Depression Literacy and Self-Reported Help-Giving Behaviour in Adolescents in Ireland.

This questionnaire-based study aimed to explore depression literacy (DL) and help-giving experiences in 12-18-year-old adolescents (N = 535, Mage = 14.9 years, 51.8% male) in Ireland. In response to a vignette depicting a character displaying symptoms of depression, 46.7% labelled these symptoms 'depression', with increasing age and empathy associated with increased likelihood of labelling as such. Almost all (92.1%) believed the character needed help, but the perceived helpfulness of potential responses varied. Over one-third (38.2%) indicated they knew someone who had displayed similar symptoms in the past year, with 85.2% of these reporting having helped this person. Reported help-giving responses included comforting the person, encouraging professional help-seeking, and informing an adult. The findings suggest adolescent DL can be best supported by developmentally-sensitive interventions that encourage empathy and the importance of engaging adults' assistance.

Two Sides of the Coin: The Roles of Adverse Childhood Experiences and Positive Childhood Experiences in College Students' Mental Health.

Several studies have established a link between adverse childhood experiences (ACEs) and mental health issues in college students. However, less is known about how positive childhood experiences (PCEs) may promote mental health and well-being, and potentially act as a buffer in the relationship between risk exposure and poor outcomes. This study investigates how ACEs and PCEs relate to college students' mental health (N = 321), within the framework of Resiliency Theory with specific attention focus on the compensatory and the protective factors models. Three key hypotheses were examined using quantitative data collected by way of an online anonymous survey: (1) ACEs will predict poorer mental health outcomes; (2) PCEs will predict better mental health outcomes and will lessen the negative effects of ACEs on mental health outcomes (compensatory factor model), and (3) PCEs will moderate the association between ACEs and mental health outcomes so that the relationship will be weaker among participants with higher PCEs (protective factor model). Findings supported each of these hypotheses and are important for our understanding of the long-term mental health correlates of ACEs and PCEs among college students. Our study underscores the importance of promoting PCEs while also underscoring the necessity of proactively preventing ACEs. Practical implications are discussed in relation to improving assessments of student needs and providing targeted interventions for those at risk.

The Precision in Psychiatry (PIP) study: Testing an internet-based methodology for accelerating research in treatment prediction and personalisation.

BACKGROUND: Evidence-based treatments for depression exist but not all patients benefit from them. Efforts to develop predictive models that can assist clinicians in allocating treatments are ongoing, but there are major issues with acquiring the volume and breadth of data needed to train these models. We examined the feasibility, tolerability, patient characteristics, and data quality of a novel protocol for internet-based treatment research in psychiatry that may help advance this field. METHODS: A fully internet-based protocol was used to gather repeated observational data from patient cohorts receiving internet-based cognitive behavioural therapy (iCBT) (N = 600) or antidepressant medication treatment (N = 110). At baseline, participants provided > 600 data points of self-report data, spanning socio-demographics, lifestyle, physical health, clinical and other psychological variables and completed 4 cognitive tests. They were followed weekly and completed another detailed clinical and cognitive assessment at week 4. In this paper, we describe our study design, the demographic and clinical characteristics of participants, their treatment adherence, study retention and compliance, the quality of the data gathered, and qualitative feedback from patients on study design and implementation. RESULTS: Participant retention was 92% at week 3 and 84% for the final assessment. The relatively short study duration of 4 weeks was sufficient to reveal early treatment effects; there were significant reductions in 11 transdiagnostic psychiatric symptoms assessed, with the largest improvement seen for depression. Most participants (66%) reported being distracted at some point during the study, 11% failed 1 or more attention checks and 3% consumed an intoxicating substance. Data quality was nonetheless high, with near perfect 4-week test retest reliability for self-reported height (ICC = 0.97). CONCLUSIONS: An internet-based methodology can be used efficiently to gather large amounts of detailed patient data during iCBT and antidepressant treatment. Recruitment was rapid, retention was relatively high and data quality was good. This paper provides a template methodology for future internet-based treatment studies, showing that such an approach facilitates data collection at a scale required for machine learning and other data-intensive methods that hope to deliver algorithmic tools that can aid clinical decision-making in psychiatry.

Risk factors for COVID-19-related stress among college-going students.

OBJECTIVE: To explore the degree of COVID-19-related stress among college students enrolled in higher level institutions and identify socio-demographic and psychosocial factors that may predict, or be associated with, higher levels of pandemic-related distress. METHOD: Data were obtained from a cross-sectional survey completed by 321 college students primarily recruited from Universities in Ireland. Ages ranged between 18-21 years (n = 176) and 22-25 years (n = 145). Participants answered some demographic questions before completing scales assessing their experience of childhood adversity, their present resilience and levels of psychological distress, as well as their COVID-19-specific stress. RESULTS: Multiple regression analysis revealed that students who were female, who had chronic illness, who experienced monetary concerns and who expressed psychological distress experienced greater stress related to COVID-19. CONCLUSION: Findings suggest that certain categories of college students may be at higher risk for experiencing poor mental health during a global pandemic. Higher level institutions should consider this when designing and delivering support services aiming to promote student mental health and alleviate mental distress.

Role of thwarted belongingness, perceived burdensomeness and psychological distress in the association between adverse childhood experiences and suicidal ideation in college students.

BACKGROUND: Adverse childhood experiences (ACEs) have a detrimental impact on short- and long-term mental and physical health. A growing body of research has indicated that the prevalence of suicidal phenomena is significantly higher among individuals with a history of ACEs. However, there is a lack of understanding about processes that result in ACEs leading to suicidal ideation when testing within a theoretical framework. AIMS: To develop and test a multidimensional model that would explain the association between ACEs and suicidal ideation in college students. METHOD: Data were obtained from a cross-sectional survey completed by 321 college students primarily recruited from universities in Ireland. Participants were aged 18-21 (n = 176) and 22-25 years (n = 145). An ACEs questionnaire, the Interpersonal Needs Questionnaire, which assessed thwarted belongingness and perceived burdensomeness, the CORE-10, which assessed psychological distress, and the Suicide Ideation Scale (SIS) were administered. RESULTS: After controlling for gender and sexual orientation, results revealed a significant direct effect of ACEs on suicidal ideation such that more accumulated ACEs were associated with higher suicidal ideation (effect size 0.30; 95% CI 0.047-0.538). A significant indirect effect of ACEs on suicidal ideation through perceived burdensomeness and psychological distress, and thwarted belongingness and psychological distress, was observed (effect size 0.90; 95% CI 0.558-1.270). CONCLUSIONS: Findings suggest that ACEs have a detrimental impact on college students' mental health. Results highlight the potential benefits of ACE-informed interventions that target thwarted belongingness and perceived burdensomeness to countervail suicidal ideation in college students.

Parents' Experiences of Their Child's Solid-Organ Transplant: A Meta-Ethnography of Qualitative Studies.

OBJECTIVE: The aim of this paper was to conduct a systematic review and meta-ethnography of qualitative studies examining the experiences of parents adjusting to life after the solid organ transplant (SOT) of their child. METHODS: A systematic review of the literature was conducted to identify qualitative studies that examined this topic. The search retrieved 4,964 studies to review against inclusion criteria. A total of 21 studies were included in the meta-ethnography. A reciprocal translation was conducted to compare themes identified in each study. A line of argument synthesis was then conducted in order to integrate the similarities and differences between all of the studies into a new interpretative context. RESULTS: The synthesis identified four themes: (a) adjusting to life after transplant, (b) factors that facilitate adjustment, (c) factors that disrupt adjustment, and (d) changes caused by transplant. As a result of the synthesis, a new interpretation of parents' experiences of adjusting to life after the SOT of their child was constructed. A summary figure is presented. CONCLUSION: This review found that while parents may struggle to adapt to life post-transplant and the demands of caring for their child, the experience can also result in the development of new skills, a new appreciation for life, and viewing the self in a more positive manner. A better understanding of parental experiences will promote the development of more effective interventions for the adjustment of parents and families to post-transplant life.

Parenting with a spinal cord injury: A systematic review of mothers' and fathers' experiences.

OBJECTIVE: A significant gap in the literature is the synthesis of qualitative studies exploring experiences of parenting with a spinal cord injury (SCI). Recent articles have tended to focus on disability more broadly, failing to account for the unique experience of the suddenness of SCI. METHOD: This article focuses on a qualitative systematic review of articles that addresses parents' experiences of parenting with an SCI. An analysis of seven articles and one book that met the inclusion criteria was conducted. RESULTS: Three key themes were identified as pertinent factors that impact parents' experiences: parenting amplifying the disability, experiencing and challenging negative social attitudes, and continuities and change in the parenting role. CONCLUSIONS: These findings highlighted the constraints imposed upon people within both the public and private domains of their lives. Psychoeducation about SCI can facilitate greater inclusion and reduced stigma in society, while support in adjusting to their SCI would be helpful in fostering the parent-child relationship in the context of a life-changing injury. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Adolescent Endorsement of the "Weak-Not-Sick" Stereotype for Generalised Anxiety Disorder: Associations with Prejudice, Discrimination, and Help-Giving Intentions toward Peers.

Stigma, comprising negative stereotypes, prejudice (negative affective reactions) and discrimination towards a member of a particular group, is of increasing interest in the context of mental illness. However, studies examining clinical anxiety stigma are lacking, particularly with regard to generalised anxiety disorder (GAD). There is also a lack of research into adolescent anxiety stigma, despite adolescence being a key period for early intervention for anxiety disorders, and research showing that stigma has been implicated in low rates of help-seeking and problematic peer relationships among adolescents with mental illness. Stigma has also been negatively associated with help-giving responses toward those with mental illness. Initial studies suggest that the 'weak-not-sick' (WNS) stereotype may be central to anxiety stigma. The present study aims to examine the endorsement of the WNS stereotype in the context of GAD, and its relationship to prejudice, discrimination, and help-giving responses among adolescents. A vignette-based survey measure was completed by 242 adolescents (74 male, 165 female, and three participants who recorded their gender as "other") in Ireland aged between 15 and 19 years. The results of the study found that endorsement of the WNS stereotype was significantly associated with higher prejudice and discrimination, as well as lower levels of help-giving intentions. A multiple mediator model is presented showing both a direct relationship between endorsement of WNS and help-giving, and an indirect relationship between WNS and help-giving mediated by the prejudicial components of anger, fear and pity, and discrimination as assessed by desired social distance. This study adds to the limited knowledge base on stigma towards GAD in adolescents and provides a model for how anxiety stigma may relate to help-giving. This has implications for interventions to reduce stigmatising and increase help-giving responses.

Patient and family perspectives of paediatric psychogenic non-epileptic seizures: A systematic review.

Exploring the perspectives of those affected by psychogenic non-epileptic seizures (PNES) may be essential in learning more about the nature of this condition. The aim of this systematic review is to synthesise the evidence regarding the perspectives of children and adolescents with PNES, and the perspectives of their parents, caregivers and families. Studies were included if they (1) explored PNES in a paediatric population, (2) explored the perspectives of the child or adolescent with PNES, or the perspectives of their parents, caregivers or families, (3) were original research, and (4) were written in the English language. Eight studies were identified for inclusion following searching of CINAHL Complete, Medline (Ovid), PsycINFO, PubMed and Web of Science databases, along with additional hand searching of reference lists. Quality assessment of articles was conducted using the Critical Appraisal Skills Programme (CASP) qualitative checklist. Seven articles were deemed high quality, and one article was deemed moderate quality. Common threads across studies included: "legitimacy and the importance of understanding", "distress and the social and emotional impact of PNES" and "moving forward". Clinicians must take care in the delivery of the diagnosis; including the use of an appropriate name for this condition, and providing an explanation of PNES that is acceptable to the patient, as well as ensuring that follow-up support is provided. Further reviews are required that utilise more well-established quality appraisal scoring systems and with the inclusion of grey literature, which refers to evidence not published by commercial academic publishers.

The predictive effect of empathy and social norms on adolescents' implicit and explicit stigma responses.

Research indicates that adolescents who experience mental health difficulties are frequently stigmatised by their peers. Stigmatisation is associated with a host of negative social and psychological effects, which impacts a young person's well-being. As a result, the development of effective anti-stigma strategies is considered a major research priority. However, in order to design effective stigma reduction strategies, researchers must be informed by an understanding of the factors that influence the expression of stigma. Although evidence suggests that empathy and social norms have a considerable effect on adolescents' social attitudes and behaviours, research has yet to examine whether these factors significantly influence adolescents' responses toward their peers with mental health difficulties. Thus, this study aims to examine whether empathy (cognitive and affective) and peer norms (descriptive and injunctive) influence adolescents' implicit and explicit stigmatising responses toward peers with mental health problems. A total of 570 (221 male and 348 female; 1 non-specified) adolescents, aged between 13 and 18 years (M = 15.51, SD = 1.13), participated in this research. Adolescents read vignettes describing male/female depressed and 'typically developing' peers. Adolescents answered questions assessing their stigmatising responses toward each target, as well as their empathic responding and normative perceptions. A sub-sample of participants (n=173) also completed an IAT assessing their implicit stigmatising responses. Results showed that descriptive norms exerted a substantial effect on adolescents' explicit responses. Cognitive empathy, affective empathy and injunctive norms exerted more limited effects on explicit responses. No significant effects were observed for implicit stigma. Overall, empathy was found to have limited effects on adolescents' explicit and implicit stigmatising responses, which may suggest that other contextual variables moderate the effects of dispositional empathy on responding. In conclusion, these findings suggest that tackling the perception of negative descriptive norms may be an effective strategy for reducing explicit stigmatising responses among adolescents.

The Development of an Empirical Model of Mental Health Stigma in Adolescents.

BACKGROUND: Research on mental health stigma in adolescents is hampered by a lack of empirical investigation into the theoretical conceptualisation of stigma, as well as by the lack of validated stigma measures. This research aims to develop a model of public stigma toward depression in adolescents and to use this model to empirically examine whether stigma is composed of three separate dimensions (Stereotypes, Prejudice and Discrimination), as is theoretically proposed. METHOD: Adolescents completed self-report measures assessing their stigmatising responses toward a fictional peer with depression. An exploratory factor analysis (EFA; N=332) was carried out on 58-items, which proposed to measure aspects of stigma. A confirmatory factor analysis (CFA; N=236) was then carried out to evaluate the validity of the observed stigma model. Finally, higher-order CFAs were conducted in order to assess whether the observed model supported the tripartite conceptualisation of stigma. RESULTS: The EFA returned a seven-factor model of stigma. These factors were designated as Dangerousness, Warmth & Competency, Responsibility, Negative Attributes, Prejudice, Classroom Discrimination and Friendship Discrimination. The CFA supported the goodness-of-fit of this seven-factor model. The higher-order CFAs indicated that these seven factors represented the latent constructs of, Stereotypes, Prejudice and Discrimination, which in turn represented Stigma. CONCLUSIONS: Overall, results support the tripartite conceptualisation of stigma and suggest that measurements of mental health stigma in adolescents should include assessments of all three dimensions. These results also highlight the importance of establishing valid and reliable measures for assessing stigma in adolescents.

Factors associated with acceptance of peers with mental health problems in childhood and adolescence.

BACKGROUND: Research suggests that children's reactions to peers with mental health problems are related to the maintenance and outcomes of these problems. However, children's perceptions of such peers, particularly those with internalising problems, are neither well researched nor understood. The present study aimed to test a series of models relating socio-demographic and attributional variables to the acceptance of hypothetical boys and girls with attention deficit hyperactivity disorder (ADHD) and depression. METHODS: A sample of 595 participants, drawn from five different age-groups spanning early childhood to late adolescence, completed a booklet of questions in response to two vignettes describing the behaviour of hypothetical target peers with depression and ADHD. The sample was drawn from schools randomly selected in the east of Ireland. RESULTS: The models indicated that age and gender of the participant, and the perceived responsibility of the target character for his/her condition, were the three most important predictors of acceptance in all models. However, the relationship between these variables and acceptance varied depending on the gender of the target child and the condition (depression or ADHD) in the models tested. CONCLUSIONS: The findings of the study suggest that the relationships between socio-demographic and attributional variables and acceptance of peers with mental health problems depend on the type of mental health problem under consideration. The findings have implications for the development of information and education programmes to improve the integration of children with mental health problems.

Adolescents' beliefs about sources of help for ADHD and depression.

The peer group begins to become a source of support during late childhood and adolescence making it important to understand what type of help young people might suggest to a friend with an emotional or behavioral problem. Three groups of young people participated in the study with average ages of 12 (N = 107), 14 (N = 153) and 16 years (N = 133). All participants were presented with vignettes describing fictional peers, two of whom had symptoms of clinical problems (ADHD and depression) and a third comparison peer without symptoms. Results indicate that all participants distinguished between clinical and comparison vignette characters and they believed that the characters with clinical symptoms needed help. The 16-year-olds were more likely to differentiate between the two clinical vignettes in terms of the type of help suggested. The results are discussed in light of previous research on adolescents' understanding of sources of help for mental health problems.