Severity of mental illness as a result of multiple childhood adversities: US National Epidemiologic Survey.

PURPOSE: To examine patterns of childhood adversity, their long-term consequences and the combined effect of different childhood adversity patterns as predictors of subsequent psychopathology. METHODS: Secondary analysis of data from the US National Epidemiologic Survey on alcohol and related conditions. Using latent class analysis to identify childhood adversity profiles; and using multinomial logistic regression to validate and further explore these profiles with a range of associated demographic and household characteristics. Finally, confirmatory factor analysis substantiated initial latent class analysis findings by investigating a range of mental health diagnoses. RESULTS: Latent class analysis generated a three-class model of childhood adversity in which 60 % of participants were allocated to a low adversity class; 14 % to a global adversities class (reporting exposures for all the derived latent classes); and 26 % to a domestic emotional and physical abuse class (exposed to a range of childhood adversities). Confirmatory Factor analysis defined an internalising-externalising spectrum to represent lifetime reporting patterns of mental health disorders. Using logistic regression, both adversity groups showed specific gender and race/ethnicity differences, related family discord and increased psychopathology. CONCLUSIONS: We identified underlying patterns in the exposure to childhood adversity and associated mental health. These findings are informative in their description of the configuration of adversities, rather than focusing solely on the cumulative aspect of experience. Amelioration of longer-term negative consequences requires early identification of psychopathology risk factors that can inform protective and preventive interventions. This study highlights the utility of screening for childhood adversities when individuals present with symptoms of psychiatric disorders.

Identifying latent profiles of posttraumatic stress and major depression symptoms in Canadian veterans: Exploring differences across profiles in health related functioning.

Posttraumatic stress disorder (PTSD) has been consistently reported as being highly comorbid with major depressive disorder (MDD) and as being associated with health related functional impairment (HRF). We used archival data from 283 previously war-zone deployed Canadian veterans. Latent profile analysis (LPA) was used to uncover patterns of PTSD and MDD comorbidity as measured via the PTSD Checklist-Military version (PCL-M) and the Patient Health Questionnaire-9 (PHQ-9). Individual membership of latent classes was used in a series of one-way ANOVAs to ascertain group differences related to HRF as measured via the Short-Form-36 Health Survey (SF-36). LPA resulted in three discrete patterns of PTSD and MDD comorbidity which were characterized by high symptoms of PTSD and MDD, moderate symptoms, and low symptoms. All ANOVAs comparing class membership on the SF-36 subscales were statistically significant demonstrating group differences across levels of HRF. The group with the highest symptoms reported the worst HRF followed by the medium and low symptom groups. These findings are clinically relevant as they demonstrate the need for continual assessment and targeted treatment of co-occurring PTSD and MDD.

Adult experience of mental health outcomes as a result of intimate partner violence victimisation: a systematic review.

BACKGROUND: Intimate partner violence (IPV) has been known to adversely affect the mental health of victims. Research has tended to focus on the mental health impact of physical violence rather than considering other forms of violence. OBJECTIVE: To systematically review the literature in order to identify the impact of all types of IPV victimisation on various mental health outcomes. METHOD: A systematic review of 11 electronic databases (2004-2014) was conducted. Fifty eight papers were identified and later described and reviewed in relation to the main objective. RESULTS: Main findings suggest that IPV can have increasing adverse effects on the mental health of victims in comparison with those who have never experienced IPV or those experiencing other traumatic events. The most significant outcomes were associations between IPV experiences with depression, posttraumatic stress disorder, and anxiety. Findings confirm previous observations that the severity and extent of IPV exposure can increase mental health symptoms. The effect of psychological violence on mental health is more prominent than originally thought. Individual differences such as gender and childhood experience of violence also increase IPV risk and affect mental health outcomes in diverse ways. CONCLUSIONS: Psychological violence should be considered as a more serious form of IPV which can affect the mental health of victims. Experiencing more than one form of IPV can increase severity of outcomes. Researchers should look at IPV as a multi-dimensional experience. A uniformed definition and measure of IPV could help advance knowledge and understanding of this disparaging global issue.

Adolescent loneliness and psychiatric morbidity in Northern Ireland.

OBJECTIVE: Previous research has identified an association between loneliness and psychiatric morbidity, but many of the studies have been based on small convenience samples and have not always used standardized measures. AIMS AND METHODS: This study aimed to assess the association between standardized measures of loneliness and psychiatric morbidity using data from a large sample of adolescents from Northern Ireland (Young Life and Times Survey, 2011). A total of 1,434 participants completed the survey. RESULTS: The prevalence of loneliness and psychiatric morbidity was 15.6% and 28.4% respectively. A multivariate binary logistic regression was used to identify the significant correlates of psychiatric morbidity. Demographic and loneliness variables were entered as covariates and female gender and perceptions of familial poverty were significantly associated with GHQ caseness. Loneliness increased the likelihood of GHQ caseness by more than five times. CONCLUSIONS: Adolescent loneliness is significantly associated with psychiatric morbidity for Northern Irish adolescents. School-based screening and interventions to reduce loneliness may reduce the prevalence of loneliness.

Empirical derived AUD sub types in the US general population: a latent class analysis.

AIMS: This study examined the homogenous expression of DSM-5-based alcohol use disorder (AUD) latent subtypes. METHOD: Using data from the National Epidemiologic Survey of Alcohol and Related Conditions Wave 2 (n = 22,177) the typology was established utilising latent class analysis and the model was further validated by multivariate regression on a range of covariates. RESULTS: Three AUD classes based on a severity gradient and one non-problematic class were the most parsimonious description of the data. These classes displayed both quantitative and qualitative differences on the covariates. CONCLUSIONS: The resulting typology has high clinical utility, enhances AUD classification and adds to our understanding of AUD trajectories, prevention and treatment.

Micro-ecological behavior and intergroup contact.

Research evaluating intergroup contact has tended to rely on self-report measures. Drawing on recent micro-ecological research, the two studies reported here used a multi-method approach to examine contact in a more holistic fashion. This involved the measurement of observable behavior at the micro-level, intergroup attitudes via infrahumanization and focus groups. Participants were taking part in a community intervention program in Northern Ireland. We conclude that micro-ecological behavior is not necessarily indicative of outgroup attitudes. Although behavior and attitudes changed in line with one another in Study 1 (less aggregation and significantly less infrahumanization), there were no infrahumanization differences between those who sat beside an outgroup member and those who did not. Importantly, the work presented here illustrates a unique method that allows micro-ecological behavioral observations to be made for the first time in non-racial settings.

Examining non-racial segregation: a micro-ecological approach.

A number of studies in both South Africa and the United States of America have indicated the presence of an 'informal' segregation that is active in everyday life spaces and which is resistant to changes in macro level social policy. This research has however been conducted in societies where segregation and division has been based on skin colour. We sought to adapt a micro-ecological technique for use in a non-racially segregated setting, in this case lecture theatres at a University in Northern Ireland. Using seat numbers to examine seating patterns we found that levels of segregation persisted throughout a semester. The success of this methodology in capturing this information has far-reaching implications for the future study of the micro-ecology of contact.

Parental and school effects on children's political attitudes in Northern Ireland.

BACKGROUND: Recent research has suggested that intergroup contacts with out-group members can both reduce prejudice and is associated with attitude change. AIM: This study extends prior work in Northern Ireland to examine parental and schooling effects on children's attitudes in a post-conflict environment. SAMPLE: A large-scale cross-sectional survey of secondary schoolchildren (N=1,732) and their parents (N=800) in Northern Ireland assessed the effects of in-school and out-of-school intergroup contacts on intergroup attitudes. METHOD: Multivariate analysis of variance was employed to examine associations between children's political attitudes and parental, group membership, school, and contact variables. CONCLUSIONS: The results suggest that parental attitudes, group membership, and cross-group contacts explain the majority of variance (58%) in children's political attitudes. The findings provide a comprehensive account of the factors that influence children's political attitudes within a deeply divided society and offer teachers and educationalists a way to improve community relations in a segregated society.

Intergroup contact, friendship quality and political attitudes in integrated and segregated schools in Northern Ireland.

BACKGROUND: This study examines the effects of integrated and segregated schooling on Northern Irish children's self-reported contact and friendship with members of the other denominational group in school and community settings. AIM: To assess the effects of cross group friendships and cross group contacts in school and outside school on children's political attitudes. SAMPLE: A cross-sectional design was employed with 1732 children being assessed at three age levels 11,12 & 14 years in eight-matched integrated, maintained (Catholic) and controlled (Protestant) schools. METHOD: Lisrel modelling was used to investigate the interrelationships among cross group friendship quality, cross group contacts in school and outside school and children's political attitudes. RESULTS: Intergroup contact within and outside school was reported frequently in integrated schools but only occasionally in segregated schools. Modelling revealed that cross group contacts in school and outside school were both associated with less extreme political attitudes. Friendship quality with cross group members had no significant effects on political attitudes. CONCLUSIONS: The results provide support for educating Protestants and Catholics together as a means of moderating attitudes and creating cross-community friendships in a divided society.

Childhood sexual abuse, early cannabis use, and psychosis: testing an interaction model based on the National Comorbidity Survey.

Previous research investigating the etiology of psychosis has identified risk factors such as childhood sexual abuse and cannabis use. This study investigated the multiplicative effect of these variables on clinically assessed diagnoses of psychosis based on a large community sample (the National Comorbidity Survey). Demographic variables (sex, age, urbanicity, ethnicity, education, employment, and living arrangements) and depression were used as predictors in the first block of a binary logistic regression. In the second block, the variables representing early cannabis use, childhood sexual trauma, and the interaction between these variables were entered. There was no significant main effect for early cannabis use or childhood sexual trauma. The interaction was statistically significant (odds ratio [OR] = 6.93, 95% confidence interval [CI] = 1.39-34.63, P = .02). The effect for the sexual trauma variable was statistically significant for those who used cannabis under 16 years (OR = 11.96, 95% CI = 2.10-68.22, P = .01) but not for those who had not used cannabis under 16 years (OR = 1.80, 95% CI = 0.91-3.57, P = .09). Many factors have been shown to be significant in the etiology of psychosis; however, the current research augments previous findings by examining psychosis in terms of an interaction between 2 of these factors.

Threats to group value, domain-specific self-esteem and intergroup discrimination amongst minimal and national groups.

The research reported in this investigation sought to examine the self-esteem hypothesis (SEH) using measures of domain-specific and public collective self-esteem (CSE). Two studies were conducted. Each tested both propositions of the SEH. The first study revealed that minimal group members (a) experienced an increase in that domain of self-esteem judged to be relatively more important to the in-group, following the display of in-group favouritism and (b) that minimal group members with low public CSE (and who thus believed that the in-group was negatively evaluated by the out-group) showed enhanced levels of in-group favouritism. The second study, which utilized the members of real social categories (i.e. New Zealanders and Australians) and negative outcome allocations (i.e. white noise) revealed identical findings. The theoretical implications of these results are discussed.

Stroke: awareness of the signs, symptoms and risk factors--a population-based survey.

BACKGROUND: This article reports the findings from a population-based survey conducted to determine baseline knowledge regarding the signs, symptoms and risk factors of stroke. METHODS: Data were collected in Northern Ireland from 892 adults using a self-completed questionnaire. RESULTS: In general, the results indicate that respondents appeared knowledgeable about the risk factors of stroke but their recognition of the warning signs was poor. In addition, approximately half of those surveyed would not contact the ambulance service in the case of a suspected stroke but instead would make initial contact with their general practitioner (41.5%) or family/relatives (2.3%). CONCLUSIONS: Given the importance of early hospital presentation for effective stroke rehabilitation, these findings are of particular concern in a community where the death rate from stroke is one of the highest in Europe. Future health education campaigns should provide accurate and appropriate information regarding the warning signs of stroke and highlight the importance of early hospital presentation.