Showing papers on "Mental health published in 1987"

Measuring Health: A Guide to Rating Scales and Questionnaires

Abstract: This is a convenient guide to the health measurement methods used in health and social surveys, epidemiological studies, and clinical trials. It describes the theory and the leading methods of measurement, all of which rely on subjective judgments in questionnaires and rating scales. The authors discuss the validity and reliability of each method, showing readers how to select the most suitable one, apply it, and score the results. Epidemiologists and health care researchers; social scientists; health care planners and analysts.

Work, unemployment, and mental health

Abstract: Here is a challenging study on the effects of work and unemployment on mental health. Examined in this comprehensive study are issues such as why some people are more harmed by unemployment than others; why certain job transitions are more difficult; and what we mean by "mental health" and how we can measure it. The author introduces nine characteristics of any environment and shows how they give rise to the harmful and beneficial consequences of work and unemployment. The book gathers integrates the extensive and widely-dissemenated research into the topic and places it in an original and logical conceptual framework.

Does coping help? A reexamination of the relation between coping and mental health.

Abstract: In a longitudinal community survey of 291 adults, we explored the relation between coping strategies and psychological symptoms. Respondents completed the revised Ways of Coping Scale (Folkman & Lazarus, 1985) for a self-named stressful episode. Factor analysis produced eight coping factors: three problem focused, four emotion focused, and one (support mobilization) that contained elements of both. Multiple regression analyses indicated bidirectionality in the relation between coping and psychological symptoms. Those in poorer mental health and under greater stress used less adaptive coping strategies, such as escapism, but coping efforts still affected mental health independent of prior symptom levels and degree of stress. We compared main versus interactive effects models of stress buffering. Main effects were confined primarily to the emotion-focused coping scales and showed little or negative impacts of coping on mental health; interactive effects, though small, were found with the problem-focused scales. The direction of the relation between problem-focused scales and symptoms may depend in part on perceived efficacy, or how the respondent thought he or she handled the problem. Implications for the measurement of adaptive coping mechanisms and their contextual appropriateness are discussed.

Ontario Child Health Study: II. Six-Month Prevalence of Disorder and Rates of Service Utilization

Abstract: • We studied the six-month prevalence of four child psychiatric disorders (conduct disorder, hyperactivity, emotional disorder, and somatization) and patterns of service utilization for mental health and social services, ambulatory medical care and special education by different regions of Ontario, urbanrural residence, and age and sex groupings. Among children 4 to 16 years of age, the overall six-month prevalence rate of one or more of these disorders was 18.1%. The prevalences of hyperactivity and one or more disorders were significantly higher in urban areas than rural areas. The utilization data indicated that children with these psychiatric disorders, compared with children without these disorders, were almost four times more likely to have received mental health or social services in the six months preceding this study. However, five of six of these children had not received these specialized services in the previous six-month period. Over 50% of the children in the province had received ambulatory medical care in the last six months. Over 15% of the children in the province had received special education services at some time thus far in their school careers. Implications of these findings, especially for the provision of child mental health services, are discussed.

Empirically based assessment of the behavioral/emotional problems of 2- and 3- year-old children.

Abstract: The aim was to determine whether ratings of 2- and 3-year-olds could yield more differentiation among their behavioral/emotional problems than the internalizing-externalizing dichotomy found in previous studies. The 99-item Child Behavior Checklist for Ages 2-3 (CBCL/2-3) was designed to extend previously developed empirically based assessment procedures to 2-and 3-year-olds. Factor analyses of the CBCL/2-3 completed by parents of 398 2- and 3-year-olds yielded six syndromes having at least eight items loading greater than or equal to .30 and designated as Social Withdrawal, Depressed, Sleep Problems, Somatic Problems, Aggressive, and Destructive. Second-order analyses showed that the first two were related to a broad-band internalizing grouping, whereas the last two were related to a broad-band externalizing grouping. Scales for the six syndromes, two broad-band groupings, and total problem score were constructed from scores obtained by 273 children in a general population sample. Mean test-retest reliability r was .87, 1-year stability r was .69, 1-year predictive r with CBCL/4-16 scales at age 4 was .63, 2-year predictive r was .55, and 3-year predictive r was .49. Children referred for mental health services scored significantly higher than nonreferred children on all scales. A lack of significant r's with the Minnesota Child Development Inventory, Bayley, and McCarthy indicate that the CBCL/2-3 taps behavioral/emotional problems independently of the developmental variance tapped by these measures.

Indochinese versions of the Hopkins Symptom Checklist-25: a screening instrument for the psychiatric care of refugees.

Abstract: The United States is accepting the largest number of displaced persons since World War II. Over 70% are Southeast Asians; many have suffered serious war trauma and torture. Cultural differences in health-seeking behavior and lack of specialized mental health services make the recognition of psychiatric distress in Southeast Asia refugees difficult for American health care providers. The authors describe the development and validation of Cambodian, Laotian, and Vietnamese versions of the Hopkins Symptom Checklist-25. This brief, simple, and reliable instrument is well received by refugee patients, offers an effective screening method for the psychiatric symptoms of anxiety and depression, and is especially helpful for evaluating trauma victims.

Chronic Illness, Disability, and Mental and Social Well-Being: Findings of the Ontario Child Health Study

Abstract: Chronic childhood illness, disability, and psychosocial problems are receiving major attention in current pediatric care. Much of the evidence associating chronic physical problems and mental health and adjustment problems has come from clinic-based studies and is often inconsistent in its conclusions. This paper reports the findings of the Ontario Child Health Study, an epidemiologic survey of 3,294 children 4 to 16 years of age in the general community, concerning the relationship of psychiatric disorders and social adjustment problems among children with chronic illness, medical conditions, and long-term disability in contrast to children free of chronic physical health problems. Age- and sex-adjusted risks for psychiatric disorders and social problems, compared with those for healthy peers, were calculated: children with both chronic illness and associated disability were at greater than threefold risk for psychiatric disorders and considerable risk for social adjustment problems. Children with chronic medical conditions, but no disability, were at considerably less risk: about a twofold increase in psychiatric disorders but little increased risk for social adjustment problems was observed. A relative underuse of specialized mental health services by children who might benefit supports the opinion that all physicians in the community who care for children with chronic health problems should become skilled in the recognition of existing or incipient mental health and social problems and familiar with preventive and treatment approaches that may lessen the excessive burden of psychosocial problems among those with chronic ill-health.

Post Sexual Abuse Trauma: Data and Implications for Clinical Practice

Abstract: The incidence and long-term effects of childhood sexual abuse were studied in a clinical sample of 152 adult women. Approximately 44% of female clients presenting to a health center crisis service reported a childhood history of sexual victimization. Prior victimization was associated with increased dissociation, sleep disturbance, tension, sexual problems, and anger on a Crisis Symptom Checklist, as well as greater current use of psychoactive medications, and more frequent histories of suicide attempts, substance addiction, and revictimization. Long-term psychological effects of sexual abuse are interpreted within both a developmental context and in terms of Post Traumatic Stress Disorder. Implications of the current data and related literature for mental health workers are briefly discussed.

Parenthood and Psychological Well-Being

Abstract: Recent studies suggest that parenthood may have negative consequences for the psychological well-being of adults. Adults with children at home report that they are less happy and less satisfied with their lives than other groups. They also appear to worry more and to experience higher levels of anxiety and depression. The overall difference between parents and nonparents appears to be small, although it has increased during the past two decades. Differences between parents and nonparents stem from economic and time constraints, which in turn arise from general social trends such as the increase in women’s labor force participation and the increase in marital disruption and single parenthood. We expect these trends to continue in the near future, reducing the desire for children and increasing gender conflict over the division of parental obligations. Parental strain might be alleviated by some form of state-supported childcare or child allowance.

Ontario Child Health Study. I. Methodology.

Abstract: • We developed the methodology for a community survey to determine the prevalence of emotional and behavioral disorders among children 4 to 16 years of age in Ontario, Canada. Our discussion includes the objectives of the survey, the measurement of disorder, sampling methods and survey design, and a description of the data collected and instrumentation. Among 2052 households with eligible children, 1869 (91%) participated in the survey. The results can be used to help plan the future allocation of mental health resources In Ontario.

Psychiatric disorders in a community sample of adolescents.

Abstract: OBJECTIVE: The aim of this study by Kashani et al. was to identify the prevalence of psychiatric disorders in an adolescent population via use of the Diagnostic and Statistical Manual, third edition. The researchers also aimed to examine correlations between psychiatric disorders and demographic characteristics, the association between psychopathology and physical abuse, different types of conflict resolution of those with disorders, how adolescents with disorders view their parents, as well as general issues concerning adolescent behavior and mental health. METHODOLOGY: A quasi-experimental cross-sectional design was used with a non-probability sample of 150 adolescents between the ages of 14 and 16. Subjects' names were drawn in a systematic fashion to end up with 50 in each age group and 75 of each sex. Participation was solicited by telephone, with an original population of 214 being contacted. Participation rate was 72%. Data were collected both by face-to-face structured psychiatric interviews and by mailed questionnaires, with one parent of the subject also being interviewed. The Diagnostic Interview for Children and Adolescents was administered to the subjects, and the Diagnostic Interview for Children and Adolescents - Parent Version was used for the subjects' parents. Parents also completed the Child Behavior Profile during the course of the home visit, and provided information about economic and marital status. Questionnaires completed by the subjects included the Parental Bonding Instrument, the Conflict Resolution Scale and the Piers-Harris Children's Self-Concept Scale. Interrater reliability for the interviewers was established at a level of agreement of at least 95% before the actual study interviews began. A four-point scale was used to rate the mental status of each subject. Subjects were accepted as "cases" if they met DSMIII criteria for a disorder, as well as being rated as needing treatment by at least two interviewers. Two-way contingency tables were analyzed by Chi-Square, with tests for location and confidence intervals for proportions also being determined. FINDINGS/DISCUSSION: Researchers identified 19% of the population (12 boys and 16 girls) as having a psychiatric disorder and needing treatment. The three most common disorders were conduct disorder, anxiety disorder and depression. The relationship between psychiatric disorder and each of sex, socio-economic status and race was non-significant, and divorce or separation of parents also did not distinguish between those with disorder and those without. However, 43% of adolescents with psychiatric disorders reported physical abuse, whilst only 5% of those without disorder reporting victimization experiences. The relationship between psychiatric disorder and sexual relations was also significant, with 54% of those with disorder and 17% of those without reporting sexual experiences. Subjects with psychiatric disorders also reported daily smoking significantly more than those without disorder (46% and 4% respectively). A significant difference was also found between groups in types of interpersonal interaction. Those with disorder reported using verbal aggression and physical violence for conflict resolution more than those without disorder, and they also had a lower self-concept and described their parents as less caring. AUTHORS' RECOMMENDATIONS: The researchers stress the importance of parental care and high levels of self-concept in the development of children into mentally healthy adolescents and adults. For future studies, the authors recommend the use of trained professionals for interviewing and rating subjects. EVALUATION: By employing interviews that were originally designed for clinical populations, the findings may overestimate the prevalence of the disorders in the general community. However, the additional criteria of being considered as needing treatment by at least two mental health professionals to be defined as a case has somewhat remedied this problem. Although the sample is rather small, the statistical analyses are appropriate and provide useful information upon which to base further research. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado) KW - Psychopathology KW - Psychosocial Factors KW - Mental Illness KW - Domestic Violence Victim KW - Child Abuse Victim KW - Child Abuse Effects KW - Domestic Violence Effects KW - Juvenile Victim KW - Demographic Factors KW - Mental Health KW - Juvenile Abuse KW - Depression Language: en

Exercise and mental health

Abstract: Published in the year 1987, Exercise and Mental Health is a valuable contribution to the field of Counseling and School Pscyhology.

Adolescent homosexuality: psychosocial and medical implications.

Abstract: Despite a widespread interest in the health of the gay community, the psychosocial and medical problems of gay and bisexual adolescents have not been adequately investigated. In this study, 29 gay and bisexual male teenagers participated in anonymous and confidential interviews regarding the impact of sexuality on family, employment, education, peers, intimate relationships, and physical and mental health. The majority of subjects experienced school problems related to sexuality, substance abuse, and/or emotional difficulties warranting mental health interventions. In addition, nearly half of the subjects reported a history of sexually transmitted diseases, running away from home, or conflict with the law. A minority had been victims of sexual assaults or involved in prostitution. Those less than 18 years of age experienced higher rates of psychiatric hospitalization, substance abuse, high school drop-out, and conflict with the law than did older participants. Various explanations for the prevalence of these problems and their implications for health professionals are discussed.

The impact of culture on the cognitive structure of illness

Abstract: This paper presents a theoretical framework for understanding the impact of culture on the processes of symptom recognition, labeling, and help-seeking and consequently on large-scale epidemiological studies involving different ethnic groups. We begin with the assumption that the subjective experience of illness is culture- bound and that the cognitive and linguistic categories of illness characteristic of any culture constrain the interpretative and behavioral options available to individuals in response to symptoms. We hypothesize the existence of learned cognitive structures, through which bodily experiences are filtered, that influence the interpretation of deviations from culturally-defined physical and mental health norms. Certain contradictory findings concerning the self-reported health of Mexican Americans are discussed in order to illustrate the impact of culture on perceived health status.

Early Indicators of Developmental Risk: Rochester Longitudinal Study

Abstract: Early indicators of schizophrenic outcomes were sought in a group of children of chronically ill schizophrenic women. A sample of pregnant women with varying degrees of mental illness were examined during the perinatal period and recruited into a 4-year longitudinal evaluation, which included cognitive, psychomotor, social, and emotional assessments at birth, 4, 12, 30, and 48 months of age. The mothers varied on mental health dimensions of diagnosis, severity of symptomatology, and chronicity of illness. Other factors included in the analyses were socioeconomic status (SES), race, sex of child, and family size. Hypotheses were tested to determine the relative impact of three sets of variables on the child's behavior: (1) specific maternal psychiatric diagnosis, (2) severity and chronicity of disturbance independent of diagnosis, and (3) general social status. We found that a specific maternal diagnosis of schizophrenia had the least impact. Neurotic-depressive mothers produced worse development in their children than schizophrenic or personality-disordered mothers. Both social status and severity/chronicity of illness showed a greater impact on development. Children of more severely or chronically ill mothers and lower-SES black children performed most poorly. These results do not support etiological models based on simple biological or environmental transmission of schizophrenia. The role of social and family environmental factors in predicting child cognitive and socialemotional competence was further evaluated using a multiple risk index. Children with high multiple environmental risk scores had much worse outcomes than children with low multiple risk scores. We have been conducting a longitudinal study since 1970 that investigates the role of parental mental illness, social status, and other family cognitive and social variables that might be risk factors in the early development of children from birth through 4 years of age. Our investigation was cast as an attempt to identify variables that place a child at risk for the later development of schizophrenia. The target population was the offspring of schizophrenic women, who have been shown to be more than 10 times

Understanding, prediction, and control as moderators of the relationships between perceived stress, satisfaction, and psychological well-being.

Abstract: This study provides a preliminary test of a model proposed by Sutton and Kahn (1986). In the model, the ability to understand, predict, and control events in the work environment can reduce the potential adverse effects generally associated with certain work conditions. Using a sample of physicians,

Utilization of Health and Mental Health Services by Los Angeles Mexican Americans and Non-Hispanic Whites

Abstract: • Utilization of general medical and mental health services by respondents in the Los Angeles Epidemiologic Catchment Area (ECA) site was compared with that in three ECA sites studied previously (New Haven, Conn, Baltimore, and St Louis). Within the Los Angeles sample, Mexican-American patterns of utilization were compared with those for non-Hispanic whites. Los Angeles respondents were less likely than those at other ECA sites to make ambulatory health care visits and to be hospitalized for physical or mental health reasons. Mexican Americans were less likely than non-Hispanic whites to report ambulatory health care but were as likely to have been hospitalized. Six percent of Los Angeles respondents reported a recent mental-health-care visit as compared with 6% to 7% of respondents at the other ECA sites. However, among respondents with Diagnostic Interview Schedule DSM-III disorders diagnosed within the six months prior to the interview, a lower proportion made a mental health visit in Los Angeles (14%) compared with the other sites (16% to 20%). Of those who made a mental-health-care visit, Los Angeles respondents with a recently diagnosed disorder were more likely than comparable respondents at the other ECA sites to visit a mental health specialist rather than a general medical care provider. Mexican Americans with a recently diagnosed mental disorder were only half as likely as non-Hispanic whites (11% vs 22%, respectively) to have made a mental health visit. However, when Mexican Americans with Diagnostic Interview Schedule/ DSM-III did make a mental health visit, they were as likely as non-Hispanic whites to see a mental health specialist.

Empowerment: An emerging mental health technology.

Abstract: This paper addresses the theory and practice of empowerment as an emerging mental health technology, as well as its relationship to prevention. The paper begins with a discussion of the increasing interest in empowerment by preventionists. Definitional issues are then considered; in this context the disparate philosophical world views of empowerment and prevention are outlined. Next, attention is directed to emprowerment in practice. This section is followed by a discussion of possible roles for professionals in empowerment activities. The paper ends with a note of caution to mental health professionals who plan to use the emerging technology of empowerment.

Social Interaction, Loneliness, and Emotional Well-Being among the Elderly:

Abstract: This study examines the effects of interaction with different types of role partners on the emotional well-being (morale) of older persons, and the extent to which these effects are mediated by subjective feelings of social integration (loneliness). Hypotheses regarding the differential effects of friendship and kinship on these emotional states are developed and tested on a sample of 2872 respondents aged 55 and over. Consistent with the hypotheses, loneliness has a major negative effect on morale, and transmits large proportions of the effects of social integration measures. Feelings of loneliness are reduced, and morale increased, by interaction with friends and, to a lesser extent, neighbors. Interaction with children and grandchildren has no such effects.

The effect of stressful life events and transitions on family functioning and well-being.

Abstract: This study examines a multivariate model of the effect of life events and transitions, intrafamily strain, marital adjustment, and appraisal on family well-being. Data from 1,140 families were analyzed by LISREL Vlprogram. The model was tested and modified by using data from a random split-half of the sample and cross-validated with data from the second half by using a multisample analysis. The results show that life events and transitions had no direct effect on family well-being, but they intensified intrafamily strain. Family strain, in turn, negatively affected marital adjustment and perceived well-being. Contrary to our hypothesis, family strain was positively associated with a more optimistic appraisal of the situation. Both marital adjustment and appraisal were positively related to wellbeing, thereby counteracting the effect of the pileup of demands. It was concluded, however, that they play different intervening roles between demands and well-being: marital adjustment is a mediating factor, whereas appraisal of the situation plays a stressbuffering role. Methodological issues and theoretical implications are discussed.

Somatization in the community: relationship to disability and use of services.

Abstract: We tested the hypotheses that an abridged somatization construct that we had developed would be associated with use of health services, preferential use of medical over mental health services, and an index of disability. These hypotheses were tested using structured interview data from 3,132 randomly selected community respondents. We found that: respondents meeting criteria for somatization reported a heavier use of health services than non-somatizers; of those respondents meeting criteria for a psychiatric diagnosis, somatizers preferentially used medical over mental health services whereas non-somatizers reported the opposite trend; and somatizers were more likely than non-somatizers to report recent sick leave or restricted activity.

Longitudinal Analyses of Psychological Well-being in a National Sample: Stability of Mean Levels

Abstract: Maturational changes, cohort differences, and time of measurement effects on psychological well-being were examined in data from the National Health and Nutrition Examination Survey (NHANES) I Epidemiologic Followup Study. A 9-year longitudinal study of 4,942 men and women initially aged 25 to 74 was supplemented by cross- and time-sequential analyses using an independent sample of 4,986 participants who were first administered the well-being measures at the time of the follow-up. Older participants in the study tended to be lower in both Positive and Negative Affect, but longitudinal changes in these two subscales were not found, and Total Well-Being showed no significant age, birth cohort, or time effects in any of the analyses. Given the size and representativeness of the sample, this is strong evidence of the stability of mean levels of psychological well-being in adulthood, and points to the importance of enduring personality dispositions and processes of adaptation in determining levels of well-being.

Relationships of organizational frustration with reported behavioural reactions: The moderating effect of locus of control

Abstract: The present field study was designed to examine the influence of organizational frustration and locus of control on emotional and behavioural reactions to frustrating conditions. Data were collected by questionnaire from 160 employees from all levels of a community mental health facility. As hypothesized, organizational frustration was found to be positively related to interpersonal aggression, sabotage and withdrawal. Subgroup moderator analysis supported the hypothesized moderating relationship of locus of control on the perceived frustration behavioural reactions relationship. These results suggest that persons with an external locus of control are more likely to respond to frustration with counterproductive behaviour than persons with an internal locus of control. The implications of these findings for organizations are discussed.

The relationship between demographic factors and attitudes toward mental health services

Abstract: Considerable effort has been exerted in recent years toward educating the public concerning mental illness and the efficacy of various treatment modalities. Most previous studies of attitudes have focused solely on attitudes toward the mentally ill. In this study we investigated attitudes toward mental health services and found that most people are positively disposed toward the use of these services. Attitudes toward the use of mental health services were affected by the age, sex, race, education, and income of the subjects. In general, differences of attitude lie in the direction that would tend to inhibit utilization among those most at risk.

Substance Abuse by Young Adult Chronic Patients

Abstract: Of 41 chronic psychiatric patients between the ages of 19 to 39 seen at a community mental health center, 44 percent were current substance abusers, 29 percent had a history of substance abuse, and only 27 percent had little or no substance abuse history. The three subgroups were similar in diagnosis, gender, and age at first hospitalization. However, the persistent substance abusers had a psychiatric hospitalization rate more than twice as high as the other two groups, and for these patients substance abuse frequently preceded hospitalization. The author recommends that consideration be given to routinely testing all hospitalized young adult chronic patients for drug and alcohol abuse. He also suggests using outside sources to obtain information on substance abuse, since most patients deny abuse. He stresses the need for more data on the physical and psychological effects of abused substances on the young mental patient.