Health care practitioners' perceptions of public mental health care in the Eastern Cape,South Africa

This qualitative study explored the perceptions of health care practitioners (HCPs) concerning public mental health care in the Eastern Cape Province of South Africa. Data were collected from thirteen purposively selected HCPs using in-depth unstructured interviews (males?=?6, females?=?7). Data were transcribed verbatim and later thematically analysed. The findings suggest that mental health professionals perceive mental health services to be both inadequate and of suboptimal quality. Specifically, they perceived public mental health care to have lower priority, to be poorly resourced and lacking in patient-oriented care qualities.     

Measuring executive function skills in young children in Kenya

Interest in measuring executive function skills in young children in low- and middle-income country contexts has been stymied by the lack of assessments that are both easy to deploy and scalable. This study reports on an initial effort to develop a tablet-based battery of executive function tasks, which were designed and extensively studied in the United States, for use in Kenya. Participants were 193 children, aged 3–6 years old, who attended early childhood development and education centers. The rates of individual task completion were high (65–100%), and 85% of children completed three or more tasks. Assessors indicated that 90% of all task administrations were of acceptable quality. An executive function composite score was approximately normally distributed, despite higher-than-expected floor and ceiling effects on inhibitory control tasks. Children’s simple reaction time (β = –0.20, p = .004), attention-related behaviors during testing (β = 0.24, p = .0005), and age (β = –0.24, p = .0009) were all uniquely related to performance on the executive function composite. Results are discussed as they inform efforts to develop valid and reliable measures of executive function skills among young children in developing country contexts.     

Association between tobacco use,depression, and anxiety: A cross-national study among university students from 30 low- and middle-income countries

This study aimed to investigate the association between tobacco use and depression and anxiety in a cross-national study among university students from 30 predominantly low- and middle-income countries. Self-report survey data were collected from 23 073 university students (58.0% female), with a mean age of 20.8 years (SD = 2.5). Following logistic regression analyses, tobacco using university students were more likely to have depressive symptoms and anxiety (posttraumatic stress symptoms = PTSS) than non-tobacco using students. Gender stratified analysis found associations between tobacco use and depressive symptoms were stronger among women than men. The associations between tobacco use and anxiety (PTSD) symptoms were stronger among men than women. In this large cross-national study, current tobacco use was significantly associated with depression and anxiety (PTSD) symptoms. Tobacco use prevention efforts can help alleviating mental health problems among university students.     

Exploring the relationships between pedestrian behaviours and traffic safety attitudes in six countries

The majority of cross-cultural research on traffic safety has investigated driver behaviour, yet in most low- and middle-income countries, where the weight of the road fatality burden is felt, motorisation rates are significantly lower than in higher-income countries. As such, this approach necessarily excludes large parts of the populations in those settings. In order to investigate the link between traffic safety attitudes and road user behaviours, this study used a self-report measure of pedestrian behaviour, applying it in six countries; Bangladesh, China, Kenya, Thailand, the UK, and Vietnam. Focus was on the relationships between a respondent’s attitude towards risky or rule violating on-road behaviours (of other road users, or more generally, not specific to pedestrians), and the extent to which they reported performing three types of risky pedestrian behaviours (i.e., intentional rule violations, errors in judgement or memory, and aggressive behaviours). Data from a sample of 3,423 individuals was subjected to a series of regression models, revealing significant links between attitudes and pedestrian behaviours in all countries, in all three behavioural factors, after controlling for age, gender, and exposure to the road environment. Differences were found between countries in the strength of these relationships, with weaker connections between attitudes and behaviours in Kenya, and stronger connections in China (with other countries in-between the two). Results are discussed in terms of the need to understand the relationships between social cognitive constructs in the specific country in which a road safety intervention is intended to be implemented.     

Selecting measures for the neurodevelopmental assessment of children in low- and middle-income countries

Diseases affecting millions of children in low- and middle-income countries (LMICs), such as malnutrition, micronutrient deficiency, malaria, and HIV, can lead to adverse neurodevelopmental outcomes. Thus, a key health outcome in children is neurodevelopmental status. In this paper, the neurodevelopmental screening and testing measures most commonly utilized in LMICs are reviewed, and a matrix is presented to help researchers and clinicians determine which measures may be most useful for various LMIC inquiries. The matrix is based on an Internet literature review of 114 publications for the period January 1998 to February 2016, reporting the psychometric properties of instruments tested in LMIC children. The measures are classified as screening tests or more detailed tests that include both comprehensive batteries of general development and tests of specific domains. For completeness, two experts have reviewed this paper, as well as the authors. An overview of the tests used to date is presented, including the benefits and drawbacks of each test, in order to provide researchers and developmental clinicians with a way to decide which tests may be best suited to their developmental assessment goals. Remarkable progress has been made in neurodevelopmental testing in children in LMICs over the past two decades but there remains a need for additional research in this area to develop new tests, better evaluate and adapt current tests, and assess test validity and reliability across cultures.     

Trustworthiness Processing and Psychobiological Responses to Natural Disaster-Induced Distress in Adolescents

In this study, we examine the role of trust perceptions on psychological well-being and salivary cortisol levels of adolescents who were exposed to pervasive, noninterpersonal trauma, displacement, and relocation caused by Hurricane Katrina. Compared to demographically matched controls, affected adolescents reported higher perceptions of other people's trustworthiness, decreased externalizing behaviors, increased internalizing behaviors, greater desire for consolation from others, and lower cortisol activity. Follow-up analyses suggested that the relation between hurricane exposure and lower self-esteem might be mediated partly by increased trustworthiness perceptions. These results suggest that adolescents might respond to different types of stressors with varying patterns of distress and the manner in which the stressors alter trust processing might predict the development of internalizing or externalizing behaviors.     

‘Someone to talk to who'll listen’: addressing the psychosocial needs of children and families

The paper presents the Lewisham Community Child and Family Service (LCCFS), a community‐based intervention providing psychosocial help for children, young people, parents and families. The service is focused on early intervention, prevention and promotion in the improvement of local health. It works under a service framework based on inter‐agency collaboration, and a counselling model based on community and interpersonal partnerships, grounded in personal construct theory (Kelly, 1955). The policy demands and local need for accessible and acceptable mental health are discussed, and quantitative and qualitative findings of the needs assessment preceding the establishment of the LCCFS are presented, supporting the need for community mental health provision. The feasibility for the LCCFS to reconcile and meet the policy demands and the needs of parents with respect to child psychosocial help and services are discussed. Copyright © 2001 John Wiley & Sons, Ltd.     

Active school travel is associated with fewer suicide attempts among adolescents from low-and middle-income countries

Background/Objective: This study explored the association between active school travel (AST) and suicide attempts among adolescents in low- and middle-income countries (LMICs). Method: We used the data from the Global School-based Health Survey, including 127,097 adolescents aged 13-17 years from 34 LMICs. A self-reported survey was used to collect data on AST and suicide attempts as well as some variables. Multivariable logistic regression was performed to assess the association between AST and suicide attempts. A meta-analysis with random effects was undertaken to identify the difference in the association between AST and suicide attempts. Results: Across all the adolescents, the prevalence of AST was 37% and the prevalence of suicide attempts was 11.60%. Adolescents who engaged in AST were less likely to have suicide attempts irrespective of gender. The country-wise analysis indicated a large inconsistency in the association between AST and suicide attempt across the countries. Conclusions: AST would appear to be a protective factor for reducing suicide attempts among adolescents. However, the association between AST and suicide attempts varied greatly across the countries. Future studies should confirm the association between AST and suicide attempts.     

Human rights and applied psychology

Applied and community psychology necessarily involves the consideration of human rights issues. The problems experienced by many of the clients of applied psychologists result from human rights abuses, the provisions of the Human Rights Act (1998) relate to the everyday practice of applied and community psychologists, and psychologists have a distinctive perspective on human rights. For psychologists, human rights reflect formalized systems for ensuring that people's basic needs are satisfied. Declarations of human rights and legal provisions therefore represent, for psychologists, codifications of how we collectively understand our relationships and social obligations. It is therefore argued that psychologists should positively advocate for the application of psychological science to these issues. Copyright © 2007 John Wiley & Sons, Ltd.     

Exploring the psychometric properties of the CES-D-10 and its practicality in detecting depressive symptomatology in 27 low- and middle-income countries

The Center for Epidemiological Studies Depression-10 (CES-D-10) scale is known for its good psychometric properties in measuring depressive symptoms, however, some researchers question its applicability across various settings. This study explored the factor structure of the CES-D-10 in low- and middle-income countries (LMICs). This cross-sectional survey consisted of 16,723 university students across 27 LMICs that completed self-report instruments assessing socio-demographic information and depressive symptoms using the CES-D-10. Data analysis included: exploratory factor analysis, item response theory and differential item functioning. Results indicate that a two-factor model (depressive affect and positive affect) had the best fit for this population and accounted for 52% of the total observed variance with an internal consistency, α = .77 for the depressive affect items and α = .57 for the positive affect items. The graded response model (GRM), however, indicated that the depressive affect factor had a good fit, unlike the positive affect factor. The depressive affect factor was found to consistently model depression for females better than males. Relative to their Asian counterparts, African, Caribbean and South American participants of similar depressive affect responded differently on all items of the depressive affect factor. The depressive affect factor seems most ideal for LMICs and shows gender and cross-cultural variability.     

Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm

In this article, I argue that (1) transgender adolescents should have the legal right to access puberty-blocking treatment (PBT) without parental approval, and (2) the state has a role to play in publicizing information about gender dysphoria. Not only are transgender children harmed psychologically and physically via lack of access to PBT, but PBT is the established standard of care. Given that we generally think that parental authority should not go so far as to (1) severally and permanently harm a child and (2) prevent a child from access to standard physical care, then it follows that parental authority should not encompass denying gender-dysphoric children access to PBT. Moreover, transgender children without supportive parents cannot be helped without access to health care clinics and counseling to facilitate the transition. Hence there is an additional duty of the state to help facilitate sharing this information with vulnerable teens.     

中西方心理健康标准的比较与整合

心理健康标准是心理健康研究中的重要理论问题。比较中西方心理健康标准,在研究恩路、自我观念、人格观念等方面存在差异,在重视人际关系的和谐、重视对自我和现实的认识、重视对人生意义的探索等方面有相似之处。整合中西方心理健康标准应重视探讨社会群体的心理健康标准;引导青少年树立正确的自我观念;塑造具有独立性与创造性的现代社会人格。     

表达性写作应用于社会灾难时期心理救援的理论探讨

疫情等社会灾难时期, 创伤经历者急剧增加, 加之交通阻断, 传统的心理救援很难及时应对大范围的灾民心理危机; 而表达性写作便于心理学工作者大规模实施, 且可通过电话、网络等远程通讯工具进行指导, 治疗PTSD等心理创伤, 改善生理、心理健康。社会灾难时期表达性写作的机制复杂, 涉及暴露脱敏、意义重建、自我抽离—自我调节、工作记忆优化和认知神经机制正常化; 其疗效受到作者特质、干预时间和写作形式等潜在因素的影响。相应地, 未来应结合本土社会文化因素, 重视在线干预研究, 探索表达性写作相关的认知神经机制, 综合不同的生理、心理健康指标评估表达性写作的疗效。     

Parental involvement and mental health among school-going adolescents in five Caribbean countries

The aim of this study was to assess the association between parental involvement and mental health among adolescents in five Caribbean countries: Antigua and Barbuda, Bahamas, Saint Kitts and Nevis, Jamaica and Trinidad, and Tobago. Data were from the cross-sectional Global School-Based Student Health Survey (GSHS) which sampled 10 063 adolescents (mean age 14.3 years, SD = 1.3) from 2009 to 2013. In multivariable logistic regression analyses (adjusted for age, sex, and socioeconomic status), bullied, having close friends and peer support, and higher levels of parental involvement were negatively associated with loneliness, anxiety, and suicidal ideation in all five countries. In Jamaica, parental involvement was not associated with suicide attempt. Parental involvement interventions for improving mental health among the Caribbean adolescents should consider peer influences.     

Performance of Mental Health Counselors in Integrated Primary and Behavioral Health Care

Integrated primary and behavioral health care (IPBH) is becoming a preferred mode of service delivery in the United States. Integrated care includes the participation of medical and mental health professionals, such as mental health counselors. The clinical outcomes of these professionals need to be studied to determine their effectiveness in such settings. We examined the performance of 10 mental health counselors on the clinical outcome of 1,747 clients treated in an IPBH center. Analyses using growth curve modeling and pre‐post test design revealed that mental health counselors were effective overall, but they differed in client dropout rates and efficiency in reducing clients' initial symptoms. We used the analyses to rank order counselors based on their effectiveness. Counselors who were the most effective varied in their efficiency but demonstrated the lowest client dropout rates. Implications for future research and counseling practice were discussed.     

The influence of culture on disaster mental health and psychosocial support interventions in Southeast Asia

Southeast Asia (SEA), which has borne the brunt of some of the most severe natural disasters in the past decade, has unfortunately, been largely under-represented in the world literature on disaster mental health. This article describes cultural factors that may inform the design and conduct of disaster-related mental health psychosocial support (MHPSS) interventions. Specifically, it discusses cultural nuances in emotional expression, shame, power distance, collectivism, and spiritual beliefs and their implications on providing post-disaster psychosocial interventions. It describes the MHPSS interventions implemented in the region using the Johns Hopkins Perspectives Model of Disaster Mental Health categories of resistance, resilience and recovery. Given the challenges on the delivery of MHPSS, there is a need for evidence-based interventions and to ensure that disaster responders in SEA understand the cultural factors that impact the delivery of MHPSS interventions.     

Parent-Reported Behavioral and Emotional Responses of Children to Disaster and Parental Psychopathology

Child disaster mental health research has been largely limited by investigation of one disaster at a time and inconsistent methods across different studies. This study assessed 160 survivors of 3 disasters with structured diagnostic interviews, asking about the behavioral and emotional disaster reactions of their 266 children, ages 3–17. Most children had ≥1 postdisaster behavior change or disaster-related posttraumatic stress symptom. The children’s postdisaster behavioral and emotional problems were associated with parental postdisaster psychopathology. The results underscore the importance of asking disaster survivors about their children’s disaster reactions and considering parental disaster experiences and reactions in addressing their children’s reactions.     

Recovering the context in posttraumatic stress disorder: The psychosocial trauma in victims of political violence and terrorism

Abstract

Throughout history, humans have frequently carried out harmful actions against one another. Often, these actions result in intensive and long lasting pain and suffering. Posttraumatic stress disorder (PTSD) diagnosis has been the theoretical tool used mostly by psychologists to understand the physical, emotional and behavioural symptoms following a traumatic experience. Due to its clinical and medical roots, PTSD diagnosis represents man in a social vacuum, a man without context, and a model of health closely tied to illness. The aim of the paper is to reintroduce the social context of human beings into trauma diagnosis, and to develop a health model that is more focused on well-being than on illness. Both points of view help us to seek a theoretical way for better understanding the psychosocial trauma that result from political violence and terrorism. Psychosocial trauma has definite roots, and destroys our inner world—the world of our most valuable meanings—infects our minds with hate against others, and breaks the social fabric we belong to.     

Self‐Stigma,Mental Health Literacy,and Health Outcomes in Integrated Care

The authors describe research on the self‐stigma of mental illness and help seeking, mental health literacy, and health outcomes in an integrated care medical center. Results revealed that self‐stigma of mental illness and self‐stigma of seeking help had an inverse relationship with mental health literacy. No statistically significant relationships were found between health outcomes, either type of self‐stigma, and mental health literacy. The authors discuss these and other findings and offer research and counseling implications.