Problem Gambling Among Urban and Rural Gamblers in Limpopo Province,South Africa: Associations with Hazardous and Harmful Alcohol Use and Psychological Distress

Little is known about the mental health correlates of problem gambling in low- and-middle-income countries such as South Africa and whether these correlates vary by urbanicity. To address this gap, we examined mental health factors associated with problem gambling among gamblers in Limpopo Province, South Africa disaggregated by rural, peri-urban and urban location. A survey of gambling behaviour and mental health was conducted among 900 gamblers. Overall, 28.3 % were at high risk and 38.1 % were at moderate risk for problem gambling. For the entire sample, hazardous/harmful alcohol use was associated with almost twofold increased chance of being at moderate risk (AOR 1.83; 95 % CI 1.08, 3.11) and almost sevenfold greater odds (AOR 6.93; 95 % CI 4.03–11.93) of being at high risk for problem gambling. Psychological distress was associated with being at high risk for problem gambling only (AOR 1.18; 95 % CI 1.14–1.22). After stratifying by urbanicity, hazardous/harmful alcohol use and psychological distress remained associated with high risk gambling across all locations. We found little knowledge of a free gambling helpline and other gambling services—particularly in less urbanised environments [χ² (2), 900 = 40.4; p < 0.001]. These findings highlight the need to increase awareness of free helpline services among gamblers and to ensure gambling services include screening and treatment for common mental disorders.     

Development,Implementation, and Outcomes of Post-stroke Mood Assessment Pathways: Implications for Social Workers

Depression and anxiety are prevalent in the stroke population and can have a significant impact on the patient and their family’s long-term outcomes, however the screening for these conditions does not meet best practice recommendations. To address this deficit, this study developed “Post-Stroke Mood Assessment Pathways” and embedded them into practice by utilising the PARiHS framework (for the implementation of evidence-based practice), in conjunction with staff training. The study examined the rates of mood screening, clinical interviews, and completion of interventions for stroke patients through a retrospective chart audit (n?=?213) one year prior to, and one year post-implementation (n?=?238) of the pathways. The data show statistically significant increased documentation around mood screening and clinical interview 95% CI [4.86, 19.88], p?<?.0012 and specifically, an increase in the number of patients who had a clinical interview following the introduction of the pathways 95% CI [8.05, 19.69], p?<?.0001.     

Cigarette,alcohol, and marijuana use among adolescents in foster family homes

Data from a cross-sectional study conducted in a random sample of children who were placed in foster family homes were used to examine the prevalence and associated factors of substance use (i.e., cigarette, alcohol, and marijuana), and to explore if adolescents in foster family homes had different rates of substance use than those in the general population matched on age, gender and race/ethnicity. Logistic regression models were used to determine factors associated with substance use and McNemar tests were used to compare prevalence rates of substance use. Substance use was common among adolescents in foster family homes. A higher number of placement settings were significantly associated with current cigarette use (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.09–1.60), and being placed in special study homes (i.e., fictive kin) was significantly associated with current marijuana use (OR, 6.43; 95% CI, 1.40–29.52). Compared to adolescents in the general population, those in foster family homes had lower rates of current alcohol (9.1% vs. 38.3%, p < 0.0001) and marijuana (13.6% vs. 29.7%, p = 0.005) use. No significant difference was observed for current cigarette use (18.2% vs. 11.5%, p = 0.08). More research is needed to confirm the lower rate of current substance use in foster family homes than those matched in the general population, and to explore why adolescents in special study homes were more vulnerable to marijuana use.     

Cumulative victimization, psychological distress, and high-risk behavior among substance-involved women

This research addressed two questions: (a) What is the relationship between different patterns of cumulative victimization and psychological distress? And (b) How does the pattern of cumulative victimization and psychological distress influence women's engagement in substance- and sex-related risk behavior? Data were analyzed from interviews with 149 sexually active, crack-using women who completed a follow-up interview after participating in the Kentucky National Institute on Drug Abuse (NIDA) AIDS Cooperative Agreement. Findings from the multivariate analyses indicated that victimization accounted for 5% and 39% of the variance in psychological distress and high-risk behavior, respectively; cumulative victimization and psychological distress accounted for 6% to 11% of the variance in the high-risk behaviors. Results highlight the affects of childhood and adult victimization on psychological distress and the associations between different types of psychological distress and risk behavior.     

Acculturative Stress and Mental Health Among Korean Adolescents in the United States

This study investigated Korean-American adolescents' stress related to their acculturation experiences and mental health. A total of 260 Korean-American adolescents from immigrant families (ages 12–18 years) participated in the study. The U.S. born group had a higher level of acculturative stress than the Korea-born group (t = 2.222; df = 258; p < .05). Males reported a higher level of self-esteem than females (t = ?2.112; df = 257; p < .05). Acculturative stress was positively correlated with depression (r = .299; p < .01) and negatively related to self-esteem (r = ?.292; p < .01). Self-esteem was negatively related to depression (r = ?.536; p < .01).     

Parent Psychological Distress: A Moderator of Behavioral Health Intervention Outcomes among Justice‐Involved Adolescents

We examined whether pre‐existing parent psychological distress moderated juvenile offenders’ substance use, sexual risk, and mental health outcomes in a randomized trial. Forty‐seven parent–adolescent dyads received either Family‐based Affect Management Intervention (FAMI) for adolescent substance use and HIV prevention or adolescent‐only Health Promotion Intervention (HPI). Parents’ self‐reported distress at baseline significantly moderated adolescents’ self‐reported marijuana use and alcohol use but not other outcomes at 3 months postintervention, producing crossover interactions. FAMI outperformed HPI when parents reported high‐level distress, whereas HPI outperformed FAMI when parents reported low‐level distress. This finding that the relative efficacy of interventions depends on the severity of parent psychological distress could inform efforts to match substance‐using, justice‐involved adolescents with the intervention most likely to benefit them.     

Adolescent drug use, psychological distress, and physical symptoms

The longitudinal interrelationships among general drug use, psychological distress, and physical symptoms were investigated in a three wave panel study of a community sample of adolescents interviewed when they were 12, 15, and 18 years of age. Results did not provide any support for the hypothesis that adolescents use drugs in general to cope with pre-existing psychological distress and physical symptoms. In contrast, the results supported the hypothesis that general drug use contributes to physical and psychological impairments over time. However, such drug-induced psychological distress and physical symptoms only occurred in later adolescence (from ages 15 to 18), and no evidence of impairments due to general drug use or specific alcohol use was found in early adolescence (from ages 12 to 15). Psychological distress and physical symptoms influenced each other over time, and physical symptoms partially mediated longitudinal changes in psychological distress. However, general drug use did not mediate any longitudinal changes in psychological distress and physical symptoms.     

The psychological measurement of childhood sexual development in Western societies: methodological challenges

Children can display sexual behavior or have sexual experiences. Different psychological research methods are available for studying these kinds of behaviors and feelings, such as interviewing or observing children (direct methods), asking adolescents or adults to retrospectively report their childhood memories or using intermediaries to observe children (indirect methods). Each of these methods has its own advantages and limitations. Based on a review of the literature, this work answers three questions: (a) What research methods are generally used to study childhood sexual development? (b) What insight do these methods give into the sexual behaviors or feelings of children? and (c) What are the advantages and limitations of each of these research methods in this research domain? Almost all studies on childhood sexual behavior and feelings use either observational or retrospective methods. In both types of studies, only behavior that is considered to be sexual from an adult perspective is reported. To gain insight into the child's perspective, one has to rely on methods other than observations or retrospective research, such as interviews with children that match their developmental limitations and competencies.     

Analysis of cardiovascular risk factors associated with serum testosterone levels according to the US 2011–2012 National Health and Nutrition Examination Survey

Objective: To investigate associations between cardiovascular disease risk factors, including fasting glucose, cholesterol, high density lipoprotein cholesterol (HDL-c), LDL-c, blood pressure, body mass index (BMI), C-peptide, creatinine kinase, smoking, alcohol use, physical activity, C-reactive protein as well as homocysteine levels and cardiovascular events.

Methods: Data from 1545 men aged ≥40?years, with testosterone deficiency (TD) (<300?ng/dL) and non-TD (≥300?ng/dL) which were extracted from the National Health and Nutrition Examination Survey database 2011–2012 and analyzed.

Results: Multivariate logistic regression analysis showed positive associations between TD and BMI (≥35 vs.?p?=?.016), HDL-c (<0.91 vs. ≥0.91: OR?=?1.60, 95% CI: 1.14–2.24, p?=?.006) and diabetes (diabetes vs. non-diabetes: OR?=?1.48, 95% CI: 1.14–1.92, p?=?.004) as well as negative associations between TD and metabolic equivalent scores (≥12 vs. <12: OR?=?0.69, 95% CI: 0.52–0.91, p?=?.009) and smoking (Ever vs. never: OR?=?0.69, 95% CI: 0.51–0.94, p?=?.018). Furthermore, total serum testosterone levels were lower in patients with heart failure (p?=?.04) and angina/angina pectoris (p?=?.001) compared with subjects without these cardiac problems.

Conclusion: Low serum testosterone was associated with multiple risk factors for CHD.     

Associations between acoustic features of maternal speech and infants’ emotion regulation following a social stressor

Caregiver voices may provide cues to mobilize or calm infants. This study examined whether maternal prosody predicted changes in infants’ biobehavioral state after the still face, a stressor in which the mother withdraws and reinstates social engagement. Ninety-four dyads participated in the study (infant age 4–8 months). Infants’ heart rate and respiratory sinus arrhythmia (measuring cardiac vagal tone) were derived from an electrocardiogram (ECG). Infants’ behavioral distress was measured by negative vocalizations, facial expressions, and gaze aversion. Mothers’ vocalizations were measured via a composite of spectral analysis and spectro-temporal modulation using a two-dimensional fast Fourier transformation of the audio spectrogram. High values on the maternal prosody composite were associated with decreases in infants’ heart rate (β = ?.26, 95% CI: [?0.46, ?0.05]) and behavioral distress (β = ?.23, 95% CI: [?0.42, ?0.03]), and increases in cardiac vagal tone in infants whose vagal tone was low during the stressor (1 SD below mean β = .39, 95% CI: [0.06, 0.73]). High infant heart rate predicted increases in the maternal prosody composite (β = .18, 95% CI: [0.03, 0.33]). These results suggest specific vocal acoustic features of speech that are relevant for regulating infants’ biobehavioral state and demonstrate mother–infant bi-directional dynamics.     

Prevalence and patterns of tobacco,alcohol, and drug use among Iranian adolescents: A meta-analysis of 58 studies

Adolescence is the critical age when adopting high-risk and health-threatening behaviors including smoking, drug and alcohol use is at its peak. Accordingly, this meta-analysis aimed to provide comprehensive nationwide estimates of tobacco, alcohol, and drug use among Iranian adolescents; and to compare their habits with other societies.Electronic databases, including PubMed, Medline, Embase, Google scholar and National Persian databases of SID, Magiran, and IranMedex were utilized in identifying relevant articles. The included studies were those having publications of quantitative estimates and standard errors of the prevalence of cigarette and drug use among 14–19-year-old high school students in Iran from 2000 to 2014. Random-effects meta-analyses were done including a total of 80,588 high school students.The most common drugs among adolescents in Iran were hallucinogens [25.3% (95% CI: 23.9–26.8)], sleeping pills and tranquilizers [25% (95% CI: 24–26.1)], hookah [23.1% (95% CI: 22.2–23.9)], opiates [22% (95% CI: 21.3–22.7)] and central nervous system (CNS) stimulants [20.1% (95% CI: 19.1–21.1)]. Furthermore, overall estimates for cigarette smoking, alcohol and chewing tobacco/Pan/Nas in the participants were 16.8% (95% CI: 16.4–17.2), 14.7% (95% CI: 14.2–15.3) and 10.0% (95% CI: 8.7–11.4), respectively. However, there was some heterogeneity in the pattern of drug use across the country (P < 0.01). Additionally, the risk of smoking, drinking and drug use by boys was considerably greater than girls. Moreover, data showed a varying trend of drug use over three studied periods of time.In conclusion, a diverse pattern and trend of tobacco smoking, alcohol drinking and drug use among adolescents in Iran was verified. Therefore, preventive and control measures (i.e. education) provided in schools should be compatible with age groups, with emphasis being laid on pattern of use in different parts of the country.     

Consequences of Casual Sex Relationships and Experiences on Adolescents’ Psychological Well-Being: A Prospective Study

Casual sexual relationships and experiences (CSREs) are still considered to be detrimental to the psychological well-being of youth even though findings remain inconclusive. Most studies have focused on emerging adulthood. Using a prospective design based on a representative sample of high school students in the province of Québec, we measured sexually active adolescents’ (N = 2,304) psychological well-being six months after engaging in these relationships while controlling for prior well-being. We analyzed two forms of CSREs, friends with benefits (FWB) and one-night stand (ONS) relationships, as well as levels of sexual intimacy. The results show that CSREs had a small impact (small effect sizes) on subsequent psychological well-being, especially among girls; FWB relationships involving penetrative contact increased girls’ psychological distress and both their alcohol and drug consumption. ONSs including sexual touching increased girls’ psychological distress and their drug use. None of the CSREs influenced boys’ psychological well-being. The findings underscored the importance of using caution when arguing that CSREs are detrimental or harmless to the psychological well-being of adolescents. The results also highlight the importance of taking into account gender and forms of CSREs in prevention and health interventions.     

Testosterone is not associated with mortality in older African-American males

Introduction.?Although testosterone and its association with disease progression and mortality is a widely studied topic, no studies have evaluated mortality risks related to testosterone levels in an older African-American population. The mechanisms for known racial differences in mortality risk for certain cancers and cardiovascular risk factors are largely unknown. Elucidating a mortality risk associated with testosterone levels may give insight into the elevated risk for certain diseases in African-Americans.

Methods and results.?Study data were derived from a cohort 622 African-Americans (age 80.05?±?6.4, range 68–102) from Saint Louis, Missouri that includes 190 males (age 79.38?±?6.2, range 70–102). The eligible sample for this report includes 56 of the 190 males (age 78.89?±?6.9, range 70–102) who donated blood at baseline in 1992–1994 and subsequently tested for total testosterone and bioavailable testosterone. Covariates for adjusted analyses were lower body functional limitations, physician visits and comorbidities, also collected at baseline. Males' mean bioavailable testosterone levels (ng/dl) were 33.33?±?24.4 (n above 70?ng/dl?=?5) and mean total testosterone levels (ng/dl) were 246.63?±?118.7 (n above 300?ng/dl?=?20). Vital status was determined through 2002; 41 males (73%) were deceased and 15 were alive. Mortality did not differ among males with testosterone levels?<300 versus 300+ (p?=?0.42) or with bioavailable testosterone levels?<70 versus > 70 (p?=?0.34). Total testosterone levels did not predict mortality when adjusted for age (Adjusted Hazard Ratio [AHR]?=?0.998; 95% confidence interval [CI] 0.995–1.001; p?=?0.28) or adjusted for age and other covariates (AHR?=?0.099; 95% CI 0.996, 1.002; p?=?0.35). Bioavailable testosterone levels did not predict mortality when adjusted for age (AHR?=?0.992; 95% CI .977–1.007; p?=?0.30) or when adjusted for age and other covariates (AHR 0.991; 95% CI .976–1.006; p?=?0.261).

Conclusion.?In older African-American males, total and bioavailable testosterone levels, with and without adjustment for covariates, are not independently associated with mortality risk.     

Emergency department use for injuries by adolescents in foster care

Youth in foster care are overrepresented with respect to their utilization of emergency department (ED) services. This study examines the ED utilization patterns of adolescents in foster care and evaluates the characteristics of injury related versus non-injury related visits. We found that adolescents in foster care have high rates of ED use (1.84 visits per year (95% CI 1.59, 2.12)), with 31.2% of ED visits being injury-related. Male gender was found to be the only independent predictor of having an injury related vs. non-injury related ED visit (odds ratio 2.22 (95% CI 1.27–3.87)). Regarding the mechanisms of injury, adolescent youth in group homes were significantly more likely to present with injuries inflicted by themselves or by others in their residence (p < 0.05 for both) but less likely to present with accidental injuries or injuries sustained during recreation (p < 0.05 for both). Resources and interventions targeted at both youth and group home staff related to behavioral health assessment, post-traumatic coping skills and conflict management may have beneficial effects.     

Effects of beverage-specific alcohol consumption on drinking behaviors among urban youth

Alcoholic beverage consumption among high school students has shifted from beer to liquor. The current longitudinal study examined the effects of beverage-specific alcohol use on drinking behaviors among urban youth. Data included 731 adolescents who participated in Project Northland Chicago and reported consuming alcohol in 7th grade. Logistic regression tested the effects of beverage-specific use on consequences (e.g., alcohol use in the past month, week, heavy drinking, and ever drunkenness). Compared to wine users, adolescents who reported drinking hard liquor during their last drinking occasion had increased odds of alcohol use during the past month (OR = 1.44; 95% CI = 1.01-2.05), past week (OR = 3.37; 95% CI = 1.39-8.18), and ever drunkenness (OR = 1.56; 95% CI = 1.07-2.29). Use of hard liquor was associated with increased risk of alcohol-related consequences. Early selection of certain alcoholic beverages (e.g., hard liquor) may result in negative health outcomes and problematic alcohol use over time.     

Support for Resilience Theory with Female Adolescents Who Are Violent: A MIMIC Model

Resilience theory has been shown to explain aggression and violence in adolescents in general. No studies were found that supported this theory specifically with female adolescents. A multiple indicators multiple causes (MIMIC) model was developed from the review of the literature. Structural equation modeling was then used to quantitatively test this theoretical MIMIC model. Results indicate that the direct effect of the demographic contingencies are significantly related to violent behavior: race (β = ?.53, t = 0.04, p < .001), community supports (β = ?0.55, t = ?0.04, p < .001), and subsidized income supports (β = 0.54, t = 0.04, p < .001). These results suggest demographic contingencies play an important role in predicting violent behavior in female adolescents.     

Psychological and Physical Health of Nonoffending Parents After Disclosure of Sexual Abuse of Their Child

Disclosure of child sexual abuse can be traumatic for nonoffending parents. Research has shown its impact on mothers’ mental health, which includes heightened psychological distress, depression, and post-traumatic stress disorder. Very little is known, however, about its impact on their physical health or on fathers’ health. The self-perceived mental and physical health of nonoffending parents after child sexual abuse disclosure was compared to determine gender-related differences in this regard. Interviews were conducted with 109 mothers and 43 fathers of 6- to 13-year-old sexually abused children. Bivariate analyses revealed that a fair proportion of parents reported psychological and physical problems after disclosure. However, proportionally more mothers than fathers reported psychological distress, depression, and use of professional services. Fathers were more likely to resort to health services instead of social services and to use medication for depression. Study findings provide leads for health and social service providers for the development of intervention protocols and referral procedures sensitive to gender issues, and they shed new light on specific needs of nonoffending parents.     

Secondary Traumatization Among Adult Children of PTSD Veterans: The Role of Mother–Child Relationships

The study examined the level of secondary traumatization among adult children of Israeli war veterans with post-traumatic stress disorder (PTSD) as manifested in emotional distress, stress resulting from terrorist attacks, and capacity for intimacy. In addition, the role of the mother–child relationship as a moderator of these manifestations of distress was examined. Forty-six adult children of fathers with chronic PTSD, and 46 adult children of fathers who had participated in a war but did not have PTSD participated. Findings revealed that adult children of PTSD veterans showed higher levels of psychological distress, greater terror-related stress, and a lower capacity for intimacy than children of non-PTSD veterans. Positive relationship with the mother was found to moderate the level of participants' capacity for intimacy and their levels of psychiatric symptoms.