Suicide is the third leading cause of death worldwide among youth aged 10- to 19, and mental disorders are often associated in the etiology of suicidal behavior. Mental disorders are often ...under-diagnosed and under-treated in young people, a situation likely to increase the severity of the disorder and suicide risk. Presence of school difficulties may, in some cases, be a consequence of mental disorder, and theses difficulties are observable. Therefore, early detection and early intervention of school difficulties may alleviate the development of mental disorders and suicide vulnerability. The aim of this study is to understand the link between school difficulties and suicide risk.
We used the data bank gathered by the McGill Group on Suicide Studies over the past two decades through interviews with the relatives of individuals who died by suicide and with individuals from the community as a control group. We included data on common sociodemographic characteristics, life events and mental health characteristics identified before age 18, among individuals who died before the age of 35 or were interviewed before the age of 35. We identified 200 individuals who died by suicide and 97 living controls. We compared groups according to gender and characteristics.
Within the total sample, 74% were male, 13% had met with academic failure, 18% had engaged in inappropriate behavior at school, and 18% presented combined school difficulties. Combined school difficulties (academic failure and inappropriate behavior) for both sexes and academic failure alone for males were associated with higher suicide risk before the age of 35. School difficulties generally began in early childhood and were linked to mental disorders/difficulties and substance abuse before age 18.
This study underlines the importance for parents, teachers, and educators to identify children with school difficulties-academic failure and behavioral difficulties at school-as early as possible in order to be able to propose adapted interventions. Early identification and proper diagnosis may prevent chronicity of some disorders, accumulation of adverse events, and even suicide.
Beyond sex as a binary or biological variable, within-sex variations related to sociocultural gender variables are of increasing interest in psychiatric research to better understand individual ...differences. Using a data-driven approach, we developed a composite gender score based on sociodemographic and psychosocial variables showing sex differences in a sample of psychiatric emergency patients upon admission (N = 1708; 39.4% birth-assigned females; mean age = 40 years; age standard deviation = 14). This gender score was extracted from a confirmatory factor analysis (CFI = 0.966; RMSEA = 0.044, SRMR = 0.030) and could predict a person's birth-assigned sex with 67% accuracy. This score allowed the further identification of differences on impulsivity measures that were absent when looking solely at birth-assigned sex. Female birth-assigned sex was also associated with higher rates of mood and personality disorder diagnoses, while higher feminine gender scores were related to higher proportions of anxiety and mood disorder diagnoses. By contrast, male birth-assigned sex and higher masculine gender scores were associated with higher proportions of psychotic and substance use disorder diagnoses. Patients with undifferentiated gender scores (i.e., scoring between masculine and feminine threshold defined by terciles) were more represented in the psychotic disorder group. Considering both sex and gender in psychiatric research is essential and can be achieved even when using secondary data to index gender comprised of demographic and psychosocial variables.
The merging of evidence-based interventions with supported employment programs are being increasingly studied, with encouraging results. The current study is aimed at determining the impact of a ...brief cognitive behaviour therapy group intervention adapted for supported employment programs (called CBT-SE) on the work outcomes of: obtaining a competitive job, number of weeks worked, and number of hours worked per week. Participants were randomized to either receive the 8-session CBT-SE group on top of their supported employment program, or to only receive their support employment program. The results show that those who received CBT-SE were significantly more likely to obtain a job (75% vs 58%), and worked a significantly greater number of hours (24 vs 18 hours per week). No differences were found in terms of number of weeks worked. Those in the CBT-SE condition also experienced a significant decrease in their negative symptoms over time, compared to the control condition. Although replication is needed, these results suggest that a brief cognitive-behavioural intervention specifically tailored to work-related issues can be greatly beneficial.
Physical and sexual abuse in childhood is a worldwide phenomenon with potentially dramatic consequences of both a psychological and physical nature. Measures of primary prevention have been developed ...in some countries. In the USA, child protection services reports and research surveys indicate that child sexual abuse has been on the decline in recent decades. Results are less clear for physical and overall abuse. The aim of this study was to describe how childhood abuse has changed over the years in Canada through an analysis of the 2012 Canadian Community Health Survey: Mental Health Edition data. The sample comprised 22,775 respondents ages 20 and over who completed a child abuse questionnaire. Respondents born from 1983 to 1992 reported significantly less overall abuse, physical abuse, and sexual abuse than did older generations, with the exception of people born in 1942 or earlier. The decrease was observed among men and women and across all the regions of Canada.
Conclusion:
The results are encouraging in that they may have an impact on life expectancy, severity of various chronic disorders, and suicide in the population. They also support policies that have focused on improving the childhood environment in the 1990s. Results also underline the importance of using different kinds of data sources for evaluating child abuse.
What is Known:
• Physical and sexual abuse in childhood has been associated with lower life expectancy in connection with an array of chronic diseases, including mental disorders, and with suicide.
• Measures of primary prevention have been developed in some countries, such as the USA and Canada.
What is New:
• Canadians born from 1983 to 1992 report significantly less overall abuse, physical abuse, and sexual abuse than older generations do.
• These encouraging results support policies implemented in the 1990s focused on improving the childhood environment.
Individuals with severe mental illnesses are at greater risk of offenses and violence, though the relationship remains unclear due to the interplay of static and dynamic risk factors. Static factors ...have generally been emphasized, leaving little room for temporal changes in risk. Hence, this longitudinal study aims to identify subgroups of psychiatric populations at risk of violence and criminality by taking into account the dynamic changes of symptomatology and substance use.
A total of 825 patients from the MacArthur Violence Risk Assessment Study having completed five postdischarge follow-ups were analyzed. Individuals were classified into outcome trajectories (violence and criminality). Trajectories were computed for each substance (cannabis, alcohol, and cocaine, alone or combined) and for symptomatology and inputted as dynamic factors, along with other demographic and psychiatric static factors, into binary logistic regressions for predicting violence and criminality. Best predictors were then identified using backward elimination, and receiver operator characteristic (ROC) curves were calculated for both models.
Two trajectories were found for violence (low versus high violence). Best predictors for belonging in the high-violence group were low verbal intelligence (baseline), higher psychopathy (baseline) and anger (mean) scores, persistent cannabis use (alone), and persistent moderate affective symptoms. The model's area under the curve (AUC) was 0.773. Two trajectories were also chosen as being optimal for criminality. The final model to predict high criminality yielded an AUC of 0.788, retaining as predictors male sex, lower educational level, higher score of psychopathy (baseline), persistent polysubstance use (cannabis, cocaine, and alcohol), and persistent cannabis use (alone). Both models were moderately predictive of outcomes.
Static factors identified as predictors are consistent with previously published literature. Concerning dynamic factors, unexpectedly, cannabis alone was an independent co-occurring variable, as well as affective symptoms, in the violence model. For criminality, our results are novel, as there are very few studies on criminal behaviors in nonforensic psychiatric populations. In conclusion, these results emphasize the need to further study the predictors of crime, separately from violence and the impact of longitudinal patterns of specific substance use and high affective symptoms.
To determine whether studying aetiological pathways of depression, in particular the well-established determinant of childhood trauma, only in a specialised mental healthcare setting can yield biased ...estimates of the aetiological association, given that the majority of individuals are treated in primary care settings.
Two databanks were used in this study. The Canadian Community Health Survey (CCHS) on Mental Health and Well-Being 2012 is a national survey about mental health of adult Canadians. It measured common mental disorders and utilisation of services. The Signature mental health biobank includes adults from the Island of Montreal recruited at the emergency department of a major university mental health centre. After consent, participants filled standardised psychosocial questionnaires, gave blood samples, and their clinical diagnosis was recorded. We compared the cohort of depressed individuals from CCHS and Signature in contact with specialised services with those in contact with primary care or not in treatment.
There were 860 participants with depression in the CCHS and 207 participants with depression in the Signature Bank.
The Childhood Experiences of Violence Questionnaire was used to measure childhood trauma in both settings. Childhood trauma is associated with depression as with other common mental and physical disorders.
Individuals with depression in the CCHS who reported having been hospitalised for psychiatric treatment or having seen a psychiatrist or those from Signature were found to be more strongly associated with childhood abuse than individuals with depression who were treated in primary care settings or did not seek mental healthcare in the preceding year.
Berkson's bias limits the generalisability of aetiological associations observed in such university-hospital-based biobanks, but the problem can be remedied by broadening recruitment to primary care settings and the general population.
The Professional Quality of Life (ProQOL) scale is one of the most widely used measures of compassion satisfaction and fatigue despite there being little publicly available evidence to support its ...validity. This study, conducted among a sample of 310 child protection workers, assessed the construct validity of this measure using confirmatory factor analysis (CFA) and bifactor modeling. The CFA failed to confirm the adequacy of the three‐factor structure proposed by Stamm (2010). In response, a bifactor model postulating a factor structure with a general factor in addition to independent factors (compassion satisfaction, job burnout, and secondary traumatic stress) was proposed, highlighting the unidimensionality of the ProQOL while allowing for each subscale to be used separately. Moreover, this bifactor model of the ProQOL was moderately correlated with the Posttraumatic Disorder Checklist, r = −.427, p < .001, and strongly correlated with scales of well‐being at work, r = .694, p < .001, and psychological distress at work, r = −.666, p < .001, thus supporting the ProQOL's convergent validity. No associations were found between the ProQOL and the Life Event Checklist, which supports the ProQOL's discriminant validity. Overall, the results indicated that compassion satisfaction and compassion fatigue represent higher and lower levels of the same construct rather than two different constructs. Researchers and clinicians could therefore compute a single score to rate professionals’ individual levels of professional quality of life.
Resumen
Spanish s by Asociación Chilena de Estrés Traumático (ACET)
Validez de Constructo del instrumento de medición de Calidad de Vida Profesional (ProQoL) en una muestra de trabajadores de protección infantil
ESCALA DE CALIDAD DE VIDA PROFESIONAL: VALIDEZ DE CONSTRUCTO
La escala de Calidad de Vida Profesional (ProQoL en su sigla en inglés) es una de las medidas más ampliamente usadas de compasión satisfacción y fatiga por compasión, a pesar de que hay escasa evidencia disponible públicamente que soporte su validez. Este estudio, realizado en una muestra de 310 trabajadores de protección infantil, evaluó la validez de constructo de esta medición usando análisis confirmatorio de factores (CFA, por su sigla en inglés) y modelado bifactor.
El CFA no confirmó la idoneidad de la estructura de tres factores propuesta por Stamm (2010). En respuesta, se propone un modelo bifactor que postula una estructura factorial con un factor general junto a factores independientes (compasión satisfacción, agotamiento laboral y estrés traumático secundario), destacando la unidimensionalidad de la ProQoL mientras permite el uso por separado de cada subescala. Más aún, este modelo bifactor de la ProQoL estuvo moderadamente correlacionado con la Lista de Chequeo de Trastorno Postraumático, r = ‐.427, p < .001, y fuertemente correlacionado con escalas de bienestar en el trabajo, r = .694, p <.001, y malestar psicológico en el trabajo, r = ‐.666, p <.001, apoyando por tanto la validez convergente de la ProQoL. No se encontraron asociaciones entre la ProQoL y la Lista de Chequeo de Eventos Vitales, lo cual apoya la validez discriminante de la ProQoL. En suma, los resultados indicaron que la compasión satisfacción y la fatiga por compasión representan niveles más altos y más bajos del mismo constructo más que dos constructos diferentes. Los investigadores y los clínicos podrían por lo tanto calcular un único puntaje para calificar los niveles individuales de calidad de vida profesional de los profesionales.
抽象
Traditional and Simplified Chinese s by the Asian Society for Traumatic Stress Studies (AsianSTSS)
簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯
Construct Validity of the Professional Quality of Life (ProQoL) measurement instrument among a sample of child protection workers
Traditional Chinese
標題: 兒童護理工作者中, 專業生活品質(ProQOL)量表作為測量工具的建構效度
撮要: 雖然目前仍欠缺公開的實證以證明專業生活品質(ProQOL)量表的效度, 其仍為最廣泛用以測量慈心滿足及慈心疲倦的量表。本研究樣本為310名兒童護理工作者, 運用驗證性因素分析(CFA)和雙因素模型, 評估此量表的建構效度。CFA未能證實Stamm(2010)提出的三因素結構的適當性。因此, 我們採用一個雙因素模型, 假設一個除了獨立因素 (慈心滿足、工作枯竭、次級創傷後壓力) 外, 亦有一個共通因素的因素結構, 凸顯ProQOL量表的單向度性, 同時讓各個子量表可分開使用。此外, 這個ProQOL的雙因素模型跟創傷後壓力症檢查表有中等的關連(r = ‐.427, p < .001), 並跟工作幸福感(r = .694, p < .001)和工作中的心理悲痛(r = ‐.666, p < .001)量表分數有強勁關連, 繼而證實了量表的聚合效度。ProQOL與生命事件量表並無關連, 證實了ProQOL的區別效度。整體來說, 慈心滿足及慈心疲倦反映為同一構念高低水平的分別, 而非來自兩個不同構念。因此, 研究員和臨床治療師可以單一分數, 為專業人員的專業生活品質水平評分。
Simplified Chinese
标题: 儿童护理工作者中, 专业生活质量(ProQOL)量表作为测量工具的建构效度
撮要: 虽然目前仍欠缺公开的实证以证明专业生活质量(ProQOL)量表的效度, 其仍为最广泛用以测量慈心满足及慈心疲倦的量表。本研究样本为310名儿童护理工作者, 运用验证性因素分析(CFA)和双因素模型, 评估此量表的建构效度。CFA未能证实Stamm(2010)提出的三因素结构的适当性。因此, 我们采用一个双因素模型, 假设一个除了独立因素 (慈心满足、工作枯竭、次级创伤后压力) 外, 亦有一个共通因素的因素结构, 凸显ProQOL量表的单向度性, 同时让各个子量表可分开使用。此外, 这个ProQOL的双因素模型跟创伤后压力症检查表有中等的关连(r = ‐.427, p < .001), 并跟工作幸福感(r = .694, p < .001)和工作中的心理悲痛(r = ‐.666, p < .001)量表分数有强劲关连, 继而证实了量表的聚合效度。ProQOL与生命事件量表并无关连, 证实了ProQOL的区别效度。整体来说, 慈心满足及慈心疲倦反映为同一构念高低水平的分别, 而非来自两个不同构念。因此, 研究员和临床治疗师可以单一分数, 为专业人员的专业生活质量水平评分。
Abstract
Background
Cognitive biases are recognized as important treatment targets for reducing symptoms associated with severe mental disorders. Although cognitive biases have been linked to ...symptoms in most studies, few studies have looked at such biases transdiagnostically. The Cognitive Bias Questionnaire for psychosis (CBQp) is a self-reported questionnaire that assesses cognitive biases amongst individuals with a psychotic disorder, as well as individuals with other severe mental disorders. The current study aims to validate a French version of the CBQp and to explore transdiagnostic cognitive biases in individuals with psychotic disorders, individuals with depression, and in healthy controls.
Methods
The CBQp was translated into French following a protocol based on international standards. Discriminant validity and internal consistency were determined for total score and each subscale score. Confirmatory factor analyses were performed to test construct validity. Finally, cluster analyses were conducted to investigate cognitive biases across diagnostic groups.
Results
Our results were similar to those of the original authors, with the one-factor solution (assessment of a general thinking bias) being the strongest, but the two-factor solution (assessing biases within two themes relating to psychosis) and the five-factor solution (assessment of multiple distinct biases) being clinically more interesting. A six-cluster solution emerged, suggesting that individuals with similar diagnoses score differently on all cognitive biases, and that individuals with different diagnoses might have similar cognitive biases.
Conclusions
The current findings support the validity of the French translation of the CBQp. Our cluster analyses overall support the transdiagnostic presence of cognitive biases.
Hair has become an increasingly valuable medium to investigate the association between chronic stress, stable differences in systemic cortisol secretion and later health. Assessing cortisol in hair ...has many advantages, notably its non-invasive and retrospective nature, the need for a single biospecimen and convenient storage until analysis. However, few studies offered empirical evidence documenting the long-term temporal stability of hair cortisol concentration (HCC) prior to analysis, especially in humans. Yet, knowing how long hair samples can be stored without compromising the accuracy of cortisol measurement is of crucial importance when planning data collection and analysis. This study examined the stability of HCC in hair samples assayed twice, five years apart.
We randomly selected from a larger distribution of HCC measured in 17-year-old participants 39 hair samples to be reanalyzed five years later, under the same general conditions. Samples were assayed in duplicate using a luminescence immunoassay and compared with the original HCC using the Lin's concordance correlation coefficient (CCC), Bland-Altman plot analysis and Wilcoxon rank test.
Findings indicated a good concordance and temporal stability between the two samples assayed five years apart (CCC 95% confidence interval = 0.84 0.72–0.91), although a small decrease in HCC was noted 5 years later (8.4% reduction, p = 0.001).
Our study confirms that hair samples, when stored at room temperature and away from sunlight, can be assayed for at least five years without risking a loss of precision in HCC measurement.
•Hair cortisol concentration (HCC) is increasingly used in large cohorts and longitudinal studies.•Evidence of robustness over time is lacking to plan sample collection and analysis.•Hair can be stored for at least five years without compromising HCC.
Surveys report that about three-quarters of visits to general practitioners in America are for stress-related complaints. Animal and human studies have consistently demonstrated that exposure to ...acute and/or chronic stress leads to the activation of the autonomic nervous system (ANS) and/or hypothalamic-pituitary-adrenal (HPA) axis, and to the production of catecholamines and glucocorticoids. Yet, many studies performed in humans do not report significant associations between subjective feelings of stress and increases in these stress biomarkers. Consequently, it is not clear whether the stress-related complaints of individuals are associated with significant increases in these stress biomarkers. In the present study, we measured whether individuals who self-identify as being ‘very stressed out’ or ‘zen’ present differences in psychological (depression and anxiety symptoms), biological (basal and reactive levels of glucocorticoids and alpha-amylase) and socioemotional (emotion regulation, mind wandering, personality, resilience and positive mental health) factors associated with stress. Salivary levels of cortisol and alpha-amylase were obtained in the home environment and in reaction to the Trier Social Stress Test in 123 adults aged between 19 and 55 years. All participants completed questionnaires assessing the psychological and socioemotional factors described above. The results showed that groups significantly differed on almost all psychological and socioemotional factors, although we found no significant group differences on biological markers of stress (cortisol or alpha-amylase). These results suggest that when people complain of being ‘very stressed out’, what they may really be alluding to is an experience of psychological distress that is related to poor emotion regulation capacities. It is thus possible that the construct of stress used by people to discuss their internal state of 'stress' is quite different than the construct of stress measured in animal and human laboratories using biomarkers of 'stress'.
•‘Very stressed out’ individuals present more symptoms of depression and anxiety than ‘zen’ individuals.•They also present more difficulties in emotion regulation and more mind wandering.•However, there is no difference between groups on basal alpha-amylase and reactive cortisol and alpha-amylase.•‘Stress’ in the public may be more related to difficulties in emotion regulation capacities than to dysregulations of stress biomarkers.
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