Psychosocial and coping responses toward 2019 coronavirus diseases (COVID-19): a cross-sectional study within the Chinese general population.

BACKGROUND: The 2019 coronavirus diseases (COVID-19) led out the mental health crisis. AIM: To determine the psychological status and post-traumatic stress symptoms (PTSD) among general population (except confirmed and suspected cases, and close contacts) and their association with the coping strategy types during the COVID-19 outbreak. DESIGN: A cross-sectional study. METHODS: Participants were recruited from the community through snowball sampling with anonymous online questionnaires, using 28-item General Health Questionnaire, 22-item Impact of Events Scale-Revised and 28-item Brief Coping Inventory to measure their psychiatric disorders, PTSD level and coping strategies. RESULTS: Of the total 1109 participants, 42.65% and 67.09% self-reported psychiatric disorders and high PTSD level, respectively. Age, occupation and education level were significantly association with psychological status. The status of psychiatric disorders was also significantly related to high PTSD level. Using both emotion and problem coping was better for psychiatric status [adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI): 0.54-0.98], and problem-focused coping was significantly associated with high PTSD level (aOR = 2.09, 95% CI: 1.25-3.51). CONCLUSION: Negative psychological outcomes were common among the general people during the COVID-19 outbreak, and the findings may provide references for intervention guidelines of mental health for the community population.

The psychological impact of quarantine and how to reduce it: rapid review of the evidence.

The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

Identifying Research Gaps and Prioritizing Psychological Health Evidence Synthesis Needs.

BACKGROUND: Evidence synthesis is key in promoting evidence-based health care, but it is resource-intense. Methods are needed to identify and prioritize evidence synthesis needs within health care systems. We describe a collaboration between an agency charged with facilitating the implementation of evidence-based research and practices across the Military Health System and a research center specializing in evidence synthesis. METHODS: Scoping searches targeted 15 sources, including the Veterans Affairs/Department of Defense Guidelines and National Defense Authorization Acts. We screened for evidence gaps in psychological health management approaches relevant to the target population. We translated gaps into potential topics for evidence maps and/or systematic reviews. Gaps amenable to evidence synthesis format provided the basis for stakeholder input. Stakeholders rated topics for their potential to inform psychological health care in the military health system. Feasibility scans determined whether topics were ready to be pursued, that is, sufficient literature exists, and duplicative efforts are avoided. RESULTS: We identified 58 intervention, 9 diagnostics, 12 outcome, 19 population, and 24 health services evidence synthesis gaps. Areas included: posttraumatic stress disorder (PTSD) (19), suicide prevention (14), depression (9), bipolar disorder (9), substance use (24), traumatic brain injury (20), anxiety (1), and cross-cutting (14) synthesis topics. Stakeholder input helped prioritize 19 potential PTSD topics and 22 other psychological health topics. To date, 46 topics have undergone feasibility scans. We document lessons learned across clinical topics and research methods. CONCLUSION: We describe a transparent and structured approach to evidence synthesis topic selection for a health care system using scoping searches, translation into evidence synthesis format, stakeholder input, and feasibility scans.

[Indication and Evidence of Internationally Developed Online Coaches as Intervention for Mental Illness - a Meta-Review]. / Indikationen und Evidenz von international entwickelten Online-Coaches zur Intervention bei psychischen Erkrankungen ­ ein Meta-Review.

OBJECTIVE: The aim of the study was to investigate the current state of research concerning internationally developed Online Coaches for treatment support and prevention of mental disorders. Evidence and effectiveness of the Online Coaches ought to be explored. METHODS: A systematic literature search was performed in international databases in order to provide a meta-review of existing Online Coaches for mental disorders. The assessment of the methodological quality and evidence of the studies was based on the established guidelines of the Scottish Intercollegiate Guideline Network. RESULTS: 52 studies (24 meta-analyses, 16 systematic reviews, 2 health-technology assessment reports, and 10 RCT studies) were identified. The efficacy was demonstrated for a variety of Online Coaches for mental disorders, especially for anxiety and depressive disorders, insomnia, and post-traumatic stress disorders, with predominantly acceptable and high quality. CONCLUSION: The present work provides an overview of internationally developed Online Coaches in the field of mental health care. Online Coaches can serve as a useful supplement to the treatment and prevention of mental disorders.

The odd couple: using biomedical and intersectional approaches to address health inequities.

BACKGROUND: Better understanding and addressing health inequities is a growing global priority. OBJECTIVE: In this paper, we contribute to the literature examining complex relationships between biological and social dimensions in the field of health inequalities. Specifically, we explore the potential of intersectionality to advance current approaches to socio-biological entwinements. DESIGN: We provide a brief overview of current approaches to combining both biological and social factors in a single study, and then investigate the contributions of an intersectional framework to such work. RESULTS: We offer a number of concrete examples of how intersectionality has been used empirically to bring both biological and social factors together in the areas of HIV, post-traumatic stress disorder, female genital circumcision/mutilation/cutting, and cardiovascular disease. CONCLUSION: We argue that an intersectional approach can further research that integrates biological and social aspects of human lives and human health and ultimately generate better and more precise evidence for effective policies and practices aimed at tackling health inequities.

Addressing the Needs of Preschool Children in the Context of Disasters and Terrorism: Assessment, Prevention, and Intervention.

PURPOSE OF REVIEW: The goal of this paper is to review the research literature regarding the needs of preschoolers in the context of disasters and terrorism with the aim of understanding the existing methods for assessment, prevention, and intervention to provide recommendations and point out required research and development. RECENT FINDINGS: We differentiate between screening tools that provide initial evaluation and assessment tools for diagnosing preschooler children's pathology and review possible interventions that address the preschool child's needs before, during, and after the incident itself. We also emphasize the lack of dissemination and research of prevention programs and mass interventions for preschoolers. Programs for community mass prevention and intervention for preschoolers should be developed and evaluated and interventions should be adapted for individual and group delivery. Moreover, the increase in the number of children refugees requires cultural adaptations of assessment measures and interventions.

Examining Patterns of Exposure to Family Violence in Preschool Children: A Latent Class Approach.

Young children can experience violence directly or indirectly in the home, with some children exposed to multiple forms of violence. These polyvictims often experience violence that is severe, chronic, and multifaceted. The current study used latent class analysis to identify and examine the pattern of profiles of exposure to family violence (i.e., violence directed towards the child and between caregivers) among a sample of 474 children ages 3-6 year who were drawn from the Multidimensional Assessment of Preschoolers Study (Wakschlag et al., 2014). The data yielded 3 classes: a polyvictimized class (n = 72; 15.2%) with high probability of exposure to all forms of violence, a harsh parenting class (n = 235; 49.5%), distinguished mainly by child-directed physical discipline in the absence of more severe forms of violence, and a low-exposure class (n = 167; 35.2%). Classes were differentiated by contextual factors, maternal characteristics, and mother-reported and observational indicators of parenting and child functioning with most effect sizes between medium and large. These findings add to emerging evidence linking polyvictimization to impaired caregiving and adverse psychological outcomes for children and offer important insight for prevention and intervention for this vulnerable population.

Preventing PTSD and Depression and Reducing Health Care Costs in the Military: A Call for Building Resilience Among Service Members.

The present study investigates the role of psychological resilience in protecting against the development of post-traumatic stress disorder (PTSD), depression, and comorbid PTSD and depression; and estimates the percent reductions in incidence of, and associated treatment cost savings for, each condition as a function of increasing resilience. A retrospective cohort of mental health care-seeking service members (n = 2,171) completed patient-reported outcome measures approximately every 10 weeks as part of the Psychological Health Pathways program. Patients with low resilience were at significantly greater odds for developing physical, behavioral, and mental health conditions, particularly sleep disorder (adjusted odds ratio [AOR] = 2.60, 95% confidence interval [CI] = 1.81-3.73), perceived stress (AOR = 2.86, 95% CI = 1.05-7.75), and depression (AOR = 2.89, 95% CI = 2.34-3.57) compared to patients with moderate/high resilience. Increasing resilience across services by 20% is estimated to reduce the odds of developing PTSD, depression, and comorbid PTSD and depression by 73%, 54%, and 93%, respectively; the incidence by 32%, 19%, and 61%, respectively; and save approximately $196, $288, and $597 million in annual treatment costs, respectively, or approximately $1.1 billion total (a 35% reduction in costs). Using resilience as a preventive model may reduce health care utilization and costs in an already overtaxed health care system.

Attitudes towards mental health and help-seeking in railway workers.

BACKGROUND: TRiM (Trauma Risk Management) has been shown to improve mental health and attitudes towards mental health in high-risk occupational groups; however, there has been no research into how TRiM might work for railway workers. AIMS: To assess whether attending a TRiM training course alters mental health and attitudes to mental health-related help-seeking in railway workers. METHODS: Workers completed a survey assessing mental health and attitudes towards mental health and help-seeking, before and after a 2-day TRiM course; follow-up questionnaires were administered 4 months post-course. RESULTS: Fifty railway employees completed the questionnaires. Post-course scores for cohesion and mental health peer literacy (i.e. feeling able to recognize and discuss mental health symptoms with colleagues) and some aspects of stigma significantly improved, while there were non-significant improvements in common mental disorder and post-traumatic stress symptoms. The response rate for completing follow-up surveys was small (n = 8) but results from these subjects suggested mental health peer literacy scores remained significantly improved. CONCLUSIONS: This study provides a useful insight into attitudes of railway workers regarding stigma and their confidence in discussing trauma-related mental health. Significant improvements in cohesion and mental health peer literacy along with the general improvement in scores post-TRiM course provide some evidence of the potential benefits of TRiM training in railway workers. Follow-up results have limited reliability due to the small number of responders but suggest possible long-term benefits of attending a TRiM course. Further research is required to confirm this finding.

Informal caregivers of advanced-stage cancer patients: Every second is at risk for psychiatric morbidity.

PURPOSE: Informal caregivers of advanced cancer patients are known to suffer from high distress due to their caregiving responsibilities. Nevertheless, a comprehensive evaluation of psychiatric morbidity is often missing in clinical practice due to time resources, and mental health problems may be unnoticed in this population. A feasible approach is needed to identify caregivers at risk for psychiatric disorders to offer targeted interventions and enhance their well-being. METHODS: This cross-sectional, multi-institutional study screened 345 caregivers of advanced cancer patients for psychiatric disorders (i.e., depression, anxiety, posttraumatic stress disorder, and alcohol abuse/dependence) and assessed factors potentially associated with mental health diagnoses (including socio-demographic factors, burden, hope, caring-related quality of life, and coping preferences). RESULTS: Overall, almost 52 % of participants had one or more suspected psychiatric disorders, with anxiety being the most prevalent. Perceived hope, higher burden, and more emotion-oriented coping were associated with psychiatric morbidity in this sample. Spouses and parents showed significantly more symptoms of psychiatric disorders than other relatives. CONCLUSIONS: This study confirms the high risk of informal caregivers of advanced cancer patients to develop psychiatric disorders and suggests a practically feasible approach to identify at risk caregivers to offer support.

[Violence and discrimination in the workplace. The effects on health and setting-related approaches to prevention and rehabilitation]. / Gewalt und Diskriminierung am Arbeitsplatz. Gesundheitliche Folgen und settingbezogene Ansätze zur Prävention und Rehabilitation.

Violence in the workplace is a widespread problem that manifests itself in very different forms. The consequences for victims and companies are equally diverse. Sexual harassment is a special form of violence at the workplace. Violence may come from external perpetrators (attacks on cashiers) or from persons inside a company or establishment (colleagues, patients, people in care). Statutory accident insurance institutions in Germany (UV, "Unfallversicherungsträger") receive approximately 16,000 occupational injury reports per year that resulted from violence and led to extended incapacity to work. The numbers are increasing steadily. Particularly affected by violence are people working in healthcare and social welfare. Both psychological and physical violence can lead to severe disorders such as post-traumatic stress disorder (PTSD). To avoid violence, technical, organisational, and personal protective measures are needed. The training of de-escalation officers in the areas affected can be helpful. For victims of psychological and physical violence in the workplace, the UV offers special psychotherapeutic support and recommends the training of first-aiders.

Assessment of a postdeployment Yellow Ribbon Reintegration Program for National Guard members and supporters.

The Yellow Ribbon Reintegration Program (YRRP) was created to meet the needs of National Guard members and their families throughout the deployment cycle. This study examined the perceived utility of the YRRP's delivery of information and assistance during the postdeployment reintegration period by National Guard members and accompanying supporters who were mostly spouses. Over 22 months, from 10 YRRP events, 683 service members and 411 supporters completed questionnaires immediately after the YRRP. We analyzed questions on information and avenues for help, timeliness and concerns related to education, employment, legal, family, and health. Service members and supporters most often endorsed information delivery on education being met (76.8% and 78.2%, respectively) and were least likely to endorse legal information delivery (63.5% and 60%, respectively). Significantly more supporters than service members (p < 0.0001) reported that the YRRP was the first time they learned of available services across all domains. Service members were significantly more likely than supporters to report concerns about education, employment, and health, while supporters were significantly more likely to report concerns about family. Results suggest the YRRP fills gaps in supporter knowledge and provides needed information and resources to most National Guard families 2 to 4 months after a deployment.

The legislative response to PTSD in the United States (1989-2009): a content analysis.

Although knowledge about posttraumatic stress disorder (PTSD) has grown over the past 40 years, PTSD policy research is undeveloped. This gap in knowledge warrants attention because policy is among the most powerful tools to prevent and mitigate the effects of PTSD. This study provides a content analysis of all bills introduced in U.S. Congress that explicitly mentioned PTSD. All bills and bill sections mentioning PTSD were coded to create a legislative dataset. Bills that addressed traumatic stress, but did not mention PTSD, were also identified as a comparison group. One hundred sixty-one PTSD explicit bills containing 382 sections of legislative text were identified, as were 43 traumatic stress, non-PTSD bills containing 55 sections (the 2 categories were mutually exclusive). Compared to traumatic stress, non-PTSD sections, PTSD explicit sections were far more likely to target military populations (23.6% vs. 91.4%) and combat exposures (14.5% vs. 91.4%). PTSD, as a discrete diagnostic entity, has been largely defined as a problem unique to combat exposure and military populations in federal legislation. Research is needed to understand knowledge and perceptions of PTSD among policy makers and the public to inform science-based advocacy strategies that translate the full spectrum of PTSD research into policy.

Examining the impact of a family treatment component for CBITS: when and for whom is it helpful?

This study compared the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), as it is typically delivered, to CBITS-plus-family treatment component (CBITS + Family), developed through a community partnership. This study used a quasi-experimental design, capitalizing on ongoing CBITS implementation within a school system. In total, 32 parent/student dyads were recruited in CBITS groups and 32 parent/student dyads were recruited in CBITS + Family groups. Parents and students in both conditions completed pre- and posttreatment measures, in addition to a 6-month posttreatment follow-up assessing symptoms. Families were low-income and predominately Latino. Children were 59% female with an average age of 11.70. Participating parents were 84% female with an average age of 38.18. The majority of parents (80%) were immigrants and 70% reported not finishing high school. Parents who received CBITS + Family showed significant improvements in attitudes toward mental health, school involvement, and primary control coping, while demonstrating significant reductions in involuntary engagement and inconsistent discipline. CBITS + Family appears to be most beneficial for children with high symptom severity in terms of reducing posttraumatic stress disorder symptoms and disengagement coping. Finally, greater improvements in parent variables predicted larger symptom reductions among children within the CBITS + Family group. This study suggests that CBITS + Family is beneficial for parents of children exposed to trauma and may be especially helpful for children with high initial symptom severity. Children in CBITS + Family appear to benefit most when their parents show larger improvements in school involvement and greater reductions in parental inconsistency and involuntary engagement.