Depression screening and treatment among uninsured populations in Primary Care

Uninsured populations have poor treatment engagement and are less likely to receive evidence-based interventions for depression. The objective of the current study was to retrospectively examine depression screening, diagnosis, and treatment patterns among uninsured patients in primary care. Study sample included all patients (N = 11,803) seen in nine community-based clinics. Key variables included depression screener and/or a depression diagnosis, anti-depressant initiation, behavioral health visits, and patient follow up measures. Treatment patterns from the subsample of patients diagnosed with depression were analyzed by collecting the number of behavioral health visits and antidepressant use six months (180 days) following the diagnosis. Utilization of the depression screening tool was high (67%, n = 7,935) and 24% (n = 2,789) of the patients had a diagnosis of depression, however, more than half of the patients with a depression diagnosis did not have a recorded treatment plan (n = 1,474). The odds of anti-depressant use and behavioral visits for Hispanic patients were significantly greater than for Non-Hispanic patients. Universal screening with brief measures in primary care is improving, however, guideline-concordant depression treatment remains elusive for uninsured populations.     

Social status and friendship in peer victimization trajectories

Background/Objective: Most studies have evaluated victimization at a single time point, making it difficult to determine the impact of the time during which an individual is victimized. This longitudinal study aims to examine the differences in the levels of social status (social preference and perceived popularity) and friendship in peer victimization trajectories, and to analyse if there were changes over time in the levels of social status and friendship in each trajectory. Method: The final sample was composed of 1,239 students (49% girls) with ages between 9 and 18 (M = 12.23, SD = 1.73), from 22 schools in southern Spain. Peer nominations were collected. Results: The General Linear Model results associated the highest levels of social preference, perceived popularity and friendship with the sporadic victimization profile and the lowest levels of these dimensions with the stable profile. Conclusions:The results are discussed based on important personal aspects of stable victimization that confirms social rejection, unpopularity, and the low social support that victimization causes. This contribution is discussed in terms of health and social welfare in adolescence.     

Opposite strain-dependent differences for intermale aggressive behavior elicited by individual housing and housing with a female in the mouse

Male mice of the C57BL/6 strain show a significant increase in aggression toward a nonaggressive male conspecific following 72 hr of individual housing. However, this increase was no longer evident following 2 weeks of individual housing. When housed with a female, C57BL/6 mice show significantly more aggression than singly housed mice of the same strain after 72 hr as well as 2, 4, 8 weeks of differential housing. Male C57BL/6 mice housed with a female also show significantly higher levels of aggression than DBA/2 mice living in the same housing condition after 4 or 8 weeks of differential housing. Finally, male DBA/2 mice individually housed for 8 weeks are significantly more aggressive than mice of the same strain housed with a female for the same time. These results indicate that the increase in aggressive behavior observed following isolation and cohabitation with a female in the mouse is not the same phenomenon. © 1994 Wiley-Liss, Inc.     

Be a Mom,a Web-Based Intervention to Prevent Postpartum Depression: Results From a Pilot Randomized Controlled Trial

Be a Mom is a self-guided web-based intervention, grounded in cognitive behavioral therapy, delivered to postpartum women to prevent persistent postpartum depression [PPD] symptoms. We aimed to evaluate Be a Mom in terms of its preliminary efficacy, feasibility, and acceptability. A pilot randomized, two-arm controlled trial was conducted. Eligible women (presenting PPD risk-factors and/or early-onset PPD symptoms) were enrolled in the study and were randomly assigned to the intervention (Be a Mom) or to the waiting-list control group. Participants in both groups completed baseline (T1) and postintervention (T2) assessments. The 194 women presenting risk factors/early-onset PPD symptoms were allocated to the intervention (n = 98) or to the control (n = 96) group. A significant Time × Group interaction effect was found for both depressive and anxiety symptoms, with women in the intervention group presenting a larger decrease in symptoms from T1 to T2 (p < .05). Less than half of the women (41.8%) completed Be a Mom. Most women (71.4%) would use Be a Mom again if needed. Results provide preliminary evidence of the Be a Mom’s efficacy, acceptability and feasibility, although further research is needed to establish Be a Mom as a selective/indicative preventive intervention for persistent PPD.     

Conversation Orientation Moderates the Relationship between Information Sharing of Medically Assisted Reproduction and Child Adjustment

Parents who experienced infertility have increasingly used medically assisted reproduction (MAR) to add children to their families over the past few decades. These parents will need to decide if they will tell their children about being conceived using MAR. Although MAR information sharing operates within family contexts, little is known about the role of conversation orientation—one family contextual factor—in child outcomes associated with MAR information sharing in middle childhood. Derived from the Family Communication Patterns Theory, this study proposes that conversation orientation moderates the associations between MAR information sharing and children's psychosocial adjustment. This proposal was tested using a sample of 81 6- to 12-year-old MAR-conceived children from 55 families and a structured observational measure of conversation orientation. Multiple regression analyses showed that MAR information sharing interacted with conversation orientation to influence children's behavioral and attention problems but not emotional problems. In families with high conversation orientation, MAR information sharing was not significantly associated with children's behavioral and attention problems. In families with low conversation orientation, MAR information sharing was significantly associated with an increase in children's behavioral and attention problems. Results of this exploratory study demonstrate the potential significance of general communication orientation in understanding child outcomes of MAR information sharing and highlight the needed family context nuances in MAR research.     

Fathers’ Dosage in Community-based Programs for Low-income Fathers

Community-based programs for low-income fathers often struggle to get fathers to attend services and activities. This paper reviews the literature examining approaches to measuring dosage in fatherhood programs, rates of dosage, influences on dosage, and the associations between dosage and fathers’ outcomes. Studies were limited to programs that conducted randomized control trials, quasi-experimental studies, and one-group pretest/post-test designs. Although most programs report low or moderate dosage levels, some programs achieve high levels of fathers’ participation in parenting, coparenting, and economic security classes. Few studies examined dosage in relation to father outcomes. All but one of seven studies reporting effects showed that higher dose levels had positive associations with outcomes such as engagement with children, parenting satisfaction and self-efficacy, perception of coparenting quality, payment of child support, and earnings from work. This paper discusses future directions for studying father's dosage in fatherhood programs.     

Identity,Couple and Intergroup Dynamics in Intercultural Families: Implications on Life Satisfaction of Partners

The current study analyzed how identity, couple, and intergroup dynamics are related to life satisfaction among 210 intercultural partners living in Italy. Three levels of analysis were considered: a micro level, taking into account the identity aspect of each partner in terms of self- or hetero-ethnic identification; a meso level, examining the passion, commitment, and intimacy of the couple sphere of the partners; a macro level investigating the discrimination that partners can perceive by the community as an effect of the relationship between dominant and minority groups. The results show that for both partners, foreign and Italian, the variables that have a predictive value on life satisfaction bring into play the couple and the intergroup dynamics, leaving out the identitary one. Specifically, increased perceived discrimination as a member of a mixed couple leads to decreased life satisfaction by partners. In turn, we can see that a strong intimacy between partners enhances their life satisfaction. These results introduce a reflection on the role of the differences about the ethnic identity, considered erroneously the main cause of dissatisfaction in the mixed couple. The implications of the study are described and suggestions for future research discussed.     

The Role of Children's Neurophysiological Functioning in the Links Between Emotion-Parenting Behaviors and Child Anxiety Symptoms: A Biological Sensitivity to Context Framework

A plethora of data supports links between parenting behaviors and child anxiety, but few studies have examined factors that can contribute to variability in these relations. Adopting a biological sensitivity to context framework, this study explored the role of children's physiological stress reactivity in the links between emotion-parenting and child anxiety symptoms in a group of Chinese families. Sixty-one parent–child dyads (child M_age = 8.21 years, SD = 1.40, range = 6–12 years) participated in an acute stress protocol, from which children's physiological (cortisol and respiratory sinus arrhythmia) responses to a social speech task were recorded. Participants then completed questionnaires assessing parents’ emotion-parenting behaviors and children's anxiety symptoms. Results showed that the relation between supportive emotion-parenting and child anxiety was stronger in the context of greater child RSA suppression to acute stress, such that children higher in RSA suppression exhibited lower anxiety symptoms when supportive emotion-parenting was higher than when it was lower. Thus, these findings supported the biological sensitivity to context model. No significant moderation effect was detected for cortisol reactivity or recovery. Instead, exploratory mediation analyses showed that supportive emotion-parenting was negatively related to child anxiety via greater cortisol recovery. There was also a significant indirect path where unsupportive emotion-parenting was related to blunted cortisol recovery, which in turn was associated with higher child anxiety. The results highlight the importance of coaching parents to respond in supportive ways to children's emotional expressions, particularly in the context of greater child reactivity, to help buffer against childhood anxiety symptoms.     

Relationships Among Emerging Adult Psychological Problems,Maltreatment, and Parental Psychopathology: Moderation by Parent–Child Relationship Quality

Current research supports clear relationships between parental psychopathology, parental maltreatment, and emerging adult child psychopathology. Less research has examined how the role of the parent–child relationship influences these existing associations. The current study tested two models that examined the moderating effect of parent–child relationship quality on parental psychopathology and emerging adult mental health as well as the effect on parental maltreatment and emerging adult mental health. It was expected that high parent–child relationship quality would buffer against the negative effects of parental psychopathology and maltreatment while enhancing the effects of functional parenting characteristics. Participants included 1,452 emerging adults, predominantly Caucasian (73.3%) college students who completed surveys on their mental health, recent experienced maltreatment, and their parents’ mental health problems. Results suggested lowest rates of mental health problems for emerging adults were associated with higher parent–child relationship quality and lower parental psychological problems, whereas negative outcomes were associated with higher parental psychopathology, regardless of parent–child relationship quality. Additionally, physical maltreatment was associated with lower rates of mental health concerns in the context of higher mother-daughter relationship quality. Results emphasize the continuing impact of the parent–child relationship, particularly the mother-daughter relationship, on emerging adults’ mental health. Moreover, the current study demonstrates the continuing influence of parents on their emerging adult children.