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.     

Knowledge and Beliefs about Bulimia Nervosa and its Treatment: A Comparative Study of Three Disciplines

Poor Mental Health Literacy (MHL), i.e. knowledge and beliefs about bulimia nervosa (BN), among health professionals may contribute to low rates of recognition and less optimal management. The aim of this study was to investigate the BN-MHL of health professionals. A total of 534 professionals selected randomly from Internet based lists were surveyed with a MHL questionnaire regarding a fictional vignette of a woman with BN. One hundred and thirty-six dieticians, 68 psychologists and 97 counselors, total 56% (n = 301) responded. The majority of respondents indicated the woman in the vignette suffered from BN (49%) or an eating disorder (20%) and endorsed evidenced based approaches. On post hoc between group analyses there was a trend (p = .02) for dieticians and psychologists to be more likely than counselors to accurately identify the diagnosis of BN. Dieticians and psychologists were also more likely than counselors to endorse a psychologist as the most helpful treatment provider (p<.001) and to be more likely to endorse cognitive behavioral therapy as the most helpful treatment (p<.001). These results indicate a need for greater training and support for non specialist primary care health professionals.     

Children's coping with peer rejection: the role of depressive symptoms,social competence,and gender

The present study investigated children's anticipated emotional response and anticipated coping in response to peer rejection, as well as the qualifying effects of gender, depressive symptoms, and perceived social competence. Participants (N = 234), ranging in age between 10 and 13 years, were presented with two written vignettes depicting peer rejection. The most highly endorsed coping strategies were behavioural distraction, problem‐focused behaviour, and positive reappraisal. Results indicate that children higher in depressive symptoms reported a more negative anticipated mood impact. Moreover, children higher in depressive symptoms were less inclined to endorse behavioural and cognitive coping strategies typically associated with mood improvement (e.g., behavioural distraction, positive reappraisal). Independent of depression, children scoring higher on perceived social competence reported more active, problem‐oriented coping behaviour in response to the stressors. Types of coping were largely unaffected by gender, however girls reported higher levels of anticipated sadness than boys in response to the rejection vignettes. Theoretical and clinical implications are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

Affective communication differences between distressed and nondistressed mother-adolescent dyads

An assessment technique of having mothers and young adolescents describe in brief written form what they like and dislike about each other was evaluated. Distressed dyads (N=38) produced responses that were rated significantly more negative (Demanding, Personal Attack, Anger and Hostility, Complaining About Unfairness or Disrespect) and less positive (Good Relationship, Appreciation of Other, Complimentary, and Enjoyment) than nondistressed dyads (N=40). Evidence of reliability was reported. Ratings of the written responses correlated significantly with independently obtained codings of taperecorded interactions, thus offering support for validity of the method.The authors wish to thank Diane Follingstad and Peter Kilmann for their comments on an earlier draft.     

The Effects of Dysphoria and Personality on Negative Self-Referent Attitudes and Perceptions of the Attitudes of Others

The cognitive model of depression posits that depressed individuals harbor more dysfunctional self-referent attitudes, but little is known about how depressed individuals perceive the attitudes and perceptions of others in their social arena. This study examined whether dysphoric individuals perceive others to hold equally negative attitudes about themselves, and whether such perceptions depend on sociotropic (i.e., highly invested in social approval and relationship success) and autonomous (i.e., highly invested in vocational or academic achievement and goal attainment) personality styles. A sample of undergraduate students (N = 197) was recruited, and after the assessment of their depression symptoms and personality style, participants read vignettes that described negative scenarios, and imagined that these scenarios occurred to themselves or the general university student. After reading each vignette, participants also rated their agreement with a number of statements that assessed dysfunctional attitudes. Results indicated that elevated dysphoria (i.e., showing signs of depression) scores were positively associated with dysfunctional self-referent attitudes. Further, moderational analyses examining the interaction of sociotropy and dysphoria did not support the hypothesis that individuals higher on dysphoria and sociotropy were less likely to perceive others as harboring negative attitudes about themselves in comparison to those with elevated dysphoria and lower levels of sociotropy. Last, individuals showing elevated dysphoria and higher scores on subdomains of autonomy were more likely to perceive others as exhibiting negative attitudes about themselves than those with low levels of the trait. These findings, their implications, and strengths and limitations of the current investigation are further discussed.     

Selected risk factors in adolescent suicide attempts.

This study examined stress, depression, attempted suicide, and knowledge of common signs of potential suicide in Alabama adolescents. A modified version of the National Adolescent Student Health Survey (NASHS) was administered to 3,803 eighth- and tenth-grade public school students during the fall of 1988. The incidence of stress, depression, and attempted suicide was analyzed by gender, ethnicity, locale (urban vs. rural), and participation in sexual intercourse and use of alcohol. Chi-square tests were used to determine if there were significant differences between groups. Findings indicated that females were at greater risk than were males. Both males and females who engaged in sexual intercourse and alcohol consumption were at greater risk than were abstainers. When analyzed by ethnicity, white adolescents who engaged in these behaviors were at significantly greater risk than were those who abstained; differences were not as pronounced for black youth. Comparisons on the knowledge scale indicated that females scored better than males, whites scored better than blacks, and urban students scored better than rural students. The data suggest that many adolescents are having difficulty coping with stress and depression, and that those who are engaging in various types of risk-taking behavior are at greater risk for depression and suicide.     

Negative Life Events and Substance Use Moderate Cognitive Behavioral Adolescent Depression Prevention Intervention

Investigate factors that amplify or mitigate the effects of an indicated cognitive behavioral (CB) depression prevention program for adolescents with elevated depressive symptoms. Using data from a randomized trial (Registration No. NCT00183417; n = 173) in which adolescents (M age = 15.5, SD = 1.2) were assigned to a brief cognitive behavioral prevention program or an educational brochure control condition, we tested whether elevated motivation to reduce depression and initial depressive symptom severity amplified intervention effects and whether negative life events, social support deficits, and substance use attenuated intervention effects. Hierarchical linear modeling (HLM) indicated differential intervention effects for two of the five examined variables: negative life events and substance use. For adolescents at low and medium levels of substance use or negative life events, the CB intervention produced declines in depressive symptoms relative to controls. However, at high levels of substance use or negative life events, the CB intervention did not significantly reduce depressive symptoms in comparison to controls. Results imply that high-risk adolescents with either high rates of major life stress or initial substance use may require specialized depression prevention efforts.     

Coping and Positive Affect in Adolescents of Mothers With and Without a History of Depression

The adolescent children of depressed mothers are at increased risk for depression, but little is known about protective factors for these children. Maintenance of positive affect in a stressful context may be an important marker of resilience. Mothers with (n = 34) and without (n = 38) a history of depression and their adolescent children completed questionnaires regarding adolescents’ coping and depressive symptoms and engaged in a 15 min videotaped interaction about family stress. Adolescents’ observed behaviors were coded using the Iowa Family Interaction Rating Scales. No significant differences emerged in observed behavior between adolescents of mothers with and without a history of depression. Higher levels of primary and secondary control coping and lower levels of disengagement coping were related to higher levels of observed positive mood and fewer depressive symptoms in adolescents. Observed positive mood was related to fewer depressive symptoms in adolescents, even after accounting for maternal history of depression and current maternal depressive symptoms. Results suggest the importance of considering positive affect in the context of family stress as a marker of resilience in adolescents at risk for depression. The current study provides evidence for coping as a protective factor, related to higher levels of positive affect and fewer depressive symptoms, in adolescents exposed to maternal depressive symptoms.     

What do mothers know? Maternal knowledge of child development

Maternal knowledge of child development has been shown to affect how mothers raise their children and the environments they provide. This study examines maternal knowledge of child development and whether level of knowledge varies by content area. Additionally, this study explored maternal characteristics that predict knowledge levels globally and by content area. Low‐income women (N = 203) in the waiting room of an obstetric clinic (n = 97) and pediatric clinic (n = 106) in a southern state were asked to complete questionnaires on typical child development and demographic characteristics. Overall, women correctly answered 65% of the criterion‐referenced knowledge questions. Mothers lacked the most knowledge about infant sleep patterns and developmental ability of 6‐month‐old infants. Maternal education, race, number of children, and assistance with childcare were significantly related to maternal knowledge. Identifying gaps in maternal knowledge and characteristics that correspond to knowledge deficits provides insight into how best to tailor educational interventions for mothers. ©2005 Michigan Association for Infant Mental Health.     

心理健康素养：概念、评估、干预与作用

心理健康素养是促进心理健康的重要途径。狭义概念指帮助人们认识、处理和预防心理疾病的相关知识和信念; 广义概念指综合运用心理健康知识、技能和态度, 保持和促进心理健康的能力。心理健康素养常采用情景案例问卷、单维或多维评估量表等进行评估, 可以通过社会运动、学校教育、自助式应用程序、心理健康急救培训等方式进行有效干预提高, 其中心理健康知识、心理疾病识别、情绪调节、减少病耻感、积极的求助态度等成分都有促进心理健康的作用。未来研究可以在建构评估指标体系、探索作用机制、扩展涵盖群体与内容、加强实证干预研究等方面深入开展。     

Association between anxiety and depression in children and adolescents with anxiety disorders

The relationship between anxiety and depression was examined in a sample of 106 children and adolescents referred to an outpatient anxiety disorder clinic for children. Twenty-eight percent of patients with DSM-III diagnoses of anxiety disorders displayed a concurrent major depression. Children with anxiety disorders plus major depression were found (1) to be older, (2) to demonstrate more severe anxiety symptomatology, and (3) to be diagnosed with different rates of certain anxiety-disorder subtypes, when compared to anxious patients without major depression. Nondepressed anxious children and adolescents did not differ from a psychopathological control group in severity of either anxiety or depression symptoms.     

Emotional intelligence and aggression among South African adolescents: Preliminary evidence

We investigated gender differences in emotional intelligence and aggression among South African adolescents. Four hundred and forty-four adolescents (female =51.4 %; mean age =15.5 years, SD= 1.42 years; rural residence = 35.5%, urban residence = 65.5%) completed an emotional intelligence scale and an aggression expression survey. Exploratory independent sample t-test analysis revealed female adolescents to score higher on perception of and management of emotions than male adolescents. Female adolescents also scored higher on verbal aggression than their male peers, whereas male adolescents scored higher on physical aggression than the female adolescents.     

Should psychotherapists disclose their own psychological problems?

Background: Self‐disclosures by psychotherapists can encompass a wide array of content, including information about the personal life of the psychotherapist. Aim: The goal of this study was to empirically assess reactions to psychotherapists disclosing their own personal problems to clients with similar problems. Methodology: This study explored participants' (n = 155) reactions to vignettes describing psychotherapists as either disclosing or not disclosing their own history of psychological problems to clients presenting with similar problems. Findings: Compared to otherwise identical vignettes featuring psychotherapists who did not self‐disclose, vignettes featuring psychotherapists who self‐disclosed were rated more positively in a variety of ways. Specifically, psychotherapists in the vignettes featuring self‐disclosure were perceived as possessing a higher level of favourable personal qualities and as more likely to establish strong working relationships with clients and achieve success in therapy. Limitations of the method and alternate explanations for the results are considered. Implications: Implications regarding the judicious use by psychotherapists of self‐disclosure regarding their own past psychological problems are discussed.     

Children's judgments about their own self‐knowledge: The role of disclosure to other

Previous research has suggested that children of 5/6 years fail to understand that they are the authority on their own self‐knowledge. That is, when asked questions like, ‘Who knows best when you are feeling tired?’, they tend to cite their mother rather than themselves. Here we report a study that, rather than asking about generalities (‘Who knows best what you are thinking?’), presented 5‐, 7‐ 9‐ and 11‐year‐children with hypothetical vignettes about specific circumstances in which they were described as either disclosing or not disclosing a specified state to their mother. Children were subsequently asked to judge who would best know the state. Over all age groups children were significantly more likely to identify themselves as authorities on their own self‐knowledge when states had not been disclosed to mother than when they had. However, in the case of disclosed states, young children (though not older ones) asserted that, ‘mum knows best’. These findings are interpreted as suggesting not that young children entirely fail to understand first person authority, but instead that they make the relatively sophisticated assumption that mothers' interpretive competence is greater than their own.     

The impact of onlooking and including bystander behaviour on judgments and emotions regarding peer exclusion

We investigated judgments and emotions in contexts of social exclusion that varied as a function of bystander behaviour (N = 173, 12‐ and 16‐year‐olds). Adolescents responded to film vignettes depicting a target excluded by a group with no bystanders, onlooking bystanders, or bystanders who included the target. Adolescents were asked to judge the behaviour and attribute emotions to the excluding group, the excluded target, and the bystanders. Younger adolescents judged the behaviour of the excluding group as more wrong than older adolescents when there were no bystanders present, indicating that the presence of bystanders was viewed as lessening the negative outcome of exclusion by the younger group. Yet, bystanders play a positive role only when they are includers, not when they are silent observers. This distinction was revealed by the findings that adolescents rated the behaviour of onlooking bystanders as more wrong compared with the behaviour of including bystanders. Moreover, all adolescents justified the inclusive behaviour more frequently with empathy than the onlooking behaviour. Adolescents also anticipated more empathy to including bystanders than to onlooking bystanders, as well as anticipated more guilt to onlooking bystanders than including bystanders. The findings are discussed in light of the role of group norms and group processes regarding bystanders' roles in social exclusion peer encounters.     

A growth mindset intervention to improve mental health in adolescents during COVID-19

COVID-19 poses a considerable threat to adolescent mental health. We investigated depression rates in teens from pre to post-COVID. We also explored if leveraging a growth mindset intervention (“Healthy Minds”) could improve adolescent mental health outcomes during the pandemic, especially for adolescents experiencing the most distress. In Study 1, we recruited youth from schools in a rural southern community (N = 239) and used a pre-post design. In Study 2, we recruited an online sample (N = 833) and used a longitudinal randomized control trial design to test the effectiveness of Healthy Minds. Across both studies, there is evidence of higher rates of depression in youth during COVID-19, relative to pre-pandemic numbers. In Study 1, the intervention effectively changed psychological and behavioral processes related to mental health, especially for adolescents experiencing greater COVID-19 stress. However, in Study 2, the intervention failed to impact depression rates or symptoms at follow-up.     

Religiosity,subjective well-being,and depression in Saudi children and adolescents

To explore the associations between religiosity and both subjective well-being (SW-B) and depression, a sample of 7211 Saudi school children and adolescents was recruited (2159 boys, 5052 girls). Their ages ranged from 11 to 18 years (M _age = 16.1, SD = 1.5 for boys; M _age = 15.6, SD = 1.9 for girls). They responded to five self-rating-scales of religiosity and SW-B, that is, happiness, satisfaction, mental health, and physical health, as well as the Multidimensional Child and Adolescent Depression Scale. It was found that males obtained significantly higher mean scores than their female counterparts on the religiosity and the SW-B self-rating-scales, whereas females obtained a significantly higher mean score on depression than their male peers. All the correlations among males and female were significant between religiosity and both SW-B rating scales (positive) and depression (negative). A principle components analysis was conducted. A high-loaded and bipolar factor was disclosed and labelled “Religiosity and well-being vs. depression.” In the stepwise multiple regression, the main predictor of religiosity in both sexes was satisfaction. In the light of the high mean score on religiosity, it was concluded that religiosity is an important element in the lives of the present sample of Saudi Muslim children and adolescents. Based on the correlations and factor analysis, it was also concluded that religious persons (in this sample) are happier, healthier, and less depressed.