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Patients receiving palliative care experience stigma associated with their illness, personal identity, and healthcare utilization. These stigmas can occur at any stage of the disease process. Varying stigmas combine to cause palliative care patients to feel misunderstood, contribute to treatment barriers, and further negative stereotypes held by clinicians. Stigma surrounding palliative care patients stems from complex intersections of varied access to resources, familial and physical environment, socioeconomic status, mental health and disorders, and identity characteristics. This article examines the relationship between the stigmatization of mental health and palliative care through three pathways: stigma and barriers existing within healthcare, the tendency of this stigma to undermine social support, and patient deferral of treatment-seeking in response to stigma. Recommendations to address and diminish stigmatization are presented, including advocacy, increased research and assessment, and contextual and intersectional awareness. Clinicians are also encouraged to turn to their colleagues for peer support and team-based care. [ABSTRACT FROM AUTHOR]

Stigma surrounding mental health, particularly among men, remains a significant barrier to men engaging with support services for their mental health. Despite increasing evidence of interventions targeting different aspects of stigma reduction, there is a notable gap in the literature concerning male-specific mental health stigma reduction interventions and on the underlying behavior change techniques (BCTs) used to reduce stigma. The purpose of this review is to synthesize the evidence relating to the impact of mental health stigma reduction interventions among men and to explore the underlying BCTs associated with each intervention. The review was restricted to empirical research reporting on interventions targeting mental health stigma in male-dominated populations. The quality appraisal was conducted using the Mixed Methods Analysis Tool and a narrative synthesis was conducted. Fourteen articles reporting on 11 interventions were included for review, while 20 outcome measures were used. Perceived public stigma attracted the largest number of interventions with a lesser focus on self or personal stigma. Nineteen BCTs were identified across the interventions with information about health consequences and self-monitoring of behavior being the most common followed by credible source, social contact, and behavior practice/rehearsal. This is discussed in relation to the wider literature. The methodological issues highlighted in the articles limit the conclusions and recommendations that can be drawn from the review. Recommendations for further research include standardizing the scales used in stigma measurement, in-depth reporting of intervention descriptions, and greater use of theory to guide intervention development. [ABSTRACT FROM AUTHOR]

Mental health professionals stigmatize mental illness, which has significant ramifications for public health and policy. Within this domain, there is a lack of comprehensive research on relative stigma, emotions, and behaviors and an absence of literature that can guide research on these topics. The current study sought to address these limitations. Unstructured interviews were conducted with 22 mental health professionals, and data were analyzed using a grounded theory approach. The current study identified a collection of mental disorders (e.g., borderline personality disorder), stereotypes (e.g., dangerousness), emotion-related responses (e.g., fear), and behaviors (e.g., helping) as being key to the relative stigmatization of mental illness by mental health professionals. The results also suggested that professional context and familiarity with mental illness decrease the stigmatization of mental illness by mental health professionals. These variables and constructs were combined to form a grounded theory of mental health professionals stigmatizing mental illness. The current study has implications for the direction of future research on the stigmatization of mental illness by mental health professionals and interventions that strive to mitigate this type of stigmatization. [ABSTRACT FROM AUTHOR]

Most medical researchers and social scientists concur that mental illness is caused by "nature" and "nurture," yet efforts to reduce stigma tend to focus on biomedical causes. This study analyzed original survey data collected from 1,849 respondents in 2021–2022 who were randomly assigned to 16 experimental vignette conditions. Each vignette portrayed a man and varied according to which psychiatric diagnosis his situation resembled (alcohol dependence, depression, or schizophrenia) and what caused it: genetics (nature), environmental stress (nurture), or both. Control conditions included subclinical distress and no explanation. Exposure to the environmental explanation (vs. no explanation) predicted identifying mental illness, reduced expectation of violence toward others, increased willingness to socially interact, and optimism for recovery with treatment. Exposure to the nature and nurture explanation (vs. no explanation) predicted reduced desire for social distance. Implications of these findings for future research and for contact-based anti-stigma efforts are presented. [ABSTRACT FROM AUTHOR]

The frequency, intensity and variability of emotional experiences increase in early adolescence, which may be partly due to adolescents' heightened affective sensitivity to social stimuli. While this increased variability is likely intrinsic to adolescent development, greater mood variability is nevertheless associated with the risk of internalising psychopathology. Early adolescents (N = 58, ages 13–14) reported their social context and mood when prompted by a smartphone application. Valence, arousal, and their variability were compared across social contexts using multilevel regression models. Social contexts were defined by the presence of close others, peripheral others, both, or neither. Arousal was lower when alone. Valence was lower and more variable, and arousal was more variable when alone than in either close or peripheral company. This is the first time that level and variability of valence and arousal in adolescent affect have been shown systematically to differ for the same individual in different daily-life social contexts. [ABSTRACT FROM AUTHOR]

Background: Mental health stigma is a relevant phenomenon with implications for the people who suffer from it. Despite its importance, no studies have been carried out in Spain at national level with a representative sample of the population. Aims: The aim of this research is to analyze the stigma associated with MHPs in a representative sample of the Spanish population for the first time. Method: A cross-sectional quantitative descriptive study was carried out with a representative sample of the population (N = 2746). Descriptive analyses and regressions are carried out on the different dimensions of stigma such as attitude, attribution and intention of social distance. Results: Medium levels of stigma are obtained in stigmatizing attitudes and attributions, and medium-low levels in the intention of social distance. The best predictors of stigma in its different dimensions are attitudes, attributions and intention of social distance themselves. Progressive political ideology is related to less stigma in all dimensions. Knowing someone with mental health problems and talking openly about it together with higher education are also relevant protectors. Mixed results are obtained regarding age, gender and help-seeking. Conclusion: National programs and campaigns focused on attitudes, attributions and behavioral intentions are necessary to reduce the stigma still present in Spanish society. [ABSTRACT FROM AUTHOR]

Objectives: This study examined age differences in mental health problems (depression and anxiety) during the COVID-19 pandemic using nationally representative data from the United States. Drawing from a life course perspective, we also assessed if a secure attachment to God conditioned the relationship between age and mental health. Methods: Data were from the 2021 Values and Beliefs of the American Public Study (N = 1168), collected roughly 1 year into the pandemic. Results: Older adults (61 years and over) reported lower depression and anxiety than respondents 18–30 years of age. However, stronger perceptions of attachment to God significantly closed the age gap in anxiety between these age groups. Discussion: Though absolute levels of religiosity tend to be higher for older adults, secure attachment to God was more protective of the mental health of younger adults during the pandemic. We reflect on our findings through a life course lens. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers are vulnerable to burnout, especially during the COVID-19 pandemic in the low resource settings. Belize is a small Central American developing country known for its chronic healthcare worker shortage and this is the first study to assess burnout prevalence and its associated factors among healthcare workers in Belize. Aim: To evaluate the prevalence of burnout and its associated factors in HCWs in Belize covering multiple domains (mental health, physical symptoms, and coping behaviors) during the COVID-19 pandemic. Methods: A cross-sectional survey that was developed and validated by a panel of experts was delivered online to all the healthcare workers in Belize from September to November 2021. Burnout was assessed using Copenhagen Burnout Inventory. Depression and anxiety screening was carried out using the Patient Health Questionnaire – 2 (PHQ-2) and Generalized Anxiety Disorder 2-item (GAD-2). Burnout associated factors were estimated using logistic regression models. Findings: Of the total of 263 participants, 27.76% had overall burnout: 56.65% had personal, 54.37% had work-related, and 19.39% had patient-related burnout. Burnout was positively associated with anxiety (OR: 3.14 [1.67, 5.92]), depression (OR: 4.45 [2.30, 8.61]), intentions of quitting their jobs (OR: 2.59 [1.49, 4.51]), health status worsening (OR: 2.21 [1.26, 3.87]), multiple physical symptom presentation (OR: 1.19, [1.10, 1.29]), and use of multiple maladaptive coping behaviors (OR: 1.66, [1.30, 2.12]). Interpretation: Healthcare workers in Belize showed substantial levels of burnout which were significantly associated with using maladaptive coping behaviors, presenting multiple physical symptoms, quitting their jobs, health status worsening, and other mental health issues. These findings should be used to develop and implement programs such as regular health check-ups, health promotion awareness campaigns, and worker recruitment strategies which would improve the working conditions, quality of life, and psychological well-being of our healthcare workers. [ABSTRACT FROM AUTHOR]

Mental health disparities in sexual minorities, particularly homosexual and bisexual men, are a significant public health concern. This study examines six key themes: general psychiatric issues, health services, minority stress, trauma and PTSD, substance and drug misuse, and suicidal ideation. The aim is to provide a comprehensive synthesis of the evidence, identify potential intervention and prevention strategies, and address knowledge gaps in understanding the unique experiences of homosexual and bisexual men. Reported as per the PRISMA Statement 2020 guidelines, PubMed, PsycINFO, Web of Science, and Scopus were searched until February 15, 2023, with no language restrictions. A combination of the following keywords and MeSH terms was used: homosexual, bisexual, gay, men who have sex with men, mental health, psychiatric disorders, health disparities, sexual minorities, anxiety, depression, minority, stress, trauma, substance, drug misuse, and/or suicidality. Out of 1,971 studies located through database searching, 28 were included in this study pooling a total of 199,082 participants from the United States, the United Kingdom, Australia, China, Canada, Germany, the Netherlands, Israel, Switzerland, and Russia. Thematic findings of all the studies were tabulated and thereby synthesized. Addressing mental health disparities in gay, bisexual men, and sexual minorities requires evidence-based, comprehensive approaches, culturally competent care, accessible services, targeted prevention strategies, community-based support, public awareness, routine screenings, and research collaboration. This inclusive, research-informed approach can effectively reduce mental health issues and enable optimal well-being in these populations. [ABSTRACT FROM AUTHOR]

Public attitudes toward people with mental disorders determine their life chances and potential integration in society. In this article, we present results from a large representative study that aims to understand whether and how Bulgarian society stigmatizes people with mental disorder, and how demographic characteristics relate to certain types of attitudes. The CAMI III instrument was the basis for the specific research design. The article presents two types of analysis of the data. Firstly, Factor analysis revealed three factors which partially coincide with original categories of the CAMI III Scale – Factor 1 'Authoritarianism and Social Restrictiveness', Factor 2 'Benevolence and Community Mental Health Ideology', and Factor 3 'Liberalism'. Secondly, a one-way ANOVA test was carried out, taking the assigned factor scores as dependent variable, on one hand, and demographic and social-economic characteristics as independent variables, on the other. Results reveal that people between 18–24 and over 75 years old are the most authoritarian and socially restrictive, while those between 24–75 years old are the most benevolent. Our analysis show an influence of religion and ethnicity on authoritarianism and social restrictiveness, but on benevolence as well. Education, occupation, and profession is related to the scores of the factors. The results correspond to findings from studies form other contexts but reveal underrepresented aspects such as 1. socio-economic characteristics – ethnicity and religion; 2. the socializing role of the institutions in the formation of the image of the mentally ill among different age groups. [ABSTRACT FROM AUTHOR]

We examined the association between mental health and relationship and wedding factors among engaged women planning their weddings before and during Covid-19. Survey data from 715 non-Covid-19 and 427 Covid-19 participants revealed that Covid-19 participants experienced depression in greater proportion than non-Covid-19 participants. Wedding satisfaction and financial strain were stronger predictors of depression for Covid-19 than non-Covid-19 participants. Other significant predictors of Covid-19 participants' depression included social isolation, relational satisfaction and turbulence, and wedding disillusionment. Additionally, 22.0% of Covid-19 participants reported severe levels of anxiety, which was significantly predicted by social isolation, relational turbulence, wedding financial strain, wedding disillusionment, and wedding satisfaction. According to Covid-19 participants' open-ended responses, less depressed participants liked something better about their revised wedding plans, more anxious participants could not identify positive aspects of their revised plans, and less anxious participants appreciated the perspective that came with revising wedding plans due to Covid-19. [ABSTRACT FROM AUTHOR]

Human health is dependent on the health of the planet. Overwhelming evidence indicates that environmental degradation and climate change is negatively affecting planetary health and is on a worsening trajectory. The health of our children, especially those who live in poverty, suffer from chronic disease, or are otherwise disadvantaged, will benefit most from successful efforts to change this trajectory or will suffer the most if we do nothing. School nurses, members of the largest and most trusted group of healthcare providers, have a professional and ethical obligation to address environmental degradation and the impact on our students and communities. Research suggests that knowledge about climate change and the associated health impacts are positively correlated to school nurses' attitudes and behaviors. This article aims to raise school nurse awareness, understanding, and agency regarding the possible trajectories of environmental degradation, implications to the health and well-being of current and future generations of children, and evidence-based actions to positively influence the trajectory. The Framework for 21st Century School Nurse Practice™ advocates a practice model that is student centered and provides a mind-set for school nursing to approach the topic of planetary and environmental health. [ABSTRACT FROM AUTHOR]

Background: Mental health issues are increasing in higher education and finding ways for students to get help when needed is important. Objective: We tested if the tone of a short syllabus and the presence of a special statement addressing mental health would increase intentions to approach instructors for help. Method: We used a 2 (Tone: warm vs. cold) × 2(Statement: present vs. absent) experimental design. Participants (N = 257) read one of four, two-page syllabi, and rated intentions to reach out for help and the instructor. Results: We found a main effect for tone on three Reach Out statements and ratings of the instructor. Presence of the statement influenced likelihood to reach out for help with personal problems. Conclusions: Both the tone of a short syllabus and the presence of statements normalizing reaching out for help can influence student intentions to contact instructors for help. Teaching Implications: Writing a warm toned syllabus and addressing stress and mental health with a university statement may increase student's intentions to ask for help. [ABSTRACT FROM AUTHOR]

Background: Physicians, including psychiatrists and general practitioners (GPs), have been reported as essential sources of stigma towards people diagnosed with a mental disorder (PDMDs), which constitutes an important barrier to recovery and is associated with poorer clinical outcomes. Therefore, psychiatrists and GPs are key populations where it is crucial to examine stigma, improve attitudes and reduce discrimination towards psychiatric patients. Aims: This study is the first to explore mental health-related stigma among Portuguese psychiatrists and GPs, examining the differences between these two specialities and assessing whether sociodemographic and professional variables are associated with stigma. Method: A cross-sectional study was performed between June 2018 and August 2019. A consecutive sample of 55 Psychiatrists and 67 GPs working in Porto (Portugal) filled a 25-item self-report questionnaire to assess their attitudes towards PDMDs in clinical practice. The instrument was designed by the authors, based on previous mental health-related stigma studies and validated scales. The questionnaire includes 12 stigma dimensions (Autonomy, Coercion, Incompetence, Dangerousness, Permanence, Pity, Responsibility, Segregation, Labelling, Diagnostic Overshadowing, Shame and Parental Incompetence), and its total score was used to measure Overall Stigma (OS). Sample characteristics were examined using descriptive statistics, and the factors affecting stigma were assessed through regression analysis. Results: GPs exhibit significantly higher OS levels than psychiatrists, and present higher scores in the dimensions of dangerousness, parental incompetence, diagnostic overshadowing and responsibility. Besides medical speciality, several other sociodemographic variables were associated with sigma, including age, gender, having a friend with a mental disorder, professional category, agreement that Psychiatry diverges from core medicine and physician's interest in mental health topics. Conclusions: Our data suggest that both psychiatrists and GPs hold some degree of stigmatizing attitudes towards PDMDs. Overall, these results bring new light to stigma research, and provide information to tailor anti-stigma interventions to Portuguese psychiatrists and GPs. [ABSTRACT FROM AUTHOR]

The widespread psychological effects of contagion mitigation measures associated with the novel coronavirus disease 2019 (COVID-19) are well known. Phases of "lockdown" have increased levels of anxiety and depression globally. Most research uses methods such as self-reporting that highlight the greater impact of the pandemic on the mental health of females. Emergency medical data from ambulance services may be a better reflection of male mental health. We use ambulance data to identify unusual clusters of high rates of male mental health emergencies occurring in the East Midlands of the United Kingdom during the first national "lockdown" and to explore factors that may explain clusters. Analysis of more than 5,000 cases of male mental health emergencies revealed 19 unusual spatial clusters. Binary logistic regression analysis (χ2 = 787.22, df = 20, p ≤.001) identified 16 factors that explained clusters, including proximity to "healthy" features of the physical landscape, urban and rural dynamics, and socioeconomic condition. Our findings suggest that the factors underlying vulnerability of males to severe mental health conditions during "lockdown" vary within and between rural and urban spaces, and that the wider "hinterland" surrounding clusters influences the social and physical access of males to services that facilitate mental health support. Limitations on social engagement to mitigate effects of the pandemic are likely to continue. Our approach could inform delivery of emergency services and the development of community-level services to support vulnerable males during periods of social isolation. [ABSTRACT FROM AUTHOR]

Background and aims: The increasing prevalence of mental illness and low treatment rate presents a pressing public health issue in China. Pervasive stigma is a significant barrier to mental health recovery and community inclusion. In particular, stigmatizing or supportive attitudes held by healthcare providers could either perpetuate or mitigate self-stigma of people with mental illness. Moreover, mental health resources are unevenly distributed in China, with most of them concentrated in urban centers and provincial capitals. This study explores healthcare providers' attitudes toward mental illness and the challenges they faced at work in a rural Chinese county. Method: Four focus groups were conducted with 36 healthcare providers from a three-tier mental healthcare system in a rural county in southwestern China. Focus group discussions were recorded and transcribed verbatim. The team employed a conventional content analysis approach for data analysis. All transcripts were double-coded by three bilingual team members who are native Chinese speakers. Coding discrepancies were resolved by consensus. Results: Healthcare providers recruited from the county, township, and village levels varied in educational background, professional qualification, and experience of working with people with mental illness. Five thematic categories identified across four groups include (1) barriers to mental healthcare delivery, (2) keys to mental health recovery, (3) providers' attitudes toward providing care, (4) providers' perception toward patients and family members, and (5) providers' perception of training needs. Conclusions: This is a unique study that included healthcare providers from a three-tier healthcare system. Findings signal the importance of understanding healthcare practitioners' experiences and views to inform the design of training initiatives in rural or low-resource communities. [ABSTRACT FROM AUTHOR]

Decentering, a detached, observer perspective on one's mental activity, is an important concept for understanding mental health. Meta-awareness, people's awareness of their own current mental activity, is thought to facilitate decentering. However, trait measures of these concepts are not available or have validity concerns. We sought to create a theoretically derived measure of meta-awareness and decentering that allowed an exploration of questions in the literature regarding whether there are multiple forms of decentered awareness and whether meta-awareness and external awareness are distinct. Across six samples and 2,480 participants, we developed the 25-item Multidimensional Awareness Scale, with subscales assessing meta-awareness (present moment awareness of mental activity), decentered awareness (meta-awareness from a psychologically distant perspective), and external awareness (present moment awareness of the world outside of oneself). The scales demonstrated acceptable reliability and validity. Results are discussed in terms of the conceptual implications of the scale structure and its potential uses. [ABSTRACT FROM AUTHOR]

The novel coronavirus disease 2019 (COVID-19) pandemic and associated mitigation strategies such as "lockdown" are having widespread adverse psychological effects, including increased levels of anxiety and depression. Most research using self-reported data highlights the pandemic's impact on the psychological well-being of females, whereas data for mental health emergency presentations may reflect the impact on male mental health more accurately. We analyzed records of male mental health emergencies occurring in the East Midlands of the United Kingdom during the first national "lockdown." We computed two binary logistic regression models to (a) compare male mental health emergencies occurring during "lockdown," 2020 (5,779) with those occurring in the same period in 2019 (N = 4,744) and (b) compare male (N = 5,779) and female (N = 7,695) mental health emergencies occurring during "lockdown." Comparisons considered the characteristics of mental health emergencies recorded by ambulance clinicians (Primary Impressions), and the socioeconomic characteristics of communities where emergencies use the Index of Multiple Deprivation. We found that during "lockdown," male emergencies were more likely to involve acute anxiety (odds ratio [OR]: 1.42) and less likely to involve intentional drug overdose (OR: 0.86) or attempted suicide (OR: 0.71) compared with 2019. Compared with females, male emergencies were more likely to involve acute behavioral disturbance (OR: 1.99) and less likely to involve anxiety (OR: 0.67), attempted suicide (OR: 0.83), or intentional drug overdose (OR: 0.76). Compared with 2019, and compared with females, males experiencing mental health emergencies during "lockdown" were more likely to present in areas of high deprivation. Understanding the presentation of male mental health emergencies could inform improved patient care pathways. [ABSTRACT FROM AUTHOR]

This study examined the impact of perceived social support on mental health and psychosocial functioning in combat veterans after military deployment, including veterans with post-traumatic stress disorder (PTSD) and veterans with comorbid PTSD and alcohol use disorder. Veterans (n = 139; female = 23) completed self-report and clinician-administered measures of social support, mental and physical health, functional impairment, and quality of life. The cohort was divided into high, medium, and low perceived social support based on averages of the total score from the Multidimensional Scale of Perceived Social Support. Relative to the low perceived social support group, the high perceived social support group reported fewer symptoms of PTSD, anxiety, and depression. The high perceived social support group also reported a more diverse and embedded social network, less disability, and better quality of life. Of note, the high and low perceived social support groups did not differ on age, gender, education, race ethnicity, or combat trauma exposure. These findings highlight that perceived social support may play an important role in the treatment of postwar veterans as they transition back to civilian life. [ABSTRACT FROM AUTHOR]

This study explored the relationship between emotional control, resilience, and mental health in cancer. Patients with cancer were recruited (n = 170). Courtauld Scale of Emotional Control, Connor-Davidson Resilience Scale, and the General Health Questionnaire were selected. Assuming the absence of interaction among the variables, they were analyzed separately. Four groups resulted, finding statistically significant differences (F (4, 165) = 18.03; p < 0.001). High resilience and low emotional control seem to be protective attributes, and high emotional control has demonstrated to be a risk factor for mental health. Considering differences in cancer-related psychological variables could derive in personalized psychotherapeutic interventions. [ABSTRACT FROM AUTHOR]

Literature has shown that temporal focus (TF) is closely related to mental health, and both of them are associated with meaning in life (MIL). Nevertheless, few studies have investigated the functional role of MIL in the relationship between TF and mental health, especially in the context of COVID-19. The present study aims to explore the mediating role of MIL between different categories of TF (i.e., past, present, and future TF) and mental health. A two-wave longitudinal survey was conducted among 538 Chinese participants aged between 22 and 70 (M ± SD  = 35.07 ± 8.82). TF was assessed at Time 1, while MIL, anxiety, and life satisfaction were measured at Time 2. The results of SEM showed that past TF negatively predicted MIL, while present and future TF positively predicted MIL. In addition, MIL mediated the relationship between TF and mental health indicators (anxiety and life satisfaction). Specifically, past TF demonstrated a negative indirect effect on life satisfaction by reducing MIL, while present and future TF had a positive indirect effect on life satisfaction by strengthening MIL. In contrast, past TF demonstrated a positive indirect effect on anxiety by reducing MIL, while present and future TF had a negative indirect effect on anxiety by strengthening MIL. Therefore, the present results supported the positive roles of present and future TF in promoting MIL and mental health during the COVID-19 pandemic. For the MIL intervention during the pandemic, the present findings suggested that compared to recalling the past, more attention should be paid to living in the present and hoping for the future. [ABSTRACT FROM AUTHOR]

COVID-19, the disease caused by severe acute respiratory syndrome coronavirus 2, has affected most parts of the globe since its first appearance in the city of Wuhan, China, in December 2019. As a result, the World Health Organization declared the virus a global public health crisis and a pandemic within 2 weeks, after the virus had spread to 114 countries with 118 000 recorded cases and 4291 deaths due to the virus and related complications. The World Health Organization declaration is indicative of the enormous impact of the pandemic on human life globally. South Africa has not been exempted from that impact. While the pandemic has affected all South Africans in various ways, the poor have been most affected due to structural inequality, poverty, unemployment, and lack of access to quality health care and other services. Furthermore, public mental health has also been negatively affected by the pandemic, and this comes against a backdrop of an ailing mental health care system. We argue that the psychology profession, as a mental health profession and behavioural science, working as part of a multidisciplinary team, ought to play a significant role in addressing the mental health ramifications of the pandemic. In so doing, lessons can be drawn from other countries while establishing contextual immediate and long-term interventions. [ABSTRACT FROM AUTHOR]

This study aimed to identify the motives for social media sites use in the general population and determine what personality traits (normal and maladaptive) predict different motives for social media sites use. Another objective was to analyze which motives for SMSs use are related to well-being. The sample consisted of 420 subjects (211 men, 209 women), mean age 40.29 years (SD = 14.93). Data were gathered using the Big Five Inventory, the Personality Inventory for DSM-5-Brief Form -Adult, the Mental Health Continuum-Short Form, and a scale designed ad hoc to evaluate the motives for social media sites use. The results showed that the most frequent motives were Personal relationship maintenance/Search for information, Pastime/Exhibitionism, and Search for companionship. In addition, it was found that normal and, especially, maladaptive personality traits increased the explained variance for the three motives for social media sites use, beyond age and gender. Predictors of relationship initiation and pastime/exhibitionism motives were related to more negative features (e.g., antagonism and disinhibition) than predictors of personal relationship maintenance/search for information. Finally, personal relationship maintenance/search for information was positively related to all the components of well-being, while the other motives for social media sites use were negatively associated with well-being. [ABSTRACT FROM AUTHOR]

Background: It is unknown whether and how poverty influences the long-term outcome of persons with severe mental illness (SMI). Aims: To explore the change of poverty status in persons with SMI from 1994 to 2015 and examine the impact of poverty status on patients' outcome in rural China. Method: Two mental health surveys using identical methods and International Classification of Disease (ICD-10) were conducted in 1994 and 2015 in the same six townships of Xinjin County, Chengdu, China. Results: The annual net income per person was 19.8% and 100.2% higher for the general population than for persons with SMI in 1994 and 2015 respectively. Compared with 1994 (48.2%), persons with SMI in 2015 had significantly higher rates of poor family economic status (

People with mental illness (MI) are overrepresented in prisons, in part, because people with MI stay in prison longer. Correctional officers (COs) use discretion in force, violations, and segregation. Crisis intervention teams (CITs) are being used in corrections to reduce disparities in sanctioning and improve safety. This quasi-experimental, mixed-methods study includes 235 CIT COs who were surveyed before and after training on knowledge of MI, stigmatizing attitudes, and perception of response options. Non-CIT (n = 599) officers completed the same survey. Randomly selected CIT COs completed interviews 6 to 9 months following training (n = 17). CIT COs had significantly lower stigmatizing attitudes, more mental health knowledge, and better perceptions of options following CIT training compared with non-CIT COs. This preliminary work on CIT use in prison is promising; additional work is needed to determine whether these changes result in behavior change among COs and improvements in outcomes for people with MI. [ABSTRACT FROM AUTHOR]

Informal carers are increasingly involved in supporting people with severe and enduring mental health problems, and carers' perceptions impact the wellbeing of both parties. However, there is little research on how carers actually make sense of what their loved one is experiencing. Ten carers were interviewed about how they understood a loved one's psychosis. Data were analysed using a hermeneutic-phenomenological approach. Three themes described the carers' effortful quest to understand their loved one's experiences while maintaining their relational bonds. Carers described psychosis as incomprehensible, seeing their loved one as incompatible with the shared world. To overcome this, carers developed hermeneutic 'mooring points', making sense of their loved one's unusual experiences through novel accounts that drew on material or spiritual explanations. The findings suggest that informal carers resist biomedical narratives and develop idiosyncratic understandings of psychosis, in an attempt to maintain relational closeness. We suggest that this process is effortful – it is hermeneutic labour – done in the service of maintaining the caring relationship. Findings imply that services should better acknowledge the bond between carers and care-receivers, and that more relationally oriented approaches should be used to support carers of people experiencing severe mental health problems. [ABSTRACT FROM AUTHOR]

This study presents an adaptation of the Crisis Intervention Team Model (CIT) to a jail setting. Pre-post surveys and interviews assessed changes in corrections officers' (CO) knowledge of and attitudes toward mental health. Cell Removal Team (CRT) services assessed the impact of CIT on the use of this specialized unit. Results indicate positive changes in CO attitudes, increased de-escalation skills, and an abrupt decrease in the level of CRT usage, with results sustained in the 8-month follow-up period. [ABSTRACT FROM AUTHOR]

Little is known about how mental health court (MHC) experiences (including satisfaction and sanctioning, incentivizing, and life change events) differ by race and how this variation affects recidivism among MHC participants. This study examined how MHC experiences and recidivism differ between White (n = 170) and Black (n = 132) participants from four different MHCs in the United Sates. Negative binomial regression models, conducted separately for the two groups, indicated that life changes were associated with decreased arrests and that court sanctions were associated with increased number of arrests for both White and Black participants. Higher program satisfaction was positively associated with recidivism among Black participants only. To provide equitable services for people convicted of a crime with mental illness, professionals should acknowledge racial variation in the experiences of MHC participants (both within the MHC and the communities in which they are situated) and how these experiences relate to recidivism. [ABSTRACT FROM AUTHOR]

Perceptions of mental health conditions influence how individuals with psychiatric diagnoses are treated within the community, in the legal system, and at different institutions. We examined perceptions of mental health conditions among lay judges (N = 643), working at district and appellate courts throughout Sweden. Participants read a web-based survey including a crime vignette in which the person charged with a crime was described as having schizophrenia (n = 186), antisocial personality disorder (ASPD) with psychopathic traits (n = 219), or intellectual disability (n = 238). Participants' perceptions of schizophrenia were largely in line with Swedish legislation regarding the medicolegal concept of severe mental disturbance (SMD). Findings were more varied for the other two conditions, however. Perceptions of individuals with ASPD with psychopathic traits were not consistent with the Swedish SMD legislation. The results highlight the complexity of legislation addressing mental illness and criminality. [ABSTRACT FROM AUTHOR]

Adolescents with diabetes are at increased risk for depression and anxiety, which when untreated negatively affects diabetes control. During a 6-month period, the Patient Health Questionnaire for Depression and Anxiety (PHQ-4) screening tool was utilized. Those with a positive screen then completed the Patient Health Questionnaire for Adolescents (PHQ-A) and the Generalized Anxiety Disorder 7-item (GAD-7) scale. In this article, we report on the correlations in outcomes between the PHQ-4 and the PHQ-A and GAD-7 and its clinical utility for determining the need for standard versus acute behavioral health care. Over 6 months, 77 patients aged 10 to 18 years screened positive on the PHQ-4. Thirty-two patients had positive screening with the PHQ-A and/or the GAD-7. Thoughts of self-harm were reported by 13 (40%), with 1 experiencing current/active symptoms. The PHQ-4 as a screening tool was able to identify adolescents with symptoms of depression and/or anxiety who would benefit from further evaluation by a behavioral health provider. [ABSTRACT FROM AUTHOR]

Background: Exposure to war and conflict increases the risk of mental health problems. Poor living conditions are known to negatively impact mental health. Hypothesis: It is hypothesized that exposure to negative events after armed conflict interacts with past negative experiences, socioeconomic factors and current mental health problems. Methods: A cross-sectional survey was carried out in three contexts of previous internal armed conflict: Nepal, Guatemala and Northern Ireland. Three nationally representative samples were drawn, comprising a net sample of 3,229 respondents. Results: Both recent negative events and past negative events linked to the previous conflicts were found to be associated with elevated risk of post-traumatic stress syndrome (PTSD). Economic marginalization and urban residency also contributed to current risk of PTSD. Conclusions: The results support the study hypothesis that both past and recent negative events in combination with economic marginalization contribute to explain current risk of PTSD. It is necessary both to improve living conditions more broadly and to establish and develop health services that have the capacity to screen, prevent and treat mental health problems also in poor contexts, in particular against a background of previous armed conflict. [ABSTRACT FROM AUTHOR]

While previous research has demonstrated the negative impact of stigma in individuals with mental health problems, little is known about cross-cultural differences in experiences and explanations of mental health, in particular in young people, despite the first episode of psychosis often occurring in adolescence. Aim of this study was to examine cultural differences in causal beliefs and stigma toward mental health, in particular psychosis. White British and South Asian young people (N = 128) from two schools and colleges in the United Kingdom, aged 16 to 20 years, completed a cross-sectional survey. Results revealed significant associations between ethnic group and our dependent measures. White British reported more previous contact with a mental health service as well as with people with mental health problems than South Asians. They also reported lower stigma in form of a greater intentions to engage in contact with people with mental health problems. Furthermore, South Asians reported higher beliefs in supernatural causes of psychosis than White British. Psychotic experiences moderated the effect of ethnic group on supernatural beliefs, with South Asians reporting higher supernatural beliefs than White British when their own psychotic experiences were low to moderate. We discuss the implications of the findings, arguing that a greater culture-sensitive understanding of mental health is important to reach ethnic minorities with psychosis, and to challenge stigma toward psychosis from an early age on. [ABSTRACT FROM AUTHOR]

Recent studies have successfully investigated the validity of the DSM-5 Alternative Model for Personality Disorders. In a final sample of 174 psychiatric patients, the present study examined the relationship between the Personality Inventory for the DSM-5 (PID-5) and syndromal psychosis. Results showed that patients diagnosed with versus without a psychotic disorder significantly differed on all PID-5 domains except Antagonism. Discriminant function analysis indicated that lower Detachment, lower Negative Affect, lower Disinhibition, and higher Psychoticism best discriminated patients with a psychotic disorder from patients with other psychiatric conditions. Subsequent stepwise discriminant analysis on all facet scales of the contributing PID-5 domains revealed that higher Unusual Beliefs, lower Depressivity, and lower Distractibility contributed the most to this differentiation. PID-5 Psychoticism scores showed moderate correlations with current psychotic symptoms and were not influenced by dose of antipsychotic medication. Our results support the ability of the PID-5 to discriminate between patients with and without psychotic disorder. [ABSTRACT FROM AUTHOR]

Theory of mind, or mentalizing, defined as the ability to reason about another's mental states, is a crucial psychological function that is disrupted in some forms of psychopathology, but little is known about how individual differences in this ability relate to personality or brain function. One previous study linked mentalizing ability to individual differences in the personality trait Agreeableness. Agreeableness encompasses two major subdimensions: Compassion reflects tendencies toward empathy, prosocial behaviour, and interpersonal concern, whereas Politeness captures tendencies to suppress aggressive and exploitative impulses. We hypothesized that Compassion but not Politeness would be associated with better mentalizing ability. This hypothesis was confirmed in Study 1 ( N = 329) using a theory of mind task that required reasoning about the beliefs of fictional characters. Post hoc analyses indicated that the honesty facet of Agreeableness was negatively associated with mentalizing. In Study 2 ( N = 217), we examined whether individual differences in mentalizing and related traits were associated with patterns of resting-state functional connectivity in the brain. Performance on the theory of mind task was significantly associated with patterns of connectivity between the dorsal medial and core subsystems of the default network, consistent with evidence implicating these regions in mentalization. Copyright © 2017 European Association of Personality Psychology [ABSTRACT FROM AUTHOR]

We investigated the cross-cultural construct validity of hope, a factor associated with mental health protection and promotion, using the Children’s Hope Scale (CHS). The sample (n = 1,057; 48% girls) included baseline data from three cluster-randomized controlled trials with children affected by armed conflict (n = 329 Burundi; n = 403 Indonesia; n = 325 Nepal). The confirmatory factor analysis in each country indicated good fit for the hypothesized two-factor model. Analysis by gender indicated that configural invariance was supported and that scalar invariance was demonstrated in Indonesia. However, metric and scalar invariance were not supported in Burundi and Nepal. In country comparisons, configural and metric invariance were met, but scalar invariance was not supported. Evidence from this study supports the use of the CHS within various sociocultural settings and across genders, but direct comparisons of CHS scores across groups should be done with caution. Rigorous evaluations of the measurement properties of mental health protective and promotive factors are necessary to inform both research and practice. [ABSTRACT FROM AUTHOR]

Mass shooting episodes have increased over recent decades and received substantial media coverage. Despite the potentially widespread and increasing mental health impact of mass shootings, no efforts to our knowledge have been made to review the empirical literature on this topic. We identified 49 peer-reviewed articles, comprised of 27 independent samples in the aftermath of 15 mass shooting incidents. Based on our review, we concluded that mass shootings are associated with a variety of adverse psychological outcomes in survivors and members of affected communities. Less is known about the psychological effects of mass shootings on indirectly exposed populations; however, there is evidence that such events lead to at least short-term increases in fears and declines in perceived safety. A variety of risk factors for adverse psychological outcomes have been identified, including demographic and pre-incident characteristics (e.g., female gender and pre-incident psychological symptoms), event exposure (e.g., greater proximity to the attack and acquaintance with the deceased), and fewer psychosocial resources (e.g., emotion regulation difficulties and lower social support). Further research that draws on pre-incident and longitudinal data will yield important insights into the processes that exacerbate or sustain post-incident psychological symptoms over time and provide important information for crisis preparedness and post-incident mental health interventions. [ABSTRACT FROM AUTHOR]

People who endure mental and emotional distress experience a plethora of negative experiences beyond the effects of the symptoms themselves. For centuries, the designation of labels of difference; that is, those which transgress approved social norms have affected the lived experiences of those individuals, and more widely in structuring responses, engagements with, and attitudes between society and the individual. Understanding the creation of tainted identities, particularly of those with experience of mental and emotional distress, has been well rehearsed in the sociological literature of the second half of the 20th century. Central to much of this analysis has been to understand the nature of the manufacture of deviant identities, how they are sustained, and the impact of these identities on those who experience them. This article explores the experience of those with mental and emotional distress as a victim of crime. The interconnectedness of matters of identity created though the application of a diagnosis of illness or disorder is addressed as is the crisis of criminal victimization. This is achieved via an exploration of contemporary concerns surrounding victims of crime with experience of mental and emotional distress, including the (further) loss of voice and agency when interfacing with agencies of the state. [ABSTRACT FROM AUTHOR]

Specialized court programs have expanded beyond drug treatment to address issues such as mental health, domestic violence, veterans, and reentry through evidenced-based treatment. Although these programs have been successful at reducing recidivism, their lack of an overarching theoretical framework has limited generalizability to other offender populations and contexts. The purpose of this article is to present an integrated model for specialized court programs that incorporates therapeutic jurisprudence and procedural justice concepts. We argue that although therapeutic jurisprudence offers guiding principles, it lacks the ability to explain how these programs work to change offender behavior and perceptions. Procedural justice can provide this missing piece of the puzzle in understanding the effectiveness of specialized courts. We conclude with a discussion of directions for future research and practice that is guided by this integrated perspective. [ABSTRACT FROM AUTHOR]

Purpose: Untreated parent mental health problems have deleterious effects upon the family, yet caregivers are unlikely to receive services for their emotional health. We conducted a review of treatments and services for children and adolescents that also offered services to parents. Methods: Child treatment and service studies were included in the present study if they analyzed parent symptoms or diagnoses over time, and the intervention contained a parent component. Results: Of 200 studies reviewed, 20 contained a component for the parent and assessed the parent’s emotional health at multiple time points. Depression and anxiety were the most commonly studied parental mental health problem; most parent components consisted of behavioral strategies in service of the child’s psychological health. Conclusion: Major shifts in health care policy affecting mental health services provide an opportunity to create integrated and coordinated health and behavioral health systems. Attention must be given to ensure that the workforce of providers, the administrative structures, and the reimbursement strategies are strengthened and connected to serve the needs of parents/caregivers and children in order to enhance family outcomes. [ABSTRACT FROM AUTHOR]

For three decades, social-personality research on overt narcissism has relied almost exclusively on the Narcissistic Personality Inventory (NPI). However, the NPI suffers from a host of psychometric and validity concerns that make composite NPI scores (summed across its subscales) difficult to interpret. The present studies propose that narcissistic characteristics tend to fall under two general clusters: grandiosity and entitlement. The studies show that measures of grandiosity and entitlement interact to predict scores on the NPI, controlling for gender, self-esteem, and basic personality (Study 1), but also that grandiosity and entitlement function independently with respect to mental health (Study 2) and ethical misconduct (Study 3). Together, these results challenge the view of overt narcissism as a unidimensional construct and underscore the importance of distinguishing between grandiose and entitled aspects of the narcissistic self-concept. [ABSTRACT FROM AUTHOR]

The validity of selecting treatment contingencies on the basis of the results obtained through functional analysis is well documented. However, a number of second-generation questions have emerged: For example, what are the parameters required to achieve desired treatment outcomes? More specifically, what is the degree of treatment integrity needed for the successful reduction of problem behavior? This study had two purposes: to describe the relationship between treatment integrity levels and treatment effectiveness and to highlight the importance of reporting the treatment integrity in outcome-based research. The results indicate that a high level of treatment integrity is required for treatment success. Furthermore, the authors found that very low levels of integrity may be required for behavioral reduction procedures (i.e., extinction) if high levels of reinforcement are provided. [ABSTRACT FROM AUTHOR]

Objective: To examine 9-year rates of family physician (FP) and psychiatrist use, as well as patterns of mental health services delivery by FPs. Method: We used population-based data from Winnipeg, Manitoba, to construct mutually exclusive cohorts of adults treated for major or minor mental health disorders in fiscal years 1992-1993 to 2000-2001. For each year, we measured patterns of use in this population and patterns of mental health practice among FPs. Results: The treatment prevalence rate was 224 per 1000 in 2000-2001 and 174 per 1000 in 1992-1993, and the rates for major and minor mental health disorders increased over the 9-year period by 15% and 31%. respectively. In 2000-2001. 92% of adults treated for mental illness saw at least one FP, and 45% saw an FP but no psychiatrist. Adults with major or minor mental health disorders visited an FP on average 9.1 and 6.9 times yearly, respectively, and FP visit rates remained relatively stable. There was a gradient in use by socioeconomic status: adults from communities with lower socioeconomic status had the highest rates of use. By 2000-2001, 24% of FPs billed for services related to psychosocial conditions as often as they did for the most frequent conditions seen in primary care. Conclusion: Between 1992-1993 and 2000-2001, the study population's patterns of FP and psychiatrist use remained relatively stable. In more recent years, FPs provided more mental health services than in previous years; this related to increased treatment prevalence rather than to increases in use per adult. FPs played a major role in the provision of mental health care. [ABSTRACT FROM AUTHOR]

Expanded school mental health (ESMH) programs, the focus of this special issue, provide comprehensive mental health care to youth in general and special education through partnerships between schools and community mental health agencies and programs. As these programs progressively develop in the United States, there is a critical need to build the research and evidence base for them. This article presents background to the national movement toward ESMH and provides an overview of articles contained in this special issue, which provide in-depth details and early research findings on diverse aspects of mental health programs in schools. Advantages of greater involvement of behavioral professionals in ESMH are discussed. [ABSTRACT FROM AUTHOR]

Football supporters, by and large, continue to have a negative image and be presented in a very destructive way by the media generally. This has been reflected academically by the fact that much of the research that has been done into football and football fans has focused on negative aspects of small numbers of supporters' behaviours such as hooliganism and racism.This paper describes a two stage study exploring some of the more positive effects noted during studies with football fans from Mansfield Town, a team currently in the third division of the English Football League.The study explores the perceived benefits to mental health for fans gained from the supporting experience in such areas as stress relief, catharsis and the development of good parent-child relationships.Discussion takes place around the paradox that some of the behaviours described by supporters as beneficial and done in ‘the spirit of carnival’ may challenge liberal beliefs and be viewed as antisocial and offensive. The key feature in health promotional terms is the overwhelming view of fans that the ‘carnivalesque’ behaviours stay in the football ground where such behaviours are viewed as acceptable and socially sanctioned. [ABSTRACT FROM PUBLISHER]

This article surveys the systematic formulations, the techniques employed in diagnosis and treatment, illustrative case procedures, and the appraisals of the effects of treatment of mental hygiene in children. Research in child development has been a particularly productive source of accurate descriptions of the physical, mental, emotional, and social growth of normal children and of experimental studies of the conditions under which behavior may be modified. On the other hand, diagnosis in the sense of classification has a relatively small place in the mental hygiene literature, since most of the attention is devoted to securing types of evidence significant for a solution of a particular problem.