Psychological and health problems in a geographically proximate population time-sampled continuously for three months after the September 11th, 2001 terrorist incidents

Abstract

This study assessed the mental and physical health status and psychological problems related to the September 11th terrorist incidents among a representative sample of adults living near New York City, using continuously time-sampled data collected throughout 2001. Prevalence estimates for poor mental or physical health after September 11th (October through December) were comparable to those for the entire year of 2001 (i.e. approximately 33%). Psychological problems related to the terrorist incidents were reported by more than half of the respondents, and appeared to peak in prevalence approximately two to three months following the incidents, followed by a decline in the next month and subsequent year. Poor mental health, female gender, media re-exposure, and ongoing or increased alcohol use were risk factors for psychological problems, while older age (65+ years old) and being married were protective factors. Risk factors for poor physical and mental health or psychological problems were generally stable over the three-month period following September 11th, but some changes were identified consistent with stage models of post-disaster psychological adjustment. Implications are discussed for using continuous time-sampling as a strategy to research patterns of relatively acute stress-related sequelae of terrorism in populations whose members are affected despite primarily not having been at the disaster epicenter.     

Acceptance of Tinnitus: Validation of the Tinnitus Acceptance Questionnaire

Internet‐based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty‐seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8‐week Internet‐based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e‐mails per week) or infrequent (one e‐mail per week) support from a psychologist. Posttreatment, intention‐to‐treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panic‐related cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end‐state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet‐based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost‐effective than previously reported.     

Mental Health Clinicians' Beliefs About the Biological, Psychological, and Environmental Bases of Mental Disorders

The current experiments examine mental health clinicians' beliefs about biological, psychological, and environmental bases of the DSM-IV-TR mental disorders and the consequences of those causal beliefs for judging treatment effectiveness. Study 1 found a large negative correlation between clinicians' beliefs about biological bases and environmental/psychological bases, suggesting that clinicians conceptualize mental disorders along a single continuum spanning from highly biological disorders (e.g., autistic disorder) to highly nonbiological disorders (e.g., adjustment disorders). Study 2 replicated this finding by having clinicians list what they thought were the specific causes of nine familiar mental disorders and rate their bio–psycho–environmental bases. Study 3 further found that clinicians believe medication to be more effective for biologically based mental disorders and psychotherapy to be more effective for psychosocially based mental disorders. These results demonstrate that even expert mental health clinicians make strong distinctions between psychological and biological phenomena.     

Impact of maternal adverse childhood experiences on child socioemotional function in rural Kenya: Mediating role of maternal mental health

Mothers in low‐ and middle‐income countries (LMIC) suffer heightened vulnerability for adverse childhood experiences (ACEs), which is exacerbated by the multitude of risk factors associated with poverty and may lead to increased risk of psychiatric disorder. The constellation of complex, co‐occurring biological, environmental, social, economic and psychological risk factors are in turn transmitted to her child, conferring vulnerability for adverse development. This study examines the association between maternal intra‐ and extra‐familial ACEs, maternal education and the mental health of her child, mediated by maternal mental health. Mother‐child dyads (n = 121) in Machakos, Kenya were examined cross‐sectionally using self‐report measures of ACEs, maternal mental health and child internalizing and externalizing mental health problems. The four models proposed to examine the relationship between intra‐ and extra‐familial maternal ACEs and child internalizing and externalizing problems demonstrated indirect pathways through maternal mental health. These effects were found to be conditional on levels of maternal education, which served as a protective factor at lower levels of maternal ACEs. These models demonstrate how the impact of ACEs persists across the lifespan resulting in a negative impact on maternal mental health and conferring further risk to subsequent generations. Elucidating the association between ACEs and subsequent intergenerational sequelae, especially in LMIC where risk is heightened, may improve targeted caregiver mental health programs for prevention and intervention.     

Psychological and health problems in a geographically proximate population time-sampled continuously for three months after the September 11th, 2001 terrorist incidents

This study assessed the mental and physical health status and psychological problems related to the September 11th terrorist incidents among a representative sample of adults living near New York City, using continuously time-sampled data collected throughout 2001. Prevalence estimates for poor mental or physical health after September 11th (October through December) were comparable to those for the entire year of 2001 (i.e. approximately 33%). Psychological problems related to the terrorist incidents were reported by more than half of the respondents, and appeared to peak in prevalence approximately two to three months following the incidents, followed by a decline in the next month and subsequent year. Poor mental health, female gender, media re-exposure, and ongoing or increased alcohol use were risk factors for psychological problems, while older age (65+ years old) and being married were protective factors. Risk factors for poor physical and mental health or psychological problems were generally stable over the three-month period following September 11th, but some changes were identified consistent with stage models of post-disaster psychological adjustment. Implications are discussed for using continuous time-sampling as a strategy to research patterns of relatively acute stress-related sequelae of terrorism in populations whose members are affected despite primarily not having been at the disaster epicenter.     

1993~2013年常驻高海拔地区军人心理健康状态的横断历史研究

研究为探索常驻高海拔地区军人心理健康水平如何随社会年代变迁而改变,运用了横断历史元分析的方法,对1993年至2013年38篇采用90项症状自评量表(SCL-90)的文献调查数据进行分析,考察了11454名常驻高海拔地区军人在该量表上9个因子得分随年代变化的趋势.结果发现:(1)SCL-90的7个因子均值与年代负相关,且不受期刊类型等的影响.20年来,7个因子下降了5%~15%不等.其中,强迫变化最大,抑郁、焦虑、人际敏感、偏执和精神病性均变化明显.这说明,常驻高海拔地区军人心理健康虽有所波动但整体水平逐步提升,变化幅度大致属于中等程度.(2)当年军费占GDP比值、居民消费水平指数与SCL-90部分因子均值负相关显著;5年前的居民消费水平指数与7个因子显著负相关.这说明,国防建设的经济投入和居民消费水平可能是影响常驻高海拔地区军人心理健康水平的重要因素.     

FAMILY AND WORK PREDICTORS OF PSYCHOLOGICAL WELL-BEING AMONG HISPANIC WOMEN PROFESSIONALS

This study examines the relative contributions of job- and gender-related variables to the mental health of Hispanic women professionals. Hispanic women professionals, managers and business owners ( n = 303) were surveyed using the mailing list of a Hispanic professional women's organization. Results of multiple regression analyses indicate that income and Hispanic group were consistently related to mental health measures. Spouse support and ethnicity of spouse were associated with measures of stress in balancing roles and psychological distress symptoms. Marital status was related to personal life satisfaction (married women reported more satisfaction), and having young children was negatively associated with personal and professional satisfaction. Experience of discrimination, job stress and peer support were also significantly related to mental health measures. Although preliminary, this study underscores the importance of both job- and gender-related factors in research on the effects of employment on Hispanic women's mental health.     

An application of the stress-diathesis model: A review about the association between smoking tobacco,smoking cessation,and mental health

BackgroundWorldwide, approximately 24% of all adults smoke, but smoking is up to twice as prevalent in people with mental ill-health. There is growing evidence that smoking may be a causal risk factor in the development of mental illness, and that smoking cessation leads to improved mental health.MethodsIn this scholarly review we have: (1) used a modern adaptation of the Bradford-Hill criteria to bolster the argument that smoking could cause mental ill-health and that smoking cessation could reverse these effects, and (2) by considering psychological, biological, and environmental factors, we have structured the evidence to-date into a stress-diathesis model.ResultsOur model suggests that smoking is a psychobiological stressor, but that the magnitude of this effect is mediated and modulated by the individual's diathesis to develop mental ill-health and other vulnerability and protective factors. We explore biological mechanisms that underpin the model, such as tobacco induced damage to neurological systems and oxidative stress pathways. Furthermore, we discuss evidence indicating that it is likely that these systems repair after smoking cessation, leading to better mental health.ConclusionBased on a large body of literature including experimental, observational, and novel causal inference studies, there is consistent evidence showing that smoking can negatively affect the brain and mental health, and that smoking cessation could reverse the mental ill-health caused by smoking. Our model suggests that smoking prevention and treatment strategies have a role in preventing and treating mental illness as well as physical illness.     

A case-controlled field study evaluating ICD-11 proposals for relational problems and intimate partner violence

Background/Objective: Intimate partner relationship problems and intimate partner abuse and neglect — referred to in this paper as “relational problems and maltreatment” — have substantial and well-documented impact on both physical and mental health. However, classification guidelines, such as those found in the International Classification of Diseases (ICD-10), are vague and unlikely to support consistent application. Revised guidelines proposed for ICD-11 are much more operationalized. We used standardized clinical vignette conditions with an international panel of clinicians to test if ICD-11 changes resulted in improved classification accuracy. Method: English-speaking mental health professionals (N = 738) from 65 nations applied ICD-10 or ICD-11 (proposed) guidelines with experimentally manipulated case presentations of presence or absence of (a) individual mental health diagnoses and (b) relational problems or maltreatment. Results: ICD-11, compared with ICD-10, guidelines resulted in significantly better classification accuracy, although only in the presence of co-morbid mental health problems. Clinician factors (e. g., gender, language, world region) largely did not impact classification performance. Conclusions: Despite being considerably more explicated, raters’ performance with ICD-11 guidelines reveals training issues that should be addressed prior to the release of ICD-11 in 2018 (e. g., overriding the guidelines with pre-existing archetypes for relationship problems and physical and psychological abuse).     

A Salutogenic Analysis of the Well-Being Paradox in Older Age

Following Antonovsky’s salutogenic perspective, we investigate to what extent the sense of coherence and psychological resources mediate the physical health-mental health relationship, assuming that these resilience factors mutually influence each other. In our questionnaire study, 387 older persons at the mean age of 73.8 years volunteered. We assessed physical health appraisals, sense of coherence components (comprehensibility, manageability, and meaningfulness), psychological resources (self-efficacy and self-esteem) and mental health (subjective well-being, depressive mood, and psychological health). We used structural equation modeling with latent variables and a bootstrapping method to test hypothesized mediation chains. We found (a) a significant direct effect of physical health on mental health, (b) two significant specific indirect effects of physical health on mental health, substantiating that the sense of coherence was a stronger mediator than psychological resources, and (c) two significant 3-path mediated effects. Physical health is profoundly associated with mental health. However, resilience factors such as the sense of coherence and psychological resources enable older people to maintain mental health when confronted with chronic physical health problems.     

Sleep,resilience, and psychological distress in United States military Veterans

Sleep problems are prevalent among Veterans. Left untreated, such problems may elevate psychological distress and increase risk of subsequent mental health disorders. Psychological resilience may buffer against negative psychological outcomes, yet the relationship between sleep and resilience has not been studied. This study explored poor sleep, resilience, and psychological distress using questionnaires collected as part of the Study of Post-Deployment Mental Health. Participants (N = 1,118) had served in the US military since September 11, 2001, had one or more overseas deployments, and were free from a past-month DSM-defined mental health disorder. Hierarchical linear regression was used to examine the association between poor sleep quality (Pittsburgh Sleep Quality Index total score) and psychological distress (Global Symptom Index; Symptom Checklist-90-R), controlling for demographic and health characteristics. Moderation analyses tested for a potential buffering effect of resilience (Connor-Davidson Resilience Scale). Poor sleeping Veterans had worse physical and psychological health, lower resilience, and endorsed more lifetime traumatic events. Poor sleep was associated with greater psychological distress controlling for health and demographic characteristics. Both resilience factors—adaptability and self-efficacy—had significant buffering effects on the relationship between poor sleep and psychological distress, suggesting that resilience may protect against negative outcomes in poor sleepers. Additional research is warranted to better understand the relationships between sleep, resilience, and psychological distress. Such research may inform pertinent prevention efforts, including interventions that improve sleep, enhance resilience, and protect against incident mental health diagnoses.     

Self-Disclosure and Spiritual Well-Being in Pastors Seeking Professional Psychological Help

Pastoral mental health is a topic that has only rarely been researched empirically in the psychological literature, yet a pastor’s mental health can have a significant impact on churches, communities, and even nations (Royal and Thompson, Journal of Psychology and Christianity, 31(3), 195–204, 2012). One of the thoughts prompting this research is that evangelical pastors might be expected to resist the findings of psychological research and lack understanding of specific mental illnesses they are potentially facing. Combined with historical and cultural dynamics that could influence resistance to professional psychological help, evangelical pastors have personal, internal factors that could also strengthen resistance, including the researched issues of self-disclosure flexibility and spiritual well-being. A correlational research design with multivariate regression was used to determine potentially significant or predictive relationships between the relevant factors. Among evangelical seminary students (N = 251) preparing for parish-based pastoral ministry, this research determined that no significant relationship, predictive or otherwise, existed between self-disclosure flexibility, spiritual well-being, and attitudes toward seeking professional psychological help. Implications include a shift in focus toward external factors influencing pastors’ help-seeking attitudes, such as the need for the mental health community to develop connections with evangelical pastors and the development of more support for Christian mental health professionals in the larger evangelical community.     

Biological attributions for postdeployment distress relate to higher likelihood of seeking mental health treatment in Iraq/Afghanistan service members/veterans

Service members/veterans (SM/Vs) underuse mental health care. Attribution theory suggests that attributions for psychological distress might inform help-seeking. Given recent mental health campaigns leveraging military values aimed at facilitating help-seeking for postdeployment distress, understanding how SM/Vs explain psychological distress may contribute to a better grasp of the low help-seeking rate in this population. The authors examined the association of biological and psychological attributions for postdeployment distress with help-seeking intentions from a mental health professional and medical doctor in 162 Iraq/Afghanistan SM/Vs. At the bivariate level, biological attributions were positively associated with help-seeking intentions from a mental health professional and medical doctor with small effect sizes. Psychological attributions were unrelated to help-seeking intentions from either provider. Path analysis revealed that biological attributions were positively correlated with help-seeking intentions from a medical doctor with a small effect size above and beyond the effects of psychological attributions and correlates. Biological attributions were also positively correlated with help-seeking intentions from a mental health professional with a small effect size but the significance value only trended toward significance (p = .06). Emphasizing the role of biology in postdeployment distress may promote help-seeking in SM/Vs, particularly help-seeking from medical professionals. Interventions that test the effectiveness of promoting biological explanations in campaigns aimed at increasing help-seeking may be a necessary next step in this area of inquiry.     

The Interactive Contributions of Perceived Control and Anxiety Sensitivity in Panic Disorder: A Triple Vulnerabilities Perspective

Within the triple vulnerabilities model of anxiety disorders, a genetic contribution to the development of anxiety and negative affect (i.e., generalized biological vulnerability), a diminished sense of perceived control over aversive events and emotional experiences (i.e., generalized psychological vulnerability), and elevated levels of anxiety sensitivity (i.e., specific psychological vulnerability) are posited to increase the risk of developing and maintaining panic disorder (Barlow American Psychologist 55(11):1247–1263, 2000). The purpose of the present study was to investigate the direct and interactive effects of perceived control and anxiety sensitivity on panic disorder symptom severity. Structural equation models (SEM) were conducted in data derived from a sample of 379 adults with panic disorder participating in a multi-site randomized controlled trial. Findings indicated that both perceived control and anxiety sensitivity uniquely predicted panic disorder symptoms. A moderation model examining the interactive effects of perceived control and anxiety sensitivity on panic symptoms indicated that the effect of anxiety sensitivity on panic symptoms increased with greater deficits in perceived control. The present findings suggest that deficits in perceived control and elevated levels of anxiety sensitivity exert unique and shared effects on panic disorder symptoms, thereby illustrating the relationship between putative vulnerability factors and panic disorder symptoms as predicted by the triple vulnerabilities model.     

Axis I anxiety and mental health disorders among stuttering adolescents

PurposeThe purpose of this study was to evaluate anxiety and psychological functioning among adolescents seeking speech therapy for stuttering using a structured, diagnostic interview and psychological questionnaires. This study also sought to determine whether any differences in psychological status were evident between younger and older adolescents.MethodParticipants were 37 stuttering adolescents seeking stuttering treatment. We administered the Computerized Voice Version of the Diagnostic Interview Schedule for Children, and five psychometric tests. Participants were classified into younger (12–14 years; n = 20) and older adolescents (15–17 years; n = 17).ResultsThirty-eight percent of participants attained at least one diagnosis of a mental disorder, according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; APA, 2000), with the majority of these diagnoses involving anxiety. This figure is double current estimates for general adolescent populations, and is consistent with our finding of moderate and moderate–severe quality of life impairment. Although many of the scores on psychological measures fell within the normal range, older adolescents (15–17 years) reported significantly higher anxiety, depression, reactions to stuttering, and emotional/behavioral problems, than younger adolescents (12–14 years). There was scant evidence that self-reported stuttering severity is correlated with mental health issues. There are good reasons to believe these results are conservative because many participants gave socially desirable responses about their mental health status.DiscussionThese results reveal a need for large-scale, statistically powerful assessments of anxiety and other mental disorders among stuttering adolescents with reference to control populations.Educational Objectives: The reader will be able to: (a) explain the clinical importance of assessing for mental health with stuttering adolescents, (b) state the superior method for adolescent mental health assessment and (c) state a major issue with determining the genuineness of stuttering adolescent responses to psychological assessment.     

亲子关系对中学生心理健康的影响:社会支持和心理素质的链式中介作用

为探究亲子关系、社会支持和心理素质对中学生心理健康的影响,本研究采用问卷调查的方式,对全国23个省（市）共10190名初一至高三年级的中学生展开调查。结果表明：（1）父子关系、母子关系、社会支持和心理素质两两之间呈显著正相关,且均与心理健康问题呈显著负相关;（2）相比于母子关系,父子关系对中学生心理健康的影响更大;（3）亲子关系通过三条中介路径对中学生心理健康产生影响：①是社会支持和心理素质的单独中介作用;②社会支持和心理素质的链式中介作用。本研究进一步明确了亲子关系和中学生心理健康之间的内在心理机制,同时能帮助教育工作者预防和干预中学生的心理健康问题。     

Mental Health and Obesity: A Meta-Analysis

The relationship between obesity and psychological distress is not clear because research conducted so far is not conclusive, with some studies finding that obese people report less mental health than normal-weight individuals, whilst others find that obesity may work as a protective factor that prevents people with weight problems from developing mental health issues. In this meta-analysis we review research that compares the mental health (measured with SF-36) of class I obese people (Body Mass Index between 30 and 34.99) with normal weight people (Body Mass Index between 18 and 24.99) in non-clinical adult populations. The meta-analysis conducted assumed a random-effects model and a weighted mean effect size was calculated (d), together with its statistical significance and confidence interval. Results reveal that obese women report less mental health than normal weight females (d?=??.26) but that obese men show more mental health than normal weight individuals (d?=?.62). The results give support to the so-called “Jolly Fat” hypothesis.     

2010~2020中国内地高中生心理健康问题检出率的元分析

我国高中生心理健康问题的检出率亟需关注, 许多研究对此进行了探究, 但结果并不一致。为明确近10年来我国高中生心理健康问题的检出状况及其影响因素, 对检索后获得的252项研究进行了元分析。结果发现: 检出率由高到低依次是抑郁(28.0%)、焦虑(26.3%)、睡眠问题(23.0%)、自我伤害(22.8%)、自杀意念(17.1%)、躯体化(9.8%)、自杀计划(6.9%)、自杀企图(未遂) (2.9%)。我国高中生心理健康问题检出率受出版年代、测量工具、检出标准、检出时间、年级和区域影响。未来应着力编制标准化测评工具、构建心理健康教育长效机制并对高年级、欠发达地区高中生的心理健康问题予以重点关注。     

构建学校-家庭-社会一体化心理健康教育模式*

影响中小学生心理健康的因素包括学校、家庭和社会多个方面,但是本研究通过调查发现目前我国的中小学生心理健康教育呈现出单一化的倾向,心理健康教育的主要实施者是学校,家庭和社会在学生心理健康教育中的地位和作用没有得到充分的体现,这种状况势必会影响中小学心理健康教育的成效。本文系统阐释了建立学校-家庭-社会一体化心理健康教育模式的必要性、途径和方法,并根据实际提出了相应的对策建议。     

高中生心理健康水平及其影响因素的研究

采用ＳＣＬ－９０量表评定了５００名高中生的心理健康状况,运用因素分析的方法探讨了影响高中生心理健康的主要因素。结果表明：有１０．８％的高中生存在着各种明显的心理健康问题;高中生的心理健康问题主要表现为强迫、敌对、偏执、人际关系敏感和忧郁等症状;影响高中生心理健康的主要因素为学校教育、家庭环境、社会文化及学生自身等方面的生活事件;高中生不同的心理健康问题有其不同的影响因素。