Showing papers on "Mental health published in 2006"

Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan.

Abstract: ContextThe US military has conducted population-level screening for mental health problems among all service members returning from deployment to Afghanistan, Iraq, and other locations. To date, no systematic analysis of this program has been conducted, and studies have not assessed the impact of these deployments on mental health care utilization after deployment.ObjectivesTo determine the relationship between combat deployment and mental health care use during the first year after return and to assess the lessons learned from the postdeployment mental health screening effort, particularly the correlation between the screening results, actual use of mental health services, and attrition from military service.Design, Setting, and ParticipantsPopulation-based descriptive study of all Army soldiers and Marines who completed the routine postdeployment health assessment between May 1, 2003, and April 30, 2004, on return from deployment to Operation Enduring Freedom in Afghanistan (n = 16 318), Operation Iraqi Freedom (n = 222 620), and other locations (n = 64 967). Health care utilization and occupational outcomes were measured for 1 year after deployment or until leaving the service if this occurred sooner.Main Outcome MeasuresScreening positive for posttraumatic stress disorder, major depression, or other mental health problems; referral for a mental health reason; use of mental health care services after returning from deployment; and attrition from military service.ResultsThe prevalence of reporting a mental health problem was 19.1% among service members returning from Iraq compared with 11.3% after returning from Afghanistan and 8.5% after returning from other locations (P<.001). Mental health problems reported on the postdeployment assessment were significantly associated with combat experiences, mental health care referral and utilization, and attrition from military service. Thirty-five percent of Iraq war veterans accessed mental health services in the year after returning home; 12% per year were diagnosed with a mental health problem. More than 50% of those referred for a mental health reason were documented to receive follow-up care although less than 10% of all service members who received mental health treatment were referred through the screening program.ConclusionsCombat duty in Iraq was associated with high utilization of mental health services and attrition from military service after deployment. The deployment mental health screening program provided another indicator of the mental health impact of deployment on a population level but had limited utility in predicting the level of mental health services that were needed after deployment. The high rate of using mental health services among Operation Iraqi Freedom veterans after deployment highlights challenges in ensuring that there are adequate resources to meet the mental health needs of returning veterans.

Psychosocial work environment and mental health--a meta-analytic review

Abstract: Objectives To clarify the associations between psychosocial work stressors and mental ill health, a meta-analysis of psychosocial work stressors and common mental disorders was undertaken using longitudinal studies identified through a systematic literature review. Methods The review used a standardized search strategy and strict inclusion and quality criteria in seven databases in 1994–2005. Papers were identified from 24 939 citations covering social determinants of health, 50 relevant papers were identified, 38 fulfilled inclusion criteria, and 11 were suitable for a meta-analysis. The Comprehensive Meta-analysis Programme was used for decision authority, decision latitude, psychological demands, and work social support, components of the job-strain and iso-strain models, and the combination of effort and reward that makes up the effort–reward imbalance model and job insecurity. Cochran’s Q statistic assessed the heterogeneity of the results, and the I2 statistic determined any inconsistency between studies. Results Job strain, low decision latitude, low social support, high psychological demands, effort–reward imbalance, and high job insecurity predicted common mental disorders despite the heterogeneity for psychological demands and social support among men. The strongest effects were found for job strain and effort–reward imbalance. Conclusions This meta-analysis provides robust consistent evidence that (combinations of) high demands and low decision latitude and (combinations of) high efforts and low rewards are prospective risk factors for common mental disorders and suggests that the psychosocial work environment is important for mental health. The associations are not merely explained by response bias. The impact of work stressors on common mental disorders differs for women and men.

A systematic review of empirical research on self-reported racism and health

Abstract: This paper reviews 138 empirical quantitative population-based studies of self-reported racism and health. These studies show an association between self-reported racism and ill health for oppressed racial groups after adjustment for a range of confounders. The strongest and most consistent findings are for negative mental health outcomes and health-related behaviours, with weaker associations existing for positive mental health outcomes, self-assessed health status, and physical health outcomes. Most studies in this emerging field have been published in the past 5 years and have been limited by a dearth of cohort studies, a lack of psychometrically validated exposure instruments, poor conceptualization and definition of racism, conflation of racism with stress, and debate about the aetiologically relevant period for self-reported racism. Future research should examine the psychometric validity of racism instruments and include these instruments, along with objectively measured health outcomes, in existing large-scale survey vehicles as well as longitudinal studies and studies involving children. There is also a need to gain a better understanding of the perception, attribution, and reporting of racism, to investigate the pathways via which self-reported racism affects health, the interplay between mental and physical health outcomes, and exposure to intra-racial, internalized, and systemic racism. Ensuring the quality of studies in this field will allow future research to reveal the complex role that racism plays as a determinant of population health.

Antonovsky’s sense of coherence scale and the relation with health: a systematic review

Abstract: Study objective: The aim of this paper is to synthesise empirical findings on the salutogenic concept sense of coherence (SOC) and examine its capacity to explain health and its dimensions. Design: The study is descriptive and analytical with a systematic integration of the contemporary knowledge base on the salutogenic research published 1992–2003. The review includes 458 scientific publications and 13 doctoral theses. Setting: Worldwide, based on postgraduate scientific publications in eight authorised databases, doctoral theses, and available books. Main results: SOC is strongly related to perceived health, especially mental health. The stronger the SOC the better the perceived health in general, at least for those with an initial high SOC. This relation is manifested in study populations regardless of age, sex, ethnicity, nationality, and study design. SOC seems to have a main, moderating or mediating role in the explanation of health. Furthermore, the SOC seems to be able to predict health. SOC is an important contributor for the development and maintenance of people’s health but does not alone explain the overall health. Conclusion: SOC seems to be a health promoting resource, which strengthens resilience and develops a positive subjective state of health. Salutogenesis is a valuable approach for health promotion and would be worth to implement in practice much more than to date.

Congruencies in Increased Mortality Rates, Years of Potential Life Lost, and Causes of Death Among Public Mental Health Clients in Eight States ORIGINAL RESEARCH

Abstract: Introduction Mortality rates are used as global measures of a population's health status and as indicators for public health efforts and medical treatments. Elevated mortality rates among individuals with mental illness have been reported in various studies, but very little focus has been placed on interstate comparisons and congruency of mortality and causes of death among public mental health clients. Methods Using age-adjusted death rates, standardized mortality ratios, and years of potential life lost, we compared the mortality of public mental health clients in eight states with the mortality of their state general populations. The data used in our study were submitted by public mental health agencies in eight states (Arizona, Missouri, Oklahoma, Rhode Island, Texas, Utah, Vermont, and Virginia) for 1997 through 2000 during the Sixteen-State Study on Mental Health Performance Measures, a multistate study federally funded by the Center for Mental Health Services in collaboration with the National Association of State Mental Health Program Directors. Results In all eight states, we found that public mental health clients had a higher relative risk of death than the general populations of their states. Deceased public mental health clients had died at much younger ages and lost decades of potential life when compared with their living cohorts nationwide. Clients with major mental illness diagnoses died at younger ages and lost more years of life than people with non-major mental illness diagnoses. Most mental health clients died of natural causes similar to the leading causes of death found nationwide, including heart disease, cancer, and cerebrovascular, respiratory, and lung diseases. Conclusion Mental health and physical health are intertwined; both types of care should be provided and linked together within health care delivery systems. Research to track mortality and primary care should be increased to provide information for additional action, treatment modification, diagnosis-specific risk, and evidence-based practices.

Healthy nature healthy people: 'Contact with nature' as an upstream health promotion intervention for populations.

Abstract: Whilst urban-dwelling individuals who seek out parks and gardens appear to intuitively understand the personal health and well-being benefits arising from ﾑcontact with natureﾒ, public health strategies are yet to maximize the untapped resource nature provides, including the benefits of nature contact as an upstream health promotion interventionfor populations. Initial findings indicate that nature plays a vital role in human health and well-being, and that parks and nature reserves play a significant role by providing access to nature for individuals. Implications suggest contact with nature may provide an effective population-wide strategy in prevention of mental ill health, with potential application for sub-populations, communities and individuals at higher risk of ill health. Recommendations include further investigation of ﾑcontact with natureﾒ in population health, and examination of the benefits of nature-based interventions.

Mental Health Problems of Prison and Jail Inmates

Abstract: At midyear 2005 more than half of all prison and jail inmates had a mental health problem, including 705,600 inmates in State prisons, 70,200 in Federal prisons, and 479,900 in local jails. These estimates represented 56% of State prisoners, 45% of Federal prisoners, and 64% of jail inmates. The findings in this report were based on data from personal interviews with State and Federal prisoners in 2004 and local jail inmates in 2002.

Gene-environment interplay and psychopathology: multiple varieties but real effects

Abstract: Gene–environment interplay is a general term that covers several divergent concepts with different meanings and different implications. In this review, we evaluate research evidence on four varieties of gene–environment interplay. First, we consider epigenetic mechanisms by which environmental influences alter the effects of genes. Second, we focus on variations in heritability according to environmental circumstances. Third, we discuss what is known about gene–environment correlations. Finally, we assess concepts and findings on the interaction between specific identified genes and specific measured environmental risks. In order to provide an understanding of what may be involved in gene–environment interplay, we begin our presentation with a brief historical review of prevailing views about the role of genetic and environmental factors in the causation of mental disorders, and we provide a simplified account of some of the key features of how genes ‘work’. Over the past half-century there has been a series of changes in the generally prevailing views about the role of genetic and environmental factors in the causation of mental disorders. These changes were preceded in the first half of the 20th century (Cameron, 1956; Cairns, 1983; Kanner, 1959) by two background features. First, there was the introduction of unethical and abhorrent eugenic interventions on the misguided view of deterministic genetic effects (Devlin, Fienberg, Resnick, & Roeder, 1997). This background created a distrust of genetics in many behavioural scientists that has not entirely disappeared today despite genetic thinking and practice having changed completely (see Rutter, in press a). Second, there were numerous research reports of substantial associations between various environmental risk factors and the development of mental disorder. The Mental Hygiene movement placed great emphasis on the role of adverse experiences, both within and outside the family, in the predisposition to some mental disorders. This period also constituted the heyday of the influence of psychoanalysis on concepts and thinking in most of psychiatry and psychology. Behaviourism, led by the theorising of Pavlov and of Skinner, as well as by the advocacy of Watson, placed predominate emphasis on the power of learning with respect to all forms of behaviour. Within the field of child mental health, Bowlby’s (1951) review for the WHO of ‘maternal deprivation’, followed by Ainsworth’s (1962) reassessment a decade or so later, put forward a powerful case for the overwhelming influence of children’s upbringing in the early years. Reviews such as those by Pringle (1974) did much to popularise these views and foster

Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states.

Abstract: Introduction Mortality rates are used as global measures of a population's health status and as indicators for public health efforts and medical treatments. Elevated mortality rates among individuals with mental illness have been reported in various studies, but very little focus has been placed on interstate comparisons and congruency of mortality and causes of death among public mental health clients.

Culturally adapted mental health intervention: A meta-analytic review.

Abstract: There is a pressing need to enhance the availability and quality of mental health services provided to persons from historically disadvantaged racial and ethnic groups. Many previous authors have advocated that traditional mental health treatments be modified to better match clients' cultural contexts. Numerous studies evaluating culturally adapted interventions have appeared, and the present study used meta-analytic methodology to summarize these data. Across 76 studies the resulting random effects weighted average effect size was d = .45, indicating a moderately strong benefit of culturally adapted interventions. Interventions targeted to a specific cultural group were four times more effective than interventions provided to groups consisting of clients from a variety of cultural backgrounds. Interventions conducted in clients' native language (if other than English) were twice as effective as interventions conducted in English. Recommendations are provided for improving the study of outcomes associated with mental health interventions adapted to the cultural context of the client. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Gender Differences in Caregiver Stressors, Social Resources, and Health: An Updated Meta-Analysis

Abstract: This meta-analysis integrates results from 229 studies on gender differences in caregiver psychological and physical health, caregiving stressors, and social resources. Contrary to common perceptions, gender differences in caregiving variables were small to very small. Women had higher levels of burden and depression, and lower levels of subjective well-being and physical health. They reported that their care recipient had more behavioral problems; they provided more caregiving hours, helped with more caregiving tasks, and assisted with more personal care. Women and men did not differ in the use of informal and formal support. Statistically controlling for gender differences in stressors and resources reduced the size of gender differences in depression and physical health to levels that have been observed in noncaregiving samples. The results support stress-and-coping theories on gender differences in caregiving.

Low Self-Esteem During Adolescence Predicts Poor Health, Criminal Behavior, and Limited Economic Prospects During Adulthood

Abstract: Using prospective data from the Dunedin Multidisciplinary Health and Development Study birth cohort, the authors found that adolescents with low self-esteem had poorer mental and physical health, worse economic prospects, and higher levels of criminal behavior during adulthood, compared with adolescents with high self-esteem. The long-term consequences of self-esteem could not be explained by adolescent depression, gender, or socioeconomic status. Moreover, the findings held when the outcome variables were assessed using objective measures and informant reports; therefore, the findings cannot be explained by shared method variance in self-report data. The findings suggest that low self-esteem during adolescence predicts negative real-world consequences during adulthood.

Confronting and Coping with Weight Stigma: An Investigation of Overweight and Obese Adults

Abstract: The total sample of 2671 overweight and obese adults were partitioned into two subsamples for investigation. Sample I was comprised of 2449 adult women, and Sample II was a matched sample of adult men and women (N = 222) that was disaggregated to investigate gender differences. Both samples completed an online battery of self-report questionnaires measuring frequency of weight stigmatization and coping responses to deal with bias, the most common sources of the bias, symptoms of depression, self-esteem, attitudes about weight and obesity, and binge eating behaviors .Experiences of weight stigmatization was common in both samples. A variety of coping strategies were used in response. More frequent exposure to stigma was related to more attempts to cope and higher BMI. Physicians and family members were the most frequent sources of weight bias reported. No gender differences were observed in types or frequency of stigmatization. Frequency of stigmatization was not related to current psychological functioning, although coping responses were associated with emotional well-being. These findings raise questions about the relationship between stigma and psychological functioning and have important implications for obesity treatment and stigma reduction intervention efforts, both of which are discussed.

Self-injurious behaviors in a college population.

Abstract: OBJECTIVE.The goal was to assess the prevalence, forms, demographic and mental health correlates of self-injurious behaviors in a representative college sample. METHODS.A random sample of undergraduate and graduate students at 2 northeastern US universities were invited to participate in an Internet-based survey in the spring of 2005. Thirty-seven percent of the 8300 invited participants responded. RESULTS.The lifetime prevalence rate of having 1 self-injurious behavior incident was 17.0%. Seventy-five percent of those students engaged in self-injurious behaviors more than once. Thirty-six percent reported that no one knew about their self-injurious behaviors and only 3.29% indicated that a physician knew. Compared with non-self-injurers, those with repeat self-injurious behavior incidents were more likely to be female, bisexual or questioning their sexual orientation. They were less likely to be Asian/Asian American and 24 years of age. When controlling for demographic characteristics, those with repeat self-injurious behavior incidents were more likely to report a history of emotional abuse or sexual abuse, ever having considered or attempted suicide, elevated levels of psychological distress, and 1 characteristic of an eating disorder. A dose-response gradient was evident in each of these areas when single-incident self-injurious behaviors were compared with repeat-incident self-injurious behaviors. CONCLUSIONS.A substantial number of college students reported self-injurious behaviors in their lifetimes. Many of the behaviors occurred among individuals who had never been in therapy for any reason and who only rarely disclosed their selfinjurious behaviors to anyone. Single self-injurious behavior incidents were correlated with a history of abuse and comorbid adverse health conditions but less strongly than were repeat self-injurious behavior incidents. The reticence of these clients to seek help or advice renders it critical that medical and mental health providers find effective strategies for detecting and addressing self-injurious behaviors.

Prevalence and correlates of personality disorder in Great Britain.

Abstract: Background Epidemiological data on personality disorders, comorbidity and associated use of services are essential for health service policy. Aims To measure the prevalence and correlates of personality disorder in a representative community sample. Method The Structured Clinical Interview for DSM–IVAxis II disorders was used to measure personality disorder in 626 persons aged 16–74 years in households in England, Scotland and Wales, in a two-phase survey. Results The weighted prevalence of personality disorder was 4.4% (95% CI 2.9–6.7).Rates were highest among men, separated and unemployed participants in urban locations. High use of healthcare services was confounded by comorbid mental disorder and substance misuse. Cluster B disorders were associated with early institutional care and criminality. Conclusions Personality disorder is common in the community, especially in urban areas. Services are normally restricted to symptomatic, help-seeking individuals, but a vulnerable group with cluster B disorders can be identified early, are in care during childhood and enter the criminal justice system when young. This suggests the need for preventive interventions at the public mental health level.

Is Work Good for Your Health and Well-being?

Abstract: Increasing employment and supporting people into work are key elements of the Government's public health and welfare reform agendas. This independent review, 'Is Work Good for Your Health and Well-being?', commissioned by the Department for Work and Pensions, examines scientific evidence on the health benefits of work, focusing on adults of working age and the common health problems that account for two-thirds of sickness absence and long-term incapacity. The study finds that there is a strong evidence base showing that work is generally good for physical and mental health and well-being, taking into account the nature and quality of work and its social context, and that worklessness is associated with poorer physical and mental health. Work can be therapeutic and can reverse the adverse health effects of unemployment, in relation to healthy people of working age, for many disabled people, for most people with common health problems, and for social security beneficiaries

The Impact of Physical, Psychological, and Sexual Intimate Male Partner Violence on Women's Mental Health: Depressive Symptoms, Posttraumatic Stress Disorder, State Anxiety, and Suicide

Abstract: Objective: This study aimed to determine the impact of lifetime physical, psychological, and sexual intimate male partner violence (IPV) on the mental health of women, after controlling for the contribution of lifetime victimization. The comorbidity of depressive symptoms and posttraumatic stress disorder (PTSD) and their relation to state anxiety and suicide were also assessed. Methods: Physically/psychologically (n = 75) and psychologically abused women (n = 55) were compared with nonabused control women (n = 52). Information about sociodemographic characteristics, lifetime victimization, and mental health status (depressive and state anxiety symptoms, PTSD, and suicide) was obtained through face-to-face structured interviews. Results: Women exposed to physical/psychological and psychological IPV had a higher incidence and severity of depressive and anxiety symptoms, PTSD, and thoughts of suicide than control women, with no differences between the two abused groups. The concomitance of sexual violence w...

Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes

Abstract: The objectives of this study were to explore age and gender differences in attitudes toward seeking professional psychological help, and to examine whether attitudes negatively influence intentions to seek help among older adults and men, whose mental health needs are underserved. To achieve these objectives 206 community-dwelling adults completed questionnaires measuring help-seeking attitudes, psychiatric symptomatology, prior help-seeking, and intentions to seek help. Older age and female gender were associated with more positive help-seeking attitudes in this sample, although age and gender interacted with marital status and education, and had varying influences on different attitude components. Age and gender also influenced intentions to seek professional psychological help. Women exhibited more favourable intentions to seek help from mental health professionals than men, likely due to their positive attitudes concerning psychological openness. Older adults exhibited more favourable intentions to seek help from primary care physicians than younger adults, a finding that was not explained by age differences in attitudes. Results from this study suggest that negative attitudes related to psychological openness might contribute to men's underutilization of mental health services. Help-seeking attitudes do not appear to be a barrier to seeking professional help among older adults, although their intentions to visit primary care physicians might be. These findings suggest the need for education to improve men's help-seeking attitudes and to enhance older adults' willingness to seek specialty mental health services.

American College Health Association National College Health Assessment (ACHA-NCHA) Spring 2005 Reference Group Data Report (Abridged).

Abstract: Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey instrument developed by the ACHA in 1998 to assist institutions of higher education in achieving this goal. The ACHA-NCHA contains approximately 300 questions assessing student health status and health problems, risk and protective behaviors, access to health information, impediments to academic performance, and perceived norms across a variety of content areas (eg, injury prevention; personal safety and violence; alcohol, tobacco, and other drug use; sexual health; weight, nutrition, and exercise; mental health). Twice a year, the ACHA compiles aggregate data from participating institutions in a reference group report for data comparison. Results from the Spring 2005 Reference Group (N = 54,111) are presented in this article.

Stigma about Depression and its Impact on Help-Seeking Intentions

Abstract: Objective: Research has shown that people are reluctant to seek professional help for depression, especially from mental health professionals. This may be because of the impact of stigma which can ...

Social Network Typologies and Mental Health Among Older Adults

Abstract: In this study, we test the robustness of previous social network research and extend this work to determine if support quality is one mechanism by which network types predict mental health. Participants included 1,669 adults aged 60 or older from the Americans' Changing Lives study. Using cluster analysis, we found diverse, family, and friends network types, which is consistent with the work by Litwin from 2001. However, we found two types of restricted networks, rather than just one: a nonfamily network and a nonfriends network. Depressive symptomatology was highest for individuals in the nonfriends network and lowest for individuals in the diverse network. Positive support quality partially mediated the association between network type and depressive symptomatology. Results suggest that the absence of family in the context of friends is less detrimental than the absence of friends in the context of family, and that support quality is one mechanism through which network types affect mental health.

Mental health in adolescence: is America's youth flourishing?

Abstract: A continuous assessment and a categorical diagnosis of the presence of mental health, described as flourishing, and the absence of mental health, characterized as languishing, are proposed and applied to data from the second wave of the Child Development Supplement (CDS-II) of the Panel Study of Income Dynamics (PSID), in which a comprehensive set of subjective well-being items were administered to a sample of 1,234 youth ages 12-18. Flourishing was the most prevalent diagnosis among youth ages 12-14; moderate mental health was the most prevalent diagnosis among youth ages 15-18. Depressive symptoms decreased as mental health increased. Prevalence of conduct problems (arrested, skipped school, alcohol use, cigarette smoking, and marijuana use) also decreased and measures of psychosocial functioning (global self-concept, self-determination, closeness to others, and school integration) increased as mental health increased. Findings suggest the importance of positive mental health in future research on adolescent development.

Compassion Fatigue and Psychological Distress Among Social Workers: A Validation Study

Abstract: Few studies have focused on caring professionals and their emotional exhaustion from working with traumatized clients, referred to as compassion fatigue (CF). The present study had 2 goals: (a) to assess the psychometric properties of a CF scale, and (b) to examine the scale's predictive validity in a multivariate model. The data came from a survey of social workers living in New York City following the September 11, 2001, terrorist attacks on the World Trade Center. Factor analyses indicated that the CF scale measured multiple dimensions. After overlapping items were eliminated, the scale measured 2 key underlying dimensions—secondary trauma and job burnout. In a multivariate model, these dimensions were related to psychological distress, even after other risk factors were controlled. The authors discuss the results in light of increasing the ability of professional caregivers to meet the emotional needs of their clients within a stressful environment without experiencing CF.

Trauma, post-migration living difficulties, and social support as predictors of psychological adjustment in resettled Sudanese refugees.

Abstract: Objective: This paper explores the impact of pre-migration trauma, post-migration living difficulties and social support on the current mental health of 63 resettled Sudanese refugees.Method: A sem...

Social-Emotional Competence as Support for School Readiness: What Is It and How Do We Assess It?

Abstract: The overall issue of assessment during early childhood, and its relation to school readiness and other decisions, is currently widely debated. Expanding early childhood education and child care enrollments, better scientific knowledge about early childhood development, and decisions about public spending, necessitate careful consideration of which assessment tools to use, as well as why and when to use them. More specifically, the disconnection between the importance of social and emotional domains of development, and their status within educational programming and assessment, has long been lamented. The last several years have, however, witnessed a blossoming of attention to these areas during early childhood, as crucial for both concurrent and later well-being and mental health, as well as learning and academic success. Teachers view children's "readiness to learn" and "teachability" as marked by positive emotional expressiveness, enthusiasm, and ability to regulate emotions and behaviors. Based on thes...

Using the Patient Health Questionnaire-9 to Measure Depression among Racially and Ethnically Diverse Primary Care Patients

Abstract: OBJECTIVE: The Patient Health Questionnaire depression scale (PHQ-9) is a well-validated, Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition (DSM-IV) criterion-based measure for diagnosing depression, assessing severity and monitoring treatment response. The performance of most depression scales including the PHQ-9, however, has not been rigorously evaluated in different racial/ethnic populations. Therefore, we compared the factor structure of the PHQ-9 between different racial/ethnic groups as well as the rates of endorsement and differential item functioning (DIF) of the 9 items of the PHQ-9. The presence of DIF would indicate that responses to an individual item differ significantly between groups, controlling for the level of depression.

School connectedness is an underemphasized parameter in adolescent mental health: results of a community prediction study.

Abstract: There is limited prospective research on the relation between school connectedness (i.e., the extent to which students feel accepted, valued, respected, and included in the school) and mental health symptoms in adolescents. A sample of 2,022 students (999 boys and 1,023 girls) ages 12 to 14 years were measured at 2 time points (12 months apart) on school connectedness and mental health symptoms (general functioning, depression, and anxiety symptoms). School connectedness correlated extensively with concurrent mental health symptoms at both time points (between 38% and 55% covariation with depression, 26% to 46% with general functioning, and 9% and 16% for anxiety symptoms). Using hierarchical linear modeling, school connectedness also predicted depressive symptoms 1 year later for both boys and girls, anxiety symptoms for girls, and general functioning for boys, even after controlling for prior symptoms. The reverse, however, was not true: Prior mental health symptoms did not predict school connectedness 1 year later when controlling for prior school connectedness. Results suggest a stronger than previously reported association with school connectedness and adolescent depressive symptoms in particular and a predictive link from school connectedness to future mental health problems.