Dyadic Influence of Adverse Childhood Experiences: Counseling Implications for Mental and Relational Health

Adverse childhood experiences (ACEs) predict physical and mental health. We examined dyadic differences in intimate partner relationship health by ACE score among couples with low to moderate income enrolled in a relationship education program. Overall, we found a high prevalence of ACEs, disproportionate representation in the highest risk ACE group, and a significant effect between ACEs and indicators of mental and relational health. Implications for counselors include support for an ACE‐informed approach to couples counseling services, as well as a holistic and systemic view of mental and relational health.     

Hmong Mental Health Needs Assessment: A Community-Based Partnership in a Small Mid-Western Community

The overall goal of this assessment was to verify the mental health needs of Hmong living in a mid-west community in order clarify the format, content, and feasibility of providing mental health services for Hmong in the future. Using a Community-Based Participatory Research (CBPR) model, we held four focus groups with 36 men, women, adolescents and professionals, all of Hmong descent, as well as interviewed 28 individual medical, mental health, education, and social service providers in the Eau Claire community. Our Hmong sample was frequently unclear about what “mental” health meant, indicating a low level of mental health literacy. Results confirmed that there are significant mental health needs in this refugee and immigrant population. Participants described problems consistent with depression, post-traumatic stress disorder (PTSD), anxiety disorders, somatoform disorders, and severe social stress and acculturation difficulties in every generation. Elder people and male adolescents were described as the most disaffected and in need of immediate services. It will be critical to address mental health literacy before designing future interventions. Treatment suggestions were provided with the intention of removing barriers and incorporating culturally sensitive methodologies, while continuing to work closely with our local mental health providers and Hmong leadership.     

Attitude similarity and familiarity and their links to mental health: An examination of potential interpersonal mediators

Similarity and familiarity with partner’s attitudes are linked to positive relationship outcomes, while interpersonal variables have been linked to mental health. Using multilevel models (MLMs), we modeled the associations between these attitudinal variables and mental health outcomes in 74 married couples. We found that higher levels of attitude similarity in couples were linked to lower depression, while higher levels of attitude familiarity in couples were associated with greater satisfaction with life. Mediational analyses indicated marital satisfaction and interpersonal stress mediated the link between attitude similarity and depression. Marital satisfaction also mediated the link between familiarity and satisfaction with life. This study is the first linking attitude familiarity to mental health and provides evidence that familiarity and similarity have mental health effects partly due to their interpersonal consequences.     

Mental health, life stress and social support among young Norwegian adolescents with immigrant and host national background

The first aim of the study was to investigate differences in level of mental health, life stress and social support among adolescents with immigrant and domestic background. A second aim was to identify culture group and gender specific sources of risk and protective factors and their relation to mental health. Questionnaire data were collected from 633 students, aged 13, in Oslo, Norway. Immigrant adolescents reported higher level of psychological distress and lower social support than host students. Of the four gender-culture groups, immigrant boys reported the highest level of problems, with a 28% prevalence of anxiety/depression. There were no significant differences in prevalence among the girls. Specific patterns of relationships between life stress, support, and mental health were found across gender and culture. The results were discussed within a framework of culture differences in values and gender role expectancies, underscoring the importance of studying each gender/culture group separately.     

Supporting the Need for an Integrated System of Care for Youth with Co-occurring Traumatic Stress and Substance Abuse Problems

Adolescents are at high risk for violence exposure and initiation of drug use. Co-occurring substance use and trauma exposure are associated with increased risk of mental health disorders, school underachievement, and involvement with multiple systems of care. Coordination and integration of systems of care are of utmost importance for these vulnerable youth. This study delineates the negative sequelae and increased service utilization patterns of adolescents with a history of trauma, substance abuse, and co-occurring trauma and substance abuse to support the need for integrated mental health and substance abuse services for youth. Data from two national sources, the National Child Traumatic Stress Network and Center for Substance Abuse Treatment demonstrate the increased clinical severity (measured by reports of emotional and behavioral problems), dysfunction, and service utilization patterns for youth with co-occurring trauma exposure and substance abuse. We conclude with recommendations for an integrated system of care that includes trauma-informed mental health treatment and substance abuse services aimed at reducing the morbidity and relapse probability of this high-risk group.     

Race differences in the receipt of mental health services among young adults

This study investigates race and ethnic differences in the receipt of mental health services among young adults. Research has indicated that racial minorities receive treatment at a much lower rate than those with middle and upper incomes and whites. We use data from the National Longitudinal Study of Adolescent Health, a nationally representative study of young adults, first interviewed when in Grades 7 through 12. We find significant differences across race-ethnicity. Consistent with prior research, blacks are less likely to have received mental health services. Findings for gender and education differed from previous studies. The relationship of gender on services receipt is mediated by depression. The relationship of race-ethnicity on services receipt is moderated by levels of education and prior services use. Education is associated with greater services use for Whites, but less services use for blacks. Also, blacks who used services in the past are significantly less likely to be current users. The implications of these results are discussed.     

Health and Social Services for Male-to-Female Transgender Persons of Color in San Francisco

SUMMARY

This article presents findings from an investigation of health needs, service utilization, and perceived barriers to services among male-to-female (MtF) transgender persons of color in San Francisco. Focus groups (n = 48) and survey interviews (n = 332) were conducted with convenience samples recruited from the community. Participants reported a range of health and social services needed during the previous year, with African-Americans and Latinas showing particularly strong service needs. Rates of utilizing services were high for basic health care but lower for social services, substance abuse treatment, psychological counseling, and gender transition-related medical services. No significant ethnic group differences in health service utilization were found. Qualitative findings evinced the call for transgender-specific programs and advanced provider training on transgender issues such as hormone use, gender transition, HIV/ AIDS care and prevention, substance abuse, and mental health problems.     

Family Support and Mental Health Service Use Among Suicidal Adolescents

Despite the fact that multiple evidence-based treatments exist for suicidal adolescents, these youth are unlikely to engage in mental health treatment. While family members can be influential in connecting adolescents to mental health care, suicidal youth are more likely to be exposed to family environments characterized by abuse, neglect, and to have poorer parent–child attachment quality than non-suicidal youth. This study analyzed data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine the relationships between perceived levels of parental support, symptom severity, and mental health service use in a nationally representative sample of suicidal adolescents in the U.S. (n = 1804). Higher levels of parental support were associated with a lower likelihood of mental health service use, lower levels of depression, and lower likelihood of an actual suicide attempt. Additionally, the presence of a suicide attempt and higher levels of depression were associated with a higher likelihood of mental health service use. When mediation effects were tested, the presence of a suicide attempt partially mediated the relationship between parental support and mental health service use. Implications discussed include the protective nature of parental support the need for more family-based interventions for this population.     

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.     

Coventry university students’ experience of mental health problems

Growing numbers of university students are reporting mental health problems and using counselling services. The purpose of this study was to examine Coventry University students’ experience of mental health problems. The Department of Health (DoH) Mental Health Survey questionnaire (2003) was used to examine the experience of mental health problems and help seeking behaviour. Within the last 12 months nearly three quarters of students had experienced anxious or depressed moods, or, personal, mental, nervous or emotional problems, with a third of students failing to seek help. Ethnic minority students were more likely to report problems and less likely to seek help when compared to white students. Male students were less likely to seek help compared to female students. There are few existing studies that have focused on the mental health of students at universities established after 1992 from existing polytechnics. Coventry University exceeds the Government benchmark targets for recruiting students from non-traditional backgrounds. Our results show that it is these groups of students who are more likely to experience mental health problems.     

Patterns of service utilization among pregnant and parenting African American adolescents

This study explored factors associated with differential patterns of social and health service use among pregnant and parenting African American adolescents. One hundred seventy-seven young women between the ages of 14 and 22 took part in the study. Cluster analysis suggested three groups of users: frequent users, moderate users, and inconsistent users. These groups were distinct in terms of their frequency of service usage, perceptions of barriers to usage, and psychological and social functioning. Moderate users appeared to be healthier than either the frequent or inconsistent users, as indicated by their relatively higher levels of psychological functioning. In contrast, inconsistent users were distinguished by their high rates of sexual victimization, their low use of medical services, and their perceptions of many programmatic and personal barriers to usage. Suggestions for research and interventions that encompass the diverse needs of young African American women are made.     

Postpartum Depression in Mothers and Fathers: The Role of Parenting Efficacy Expectations During the Transition to Parenthood

Research demonstrates that belief in one’s effectiveness as a parent (parenting efficacy) is linked to numerous positive outcomes for new parents. Conversely, the perceived inability to meet expectations is associated with negative mental health consequences for mothers and fathers. In the present paper we examine the impact of parenting efficacy expectations on the mental health statuses of new parents. Using three waves of data spanning from the prenatal period to the 4-months postpartum period from a sample of 150 first-time mothers and fathers in the Midwestern United States, we find that parenting efficacy is negatively associated with postpartum depression (PPD) for both mothers and fathers throughout the transition period. We also find that mothers and fathers whose parenting efficacy experiences were more negative than expected reported higher levels of PPD at 1-month postpartum. This effect dissipates for mothers, but not fathers, by 4-months postpartum, suggesting differences in the experiences of mothers and fathers during this transition. We conclude that research on the transition to parenthood should continue to include fathers in an effort to better understand the mental health consequences of becoming a parent for the first time, as well as enhance interventions designed to assist couples experiencing this important transition.     

Clinician competencies: Strengths and limitations for work with transgender and gender non-conforming (TGNC) clients

Individuals who identify as transgender or gender nonconforming (TGNC) face a number of health disparities compared to individuals who identify as cisgender (those who self-identify with the sex they were assigned at birth). For example, TGNC individuals experience heightened rates of clinical depression, anxiety, general psychological distress, suicidal ideation, and suicide attempts. Despite these troubling disparities, many TGNC individuals report hesitance to seek mental health services due to concerns regarding culturally insensitive or even overtly discriminatory services from providers. In addition to decreasing service utilization among TGNC populations, discriminatory services impair intervention effectiveness even when TGNC individuals persist in seeking mental health services. The American Psychological Association (APA) and the World Professional Association for Transgender Health (WPATH) provide guidelines for culturally competent work with TGNC clients; however, research indicates a profound lack of TGNC-specific training and resources among mental health care providers. To address this gap, the present investigation utilized a mixed-method design to assess training experiences, understanding of terminology, and TGNC competence among mental health care providers at various training levels. Participants were current mental health clinicians across the United States. Implications for improving reported and demonstrated weaknesses are discussed.     

Mental Health and Incarcerated Youth. II: Service Utilization

The incarceration of mentally ill youth is a serious problem not receiving the same attention as in adults. In this study, we examine the level of prior service utilization in incarcerated youth versus youth receiving community mental health services. We randomly recruited youth from middle South Carolina served by a local community mental health center (CMHC; n = 60), hospitalized in the state adolescent inpatient program (n = 50), and incarcerated in the S.C. Dept. of Juvenile Justice facilities (n = 75). We used a Services History to evaluate episodes of prior utilization of mental health, social service, educational, residential, and volunteer services, as well as the DISC-PC 2.3 to evaluate DSM-III-R diagnoses and symptoms and the CBCL and YSR to evaluate behavioral symptomatology. Incarcerated, hospitalized, and CMHC youth utilized similar levels of educational services and social services. Incarcerated youth had a significantly lower lifetime utilization of outpatient and acute mental health services and significantly higher utilization of out-of-home residential services than the other groups. These services utilization variables, along with gender and age, significantly distinguish incarcerated youth from the clinical groups, with clinical variables not serving to significantly distinguish them. Our results indicate the need to develop programs to prevent the entry of mentally ill/emotionally disturbed youth into the juvenile justice system. Youth who are at risk for incarcenation may benefit from intensive mental health services to prevent out-of-home placement and later incarceration.     

亲子分离与青少年同伴侵害和抑郁的关系:一项追踪研究

采用追踪研究设计,对贵州省1094名青少年进行了间隔半年的两次测查,考察早期亲子分离对青少年后期同伴侵害经历及抑郁水平的影响及性别差异。结果表明：（1）早期亲子分离能显著增加T1同伴侵害和抑郁,并通过T1的同伴侵害和抑郁间接影响T2的同伴侵害和抑郁;（2）亲子分离、同伴侵害和抑郁的关系存在显著性别差异：在女生组中,早期亲子分离不仅能够显著增加T1抑郁水平,还通过影响T1抑郁间接影响T2的同伴侵害状况,且早期亲子分离也可以边缘显著预测T1的同伴侵害状况;在男生组中,亲子分离仅能显著预测T1的同伴侵害经历,对于T1抑郁及T2时间点的各变量则无显著影响;（3）无论是否受到亲子分离的影响,同伴侵害与青少年抑郁之间均存在相互作用关系。研究结果提示早期亲子分离会导致青少年后期同伴侵害经历及抑郁水平上升,且主要体现在女生群体中,这为经历亲子分离后青少年心理健康干预方案的制定提供了科学依据。     

手机依赖与青少年心理健康的关系:学业倦怠的中介作用和应对方式的调节作用

为探讨青少年手机依赖、学业倦怠、应对方式与心理健康的关系及作用机制,采用手机依赖指数量表、初中生学习倦怠问卷、简易应对方式问卷和SCL-90心理症状自评量表,对黑龙江、天津、山东、河南、江西8所高校的在校大学生以及河南省2所初中、2所高中的中学生共1191名青少年进行测查。结构方程模型的分析结果表明:(1)手机依赖对青少年心理健康有显著的负向预测作用;(2)学业倦怠在手机依赖和心理健康之间发挥部分中介作用;(3)消极应对方式调节了手机依赖通过学业倦怠影响青少年心理健康中介作用的后半段路径,相对于低消极应对的青少年,中介作用在高消极应对的青少年中更显著。该研究结果对维护和促进手机移动互联网时代青少年心理健康具有积极启示意义。     

(Mis-)Coordinating identities in the transition to parenthood: Investigating the co-development of partners’ parenting,domestic and provider identities before and after the birth of the first child

This research takes a socio-psychological perspective to studying the transition to parenthood, by longitudinally investigating how couples dyadically coordinate: (a) the changing centralities of parenting domestic and provider identities, and (b) the consequences of this for stress and relationship satisfaction. We collected longitudinal data from a Swiss community sample of 213 heterosexual, first-time parents, in approximately the 24th week of pregnancy (T1) and 2 years later (T2). Participants completed a sociogram task, sketching the centrality of parenting, domestic and provider identities, for themselves and their partner. We applied actor partner interdependence models to model changing identity centralities at T2, from the (coordination) of T1 identities, distinguishing effects due to one's partner and the individual. Results support identity coordination in couples, especially in the development of the domestic identity. This coordination also had longitudinal effects for couples’ well-being. Results emphasize the social forces that structure the self-concept, and their health consequences.     

Mothers’ Mental Health Treatment Associated with Greater Adolescent Mental Health Service Use for Depression

Despite concerns surrounding depression in adolescence and the existence of effective treatments, adolescent depression often goes untreated. In 2014, only 41.2% of adolescents experiencing a major depressive episode (MDE) received mental health treatment. Parents play a key role in adolescents’ treatment utilization. We examined whether among mothers with any mental illness, mothers’ utilization of mental health treatment was associated with greater likelihood of their adolescent children who experienced an MDE receiving mental health treatment. Using nationally representative data from the National Survey on Drug Use and Health (2008–2014), we performed logistic regression analysis to model the odds of adolescents (aged 12 to 17 years) with a past year MDE receiving any mental health treatment in the past year as a function of their mothers’ mental health treatment utilization in the past year, adjusting for control variables. The rate of adolescent treatment utilization was 66% when mothers had utilized treatment, as compared to 45% when mothers did not utilize treatment (p?<?0.001). The odds of an adolescent with an MDE receiving mental health treatment were two times greater when the mother received mental health treatment as compared to adolescents whose mothers did not receive any mental health treatment (OR?=?2.09, 95% CI [1.04, 4.17]). There was no effect of adolescent gender (OR?=?1.15, 95% CI [0.40, 3.28]) or interaction between gender and mothers’ treatment (OR?=?0.95, 95% CI [0.26, 3.46]). Barriers to adolescent mental health treatment may be lower when mothers receive mental health treatment.     

2010~2020中国内地大学生心理健康问题检出率的元分析

估计我国大学生心理健康问题的检出率, 能够为心理健康政策完善和教育活动开展提供证据支持。对2010~2020年我国大学生主要心理健康问题检出率及影响因素进行元分析, 结果表明, 睡眠问题、抑郁、自我伤害在大学生中较为突出; 近10年, 大学生焦虑、抑郁、睡眠问题和自杀未遂的检出率显著上升, 自我伤害的检出率显著下降; 测量工具、检出标准和检出时间是导致检出率大小不一的关键因素; 整体而言, 东北和中部地区大学生的心理健康情况优于西部和东部大学生; 性别、生源地、独生与否对大学生心理健康问题检出率的影响均不显著。未来应重视研制适合我国大学生的心理健康测评工具并确定检出标准, 同时据此积极开展心理行为问题的筛查与控制。     

Evaluating Turkish university students’ preferences for mental health therapists: A conjoint analysis approach

Due to fast-paced cultural and societal changes in Turkey, Turkish students now accrue both eastern and western cultural motives, which place Turkish students under stress. However, Turkish students have a stigma toward seeking mental health services. The current study aimed to use conjoint analysis to examine Turkish students’ preferences for mental health therapist variables regarding seeking help for adjustment problems to life in college. Students from two universities in Turkey were recruited on a volunteer basis to participate in this study (N = 235). The results indicated that the training institution, age, professional background, geographical region and gender significantly influence students’ formation of preferences for mental health therapists. The training institution had the most predominant effect on preferences. Implications for promoting help-seeking and mental health service utilization in Turkey are discussed.