Group critical incident stress debriefing with emergency services personnel: a randomized controlled trial

Although single-session individual debriefing is contraindicated, the efficacy of group psychological debriefing remains unresolved. We conducted the first randomized controlled trial of critical incident stress debriefing (CISD) with emergency workers (67 volunteer fire-fighters) following shared exposure to an occupational potentially traumatic event (PTE). The goals of group CISD are to prevent post-traumatic stress and promote return to normal functioning following a PTE. To assess both goals we measured four outcomes, before and after the intervention: post-traumatic stress, psychological distress, quality of life, and alcohol use. Fire brigades were randomly assigned to one of three treatment conditions: (1) CISD, (2) Screening (i.e., no-treatment), or (3) stress management Education. Controlling for pre-intervention scores, CISD was associated with significantly less alcohol use post-intervention relative to Screening, and significantly greater post-intervention quality of life relative to Education. There were no significant effects on post-traumatic stress or psychological distress. Overall, CISD may benefit broader functioning following exposure to work-related PTEs. Future research should focus on individual, group, and organizational factors and processes that can promote recovery from operational stressors. Ultimately, an occupational health (rather than victim-based) approach will provide the best framework for understanding and combating potential threats to the health and well-being of workers at high risk for PTE exposure.     

The Culture-Embedded Social Problem of Elder Mistreatment: A Review of International Literature on Asian Elders

Elder mistreatment is now recognized as a worldwide social problem occurring in all racial and ethnic groups. The research on elder mistreatment started in the late 1970s and expanded its focus to ethnic elderly groups including Asian elders in the mid-1980s. Many researchers have explored the issues of elder mistreatment in conjunction with Asian elders’ culture and immigration backgrounds. This article reviews the state of the literature on elder mistreatment among Asians living in Asia or abroad to identify future directions of research, prevention, intervention, and policy. This research indicates that prevention, education, and intervention must take into account the cultural backgrounds of Asian elders and their family members. There is clearly a need for greater research into appropriate elder mistreatment prevention and intervention with Asian elders and their family members.     

College students' search for sexual health information from their best friends: An application of the theory of motivated information management

Guided by the theory of motivated information management, this study investigated the extent to which Singaporean college students' sexual health information‐seeking behaviour could be accounted for by their anxiety of uncertainty discrepancy, their perceived outcomes of information seeking and their perceived confidence in seeking and coping with sexual health information acquired from their best friends. Taking into account that issue relevance may play a role in individuals' health decision‐making, this study also examined the effect of perceived vulnerability on respondents' sexual health information‐seeking behaviour. An online survey was conducted with 202 undergraduate students at a university in Singapore. Respondents were asked to report the frequency with which they sought four types of sexual health information from their best friends: unwanted pregnancy, abortion, HIV/AIDS and other sexually transmitted infections. Survey data showed that respondents' uncertainty discrepancy was positively associated with their anxiety. Anxiety had negative effects on efficacy and outcome expectancy. Outcome expectancy was positively associated with efficacy. Both efficacy and perceived vulnerability accounted for a significant amount of variance in respondents' sexual health information‐seeking behaviour. Findings from this study contribute to a better understanding of young adults' sexual health information behaviour in a Singapore context.     

How professional pilots perceive interactions of working conditions,rosters, stress,sleep problems,fatigue and mental health. A qualitative content analysis

IntroductionSo far, no qualitative content analysis (QCA) has analysed pilots’ experiences and perceptions regarding weaknesses of fatigue risk management (FRM), flight time limitations (FTL), rosters, fatigue-severity, sleep problems, and how they relate to pilots’ mental health and well-being.ObjectiveThis research analyses pilots’ described perceptions of stress, fatigue, aviation safety and how regulations like FTL can affect their health and well-being.MethodIn total, 119 international pilots described their perceptions of FTL, rosters, aviation safety, and how they relate to fatigue and health. The QCA was conducted to analyse interactions of working conditions, stressors, fatigue, sleep problems and mental health of EASA-based and Australian pilots.ResultsAlthough pilots were rostered for only 60.8% to 62.5% of the legally allowed duty and flight hours/month, 78.6% reported severe or very high fatigue, 22.8% significant depression, 12.3% significant anxiety symptoms, 10.5% reported significant depression and anxiety symptoms. Pilots uttered severe concerns about FTL, sleep restrictions associated with early starts, minimum rest, etc. Pilots also expressed distinct fears regarding more fatigue-related crashes, and how adverse working conditions, work-related and psychosocial stress could impair their health.ConclusionsThis QCA provided valuable insights into interactions of working conditions, fatigue, sleep restrictions, physical and mental health. Progressive health impairment due to lack of sleep and accumulated fatigue promote burnout, mental and physical health problems, which not only threaten flight safety, but also sustainability of aviation.     

城镇化进程中离乡农民心理健康特点调查及心理素质、相对剥夺感的影响机制

为探讨城镇化进程中离乡农民的心理健康特点以及心理素质、相对剥夺感对其的影响,通过量表对1339名城乡居民进行调查。结果发现:离乡与留乡农民在幸福感、拥有生命意义感、感知控制感、心理素质方面显著低于城镇居民,在状态焦虑方面显著高于城镇居民; 离乡农民在抑郁上显著高于城镇居民,在感知控制感上显著高于留乡农民,在心理素质上显著低于留乡农民; 留乡农民在相对剥夺感上显著高于城镇居民; 离乡农民的幸福感、拥有生命意义感、感知控制感态与相对剥夺感呈显著负相关,与心理素质呈显著正相关; 离乡农民的抑郁、状态焦虑与相对剥夺感呈显著正相关,与心理素质呈显著负相关; 离乡农民的相对剥夺感与心理素质之间呈显著负相关。心理素质除了可以直接预测心理健康各项指标,还可以通过相对剥夺感的中介作用,间接预测幸福感、抑郁及状态焦虑。提升心理素质和降低相对剥夺感是离乡农民心理健康服务的重要切入点。     

Digital Mental Health Services: Moving From Promise to Results

The papers in this special series make a compelling case for the value of digital mental health services (DMHS; including technology-based interventions, assessments, and prevention programs) to help address some of the currently unmet needs in mental health care. At the same time, the papers highlight the work that needs to be accomplished for DMHS to fulfill their promise. We review the papers’ contributions in terms of (a) the imperative to increase access to evidence-informed, high-quality care, especially for underserved populations, both in the United States and globally; (b) ways to use DMHS to improve the ways that clinical care is provided to make treatment provision more effective and efficient; and (c) the current state of the research on DMHS for emotional disorders. We then consider lessons learned and recommendations to move the field forward, such as increasing (and making transparent) the research base on DMHS, adopting regulatory standards for DMHS, attending carefully to training issues for DMHS and best practices for dissemination and implementation, designing specifically for digital platforms, and being intentional about efforts to reduce disparities regarding who benefits from DMHS.     

Digital Mental Health Interventions for Child and Adolescent Anxiety

Anxiety disorders are the most common mental health conditions in children, with approximately 13% of kids struggling with excessive anxiety. The vast majority do not have access to effective treatments and there continues to be a disjunction between treatments that are empirically supported and those that are available in the community. Digital mental health interventions (DMHI) can increase efficiency, reach, and standardization as well as reduce costs of providing of mental health care. Here we review the extant research on DMHI, including web- or cloud-based programs, mobile applications (apps), virtual reality (VR), and digital assessment methods such as ecological momentary assessment (EMA) for the delivery and/or support of evidence-based care in child anxiety. Preliminary research is promising for these tools to improve access and efficiency of evidence-based practice. However, ethics and practice guidelines are needed and questions remain regarding what level and quality of therapeutic involvement is needed to maximize treatment completion and outcomes in youth and whether DMHIs are contraindicated for certain populations or whether they are similarly effective with those with comorbid conditions is unclear.     

Australian parents’ willingness to use a rideshare vehicle to transport their unaccompanied children

This study aimed to identify the key factors associated with Australian parents' willingness to use a rideshare vehicle to transport their unaccompanied child(ren). Six hundred and thirty-one participants completed an online survey (M = 39.2 years, SD = 10.5, Range = 18.0–70.0 years; Female: 63.4%). Most participants (62.1%) reported that they would 'never' use a rideshare vehicle to transport their unaccompanied child(ren). The results of a logistic regression model showed that participants': previous use of a rideshare vehicle with their child, annual mileage, propensity for technology adoption, aberrant driving behaviours, as well their requirements for vehicle features were significantly associated with their willingness to use a rideshare vehicle to transport their unaccompanied child, χ2(7) = 159.59, p < 0.001. Overall, the findings suggest that Australian parents are mostly ‘unwilling’ to use a rideshare vehicle to transport their unaccompanied children. Understanding the views of parents towards emerging transportation modes for their children is crucial for urban planning, traffic engineering, economic and social mobility and ultimately, on supporting safe modes of transportation.     

Profession Differences in Family Focused Practice in the Adult Mental Health System

There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross‐sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices.