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, , Kenya Minott, Diane Santa Maria, Kimberly Bender, , Kristin Ferguson, Hsun-Ta Hsu, Anamika Barman-Adhikari, Robin Petering
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000585

Kathrine S. Sullivan, Yangjin Park, Charles M. Cleland, Julie C. Merrill, Kristina Clarke-Walper, Lyndon A. Riviere
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000579

American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000575

Abstract:
Due to increasing incidence of mental health challenges in college students and its relation to poorer student outcomes (e.g., recruitment, retention, graduation), higher education institutions have turned their attention toward the needs of students experiencing mental health challenges (Collins & Mowbray, 2005). In attempts to ameliorate poorer student outcomes, some states have investigated the impact of mental health on those enrolled in higher education as well as the needs for supports and services for those impacted (e.g., Oregon Higher Education Coordinating Commission [OHECC], Office of Academic Policy and Authorization, 2018). However, despite these initiatives, limited empirical research is available related to the lived experiences of individuals with mental health challenges in higher education settings; including the supports and barriers they may experience while navigating these complex settings. This study begins to address this knowledge gap by using qualitative content analysis to examine and compare key stakeholder lived experiences related to mental health challenges in higher education, including the similarities and differences regarding service and support needs, determinants to usage (support and barriers), and recommendations for future research and improving the continuum of care. Considerations for policy, practice, and future research are provided. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Julie A Tippens, Holly Hatton-Bowers, Ryan Honomichl, Lorey A Wheeler, Helen M Miamidian, Kirstie L Bash, Michelle C Howell Smith, Dulo Nyaoro, J Joshua Byrd, Samuel E Packard, et al.
Published: 22 July 2021
by 10.1037
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000564

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Magdalena Skrodzka, Piotr Sosnowski, ,
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000571

Abstract:
Kurds have a long history of victimization and struggle for even the most basic rights. This is reflected in a widely shared belief, according to which they have "no friends but the mountains." Such difficult history may have ongoing negative impact on mental health of present-day Kurds. This article investigates the relations between cognitive availability of historical trauma, historical trauma symptoms, and negative mental health outcomes in a sample of young Kurds who live in the Region of Kurdistan in Iraq. We also examined the potential protective role of strong identification as members of a national minority (Iraqi Kurds) and as members of an ethnic group (Kurdish people in general). The results showed that tragic group history is significantly related to negative mental health outcomes among young Iraqi Kurds. However, strong identification with other Iraqi Kurds (but not with Kurds in general) had an attenuating effect on the link between historical trauma and present-day negative mental health outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
, , Sy-Woei Hao, Yanzheng Li
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000568

Abstract:
In this article, we tested if female adopted Chinese youth's sense of exclusion predicted their behavioral adjustment and mental disorder diagnoses concurrently (Study 1) and longitudinally 5 years later (Study 2). In Study 1, 224 adoptees (M = 13.6 years, SD = 2.1) provided survey data on sense of exclusion (as indexed by ethnic marginality, ethnic identity search, and negative feelings toward adoption) and Internalizing Problems (i.e., anxiety, withdrawal, and somatic complaints), measured with the Child Behavior Checklist (CBCL)-Youth Self-Report. In Study 1, the adoptive parents additionally completed the CBCL parent-report on the adopted children's Internalizing Problems and reported if the adopted children had any mental disorder diagnoses. In Study 2, 60 youth from Study 1 (M = 18.6 years, SD = 2.1) completed the 3rd edition of the Behavioral Assessment System for Children-Self Report of Personality (BASC-3-SRP) that measures School Problems (i.e., negative attitudes toward teacher, negative attitudes toward school, and sensation seeking), Internalizing Problems (i.e., atypicality, locus of control, social stress, anxiety, depression, sense of inadequacy, and somatization), Attention-Deficit/Hyperactivity Disorder (ADHD; i.e., inattention and hyperactivity), and Personal Adjustment (i.e., relations with parents, peer relations, self-esteem, and self-reliance). They also responded to questions on receiving mental disorder diagnoses and treatments. We found that in Study 1, 33.2% of the youth had at least one diagnosis, with Anxiety Disorder (21.4%), ADD/ADHD (16.7%), and Attachment Disorder (7.5%) being the top three disorders. In Study 2, 40.3% had at least one diagnosis, with Anxiety Disorder (25.0%), Depression (21.7%), and ADD/ADHD (16.7%) being the top three disorders. Path analyses showed that in Study 1, ethnic marginality and negative feelings about adoption, but not ethnic identity search, significantly predicted parent-reported and self-reported Internalizing Problems; in Study 2, none of the three indicators of sense of exclusion predicted the adopted youth's adjustment. Implications for clinical practice and future research were discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Yanet Quijada, Carolina Inostroza, Pamela Vaccari, Julie Riese, Carolina Hausmann-Stabile
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000558

Abstract:
Adolescent suicide is a serious public health problem in Chile. Given the high prevalence of suicidal behaviors and suicide, youth suicide researchers must approach participants, families, and communities with care. Special attention must be given to suicide-related trauma among survivors of suicidal behaviors and of suicide. In this article, we discuss how investigators can infuse the trauma-informed model in their work. Our discussion is organized around research stages and tasks: study design, recruitment, data collection and analysis, and care for the research team. We illustrate the integration of the trauma-informed (TI) model key elements and principles with examples from our work in youth suicide research. We posit that infusing the TI model in research aligns with the ethical mandate of beneficence. Our goal is to help other researchers reflect on how to design and implement TI informed research that is attuned to participants, staff, and communities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000573

Abstract:
The COVID-19 pandemic has required public social services departments to cope with an unexpected and unprecedented emergency situation. As community social workers work on the macrolevel and deal with entire communities in emergency situations, the present study investigated the challenges they face as well as the factors that promoted they are coping during the "age of COVID." Drawing on in-depth interviews with 20 managers of community social work departments in Israel, findings highlighted three main themes: (a) organizational politics, which impeded community social workers' work; (b) the mobilization of both professional community social work staff as well as civilians; and (c) the perception of the crisis as an opportunity. Findings pointed to the challenges, promotive factors, and perceptions of community social workers in public social services departments who have had to cope with the pandemic. We discuss these findings in light of the theoretical perspectives of "the politics of pandemic" pandemic, social support, and resilience. Implications for community practice are outlined. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
, , Wen Qu, Yidan Wang, Xiaotian Feng
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000554

Abstract:
Popular media has aroused concern that Chinese only children are growing up lonely owing to their lack of sibling interaction Mu et al. (2007). However, little research has been directed at determining whether Chinese adults believe in the only-child-as-lonely stereotype and whether Chinese only children actually suffer more loneliness than their peers with siblings. Three studies were conducted to examine belief in the only-child-as-lonely stereotype and determine whether only children report greater loneliness than children with siblings. With the first study, the prevalence of the only-child-as-lonely stereotype among young adults from six cities (Study 1, N = 588) was examined. The results showed that belief in this stereotypical perception was common among young Chinese adults, particularly those who had siblings. We then examined the validity of this stereotype by analyzing data from three samples, consisting of Chinese emerging adults (Study 2, N = 699) and late adolescents (Studies 3.1 and 3.2, N = 345 and 210, respectively). Results from Studies 2 and 3 consistently showed that, contrary to the stereotype, Chinese only children reported lower levels of loneliness than their counterparts with siblings. Additionally, open-ended responses from the adolescent participants in Study 3 provided hints about the situations that provoke their loneliness. The results are explained in terms of the two theoretical approaches to loneliness. In sum, our research suggests that belief in the loneliness of only children is widespread in Chinese society, but the evidence indicates that reports of loneliness are greater for those who grew up with siblings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
, James Topitzes, Jeffrey Langlieb, Kenneth A. Dodge
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000572

Abstract:
Adverse childhood experiences and other potentially traumatic events have lasting implications for mental health. Evidence-based treatments are available to address trauma-related symptoms, but their impact is hindered because access is limited and unequal. In the U.S., adverse experiences and mental disorders disproportionately affect socioeconomically disadvantaged groups that face treatment access barriers-disparities that are compounded by passive systems of care that wait for clients to seek treatment. This article presents a conceptual argument, backed by empirical evidence, that population health can be improved by implementing trauma-responsive practices, and that greater mental health equity can be achieved if these strategies are used to engage underserved clients. A description is provided of the Trauma Screening, Brief Intervention, and Referral to Treatment (T-SBIRT), a promising protocol that can be used by nonclinical providers to detect trauma-related mental health concerns in adults and help them access therapeutic services. The T-SBIRT protocol has been successfully implemented in diverse settings, and it is currently being piloted in a universal postpartum home visiting program called Family Connects. Prior results from three trials of Family Connects are summarized, including evidence of program impact on maternal mental health. New results are also presented indicating that T-SBIRT is feasible to implement within Family Connects, as denoted by indicators of suitability, tolerability, provider adherence, and referral acceptance. Closing recommendations are offered for reducing mental health disparities by testing and disseminating T-SBIRT through Family Connects and other large-scale programs and systems of care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Jing Zhang, ,
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000569

Abstract:
Cognitive distortions are conceptualized as one of the most potent predictors of suicide. However, little is known about the mediating and moderating mechanisms linking cognitive distortions and suicidal ideation. The present study examined a prospective moderated mediation model linking cognitive distortions and suicidal ideation, with drug use, social problem-solving, and perceived burdensomeness as the mediators and childhood sexual abuse as the moderator. Participants included 150 homeless youth who participated in a randomized clinical trial for suicide intervention. Participants were assessed at baseline, 3, 6, and 9 months post-baseline. We analyzed the data using a multiple-group path model. Findings showed that social problem-solving and perceived burdensomeness sequentially mediated the association between cognitive distortions and suicidal ideation regardless of childhood sexual abuse, whereas drug use mediated the association between cognitive distortions and suicidal ideation only among youth reporting no history of sexual abuse. Findings highlight how coping processes, both adaptive and maladaptive, operate differently to predict suicidal ideation contingent on the effects of childhood sexual abuse in the context of cognitive distortions. Findings also underscore the importance of addressing the effects of childhood abuse to facilitate the efficiency of interventions that seek to reduce suicidal ideation among a vulnerable population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Humama Khan, Shujing Zhang, , Sehar N. Jessani,
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000561

Abstract:
Historically rates of death by suicide in African Americans have been lower than in other communities, although no ethno-racial differences have emerged in rates of suicidal ideation. Despite the fact that suicidal ideation impacts millions of people every year and is commonly reported by individuals who have attempted suicide, it has not been a focus of investigation among African American adults. One major predictor of suicidal ideation is depressive symptoms, although this association in African Americans has received little empirical attention. This study examines the impact of one potential culturally relevant moderator, social support, on the link between depressive symptoms and suicidal ideation in a sample of low income, African American adults with a recent suicide attempt (n = 267). Correlational analyses confirmed a positive, significant relation between depressive symptoms and suicidal ideation among the entire sample and separately for women and men. Linear regression analyses revealed that friend, but not family, support moderated the association between depressive symptoms and suicidal ideation, when controlling for homelessness. This moderating effect, however, was only found for the women (n = 152) in the sample. The results highlight the value of social support from friends in fostering resilience against suicidal ideation in high-risk low-income African American women. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
, John K. Kellerman, Kara Binder Fehling, , Edward A. Selby
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000562

Abstract:
Compared to heterosexual individuals, sexual minorities exhibit elevated risk for depression and borderline personality disorder (BPD). One psychosocial factor relevant to sexual minority mental health is outness, or the degree to which an individual discloses or conceals their sexual orientation. Previous findings are mixed regarding whether outness is associated with better or worse mental health, likely because outness can have positive consequences (e.g., social support) and negative consequences (e.g., discrimination). Support exists for both mechanisms, but previous studies have not simultaneously considered how outness may be related to mental health outcomes in different ways through social support versus discrimination. The present study examined: (a) the association between outness and depressive symptoms, (b) the association between outness and BPD symptoms, and (c) the indirect effects of outness on depressive/BPD symptoms through social support and discrimination. A total of 256 sexual minority participants completed an online or in-person survey. Greater outness was associated with lower depressive symptoms and BPD symptoms. There was an indirect effect of outness on depressive symptoms through social support, with greater outness being associated with greater social support and, in turn, lower depressive symptoms. Outness had an indirect effect on BPD symptoms through both social support and discrimination. Greater outness was associated with both greater social support and discrimination, with greater social support being associated with lower BPD symptoms, and greater discrimination with greater BPD symptoms. Outness may contribute to mental health through multiple mechanisms, serving as either a risk or protective factor. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
, Timothy McAuliffe, Katherine Quinn, , Peter Toepfer, Arturo Bendixen, Wayne DiFranceisco
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000550

Abstract:
To compare the effectiveness of different models of permanent supportive housing (PSH), housing configuration, and service provision model on substance use, depression, and anxiety symptoms among residents over time. Linear mixed model regression was used with 888 residents of PSH to investigate the relationship between supportive housing type, service model, and housing configuration and change in mental health and substance use at baseline, 6-, 12-, and 18-month follow-up. There were few significant differences in problematic substance use, depression, or anxiety symptoms among those in different PSH types, different housing configuration models, or different service provision models. Similarly, there were no significant differences in PSH type, housing configuration, or service delivery model among those with severe mental illness (SMI), substance use disorder (SUD), or those with dual diagnoses. There is little evidence that different models of PSH result in differences in mental health and substance use outcomes. Future research should consider the number of services clients receive and critical periods in PSH residency in improving mental health and substance use outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
, , Andréanne Fortin
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000548

Abstract:
Child sexual abuse (CSA) is associated with a host of negative repercussions. Yet, scholarly reports highlight the diversity of symptom presentation in survivors of CSA. Relying on the complex posttraumatic stress disorder (C-PTSD) framework, this study aimed to identify symptom profiles in teenage girls seeking services following disclosure of CSA. Participants included 207 teenage girls aged 12-18. They completed questionnaires on PTSD symptoms (i.e., reexperiencing, avoidance, and hyperarousal) and domains of impairments of the C-PTSD (i.e., interpersonal difficulties, biology, affect and behavioral regulation, dissociation, cognition, and self-concept). A latent profile analysis identified three profiles: PTSD, Complex PTSD, and Resilient. Results support the validity of the C-PTSD model with a subgroup reporting classic PTSD symptoms as well as alterations in several domains of functioning. Our second aim was to explore potential correlates of the resulting symptom profiles. Both personal and family factors were found to distinguish profiles, with teens in the Resilient group reporting fewer associations with delinquent peers, less use of avoidance coping strategies, and more maternal support than the two other profiles. Furthermore, CSA severity did not differ between the Complex PTSD and the Resilient profiles. The current findings argue in favor of a more individualized approach to treatment taking into consideration differences in presentation of symptoms among profile teenage survivors of CSA. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Namrita S. Singh, , Benjamin Doty, Emily Haroz, Andriy Girnyk, Vira Chernobrovkina, Laura K. Murray, Judith K. Bass, Paul A. Bolton
American Journal of Orthopsychiatry; https://doi.org/10.1037/ort0000537

Abstract:
Objective: This article reports findings from a qualitative study that sought to identify and describe psychosocial and mental health consequences of conflict among internally displaced persons (IDPs) and military veterans in Ukraine. The study was the first phase of a clinical intervention trial and was designed to understand local experiences of mental health problems and function, inform the selection and adaptation of local measures, and guide the modification, and implementation of a psychotherapy intervention that could support conflict-affected persons. Method: Free-list interviews (FLs), key informant interviews (KIIs), and focus group discussions (FDGs) were conducted with IDPs, military veterans, and providers working with these two groups. A total of 227 respondents were interviewed from two study regions in eastern Ukraine-Zaporizhia and Kharkiv-including 136 IDPs and 91 military veterans. Results: Both IDPs and veterans were described as experiencing high levels of psychological stress symptoms, including depression, isolation, anxiety, and intrusive memories. Although IDPs and veterans were exposed to different traumas, they both identified struggles with social adaptation, including feeling isolated and misunderstood by their communities. Both groups also described relational conflict within and outside the family. Social support mechanisms were considered essential for recovery, and positive social interaction was described as a key example of healthy functioning. Conclusion: Findings suggest a need for community-based programming that facilitates social adaptation, supports social network building, and helps engage conflict-affected people into mental health services. Programs that promote greater awareness, interaction, and understanding among the general public, military veterans, and IDPs are also warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
, Allison W. Watts, Nicole Larson, ,
American Journal of Orthopsychiatry, Volume 91, pp 109-119; https://doi.org/10.1037/ort0000482

Abstract:
Research addressing the linkages between acculturation and markers of adolescent well-being across multiple ethnic minority groups is limited in scope and breadth, even though children of immigrant origin are the fastest growing population. We examined cross-sectional relationships between acculturation and substance use, socioemotional well-being, and academic achievement. Somali, Latino, and Hmong adolescents in Minnesota provided data as part of the EAT 2010 (Eating and Activity in Teens) cohort study (N = 1,066). Acculturation was based on nativity, language usually spoken at home, and length of residence in the United States. Chi-square, ANOVA, and regression models were used to test for differences in adolescent well-being by acculturation and ethnic group, and interaction terms were added to models to test effect modification by ethnicity. Hmong adolescents had the highest mean acculturation scores (4.4 ± 1.5), whereas Somali adolescents (2.2 ± 1.8) were the least acculturated. Independent of ethnicity, acculturation was positively associated with marijuana (OR: 1.38; CI [1.25, 1.53]) and alcohol use (OR: 1.12; CI [1.02, 1.22]), and was negatively associated with academic achievement, based on grade point average (β = -0.07; CI [-0.12, -0.03]). Interaction effects indicated significant differences by ethnicity only for academic achievement; significant associations between acculturation and academic achievement were evident only for Somali and Latino youth. Prevention programming should include supports for multilingual and multicultural learners and account for cultural assets within immigrant origin families that maintain and nurture protective factors as adolescents acculturate and transition into young adulthood. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Suzanne M. Cox, Cynthia O. Lashley, Linda G. Henson, Nora Y. Medina,
American Journal of Orthopsychiatry, Volume 91, pp 120-131; https://doi.org/10.1037/ort0000521

Abstract:
Although adolescent childbearing is widely viewed as a major social problem, and research suggests that young mothers and their children are at risk for poor economic and academic outcomes, these ideas may be in need of revision. Recent scholarship has pointed out that young mothers have been unfairly blamed and stigmatized for problems that should be attributed to social and economic inequality, racism, and poverty. The present study extends that research by listening to the voices of young mothers. In total, 179 urban African American women were asked at 4, 12, and 24 months after giving birth to describe how their lives had changed since becoming a mother. A team of coders content coded themes with rigorous checks for intercoder reliability. Positive themes were far more prevalent than negative themes. Motherhood was often described as a positive developmental change, providing the young women with a sense of maturity, responsibility, motivation, and commitment to placing the baby's needs ahead of their own. Motherhood was sometimes described as a life-turning point whereby young women turned away from undesirable activities and became focused on school, work, and their family's future. Challenges reflected common stresses of parenting for people of all ages, such as lack of sleep and burden of caregiving, but also limited time to socialize with friends. Findings suggest that although policymakers and professionals view adolescent parenthood as a social ill to be eradicated, for the mothers themselves, the experience is more complex, meaningful, and positive. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Michal Krumer-Nevo,
American Journal of Orthopsychiatry, Volume 91, pp 423-431; https://doi.org/10.1037/ort0000566

Abstract:
Preliminary evidence indicates that Coronavirus Disease 2019 (COVID-19) affects people differently along social axes, among which socioeconomic status is key. This study used mixed methods to add data from Israel to this developing body of knowledge. Using closed questions, the study compared 126 people living in poverty with 147 people not living in poverty in terms of their economic and employment status, need for assistance, and mental distress. In addition, in order to better understand the experiences of poverty, open questions regarding the effect of COVID-19 on the participants' lives and their means of coping with the pandemic were employed. The study was conducted in May 2020, just after the first lockdown, through online media and through social workers who personally went to disadvantaged neighborhoods to reach out to participants who are vulnerable to digital illiteracy. The analysis points to major differences between the groups, with people in poverty suffering more in terms of their economic and employment situation and mental distress. In addition, we found that people in poverty needed and received more support. The qualitative analysis indicates the specificities of the severe nature of the intersection of poverty and the pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
, Manuel Muñoz, , Clara González-Sanguino, Miguel Ángel Castellanos, Carlos Vaquero, Carolina Ugidos, Aída López-Gómez
American Journal of Orthopsychiatry, Volume 91, pp 407-411; https://doi.org/10.1037/ort0000542

Abstract:
COVID-19 disease control efforts and consequences are likely to be complicated by the impact of fear and stigmatization of the novel coronavirus. These complications may also worsen due to the potential compounding of COVID-19 related stigma with stigmatization associated with previously diagnosed conditions. This exploratory study analyzes the experiences of the stigma associated with COVID-19 lockdown in people with different previous diagnoses 2 and 5 weeks after the beginning of the state of emergency in Spain. Gender and age were controlled as covariables and 1,052 people participated in the study. The diagnosis groups were: Psychiatry and mental health (n = 71), Cardiovascular disease (n = 42), Neurological disease (n = 23), Lung disease (n = 53), and No diagnosis (n = 863). The instruments used to measure the stigma were the Intersectional Day-to-Day Discrimination Index and two items of the Internalized Stigma of Mental Illness scale. Analysis of covariance of repeated measures and analysis of variance, including Scheffe's post hoc test, were performed. We found significant differences in stigma among the first and second evaluation. Regarding the previous diagnosis, no differences were found at Time 1, but significant differences were found at Time 2, with those having a previous psychiatric or mental health diagnosis reporting higher levels of perceived discrimination and internalized stigmatization. Our results suggest that people with previous stigmatizing conditions might be more vulnerable to experiencing stigma in a confinement situation. In order to reduce the burden of the COVID-19 stigma, health interventions should also consider the resulting intersection of effects on internalized stigma and perceived discrimination. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
, Portia L. Brown, Heather Rice, Cassaundra Bronson, Emily Cherney, Christin Farmer,
American Journal of Orthopsychiatry, Volume 91, pp 589-597; https://doi.org/10.1037/ort0000557

Ginny Sprang, Feitong Lei, Heather Bush
American Journal of Orthopsychiatry, Volume 91, pp 443-453; https://doi.org/10.1037/ort0000546

Abstract:
Objectives: Current best practice approaches suggest that to address secondary traumatic stress (STS) a two-pronged perspective that considers individual and organizational factors over time is warranted. However, research documenting the impact of organizational efforts on individual experience with STS is lacking. In this study, it was hypothesized that as an organization becomes more STS informed, there would be decreases in reported levels of STS and burnout (BO) in individuals over time; and these changes would be associated with higher levels of implementation activity and increased use of interventions to improve physical and psychological safety. Methods: This study uses data from 2,345 responses, representing 7 groups involved in an organizational change process aimed at creating STS informed organizations in a department of health and human services. The Secondary Traumatic Stress Informed Organizational Assessment (STSI-OA), the Secondary Traumatic Stress Scale (STSS), and the Professional Quality of Life-5 BO subscales measured variables of interest. Using a longitudinal design, baseline, post, and follow-up data were collected. Results: One-way ANOVAs revealed significant improvements in STSI-OA, STSS, and BO scores across time (p-value < .05). Linear mixed models reveal that significant declines in STSS scores were associated with improved STSI-OA scores (p = <.001), after adjusting for age, gender, time, and level of implementation activity. Implications: These results support the hypothesis that organizational efforts can improve an individual's perceived level of distress, and that focused attention to the issue of secondary trauma in an organization can improve organizational and individual outcomes using a data-driven change approach. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Emily Leickly, Greg Townley, Tessa L. Dover, , Mark S. Salzer
American Journal of Orthopsychiatry, Volume 91, pp 208-216; https://doi.org/10.1037/ort0000466

Abstract:
Following deinstitutionalization, services and housing for people with serious mental illnesses (SMI) became concentrated in economically disadvantaged urban centers. As these areas gentrify, affordable housing for people with SMI is increasingly found in nonurban areas. Although nonurban environments provide benefits for the general population, people with SMI living in nonurban areas perceive higher levels of mental illness stigma. Thus, the relationship between perceived stigma and negative outcomes such as high psychological distress and low sense of community may be stronger in nonurban areas. Data collected from 300 adults with SMI living in urban and nonurban areas were analyzed using a moderated regression design. Urbanicity did not moderate the relationships between perceived stigma and negative outcomes. However, associations were found between urbanicity, perceived stigma, sense of community, and psychological distress, supporting the need to address mental illness stigma in all settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Sharon Avidor, , Zahava Solomon
American Journal of Orthopsychiatry, Volume 91, pp 162-170; https://doi.org/10.1037/ort0000530

Abstract:
For combat veterans, the trauma of war can have lasting effects, that may later extend to attitudes toward one's own aging (ATOA). The present study sought to examine whether attachment insecurities may help to predict ATOA in later life, while also exploring the moderating role of combat exposure concerning the effects of attachment insecurities on subsequent ATOA. A cohort of 171 veterans of the Israeli 1973 Yom Kippur War (mean age = 68.4, SD = 5.1) were interviewed in 1991 (Time 1; T1) and again in 2018 (Time 2; T2). The present study examined the moderating role of combat exposure, within the associations between T1 attachment insecurities and T2 ATOA. A regression analysis revealed that T1 attachment insecurities, T2 health problems, and post-traumatic stress disorder (PTSD) symptoms predicted more negative T2 ATOA. A significant interaction was found between combat exposure and attachment avoidance, suggesting that the effect of attachment avoidance on ATOA was only significant among participants with high levels of combat exposure. The present findings point to the importance of attachment insecurities for ATOA among veterans, and to the role of combat exposure in moderating these associations. Results indicate possible avenues of intervention and policy for those most vulnerable to negative ATOA. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Irit V. Felsen
American Journal of Orthopsychiatry, Volume 91, pp 171-180; https://doi.org/10.1037/ort0000535

Abstract:
Evidence from multiple samples of trauma-exposed populations across the globe suggests that intergenerational trauma constitutes a biopsychological risk factor which manifests itself throughout the life cycle of offspring of trauma survivors. Prior empirical studies have shown that adult children of Holocaust survivors (OHS, also referred to in select quotes as 2G for "Second Generation") are vulnerable to life-threatening situations. This study aimed to examine the reactions of OHS to the COVID-19 pandemic, which posed a serious threat to the lives of many, in particular to older adults. As they enter middle age, OHS were observed to have more medical health issues and less positive perceptions of their own aging relative to peers. Less positive subjective aging was associated with more negative psychiatric symptoms in relation to Covid-19-related loneliness, further suggesting that OHS are a group of aging adults with particular vulnerabilities to negative mental health effects of the pandemic and of the social distancing and isolation it imposed. This study is a qualitative report of experiences expressed by over 1,200 participants in several web-based interactive webinars for OHS during the period of "shelter at home" in March and April 2020. It is proposed that this format of "web-based, second-best" way of being together, an intervention that emerged spontaneously in response to the coronavirus and social distancing, offers a novel, nonpathologizing, effective form of supportive psychosocial intervention uniquely suited to the unprecedented challenges experienced during times requiring social distancing. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
, Katherine E. Grimes, Timothy B. Creedon, Priya R. Pathak, Lindsay A. DiBona, Gregory N. Hagan
American Journal of Orthopsychiatry, Volume 91, pp 386-397; https://doi.org/10.1037/ort0000536

American Journal of Orthopsychiatry, Volume 91, pp 598-606; https://doi.org/10.1037/ort0000560

Abstract:
Community participation is important to the well-being of people with serious mental illnesses. While theories suggest that depressive symptoms can negatively impact community participation, evidence from previous studies was inconclusive. This study analyzed the relationship between severity of depressive symptoms and various participation constructs including number of days of participation in various community activities, breadth of interests in participating in community activities, and satisfaction with the amount to which one participates. A national sample of individuals with serious mental illnesses (n = 296) was employed. Overall, those who were severely depressed had fewer total days of participation, reported fewer participation areas as important, were less likely to participate in those areas that were important to them, and were less likely to participate as much as they wanted to in areas that were important to them. This relationship generally remained even after controlling for demographics. Overall, the findings from this study suggest that greater attention should be paid to the relationship between depressive symptoms and community participation in this population, including explorations that examine how the promotion of participation may have an impact on depressive symptoms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
American Journal of Orthopsychiatry, Volume 91, pp 271-279; https://doi.org/10.1037/ort0000527

Abstract:
In the United States, citizens opposed to stricter gun control laws as a response to mass shootings frequently reframe the problem of gun violence as a mental health issue. As a result, it has been suggested that pro-gun attitudes (i.e., pro-gun rights attitudes and favorable attitudes toward the National Rifle Association) might be associated with stigmatizing attitudes toward people with mental illness. In three studies (total N = 756), we assessed gun attitudes as predictors of mental illness stigma among college students in the United States (data collected in 2018 and 2019). While zero-order correlations revealed that pro-gun attitudes predict more negative attitudes toward people with mental illness, they were not unique predictors after adjusting for political affiliation. These findings replicate previous research on the relationship between conservatism and mental illness stigma and provide a starting point for future research assessing relationships between gun attitudes, political affiliation, and mental illness stigma. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Jong-Woo Suh, Eun-Byeol Lee, Yeoul Han, , Kee-Hong Choi
American Journal of Orthopsychiatry, Volume 91, pp 86-95; https://doi.org/10.1037/ort0000517

Abstract:
The majority of children with physical disabilities experience significant restrictions in their daily lives. Notably, they are at a risk for lower levels of activity and involvement in critical life domains. To address this issue, this study investigated whether behavioral activation (BA), in tandem with the installment of power-assisted devices (PAD), would have beneficial effects on activity levels, overall involvement in life domains, mobility, and depressive symptoms among children with physical disabilities. From among 123 children with physical disabilities aged 6-13 who used a nonpowered wheelchair device, 40 who met the inclusion and exclusion criteria were randomized into either the PAD-only group or the BA + PAD group. The participants were assessed at 3 time periods (pretreatment, 4 weeks, and 8 weeks), using standardized self-report measures and digital odometers. Both groups showed an increase in the distance traveled. Although BA + PAD had no additional benefits over PAD-only in improving the distance traveled and depressive symptoms, the BA + PAD group showed significantly higher levels of activity and overall involvement in life domains than the PAD-only group did. The findings provide preliminary support for the provision of BA for children with physical disabilities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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