Provider Perspectives on Barriers and Strategies for Achieving Culturally Sensitive Mental Health Services for Immigrants: A Hamilton, Ontario Case Study

As research reveals that the healthy immigrant effect, whereby the health of immigrants at the time of arrival is high but subsequently declines and converges toward that of the native-born population, also extends to mental well-being, this paper aims to examine the barriers to mental health care for immigrants in Hamilton, Ontario. Through the use of face-to-face interviews with eight service providers, barriers to care were revealed to include cultural insensitivity, stigma and shame, and limited resources. Suggestions for improvements to mental health care are also discussed.     

Deconstructing the age-prevalence curve of alcohol dependence: why "maturing out" is only a small piece of the puzzle

Epidemiological studies have consistently demonstrated that heavy alcohol use and alcohol dependence (AD) tend to increase in adolescence and emerging adulthood and then show a large decline in the late 20s, a phenomenon called maturing out. This decline has been explained as an effect of "role incompatibility" in which involvement in new roles and activities interferes with a heavy drinking lifestyle. However, maturing out has been conceived mostly as a decrease in offset, with little attention paid to reductions in new onset or recurrence across decades of life. Moreover, although role incompatibility processes have been studied with young samples, little is known about the effect of life transitions (e.g., marriage, parenthood, changes in employment status) on AD later in life and whether similar effects are observed. Using longitudinal data from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative epidemiologic survey, we examined the patterns of stability and change in AD across the life span and the differential effect of life transitions on AD across different age strata. Results showed that persistence of AD tended to increase with age, although not dramatically, and that onset and recurrence tended to decrease with age. Moreover, the effects of life transitions on the course of AD varied across the life span and were different for men and women. These results indicate that life transitions differentially affect the patterns of stability and change in younger versus older people, have a different impact for men and women, and highlight the need to consider the unique aspects of each stage of adult development on the course of AD.     

Perceptions of personal sex discrimination: the role of belief in a just world and situational ambiguity

The roles of belief in a just world (BJW) and discrimination against ones' group in perceptions of personal discrimination were examined. Female participants (n = 63) were personally discriminated against in a laboratory setting. We manipulated whether the experimenter appeared to discriminate against other participants, which presumably made the presence of personal discrimination less ambiguous, or did not appear to discriminate against others, which presumably made personal discrimination more ambiguous. In the no group discrimination condition, but not in the group discrimination condition, participants' perceptions of being personally discriminated against depended on individual differences in BJW: Women with a strong BJW perceived less personal discrimination than those with a weak BJW. Also, strong BJW women in the group discrimination condition perceived less personal discrimination than strong BJW women in the no group discrimination condition.     

EFFECTS OF A SIGNALED DELAY TO REINFORCEMENT IN THE PREVIOUS AND UPCOMING RATIOS ON BETWEEN-RATIO PAUSING IN FIXED-RATIO SCHEDULES

Domestic hens responded under multiple fixed‐ratio fixed‐ratio schedules with equal fixed ratios. One component provided immediate reinforcement and the other provided reinforcement after a delay, signaled by the offset of the key light. The components were presented quasirandomly so that all four possible transitions occurred in each session. The delay was varied over 0, 4, 8, 16, and 32 s with fixed‐ratio 5 schedules, and over 0, 8 and 32 s with fixed‐ratio 1, 15 and 40 schedules. Main effects of fixed‐ratio value and delay duration were detected on between‐ratio pauses. Pauses were longer when the multiple‐schedule stimulus correlated with a delayed‐reinforcer component was presented, with the longest pauses occurring at the transition from a component with an immediate reinforcer to one with a delayed reinforcer. Pause durations were shortest during immediate components. Overall, both the presence or absence of a delay in the upcoming component, and the presence or absence of a delay in the preceding component affected pause length, but the upcoming delay had the larger effect. Thus changes in delay had similar effects to past reports of the effects of changes in response force, response requirement, and reinforcer magnitude in multiple fixed‐ratio fixed‐ratio schedules.     

Stress, Cortisol, and Externalizing Behavior in Adolescent Males: An Examination in the Context of Multisystemic Therapy

Stress and hypothalamic-pituitary-adrenal (HPA) axis dysregulation have been associated with externalizing behavior in adolescence, but few studies have examined these factors in a treatment context. This study investigated the relationship between stress, cortisol, and externalizing behavior among 120 adolescent males (mean age?=?15) receiving Multisystemic Therapy (MST). To examine the differential relationship of cortisol with various types of stressors, self-report measures assessed lifetime stress, current episodic stress, and daily hassles. Morning and afternoon cortisol samples were collected to examine whether the relationship between stress and treatment outcome depended on the youth's biological stress levels. Regression analyses indicated that awakening cortisol levels moderated the relationship between daily hassles and externalizing behaviors at post-treatment. More specifically, higher levels of daily hassles predicted worse outcomes only among adolescents with high levels of morning cortisol. In addition, lifetime stressors and afternoon measures of cortisol interacted to predict changes in caretaker reports of externalizing problems and youth arrests following treatment; lifetime stressors were positively associated with externalizing behavior when adolescents had low levels of afternoon cortisol. Implications for theory and future directions for evidence-based treatment are discussed.     

The role of defeat and entrapment in depression, anxiety, and suicide

Defeat and entrapment are psychological constructs that have played a central role in evolutionary accounts of depression. These concepts have since been implicated in theoretical accounts of anxiety disorders and suicidality. The current article reports on a systematic review of the existing research investigating the links among defeat, entrapment, and psychopathology in the domains of depression, suicidality, posttraumatic stress disorder (PTSD), and other anxiety syndromes. Fifty-one original research articles were identified and critically reviewed. There was strong convergent evidence for a link with depressive symptoms, across a variety of clinical and nonclinical samples. Preliminary support for an association with suicidality was also observed, with effects not readily explainable in terms of comorbid depression. There was strong evidence for an association between defeat and PTSD, although this may have been partly accounted for by comorbid depression. The findings for other anxiety disorders were less consistent. There was, however, evidence that social anxiety in individuals with psychosis may be related to perceptions of entrapment. Overall, there was evidence that perceptions of defeat and entrapment were closely associated with various forms of human psychopathology. These effects were often in the moderate to large range and superseded the impact of other environmental and psychological stressors on psychopathology. We provide a unified theoretical model of how defeat and entrapment may contribute to these different psychopathological conditions. Clinical implications and avenues for future research are discussed.     

Maternal Depressive Symptoms and Child Social Preference During the Early School Years: Mediation by Maternal Warmth and Child Emotion Regulation

This longitudinal study examined processes that mediate the association between maternal depressive symptoms and peer social preference during the early school years. Three hundred and fifty six kindergarten children (182 boys) and their mothers participated in the study. During kindergarten, mothers reported their level of depressive symptomatology. In first grade, teachers rated children’s emotion regulation at school and observers rated the affective quality of mother-child interactions. During second grade, children’s social preference was assessed by peer nomination. Results indicated that mothers’ level of depressive symptomatology negatively predicted their child’s social preference 2 years later, controlling for the family SES and teacher-rated social preference during kindergarten. Among European American families, the association between maternal depressive symptoms and social preference was partially mediated by maternal warmth and the child’s emotion regulation. Although the relation between maternal depressive symptoms and children peer preference was stronger among African American families than Europrean American families, its mediation by the maternal warmth and child’s emotion regulation was not found in African American families.