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Bala J, Newson JJ, Thiagarajan TC. Hierarchy of demographic and social determinants of mental health: analysis of cross-sectional survey data from the Global Mind Project. BMJ Open 2024; 14:e075095. [PMID: 38490653 PMCID: PMC10946366 DOI: 10.1136/bmjopen-2023-075095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 02/16/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES To understand the extent to which various demographic and social determinants predict mental health status and their relative hierarchy of predictive power in order to prioritise and develop population-based preventative approaches. DESIGN Cross-sectional analysis of survey data. SETTING Internet-based survey from 32 countries across North America, Europe, Latin America, Middle East and North Africa, Sub-Saharan Africa, South Asia and Australia, collected between April 2020 and December 2021. PARTICIPANTS 270 000 adults aged 18-85+ years who participated in the Global Mind Project. OUTCOME MEASURES We used 120+ demographic and social determinants to predict aggregate mental health status and scores of individuals (mental health quotient (MHQ)) and determine their relative predictive influence using various machine learning models including gradient boosting and random forest classification for various demographic stratifications by age, gender, geographical region and language. Outcomes reported include model performance metrics of accuracy, precision, recall, F1 scores and importance of individual factors determined by reduction in the squared error attributable to that factor. RESULTS Across all demographic classification models, 80% of those with negative MHQs were correctly identified, while regression models predicted specific MHQ scores within ±15% of the position on the scale. Predictions were higher for older ages (0.9+ accuracy, 0.9+ F1 Score; 65+ years) and poorer for younger ages (0.68 accuracy, 0.68 F1 Score; 18-24 years). Across all age groups, genders, regions and language groups, lack of social interaction and sufficient sleep were several times more important than all other factors. For younger ages (18-24 years), other highly predictive factors included cyberbullying and sexual abuse while not being able to work was high for ages 45-54 years. CONCLUSION Social determinants of traumas, adversities and lifestyle can account for 60%-90% of mental health challenges. However, additional factors are at play, particularly for younger ages, that are not included in these data and need further investigation.
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Qin N, Li Y, Duan YL, Luo YT, Li J, Cao H, Zhou X, Wang YQ, Yang PT, Xie JF, Cheng ASK. Associations between healthy lifestyle behavioral patterns and mental health problems: A latent class analysis of 161,744 Chinese young adults. J Affect Disord 2024; 347:414-421. [PMID: 38000470 DOI: 10.1016/j.jad.2023.11.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Youth mental health problems are a public health priority. Multiple healthy lifestyle behaviors may cluster into healthy lifestyle behavioral patterns (HLBPs) that increase mental health risks in adolescents and older adults, but little is known regarding young adults. This study aimed to explore the associations between cluster HLBPs and mental health problems in young adults. METHODS We selected 161,744 young adults aged 20-39 as participants from the database of a Chinese general hospital health management center for the years 2015-2020. The latent class analysis was used to identify HLBPs. RESULTS A total of 15.0 % of young adults have at least one mental health problem. Five clusters of HLBPs were identified, characterized as low-risk class (1.6 %), moderate-risk class 1 (12.0 %), moderate-risk class 2 (2.1 %), moderate-risk class 3 (56.8 %), and high-risk class (27.4 %). The odds ratios (ORs) for young adults with two mental health problems increased with the risk grade of HLBPs, while the ORs for young adults with one or three mental health problems ranged from high to low according to the risk grade of HLBPs: high-risk class, moderate-risk class 2, moderate-risk class 3, moderate-risk class 1. LIMITATIONS Cross-sectional design and no causal conclusions could be drawn. CONCLUSION Young adults demonstrated a cluster phenomenon of healthy lifestyle behaviors and significant associations between HLBPs and mental health problems. Young adults with a higher risk grade for HLBPs were more likely to have mental health problems. Different HLBPs should be taken into account when implementing mental health interventions.
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Affiliation(s)
- Ning Qin
- Department of Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Ying Li
- Department of Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ying-Long Duan
- Department of Emergency, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ya-Ting Luo
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Jing Li
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Huan Cao
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Xing Zhou
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Ya-Qin Wang
- Department of Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ping-Ting Yang
- Department of Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jian-Fei Xie
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Hammoudi Halat D, Soltani A, Dalli R, Alsarraj L, Malki A. Understanding and Fostering Mental Health and Well-Being among University Faculty: A Narrative Review. J Clin Med 2023; 12:4425. [PMID: 37445459 DOI: 10.3390/jcm12134425] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 06/17/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
In recent years, there has been increasing recognition of mental health concerns in academia, with stress, burnout, anxiety, and depression being reported among faculty members. The demanding work environment, the need to balance personal and professional duties, and the constant pressure of productivity while navigating multiple tasks of teaching, research, mentorship, professional development, and service all impact the mental health and overall well-being of faculty. Higher education institutions have structurally changed as has the research landscape. These changes as well as faculty-specific and student-specific factors coupled to the effect of the COVID-19 pandemic have led to profound effects on the mental health of academics. This paper is a narrative review of the pertinent literature describing faculty mental health and well-being. It summarizes the available evidence on factors influencing faculty mental health and shows the prevalence of anxiety, depression, stress, and burnout among faculty from various academic fields and along the whole academic ladder. Using a suggested framework that collates the efforts of leaders and faculty, the paper concludes by exploring strategies that promote work-life balance among academics and suggesting effective interventions to improve their mental health outcomes.
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Affiliation(s)
- Dalal Hammoudi Halat
- Academic Quality Department, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Abderrezzaq Soltani
- Academic Quality Department, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Roua Dalli
- Academic Quality Department, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Lama Alsarraj
- Academic Quality Department, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Ahmed Malki
- Academic Quality Department, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
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Kang JS, Baek JH, Song MY, Rehman NU, Chung HJ, Lee DK, Yoo DY, Kim HJ. Long-term exposure changes the environmentally relevant bis(2-ethylhexyl) phthalate to be a neuro-hazardous substance disrupting neural homeostasis in emotional and cognitive functions. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 324:121387. [PMID: 36870594 DOI: 10.1016/j.envpol.2023.121387] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/21/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Bis(2-ethylhexyl) phthalate (DEHP) is the most used member of the phthalate class of compounds. Extensive use of this plasticizer allows daily exposure to humans via various routes. A positive relationship between DEHP exposure and neurobehavioral disorders is suspected. But, there are insufficient data on the harmfulness of neurobehavioral disorders caused by DEHP exposure, particularly at daily exposure levels. In this study, we assessed the consequences of daily DEHP ingestion (2 and 20 mg/kg diets) in male mice for at least 100 days and examined its effects on neuronal functions associated with neurobehavioral disorders, such as depression and cognitive decline. We found the marked depressive behaviors and reduced learning and memory function in the DEHP-ingestion groups, and that biomarkers related to chronic stress were increased in plasma and brain tissues. Long-term DEHP ingestion induced collapse of glutamate (Glu) and glutamine (Gln) homeostasis as a result of disruption of the Glu-Gln cycle in the medial prefrontal cortex and hippocampus. The reduced glutamatergic neurotransmission activity caused by DEHP ingestion was demonstrated using an electrophysiological method. This study revealed that long-term exposure to DEHP is hazardous and can cause neurobehavioral disorders, even at daily exposure levels.
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Affiliation(s)
- Jae Soon Kang
- Department of Anatomy and Convergence Medical Sciences, Institute of Health Sciences, Tyrosine Peptide Multiuse Research Group, Anti-aging Bio Cell Factory Regional Leading Research Center, Gyeongsang National University Medical School, 15 Jinju-daero 816 Beongil, Jinju, Gyeongnam, 52727, Republic of Korea
| | - Ji Hyeong Baek
- Department of Anatomy and Convergence Medical Sciences, Institute of Health Sciences, Tyrosine Peptide Multiuse Research Group, Anti-aging Bio Cell Factory Regional Leading Research Center, Gyeongsang National University Medical School, 15 Jinju-daero 816 Beongil, Jinju, Gyeongnam, 52727, Republic of Korea
| | - Mi Yeong Song
- Department of Anatomy and Convergence Medical Sciences, Institute of Health Sciences, Tyrosine Peptide Multiuse Research Group, Anti-aging Bio Cell Factory Regional Leading Research Center, Gyeongsang National University Medical School, 15 Jinju-daero 816 Beongil, Jinju, Gyeongnam, 52727, Republic of Korea
| | - Naveed Ur Rehman
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Gyeongsang National University, 501 Jinju-daero, Jinju, Gyeongnam, 52828, Republic of Korea
| | - Hye Jin Chung
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Gyeongsang National University, 501 Jinju-daero, Jinju, Gyeongnam, 52828, Republic of Korea
| | - Dong Kun Lee
- Department of Physiology, Institute of Health Sciences, Tyrosine Peptide Multiuse Research Group, Gyeongsang National University Medical School, 15 Jinju-daero 816 Beongil, Jinju, Gyeongnam, 52727, Republic of Korea
| | - Dae Young Yoo
- Department of Anatomy and Convergence Medical Sciences, Institute of Health Sciences, Tyrosine Peptide Multiuse Research Group, Anti-aging Bio Cell Factory Regional Leading Research Center, Gyeongsang National University Medical School, 15 Jinju-daero 816 Beongil, Jinju, Gyeongnam, 52727, Republic of Korea
| | - Hyun Joon Kim
- Department of Anatomy and Convergence Medical Sciences, Institute of Health Sciences, Tyrosine Peptide Multiuse Research Group, Anti-aging Bio Cell Factory Regional Leading Research Center, Gyeongsang National University Medical School, 15 Jinju-daero 816 Beongil, Jinju, Gyeongnam, 52727, Republic of Korea.
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Kreski NT, Riehm KE, Cerdá M, Chen Q, Hasin DS, Martins SS, Mauro PM, Olfson M, Keyes KM. Parenting Practices and Adolescent Internalizing Symptoms in the United States, 1991-2019. J Adolesc Health 2023; 72:189-196. [PMID: 36424334 DOI: 10.1016/j.jadohealth.2022.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/24/2022] [Accepted: 09/07/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE Adolescent internalizing symptoms are increasing in the United States. Changes in parenting practices, including monitoring and communication, have been hypothesized to contribute to these increases. We aimed to estimate trends in parenting practices and understand whether shifts in such practices explain increases in internalizing symptoms. METHODS Using 1991-2019 Monitoring the Future data (N = 933,645), we examined trends in five parental practices (i.e., knowledge [three combined indicators], monitoring [four combined indicators], communication, weekend curfew, social permission) with ordinal regressions. We tested associations between parental practices and indicators of being in the top decile of depressive affect, low self-esteem, and self-derogation using survey-weighted logistic regressions, adjusted for gender, race/ethnicity, grade, and parental education. RESULTS The prevalences of parental practices have not changed over time, with the exception of increases in parental knowledge, specifically parents knowing where an adolescent is after school (1999-2019 mean increase: 4.34 to 4.61 out of 5) and knowing an adolescent's location (4.16-4.49) and company at night (4.26-4.51). Higher levels of each practice were associated with lower internalizing symptoms (e.g., adjusted odds ratio for a high depressive affect based on a one-unit increase in parental knowledge: 0.89, 95% confidence interval: 0.88, 0.90). Patterns were consistent across internalizing outcomes and decade. DISCUSSION Parental knowledge, monitoring, and other practices are stable protective factors for adolescent mental health. These factors are not changing in a manner that would plausibly underlie increases in internalizing symptoms. Future interventions should provide resources that support these parental practices which are tied to adolescent internalizing symptoms.
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Affiliation(s)
- Noah T Kreski
- Mailman School of Public Health, Columbia University, New York, New York.
| | - Kira E Riehm
- Mailman School of Public Health, Columbia University, New York, New York
| | - Magdalena Cerdá
- New York University Grossman School of Medicine, New York, New York
| | - Qixuan Chen
- Mailman School of Public Health, Columbia University, New York, New York
| | - Deborah S Hasin
- Mailman School of Public Health/New York State Psychiatric Institute, Columbia University, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York
| | - Silvia S Martins
- Mailman School of Public Health, Columbia University, New York, New York
| | - Pia M Mauro
- Mailman School of Public Health, Columbia University, New York, New York
| | - Mark Olfson
- Mailman School of Public Health/New York State Psychiatric Institute, Columbia University, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York
| | - Katherine M Keyes
- Mailman School of Public Health, Columbia University, New York, New York
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Draghetti S, Alberti S, Borgiani G, Panariello F, De Ronchi D, Atti AR. Compulsory and voluntary admissions in comparison: A 9-year long observational study. Int J Soc Psychiatry 2022; 68:1716-1726. [PMID: 34927496 DOI: 10.1177/00207640211057731] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Few studies, so far, have been specifically designed to highlight the features related to Compulsory Admissions (CA) and Voluntary Admissions (VA) in Italian psychiatric emergency wards. AIMS The main purpose of this observational study was to compare the sociodemographic and clinical characteristics of VA and CA and to explore possible predictors of re-admissions. METHODS During a 6-month Index Period (February, the 1st-July, the 31st 2008) all psychiatric admissions were documented and then followed-up through all available informatic systems for the next 9 years. RESULTS Out of 390 hospitalizations, 101 (25.9%) were compulsory (CA rate was 2.79 per 10,000 inhabitants per year, mean duration of hospitalizations of 7.33 ± 7.84 days). Diagnoses were recorded for the 325 patients who had been hospitalized during index period: schizophrenic psychoses ([p = .042], in particular schizophrenia [p = .027]), manic episode (p = .044), and delusional disorders (p = .009) were associated with CA; conversely, the diagnosis of unipolar major depression (p = .005) and personality disorders (p = .048) were significantly more frequent in VA. The 325 admitted patients were followed up for 1,801 person-years. No significant differences were found in terms of drop-outs, transferring, and discharge rates, and mortality rates due to both natural causes and suicides. Factors associated with at least one compulsory readmission were younger age and having had a previous CA (p = .011); conversely having been engaged with psychiatric services for over 1 year prior to index hospitalization was protective for a subsequent CA (p = .013). CONCLUSIONS After a 40-year old political reform, the current study shows that, in a context of integrated outpatient and inpatient services, engagement with outpatient care may be protective for compulsory rehospitalization.
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Affiliation(s)
- Stefano Draghetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Siegfried Alberti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Gianluca Borgiani
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Fabio Panariello
- Servizio Psichiatrico di Diagnosi e Cura "P. Ottonello" - Azienda Sanitaria Locale di Bologna, Italy
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Anna Rita Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
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Riehm KE, Mojtabai R, Adams LB, Krueger EA, Mattingly DT, Nestadt PS, Leventhal AM. Adolescents' Concerns About School Violence or Shootings and Association With Depressive, Anxiety, and Panic Symptoms. JAMA Netw Open 2021; 4:e2132131. [PMID: 34724552 PMCID: PMC8561324 DOI: 10.1001/jamanetworkopen.2021.32131] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE The prevalence of internalizing problems among US adolescents has risen in the past decade. The extent to which concerns about school violence or shootings are associated with risk of internalizing problems is unknown. OBJECTIVE To examine the prospective association of concern, worry, and stress related to school violence or shootings with internalizing problems and to examine sex and racial and ethnic differences in the magnitude of the associations. DESIGN, SETTING, AND PARTICIPANTS This longitudinal cohort study involved 3 surveys administered 6 months apart (fall of grade 11 [prebaseline]; spring of grade 11 [baseline]; and fall of grade 12 [follow-up]) from 2015 to 2016. Participants included 2263 students from 10 high schools in Los Angeles, California. Analyses were performed from April 29, 2020, to April 8, 2021. EXPOSURES Baseline self-reported level of concern, worry, and stress about shootings or violence at the student's school or other schools, each rated on 5-point scales (ranging from not at all [0] to extremely [4]) with a mean score calculated as a 3-item composite index rescaled into z-score standard deviation units. MAIN OUTCOMES AND MEASURES Surpassing clinically significant or borderline significant thresholds for major depressive disorder, generalized anxiety disorder, or panic disorder based on symptom ratings on the Revised Children's Anxiety and Depression Scale at 6-month follow-up. RESULTS Of the 2263 students included in the analyses (1250 [55.2%] girls; mean [SD] age, 16.5 [0.4] years), appreciable proportions reported being very or extremely concerned (850 0f 2226 [38.2%]), worried (703 of 2209 [31.8%]), or stressed (332 of 2183 [15.2%]) about shootings or violence at their school or other schools. After adjusting for prebaseline covariates, concerns about school violence or shootings were associated with clinically significant generalized anxiety symptoms (odds ratio [OR], 1.31; 95% CI, 1.15-1.50) and panic symptoms (OR, 1.18; 95% CI, 1.05-1.32), but not depressive symptoms (OR, 1.13; 95% CI, 0.99-1.30) at the 6-month follow-up. There was a significant association between concern with school violence or shootings and depressive symptoms for Black youth (OR, 3.15; 95% CI, 1.38-7.19) and non-Hispanic/Latinx White youth (OR, 1.62 [95% CI, 1.25-2.09]) but not for youth of other races and ethnicities (OR for Asian, 1.26 [95% CI, 0.86-1.85]; OR for Hispanic/Latinx, 0.94 [95% CI, 0.76-1.16]; OR for other, 0.93 [95% CI, 0.54-1.61]). Sex did not moderate these associations. CONCLUSIONS AND RELEVANCE The findings of this study suggest that concern, worry, and stress related to school violence or shootings may be risk factors for internalizing problems among adolescents, with variation in the strength of the association by race/ethnicity.
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Affiliation(s)
- Kira E. Riehm
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland
| | - Ramin Mojtabai
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland
| | - Leslie B. Adams
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland
| | - Evan A. Krueger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Delvon T. Mattingly
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Paul S. Nestadt
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Adam M. Leventhal
- Institute for Addiction Science, Keck School of Medicine, University of Southern California, Los Angeles
- Department of Psychology, University of Southern California, Los Angeles
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Lundqvist C, Andersson G. Let's Talk About Mental Health and Mental Disorders in Elite Sports: A Narrative Review of Theoretical Perspectives. Front Psychol 2021; 12:700829. [PMID: 34267715 PMCID: PMC8275956 DOI: 10.3389/fpsyg.2021.700829] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/01/2021] [Indexed: 12/13/2022] Open
Abstract
The objective of this article is to discuss: (a) the various theoretical perspectives on mental health and mental health disorders adopted in sport psychology, and (b) how the adoption of these various theoretical perspectives in studies might impact upon the interpretations and conclusions in research about the mental health of participants in elite sports. Well-being as a target construct, holistic models, the single continuum or stage models, and Keyes' dual-continuum model of mental health are described, together with a sports psychiatric view of mental health. The strengths and limitations of various mental health perspectives are discussed. We conclude that mental health is a complex construct and that the sport psychology literature, much like the clinical psychology literature, has struggled to reach a consensus regarding a definition or a feasible approach to investigating mental health. For the researcher, it becomes important to make explicit the underlying theoretical perspective adopted and the operationalization upon which conclusions about elite athletes' mental health are based so that an increased knowledge base with high scientific credibility can be established and consolidated over time.
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Affiliation(s)
- Carolina Lundqvist
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - Gerhard Andersson
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Brenner MH, Bhugra D. Acceleration of Anxiety, Depression, and Suicide: Secondary Effects of Economic Disruption Related to COVID-19. Front Psychiatry 2020; 11:592467. [PMID: 33384627 PMCID: PMC7771384 DOI: 10.3389/fpsyt.2020.592467] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/16/2020] [Indexed: 12/23/2022] Open
Abstract
The SARS-CoV-2 (COVID-19) pandemic has contributed to increasing levels of anxiety, depression and other symptoms of stress around the globe. Reasons for this increase are understandable in the context of individual level factors such as self-isolation, lockdown, grief, survivor guilt, and other factors but also broader social and economic factors such as unemployment, insecure employment and resulting poverty, especially as the impacts of 2008 recession are still being felt in many countries further accompanied by social isolation. For those who are actively employed a fear of job and income loss and those who have actually become ill and recovered or those who have lost family and friends to illness, it is not surprising that they are stressed and feeling the psychological impact. Furthermore, multiple uncertainties contribute to this sense of anxiety. These fears and losses are major immediate stresses and undoubtedly can have long-term implications on mental health. Economic uncertainty combined with a sense of feeling trapped and resulting lack of control can contribute to helplessness and hopelessness where people may see suicide as a way out. Taking a macro view, we present a statistical model of the impact of unemployment, and national income declines, on suicide, separately for males and females over the life cycle in developed countries. This impact may reflect a potent combination of social changes and economic factors resulting in anomie. The governments and policymakers have a moral and ethical obligation to ensure the physical health and well-being of their populations. While setting in place preventive measures to avoid infections and then subsequent mortality, the focus on economic and social recovery is crucial. A global pandemic requires a global response with a clear inter-linked strategy for health as well as economic solutions. The models we have constructed represent predictions of suicide rates among the 38 highly industrialized OECD countries over a period of 18 years (2000-2017). Unemployment has a major effect on increasing suicide, especially in middle-aged groups. However, the impact of economic decline through losses of national income (GDP per capita) are substantially greater than those of unemployment and influence suicide throughout the life course, especially at the oldest ages.
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Affiliation(s)
- M. Harvey Brenner
- Johns Hopkins University Bloomberg School of Public Health, Health Policy and Management, Baltimore, MD, United States
- University of North Texas Health Science Center, Fort Worth, TX, United States
- Medizinische Hochschule Hannover, Hanover, Germany
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