The Relationship Between Trajectories of Family/Cultural Stressors and Depression and Suicidal Ideation Among Substance Using Mexican-American Adults

We used an intersectional minority stress perspective to examine the association between family/cultural stress and mental health among substance-using Mexican-Americans. Employing a unique longitudinal sample of 239 socioeconomically disadvantaged, non-injecting heroin-using Mexican-Americans from San Antonio, Texas, we examined how culturally relevant stressors are related to depression and suicidal ideation. First, we identified depression and suicidal ideation prevalence rates for this disadvantaged sample. Second, we determined how cultural stress is experienced over time using stress trajectories. Third, we evaluated how family/cultural stressors and stress trajectories are related to depression and suicidal ideation outcomes. Results showed high rates of baseline depression (24 %) and suicidal ideation (30 %). We used latent class growth analysis to identify three primary stress trajectories (stable, high but decreasing, and increasing) over three time points during 1 year. We found that the increasing stressors trajectory was associated with higher rates of depression and suicidal ideation, and that stress trajectories had unique relationships with mental illness. We also showed that baseline stressors, sum stressors, and high but decreasing stressors maintained positive associations with mental illness after controlling for baseline depression. Our results highlight the importance of focusing on within-group, culturally specific stressors and addressing both operant and cumulative stressors in the study of mental health for marginalized populations and suggest the importance of early intervention in minimizing stressors.     

A Little Goes a Long Way: The Impact of Distal Social Support on Community Integration and Recovery of Individuals with Psychiatric Disabilities

Although an extensive body of literature highlights the important role of social support for individuals with psychiatric disabilities, definitions of support tend to be restricted—focusing on intimate relationships such as friend and family networks and ignoring the role of casual relationships existing naturally in the community. This mixed-methods study of 300 consumers of mental health services in the Southeastern US aims to better understand the impact of community supports, termed distal supports, on community integration and recovery from mental illness. Qualitative content analysis, tests of group mean differences, and hierarchical linear regression analyses revealed the following: (1) participants primarily reported receiving tangible support (e.g., free medication/discounted goods) from distal supports rather than emotional support (e.g., displays of warmth/affection) or informational support (e.g., provision of advice); (2) women and older participants reported more distal supports than men or younger participants; and (3) distal supports played a unique role in predicting community integration and recovery even after accounting for the influence of traditional support networks. Results highlight the importance of considering diverse types of social support in naturally occurring settings when designing treatment plans and interventions aimed at encouraging community participation and adaptive functioning for individuals with psychiatric disabilities.     

Some considerations on the capacity to be alone

This paper considers the lack of coherence of the psychoanalytic theories of the primary and secondary process. As a consequence, the interplay of primary and secondary process modes of thought cannot be conceptualised properly. Firstly, we summarize the results of an elsewhere-made metapsychological re-examination of both principles of mental functioning, and argue that Rapaport's distinction between a drive and a conceptual organization of memory, elaborated on by Siegfried Zepf is an extremely useful means of understanding primary and secondary process activity. As a central thesis, we state that primary process operates by affects, whilst secondary process utilizes concepts. The second part of the paper makes an attempt to show the dialectical relationship of affective and conceptual thought in the functioning of the living psyche. Temporarily dominating mental functioning, primary and secondary process thinking each utilize the other as a means, but never work purely within the psychic apparatus. It is shown that it is the specific interplay of primary and secondary process activity, which produces new adaptive substitutive formations. Some basic assumptions about the concepts of regression and progression are made to elucidate the shift from secondary to primary process dominance and vice versa.     

The impact of parents’ mental health on parent–baby interaction: A prospective study

The aims of the current study were to examine the effect of fathers’ and mothers’ pre and postnatal mental health on mother–infant and father–infant interactions. Mental health was broadly defined to include anxiety, depression and PTSD. A community sample of 44 mothers and 40 fathers from 45 families completed questionnaire measures of mental health in late pregnancy and three months postpartum. Mother–infant and father–infant interactions were observed and videoed three months postpartum and analysed using the CARE-index. Results showed that prenatal mental health, in particular anxiety, was associated with parent–infant interactions to a greater extent than postnatal mental health. Fathers’ prenatal symptoms were associated with higher paternal unresponsiveness and infant passivity whilst fathers’ postnatal symptoms were associated with higher levels of infant difficulty in the father–baby interaction. The results also indicated that mothers and fathers interaction with their babies were similar, both on average and within the couples, with 34% being inept or at risk. These findings highlight the need for early detection and prevention of both mental health and parent–infant relationship problems in fathers as well as mothers. However, further prospective and longitudinal studies are needed to understand the influences of parental mental health on the parent–infant interactions further. Also it should be noted that the mental health scores were low in this sample, which may reflect the sample characteristics. Future studies therefore would benefit from focusing on more vulnerable groups of parents.     

THE INTERPLAY BETWEEN RELIGIOUS LEADERS AND ORGAN DONATION AMONG MUSLIMS

Bioethics and health researchers often turn to Islamic jurisconsults (fuqahā’) and their verdicts (fatāwā) to understand how Islam and health intersect. Yet when using fatwā to promote health behavior change, researchers have often found less than ideal results. In this article we examine several health behavior change interventions that partnered with Muslim religious leaders aiming at promoting organ donation. As these efforts have generally met with limited success, we reanalyze these efforts through the lens of the theory of planned behavior, and in light of two distinct scholarly imperatives of Muslim religious leaders, the ?ilmī and the islāhī. We argue for a new approach to health behavior change interventions within the Muslim community that are grounded in theoretical frameworks from the science of behavior change, as well the religious leadership paradigms innate to the Islamic tradition. We conclude by exploring the implications of our proposed model for applied Islamic bioethics and health research.     

A description of 5- to 12-year old children's conception of health within the context of their daily life

Abstract

This study describes children's conception of health within the context of their daily life. Participants were boys and girls (n = 1,674) from three age groups (5–6, 8–9, and 11–12 years old) from different socio-economic living environments in urban and rural areas. In general, the results indicate that children's conception of health is multidimensional and is rooted in their daily-life experiences. Essentially, it is organized around three main dimensions, functionality, adherence to good lifestyle health habits, and mental health. Variations by age and living environment differences suggest that children's conception of health may reflect differences in their organization of information into schemata on the basis of their experience as well as structural changes in cognitive development.     

Adolescent beliefs about AIDS prevention

Abstract

Four hundred and ten school children, aged between 13 and 16 years, were administered a questionnaire to investigate (a) their perceptions of AIDS and implications of the disease for the victim; (b) beliefs about how best to prevent the spread of disease; (c) sources of information and (d) AIDS relevant topics they would like to learn in school. The results suggested that there were few differences in knowledge or attitude as a function of age, but some significant differences due to sex. Boys were more likely to derogate the AIDS victim compared with girls. In terms of different strategies for prevention, boys were more in favour of “scare” approaches, and girls of information-giving. The success of any AIDS education package may be at least partly determined by individual beliefs about the disease, and preferences for different educational strategies.