Gambling problems seldom come alone: prevalence and temporal relationships of mental health problems in casino excluders

ABSTRACT

To estimate the effectiveness of gambling exclusion programmes, previous research focused on changes in gambling behaviour post-exclusion. Although other mental health problems, especially co-morbid mental disorders, may be crucial for relapse and recovery of gambling-related problems, these factors have rarely been studied in excluders. Therefore, this study aimed to assess a comprehensive mental health status of excluders using well-validated diagnostic instruments. Fifty-eight casino excluders participated in face-to-face diagnostic interviews and completed several validated questionnaires (e.g. Stinchfield Questionnaire, Brief Symptom Inventory). Retrospective temporal sequences of diagnosed mental disorders, help-seeking behaviour and exclusion were examined. The majority of excluders reported impairments in mental health aspects. About three-quarters met criteria of lifetime gambling disorder, more than half in the last 12 months whereby screening and diagnostic measures correlated moderately. Other mental disorders were frequent, especially affective and substance-related disorders and typically preceded the onset of gambling disorder. Six years passed between self-awareness of gambling problems and help-seeking. Two more years passed until exclusion. Frequent mental health problems suggest the need for individually tailored support beyond exclusion programmes (e.g. psychotherapy, pharmacotherapy, counselling services). Late help-seeking and exclusion entry claim for improved early detection and intervention concepts that consider underlying mental disorders.     

Mental Health Care for American Indians in Prison

Abstract

Based on an earlier finding that as many Native Americans in upstate New York received mental health care in prison as outside of prison during a 10-month period, this study was designed to investigate if prisons had become an alternative treatment option for Native Americans with a mental illness in New York State. The study was not able to answer this question due to the limited number of cases and to outside constraints. However, it is possible from the results to provide a picture of mental health needs and attitudes among Native American inmates which is surprising and instructive for those who provide psychiatric care to American Indians, either within or outside of prison walls. A noteworthy finding was the importance placed by these inmates on the use of culturally appropriate ceremonies to assist in their rehabilitation. Low rates of serious mental illness among the American Indian sample highlight the need for further study in this area.     

Women's Experience of Co-Occurring Substance Abuse and Mental Health Conditions

ABSTRACT

This study explored the relationship between gender and co-occurring substance abuse and mental health conditions among a sample of 754 consumers of behavioral health services in the southwest U.S. Logistic regression was used to determine factors that would predict women's unique experience of dual diagnosis. Women were almost seven times more likely than men in this sample to have a diagnosis of posttraumatic stress disorder in conjunction with substance abuse. Women were also significantly more likely to experience anxiety and mood disorders and to have been married. Implications of these findings for social work practice are suggested.     

Co-Occurring Disorders Among Female Jail Detainees: Implications for Service Delivery

ABSTRACT

The increase in the numbers of women incarcerated in prisons and jails has given rise to questions about their mental health and substance abuse treatment needs. This study used DSM-IV criteria to describe both lifetime and current diagnoses for substance use disorders, major depressive disorder, posttraumatic stress disorder and generalized anxiety disorder in a sample of 198 female jail detainees. Women were asked about readiness for treatment and AODA and mental health service use. Findings underscore the view that female jail detainees have complicated diagnostic histories and that the jail setting can provide opportunities for assessment and services.     

Self-rated Health in Relation to Rape and Mental Health Disorders in a National Sample of College Women

Abstract

Objective: The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. Participants: A national sample of 2,000 female college students participated in a structured phone interview between January and June 2006. Methods: Interview modules assessed demographics, posttraumatic stress disorder, major depressive episode, substance use, rape experiences, and physical health. Results: Logistic regression analyses showed that poor self-rated health was associated with low income (odds ratio [OR] = 2.70), lifetime posttraumatic stress disorder (OR = 2.47), lifetime major depressive episode (OR = 2.56), past year illicit drug use (OR = 2.48), and multiple rape history (OR = 2.25). Conclusions: These findings highlight the need for university mental health and medical service providers to assess for rape history, and to diagnose and treat related psychiatric problems in order to reduce physical morbidity.     

Eating Disorder Symptoms Among College Students: Prevalence,Persistence, Correlates,and Treatment-Seeking

Abstract

Objective: To examine the prevalence, correlates, persistence, and treatment-seeking related to symptoms of eating disorders (EDs) in a random sample of college students. Participants: A random sample of students at a large university were recruited for an Internet survey in Fall 2005 and a follow-up survey in Fall 2007. Methods: ED symptoms were measured using the SCOFF screen and adjusted for nonresponse using administrative data and a nonresponse survey. Results: 2,822 (56%) students completed the baseline survey. Among undergraduates the prevalence of positive screens was 13.5% for women and 3.6% for men. Among students with positive screens, 20% had received past-year mental health treatment. In the follow-up sample (N = 753), ED symptoms at baseline significantly predicted symptoms 2 years later. Conclusions: Symptoms of EDs were prevalent and persistent among college students in this study. These findings suggest that brief screens can identify a large number of students with untreated EDs.     

The Connections of Mental Health Problems,Violent Life Experiences,and the Social Milieu of the “Stroll” with the HIV Risk Behaviors of Female Street Sex Workers

Abstract

This paper examines the connections of mental health, victimization, and sexual risk behaviors among a sample of 278 street-based female sex workers in Miami. Using targeted sampling strategies, drug-using sex workers were recruited into an HIV prevention research program. Data were collected by trained interviewers, and focused on drug use and sexual risk for HIV, childhood abuse, recent victimization, and mental health. More than half of the participants reported histories of physical (51.1%) or sexual (53.1%) abuse as children, 37.4% were classified with moderate or severe anxiety symptoms, and 52.9% had symptoms of moderate or severe depression. Logistic regression analyses demonstrated significant associations between mental health issues and engagement in recent unprotected vaginal and oral sex. The program development and policy implications of these findings are discussed.     

Diagnostic sequence of cocaine use disorder in relation to other mental health conditions among college students

Abstract

Objective: Cocaine use is increasing. Comorbidities and diagnostic sequencing are needed among college students to inform treatment of cocaine use disorder (CUD). Method: Using electronic medical records from the psychiatric clinic at the student health care center of a large, public university from 2005 to 2015, patients diagnosed with CUD were identified. Their top mental health conditions were identified and assessed to see whether the first diagnosis of these conditions was made (1) before, (2) at the same time as, or (3) after the first diagnosis of CUD. Results: Among the 50 CUD patients, their most common mental health comorbidities were alcohol use disorder, anxiety, depression, and cannabis use disorder. Anxiety and depression were likely to be diagnosed before CUD; alcohol and cannabis use disorders were likely to be diagnosed concurrently with CUD. Conclusion: Diagnostic sequencing can be used to inform screening, workup, and treatment for patients with CUD.     

Disparate Juvenile Court Outcomes for Disabled Delinquent Youth: A Social Work Call to Action

Current service delivery for at-risk youth is through four separate systems: special education; mental health and substance abuse; juvenile justice; and child welfare. Many youth (and their families) are involved with more than one of these systems, making early disability identification and subsequent systems coordination paramount in leading to more successful juvenile court outcomes. This coordination is an important and prioritized public policy concern because a majority of youth (disproportionately minority) within juvenile justice populations has been identified with mental health disorders, special education disabilities, or maltreatment histories. This study of a unique sample of probation-supervised delinquent youths (n = 397) identifies these disabilities and their corresponding court supervision, detention, and incarceration outcomes for a 48-month period in Cuyahoga County, Ohio (greater Cleveland). Within this youth sample over 32% had a special education disability, over 39% had a mental health disorder, over 32% had a substance abuse disorder, and over 56% were victims of maltreatment. Even higher disability rates were found for those youth who were subsequently detained or incarcerated. Many of these youth had multiple disabilities (and subsequently poorer juvenile court outcomes) and were concurrently involved in more than one disability service system. Policy and client services implications are reviewed and discussed.

Depressive Symptoms and Mental Health Treatment in an Ethnoracially Diverse College Student Sample

Abstract

Objectives: To study (a) the prevalence of depressive symptoms and (b) the utilization of mental health treatment in an ethnoracially diverse sample consisting primarily of Asian Americans, European Americans, Native Hawaiians, and Pacific Islanders. Participants: Five hundred eighty-nine college students. Method: A questionnaire packet that included the Center for Epidemiological Studies Depression Scale (CES-D) was administered to students in introductory psychology courses. Results: (a) There were no differences among ethnoracial groups in levels of depressive symptoms as measured by the CES-D; (b) 71% of participants with high levels of depressive symptoms had not received any mental health treatment in the previous 12 months; and (c) European Americans were 3.7 times more likely to have received mental health treatment in the previous 12 months than other students. Conclusion: Outreach efforts designed to improve utilization of mental health treatment services by depressed college students, especially by members of ethnoracial minority groups, should be increased.     

Do religiosity and spirituality really matter for social,mental, and physical health?: A tale of two samples

ABSTRACT

Some prior research has found that religiosity and spirituality can be related to health. However, the relationships are inconsistent, measures of religiosity and spirituality are often problematic and conflated with the health outcomes they are supposed to predict, and very little research on this topic specifies which aspects of health supposedly benefit from religiosity and spirituality. Using two sets of survey data (Sample 1 N = 347; Sample 2 N = 404), we examined whether religiosity and spirituality had direct or indirect effects on physical, mental, and/or social health. We found that spirituality, when conceptualized as belief and experience of the supernatural, had no direct or indirect effect on physical, mental, or social health. Religiosity had a small but significant direct effect on social health in one sample but not the other. We consider our findings in relation to religious privileging in the United States and how proreligious biases can lead to health inequalities.     

Concept of ‘personality disorder’ and its relationship to social work

Abstract

Inherently difficult to define and apply in a valid and reliable way, the concept of ‘personality disorder’ is, nonetheless, a very important psychological construct in the assessment and treatment of clients. This paper discusses the nature and limitations of personality disorder diagnoses. It also refers to data suggesting a paucity of formal training and research on personality disorders, and mental health in general, within Australian social work. The authors call for greater research, analysis and debate by social work educators and the profession on these issues.     

College Women Eating Disorder Diagnostic Profile and DSM-5

Abstract

A consistent diagnostic profile describing college women with eating disorders has been well established in the college health and mental health literature. This diagnostic framework traditionally has been associated with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision¹ Eating Disorders Not Otherwise Specified category. In this article, the authors discuss implications of the recently revised Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition² eating disorder diagnostic categories for the existing college women eating disorder profile.     

Eating Disorders and Body Image of Undergraduate Men

Eating disorders and body dissatisfaction among undergraduate men are less documented and researched than are eating disorders and body dissatisfaction among undergraduate women. Objective and Participants: In this study, the authors examined these issues in undergraduate men to identify similarities and differences between this population and undergraduate women. Methods: In a random sample of undergraduates, the authors categorized respondents by gender and by presence or absence of an eating disorder. The authors compared undergraduate men with an eating disorder with (1) undergraduate women with an eating disorder and (2) undergraduate men without an eating disorder. Results: The patterns of responses suggest that undergraduate men with an eating disorder are preoccupied with body shape and tone but not necessarily with losing weight. Conclusions: The authors discuss implications for future prevention as well as clinical and research efforts based on male symptoms within the diagnostic category of bulimia nervosa and eating disorder, not otherwise specified.     

Suicidal Ideation and Comorbid Disorders in Adolescents and Young Adults Diagnosed with Asperger's Syndrome: A Population at Risk

ABSTRACT

The purpose of this study was to examine the level of suicidal ideation and comorbid disorders (major depressive disorder, generalized anxiety disorder) among adolescents and young adults with diagnosed Asperger's syndrome (AS). A cross-sectional study using a self-administrated mail questionnaire and a Web-based questionnaire were used. Two samples were selected for this study. The first sample used snowball sampling, starting with parents of adolescents and young adults with diagnosed AS who participated in a qualitative study conducted in 2002. The second sample consisted of a volunteer sample of parents who visited Web sites for parents and individuals with diagnosed autism spectrum disorder. The sample included 10 adolescents and young adults with diagnosed AS. Fifty percent of the sample had a clinically significant level of suicidal ideation, 20% met criteria for a diagnosis of major depressive disorder, and 30% met criteria for generalized anxiety disorder.     

Rural and Urban Differences Among Mental Health Consumers in One Midwestern State

Abstract

This study examines differences in rural and urban mental health service utilization and service satisfaction. A cross-sectional survey design was used to gather information from a sample of 311 mental health consumers regarding their use of services relative to accessibility, availability, affordability, and acceptability. Data were collected from respondents individually or in small groups in various locations in one Midwestern state. Study findings showed that rural consumers are aware of fewer services, use fewer services, and are less satisfied with services than are urban consumers. Implications for rural mental health policy, practice, and future research are discussed.     

Residential group care workers' recognition of depression: Assessment of mental health literacy using clinical vignettes

BackgroundResidential group-care workers have a critical role to play in recognizing mental health problems amongst children in their care. However, little is known about the extent to which workers recognize and respond to mental health and behavioral concerns.MethodA sample of 124 residential group care workers completed an online survey in which vignettes of children experiencing either internalized or externalized symptoms of depression and ‘typical’ behavior were presented. In order to explore aspects of mental health literacy, workers were asked to rate each vignette for severity of a specific mental health concern (adolescent depression), portrayed as internalized or externalized behavior. Ratings of worker confidence and concern for the young person were also obtained.ResultsWorkers were able to recognize the existence of depression in these fictional vignettes. Depression in the presence of externalized behavior was rated as both more severe and more concerning than depression accompanied by internalized behaviors. Furthermore, workers had greater confidence in endorsing the presence of a mental health issue when accompanied by externalized behavior compared to an internalized presentation.ConclusionsResidential group-care workers are able to recognize the existence of depression amongst children in their care. Externalized presentation of mental health appears to be more easily recognized by workers and they are also more confident in identifying mental health concern when it is accompanied by externalized, compared with internalized behaviors. The implications for training and support of residential group care workers are discussed.     

Transactional sexual activity among university students: Prevalence and clinical correlates

Abstract

Objectives: This study examined the prevalence and mental health correlates of transactional sexual activity (sex for compensation) in a university sample. Methods: A 156-item anonymous survey was distributed via random email generation to 9,449 university students. Results: The prevalence of transactional sex was 2.1%. Respondents who had sold sex (n?=?30) reported significantly higher rates of risky sexual behavior and mental health problems than those who had not sold sex (n?=?1,405). Conclusions: Transactional sex in our sample of university students was associated with a range of impulsive or compulsive behaviors that may affect students’ health and well-being.     

Cultural Factors in Collegiate Eating Disorder Pathology: When Family Culture Clashes With Individual Culture

Objective: The authors evaluated the validity of familial enmeshment (extreme proximity in family relationships) as a risk factor for eating disorders across cultural value orientations. They tested the hypothesis that although familial enmeshment may be a risk factor for eating disorder pathology for (1) participants of non-Asian descent or (2) culturally independent participants, enmeshment will not be a risk factor for (1) participants of Asian descent or (2) culturally interdependent participants. Participants: 255 undergraduate women participated. Methods: Participants completed questionnaires on cultural value orientations, enmeshment, and eating disorder pathology. Results: As hypothesized, enmeshment was related to eating disorder pathology in non-Asian American and culturally independent participants, but not in Asian American and culturally interdependent participants. Conclusions: Depending on cultural values, enmeshment may or may not be a risk factor for eating disorders. This study highlights the importance of examining risk factors in the appropriate cultural framework when considering college student mental health.