The Stride program: Feasibility and pre-to-post program change of an exercise service for university students experiencing mental distress

Rates of mental illness are disproportionately high for young adult and higher education (e.g., university student) populations. As such, universities and tertiary institutions often devote significant efforts to services and programs that support and treat mental illness and/or mental distress. However, within that portfolio of treatment approaches, structured exercise has been relatively underutilised and greater research attention is needed to develop this evidence base. The Stride program is a structured 12-week exercise service for students experiencing mental distress. We aimed to explore the feasibility of the program and assess pre- and post-program change, through assessments of student health, lifestyle, and wellbeing outcomes. Drawing from feasibility and effectiveness-implementation hybrid design literatures, we conducted a non-randomised feasibility trial of the Stride program. Participants were recruited from the Stride program (N = 114, M_age = 24.21 years). Feasibility results indicated the program was perceived as acceptable and that participants reported positive perceptions of program components, personnel, and sessions. Participants’ pre-to-post program change in depressive symptomatology, physical activity levels, mental health-related quality of life, and various behavioural outcomes were found to be desirable. Our results provide support for the feasibility of the Stride program, and more broadly for the delivery and potential effectiveness of structured exercise programs to support university students experiencing mental distress.     

The impact of living in a bio-secure bubble on mental health: An examination in elite cricket

The COVID-19 pandemic has had a profound impact on many people’s lives, including the use of bio-secure environments to facilitate the continuation of professional sport. Although it is well documented that the pandemic has negatively impacted mental health, the impact of bio-bubbles on mental health is yet to be investigated. In the present study we sought to identify the impact of bio-bubbles on the mental health of those residing within, and then to explore the underlying mechanism of any such impact. Individuals (n = 68) who resided in England and Wales Cricket Board (ECB) created bio-bubbles between March 2020 and April 2021 provided data, regarding their time inside and outside of bio-bubbles, on measures of mental health and basic psychological need satisfaction and frustration. Analysis revealed that bio-bubbles increased anxiety and depression and reduced wellbeing. Additionally, MEMORE mediation analyses revealed that autonomy frustration mediated the relationship between bubble status and all mental health markers. Furthermore, compared to men, women were more likely to experience elevated levels of anxiety and depression inside the bubble. The findings suggest that bio-bubbles negatively impact mental health and further suggest that satisfaction and frustration of basic psychological needs is a contributing factor. Findings suggest organizations tasked with creating bio-bubbles would do well to tailor their environment with an awareness of the importance of basic psychological needs and sex differences in relation to mental health. To the best of our knowledge, this research represents the first investigation of the impact of bio-bubbles on mental health.     

Examining associations among factor-analytically derived components of mental health stigma, distress, and psychological flexibility

Mental health stigma can be detrimental not only for the recipient, but also for the stigmatizer. As mental health stigma is often conceptualized as a multidimensional construct, Study 1 first examined the factor structure of mental health stigma as assessed by the Stigmatizing Attitudes-Believability (SAB; Masuda, Price, Anderson, Schmertz, & Calamaras, 2009). Study 2 investigated differential relations between the factor-analytically derived components of mental health stigma and psychological distress and psychological flexibility. Results of Study 1 revealed that mental health stigma consisted of two related, yet separable components: Exclusion and Course/Origin. The Exclusion component was characterized by negative emotions and cognitions associated with an increased desire for social distance. Course/Origin was marked by pessimistic views toward treatment prognosis and recovery. Results of Study 2 suggested that these two components have differential associations with psychological distress and flexibility. The Course/Origin component of stigma, but not Exclusion, was associated with psychological distress of the stigmatizer. Furthermore, this association was fully mediated by lower levels of psychological flexibility. These findings suggest the importance of conceptualizing mental health stigma multidimensionally.     

Predictors of mental distress and poor physical health among homeless women

Abstract

We tested a latent variable path model in which situational, personal, and social resources predicted several mediators and the key health outcomes of mental distress and poor physical health among 871 homeless women. Mental distress was predicted by risky sexual behavior, less social support, avoidant coping, less self-esteem, client abuse history, social support from deviant sources, less drug self-efficacy and health care utilization. Poor physical health was predicted by a client abuse history, less drug self-efficacy, fewer perceived rewards for drug use, higher perceived costs for drug use, and a doctor visit. Current risky sexual behavior was predicted by a parent drug abuse history, less drug self-efficacy, and more social support from deviant sources. Current drug use was predicted by parent drug abuse history, less drug self-efficacy, more social support from deviant sources and by high perceived costs for drug use. Implications of results for intervention and theory are discussed.     

The link between mental health,crime and violence

Research investigating the link between mental health, crime and violence often rely on populations that are at a high-risk of violent and criminal behaviour, such as prison inmates and psychiatric patients. As a result of this selection bias, the relationship between mental health, criminal and violent behaviour is significantly over-estimated, with mental health being incorrectly linked with violent and criminal behaviours. This study examines the relationship between mental health, violence and crime in a more representative community-based sample. One hundred and twenty-one individuals with and without a mental health disorder reported their involvement in crime and completed an aggression questionnaire. The results revealed that there is no statistically significant difference in terms of violence and crime involvement between individuals with a mental health diagnosis and those without. Moreover, the study did not find any statistically significant associations between specific mental health disorders and specific crime offences. The findings suggest that certain mental health disorders do not strongly contribute to crime violence and involvement. Limitations and implications are discussed in detail.     

Mindfulness and emotional distress: The role of negatively biased cognition

Mindfulness is a receptive attention to and awareness of events and experiences as they occur. A substantial body of literature supports the usefulness of mindfulness-based approaches for preventing or reducing emotional distress (e.g., depression and anxiety). However, mechanisms by which mindfulness produces these benefits are still being explored. Cognitive theories of emotional disorder implicate negatively biased cognition as a primary source of distress, and the theoretical literature on mindfulness suggests that it may reduce biased thoughts and judgments. Thus, the present research tested a mediation model in which less negatively biased cognition explains the inverse relation between mindfulness and emotional distress. Participants completed multiple standardized measures of trait mindfulness, negatively biased cognition, and emotional distress. The proposed relations between these constructs then were examined using structural equation modeling. Support was found for a partial mediation model, and possible alternative models were ruled out. These findings highlight a previously unidentified cognitive mechanism to explain the relation between mindfulness and reduced emotional distress. Specifically, mindfulness may reduce negative, maladaptive cognitive styles, which in turn may reduce predisposition to emotional disorders.     

The impact of direct and indirect bullying on the mental and physical health of Italian youngsters

The aim of the present study was to determine the extent to which direct and indirect bullying and victimization at school affects the mental and physical health of 661 Italian boys and girls, aged 11 to 15 years old. The impact of bullying and victimization is assessed by taking into account the relative buffering effect of a positive relationship with one or both parents. Internalizing symptoms such as withdrawn behaviors, somatic complaints, and anxiety and depression, measured with the self‐administered Youth Form of the Achenbach's Child Behavioral Checklist, are indicators of maladjustment. Multiple regression analyses revealed that being a girl is a strong significant risk factor for all internalizing symptoms. Being a victim of indirect bullying is the strongest predictor of withdrawn behaviors, somatic complaints, and anxiety/depression, independent of direct victimization, which significantly predicts somatic complaints, anxiety, and depression, but not withdrawn behaviors. Bullying others directly by hitting, threatening, or calling names is not a significant predictor the poor mental and somatic health of youngsters, whereas indirect bullying (spreading rumors or not talking to someone on purpose) does significantly predict anxiety and depression, as well as withdrawn behaviors. The negative impact of victimization and bullying is buffered by youngsters' positive relationship with one or both parents. Recommendations are provided with regard to possible intervention strategies underlying the importance of distinguishing between different forms of bullying and victimization and providing social support in each different case. Aggr. Behav. 30:343–355, 2004. © 2004 Wiley‐Liss, Inc.     

To Flourish or Languish,that is the question: Exploring the mental health profiles of Danish elite athletes

ObjectivesThe purpose of this study was (a) to investigate mental well-being and the prevalence of anxiety and depressive symptoms in Danish male and female elite athletes, (b) to identify latent profiles in athletes based on their mental health and ill health, and (c) to examine whether the different profiles vary in selected protective and risk factors concerning mental health.MethodsA total of 612 Danish athletes (M = 18.99, SD = 4.29) from 18 different sports completed an online version of the Holistic Athlete Mental Health Survey that assessed well-being, depression, and anxiety together with potential risk and protective factors (e.g., injuries, stress, sleep, social support, sport environment).ResultsOverall, 13.9% of athletes reported moderate or severe anxiety symptoms while 21.1% reported moderate or severe depressive symptoms. Female athletes had a significantly higher prevalence of anxiety and depressive symptoms and lower mental well-being scores than male athletes. Through a latent profile analysis, three distinctive mental health profiles (flourishing, moderate mental health, languishing) were discovered. MANOVA following Kruskal-Wallis tests revealed substantial differences between these profiles regarding their perception of social support, sport environment, and stressors from different life domains.Conclusions: Danish elite athletes display similar levels of anxiety and depressive symptoms as the Danish general population. Flourishing athletes report lower stress levels, receive higher support from the private and sport domain, and perceive their sport environment as more supportive than athletes who are languishing. A tailored approach is proposed to support athletes' mental health.     

Understanding the role of social support in trajectories of mental health symptoms for immigrant adolescents

This longitudinal study of 286, urban residing, first- and second-generation immigrant adolescents examined the degree to which acculturative stress is related to the developmental trajectories of mental health problems and the role of social support in this process. Participants were recruited when they entered 10th grade and two additional waves of data were gathered at 12-month intervals. Using individual growth curve modeling, the results show significant decline in internalizing mental health problems during the high school years. At the same time, greater exposure to acculturative stress predicted significantly more withdrawn/depressed, somatic, and anxious/depressed symptoms. Additionally, social support moderated the relation between acculturative stress and anxious/depressed symptoms. Gender and generation status differences were found only at baseline (10th grade).     

Surf therapy for improving child and adolescent mental health: A pilot randomised control trial

The aim of this pilot randomised control trial (RCT) was to test, 1) feasibility and acceptability of a surf therapy program to improve symptoms of mental ill-health among children and adolescents, and 2) the design and procedures of an evaluative study. This pilot RCT compared a 6-week mentor-supported surf therapy program with a wait list control group, in Australian children and adolescents aged 8–18yrs (M age = 11.28, SD = 2.34; 15 females), who were help seeking for issues relating to their mental health. Exclusion criteria included if an individual was actively suicidal or experiencing a psychotic episode or being unavailable for program dates. The primary outcome was the feasibility and acceptability of the intervention and study design assessed via 11 pre-defined criteria. A secondary outcome was to investigate the effectiveness signal of the intervention on child indicators of depression and anxiety, assessed via the Revised Children’s Anxiety and Depression Scale-Short Form and the Strengths and Difficulties Questionnaire. Random allocation was computer generated and while it was not possible to blind participants, researchers collecting assessments were blinded to group allocation. Thirty-six youth were randomised (intervention = 18; wait list controls = 18), representing an 84% participation rate among eligible youth. Of the 11 a priori feasibility and acceptability criteria, 4 of 5 relating to the intervention, and 4 of 6 addressing the study design were fully met, with the unmet factors guiding program revision. At the completion of the intervention, children and adolescents receiving the intervention reported reductions in symptoms of depression (ES = 0.57), anxiety (ES = 0.43), emotional problems, (ES = 0.79), peer problems (ES = 0.56), hyperactivity/inattention (ES = 0.28), and overall difficulties (ES = 0.64). These reductions were not sustained 6-weeks after completion of the intervention. Surf therapy is an acceptable and feasible intervention for addressing symptoms of mental ill-health among children and adolescents. Preliminary evidence suggests that surf therapy improves symptoms of mental ill-health in the short-term but that these improvements were not sustained after the intervention is ceased.     

Stability of maternal postnatal bonding between 3 and 6 months: Associations with maternal mental health and infant temperament

Maternal bonding is key for infant development and well-being. Research to date focused on prenatal bonding experience, with fewer studies looking at the postnatal period. Moreover, evidence suggests significant associations among maternal bonding, maternal mental health, and infant temperament. The joint impact of maternal mental health and infant temperament on maternal postnatal bonding remains unclear, with limited research reporting longitudinal data. Hence, the present study aims (1) to explore the impact of maternal mental health and infant temperament on postnatal bonding at both 3 and 6 months of age, (2) to explore postnatal bonding stability from 3 to 6 months, and (3) to determine which factors are linked with 3-to-6-month changes in bonding. At the infants' 3 months (n = 261) and 6 months of age (n = 217), mothers provided measures of bonding, depressive and anxious symptoms, and infant temperament via validated questionnaires. At 3 months, higher levels of maternal bonding were predicted by lower levels of anxiety and depression in the mothers and by higher infants' regulation scores. At 6 months, lower levels of anxiety and depression predicted higher levels of bonding. Moreover, mothers showing decreases in bonding were characterized by 3-to-6-month increases in depression and anxiety, as well as increased reported difficulties in regulation dimensions of infant temperament. This study highlights the impact of both maternal mental health and infant temperament on maternal postnatal bonding in a longitudinal sample and could offer useful information for early childhood prevention and care.     

AIRA: Measurement of adolescents’ judgments regarding intentions to respond to physical and verbal aggression

The current study utilized a structural equations approach in developing an instrument to investigate adolescents’ (N = 510; 9th–12th graders) judgments about the likelihood that they would actively respond to a witnessed aggressive situation. Two aggressive subscales were developed: physical and verbal. The instrument controlled for the relationship (acquaintance vs. friend) of the witness to the perpetrator and to the victim involved in the event. Results provided evidence for a domain approach to judgments about active responses to aggression. Furthermore, as predicted, the factors of gender, age, relationship of the witness to both the victim and the perpetrator, and aggressive situation influenced adolescents’ judgments. Regardless of whether the perpetrator and the victim were acquaintances or friends of the witness, younger males indicated that they were less likely to respond to acts of physical aggression than were adolescents in the other three groups. In contrast, when acquaintances were involved in situations involving verbal aggression, younger males were less likely to respond than were younger females. When the perpetrator and the victim were friends of the witness, females, regardless of age, were more likely than males to respond to verbally aggressive acts. Aggr. Behav. 28:207–223, 2002. © 2002 Wiley‐Liss, Inc.     

High self-reported rates of neglect and emotional abuse, by persons with binge eating disorder and night eating syndrome

This study compared rates of self-reported childhood maltreatment in three groups diagnosed using semi-structured interviews: binge eating disorder (BED; n=176), night eating syndrome (NES, n=57), and overweight/obese comparison (OC, n=38). We used the Childhood Trauma Questionnaire (CTQ) to assess childhood maltreatment and the Beck Depression Inventory-II to assess depression levels. Reports of maltreatment were common in patients with BED (82%), NES (79%), and OC (71%). The BED group reported significantly more forms of maltreatment above clinical cut-points (2.4) than the OC (1.4) group but not the NES (1.8) group. The BED and NES groups reported more emotional abuse than the OC group. A higher proportion of the BED group reported emotional neglect and a higher proportion of the NES group reported physical neglect. Depression levels, which were higher in BED and NES than OC, were associated with higher levels of physical and emotional abuse and neglect. In conclusion, reported rates of physical and sexual abuse differed little across groups, whereas reports of neglect and emotional abuse were higher in the BED and NES groups than in the OC group and were associated with elevated depression levels.     

Child abuse and negative explicit and automatic self-associations: The cognitive scars of emotional maltreatment

Individuals reporting Childhood Abuse (CA) (i.e., emotional neglect, emotional-, physical- and sexual-abuse) are marked by increased explicit (i.e. self-reported) negative self-associations, and an increased risk to develop depression or anxiety disorders. Automatic self-associations might play an important role in the development and maintenance of affective disorders after exposure to CA, since automatic associations are assumed to be involved in uncontrolled (spontaneous) affective behavior. This study examined whether individuals reporting a history of CA show stronger automatic (and explicit) self-depression and/or self-anxiety associations than individuals who report no CA in a large cohort study (Netherlands Study of Depression and Anxiety (NESDA), n = 2981). The Implicit Association Test (IAT) was utilized to assess automatic self-depression and self-anxiety associations. We found that CA was associated with enhanced automatic (and explicit) self-depression and self-anxiety associations. Additionally, when compared to physical- and sexual-abuse, Childhood Emotional Maltreatment (CEM; emotional abuse and emotional neglect) had the strongest link with enhanced automatic (and explicit) self-depression and self-anxiety associations. In addition, automatic and explicit negative self-associations partially mediated the association between CEM and depressive or anxious symptomatology. Implications regarding the importance of CA, and CEM in particular will be discussed.     

Specificity of parental bonding and rumination in depressive and anxious emotional distress

We examined how different dimensions of rumination may mediate the impact of parental bonding (lack of care and overprotectiveness) on negative emotional symptomatology (anxiety and depression). Survey data from participants were analyzed using structural equation modeling. Results indicated that brooding rumination fully mediated the relationship between maternal care and depressive and anxious symptomatology. These findings suggest that to the extent that maternal caregivers are low in warmth and support, offspring are more likely to develop a brooding style of ruminative thinking associated with heightened emotional distress. This research supports the growing body of evidence suggesting that cognitive variables form a pathway between troublesome parent/child interactions and psychopathology.     

Physical activity in employees with differing occupational stress and mental health profiles: A latent profile analysis

ObjectivesTo examine whether employees with differing occupational stress and mental health profiles differ in their self-reported levels of physical activity.DesignCross-sectional survey data.MethodThe sample consisted of 2660 Swedish health care workers and social insurance officers (85% women, M = 46.3 years). Latent profile analysis was performed to identify classes. Between-class-differences in physical activity were tested via χ²-tests and multinominal logistic regression analyses using sex, age, BMI, marital status, children at home, caregiving, and smoking as covariates.ResultsLatent profile analysis resulted in a six-profile solution. Two pairs of classes had equal stress levels, one pair with high stress, one pair with moderate stress. Within each pair, one group showed some resilience (i.e. only moderate mental health problems despite high stress or good mental health despite moderate stress), whereas the other did not. The other two classes were characterized by either low stress and good mental health or moderate-to-high stress and elevated mental health problems. Participants who were resilient to high or moderate stress were more active than participants of the corresponding non-resilient classes. Participants with low stress and good mental health reported the highest physical activity levels, participants with high stress and high mental health problems reported the lowest physical activity levels.ConclusionsThe findings suggest that physical activity is associated with resilience to occupational stress, and that beyond primary prevention efforts to make work less stressful regular physical activity should be a target variable for health professionals working in the occupational setting.     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition.     

Seeking help when transgender: Exploring the difference in mental and physical health seeking behaviors between transgender and cisgender individuals in Ireland

Abstract

Background: While there is growing awareness of the need to support the physical and mental wellbeing of transgender people, some may be reluctant to seek help from healthcare professionals. Little is understood about the mechanisms that influence help-seeking behavior in this group.

Aims: This study aimed to compare transgender and cisgender participants in their likelihood to seek help for both physical and mental health conditions, and to explore whether this help-seeking behavior is predicted by a range of sociodemographic and psychological variables.

Methods: 123 participants living in Ireland (cisgender= 67; transgender= 56) completed a questionnaire which included demographic questions, as well as measures of optimism (LOT-R), self-esteem (RSES), psychological distress (GHQ-12), attitudes towards seeking psychological help (ATSPPH-SF), and attitudes towards seeking help for a physical health problem (Attitudes Towards Seeking Medical Help Scale- Action/Intervention subscale). Associations between predictor variables and mental and physical health seeking were explored using correlation analysis and stepwise regressions.

Results: Transgender participants were less likely to seek help for a physical health issue than cisgender participants, but did not differ in mental health help-seeking behaviors. Results suggest that this may be due to differences in optimism, self-esteem and psychological distress. Transgender participants had significantly lower optimism and self-esteem, which were two factors linked to poorer physical health seeking behaviors. Optimism also emerged as a significant predictor in mental health seeking behaviors.

Discussion: The lack of a significant difference for mental health help-seeking between the transgender and cisgender participants is encouraging, as it suggests that there is less stigma surrounding mental illness than expected, however findings also contradict previous findings suggesting that physical health is less stigmatized. This could be due to stigma relating to gender-specific healthcare and suggests that healthcare professionals should acknowledge the specific healthcare needs and concerns among transgender individuals.     

The Big-Five, sense of control, mental health and fear of crime as contributory factors to attitudes towards punishment

Low sense of control (SoC), mental health problems and fear of crime (FoC) have separately and previously been linked to the Big-Five personality dimensions, but no study to date has sought to integrate these constructs simultaneously in relation to overall punitiveness. These constructs were assessed in 232 participants using an online survey to examine hypothesised relations between FoC and SoC, poorer mental health, Neuroticism (N), Extraversion (E) and Conscientiousness (C), and any resultant punitiveness. Measures were highly correlated, and an exploratory factor analysis summarised these as ‘instability’ and ‘crime attitude’ dimensions. A structural equation model found that high levels of N and poor mental health, as well as low levels of C, E and SoC were related to a latent variable of ‘distress’, which fed into heightened FoC. High levels of C further influenced FoC, which subsequently had an effect on individuals’ greater punitiveness. The current study supports the previous literature regarding variables that influence FoC and attitudes to punishment, and establishes novel associations involving personality.