Social psychiatry

From a survey of 40- to 49-year-old women from Chichester, West Sussex, 45 were selected whose mothers died before they were aged 11, 38 who were evacuated from their mothers during the 1939–1945 War and 45 who were separated from their mothers for other reasons for at least a year before they were aged 10. A series of 69 non-mother-bereaved or non-mother-separated controls of similar age-range was also collected. Each subject was interviewed at home and asked to complete the Middlesex Hospital Questionnaire, a modified Zung Depression Scale and the Navran Dependency Scale of the MMPI. There were significant differences between the groups in terms of place of birth, age of the mother at time of the initial break and size of the original sibship. Significantly more evacuees were cared for by foster mothers and significantly more of the “other” separations had a poor relationship with their natural mother. For all groups increased test scores were associated with lower parental social class and poor replacement care. Poor outcome was also associated with being later born for the early bereaved, having a poor relationship with the natural mother for the evacuees and being separated after age 4 for the “other” separations.

The high burden of witnessing traumatic events has been demonstrated in previous research in South Africa. However, previous work has focused on PTSD rather than a broader range of psychopathological outcomes. This study examined the association between witnessing trauma and multiple outcomes including mood, anxiety, and substance use disorders. Regression models measured the odds of mood, anxiety, and substance use disorders among those who reported witnessing in the South African Stress and Health Study. Discrete-time survival analysis was used to examine whether witnessing was associated with earlier onset of mental disorders. Witnessing trauma was more commonly reported among males and those with low-average education. Posttraumatic stress disorder, mood, and anxiety disorders varied significantly with witnessing status, and witnessing was associated with exposure to a higher number of traumatic events compared to other types of traumatic events. Respondents reporting witnessing trauma had elevated odds of mood and anxiety disorders, but not substance use disorders. Witnessing trauma is common in the South African population and results in increased risk of mood and anxiety disorders. Interventions aimed at reducing the burden of trauma and its outcomes must now increase their focus on bystanders and other observers, rather than just focusing on those directly affected.

We sought to investigate the association between social capital and child behavior problems in Iwate prefecture, Japan, in the aftermath of the 2011 Great East Japan Earthquake. Children and their caregivers were recruited from four nursery schools in coastal areas affected by the tsunami, as well as one in an unaffected inland area (N = 94). We assessed the following via caregiver questionnaire: perceptions of social capital in the community, child behavior problems (Child Behavior Checklist, Strength and Difficulty Questionnaire), post-traumatic stress disorder (PTSD) symptoms, child’s exposure to trauma (e.g. loss of family members), and caregiver’s mental health (Impact of Event Scale-R for PTSD symptoms; K6 for general mental health). We collected details on trauma exposure by interviewing child participants. Structural equation modeling was used to assess whether the association between social capital and child behavior problems was mediated by caregiver’s mental health status. Children of caregivers who perceived higher community social capital (trust and mutual aid) showed fewer PTSD symptoms. Furthermore, caregiver’s mental health mediated the association between social trust and child PTSD symptoms. Social capital had no direct impact on child behavior problems. Community social capital was indirectly associated (via caregiver mental health status) with child behavior problems following exposure to disaster. Community development to boost social capital among caregivers may help to prevent child behavior problems.

Caring for someone with an eating disorder is associated with a high level of burden and psychological distress. While models for the prediction of carer burden have previously been investigated, these have typically neglected the role of coping strategies and social support. Thus, the current study will examine predictors of both carer burden and carer psychological distress in eating disorder carers. Further, the mediating roles of coping strategies and social support will be investigated. Fifty-six carers completed a self-report questionnaire assessing burden, psychological distress, needs, expressed emotion, coping strategies and social support. Use of maladaptive coping strategies was a unique predictor of both burden and psychological distress. Further, maladaptive coping was a consistent mediator on the outcome of carer burden. Social support, however, did not significantly predict, or mediate, carer burden. Interventions focusing on teaching appropriate coping strategies would benefit carers.

In this review we discuss how the study of dementia epidemiology in Low- and Middle-Income Countries (LMICs) has changed in the last 20 years, and specifically to review the evidence created by the 10/66 Dementia Research Group (DRG) and discuss future directions for research. We identified and collated all the papers related to the 10/66 Dementia Research Group, including papers from groups who adopted the 10/66 methodology, that have been published in peer-reviewed journals. Over 200 papers including data from Africa, Asia, Europe and Latin America and the Caribbean were identified by this review. Many of the findings revolved around the epidemiology of dementia, mental health and non-communicable diseases, including the cross-cultural development and validation of measurement tools of cognition and functioning, need for care, care arrangements and mental health. Social ageing, care dependence and caregiver interventions were also topics that the group had published on. A body of evidence has been generated that has challenged the view, prevalent when the group started, that dementia is comparatively rare in LMICs. The experience of the 10/66 DRG has shown that descriptive epidemiological research can be important and impactful, where few data exist. Monitoring population trends in the prevalence and incidence of dementia may be our best chance to confirm hypotheses regarding modifiable risk factors of dementia.

Refugee children face numerous challenges associated with pre-migration trauma and post-migration adaptation. Much research pertaining to refugee children’s well-being focuses on psychiatric symptoms. Relatively few studies have examined how social context factors—such as perceptions of peer belonging, and support from adults at home and at school—contribute to the emotional health of refugee children. Informed by social–ecological theories emphasizing dynamic interactions between the contexts in which children develop, we examined associations between social context factors and emotional health in refugee children. Data were drawn from a population-based data linkage in British Columbia, Canada. The analytic sample included 682 grade 4 students (Mage 9.2 years; 46.3% female) with a refugee background who responded to the Middle Years Development Instrument (MDI) during the 2010/2011–2016/2017 school years. The MDI is a self-report survey of children’s social and emotional competencies and social context factors completed at school. Regression analyses were used to examine associations of social context factors (school climate, supportive adults at school and at home, and peer belonging) with indicators of emotional health (life satisfaction, self-concept, optimism, and sadness). Refugee generation status (first/second) was considered through stratification and testing of interactions with social context factors. Perceived supportive school climate, support from adults in school and at home, and peer belonging were each independently associated with better emotional health. Results were similar for first- and second-generation children. Taken together, results suggest a unique role of the school context to refugee children’s emotional health. School-based programming that promotes positive school climate can be considered as an important approach to support newcomer refugee children and their families.

The Peters et al. Delusions Inventory (PDI) is a commonly used instrument to measure delusion proneness in the general population and includes dimensions that measure distress, preoccupation, and conviction of unusual beliefs. This self-report scale has already been translated into several languages. However, there has not been a validated Taiwanese version previously reported. The aims of the present study were to translate and test the cross-cultural reliability and validity of the PDI in Taiwanese as well as to establish its sensitivity, specificity, and discriminative validity. We administered the questionnaire to a consecutive sample of 253 participants with (n = 154; clinical group including schizophrenia and affective psychosis) or without psychotic disorders (n = 99; non-clinical group). In addition to the Taiwanese version of the PDI (PDI-T), the Taiwanese version of the Brief Psychiatric Symptom Rating Scale (BSRS) was used to measure the severity of psychopathology. We tested the psychometric properties of the PDI-T, including its construct validity, internal consistency, test–retest reliability, concurrent, and discriminative validity. Overall, the PDI-T showed good construct validity, internal consistency, and stability over time, and it was significantly correlated with the BSRS subscales of psychotic symptoms. The convergent and discriminative validity was satisfactory. The area under the receiver operating characteristic curve of the PDI-T was 0.752. This research found that the most appropriate PDI-T yes/no cut-off scores for determining the absence and presence of delusion proneness were 5 and 13. The PDI is a reliable and valid instrument for measuring the dimensionality of delusion proneness and appears to complement subclinical psychosis assessment scales for both epidemiological and clinical research in Taiwan.

Obesity has been associated with an increased risk of the depression in the general population, but it is unknown whether this relationship applies equally to immigrants as well as non-immigrants. Furthermore, the nature of the relationship is uncertain, is it direct or curvilinear? The aim of this study is to examine the relationship between body mass index and major depressive episode among immigrants and non-immigrants. To provide more statistically robust data, a series of cross-sectional health surveys of the Canadian population for the 5 years 2010–2014 were pooled to increase the number of immigrants in the study. Restricted cubic splines analysis was used to examine the nature of the association. Immigrants had lower 12-month depression and obesity prevalence rates than non-immigrants. In addition, it was found that non-immigrants were more likely to develop depression than immigrants, OR = 1.40 (95% CI, 1.16–1.67). Obese respondents were more likely to develop depression than normal weight respondents in both immigrant (OR = 1.55; 95% CI, 1.03–2.32) and non-immigrant groups (OR = 1.23; 95% CI, 1.15–1.32). A significant nonlinear elongated J-shaped association between obesity and depression was found for both immigrants and non-immigrants with increased risk of depression in obese individuals. Culture-specific, clinical-based interventions should be developed to improve the early identification, treatment and recovery of individuals with a high BMI particularly among those with BMIs in the obese range.