Mental Health Literacy of Australian Rural Adolescents: An Analysis Using Vignettes and Short Films

The mental health literacy (MHL) of rural adolescents has rarely been investigated. This study examined the MHL of 122 rural‐based adolescents (49 males, 73 females) aged 12–18 years (M = 16, SD = 1) using written vignettes and short films to examine knowledge about depression. For the written vignettes, 68% of the rural adolescents were able to correctly identify someone with depression, which is similar to the findings for metropolitan adolescents; however, knowledge about recovery times and avenues of assistance were below that of their metropolitan peers. Participants were less likely to correctly diagnose depression when suicidal intent was not expressed and when the scenario was presented in the more naturalistic form of a film. This finding raises questions about the place of films and written vignettes in future MHL research.     

Knowledge and causal attributions for mental disorders in HIV-positive children and adolescents: results from rural and urban Uganda

Increasing availability of antiretroviral treatment (ART) has led HIV to be considered a chronic disease, shifting attention to focus on quality of life including mental wellbeing. We investigated knowledge and causal attributions for mental disorders in HIV-positive children and adolescents in rural and urban Uganda. This qualitative study was nested in an epidemiological mental health study among HIV-positive children and adolescents aged 5–17 years in rural and urban Uganda. In-depth interviews were conducted with caregivers of HIV-positive children (5–11 years) and adolescents (12–17 years) in HIV care. Interviews were audio recorded with permission from participants and written consent and assent sought before study procedures. Thirty eight participants (19 caregivers, 19 children/adolescents) were interviewed. Age range of caregivers was 28–69 years; majority were female (17). Caregivers had little knowledge on mental disorders ;only 3 related the vignette to a mental problem and attributed it to: improper upbringing, violence, poverty and bereavement. Five adolescents identified vignettes as portraying mental disorders caused by: ill-health of parents, bereavement, child abuse, discrimination, HIV and poverty. Caregivers are not knowledgeable about behavioural and emotional challenges in HIV-positive children/adolescents. Mental health literacy programmes at HIV care clinics are essential to enhance treatment-seeking for mental health.     

Identity and sociocultural change: Comparing young indigenous people in Chiapas who have different sociodemographic trajectories

One of the most commonly used distinctions in cross‐cultural studies is the one between individualism and collectivism. One of the criticisms levelled at this distinction is that it fails to incorporate the differences that may exist when comparing people from a rural context with little formal education to people from the same group who live in an urban context where formal education is the norm. Bearing in mind these sociodemographic factors, we have compared the self‐concepts among 104 young indigenous people in Chiapas (Mexico), having divided them into three groups: “rural‐traditional,” “rural–urban” and “urban.” These people's self‐concepts were analysed using a task that contrasts personal self‐concept with social self‐concept and a technique in which participants draw themselves along with the things and people they consider most important to them. The results reveal significant differences between the three groups. The personal categories are given a higher value in the “urban” group while the social categories score higher in the “rural‐traditional” group. Regarding the results of the indigenous self‐portraits, from the content analysis of the drawings, 16 categories emerged. These findings are discussed in the light of Greenfield's theory of social change and human development.     

Mental health literacy of those with major depression and suicidal ideation: an impediment to help seeking

Mental health literacy is the knowledge and beliefs about mental disorders that aid their recognition, management, or prevention, and is an important determinant of help seeking. This has relevance in suicide prevention, particularly for those with major depression, the clinical condition most frequently associated with suicidal behavior. In this study of a random and representative community sample, a vignette depicting classical features of major depression was presented to subjects along with questions related to mental health literacy. The responses of those with major depression, as delineated by the Primary Care Evaluation of Mental Disorders instrument, both with and without suicidal ideation, were compared to those of a third group of respondents. The results demonstrated that despite increased professional contact by those with major depression and suicidal ideation, there were few differences among the three groups on either open-ended or direct questions related to mental health literacy. This indicates that increased professional contact in itself was not related to increased mental health literacy, and suggests that more specific psychoeducational programs are required.     

Qualitative Exploration of an Effective Depression Literacy Fotonovela with at Risk Latina Immigrants

While depression is prevalent among immigrant Latinas, mental health literacy is low. Culturally tailored health narratives can improve mental health literacy and are now increasingly featured in Spanish language fotonovelas (i.e., booklets in a comic book format with posed photographs and dialogue bubbles). The purpose of this qualitative study is to explore why a depression literacy fotonovela proved effective with Latina immigrants at risk for depression in a quantitative randomized control study. This study is the qualitative companion of the previously published quantitative piece of a mixed methods study, the latter revealing posttest improvements in depression knowledge, self‐efficacy to identify the need for treatment, and decreased stigma towards mental health care (Hernandez and Organista in Am J Community Psychol 2013 . doi:10.1007/s10464‐013‐9587‐1). Twenty‐five immigrant Latinas participated in structured interviews, in the current qualitative study, 3 weeks after participating in the quantitative study. Results suggest depression literacy improved because participants evidenced high recall of the storyline and characters, which they also found appealing (e.g., liked peer and professional support offered to depressed main character). Further, identification with the main character was reflected in participants recalling similar circumstances impacting their mental health. Despite some improvement, stigma related to depression and its treatment remained for some women. Future research for the improvement of health literacy tools is discussed.     

Cognitive, Linguistic, and Social Aspects of Adults' Noun Definitions

Low-income, rural adults and middle-income, urban adults provided oral definitions for eight common nouns. Two general issues were addressed: (1) whether the rural adults' definitions would conform to the well-documented Aristotelian form typically found among middle-class, well-educated adults; and (2) whether different definitional types would emerge for two different noun classes, social vs. object nouns. Participants' definitions were examined for conceptual content and linguistic form. Among rural participants, the mean proportion of definitions conforming to the Aristotelian model was .13, contrasted with .69 for the urban participants. Also, rural adults were significantly less likely to cast definitions in the conventional linguistic form than were urban adults. On other measures of definitional skill as well, rural participants demonstrated less mastery. There were no significant differences in definitional form between social and object nouns. Various explanations for the findings are considered.     

城镇化进程中离乡农民心理健康特点调查及心理素质、相对剥夺感的影响机制

为探讨城镇化进程中离乡农民的心理健康特点以及心理素质、相对剥夺感对其的影响,通过量表对1339名城乡居民进行调查。结果发现:离乡与留乡农民在幸福感、拥有生命意义感、感知控制感、心理素质方面显著低于城镇居民,在状态焦虑方面显著高于城镇居民; 离乡农民在抑郁上显著高于城镇居民,在感知控制感上显著高于留乡农民,在心理素质上显著低于留乡农民; 留乡农民在相对剥夺感上显著高于城镇居民; 离乡农民的幸福感、拥有生命意义感、感知控制感态与相对剥夺感呈显著负相关,与心理素质呈显著正相关; 离乡农民的抑郁、状态焦虑与相对剥夺感呈显著正相关,与心理素质呈显著负相关; 离乡农民的相对剥夺感与心理素质之间呈显著负相关。心理素质除了可以直接预测心理健康各项指标,还可以通过相对剥夺感的中介作用,间接预测幸福感、抑郁及状态焦虑。提升心理素质和降低相对剥夺感是离乡农民心理健康服务的重要切入点。     

Rural Young Adults’ Lay Theories of Intimate Partner Violence: A Qualitative Examination

This study qualitatively examined rural emerging adults’ ways of thinking (i.e., lay theories) about the causes of intimate partner violence (IPV) and ideas on how to prevent IPV most effectively. Participants were 74 individuals (majority Caucasian, heterosexual, low income) between the ages of 18 and 24 who resided in one of 16 rural communities. Participants’ perceptions of the causes of IPV included (a) individual‐level pathology, stress, and lack of education; (b) intergenerational transmission of violence and early‐life factors; (c) relationship stressors and challenges; and (d) community factors. Furthermore, participants felt that IPV could most effectively be prevented through (a) education and awareness; (b) victim‐focused efforts (e.g., teaching self‐esteem); and (c) job creation. Overall, participants identified a number of established risk factors for IPV perpetration across the social ecological model, although a number were never or rarely mentioned (e.g., peer group norms, positive bystander action, and collective efficacy). Future research should examine if and how perceptions of the causes of IPV impact IPV prevention engagement and impact. Further, prevention initiatives that take into account understandings of lay theories about IPV may be more impactful in reducing IPV than prevention initiatives that do not.     

Emotional Reactions to Health Status Changes and Emotional Well-Being Among HIV-Positive Persons with Limited Reading Literacy

People living with HIV-AIDS experience emotional distress in response to negative changes in their health status. The current study hypothesized that individuals with poorer health literacy skills would evidence greater emotional distress in response to negative changes in health status compared to persons with higher health literacy skills. HIV positive persons (N = 294) completed anonymous surveys that included measures of depression and social support and a subset of 98 participants completed two experimental vignettes depicting a person receiving test results showing an increase in HIV viral load (negative health changes) followed by a vignette suggesting decreased viral load (improved health changes). Responses to affective reactions and coping strategies indicated that persons with lower health literacy skills more strongly endorsed negative affective states and maladaptive coping strategies compared to persons with higher health literacy skills. In addition, lower health literacy was associated with greater symptoms of affective depression and poorer social support, whereas higher literacy was associated with greater negativistic thinking. Findings suggest the need for patient education and counseling regarding changes in health status among people living with HIV-AIDS, particularly persons with limited health literacy skills.     

The Social Contextual Approach and Rural Adolescent Substance Use: Implications for Prevention in Rural Settings

Adolescents in rural areas use substances at rates comparable to urban adolescents; understanding causes of rural adolescent substance use is critical if prevention efforts are to succeed. The present review has three primary goals: (1) to define rural, (2) to evaluate the empirical evidence regarding correlates and causes of rural adolescent substance use from a social contextual framework (L. V. Scaramella, R. D. Conger, R. Spoth, & R. L. Simons, in press), and (3) to discuss the malleability of theoretically based risk or protective factors in rural settings. The review concludes with a discussion of the difficulties and challenges of implementing prevention programs in rural areas.     

Does the effect of traffic calming measures endure over time? – A simulator study on the influence of gates

Accident statistics show that transitions from rural to urban areas are accident prone locations. Inappropriate speed and mental underload have been identified as important causal factors nearby such transitions. A variety of traffic calming measures (TCM) near rural–urban transitions has been tested in field experiments and driving simulator studies. Simulator experiments repeatedly exposing participants to the same treatment are scarce, hence it is unclear to what extent the effects of a TCM endure over time.This is precisely the objective of the current study: to examine what happens with the behavior of drivers when they are exposed multiple times to the same treatment (in this case a gate construction located at a rural–urban transition). Over a period of five successive days, seventeen participants completed a 17 km test-drive on a driving simulator with two thoroughfare configurations (gates present or absent) in a within-subject design. Results indicate that gates induced a local speed reduction that sustained over this five-day period. Even though participants were inclined to accelerate again once passed by this gate configuration, they always kept driving at an appropriate speed. We did not find any negative side effects on SD of acceleration/deceleration or SDLP.Overall we conclude that gate constructions have the potential to improve traffic safety in the direct vicinity of rural–urban transitions, even if drivers are repeatedly exposed. Notwithstanding, we advise policy makers to appropriately use this measure. Best is to always carefully consider the broader situational context (such as whether the road serves a traffic- rather than a residential function) of each particular location where the implementation of a gate construction is one of the options.     

Attribution style and post-traumatic stress severity in the Central Region of Kenya: Influences of dwelling location

This study investigated the influence of attribution styles as predictors of post-traumatic stress severity (PTSS) by dwelling in Kenya. A non-clinical convenience sample of 354 rural (n = 178) and urban (n = 176) Kenyans from the Central Region of Kenya were participants. They responded to a post-traumatic stress screener, attribution style questionnaire and post-traumatic disorder (PTSD) checklist. A regression analysis showed that the urban dweller (UD) sample was significantly more likely to attribute negative events to internal, specific causes than the rural dweller (RD) sample. Findings suggest social support protections in RD to buffer them from negative self-attributions for PTSS among this Kenyan sample.     

人际关系状况与学龄前流动儿童的问题行为

以北京市40所幼儿园的336个班级的3430名儿童为被试, 构建多层线性模型, 分析亲子关系、班级师幼关系氛围对学龄前城市和流动儿童问题行为的影响。发现亲子冲突和班级师幼冲突氛围显著正向预测儿童的内、外向问题行为; 班级师幼亲密和冲突氛围对城市儿童内向问题行为的预测作用相比流动儿童更大; 班级师幼冲突氛围对亲子冲突高的流动儿童的外向问题行为的消极作用降低, 高亲子亲密缓解了班级师幼冲突氛围对流动儿童内向问题行为的消极作用。     

Perceptions of Cognitive-Behavioral Therapy and Antidepressant Medication for Depression After Brief Psychoeducation: Examining Shifts in Attitudes

The majority of people with depression in the United States either never seek treatment or gravitate exclusively to antidepressant medication (ADM), despite the existence of other effective treatments, such as cognitive-behavioral therapy (CBT). Reluctance to use psychotherapy is partly due to lack of appropriate mental health literacy and perceptions of low treatment acceptability (appropriateness for a given problem) and credibility (treatment logicalness, and whether the patient expects improvement). In the current investigation, we examined whether providing psychoeducation about CBT for depression would change participant perceptions of the treatment’s acceptability and credibility. We recruited 554 (female n = 314; 57%) participants across two online studies, and assessed their baseline perceptions of CBT and ADM using modified Treatment Acceptability (TAAS) and Treatment Credibility and Expectancy (CEQ) scales. Participants were subsequently presented with evidence-based, expert-vetted psychoeducational materials describing CBT and ADM, and were asked to recomplete the TAAS and CEQ. In Study 1, participants endorsed significantly higher CBT-CEQ (credibility/expectancy) scores postpsychoeducation. In Study 2, participants endorsed significantly lower CBT-TAAS (acceptability), and among those with no exposure to depression treatments, endorsed significantly higher CBT-CEQ scores postpsychoeducation. In both studies, there were no perceptual changes of ADM after the psychoeducation. Finally, in Study 2, endorsement of a biological model of depression and depressive symptoms were negatively predictive of CBT’s acceptability and credibility and expectancy postpsychoeducation. Perceptions of credibility and expectancy of CBT for depression appear malleable even after exposure to brief psychoeducation, whereas shifting perceptions of CBT’s acceptability may require more extensive intervention.     

Protective Factors for Deviance: A Comparison of Rural and Urban Youth

Based on data from the 2010, 2012, and 2014 Communities that Care Youth Survey, the authors examine the protective factors associated with rural and urban students in grades 6 through 12 across several domains. This research is based on the literature that associates rural areas with a more protective environment and resulting lower rates of deviance. Findings were mixed, but overall rural youth had higher protective factor scores. A summary of all 84 protective factor scores follows: 26 factors shown no significant different between rural and urban students; on 42 protective factors rural youth had higher scores, as opposed to urban youth with higher protective scores on only 16 factors. Implications of findings for crime and delinquency are discussed.     

Activating and Suppressing Hostile and Benevolent Racism: Evidence for Comparative Media Stereotyping

This research examines the role of media literacy training and counter-stereotypical news stories in prejudice reduction. Research participants read either stereotypical or counter-stereotypical news stories after exposure to a media literacy video or a control video. After this, they completed a paper-and-pencil questionnaire that included Likert-type scales and feeling-thermometer ratings about their feelings toward African Americans, Asian-Indians, and Caucasian-Americans. The findings reveal that hostile prejudice is more likely to be expressed toward African-Americans and benevolent prejudice is more likely to be expressed toward Asian-Indians. As predicted, counter-stereotypical news stories as compared to stereotypical news stories decrease prejudice toward Asian-Indians. Contrary to expectations, the media literacy video seems to prime prejudices rather than suppress them. Interestingly, news stories about Asian-Indians increase hostility toward African-Americans. These comparative stereotyping are explained using modern racist beliefs and model minority stereotypes.     

Have Broad‐Based Community and Professional Education Programs Influenced Mental Health Literacy and Treatment Seeking of those with Major Depression and Suicidal Ideation?

Mental health literacy is the knowledge and beliefs about mental disorders that aid in their recognition, management, or prevention; it is also a determinant of help seeking. As such, it is presumed to be important in community suicide prevention programs. In Australia there have been a number of government, professional, and charitable organizations as well as pharmaceutical company suicide prevention initiatives which have been designed to enhance public and professional knowledge about mental disorders, particularly depression. This naturalistic study conducted between 1998 and 2004 in a random and representative population sample examined the changes in mental health literacy and treatment seeking of those with major depression, both with and without suicidal ideation, and those who were neither depressed nor suicidal. Results indicated that there was marked improvement in mental health literacy for all three groups, although there was less change for those most in need of intervention (i.e., those with major depression and suicidal ideation). Furthermore, there were fewer changes in appropriate treatment seeking in those with major depression and suicidal ideation. These findings are consistent with literature reporting limited problem solving and decision making in those who are suicidal, and indicate that there are limits to broadbased community education programs. More focused suicide prevention initiatives are required, specifically for those who are depressed and suicidal.     

Male physical attractiveness in Britain and Malaysia: A cross-cultural study

Three purported cues to perceived male physical attractiveness are the waist-to-chest ratio (WCR), body mass index (BMI) and the waist-to-hip ratio (WHR). This study examined the relative contribution of each cue in several socio-economically distinct populations. Ninety-five female participants from Britain and Malaysia were asked to rate a set of images of real men with known WCR, BMI and WHR. The results showed clear differences along a gradient of socio-economic development. In urban settings, WCR was the primary component of attractiveness ratings, with BMI playing a smaller role and WHR not reaching significance. In the rural setting, BMI was the primary predictor of attractiveness, with WCR playing a more minor role and WHR not reaching significance. In general, urban participants were more reliant on body shape and chose a relatively slim figure with an ‘inverted triangle’ shape; rural participants were more reliant on body weight and chose a heavier figure with a less triangular shape. These findings are discussed in terms of evolutionary psychological explanations of mate selection and sociological theories that emphasise the effect of resource scarcity on preferences for body shapes and sizes.     

Factors underlying bus-related crashes in Hanoi,Vietnam

Road traffic crashes accounted for almost 13% of the total mortality recorded at the public health facilities in Vietnam in 2010. This qualitative study investigated factors related to bus-related crashes in Hanoi, Vietnam using focus group discussions and in-depth interviews among 75 participants who are bus drivers, motorcycle users, bus passengers, bus company managers, traffic policemen and local authorities. The results suggested that bus drivers were not the sole contributor to road traffic crashes with other vehicles. The rapid population growth due to rural to urban migration and the poor transport system appeared to be important contributing factors. In addition, “village culture” was likely to influence both the traffic behaviors of road users and the practices of law enforcement officers. Moreover, drink-driving behaviors appeared to be an important contributor to bus-related crashes. Supervision and penalty policies of bus companies also appeared to influence the driving performance of bus drivers. For a long-term solution to reduce bus-related crashes, it is vital to improve the transport infrastructure and the state management capacity regarding road safety as well as to assist the positive transition of citizens migrating from rural areas to their new urban lifestyle.     

Work attitudes, employment barriers, and mental health symptoms in a sample of rural welfare recipients

Most of the extant research on welfare reform has neglected to consider the experiences of families in rural settings. Fifty women receiving welfare for their dependent children in a rural community were interviewed about their work experiences and aspirations, barriers to employment and service use, as well as mental health and social support. The findings indicate that the majority of participants were connected to the labor force and expressed positive attitudes about work. Barriers to employment (lack of available jobs, child care) and service use (transportation, inconvenient office hours) were endorsed. Perceived social support was negatively related to depression symptoms and positively related to self-efficacy and self-esteem. The importance of understanding the life experiences of welfare recipients in different contexts is discussed.