 57.41% girls). In total, 529 adolescents provided complete data across all three-time points.

RESULTS

Analyses showed a bidirectional association between NSSI and both attitudes towards school and stressful life events. Specifically, stressful life events at T2 predicted engagement in NSSI at T3, and NSSI at T2 predicted increased risk of stressful life events at T3. Similarly, having negative attitudes towards school predicted NSSI at T2, which, in turn, predicted negative attitudes towards school at T3. Further, academic achievement at T1 was negatively associated with NSSI at T2. Peer relationships were neither a predictor nor a consequence of NSSI.

CONCLUSIONS

Our results suggest that NSSI can be both a predictor and a consequence of various life, and school factors. Focus on these factors in prevention and intervention efforts for NSSI among adolescents may be warranted.

Socio-economic resources and adult mental health in Canada: controlling for time-invariant confounders and investigating causal directionality

OBJECTIVE

The aim of this study was to investigate whether family income and education have a causal effect on psychological distress among Canadian adults.

METHODS

We executed fixed-effects regression analyses using data from the Longitudinal and International Study of Adults (LISA). We investigated whether changes in family income and education from wave 2 (2014) to wave 3 (2016) corresponded with changes in psychological distress during this same time period. We also investigated whether changes in these socio-economic resources from wave 1 (2012) to wave 2 (2014) corresponded with lagged changes in psychological distress from wave 2 (2014) to wave 3 (2016). These models controlled for all time-invariant confounders with time-invariant effects, as well as the time-varying factors age, marital status, household size, and employment status.

RESULTS

Obtaining a postsecondary degree corresponded with lagged decreases in psychological distress among women ages 18 to 32 (b = -1.97; 95% CI = -3.53, -0.42) and men over the age of 32 (b = -1.86; 95% CI = -3.57, -0.15). The effect of postsecondary education was stronger when considering adults who stayed married throughout the three waves (b = -2.29; 95% CI = -4.37, -0.21).

CONCLUSION

Completing postsecondary education may have a lagged causal effect on psychological distress, and the life course timing for when postsecondary completion reduces distress is different for women and men.

Severe Mental Health Symptoms during COVID-19: A Comparison of the United Kingdom and Austria

This study evaluated severe psychological symptoms in the United Kingdom and Austria after four weeks of lockdown due to COVID-19. Two cross-sectional online surveys were performed with representative population samples according to age, gender, region, and education. Depressive symptoms were measured with the Patient Health Questionnaire (PHQ-9), anxiety symptoms with the Generalized Anxiety Disorder scale (GAD-7), and insomnia symptoms with the Insomnia Severity Index (ISI). The sample size was N = 1005 for Austria (52% women) and N = 1006 (54% women) for the UK. In total, 3.2% of the Austrian sample and 12.1% of the UK sample had severe depressive symptoms (PHQ-9 ≥ 20 points; χ2(1) = 57.24; p < 0.001), 6.0% in Austria vs. 18.9% in the UK had severe anxiety symptoms (GAD-7 ≥ 15 points; χ2(1) = 76.17; p < 0.001), and 2.2% in Austria and 7.3% in the UK had severe insomnia (ISI; ≥22 points; χ2(1) = 28.89; p < 0.001). The prevalence of severe depressive, anxiety or insomnia symptoms was around three times higher in the UK than in Austria.

Educational attainment reduces the risk of suicide attempt among individuals with and without psychiatric disorders independent of cognition: a bidirectional and multivariable Mendelian randomization study with more than 815,000 participants

Rates of suicidal behavior are increasing in the United States and identifying causal risk factors continues to be a public health priority. Observational literature has shown that educational attainment (EA) and cognitive performance (CP) influence suicide attempt risk; however, the causal nature of these relationships is unknown. Using summary statistics from genome-wide association studies (GWAS) of EA, CP, and suicide attempt risk with > 815,000 combined white participants of European ancestry, we performed multivariable Mendelian randomization (MR) to disentangle the effects of EA and CP on attempted suicide. In single-variable MR (SVMR), EA and CP appeared to reduce suicide attempt risk (EA odds ratio (OR) per standard deviation (SD) increase in EA (4.2 years), 0.524, 95% CI, 0.412-0.666, P = 1.07 × 10-7; CP OR per SD increase in standardized score, 0.714, 95% CI, 0.577-0.885, P = 0.002). Conversely, bidirectional analyses found no effect of a suicide attempt on EA or CP. Using various multivariable MR (MVMR) models, EA seems to be the predominant risk factor for suicide attempt risk with the independent effect (OR, 0.342, 95% CI, 0.206-0.568, P = 1.61 × 10-4), while CP had no effect (OR, 1.182, 95% CI, 0.842-1.659, P = 0.333). In additional MVMR analyses accounting simultaneously for potential behavioral and psychiatric mediators (tobacco smoking; alcohol consumption; and self-reported nerves, tension, anxiety, or depression), the effect of EA was little changed (OR, 0.541, 95% CI, 0.421-0.696, P = 3.33 × 10-6). Consistency of results across complementary MR methods accommodating different assumptions about genetic pleiotropy strengthened causal inference. Our results show that even after accounting for psychiatric disorders and behavioral mediators, EA, but not CP, may causally influence suicide attempt risk among white individuals of European ancestry, which could have important implications for health policy and programs aimed at reducing the increasing rates of suicide. Future work is necessary to examine the EA-suicide relationship populations of different ethnicities.

Effect of Exercise Interventions on Anxiety in People with Multiple Sclerosis: A Systematic Review and Meta-analysis

BACKGROUND

Evidence suggests that exercise can alleviate symptoms associated with multiple sclerosis (MS). However, it is unclear whether exercise alleviates symptoms of anxiety, present in one-third of people with MS. This systematic review and meta-analysis investigates whether exercise interventions are effective in reducing anxiety in people with MS.

METHODS

CINAHL, Embase, MEDLINE, PsycINFO, and the Cochrane Controlled Clinical Trials Register were searched to identify relevant randomized controlled trials (RCTs) published up to March 30, 2018. The primary outcome was postintervention difference in anxiety scores between intervention and control groups. Using a restricted maximum likelihood random-effects model, standardized mean differences were pooled and heterogeneity was estimated. Risk of bias was assessed using an a priori modified Cochrane Risk of Bias 2.0 tool.

RESULTS

Four RCTs with 133 participants were included. Exercise type included walking, aerobic activities, and cycling. Intervention duration ranged from 8 to 26 weeks. The pooled standardized mean difference in anxiety score was -0.16 (95% CI, -0.50 to 0.19), without heterogeneity. Two studies had high risk of bias, and two had some risk of bias.

CONCLUSIONS

Based on available RCT data, exercise does not seem to have an effect on anxiety in people with MS. These results should be interpreted with caution because studies had concerns of bias and small sample sizes, and anxiety was not the primary outcome measure. Future studies should exhibit sufficient reporting standards, alongside publishing protocols. There is opportunity to investigate the effect of exercise in people with MS experiencing clinically relevant levels of anxiety rather than in the general MS population.

Divorce and adolescent academic achievement: Heterogeneity in the associations by parental education

Background

The link between parental divorce and adolescents’ academic achievement may depend on parental educational levels. However, findings have been inconsistent regarding whether the negative associations between parental divorce and adolescents’ academic outcomes are greater or smaller in highly educated families. The present study aimed to investigate the possible heterogeneity in the associations between divorce and adolescents’ academic achievement by parental educational levels, within the context of the elaborate Norwegian welfare state.

Methods

The population-based cross-sectional youth@hordaland study of adolescents aged 16–19 years conducted in Norway in 2012, provided information about parental divorce and was linked to national administrative registries (N = 9,166) to obtain high-quality, objective data on the adolescents’ grade point average (GPA), and their parents’ educational qualifications and income.

Results

The negative association between parental divorce and GPA was stronger among adolescents with educated or highly educated parents compared to adolescents with less educated parents. This heterogeneity was driven by maternal educational qualifications, whereby divorce was more strongly and negatively associated with GPA among adolescents with educated mothers compared to those with less educated mothers, independent of paternal educational levels and income measures.

Conclusions

Among adolescents whose parents have low educational qualifications, parental divorce is not associated with their academic achievement. Educated divorced mothers appear less likely to transfer their educational advantages onto their children than nondivorced equally educated mothers, perhaps due to a “double-burden” regarding work pressure and child-rearing responsibilities. There is a need for future studies to detail the mechanisms underlying this finding.

Binge eating and purging in first-year college students: Prevalence, psychiatric comorbidity, and academic performance

BACKGROUND

Binge eating and purging behaviors (BPB) are common among college students, but evidence is scant on prevalence and associations of BPB with mental health problems and objective academic performance. This study aims to investigate: (a) 12-month prevalence of BPB among college first-year students, (b) comorbidity patterns of BPB with various mental health problems, and (c) the association of BPB with objective academic functioning.

METHODS

Using data from the Leuven College Surveys (Belgium), as part of the World Mental Health Surveys International College Student initiative, we cross-sectionally assessed 12-month BPB and mental health problems among college first-year students (n = 4,889; response rate = 73.2%) at the beginning of the academic year. Objective measures of academic functioning (final grades, expressed in academic year percentage "AYP" [0-100%] and academic failure) were obtained from administrative records at the end of the academic year.

RESULTS

Twelve-month prevalence of BPB was 7.6% (7.3%binge eating and 1.0%purging), with higher rates among females than males. Bivariate models showed an association between BPB and numerous mental health problems (ORs = 3.4-18.4). Multivariate models showed associations with non-suicidal self-injury, post-traumatic stress, internalizing/externalizing problems and suicidal ideation. After controlling for sociodemographic characteristics and comorbid mental health problems, BPB were still associated with lower AYP (-4.1 to -11.2% range) and elevated odds of academic year failure (ORs = 1.4-4.2).

CONCLUSIONS

BPB (especially binge eating) are relatively common and associated with mental health problems, comparatively low academic performance, and higher risk of academic failure among college first-year students. Further study is needed to examine the causal dynamics underlying these associations.

Associations Among Emotional State, Sleep Quality, and Resting-State EEG Spectra: A Longitudinal Study in Graduate Students

University students are routinely influenced by a variety of natural stressors and experience irregular sleep-wake cycles caused by the necessity to trade sleep for studying while dealing with academic assignments. Often these factors result in long-term issues with daytime sleepiness, emotional instability, and mental exhaustion, which may lead to difficulties in the educational process. This study introduces the Daily Sampling System (DSS) implemented as a smartphone application, which combines a set of self-assessment scales for evaluating variations in the emotional state and sleep quality throughout a full academic term. In addition to submitting the daily sampling scores, the participants regularly filled in the Depression, Anxiety, and Stress Scales (DASS) reports and took part in resting-state EEG data recording immediately after report completion. In total, this study collected 1835 daily samples and 94 combined DASS with EEG datasets from 18 university students (aged 23-27 years), with 79.3± 15.3% response ratio in submitting the daily reports during an academic semester. The results of pairwise testing and multiple regression analysis demonstrate that the daily level of self-perceived fatigue correlates positively with stress, daytime sleepiness, and negatively with alertness on awakening, self-evaluated sleep quality, and sleep duration. The spectral analysis of the EEG data reveals a significant increase in the resting-state spectral power density across the theta and low-alpha frequency bands associated with increased levels of anxiety and stress. Additionally, the state of depression was accompanied by an intensification of high-frequency EEG activity over the temporal regions. No significant differences in prefrontal alpha power asymmetry were observed under the described experimental conditions while comparing the states of calmness and emotional arousal of the participants for the three conditions of depression, anxiety, and stress.

Patterns of Social Connectedness and Psychosocial Wellbeing among African American and Caribbean Black Adolescents

Adolescents are connected to multiple and interrelated settings (e.g., family, school), which interact to influence their development. Using the National Survey of American Life-Adolescent (NSAL-A), a nationally representative cross-sectional survey, this study examined patterns of social connection and Black adolescents' wellbeing and whether social connection-wellbeing links differed by ethnicity and gender. The sample included 1170 Black adolescents ages 13-17 (69% African American, 31% Caribbean Black, 52% female, mean age 15). Latent profile analysis was used to identify profiles of adolescent connections across family, peer, school, religion, and neighborhood settings. Four profiles of social connection emerged: unconnected, minimal connection, high family connection, and well-connected. The profiles differed in life satisfaction, self-esteem, mastery, coping, perceived stress, and depressive symptoms. The well-connected profile, characterized by connection to all five settings, had significantly higher life satisfaction, self-esteem, mastery, and coping, and lower perceived stress compared to the unconnected and minimal connection profiles and lower depressive symptoms than the unconnected profile. The well-connected profile also had better self-esteem and coping compared to the high family connection profile. The youth in the unconnected profile had significantly lower self-esteem and mastery and significantly higher depressive symptoms than the minimally connected youth. Moderation analyses showed no differences by ethnicity. However, differences by gender were observed for the association between connectedness and life satisfaction. The results support the critical need to examine connectedness across multiple settings and within group heterogeneity among Black youth to develop strategies to promote their psychosocial wellbeing.

Impact of effort reward imbalance at work on suicidal ideation in ten European countries: The role of depressive symptoms

BACKGROUND

Evidence of the association between effort reward imbalance (ERI) and suicidal ideation is sparse. This study examined the influence of ERI at work on suicidal ideation and the mediating effect of depressive symptoms.

METHODS

There were 4963 workers aged 50+ without suicidal ideation at baseline in the Survey of Health, Aging and Retirement in Europe, these workers were followed-up for 8-years to detect incident suicidal ideation. ERI was measured by a short ERI questionnaire. Suicidal ideation was evaluated by one item derived from the 12-item Europe-depression scale, and depressive symptoms were assessed by the remaining 11 items in the scale. Cox models were employed to explore the relationship adjusting for potential confounders. Mediation analysis was used to test the mediating effect of depressive symptoms.

RESULTS

A significantly higher incidence of suicidal ideation was related with high effort (HR = 1.51) and low reward (HR = 1.42), respectively. A high effort-low reward imbalance was associated with even higher risk of suicidal ideation (HR = 1.96) as compared to low effort-high reward combination. The association was varied by gender, region, education and household income. Depressive symptoms mediated a modest proportion (natural indirect effect 14.4%) of the total association between ERI and suicidal ideation.

LIMITATION

Suicidal ideation definition based on self-administered questionnaires which could lead to false negatives. And some unmeasured confounders might have biased the results.

CONCLUSIONS

Efforts in promoting balanced effort-reward at work may reduce suicidal ideation among working population aged 50+. Avoiding depressive symptoms may further enhance such efforts.

Demands and resources associated with mental health among Norwegian professional musicians

BACKGROUND

Previous studies indicate a variety of health challenges among musicians. Despite this, less is known concerning the roles of work-related and personal factors associated with the musicians' mental health.

OBJECTIVE

We wanted to investigate personal and work-related demands and resources associated with psychological distress in professional musicians.

METHODS

Based on a sample of 1,607 of professional Norwegian musicians, we conducted a hierarchical multiple regression analysis.

RESULTS

We found that personal factors such as level of neuroticism and sense of mastery had the strongest association with PD. Extraversion, openness to experience, conscientiousness, job demands and social support did also contribute to distress in our final statistical model, but to a lesser degree. Somewhat surprisingly, work-family conflict, effort-reward imbalance and job control were not associated with PD in our final model.

CONCLUSIONS

Our results show that both work-related factors (job demands and social support) and personal resources (personality and sense of mastery) are associated with PD among musicians in this cross-sectional study. Prospective research is needed in order to investigate these associations further. Meanwhile, we suggest to emphasize early development of sense of mastery and social support in music education and industry.

Trauma Exposure and Mental Health Problems Among Adults in Central Vietnam: A Randomized Cross-Sectional Survey

Background: There is relatively little evidence about the psychological and social impacts of trauma exposure in the general population in East Asian countries. Vietnam has a long history of war and poverty, is prone to natural disasters and has high mortality related to traffic accidents. The mental health systems may be inadequate to cope with the resultant trauma. Objectives: This research examines the lifetime prevalence of single and multiple traumas and the association between trauma exposure and depression, anxiety and post-traumatic stress disorder (PTSD) among a randomly selected sample of the adult population in Thua Thien-Hue province in central Vietnam. Methods: Six hundred and eight Vietnamese adults aged 18 years or older participated in the survey. The main tools in the face-to-face interview included the Life Event Checklist (LEC) to measure trauma exposure, the Hospital Anxiety and Depression Scale (HADS) and the PTSD Checklist for DSM-IV (PCL-IV). Hierarchical multiple logistic regression was used to examine associations between trauma exposure and mental health. Results: Forty seven percent of the participants experienced at least one traumatic event in their lifetime and about half of these people were exposed to multiple traumas. The prevalence of depression, anxiety, and PTSD symptoms among the total sample was 12.7, 15.5, and 6.9%, respectively. Prevalence of PTSD among those reporting trauma exposure was 14.8%. Exposure to a higher number of trauma types was associated with increased risk of having depression, anxiety, and PTSD symptoms. Interpersonal traumas were strongly associated with symptoms of all three mental disorders while non-interpersonal traumas were only associated with depressive symptoms. Conclusion: Our findings indicate high burden of lifetime trauma and mental ill health in the adult population of central Vietnam and show a cumulative effect of multiple traumas on symptoms of the three mental disorders. Interpersonal trauma appears to have a more harmful effect on mental health than non-interpersonal trauma. Efforts to improve mental health in Vietnam should focus on reducing risk of preventable interpersonal trauma in every stage of life, and more broadly, ensure greater availability of trauma-sensitive mental health programs and services.

Does education protect against depression? Evidence from the Young Finns Study using Mendelian randomization

Using participants (N = 1733) drawn from the nationally representative longitudinal Young Finns Study (YFS) we estimate the effect of education on depressive symptoms. In 2007, when the participants were between 30 and 45 years old, they reported their depressive symptoms using a revised version of Beck's Depression Inventory. Education was measured using register information on the highest completed level of education in 2007, which was converted to years of education. To identify a causal relationship between education and depressive symptoms we use an instrumental variables approach (Mendelian randomization, MR) with a genetic risk score as an instrument for years of education. The genetic risk score was based on 74 genetic variants, which were associated with years of education in a genome-wide association study (GWAS). Because the genetic variants are randomly assigned at conception, they induce exogenous variation in years of education and thus identify a causal effect if the assumptions of the MR approach are met. In Ordinary Least Squares (OLS) estimation years of education in 2007 were negatively associated with depressive symptoms in 2007 (b = -0.027, 95% Confidence Interval (CI) = -0.040, -0.015). However, the results based on Mendelian randomization suggested that the effect is not causal (b = 0.017; 95% CI = -0.144, 0.178). This indicates that omitted variables correlated with education and depression may bias the linear regression coefficients and exogenous variation in education caused by differences in genetic make-up does not seem to protect against depressive symptoms.

Mastery and social support moderate the effects of educational level on adjustment of Arab mothers of children diagnosed with cancer

The study explored the adjustment of Arab mothers of children diagnosed with cancer, as shown by the mothers' distress and quality of life. The aim was twofold: to examine the associations between educational level, psychosocial resources and adjustment indices and to assess the moderating effects of psychosocial resources on the education and adjustment association. The sample consisted of 100 Arab mothers who completed questionnaires assessing demographic and illness variables, mastery, social support, psychological distress and quality of life. High levels of education and psychosocial resources contributed to low distress and high levels of quality of life. Mastery and social support moderated the effects of education on adjustment: Under low levels of education, higher mastery was related to lower distress and higher quality of life, and higher social support was related to lower distress. Education, mastery and social support are important resources in the context of adjustment to cancer. In addition, psychosocial resources are important factors for adjustment under low levels of education and should be taken into consideration when developing intervention programmes for Arab parents coping with their child's cancer.

Gender inequalities in the association between area deprivation and perceived social support: a cross-sectional multilevel analysis at the municipality level in Germany

OBJECTIVES

To investigate the association between area deprivation at municipality level with low perceived social support, independent of individual socioeconomic position and demographic characteristics. To assess whether there are gender inequalities in this association.

DESIGN

Cross-sectional multilevel analysis of survey data.

SETTING

Germany.

PARTICIPANTS

3350 men and 3665 women living in 167 municipalities throughout Germany participating in the 'German Health Interview and Examination Survey for Adults' (DEGS1 2008-2011) as part of the national health monitoring.

OUTCOME

Perceived social support as measured by Oslo-3 Social Support Scale.

RESULTS

Prevalence of low perceived social support was 11.4% in men and 11.1% in women. Low social support was associated in men and women with sociodemographic characteristics that indicate more disadvantaged living situations. Taking these individual-level characteristics into account, municipal-level deprivation was independently associated with low perceived social support in men (OR for the most deprived quintile: 1.80 (95% CI 1.14 to 2.84)), but not in women (OR 1.22 (95% CI 0.78 to 1.90)).

CONCLUSION

The results of our multilevel analysis suggest that there are gender inequalities in the association of municipal-level deprivation with the prevalence of low perceived social support in Germany independent of individual socioeconomic position. Community health interventions aiming at promotion of social support among residents might profit from a further understanding of the observed gender differences.

Intrinsic factors influence self-management participation in COPD: effects on self-efficacy

Personal traits should be addressed before offering self-management programmes to patients with COPD http://ow.ly/DtNh30k1A15.

Mindfulness and Other Psycho-Social Resources Protective Against Mental Illness and Suicidality Among Gay Men

Background: There is considerable evidence of health disparities among gay men characterized by higher levels of stress and distress. Psycho-social resources have been linked to numerous positive health outcomes and shown to act as buffers in the stress-distress pathway. Methods: With data from the 3rd Geneva Gay Men's Health Survey carried out in 2011 using time-space sampling (n = 428), a relatively elaborate profile of 14 psycho-social resources-including mindfulness-is presented. Using their original scores, latent class analysis created an index variable dividing the respondents into meaningful groups. Psycho-social resources-the index variable as well as each resource individually-were then compared to two recent outcomes-i.e., serious mental illness in the past 4 weeks and short-term disability in the past 2 weeks-using a series of logistic regression models, controlling for all other psycho-social resources and socio-demographic confounders. To assess their potential role as buffers, a similar series of logistic regression models were erected using victimization and three outcomes-i.e., major depression, suicidal ideation, and suicide attempt-in the past 12 months. Results: According to the latent class analyses, (1) 5.1% of this sample had a low level of psycho-social resources (i.e., one standard deviation (SD) below the group means), (2) 25.2% a medium-low level, (3) 47.4% a medium level (i.e., at the group means), and (4) 22.2% a high level of psycho-social resources (i.e., one SD above the group means). Psycho-social resources appeared to strongly protect against recent mental morbidity and buffer against the impact of victimization on major depression and suicidality in the past 12 months, reducing the adjusted odds ratios below statistical significance. The explained variance and the individual psycho-social resources which remained independent in the models differed for each outcome. Conclusions: There may be disparities in several psycho-social resources among gay men, and as strong compensatory and protective factors, they may explain in part the well-established disparities in stress and distress in this population. While multiple psycho-social resources should be promoted in this population, gay men under 25 years should receive particular attention as all three disparities are most pronounced in this age group.

The social income inequality, social integration and health status of internal migrants in China

Background

To examine the interaction between social income inequality, social integration, and health status among internal migrants (IMs) who migrate between regions in China.

Methods

We used the data from the 2014 Internal Migrant Dynamic Monitoring Survey in China, which sampled 15,999 IMs in eight cities in China. The Gini coefficient at the city level was calculated to measure social income inequality and was categorized into low (0.2 < Gini <= 0.3), medium (0.3 < Gini <= 0.4), high (0.4 < x < = 0.5), and very high (Gini >0.5). Health status was measured based upon self-reported health, subjective well-being, and perceptions of stress and mental health. Social integration was measured from four perspectives (acculturation and integration willingness, social insurance, economy, social communication). Linear mixed models were used to examine the interaction effects between health statuses, social integration, and the Gini coefficient.

Results

Factors of social integration, such as economic integration and acculturation and integration willingness, were significantly related to health. Social income inequality had a negative relationship with the health status of IMs. For example, IMs in one city, Qingdao, with a medium income inequality level (Gini = 0.329), had the best health statuses and better social integration. On the other hand, IMs in another city, Shenzhen, who had a large income inequality (Gini = 0.447) were worst in health statues and had worse social integration.

Conclusion

Policies or programs targeting IMs should support integration willingness, promote a sense of belonging, and improve economic equality. In the meantime, social activities to facilitate employment and create social trust should also be promoted. At the societal level, structural and policy changes are necessary to promote income equity to promote IMs’ general health status.

The Relationship Between Violence and Psychological Distress Among Men and Women: Do Sense of Mastery and Social Support Matter?

The aims of this study were to examine associations between reported exposure to psychological and physical violence and psychological distress (PD) among men and women, and to explore the possible mediating or moderating roles of sense of mastery and social support. We used data from the nationally representative Norwegian Health and Level of Living Survey in 2005 and 2012 (Weighted N = 19,386). PD was measured with the Hopkins Symptom Checklist-25, using the subscales for anxiety and depression separately and in combination. Analyses were conducted using hierarchical logistic regression with complex sample adjustment. Altogether, 3.8% of men and 5.4% of women reported psychological violence during the last 12 months, while 2.3% and 1.6% reported physical violence, respectively. Both forms of violence were associated with excess risk of comorbid anxiety and depressive symptoms above clinical cut-point (CAD) in men and women alike, and CAD occurred more frequently than anxiety or depressive problems separately. Sense of mastery, but not social support, partly mediated the association between both forms of violence and CAD in men, whereas both partly mediated the association between psychological violence and CAD in women. No moderator role was indicated. Overall, the results provide evidence for excess risk of PD, particularly CAD, in men and women reporting exposure to violence. Sense of mastery and to a lesser degree social support were shown to constitute significant mediators, underscoring the importance of systems for strengthening coping strategies and social support among violence victims, such as psychological and practical support by the health services.

The effect of trauma and PTSD on telomere length: An exploratory study in people exposed to combat trauma

Telomere length has been suggested to be a cellular marker for age-related diseases as well as psychosocial stress. The present study investigated whether telomere length is associated with post-traumatic stress disorder (PTSD) among veterans exposed to combat trauma in the Vietnam War. The potentially associated factors on cellular aging were considered. Korean male veterans with (n = 122) and without (n = 120) PTSD were included and leukocyte telomere length was measured with a quantitative PCR-based technique. As a whole, no significant difference in telomere length was found between PTSD and non-PTSD groups. In linear regression analysis stratified by trauma levels, among veterans exposed to severe combat (n = 45), PTSD status (B = -1.176, t = -2.259, p = 0.029), antidepressant use (B = 0.168, t = 2.528, p = 0.015), and education level (B = 0.019, t = 2.369, p = 0.023) affected telomere length. However, among veterans with light-to-moderate combat exposure (n = 197), only age (B = -0.007, t = -2.434, p = 0.016) and education level (B = 0.010, t = 2.295, p = 0.023) were associated with telomere length. In the Post-hoc analysis, antidepressant use was associated with longer telomere length in subjects exposed to severe combat. Our exploratory results suggest that PTSD status in combination with severe trauma may be associated with accelerated telomere shortening, and that antidepressant use may have a protective effect on telomere dynamics.

Perceived social support among students of medical sciences

BACKGROUND

Social support is emotional and instrumental assistance from family, friends or neighbors, and has an important but different impact on individuals, mainly depending on contextual factors.

OBJECTIVE

To determine the status of perceived social support and related personal and family characteristics of medical sciences students in Ahvaz, Iran.

METHODS

In this cross-sectional study, the target population included the students of Ahvaz Jundishapur University of Medical Sciences in the second semester of 2013-2014, of whom 763 were selected by cluster random sampling method. The study tool was a two-part questionnaire containing 48 self-administered questions including 25 questions of measurements of personal and family characteristics and a Persian modified version of Vaux's social support scale (Cronbach's α=0.745). Data were analyzed with T test, ANOVA and chi-square and using SPSS version 16 and 0.05 was considered as the level of significance.

RESULTS

The mean score of the perceived social support was 17.06±3.6 and 60.3% of them reported low social support. There was a significant relationship among the perceived social support and sex (p=0.02), faculty (p<0.0001), ethnicity (p=0.034) and the duration of weekly residence in dormitory (p=0.031). But no significant relationship was found between this variable and other individual and familial characteristics.

CONCLUSION

Based on students' low social support and importance of social support in reducing stress and academic failure, the planners need to provide efficient supportive interventions for students.

Prevalence and prognostic implications of psychological distress in patients with gastric cancer

Background

The aim of this study was to investigate the prevalence and prognostic significance of psychological distress in gastric cancer patients.

Methods

The study population included 229 gastric cancer patients visiting Yonsei Cancer Center between November 2009 and March 2011. The distress was measured by available tools including the Modified Distress Thermometer (MDT), Hospital Anxiety and Depression Scale (HADS), and Center for Epidemiologic Studies–Depression Scale (CES-D). Patients with psychological distress were defined as those who scored above the cut-off values in both the MDT and either one of the HADS or CES-D.

Results

The median age of patients was 56 (range, 20 to 86) and 97 (42.4%) patients were with stage IV disease status at enrollment. The overall prevalence of psychological distress was 33.6% (95% CI: 27.5–39.8%) in 229 gastric cancer patients. In multiple logistic regression analysis, lower education level (odds ratio [OR] 2.39; 95% confidence interval [CI] 1.11–5.17, P = 0.026) and higher disease stage (OR 2.72; 95% CI 1.47–5.03, P = 0.001) were associated with psychological distress. In stage I-III disease, patients with psychological distress had worse disease-free survival (DFS) (5-year DFS rate: 60% vs 76%, P = 0.49) compared with those without psychological distress. In stage IV disease (n = 97), patients with psychological distress showed poorer overall survival than those without psychological distress (median OS (Overall Survival): 12.2 vs. 13.8 months, P = 0.019).

Conclusion

Psychological distress is common in patients with all stages of gastric cancer and is associated with worse outcomes.

Electronic supplementary material

The online version of this article (doi:10.1186/s12885-017-3260-2) contains supplementary material, which is available to authorized users.

Sense of mastery differences between working-age Swedish- and Finnish-speaking Finns: a population-based study

AIM

To examine the probability of a high sense of mastery in a population-representative sample of working-age people and to study the differences in mastery between Finnish-speaking and Swedish-speaking Finns in particular.

METHODS

The data originates from the Western Finland Mental Health Surveys (2008-2014). Associations between sense of mastery and language groups were analyzed with logistic regressions.

RESULTS

Swedish-speaking Finns have a higher sense of mastery and the association is mediated by social support. Moreover, a difference in a high sense of mastery is found between Swedish- and Finnish-speaking married women that are outside the labor market.

CONCLUSIONS

Our findings imply that Finnish-speaking women that are outside the labor market, e.g. on maternity leave or taking care of the household, should be recognized in health and social care services as a group that can benefit from additional support.

Health-Related Quality of Life, Subjective Health Complaints, Psychological Distress and Coping in Pakistani Immigrant Women With and Without the Metabolic Syndrome : The InnvaDiab-DEPLAN Study on Pakistani Immigrant Women Living in Oslo, Norway

The increasingly high number of immigrants from South-East Asia with The Metabolic Syndrome (MetS) is an important challenge for the public health sector. Impaired glucose is essential in MetS. The blood glucose concentration is not only governed by diet and physical activity, but also by psychological distress which could contribute to the development of MetS. The aim of this study is to describe health-related quality of life, subjective health complaints (SHC), psychological distress, and coping in Pakistani immigrant women, with and without MetS. As a part of an randomized controlled intervention study in Oslo, Norway, female Pakistani immigrants (n = 198) answered questionnaires regarding health related quality of life, SHC, psychological distress, and coping. Blood variables were determined and a standardized oral glucose tolerance test was performed. The participants had a high score on SHC and psychological distress. About 40% of the participants had MetS, and this group showed significantly lower general health, lower physical function, and more bodily pain, than those without MetS. Those with MetS also had more SHC, depressive symptoms, higher levels of somatisation, and scored significantly lower on the coping strategy of active problem solving. Pakistani immigrant women seem to have a high prevalence of SHC and psychological distress, especially those with MetS.

PREVALENCE of psychiatric morbidity in a community sample in Western Kenya

BACKGROUND

About 25% of the worldwide population suffers from mental, neurological and substance use disorders but unfortunately, up to 75% of affected persons do not have access to the treatment they need. Data on the magnitude of the mental health problem in Kenya is scarce. The objectives of this study were to establish the prevalence and the socio-demographic factors associated with mental and substance use disorders in Kosirai division, Nandi County, Western Kenya.

METHODS

This was a cross sectional descriptive study in which participants were selected by simple random sampling. The sampling frame was obtained from a data base of the population in the study area developed during door-to-door testing and counseling exercises for HIV/AIDS. Four hundred and twenty consenting adults were interviewed by psychologists using the Mini International Neuropsychiatric Interview Version 7 for Diagnostic and Statistical Manual 5th Edition and a researcher-designed social demographic questionnaire.

RESULTS

One hundred and ninety one (45%) of the participants had a lifetime diagnosis of at least one of the mental disorders. Of these, 66 (15.7%) had anxiety disorder, 53 (12.3%) had major depressive disorder; 49 (11.7%) had alcohol and substance use disorder. 32 (7.6%) had experienced a psychotic episode and 69 (16.4%) had a life-time suicidal attempt. Only 7 (1.7%) had ever been diagnosed with a mental illness. Having a mental condition was associated with age less than 60 years and having a medical condition.

CONCLUSION

A large proportion of the community has had a mental disorder in their lifetime and most of these conditions are undiagnosed and therefore not treated. These findings indicate a need for strategies that will promote diagnosis and treatment of community members with psychiatric disorders. In order to screen more people for mental illness, we recommend further research to evaluate a strategy similar to the home based counseling and testing for HIV and the use of simple screening tools.