阿尔兹海默氏症患者的家属照顾者(隐形的病患)健康状况探讨

台湾地区有超过91.5%的阿尔兹海默症照顾者为家庭成员。他们平均对轻度、中度和重度此症患者的全部照顾时间为2166、4299和5871小时。根据一项以“中国人健康问卷”所做的调查,照顾者身体健康状况平均值为2.73(标准差0.85);心理健康状况平均值为2.74(标准差0.8);社会健康状况平均值为2.98(标准差0.78);在压力的排序上以情绪上的压力和困扰为最高(3.02)。这些数据显示照顾者的身心健康已受到严重的负面影响。因此,照顾者应该首先照顾好自身,才能给予被照顾者亲属更好的必要照顾。     

Primary Prevention Mental Health Programs for Children and Adolescents: A Meta-Analytic Review

Used meta-analysis to review 177 primary prevention programs designed to prevent behavioral and social problems in children and adolescents. Findings provide empirical support for further research and practice in primary prevention. Most categories of programs produced outcomes similar to or higher in magnitude than those obtained by many other established preventive and treatment interventions in the social sciences and medicine. Programs modifying the school environment, individually focused mental health promotion efforts, and attempts to help children negotiate stressful transitions yield significant mean effects ranging from 0.24 to 0.93. In practical terms, the average participant in a primary prevention program surpasses the performance of between 59% to 82% of those in a control group, and outcomes reflect an 8% to 46% difference in success rates favoring prevention groups. Most categories of programs had the dual benefit of significantly reducing problems and significantly increasing competencies. Priorities for future research include clearer specification of intervention procedures and program goals, assessment of program implementation, more follow-up studies, and determining how characteristics of the intervention and participants relate to different outcomes.     

Effectiveness of School-Based Mental Health Services for Children: A 10-Year Research Review

A review of the literature from 1985 to 1995 on school-based mental health services for children was conducted using a computerized data-base search. Of the 5,046 references initially identified, 228 were program evaluations. Three inclusion criteria were applied to those studies: use of random assignment to the intervention; inclusion of a control group; and use of standardized outcome measures. Only 16 studies met these criteria. Three types of interventions were found to have empirical support for their effectiveness, although some of the evidence was mixed: cognitive-behavioral therapy, social skills training, and teacher consultation. The studies are discussed with reference to the sample, targeted problem, implementation, and types of outcomes assessed, using a comprehensive model of outcome domains, called the SFCES model. Future studies of school-based mental health services should (a) investigate the effectiveness of these interventions with a wider range of children's psychiatric disorders; (b) broaden the range of outcomes to include variables related to service placements and family perspectives; (c) examine the combined effectiveness of these empirically-validated interventions; and (d) evaluate the impact of these services when linked to home-based interventions.     

Psychoeducation for Adults with Post-Traumatic Stress Symptomatology: A Systematic Review and Meta-Analysis

Journal of Contemporary Psychotherapy - Post-traumatic stress disorder (PTSD) is a condition that can develop after experiencing a traumatic event. Psychoeducation is a treatment approach often...     

Family Processes and Mental Health among Children and Caregivers in a Family Strengthening Program

Oppositional defiant disorder (ODD) is a common mental health concern and is particularly prevalent among children living in poverty-impacted communities. A family strengthening/parent management training (PMT)-based multiple family group (MFG) program entitled, the 4 Rs and 2 Ss for Strengthening Families, focuses on the following family process variables: rules, responsibilities, relationships, respectful communication, social support, and stress. While evidence supports effectiveness of this treatment program, less is known about the specific relationship between the family process variables and mental health outcomes of children and caregivers. The current study examined these relationships among a sample of 287 caregiver/child dyads who participated in a NIMH-funded Type II hybrid effectiveness-implementation study in New York City. Data were analyzed using SPSS 27 and Mplus 8. Results indicated that two of the six family process variables related to one or more child and caregiver mental health outcome. Caregiver stress significantly related to child inattention (b?=?0.034, SE?=?0.01, p?<?0.001), child ODD (b?=?0.053, SE?=?0.02, p?<?0.01), and caregiver depression (b?=?0.049, SE?=?0.02, p?<?0.01). Family rules significantly related to caregiver depression (b?=?0.228, SE?=?0.11, p?<?0.05) over time. Findings point towards the substantial role of caregiver stress in child and caregiver mental health, in addition to the impact of inconsistent discipline with difficulty establishing rules on caregiver depression. Examinations of treatment components in relation to improvements in child and caregiver mental health can guide practitioners towards utilizing models that result in positive therapeutic outcomes and/or making adaptations with added content that has been shown to be effective.

     

Treatment Engagement with Caregivers of At-risk Children: Gaps in Research and Conceptualization

The high rates of dropping out and other engagement problems are significant concerns in the delivery of mental health and adjunct services to the families of at-risk children. Consequently, researchers have examined the correlates of attrition and have developed interventions to increase engagement and retention. However, the lack of a clear definition of engagement and gaps in theory about the relationship of engagement to other treatment processes hinder knowledge development. In this paper the behavioral and attitudinal aspects of engagement are disentangled. Current knowledge about treatment barriers and interventions to increase appointment keeping is summarized. A preliminary conceptualization of the engagement process is presented and research needs and practice implications are discussed.     

Children Who Murder: A Review

Despite considerable research on juvenile homicide, pre-adolescent homicide offenders have received less attention. This paper reviews the existing literature on preteen murderers in order to characterize the current state of research knowledge about this population, and draws on some of the work on adolescent homicide as well. The analysis of this literature considers historical context, methodological issues, previous attempts to classify youthful homicide offenders, and predictors of preteen homicidal behavior. While there is a high degree of heterogeneity within this population, several developmental similarities emerged across cases that were associated with the perpetration of homicide by preteens. A high percentage of preteen homicide offenders come from homes characterized by physical abuse, domestic violence, poor or absent parenting, and overall instability. Gun availability may have been a facilitating factor. Support for different etiologies of preteen versus adolescent homicide is weak. Recommendations for future research directions are offered.     

Linguistic Analysis of Written Narratives of Caregivers of Children and Adolescents with Chronic Illness: Cognitive and Emotional Processes and Physical and Psychological Health Outcomes

Used linguistic analysis of written narratives of caregivers of hospitalized youth with chronic illness to identify emotional and cognitive processes related to physical and psychological health outcomes following writing. Measures were administered at baseline and 4 months. Experimental group (n = 29) wrote about traumas whereas the control group (n = 24) wrote about summer activities for 20 min on three different days. Compared groups on negative emotion- and cognition-related word use. Tested change in negative emotion- and cognition-related word use as predictors of outcomes in experimental group. Consistent with hypotheses, experimental group used more negative emotion words [F(1, 53) = 77.55, p < .001] and cognition-related words than control group [F(1, 53) = 19.09, p < .001] and an increase in cognition words predicted Physical Health Summary Score on SF-36 (standardized = .37, p < .05). A decrease in negative emotion words was related to Physical Health Summary Score on SF-36 only when entered into regression with change in cognition words (standardized = –.31, p < .05). A decrease in negative emotion together with an increase in cognitive processing facilitated by written emotional disclosure has beneficial effects on physical health-related quality of life.     

Social Function and Autism Spectrum Disorder in Children and Adults with Neurofibromatosis Type 1: a Systematic Review and Meta-Analysis

In light of the proliferation of recent research into social function in neurofibromatosis type 1 (NF1), a systematic review and meta-analysis is required to synthesise data and place findings within the context of a theoretical framework. This paper reviews findings from research into social function and autism spectrum disorder (ASD) in children and adults with NF1 and integrates these findings with the Socio-Cognitive Integration Abilities Model (SOCIAL). It also critically appraises links between social outcomes, internal and external factors moderating social functioning, cognitive domains implicated in social functioning, and underlying neural pathology in NF1. A systematic literature search conducted in MedLine (Ovid), PsycINFO (Ovid), Embase (Ovid), and PubMed electronic databases yielded 35 papers that met inclusion criteria for the systematic review. Out of these papers, 22 papers provided sufficient data for meta-analysis. Findings from this review and meta-analysis provide evidence that children and adults with NF1 exhibit significantly higher prevalence and severity of social dysfunction and ASD symptomatology. To date, very few studies have examined social cognition in NF1 but results indicate the presence of both perceptual and higher-level impairments in this population. The results of this review also provide support for age, gender, and comorbid ADHD as moderating factors for social outcomes in NF1. Suggestions for future research are offered to further our understanding of the social phenotype in NF1 and to facilitate the development of targeted interventions.     

Impact of Youth Strengths and Objective Strain on the Experiences of Subjective Strain Among Caregivers of Youth with Behavioral Health Conditions

Caregivers of youth with behavioral health conditions often experience significant and chronic caregiving strain. Caregiving strain is thought to consist of three dimensions: objective strain (observable negative events), subjective internalized strain (negative feelings directed inwardly), and subjective externalized strain (negative feelings directed outwardly). Based on a modified stress process model, the aims of this study were to: (1) examine whether the association between youth emotional-behavioral problem severity (measured with the Child Behavior Checklist/6–18) and subjective internalized and subjective externalized caregiving strain is mediated by objective strain for caregivers, and; (2) identify other predictors of subjective internalized and subjective externalized strain, particularly related to youth emotional-behavioral strengths as measured by the Behavioral and Emotional Rating Scale-Parent Rating Scale. We also explored the extent to which the association between youth emotional-behavioral problem severity and subjective internalized and subjective externalized strain may be moderated by perceived youth emotional-behavioral strengths. One-hundred and eighty-five (N = 185) caregivers of youth served by a community-based system of care participated in structured survey interviews at program enrollment. Regression analyses indicated that objective strain was found to fully mediate the association between youth emotional-behavioral problem severity and subjective externalized strain. Greater youth strengths related to family involvement were also associated with lower subjective externalized strain. Higher caregiver age, lower education, biological parent relationship to youth, greater youth emotional-behavioral problem severity, higher objective strain, and lower youth strengths related to school functioning were associated with higher subjective internalized strain. A significant interaction was found between youth problem severity, youth affective strengths, and subjective internalized strain such that caregivers who reported higher levels of youth affective strengths experienced stronger effects from youth emotional-behavioral problem severity on subjective internalized strain. These findings shed light upon the complex set of circumstances that may lead caregivers of youth with behavioral health conditions to experience subjective internalized and subjective externalized strain.     

Caregivers of School-aged Children with Autism: Social Media as a Source of Support

Support groups provide parents of children with Autism Spectrum Disorder (ASD) with additional support which they may not receive from health care professionals. Rapid technological growth has increased the opportunity for parents to access information and support. In this study, we used a qualitative phenomenological design to explore the use of a social media support group, on WhatsApp, to provide support to parents of children with ASD. We used convenience sampling to select six participants who had a child diagnosed with ASD who was in the foundation or intermediate phase at school and between the ages of 5 and 12 years, had been a part of the WhatsApp support group for 6 months or longer, and lived in KwaZulu-Natal, South Africa. Data analysis revealed eight emergent themes, (a) communication support, (b) behavior support, (c) feeding support, (d) emotional support, (e) informational support, (f) the presence of a professional, (g) positive experiences in the group, and (h) limitations of the group. Findings indicate managing behavioral difficulties and emotional support for caregivers were the core functions of the group, and having a professional on the group served as a valuable resource. The use of a social media support group on WhatsApp provided ongoing support to parents of children with ASD, implying that such a group may have clinical significance for use by practitioners as well as the creation of similar groups on other platforms.     

Meaning and Health: A Systematic Review

The research base linking meaning with physical health is significantly underdeveloped in comparison to that linking subjective well-being and physical health. We address this deficit by first providing an overview of the study of meaning, and then examining evidence of its positive relationship to physical health in a systematic review of relevant literature. We searched PsycINFO and PubMed databases for studies of varying design and populations, excluding studies that did not have clear measures of meaning and physical health and/or did not address their relationship. Overall, higher levels of meaning are clearly associated with better physical health, as well as with behavioral factors that decrease the probability of negative health outcomes or increase that of positive health outcomes. Methodological challenges and future directions are discussed.     

The Prevalence of Anxiety Disorders Among Adults with Asthma: A Meta-Analytic Review

Research estimating the comorbidity of asthma and anxiety disorders has produced highly disparate findings and little consensus. This study is a meta-analytic review of data from 15 independent studies of the co-occurrence of adult asthma and anxiety disorders and was conducted to provide more precise comorbidity estimates. Aggregating across studies, the average prevalence of any anxiety disorder among adults with asthma was 34%, indicating a strong relationship between the two conditions in general. More specifically, the prevalence of panic attacks (25%), panic disorder (12%), agoraphobia (12%), and generalized anxiety disorder (9%) were considerably higher among adults with asthma than in the general population. However, additional analyses yielded prevalence estimates for specific phobia (10%), social phobia (7%) and posttraumatic stress disorder (6%) comparable to or lower than rates observed in the population at large. Attention to psychiatric symptoms should be a crucial component of asthma management, as anxiety disorders appear to be highly prevalent among persons with asthma and may be associated with increased asthma morbidity.

A Systematic Review of the Effectiveness of Self-Compassion-Related Interventions for Individuals With Chronic Physical Health Conditions

Self-compassion, defined as a mindful way of coping with pain and suffering by showing kindness, care, and concern towards the self, may improve psychological adjustment in people living with a chronic physical health condition (CPHC). Various studies illustrate that self-compassion is associated with positive outcomes in general. The aim of this systematic review is to establish the effect of compassion-related therapies on self-compassion specifically in people with CPHCs. Secondary aims are to (a) establish the effect on other psychological and physiological outcomes and (b) explore the relative effectiveness of different therapy types among those identified. Cochrane, Embase, Medline, PsycINFO, and CINAHL databases were searched using “compassion” AND “chronic disease” AND “psychological outcomes” and their synonyms, from 2004 to March 2019. Eligible studies had an experimental design using a self-compassion scale with an adult population. Risk of bias (RoB) was assessed using the Cochrane RoB tool. Effect sizes were calculated for study outcomes. Fifteen studies, including a total of 1,190 participants, 7 different CPHCs, and 11 types of therapies, were included in the review. Nearly all included therapies significantly increased self-compassion with medium to large effect sizes, and reported positive outcomes, such as decreased depression. None of the therapy types appeared clearly superior to the others. Findings from this review show that included therapies increased self-compassion and improved various outcomes, which may represent clinically significant benefits for patients. However, there is a need to further understand how self-compassion exerts its benefits and determine the best methods to increase self-compassion.     

Rehabilitation Treatments for Adults with Behavioral and Psychosocial Disorders Following Acquired Brain Injury: A Systematic Review

This review was aimed at systematically investigating the treatment efficacy and clinical effectiveness of neurobehavioral rehabilitation programs for adults with acquired brain injury and making evidence-based recommendations for the adoption of these rehabilitation trainings. Using a variety of search procedures, 63 studies were identified and reviewed using a set of questions about research methods, treatments, results and outcomes for the 1,094 participants. The 63 studies included treatments falling into three general categories: approaches based on applied behavior analysis, interventions based on cognitive-behavior therapy (CBT), and comprehensive-holistic rehabilitation programs (CHRPs). Considerable heterogeneity exists in the reviewed literature among treatment methods and within reported sample subjects. Despite the variety of methodological concerns, results indicate that the greatest overall improvement in psychosocial functioning is achieved by CHRP that can be considered a treatment standard for adults with behavioral and psychosocial disorders following acquired brain injury. Both approaches based on applied behavior analysis and CBT can be said to be evidence-based treatment options. However, findings raise questions about the role of uncontrolled factors in determining treatment effects and suggest the need for rigorous inclusion/exclusion criteria, with greater specification of theoretical basis, design, and contents of treatments for both interdisciplinary-comprehensive approaches and single-case methodologies.     

Promoting Mental Health in Parents of Young Children Using eHealth Interventions: A Systematic Review and Meta-analysis

Clinical Child and Family Psychology Review - Parent stress and mental health problems negatively impact early child development. This study aimed to systematically review and meta-analyze the...