Assessment of kinesiophobia levels in patients with musculoskeletal pathologies: A demographic, physical, and clinical perspective.

INTRODUCTION: Kinesiophobia is a crucial factor influencing the rehabilitation process for individuals with musculoskeletal pathologies. Assessing kinesiophobia levels is crucial for personalized interventions. AIM: The aim of this study is to investigate the level of kinesiophobia in individuals with musculoskeletal pathology based on the pathology areas, demographic, physical, and clinical characteristics. METHODS: A total of 210 participants with musculoskeletal pathologies were included in the study. All participants were assessed using a sociodemographic information form for demographic and physical characteristics, the Tampa Kinesiophobia Scale for kinesiophobia level, and the McGill-Melzack Pain Questionnaire for pain location and intensity. RESULTS: There was no statistically significant difference observed in kinesiophobia level between patients in terms of pathology location and sex. However, a significant difference in kinesiophobia levels was found among patients based on the acute and chronic duration of the disease (p = 0.00), previous treatment history (p = 0.04), and exercise engagement (p = 0.00). When kinesiophobia levels were examined according to educational status, a significant difference was found between the primary education group and the undergraduate and above group (p = 0.00). CONCLUSIONS: According to the results of this study, kinesiophobia levels appear to be independent of pathology location and sex, but vary based on educational level, exercise habits, pain duration and history of previous treatment. Considering these findings, it is essential to take into account these factors in treatment programs in clinical practice and to provide support in exercise and physical activity training to individuals who have previously received treatment and individuals with low education levels.

Prevalence, factors associated and management of needle phobia among the general population in Saudi Arabia and Egypt.

OBJECTIVE: This study aims to assess the prevalence of needle phobia among Saudi and Egyptian adult populations. In addition, underlying causes and strategies that can be utilized to address needle fear were investigated. METHODS: A cross-sectional online survey study was conducted in Saudi Arabia and Egypt between 1 May and 30 June 2023. Participants aged 18 years and above and living in Saudi Arabia and Egypt were eligible to complete the survey. Participants were invited to participate in this study through social media platforms (Facebook, X, Snapchat, and Instagram). A convenience sampling technique was used to recruit the study participants. A 21-item questionnaire consisting of four sections including a Likert scale score was used to answer the research objectives. Numeric data were presented as mean ± SD. For categorical variables, percentages were used. Comparison between groups were made by Student's t-test or Mann Whitney test according to data distribution. Chi squared tests for categorical values were conducted. A binary logistic regression analysis was conducted to investigate factors associated with needle phobia. RESULTS: A total of 4065 participants were involved in this study (Saudi Arabia: 2628 and Egypt: 1437). Around one-third of the study participants (36.5%) confirmed that they have needle phobia. Most of the study participants (81.1%) reported that they have had needle phobia since they were under 18 years of age. Pain, general anxiety, and fear of making a mistake during the procedure were the most commonly reported contributors for fear of needles during or before a medical procedure. Around 15.8% of the study participants reported that they have tried to get rid of phobia from needles. Non-surgical alternatives (such as oral medications and patches) and using smaller/thinner needles were the most commonly reported interventions that reduced fear of needles. Binary logistic regression analysis identified that females, those who are aged (41-50 years), widowed, those with bachelor's degrees and higher education, and those unemployed were more likely to have needle phobia compared to others. CONCLUSION: Our study highlighted the high prevalence of needle fear within an adult population in Egypt and Saudi Arabia. Females, those who are aged (41-50 years), those widowed, those with higher education degrees, those unemployed, those working in the health sector and people with low income were more likely to have needle phobia compared to others.

Prevalence, causes, impacts, and management of needle phobia: An international survey of a general adult population.

Needle phobia is an overlooked condition that affects virtually all medical procedures. Our study aimed to identify how commonly needle phobia is experienced, its underlying reasons, impacts, and potential mitigation strategies. A global survey was conducted in a general adult population using a questionnaire based on a targeted literature review that identified under-researched areas. The 21-item questionnaire was completed on a secure, web-based survey platform. Statistical analyses and models were utilized to identify relationships between participant characteristics and needle phobia. Of the 2,098 participants enrolled in the study, 63.2% (n = 1,325) reported experiencing needle phobia, and rated the intensity of their fear as 5.7 (±2.6) on average on a scale from 0 (no fear) to 10 (very strong/unreasonable fear or avoidance). According to the logistic regression model, other medical fears (odds coefficient = 2.14) and family history (1.67) were the most important factors associated with needle phobia. General anxiety (96.1%) and pain (95.5%) were the most common reasons for needle fear. Of the participants experiencing needle phobia, 52.2% stated avoiding blood draws, followed by 49.0% for blood donations, and 33.1% for vaccinations. While 24.3% of participants have seen a therapist, most have never sought help. The majority have shared their fear with nurses (61.1%) or physicians (44.4%); however, the provider helpfulness was rated as 4.9 (±3.1) on average on a scale from 0 (unhelpful) to 10 (extremely helpful). Utilizing non-invasive alternatives (94.1%) and smaller needles (91.1%) were most commonly identified as potential device-related solutions to alleviate fear; distractions (92.1%) and relaxation techniques (91.7%) were the top non-device-related approaches. Our findings highlight the prevalent nature of needle phobia and provide insights into its etiology and effects on patient care. Clinician responses were not perceived as helpful, emphasizing the need to address needle phobia, and improve patient experience.

Phobia of Coronavirus (Covid-19) Pandemic in Turkish Society.

BACKGROUND: The American Psychiatric Association describes phobia as a state of constant, extreme, and high level of fear against an object or situation. This study determines the level of phobia related to the coronavirus (COVID-19) pandemic in Turkish society. SUBJECTS AND METHODS: Data were collected through an online survey between May 26 and June 5, 2020, using an introductory information form, a COVID-19 specification questionnaire, and a COVID-19 Phobia Scale (CP19-S). The data were then analysed through a descriptive statistical analysis, the Kruskal-Wallis and Mann-Whitney U tests in independent groups. RESULTS: Participants' phobia of COVID-19 was close to the moderate level (46.43±14.88). It was found that the scores for the COVID-19 Phobia Scale were higher in female participants, individuals who had to change duties during the pandemic, have a chronic illness, individuals who did not have social security, participants who had a relative/friend die due to COVID-19, those having no idea about preventive studies in Turkey, those stating that preventive studies in the globally are insufficient, those expressing that it is partially possible to be protected by taking personal measures, those expressing that it is partially possible to treat with medicine, those who have no idea about finding the vaccine and preventing its spread. The difference was found to be statistically significant (p<0.05). CONCLUSION: In conclusion, the findings of this study are important for the development of intervention programs and support strategies to protect mental health and increase psychological resilience during the COVID-19 outbreak.

The prevalence and evidence-based management of needle fear in adults with chronic disease: A scoping review.

BACKGROUND: Little is known about the prevalence and best management of needle fear in adults with chronic disease, who may experience frequent and long-term exposure to needles for lifesaving therapies such as renal dialysis and cancer treatment. Identifying interventions that assist in management of needle fear and associated distress is essential to support these patients with repeated needle and cannula exposure. METHOD: We followed the PRISMA methodology for scoping reviews and systematically searched PsychINFO, PubMed (MEDLINE), ProQuest, Embase and grey literature and reference lists between 1989 and October 2020 for articles related to needle discomfort, distress, anxiety, fear or phobia. The following chronic diseases were included: arthritis, asthma, chronic back pain, cancer, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, and mental illness, or kidney failure. Literature concerning dentistry, vaccination, intravenous drug users and paediatric populations were excluded. RESULTS: We identified 32 papers reporting prevalence (n = 24), management (n = 5) or both (n = 3). Needle fear prevalence varied in disease cohorts: 17-52% (cancer), 25-47% (chronic kidney disease) and 0.2-80% (diabetes). Assessment methods varied across studies. Management strategies had poor evidence-base, but included needle-specific education, decorated devices, cognitive-behavioural stress management techniques, distraction, and changing the therapy environment or modality. CONCLUSION: Although needle fear is common there is a paucity of evidence regarding interventions to address it among adults living with chronic disease. This scoping review has highlighted the need for improved identification of needle fear in adults and development of interventions are required for these cohorts.

Association of Outdoor Artificial Light at Night With Mental Disorders and Sleep Patterns Among US Adolescents.

Importance: Indoor nighttime light exposure influences sleep and circadian rhythms and is known to affect mood-associated brain circuits in animals. However, little is known about the association between levels of nighttime outdoor light and sleep and mental health in the population, especially among adolescents. Objective: To estimate associations of outdoor artificial light at night (ALAN) with sleep patterns and past-year mental disorder among US adolescents. Design, Setting, and Participants: This population-based, cross-sectional study of US adolescents used the National Comorbidity Survey-Adolescent Supplement, a nationally representative cross-sectional survey conducted from February 2001 through January 2004. A probability sample of adolescents aged 13 to 18 years was included. Analyses were conducted between February 2019 and April 2020. Exposures: Levels of outdoor ALAN, measured by satellite, with means calculated within census block groups. ALAN values were transformed into units of radiance (nW/cm2/sr). Main Outcomes and Measures: Self-reported habitual sleep patterns (weeknight bedtime, weeknight sleep duration, weekend bedtime delay, and weekend oversleep) and past-year mood, anxiety, behavior, and substance use disorders, measured via an in-person structured diagnostic interview. Parent-reported information was included in behavior disorder diagnoses. Results: Among 10 123 adolescents (4953 boys [51.3%]; mean [SE] age, 15.2 [0.06] years [weighted]; 6483 for behavior disorder outcomes), ALAN was positively associated with indicators of social disadvantage, such as racial/ethnic minority status (median [IQR] ALAN: white adolescents, 12.96 [30.51] nW/cm2/sr; Hispanic adolescents: 38.54 [47.84] nW/cm2/sr; non-Hispanic black adolescents: 37.39 [51.88] nW/cm2/sr; adolescents of other races/ethnicities: 30.94 [49.93] nW/cm2/sr; P < .001) and lower family income (median [IQR] ALAN by family income-to-poverty ratio ≤1.5: 26.76 [52.48] nW/cm2/sr; >6: 21.46 [34.38] nW/cm2/sr; P = .005). After adjustment for several sociodemographic characteristics, as well as area-level population density and socioeconomic status, this study found that higher ALAN levels were associated with later weeknight bedtime, and those in the lowest quartile of ALAN reported the longest weeknight sleep duration. Those in the highest quartile of ALAN went to bed 29 (95% CI, 15-43) minutes later and reported 11 (95% CI, 19-2) fewer minutes of sleep than those in the lowest quartile. ALAN was also positively associated with prevalence of past-year mood and anxiety disorder: each median absolute deviation increase in ALAN was associated with 1.07 (95% CI, 1.00-1.14) times the odds of mood disorder and 1.10 (95% CI, 1.05-1.16) times the odds of anxiety disorder. Further analyses revealed associations with bipolar disorder (odds ratio [OR], 1.19 [95% CI, 1.05-1.35]), specific phobias (OR, 1.18 [95% CI, 1.11-1.26]), and major depressive disorder or dysthymia (OR, 1.07 [95% CI, 1.00-1.15]). Among adolescent girls, differences in weeknight bedtime by ALAN (third and fourth quartiles vs first quartile) were greater with increasing years since menarche (F3, 8.15; P < .001). Conclusions and Relevance: In this study, area-level outdoor ALAN was associated with less favorable sleep patterns and mood and anxiety disorder in adolescents. Future studies should elucidate whether interventions to reduce exposure to ALAN may positively affect mental and sleep health.

Prevalence and Financial Impact of Claustrophobia, Anxiety, Patient Motion, and Other Patient Events in Magnetic Resonance Imaging.

Claustrophobia, other anxiety reactions, excessive motion, and other unanticipated patient events in magnetic resonance imaging (MRI) not only delay or preclude diagnostic-quality imaging but can also negatively affect the patient experience. In addition, by impeding MRI workflow, they may affect the finances of an imaging practice. This review article offers an overview of the various types of patient-related unanticipated events that occur in MRI, along with estimates of their frequency of occurrence as documented in the available literature. In addition, the financial implications of these events are discussed from a microeconomic perspective, primarily from the point of view of a radiology practice or hospital, although associated limitations and other economic viewpoints are also included. Efforts to minimize these unanticipated patient events can potentially improve not only patient satisfaction and comfort but also an imaging practice's operational efficiency and diagnostic capabilities.

[Legitimate resistance without technophobia: Analysis of electronic medical records impacts on the medical profession]. / Résistance légitime sans technophobie : analyse des impacts de l'informatisation du dossier du patient sur le cœur du métier médical.

The objective of this short narrative literature review is to highlight the different difficulties encountered by medical doctor in the daily use of EMR. We show that these are not simple transitional phenomena related to a "resistance to change", but rather the fact of a deeper and unfinished transformation. Beyond the "perception of misfit with work processes" or the threat of a loss of autonomy, we propose to analyze this so-called "resistance" in relation to the formalization of medical work induced by EMR. Our question concerns the compatibility of the multiple objectives of EMR, the potential influence of computerization on the steps of entering and consulting medical information, the impact on the clinical reasoning, the reality of assistance to medical "performance". The question is not so much what EMRs do less well than the paper record, but to provide insights into how tomorrow's EMRs will do better than today's.

Psychological aspects of COVID-19.

BACKGROUND: COVID-19 pandemic has affected the world from every aspect. Individuals are drained from social, financial, and emotional percussion of this pandemic. Psychosocial consequences are far greater than are being perceived. It is anticipated that once the pandemic is over the psycho-emotional turbulence would shake the whole populations of affected countries. AIMS AND OBJECTIVES: To review the psychological consequences of COVID-19 pandemic. METHODS: A literature search was conducted on major databases from January 2020 to April 2020 with the search terms of Covid-19, Corona virus, psychological, depression, anxiety, phobias, obsessive behaviors, paranoia, parental relationship, marital life and maternal and fetal bond. CONCLUSION: Patients with COVID-19 infection are more likely to suffer from a myriad of psychological consequences, and this infection may have profound effect on parenting, relationships, marital life, elderly, and maternal-fetal bond.

Different Clinical Expression of Anxiety Disorders in Children and Adolescents: Assessment and Treatment.

BACKGROUND: Fearful and anxious behaviour is especially common in children, when they come across new situations and experiences. The difference between normal worry and an anxiety disorder is in the severity and in the interference with everyday life and normal developmental steps. Many longitudinal studies in children suggest that anxiety disorders are relatively stable over time and predict anxiety and depressive disorders in adolescence and adulthood. For this reason, the early diagnostic and treatment are needed. Researchers supposed that anxiety is a result of repeated stress. Additionally, some genetic, neurobiological, developmental factors are also involved in the aetiology. METHODS AND SUBJECTS: The aim of this article is to summarize and to present our own results obtained with the assessment and treatment of different forms of anxiety disorders in children and adolescents such as: Posttraumatic Stress Disorder (PTSD), Obsessive Compulsive Disorder (OCD), Dental anxiety, General Anxiety Disorder (GAD), and Anxious-phobic syndrome. Some results are published separately in different journals. a) Post Traumatic Stress Disorder (PTSD) in 10 young children aged 9 ± 2, 05 y. is evaluated and discussed concerning the attachment quality. b) The group with OCD comprises 20 patients, mean age 14,5 ± 2,2 years, evaluated with Eysenck Personality Questionnaire (EPQ), Child behaviour Checklist (CBCL), K-SADS (Schedule for Affective Disorders and Schizophrenia for School age children), Beck Depression Inventory (BDI), SCWT (Stroop Colour Word task), WCST (Wisconsin Card Scoring test). c) Dental stress is evaluated in a group of 50 patients; mean age for girls 11,4 ± 2,4 years; for boys 10,7 ± 2,6 years, evaluated with (General Anxiety Scale (GASC), and Eysenck Personality Questionnaire (EPQ). d) Minnesota Multiphasic Personality Inventory (MMPI) profiles obtained for General Anxiety Disorder in 20 young females and 15 males aged 25,7± 5,35 years, and a group with Panic attack syndrome N=15 aged 19,3±4,9 years are presented and discussed by comparison of the results for healthy people. e) Heart Rate Variability (HRV) was applied for assessment and treatment in 15 anxious-phobic patients, mean age 12, 5±2,25 years and results are compared with other groups of mental disorder. RESULTS: Children with PTSD showed a high level of anxiety and stress, somatization and behavioural problems (aggression, impulsivity, non-obedience and nightmares), complemented by hypersensitive and depressed mothers and misattachment in the early period of infancy. Consequently, the explanation of the early predisposition to PTSD was related to be the non-developed Right Orbital Cortex. The later resulted from insecure attachment confirmed in all examined children. The obtained neuropsychological profile of children with OCD confirmed a clear presence of obsessions and compulsions, average intellectual capacities, but the absence of depressive symptoms. Executive functions were investigated through Event Related Potentials on Go/NoGo tasks. Results showed that no significant clinical manifestations of cognitive dysfunction among children with OCD in the early stage of the disorder are present, but it could be expected to be appearing in the later stage of the disorder if it is no treated. In a study of 50 children randomly selected, two psychometric instruments were applied for measuring general anxiety and personal characteristics. It was confirmed that there was presence of significant anxiety level (evaluated with GASC) among children undergoing dental intervention. The difference in anxiety scores between girls and boys was also confirmed (girls having higher scores for anxiety). Results obtained with EPQ showed low psychopathological traits, moderate extraversion and neuroticism, but accentuated insincerity (L scale). L scales are lower by increasing of age, but P scores rise with age, which can be related to puberty. No correlation was found between personality traits and anxiety except for neuroticism, which is positively correlated with the level of anxiety. The obtained profiles for MMPI-201 in a group of patients with general anxiety are presented as a figure. Females showed only Hy peak, but in the normal range. However, statistics confirmed significant difference between scores in anxiety group and control (t= 2, 25164; p= 0, 038749). Males showed Hs-Hy-Pt peaks with higher (pathological) scores, related to hypersensitivity of the autonomic nervous system, as well as with manifested anxiety. Calculation confirmed significant difference between control and anxiety in men (t= 15.13, p=0.000). Additionally, MMPI profiles for patients with attack panic syndrome are also presented as a figure. Control scales for females showed typical V form (scales 1 and 3) related to conversing tendencies. In addition, females showed peaks on Pt-Sc scales, but in normal ranges. Pathological profile is obtained in males, with Hy-Sc peaks; this profile corresponds to persons with regressive characteristics, emotionally instable and with accentuated social withdraw. Heart rate variability (HRV) is a measure of the beat to beat variability in heart rate, related to the work of autonomic nervous system. It may serve as a psychophysiological indicator for arousal, emotional state and stress level. We used HRV in both, the assessment and biofeedback training, in a group of anxious-phobic and obsessive-compulsive school children. Results obtained with Eysenck Personality Questionnaire showed significantly higher psychopathological traits, higher neuroticism and lower lie scores. After 15 session HRV training very satisfying results for diminishing stress and anxiety were obtained.

Prevalence and determinants of anxiety disorders among adolescents in a rural community from northern India.

INTRODUCTION: There is scarce data available on community based prevalence of Anxiety Disorders (ADs) amongst adolescents in north Indian settings. OBJECTIVE: To determine the prevalence of anxiety disorders, and associated factors amongst adolescents in a rural community of Ballabgarh block, district Faridabad, Haryana. METHODS: Participants (10-19 years) were enrolled through simple random sequence from a sampling frame of adolescents residing in 28 villages of Ballabgarh block using household survey technique. They were screened using Screen for Childhood Anxiety Related Emotional Disorders (SCARED) tool and then subjected to confirmatory diagnosis using Mini-International Neuropsychiatric Interview for Children/Adolescent (MINI KID). All adolescents with ADs were assessed for co-psychiatric morbidities using MINI-KID and functional impairment using Children Global Assessment Scale (CGAS). Prevalence and 95% Confidence intervals are reported. Additionally, socio-demographic factors were elicited using a semi-structured interview schedule and associations were determined using multivariable logistic regression analysis. RESULTS: A total of 678 adolescents participated in this study with mean age (SD) as 14.2 (2.5) years. The age adjusted prevalence of anxiety disorders was found to be 16.6% (95% CI: 16.0-17.2). The most prevalent anxiety disorder among participants was social anxiety disorders followed by specific phobias. Female sex and low socio-economic status were associated with anxiety disorders. Two third of adolescents with ADs had no functional impairment and almost one third were found to have one or more co-existing psychiatric co-morbidity. CONCLUSION: We found a high prevalence of ADs in rural north Indian community settings warranting adequate health system response at primary care level.

Who Are the Turkers? A Characterization of MTurk Workers Using the Personality Assessment Inventory.

As online data collection services such as Amazon's Mechanical Turk (MTurk) gain popularity, the quality and representativeness of such data sources have gained research attention. To date, the majority of existing studies have compared MTurk workers with undergraduate samples, localized community samples, or other Internet-based samples, and thus, there remains little known about the personality and mental health constructs of MTurk workers relative to a national representative sample. The present study addresses these limitations and broadens the scope of existing research through the use of the Personality Assessment Inventory, a multiscale, self-report questionnaire which provides information regarding data validity and personality and psychopathology features standardized against a national U.S. census-matched normative sample. Results indicate that MTurk workers generally provide high-quality data and are reasonably representative of the general population across most psychological dimensions assessed. However, several distinguishing features of MTurk workers emerged that were consistent with prior findings of such individuals, primarily involving somewhat higher negative affect and lower social engagement.

Fear of future terrorism: Associated psychiatric burden.

BACKGROUND: The mental health burden from fear of future terrorism has not been given much research attention compared to the immediate mental distress such as post-traumatic stress disorder (PTSD). Such neglected ongoing mental health morbidity associated with threats of terrorism had been described as pre-traumatic stress syndrome (PTSS). OBJECTIVE: The study highlighted this phenomenon (PTSS) in Nigeria by examining the catastrophic burden of the fear of future terrorism and associated psychiatric burden among adult population in Kaduna city. METHOD: Participants were students and staff of Kaduna State University (KASU), Kaduna Polytechnic, and students awaiting admission into Kaduna State University. They responded to the following instruments after obtaining their informed consents: a sociodemographic questionnaire, the Terrorism Catastrophising Scale (TCS), and the depression and Generalised Anxiety Disorder (GAD) portion of Mini International Neuropsychiatric Interview (MINI). RESULTS: The TCS showed that 78.8% of the participants had from moderate to severe clinical distress on fear of terrorism. The TCS has a Cronbach's alpha of 0.721 and also had significant moderate correlation with depression (r=0.278; p<0.01) and GAD (r=0.201; p<0.01) scales of MINI. CONCLUSION: The study illustrated that the mental health burden from the fear of terrorism was high and this was relatively related to depression and GAD. This highlighted the need for ongoing monitoring and called for their effective prevention from the identified underlying cognitive mechanisms.

The cross-national epidemiology of specific phobia in the World Mental Health Surveys.

BACKGROUND: Although specific phobia is highly prevalent, associated with impairment, and an important risk factor for the development of other mental disorders, cross-national epidemiological data are scarce, especially from low- and middle-income countries. This paper presents epidemiological data from 22 low-, lower-middle-, upper-middle- and high-income countries. METHOD: Data came from 25 representative population-based surveys conducted in 22 countries (2001-2011) as part of the World Health Organization World Mental Health Surveys initiative (n = 124 902). The presence of specific phobia as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition was evaluated using the World Health Organization Composite International Diagnostic Interview. RESULTS: The cross-national lifetime and 12-month prevalence rates of specific phobia were, respectively, 7.4% and 5.5%, being higher in females (9.8 and 7.7%) than in males (4.9% and 3.3%) and higher in high- and higher-middle-income countries than in low-/lower-middle-income countries. The median age of onset was young (8 years). Of the 12-month patients, 18.7% reported severe role impairment (13.3-21.9% across income groups) and 23.1% reported any treatment (9.6-30.1% across income groups). Lifetime co-morbidity was observed in 60.5% of those with lifetime specific phobia, with the onset of specific phobia preceding the other disorder in most cases (72.6%). Interestingly, rates of impairment, treatment use and co-morbidity increased with the number of fear subtypes. CONCLUSIONS: Specific phobia is common and associated with impairment in a considerable percentage of cases. Importantly, specific phobia often precedes the onset of other mental disorders, making it a possible early-life indicator of psychopathology vulnerability.

Ethnic differences in prevalence and correlates of self-harm behaviors in a treatment-seeking sample of emerging adults.

The present study examined differences between White and ethnic minority emerging adults in the prevalence of self-harm behaviors ­ i.e., non-suicidal self-injury (NSSI) and suicide attempts (SA) ­ and in well-documented risk (i.e., depressive symptoms, generalized anxiety symptoms, social anxiety symptoms, suicidal ideation (SI), substance use, abuse history) and protective factors (i.e., religiosity/spirituality, family support, friend support) associated with NSSI and SAs. Emerging adults (N=1156; 56% ethnic minority), ages 17­29 (M=22.3, S.D.=3.0), who were presented at a counseling center at a public university in the Northeastern U.S., completed a clinical interview and self-report symptom measures. Univariate and multivariate logistic regression models were used to examine the association between risk and protective factors in predicting history of NSSI-only, any SA, and no self-harm separately among White and ethnic minority individuals. Ethnic differences emerged in the prevalence and correlates of NSSI and SAs. Social anxiety was associated with SAs among White individuals but with NSSI among ethnic minority individuals. Substance use was a more relevant risk factor for White individuals, and friend support was a more relevant protective factor for ethnic minority individuals. These findings suggest differing vulnerabilities to NSSI and SAs between White and ethnic minority emerging adults.

Antenatal fear of childbirth and sense of coherence among healthy pregnant women in Japan: a cross-sectional study.

While antenatal fear of childbirth (FOC) has been associated with many psychosocial variables, few studies have focused on individual stress resiliency. Sense of coherence (SOC) is one of the essential components of individual stress resiliency. This study investigates the relationship between antenatal FOC and SOC in Japanese healthy pregnant women. Self-reported questionnaires were distributed to 240 women at 37 gestational weeks at an obstetric clinic in Tokyo, Japan. Structural regression modeling was conducted to identify the causal relationships between FOC and SOC. The non-recursive model showed significant acceptance of fit (chi-square value/degree of freedom = 1.72, comparative fit index = 0.97, and root mean square error of approximation = 0.05). The model identified SOC as a direct cause of FOC (ß = -0.89, p < 0.001), not a reflection of FOC. We found that SOC was negatively linked with antenatal fear of childbirth. High SOC works as a resiliency factor that helps pregnant women cope with the stress of their upcoming childbirth and reduces FOC.

Diagnostic specificity and mental health service utilization among veterans with newly diagnosed anxiety disorders.

OBJECTIVE: This study examined rates of specific anxiety diagnoses (posttraumatic stress disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, and specific phobia) and anxiety disorder not otherwise specified (anxiety NOS) in a national sample of Veterans and assessed their mental health service utilization. METHOD: This study used administrative data extracted from Veteran Health Administration outpatient records to identify patients with a new anxiety diagnosis in fiscal year 2010 (N = 292,244). Logistic regression analyses examined associations among diagnostic specificity, diagnostic location, and mental health service utilization. RESULTS: Anxiety NOS was diagnosed in 38% of the sample. Patients in specialty mental health were less likely to receive an anxiety NOS diagnosis than patients in primary care (odds ratio [OR] = 0.36). Patients with a specific anxiety diagnosis were more likely to receive mental health services than those with anxiety NOS (OR = 1.65), as were patients diagnosed in specialty mental health compared with those diagnosed in primary care (OR = 16.29). CONCLUSION: Veterans diagnosed with anxiety NOS are less likely to access mental health services than those with a specific anxiety diagnosis, suggesting the need for enhanced diagnostic and referral practices, particularly in primary care settings.

Depersonalization experiences are strongly associated with dizziness and vertigo symptoms leading to increased health care consumption in the German general population.

This study investigated the association of depersonalization (DP) experiences with dizziness and its impact on subjective impairment and health care use. Trained interviewers surveyed a representative sample of 1287 persons using standardized self-rating questionnaires on dizziness, DP, and mental distress. Symptoms of dizziness were reported by 15.8% (n = 201). Thereof, 62.7% endorsed at least one symptom of DP, 40% reported impairment by symptoms of DP, and 8.5% reported clinically significant DP. Regression analyses identified DP as a significant, independent predictor for dizziness symptom severity, health care use, and impairment by dizziness. With regard to the Vertigo Symptom Scale, DP explained 34.1% (p < 0.001) of the variance for severity of symptoms of dysfunction in the balance system. In conclusion, symptoms of DP, highly prevalent in patients complaining of dizziness and vertigo, were independently associated with increased impairment and health care use. The presence of DP symptoms should actively be explored in patients complaining of dizziness.

The relationship between personal debt and specific common mental disorders.

BACKGROUND: Personal debt is now recognized as one of the many factors associated with common mental disorders (CMD). We aim to estimate the prevalence of 'specific' mental disorders based on ICD-10 research diagnostic criteria by type of debt and quantify the additional influence of addictive behaviours. METHOD: A random probability sample comprising 7461 respondents were interviewed for the third national survey of psychiatric morbidity of adults in England carried out in 2007. The prevalence of CMD was estimated from the administration of the CIS-R. Respondents were asked about sources of debt and their borrowing choices. RESULTS: In 2007, 8.5% of adults were in arrears. Adults in debt were three times more likely than those not in debt to have CMD. The increased likelihood of CMD among those in arrears was found for all CMD and was irrespective of source of debt--housing, utilities and purchases on credit. The situation was exacerbated among those with addictive behaviours--alcohol or drug dependence or problem gambling. Those with multiple sources of debt and who had to obtain money from pawnbrokers and moneylenders had the highest rate of CMD, ≈ 50%. CONCLUSIONS: Debt is one of the major risk factors for CMD. This has practical implications for both health services and financial services, which both need to be alert to the association and adapt and train their respective services accordingly so that people in debt can access help for mental disorders and people with mental disorders can access help for debt.

Intimate partner violence and welfare participation: a longitudinal causal analysis.

This longitudinal study examined the temporal-ordered causal relationship between intimate partner violence (IPV), five mental disorders (depression, generalized anxiety disorder, social phobia, panic attack, posttraumatic stress disorder [PTSD]), alcohol abuse/dependence, drug abuse/dependence, treatment seeking (from physician, counselor, and self-help group), employment, child support, and welfare participation. It was a secondary data analysis of records of 571 women; the records were extracted from the study "Violence Against Women and the Role of Welfare Reform" (VAWRWR). Results from generalized estimating equations (GEE) showed that experiencing controlling behaviors reduced likelihood of welfare participation whereas experiencing physical abuse increased it. Significant impact on welfare participation was wielded by panic attack, drug abuse/dependence, and employment; treatment seeking and child support made no significant impact. The study found no significant mediating effect wielded by panic attack, drug abuse/dependence, employment, or child support on welfare participation's relationship to controlling behaviors or physically abusive behaviors experienced. Implications for intervention are discussed.