137. The Impact of Past Year Difficult Worries On Recency of Adolescent Mental Health Outcomes By Gender, Age, Sexual Orientation And Race/Ethnicity – Results From A Nationally Representative Probability Survey of U.S. Adolescents 14-17 Years

Objective: Child abuse can have devastating mental health consequences. Fortunately, not all individuals exposed to child abuse will suffer from poor mental health. Understanding what factors are related to good mental health following child abuse can provide evidence to inform prevention of impairment. Our objectives were to 1) describe the prevalence of good, moderate, and poor mental health among respondents with and without a child abuse history; 2) examine the relationships between child abuse and good, moderate, and poor mental health outcomes; 3) examine the relationships between individual- and relationship-level factors and better mental health outcomes; and 4) determine if individual- and relationship-level factors moderate the relationship between child abuse and mental health. Method: Data were from the nationally representative 2012 Canadian Community Health Survey: Mental Health ( n = 23,395; household response rate = 79.8%; 18 years and older). Good, moderate, and poor mental health was assessed using current functioning and well-being, past-year mental disorders, and past-year suicidal ideation. Results: Only 56.3% of respondents with a child abuse history report good mental health compared to 72.4% of those without a child abuse history. Individual- and relationship-level factors associated with better mental health included higher education and income, physical activity, good coping skills to handle problems and daily demands, and supportive relationships that foster attachment, guidance, reliable alliance, social integration, and reassurance of worth. Conclusions: This study identifies several individual- and relationship-level factors that could be targeted for intervention strategies aimed at improving mental health outcomes following child abuse.

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The Impact of Mobile Application Systems Use on Mental Health Outcomes: A Secondary Analysis of the Effect of Systems Usage on Anxiety, Worry, & Emotional Reactivity Among Participants in the Unwinding Anxiety Program (Preprint)

10.2196/preprints.33696 ◽

2021 ◽

Author(s):

William Nardi ◽

Alexandra Roy ◽

Shira Dunsiger ◽

Judson Brewer

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Emotional Regulation ◽

Mobile Application ◽

Secondary Analysis ◽

Health Behavior Change ◽

Mental Health Outcomes ◽

Interoceptive Awareness ◽

Point Increase ◽

The Impact

BACKGROUND Mobile health applications provide a promising avenue to help mitigate the burden on mental health services by complimenting therapist-led treatments for anxiety. However, it remains unclear how specific systems' use of application components (i.e., tools) may be associated with changes in clinical symptomatology (i.e., anxiety, worry). OBJECTIVE This study was a secondary analysis of systems usage data from the Stage I randomized controlled trial testing the impact of the Unwinding Anxiety mobile application among adults with GAD. This secondary analysis was conducted to assess how using specific application tools may be associated with improvements in anxiety, worry, emotional regulation, and interoceptive awareness. METHODS We present analyses of the intervention group (i.e., those who received the Unwinding Anxiety program) during the Stage 1 trial. Total use of specific mobile application tools (i.e., ecological tools, meditation practices, educational modules) as well use specific to each tool (e.g., stress meter, lovingkindness meditation practice) were calculated. We utilized multivariate linear models to investigate the effect of total use of these tools on anxiety, worry, interoceptive awareness, emotional regulation at 2-months post-program initiation controlling for baseline scores, age, and education level. In addition, associations between systems usage metrics and baseline participant characteristics were assessed for differences in usage groupings. RESULTS The sample was primarily female (n=25; 92.6%) and the average age was 42.9 years old (SD=15.6) and educational module completion, the central intervention component, averaged 20.2 + 11.4 modules out of XXX for the total sample. Multivariate models revealed that completing >75% of the program was associated with an average 22.6-point increase in interoceptive awareness (SE=8.32, p=0.013) and an 11.6-point decrease in worry (SE=4.12, p=0.009). In addition, a single log unit change in total number of meditations was associated with a 0.95-point reduction in GAD-7 scores (SE=0.27, p=0.005) while a single log unit use of the stress meter was associated with an average of a 0.5-point increase in emotional regulation scores (FFMQ) (SE=0.21, p=0.027). CONCLUSIONS The work presented offers a clearer understanding of the impact of specific mobile app systems use on mental health outcomes. In addition, this research lays the groundwork for future comprehensive investigations of systems usage in dosing studies for health behavior change. CLINICALTRIAL Developing a Novel Digital Therapeutic for the Treatment of Generalized Anxiety Disorder (NCT03683472).

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Disability, sexual orientation, and the mental health outcomes of intimate partner violence: A comparative study of women in the U.S.

Disability and Health Journal ◽

10.1016/j.dhjo.2018.11.002 ◽

2019 ◽

Vol 12 (2) ◽

pp. 164-170 ◽

Cited By ~ 5

Author(s):

Bethany M. Coston

Keyword(s):

Mental Health ◽

Intimate Partner Violence ◽

Sexual Orientation ◽

Comparative Study ◽

Health Outcomes ◽

Partner Violence ◽

Intimate Partner ◽

Mental Health Outcomes ◽

The U.S

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Understanding and evaluating new models of Child and Adolescent Mental Health Services in South-East England: a study protocol for an observational mixed-methods study

BMJ Open ◽

10.1136/bmjopen-2018-024230 ◽

2018 ◽

Vol 8 (12) ◽

pp. e024230 ◽

Cited By ~ 2

Author(s):

Stephen Rocks ◽

Melissa Stepney ◽

Margaret Glogowska ◽

Mina Fazel ◽

Apostolos Tsiachristas

Keyword(s):

Mental Health ◽

Mixed Methods ◽

Mental Health Services ◽

Health Services ◽

Health Outcomes ◽

Adolescent Mental Health ◽

Child And Adolescent ◽

Resource Utilisation ◽

South East England ◽

The Impact

IntroductionIncreased demand for Child and Adolescent Mental Health Services (CAMHS), alongside concerns that services should be better commissioned to meet the needs of the most vulnerable, has contributed to a requirement to transform services to improve accessibility, quality of care and health outcomes. Following the submission of government-mandated transformation plans for CAMHS, services in England are changing in how, where and by whom they are delivered. This protocol describes the research methods to be applied to understand CAMHS transformations and evaluate the impact on the use of mental health services, patient care, satisfaction, health outcomes and health resource utilisation costs.Methods and analysisA mixed-methods approach will be taken in an observational retrospective study of CAMHS provided by a large National Health Service (NHS) mental health trust in South-East England (Oxford Health NHS Foundation Trust). Quantitative research will include descriptive analysis of routinely collected data, with difference-in-differences analysis supplemented with propensity score matching performed to assess the impact of CAMHS transformations from 2015 onwards. An economic evaluation will be conducted from a healthcare perspective to provide commissioners with indications of value for money. Qualitative research will include observations of services and interviews with key stakeholders including CAMHS staff, service users and guardians, to help identify mechanisms leading to changes in service delivery, as well as barriers and enabling factors in this phase of transformation.Ethics and disseminationThis project has been registered with NHS Oxford Health Foundation Trust as a service evaluation. Informed consent will be sought from all stakeholders partaking in interviews according to good clinical practice. A local data sharing protocol will govern the transfer of quantitative data. Study findings will be published in professional journals for NHS managers and peer-reviewed scientific journals. They will be discussed in seminars targeting CAMHS providers, managers and commissioners and presented at scientific conferences.

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Longitudinal Effects of Gendered Harassment Perpetration and Victimization on Mental Health Outcomes in Adolescence

Journal of Interpersonal Violence ◽

10.1177/0886260517723746 ◽

2017 ◽

Vol 35 (23-24) ◽

pp. 5997-6016 ◽

Cited By ~ 11

Author(s):

Sarah J. Rinehart ◽

Dorothy L. Espelage ◽

Kristen L. Bub

Keyword(s):

Mental Health ◽

Sexual Harassment ◽

Health Outcomes ◽

Mental Health Outcomes ◽

Depression Symptoms ◽

Negative Outcomes ◽

Cross Sectional ◽

The Impact ◽

Homophobic Name Calling ◽

Gendered Harassment

Gendered harassment, including sexual harassment and homophobic name-calling, is prevalent in adolescents and is linked to negative outcomes including depression, anxiety, suicidality, substance abuse, and personal distress. However, much of the extant literature is cross-sectional and rarely are perpetrators of these behaviors included in studies of outcomes. Therefore, the current study examined the effects of longitudinal changes in gendered harassment perpetration and victimization on changes in mental health outcomes among a large sample of early adolescents. Given that these behaviors commonly occur in the context of a patriarchal society (males hold power), we also investigated the impact of gender on gendered harassment. Participants included 3,549 students from four Midwestern middle schools (50.4% female, 49% African American, 34% White) at two time points (13 and 17 years old). Results indicated that increases from age 13 to 17 years in sexual harassment perpetration and victimization and homophobic name-calling perpetration and victimization predicted increases in depression symptoms and substance use. Gender did not moderate these pathways. These findings highlight that negative outcomes are associated with changes in gendered harassment among adolescents and emphasize the importance of prevention efforts. Implications for school interventions are discussed.

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The impact of childhood parental quality on mental health outcomes in older adults

Aging & Mental Health ◽

10.1080/13607863.2017.1317331 ◽

2017 ◽

Vol 22 (6) ◽

pp. 819-825 ◽

Cited By ~ 2

Author(s):

R.A. Burns ◽

V. Loh ◽

J.E. Byles ◽

H.L. Kendig

Keyword(s):

Mental Health ◽

Older Adults ◽

Health Outcomes ◽

Mental Health Outcomes ◽

Parental Quality ◽

The Impact

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Impact of Internet-Based Interventions on Caregiver Mental Health: Systematic Review and Meta-Analysis (Preprint)

10.2196/preprints.10668 ◽

2018 ◽

Author(s):

Diana Sherifali ◽

Muhammad Usman Ali ◽

Jenny Ploeg ◽

Maureen Markle-Reid ◽

Ruta Valaitis ◽

...

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Chronic Condition ◽

Intervention Program ◽

Meta Analysis ◽

Informal Caregivers ◽

Intervention Programs ◽

Mental Health Outcomes ◽

The Impact ◽

Internet Based Intervention

BACKGROUND The health of informal caregivers of adults with chronic conditions is increasingly vital since caregivers comprise a large proportion of supportive care to family members living in the community. Due to efficiency and reach, internet-based interventions for informal caregivers have the potential to mitigate the negative mental health outcomes associated with caregiving. OBJECTIVE The objective of this systematic review and meta-analysis was to examine the impact of internet-based interventions on caregiver mental health outcomes and the impact of different types of internet-based intervention programs. METHODS MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, and AgeLine databases were searched for randomized controlled trials or controlled clinical trials published from January 1995 to April 2017 that compared internet-based intervention programs with no or minimal internet-based interventions for caregivers of adults with at least 1 chronic condition. The inclusion criteria were studies that included (1) adult informal caregivers (aged 18 years or older) of adults living in the community with a chronic condition; (2) an internet-based intervention program to deliver education, support, or monitoring to informal caregivers; and (3) outcomes of mental health. Title and abstract and full-text screening were completed in duplicate. Data were extracted by a single reviewer and verified by a second reviewer, and risk of bias assessments were completed accordingly. Where possible, data for mental health outcomes were meta-analyzed. RESULTS The search yielded 7923 unique citations of which 290 studies were screened at full-text. Of those, 13 studies met the inclusion criteria; 11 were randomized controlled trials, 1 study was a controlled clinical trial, and 1 study comprised both study designs. Beneficial effects of any internet-based intervention program resulted in a mean decrease of 0.48 points (95% CI –0.75 to –0.22) for stress and distress and a mean decrease of 0.40 points (95% CI –0.58 to –0.22) for anxiety among caregivers. For studies that examined internet-based information and education plus professional psychosocial support, the meta-analysis results showed small to medium beneficial effect sizes of the intervention for the mental health outcomes of depression (–0.34; 95% CI –0.63 to –0.05) and anxiety (–0.36; 95% CI –0.66 to –0.07). Some suggestion of a beneficial effect on overall health for the use of information and education plus combined peer and professional support was also shown (1.25; 95% CI 0.24 to 2.25). Overall, many studies were of poor quality and were rated at high risk of bias. CONCLUSIONS The review found evidence for the benefit of internet-based intervention programs on mental health for caregivers of adults living with a chronic condition, particularly for the outcomes of caregiver depression, stress and distress, and anxiety. The types of interventions that predominated as efficacious included information and education with or without professional psychological support, and, to a lesser extent, with combined peer and psychological support. Further high-quality research is needed to inform the effectiveness of interactive, dynamic, and multicomponent internet-based interventions. CLINICALTRIAL PROSPERO CRD42017075436; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=75436 (Archived by WebCite at http://www.webcitation.org/709M3tDvn)

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