Mental health symptoms,well-being and experiences of the COVID-19 pandemic: A mixed-methods practice-based study

The COVID-19 pandemic necessitated abrupt and substantial changes in daily life, and public health strategies intended to protect physical health can negatively affect mental health and well-being, especially for individuals with pre-existing mental health challenges. For this study, we surveyed a sample of clients (N = 94) in the summer of 2020 from a community mental health clinic in the northeast United States. A mixed-methods, concurrent triangulation design was used to (a) identify client subgroups on indicators of mental health (i.e. anxious and depressive symptoms) and emotional, psychological, and social well-being using latent profile analysis (LPA), and (b) within these subgroups, examine qualitative, thematic patterns in self-described challenges, benefits and learning related to the pandemic. The LPA revealed five distinct subgroups with various levels of symptoms and well-being, including Stagnant (moderate symptoms/moderate well-being), Languishing (high symptoms/low well-being), Flourishing (low symptoms, high well-being), Fortitudinous (high symptoms, moderate well-being) and Mobilized (moderate symptoms, high well-being). These divergent subgroups support the need to conceptualise mental health symptoms apart from well-being and assess for heterogeneous constellations of such constructs among psychotherapy clients. Thematic analysis offered additional insight into pandemic experiences within each subgroup, including attention to psychological, emotional, behavioural/lifestyle, relational, physical and ecological/contextual dimensions of self-experience, as well as the ways clients had adjusted to the pandemic's circumstances. Findings support nuanced conceptualisations of positive mental health and offer insight into coping and adaptation during this public health crisis.     

Toward a tripartite factor structure of mental health: subjective well-being, personal growth, and religiosity.

According to recent research findings, the domain of psychological well-being may be represented by 2 basic factors: subjective well-being (e.g., happiness, life satisfaction) and personal growth (e.g., self-actualization, a sense of meaningfulness). This study tested the hypothesis that in addition to those 2 factors, a 3rd basic factor is necessary to adequately describe the ways in which people search for well-being. That factor is a type of religiosity that is based on other-centeredness and self-renunciation. A sample of 242 undergraduate and graduate students completed 10 measures of psychological well-being that resulted in 21 scales and subscales. Principal components analyses provided initial support for a tripartite model of psychological well-being. Results also suggested that current measures of personal growth may measure either the autonomy or mature social relationships components of the construct.     

Mental health and welfare transitions: depression and alcohol abuse in AFDC women

From a selection perspective, does prior dysfunction select women into welfare or serve as a barrier to leaving welfare? From a social causation perspective, does entering or exiting welfare lead to changes in well being? These questions were analyzed in panel data for over 3,600 women drawn from the National Longitudinal Survey of Youth for the period 1992–94. Welfare is associated with both depression and alcohol consumption cross‐sectionally. This link appears to derive in small part from selection into welfare by depression (in interaction with marital status), but depression and alcohol abuse did not operate as barriers to leaving welfare. Entering welfare was clearly associated with increased depression and alcohol consumption, but confidence in an apparent beneficial effect on alcohol symptoms of leaving welfare for employment was limited by small sample sizes. These findings are located in the context of the 1996‐welfare reform and the recent economic expansion. One implication is that community psychology should consider welfare entry as a risk factor similar to adverse employment changes such as job loss.     

Knowledge structuring and societal well-being: Toward biomedical impact indicators

Advances in science and technology have been credited with improving quality of life, as well as blamed for creating or contributing to a host of problems. This article attempts to establish that a unidirectional, causal perspective of science-society linkages is untenable, that technological knowledge rather than science affects society, and that an action-oriented focus is consistent with the complex dynamics of society. A model relating knowledge structuring to societal well-being, with a special focus on biomedicine, is advanced and utilized for the design of indicators to support policies that shape the impact of knowledge structuring technologies on well-being.     

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.     

Mental health protective factors among flourishing Canadian women university student-athletes

Mental health is an important resource for student-athletes. Flourishing (Keyes, 2002) may be a useful concept for examining aspects of mental health. Therefore, the purpose of this study was to investigate mental health protective factors among flourishing Canadian university student-athletes over the course of their sport season. Initially, 36 Canadian student-athletes completed the Mental Health Continuum – Short Form (Keyes, 2009) and Sport Mental Health Continuum – Short Form (Foster & Chow, 2019). Based on the results from the questionnaires, six women athletes who were identified as flourishing at global and sport levels then participated in the study. Data were generated through individual pre- and post-season semi-structured interviews, and in-season weekly written diaries. Analysis followed guidelines outlined by Smith et al. (2009) for interpretative phenomenological analysis. Results are presented over three stages of the seasons (pre-, in-, and post-season). In the pre-season, participants invested in their flourishing by making positive connections and planning their schedule. In-season, participants discussed facing challenges and tried to maintain flourishing by managing their commitments, communicating with coaches, and looking for positives. In the post-season, the participants attempted to re-invest in their flourishing by reflecting on their season and taking a break from sport. It appeared that the athletes were able to identify potential challenges to their flourishing in sport and use global resources to buffer the impact. These results reveal strategies that may help promote and protect mental health among student-athletes.     

Character strengths and well-being among volunteers and employees: Toward an integrative model

The endorsement and deployment of character strengths in occupational contexts are two promising components for understanding how people create well-being. In this study, a model integrating character strengths, satisfaction with occupational activities, and meaning and well-being was proposed and tested in two samples of volunteers and a sample of working adults. The model fit the data well in all three samples. Results demonstrated that deploying strengths at work provided key links to satisfaction with voluntary and paid occupational activities and to meaning among both young and middle-aged volunteers, and adult working women. Among adult volunteers and paid workers, endorsing strengths was related to meaning, while both endorsing and deploying strengths were related to well-being. Together, these studies provide a model for understanding how strengths may play a role in how both volunteer and paid workers find meaning, well-being, and satisfaction.     

Mental balance and well-being: building bridges between Buddhism and Western psychology

Clinical psychology has focused primarily on the diagnosis and treatment of mental disease, and only recently has scientific attention turned to understanding and cultivating positive mental health. The Buddhist tradition, on the other hand, has focused for over 2,500 years on cultivating exceptional states of mental well-being as well as identifying and treating psychological problems. This article attempts to draw on centuries of Buddhist experiential and theoretical inquiry as well as current Western experimental research to highlight specific themes that are particularly relevant to exploring the nature of mental health. Specifically, the authors discuss the nature of mental well-being and then present an innovative model of how to attain such well-being through the cultivation of four types of mental balance: conative, attentional, cognitive, and affective.     

Terms of empowerment/exemplars of prevention: Toward a theory for community psychology

In order to develop theory any community of scientists must agree as to what constitutes its phenomena of interest. A distinction is made between phenomena of interest and exemplars. The concept "prevention" is viewed as an exemplar, whereas the concept "empowerment" is suggested as a leading candidate for the title "phenomena of interest" to Community Psychology. The ecological nature of empowerment theory is described, and some of the terms of empowerment (definitions, conditions, and periods of time) are explicated. Eleven assumptions, presuppositions, and hypotheses are offered as guidelines for theory development and empirical study.     

Violence against women: Mental health effects. Part II. Conceptualizations of posttraumatic stress

A broad range of psychological aftereffects have been noted among women who have experienced male-perpetrated violence. These symptoms vary considerably among individuals, across social contexts, and across different types of violent encounters (Coley & Beckett, 1988; Goodman, Koss, & Russo, 1992; Koss, 1988; Straus, Gelles, & Steinmetz, 1980). Nevertheless, a remarkably consistent picture of the psychological sequelae of violence—particularly sexual and physical assault—emerges from the empirical and clinical literature (Koss, 1988). In this article, we use the posttraumatic stress disorder diagnosis—a frame that captures many of the disparate symptoms described by researchers—as a basis for exploring several conceptual models that have been developed to explain women's responses to violence.     

Structural power and experienced job satisfactions: The empowerment paradox for women

This study related the structural power of women's occupational roles to their job values, perceptions, satisfactions, and dissatisfactions regarding power and affiliation. For 110 mostly Caucasian college-educated women in their mid-30s returning mailed questionnaires, analyses compared women in relational power, directive power, and low power jobs. Women in supervisory roles were compared with nonsupervisors. Perceived Autonomy/Challenge and Affiliation correlated with Interpersonal Power satisfaction; these and Perceived Status Mobility correlated with Interpersonal Power dissatisfaction. More women in relational power jobs reported Affiliative values and Interpersonal Power satisfactions, and fewer reported Status Mobility values and perceptions or Autonomy/Challenge satisfactions. Supervisors valued and perceived Status Mobility and Autonomy/Challenge more than did nonsupervisors, and reported more Autonomy/Challenge satisfaction. More nonsupervisors reported Interpersonal Power and Affiliative satisfactions. Thus, as women gain more structural power, they report less satisfaction from Interpersonal Power despite greater satisfaction with Autonomy/Challenge.I thank Sandra S. Tangri for initiating and continuing this longitudinal study; Sandra S. Tangri, Jo Ruggiero, and Jan Hitchcock for their collaborative work on the 1981 data collection; and Karen Chandler and Kathy MacDonald for coding of open-ended data. I appreciate Harriett Aronson's comments on previous drafts, and those of two anonymous reviewers.This research has been supported by the National Institute of Mental Health (NIMH) Grant No. 5-F1-MH-30#493-03; by Radcliffe Research Support Grants from The Henry A. Murray Research Center of Radcliffe College to Jo Ruggiero and to Sharon Rae Jenkins; a faculty research grant from the University of California, Santa Cruz to Sharon Rae Jenkins; and by a grant from the Mobil Foundation to Radcliffe College awarded to Sharon Rae Jenkins. Portions of these analyses were supported by NIMH Postdoctoral Fellowship MH-15122-07 from the Department of Sociology and Institute of Human Development, University of California, Berkeley. The 1967 and 1970 data sets are archived at The Henry A. Murray Research Center, Radcliffe College, Ten Garden St., Cambridge, MA 02138, are used with the Center's permission, and are available for secondary analysis by qualified researchers.     

Public health, well-being and reciprocity

Public-health measures are very effective and efficient means of improving health, yet public health is either neglected by the literature or fraught with unease, mainly due to the combination of the aggregate-distributive tension with the element of compulsion. I argue that this unease can be decreased by 1) a pluralist-holistic view of health, situating the normative value of health in its effect on well-being, incorporating both the objective and subjective source of the value of health; and 2) by a rich concept of reciprocity. This article supports Martha Nussbaum's critique of social-contract thinking for placing too much weight on the scale of normal functioning and productive reciprocity, as well as Sen's distinction between well-being and agency freedom. To reach an adequate understanding of the value and goal of public health within the general setting of health care, a pluralist conception of health, well-being and reciprocity is necessary.     

Measuring Stigma Toward Mental Illness: Development and Application of the Mental Illness Stigma Scale1

Guided by theory on stigma, a Likert‐type scale was developed to measure 7 factors of attitudes toward people with mental illness: interpersonal anxiety, relationship disruption, poor hygiene, visibility, treatability, professional efficacy, and recovery. The scale was validated among college students and community members, measuring attitudes toward people with mental illness, depression, bipolar disorder, and schizophrenia. In a second application, college students completed the scale from their own perspective, then from an imagined perspective of someone with mental illness, while psychiatric patients completed the scale from their own perspective, then from an imagined viewpoint of someone without mental illness. Psychiatric patients assumed that they were stigmatized to a greater extent than was admitted by the student sample.     

Mental control and visual illusions: Toward explaining race-biased weapon misidentifications

People are biased to misidentify harmless objects as weapons when the objects are associated with African Americans (Payne, 2001). Two studies examined the processes underlying this bias. The illusory perception hypothesis argues that stereotypes alter the subjective construal of the object. In contrast, the executive failure hypothesis argues that even when perception of the item is intact, misidentifications can result from failures to control responses. Immediately after making an error, participants were able to accurately express that they had made a mistake via confidence ratings (Experiment 1) and by correcting their judgment (Experiment 2). Subjective confidence judgments were extremely well calibrated to accuracy, and participants virtually never believed their own mistakes. Conditions likely to create errors through both illusions and control failures are discussed.     

Psychological functioning and well-being among Ghanaian women: A brief report

This study examined correlates of psychological well-being and distress among women in Accra, Ghana. A total of 200 women between 18 and 65 years completed measures of psychological well-being and distress. Independent t-test and One-way ANOVA F-test analysis of the data suggested differences among the women in their psychological well-being and distress levels by their religiosity, education, and monthly income. Christian women reported higher psychological well-being compared to non-Christians. Religiosity, higher education, and income appear to be protective resources against psychological distress among Ghanaian women.     

Mental health measurement among women veterans receiving co-located,collaborative care services

Routine use of measurement to identify patient concerns and track treatment progress is critical to high quality patient care. This is particularly relevant to the Primary Care Behavioral Health model, where rapid symptom assessment and effective referral management are critical to sustaining population-based care. However, research suggests that women who receive treatment in co-located collaborative care settings utilizing the PCBH model are less likely to be assessed with standard measures than men in these settings. The current study utilized regional retrospective data obtained from the Veterans Health Administration’s electronic medical record system to: (1) explore rates of mental health measurement for women receiving co-located collaborative care services (N = 1008); and (2) to identify predictors of mental health measurement in women veterans in these settings. Overall, only 8% of women had documentation of standard mental health measures. Measurement was predicted by diagnosis, facility size, length of care episode and care setting. Specifically, women diagnosed with depression were less likely than those with anxiety disorders to have standard mental health measurement documented. Several suggestions are offered to increase the quality of mental health care for women through regular use of measurement in integrated care settings.