Search

Background: Mobile crisis (MC) services is a pediatric behavioral health service that diverts those who need a lower level of care away from the Emergency Department (ED), enabling EDs to focus on providing acute behavioral health services. However, despite MC's efficacy, utilization could be enhanced. Implementation science provides an informative analytic framework. Objective: This study explores implementation-related factors from the service providers' perspective using qualitative methods, to ascertain the strengths, challenges, and adaptations made in accord with local factors. Method: Between April and November 2017, seven focus groups were conducted with 33 MC services providers. A semi-structured interview elicited descriptions of program strengths and challenges including micro and macro factors affecting MC services delivery. Transcripts were coded thematically and related to the four implementation science concepts--fidelity, acceptability, penetration, and sustainability. Results: MC providers prioritize safety and family engagement. They are aware of the many community and personal barriers to practice, including the inadequacy of the continuum of care, and intervene accordingly. Conclusions: Implementing a community-based program such as MC requires focused efforts to build relationships with families, agencies, and community organizations. To get families and referring agencies to use MC rather than the ED for youth in behavioral health crisis, practitioners coordinate with EDs, hospitals, and the needed services. By building essential relationships, providers were able to overcome many barriers and challenges, enabling them to successfully implement MC programs throughout the state. Nevertheless, several remaining challenges will need to be addressed to sustain successful program implementation in the future.

Scales assessing stressor exposure often fail to demonstrate adequate psychometric qualities, demonstrating low interitem reliability or complex factor structures, as would be expected, given that the majority of stressors are independent events. However, in large-scale mass crisis events, the stressors may be highly interrelated, indicating shared experience. Furthermore, few stressor exposure scales also measure appraised stressfulness of those stressors. Development of a psychometrically sound measure of both stressor exposure and appraisal advances the study of highly stressful events such as community-wide crises, especially in providing a useful measure of its cumulative stressfulness. The coronavirus disease 2019 (COVID-19) pandemic is an enduring, worldwide stressor with an indefinite timeline. The COVID-19 Stressor Scale is a 23-item measure of stressor exposure and appraisal related to the pandemic developed within the first weeks of widespread shelter-in-place practices in the Unites States. We present initial psychometric results of the COVID-19 Stressor Scale. Results of a principal components analysis indicate that the measure is unidimensional and has strong internal consistency. Evidence of convergent and discriminant validity were demonstrated. The COVID-19 Stressor Scale is a useful measure for studying the ongoing stressors associated with the pandemic and presents a model for measuring other massive, ongoing crises.

We present the findings of a statewide survey of behavioral healthcare providers based in New England conducted in November 2021. The study included a measure of COVID-19 stress and the Copenhagen Burnout Scale. The sample was mostly white, female and 45 years of age or older. Overall, the stresses causing the most concern were related to financial issues, the infection of loved ones, and concerns about social distancing and quarantining. We found elevated rates of stress appraisal among people of color. With respect to burnout, women had higher levels of burnout as did those in the youngest age groups in the sample. We found a strong association between COVID-19 stress appraisal and burnout, both at the zero-order level and in the OLS multiple regression model. Implications for the behavioral healthcare workplace are discussed. [ABSTRACT FROM AUTHOR]

Objectives: Since the onset of COVID-19 pandemic, additional risk factors affecting family caregivers' mental health have arisen. Therefore, personal stress coping strategies and family dynamics became important factors in reducing the impact of the pandemic on family caregivers' mental health. The present research aimed to estimate the association between COVID-19 stressors and family caregiving burden. Moreover, moderating effects of emotion dysregulation and family functioning on this association were investigated. Methods: This study analyzed data collected in April 2021 from 154 family caregivers (M age = 38.79, SD age = 9.36, range = 22–64) recruited through Amazon's Mechanical Turk (MTurk). The impact of COVID-19 stressors on family caregiving burden was tested, and moderating impacts of emotion dysregulation and family functioning were also investigated. Results: Both COVID-19 stress exposure and stress appraisal were positively associated with family caregiving burden. Emotion dysregulation and problematic family functioning were also positively associated with family caregiving burden. A significant moderating effect of emotion dysregulation was found, such that family caregivers with higher emotion dysregulation were likely to feel more caregiving burden when they experienced more COVID-19 stressors. Significance of results: The current research highlighted the role of emotion regulation in reducing the negative impact of COVID-19 stressors on family caregiving burden. The research also emphasizes the need for intervention programs to improve emotion regulation strategies to decrease family caregiving burden during the pandemic. [ABSTRACT FROM AUTHOR]

People commonly report positive changes following stressful experiences (perceived posttraumatic growth; PPTG), yet whether PPTG validly reflects positive changes remains unestablished. We tested the extent to which COVID-19 pandemic-related PPTG relates to positive changes in corresponding psychosocial resources in a national US sample participating in a five wave study (T1-T5), focusing here on T2-T5: ns = 712 –860. We examined correlations between resource change (both latent and observed difference scores) and PPTG at each occasion and conducted structural equation models to separate occasion-specific and stable (traitlike) PPTG variance. We related changes in resources to occasion-specific and stable PPTG components. Associations between change scores and occasion-specific PPTG were sparse, providing limited evidence of PPTG validity. Associations between change scores and stable PPTG tended to be positive and stronger than associations for occasion-specific PPTG. Perceptions of growth were largely unrelated to experienced positive changes and thus appear to be largely illusory. However, a personality-like tendency to believe one grows from stressful experiences relates more strongly to actual resource growth. These results suggest that people are not accurate reporters of positive changes they experience and that interventions aimed at promoting post-traumatic growth may be premature. [ABSTRACT FROM AUTHOR]

Social media use increased early in the Covid-19 pandemic, but little information is available about its impact. The present study examined associations of frequency of use of different social media and the motives for use with subsequent social well-being and mental health. Data were gathered on a nationwide sample of 843 Americans during the first wave of lockdowns and infections in mid-April 2020, and again five weeks later. Participants were adults ages 20 to 88 years old (M = 39.3 years old) recruited from Amazon Mechanical Turk (MTurk). Controlling for age and gender, greater frequency of Facebook and video chat app use predicted higher levels social support but also higher levels of cumulative Covid-19–related stress appraisals and posttraumatic stress symptoms. Greater use of video chat apps also predicted less loneliness. Greater use of both Instagram and Snapchat predicted more anxiety and cumulative Covid-19–related stress appraisals. Greater use of Instagram also predicted higher levels of posttraumatic stress symptoms. Motives for use (e.g., connect with others, waste time/avoid responsibility, online video gaming with others) also differentially predicted social well-being and mental health. Results indicate that greater social media use early in the pandemic was often associated with more distress and lower levels of social well-being but, effects varied depending on types, frequency, and motivations for use. Overall, the study revealed that social media use related to social well-being and mental health in complex ways. [ABSTRACT FROM AUTHOR]

Objective: Researchers who study the etiology of college drinking typically employ measures of alcohol-use behaviors as outcomes; however, relatively little is known about the properties of alcohol-related problems (AP). This study aims to develop a single continuous measure of AP. Participants: The sample included 531 undergraduate college students who were surveyed in March 2007. Methods: The Rasch model was employed for dichotomous variables to analyze the measurement properties of 17 AP items. Results: Although issues with respect to differentiation at low levels of problem severity were identified, based on most strategies, the Rasch-based scale was shown to be a valid and reliable measure of AP among college students. Conclusions: Although there may be some need for slight modification and adjustment in the future, the AP scale developed here can potentially serve as a useful measure for etiological and prevention research. (Contains 4 tables and 1 figure.)

Grandparents and other relatives increasingly assume the role of primary caregiver to minor children. This study interviewed family members caring for children whose parents were not available due to parental incarceration, other involvement in the criminal justice system, and substance abuse-related issues. Interviews with 25 African American women examined the impact of caregiving including stress and depression. Stress included caregiver issues related to finances, time allocation, care responsibilities, and concerns about the absent parent, as well as issues specific to the children related to school concerns, child behavior, and emotional problems. These stresses were examined along with caregiver depression scores using the Center for Epidemiological Studies Depression Scale, which indicated more depression related to caregiver illnesses, older caregivers, and care for older and a larger number of children. This study suggests that caring for these children is both challenging and stressful, and caregivers are at risk for depression and other mental health concerns. Health and service providers should carefully assess the needs of caregivers when determining the needs of families where children are under care of nonparental relatives. Family-based services are needed that include caregiver supports as well as support for children. (Contains 4 tables.)

We compared emerging adults with older adults who were admitted to the Drug Treatment Court (DTC) in a large Midwestern county. Emerging adults were more likely to be lower risk and to be opioid/heroin users. Compared to older adults, emerging adults were more likely to have increased violations in the DTC program. Emerging adults compared to older adults were more likely to be terminated than to graduate with no recidivism (odds ratio 1.83), and more likely to recidivate after they graduated (odds ratio 2.16). Elevated risks for program termination and recidivism for emerging adults, despite a reduced risk profile at entry, underscore the need for program modifications (such as peer support) that specifically target this age group. [ABSTRACT FROM AUTHOR]

Associations between parents' poor marital adjustment, parent-child discord, affectionless control, low family cohesion, and parental divorce and DSM-III diagnoses were explored among 220 offspring of parents with and without major depression. Parental depression and family risk factors were significant predictors of conduct disorder. (RH)

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jsat.2008.06.004 Byline: Mary Ellen Mackesy-Amiti (a), Michael Fendrich (b), Timothy P. Johnson (c) Keywords: MSM; Drug dependence; Alcohol dependence; Substance treatment; HIV Abstract: This study compares a sample of urban men who have sex with men (MSM) with a general population sample of men in the same city on self-reported problems with substance use indicative of dependence and history of substance use treatment. Both samples were randomly selected using multistage probability methods. All participants completed audio computer-assisted self-interviews, including questions on substance use, problems related to substance use experienced in the past 12 months, and substance treatment. Problem use of alcohol, marijuana, and cocaine did not differ between samples. Compared to men in the general population sample, MSM were significantly more likely to experience problems related to the use of sedatives, tranquilizers, or prescription pain relievers. Among MSM, history of substance treatment was associated with a positive HIV test, and treatment usually preceded HIV diagnosis. Research is needed on effective methods for integrating HIV prevention for MSM into substance treatment settings, including physician-administered buprenorphine treatment for opiate addiction. Author Affiliation: (a) Community Outreach Intervention Projects, School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA (b) Center for Addiction and Behavioral Health Research, Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA (c) Survey Research Laboratory, College of Urban Planning and Public Affairs, University of Illinois at Chicago, Chicago, IL 60607, USA Article History: Received 29 February 2008; Revised 2 June 2008; Accepted 22 June 2008