Tânia Gaspar

Bio: Tânia Gaspar is an academic researcher from University of Lisbon. The author has contributed to research in topics: Unemployment & Recession. The author has an hindex of 12, co-authored 42 publications receiving 660 citations. Previous affiliations of Tânia Gaspar include University of Huelva & Technical University of Lisbon.

Mental health outcomes in times of economic recession: a systematic literature review.

Abstract: Countries in recession experience high unemployment rates and a decline in living conditions, which, it has been suggested, negatively influences their populations’ health. The present review examines the recent evidence of the possible association between economic recessions and mental health outcomes. Literature review of records identified through Medline, PsycINFO, SciELO, and EBSCO Host. Only original research papers, published between 2004 and 2014, peer-reviewed, non-qualitative research, and reporting on associations between economic factors and proxies of mental health were considered. One-hundred-one papers met the inclusion criteria. The evidence was consistent that economic recessions and mediators such as unemployment, income decline, and unmanageable debts are significantly associated with poor mental wellbeing, increased rates of common mental disorders, substance-related disorders, and suicidal behaviours. On the basis of a thorough analysis of the selected investigations, we conclude that periods of economic recession are possibly associated with a higher prevalence of mental health problems, including common mental disorders, substance disorders, and ultimately suicidal behaviour. Most of the research is based on cross-sectional studies, which seriously limits causality inferences. Conclusions are summarised, taking into account international policy recommendations concerning the cost-effective measures that can possibly reduce the occurrence of negative mental health outcomes in populations during periods of economic recession.

Health related quality of life in children and adolescents and associated factors

Abstract: The main objective of this study was to propose a model, which includes personal and social factors associated to health-related quality of Life (HRQoL) in children and in adolescents. A sample of 3195 children and adolescents was randomly selected from 5th and 7th graders, in Portuguese public schools. The Portuguese versions of KIDSCREEN-52, Harter's SPPS, LOT-R, SSSS and HBSC (selected items) were used to evaluate personal and social factors and health behaviors. Various structural equation models were developed in association with gender, age, socioeconomic status (SES) and using the global sample. The studied models presented good adjustment indexes, which suggest a good fit for the hypothesized model. The psychosocial variables have a strong impact in the HRQoL. Consequently, health promotion programs for children and adolescents should include the psychosocial approach. Based on our results, we discuss and propose strategies to develop HRQoL in children and adolescents, in schools and in families. Keywords: health -related quality of life, children, adolescents The most widely cited definition of Quality of Life (QoL) is provided by the World Health Organization (WHOQoL group), which defines QoL as the individual's physical health, psychological well-being, independence level, social relationships and relationship with their environment and social context, and it is seen as a " self- perception", a personal perception of individuals' own life in their specific cultural context and value systems; and related with their goals, expectations, values and perspectives (WHOQOL, 1994,1995;1996; 1998a; 1998b). Health-related quality of life (HRQoL) is generally conceptualized as a multidimensional construct encompassing domains such as psychological, mental, social and spiritual areas of life (Eiser & Morse, 2001). HRQoL can be viewed as a psychological construct which describes the physical, mental, social, psychological and functional aspects of well-being and function (Ravens et al. 2005). The Well-being and health-related quality of life (HRQoL) in children and in adolescents is a quite recent concept and is a concern amongst health professionals (Koot, 2002). This must be considered within an ecological perspective, including multiple levels of analysis, namely self-perceptions and family perceptions (Harding, 2001). Children's perceptions of their HRQoL are influenced by several factors such as gender, age, personal and family characteristics, as well as their socio economic status (Caldera & Hart, 2004). Studies focusing on children's subjective well-being include interactions between demographics (e.g. age, gender and socio economic status), interpersonal characteristics (Self Perceptions, Psychological Well-being, Mood and Emotions) and perception of well-being and happiness (McCullough, Huebner & Laughlin, 2000). Clear differences between gender, age and socioeconomic status can be found in the HRQoL of children and adolescents. For instance, according to previous Kidscreen surveys in other countries, girls' perception of health-related quality of life is inferior in all dimensions with the exception of "Social Support and Peers", "School Environment" and "Social Acceptance and Bullying". Adolescents (aged 12 to 16) presented an inferior perception of HRQoL in all measures except in the "Financial Resources" and "Social Acceptance and Bullying"; low SES perception of HRQoL is also inferior in all dimensions on behalf of children and adolescents (Bisegger et al. 2005; The KIDSCREEN Group Europe, 2006; Ravens-Sieberer et al.; 2005; Rueden et al. 2006). The socioeconomic status has a deep impact on HRQoL, and is often associated to low academic background on the parents' behalf, interpersonal conflict, low socioeconomic status and ethnic minorities (Chen, Matthews & Boyce, 2002; STEP/BIT, 2003). According to the presented literature, and based on an ecological approach, we expect that all health aspects, such as, physical aspects, psychological aspects, social aspects and health behavior related aspects, influence several HRQoL dimensions in children and adolescents. …

Psychometric Properties of a Brief Version of the Escala de Satisfação com o Suporte Social for Children and Adolescents

Abstract: The main objective of this study was to develop a brief version of the Escala de Satisfacao com o Suporte Social for children and adolescents (Ribeiro, 1999). A representative sample of 3195 children and adolescents was obtained from 5 th and 7 th graders throughout all five Portuguese regions. The results showed a good internal consistency for the social support satisfaction factor, α = 0.84; acceptable for the necessity for activities connected to social support factor, α = 0.69. By using ANOVA, gender, age and socioeconomic status related differences were identified. A confirmatory factorial analysis was done and an adjusted model was found by taking off item 5. The concurrent validity was inspected with measures related to social support, such as optimism, self-worth and perceptions of health related quality of life. With this analysis, we verified that women and younger participants (< 12 years) showed a higher social support satisfaction. Mediumhigh socioeconomic status participants showed a higher negative social support satisfaction. These results suggest the validity of the scale in assesing perceptions of social support.

Unemployment, Parental Distress and Youth Emotional Well-Being: The Moderation Roles of Parent–Youth Relationship and Financial Deprivation

Abstract: We investigated, in a sample of 112 unemployed parents of adolescents aged 10-19 years, the links between parental distress and change in youth emotional problems related to parental unemployment, and the moderation roles of parent-youth relationship and financial deprivation. Data were analyzed using descriptive statistics and correlations. Further, simple moderation, additive moderation, and moderated moderation models of regression were performed to analyze the effects of parental distress, parent-youth relationship and financial deprivation in predicting change in youth emotional problems related to parental unemployment. Results show that parental distress moderated by parent-youth relationship predicted levels of change in youth emotional problems related to parental unemployment. This study provides evidence that during job loss, parental distress is linked to youth emotional well-being and that parent-youth relationships play an important moderation role. This raises the importance of further researching parental distress impacts on youth well-being, especially during periods of high unemployment rates.

Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic.

Abstract: Importance The coronavirus disease 2019 (COVID-19) pandemic and the policies to contain it have been a near ubiquitous exposure in the US with unknown effects on depression symptoms. Objective To estimate the prevalence of and risk factors associated with depression symptoms among US adults during vs before the COVID-19 pandemic. Design, Setting, and Participants This nationally representative survey study used 2 population-based surveys of US adults aged 18 or older. During COVID-19, estimates were derived from the COVID-19 and Life Stressors Impact on Mental Health and Well-being study, conducted from March 31, 2020, to April 13, 2020. Before COVID-19 estimates were derived from the National Health and Nutrition Examination Survey, conducted from 2017 to 2018. Data were analyzed from April 15 to 20, 2020. Exposures The COVID-19 pandemic and outcomes associated with the measures to mitigate it. Main Outcomes and Measures Depression symptoms, defined using the Patient Health Questionnaire-9 cutoff of 10 or higher. Categories of depression symptoms were defined as none (score, 0-4), mild (score, 5-9), moderate (score, 10-14), moderately severe (score, 15-19), and severe (score, ≥20). Results A total of 1470 participants completed the COVID-19 and Life Stressors Impact on Mental Health and Well-being survey (completion rate, 64.3%), and after removing those with missing data, the final during–COVID-19 sample included 1441 participants (619 participants [43.0%] aged 18-39 years; 723 [50.2%] men; 933 [64.7%] non-Hispanic White). The pre–COVID-19 sample included 5065 participants (1704 participants [37.8%] aged 18-39 years; 2588 [51.4%] women; 1790 [62.9%] non-Hispanic White). Depression symptom prevalence was higher in every category during COVID-19 compared with before (mild: 24.6% [95% CI, 21.8%-27.7%] vs 16.2% [95% CI, 15.1%-17.4%]; moderate: 14.8% [95% CI, 12.6%-17.4%] vs 5.7% [95% CI, 4.8%-6.9%]; moderately severe: 7.9% [95% CI, 6.3%-9.8%] vs 2.1% [95% CI, 1.6%-2.8%]; severe: 5.1% [95% CI, 3.8%-6.9%] vs 0.7% [95% CI, 0.5%-0.9%]). Higher risk of depression symptoms during COVID-19 was associated with having lower income (odds ratio, 2.37 [95% CI, 1.26-4.43]), having less than $5000 in savings (odds ratio, 1.52 [95% CI, 1.02-2.26]), and exposure to more stressors (odds ratio, 3.05 [95% CI, 1.95-4.77]). Conclusions and Relevance These findings suggest that prevalence of depression symptoms in the US was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. Individuals with lower social resources, lower economic resources, and greater exposure to stressors (eg, job loss) reported a greater burden of depression symptoms. Post–COVID-19 plans should account for the probable increase in mental illness to come, particularly among at-risk populations.

Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: A narrative review to highlight clinical and research needs in the acute phase and the long return to normality

Abstract: The coronavirus disease 2019 (COVID-19) is profoundly affecting life around the globe. Isolation, contact restrictions and economic shutdown impose a complete change to the psychosocial environment in affected countries. These measures have the potential to threaten the mental health of children and adolescents significantly. Even though the current crisis can bring with it opportunities for personal growth and family cohesion, disadvantages may outweigh these benefits. Anxiety, lack of peer contact and reduced opportunities for stress regulation are main concerns. Another main threat is an increased risk for parental mental illness, domestic violence and child maltreatment. Especially for children and adolescents with special needs or disadvantages, such as disabilities, trauma experiences, already existing mental health problems, migrant background and low socioeconomic status, this may be a particularly challenging time. To maintain regular and emergency child and adolescent psychiatric treatment during the pandemic is a major challenge but is necessary for limiting long-term consequences for the mental health of children and adolescents. Urgent research questions comprise understanding the mental health effects of social distancing and economic pressure, identifying risk and resilience factors, and preventing long-term consequences, including—but not restricted to—child maltreatment. The efficacy of telepsychiatry is another highly relevant issue is to evaluate the efficacy of telehealth and perfect its applications to child and adolescent psychiatry. There are numerous mental health threats associated with the current pandemic and subsequent restrictions. Child and adolescent psychiatrists must ensure continuity of care during all phases of the pandemic. COVID-19-associated mental health risks will disproportionately hit children and adolescents who are already disadvantaged and marginalized. Research is needed to assess the implications of policies enacted to contain the pandemic on mental health of children and adolescents, and to estimate the risk/benefit ratio of measures such as home schooling, in order to be better prepared for future developments.

Digital Mental Health and COVID-19: Using Technology Today to Accelerate the Curve on Access and Quality Tomorrow

Abstract: As interest in and use of telehealth during the COVID-19 global pandemic increase, the potential of digital health to increase access and quality of mental health is becoming clear. Although the world today must “flatten the curve” of spread of the virus, we argue that now is the time to “accelerate and bend the curve” on digital health. Increased investments in digital health today will yield unprecedented access to high-quality mental health care. Focusing on personal experiences and projects from our diverse authorship team, we share selected examples of digital health innovations while acknowledging that no single piece can discuss all the impressive global efforts past and present. Exploring the success of telehealth during the present crisis and how technologies like apps can soon play a larger role, we discuss the need for workforce training, high-quality evidence, and digital equity among other factors critical for bending the curve further.