Effectiveness of Online Interventions for the Universal and Selective Prevention of Mental Health Problems Among Adolescents: a Systematic Review and Meta-Analysis.

With the emergence of the coronavirus disease 2019 pandemic as a threat to mental health, the demand for online interventions that can replace face-to-face approaches for the prevention of mental health problems is increasing. Although several previous reviews on online interventions have targeted adolescents with symptoms of or those diagnosed with mental illness, there is still a lack of evidence on the effectiveness of online preventive interventions for general and at-risk adolescents. Therefore, this review aimed to evaluate the effectiveness of online interventions on the prevention of an increase in the scores of stress, anxiety, and depression in general and at-risk adolescents. A search was performed using PubMed, EMBASE, and Cochrane Library CENTRAL. Altogether, 19 studies were included, and 16 studies were used for the meta-analysis. Our results showed that cognitive behavioral therapy and family-based interventions were most commonly used. Twelve and seven studies conducted universal and selective preventive interventions, respectively. The meta-analysis showed that online interventions significantly prevent an increase in depression score but not in stress and anxiety scores. Evidence regarding the prevention of increases in stress and anxiety scores is limited, suggesting the need for further randomized controlled trials on online interventions for stress and anxiety in adolescents.

Effects of social support on mental health outcomes in disasters: A cross-sectional study.

This study examined the mediating effects of social support on the association between disaster distress and mental health outcomes. We analyzed the data of 1006 participants with either direct or indirect exposure to one or more disasters. Disaster distress, social support, depression, and anxiety were significantly correlated. Multiple regression and mediation analyses with bootstrapping showed that social support was a partial mediator between disaster distress and depression, and between disaster distress and trait anxiety. It was a complete mediator between disaster distress and state anxiety. The results suggest that enhancing social support may reduce the negative effects of disaster distress on depression and anxiety. Therefore, comprehensive interventions incorporating disaster distress management and enhanced social support are essential in national disaster management policies and psychiatric and mental health nursing services for individuals who have experienced disasters.

Systematic review and meta-analyses of randomized control trials of the effectiveness of psychosocial interventions for homeless adults.

AIMS: To evaluate the effect of psychosocial interventions for homeless adults on their psychosocial outcomes. DESIGN: A systematic review and meta-analyses were performed for critical appraisal and synthesis of the included studies. DATA SOURCES: A systematic search of studies published before 10 September 2018 was performed using PubMed, Cochrane Library, EMBASE, PsycINFO, and CINAHL. REVIEW METHODS: The review included randomized controlled trials conducting psychosocial interventions and assessing psychosocial outcomes for homeless adults. After systematically describing study and intervention characteristics, we conducted meta-analyses by the type of outcome and subgroup meta-analyses by the type of intervention and outcome. Fourteen studies were included in this review and 11 were included in the meta-analyses. RESULTS: A significant effect of psychosocial interventions in reducing anxiety and enhancing mental health status among homeless adults was noted. CONCLUSION: The meta-analyses showed that psychosocial interventions may reduce anxiety and enhance the mental health status of homeless people. Specifically, we suggest that relaxation response training may be effective in improving anxiety and mental health status and cognitive behavioural therapy may reduce anxiety. IMPACT: Although psychosocial interventions for homeless persons have been implemented for a decade, their impact for psychosocial outcomes among homeless adults has not been evaluated. This review suggest that psychosocial interventions may improve anxiety and mental health status among homeless adults. The findings of the present study may provide directions for developing psychosocial interventions to help vulnerable homeless adults in managing psychological outcomes.

Relational-Level Factors Influencing Suicidal Behaviors Among Korean Adolescents.

PURPOSE: To identify relational-level risk and protective factors for suicidal ideation, suicide plan, and suicide attempt in a nationally representative sample of Korean adolescents. STUDY DESIGN: This study is a secondary data analysis of cross-sectional national data on Youth Health Behavior collected in June 2017. The final sample (n = 62,276), collected from 2,400 classes in 800 schools, reflects stratification, clustering, and weight. It is representative of the population (n = 3,027,488). METHODS: This study used relational factor variables, including experiences of assault, living with family or not, and adolescents' confidants. Dependent variables included suicidal ideation, suicide plan, and suicide attempt. This study used logistic regression analyses on the complex sample to examine relational-level risk and protective factors for suicidal ideation, plan, and attempt. FINDINGS: The adjusted logistic regression models found that experiences of assault, living with family or not, and adolescents' confidants were all significantly associated with suicidal ideation, plan, and attempt. In particular, 35.3% of victims had thought about suicide seriously, and victims of assault were approximately eight times more likely to attempt suicide compared to nonvictims. CONCLUSIONS: The experience of assault by others was found to be a strongly associated risk factor for suicidal behaviors in adolescents. Living with family and the presence of confidants to talk with were found to be protective factors against suicidal behaviors. To be specific, talking with parents about personal worries and troubles was more protective against suicidal behaviors than talking with a sibling, friend, or teacher. CLINICAL RELEVANCE: Nurses should provide crisis intervention for symptoms of trauma and suicidal behaviors among assault victims. Suicide prevention efforts should focus more on adolescents not living with family. They should also aim to enhance adolescents' family interactions. Encouraging adolescents to talk with their parents may mitigate the effects of risk factors on suicidal behaviors.

The Current Status of Psychological Intervention Research for Internet Addiction and Internet Gaming Disorder.

This integrative review assesses the effectiveness of psychological interventions for reducing the severity of Internet addiction and/or Internet gaming disorder. We searched five databases, and both a narrative synthesis and meta-analyses were conducted. Five randomized controlled trials (RCTs) and six quasi-experimental studies met the inclusion criteria. The included interventions were categorized as cognitive-behavioral therapy, family-based intervention, and counseling program. A meta-analysis showed significant effects of psychological interventions, whereas a narrative synthesis showed some evidence that they could reduce addiction severity. Psychological interventions may help to reduce addiction severity, but further RCTs are needed to identify the most effective type.

Psychological Interventions for Runaway and Homeless Youth.

PURPOSE: In this review we examined previous studies of psychological interventions for runaway and homeless youth and evaluated the effectiveness of these interventions in terms of mental health outcomes. DESIGN: Literature review. METHODS: A search of various databases, including PubMed, EMBASE, Cochrane Library, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), was conducted. In this review we systematically described the characteristics of the included studies and interventions, and conducted a narrative synthesis and meta-analyses of the mental health outcomes of the interventions. FINDINGS: Five types of psychological interventions were identified in the included 11 studies: art therapy, cognitive behavioral therapy (CBT)-based interventions, family therapy, motivational interviewing, and strengths-based interventions. The narrative synthesis found positive effects of family therapy on substance use and positive effects of CBT-based interventions on depression. However, according to the meta-analyses, none of the interventions had any significant effects. CONCLUSIONS: Family therapies are likely to be effective in cases of substance use, and CBT-based interventions are likely to be effective in dealing with cases of depression. However, as the quantitative synthesis did not support the effects of any of the psychological interventions on mental health outcomes, further research is needed. CLINICAL RELEVANCE: Nurse-led interventions were identified in two studies. Mental health nurses should assess the mental health status of runaway and homeless youth and provide timely and effective interventions.

The Effect of a Resilience Enhancement Programme for Female Runaway Youths: A Quasi-Experimental Study.

The effects of a resilience enhancement programme on resilience, depression, anxiety, and problem drinking among female runaway youths living in shelters were evaluated. Participants were 32 youths (16 experimental and 16 control participants), assessed at pre-test, post-test, and one-month follow-up. The programme incorporated five protective factors associated with resilience: self-esteem, self-regulation, relational skills, problem-solving skills, and goal-setting skills. There were significant group-by-time interaction effects for resilience, anxiety, and problem drinking at one-month follow-up. The preliminary results suggest that providing female runaway youths with this programme focusing on protective factors may enhance resilience and mitigate anxiety, and problem drinking.

Effectiveness of Telephone-Delivered Interventions Following Suicide Attempts: A Systematic Review.

AIM: To evaluate efficacy of telephone-delivered interventions following suicide attempts. METHODS: Systematic review, meta-analysis, and narrative synthesis. RESULTS: Five papers evaluating telephone interventions were included. Three studies provided suicide attempters with telephone contact intervention, and two studies provided deliberate self-harm patients with crisis cards to help after discharge. Meta-analyses showed that telephone contact intervention did not significantly reduce further suicide attempts and completed suicides, and the crisis card did not significantly reduce further deliberate self-harm. CONCLUSION: Telephone-delivered interventions have been suggested as an alternative to face-to-face psychotherapy, but their effectiveness in reducing the recurrence of suicide attempts is not supported.

A Summary of Selective Experimental Research on Psychosocial Interventions for Sexually Abused Children.

This study was conducted to explore current trends in psychosocial interventions for sexually abused children through a review of recent research. Our comprehensive review is limited to published (quasi) experimental studies in the English language over a period of 2000-2013. It provides a detailed analysis of the final 18 articles that met our inclusion criteria, from the 670 potentially relevant articles that were identified. Reviewers analyzed candidate articles to determine whether they met inclusion or exclusion criteria. The retrieved studies reported positive results with respect to improvements in the negative psychosocial sequelae of child sexual abuse following the use of a diverse set of treatment strategies. Of the various interventions, cognitive behavioral therapy was shown to be the most promising type of intervention for sexually abused children. In this review, we discuss some of the implications of psychosocial interventions for victims of child sexual abuse, citing both the methodological and ethical issues that should be considered.

Factors influencing smartphone overdependence among adolescents.

Adolescents are particularly vulnerable to smartphone overdependence. Therefore, we identified the factors influencing smartphone overdependence and risk subgroups among adolescents. The current study is a secondary analysis of nationally representative data from the 2020 Korea Youth Risk Behavior Survey. The survey targeted middle- and high-school students in South Korea aged 12-18 using stratified, clustered, multistage probability sampling, and 53,457 students from 793 schools participated in this study. Complex sample data were analyzed considering the strata, clusters, and weights. Multiple logistic regression analysis revealed age, gender, household economic status, anxiety, loneliness, depressive symptoms, and experience of violent treatment as significant predictors of smartphone overdependence. Adolescents with severe anxiety were at a 3.326 times higher risk of smartphone overdependence than adolescents with minimal anxiety. Decision tree analysis showed that anxiety, gender, loneliness, and depressive symptoms were important in differentiating risk subgroups, with anxiety being the most significant factor. Group 13, comprising girls with severe anxiety, had the highest risk at 52.9%. Thus, early detection and prevention of issues such as anxiety, loneliness, and depressive symptoms, as well as treatment for violence, can prevent smartphone overdependence among adolescents. Additionally, more thorough interventions for anxiety are warranted to prevent smartphone overdependence.

Effectiveness of Robot Interventions for Cognitive and Psychological Outcomes among Older Adults with Cognitive Impairment: A Meta-Analysis.

This review was performed to evaluate the effects of robot interventions on cognitive and psychological outcomes among older adults with cognitive impairment. Three databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) were searched for studies published in English between January 2015 and August 2021. We included studies that involved older adults with cognitive impairment, interventions using robots, outcome measures related to cognitive and psychological status, and randomized controlled trials. Ten studies included in the systematic review, and nine studies derived from these ten articles were included in the meta-analyses. The meta-analyses revealed that robot interventions significantly decreased anxiety and agitation but exerted no significant effects on cognitive function, neuropsychiatric symptoms, and quality of life. The subgroup analyses according to robot types revealed that pet-type robot interventions reduced anxiety and agitation. In addition, subgroup analysis according to the intervention format of robot interventions found that individual intervention was effective for improving agitation, but a group-based intervention was effective for improving depression. We suggest using robot interventions to improve psychological outcomes such as anxiety and agitation; however, further research is needed to determine whether robot interventions affect symptoms such as cognitive function, neuropsychiatric symptoms, and quality of life.

Mediating Effects of Social Support and Resilience on the Association between COVID-19-Related Stress and Mental Health in Korean Young Adults.

Young adults were vulnerable to mental health issues during the COVID-19 pandemic. However, the underlying pathway by which COVID-19-related stress influences mental health outcomes among young adults remains unclear. This study aimed to examine the mediating effects of social support and resilience between COVID-19-related stress and mental health outcomes. A sample of 1000 Korean young adults was obtained via online survey. Participants completed self-report questionnaires assessing COVID-19-related stress, social support, resilience, depression, and anxiety. Overall, 48.1% and 23.4% of participants were classified as having depression and anxiety states, respectively. Path analysis using AMOS version 26.0 (IBM Corp., Armonk, NY, USA) showed that the direct effects of stress from social distancing difficulties on depression and anxiety were much greater than those of stress from fear of infection and anger toward others. In addition, there were significant indirect effects of social support and resilience in the relationship between stress related to difficulties due to social distancing and mental health outcomes. The mediating roles of social support and resilience suggest that interventions to increase these factors can be effective strategies to reduce the risks of depression and anxiety among young adults suffering from stress related to social distancing difficulties.

Effects of Physical Activity Interventions on Health Outcomes among Older Adults Living with HIV: A Systematic Review and Meta-Analysis.

There is a lack of evidence regarding the effects of exercise on older individuals living with HIV. This systematic review and meta-analysis examined previous studies on physical activity interventions for people living with HIV aged ≥50 years. The effectiveness of the interventions on various physical and psychological health outcomes was evaluated. Databases used for this review included PubMed, EMBASE, CINAHL, and Cochrane Library CENTRAL. Twelve randomized controlled trials on physical activity interventions for people ≥50 years and living with HIV were included. Standardized mean differences were calculated using random-effect models. All effect sizes were expressed using Cohen's d values and their 95% confidence intervals (CIs). Physical activity interventions had a significant effect on walking capacity (Cohen's d: 0.467; 95% CI [0.069, 0.865]). The effect sizes on cardiorespiratory fitness, weight, and health-related quality of life were not significant. These findings suggest that physical activity interventions for people living with HIV aged ≥50 years are effective for the improvement of walking capacity. Further larger and higher-quality studies are required to determine the full effects of physical activity interventions on various health outcomes among older adults with HIV.

Factors Associated With Self-Care Among Patients Receiving Hemodialysis: A Cross-Sectional Observational Study.

BACKGROUND AND PURPOSE: The global increase in prevalence of individuals with end-stage renal disease is a rising concern. Self-care is an essential and important component of chronic disease management. Poor self-care in patients receiving hemodialysis is associated with an increased risk of mortality and hospitalization. This study aimed to identify predictive factors for self-care in patients receiving hemodialysis based on a middle-range theory of self-care for chronic illness. METHODS: Adult patients with end-stage renal disease receiving hemodialysis were recruited at an artificial kidney unit in a general hospital. Data from 131 patients were analyzed. Self-report questionnaires assessed hemodialysis-related knowledge, health motivation, self-efficacy, social support, access to care, and self-care. RESULTS: Participants who had a family caregiver showed significantly higher selfcare scores than those who did not, and self-care scores were higher in patients who reported hypertension as a causal disease of end-stage renal disease than in those who did not. Self-care was significantly correlated with knowledge, health motivation, self-efficacy, social support, and access to care. The study's regression model showed that self-efficacy, health motivation, and knowledge were predictive variables influencing self-care, and the explanatory power of this model was 55.9%. IMPLICATIONS FOR PRACTICE: The results support the middle-range theory of self-care for chronic illness. Strategies and education to improve self-efficacy, health motivation, and knowledge must be incorporated when designing self-care programs. Nursing interventions that patients can participate in with their family members might facilitate improving self-care.

Development of a Family-Based Mental Health Program for Runaway Adolescents Using an Intervention Mapping Protocol.

The mental health and related quality of life of runaway adolescents are global public health issues. As few intervention studies have considered the family contexts of runaway adolescents, we aimed to develop an intervention tailored specifically to the needs of this population using an Intervention Mapping protocol. First, a literature review and interviews with runaway adolescents and youth shelter workers were conducted to create a logic model of the problem. Second, the behavioral and environmental outcomes were set to adapt to stressful situations and enable families to become more resourceful in dealing with family adversity, based on the results of needs assessment. Performance objectives and changeable determinants were also created by reviewing the pertinent theories and studies. Third, theory- and evidence-based methods to influence changes in the determinants were identified. Fourth, we designed an eight-session family-based mental health program incorporating individual and family approaches for runaway adolescents. Fifth, we determined that mental health nurses at community mental health centers linked to youth shelters would serve as the program implementers. Finally, we planned a randomized controlled trial to evaluate the effects of our program on improving runaway adolescents' mental health status and perceived family functioning.

Effectiveness of a brief stress management intervention in male college students.

PURPOSE: This study aimed to examine the effects of a brief stress management intervention on depression, anxiety, suicidal ideation, and aggression among Korean male college students. DESIGN AND METHODS: In a repeated measures design, participants were assessed before, immediately after, and 3 months after the intervention. Data of 40 experimental and 32 control participants were analyzed using linear mixed models. FINDINGS: There were significant time-by-group interaction effects for depression and trait anxiety, but not for state anxiety, suicidal ideation, and aggression. PRACTICE IMPLICATIONS: The intervention has long-term effects for depression and trait anxiety. Future research should involve a randomized controlled trial on a larger scale.

Effects of an Integrated Stress Management Program (ISMP) for Psychologically Distressed Students: A Randomized Controlled Trial.

PURPOSE: This study aimed to evaluate the effects of an integrated stress management program (ISMP) on college life stress, stress coping, psychological distress, and cortisol among male college students. DESIGN AND METHODS: Out of 137 initially enrolled students, 99 participants were identified as distressed subjects and randomly assigned to either the ISMP or control group. Ultimately, 84 participants (43: experimental, 41: control) completed pretest-posttest. The experimental group received eight 2-hr sessions over 4 weeks. FINDINGS: Stress and psychological distress decreased significantly, whereas stress coping and cortisol did not improve significantly. PRACTICE IMPLICATIONS: Further studies with longer follow-up periods and physiological interventions are required.