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BACKGROUND: Non-suicidal self-injury (NSSI) can be motivated by a broad range of functions and many individuals report multiple reasons for self-injuring. Most NSSI research has involved predominantly female samples and few studies have examined gender similarities and differences in function endorsement. METHODS: We characterise the prevalence and versatility of NSSI functions within a gender-diverse online sample of cisgender women (cis-women; n = 280), cisgender men (cis-men; n = 176), and transgender, non-binary, and other gender non-conforming young adults (TGNC; n = 80) age 18-30 (M = 23.73, SD = 3.55). The Ottawa Self-Injury Inventory (OSI-F) assessed 24 intrapersonal and social functions across nine domains: affect regulation, self-punishment, anti-dissociation, anti-suicide, sensation seeking, sexuality, interpersonal influence, and body image. RESULTS: TGNC participants and cis-women were significantly more likely to report intrapersonally motivated NSSI and greater function versatility than cis-men. Low mood, emotional distress, suicidality, and trauma symptomology appeared to contribute to gender differences in function endorsement. Gender similarities also emerged; across groups, intrapersonal functions were substantially more common than social functions, and the most endorsed domains were affect regulation and self-punishment. No domains were gender specific. LIMITATIONS: The OSI-F was developed from majority female samples and may not adequately capture the experiences of other gender groups. CONCLUSIONS: Interventions which reduce distress and strengthen emotion regulation are likely to benefit individuals who self-injure regardless of gender. However, most individuals report multiple NSSI functions and person-centred interventions which address this complexity are needed. Future research should develop gender-informed treatment models which consider the unique experiences of TGNC individuals and cis-men who self-injure.
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There is growing recognition that earliest signs of autism need not clearly manifest in the first three years of life. To what extent is this variation in developmental trajectories associated with age at autism diagnosis? Does the genetic profile of autism vary with age at autism diagnosis? Using longitudinal data from four birth cohorts, we demonstrate that two different trajectories of socio-emotional behaviours are associated with age at diagnosis. We further demonstrate that the age at autism diagnosis is partly heritable (h2 SNP = 0.12, s.e.m = 0.01), and is associated with two moderately correlated (rg = 0.38, s.e.m = 0.07) autism polygenic factors. One of these factors is associated with earlier diagnosis of autism, lower social and communication abilities in early childhood. The second factor is associated with later autism diagnosis, increased socio-emotional difficulties in adolescence, and has moderate to high positive genetic correlations with Attention-Deficit/Hyperactivity Disorder, mental health conditions, and trauma. Overall, our research identifies an axis of heterogeneity in autism, indexed by age at diagnosis, which partly explains heterogeneity in autism and the profiles of co-occurring neurodevelopmental and mental health profiles. Our findings have important implications for how we conceptualise autism and provide one model to explain some of the diversity within autism.
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Understanding developmental trajectories and gender differences in depressive symptoms is clinically relevant. Discerning true differences across gender, age groups, and time is based on the often-neglected premise of measurement invariance (MI) of child and adolescent depression scales. In this systematic review, we assessed available evidence for MI across gender, age groups, and time for depression scales validated in children and adolescents, in studies with at least one assessment under age 18. A literature search using Medline, PsychInfo, Scopus, Web of Science, and Google Scholar databases identified 42 studies that examined MI. MI of eleven scales was tested in 1-9 studies per scale. Conclusions are hampered by different factor solutions tested within some scales. All included questionnaires showed preliminary evidence for MI across gender. Across some studies, crying had higher factor loadings in females compared to males, indicating that crying may be differently related to depression across gender. MI evidence was preliminary in just four scales across time, mostly confined to ages 13-17. One study showed developmental conclusions differed when non-invariance is not accounted for in observed scores. Overall, evidence for MI in child and adolescent depression scales is currently limited.
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Depressão , Humanos , Adolescente , Criança , Masculino , Feminino , Depressão/diagnóstico , Depressão/psicologia , Fatores Sexuais , Fatores Etários , Escalas de Graduação Psiquiátrica/normas , PsicometriaRESUMO
BACKGROUND: Little information is available on the clinical trajectories of children and adolescents who attend general practice (GP) with psychiatric symptoms. We aimed to examine 5-year service use in English primary care for children and adolescents with neurodevelopmental or mental health symptoms or diagnoses. METHODS: In this retrospective cohort study, we used anonymised primary care health records from the Clinical Practice Research Datalink Aurum database (CPRD-Aurum). We identified children and adolescents (aged 3-18 years) presenting to primary care in England between Jan 1, 2000, and May 9, 2016, with a symptom or diagnosis of a mental health, behavioural, or neurodevelopmental condition. Participants were excluded if they had less than 1 year of follow-up. We followed up participants from their index date until either death, transfer out of the practice, or the end of data collection on May 5, 2021, and for trajectory analysis we limited follow-up to 5 years. We used group-based multi-trajectory models to identify clusters with similar trajectories over 5 years of follow-up for three primary outcomes: mental health-related GP contacts, psychotropic medication prescriptions, and specialist mental health-care contact. We did survival analysis to examine the associations between trajectory-group membership and hospital admission for self-harm or death by suicide, as indicators of severe psychiatric distress. FINDINGS: We included 369â340 children and adolescents, of whom 180â863 (49·0%) were girls, 188â438 (51·0%) were boys, 39 (<0·1%) were of indeterminate gender, 290â125 (78·6%) were White, 9161 (2·5%) were South Asian, 10â418 (2·8%) were Black, 8115 (2·2%) were of mixed ethnicity, and 8587 (2·3%) were other ethnicities, and the median age at index presentation was 13·6 years (IQR 8·4-16·7). In the best-fitting, seven-group, group-based multi-trajectory model, over a 5-year period, the largest group (low contact; 207â985 [51·2%]) had low rates of additional service contact or psychotropic prescriptions. The other trajectory groups were moderate, non-pharmacological contact (43â836 [13·0%]); declining contact (25â469 [8·7%]); year-4 escalating contact (18â277 [6·9%]); year-5 escalating contact (18â139; 5·2%); prolonged GP contact (32â147 [8·6%]); and prolonged specialist contact (23â487 [6·5%]). Non-White ethnicity and presentation in earlier study years (eg, 2000-2004) were associated with low-contact group membership. The prolonged specialist-contact group had the highest risk of hospital admission for self-harm (hazard ratio vs low-contact group 2·19 [95% CI 2·03-2·36]) and suicide (2·67 [1·72-4·14]). INTERPRETATION: Most children and adolescents presenting to primary care with psychiatric symptoms or diagnoses have low or declining rates of ongoing contact. If these trajectories reflect symptomatic improvement, these findings provide reassurance for children and adolescents and their caregivers. However, these trajectories might reflect an unmet need for some children and adolescents. FUNDING: National Institute for Health and Care Research and the Wellcome Trust.
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Clínicos Gerais , Transtornos Mentais , Masculino , Criança , Feminino , Humanos , Adolescente , Estudos Retrospectivos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Transtornos Mentais/psicologia , Inglaterra/epidemiologia , Psicotrópicos , Avaliação de Resultados em Cuidados de SaúdeRESUMO
BACKGROUND: Eating disorders (EDs) peak in mid-to-late adolescence and often persist into adulthood. Given their early onset and chronicity, many patients transition from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) for ongoing, speciality ED care. This transition typically occurs at 18 years of age, when important biological, psychosocial, and vocational changes take place. Thus, smooth and effective transitions are paramount for ensuring service continuity, as well as reducing the risk of ED relapse and premature death. Here, we synthesized evidence on transitions from CAMHS to AMHS for young people with EDs, aiming to inform future research, clinical practice, and healthcare policy. METHODS: A systematic review of the literature was conducted. This adhered to PRISMA guidelines. PubMed, Embase, and Scopus electronic databases were queried from inception to December 3, 2023. Leveraging the PICOS framework, study eligibility was evaluated in the qualitative synthesis. Data regarding methodology, analytic approach, and associated outcomes were then extracted. The quality of evidence was examined using critical appraisal tools. Finally, concept mapping was applied to organize findings into a transition framework. RESULTS: The search returned 76 articles. Of these, 14 were included in the final review. Articles were grouped into 'qualitative' (n = 10), 'cross-sectional' (n = 2), and 'longitudinal cohort' (n = 2) studies based on research design. Overall, ED transitions were complex, multifaceted, and challenging for patients, caregivers, and providers alike. This resulted from an interplay of temporal- (e.g., timing of ED onset and transition), stakeholder- (e.g., patient ambivalence towards recovery) and systemic- (e.g., differences between services) related factors. Most studies were of moderate-to-high quality. Findings informed the development of five transition strategies designed to facilitate effective transfers across ED care: Timely talks, Readiness, Inclusion, Preparation, and Synergy (TRIPS). CONCLUSIONS: Transitions from CAMHS to AMHS appear problematic for young people with EDs and other involved stakeholders. The field stands to benefit from TRIPS, an actionable, evidence-based framework that aims to alleviate challenges of transitioning and subsequently improve ED trajectories. As a logical next step, future work should empirically test the TRIPS framework, exploring its predictive utility and clinical value.
Eating disorders often develop in youth and persist into adulthood. Given this, many young people transition from pediatric to adult care for ongoing treatment. This usually occurs at 18 years of age, when important life changes take place, such as leaving home or pursuing higher education. Hence, smooth and effective transitions are critical for mental health. The present review summarized studies investigating transitions from pediatric to adult care for young people with eating disorders, and subsequently developed an evidence-informed transition framework (TRIPS). Based on the 14 studies included in the review, transitions from pediatric to adult care are challenging for young people with eating disorders, as well as for caregivers and providers. This is due to several factors related to the timing of transitions, the types of stakeholders involved, and the differences between care. Looking ahead, the field may benefit from the TRIPS framework that aims to improve transitions and clinical outcomes.
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Psychological distress often onsets during adolescence, necessitating an accurate understanding of its development. Assessing change in distress is based on the seldom examined premise of longitudinal measurement invariance (MI). Thus, we used three waves of data from Next Steps, a representative cohort of young people in the UK (N = 13,539) to examine MI of the General Health Questionnaire-12 (GHQ-12). We examined MI across time and gender from ages 15 to 25 in four competing latent models: (a) a single-factor model, (b) a three-factor correlated model, (c) a bifactor model of "general distress" and two orthogonal specific factors capturing positive and negative wording, and (d) a single-factor model including error covariances of negatively phrased items. We also tested acceptability of assumptions underlying sum score models. For all factor models, residual MI was confirmed from ages 15 to 25 years and across gender. The bifactor model had the best fit. While sum score model fit was not unequivocally acceptable, most mean differences across time and gender were equivalent across sum scores and latent difference scores. Thus, GHQ-12 sum scores may be used to assess change in psychological distress in young people. However, latent scores appear more accurate, and model fit can be improved by accounting for item wording.
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BACKGROUND: There is a scarcity of studies on the association between physical multimorbidity and lower levels of physical activity among older adults from low- and middle-income countries, while the potential mediating variables in this association are largely unknown. METHODS: Cross-sectional, community-based, nationally representative data from the World Health Organization Study on global AGEing and adult health were analyzed. Data on 11 chronic physical conditions were collected. Scoring <150 minutes of moderate- to high-intensity physical activity per week was considered low physical activity. Multivariable logistic regression and mediation analysis were done to assess associations and quality of life measures which might influence these associations. RESULTS: Data on 14,585 people aged ≥65 years were analyzed (mean [SD] age 72.6 (11.5) y, maximum age 114 y; 55.0% women). After adjustment for potential confounders, compared with no chronic conditions, ≥3 conditions were associated with a significant 1.59 to 2.42 times higher odds for low physical activity. Finally, mobility mediated the largest proportion of the association between ≥3 chronic physical conditions and low physical activity (mediated percentage 50.7%), followed by activities of daily living disability (30.7%), cognition (24.0%), affect (23.6%), and pain/discomfort (22.0%). CONCLUSIONS: Physical multimorbidity was associated with higher odds for low physical activity among older adults residing in low- and middle-income countries. Mobility, disability, cognition, affect, and pain/discomfort explained the largest proportion of this association. Given the universal benefits of regular and sustained participation in physical activity, it would be prudent to implement interventions among older people with physical multimorbidity to increase levels of physical activity. Future studies should assess the impact of addressing the identified potential mediators among people with multimorbidity on physical activity levels.
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Atividades Cotidianas , Países em Desenvolvimento , Humanos , Feminino , Idoso , Masculino , Estudos Transversais , Exercício Físico , Multimorbidade , Qualidade de Vida , DorRESUMO
An increased understanding of the interrelations between depressive symptoms among older populations could help improve interventions. However, studies often use sum scores to understand depression in older populations, neglecting important symptom dynamics that can be elucidated in evolving depressive symptom networks. We computed Cross-Lagged Panel Network Models (CLPN) of depression symptoms in 11,391 adults from the English Longitudinal Study of Ageing. Adults aged 50 and above (mean age 65) were followed over 16 years throughout this nine-wave representative population study. Using the eight-item Center for Epidemiological Studies Depression Scale, we computed eight CLPNs covering each consecutive wave. Across waves, networks were consistent with respect to the strength of lagged associations (edge weights) and the degree of interrelationships among symptoms (centrality indices). Everything was an effort and could not get going displayed the strongest reciprocal cross-lagged associations across waves. These two symptoms and loneliness were core symptoms as reflected in strong incoming and outgoing connections. Feeling depressed was strongly predicted by other symptoms only (incoming but not strong outgoing connections were observed) and thus was not related to new symptom onset. Restless sleep had outgoing connections only and thus was a precursor to other depression symptoms. Being happy and enjoying life were the least central symptoms. This research underscores the relevance of somatic symptoms in evolving depression networks among older populations. Findings suggest the central symptoms from the present study (everything was an effort, could not get going, loneliness) may be potential key intervention targets to mitigate depression in older adults.
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Depressão , Solidão , Estudos Longitudinais , Depressão/epidemiologia , SonoRESUMO
BACKGROUND: People with severe mental illness (SMI) have a higher prevalence of several chronic physical health conditions, and the prevalence of physical multimorbidity is expected to rise. The aim of this study was to assess the strength of the association between SMI and physical multimorbidity. STUDY SELECTION AND ANALYSIS: We systematically searched PubMed/Medline, Scopus, Embase, Web of Science, PsycINFO and the behavioural sciences collection databases, from inception to 31 January 2023, for studies that investigated the association between SMI and physical multimorbidity. Humans of any age either clinically diagnosed and/or currently receiving treatment for SMI, specified as schizophrenia (and related psychotic disorders), bipolar disorder and psychotic depression, were eligible. Data from studies selected for inclusion were converted into ORs, with a subsequent meta-analysis conducted. FINDINGS: We included 19 studies with a total of 194 123 patients with SMI with different diagnoses and drawn from the general population. The pooled OR for physical multimorbidity in people with versus without SMI was 1.84 (95% CI 1.33 to 2.54), with the analysis indicating a high level of heterogeneity (98.38%). The other 15 studies included in the systematic review for which it was not possible to conduct a meta-analysis showed strong associations between SMI and physical multimorbidity. CONCLUSIONS: The current evidence highlights the link between SMI and physical multimorbidity. A multidisciplinary approach is now urgent to develop the best models of services tailored to patients with SMI with physical multimorbidities to improve physical, mental and social outcomes. PROSPERO registration number CRD42023395165.
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Transtorno Bipolar , Transtornos Mentais , Transtornos Psicóticos , Esquizofrenia , Humanos , Multimorbidade , Transtornos Mentais/epidemiologia , Transtornos Psicóticos/epidemiologia , Doença CrônicaRESUMO
To understand psychological distress during COVID-19, we need to ensure that the same construct is measured over time and investigate how much of the variance in distress is attributable to chronic time-invariant variance compared to transient time-varying variance. We conducted secondary data analyses of Understanding Society, a U.K. probability-based longitudinal study of adults, using prepandemic (2015-2020) and pandemic data (N = 17,761, April 2020-March 2021). Using the General Health Questionnaire-12 (GHQ-12), analyses encompassed (a) five annual waves before COVID-19 plus the first survey wave during COVID-19 and (b) eight (bi)monthly waves during COVID-19. We investigated (a) longitudinal measurement invariance of distress, (b) time-invariant and time-varying variance components of distress using latent trait-occasion modeling, and (c) predictors of these different variance components. In all analyses, unique measurement invariance in distress was established, indicating the same unidimensional construct was measured using the GHQ before and during COVID-19. Time-varying variance was higher at the first COVID-19 lockdown (April 2020, 61.2%) compared to before COVID-19 (â¼50%), suggesting increased fluctuations in distress at the start of the pandemic. Sensitivity analyses with equal time lags pre- and during COVID-19 confirmed this interpretation. During the pandemic, the highest distress time-varying variance (40.7%) was detected in April 2020, decreasing to 29.0% (July 2020) after restrictions eased. Despite mean-level fluctuations, time-varying variance remained stable during subsequent lockdowns, indicating more rank-order stability after this first major disruption. Loneliness most strongly predicted time-varying variance during the first lockdown. Life dissatisfaction and financial difficulties were associated with both variance components throughout the pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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COVID-19 , Angústia Psicológica , Adulto , Humanos , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Estudos Longitudinais , EmoçõesRESUMO
BACKGROUND: Despite the importance of understanding depressive symptom constellations during adolescence and specifically in looked-after children, studies often only apply sum score models to understand depression in these populations, neglecting associations among single symptoms that can be elucidated in network analysis. The few network analyses in adolescents have relied on different measures to assess depressive symptoms, contributing to inconsistent cross-study results. OBJECTIVE: In three population-based studies using the Short Mood and Feelings Questionnaire, we used network analyses to study depressive symptoms during adolescence and specifically in looked-after children. METHOD: We computed cross-sectional networks (Gaussian Graphical Model) in three separate datasets: the Mental Health of Children and Young People in Great Britain 1999 survey (n=4235, age 10-15 years), the mental health of young people looked after by local authorities in Great Britain 2002 survey (n=643, age 11-17 years) and the Millennium Cohort Study in the UK 2015 (n=11 176, age 14 years). FINDINGS: In all three networks, self-hate emerged as a key symptom, which aligns with former network studies. I was no good anymore was also among the most central symptoms. Among looked-after children, I was a bad person constituted a central symptom, while this was among the least central symptom in the other two datasets. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition symptom I did not enjoy anything was not central. CONCLUSIONS: Findings indicate that looked-after children's depressive symptoms may be more affected by negative self-evaluation compared with the general population. CLINICAL IMPLICATIONS: Intervention efforts may benefit from being tailored to negative self-evaluations.
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Afeto , Depressão , Criança , Humanos , Adolescente , Depressão/diagnóstico , Estudos de Coortes , Estudos Transversais , Reino Unido/epidemiologiaRESUMO
Bifactor models are increasingly being utilized to study latent constructs such as psychopathology and cognition, which change over the lifespan. Although longitudinal measurement invariance (MI) testing helps ensure valid interpretation of change in a construct over time, this is rarely and inconsistently performed in bifactor models. Our review of MI simulation literature revealed that only one study assessed MI in bifactor models under limited conditions. Recommendations for how to assess MI in bifactor models are suggested based on existing simulation studies of related models. Estimator choice and influence of missing data on MI are also discussed. An empirical example based on a model of the general psychopathology factor (p) elucidates our recommendations, with the present model of p being the first to exhibit residual MI across gender and time. Thus, changes in the ordered-categorical indicators can be attributed to changes in the latent factors. However, further work is needed to clarify MI guidelines for bifactor models, including considering the impact of model complexity and number of indicators. Nonetheless, using the guidelines justified herein to establish MI allows findings from bifactor models to be more confidently interpreted, increasing their comparability and utility.
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Adolescence to emerging adulthood is a critical period for the onset of depressive symptoms. Understanding symptom change during this period is thus of great clinical relevance. This understanding is, however, based on the premise of the accurate measurement of depressive symptoms across time and sex, typically untested in applied research. The present study investigated longitudinal and sex measurement invariance (MI) of the Short Mood and Feelings Questionnaire (SMFQ), a widely used unidimensional 13-item measure of self-reported depressive symptoms. We employed 10 waves of the Avon Longitudinal Study of Parents and Children, a population-based study in South-West England (N = 7,364; ages 11-26). The SMFQ exhibited increasing consistency with age: Scalar longitudinal MI was not supported by all indices in models that included ages 11 and 13, but strict MI was established from ages 14-26. At each wave, at least partial strict MI across sex was established. Sum score models with equal weightings had acceptable fit, and good reliability which was equivalent to reliability using differential weightings. External validity for sum scores was also comparable to factor scores. Thus, sum scores seem an appropriate, practical choice in many settings. Overall, findings support the use of SMFQ in assessing change in depressive symptoms from adolescence into emerging adulthood, specifically ages 14-26. Some caution is necessary when comparing the construct at ages 11-13 with ages greater than 17, when measurement models were not fully invariant. This research informs epidemiological and clinical studies on the applicability of the SMFQ across time and sex. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Afeto , Emoções , Criança , Humanos , Adolescente , Adulto , Adulto Jovem , Estudos Longitudinais , Reprodutibilidade dos Testes , Inquéritos e Questionários , Depressão/diagnósticoRESUMO
Human males and females show average gender/sex differences for certain psychological phenomena. Multiple factors may contribute to these differences, including sex chromosomes, exposure to gonadal hormones, and socialization or learning. This study investigated potential hormonal and socialization/learning influences on gender/sex differences in childhood preferences for color, specifically pink and red vs. blues, and for toys. Children (aged 4 to 11 years) with congenital adrenal hyperplasia (CAH, n = 43 girls and 37 boys), marked by elevated prenatal adrenal androgen exposure, and without CAH (n = 41 girls and 31 boys) were studied. Prior research indicates girls with CAH are masculinized for certain behaviors, such as toy choices, while boys with CAH generally do not differ from boys without CAH. In the current study, children indicated preferences for stereotyped hues of pink vs. blue as well as two control color pairs. They also indicated their preference between gender/sex-typed toys (doll vs. car) presented in black and white, in gender/sex-congruent colors (pink doll vs. blue car) and in gender/sex-incongruent colors (pink car vs. blue doll). Color findings: Control girls preferred stereotyped pink over blue more than boys or girls with CAH did; the latter two groups did not differ in their color preferences. No preference differences occurred for other color pairs. Toy findings: In black/white or gender/sex-congruent colors, boys preferred the car more than control girls or girls with CAH did, while girls with CAH preferred the car more than control girls did. In gender/sex-incongruent colors (pink car vs. blue doll), boys still preferred the car, while girls with CAH showed reduced and control girls showed increased preferences for the pink car compared to the car preferences in black/white. Results support learning theories of color preferences, perhaps also influenced by pre-existing toy preferences which may occur for other reasons, including early androgen exposure. Specifically, girls with CAH may have learned they do not enjoy stereotypical toys for girls, often colored pink, and pink coloring may subsequently diminish their preference for a car. Our results highlight the importance of gonadal hormones and learning in the development of childhood toy and color preferences.
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Hiperplasia Suprarrenal Congênita , Androgênios , Gravidez , Humanos , Criança , Masculino , Feminino , Hiperplasia Suprarrenal Congênita/psicologia , Caracteres Sexuais , Identidade de Gênero , Comportamento Infantil/psicologiaRESUMO
OBJECTIVE: Non-suicidal self-injury (NSSI) appears to be more common among women than men, though the underlying reasons for this remain unclear. In a community sample of young adults (N = 996, aged 18-33) assessed during the COVID-19 pandemic, we investigated alternative explanation for the NSSI prevalence gap: are women more likely to experience the feelings which lead to NSSI as a coping strategy, or does this prevalence gap result from differences in how men and women respond to distress? METHODS: Cross-sectional mediation and moderation analyses tested how self-reported psychological distress (K10), emotion dysregulation (DERS), and impulsivity (UPPS-P) may contribute to a higher prevalence of NSSI among women. RESULTS: Women were twice as likely as men to report past-year NSSI (14.47% versus 7.78%, OR = 2.00, 95% CI [1.29, 3.13]). Women reported significantly higher psychological distress and significantly lower sensation seeking and positive urgency than men. Psychological distress partially statistically mediated the relationship between gender and past-year NSSI. Gender did not significantly moderate associations between psychological distress, emotion dysregulation, or impulsivity and past-year NSSI. Past-year NSSI prevalence did not significantly decrease with age and we found no significant age by gender interaction. CONCLUSIONS: Greater levels of NSSI in young women are partly explained by their greater levels of psychological distress, but not by differences in how men and women respond to this distress. Given similar levels of psychological distress, emotion dysregulation, and impulsivity, women and men are similarly likely to experience NSSI. HighlightsWomen aged 18-33 were significantly more likely to report past-year NSSI than menWomen's greater psychological distress contributed to their higher NSSI prevalenceVariables investigated here were similarly associated with NSSI in men and women.
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COVID-19 , Angústia Psicológica , Comportamento Autodestrutivo , Masculino , Adulto Jovem , Humanos , Feminino , Estudos Transversais , Pandemias , COVID-19/epidemiologia , Emoções , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Comportamento ImpulsivoRESUMO
The disease burden of depression among older populations is high. Detecting changes in late-life depression is predicated on the seldom-examined assumption of longitudinal measurement invariance (MI). Therefore, we investigated longitudinal MI of the 8-item Center for Epidemiological Studies Depression Scale in core members repeatedly assessed in the English Longitudinal Study of Aging, a nine-wave representative study of the English population above 50 years of age (initial N = 11,391). Based on prior literature, we tested MI of a one-factor solution, a one-factor solution with correlated errors of reversely coded items, and a two-factor solution (depressed affect/somatic complaints). For all factor solutions, residual MI was confirmed across nine waves and gender. Sum score models (i.e., all factor loadings constrained to equity) had a good fit. Depression scores correlated with psychiatric diagnoses, ill health, lower life quality, and female gender. Associations slightly differed depending on the factor solutions, signifying their applicability across contexts.
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Envelhecimento , Depressão , Humanos , Feminino , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Estudos Longitudinais , Psicometria , Reprodutibilidade dos Testes , Estudos Epidemiológicos , Análise FatorialRESUMO
Few studies assessing the effects of COVID-19 on mental health include prospective markers of risk and resilience necessary to understand and mitigate the combined impacts of the pandemic, lockdowns, and other societal responses. This population-based study of young adults includes individuals from the Neuroscience in Psychiatry Network (n = 2403) recruited from English primary care services and schools in 2012-2013 when aged 14-24. Participants were followed up three times thereafter, most recently during the initial outbreak of the COVID-19 outbreak when they were aged between 19 and 34. Repeated measures of psychological distress (K6) and mental wellbeing (SWEMWBS) were supplemented at the latest assessment by clinical measures of depression (PHQ-9) and anxiety (GAD-7). A total of 1000 participants, 42% of the original cohort, returned to take part in the COVID-19 follow-up; 737 completed all four assessments [mean age (SD), 25.6 (3.2) years; 65.4% female; 79.1% White]. Our findings show that the pandemic led to pronounced deviations from existing mental health-related trajectories compared to expected levels over approximately seven years. About three-in-ten young adults reported clinically significant depression (28.8%) or anxiety (27.6%) under current NHS guidelines; two-in-ten met clinical cut-offs for both. About 9% reported levels of psychological distress likely to be associated with serious functional impairments that substantially interfere with major life activities; an increase by 3% compared to pre-pandemic levels. Deviations from personal trajectories were not necessarily restricted to conventional risk factors; however, individuals with pre-existing health conditions suffered disproportionately during the initial outbreak of the COVID-19 pandemic. Resilience factors known to support mental health, particularly in response to adverse events, were at best mildly protective of individual psychological responses to the pandemic. Our findings underline the importance of monitoring the long-term effects of the ongoing pandemic on young adults' mental health, an age group at particular risk for the emergence of psychopathologies. Our findings further suggest that maintaining access to mental health care services during future waves, or potential new pandemics, is particularly crucial for those with pre-existing health conditions. Even though resilience factors known to support mental health were only mildly protective during the initial outbreak of the COVID-19 pandemic, it remains to be seen whether these factors facilitate mental health in the long term.
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COVID-19 , Adulto , Ansiedade/epidemiologia , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Depressão/epidemiologia , Surtos de Doenças , Feminino , Humanos , Estudos Longitudinais , Masculino , Saúde Mental , Pandemias , Estudos Prospectivos , SARS-CoV-2 , Adulto JovemRESUMO
Background: Studies report a strong impact of the COVID-19 pandemic and related stressors on the mental well-being of the general population. In this paper, we investigated whether COVID-19 related concerns and social adversity affected schizotypal traits, anxiety, and depression using structural equational modelling. In mediation analyses, we furthermore explored whether these associations were mediated by healthy (sleep and physical exercise) or unhealthy behaviours (drug and alcohol consumption, excessive media use). Methods: We assessed schizotypy, depression, and anxiety as well as healthy and unhealthy behaviours and a wide range of sociodemographic scores using online surveys from residents of Germany and the United Kingdom over 1 year during the COVID-19 pandemic. Four independent samples were collected (April/May 2020: N=781, September/October 2020: N=498, January/February 2021: N=544, May 2021: N=486). The degree of schizotypy was measured using the Schizotypal Personality Questionnaire (SPQ), anxiety, and depression symptoms were surveyed with the Symptom Checklist (SCL-27), and healthy and unhealthy behaviours were assessed with the Coronavirus Health Impact Survey (CRISIS). Structural equation models were used to consider the influence of COVID-19 related concerns and social adversity on depressive and anxiety-related symptoms and schizotypal traits in relation to certain healthy (sleep and exercise) and unhealthy behaviours (alcohol and drug consumption, excessive media use). Results: The results revealed that COVID-19 related life concerns were significantly associated with schizotypy in the September/October 2020 and May 2021 surveys, with anxiety in the September/October 2020, January/February 2021, and May 2021 surveys, and with depressive symptoms in all surveys. Social adversity significantly affected the expression of schizotypal traits and depressive and anxiety symptoms in all four surveys. Importantly, we found that excessive media consumption (>4 hr per day) fully mediated the relationship between COVID-19 related life concerns and schizotypal traits in the January/February 2021 survey. Furthermore, several of the surveys showed that excessive media consumption was associated with increased depressive and anxiety-related symptoms in people burdened by COVID-19 related life. Conclusions: The ongoing uncertainties of the pandemic and the restrictions on social life have a strong impact on mental well-being and especially the expression of schizotypal traits. The negative impact is further boosted by excessive media consumption, which is especially critical for people with high schizotypal traits. Funding: FK received funding from the European Union's Horizon 2020 (Grant number 754,462). SN received funding from the Cundill Centre for Child and Youth Depression at the Centre for Addiction and Mental Health, Toronto, Canada and the Wellcome Trust Institutional Strategic Support Fund from the University of Cambridge.
The 2020 COVID-19 pandemic, and the measures different governments took to contain it, harmed many people's mental well-being. The restrictions, combined with pandemic-related uncertainty, caused many individuals to experience increased stress, depression, and anxiety. Many people turned to unhealthy behaviours to cope, including consuming more alcohol or drugs, using media excessively, developing poor sleeping habits, or reducing the amount of exercise they did. Stress, drugs, poor sleep, and uncertainty can increase an individual's risk of developing psychotic symptoms, including delusions, hallucinations, or difficulty thinking clearly. These symptoms may be temporary or part of a more lasting condition, like schizophrenia. The risk of developing these symptoms increases in people with 'schizotypal traits', such as a lack of close relationships, paranoia, or unusual or implausible beliefs. These individuals may be especially vulnerable to the harmful mental health effects of the pandemic. Daimer et al. demonstrated that people who were more worried about their life stability or financial situation during the 2020 COVID-19 pandemic had worse mental well-being than those who felt secure. In the experiments, volunteers completed a series of online mental health questionnaires at four different time points during the pandemic. People who reported feeling lonely, having negative thoughts, or experiencing fewer positive social interactions had more symptoms of mental illness. People who experienced more life disruptions also reported more anxiety or depression symptoms and more schizotypal traits. Daily consumption of at least four hours of digital media exacerbated negative mental health symptoms, and people with more pandemic-related life concerns also spent more time on digital media Daimer et al. suggest that increased media consumption among people with pandemic-related hardships may have increased mental health symptoms and schizotypal traits in these individuals. The survey results suggest that maintaining a healthy lifestyle, including meaningful relationships, is essential to staying mentally healthy during extreme situations like a global pandemic. Protective interventions such as strengthening social support networks, providing mental health education, or increasing mental healthcare provisions are essential to prevent poor mental health outcomes during future crises.