Addressing social determinants of mental health in therapy: A thematic synthesis

Background

The importance of addressing social determinants of mental health in therapy is well-documented. However, there appears to be limited research on what this actually involves in practice and how best to prepare therapists to work with individuals experiencing adverse social determinants.

Aims

The aim of this review was to draw implications for practice and training from reviewing research on addressing social determinants of mental health in therapy.

Methodology

A qualitative systematic review of the research on addressing social determinants of mental health in therapy was conducted, extracting papers from eight databases: Cochrane Library, ASSIA, CINAHL Plus, PsycInfo, Psychoanalytic Electronic Publishing, Science Direct, Scopus and Web of Science. Out of 127 papers found, five met the eligibility criteria and were quality-assessed and analysed thematically.

Findings

The thematic synthesis generated three main themes: “the therapeutic relationship,” “adapting to client context” and “community as a resource,” with eight subthemes.

Conclusion

This thematic synthesis highlights the importance of the therapeutic relationship and adapting mental health support to client frame of reference and context to address social determinants of mental health in therapy. It emphasises community as a helpful resource for informing training and therapeutic interventions, as well as a significant resource for people experiencing adverse social determinants.     

Romantic relationship quality during the COVID-19 pandemic: The longitudinal associations with relationship loneliness and depression

The COVID-19 pandemic created significant strain on both mental health and romantic relationships. Therefore, we examined longitudinal associations between romantic relationship quality, relationship loneliness, and depressive symptoms over 6 months of the COVID-19 pandemic. We surveyed 122 couples (n = 244 individuals) in approximately May, September, and November 2020. Using a dyadic mediation model, findings indicated that relationship quality at Time 1 was positively associated with depression at Time 3 for men, but not for women. A significant indirect effect of relationship quality on depression via relationship loneliness at Time 2 was found for both men and women. Self-mastery, or feeling in control of one's life circumstances, was an important covariate of women's depressive symptoms. Overall, these findings highlight relationship loneliness as particularly salient for mental health and demonstrate the importance of high-quality relationships for promoting well-being during stressful events, such as global pandemics.     

Sleep as a mediator of the relationship between social class and health in higher education students

A substantial body of research indicates that higher education students from lower social class backgrounds tend to have poorer health than those from higher social class backgrounds. To investigate sleep as a potential mediator of this relationship, online survey responses of students from five large Australian universities, one Irish university and one large Australian technical college were analysed in three studies (Study 1 N = 628; Study 2 N = 376; Study 3 N = 446). The results revealed that sleep quality, sleep duration, sleep disturbances, pre-sleep worries and sleep schedule variability mediated the relationship between social class and physical and mental health. Sleep remained a significant mediator when controlling for related variables and other mediators. Thus, the findings suggest that sleep partly explains social class differences in health. We discuss the importance of addressing sleep issues among students from lower social class backgrounds.     

职业卫生与企业社会责任探讨

就企业社会责任、企业伦理和职业卫生的关系展开讨论。在企业中,职业卫生是保障员工健康的措施,也是企业社会责任和伦理的体现。并就企业社会责任缺失,对存在的职业卫生问题进行探讨。针对企业的社会责任缺失导致的卫生意识缺乏、管理不合理和忽视职业病防治等,建议强化文化建设、道德建设及安全生产管理,提高员工健康意识和维权能力。而职业卫生工作者应该保持职业道德和专业精神,积极参与卫生监督和评估工作。最后,探讨我国部分新兴企业和传统企业的职业卫生伦理问题,强调企业可持续发展中需履行的社会责任和遵守的伦理规范。

     

贫困对儿童心理健康的影响及其内在机制

儿童贫困问题是世界范围内的一个重大公共卫生问题。近几十年来,国内外的研究发现贫困对儿童的消极心理健康状态和积极心理健康状态均会产生影响。研究者试图从家庭和社会两个层面来解释贫困对儿童心理健康的影响,以揭示其内在影响机制。未来的研究应加强贫困儿童心理健康发展过程中的保护因素研究,探索儿童期贫困对个体心理健康的长期影响及其成因,进一步在我国社会文化背景下开展本土化研究,为实践上的预防和干预提供帮助。     

iCOPE With COVID-19: A Brief Telemental Health Intervention for Children and Adolescents During the COVID-19 Pandemic

The COVID-19 pandemic has prompted extensive disruptions to the daily lives of children and adolescents worldwide, which has been associated with an increase in anxiety and depressive symptoms in youth. However, due to public health measures, in-person psychosocial care was initially reduced, causing barriers to mental health care access. This study investigated the feasibility, acceptability and preliminary effectiveness of iCOPE with COVID-19, a brief telemental health intervention for children and adolescents to address anxiety symptoms. Sessions were provided exclusively using videoconferencing technology. Feasibility and acceptability were measured with client satisfaction data. The main outcome measure for effectiveness was anxiety symptom severity measured using the Screen for Child Anxiety and Related Disorders (SCARED). Results indicated that the treatment was well accepted by participants. Significant reductions in anxiety were noted for social anxiety, and were observed to be trending towards a mean decrease for total anxiety. The findings suggest that this brief telemental health intervention focused on reducing anxiety related to COVID-19 is acceptable and feasible to children and adolescents. Future research using a large sample and with a longer follow-up period could inform whether symptom decreases are sustained over time.     

Dynamics and moderating factors of esport participation and loneliness: A daily diary study

The purpose of this study was to examine the association between esport participation and loneliness, as well as its moderating factors. Chinese college students (N = 216) self-reported their esport playing time and degree of loneliness each day immediately before bedtime for four consecutive weeks. The findings revealed that as playing time increased, students did not experience reduced sense of loneliness during playing esport, but they experienced a temporary and intensified feeling of loneliness the same day following gameplay. Students with higher general loneliness tended to feel more after-game loneliness associated with increased esport participation. Students with higher obsessive passion about esport tended to experience more loneliness (both in-game and after-game) associated with increased esport participation. Students with greater coping motivation about esport tended to experience more in-game loneliness associated with previous increased esport participation. Students who played esport less often with friends in person, or with more escape motivation toward esport, tended to increase esport participation time more following previous increased after-game loneliness. The findings suggested that college students should avoid utilizing esport to achieve a sense of belonging and should be cautious of the loneliness-inducing effect after gameplay. A healthy level of loneliness can be maintained by playing esport more with friends in person, learning strategies to avoid obsessive passion, coping motivation, and escape motivation towards esport.     

New students' psychological well‐being and its relation to first year academic performance in a UK university

Aims: This study (1) profiled the well‐being of first year students entering one UK university, and (2) explored whether initial well‐being and year end academic performance were correlated. Method: A total of 117 students (mean age 21, 67% female) completed the Rosenberg Self‐Esteem Scale, Clinical Outcomes in Routine Evaluation‐General Population, and Liebowitz Social Anxiety Scale; academic achievement data were collected from academic records. Results: Almost a quarter of the sample reported quasi‐clinical levels of psychological distress and moderate to very severe social anxiety. Quasi‐clinical levels of psychological distress were associated with low self‐esteem and social anxiety. No statistically significant links were found between well‐being as assessed at the beginning of the first year and academic achievement at the end of the first year. Discussion: The failure to find a link in this study between initial well‐being and academic performance at the end of the first year suggests that further investigation is required to understand how academic achievement is related to student well‐being.     

无聊：一个久远而又新兴的研究主题

无聊是个体由于知觉到生活无意义而产生的负性情绪体验, 它会直接或间接地影响各种社会心理功能。目前, 有关心理健康、社会适应、学业成绩等一系列心理问题的研究已经揭示了无聊的负性作用。但是, 无聊领域的研究还停留在理论探讨和相关研究层面, 概念定义尚没有完全统一, 缺乏系统的理论和完整的模型结构。未来研究可进一步深入探究无聊的作用机制, 并制定有效的干预方案来改善人们的无聊状态。     

健康行动过程取向模型的发展与前景

健康行动过程取向(HAPA)模型的提出源于健康行为社会认知模型的发展和Bandura社会认知理论的应用。在HAPA中, 健康行为变化被视为一个包括行为产生、保持和恢复在内的连续过程; 结果预期、危险感知、三种自我效能感和两类计划被用来解释意图的形成及其向行动的转化; 两个阶段的划分有助于区分三类干预对象, 建议实施菜单式干预。HAPA模型具有明显的理论优势, 也引发了有关模型实质的争论。当前和未来的研究旨在考察更多的自我调节变量、检验因果模型, 在健康行为的多个领域开展应用和干预研究。