Adapting and testing telephone-based depression care management intervention for adolescent mothers.

This phase 1 clinical trial combined qualitative and quantitative methods to modify a collaborative care, telephone-based, depression care management intervention for adolescent mothers and to determine the acceptability, feasibility, and initial efficacy of the intervention in a sample of adolescent mothers (n = 97) who were recruited from a Teen Parent Program. Outcomes included measures of depressive symptoms, functioning, and use of mental health services. Acceptability of the intervention was demonstrated, but feasibility issues related to the complex life challenges confronting the adolescent mother. Although only four adolescent mothers received mental health treatment, there was a trend for improved depressive symptoms over time. Results of the study provide data for the need of further refinement of the intervention before a large clinical trial is conducted for adolescent mothers with symptoms of depression.

Validation of Edinburgh postnatal depression scale for adolescent mothers.

The Edinburgh Postnatal Depression Scale has widespread use internationally with adult women, but few psychometric properties have been described for samples of adolescent mothers. The purpose of this paper is to validate the psychometric properties of the EPDS in a sample of adolescent mothers (n = 149) in a southern, urban area of the United States. Internal consistency reliability was .88. Principal components analysis supported a two factor structure accounting for 60% of variance. Results of item response theory analysis suggest that the EPDS and the Center for Epidemiologic Studies of Depression Scale have similar psychometric properties. This data can be used to provide evidence of construct validity of the EPDS. The study provides a foundation for further psychometric testing of the instrument.

Intention to seek depression treatment in adolescent mothers and a comparison group of adolescent girls.

The aims of the study were (a) to determine the efficacy of the theory of reasoned action in predicting intention to seek depression treatment in adolescent mothers (n = 64) and a comparison group of adolescent girls (n = 65) and (b) to explore the role of empirically suggested variables (e.g., social support and current symptoms of depression) in increasing the explanatory power of the model. Findings between the two groups differed. Subjective norms, but not attitude, was a significant predictor of intention to seek depression treatment in adolescent mothers (F = 4.82, P = .00; R(2) = .14). In the comparison group of adolescent girls, both attitude and subjective norms predicted intention to seek depression treatment (F = 8.56, P = .00, R(2) = .22). The addition of depressive symptoms and social support increased the explanatory power of the model in the comparison group of adolescent girls (R(2) change = 0.10, P = .02) but resulted in the deletion of subjective norms from the regression equation. Implications for further research and practice are discussed.

The Postpartum Support Questionnaire: psychometric properties in adolescents.

PROBLEM: Receiving adequate social support has been associated with positive outcomes for the postpartum adolescent and her baby. Therefore, social support is an important variable to include in research studies of postpartum adolescents. However, instruments developed for use in adults cannot be assumed to reliably and validly measure health-related concepts such as social support in adolescents (Rogler, 1999; Yarcheski, Mahon, & Yarcheski, 1992) without psychometric evaluation. PURPOSE: Therefore, the purpose of this study was to describe the reliability and validity of the Postpartum Support Questionnaire (PSQ) (Logsdon, 2002; Logsdon, Usui, Birkimer, McBride, 1996) with adolescents. METHOD: The PSQ was revised for use with adolescents, based upon focus groups with adolescents and professionals. Then, the PSQ was administered to a convenience sample of postpartum adolescents (N = 109) recruited from the Teenage Parent Program. FINDINGS: High internal consistency reliability was demonstrated for the total instrument and subscales. Factor analysis supported four factors, in line with the PSQ data with adults, with some indication for an additional adolescent factor. However, in adolescents material support and emotional support tend to load on the same factor. CONCLUSIONS: Social support may be defined differently in postpartum adolescents, but further research with a larger sample is needed to substantiate this finding. Instruments with psychometric data specific to adolescents should be chosen by researchers who study this group.

Family functioning, perceived control, and anxiety: a mediational model.

Research has focused on defining which types of family interactions promote development of anxiety. Control has emerged as an important construct in anxious families. Central to conceptualizing the relationship between family functioning, control beliefs, and anxiety is establishing a sequential relationship among these variable, which may entail mediating or moderating relationships, or relationships that change over the course of development. The current study investigated whether control acts as a moderator or a mediator between perceived family environment and anxiety in your adults. An undergraduate sample (N=364) completed the family assessment device (FAD), anxiety control questionnaire (ACQ), Beck anxiety inventory (BAI), and a demographic questionnaire. Structural equation modeling (SEM) was used to test both moderating and mediating models. No moderating effects were found. Sense of control mediated the relation between aspects of family functioning and anxiety. Theoretical implications and suggestions for future research are discussed.

Nursing telephonic case management and pregnancy outcomes of mothers and infants.

Limited success has been achieved in identifying high-risk pregnant women via prenatal risk identification tools. The purposes of this study were to examine a risk assessment and nursing telephonic case management protocol used to identify high-risk mothers and infants, and to evaluate the costs and benefits of the protocol. This study involved a retrospective review of insurance data held by a large managed care organization (MCO). Analyzed data included information about current and past medical problems, and current lifestyle risk factors. Data analysis included frequencies, chi2, t tests, and logistic regression analysis. Pregnant MCO members experienced fewer high-risk conditions versus nonmembers. The overall pregnancy cost for a member was 1,818 dollars versus 4,587 dollars for a nonmember. Members experienced 2.5 times fewer babies hospitalized in the NICU, and significantly fewer mothers with high-risk conditions. The MCO program reduces costs and promotes better maternal and infant outcomes.

A comparison of influences on attitudes towards mental health service use in an African-American and White community.

The purpose of this study was to examine the attitudes toward mental health service (MHS) use within a sample of African-American and White adults (N = 739) and to identify correlates associated with those expressed attitudes. African-Americans (n = 132) and Whites (n = 607) were interviewed using the Louisville Metropolitan Survey that included the Attitudes Toward Seeking Professional Psychological Help Scale. Findings from this study indicated that responses regarding seeking mental health services were positively correlated with educational attainment and gender In addition, further findings also suggested that while race was significantly associated with attitudes toward seeking mental health services, it was also associated with prior familiarity with mental health services African-Americans reported both less willingness to seek mental health services and less familiarity with mental health services. The unexpected finding of the association between familiarity and attitudes toward mental health services use has value in furthering scientific inquiry. Investigation into the role of familiarity with mental health services and the decision-making process leading to mental health services use in diverse populations holds potential.

Authoritarianism and attitudes toward mental health services.

Right-wing authoritarians have been shown to resist change and to demonstrate hostility toward out-groups and social movements that may advocate change from traditional and conventional beliefs. Using data from the Louisville Metropolitan Survey, an omnibus survey of 771 adults interviewed by telephone, the authors investigated the relationship between right-wing authoritarianism (RWA) and attitudes toward mental health services. The findings of the bivariate and regression analyses indicated that high scorers on a version of B. Altemeyer's (1988) RWA index were more likely to hold negative attitudes on mental health services. In particular, the Submissive Authoritarianism scale predicted negative attitudes toward mental health services; however, scores on the Conventionality subscale were not related to attitudes toward mental health services.

High blood glutathione levels accompany excellent physical and mental health in women ages 60 to 103 years.

Earlier we found a high percentage of subnormal total glutathione (G(T)) levels in blood from elderly subjects and patients with chronic diseases. These findings suggested a hypothesis that high levels of G(T) in the blood occur in old persons who are in excellent physical and mental health. To this end, we recruited 87 white women who ranged in age from 60 to 103 years and reported that they felt healthy. Their health was verified with physical examinations, clinical chemistry profiles, psychosocial assessments, and blood G(T) determinations. This evaluation was performed in three waves over a 5-year period. The values were compared with those from representative individuals in this region and with normal national data. The results verified that these healthy subjects were in top physical and mental health. We also found that subjects of all ages had very high blood G(T) levels in waves I and II but only normal levels in wave III. These findings confirm that high blood G(T) concentrations and excellent physical and mental health are characteristics of long-lived women.