Association between cognitive vulnerability to depression - dysfunctional attitudes and glycaemic control among in-patients with type 2 diabetes in a hospital in Beijing: a multivariate regression analysis

This cross-sectional study aimed to investigate the relationship between glycosylated haemoglobin (HbA1c) and cognitive vulnerability to depression (dysfunctional attitudes) in patients with type 2 diabetes mellitus. A total of 245 valid records from June 2016 to December 2016 were collected from a hospital in Beijing. Participants were asked to complete four questionnaires (Dysfunctional Attitudes Scale, Automatic Thoughts Questionnaire, Zung Self-rating Depression Scale, and World Health Organization Quality of Life Instrument-Short Form) to assess mental health and quality of life. Multivariate regression analysis was conducted to determine the correlations between HbA1c, mental health, quality of life and other clinical variables. The results showed that dysfunctional attitudes were associated with HbA1c, with a standardized regression coefficient (β) of .13 (p = .01), although 1 h C-peptide (β = ?.75, p < .0001) was the most significant predictor of HbA1c in the regression model. The results indicated that dysfunctional attitudes, as a cognitive vulnerability to depression, were a relevant factor in HbA1c, although further studies are needed to establish the nature of the connection between dysfunctional attitudes and glycaemic control in diabetes patients.     

Behavioral Therapy Teams for Obsessive-Compulsive Disorder: Lessons Learned From a Pilot Randomized Trial in a Community Mental Health Center

Community mental health centers (CMHCs) provide the majority of mental health services for low-income individuals in the United States. Exposure and response prevention (ERP), the psychotherapy of choice for obsessive-compulsive disorder (OCD), is rarely delivered in CMHCs. This study aimed to establish the acceptability and feasibility of testing a behavioral therapy team (BTT) intervention to deliver ERP in CMHCs. BTT consisted of individual information-gathering sessions followed by 12 weeks of group ERP and concurrent home-based coaching sessions. The sample consisted of 47 low-income individuals with OCD who were randomized to receive BTT or treatment as usual (TAU). Symptom severity and quality-of-life measures were assessed at pretreatment, posttreatment, and 3- and 6-month posttreatment. Feasibility of training CMHC staff was partially successful. CMHC therapists successfully completed rigorous training and delivered ERP with high fidelity. However, training paraprofessionals as ERP coaches was more challenging. ERP was feasible and acceptable to patients. BTT participants were more likely than TAU participants to attend their first therapy session and attended significantly more treatment sessions. A large between-group effect size was observed for reduction in OCD symptoms at posttreatment but differences were not maintained across 3- and 6-month follow-ups. For BTT participants, within-group effect sizes reflecting change from baseline to posttreatment were large. For TAU participants, depression scores did not change during the active treatment phase but gradually improved during follow-up. Results support feasibility and acceptability of ERP for this patient population. Findings also underscore the importance of implementation frameworks to help understand factors that impact training professionals.     

The Coronary Health Improvement Project (CHIP) for lowering weight and improving psychosocial health

This study extends previous research evaluating the association between the CHIP intervention, change in body weight, and change in psychological health. A randomized controlled health intervention study lasting 4 wk. was used with 348 participants from metropolitan Rockford, Illinois; ages ranged from 24 to 81 yr. Participants were assessed at baseline, 6 wk., and 6 mo. The Beck Depression Inventory (BDI) and three selected psychosocial measures from the SF-36 Health Survey were used. Significantly greater decreases in Body Mass Index (BMI) occurred after 6 wk. and 6 mo. follow-up for the intervention group compared with the control group, with greater decreases for participants in the overweight and obese categories. Significantly greater improvements were observed in BDI scores, role-emotional and social functioning, and mental health throughout follow-up for the intervention group. The greater the decrease in BMI through 6 wk., the better the chance of improved BDI score, role-emotional score, social functioning score, and mental health score, with odds ratios of 1.3 to 1.9. Similar results occurred through 6 mo., except the mental health variable became nonsignificant. These results indicate that the CHIP intervention significantly improved psychological health for at least six months afterwards, in part through its influence on lowering BMI.     

Effect of the Healthy MOMs Lifestyle Intervention on Reducing Depressive Symptoms Among Pregnant Latinas

Depression during the prenatal and postpartum periods is associated with poor maternal, perinatal and child outcomes. This study examines the effectiveness of a culturally and linguistically tailored, social support-based, healthy lifestyle intervention led by trained community health workers in reducing depressive symptoms among pregnant and early postpartum Latinas. A sample of 275 pregnant Latinas was randomized to the Healthy MOMs Healthy Lifestyle Intervention (MOMs) or the Healthy Pregnancy Education (control) group. More than one-third of participants were at risk for depression at baseline. MOMs participants were less likely than control group participants to be at risk for depression at follow-up. Between baseline and 6 weeks postpartum, MOMs participants experienced a significant decline in depressive symptoms; control participants experienced a marginally significant decline. For MOMs participants, most of this decline occurred during the pregnancy intervention period, a time when no change occurred for control participants. The change in depressive symptoms during this period was greater among MOMs than control participants (“intervention effect”). From baseline to postpartum, there was a significant intervention effect among non-English-speaking women only. These findings provide evidence that a community-planned, culturally tailored healthy lifestyle intervention led by community health workers can reduce depressive symptoms among pregnant, Spanish-speaking Latinas.     

Can Messages Make a Difference? The Association Between E‐Mail Messages and Health Outcomes in Diabetes Patients

This investigation examined the impact of social support messages on patient health outcomes. Forty‐one American Indian, Alaska Native, and Native Hawaiian patients received a total of 618 e‐mail messages from their healthcare provider (HCP). The e‐mail messages were divided into 3,565 message units and coded for instances of emotional social support. Patient glycosulated hemoglobin scores (HbA1c) showed significantly improved glycemic control and emotional social support messages were associated with significant decreases in HbA1c values. Patient involvement with the system, measured by system login frequency and the frequency of uploaded blood glucose scores to the HCP, did not predict change in HbA1c.     

Adolescents with Poorly Controlled Type 1 Diabetes can Benefit from Coaching: A Case Report and Discussion

Traditional interventions aimed at improving patient self-management and at motivating the patients to change behaviour seem to be insufficient in adolescents with very high HbA1c. In this paper we present a case consisting of nine adolescents with poorly controlled diabetes type 1. They had previously shown continuously high levels of HbA1c for 2 years despite intensive follow-up and were therefore invited to participate in a coaching program. The coaching program was conducted by professional certified coaches and consisted of two group and eight individual coaching sessions. After completing the coaching sessions, HbA1c had decreased significantly in six out of nine of the adolescents. The participants were interviewed twice following the coaching sessions. All participants reported that they found the sessions very rewarding, and several explained that they now saw themselves differently and had gained more self-esteem and more energy.     

A Longitudinal Study of Predictors of Housing Stability,Housing Quality,and Mental Health Functioning Among Single Homeless Individuals Staying in Emergency Shelters

The current study examined risk and resilience factors at multiple levels that affect homeless individuals' ability to exit homelessness and achieve housing stability. It also examined the relationship between housing status, housing quality and mental health functioning. The methodology is a longitudinal study of single homeless individuals staying in emergency shelters in a medium‐sized Canadian city who were followed for a 2 year period. Data were collected from participants at a baseline interview when they were homeless and at a 2‐year follow‐up. There were 329 participants interviewed at baseline and 197 (59.9%) participants interviewed at follow‐up. Results from a structural equation modelling analysis found that having interpersonal and community resources were predictive of achieving housing stability. Specifically, having a larger social support network, access to subsidized housing, and greater income was related to achieving housing stability. On the other hand, having a substance use problem was a risk factor associated with a failure to achieving housing stability. Being female, feeling personally empowered, having housing that is perceived of being of higher quality were directly predictive of mental health functioning at follow‐up. Findings are discussed in the context of previous research and their policy implications.     

Glycosylated Hemoglobin Level,Race/Ethnicity,and Cognition in Midlife and Early Old Age

Empirical evidence linking racial/ethnic differences in glycosylated hemoglobin levels (HbA1c) to cognitive function in midlife and early old age is limited. We use biomarker data from the Health and Retirement Study (HRS, 2006–2014), on adults 50–64 years at baseline (57–73 years by 2014), and fit multinomial logistic regression models to assess the association between baseline HbA1c, cognitive function (using Langa–Weir classifications) and mortality across 8 years. Additionally, we test for modification effects by race/ethnicity. In age- and sex-adjusted models high HbA1c level was associated with lower baseline cognition and higher relative risk ratios (RRR; vs. normal cognition) for cognitive impairment no dementia (CIND; RRR = 2.3; 95%CI = [1.38;3.84]; p < .01), and dementia (RRR = 4.00; 95%CI = [1.76;9.10]; p < .01). Adjusting for sociodemographic, behavioral risk factors, and other health conditions explained the higher RRR for CIND and attenuated the RRR for dementia by approximately 30%. HbA1c levels were not linked to the slope of cognitive decline, and we found no evidence of modification effects for HbA1c by race/ethnicity. Targeting interventions for glycemic control in the critical midlife period can protect baseline cognition and buffer against downstream development of cognitive impairment. This can yield important public health benefits and reductions in burdens associated with cognitive impairment, particularly among race/ethnic minorities who are at higher risk for metabolic diseases.     

The Development,Pilot, and Process Evaluation of a Parent Mental Health Literacy Intervention Through Community Sports Clubs

The mental health literacy of parents may be critical in facilitating positive child and adolescent mental health outcomes. The purpose of this study was to develop, pilot, and evaluate a targeted parent mental health literacy intervention through community sports clubs. Sixty six parents (M_age?=?44.86?±?5.2 years) participated in either a brief mental health literacy intervention workshop delivered through community sporting clubs (n?=?42) or a community-matched control group (n?=?24). Participants’ mental health literacy was assessed at baseline, post-intervention and at 1 month follow-up. A mixed methods process evaluation was conducted with intervention participants to determine the acceptability and feasibility of the intervention. Participants in the experimental group showed greater increases in depression literacy, anxiety literacy, knowledge of help seeking options and confidence to assist an adolescent experiencing a mental health disorder, compared to those in the control group. Post-intervention changes in the experimental group were maintained at 1 month follow-up. A mixed methods process evaluation revealed that parents found the intervention content engaging, relevant to their needs, and practically useful in terms of actively supporting adolescent mental health. Findings provide evidence that a brief, targeted intervention through community sports clubs might be a particularly useful method of improving parental mental health literacy and facilitating positive youth mental health outcomes.     

The Development and Evaluation of a Parent Empowerment Program for Family Peer Advocates

Family-to-family services are emerging as an important adjunctive service to traditional mental health care and a vehicle for improving parent engagement and service use in children’s mental health services. In New York State, a growing workforce of Family Peer Advocates (FPA) is delivering family-to-family services. We describe the development and evaluation of a professional program to enhance Family Peer Advocate professional skills, called the Parent Engagement and Empowerment Program (PEP). We detail the history and content of PEP and provide data from a pre/post and 6-month follow up evaluation of 58 FPA who participated in the first Statewide regional training effort. Self-efficacy, empowerment, and skills development were assessed at 3 time points: baseline, post-training, and 6-month follow-up. The largest changes were in self-efficacy and empowerment. Regional differences suggest differences in Family Peer Advocate workforce across areas of the state. This evaluation also provides the first systematic documentation of Family Peer Advocate activities over a six-month period. Consistent with peer specialists within the adult health care field, FPA in the children’s mental health field primarily focused on providing emotional support and service access issues. Implications for expanding family-to-family services and integrating it more broadly into provider organizations are described.     

Changes over time from baseline poor self-rated health: For whom does poor self-rated health not predict mortality?

The aim of this study was to understand for whom and why poor self-rated health (SRH) is a less valid predictor of longevity or future health by examining the predictors of decline in health among people with poor baseline SRH. The sample included 409 participants in the Cross-Sectional and Longitudinal Study of the old–old (75+) in Israel, who were self-respondents and rated their health as poor at baseline and their status was known at follow-up 3.5 years later: deceased/moved to proxy interview/remained in poor SRH/or improved SRH. Baseline measures included self-reported medical status, physical, cognitive, psychological and social functioning. Findings showed that less decline in health was predicted by less difficulty in physical and cognitive functioning at baseline and by a more active physical and social life, after controlling for socio-demographics. Most of the predictors retained a unique contribution in a multivariate model, suggesting that engagement in meaningful activities serves as an indicator of better health and longer survival even within a group of old–old people in poor health. It may reflect greater social support, contribute to fitness and/or provide a sense of mastery, which could explain similar findings regarding gender and race/ethnicity groups for whom SRH is a less potent predictor of mortality.     

Changes over time from baseline poor self-rated health: for whom does poor self-rated health not predict mortality?

The aim of this study was to understand for whom and why poor self-rated health (SRH) is a less valid predictor of longevity or future health by examining the predictors of decline in health among people with poor baseline SRH. The sample included 409 participants in the Cross-Sectional and Longitudinal Study of the old-old (75+) in Israel, who were self-respondents and rated their health as poor at baseline and their status was known at follow-up 3.5 years later: deceased/moved to proxy interview/remained in poor SRH/or improved SRH. Baseline measures included self-reported medical status, physical, cognitive, psychological and social functioning. Findings showed that less decline in health was predicted by less difficulty in physical and cognitive functioning at baseline and by a more active physical and social life, after controlling for socio-demographics. Most of the predictors retained a unique contribution in a multivariate model, suggesting that engagement in meaningful activities serves as an indicator of better health and longer survival even within a group of old-old people in poor health. It may reflect greater social support, contribute to fitness and/or provide a sense of mastery, which could explain similar findings regarding gender and race/ethnicity groups for whom SRH is a less potent predictor of mortality.     

Will Improving My Marriage Improve My Sleep?

An essential component to overall health and well-being is sleep. Likewise, being happily married is associated with better physical, mental, and emotional health. In the present study, we examined links between marital satisfaction (MS) and aspects of sleep quality (SQ) among married individuals (N = 88) aged 39 to 64 years. Data were collected at baseline and 6-month follow-up. Regression analyses showed that MS at baseline was positively associated with overall SQ and sleep disturbance frequency at baseline and was negatively associated with minutes to fall asleep at follow-up. Results suggested that participants with greater MS at baseline reported better overall SQ at baseline and falling asleep faster at follow-up. However, results varied when controlling for other relevant covariates (e.g., age, depression, pain). Additionally, a negative change in MS between baseline and follow-up was a positive predictor of sleep disturbance frequency at follow-up, suggesting that participants whose MS decreased over time were more likely to report more frequent sleep disturbances 6 months later. Findings indicate that MS is linked with various aspects of SQ in married, middle-aged adults. Clinical implications, limitations of the current study, and areas for future research are discussed.     

Empowering Change Agents: Youth Organizing Groups as Sites for Sociopolitical Development

In addition to social action campaigns, some youth organizing groups provide formative learning experiences which engage youth in relevant sociopolitical issues through critical approaches. These groups support sociopolitical development (SPD), a self and socially‐oriented process which influences youth personally, politically, and professionally into adulthood. This study explored how youth organizing experiences influenced SPD in the professional domain, applying an empowerment lens. Phenomenologically‐based interviews were conducted with former sexual health education youth organizers and adult program staff. Former youth participants chose socially‐oriented career paths influenced by the group's empowering approach to sexual health education and advocacy. They related meaningful sociopolitical learning experiences (e.g., interpersonal, educational, and civic engagement) to empowerment outcomes (e.g., political efficacy, critical awareness, and participatory behaviors) which informed career decisions. Professionally, participants sought to empower others as the group empowered them, drawing upon youth organizing social and human capital as they worked toward this aim. Combining sociopolitical and empowerment theorizing, the study adds to what is known about how purposefully designed youth organizing experiences support long‐term development outcomes for individuals. Viewed as socially‐oriented career development sites, youth organizing groups build capacity for social change beyond the groups themselves. Implications for youth organizing scholars and practitioners are provided.     

The effects of a brief time perspective intervention for increasing physical activity among young adults

Past research has demonstrated that health behavior is correlated with time perspective: long-term thinkers are more likely than short-term thinkers to engage in health protective behaviors and less likely to engage in health damaging behaviors. To date, however, no research has experimentally demonstrated that time perspective is causally related to health behavior. We designed a brief (three 1/2-h weekly sessions) time perspective intervention to enhance long-term thinking about physical activity and examined its efficacy among two samples of young adults who signed up for fitness classes at a university recreational facility. Participants were assigned to one of three conditions: time perspective intervention, goal-setting control intervention, and no-treatment control. In Study 1, physical activity levels were assessed at preintervention, at postintervention (3 weeks later), and at 10-week follow-up (7 weeks after completion of the intervention). Controlling for preintervention physical activity levels, time perspective participants reported increased levels of physical activity relative to both other groups at postintervention, and relative to the no-treatment group at 10-week follow-up. This study provides the first experimental evidence that the effects of health behavior interventions may be enhanced by increasing participants’ long-term time perspective, and that time perspective is causally associated with health behavior. Study 2 replicated some of the effects of Study 1 using a larger sample, a six-month follow-up interval, and improved measurement of outcome. Together Studies 1 and 2 suggest that time perspective is an important ingredient in interventions designed to promote physical activity.     

Political ideology,helping mechanisms and empowerment of mental health self‐help/mutual aid groups

Self‐help/mutual aid groups share common attributes such as they are peer‐led, address a common problem or condition, have a voluntary character and little or no connection with professionals. However, these groups may vary according to their political ideology and focus on personal or/and societal change. This study examines the role of political ideology of self‐help/mutual aid groups and differences in psychosocial characteristics of group members. Fourteen mental health self‐help/mutual aid groups in England were studied. On the basis of stated aims and principles and following semi‐structured interviews with group leaders (facilitators/chairpersons), these were classified according to Emerick's typology as conservative (eight groups), combined (three groups), and radical (three groups). Group members (n = 67) completed questionnaires to assess personal empowerment, mental wellbeing, social networks and support, group identification and helping processes in the groups. Findings suggested that all self‐help group members experienced a large number of naturally occurring helping process and felt empowered whilst they shared limited social networks and support and marginal mental wellbeing. Different ideological types of self‐help groups may be related to specific helping processes and particular aspects of personal empowerment. Specifically, members of conservative and combined groups reported more expressive group processes like sharing of feelings and self‐disclosure, while radical group members reported more optimism/control over their lives. Furthermore, group identification was associated with specific helping processes and aspects of personal empowerment in the three group categories. Copyright © 2002 John Wiley & Sons, Ltd.     

Effectiveness of a brief intervention using mental simulations in reducing alcohol consumption in corporate employees

A theory-based intervention aimed at reducing corporate employees' alcohol consumption in excess of guideline limits is presented. The intervention adopted an outcome mental simulation technique and was administered to a sample of corporate employees from three companies. A single-arm randomized-controlled design was adopted. All participants completed baseline psychological measures and self-reported number of alcohol units consumed and binge-drinking occasions. Participants allocated to the intervention condition were presented with a mental simulation exercise. One month later, participants completed follow-up measures of the psychological variables and alcohol consumption. Results revealed a significant effect of the mental simulation intervention on number of units of alcohol consumed at follow-up. There was no effect of the intervention on frequency of binge-drinking occasions. There was no evidence for the mediation of the effect of mental simulations on alcohol consumption by the perceived behavioural control and motivation variables. Results support the efficacy of the mental simulation intervention in reducing alcohol consumption but not in reducing binge drinking or alcohol consumption in excess of guideline limits, among corporate employees. Results are discussed with respect to the importance of the mental simulation intervention to inform practice and the proposed processes by which mental simulations affect alcohol consumption.     

Job Demand–Control–Support and diabetes risk: The moderating role of self-efficacy

Work-related stressors, including high demands and low control, play a significant role in the aetiology of diabetes. Nevertheless, most studies focus on main effects, and few consider individual differences that may moderate the stress–health association. Drawing from the Job Demands–Control-–Support (JDC-S) model, this study addresses this gap by testing how baseline levels of JDC-S affect an increase in two risk factors for diabetes—glycated haemoglobin (HbA1C) and fasting plasma glucose (FPG)—and by investigating the moderating role of self-efficacy. Participants (N = 1618) were Israeli employees who attended two consecutive routine health examinations. All were free of diabetes at baseline. JDC-S and self-efficacy were assessed at baseline (T1), and HbA1C and FPG were assessed at T1 and T2. Data were analysed with logistic and linear regressions, controlling for well-established diabetes risk factors. High demands and low support predicted an increase in HbA1C and FPG. In addition, high self-efficacy interacted with high demands and with low control in the prediction of an increase in HbA1C and FPG. Although employees with high self-efficacy might function well at work, overloading them may harm their physical health. Similarly, incongruence between employees’ sense of ability and the control given to them at work may result in physical impairment.     

Homeless mothers: is there a relationship between coping strategies,mental health and goal achievement?

This study examined the relationship between coping, mental health and goal achievement among homeless mothers. Seventy-two women took part and 44 were re-interviewed 4 months later. The Family Crisis Oriented Personal Evaluation Scales (F-COPES) were used to identify their coping strategies at the time of homelessness; the General Health Questionnaire (GHQ) measured mental health problems; and a semi-structured questionnaire identified their goals. Outcome measures at follow-up were goal achievement and mental health. A variety of coping strategies were used, with some differences ascertained according to reason for homelessness and age of respondent. Lower use of problem-focussed coping was associated with poorer mental health at the time of homelessness. Mental health problems improved over time, but levels of psychopathology remained high at follow-up. Most women had achieved their primary goal of resettlement, and this was associated with use of problem-focussed coping. Lower use of problem-focussed coping, in particular, acquiring social support, was associated with continuation of mental health problems at follow-up, however the greatest predictor of mental health at follow-up was mental health status whilst homeless. Despite exposure to major stressors and poor mental health, mothers experiencing homelessness can maintain their ability to cope effectively, in order to achieve their goals. Copyright © 2007 John Wiley & Sons, Ltd.     

Effects of diversion on adults with co-occurring mental illness and substance use: outcomes from a national multi-site study

This quasi-experimental non-equivalent comparison group study examines outcomes for participants in eight programs conducting criminal justice diversion for people with co-occurring serious mental illness and substance use disorders compared with jail detainees eligible for diversion, but who were processed through standard criminal justice methods without diversion. Nearly 2000 participants were interviewed at baseline, and 1500 at 3 month and 1300 at 12 month follow-up to baseline. In these interviews, outcome measures of re-arrest, mental health functioning, substance abuse, quality of life, and service utilization were obtained. Those diverted were more likely to have received mental health counseling, mental health medication, and mental health hospitalization than those not enrolled in a diversion program, but were equally likely to have received substance abuse counseling. Overall, the differences in proportions receiving services between the two groups were small, even when these differences were statistically significant. The effect associated with diversion differed somewhat across the individual sites. However, overall cross-site pooled analyses revealed no outcome differences between groups on measures of mental health symptoms, substance use, criminal justice recidivism, or quality of life. Although the immediate benefit of diversion as an access mechanism to community treatment is indicated in pooled cross-site results, such access was driven by more coercive (pre-booking and court) models and results suggest that effecting substantially greater access to services or services use did not occur. The findings also suggest that mental health, substance abuse, and criminal justice outcomes remain dependent on the treatment intervention received, perhaps moderated by type of diversion intervention, rather than on a generic and initial diversion event.