Showing papers on "Mental health published in 2007"

The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation

Abstract: Background: There is increasing international interest in the concept of mental well-being and its contribution to all aspects of human life. Demand for instruments to monitor mental well-being at a population level and evaluate mental health promotion initiatives is growing. This article describes the development and validation of a new scale, comprised only of positively worded items relating to different aspects of positive mental health: the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). Methods: WEMWBS was developed by an expert panel drawing on current academic literature, qualitative research with focus groups, and psychometric testing of an existing scale. It was validated on a student and representative population sample. Content validity was assessed by reviewing the frequency of complete responses and the distribution of responses to each item. Confirmatory factor analysis was used to test the hypothesis that the scale measured a single construct. Internal consistency was assessed using Cronbach's alpha. Criterion validity was explored in terms of correlations between WEMWBS and other scales and by testing whether the scale discriminated between population groups in line with pre-specified hypotheses. Testretest reliability was assessed at one week using intra-class correlation coefficients. Susceptibility to bias was measured using the Balanced Inventory of Desired Responding. Results: WEMWBS showed good content validity. Confirmatory factor analysis supported the single factor hypothesis. A Cronbach's alpha score of 0.89 (student sample) and 0.91 (population sample) suggests some item redundancy in the scale. WEMWBS showed high correlations with other mental health and well-being scales and lower correlations with scales measuring overall health. Its distribution was near normal and the scale did not show ceiling effects in a population sample. It discriminated between population groups in a way that is largely consistent with the results of other population surveys. Testretest reliability at one week was high (0.83). Social desirability bias was lower or similar to that of other comparable scales. Conclusion: WEMWBS is a measure of mental well-being focusing entirely on positive aspects of mental health. As a short and psychometrically robust scale, with no ceiling effects in a population sample, it offers promise as a tool for monitoring mental well-being at a population level. Whilst WEMWBS should appeal to those evaluating mental health promotion initiatives, it is important that the scale's sensitivity to change is established before it is recommended in this context.

Age of onset of mental disorders: a review of recent literature

Abstract: Purpose of reviewThe aim of this article is to review recent epidemiological research on age-of-onset of mental disorders, focusing on the WHO World Mental Health surveys.Recent findingsMedian and inter-quartile range (IQR; 25th–75th percentiles) of age-of-onset is much earlier for phobias (7–14, IQ

Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health.

Abstract: This article summarizes the conception and diagnosis of the mental health continuum, the findings supporting the two continua model of mental health and illness, and the benefits of flourishing to individuals and society. Completely mentally healthy adults--individuals free of a 12-month mental disorder and flourishing--reported the fewest missed days of work, the fewest half-day or greater work cutbacks, the healthiest psychosocial functioning (i.e., low helplessness, clear goals in life, high resilience, and high intimacy), the lowest risk of cardiovascular disease, the lowest number of chronic physical diseases with age, the fewest health limitations of activities of daily living, and lower health care utilization. However, the prevalence of flourishing is barely 20% in the adult population, indicating the need for a national program on mental health promotion to complement ongoing efforts to prevent and treat mental illness. Findings reveal a Black advantage in mental health as flourishing and no gender disparity in flourishing among Whites.

Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war.

Abstract: ContextTo promote early identification of mental health problems among combat veterans, the Department of Defense initiated population-wide screening at 2 time points, immediately on return from deployment and 3 to 6 months later. A previous article focusing only on the initial screening is likely to have underestimated the mental health burden.ObjectiveTo measure the mental health needs among soldiers returning from Iraq and the association of screening with mental health care utilization.Design, Setting, and ParticipantsPopulation-based, longitudinal descriptive study of the initial large cohort of 88 235 US soldiers returning from Iraq who completed both a Post-Deployment Health Assessment (PDHA) and a Post-Deployment Health Re-Assessment (PDHRA) with a median of 6 months between the 2 assessments.Main Outcome MeasuresScreening positive for posttraumatic stress disorder (PTSD), major depression, alcohol misuse, or other mental health problems; referral and use of mental health services.ResultsSoldiers reported more mental health concerns and were referred at significantly higher rates from the PDHRA than from the PDHA. Based on the combined screening, clinicians identified 20.3% of active and 42.4% of reserve component soldiers as requiring mental health treatment. Concerns about interpersonal conflict increased 4-fold. Soldiers frequently reported alcohol concerns, yet very few were referred to alcohol treatment. Most soldiers who used mental health services had not been referred, even though the majority accessed care within 30 days following the screening. Although soldiers were much more likely to report PTSD symptoms on the PDHRA than on the PDHA, 49% to 59% of those who had PTSD symptoms identified on the PDHA improved by the time they took the PDHRA. There was no direct relationship of referral or treatment with symptom improvement.ConclusionsRescreening soldiers several months after their return from Iraq identified a large cohort missed on initial screening. The large clinical burden recently reported among veterans presenting to Veterans Affairs facilities seems to exist within months of returning home, highlighting the need to enhance military mental health care during this period. Increased relationship problems underscore shortcomings in services for family members. Reserve component soldiers who had returned to civilian status were referred at higher rates on the PDHRA, which could reflect their concerns about their ongoing health coverage. Lack of confidentiality may deter soldiers with alcohol problems from accessing treatment. In the context of an overburdened system of care, the effectiveness of population mental health screening was difficult to ascertain.

Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative RESEARCH REPORT

Abstract: Data are presented on the lifetime prevalence, projected lifetime risk, and age-of-onset distributions of mental disorders in the World Health Organization (WHO)’s World Mental Health (WMH) Surveys. Face-to-face community surveys were conducted in seventeen countries in Africa, Asia, the Americas, Europe, and the Middle East. The combined numbers of respondents were 85,052. Lifetime prevalence, projected lifetime risk, and age of onset of DSM-IV disorders were assessed with the WHO Composite International Diagnostic Interview (CIDI), a fully-structured lay administered diagnostic interview. Survival analysis was used to estimate lifetime risk. Median and inter-quartile range (IQR) of age of onset is very early for some anxiety disorders (7-14, IQR: 8-11) and impulse control disorders (7-15, IQR: 11-12). The age-of-onset distribution is later for mood disorders (29-43, IQR: 35-40), other anxiety disorders (24-50, IQR: 31-41), and substance use disorders (18-29, IQR: 21-26). Median and IQR lifetime prevalence estimates are: anxiety disorders 4.8-31.0% (IQR: 9.9-16.7%), mood disorders 3.3-21.4% (IQR: 9.8-15.8%), impulse control disorders 0.3-25.0% (IQR: 3.1-5.7%), substance use disorders 1.3-15.0% (IQR: 4.8-9.6%), and any disorder 12.0-47.4% (IQR: 18.1-36.1%). Projected lifetime risk is proportionally between 17% and 69% higher than estimated lifetime prevalence (IQR: 28-44%), with the highest ratios in countries exposed to sectarian violence (Israel, Nigeria, and South Africa), and a general tendency for projected risk to be highest in recent cohorts in all countries. These results document clearly that mental disorders are commonly occurring. As many mental disorders begin in childhood or adolescents, interventions aimed at early detection and treatment might help reduce the persistence or severity of primary disorders and prevent the subsequent onset of secondary disorders.

Stigma, Obesity, and the Health of the Nation's Children

Abstract: Preventing childhood obesity has become a top priority in efforts to improve our nation’s public health. Although much research is needed to address this health crisis, it is important to approach childhood obesity with an understanding of the social stigma that obese youths face, which is pervasive and can have serious consequences for emotional and physical health. This report reviews existing research on weight stigma in children and adolescents, with attention to the nature and extent of weight bias toward obese youths and to the primary sources of stigma in their lives, including peers, educators, and parents. The authors also examine the literature on psychosocial and physical health consequences of childhood obesity to illustrate the role that weight stigma may play in mediating negative health outcomes. The authors then review stigma-reduction efforts that have been tested to improve attitudes toward obese children, and they highlight complex questions about the role of weight bias in childhood obesity prevention. With these literatures assembled, areas of research are outlined to guide efforts on weight stigma in youths, with an emphasis on the importance of studying the effect of weight stigma on physical health outcomes and identifying effective interventions to improve attitudes.

Prevalence and Correlates of Depression, Anxiety, and Suicidality Among University Students

Abstract: Mental health among university students represents an important and growing public health concern for which epidemiological data are needed. A Web-based survey was administered to a random sample at a large public university with a demographic profile similar to the national student population. Depressive and anxiety disorders were assessed with the Patient Health Questionnaire (R. L. Spitzer, K. Kroenke, J. B. W. Williams, & the Patient Health Questionnaire Primary Care Study Group, 1999). Nonresponse weights were constructed with administrative data and a brief non-respondent survey. The response rate was 56.6% (N = 2,843). The estimated prevalence of any depressive or anxiety disorder was 15.6% for undergraduates and 13.0% for graduate students. Suicidal ideation in the past 4 weeks was reported by 2% of students. Students reporting financial struggles were at higher risk for mental health problems (odds ratios = 1.6-9.0). These findings highlight the need to address mental health in young adult populations, particularly among those of lower socioeconomic status. Campus communities reach over half of young adults and thus represent unique opportunities to address mental health issues in this important age group.

What predicts psychological resilience after disaster? The role of demographics, resources, and life stress.

Abstract: A growing body of evidence suggests that most adults exposed to potentially traumatic events are resilient. However, research on the factors that may promote or deter adult resilience has been limited. This study examined patterns of association between resilience and various sociocontextual factors. The authors used data from a random-digit-dial phone survey (N = 2,752) conducted in the New York City area after the September 11, 2001, terrorist attack. Resilience was defined as having 1 or 0 posttraumatic stress disorder symptoms and as being associated with low levels of depression and substance use. Multivariate analyses indicated that the prevalence of resilience was uniquely predicted by participant gender, age, race/ethnicity, education, level of trauma exposure, income change, social support, frequency of chronic disease, and recent and past life stressors. Implications for future research and intervention are discussed.

Coping Resources, Coping Processes, and Mental Health

Abstract: Coping, defined as action-oriented and intrapsychic efforts to manage the demands created by stressful events, is coming to be recognized both for its significant impact on stress-related mental and physical health outcomes and for its intervention potential. We review coping resources that aid in this process, including individual differences in optimism, mastery, self-esteem, and social support, and examine appraisal and coping processes, especially those marked by approach or avoidance. We address the origins of coping resources and processes in genes, early life experience, and gene-environment interactions, and address neural underpinnings of coping that may shed light on evaluating coping interventions. We conclude by outlining possible intervention strategies for improving coping processes.

Teaching Self-Care to Caregivers: Effects of Mindfulness-Based Stress Reduction on the Mental Health of Therapists in Training

Abstract: Preparation for the role of therapist can occur on both professional and personal levels. Research has found that therapists are at risk for occupationally related psychological problems. It follows that self-care may be a useful complement to the professional training of future therapists. The present study examined the effects of one approach to self-care, Mindfulness-Based Stress Reduction (MBSR), for therapists in training. Using a prospective, cohort-controlled design, the study found participants in the MBSR program reported significant declines in stress, negative affect, rumination, state and trait anxiety, and significant increases in positive affect and self-compassion. Further, MBSR participation was associated with increases in mindfulness, and this enhancement was related to several of the beneficial effects of MBSR participation. Discussion highlights the potential for future research addressing the mental health needs of therapists and therapist trainees.

Mental ill-health in adults with intellectual disabilities: prevalence and associated factors.

Abstract: Background Reported prevalence of mental ill-health among adults with intellectual disabilities ranges from 7 to 97%, owing to methodological limitations. Little is known about associations. Aims To determine the prevalence of mental ill-health in adults with intellectual disabilities and to investigate factors independently associated with it. Method Population-based study ( n =1023) with comprehensive individual assessments modelled using regression analyses. Results Point prevalence of mental ill-health was 40.9% (clinical diagnoses), 35.2% (DC–LD), 16.6% (ICD–10–DCR) and 15.7% (DSM–IV–TR). The most prevalent type was problem behaviours. Mental ill-health was associated with more life events, female gender, type of support, lower ability, more consultations, smoking, incontinence, not having severe physical disabilities and not having immobility; it was not associated with deprived areas, no occupation, communication impairment, epilepsy, hearing impairment or previous institutional residence. Conclusions This investigation informs further longitudinal study, and development of appropriate interventions, public health strategy and policy. ICD–10–DCR and DSM–IV–TR undercount mental ill-health in this population compared with DC–LD.

Racism and Psychological and Emotional Injury Recognizing and Assessing Race-Based Traumatic Stress

Abstract: The purpose of this article is to discuss the psychological and emotional effects of racism on people of Color. Psychological models and research on racism, discrimination, stress, and trauma will be integrated to promote a model to be used to understand, recognize, and assess race-based traumatic stress to aid counseling and psychological assessment, research, and training.

Management of Children With Autism Spectrum Disorders

Abstract: Pediatricians have an important role not only in early recognition and evaluation of autism spectrum disorders but also in chronic management of these disorders. The primary goals of treatment are to maximize the child's ultimate functional independence and quality of life by minimizing the core autism spectrum disorder features, facilitating development and learning, promoting socialization, reducing maladaptive behaviors, and educating and supporting families. To assist pediatricians in educating families and guiding them toward empirically supported interventions for their children, this report reviews the educational strategies and associated therapies that are the primary treatments for children with autism spectrum disorders. Optimization of health care is likely to have a positive effect on habilitative progress, functional outcome, and quality of life; therefore, important issues, such as management of associated medical problems, pharmacologic and nonpharmacologic intervention for challenging behaviors or coexisting mental health conditions, and use of complementary and alternative medical treatments, are also addressed.

Bringing the War Back Home: Mental Health Disorders Among 103 788 US Veterans Returning From Iraq and Afghanistan Seen at Department of Veterans Affairs Facilities

Abstract: Background Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) have endured high combat stress and are eligible for 2 years of free military service–related health care through the Department of Veterans Affairs (VA) health care system, yet little is known about the burden and clinical circumstances of mental health diagnoses among OEF/OIF veterans seen at VA facilities. Methods US veterans separated from OEF/OIF military service and first seen at VA health care facilities between September 30, 2001 (US invasion of Afghanistan), and September 30, 2005, were included. Mental health diagnoses and psychosocial problems were assessed usingInternational Classification of Diseases, Ninth Revision, Clinical Modificationcodes. The prevalence and clinical circumstances of and subgroups at greatest risk for mental health disorders are described herein. Results Of 103 788 OEF/OIF veterans seen at VA health care facilities, 25 658 (25%) received mental health diagnosis(es); 56% of whom had 2 or more distinct mental health diagnoses. Overall, 32 010 (31%) received mental health and/or psychosocial diagnoses. Mental health diagnoses were detected soon after the first VA clinic visit (median of 13 days), and most initial mental health diagnoses (60%) were made in nonmental health clinics, mostly primary care settings. The youngest group of OEF/OIF veterans (age, 18-24 years) were at greatest risk for receiving mental health or posttraumatic stress disorder diagnoses compared with veterans 40 years or older. Conclusions Co-occurring mental health diagnoses and psychosocial problems were detected early and in primary care medical settings in a substantial proportion of OEF/OIF veterans seen at VA facilities. Targeted early detection and intervention beginning in primary care settings are needed to prevent chronic mental illness and disability.

When and how do young people seek professional help for mental health problems

Abstract: • Despite the high prevalence of mental health problems and disorders that develop in adolescence and early adulthood, young people tend to not seek professional help. Young men and young people from Indigenous and ethnic minority groups tend to be those most reluctant to seek help. • Young people are more inclined to seek help for mental health problems if they: ae have some knowledge about mental health issues and sources of help; ae feel emotionally competent to express their feelings; and ae have established and trusted relationships with potential help providers. • Young people are less likely to seek help if they: ae are experiencing suicidal thoughts and depressive symptoms; ae hold negative attitudes toward seeking help or have had negative past experiences with sources of help; or ae hold beliefs that they should be able to sort out their own mental health problems on their own. • Young people may seek help through talking to their family and friends, with family being more important for younger adolescents, and friends and partners becoming more influential later on.

Pervasiveness and correlates of implicit attitudes and stereotypes

Abstract: Correspondence should be addressed to Brian A. Nosek, Department of Psychology, University of Virginia, 102 Gilmer Hall, Box 400400, Charlottesville, VA 22904, USA. E-mail: nosek@virginia.edu This research was supported by the National Institute of Mental Health (MH-41328, MH-01533, MH-57672, and MH-68447) and the National Science Foundation (SBR-9422241, SBR-9709924, and REC-0634041). The authors are grateful for technical support from N. Sriram, Ethan Sutin, and Lili Wu. Related information is available at http://briannosek.com/ and http://projectimplicit.net/ EUROPEAN REVIEW OF SOCIAL PSYCHOLOGY 2007, 1 – 53, iFirst article

Transformational leadership and psychological well-being: the mediating role of meaningful work.

Abstract: Two studies investigated the relationship between transformational leadership, the meaning that individuals ascribe to their work, and their psychological well-being. In Study 1, the perceptions of meaningful work partially mediated the relationship between transformational leadership and positive affective well-being in a sample of Canadian health care workers (N 319). In Study 2, the meaning that a separate sample of service workers (N 146) ascribed to their work fully mediated the relationship between transformational leadership and psychological well-being, after controlling for humanistic work beliefs. Overall, these results support and add to the range of positive mental health effects associated with transformational leadership and are suggestive of interventions that organizations can make to improve well-being of workers.

Psychiatric comorbidity in epilepsy: a population-based analysis.

Abstract: PURPOSE: The estimated prevalence of mental health disorders in those with epilepsy in the general population varies owing to differences in study methods and heterogeneity of epilepsy syndromes. We assessed the population-based prevalence of various psychiatric conditions associated with epilepsy using a large Canadian national population health survey. METHODS: The Canadian Community Health Survey (CCHS 1.2) was used to explore numerous aspects of mental health in persons with epilepsy in the community compared with those without epilepsy. The CCHS includes administration of the World Mental Health Composite International Diagnostic Interview to a sample of 36,984 subjects. Age-specific prevalence of mental health conditions in epilepsy was assessed using logistic regression. RESULTS: The prevalence of epilepsy was 0.6%. Individuals with epilepsy were more likely than individuals without epilepsy to report lifetime anxiety disorders or suicidal thoughts with odds ratio of 2.4 (95% CI = 1.5-3.8) and 2.2 (1.4-3.3), respectively. In the crude analysis, the odds of lifetime major depression or panic disorder/agoraphobia were not greater in those with epilepsy than those without epilepsy, but the association with lifetime major depression became significant after adjustment for covariates. CONCLUSIONS: In the community, epilepsy is associated with an increased prevalence of mental health disorders compared with the general population. Epilepsy is also associated with a higher prevalence of suicidal ideation. Understanding the psychiatric correlates of epilepsy is important to adequately manage this patient population. Language: en

Help-seeking and access to mental health care in a university student population.

Abstract: Background: University students represent an important population in which to study access to mental health care. Understanding their unmet needs will enhance efforts to prevent and treat mental disorders during a pivotal period in life. Objective: To quantify mental health service use and estimate how various factors are associated with help-seeking and access in a university student population. Design: A Web-based survey was administered to a random sample of 2785 students attending a large, public university with a demographic profile similar to the national student population. Nonresponse bias was accounted for using administrative data and a nonrespondent survey. Measures: Mental health was measured using the Patient Health Questionnaire screens for depressive and anxiety disorders. Mental health service utilization was measured as having received psychotropic medication or psychotherapy in the past year. Results: Of students with positive screens for depression or anxiety, the proportion who did not receive any services ranged from 37% to 84%, depending on the disorder. Predictors of not receiving services included a lack of perceived need, being unaware of services or insurance coverage, skepticism about treatment effectiveness, low socioeconomic background, and being Asian or Pacific Islander. Conclusions: Even in an environment with universal access to free short-term psychotherapy and basic health services, most students with apparent mental disorders did not receive treatment. Initiatives to improve access to mental health care for students have the potential to produce substantial benefits in terms of mental health and related outcomes.

Health literacy and mortality among elderly persons.

Abstract: Background Individuals with low levels of health literacy have less health knowledge, worse self-management of chronic disease, lower use of preventive services, and worse health in cross-sectional studies We sought to determine whether low health literacy levels independently predict overall and cause-specific mortality Methods We designed a prospective cohort study of 3260 Medicare managed-care enrollees in 4 US metropolitan areas who were interviewed in 1997 to determine their demographic characteristics, chronic conditions, self-reported physical and mental health, and health behaviors Participants also completed the shortened version of the Test of Functional Health Literacy in Adults Main outcome measures included all-cause and cause-specific (cardiovascular, cancer, and other) mortality using data from the National Death Index through 2003 Results The crude mortality rates for participants with adequate (n = 2094), marginal (n = 366), and inadequate (n = 800) health literacy were 189%, 287%, and 394%, respectively ( P Conclusions Inadequate health literacy, as measured by reading fluency, independently predicts all-cause mortality and cardiovascular death among community-dwelling elderly persons Reading fluency is a more powerful variable than education for examining the association between socioeconomic status and health

ADHD in Adults: What the Science Says

Abstract: Introduction. History and Prevalence of ADHD in Adults. Diagnostic Criteria for ADHD in Adults. Defining ADHD in Adults: Making the Diagnosis in the UMASS and Milwaukee Studies. DSM Symptom Utility and the Issue of Age of Onset. Impairment in Major Life Activities. Identifying New Symptoms of ADHD in Adulthood. Comorbid Psychiatric Disorders and Psychological Maladjustment. Educational and Occupational Functioning. Drug Use and Antisocial Behavior. Health, Lifestyle, Money Management, and Driving. Sex, Dating and Marriage, Parenting, and Psychological Adjustment of Offspring. Neuropsychological Functioning. Summary, Conclusions, and Treatment Implications.