Identifying Mental Disorder from the Faces of Women with Borderline Personality Disorder

Although appearance-based cues can help to diagnose physical illness, visual manifestations of mental disorder may be more elusive. Here, we investigated whether individuals could distinguish women with a serious mental disorder (borderline personality disorder) from demographically- and IQ-matched non-psychiatric controls. Participants rated mentally ill targets as more likely to have a mental disorder from photos more accurately than chance, despite not believing that such judgments were possible. The configuration of facial cues played an important role in these judgments, as interfering with the spatial relationships between facial features reduced participants’ accuracy to chance guessing. Further investigation showed similar results when participants rated the targets for specific mental disorders (borderline personality disorder, major depressive disorder) and rated the mentally ill targets as more depressed, angry, anxious, disgusted, emotionally unstable, distressed, and less happy. Moreover, the depression ratings significantly correlated with the targets’ actual depressive symptoms. Thus, individuals may be able to infer aspects of mental disorder from minimal facial cues.     

Attitudes and beliefs about mental health among African American older adults suffering from depression

Depression among older adults is a major public health concern leading to increased disability and mortality. Less than 3% of older adults utilize professional mental health services for the treatment of depression, less than any other adult age group. And despite similar rates of depression, African Americans are significantly less likely to seek, engage and be retained in professional mental health services than their white counterparts. Cultural differences in the way depression symptoms are manifested, defined, interpreted and labeled may in part explain some of these racial differences in help-seeking behaviors. Focus group methodology was utilized to identify and explore attitudes and beliefs about depression and mental health treatment utilization among 42 older African Americans who had recently suffered a major depressive episode. Thematic analysis of identified six overarching themes: (a) perceptions of depression, (b) the African American experience, (c) seeking treatment as a last resort, (d) myths about treatment, (e) stigma associated with seeking treatment and (f) culturally appropriate coping strategies. We discuss implications for practice, education and research.     

Natural Mentoring Relationships Among Adolescent Mothers: A Study of Resilience

This study focused on natural mentoring relationships between nonparental adults and African American adolescent mothers. Data were collected from 93 adolescent mothers over 5 time points, starting in the adolescent mothers' senior year of high school and ending 5 years after high school. We found that having a natural mentor was related to fewer depressive symptoms and fewer anxiety symptoms over time. Natural mentor presence also modified the relationship between stress and mental health problems over time. Facilitating these natural mentoring relationships between adolescent mothers and nonparental adults may be a useful strategy for promoting healthy development within this population.     

Family Functioning and Mental Health of Transgender and Gender-Nonconforming Youth in the Trans Teen and Family Narratives Project

Transgender and gender-nonconforming (TGN) youth are at increased risk for adverse mental health outcomes, but better family functioning may be protective. This study describes TGN youth’s mental health and associations with family functioning in a community-based sample. Participants were from 33 families (96 family members) and included 33 TGN youth, ages 13 to 17 years; 48 cisgender (non-transgender) caregivers; and 15 cisgender siblings. Participants completed a survey with measures of family functioning (family communication, family satisfaction) and mental health of TGN youth (suicidality, self-harm, depression, anxiety, self-esteem, resilience). TGN youth reported a high risk of mental health concerns: suicidality (15% to 30%), self-harm (49%), clinically significant depressive symptoms (61%); and moderate self-esteem (M = 27.55, SD = 7.15) and resiliency (M = 3.67, SD = 0.53). In adjusted models, better family functioning from the TGN youth’s perspective was associated with better mental health outcomes among TGN youth (β ranged from ?0.40 to ?0.65 for self-harm, depressive symptoms, and anxious symptoms, and 0.58 to 0.70 for self-esteem and resiliency). Findings from this study highlight the importance of considering TGN youth’s perspectives on the family to inform interventions to improve family functioning in families with TGN youth.     

Mode Effects in Self-Reported Mental Health Data

This article analyzes the impact of audio computer-assistedself-interviewing (ACASI) administration on the reporting ofmental health syndromes in a general population survey. Estimatesof four mental health syndromes (major depressive episode, generalizedanxiety disorder, panic attack, and agoraphobia) obtained froman interviewer-administered, paper-and-pencil (I-PAPI) mentalhealth module were compared with those obtained from an ACASIversion of the same module implemented in a separate field test.The mental health questions consisted of four scales from theWorld Health Organization's Composite International DiagnosticInterview Short-Form. Comparisons of ACASI and I-PAPI estimatesfor each mental health syndrome were made overall and withinage, race/ethnicity, gender, educational level, geographic region,and population density subgroups. To assess the likelihood ofreporting a mental health syndrome using ACASI versus I-PAPI,logistic regression models were utilized controlling for possibleconfounding and interaction variables. The results suggest thatadult respondents reported more mental health symptoms wheninterviewed with ACASI than when interviewed with I-PAPI, andthe results support the use of ACASI in general population surveysof mental health.     

Depression, anxiety, and religious life: a search for mediators

We examine several potential mechanisms linking religious involvement to depressive symptoms, major depression, and anxiety. Logistic and OLS regression estimations test five sets of potential psychosocial religion mediators: perceived attitudes toward and motivations for attendance; positive and negative religious coping; religious attitudes, beliefs, and spirituality; congregational support and criticism; and interpersonal and self-forgiveness. Compared to attending services less than once a month or never, attending services once a week but no more is associated with fewer depressive symptoms and anxiety symptoms. Hypothesized mediators, including meaning, interpersonal and self-forgiveness, congregational criticism, social attendance beliefs, and negative coping are independently associated with one or more mental health outcomes.     

Obstacles to research analysis

1. The homeless population is composed of subgroups with varying mental health status and needs. 2. Different research designs and data collection methods require differing psychosocial abilities and skills on the part of the respondent. 3. As a result of the psychosocial abilities required and method of sampling, studies are likely to either underrepresent or overrepresent the severely mentally ill homeless. 4. Caution must be exercised in drawing conclusions from any one study.     

Multiple Co-occurring Behaviours among Gamblers in Treatment: Implications and Assessment

A substantial portion of gamblers in treatment may have co-occurring mental health disorders including substance use disorders, especially alcohol dependency, personality disorders, affective disorders, anxiety disorders and impulse control disorders. Co-occurring mental health disorders affect treatment seeking, the treatment process and its outcome, quality of life and functioning in many mental health disorders. Participants in this study were 78 adults enrolled in state-supported out-patient services for pathological gambling and current Gamblers Anonymous attendees. The majority of participants (76.6%) had co-occurring behaviours; 55.8% had multiple co-occurring behaviours. Participants with multiple co-occurring behaviours were more likely to report that a co-occurring behaviour increased the severity of their gambling symptoms. A dose/response relationship between number of co-occurring behaviours and severity of gambling problems was found. Co-occurring behaviours can interact with gambling behaviour. Brief, validated screening instruments are available for screening and diagnosing co-occurring behaviours among gamblers presenting for treatment.     

Psychological Symptoms of Sexually Victimized Children and Adolescents Compared With Other Maltreatment Subtypes

The differential effects of sexual victimization and other forms of maltreatment on psychological functioning are not well understood. A sample of sexually victimized children and adolescents (N = 70; 6.3–17.9 years) and a group of youth with a history of nonsexual maltreatment (N = 108; 6.7–16.9 years) were compared using measures of mental health and psychosocial functioning. Assessments included standardized clinical interviews on individual maltreatment history and current psychopathology as well as questionnaires on behavioral and emotional symptoms, including posttraumatic stress symptoms. The results from this study suggest that the risk of experiencing any current mental disorders was independent of type of maltreatment. The risk of meeting the criteria for a current diagnosis of major depression, however, is greater among youth with a history of maltreatment that includes sexual victimization. The significant impact of sexual victimization on posttraumatic stress symptoms was found to be nonsignificant after controlling for age and gender effects. The results indicate that the outcomes of child maltreatment depend on type of maltreatment, but age and gender must be taken into account.     

Depression among the homeless

Very little is known about one of the most common mental health problems facing the homeless: high levels of depressive symptomatology. This paper explains variation in the prevalence of depressive symptoms (CES-D) for a random sample of 150 shelter- and street-based homeless persons in the Birmingham metropolitan area. Fifty-nine percent of the sample show the signs of "probable clinical caseness"; yet there is significant variation in the level of symptomatology. A modified version of the social resources model explains 31 percent of the variation in CES-D scores. Although psychological resources play an important role in the distress outcome, as predicted, social supports are found to have limited impact on depression. Life circumstances have significant direct effects on depression. Persons with previous histories of mental illness and with extensive life event histories are more susceptible to distress. Younger persons, the chronically homeless, the street-based homeless, the sick, and the less educated are also more likely to experience depression. This study suggests the importance of understanding homelessness both as a psychological condition and as a complex set of life circumstances and physical deprivations.     

Positive,Negative, and Ambivalent Interactions With Family and Friends: Associations With Well‐being

Although the relationship between social relationships and mental health is well established, debate continues about the relative importance of specific sources (spouses, children, relatives, friends) as well as of positive and negative interactions. The authors examined the associations of positive, negative, and ambivalent interactions with life satisfaction and depressive symptoms for spouses, children, relatives, and friends, using data from the 2008 Health and Retirement Study (N = 6,418). The findings generally showed positive associations between positive interactions and mental health and negative associations between negative or ambivalent interactions and mental health. These associations were most pronounced for relationships with spouses and children. Gender differences were found in life satisfaction but not in depressive symptoms. These results imply that future research on older adults needs to consider both positive and negative relationship features from diverse sources separately and in combination to disentangle their relative effects and their additive or compensatory potential.     

Well-Being and Family Role Strains Among Cuban American and Puerto Rican Mothers of Adults with Mental Retardation

Abstract

This article examines predictors of depressive symptoms and caregiving burden in a sample of Cuban American and Puerto Rican caregivers of an adult child with mental retardation. Using a stress process model of caregiving, the focus of this analysis was on family role strains that result from the caregiving process, which were hypothesized to be particularly strong predictors of maternal well-being in Latino families. Findings indicate that Cuban American mothers of adults with mental retardation had higher socioeconomic status than Puerto Rican mothers, yet there was a substantial amount of within-group heterogeneity in family socio-demographic characteristics, linked closely with immigration patterns for the Cuban American mothers. However, taking into account socio-demographic diversity and ethnicity, findings demonstrate that mothers whose family had more problems had higher levels of burden and depressive symptoms, supporting the hypothesized importance of family functioning to Latina mothers with a non-normative parenting challenge.     

Gender, race-ethnicity, and psychosocial barriers to mental health care: an examination of perceptions and attitudes among adults reporting unmet need

Though researchers have described psychosocial barriers to mental health care-seeking, limited research has examined ways in which gender and race-ethnicity are associated with individuals' perceptions and attitudes. This study investigates correlates of psychosocial barriers to mental health care in a population of adults reporting unmet need for mental health care, focusing on gender and race-ethnicity. Data are from the 2002 National Survey on Drug Use and Health. Multivariate analyses show that non-Latino white male status is positively associated with stigma avoidance and mistrust/fear of the mental health care system. Persons of lower income or educational status are less likely to report negative attitudes towards care. Findings imply a need to reconsider the roles of gender race-ethnicity, and socioeconomic status within investigations of psychosocial barriers to care. Future research should examine the relationships among social status, help-seeking behaviors, and attitudes toward mental health care.     

Korean immigrant older adults residing in Non-Korean ethnic enclaves: Acculturation strategies and psychosocial adaptation

ABSTRACT

Based on Berry’s bi-dimensional model of acculturation, this study examined acculturation strategies among first-generation Korean immigrant older adults residing in areas without a well-established Korean ethnic enclave and how their acculturation strategies are associated with psychosocial adaptation and acculturative stressors. Cluster analysis (N = 108) identified three acculturation strategies such as separated, moderately bicultural, and fully bicultural, indicating that the sample did not exhibit all four acculturation strategies of Berry’s model. The moderately bicultural group of the sample was the most dominant in size, which indicated strong adherence to Korean culture. The fully bicultural group reported less acculturative stress and depressive symptoms than the separated group, which indicated that biculturalism is strongly associated with a better psychosocial adaptation. A factor analysis showed that the separated group perceived stressors such as limited English proficiency and social isolation as more stressful than the other groups. The findings suggest that even though a strong adherence to ethnic culture might be a first-generation Korean immigrant older adults’ dominant acculturation strategy, it may make them more vulnerable to lingual and cultural barriers in a mono-cultural community without Korean ethnic enclaves. Implications for social work practice are explored.     

Urban and Rural Variations in the Characteristics Associated With Elder Mistreatment in a Community-Dwelling Chinese Population

This study compares the urban and rural differences in characteristics associated with elder mistreatment (EM) in a Chinese population. A cross-sectional study of 269 urban and 135 rural participants aged 60 years or greater was performed. Among those with EM, rural participants were more likely to be women, have lower levels of education and income, have lower levels of health status and quality of life, have worse change in recent health, and have lower levels of psychosocial well-being. Both higher levels of depressive symptoms and lower levels of social support were associated with increased risk of EM.     

Mental health differences between young adults with and without same-sex contact: A simultaneous examination of underlying mechanisms

Previous research has documented that sexual minorities are more likely than heterosexual people to experience mental health problems, but little is known about how these disparities emerge. Analysis of data from Miami-Dade County, Florida, shows that young adults reporting same-sex contact have higher levels of depressive symptoms and drug use than those without such contact, but that different processes explain the disparities in the two outcomes. A substantial portion of the gap in depressive symptoms is explained by sexual minorities' higher levels of stress exposure and their lower levels of family support and psychological resources. The gap in drug use is not explained by these processes, but is partially explained by self-exploratory attitudes and permissiveness of drug use in social networks. This study highlights the importance of using multiple outcome measures in research that examines mechanisms underlying mental health disparities across social groups.     

Mental health among college students: do those who need services know about and use them?

OBJECTIVE: The objective of this study was to examine connections between university students' mental health and their knowledge and use of campus mental health services. PARTICIPANTS AND METHODS: In March 2001, a sample of undergraduate students (N = 266) completed a Web-based questionnaire, providing information related to their mental health, knowledge of mental health services, and use of those services. RESULTS: Students who were mentally distressed were more likely to know about and use services; however, some students who reported to be mentally distressed either did not know about services or knew about services but did not use them. Living off campus, identifying as male, and having fewer years in college were related to less knowledge of campus mental health services. In addition, female sex and number of years in college were predictive of higher service use. CONCLUSIONS: With the high prevalence rates and severity of mental health problems, university mental health providers must continue to make strategic efforts to disseminate knowledge about mental health services to all students.     

Calorie Intake and Gambling: Is Fat and Sugar Consumption ‘Impulsive’?

Excessive calorie intake constitutes a global public health concern, due to its associated range of untoward outcomes. Gambling is commonplace and gambling disorder is now considered a behavioral addiction in DSM-5. The relationships between calorie intake, gambling, and other types of putatively addictive and impulsive behaviors have received virtually no research attention. Two-hundred twenty-five young adults who gamble were recruited from two Mid-Western university communities in the United States using media advertisements. Dietary intake over the preceding year was quantified using the Dietary Fat and Free Sugar Short questionnaire (DFS). Clinician rating scales, questionnaires, and cognitive tests germane to impulsivity were completed. Relationships between dietary fat/sugar intake and gambling behaviors, as well as other measures of psychopathology and cognition germane to addiction, were evaluated using correlational analyses controlling for multiple comparisons. Greater dietary fat and sugar intake were associated with lower educational levels and with male gender. Controlling for these variables, higher dietary fat and sugar intake were correlated significantly with worse gambling pathology and anxiety scores. Dietary sugar intake was also significantly associated with higher depressive scores, more alcohol intake, lower self-esteem, and with greater risk of having one or more mental disorders in general. Dietary intake did not correlate significantly with ADHD symptoms, presence of one or more impulse control disorders, Barratt impulsiveness, or cognitive functioning. These data suggest a particularly strong relationship between fat/sugar intake and symptoms of gambling pathology, but not most other forms of impulsivity and behavioral addiction (excepting alcohol intake). Providing education about healthy diet may be especially valuable in gamblers and in community settings where gambling advertisements feature prominently. Future work should explore the mediating mechanisms between calorie intake and gambling symptoms, such as whether this could be driven by environmental factors (e.g. advertising) or common dysfunction of brain reward pathways.     

Simple measures of case mix in mental health services.

The concept of Case Mix in community mental health service program evaluation can be useful in mental health program evaluation if the definition of case mix is expanded beyond Diagnostic Related Groups (DRG), where DRG is solely based upon diagnosis and length of hospitalization stay. A case mix definition based upon two principal characteristics is offered. One characteristic is clinical status defined in terms of diagnostic signs and symptoms, level of functioning, and age. The other characteristic is typical treatment strategy for a given period of time (e.g., 13 weeks). Two cases mixes typical of services designed for the chronically mentally ill are discussed.     

Implications of work pressure and supervisor support for fathers’, mothers’ and adolescents’ relationships and well-being in dual-earner families

The present study investigates the implications of work pressure and supervisor support for individual psychosocial functioning, marital and parent–adolescent relationships. We examined the effects of work pressure and supervisor support separately for mothers and fathers and their adolescent children (M=17.33 years) in 156 white working- and middle-class, dual-earner families. Results revealed when husbands reported high work pressure and low supervisor support, both parents reported higher levels of depressive symptoms. When wives were in the high pressure/low support group, they reported lower levels of marital love, and both spouses reported less marital satisfaction. When either parent was in the high pressure/low support group, both parents reported higher levels of role overload, and families experienced more conflict and less intimacy in their relationships with their children. Their children also reported higher levels of depressive symptoms. Results associated with parent and child depressive symptoms, however, varied by parent and child sex.