Search results for ‘Subject term:"mental health problems"’ Sort:
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Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys
- Authors:
- Ronald C. Kessler, et al
- Journal article citation:
- British Journal of Psychiatry, 197(5), November 2010, pp.378-385.
- Publisher:
- Cambridge University Press
The association between childhood adversity and adult mental problems is well known. To date, however, most research has focused on single childhood adversities predicting single disorders. This paper investigated joint associations of 12 childhood adversities with first onset of 20 DSM-IV disorders in World Mental Health (WMH) surveys in 21 countries. Surveys of 51,945 adults assessed childhood adversities and lifetime DSM-IV disorders with the WHO Composite International Diagnostic Interview (CIDI). Findings revealed that childhood adversities associated with maladaptive family functioning, such as parental mental illness, child abuse, or neglect, were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant predictive associations and little specificity across disorders. Childhood adversities were seen to account for almost 30% of all disorders across countries. The paper concluded that childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries.
Internationally adopted adults who did not suffer severe early deprivation: the role of appraisal of adoption
- Authors:
- STORSBERGEN Hester E., et al
- Journal article citation:
- Children and Youth Services Review, 32(2), February 2010, pp.191-197.
- Publisher:
- Elsevier
Little is known about the long-term consequences for the mental health and well-being of international adopted adults. This study focused on a group of adults who had been internationally adopted from Greece to the Netherlands in infancy and now have a mean age of 29 years. Psychological adjustment was examined in 53 adults, internationally adopted by Dutch parents as infants at a mean age of 9 months from the Metera children's home in Greece. At that time, guidelines consistent with attachment theory were followed to ensure relatively favourable quality of childcare in Metera. The adults completed standardised questionnaires on mental health, well-being and self-esteem. The results found that the large majority of the adults were well adjusted, although adopted males reported more depression. Adults who reported a negative appraisal of their adoption reported more problems and less well-being than adults with a positive/neutral appraisal of their adoption. In conclusion, the study did not reveal any major risks with respect to self-reported mental health problems, well-being and self-esteem in adulthood. Further research is needed to invest why adopted men seem somewhat more vulnerable for problems than adopted women.
The effects of kinship care on adult mental health outcomes of alumni of foster care
- Authors:
- FECHTER-LEGGETT Molly O., O’BRIEN Kirk
- Journal article citation:
- Children and Youth Services Review, 32(2), February 2010, pp.206-213.
- Publisher:
- Elsevier
Kinship foster care is emerging into the dominant preferred placement type for out-of-home care, exceeding traditional foster care and group care. The push towards kinship foster care has brought up questions as to whether kinship foster care can better provide for the short- and long-term emotional needs of children in care. This study examined the effects of kinship foster care on adult mental health outcomes of former foster children. Data were drawn from the Casey National Alumni Study and included case record data on 1582 alumni and interviews of 1068 alumni. The adjusted response rate was 73%. Logistic regression was used to compare several patterns of placements in kinship care and their impact on mental health functioning in the year prior to interview. The results indicated that among the participants in the study, kinship foster care alone was not a good predictor of positive mental health outcomes. However, a variety of other in-care factors were identified that were associated with positive mental health functioning. The article concludes that the results support the importance of focusing on the best fit for the child regardless of placement type, taking into account factors such as placement stability, consistency in educational, mental health, and extracurricular activities, goodness of fit of the caregiver and child, and providing the child with adequate preparation for leaving care.
Long-term follow-up of individuals on assertive outreach teams
- Authors:
- RANA Tanvir, COMMANDER Martin
- Journal article citation:
- Psychiatrist (The), 34(3), March 2010, pp.88-91.
- Publisher:
- Royal College of Psychiatrists
The introduction of assertive outreach teams has been a central pillar of UK mental health policy in recent years. Although they have been successful in engaging individuals and improving satisfaction, there is uncertainty about their ability to reduce demand on in-patient care or to improve symptoms and social functioning. This study investigates the long-term outcome of 165 people taken onto 3 assertive outreach teams in Birmingham between 1999 and 2002. It reports on follow-on data obtained through hospital case records and interviews with care coordinators. After a mean follow-up of 6 years and 8 months, 130 people remained in contact with local services of whom 100 were still under the care of an assertive outreach team. Admission rates were half those at inception, but this had reached a plateau after the initial 2 years. Sixteen patients had died, 10 spent time in prison, 12 were homeless, and 14 had protracted stays in hospital during the follow-up period. The article concludes that although assertive outreach teams are successful in engaging individuals and reducing admission rates, these benefits plateau after the first few years. It suggests that there should be more emphasis on patients moving on to other services which might be able to sustain these benefits and also focus more on other areas in which the assertive outreach teams are less effective, such as physical health, housing and employment.
Impact of childhood abuse: biopsychosocial pathways through which adult mental health is compromised
- Author:
- COATES Dominiek
- Journal article citation:
- Australian Social Work, 63(4), December 2010, pp.391-403.
- Publisher:
- Taylor and Francis
The relationship between childhood abuse and adult mental and physical health problems is well documented. Over the lifespan of victims of child abuse, social, psychological and biological consequences of abuse interact in complex ways. This paper applies a biopsychosocial model to the experiences of adult victims of child abuse to examine and make sense of the complex and varied impacts of child abuse. The long-term difficulties experienced by adult victims of child abuse are discussed in relation to the neuro-biological impacts of child abuse on the child's developing brain. The impact of child abuse on neuro-endocrine functioning and the structure of the brain are explored. A number of implications for social work practice are outlined.
Exploring coping factors amongst men who were sexually abused in childhood
- Authors:
- O'LEARY Patrick J., GOULD Nick
- Journal article citation:
- British Journal of Social Work, 40(8), December 2010, pp.2669-2686.
- Publisher:
- Oxford University Press
Men who were sexually abused in childhood are overrepresented in mental health and other clinical populations. At the same time, a substantial number develop coping strategies that minimise the negative consequences of abuse. This study aimed to explore male victims’ long-term coping strategies, in order to better understand the nature of their coping and the variability in responses to childhood sexual abuse. The paper reports on one arm of a larger study of mental health outcomes for Australian men who are survivors of childhood sexual abuse. It presents findings from thematic analysis of qualitative interviews with 39 men, exploring how their coping mechanisms have developed and the nature of the advice for coping they would give to professionals or other survivors. The study found that coping strategies developed adaptively through the life course but clustered into 2 types: those that are concerned with forms of suppression and denial, which are associated with negative mental health outcomes; and those that involve reframing the abuse, which tend to be associated with more positive outcomes. Implications for practice are consistent with the advice suggested by the men themselves, that they were helped by consistent relationships with others who could provide practical support and inspire hope.
Psychopathology in a large cohort of sexually abused children followed up to 43 years
- Authors:
- CUTAJAR Margaret C., et al
- Journal article citation:
- Child Abuse and Neglect, 34(11), November 2010, pp.813-822.
- Publisher:
- Elsevier
This long term prospective study examines the rate and risk of clinical and personality disorders in childhood and adulthood in individuals sexually abused as children. The forensic medical records of 2,759 sexually abused children living in Victoria, Australia and assessed between 1964 and 1995 were linked with a public psychiatric database between 12 and 43 years later. Control subjects for comparison, drawn at random from the general population, were matched by gender and age. A lifetime record of contact with public mental health services was found in 23.3% of cases compared to 7.7% of controls. The rate of contact among child sex abuse victims was 3.65 times higher. It was estimated that child sexual abuse accounted for approximately 7.83% of mental health contact. It increased risks for the majority of outcomes including psychosis, affective, anxiety, substance abuse, and personality disorders. Older age at sexual abuse and those exposed to more severe abuse were associated with greater risk for psychopathology. It is concluded that child sexual abuse is a substantial risk factor for a range of mental disorders in both childhood and adulthood.
Burden of psychiatric disorder in young adulthood and life outcomes at age 30
- Authors:
- GIBB Sheree J., FERGUSSON David M., HORWOOD L. John
- Journal article citation:
- British Journal of Psychiatry, 197(2), August 2010, pp.122-127.
- Publisher:
- Cambridge University Press
Psychiatric disorders are common during young adulthood and comorbidity is frequent. Individual psychiatric disorders have been shown to be associated with negative economic and educational outcomes. The aim of this study was to examine whether the extent of common psychiatric disorder between ages 18 and 25 is associated with negative economic and educational outcomes at age 30, before and after controlling for confounding factors. The participants were 987 individuals from the Christchurch Health and Development Study, a longitudinal study of a birth cohort of individuals born in Christchurch, New Zealand, in 1977 and followed to age 30. Linear and logistic regression models were used to examine the associations between psychiatric disorder from age 18 to 25 and workforce participation, income and living standards, and educational achievement at age 30, before and after adjustment for confounding factors. The results showed significant associations between the extent of psychiatric disorder reported between ages 18 and 25 and all of the outcome measures. After adjustment for confounding factors, the associations between psychiatric disorder and workforce participation, income and living standards remained significant, but the associations between psychiatric disorder and educational achievement were not significant. The article concludes that after due allowance had been made for a range of confounding factors, psychiatric disorder between ages 18 and 25 was associated with reduced workforce participation, lower income and lower economic living standards at age 30.
Long-term outcomes of obsessive-compulsive disorder: follow-up of 142 children and adolescents
- Authors:
- MICALI N., et al
- Journal article citation:
- British Journal of Psychiatry, 197(2), August 2010, pp.128-134.
- Publisher:
- Cambridge University Press
Obsessive-compulsive disorder (OCD) often starts in childhood and adolescence and can be a chronic disorder with high persistence rates. This study aimed to follow up young people with OCD to clarify persistence rates and relevant predictors, presence of other psychiatric disorders, functional impairment, service utilisation and perceived treatment needs. The study participants were young people with OCD assessed between July 1996 and June 2005 at the National and Specialist Paediatric OCD clinic, Maudsley Hospital, London. One hundred and forty two of the 222 contactable young people and parents completed computerised diagnostic interviews and questionnaires. The results found a persistence rate of OCD of 41%. Forty percentage of participants had a psychiatric diagnosis other than OCD at follow-up. The main predictor for persistent OCD was duration of illness at assessment. High levels of baseline psychopathology predicted other psychiatric disorders at follow-up. Functional impairment and quality of life were mildly to moderately affected. Approximately 50% of participants were still receiving treatment and about 50% felt a need for further treatment. This study confirms that paediatric OCD can be a chronic condition that persists into adulthood and has a substantial amount of unmet need. Important challenges for services are ensuring adequate treatment and a smooth transition from child to adult services.
Identifying experiences of physical and psychological violence in childhood that jeopardize mental health in adulthood
- Authors:
- GREENFIELD Emily A., MARKS Nadine F.
- Journal article citation:
- Child Abuse and Neglect, 34(3), March 2010, pp.161-171.
- Publisher:
- Elsevier
This study aimed to extend understanding of linkages between childhood experiences of physical and psychological violence (either experienced alone or in combination) from mothers and fathers with poorer mental health in adulthood. Profiles were distinguished by the types of violence retrospectively self-reported as well as by the frequency at which each type of violence occurred. The study conducted secondary analysis of publicly available data from the National Survey of Midlife in the U.S. (MIDUS). An adapted version of the Conflict Tactics Scales (CTS) was used to collect respondents’ reports of physical and psychological violence in childhood from each parent. The respondents also reported on current experiences of negative affect and psychological well-being. The results showed that reports of frequent psychological violence from mothers, even when coupled with never or rarely having experienced physical violence, were associated with more negative affect and less psychological well-being in adulthood. Nearly all profiles of violence in childhood from fathers, with the exception of reports of rare physical violence only, were associated with poorer adult mental health. The results provide evidence that frequent experiences of psychological violence from parents, even in the absence of physical violence and regardless of whether such violence is from mothers or fathers, can place individuals’ long-term mental health at risk. Moreover, frequent physical violence from fathers, even in the absence of psychological violence, also serves as a risk factor for poorer adult mental health.