Psychometric Analyses of the Challenges and Needs Survey for Family Caregivers of Individuals with Autism Spectrum Disorder: Implications for Practice

Understanding the needs and stressors of caregivers of individuals with autism spectrum disorder (ASD) informs targeted support strategies. However, most caregiver needs measures lack the breadth of experiences relevant to these families. This study examined the underlying factor structure of the Challenges and Needs Survey (CANS), a caregiving needs measure designed for family caregivers of individuals with ASD. The sample consisted of 286 family caregivers. Participants completed the CANS either online or in the paper form. Exploratory factor analysis was used to examine the underlying structure of the measure. T-tests and correlations were used to compare results by age and gender of the participants. Exploratory factor analysis resulted in 39 items of four factors: autism-related challenges (child), functional challenges, psychological challenges (parent), and aggressive behaviors (child). Parents with both high stress and high needs reported the lowest levels of mental health functioning.

Working conditions and mental health functioning among young public sector employees

Background: The associations between adverse working conditions and mental disorders are well established. However, associations between adverse working conditions and poor mental health functioning is a less explored area. This study examines these associations among younger public sector employees of the City of Helsinki, Finland. Methods: We use data from the Young Helsinki Health Study with a representative sample of the employees of the City of Helsinki, aged 19–39 years ( n=4 217). Mental health functioning was measured with mental composite summary of the Short Form 36. Working conditions included factors related to both the psychosocial (job control and job demands) and the physical work environment (physical workload). To examine the associations, we used logistic regression models with adjustments for socio-demographics, other working conditions and health-related covariates. Results: After adjustment for sociodemographic characteristics, poor health, health behaviours and other occupational exposures, high job demands (OR=1.69; 95% CI=1.45–1.97) and low job control (OR=1.65; 95% CI=1.40–1.94) were associated with poor mental health functioning. High physical workload was not associated with the outcome (OR=0.87; 95% CI=0.72–1.05) after the adjustments. Conclusions: Adverse psychosocial working conditions were associated with mental health functioning, whereas physical working conditions were not. As impaired functioning is likely to cause health-related lost productivity and can lead to work disability, further research and interventions with a balanced approach focusing on both psychosocial working conditions and mental health functioning are recommended.

Associations between community cultural engagement and life satisfaction, mental distress and mental health functioning using data from the UK Household Longitudinal Study (UKHLS): are associations moderated by area deprivation?

ObjectivesThe association between community cultural engagement and mental health and well-being is well established. However, little is known about whether such associations are influenced by area characteristics. This study therefore examined whether the association between engagement in community cultural assets (attendance at cultural events, visiting museums and heritage sites) and subsequent well-being (life satisfaction, mental distress and mental health functioning) is moderated by neighbourhood deprivation.DesignData were drawn from Understanding Society: The UK Household Longitudinal Study waves 2 and 5. Participating households’ addresses were geocoded into statistical neighbourhood zones categorised according to their level of area deprivation.SettingGeneral population.ParticipantsUK general adult population, with a total sample of 14 783.Main outcome measuresLife satisfaction was measured with a seven-point scale (1: completely unsatisfied to 7: completely satisfied). Mental distress was measured using the General Health Questionnaire 12. Mental health functioning was measured using 12-item Short Form Health Survey (SF-12).ResultsUsing Ordinary Least Squares (OLS) regression, we found that engagement in cultural assets was consistently and positively associated with subsequent life satisfaction and mental health functioning and negatively associated with mental distress. Importantly, such associations were independent of individuals’ demographic background, socioeconomic characteristics and regional location. The results also show that relationships between engagement in community cultural assets and well-being were stronger in more deprived areas.ConclusionsThis study shows that engagement in community cultural assets is associated with better well-being, with some evidence that individuals in areas of high deprivation potentially may benefit more from these engagements. Given that causal mechanisms were not tested, causal claims cannot be generated from the results. However, the results suggest that place-based funding schemes that involve investment in areas of higher deprivation to improve engagement rates should be explored further to see if they can help promote better well-being among residents.

Sexual Health in Emerging Adulthood

Sexual health in emerging adulthood encompasses a wide spectrum of medical and mental health functioning and associated behaviors. This chapter addresses aspects of physical sexual health that are of concern to emerging adults, including prevalence rates, determinants, and consequences of sexually transmitted infections, including HIV, and unintended pregnancy among emerging adults. The chapter also discusses sexual dysfunction and its treatment. Whenever possible, the chapter highlights differences in prevalence, risk, and protective factors related to aspects of human diversity, guided by an intersectional approach based on the ADDRESSING framework. Both protective and risky sexual health behaviors and decision making about sexual behavior are discussed, with a focus on the role of substance use in sexual risk taking. The chapter concludes with implications for future research, particularly in the area of prevention.

Trauma Symptomatology in Patients Successfully Treated for Pituitary Adenoma

The emotional symptomatology accompanying pituitary adenomas has long been recognized, though research has been scant, varied, and more focused on studies related to quality of life. The present study sought to better codify the psychological presentation of pituitary adenoma patients through the lens of trauma and PTSD symptomatology. 128 patients who were successfully treated for pituitary adenoma were recruited from the Wexner School of Medicine at Ohio State University. Ranging in age from 23 to 74, the participants’ mental health functioning was assessed by the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), the Brief Symptom Inventory (BSI), and the Dissociative Experiences Scale (DES). The findings of this pilot study showed that the rate of traumatization (PTSD) for pituitary adenoma patients was significantly higher than that of the general population. With regard to comorbid trauma-related mental health impairment, our results demonstrated that when moderated by sex, pituitary adenoma patients had significantly higher psychopathology than the non-clinical population. Replicating the existing research, there was a significant positive correlation between trauma symptoms and trauma-related psychopathology in patients successfully treated for pituitary adenoma. Overall, the results of this study demonstrate the traumatic nature of this disease and the need for applied clinical intervention. Further research is needed to replicate these findings, in light of potential selection bias and sample size.

The Effectiveness of Theraplay® as a Counseling Practice With Mothers and Their Children in a Substance Abuse Rehabilitation Residential Facility

Substance abuse in parents is damaging to their children and the family system as a whole. If family treatment is paired with substance abuse treatment for the parents, children have the possibility of having better attachment with their parents and thus increase general functioning skills and overall family well-being. This study examined the impact of Whole Family Theraplay as an effective play therapy treatment with mothers in recovery from substance abuse and their children with attachment issues in an inpatient substance abuse rehabilitation facility. Scores indicated that women/mothers had reduced symptoms of distress and improved their mental health functioning. Their children demonstrated improved interpersonal relationships, reduced interpersonal distress, and improvement in overall mental health functioning. The implications of this study were that by implementing Whole Family Theraplay, in addition to individual and group counseling in substance abuse treatment, subjects showed demonstrated improvement in attachment relationships and mental health outcomes.

The association of unfairness with mental and physical health in a multi-ethnic sample of Michigan adults. (Preprint)

BACKGROUND Two psychosocial constructs that have shown a consistent associations with negative health outcomes are discrimination and perceived unfairness. OBJECTIVE The current analyses report the effects of discrimination and unfairness on medical, psychologic, and behavioral outcomes from a recent cross-sectional survey conducted in a multi-ethnic sample of adults in Michigan. METHODS A cross section survey was collected using multiple approaches, 1) Community Settings, 2) Telephone listed sample, and 3) Online panel. Unfairness was assessed with a single-item previously used in the Whitehall Study, and everyday discrimination was assessed with the Williams 9-item scale. Outcomes included mental health symptoms, past month cigarette use, past month alcohol use, past month marijuana use, lifetime pain medication use, and self-reported medical history. RESULTS A total of 2,238 usable surveys were collected. In bivariate analyses, higher unfairness values were significantly associated with lower educational attainment, lower age, lower household income, and being unmarried. Highest unfairness values were observed for Black and multiracial respondents followed by Middle Eastern or North African (MENA) participants. Unfairness was significantly related to worse mental health functioning, net adjustment for sociodemographic variables and everyday discrimination. Unfairness was also related to self-reported history of depression and high blood pressure although after including everyday discrimination in the model, only the association with depression remained significant. Unfairness was significantly related to 30-day marijuana use, 30-day cigarette use, and lifetime opiate use. CONCLUSIONS Our findings of a generally harmful effect of perceived unfairness on health are consistent with prior studies. Perceived unfairness may be one of the psychologic pathways through which discrimination negatively impacts health. Future studies examining the relationships we observed using longitudinal data and including more objective measures of behavior and health status are needed to confirm and extend our findings.