Toward Cognitive-Behavioral Therapy for Sexual Minority Women: Voices From Stakeholders and Community Members

Sexual minority women (SMW) experience an elevated risk of mental health problems compared to heterosexual women. However, knowledge gaps remain regarding whether cognitive-behavioral therapy (CBT) interventions meet SMW’s mental health needs. Further, virtually no studies have integrated stakeholder (i.e., researchers with content expertise in SMW’s health and clinical providers who work with SMW) and community member (i.e., SMW) perspectives to identify CBT approaches that address SMW-specific issues. This study used qualitative data gathered from 39 SMW who reported depression, anxiety, suicidality, and heavy drinking in the past 3 months and 16 content experts and clinical providers to obtain information relevant to enhancing CBT for SMW. In addition, we used thematic analysis to identify themes related to the adaptation and delivery of CBT for SMW. Building on prior literature, this study’s findings revealed seven considerations for delivering mental health services to SMW: (1) attending to SMW’s diverse gender identities and expressions; (2) focusing on SMW’s nonbinary stressors; (3) formulating SMW’s gender-based stressors within a feminist framework; (4) applying intersectionality frameworks; (5) incorporating issues of diversity, multiculturalism, and social justice; (6) addressing the role of trauma exposure; and (7) addressing the role of alcohol use in SMW’s lives. These considerations are reviewed in terms of their implications for clinical practice, with a focus on enhancing applications of existing CBT interventions to best respond to the unique needs of this population.     

Positive crossover: Parent perceived partner responsiveness and health of youth with asthma

Romantic relationship functioning has implications that extend beyond the romantic dyad. This study tests whether a key positive aspect of relationships, perceived partner responsiveness, can cross over from parents' romantic relationships to children's health and well-being via parenting behavior. In a sample of 112 youth with asthma and their primary caregivers, when caregivers perceived higher partner responsiveness in their romantic relationship, youth experienced improved self-reported asthma symptoms, pulmonary functioning, and positive affect. The associations were robust while controlling for parents' relationship conflict and other relevant covariates, except for the pulmonary functioning outcome, which was instead predicted by parents' conflict. However, parenting behavior (i.e., positive and negative parenting) did not appear to mediate these links. This work highlights the importance of positive romantic relationship processes for youth health and well-being, emphasizing the relevance of clinical intervention work and the need to continue investigating mechanisms through which these processes may be linked.     

Addressing social determinants of mental health in therapy: A thematic synthesis

Background

The importance of addressing social determinants of mental health in therapy is well-documented. However, there appears to be limited research on what this actually involves in practice and how best to prepare therapists to work with individuals experiencing adverse social determinants.

Aims

The aim of this review was to draw implications for practice and training from reviewing research on addressing social determinants of mental health in therapy.

Methodology

A qualitative systematic review of the research on addressing social determinants of mental health in therapy was conducted, extracting papers from eight databases: Cochrane Library, ASSIA, CINAHL Plus, PsycInfo, Psychoanalytic Electronic Publishing, Science Direct, Scopus and Web of Science. Out of 127 papers found, five met the eligibility criteria and were quality-assessed and analysed thematically.

Findings

The thematic synthesis generated three main themes: “the therapeutic relationship,” “adapting to client context” and “community as a resource,” with eight subthemes.

Conclusion

This thematic synthesis highlights the importance of the therapeutic relationship and adapting mental health support to client frame of reference and context to address social determinants of mental health in therapy. It emphasises community as a helpful resource for informing training and therapeutic interventions, as well as a significant resource for people experiencing adverse social determinants.     

Living (dys)regulated and alienated young masculinity—Young men's embodied experiences of mental disorders and suicidality

Introduction

Mental disorders, such as depression and anxiety with interlinked suicidality, are the leading cause of health-related disability among young men. Knowledge of the interaction between emotional, bodily, social and gendered mental health processes in young men is limited and therefore needed.

Aim

This study aimed to explore young men's lived embodied experiences of mental disorders and suicidality, and to conceptualise these by integrating affective–emotional, physiological, social and gendered processes.

Methods

Semistructured individual interviews were conducted with 13 young men who had sought professional help for mental disorders and suicidality. Grounded theory (GT) was used with a social constructivist perspective.

Results

The results comprise one core category—Living (dys)regulated and alienated young masculinity—with related categories “battling with the emotional body,” “suffering in social silence” and “balancing embodied darkness and distress.” The GT illustrates how young men navigate and manage their embodied and emotional suffering in a context of “regulative” masculine and social norms alongside insufficient social support.

Conclusion

Our results suggest that young men's lived embodied experiences of mental disorders and suicidality can be understood as a dynamic process of internal and external “(dys)regulation and alienation.” The generated GT provides a broad tentative explanation model, contributing to theory development, and serves as a basis for gender-sensitive interventions—in both psychotherapy and physiotherapy—integrating body, mind and the social context.     

Dynamics and moderating factors of esport participation and loneliness: A daily diary study

The purpose of this study was to examine the association between esport participation and loneliness, as well as its moderating factors. Chinese college students (N = 216) self-reported their esport playing time and degree of loneliness each day immediately before bedtime for four consecutive weeks. The findings revealed that as playing time increased, students did not experience reduced sense of loneliness during playing esport, but they experienced a temporary and intensified feeling of loneliness the same day following gameplay. Students with higher general loneliness tended to feel more after-game loneliness associated with increased esport participation. Students with higher obsessive passion about esport tended to experience more loneliness (both in-game and after-game) associated with increased esport participation. Students with greater coping motivation about esport tended to experience more in-game loneliness associated with previous increased esport participation. Students who played esport less often with friends in person, or with more escape motivation toward esport, tended to increase esport participation time more following previous increased after-game loneliness. The findings suggested that college students should avoid utilizing esport to achieve a sense of belonging and should be cautious of the loneliness-inducing effect after gameplay. A healthy level of loneliness can be maintained by playing esport more with friends in person, learning strategies to avoid obsessive passion, coping motivation, and escape motivation towards esport.     

Macronutrient intake as a prospective predictor of depressive symptom severity: An exploratory study with adolescent elite athletes

BackgroundAppropriate availability of macro- and micronutrients has an important impact on cognitive performance, mood and mental health. Although the critical role of nutrition for elite athletes’ performance was recognized early on, little is known about whether consumption of specific macronutrients (carbohydrates, proteins, fat) predict the development of future depressive symptoms in adolescent elite athletes.MethodsParticipants were recruited from three Swiss Olympic Partner Schools (SOPS) in the Northwestern German speaking part of Switzerland. A total of 97 adolescent elite athletes (38% girls, M_age = 16.35 ± 1.19) participated in the study. Depressive symptoms (PHQ9) were assessed at baseline and after 10 months follow-up. A 3-day food recall was completed three months after the baseline assessment. Linear regression analyses were used to examine whether macronutrients predict depression symptom severity after controlling for covariates and baseline depressive symptoms.ResultsHigher protein consumption in athletes was a prospective predictor of lower depressive symptom severity at follow-up (β = −35, p < .05). Several deviations from recommended nutritional standards were observed in elite athletes.ConclusionsThe findings of this exploratory study support the notion that dietary behaviour may be prospectively associated with athletes’ mental health. However, more research is required with larger samples and more in-depth assessment techniques. Future research should also examine whether nutrition education and dietary modification can be used to prevent depressive symptoms among adolescent elite athletes.     

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.     

“讳疾忌医”：健康信息回避的影响因素与理论解释

健康信息回避是指有意识地防止或延迟获取可利用的身体健康信息的行为,对疾病的预防与治疗有着重要影响。本文通过回顾前人文献概述了个体因素、社会因素和信息因素对健康信息回避的影响。风险认知理论、信息处理与决策双加工系统理论和威胁资源管理模型为健康信息回避的产生提供了理论依据。未来研究可以关注健康信息回避的分类研究并扩展健康信息回避的研究范围,加强健康信息回避的实证干预研究并根据我国医疗背景开展健康信息回避的本土化研究。     

Does partisan media make a pawn of mistrust? Institutional trust and preventive COVID-19 health behaviors in a polarized pandemic

In a rapidly developing crisis such as the COVID-19 pandemic, people are often faced with contradictory or changing information and must determine what sources to trust. Across five time points (N = 5902) we examine how trust in various sources predicts COVID-19 health behaviors. Trust in experts and national news predicted more engagement with most health behaviors from April 2020 to March 2022 and trust in Fox news, which often positioned itself as counter to the mainstream on COVID-19, predicted less engagement. However, we also examined a particular public health behavior (masking) before and after the CDC announcement recommending masks on 3 April 2020 (which reversed earlier expert advice discouraging masks for the general public). Prior to the announcement, trust in experts predicted less mask-wearing while trust in Fox News predicted more. These relationships disappeared in the next 4 days following the announcement and reversed in the 2 years that follow, and emerged for vaccination in the later time points. We also examine how the media trusted by Democrats and Republicans predicts trust in experts and in turn health behaviors. Broadly we consider how the increasingly fragmented epistemic environment has implications for polarization on matters of public health.     

Fear of missing out and depressive symptoms during the COVID-19 pandemic

During the early stages of the COVID-19 pandemic, governments issued public health safety measures (e.g., “stay-at-home” ordinances), leaving many people “missing out” on integral social aspects of their own lives. The fear of missing out, popularly shortened as, “FoMO,” is a felt sense of unease one experiences when they perceive they may be missing out on rewarding and/or enjoyable experiences. Among 76 participants (ages M = 69.36, SD = 5.34), who were at risk for hospitalization or death if infected with COVID-19, we found that FoMO was associated with depressive symptoms at Time 1, even when controlling for perceived stress, loneliness, and fear of COVID-19. However, FoMO did not predict future depressive symptoms, about 1 week later, when controlling for Time 1 depressive symptoms. These findings provide further evidence that FoMO is associated with depressive symptoms in a short period of time even when accounting for other powerful social factors such as loneliness. Future research should explore the potential causal relationships between FoMO and depression, especially those that may establish temporal precedence.