Search results for ‘Subject term:"mental health problems"’ Sort:
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Childhood trauma levels in individuals attending adult mental health services: an evaluation of clinical records and structured measurement of childhood trauma
- Authors:
- ROSSITER Amy, et al
- Journal article citation:
- Child Abuse and Neglect, 44, 2015, pp.36-45.
- Publisher:
- Elsevier
Despite an increased awareness regarding the prevalence and impact of childhood trauma, especially childhood sexual abuse (CSA), few studies examine the clinical reporting of such childhood experiences. This study compared the prevalence of childhood trauma recorded in individual's clinical notes to those ascertained with a structured validated questionnaire, examined which forms of childhood trauma were less likely to be reported to the treating mental health team and established which demographic or clinical factors were associated with reporting of childhood trauma. The prevalence of childhood trauma was ascertained using both the Childhood Trauma Questionnaire (CTQ) and a lifetime retrospective clinical note review in 129 individuals attending a general adult mental health service. Individuals were evaluated for the presence of mental health disorders, impulsivity, symptom severity and disability. Using the CTQ, childhood trauma was noted in 77% of individuals and recorded in 38% of individual's clinical notes. The greatest differences between CTQ reporting and clinical note documentation were noted for emotional neglect (62% versus 13.2%), physical neglect (48.1% versus 5.4%) and CSA (24.8% versus 8.5%). Childhood trauma was associated with increased psychopathology and greater symptom severity, and was particularly prevalent for individuals with personality disorders. This study demonstrated high rates of childhood trauma amongst adults attending a general adult mental health service. Furthermore, we demonstrated high rates of either non-enquiry from mental health professionals and/or high rates of non-documentation of childhood trauma by mental health professionals. Given the disparity between reporting of childhood trauma in clinical notes and findings with the CTQ, the use of a standardised questionnaire for the assessment of childhood trauma should be considered when performing a comprehensive mental health history. (Edited publisher abstract)
Pre-treatment profiles of adolescent girls as predictors of the strength of their working alliances with practitioners in residential care settings
- Authors:
- AYOTTE Marie-Helene, LANCTÔT Nadine, TOURIGNY Marc
- Journal article citation:
- Children and Youth Services Review, 53, 2015, pp.61-69.
- Publisher:
- Elsevier
Given the importance of the working alliance to achieve positive outcomes in various types of treatment, it is important to better understand the factors that contribute to a good alliance. The present study aimed to determine which configuration of pre-treatment characteristics predicted a higher or weaker working alliance between 175 adolescent girls in residential care and their practitioners. Girls' self-reported pre-treatment characteristics (behavior problems, trauma-related symptoms, interpersonal problems and attitudes toward change) were assessed soon after admission in treatment and the working alliance was assessed three months later by both girls and their designated practitioner. Latent class analysis revealed three different profiles of girls at admission: “fewer problems”, “distressed” and “more/externalizing problems”. Findings indicated that girls with “more/externalizing problems” were 7.9 times more likely than girls from the “distressed” group to report a weaker working alliance. However, girls' pre-treatment profiles did not predict practitioners' assessment of the quality of their working alliance. Implications for research and practice are discussed.
Trauma, gender, and mental health symptoms in individuals with substance use disorders
- Authors:
- KEYSER-MARCUS Lori, et al
- Journal article citation:
- Journal of Interpersonal Violence, 30(1), 2014, pp.3-24.
- Publisher:
- Sage
The relationships between trauma history, lifetime endorsement of psychiatric symptoms, and gender were examined in a sample of individuals participating in outpatient substance abuse treatment. Study participants (N = 625) from six psychosocial counselling and five methadone maintenance programmes were recruited as part of a larger study conducted through the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN) in the United States. Study measures included lifetime trauma experience (yes/no), type of trauma experienced (sexual, physical, both), lifetime depression/anxiety, and lifetime suicidal thoughts/attempts (as measured by the Addiction Severity Index–Lite [ASI-Lite]). Lifetime endorsement of psychiatric symptoms was compared between individuals with and without trauma history. The role of gender was also examined. Results indicated that the experience of trauma was associated with an increase in lifetime report of psychiatric symptoms. Experience of physical and combined physical and sexual trauma consistently predicted positive report of psychiatric symptoms in both males and females, even when controlling for demographic and treatment-related variables. Employment outcomes, however, were not predicted by self-reported history of lifetime trauma. (Edited publisher abstract)
A history in-care predicts unique characteristics in a homeless population with mental illness
- Authors:
- ROOS Leslie E., et al
- Journal article citation:
- Child Abuse and Neglect, 38(10), 2014, pp.1618-1627.
- Publisher:
- Elsevier
This study investigates how a history in-care relates to demographics and multiple outcome measures in a homeless population with mental illness. Using the Mini International Neuropsychiatric Interview (MINI), the Short-Form 12, and a trauma questionnaire, the study investigates baseline differences in demographics and length of homelessness in the At Home/Chez Soi Trial (N = 504) Winnipeg homeless population with and without a history in-care. Approximately 50% of the homeless sample reported a history in-care. This group was significantly more likely to be young, female, married or cohabitating, of Aboriginal heritage, have less education, and have longer lifetime homelessness. Individuals of Aboriginal heritage with a history in-care were significantly more likely to report a familial history of residential school. Individuals with a history in-care experienced different prevalence rates of Axis 1 mental disorders. Those with a history in-care also reported significantly more traumatic events (particularly interpersonal). A distinctive high-risk profile emerged for individuals with a history in-care. Sociocultural factors of colonization and intergenerational transmission of trauma appear to be particularly relevant in the trajectories for individuals of Aboriginal heritage. Given the high prevalence of a history in-care, interventions and policy should reflect the specific vulnerability of this population, particularly in regards to trauma-informed services. (Edited publisher abstract)
Age at injury, emotional problems and executive functioning in understanding disrupted social relationships following childhood acquired brain injury
- Authors:
- GRACEY Fergus, et al
- Journal article citation:
- Social Care and Neurodisability, 5(3), 2014, pp.160-170.
- Publisher:
- Emerald
Purpose: Clinically significant childhood acquired brain injury (ABI) is associated with increased risk of emotional and behavioural dysfunction and peer relationship problems. The purpose of this paper is to determine how emotional and peer related problems for children with ABI compare with those of children referred to mental health services, and to identify clinical predictors of peer relationship problems in a heterogeneous sample typical of a specialist community rehabilitation setting. Design/methodology/approach: Participants were 51 children with clinically significant ABI (32 traumatic brain injury; 29 male) referred for outpatient neuropsychological rehabilitation. Emotional, behavioural and social outcomes were measured using the Strengths and Difficulties Questionnaire (SDQ), and executive functioning was measured with the Behaviour Rating Inventory of Executive Functions. Correlational analyses were used to explore variables associated with peer relationships. A subgroup (n=27) of children with ABI were compared to an age and sex matched mental health group to determine differences on SDQ subscales. Findings: The SDQ profiles of children with clinically significant ABI did not significantly differ from matched children referred to mental health services. Time since injury, peer relationship problems, metacognitive, and behavioural problems correlated with age at injury. These variables and SDQ emotional problems correlated with peer relationship problems. Linear multiple regression analysis indicated that only metacognitive skills remained a significant predictor of peer relationship problems, and metacognitive skills were found to significantly mediate between age at injury and peer relationship problems. Research limitations/implications: The study confirms the significant effect of childhood ABI on relationships with peers and mental health, those injured at a younger age faring worst. Within the methodological constraints of this study, the results tentatively suggest that age of injury influences later peer relationships via the mediating role of poor metacognitive skills within a heterogeneous clinical sample. Originality/value: This is the first study to examine the roles of emotional, behavioural and executive variables on the effect of age at injury on peer relationship problems in a sample with a wide range of ages and ages of injury. (Publisher abstract)
Balancing the equity of mental health injuries: examining the “trauma exception” for sex trafficking T-VISA applicants
- Authors:
- GREER Benjamin Thomas, DYLE Scott Davidson
- Journal article citation:
- International Journal of Migration Health and Social Care, 10(3), 2014, pp.159-191.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore and expand the legal discussion on T-Visa requirements and how it can be better structured to provide support for victims of sex trafficking that suffer from severe mental health injuries. Design/methodology/approach: The authors conducted extensive US legal and sociological research compiling human trafficking mental health report data, primarily conducted in Europe. Based on these finding, the authors interviewed practitioners in the legal field to verify assumed legal hurdles. Once validated the author's attempted to address and design an equitable approach towards mitigating the demonstrated legal shortfall. Findings: There is a dearth of US research on mental health trauma survivors of trafficking endure. This void prevents the legal system from adequately addressing likely outcomes suffered by the victims of this crime and prevents policy makers from structuring legal requirements equitably. Policy makers often need concrete examples of problems before reacting. This paper attempts to demonstrate how the current T-Visa requirements fail to fully recognise mental health injuries of sex trafficking and begins to provide a pathway to balance. Originality/value: While the statistical data was previously conducted by outside sources, the legal analysis is completely original by the author's and is likely to have a very high value to policy makers when addressing these issues. This paper also highlights the need for a more robust research programme into human trafficking and mental health injuries within the US so that many of the analogies and assumptions can be supported. (Edited publisher abstract)
The influence of prior rape on the psychological and physical health functioning of older adults
- Authors:
- SACHS-ERICSSON Natalie, et al
- Journal article citation:
- Aging and Mental Health, 18(6), 2014, pp.717-730.
- Publisher:
- Taylor and Francis
Objectives: Older adults who have experienced traumatic events earlier in life may be especially vulnerable to additional challenges associated with ageing. In a cross-sectional study of older females, the present study examines whether a history of rape is associated with current psychological and health problems. Method: This study used existing data from the female respondents (N = 1228) in the National Social Life, Health, and Aging Project (NSHAP), a national probability sample of adults between the ages of 57 and 85 interviewed in their homes. It was determined whether or not the participant experienced forced sexual contact since the age of 18. Measures of psychological health (e.g., scales of depression, anxiety, and loneliness), the presence or absence of a number of serious health problems, and a one-item measure of self-esteem were obtained. Results: Adult rape occurred in 7% of the sample. On average, 36 years had elapsed since the rape had occurred. Using structural equation modeling (SEM), rape was associated with lower self-esteem, psychological, and physical health functioning. Self-esteem partially mediated the association between rape and psychological functioning, but not health functioning. These associations were significant even after controlling for participant characteristics and risky health behaviours. Conclusions: Mechanisms linking prior rape to psychological and health problems in older age are discussed, as well as treatment recommendations for symptomatic older adults. (Edited publisher abstract)
Sick or sad? supporting Palestinian children living in conditions of chronic political violence
- Authors:
- RABAIA Yoke, SALEH Mahasin F., GIACAMAN Rita
- Journal article citation:
- Children and Society, 28(3), 2014, pp.172-181.
- Publisher:
- Wiley
In this article the authors reflect on the relatively recent emphasis on Palestinian children's mental health and well-being in the context of exposure to chronic warlike conditions, as they position this trend within the larger framework of the generations-long history of political turmoil and suffering. The authors describe how a process that started with no attention to psychosocial health of children in relation to exposure to dispossession, expulsion, occupation, repression and military attacks, proceeded with a focus on presumed mental disorders, and the more recent approach of designing context appropriate and community-based psychosocial interventions. (Edited publisher abstract)
Lifetime prevalence of multiple victimizations and its impact on children’s mental health
- Authors:
- CYR Katie, CLEMENT Marie-Eve, CHAMBERLAND Claire
- Journal article citation:
- Journal of Interpersonal Violence, 29(4), 2014, pp.616-634.
- Publisher:
- Sage
This study sought to document lifetime experiences of individual categories of victimizations and polyvictimization using the Juvenile Victimization Questionnaire among children from the province of Quebec (Canada) to examine whether polyvictimization predicts mental health symptoms and to assess whether categories of victimization still contribute to mental health symptoms after considering polyvictimization. Polyvictimization accounted for the most variability in scores for depression, anxiety, and anger/aggression compared with individual victimization categories. None of the individual categories of victimization made an independent contribution to the prediction of trauma scores, once polyvictimization was considered. (Publisher abstract)
Trauma-informed care training in a child welfare system: moving it to the front line
- Authors:
- CONNERS-BURROW Nicola A., et al
- Journal article citation:
- Children and Youth Services Review, 35(11), 2013, pp.1830-1835.
- Publisher:
- Elsevier
The use of trauma-informed practices in the child welfare system is critically important to prevent system-induced trauma and encourage timely assessment, triage and referral for care when indicated. Ultimately, such measures have the potential over time to decrease the risk for mental health problems in children exposed to a trauma. This study evaluates an initiative in Arkansas to train child welfare front-line staff members in trauma-informed care practices. The impact of the training on knowledge and use of trauma-informed care practices among three types of child welfare staff (caseworkers, program assistants and other front-line staff) was evaluated. Results suggest that this training process was highly successful in improving knowledge of trauma-informed care practices, especially among staff with the least formal education and training. A significant increase in staff use of trauma-informed care practices at the three-month follow-up was also found. Barriers that may prevent staff from full implementation of training concepts are described and strategies to address barriers are proposed. (Edited publisher abstract)