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1.
Artigo em Inglês | MEDLINE | ID: mdl-36498102

RESUMO

OBJECTIVE: To make the case that developmental distress needs to be assessed when evaluating adolescent depression. METHODS: Reviews of relevant papers relating to adolescent depression. RESULTS: Adolescent depression is a common and costly health condition, confounded by a lack of consensus among health professionals regarding evidence-based approaches regarding treatments. Little attention has been paid to the contribution of developmental distress. CONCLUSION: The current adult-like model of adolescent depression fails to advance the understanding of adolescent depression. A systematic evidence-based approach to identifying developmental self-perception distress in depressed adolescents could provide important advances in treatment to improve short-term and longer-term mental health outcomes. This paper proposes the creation of a psychometric tool to systematically measure developmental self-perception distress in adolescents with depression.


Assuntos
Depressão , Pessoal de Saúde , Adulto , Adolescente , Humanos , Depressão/diagnóstico , Depressão/psicologia
2.
Behav Cogn Psychother ; 50(6): 590-603, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36093926

RESUMO

BACKGROUND: Peer victimization and anxiety frequently co-occur and result in adverse outcomes in youth. Cognitive behavioural treatment is effective for anxiety and may also decrease children's vulnerability to victimization. AIMS: This study aims to examine peer victimization in youth who have presented to clinical services seeking treatment for anxiety. METHOD: Following a retrospective review of clinical research data collected within a specialized service, peer victimization was examined in 261 children and adolescents (55.6% male, mean age 10.6 years, SD = 2.83, range 6-17 years) with a diagnosed anxiety disorder who presented for cognitive behavioural treatment. Youth and their parents completed assessments of victimization, friendships, anxiety symptoms, and externalizing problems. RESULTS: High levels of victimization in this sample were reported. Children's positive perceptions of their friendships were related to lower risk of relational victimization, while conduct problems were related to an increased risk of verbal and physical victimization. A subsample of these participants (n = 112, 57.1% male, mean age 10.9 years, SD = 2.89, range 6-17 years) had completed group-based cognitive behavioural treatment for their anxiety disorder. Treatment was associated with reductions in both self-reported anxiety and victimization. Results confirm the role of friendships and externalizing symptoms as factors associated with increased risk of victimization in youth with an anxiety disorder in a treatment-seeking sample. CONCLUSIONS: Treatment for anxiety, whether in a clinic or school setting, may provide one pathway to care for young people who are victimized, as well as playing a role in preventing or reducing victimization.


Assuntos
Bullying , Vítimas de Crime , Adolescente , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Bullying/psicologia , Criança , Cognição , Vítimas de Crime/psicologia , Feminino , Humanos , Masculino , Grupo Associado
3.
JMIR Res Protoc ; 11(6): e38223, 2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35596546

RESUMO

BACKGROUND: Decentralized health systems in low- and middle-income countries (LMICs) affected by humanitarian crises lack resources and a qualified workforce to attend to the overwhelming demand for mental health care in emergencies. Innovative approaches that are safe, cost-effective, and scalable are needed to address the burden of traumatic stress caused by emergencies. High mobile phone ownership rates combined with the precision of neural, cognitive, and biometric measures of trauma and their feasible integration with artificial intelligence makes digital app interventions a promising pathway to promote precision diagnosis and high-impact care. OBJECTIVE: This study aimed to advance methods for the objective diagnosis and treatment of trauma in emergencies across LMICs by examining neural, cognitive, and biometric markers and the efficacy of the eResilience app, a neuroscience-informed mobile health mental health app intervention, via changes in clinical symptomatology, cognitive performance, and brain activity. METHODS: Trauma-exposed African refugees residing in Australia were selected for this study. A research software version of the eResilience app with advanced monitoring capabilities was designed for this trial. Participants completed the eResilience app at home during a 7-day period. Clinical, cognitive, and electrophysiological data were collected at baseline, along with posttest measurements to examine biomarkers of trauma and the efficacy of the proposed digital intervention for the treatment of trauma and its potential outcomes, including depression, anxiety, physical symptoms, self-harm, substance misuse, and cognitive impairment. In addition, biofeedback, well-being, and subjective stress data points were collected via the app during the treatment week, followed by clinical interviews at 1, 3, 6, and 12 months after the intervention. RESULTS: Data collection was conducted between 2018 and 2020. A total of 100 participants exposed to war were screened; 75 (75%) were enrolled and assigned to a trauma-exposed control (38/75, 51%) or posttraumatic stress disorder condition (37/75, 49%); and 70 (70%) completed all baseline, treatment, and posttest assessments. A total of 89% (62/70) of those who completed the intervention opted to enroll in the 3-, 6-, and 12-month follow-ups. Data collection is complete. As of May 2022, the results of all proposed analyses are being prepared for publication. If proven efficacious, this proof-of-concept clinical trial will inform fully powered randomized clinical trials in LMICs to further develop artificial intelligence-powered, app-based diagnostic and prognostic features and determine the app's cross-cultural efficacy for the treatment of trauma in emergency settings. CONCLUSIONS: This protocol provides researchers with a comprehensive background of the study rationale, a detailed guideline for replication studies interested in examining the feasibility and efficacy of the eResilience app across varied demographics, and a robust framework for investigating low-cost objective diagnostic markers in mental health interventions. Methodological limitations and suggestions are also provided. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12616001205426; https://tinyurl.com/yckwc4d7. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/38223.

4.
Death Stud ; 46(2): 257-279, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-31809665

RESUMO

Recent research suggests that the transdiagnostic construct of death anxiety may be a basic fear underlying a range of anxiety disorders. Although the investigation of death anxiety in clinical populations is relatively recent, the death anxiety literature as a whole has a longer history evidenced by the number of instruments developed to measure this construct. This systematic review aimed to evaluate the evidence supporting the psychometric properties of self-report death anxiety measures. Relevant studies were identified via a systematic search of four electronic databases in addition to reference list searches. Two independent reviewers evaluated relevant studies using the established Terwee et al. quality appraisal tool. Of the 1831 studies identified, 89 met inclusion criteria. These studies investigated the psychometric properties of 21 self-report scales of death anxiety as well as six subscales. No measure was found to possess evidence of adequacy on all evaluated quality criteria. The Templer Death Anxiety Scale, Concerns about Dying Instrument and Death Concern Scale were found to possess the most evidence supporting their validity and reliability. Overall findings suggest that additional research is needed to establish the psychometric adequacy of death anxiety instruments, especially given increased utilization of these measures in both clinical and research settings.


Assuntos
Transtornos de Ansiedade , Ansiedade , Ansiedade/diagnóstico , Humanos , Psicometria , Reprodutibilidade dos Testes , Autorrelato
5.
Br J Dev Psychol ; 40(2): 306-319, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34939686

RESUMO

Relatively little is known about features of moral reasoning among young children with callous-unemotional (CU) traits (e.g., lack of guilt and empathy). This study tested associations between CU traits and emotion attributions (i.e., identification of others' emotional states) and justifications (i.e., explanations for those emotional states), across social scenarios involving discreet versus salient distress cues. The participants were boys aged 6-to-10 years (N = 50; Mage  = 7 years 7 months), who were interviewed about 12 hypothetical scenarios (eight with discreet and four with salient distress cues). Regression models indicated that CU traits, in interaction with high levels of antisocial behaviour, were associated with reduced emotion attributions of fear in discreet but not salient immoral scenarios. Higher CU traits were also associated with reduced justifications referencing others' welfare in discreet scenarios, and increased references to action-orientated justifications in salient scenarios. These findings suggest that CU traits are associated with early moral reasoning impairments and that salience of distress may be important to these processes.


Assuntos
Transtorno da Conduta , Transtorno da Personalidade Antissocial/psicologia , Criança , Pré-Escolar , Cobre , Emoções , Empatia , Feminino , Humanos , Masculino , Princípios Morais
6.
Artigo em Inglês | MEDLINE | ID: mdl-34046746

RESUMO

The objectives of this study are to assess the association between childhood bullying and preference-based health-related quality of life (QoL) in Australian school children and their parents and estimate quality-adjusted life years (QALYs) associated with bullying chronicity. Children aged 8-10 years completed the child health utilities (CHU-9D), while parents completed the Australian quality of life (AQoL-8D). Children were grouped into four categories of bullying involvement (no bullying, victim, perpetrator, or both perpetrator and victim) based on the Revised Olweus Bully/Victim Questionnaire. Parental data were compared across two bullying involvement groups (bullying vs. no bullying). QALYs were calculated for children over two years and comparisons made based on the number of assessments where bullying was reported (baseline, 1- and 2-year follow up). Children who were involved in bullying (victims and/or perpetrators) reported statistically significantly lower mean utility scores compared to children who were not involved in bullying. Parents whose child was involved in bullying had significantly lower mean utility scores compared to parents of children not involved with bullying. There appeared to be a dose-response relationship, with higher QALY losses associated with increasing frequency of reported bullying. Bullying among Australian school children was associated with significantly lower preference-based QoL for themselves and their parents. This study also confirmed the significant burden of disease for bullying among children measured by an incremental decrease in QALY with an increasing chronicity of bullying over time.

7.
Australas Psychiatry ; 29(4): 446-449, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33626307

RESUMO

OBJECTIVE: Clinical psychologists are practitioners with expertise in mental health, who apply advanced psychological theory and knowledge to their practice in order to assess and treat complex psychological disorders. Given their robust specialised mental health training, clinical psychology is an integral component of the Australian mental health workforce, but is under-utilised. Recent reviews have identified significant problems with Australia's mental health system, including unequal access to clinical psychology services and fragmentation of service delivery, including convoluted pathways to care. CONCLUSIONS: Clinical psychology is well placed to contribute meaningfully to public mental health services (PMHS). We describe what clinical psychologists currently contribute to team-based care in PMHS, how we could further contribute and the barriers to making more extensive contributions. We identify significant historical and organisational factors that have limited the contribution made by clinical psychologists and provide suggestions for cultural change to PMHS.


Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Psicologia Clínica , Austrália , Humanos , Transtornos Mentais/terapia , Psicologia , Recursos Humanos
8.
J Interpers Violence ; 36(19-20): NP10301-NP10321, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-31510906

RESUMO

Peer victimization is a significant problem concerning young people. However, there are few brief measures that cover the key domains of victimization, including cyber victimization. Therefore, the objective of the present study was to construct and validate a short form version of the Personal Experiences Checklist (PECK) to be able to measure victimization efficiently and effectively. The PECK was originally developed to measure a young person's experience of victimization and provides scores for four subscales (relational-verbal, cyber, physical, and victimization in relation to culture) as well as a total score. A sample of N = 1,040 school students from Grades 4 to 9 (mean age = 12.2 years) derived from two studies was used to construct and cross-validate the structure of a Personal Experiences Checklist Short Form (PECK-SF) using confirmatory factor analysis and item response theory analysis. Based on discriminative ability and consideration of item content, 14 items were selected to form the PECK-SF, which demonstrated good internal consistency (Cronbach's α = .83). Given the small number of items, the use of subscales is not advised. However the PECK-SF total scale represents a potential alternative to the long form of the PECK and provides a brief and general index of victimization.


Assuntos
Bullying , Vítimas de Crime , Adolescente , Lista de Checagem , Criança , Humanos , Grupo Associado , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
9.
PLoS One ; 15(12): e0244182, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33339021

RESUMO

Beck's theory suggests that forming negative self-cognitions is a key early step in the development of depression. However, others have suggested the reverse, arguing that depression leads to development of negative self-beliefs. As such, there is debate about whether these cognitions are precursors to, or alternatively are caused by, depression. Although Beck's theory is supported in older adolescents, it has not been clearly seen in younger adolescents. This study aimed to assess the relation between two major self-cognitions (self-esteem and self-criticism) and depressive symptoms in early adolescence. Two-hundred and forty-three Australian adolescents (mean age = 12.08, 52% female) completed measures of self-esteem, self-criticism and depressive symptoms at baseline, then approximately 12- and 24-months later. Growth-curve modelling was used to assess changes in the variables. Cross-lagged analysis assessed whether either of the self-cognition variables predicted depressive symptoms, or if depressive symptoms predicted self-cognitions. Results indicated that self-criticism and depressive symptoms increased over the time period, while self-esteem decreased, and these changes were all related. Self-esteem predicted depressive symptoms from Time 2 to Time 3, while depressive symptoms predicted self-esteem from Time 1 to Time 2. Self-criticism did not predict depressive symptoms, nor did depressive symptoms predict self-criticism. These links appeared largely independent of gender. Self-esteem and depressive symptoms during the early adolescent period thus appear to have a somewhat reciprocal relation, while self-criticism does not appear to predict the development of depression. As such, while low self-esteem does appear to have an important role of in the development of depression in this age group, it is not strictly predictive, nor is this effect seen across all negative self-cognitions.


Assuntos
Depressão/psicologia , Autoavaliação (Psicologia) , Adolescente , Criança , Depressão/epidemiologia , Feminino , Humanos , Masculino
10.
Br J Dev Psychol ; 38(3): 458-477, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32167207

RESUMO

Research has focused on the role of theory of mind (ToM) for positive social behaviour, while the association between ToM and negative social behaviours is less well understood. This longitudinal study compares two mediation models examining the role of ToM and peer-rated social preference at ages 5 and 6 for bullying at age 7. Participants were 114 children (58 boys, Mage  = 67 months) at entry to primary school (T1). At Time 2 (T2), 106 children and, at Time 3 (T3), 96 children remained. Teacher-rated externalizing problems and children's language ability were controlled at T1. Poor ToM was found to indirectly predict later bullying via poor social preference, while for boys only, greater earlier ToM directly predicted greater bullying 2 years later. These results suggest that there are different pathways to bullying via ToM and social preference, which has implications for interventions to prevent the development of bullying behaviour.


Assuntos
Bullying , Comportamento Infantil/fisiologia , Desenvolvimento Infantil/fisiologia , Grupo Associado , Comportamento Social , Desejabilidade Social , Percepção Social , Teoria da Mente/fisiologia , Criança , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Masculino , Modelos Psicológicos , Fatores Sexuais
11.
Aggress Behav ; 46(3): 193-209, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32064639

RESUMO

Despite the extensive evaluation of school-based interventions for bullying, victimization remains a significant problem in schools. Bullying victimization is significantly predicted by contextual (school-related) factors. As a consequence whole-school programs have been commonly used to prevent and reduce bullying victimization. Evidence also points to individual risk factors (such as emotional distress) in predicting victimization, yet programs to prevent bullying victimization by changing these individual risks are far less developed. Few studies have approximated "real-world" implementation conditions in their trials. The current effectiveness trial evaluated the combination of a whole-school program designed to prevent bullying perpetration and victimization together with a targeted intervention for at-risk students, teaching them individual and dyadic strategies to reduce their anxiety and manage victimization, allowing schools some latitude to implement programs as they typically would. Students from Grades 3 and 4 (N = 8,732) across 135 schools were randomly assigned to one of four conditions: combined intervention; whole-school intervention only; individual intervention only; and care as usual. Victimization decreased significantly and similarly across all four conditions at 12 and 24 months following baseline. Similar reductions and failure to discriminate conditions were found on other key constructs: anxiety; bullying perpetration; and depression. Possible reasons for the failure to demonstrate victimization prevention differences and lessons learned from this large, effectiveness trial are considered.


Assuntos
Agressão/psicologia , Bullying/prevenção & controle , Bullying/psicologia , Vítimas de Crime/psicologia , Estudantes/psicologia , Bullying/estatística & dados numéricos , Humanos , Avaliação de Programas e Projetos de Saúde , Instituições Acadêmicas , Estudantes/estatística & dados numéricos
12.
Am J Orthopsychiatry ; 90(2): 212-222, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31414849

RESUMO

The knowledge of Syrian psychosocial activists in displaced communities is an invaluable resource for developing an ecological understanding of community needs and attitudes. This may elucidate the structural challenges of displacement to be addressed in psychosocial interventions. During Phase 1 of the study, we employed the community readiness model-a tool to assess community climate, needs, and resources-to determine community capacity-building needs. Eight Syrian key informants were interviewed in Amman, Jordan (December 2013 to January 2014). Community readiness scores were calculated. Thematic analysis explored community identified needs. During Phase 2, a focus group was conducted with 11 local psychosocial workers in Amman (September 2016) employing Phase 1 findings to develop a local capacity-building intervention. For the Phase 1 results, community attitudes toward mental health were reported to be rapidly changing. However, continued stigma, lack of knowledge of service availability, and insufficient number of services were noted as barriers to care. Sense of civic engagement and cultural knowledge of local psychosocial actors were noted as significant strengths. However, lack of access to work rights and technical supervision were identified as contributing to burnout, undermining the sustainability of local, grassroots initiatives. A need for training in clinical interventions, along with ongoing supervision, was identified. For the Phase 2 results, local psychologists elected to receive training in culturally adapted cognitive behavior therapy and operational capacity building. The cultural and contextual knowledge of Syrian community members are invaluable. Unfortunately, failure to provide these professionals with basic work rights and technical support have undermined the sustainability of their endeavors. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Fortalecimento Institucional , Serviços Comunitários de Saúde Mental , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Pessoal de Saúde , Necessidades e Demandas de Serviços de Saúde , Refugiados , Serviço Social , Avaliação Momentânea Ecológica , Pessoal de Saúde/educação , Pessoal de Saúde/legislação & jurisprudência , Humanos , Jordânia/etnologia , Síria/etnologia
13.
Epilepsia ; 60(10): 2068-2077, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31560136

RESUMO

OBJECTIVE: The study objective was to develop and validate the first epilepsy-specific anxiety survey instrument (Epilepsy Anxiety Survey Instrument [EASI]) alongside a briefer screening instrument to detect anxiety disorders in routine clinical practice (brEASI). METHODS: The instruments were developed utilizing a mixed-methods approach in four related studies. Pilot items were developed following qualitative interviews with people with epilepsy (PWE; Study 1) and consultation with multidisciplinary experts in anxiety and epilepsy (Study 2). PWE (n = 314) then completed pilot items alongside existing measures of anxiety and depression (Study 3). Factor analysis was conducted to refine the scale and select well-performing items for a briefer diagnostic screener (brEASI). The brEASI was validated against a gold standard diagnostic interview in 106 PWE recruited from an outpatient epilepsy service (Study 4). Receiver operating characteristic analysis was conducted to determine the brEASI's diagnostic performance. RESULTS: Twenty-six pilot items were generated based on the findings of Studies 1 and 2. Analyses in Study 3 resulted in an 18-item EASI, and eight well-performing items were selected for the brEASI. The area under the curve (AUC) of brEASI was excellent (AUC = 0.89, 95% confidence interval = 0.82-0.94). At a cutoff of 7, it demonstrated a sensitivity of 76% and specificity of 84% for identifying Diagnostic and Statistical Manual of Mental Disorders, 5th edition anxiety disorders. SIGNIFICANCE: The EASI and brEASI represent the first valid and reliable epilepsy-specific anxiety instruments. The EASI has been designed to comprehensively assess anxiety in PWE, whereas the brEASI may be used within busy neurology settings to provide rapid information to aid diagnoses of anxiety disorders. Given the significant prevalence and burden of anxiety in PWE, these tools are important potential solutions to improve the understanding and detection of anxiety in epilepsy.


Assuntos
Transtornos de Ansiedade/diagnóstico , Epilepsia/complicações , Adulto , Transtornos de Ansiedade/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
14.
J Adolesc ; 73: 26-35, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30953842

RESUMO

INTRODUCTION: Parental behavioural control is believed to be beneficial for young children. However, with increased need for independence during adolescence, parental rules may undermine self-beliefs. METHODS: The current study examined the effect of behavioural control, plus parental support and psychological control, on the self-esteem and self-criticism of 243 Australian adolescents (mean age = 12.08, 52% female) over two years. RESULTS: Behavioural control largely did not predict self-esteem. Furthermore, in girls it predicted higher self-criticism 12 and 24 months later. Behavioural control does not appear to benefit adolescents' self-cognitions and, in fact, increases self-criticism in girls. CONCLUSIONS: By providing copious rules around appropriate behaviours, parents may possibly indicate to girls that they are not capable of becoming independent, thus reducing feelings of competence.


Assuntos
Relações Pais-Filho , Autoimagem , Autoavaliação (Psicologia) , Adolescente , Comportamento do Adolescente/psicologia , Austrália , Criança , Feminino , Humanos , Masculino , Fatores Sexuais , Inquéritos e Questionários
15.
Aggress Behav ; 45(4): 450-462, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30900277

RESUMO

Over the last several years, researchers have become increasingly interested in the influence of moral factors on bullying behaviors. This is the first meta-analytic review to exclusively examine the relationship between moral disengagement (MD) and the key bullying roles of bully, victim, defender, and bystander. Forty-seven independent samples examining a total of 43,809 children/adolescents (aged 7-19) were included in this meta-analysis. Results indicated a positive relationship between MD and bullying (r = 0.31; 95% CI [0.27, 0.34]), MD and victimization (r = 0.08; 95% CI [0.05, 0.12]), and a negative relationship between MD and defending (r = -0.11; 95% CI [-0.17, -0.04]). No significant relationship was found for MD and bystanding behavior. Moderators of bullying type (traditional vs. cyberbullying), reporting type (self vs. peer report), age, and gender were included in the analyses. The results are discussed in the context of relevant literature with particular emphasis on the importance of distinguishing between guilty and unconcerned bystanders, and the significant overlap between bullying and victimization in the cyber context.


Assuntos
Agressão/psicologia , Bullying/psicologia , Vítimas de Crime/psicologia , Princípios Morais , Estudantes/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Criança , Comportamento Infantil/psicologia , Feminino , Humanos , Masculino , Grupo Associado , Autoeficácia , Comportamento Social
16.
Emotion ; 19(2): 270-282, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29697988

RESUMO

Previous research has established that the ability to manage emotions effectively is critical to healthy psychological and social development in adolescents. However, less research has considered the relationships between specific emotion regulation (ER) strategies, such as reappraisal and suppression, and social wellbeing in this age group. The current study investigated the concurrent and longitudinal relationships between 2 ER strategies (reappraisal and suppression) and social outcomes (peer victimization, friendship satisfaction, and family satisfaction) in young adolescents. Analyses also controlled for mental health (anxiety and depression). Given likely gender differences in these variables, key analyses were conducted in parallel for males and females. There were 232 Australian adolescents who completed measures in Grade 7 (Age Mean = 11.97, SD = .35; 64% female) and a year later in Grade 8. Zero-order correlations indicated an inverse relationship between suppression use and social wellbeing variables, although a number of these associations were no longer significant when controlling for mental health. There was limited evidence that reappraisal was uniquely related to social outcomes. However, interaction effects suggested that greater use of reappraisal might have provided some protection against the negative social effects of poorer mental health. Poorer mental and social wellbeing also appeared to be related to ER strategy use, particularly greater suppression use. The findings suggest that ER strategy use, mental health, and social outcomes all play important and interrelated roles in adolescent wellbeing. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Emoções/fisiologia , Saúde Mental/estatística & dados numéricos , Comportamento Social , Ansiedade/psicologia , Austrália/epidemiologia , Criança , Depressão/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Grupo Associado , Satisfação Pessoal , Caracteres Sexuais , Fatores Sexuais
17.
Front Psychol ; 9: 1097, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30022961

RESUMO

The current study aimed to examine the temporal relationship between anxiety symptoms and weight gain for adolescents with anorexia nervosa over the course of an inpatient admission targeting weight restoration through rapid refeeding. Participants were 31 females presenting to a specialist inpatient unit. Psychometric assessments using standardized procedures were conducted to assess co-morbid anxiety diagnoses, and eating disorder symptom severity at admission and discharge. Study protocols were completed on a weekly basis over the course of their admission and were compared with weekly BMI change. Multiple mixed-effects linear models with random intercepts were used to assess change in weight status and psychological variables. Results indicated a reduction in anxiety over the course of hospitalization; however, there was no evidence to support a relationship between anxiety change and weight restoration. The clinical implications of these results are discussed and directions for future research recommended.

18.
Artigo em Inglês | MEDLINE | ID: mdl-30637115

RESUMO

BACKGROUND: There is a need for ecological approaches to guide global mental health programmes that can appropriately address the personal, family, social and cultural needs of displaced populations. A transactional ecological model of adaptation to displacement was developed and applied to the case of Syrian refugees living in Jordan. METHODS: Syrian and Jordanian psychosocial workers (n = 29) supporting the Syrian refugee community in Jordan were interviewed in three waves (2013-2016). A grounded-theory approach was used to develop a model of key local concepts of distress. Emergent themes were compared with the ecological model, including the five ADAPT pillars identified by Silove (2013). RESULTS: The application of the ecological concept of niche construction demonstrated how the adaptive functions of a culturally significant concept of dignity (karama) are moderated by gender and displacement. This transactional concept brought to light the adaptive capacities of many Syrian women while highlighting the ways that stigma may restrict culturally sanctioned opportunities for others, in particular men. By examining responses to potentially traumatic events at the levels of individual, family/peers, society and culture, adaptive responses to environmental change can be included in the formulation of distress. The five ADAPT pillars showed congruence with the psychosocial needs reported in the community. CONCLUSIONS: The transactional concepts in this model can help clinicians working with displaced people to consider and formulate a broader range of causal factors than is commonly included in individualistic therapy approaches. Researchers may use this model to develop testable hypotheses.

19.
Eur Child Adolesc Psychiatry ; 27(7): 823-837, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28936622

RESUMO

This meta-analysis aimed to update existing data on the comparison of prevalence rates of psychopathology primarily among offspring with at least one parent with bipolar disorder (BD) and offspring of parents without psychiatric illness. Seventeen studies were derived from a systematic search of PsychInfo, Medline, Scopus and Embase. Inclusion criteria were use of a control offspring group, standardized diagnostic procedures and reporting of clear frequency data. Risk of psychopathology was estimated by aggregating frequency data from selected studies. Compared to control offspring, high-risk BD offspring are nine times more likely to have a bipolar-type disorder, almost two and a half times more likely to develop a non-BD affective disorder and over two times more likely to develop at least one anxiety disorder. High-risk offspring also showed a significant increased risk of other non-mood psychopathology such as attention deficit hyperactivity disorder (ADHD), any type of behavioral disorder and substance use disorder (SUDs). Risk of developing a broad range of affective and non-affective psychopathology is significantly higher in high-risk BD offspring. Identifying clinical presentations of this genetically high-risk cohort is important in establishing appropriate preventative treatment.


Assuntos
Transtorno Bipolar/psicologia , Psicopatologia/métodos , Adolescente , Criança , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Irmãos
20.
J Affect Disord ; 226: 12-20, 2018 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-28942201

RESUMO

BACKGROUND: The aim of this study was to examine the relationship between family environment (cohesion and parental bonding), high-risk status, and psychopathology (internalizing and externalizing problems) among offspring of parents with bipolar disorder (BD), from the perspective of both offspring and their parents. We further tested if family environment mediated the relationship between bipolar risk status and internalizing and externalizing problems. METHOD: High-risk (n = 90) BD offspring and control (n = 56) offspring aged 12-21 years old, and their parents, completed questionnaires on family cohesion and offspring internalizing and externalizing problems. Offspring also completed a parental bonding questionnaire. Group differences were examined, followed by multi-level mediation analysis with maximum likelihood and robust standard errors. RESULTS: Both offspring and parents in the high-risk group reported higher levels of internalizing and externalizing problems than controls. According to offspring reports, high-risk status, lower maternal and paternal care in parental bonding, was independently associated with internalizing problems. Lower maternal care alone predicted externalizing problems. Family environment did not mediate the relationship between bipolar risk status, and offspring problems. LIMITATIONS: Due to rates of missing data from parent reports of offspring psychopathology, mediation analysis was completed using offspring reports. CONCLUSIONS: The offspring-report data presented indicate that low parental warmth and connection were associated with internalizing and externalizing problems as an independent risk factor, in addition to bipolar risk status. The parent-child relationship therefore warrants attention as a potential target for prevention strategies with such families.


Assuntos
Transtorno Bipolar/psicologia , Filho de Pais Incapacitados/psicologia , Relações Familiares , Relações Pais-Filho , Psicopatologia , Adolescente , Adulto , Criança , Filho de Pais Incapacitados/estatística & dados numéricos , Relações Familiares/psicologia , Pai , Feminino , Humanos , Relações Interpessoais , Masculino , Apego ao Objeto , Inquéritos e Questionários
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