The Contributions of Political Life Events to Psychological Distress Among South African

The psychological consequences of adverse political experiences among South African youth were studied in a sample of 540 black and white adolescents from two age groups, evenly divided by gender. Three questionnaires were administered, measuring exposure to political life events, the presence of symptoms of psychopathology, and stressful personal life events during the previous 5 years. The first hypothesis, predicting a substantial contribution of stressful political experiences to psychopathology, was strongly supported; when stressful personal life events were partialed out, a significant effect for political life events remained both on general distress and symptomatology indices. The second hypothesis of a linear relation between exposure to political life events and severity of distress was also confirmed. The findings underscore the enduring impact on children's mental health of past apartheid policies in South Africa specifically, and adverse political environments in general.     

The Multilevel Relationships of HIV‐Related Stigma to Child and Caregiver Mental Health among HIV‐Affected Households in South Africa

HIV/AIDS‐related (HAR) stigma is still a prevalent problem in Sub‐Saharan Africa, and has been found to be related to mental health of HIV‐positive individuals. However, no studies in the Sub‐Saharan African context have yet examined the relationship between HAR stigma and mental health among HIV‐negative, HIV‐affected adults and families; nor have any studies in this context yet examined stigma as an ecological construct predicting mental health outcomes through supra‐individual (setting level) and individual levels of influence. Multilevel modeling was used to examine multilevel, ecological relationships between HAR stigma and mental health among child and caregiver pairs from a systematic, community‐representative sample of 508 HIV‐affected households nested within 24 communities in KwaZulu‐Natal, South Africa. Two distinct dimensions of HAR stigma were measured: individual stigmatizing attitudes, and perceptions of community normative stigma. Findings suggest that individual‐level HAR stigma significantly predicts individual mental health (depression and anxiety) among HIV‐affected adults; and that community‐level HAR stigma significantly predicts both individual‐level mental health outcomes (anxiety) among HIV‐affected adults, and mental health outcomes (PTSD and externalizing behavior scores) among HIV‐affected children. Differentiated patterns of relationships were found using the two different stigma measures. These findings of unique relationships identified when utilizing two conceptually distinct stigma measures, at two levels of analysis (individual and community) suggest that HAR stigma in this context should be conceptualized as a multilevel, multidimensional construct. These findings have important implications both for mental health interventions and for interventions to reduce HAR stigma in this context.     

How Adolescents’ Mental Health Predicts Their Physical Health: Unique Contributions of Indicators of Subjective Well-being and Psychopathology

Studies among youth have established a link between mental health and physical health, and highlight the importance of attending to these relationships to provide a more complete picture of functioning. However, most previous investigations have limited their focus to examining the relationship between physical health and either particular aspects of psychopathology or particular aspects of subjective well-being. The current study serves as a first examination that includes both positive (subjective well-being [SWB]) and negative (psychopathology) indicators of mental health in relation to physical health functioning, assessed via self-report measures completed by a sample of 401 early adolescents from the general population. Mental health indicators accounted for 30% of the variance in physical health ratings, and 4 of the 5 mental health indicators were unique predictors of physical health. Positive affect, a component of SWB, explained the most unique variance in physical health, followed by the other components of SWB. Results support the importance of attending to positive indicators of mental health when determining the link with physical health among youth. Implications for a research and practice focus on comprehensive wellness among youth are discussed.     

Experiences of Newly Married Black Women Staying with the Extended Family in a Township in South Africa

We report the results of a phenomenological study on the experiences of newly married black women staying with extended family in South African townships. Our goals for the study included in-depth interviews on experiences and guidelines to facilitate these women's mental health. We interviewed six newly married women (age range 20 to 30 years; mean period in marriage = 3 years) staying with the extended families in an urban South African township. An open central question was posed to the newly married black women who fitted the inclusion criteria and this was followed by probing questions to explore and describe the experiences of staying with the extended family in an urban township. Newly married black women who do not follow the expected practices from the teachings of the extended family experienced victimisation by the extended family. The mental health of newly married black women staying with the extended family in an urban South African township could be facilitated by empowering these women with communication skills to enable them to express their feelings and concerns effectively.     

The impact of mental health problems and religiosity on African-American girls' HIV-risk

We investigated the relationship between religiosity, mental health problems, and two sexual risk behaviors-condom use and number of partners. Participants were 80 sexually active African American girls in psychiatric care and their caregivers. Results indicated differential relationships, depending on parent versus youth report. Mother's religiosity was positively related to girls' condom use and not to girls' number of partners. Controlling for other predictors in the models, mother's religiosity explained as much as 15% of the variance in girls' condom use. Whereas parent and adolescent reports of girls' depression/anxiety and rule-breaking were positively associated with number of partners, reports of aggression were associated with having fewer partners. Neither parent nor youth reports of girls' mental health problems were associated with condom use. Controlling for other predictors in the models, girls' mental health problems accounted for as much as 31% of the variance in number of partners. Findings underscore the importance of adopting an ecological framework to understand both the risk and promotive factors for sexual risk taking among troubled girls. The roles of specific aspects of psychopathology and religiosity in relation to sexual risk behavior among African American girls in psychiatric care are discussed.     

Stress and coping among student teachers at a South African university: An exploratory study

This article reports findings from an exploratory qualitative study on the lived experience of stress among a convenience sample of 14 South African university student teachers (female = 8, black = 7; age range = 22 to 31). The students were participating in training in mindfulness meditation, and completed three interviews over a six-week period on stressors impacting on their personal and professional lives and on how they experienced them and responded. There were additional data from recordings of the mindfulness training sessions and a self-report scale, the Depression, Anxiety and Stress Scale (DASS). Thematic analysis revealed a wide range of stressors experienced by the students and provided insight into sources of resilience in dealing with them. In conclusion, the authors consider whether the extreme experiences of stress foreshadow the discontent among South African students that would fuel the serious unrest and disruption that has been negatively affecting South African universities since.     

Homeless Youths and Young Adults in Los Angeles: Prevalence of Mental Health Problems and the Relationship Between Mental Health and Substance Abuse Disorders

Although understanding of the subsistence patterns, service utilization, and HIV-risk behaviors of homeless youths and young adults is increasing, relatively little is known about the epidemiology of mental health problems in this group or the relationships between mental health problems and substance use. This study measured symptoms of depression, low self-esteem, ADHD, suicidality, self-injurious behavior (SIB), and drug and alcohol use disorder in a sample of homeless youth and young adults living in Hollywood, CA. Results indicated extremely high prevalences of mental health problems, as compared with corresponding rates of mental health problems found among housed youths in previous studies. Prevalence of mental health problems differed by age and ethnicity. African Americans were at lower risk of suicidal thoughts and SIB than were those of other ethnicities. Older respondents and females were at increased risk of depressive symptoms, and younger respondents were at increased risk of SIB. Previous history of sexual abuse and/or assault was associated with increased risk of suicidality and SIB. Risk factors for drug abuse disorder included ethnicity other than African American, homelessness for 1 year or more, suicidality, SIB, depressive symptoms, and low self-esteem. Risk factors for alcohol abuse disorder included male gender, white ethnicity, homelessness for 1 year or more, suicidality, and SIB. Extremely high rates of mental health problems and substance abuse disorders in this sample suggest the need for street-based and nontraditional mental health services targeted toward these youths and young adults.     

The Use of Religion Among HIV-Infected African American Women

A study of the associations among physical and mental health and differential patterns of religiosity among African American women was conducted with a sample of 253 participants: 104 HIV-infected, 46 chronically ill (not HIV-infected), and 103 healthy subjects. Participants' uses of private (i.e., prayer) and public (i.e., church attendance) forms of religiosity were assessed using data from semi-structured interviews. The relationship between religiosity and mental health exhibited an incongruous pattern, differing across health condition and forms of religious behavior. The practice of public religiosity was found to be inversely associated with engagement in high-risk health behaviors among HIV-infected and healthy women but not among the chronically ill. Although private religiosity was unrelated to participants' perceptions of physical health, public religiosity was positively associated with physical health among HIV-infected women and inversely associated with their CD4 count. Finally, having a sense of control over one's health was positively related to religiosity. Results from this study support the important role religion plays for persons faced with chronic terminal diseases, as in the case of HIV/AIDS.     

Ethnic and Gender Variation in Religious Involvement: Patterns of Expression in Young Adulthood

This study used latent class analysis (LCA) to empirically derive profiles of religious involvement among a sample of 808 young adults and describe ethnic and gender differences within such religious involvement patterns. Items on the Duke Religion Index (DRI) were included as part of a larger longitudinal survey of emotional, physical, and behavioral health. The scale measured the organizational, nonorganizational, and intrinsic dimensions of religiosity (Koenig et al. in Handbook of religion and health, Oxford University Press, Oxford, 2001) in a sample of young adults at two waves of the study—age 27 and age 30. At age 27, five religious profiles were distinguishable in the sample while at age 30 six profiles emerged. Ethnic differences were found for each of the religious profiles where religious involvement manifested in different ways. Religious profiles between ages 27 and 30 changed over time and were affected by gender and ethnicity.     

Adolescent mental health: the role of youth and college pastors

The present study investigates the gatekeeping role of youth and college pastors, specifically exploring their psychological training, perceptions, attitudes, and interactions concerning adolescent congregants' mental illness. Texas youth and college pastors were anonymously surveyed regarding referral patterns, mental health interventions and contact, adolescent mental health perceptions, and means of collaboration. While the sample reported actively working with numerous adolescent mental health issues, the majority did not feel qualified to work with significant psychopathology. Despite this, they reported using various intervention methods, with the most common being initial counselling followed by a referral. Although the sample frequently referred to other professionals, they described many perceived barriers in collaborating with others in the mental health field. Overall, a positive role exists for youth and college pastors in adolescent mental health; however, tensions and conflicts between pastors and mental health professionals hinder the usefulness of these unique gatekeepers. Implications and recommendations for mental health professionals are highlighted.     

Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking Among African American Boys

African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to care. Using a mixed-methods design, this study examined the influence of mental health stigma and social support on depressive symptoms among African American adolescent boys. Findings indicated the protective effects of social support in decreasing depressive symptoms, especially when participants experienced mental health stigma. Results also revealed the pivotal role of family social support over both professional and peer support for participants who struggled with depressive symptoms. The primacy of family support among the sample, combined with the frequent distrust of professionals and peer networks, would indicate that working with families may improve initial identification of depression among African American adolescent boys and decrease their barriers to care.     

Religious Doubt and Mental Health Across the Lifespan

The current study examined the connections among religious doubt, mental health, and aging in a nationwide sample of individuals 18 years and older (N = 1629). Findings indicate that that religious doubt emerging from the recognition of suffering and evil in the world has a deleterious impact on mental health. Results also show that as people grow older, religious doubts continue to be associated with psychopathology, but the magnitude of this association becomes weaker across age categories. In other words, the impact of doubt on mental distress declines as one ages. These effects were found across various measures of mental distress, including depression, general anxiety, interpersonal sensitivity, paranoia, hostility, and obsessive-compulsive symptoms. Findings are explored within the context of psychosocial development and the experiential trajectory of religious maturity.     

Mental health service use by African American women: exploration of subpopulation differences

Studies focusing on mental health service use have consistently viewed African American women as a homogeneous population, and very few studies have examined subgroup differences. However, important differences exist both within and between groups in lifestyle, stressors, type and availability of support resources, societal interactions, and risk-taking behaviors. This study examined rates and patterns of mental health service use by African American lesbian women and a matched sample of heterosexual women. Results suggest both similarities and differences in factors associated with use of services. Despite evidence of substantial emotional distress, relatively few African American lesbian and heterosexual women reported current use of mental health services. These findings are consistent with past reports on African American heterosexual women but differ from other published reports on lesbians' use of therapy. Findings from this study, including clear differences between lesbians and heterosexual women in past use of therapy and preferences for mental health providers, have important implications for service provision.     

An Evolutionary Life History Framework for Psychopathology

In this article, I outline a general framework for the evolutionary analysis of mental disorders based on the concepts of life history theory. I synthesize and extend a large body of work showing that individual differences in life history strategy set the stage for the development of psychopathology. My analysis centers on the novel distinction between fast spectrum and slow spectrum disorders. I describe four main causal pathways from life history strategies to psychopathology, argue that psychopathology can arise at both ends of the fast–slow continuum of life history variation, and provide heuristic criteria for classifying disorders as fast or slow spectrum pathologies. I then apply the fast–slow distinction to a diverse sample of common mental disorders: externalizing disorders, schizophrenia and autism spectrum disorders, obsessive-compulsive disorders, eating disorders, and depression. The framework integrates previously disconnected models of psychopathology within a common frame of reference and has far-reaching implications for the classification of mental disorders.     

HIV prevention with persons with mental health problems

The HIV seroprevalence rate among persons with mental health problems (PMHP) is substantially higher than that of the general population in the United States. This study examines the efficacy over 12 months of an HIV prevention program with 99 individuals attending outpatient mental health clinics who were randomly assigned to receive either: (a) a seven-session, small-group intervention of Project LIGHT (Living in Good Health Together); or (b) a one-session video intervention. Regression analyses of data from 87% of the sample interviewed at 1-year follow-up revealed that intervention group membership was associated with significantly fewer sexual risk acts. A significant intervention effect for condom use was found for 72% of the sample who were African American, but not for Latino or Caucasian participants. Results from this study suggest that HIV risk reduction groups such as Project LIGHT may have utility in public mental health care settings.     

Assessing psychological health: the contribution of psychological strengths

Balanced assessment of mental health involves assessing well-being and strengths as well as psychopathology. The character strengths of curiosity, gratitude, hope, optimism and forgiveness are assessed in 214 new undergraduates and their relationships to mental health, subjective well-being and self-esteem explored. Scoring the mental health scale for psychiatric caseness, case and non-case students did not differ in character strengths, positive affect or life satisfaction, supporting a dual-factor model. Hope pathways and gratitude predicted mental health. Gratitude, hope agency and exploratory curiosity predicted positive affect. Gratitude and hope agency predicted life satisfaction. Hope agency, hope pathways, exploratory curiosity and gratitude predicted self-esteem, with absorption curiosity as a negative predictor. The benefits of assessing strengths are discussed and interventions designed to develop them.     

Racial Differences in Beliefs About the Effectiveness and Necessity of Mental Health Treatment

Members of racial/ethnic minority groups are less likely than Caucasians to access mental health services despite recent evidence of more favorable attitudes regarding treatment effectiveness. The present study explored this discrepancy by examining racial differences in beliefs about how the natural course and seriousness of mental illnesses relate to perceived treatment effectiveness. The analysis is based on a nationally representative sample of 583 Caucasian and 82 African American participants in a vignette experiment about people living with mental illness. While African Americans were more likely than Caucasians to believe that mental health professionals could help individuals with schizophrenia and major depression, they were also more likely to believe mental health problems would improve on their own. This belief was unrelated to beliefs about treatment effectiveness. These findings suggest that a belief in treatment effectiveness may not increase service utilization among African Americans who are more likely to believe treatment is unnecessary.     

Academic achievement and behavioral health among Asian American and African American adolescents: testing the model minority and inferior minority assumptions

The present study tested the model minority and inferior minority assumptions by examining the relationship between academic performance and measures of behavioral health in a subsample of 3,008 (22 %) participants in a nationally representative, multicultural sample of 13,601 students in the 2001 Youth Risk Behavioral Survey, comparing Asian Americans (N = 408) and African Americans (N = 2,600). Specifically, the study examined associations of students’ self-reported grades with suicide risk, substance abuse, and violent behaviors. The findings revealed that high academic performance is a protective factor against behavioral health problems for both ethnic groups. The results raise questions about the focus on high achievement among Asian Americans versus academic underachievement among African Americans. Implications for theory, research, training and practice in addressing the mental health implications of achievement behavior in Asian American and African American youth are discussed.     

An investigation of psychopathology in nonreferred suicidal and nonsuicidal adolescents

This investigation examined self-reported psychopathology in a school-based sample of 456 suicidal and nonsuicidal adolescents. The sample consisted of four groups: three at-risk for suicidal behavior based on current suicidal ideation as assessed by the Suicidal Ideation Questionnaire (SIQ; Reynolds, 1988), past suicide attempts, or both; and one nonsuicidal comparison group. Psychopathology was examined using ten scales from the Adolescent Psychopathology Scale (APS; Reynolds, 1998a) including: Major Depression, Conduct Disorder, Substance Abuse, Schizophrenia, Adjustment Disorder, Anorexia Nervosa, Borderline Personality Disorder, Obsessive-Compulsive Personality Disorder, Schizotypal Personality Disorder, and Avoidant Personality Disorder. Analyses were conducted separately for males and females using a MANOVA design that examined psychopathology severity among the four groups. Adolescents who engaged in past or current suicidal behavior had higher psychopathology severity scores compared to their nonsuicidal peers. Males with current suicidal thoughts who had attempted suicide had the highest levels of psychopathology severity compared to males in the other three groups. Females with a past suicide attempt or current suicidal ideation had higher psychopathology severity scores compared to nonsuicidal females. Results show greater psychopathology in school-based adolescents who have engaged in past and/or current suicidal behavior. The need for clinicians and mental health professionals working with at-risk youth to focus on concurrent psychopathology along with suicidal behavior is discussed.