Young people with a variation in sex characteristics in Aotearoa/New Zealand: identity, activism and healthcare decision-making.

Young people born with variations in sex characteristics (VSC) or disorders of sex development (DSD) face numerous challenges in navigating issues relating to identity and to their lived and embodied experience. There is limited published research amplifying the voices of young people with a VSC, especially from Aotearoa/New Zealand. This qualitative study provides an up-to-date picture of the lived experience of 10 young people with a VSC in Aotearoa/New Zealand. The research was conducted in collaboration with the advocacy group, Intersex Youth Aotearoa, and explored the level of support provided by health services, peers and advocacy groups in relation to the ways the participants viewed themselves and their bodies, and their health related decision-making. Findings reveal the pressure on young people with a VSC to conform to cultural and societal norms, specifically, heteronormative and traditional constructs of how male and female bodies should look in Aotearoa/NZ society. Such views, often held and perpetuated by health professionals and parents, contributed to complexities surrounding identity, agency and acceptance of difference experienced by these young people. The implications of these findings are discussed, including the need for better psychological and peer support for young people.

Gender differences in the disability (functional limitations) associated with cardiovascular disease: a general population study.

BACKGROUND: Although it is widely believed that women with heart disease have poorer adjustment than men, the term 'adjustment' has typically been narrowly defined as depression. Gender differences in adjustment more broadly defined to encompass functional limitations in addition to depression have seldom been investigated, especially in general population samples with an adequate number of women. METHODS: A nationally representative general population survey of 7434 New Zealanders (618 with cardiovascular disease: CVD; 335 women, 283 men). DSM-IV mental disorders were measured with the Composite International Diagnostic Interview (CIDI 3.0). Health-related disability (functional limitations) was measured using the World Mental Health-World Health Organization Disability Adjustment Schedule (WHODAS-II). CVD was ascertained by self-report of a physician's diagnosis of heart disease, heart attack, or stroke. RESULTS: In age-adjusted analyses, cardiovascular disease was associated with significant functional limitations in a range of disability domains in both men and women, but there were no gender differences in the degree of disability. CONCLUSION: In this general population sample, men and women with CVD reported similar degrees of disability, despite women's higher prevalence of depression. This does not support earlier conclusions that women with heart disease cope less well than men.

Understanding Aotearoa New Zealand University Students Intentions to Seek Help If Experiencing Mental Distress: A Comparison of Naturalistic and Interventional Findings.

University students globally are consistently identified as a vulnerable group for mental distress and suicide. Despite this, students report low engagement in help-seeking behaviours. This series of studies aimed to assess barriers to help-seeking for students and the impact of an intervention that sought to increase support-seeking intentions. In Study 1, 373 undergraduate psychology students completed items related to depression, anxiety, suicidal ideation, stigma, and help-seeking intentions. In Study 2, 133 undergraduate psychology students were randomly allocated into one of three intervention groups (control, infographic, video) and completed measures as used in Study 1. Despite experiencing clinically relevant symptoms and recent suicidal ideation, students in Study 1 tended to report low intentionality to seek help, citing perceptions that their distress was not serious enough or a desire to handle their issues independently. In Study 2, an infographic about different support services increased student's intentions to access support services and reduced their perception that their issues were not serious enough. Overall, Aotearoa New Zealand students endorsed similar barriers to help-seeking as students in other countries. Importantly, we demonstrated that a simple infographic intervention reduced perceptions regarding these common barriers and may increase students' knowledge about when to seek help.

A Content Analysis of Reddit Users' Perspectives on Reasons for Not Following Through with a Suicide Attempt.

Despite a growing understanding of the triggers for suicidal thoughts and behavior, little is known about the mechanisms that prevent people from killing themselves. The goal of the present study was to use publicly available Reddit data to better understand the reasons that people give for not following through with a potentially lethal suicide attempt. Threads containing key terms (e.g., "kill yourself") within the subreddit /r/AskReddit were collected and all top posts from these threads were thematically coded. Across the posts collected, 11 different themes were identified; friends and family, curiosity and optimism about the future, spite, purpose, transience, hobbies, animals/pets, fear of survival, fear of pain, death and/or the afterlife, apathy/laziness, and intervention. Some additional themes were captured in an "other" category, and a twelfth theme, use of pharmaceutical drugs, was identified, but not discussed. These findings provide a broad overview about the proximal protective factors that directly stopped people from making a suicide attempt. They also illustrate the potential for Reddit as platform through which to better understand factors that may help to identify and support those in suicidal crisis. Such insight may help to inform intervention and prevention strategies for suicide and those in suicidal crisis.

"It's Either Do It or Die".

BACKGROUND: The role of self-management of suicidality was investigated as part of a larger qualitative study of suicidality among people with experience of mental illness in New Zealand. AIMS: To understand how people self-manage suicidality, why they self-manage, and the effects that self-management may have on suicidal thoughts and behavior. METHOD: Twenty seven people with experience of mental illness and suicidality were interviewed. A narrative thematic analysis was performed. RESULTS: People had either drifted into self-management (while still using or instead of using mental health services) or chosen self-management because they were unhappy with mental health services, desired independence, or had difficulty accessing services. Self-management of suicidality included: using active ways to reduce, distract, and protect themselves from suicidal thoughts and feelings; practical ways of looking after themselves; reframing thoughts; getting to know themselves better; and peer support. CONCLUSION: Self-management of suicidality can encourage independence and resilience, a sense of citizenship, mutuality, and achievement.

Hyperlinked suicide: assessing the prominence and accessibility of suicide websites.

BACKGROUND: The relationship between the Internet and suicide is a topic of growing concern among suicide researchers and the public, though to date few have actually attempted to investigate the accessibility and prominence of suicide-related information online, and there have been no comprehensive studies of site networking structure. AIMS: To assess the visibility of various types of online information to suicide-risk individuals, and to assess the prominence and accessibility of "pro-suicide," suicide prevention, and support sites by measuring their networking structure. METHODS: Employing empirically derived search terms, we used the web-based Virtual Observatory for the Study of Online Networks (VOSON) to conduct hyperlink network analysis (HNA) of suicide-related websites. RESULTS: Pro-suicide sites are rare and marginal, while sites dedicated to information about suicide as well as sites dedicated to prevention policy and advocacy are readily accessible. CONCLUSIONS: The networking structure of suicide-related Internet content has not been described previously. Our analysis shows that HNA is a useful method for gaining an indepth understanding of network traffic in relation to suicide-content websites. This information will be useful for strengthening the web presence of support and suicide prevention sites, and for monitoring changes over time.

When does neighbourhood matter? Multilevel relationships between neighbourhood social fragmentation and mental health.

Studies investigating relationships between mental health and residential areas suggest that certain characteristics of neighbourhood environments matter. After developing a conceptual model of neighbourhood social fragmentation and health we examine this relationship (using the New Zealand Index of Neighbourhood Social Fragmentation (NeighFrag)) with self-reported mental health (using SF-36). We used the nationally representative 2002/3 New Zealand Health Survey dataset of urban adults, employing multilevel methods. Results suggest that increasing neighbourhood-level social fragmentation is associated with poorer mental health, when simultaneously accounting for individual-level confounding factors and neighbourhood-level deprivation. The association was modified by sex (stronger association seen for women) and labour force status (unemployed women more sensitive to NeighFrag than those employed or not in labour force). There was limited evidence of any association of fragmentation with non-mental health outcomes, suggesting specificity for mental health. Social fragmentation as a property of neighbourhoods appears to have a specific association with mental health among women, and particularly unemployed women, in our study.

Death knocks, professional practice, and the public good: the media experience of suicide reporting in New Zealand.

Health, government, and media organizations around the world have responded to research demonstrating the imitative effects of suicide coverage in the news media by developing guidelines to foster responsible reporting. Implementation of these guidelines has encountered some resistance, and little is known about the media perspective on suicide coverage and its effects on guideline use. This qualitative study provides an in-depth appreciation of this perspective by investigating the experiences of journalists covering suicide in New Zealand. Fifteen newspaper, television and radio journalists were interviewed between December 2008 and March 2009 and transcripts were analyzed using a grounded hermeneutic editing approach. Five themes were identified: public responsibility, media framing of suicide, professional practice, personal experience of suicide reporting, and restricted reporting. Participants asserted the role of the media in the protection of the public good. Though this stance aligns them with the goals of health policymakers, it is derived from a set of professional mores at odds with the perceived paternalism of suicide reporting guidelines. Participants were stakeholders in the issue of suicide coverage. We conclude that policymakers must engage with the news media and acknowledge the competing imperatives that provide the context for the application of suicide reporting guidelines by individual journalists. Collaborative guideline development will be vital to effective implementation.

Psychological health of men with partners who have post-partum depression.

OBJECTIVE: To compare the psychological health of men with partners who have post-partum depression (PPD; index group) with that of men with partners without PPD (comparison group). METHOD: Using a cross-sectional survey, psychological symptoms and disturbances of index group men (n = 58) and comparison group men (n = 116) were compared. Validated self-report measures were used to assess five key areas of mental health: depression, anxiety, non-specific psychological impairment, aggression and alcohol use. RESULTS: Index group men had more symptoms of depression, aggression and non-specific psychological impairment, and had higher rates of depressive disorder, non-specific psychological problems and problem fatigue than comparison group men. Index group men were also more likely to have three or more comorbid psychological disturbances. There was no difference between the groups on measures of anxiety and alcohol use. CONCLUSIONS: Although many men in the postnatal period experience a variety of mental health problems, those who have a partner with PPD are themselves at increased risk for experiencing psychological symptoms and disturbances. Differentiation of psychological syndromes is important; higher rates of depressive disorder, non-specific psychological problems and problem fatigue were found, but rates of anxiety disorder and hazardous alcohol use did not differ between the groups. More attention from health professionals to men's mental health in the postnatal period may be beneficial to the entire family system.