Mental Health Services Use Intentions Among Canadian Military Recruits

Identifying the factors associated with mental health services use (MHSU) is an important step in developing strategies to improve services access and delivery. The aims of the present study were to (a) identify personality and individual difference characteristics associated with MHSU intentions within the framework of the Theory of Planned Behavior (TPB) and (b) explore complex relationships that might exist between these characteristics and determinants of MHSU intentions identified in TPB, including attitudes, subjective norms, and perceived behavioral control. Data for 244 Canadian Armed Forces recruits who completed a MHSU questionnaire following mental health training were linked to personality data collected earlier. Multivariate analyses showed that the relationship between agreeableness and MHSU intentions was mediated by instrumental attitudes and subjective norms. The relationship between hardiness and MHSU intentions was mediated by subjective norms and self-efficacy. Findings suggest it may be worthwhile to consider mental health education initiatives to improve MHSU.     

Stressors Experienced During Deployment Among Canadian Armed Forces Personnel: Factor Structure of Two Combat Exposure Scales

Combat exposure is linked to increased mental health problems among military personnel. Reliable, precise, and efficient measurement of combat experiences can facilitate understanding of the effects of combat on mental health. This study examined the psychometric properties of 2 scales used to assess deployment experiences in Canadian Armed Forces (CAF) personnel in 2 different settings: during a Third Location Decompression (TLD) program after deployment, and during routine postdeployment screening. Principal components analyses yielded similar results for the 2 measures. The components containing items relevant to Exposure to the Dead and Injured, Dangerous Environment, and Active Combat were common across both surveys. The TLD results revealed a fourth component, Personal Suffering, while the postdeployment screening data revealed a fourth component, Perceived Responsibility. This study found categories of deployment stressors that can be used for further analysis, and underscores the importance of assessing a broad range of exposures in the combat environment.     

Short‐term cognitive‐behavioral treatment in multicultural primary care of patients with longstanding backache

The efficacy of cognitive‐behavioral therapy in multi‐cultural primary care patients with longstanding backache is not evaluated. The purpose of this study was to investigate the outcome of a four weekly‐treatment given by primary care physicians regarding pain‐related worry, depression and severe pain and to determine which social, clinical or gender factors were associated with outcome.The study group consisted of 245 patients in consecutive order from 19 countries, 18 to 45 years, entering rehabilitation program because of longstanding backache. Prevalences of pain‐related worry and depression and severe pain was counted and compared before and after. Logistic regression was used to calculate the odds (OR; 95% CI) for persistent pain‐related worry and/or persistent depression and severe pain (VAS ≥ 50). The prevalences of pain‐related worry and depression were both significantly lower after treatment (pain‐related worry 83% before vs. 38% after; depression 43% before vs. 31% after). Also the number of patients scoring ≥ 50 VAS was a little, but significantly, fewer (68% vs. 61%). Use of interpreter doubled the risk of having persistent pain‐related worry (OR 2.1; 95% CI 1.1–4.1) but the risk was not significant regarding persistent depression (OR 1.8; 0.6‐5.4). The rating of VAS rating ≥ 50 after treatment was twice as high, OR 2.3 (95% CI 1.1–4.6) in the 38–45 year old age group. To conclude, a focus on pain ideas reduced pain‐related worry and depression in these patients with various sociocultural backgrounds and longstanding backache.     

Effect of the Healthy MOMs Lifestyle Intervention on Reducing Depressive Symptoms Among Pregnant Latinas

Depression during the prenatal and postpartum periods is associated with poor maternal, perinatal and child outcomes. This study examines the effectiveness of a culturally and linguistically tailored, social support-based, healthy lifestyle intervention led by trained community health workers in reducing depressive symptoms among pregnant and early postpartum Latinas. A sample of 275 pregnant Latinas was randomized to the Healthy MOMs Healthy Lifestyle Intervention (MOMs) or the Healthy Pregnancy Education (control) group. More than one-third of participants were at risk for depression at baseline. MOMs participants were less likely than control group participants to be at risk for depression at follow-up. Between baseline and 6 weeks postpartum, MOMs participants experienced a significant decline in depressive symptoms; control participants experienced a marginally significant decline. For MOMs participants, most of this decline occurred during the pregnancy intervention period, a time when no change occurred for control participants. The change in depressive symptoms during this period was greater among MOMs than control participants (“intervention effect”). From baseline to postpartum, there was a significant intervention effect among non-English-speaking women only. These findings provide evidence that a community-planned, culturally tailored healthy lifestyle intervention led by community health workers can reduce depressive symptoms among pregnant, Spanish-speaking Latinas.     

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.     

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.     

Functional hemispheric asymmetries of global/local processing mirrored by the steady-state visual evoked potential

While hemispheric differences in global/local processing have been reported by various studies, it is still under dispute at which processing stage they occur. Primarily, it was assumed that these asymmetries originate from an early perceptual stage. Instead, the content-level binding theory (Hübner & Volberg, 2005) suggests that the hemispheres differ at a later stage at which the stimulus information is bound to its respective level. The present study tested this assumption by means of steady-state evoked potentials (SSVEPs). In particular, we presented hierarchical letters flickering at 12 Hz while participants categorised the letters at a pre- cued level (global or local). The information at the two levels could be congruent or incongruent with respect to the required response. Since content-binding is only necessary if there is a response conflict, asymmetric hemispheric processing should be observed only for incongruent stimuli. Indeed, our results show that the cue and congruent stimuli elicited equal SSVEP global/local effects in both hemispheres. In contrast, incongruent stimuli elicited lower SSVEP amplitudes for a local than for a global target level at left posterior electrodes, whereas a reversed pattern was seen at right hemispheric electrodes. These findings provide further evidence for a level-specific hemispheric advantage with respect to content-level binding. Moreover, the fact that the SSVEP is sensitive to these processes offers the possibility to separately track global and local processing by presenting both level contents with different frequencies.