scholarly journals Study protocol: Transitions in Adolescent Girls (TAG)

2019 ◽  
Author(s):  
Marjolein Barendse ◽  
Nandita Vijayakumar ◽  
Michelle L Byrne ◽  
Jessica Flannery ◽  
Theresa W Cheng ◽  
...  

Background: Despite recent studies linking pubertal processes to brain development, as well as research demonstrating the importance of both pubertal and neurodevelopmental processes for adolescent mental health, there is limited knowledge of the full pathways and mechanisms behind the emergence of mental illnesses such as depression and anxiety disorders in adolescence. The Transitions in Adolescent Girls (TAG) study aims to understand the complex relationships between pubertal development, brain structure and connectivity, the behavioral and neural correlates of social and self-perception processes, and adolescent mental health in female adolescents. Methods: The TAG study includes 174 female adolescents aged 10.0 to 13.0 years, recruited from the local community in Lane County, Oregon, USA. The participants, along with a parent/guardian, will complete three waves of assessment over the course of three years; the third wave is currently underway. Each wave includes collection of four saliva samples (one per week) and one hair sample for the assessment of hormone levels and immune factors; an MRI session including structural, diffusion, resting-state functional and task-based functional scans; the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), a diagnostic interview on current and lifetime mental health; production of a short self-narrative video; and measurement of height, weight, and waist circumference. The functional MRI tasks include a self-evaluation paradigm and a self-disclosure paradigm. In addition, adolescents and their parents/guardians complete a number of surveys to report on the adolescent’s pubertal development, mental health, social environment and life events; adolescents also report on various indices of self-perception and social-emotional functioning. Discussion: The knowledge gained from this study will include developmental trajectories of pubertal, neurological, and social processes and their roles as mechanisms in predicting emergence of mental illness in female adolescents. This knowledge will help identify modifiable, developmentally specific risk factors as targets for early intervention and prevention efforts.Methods: The TAG study includes 174 girls aged 10.0 to 13.0 years, recruited from the local community in Lane County, Oregon, USA. The girls, along with a parent/guardian, will complete three waves of assessment over the course of three years; the second and third wave are currently underway. Each wave includes collection of four saliva samples (one per week) and one hair sample for the assessment of hormone levels and immune factors; an MRI session including structural, diffusion, resting-state functional and task-based functional scans; the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), a diagnostic interview on current and lifetime mental health; production of a short self-narrative video; and measurement of height, weight, and waist circumference. The functional MRI tasks include a self-evaluation paradigm and a self-disclosure paradigm. In addition, adolescents and their parents/guardians complete a number of surveys to report on the adolescent’s pubertal development, mental health, social environment and life events; adolescents also report on various indices of self-perception and social-emotional functioning. Discussion: The knowledge gained from this study will include developmental trajectories of pubertal, neurological, and social processes and their roles as mechanisms in predicting emergence of mental illness in adolescent girls. This knowledge will help identify modifiable, developmentally specific risk factors as targets for early intervention and prevention efforts.

1995 ◽  
Vol 77 (3_suppl) ◽  
pp. 1346-1346 ◽  
Author(s):  
Jeffrey A. Atlas

Records of 38 hospitalized female adolescents were analyzed to evaluate the relationship between a history of earlier physical and/or sexual abuse and borderline personality. Those with histories of abuse were significantly more likely to score as Borderline Personality Disorder when assessed by the Diagnostic Interview for Borderlines—Revised.


2020 ◽  
Vol 15 (1) ◽  
pp. 201-211
Author(s):  
Pranita Rajaram Jagtap ◽  

2017 ◽  
Vol 4 (3) ◽  
pp. 72-81 ◽  
Author(s):  
Helen Lea Fernandes ◽  
Stephanie Cantrill ◽  
Raj Kamal ◽  
Ram Lal Shrestha

Much of the literature about mental illness in low and middle income countries (LMICs) focuses on prevalence rates, the treatment gap, and scaling up access to medical expertise and treatment. As a cause and consequence of this, global mental health programs have focused heavily on service delivery without due exploration of how programs fit into a broader picture of culture and community. There is a need for research which highlights approaches to broader inclusion, considering historical, cultural, social, and economic life contexts and recognises the community as a determinant of mental health — in prevention, recovery, resilience, and support of holistic wellness. The purpose of this practice review is to explore the experiences of three local organisations working with people with psychosocial disability living in LMICs: Afghanistan, India, and Nepal. All three organisations have a wealth of experience in implementing mental health programs, and the review brings together evidence of this experience from interviews, reports, and evaluations. Learnings from these organisations highlight both successful approaches to strengthening inclusion and the challenges faced by people with psychosocial disability, their families, and communities.  The findings can largely be summarised in two categories, although both are very much intertwined: first, a broad advocacy, public health, and policy approach to inclusion; and second, more local, community-based initiatives. The evidence draws attention to the need to acknowledge the complexities surrounding mental health and inclusion, such as additional stigmatisation due to multidimensional poverty, gender inequality, security issues, natural disasters, and additional stressors associated with access. Organisational experiences also highlight the need to work with communities’ strengths to increase capacity around inclusion and to apply community development approaches where space is created for communities to generate holistic solutions. Most significantly, approaches at all levels require efforts to ensure that people with psychosocial disability are given a voice and are included in shaping programs, policies, and appropriate responses.


2020 ◽  
Author(s):  
Adrienne Lapidos

UNSTRUCTURED With the advent of COVID-19, psychiatry video visits have become commonplace practically overnight. Patients and mental health providers are now presented with new opportunities and risks with respect to self-disclosure. In this Viewpoint, a clinical psychologist grapples with the new self-disclosure landscape as she and a patient both connect to therapy from their homes. The piece explores how various theoretical orientations in psychotherapy have addressed self-disclosure historically, and how video visit technologies have changed the boundaries of what can be shared.


2020 ◽  
Author(s):  
Ana Radovic ◽  
Nathan Anderson ◽  
Megan Hamm ◽  
Brandie George-Milford ◽  
Carrie Fascetti ◽  
...  

BACKGROUND Screening Wizard (SW) is a technology-based decision support tool aimed at guiding primary care providers (PCPs) to respond to depression and suicidality screens in adolescents. Separate screens assess adolescents’ and parents’ reports on mental health symptoms, treatment preferences, and potential treatment barriers. A detailed summary is provided to PCPs, also identifying adolescent-parent discrepancies. The goal of SW is to enhance decision making to increase utilization of evidence-based treatments. OBJECTIVE We describe a multi-stakeholder qualitative study with adolescents, parents, and providers to understand potential barriers to implementation of SW. METHODS We interviewed 11 parents and 11 adolescents, and conducted 2 focus groups with 17 healthcare providers (PCPs, nurses, therapists, staff) across 2 pediatric practices. Participants described previous experiences with screening for depression and were shown a mock-up of SW and asked for feedback. Interviews and focus groups were transcribed verbatim, and codebooks inductively developed based on content. Transcripts were double-coded, and disagreements adjudicated to full agreement. Completed coding was used to produce thematic analyses of interviews and focus groups. RESULTS We identified five main themes across the interviews and focus groups: (1) parents, adolescents, and pediatric PCPs agree that depression screening should occur in pediatric primary care; (2) there is concern that accurate self-disclosure does not always occur during depression screening; (3) Screening Wizard is viewed as a tool that could facilitate depression screening, and which might encourage more honesty in screening responses; (4) parents, adolescents and providers do not want Screening Wizard to replace mental health discussions with providers; and (5) providers want to maintain autonomy in treatment decisions. CONCLUSIONS We identified that providers, parents, and adolescents all have concerns with current screening practices, mainly regarding inaccurate self-disclosure. They recognized value in SW as a computerized tool that may elicit more honest responses and identify adolescent-parent discrepancies. Surprisingly, providers did not want the SW report to include treatment recommendations, and all groups did not want the SW report to replace conversations with the PCP about depression. While SW was originally developed as a treatment decision algorithm, this qualitative study has led us to remove this component, and instead focus on aspects identified as most useful by all groups. We hope that this initial qualitative work will improve future implementation of SW.


Author(s):  
Dina Di Giacomo ◽  
Jessica Ranieri ◽  
Federica Guerra ◽  
Eleonora Cilli ◽  
Valeria Ciciarelli ◽  
...  

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Nishida ◽  
M Hanazato ◽  
K Kondo

Abstract Background The connection in a local community has diluted in an aging society, and the importance of intergenerational exchange has increased for older adults' health. Some positive effects of intergenerational exchange have reported. For example, a reciprocal intergenerational exchange contributes to better mental health in later life. However, there is little evidence of the relationship between neighborhood environments causing intergenerational exchange and the health status of older adults. This study investigated the association between geographical accessibility to elementary school, enhancing intergenerational exchange, and depression in older adults. Methods The data were retrieved from the Japan Gerontological Evaluation Study (JAGES) 2016, a population-based study of independently living people ≥65 years old. The dependent variable is depression evaluated by the Geriatric Depression Scale (GDS≥5). The geographical accessibility to elementary School is the distance between the representative points of their residences and the nearest elementary school. Logistic regression analysis calculates the odds ratio to determine the association between depression and accessibility to elementary school and compare models to examine the effect of intermediate factors. Results Overall, 20.4% of the participants had depression. Compared with the longest distance from elementary school (≥950m), the odds ratio was 0.91 (95% CI = 0.86, 0.96) for the nearest category (<330m), 0.91 (95% CI = 0.87, 0.96) for the second-nearest (330-490m) and 0.94 (95% CI = 0.89, 0.99) for the third (490-670m) in model 1. After adjusting for intermediate factors, the odds ratio was 0.94 for the first and second-nearest groups. Conclusions Geographical accessibility to elementary school was associated with decreased depression for older adults. The result indicates that older adults' daily meetings with children around elementary schools can result in a positive effect on their mental health. Key messages Geographical accessibility to elementary school was associated with decreased depression for older adults. The neighborhood design enhancing intergenerational exchange might be useful for age-friendly cities.


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