scholarly journals Computer adaptive testing to assess impairing behavioral health problems in emergency department patients

Author(s):  
Lauren M OReilly ◽  
Azhar I Dalal ◽  
Serena Maag ◽  
Matthew T Perry ◽  
Alex Card ◽  
...  

Study Objective: To assess the prevalence of several impairing behavioral health domains in stable patients presenting to the emergency department (ED) through the use of computer adaptive testing and the association among the domains, standard assessments, and ED utilization. Methods: This was a single-center observational study of 828 randomly selected adult patients presenting to the ED from May 2019 to March 2020. The main outcomes of interest were the self-administered, validated computer adaptive assessments of suicidality, depression, anxiety, PTSD, and substance abuse using computer adaptive testing, the CAT-MHTM. We estimated the association among the CAT-MHTM subscales, standard assessments, and the number of ED visits in the year prior and 30 days after enrollment. Results: The proportion of those who scored above the threshold of low/mild risk were: 24.1% (suicidality), 8.3% (depression), 16.5% (anxiety), 12.3% (PTSD), and 20.4% (substance use). While the CAT-MHTM subscales were highly correlated with other self-report assessments, they were not highly associated with standard ED assessments of suicidality. When examining associations with ED use, for example, individuals who had two or more ED visits in the prior year had 51% increased odds of being in the intermediate-high suicide risk category (95% Confidence Interval [CI], 1.03-2.23) compared to those with zero prior ED visits. Conclusion: The CAT-MHTM can document the high prevalence of mental health conditions in the ED, which were missed by standard ED practices. Mental health problems are associated with ED utilization in a population of patients presenting largely for somatic complaints.

2021 ◽  
pp. 189-202
Author(s):  
E.V. Rezun ◽  
◽  
H.R. Slobodskaya ◽  
N.B. Semenova ◽  
T.O. Rippinen ◽  
...  

The mental health problems among adolescents have long-lasting effects throughout life. However, research evidence indicates that only 10–30% of adolescents who needed mental health care had received specialized help. The present study reports the prevalence of mental health problems and help-seeking among adolescents, taking into account gender and age differences. The sample included 1752 adolescents (47 % boys,) aged 12-17 years. Data were collected on in two Siberian cities (Novosibirsk and Krasnoyarsk) using an international self-report questionnaire developed for the school-based Eurasian Child Mental Health Study. Participants were recruited from 18 schools, students completed questionnaires anonymously during school lessons. Statistical analysis included analysis of variance (ANOVA), multiple regression analysis, and crosstabs using a chi-squared test. The level of emotional and behavioral problems in Siberian adolescents was slightly higher than that found in European and Asian countries. Twenty three percent of adolescents reported frequent headaches (at least once a week), 11 % reported frequent abdominal pain and 14% suffered from frequent sleep disturbances (3–5 times a week or more). Girls reported a significantly higher level of problems than boys, with the largest gender differences for emotional problems, recurrent pains and sleep disturbances. Weekly consumption of alcohol and daily use of nicotine among boys was more common than among girls (3 % and 6 %, respectively), whereas less frequent use of alcohol and nicotine was commoner in girls (16 %) than in boys (10 %); 7 % of boys and girls had tried drugs at least once. Suicidal thoughts were reported by 22 % of adolescents, 6 % reported suicide attempts and 6 % reported repeated self-harm. One third of adolescents considered seeking outside help and 9 % had actually done so. Girls reported more help-seeking than boys; older girls sought help more often than younger and middle-aged ones. Around one third of adolescents sought help from their relatives; 26 % from friends, the Internet or other non-professional sources; 5 % reported seeking help from a doctor or nurse, and 3 % from a psychologist. The most important independent predictors of seeking help were emotional symptoms, suicidal ideation and hyperactivity/inattention. The results suggest a need for future investigation of the factors associated with help-seeking behavior among adolescents. It is also necessary to develop mental health promotion programs for adolescents, interventions to improve mental health literacy and access to mental health care.


2019 ◽  
Vol 23 (4) ◽  
pp. 835-846
Author(s):  
Julie H. Levison ◽  
Margarita Alegría ◽  
Ye Wang ◽  
Sheri L. Markle ◽  
Larmiar Fuentes ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Jung Hyun Lee ◽  
Dayoung Lee ◽  
Soyoen Hyun ◽  
Ji Sun Hong ◽  
Chang-Hoon Kim ◽  
...  

Experiences of infectious diseases cause stressful and traumatic life events, hence, coronavirus disease 2019 (COVID-19) patients could suffer from various mental health problems requiring psychological support services. This study investigates the severity of mental health problems among confirmed COVID-19 patients. From March to November 2020, we collected the data from 118 COVID-19 patients who voluntarily participated in the National Center for Disaster Trauma's online mental health assessment consisting of self-report scales like Primary Care of Posttraumatic Stress Disorder screen (PC-PTSD), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Patient Health Questionnaire-15 (PHQ-15), and P4 Suicidality Screener. For control, 116 other disaster-experienced and 386 non-COVID-19-experienced participants were recruited. The COVID-19 patients showed more severe symptoms including post-traumatic symptoms, depression, anxiety, and somatic symptoms than control groups across all four screening scales (p < 0.001). Regarding high-risk, COVID-19 patients had an increased association with high-risk compared to the comparison groups (PC-PTSD: OR = 24.16, 95% CI = 13.52–43.16 p < 0.001; PHQ-9: OR = 14.45, 95% CI = 8.29–25.19, p < 0.001; GAD-7: OR=20.71, 95% CI = 10.74–39.96, p < 0.001; PHQ-15: OR = 5.65, 95% CI = 3.44–9.25, p < 0.001; P4: OR = 14.67, 95% CI = 8.95–25.07, p < 0.001). This study's results imply that there is a high-risk of overall mental health problems, especially stronger associations of post-traumatic stress symptoms, in COVID-19 patients. These findings help inform practitioners about the psychological responses to COVID-19 experiences and to prepare appropriate interventions and services for the incremental number of confirmed cases.


2019 ◽  
Vol 25 (1) ◽  
pp. 91-104 ◽  
Author(s):  
Chris Margaret Aanondsen ◽  
Thomas Jozefiak ◽  
Kerstin Heiling ◽  
Tormod Rimehaug

Abstract The majority of studies on mental health in deaf and hard-of-hearing (DHH) children report a higher level of mental health problems. Inconsistencies in reports of prevalence of mental health problems have been found to be related to a number of factors such as language skills, cognitive ability, heterogeneous samples as well as validity problems caused by using written measures designed for typically hearing children. This study evaluates the psychometric properties of the self-report version of the Strengths and Difficulties Questionnaire (SDQ) in Norwegian Sign Language (NSL; SDQ-NSL) and in written Norwegian (SDQ-NOR). Forty-nine DHH children completed the SDQ-NSL as well as the SDQ-NOR in randomized order and their parents completed the parent version of the SDQ-NOR and a questionnaire on hearing and language-related information. Internal consistency was examined using Dillon–Goldstein’s rho, test–retest reliability using intraclass correlations, construct validity by confirmatory factor analysis (CFA), and partial least squares structural equation modeling. Internal consistency and test–retest reliability were established as acceptable to good. CFA resulted in a best fit for the proposed five-factor model for both versions, although not all fit indices reached acceptable levels. The reliability and validity of the SDQ-NSL seem promising even though the validation was based on a small sample size.


Author(s):  
E. L. Duinhof ◽  
K. M. Lek ◽  
M. E. de Looze ◽  
A. Cosma ◽  
J. Mazur ◽  
...  

Abstract Aims The Strengths and Difficulties Questionnaire (SDQ) has been used in many epidemiological studies to assess adolescent mental health problems, but cross-country comparisons of the self-report SDQ are scarce and so far failed to find a good-fitting, common, invariant measurement model across countries. The present study aims to evaluate and establish a version of the self-report SDQ that allows for a valid cross-country comparison of adolescent self-reported mental health problems. Methods Using the Health Behaviour in School-aged Children study, the measurement model and measurement invariance of the 20 items of the self-report SDQ measuring adolescent mental health problems were evaluated. Nationally representative samples of 11-, 13- and 15-year old adolescents (n = 33 233) from seven countries of different regions in Europe (Bulgaria, Germany, Greece, the Netherlands, Poland, Romania, Slovenia) were used. Results In order to establish a good-fitting and common measurement model, the five reverse worded items of the self-report SDQ had to be removed. Using this revised version of the self-report SDQ, the SDQ-R, partial measurement invariance was established, indicating that latent factor means assessing conduct problems, emotional symptoms, peer relationships problems and hyperactivity-inattention problems could be validly compared across the countries in this study. Results showed that adolescents in Greece scored relatively low on almost all problem subscales, whereas adolescents in Poland scored relatively high on almost all problem subscales. Adolescents in the Netherlands reported the most divergent profile of mental health problems with the lowest levels of conduct problems, low levels of emotional symptoms and peer relationship problems, but the highest levels of hyperactivity-inattention problems. Conclusions With six factor loadings being non-invariant, partial measurement invariance was established, indicating that the 15-item SDQ-R could be used in our cross-country comparison of adolescent mental health problems. To move the field of internationally comparative research on adolescent mental health forward, studies should test the applicability of the SDQ-R in other countries in- and outside Europe, continue to develop the SDQ-R as a cross-country invariant measure of adolescent mental health, and examine explanations for the found country differences in adolescent mental health problems.


2017 ◽  
Vol 33 (7) ◽  
pp. e8 ◽  
Author(s):  
Giorgio Cozzi ◽  
Marta Minute ◽  
Giovanna Ventura ◽  
Egidio Barbi

2017 ◽  
Vol 35 (11-12) ◽  
pp. 2335-2357 ◽  
Author(s):  
Åsa Källström ◽  
Karin Hellfeldt ◽  
Kathryn H. Howell ◽  
Laura E. Miller-Graff ◽  
Sandra A. Graham-Bermann

Child and adolescent victims of violence are often exposed to more than one kind of physical, sexual, or emotional maltreatment. Both individually and cumulatively, such victimizations have significant ramifications on mental health. Yet little is known about the relationships in which these different kinds of victimizations occur and how the relationship between the victim and perpetrators may influence later mental health. This retrospective, self-report study of a nationally representative sample of 2,500 young adults in Sweden examines associations between different types of victimization (including poly-victimization), the victim’s relationship to the perpetrator, and how these factors are related to current mental health. Results indicate differential patterns of abuse based on the perpetrator; parents were most likely to use physical aggression, whereas siblings typically perpetrated property crimes and partners committed sexual assault. Peers were the most likely perpetrator of both physical and verbal victimizations and also most often committed poly-victimization by subjecting youth to multiple forms of violence. While males were more likely to be victimized by peers, females were more likely to be victimized by parents, siblings, and partners. Significant positive relations were found for the amount of victimization by peers and mental health problems among both males and females. In addition, for females, higher amounts of youth victimization by parents and partners related to higher levels of mental health problems during young adulthood. Taken together, these results suggest that peer victimization presents the greatest risk for males, whereas dysfunctional family relationships are most detrimental to victimized females.


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