RESUMO
Adolescence is a time when important decisions about the future are made and vulnerability to mental health problems increases. We reviewed longitudinal studies examining the reciprocal pathways between future-related thinking (hopelessness, hope, optimism/positive future expectations) and adolescent depression and anxiety symptoms. Evidence from 22 studies (N = 10,682) found that negative future-related thinking predicted subsequent depression (r = 0.27, p < .001), an effect still significant after controlling for baseline depression (r = 0.23, p < .001). Higher hopelessness (r = 0.34, p < .001), lower hope (r = 0.16, p < .001), and reduced optimism/positive future expectations (r = 0.18, p < .001) were associated with subsequently increased depressive symptoms. Negative future-related thinking also predicted later increased anxiety symptoms (r = 0.15, p = .021). Concerning the reciprocal pathway, depressive symptoms were associated with later negative future-related thinking (r = 0.32, p < .001), which remained after baseline levels of future-related thinking were controlled (r = 0.07, p = .02). There were insufficient studies to infer reciprocal links between anxiety and future-related thinking. Our analyses provided evidence of a reciprocal developmental relationship between depressive symptoms and future-related thinking, implying a negative cycle. Identifying precursors of this cycle could provide the basis for depression prevention in adolescents and promote better decision-making about the future.
Assuntos
Ansiedade , Depressão , Pensamento , Humanos , Adolescente , Depressão/psicologia , Ansiedade/psicologia , Pensamento/fisiologia , Estudos Longitudinais , Desenvolvimento do Adolescente/fisiologiaRESUMO
BACKGROUND: Community based rehabilitation (CBR) aims to promote the inclusion and participation of people with disabilities, particularly in low- and middle-income countries (LMICs). Yet people with psychosocial disabilities are often excluded from CBR programmes. The restrictive inclusion criteria used by previous reviews make it difficult to identify promising examples that could otherwise help to inform the uptake of CBR for people with psychosocial disabilities. We aim to address this gap using gold standard methods for the review and synthesis of grey literature on CBR for people with psychosocial disabilities in LMICs. METHODS: Our search strategy was developed in consultation with an expert advisory group and covered seven grey literature databases, two customised Google Advanced searches, 34 targeted websites and four key reports. A single reviewer screened the search results and extracted relevant data using a standardised format based on the World Health Organisation's CBR matrix. The included programmes were then checked by a second reviewer with experience in CBR to ensure they met the review's criteria. A narrative synthesis with summative content analysis was performed to synthesise the findings. RESULTS: The 23 CBR programmes identified for inclusion spanned 19 countries and were mostly located in either rural areas or urban areas where a large proportion of the population was living in poverty. 13 were classified as livelihood programmes, eight as empowerment programmes, seven as social programmes, seven as health programmes and four as education programmes. Only two addressed all five of these components. 12 of the included programmes reported challenges to implementation, with stigma and lack of resources emerging as two of the most prominent themes. CONCLUSION: This grey literature review identified several CBR programmes and synthesised key learning that would have otherwise been missed by a more traditional review of the published literature. However, as evaluation by implementing organisations is not always conducted to a high standard, the quality of this evidence is generally poor. A flexible monitoring and evaluation framework for CBR programmes could help to reduce heterogeneity in terms of the quality and content of reporting.