The Relationship of Adverse Childhood Experiences to PTSD,Depression, Poly-Drug Use and Suicide Attempt in Reservation-Based Native American Adolescents and Young Adults

Adverse childhood experiences (ACEs) are associated with numerous risk behaviors and mental health outcomes among youth. This study examines the relationship between the number of types of exposures to ACEs and risk behaviors and mental health outcomes among reservation‐based Native Americans. In 2011, data were collected from Native American (N = 288; 15–24 years of age) tribal members from a remote plains reservation using an anonymous web‐based questionnaire. We analyzed the relationship between six ACEs, emotional, physical, and sexual abuse, physical and emotional neglect, witness to intimate partner violence, for those <18 years, and included historical loss associated symptoms, and perceived discrimination for those <19 years; and four risk behavior/mental health outcomes: post‐traumatic stress disorder (PTSD) symptoms, depression symptoms, poly‐drug use, and suicide attempt. Seventy‐eight percent of the sample reported at least one ACE and 40 % reported at least two. The cumulative impact of the ACEs were significant (p < .001) for the four outcomes with each additional ACE increasing the odds of suicide attempt (37 %), poly‐drug use (51 %), PTSD symptoms (55 %), and depression symptoms (57 %). To address these findings culturally appropriate childhood and adolescent interventions for reservation‐based populations must be developed, tested and evaluated longitudinally.     

Talking about daily emotional events: Psychological well-being moderates the intensity–disclosure link

The intensity of distressing events predicts people’s disclosure of those events at between-person and within-person levels. Depression symptoms seem to attenuate the within-person relation, but past research has not taken a multidimensional view of depression as a moderator. The authors tested whether two constructs related to depression-general psychological well-being and life satisfaction-account for depression’s moderating effects. In a daily diary study, college students (N = 116) rated the intensity of the day’s most unpleasant event and their disclosure of the event each day for 14 days. Participants completed measures of disclosure tendencies, depression symptoms, well-being, and life satisfaction prior to the diary portion of the study. Multilevel modeling analyses revealed moderating effects of disclosure tendencies and depression on the within-person intensity–disclosure relation. However, when psychological well-being and life satisfaction were entered, depression was no longer a significant moderator, but well-being was. Psychological well-being therefore determines the expression of individual differences in the disclosure of daily emotional events.     

Evidence that anticipated stigma predicts poorer depressive symptom trajectories among emerging adults living with concealable stigmatized identities

People living with concealable stigmatized identities are vulnerable to experiencing greater depressive symptoms as a result of occupying a lower social status. In the present research, we examine the effect of changes in enacted stigma and changes in anticipated stigma on trajectories of depressive symptoms over time. A sample of 192 college-aged emerging adults (81.0% female, 81.9% Caucasian, M_age = 18.82 years) living with a concealable stigmatized identity (e.g., mental illness and sexual minority status) completed measures of enacted stigma, anticipated stigma, and depressive symptoms at two time points across eight weeks. Hierarchical linear modeling analyses indicate that increases in anticipated stigma, but not enacted stigma, predicted poorer trajectories of depressive symptoms, controlling for the effect of baseline rumination and other identity-related variables. These data are among the first to demonstrate that worries about future devaluation predict poorer depressive symptom trajectories over time among college-aged emerging adults.     

Psychological predictors for health-related quality of life and disability in persons with chronic obstructive pulmonary disease (COPD)

Objective: Individuals with chronic obstructive pulmonary disease (COPD) exhibit low physical and mental health-related quality of life (HRQL) and high susceptibility to disability. We investigated the influence of psychological factors on HRQL and disability in COPD individuals recruited from the general population. In line with Leventhal’s common sense model, we expected psychological factors to be associated with HRQL and disability even after controlling for medical status.

Methods: Individuals with COPD (n = 502; 59.7 years old; GOLD grades were I: 3%, II: 17%, III: 34%, IV: 46%) were assessed through an online survey administered via COPD patient organisations in Germany. Individuals filled in the Short Form Health Survey (SF-12), COPD Assessment Test, Patient Health Questionnaire (modules: GAD-2, PHQ-15, PHQ-9), Brief Illness Perception Questionnaire, a questionnaire that assesses causal illness attributions, and the internal illness-related locus of control scale of the ‘KKG questionnaire for the assessment of control beliefs about illness and health’. Multiple linear regressions were calculated.

Results: The investigated factors explained high variances (disability = 56%, physical HRQL = 28%, mental HRQL = 63%, p ≤ .001). Better mental health, more optimistic illness perceptions, attribution to psychological causes, and stronger internal locus of control were associated with lower disability and better HRQL. Comorbid somatic symptoms contributed to high disability and low quality of life.

Conclusion: Psychological factors, such as illness perception, attribution and internal locus of control, were associated with disability and HRQL. These factors should be considered when designing treatments for individuals with COPD, and adequate interventions should be provided to enhance illness understanding and self-management skills.     

Brain drawings following traumatic brain injury (TBI) and links to illness perceptions and health outcomes – Findings from a population-based study

Objective: Individuals’ illness perceptions predict health behaviours and influence functional outcomes. This study examined associations between a novel assessment of illness perceptions, in the form of adult’s brain drawings after traumatic brain injury (TBI) and questionnaire measures of illness perceptions, quality of life and post-concussive symptoms.

Design: Population-based, prospective longitudinal study examining 245 adults with predominantly mild TBI with high risk of complications.

Main outcome measures: Participants were asked to draw pictures of what they thought their brain looked like before injury and at baseline and one month post-injury. Drawing characteristics (height, width and percentage damage at one month) were examined in relation to each outcome of interest at six months.

Results: Greater damage at one month was associated with more negative illness perceptions (rs = .23), poorer mental health (rs = ?.21), and more total post-concussive symptoms (rs = .27 to r = .35) at six months. The extent of damage depicted reduced over time (p < .001). No associations were found between the amount of damage drawn and injury severity, nor the height or width of drawings and injury severity or illness perceptions.

Conclusion: Drawings post-TBI offer a simple, cost- and time-effective way to begin discussions and improve understanding of peoples’ illness perceptions.     

Pathways maintaining physical health problems from childhood to young adulthood: The role of stress and mood

Objective: Poor physical health in childhood is associated with a variety of negative health-related outcomes in adulthood. Psychosocial pathways contributing to the maintenance of physical health problems from childhood to young adulthood remain largely unexamined, despite evidence that factors such as negative mood and stress impact physical health.

Design: The current study tested the direct and indirect effects of ongoing health, chronic stress, health-related chronic stress, and depressive symptoms at age 20 on the link between health problems in childhood and young adulthood (age 21) in a longitudinal sample (n = 384).

Main Outcome Measures: The hypotheses were tested using a multiple mediation path analysis framework; the primary outcome measure was a composite index of health status markers in young adulthood.

Results: The proposed model provided an adequate fit for the data, with significant total indirect effects of the four mediators and significant specific indirect effects of health-related chronic stress and depressive symptoms in maintaining health problems from childhood into young adulthood.

Conclusions: Health problems are maintained from early childhood into young adulthood in part through psychosocial mechanisms. Depressive symptoms and health-related chronic stress have significant, unique effects on the relationship between health problems in early childhood and young adulthood.     

Occupational stress,job satisfaction and physical health in teachers

IntroductionChanges within the teaching profession have been blamed for the high levels of stress reported by teachers. In recent decades, Italian schools have been characterised by continuous change, as a result of profound transitions that have affected political, social and economic development.ObjectiveThis paper investigated the relationship between occupational stress, job satisfaction and physical health in Italian teachers. Specifically, our aim is to study the role of job satisfaction as a possible mediation role between work stressors and its effects on teachers’ physical health (physical symptoms). In addition, we were interested in studying the direct effects of work stressors on the hypothetical outcomes (physical symptoms).MethodData were collected via a questionnaire from a sample of 565 teachers working in different upper secondary schools in Italy. The booklet filled by the teachers consisted of 32 items that measure perceived occupational difficulties, job satisfaction and physical symptoms.ResultsThe results showed that workload, perception of work environment, teachers’ perceptions of senior management and attitude towards change are specific perceived occupational difficulties of the Italian teachers involved in our research. In particular, workload and attitude towards change have significant direct effects on physical symptoms, and indirect effects on physical symptoms through job satisfaction. Also, job satisfaction decreases physical symptoms.ConclusionThe results suggest important implications for stress prevention in teachers. In fact, the level of stress and its consequences can be reduced and prevented through an accurate identification of its sources, with a positive effect on individual and organisational health.     

Psychological well-being of patients with insomnia and its relationship with anxiety and depression

The aims of the present study are to evaluate the impact of insomnia on psychological well-being and to examine the associations of insomnia and psychological well-being with anxiety and depression. Forty-one patients attending our hospital-based Centre for sleep medicine were administered scales for the evaluation of insomnia (ISI), anxiety (STAI-Y), depression (BDI-II) and psychological well-being (PWB). The scores were compared to those of a control group of 68 subjects attending the hospital for routine examinations or as accompanying persons. Significant differences between patients and controls were detected for anxiety and depression, as well as for psychological well-being. Even if subclinical on average, anxiety and depression symptoms were significantly related to poor psychological well-being, whereas insomnia per se was not. These findings suggest that patients with insomnia report a relevant impact on their psychological well-being, and that such an impact seems to be strongly associated with concomitant subthreshold symptoms of anxiety and depression. The implications for diagnosis and treatment are discussed.     

Post-traumatic stress symptoms in adolescents exposed to an earthquake: Association with self-efficacy,perceived magnitude,and fear

The objective of this study was to evaluate th×e relationship between the magnitude of an earthquake, the fear experienced, the self-efficacy beliefs, and post-traumatic stress symptoms in adolescents. We expected self-efficacy beliefs to predict post-traumatic stress symptoms, and this relation to be mediated by fear. We used data from a longitudinal project on adolescent normative development that was under way at the time of the 2010 earthquake in Chile. Six months before the earthquake, 218 adolescents responded to a self-efficacy beliefs scale; three months after the earthquake they reported the perceived magnitude of the event, the fear they experienced, and their post-traumatic stress symptoms. Results showed that perceived magnitude was not associated with fear or post-traumatic stress symptoms, but self-efficacy beliefs and fear were associated with post-traumatic stress symptoms. The hypothesized role of fear as a mediator in the relation between self-efficacy beliefs and post-traumatic stress symptoms was supported by the data. The results of the study, suggest that preventive interventions aimed to increase awareness of how to face a disaster may not only contribute to save lives but may also increase adolescentś sense of personal efficacy, reducing subsequent emotional reactivity associated with the event.