Using Qualitative Methods for Revising Items in the Hispanic Stress Inventory

This study examined the relationship between gender, ethnicity, psychosocial stress and generalized distress in 593 Hispanic immigrants, Mexican Americans, and Anglo Americans using the Hispanic Stress Inventory (HSI) and the Center for Epidemiologic Studies Depression Scale (CES-D). Findings revealed that immigrant females had higher scores on the Cultural/Family Conflict sub-scale of the HSI and on the CES-D than immigrant males. Also, higher levels of generalized distress and psychosocial stress associated with the immigration process were found among immigrants from Central America when compared with Mexican immigrants. Central Americans' stress appraisal ratings on specific HSI items related to pre-migration trauma were significantly higher than the ratings of Mexican immigrants. Our findings indicate that research and clinical service delivery models must be sensitive to the vast heterogeneity within the Hispanic population with respect to differences in the experiences of psychosocial stress as related to gender and ethnicity.

In the framework of modern market economy, aside from various skills and knowledge, teachers are required to contrive a complex mosaic of roles and interactions which may result in the experience of prolonged stress and professional burnout. According to Lazarus and Folkman (2004), the manner of coping with the stress, as stated in their transaction model, implies a dynamic process which changes over time depending on objective requirements and subjective assessments of the situation for the purpose of solving the problem and/or reducing the intensity of a psychophysiological reaction within the stress process. Since the 1970s increasing importance has been attached to teachers' experience of stress and the manner of coping with it. Kyriacou and Sutcliffe (1978) define teacher's stress as a reaction to negative affects - anger, anxiety, tension, frustration, or depression, which result in potentially pathogenic physiological or biochemical changes. General factors of professional stress are present in all cultures and they are determined by the general status of education. Specific factors stem from a specific social environment, as well as from the professional status of teachers and their competences. Specific stress factors are related to the teacher's personality, their value system in the process of interaction with the particular environment. Some of the significant personality traits, studied as specific factors of the professional stress, are dimensional models of personality within the five-factor model-self-efficiency, self-silencing, job satisfaction, styles of coping with stress, the level of burnout. According to research studies, the experience of professional stress and burnout is influenced by higher levels of neuroticism, aggressiveness, self-silencing, higher values of optimism, emotional competence, self-efficiency, life satisfaction, styles of coping with stress, as well as by the level of education at which teachers work. Research studies which the author has consulted mostly refer to teachers as a population at risk. Hence, aside from an analysis of professional stress factors, the author recommends that it would be essential to study and suggest possible directions of preventive actions in order to preserve and improve teachers' mental and physical health. In the current social moment, it appears that it is most beneficial to observe individual personality of teachers from the standpoint of positive psychology and develop teachers' individual resources for coping with professional stress.

Do Canada and the United States Differ in Prevalence of Depression and Utilization of Services?

This study explored the views of 241 patients with schizophrenia about their own disorder. Patients' knowledge of their diagnosis, confidence that they will be well again, and perception of limitations in their own life as a result of the disorder were explored in relation to patients' opinions about the social consequences of schizophrenia. Study results were presented to participants, and suggestions were collected regarding how these study results should be used. Seventy-two respondents (30%) reported that a psychiatrist told them that they have schizophrenia. Respondents who were confident that they would be well again had a lower duration of contact with psychiatric services and a less pronounced perception of affective and social difficulties related to schizophrenia. Respondents who did not feel limited in their life by the disorder reported less social distance and more optimism about the usefulness of treatments. Participatory studies may provide ideas for a more constructive interaction between patients and professionals.

In 2004, the American Academy of Pediatrics (AAP) Board of Directors formed the Task Force on Mental Health and charged it with developing strategies to improve the quality of child and adolescent mental health* services in primary care. The task force acknowledged early in its deliberations that enhancing the mental health care that pediatricians and other primary care clinicians† provide to children and adolescents will require systemic interventions at the national, state, and community levels to improve the financing of mental health care and access to mental health specialty resources. Systemic strategies toward achieving these improvements are the subject of other publications of the task force: “ Strategies for System Change in Children's Mental Health: A Chapter Action Kit ” (chapter action kit),1 “Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration,”2 and “Enhancing Pediatric Mental Health Care: Strategies for Preparing a Community.”3 The task force also recognized that enhanced mental health practice will require competencies not currently achieved by many primary care clinicians; in the policy statement “The Future of Pediatrics: Mental Health Competencies for Pediatric Primary Care,”4 the task force collaborated with the AAP Committee on Psychosocial Aspects of Child and Family Health to outline these competencies and propose strategies for achieving them. This report offers strategies for preparing the primary care practice itself for provision of enhanced mental health care services. The task force proposes incrementally applying chronic care principles to the care of children with mental health and substance abuse problems as primary care clinicians apply them to the care of children with chronic medical conditions such as asthma. Most primary care clinicians will find that significant gaps exist between their current practice and the proposed ideal. The task force offers guidance in … Address correspondence to Jane Meschan Foy, MD, Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157. E-mail: jmfoy{at}wfubmc.edu

Individuals with serious mental illness often are unable to access consumer- and family-oriented community care, resulting in repeated hospitalizations, incarceration, and homelessness. The "medical home" concept was developed in primary care to provide accessible and accountable services for individuals with chronic medical conditions. Building on the work done in primary care, the authors propose a "mental health home." The model of care incorporates medical home characteristics, such as access to and coordination of services, integration of primary and preventive care, adoption of recovery orientation and evidence-based practices, and family and community outreach. Barriers to and strategies for implementation of mental health homes are discussed.

A New Kind of Homelessness for Individuals With Serious Mental Illness? The Need for a "Mental Health Home"

Back to table of contents Previous article Next article Association NewsFull AccessAPA Bridges Language Gap In Mental Health InformationEve BenderEve BenderSearch for more papers by this authorPublished Online:4 Nov 2005https://doi.org/10.1176/pn.40.21.0005bAPA is extending education on mental health issues to new populations through a campaign that offers Spanish-language materials on the prevention and treatment of mental disorders.APA launched its Hispanic Mental Health Initiative in October to coincide with Hispanic Heritage Month, which celebrates the anniversary of independence for several Latin American countries.“It is critical that we address the mental health needs of Hispanic and Latino Americans,” said APA President-elect Pedro Ruiz, M.D., in an October press release. “Creating resources and materials in Spanish is an important step in helping to support the mental health of this segment of the population.”The press release pointed out that nearly 40 million people in the United States are of Hispanic or Latino origin.The initiative is the newest component of APA's “Healthy Minds, Health Lives” public-information campaign, which was launched in May (Psychiatric News, May 6).The materials can be downloaded for free through HealthyMinds.org, an APA Web site designed to provide the public with information on a wide range of mental health topics. Among features on this Web site are the following:Q & A with Ana Campo, M.D., who is chair of APA's Committee of Hispanic Psychiatrists. This section provides statistics about mental health in Hispanic/Latino populations and information about how to locate Spanish-speaking psychiatrists, for example.Access to APA's “Let's Talk Facts” series of brochures, which have been translated into Spanish. The brochures are designed for the public and contain information on depressive disorders, anxiety disorders, common mental disorders affecting children and adolescents, suicide, how to choose a psychiatrist, and other topics.A link to another APA Web site, ParentsMedGuide.org, which offers a Spanish-language translation of scientific information and practical advice for parents about depression in children and adolescents, including a discussion of medication-related issues.APA is not alone in its mission to raise awareness of mental health problems among Spanish-speaking individuals.The National Institute of Mental Health (NIMH) has translated materials from its “Real Men Real Depression” campaign into Spanish to help Spanish-speaking men understand more about depression and encourage them to seek treatment.According to an October NIMH press release, 54 percent of Latino men who have ever experienced at least one episode of major depression do not recognize that they have a mental health problem.The press release states that “Latinos also report reluctance to get treatment for depression” because many fear that doing so will put their jobs at risk.The new materials include booklets, brochures, and fact sheets from the“ Real Men Real Depression” campaign that have been translated into Spanish and address the symptoms, treatment options, and challenges faced by men with depression.APA's Hispanic Mental Health Initiative materials are posted at<www.healthyminds.org/hispanicmh.cfm> and Spanish-language materials from the NIMH “Real Men Real Depression” campaign are posted at<www.menanddepression.nimh.nih.gov/> under the “publications” section. ▪ ISSUES NewArchived

LettersJuly 2023Mental Health and Health-Related Quality of Life After Firearm Injury: A Preliminary Descriptive StudyFREESydney C. Timmer-Murillo, PhD, Sarah J.H. Melin, MPH, Carissa W. Tomas, PhD, Timothy J. Geier, PhD, Amber Brandolino, MS, Andrew T. Schramm, PhD, Christine L. Larson, PhD, Terri A. deRoon-Cassini, PhDSydney C. Timmer-Murillo, PhDDivision of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, Sarah J.H. Melin, MPHMedical College of Wisconsin, Milwaukee, Wisconsin, Carissa W. Tomas, PhDDivision of Epidemiology & Social Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, Timothy J. Geier, PhDDivision of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, Amber Brandolino, MSDivision of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, and Division of Data Surveillance & Informatics, Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, Andrew T. Schramm, PhDDivision of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, Christine L. Larson, PhDDepartment of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, Terri A. deRoon-Cassini, PhDDivision of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, and Division of Data Surveillance & Informatics, Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, WisconsinAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-0309 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Firearm injury is a public health crisis in the United States (1). Organizations have called for the consideration of long-term consequences of firearm violence, particularly for those directly impacted. Interpersonal firearm violence survivors report significantly worse physical health and functioning compared with the general population and other mechanisms of traumatic injury (1). Furthermore, firearm violence impacts the mental health of survivors and communities. Yet, there is limited work examining self-reported mental and physical health consequences of firearm violence for survivors acutely after injury, thwarting health care systems' ability to comprehensively intervene.Objective: To describe the mental health symptoms and health-related quality of life of firearm injury survivors 6 months after injury.Methods: A convenience sample of 87 adults was recruited from the trauma service of a level 1 trauma center in a midwestern, mid-sized city. Data were pooled from 2 studies occurring at the same center between the years of 2014 to 2016 and 2017 to 2021; both studies examined psychological and biological outcomes of traumatic injury (2). Participants were recruited in the emergency department or during hospitalization. Inclusion criteria were: 1) being 18 years of age or older, 2) having a Glasgow Coma Scale score of at least 13 on arrival, 3) having an unintentional suicidal self-injury, and 4) communicating in English. Exclusion criteria were: 1) experiencing loss of consciousness greater than 30 minutes, 2) experiencing posttraumatic amnesia for more than 24 hours, or 3) being in police custody. Although both studies recruited participants with all mechanisms of injury, the current investigation presents data on patients with interpersonal firearm-related injuries. Baseline sessions occurred up to 1 month postinjury and follow-up approximately 6 months after injury. After consent, participants completed measures on posttraumatic stress disorder (PTSD; PTSD Symptom Checklist for DSM-5); depression, anxiety, and stress (Depression, Anxiety, and Stress Scale [DASS-21]); and physical health-related quality of life (Short Form 12). Studies were approved by the Medical College of Wisconsin institutional review board and were funded by the National Institute of Mental Health. The funding organization was not involved in study design, data collection, or analyses.Findings: The Table provides demographic characteristics and outcome variables at baseline and 6 months. At baseline, patients exhibited symptoms of PTSD with a mean score of 27.15 (SD, 19.19), but symptoms were more severe at 6 months at a mean score of 38.66 (SD, 19.91). The PTSD mean score was above the recommended diagnostic cutoff of 34 for PTSD after interpersonal trauma and was higher than previous injury samples (3). Using interpretation guidelines from DASS-21, anxiety was "mild" at baseline with a mean score of 9.28 (SD, 9.23) and "moderate" at 6 months with a mean score of 11.20 (SD, 11.17). Depressive symptoms were in the "normal" range at baseline with a mean score of 7.25 (SD, 8.91), and higher at 6 months, nearing the cutoff to mild range at a mean score of 9.56 (SD, 10.87). Patients reported normal stress levels at a mean score of 9.52 (SD, 9.31) at baseline. Although reported stress was higher at 6 months with a mean score of 12.93 (SD, 11.29), it was still within the normal range. Patients' health-related quality of life was poor at baseline at a mean score of 30.48 (SD, 13.94), remained poor at 6 months with a mean score of 30.45 (SD, 19.22), and was well below scores reported in previous studies of both injury populations and the general population (4). The Figure shows changes in outcome measures from baseline to 6 months.Table. Sample Demographics, and Mental Health and Health-Related Quality-of-Life Descriptive StatisticsCharacteristicDescriptive StatisticRangeSex, n (%) Female77 (88.5)– Male10 (11.5)–Race, n (%) Asian1 (1.1)– Black/African American69 (79.3)– Hispanic/Latinx11 (12.6)– White/European American6 (6.9)–Psychiatric history,* n (%) Yes36 (41.4)– No50 (57.5)–Mean age (SD), y32.96 (10.06)18–57Mean Injury Severity Score (SD)13.12 (8.49)1–43Mean PCL-5–PTSD score† (SD) Baseline (n = 87)27.15 (19.19)1–72 6 mo (n = 41)38.66 (19.91)2–73Mean DASS-21–Anxiety score† (SD) Baseline (n = 87)9.29 (9.23)0–42 6 mo (n = 41)11.20 (11.17)0–42Mean DASS-21–Depression score† (SD) Baseline (n = 87)7.25 (8.91)0–42 6 mo (n = 41)9.56 (10.87)0–42Mean DASS-21–Stress score† (SD) Baseline (n = 87)9.52 (9.31)0–38 6 mo (n = 41)12.93 (11.29)0–42Mean SF-12 Physical Health score‡ (SD) Baseline (n = 87)30.48 (13.94)5.17–55.48 6 mo (n = 41)30.45 (19.22)0–60.73DASS-21 = Depression, Anxiety, Stress Scale; PCL-5 = PTSD Checklist for DSM-5, measure of PTSD symptom severity; PTSD = posttraumatic stress disorder; SF-12 = Short Form 12, for physical health.* One participant declined to answer.† Higher scores are indicative of worse symptoms for PTSD, Depression, Anxiety, and Stress.‡ Lower scores are indicative of poorer health for Physical Health. Download table Table. Sample Demographics, and Mental Health and Health-Related Quality-of-Life Descriptive StatisticsFigure. Mental and physical health outcome variables across time.Error bars depict SE. DASS-21 = Depression, Anxiety, and Stress Scale; PCL-5 = PTSD Checklist for DSM-5, measure of PTSD symptom severity; PTSD = posttraumatic stress disorder; SF-12 = Short Form 12, for physical health.* Lower SF-12 scores correspond to poorer health. General population average from Haider et al (4). Download figure Download PowerPoint Discussion: The need to understand the physical and mental health consequences of firearm injury in the United States is vital. In this preliminary descriptive study, firearm injury survivors reported poor PTSD acutely after the injury that persisted at 6 months. Furthermore, these patients endorse poor physical health–related quality of life across time, with values worse than previously studied injury samples (4). Medical advancements have increased the survivability of firearm injury, though survivors still carry the burden of injury as the mental and physical health outcomes seem poorer relative to the general population and those who have sustained other traumatic injuries (1, 4). These findings must be considered within the context of limitations including the small convenience sample, relatively short follow-up, and lack of data on preinjury mental health comorbidity. However, this preliminary study highlights the needs to better understand and manage the mental health consequences of firearm injury. Early screening and comprehensive care may improve outcomes in this at-risk population.

Student noise can affect teachers’ stress experience and work performance. Two experimental studies were conducted to examine these effects in more detail. Based on Lazarus’ transactional stress model and the maximal adaptability theory, we assumed an increase in stress experience due to noise and stimulating effects of noise up to a point of maximal adaption before performance drops. The first experiment comprised 74 and the second experiment included 104 student teachers from a German university that were randomly assigned to one of three noise conditions. Participants were asked to complete a concentration test and correct a dictation. Results from analyses of variance were in support of our hypotheses. In both experiments, noise exposure increased stress experience. The first experiment showed positive effects and the second experiment negative effects of noise on participants’ error correction. The results are discussed with respect to school noise affecting teachers’ mental health and work performance.

BackgroundCoronavirus disease 2019 (COVID-19) has become a global pandemic with serious consequences that have led to the implementation of unprecedented social isolation measures. At the early stages of the pandemic, Ecuador was one of the most affected countries in Latin America. The objective of this study was to assess the levels of depression, anxiety and stress in the Ecuadorian general population during the social isolation period due to COVID-19.MethodsA web-based survey consisting of 31 short-answer and multiple-choice questions was administered to the general population from April 22–May 3, 2020. Mental health status was assessed through the Depression, Anxiety and Stress Scale-21 Items (DASS-21) questionnaire. Ordinal logistic analyses were used to identify potential risk factors associated with the severity of mental health issues.ResultsA total of 626 individuals were included. Most of them were females (60.5%), and their mean age was 29.6 ± 11.7 years. Approximately 17.7% of the respondents had moderate to very severe levels of depression, 30.7% had similar levels of anxiety, and 14.2% experienced stress. Female sex, younger age, student status, and having a relative diagnosed with COVID-19 were associated with significantly higher levels of depression, anxiety and stress. Ordinal regression models showed that being a student was a risk factor for having more severe levels of depression (OR = 3.67; 95% CI = 2.56–5.26, p: 0.0001), anxiety (OR= 1.86; 95% CI= 1.35–2.55, p: 0.0001), and stress (OR = 2.17; 95% CI= 1.47–3.19, p: 0.0001). Having a relative with COVID-19 was also found to be a risk factor only for depression (OR= 1.70; 95% CI= 1.03–2.80, p: 0.036) and anxiety (OR = 2.17; 95% CI= 1.35–3.47, p: 0.001). Additionally, male sex, older age, and having more children were found to be protective factors for the three conditions.ConclusionsOur findings suggest that social isolation due to the COVID-19 outbreak has impacted the mental health of the general population in Ecuador. We identified potential risk and protective factors that could serve as a foundation from which to develop psychological strategies to safeguard the mental health of our population during the current pandemic.

Special Report: Women’s Reproductive Mental Health—A Clinical Framework

This paper aims to develop a conceptual framework to assist in understanding how the immigrant family is impacted by recent changes to immigration policy in Canada. We contend that neoliberalism, broadly defined, is a helpful lens through which to comprehend some of the specific policies as well as discursive outcomes which have real effects on immigrant families. Based on our findings from an in-depth literature review, our goal is to identify and summarize the recent changes to the Canadian policy environment and to develop a critical conceptual framework through which to understand policy change in relation to families and immigrants. Key Words: families, neoliberalism, policy change, social policy, multiculturalism, gender, race, neoconservatism Acknowledgements The research for this paper was supported by a Partnership Development Grant titled “Integration Trajectories of Immigrant Families” by the Social Sciences and Humanities Research Council of Canada.

The central place of psychiatry in health care worldwide.

Setting mental health priorities helps researchers, policy makers, and service funders improve mental health services. In the context of a national mental health implementation programme in England, this study aims to identify implementable evidence-based interventions in key priority areas to improve mental health service delivery. A mixed-methods research design was used for a three step prioritisation approach involving systematic scoping reviews (additional manuscript under development), expert consultations and data triangulation. Groups with diverse expertise, including experts by experience, worked together to improve decision-making quality by promoting more inclusive and comprehensive discussions. A multi-criteria decision analysis (MCDA) model was used to combine participants' varied opinions, data and judgments about the data's relevance to the issues at hand during a decision conferencing workshop where the priorities were finalised. The study identified mental health interventions in three mental health priority areas: mental health inequalities, child and adolescent mental health, comorbidities with a focus on integration of mental and physical health services and mental health and substance misuse problems. Key interventions in all the priority areas are outlined. The programme is putting some of these evidence-based interventions into action nationwide in each of these three priority mental health priority areas. We report an inclusive attempt to ensure that the list of mental health service priorities agrees with perceived needs on the ground and focuses on evidence-based interventions. Other fields of healthcare may also benefit from this methodological approach if they need to make rapid health-prioritisation decisions.