Influence of Child Factors on Health-Care Professionals’ Recognition of Common Childhood Mental-Health Problems

Early recognition of childhood mental-health problems can help minimise long-term negative outcomes. Recognition of mental-health problems, needed for referral and diagnostic evaluation, is largely dependent on health-care professionals’ (HCPs) judgement of symptoms presented by the child. This study aimed to establish whether HCPs recognition of mental-health problems varies as a function of three child-related factors (type of problem, number of symptoms, and demographic characteristics). In an online survey, HCPs (n = 431) evaluated a series of vignettes describing children with symptoms of mental-health problems. Vignettes varied by problem type (Attention-Deficit/Hyperactivity Disorder (ADHD), Generalised Anxiety Disorder (GAD), Autism Spectrum Disorder (ASD), Conduct Disorder (CD) and Major Depressive Disorder), number of symptoms presented (few and many), and child demographic characteristics (ethnicity, gender, age and socio-economic status (SES)). Results show that recognition of mental-health problems varies by problem type, with ADHD best recognised and GAD worst. Furthermore, recognition varies by the number of symptoms presented. Unexpectedly, a child’s gender, ethnicity and family SES did not influence likelihood of problem recognition. These results are the first to reveal differences in HCPs’ recognition of various common childhood mental-health problems. HCPs in practice should be advised about poor recognition of GAD, and superior recognition of ADHD, if recognition of all childhood mental-health problems is to be equal.     

Translating close-up research into action: a critical reflection

This paper argues that simple dissemination models do not work. One of the strengths of close-up research, with its emphasis on depth and understanding, is that it can identify why things are as they are and, by extension, when we identify wrongs seek to challenge them. The paper suggests, however, that making a difference is fraught with contradictions and that the translation from research to action is far from straightforward. We illustrate these tensions by reflecting on our experiences of conducting two projects for the UK Higher Education Academy. At the same time as exploring the slippages of translation and loss of criticality, however, we want to defend notion of praxis as theoretically informed change for critical social purposes. This involves a view of making a difference and research that moves beyond thinking of research as a discrete act and invokes the significance of corporate agency and the possibilities of acting collectively.     

Hospital Restructuring and Nursing Staff Well-Being: The Role of Coping

A research model incorporating hospital restructuring stressors, job satisfaction, psychosomatic symptoms and active and escapist coping was tested in a large sample of nursing staff. Almost 1,400 staff nurses participated by completing anonymous questionnaires. Concepts in the model were assessed using multiple-item scales having satisfactory psychometric properties. A LISREL analysis was undertaken in which relationships among all variables in the model were considered simultaneously. Use of active coping was negatively related to the use of escapist coping; use of escapist coping was positively related to future threats to security and psychosomatic symptoms and negatively related to self-reported job satisfaction; use of active coping was related to perceptions of less extensive hospital restructuring, greater job satisfaction, and fewer psychosomatic symptoms.     

The relationship between hospital restructuring,anger, hostility and psychosomatics in nurses

This study examines the relationship between hospital restructuring, psychosomatic reactions, anger and hostility in nurses. Scales assessed extent of hospital restructuring. Anger was assessed using the State–Trait Anger Expression Inventory (STAXI) Scales. Results suggested that restructuring is a stressful and anger‐provoking experience which increases with more restructuring initiatives. Copyright © 2000 John Wiley & Sons, Ltd.     

Gender Differences in Reactions to Mental Illness Labeling: The Role of Agency and Communion

Numerous individual characteristics influence responses to receiving a mental health diagnosis, including gender. This study sought to determine how gender influences reactions to being labeled as depressed or not depressed, which were categorized as falling into themes of communion or agency. Using the themes developed by Niedzwienska (2003), 168 college students’ responses to depression labels were coded as a part of a laboratory experiment. The results indicate that the expected sex differences do exist, but multivariate analyses indicate that the choice of communal themes was influenced by sex but the use of agency themes was not influenced by sex.     

Longitudinal Profiles of Girls’ Irritable,Defiant and Antagonistic Oppositional Symptoms: Evidence for Group Based Differences in Symptom Severity

Three subdimensions of ODD symptoms have been proposed –angry/irritable (IR), argumentative/defiant (DF) and antagonism (AN). This study tested whether longitudinal symptom trajectories could be identified by these subdimensions. Group-based trajectory analysis was used to identify developmental trajectories of IR, DF and AN symptoms. Multi-group trajectory analysis was then used to identify how subdimension trajectories were linked together over time. Data were drawn from the Pittsburgh Girls Study (PGS; N = 2450), an urban community sample of girls between the ages of five--eight at baseline. We included five waves of annual data across ages five-13 to model trajectories. Three trajectories were identified for each ODD subdimension: DF and AN were characterized by high, medium and low severity groups; IR was characterized by low, medium stable, and high increasing groups. Multi-trajectory analysis confirmed these subdimensions were best linked together based on symptom severity. We did not identify girls’ trajectory groups that were characterized predominantly by a particular subdimension of ODD symptoms. Membership in more severe symptom groups was significantly associated with worse outcomes five years later. In childhood and early adolescence girls with high levels of ODD symptoms can be identified, and these youth are characterized by a persistently elevated profile of IR, DF and AN symptoms. Further studies in clinical samples are required to examine the ICD-10 proposal that ODD with irritability is a distinct or more severe form of ODD.     

Spiritual Distress and Depression in Bereavement: A Meaning-Oriented Contribution

One key focus of a meaning reconstruction model of bereavement concerns spiritual meanings attributed to the death, whether consoling or troubling. Specifically, previous studies in our research program suggest that religiously inclined violent death survivors are at risk for elevated levels of both bereavement distress and complicated spiritual grief, a crisis of faith following loss that refers to the erosion of the mourner’s relationship to God and/or the religious community. However, more research is needed to understand the convergence of depression and spiritual struggle in the context of violent and natural loss. In this study of a diverse sample of 59 American Christians bereaved less than 5 years, we sought to: (1) determine if individuals bereaved by homicide, suicide or fatal accident differed from those bereaved by natural causes in their levels of depression and spiritual coping; (2) investigate the relation between the latter constructs; and (3) ascertain if cause of death mediates the effect of religious coping on depression. We found that: (a) violently bereaved individuals endorsed more negative religious coping, and (b) depression was associated with greater spiritual struggle, particularly a sense of disrupted relationship with God. Contrary to expectations, positive religious coping was unrelated to post-loss depression, and cause of death did not mediate the relationship between spiritual coping and depressive symptomatology. A clinical case study concludes the article, illustrating the interweaving of spiritual and psychological distress in tragic bereavement, and their implications for a meaning-oriented grief therapy.