In Their Own Words: Mental Health and Quality of Life of West African Refugees in Nigeria

Refugees are exposed to extreme stressors and are therefore at risk of mental health and social problems. Other issues refugees have to cope with include the loss of their country, culture, language, profession, family, friends, and future plans. Much of the studies that have been done on refugee mental health have not attempted to explain what these experiences mean to these individuals. Thus, this study provides explorative data on the mental health and quality of life of West African refugees living in Nigeria in order to understand their views and perspectives. This study carried out in 2010 employed qualitative methods; a total of four focus group discussions (FGDs) were conducted among adult male and female refugees purposively selected at the Oru Refugee Camp, Ogun State, Nigeria. Respondents described quality of life as a major determinant of mental health status. Most of the participants believed that women were more predisposed to mental ill health due to their sensitive emotional make-up. Factors identified by respondents as affecting mental health and quality of life among refugees included poverty, unemployment, physical health, housing and environment, discrimination, stigmatization, and insecurity. Refugees rated their mental health and quality of life as poor due to the aforementioned factors. Recommendations were made to the international community, national and local governments to invest more on education, provision of vocational and entrepreneurial skills as well as adequate housing in order to improve the mental health and quality of life of refugees.     

The Relation Between Parental Mental Illness and Adolescent Mental Health: The Role of Family Factors

Children of parents with a mental illness are often found to be at high risk of developing psychological problems themselves. Little is known about the role of family factors in the relation between parental and adolescent mental health. The current study focused on parent–child interaction and family environment. This cross-sectional questionnaire study included 124 families with a mentally ill parent and 127 families without a mentally ill parent who at the time of the study had children aged 11–16 years old. Parents completed questionnaires about their mental health, parent–child interaction (i.e., parental monitoring and parental support), and family environment (i.e., cohesion, expressiveness, and conflict). Adolescents reported their internalizing and externalizing problems. Path analyses were used to examine the direct associations between parental mental illness and adolescent problems as well as the indirect relations via parent–child interaction and family environment. The results showed that interaction between parents with a mental illness and their child was significantly worse compared to parents without a mental illness. The family environment of parents with mental illness was also more negative. Mentally ill parents monitored their adolescents less, which in turn related to more externalizing problems of the adolescents. No factors mediated the relation between parental mental health and adolescent internalizing problems. Moreover, no direct effects of parental support, family cohesion, and family expressiveness with externalizing problems were found. These findings imply that parental monitoring should get a specific focus of attention in existing interventions designed to prevent adolescents with a mentally ill parent from developing problems.     

Subjective well‐being and valuation of future health states: Discrepancies between anticipated and experienced life satisfaction

One way of informing health policy decisions is to ask people about the impact that different health states would have on their future subjective well‐being. The present research explored the relation between anticipated and experienced changes in health‐related subjective well‐being, and examined whether affective forecasting errors could be reduced by psychological distancing manipulations. Using survey methodology, we tested whether people can accurately estimate the impact of different possible health states on their subjective well‐being. We also manipulated psychological distance: Forecasts were made about present self, future self, or others. Based on construal level theory and past work on affective forecasting errors, our prediction was that increasing psychological distance may reduce the mismatch between anticipated and experienced impact of health states on subjective well‐being. We found that the impact of ill health on subjective well‐being was greatly overpredicted and that this overprediction was not eliminated when participants were asked to make predictions about themselves in the future or about other people. Consistent with past work, we found that our participants correctly expected that their subjective well‐being would deteriorate more if they experienced the highest levels of mental illness as compared to the highest intensities of pain or most severe limitations to physical functioning.     

Gendered adversity and mental health of adolescents orphaned by AIDS in a rural South African community: An exploratory study

This study explored gender differences in adversity and mental health among South African adolescents orphaned by AIDS. Adolescents (N = 121; females = 45.5%; mean age 14.14 years, SD = 2.09) self-reported their childhood adversities and probable mental ill health on the Child Trauma and General Health Questionnaire. Results revealed that female participants orphaned by AIDS were significantly more likely to report childhood adversity at total score level as compared to male participants. However, both male and female participants reported comparable scores on subscales of childhood adversity (emotional abuse, physical abuse, sexual abuse, and physical neglect). Moreover, female participants displayed higher composite mental ill health and all its subscales except for social dysfunction. Our findings suggest that gender-sensitive programmes and policies to address the effect of childhood adversity and mental ill health among adolescents orphaned by AIDS, are urgently needed.     

Culture, trauma, and wellness: a comparison of heterosexual and lesbian, gay, bisexual, and two-spirit native americans

In a community-based sample of urban American Indian and Alaska Native adults, 25 lesbian, gay, bisexual, and two-spirit participants were compared with 154 heterosexual participants with respect to sociodemographic characteristics, Native, cultural participation, trauma, physical and mental health, and substance use. Compared with their heterosexual counterparts, two-spirit participants reported higher rates of childhood physical abuse and more historical trauma in their families, higher levels of psychological symptoms, and more mental health service utilization. Two-spirit participants reported differences in patterns of alcohol use and were more likely to have used illicit drugs other than marijuana. Discussion and recommendations for health promotion interventions and future research are presented in consideration of an "indigenist" health model and the multiple minority status of two-spirit people.     

Relative Persuasiveness of Gain‐ Versus Loss‐Framed Human Papillomavirus Vaccination Messages for the Present‐ and Future‐Minded

This research examines how young adults' attitudes toward human papillomavirus (HPV) vaccination and their intentions to get the vaccine are influenced by the framing of health messages (gain vs. loss) and time orientation (i.e., the extent to which people value immediate vs. distant consequences of their decisions). Results of an experiment showed an overall persuasive advantage for loss‐framed messages. Attitudes and behavioral intentions toward HPV vaccination were found to be more favorable among future‐minded individuals. Moreover, an interaction between framing and time orientation was found to predict persuasive outcomes. Present‐minded participants responded more favorably to the loss‐framed message, whereas future‐minded participants were equally persuaded by both frames. Implications of the findings for vaccine risk communication are discussed.     

Prevention and health promotion: decades of progress, new challenges, and an emerging agenda.

Daily habits (e.g., smoking, diet, and exercise) and their immediate consequences (e.g., obesity) confer risk for most of the major health problems in industrialized nations. Hence, determinants of these behaviors and their modifications have been central topics in health psychology. Considerable scientific and applied progress has been made, but the field faces important challenges and opportunities in the future. These challenges and opportunities include changes in demographics and patterns of health, the need for a more comprehensive model of the domain of health behavior and prevention, the need to integrate behavioral and psychosocial risk and resilience, the incorporation of new technologies, and addressing a variety of professional and economic barriers to the implementation of prevention in health care.     

Relationships Between Future Orientation, Impulsive Sensation Seeking, and Risk Behavior Among Adjudicated Adolescents

Because of high levels of risk behavior, adjudicated adolescents are at high risk for negative health outcomes such as nicotine and drug addiction and sexually transmitted diseases. The goal of this article is to examine relationships between future orientation and impulsive-sensation-seeking personality constructs to risk behaviors among 300 adjudicated adolescents. Significant relationships between impulsive sensation seeking and future orientation were found for several risk behaviors. Individuals with more positive future orientation were less likely to use marijuana, hard drugs, alcohol during sex, had fewer alcohol problems, had lower levels of alcohol frequency and quantity of use, and perceived greater risks associated with such behaviors. Higher impulsivity reliably predicted alcohol problems, alcohol use, condom use, and cigarette smoking.     

Well-being and Need for Support of Adolescents with a Chronically Ill Family Member

This study investigates whether there are differences in the well-being, need for help and use of support services between adolescents with and without a chronically ill or disabled family member. It also examines the role played by the type of illness, the relationship to the family member and the nature and intensity of the help provided by the adolescent. A Dutch sample of 1581 adolescents (average age 14.6?years) completed a questionnaire in 2010 about mental health problems, pro-social behavior, need for and use of support and the illness of family members and any care tasks performed by the respondent. Young people with a sick family member had more mental health problems than their counterparts without a chronically ill family member. They also reported a greater need for and use of help and support. Performing domestic tasks was found to be a predictor for overall mental health problems. The intensity of the help given was related to the need for help by the adolescent. It is concluded that growing up with a chronically ill family member and spending a lot time performing (domestic) tasks are risk factors for adolescent mental health problems and adolescents’ need for help. Special attention is warranted for those who need support but who do not translate that need into reality by seeking help.     

Explaining prejudice toward the mentally ill: A test of sociopolitical,demographic, and socioeconomic factors

People with mental disorders often face prejudices that can further deteriorate their condition. We tested whether Social Dominance Orientation (SDO), Right‐Wing Authoritarianism (RWA), and Belief in a Just World (BJW), and characteristics of the mentally ill predict such prejudices. Both in a general population sample and a sample of health professionals and trainees, SDO, but not RWA and BJW, predicted more prejudice, although this pattern was less pronounced among health professionals/trainees. BJW interacted with the targets' gender in Study 1, predicting less empathy toward a male but not toward a female mentally ill person. In Study 2, depressed individuals were blamed more for their illness than those with schizophrenia or cancer. Implications for future research and clinical practice are discussed.     

The role of health anxiety in online health information search

This article is one of the first to empirically explore the relationship between health anxiety and online health information search. Two studies investigate how health anxiety influences the use of the Internet for health information and how health anxious individuals respond to online health information. An exploratory survey study with 104 Dutch participants indicates that health anxiety is related to an increase in online health information search. Moreover, results suggest that health anxious individuals experience more negative consequences from online health information search. Findings from an experimental study (n=120) indicate that online health information results in greater worries among health anxious individuals compared to nonhealth anxious individuals only if the information stems from a trustworthy governmental Web site. Information from a less trustworthy online forum does not lead to greater worries among health anxious individuals. In sum, the Internet appears to play a pivotal role in the lives of health anxious individuals.     

Comparative optimism about health and nonhealth events in 8- and 9-year-old children.

Comparative optimism has been studied extensively in adults and is a significant component of social- cognitive models about health. In contrast, little is known about comparative optimism in children or about the wider social- cognitive processes that underpin their health-related behavior. This study investigated comparative optimism for health- and nonhealth-related topics in 101 children 8 or 9 years of age, the youngest ages that have been investigated so far. Children were shown to be unrealistically optimistic for health and nonhealth events. The implications of these findings for understanding comparative optimism in children are discussed.     

“Disease-Breeders” Among Us: Deconstructing Race and Ethnicity as Risk Factors of Immigrant Ill Health

Race and ethnicity are well-established epidemiological categories that relate to the patients’ risk of exposure and their susceptibility/resistance to disease. However, this association creates the notion that factors other than a personal identity need not be held responsible for patients’ health problems. This work deconstructs the notion of race and ethnicity as risk factors for immigrant ill health, which is prevalent in current medical research and practice, by tracing its roots in Canadian history. The understanding that medical knowledge is subject to diverse historical, social, cultural and political influences can change the way health professionals perceive their patients as a health threat.     

Health Status and Peer Relationships in Early Adolescence: The Role of Peer Contact, Self-esteem, and Social Anxiety

We examined associations between children’s health status and the quality of their peer relationships, as well as factors that may account for individual variation in the quality of chronically ill and healthy children’s peer relationships. Our sample included 268 children (138 boys; 130 girls) with 149 European-Americans and 119 African-Americans. There were 91 children with a chronic illness; 35 with asthma, 26 with diabetes, and 30 with obesity. Chronically ill children were characterized by teachers as displaying less prosocial behavior, less overt aggression, and less relational aggression with peers than healthy children. Chronically ill children reported lower levels of peer contact and higher levels of social anxiety than healthy children. Among chronically ill children those with high self-esteem were more prosocial and less aggressive than those with low self-esteem. Our findings suggest that chronically ill children are at risk for peer relationship difficulties, but that self-esteem may serve as a protective factor against poor peer relationships for some chronically ill children.     

Exploring Violence Exposure, Stress, Protective Factors and Behavioral Problems Among Inner-City Youth

This study examined relationships between violence exposure, other stressors, family support, and self-concept on self-reported behavioral problems among 320 urban adolescents (aged 11–18) referred for mental health treatment. Overall, participants reported high levels of violence exposure, with a median of six past encounters with violence as a witness, victim, or through the experiences of associates. All forms of violence exposure (witnessing, being a victim, knowing of victims) were correlated with internalizing and externalizing behavioral problems for males and females. Total violence exposure predicted behavioral problems among participants, even after controlling for the effects of other risk, demographic and protective factors. Family support and self-concept moderated the influence of life stress and cumulative risk on problem behavior outcomes, but these protective variables did not significantly moderate violence exposure.     

The relationship between ethnicity,Christian orthodoxy,and mental health

Although researchers have noted differences in the role of religiosity in the lives of people from different ethnic backgrounds, the components of religion's influence (i.e., membership and orthodoxy) on mental health have not been previously examined. In the current study, Christian participants’ Christian Orthodox Scale (COS) scores were used to predict scores on mental health. As hypothesized, African Americans with higher COS scores exhibited fewer mental-health problems than did all ethnicities studied with lower COS scores. Implications and future directions for understanding the cultural influence of religion on African Americans are discussed.     

Gender Roles,Power Strategies,and Precautionary Sexual Self-Efficacy: Implications for Black and Latina Women's HIV/AIDS Protective Behaviors

This cross-sectional study tested a conceptual model of women's HIV/AIDS protective behaviors using gender roles, relationship power strategies, and precautionary sexual self-efficacy as predictors in a predominantly Black and Latina community sample of heterosexual women (N = 125). Results revealed no support for the full model, but partial confirmation for several components of the model. Education significantly predicted gender roles, and gender roles and use of direct power strategies were significant predictors of sexual self-efficacy. Most of the participants were married or partnered and were unconcerned about contracting HIV, suggesting that if women perceive that they are at low or no risk, their gender roles, power strategies, and precautionary sexual self-efficacy will be inconsequential to their HIV/AIDS risk reduction practices.     

Effects of active information processing on the understanding of risk information

Two experiments investigated effects of active processing of risk information on participants' understanding and judgments. It was hypothesized that more active processing would lead to better understanding and differences in affective judgments (e.g. increased satisfaction and reduced perceived risk to health). In both experiments participants were given a written scenario about their being prescribed a fictitious medication. This medication was said to cause side effects in 2% of people who took it. Before answering a series of written questions, participants in the active conditions of both experiments were asked to carry out a reflective task (portraying the size of risk on a bar chart in Experiment 1 and answering a reflective question in Experiment 2). The results showed that active participants rated the likelihood of experiencing possible side effects significantly lower than passive participants (Experiment 1), and that active participants were significantly more satisfied with the information and judged perceived risk to health from taking the medication significantly lower than passive participants (Experiment 2). In both experiments, active participants were significantly more correct in their probability and frequency estimates. The studies demonstrate that active processing of risk information leads to improved understanding of the information given. This has important implications for risk communication. In the context of health, better understanding should lead to improved decision‐making and health outcomes. Copyright © 2004 John Wiley & Sons, Ltd.     

Preferences for religious help-seeking: racial and gender differences,interfaith intolerance,and defensive theology

We examined the relation between preference for religious help-seeking and defensive theology, interfaith intolerance, spiritual conceptualisations of mental health problems, race/ethnicity, and gender in a predominantly Christian sample of 389 college students. MANOVA revealed significant main effects for race/ethnicity, with African American participants showing higher scores than Caucasians and Latinos/as across all main study variables. Follow-up ANOVA yielded main effects for race across all four variables and main effects for gender on spiritual conceptualisation of mental health problems and defensive theology. All race/ethnicity by gender interactions were nonsignificant. Preference for religious help-seeking was regressed in a hierarchical manner on race/ethnicity and gender, followed by interfaith intolerance, defensive theology, and spiritual conceptualisation of mental health problems. A statistically significant model explaining 46% of the variance emerged incorporating all variables except race. A framework for understanding help-seeking preference is presented, followed by directions for future research.     

Mental Health, Social Environment and Sexual Risk Behaviors of Adolescent Service Users: A Gender Comparison

We examined individual mental health problems (depression, conduct disorder, and substance abuse) and social environment (family, peer, and neighborhood) factors associated with the sexual risk behaviors of male and female adolescents. Interviews with 778 adolescents, aged 14 to 18, showed that both mental health problems and social environment were related to adolescents' involvement in sexual risk behaviors. Conduct disorder symptoms, substance abuse or dependence symptoms, and the interaction between peer misbehavior and neighborhood problems were significantly associated with risky sexual behaviors. Peer misbehavior was a particularly strong factor related to sexual risk behaviors for youths who lived in neighborhoods with multiple problems. The only gender differences were found in age, with older males more likely to report engaging in high risk sexual behaviors. This study suggests the utility of multidimensional intervention strategies to deal with various adolescent problem behaviors, including risky sexual behaviors, within the context of their social environment.