Age related differences in mental health scale scores and depression diagnosis: Adult responses to the CIDI-SF and MHI-5.

Inconsistencies surrounding the prevalence levels of depression in later life suggest that the measurement of depression in older people may be problematic. The current study aimed to map responses to a depressive symptom scale, the Mental Health Index-5 (MHI-5) which is part of the Short form 36 (SF-36, Ware et al., 1993) against the diagnostic screening items of the Composite International Diagnostic Instrument-Short Form (CIDI-SF, Kessler et al., 1998) to examine disagreement rates across age groups. The study examined data from a national random sample of 10,641 participants living in Ireland, 58.8% were female and 19% were over 65 (SLÁN, 2007). CIDI-SF depression screening endorsement was lower in older groups, whereas mean MHI-5 depressive symptoms showed less change across age groups. Results showed that the odds of MHI-5 endorsers aged 18–44 endorsing CIDI-SF screening questions were 5 times and 4.5 times (dysphoria and anhedonia, respectively) greater than the odds of people aged 75 or more endorsing these items. Findings suggest that although the risk of depressive disorder may decrease with age, complex diagnostic screening questions may exaggerate lower rates of depression among older people.

Marital loss, mental health and the role of perceived social support : findings from six waves of an Australian population based panel study

Objectives: To investigate the impact of transitions out of marriage (separation, widowhood) on the self reported mental health of men and women, and examine whether perceptions of social support play an intervening role. ---------- Methods: The analysis used six waves (2001–06) of an Australian population based panel study, with an analytical sample of 3017 men and 3225 women. Mental health was measured using the MHI-5 scale scored 0–100 (α=0.97), with a higher score indicating better mental health. Perceptions of social support were measured using a 10-item scale ranging from 10 to 70 (α=0.79), with a higher score indicating higher perceived social support. A linear mixed model for longitudinal data was used, with lags for marital status, mental health and social support. ---------- Results: After adjustment for social characteristics there was a decline in mental health for men who separated (−5.79 points) or widowed (−7.63 points), compared to men who remained married. Similar declines in mental health were found for women who separated (−6.65 points) or became widowed (−9.28 points). The inclusion of perceived social support in the models suggested a small mediation effect of social support for mental health with marital loss. Interactions between perceived social support and marital transitions showed a strong moderating effect for men who became widowed. No significant interactions were found for women. ---------- Conclusion: Marital loss significantly decreased mental health. Increasing, or maintaining, high levels of social support has the potential to improve widowed men's mental health immediately after the death of their spouse.

Measuring the expressed emotion in Chinese family caregivers of persons with dementia: Validation of a Chinese version of the Family Attitude Scale

- Background Expressed emotion (EE) captures the affective quality of the relationship between family caregivers and their care recipients and is known to increase the risk of poor health outcomes for caregiving dyads. Little is known about expressed emotion in the context of caregiving for persons with dementia, especially in non-Western cultures. The Family Attitude Scale (FAS) is a psychometrically sound self-reporting measure for EE. Its use in the examination of caregiving for patients with dementia has not yet been explored. - Objectives This study was performed to examine the psychometric properties of the Chinese version of the FAS (FAS-C) in Chinese caregivers of relatives with dementia, and its validity in predicting severe depressive symptoms among the caregivers. - Methods The FAS was translated into Chinese using Brislin's model. Two expert panels evaluated the semantic equivalence and content validity of this Chinese version (FAS-C), respectively. A total of 123 Chinese primary caregivers of relatives with dementia were recruited from three elderly community care centers in Hong Kong. The FAS-C was administered with the Chinese versions of the 5-item Mental Health Inventory (MHI-5), the Zarit Burden Interview (ZBI) and the Revised Memory and Behavioral Problem Checklist (RMBPC). - Results The FAS-C had excellent semantic equivalence with the original version and a content validity index of 0.92. Exploratory factor analysis identified a three-factor structure for the FAS-C (hostile acts, criticism and distancing). Cronbach's alpha of the FAS-C was 0.92. Pearson's correlation indicated that there were significant associations between a higher score on the FAS-C and greater caregiver burden (r = 0.66, p < 0.001), poorer mental health of the caregivers (r = −0.65, p < 0.001) and a higher level of dementia-related symptoms (frequency of symptoms: r = 0.45, p < 0.001; symptom disturbance: r = 0.51, p < 0.001), which serves to suggest its construct validity. For detecting severe depressive symptoms of the family caregivers, the receiving operating characteristics (ROC) curve had an area under curve of 0.78 (95% confidence interval (CI) = 0.69–0.87, p < 0.0001). The optimal cut-off score was >47 with a sensitivity of 0.720 (95% CI = 0.506–0.879) and specificity of 0.742 (95% CI = 0.643–0.826). - Conclusions The FAS-C is a reliable and valid measure to assess the affective quality of the relationship between Chinese caregivers and their relatives with dementia. It also has acceptable predictability in identifying family caregivers with severe depressive symptoms.

Associations between fruit and vegetable consumption and psychological distress: results from a population-based study.

BACKGROUND: Several studies observed associations of various aspects of diet with mental health, but little is known about the relationship between following the 5-a-day recommendation for fruit and vegetables consumption and mental health. Thus, we examined the associations of the Swiss daily recommended fruit and vegetable intake with psychological distress. METHODS: Data from 20,220 individuals aged 15+ years from the 2012 Swiss Health Survey were analyzed. The recommended portions of fruit and vegetables per day were defined as 5-a-day (at least 2 portions of fruit and 3 of vegetables). The outcome was perceived psychological distress over the previous 4 weeks (measured by the 5-item mental health index [MHI-5]). High distress (MHI-5 score ≤ 52), moderate distress (MHI-5 > 52 and ≤ 72) and low distress (MHI-5 > 72 and ≤ 100) were differentiated and multinomial logistic regression analyses adjusted for known confounding factors were performed. RESULTS: The 5-a-day recommendation was met by 11.6 % of the participants with low distress, 9.3 % of those with moderate distress, and 6.2 % of those with high distress. Consumers fulfilling the 5-a-day recommendation had lower odds of being highly or moderately distressed than individuals consuming less fruit and vegetables (moderate vs. low distress: OR = 0.82, 95 % confidence interval [CI] 0.69-0.97; high vs. low distress: OR = 0.55, 95 % CI 0.41-0.75). CONCLUSIONS: Daily intake of 5 servings of fruit and vegetable was associated with lower psychological distress. Longitudinal studies are needed to further determine the causal nature of this relationship.

An epidemiologic evaluation of a worksite based intervention

The healthcare industry spends billions on worker injury and employee turnover. Hospitals and healthcare settings have one of the highest rates of lost days due to injuries. The occupational hazards for healthcare workers can be classified into biological, chemical, ergonomic, physical, organizational, and psychosocial. Therefore, interventions addressing a range of occupational health risks are needed to prevent injuries and reduce turnover and reduce costs. ^ The Sacred Vocation Program (SVP) seeks to change the content of work, i.e., the meaningfulness of work, to improve work environments. The SVP intervenes at both the individual and organizational level. First the SVP attempts to connect healthcare workers with meaning from their work through a series of 5 self-discovery group sessions. In a sixth session the graduates take an oath recommitting them to do their work as a vocation. Once motivated to connect with meaning in their work, a representative employee group meets in a second set of five meetings. This representative group suggests organizational changes to create a culture that supports employees in their calling. The employees present their plan in the twelfth session to management beginning a new phase in the existing dialogue between employees and management. ^ The SVP was implemented in a large Dallas hospital (almost 1000 licensed beds). The Baylor University Medical Center (BUMC) Pastoral Care department invited front-line caregivers (primarily Patient Care Assistants, PCAs, or Patient Care Technicians, PCTs) to participate in the SVP. Participants completed SVP questionnaires at the beginning and following SVP implementation. Following implementation, employer records were collected on injury, absence and turnover to further evaluate the program's effectiveness on metrics that are meaningful to managers in assessing organizational performance. This provided an opportunity to perform an epidemiological evaluation of the intervention using the two sources of information: employee self-reports and employer administrative data. ^ The ability to evaluate the effectiveness of the SVP on program outcomes could be limited by the strength of the measures used. An ordinal CFA performed on baseline SVP questionnaire measurements examined the construct validity and reliability of the SVP scales. Scales whose item-factor structure was confirmed in ordinal CFA were evaluated for their psychometric properties (i.e., reliability, mean, ceiling and floor effects). CFA supported the construct validity of six of the proposed scales: blocks to spirituality, meaning at work, work satisfaction, affective commitment, collaborative communication, and MHI-5. Five of the six scales confirmed had acceptable measures of reliability (all but MHI-5 had α>0.7). All six scales had a high percentage (>30%) of the scores at the ceiling. These findings supported the use of these items in the evaluation of change although strong ceiling effects may hinder discerning change. ^ Next, the confirmed SVP scales were used to evaluate whether the intervention improved program constructs. To evaluate the SVP a one group pretest-posttest design compared participants’ self-reports before and after the intervention. It was hypothesized that measurements of reduced blocks to spirituality (α = 0.76), meaning at work (α = 0.86), collaborative communication (α = 0.67) and SVP job tasks (α = 0.97) would improve following SVP implementation. The SVP job tasks scale was included even though it was not included in the ordinal CFA analysis due to a limited sample and high inter-item correlation. Changes in scaled measurements were assessed using multilevel linear regression methods. All post-intervention measurements increased (increases <0.28 points) but only reduced blocks to spirituality was statistically significant (0.22 points on a scale from 1 to 7, p < 0.05) after adjustment for covariates. Intensity of the intervention (stratifying on high participation units) strengthened effects; but were not statistically significant. The findings provide preliminary support for the hypothesis that meaning in work can be improved and, importantly, lend greater credence to any observed improvements in the outcomes. (Abstract shortened by UMI.)^

Impacte do Cuidado no Cuidador Informal

A família continua a ser considerada a principal fonte de suporte dos idosos, sendo neste sistema que encontramos a maioria dos cuidadores informais. Cuidar é um processo complexo e exige muito tempo e dedicação, sendo que muitos cuidadores consideram-no como algo gratificante, no entanto é incontestável que também acarreta consequências negativas. Assim, o presente estudo tem como objectivo analisar o impacte pessoal, profissional e socioeconómico nos cuidadores informais de idosos que se encontram em centro de dia ou em serviço de apoio domiciliário, em instituições situadas na zona do Baixo Mondego. Para a avaliação das variáveis em estudo foram utilizados um inquérito por questionário para a caracterização sociodemográfica dos cuidadores e a versão portuguesa do MHI-5 (Mental Health Inventory) para avaliar o distress e o bem-estar psicológico dos cuidadores dos idosos. A amostra é constituída por 60 cuidadores sendo, na sua maioria mulheres (65%). Mais de metade da amostra dos cuidadores são casados (76,7%), predominantemente com idades entre os 56 e os 65 anos de idade, sendo estes, na generalidade, filhos (48,7%) e cônjuges dos idosos (21,7%). A amostra deste estudo vive na mesma casa (56,7%) ou perto do idoso de quem cuida, tendo metade uma actividade profissional (50%), sendo o número de horas diárias que dispensa na prestação de cuidados ao idoso entre 1 a 4 horas. Constatou-se que os cuidadores informais destes idosos sentem um impacte baixo a moderado principalmente nas áreas do trabalho e da saúde, no entanto, as mulheres inquiridas consideram que o maior impacte é ao nível económico pelas despesas feitas com o idoso, principalmente com os medicamentos. A maioria dos cuidadores apontam que um dos motivos pelos quais decidiram cuidar do idoso foi por amor e ternura, já o motivo que menos pesou para os cuidadores foi a possibilidade de herdar mais. Sendo os cuidadores informais um grupo importante na prestação de cuidados, é necessário reflectir sobre as políticas de cuidados existentes e políticas sociais, assim como sobre a sua informação e formação, considerando ser fundamental definir estratégias de assegurar-lhes direitos sociais associados à missão que assumem e capacitá-los para prevenirem impactes negativos e o seu agravamento eventual.

Comprometimento Organizacional, Autocriticismo e Autocompaixão na PSP

Introdução: São poucos os estudos que em Portugal se dedicaram a explorar constructos como o autocriticismo, autocompaixão, saúde mental e o comprometimento organizacional. São nossos objetivos analisar estas associações na Polícia de Segurança Pública, considerando igualmente a influência de variáveis sociodemográficas e profissionais, bem como realizar análises preditivas que permitam verificar quais são as variáveis preditores do comprometimento organizacional. Metodologia: A amostra é constituída por 188 polícias com idades compreendidas entre os 30 e 56 anos (M = 43,75, DP = 5,66). Os participantes preencheram um protocolo integrante do projeto Organizar Positivamente do Instituto Superior Miguel Torga, composto por um questionário sociodemográfico, a SELFCS (Escala da Autocompaixão), a FSCRS (Escala das Formas do Autocriticismo e Autotranquilização), o MHI-5 (Mental Health Inventory) e o QCO (Questionário do Comprometimento Organizacional). Resultados: Os polícias parecem regular a sua relação com a organização através do comprometimento calculativo. A autocompaixão associa-se positivamente ao comprometimento afetivo, sobressaindo a capacidade de mindfulness. O autocriticismo, na forma eu inadequado - menos corrosivo que a forma eu detestado -, revela uma relação positiva com o comprometimento calculativo, pelo que a permanência na organização pode ser emocionalmente negativa, originar ataques ao eu e diminuir a capacidade afetiva. Porém, a capacidade autotranquilizadora (forma eu tranquilizador do autocriticismo) parece capacitar os polícias para o desenvolvimento de maiores níveis de comprometimento organizacional e afetivo. A idade, a antiguidade e menos habilitações literárias parecem favorecer o comprometimento calculativo. Discussão: A autocompaixão pode contribuir para uma atitude positiva e afetuosa do polícia para com a organização. Assim, através de uma intervenção baseada na autocompaixão e no mindfulness, com impacto positivo no comportamento afetivo e normativo, não só se poderá preservar e promover a saúde e o bem-estar dos polícias, mas também fomentar o empenho organizacional, atenuando os efeitos negativos da profissão policial. Esta abordagem poderá contribuir para os objetivos organizacionais, através da supressão das emoções aversivas, da diminuição da intenção de turnover e abandono da organização. / Introduction: There are few studies in Portugal that have been dedicated to explore constructs such as self-criticism, self-compassion, mental health and organizational commitment. Our goals are to analyze these associations at the Public Safety Police, considering also the influence of sociodemographic and professionals variables, as well as to conduct predictive analyses, in order to verify which variables may predict organizational commitment. Methodology: The sample consisted of 188 police with ages between 30 and 56 years (M = 43.75, SD = 5.66). The participants filled in a protocol from the project Organizar Positivamente, from Instituto Superior Miguel Torga, composed by a sociodemographic questionnaire, the SELFCS (Self-Compassion Scale), the FSCRS (Scale of Forms of Self-Criticism and Self-Reassurance, the MHI-5 (Mental Health Inventory) and the QCO (Organizational Commitment Questionnaire). Results: The police officers appear to regulate their relationship with the organization through calculative commitment. Self-compassion is associated positively to affective commitment, with mindfulness showing to be the most important competence in this professional group. Self-criticism, in its inadequate self form – which is less corrosive than the hated self form - reveals a positive relationship with calculative commitment, which might imply that staying in the organization may be emotionally negative, may provoke attacks against the self and diminish the affective capacity. However, the self reassurance capacity (reassure self form of self-criticism) may enable the police officers to develop higher levels of organizational commitment and affective commitment, as well. Age, seniority and fewer qualifications seem to support the calculative commitment. Discussion: Through self-compassion police officers may experience a positive and warmth attitude towards the organization. Thus, an intervention program based on self-compassion and mindfulness may stimulate affective and normative commitment, not only preserving and promoting health and the well-being of police officers, but also fostering organizational commitment and mitigating negative effects in the police profession. This approach may contribute to organizational goals’ through the suppression of aversive emotions, decreasing turnover and intention to abandon the organization.

Age and gender differences in the influence of social support on mental health : a longitudinal fixed-effects analysis using 13 annual waves of the HILDA cohort

OBJECTIVES: Perceived social support is associated with better mental health. There has been limited attention to how these relationships are modified by age and gender. We assessed this topic using 13 years of cohort data. STUDY DESIGN: Prospective cohort study. METHODS: The outcome was the Mental Health Inventory-5 (MHI-5), a reliable and valid screening instrument for mood disorders. The main exposure was a social support scale composed of 10 items. We used longitudinal fixed-effects regression modelling to investigate within-person changes in mental health. Analytic models controlled for within-person sources of bias. We controlled for time-related factors by including them into regression modelling. RESULTS: The provision of higher levels of social support was associated with greater improvements in mental health for people aged under 30 years than for older age groups. The mental health of females appeared to benefit slightly more from higher levels of social support than males. Improvements in the MHI-5 were on a scale that could be considered clinically significant. CONCLUSIONS: The benefits of social support for young people may be connected to age-related transitions in self-identity and peer friendship networks. Results for females may reflect their tendency to place greater emphasis on social networks than males.

Raman spectroscopic characteristics of phthalocyanine and naphthalocyanine in sandwich-type phthalocyaninato and porphyrinato rare earth complexes Part 5. – Raman spectroscopic characteristics of naphthalocyanine in mixed [tetrakis(4-tert-butylphenyl)porphyrinato]-(naphthalocyaninato) rare earth double-deckers

Raman spectra were recorded in the range 400–1800 cm−1 for a series of 15 mixed \[tetrakis(4-tert-butylphenyl)porphyrinato](2,3-naphthalocyaninato) rare earth double-deckers M(TBPP)(Nc) (M = Y; La–Lu except Pm) using laser excitation at 632.8 and 785 nm. Comparisons with bis(naphthalocyaninato) rare earth counterparts reveal that the vibrations of the metallonaphthalocyanine M(Nc) fragment dominate the Raman features of M(TBPP)(Nc). When excited with radiation of 632.8 nm, the most intense vibration appears at about 1595 cm−1, due to the naphthalene stretching. These complexes exhibit the marker Raman band for Nc•− as a medium-intense band in the range 1496–1507 cm−1, attributed to the coupling of pyrrole and aza stretching, while the marker Raman band of Nc2− in intermediate-valence Ce(TBPP)(Nc) appears as a strong band at 1493 cm−1 and is due to the isoindole stretchings. By contrast, when excited with radiation of 785 nm that is in close resonance with the main Q absorption band of the naphthalocyanine ligand, the ring radial vibrations at ca 680 and 735 cm−1 for MIII(TBPP)(Nc) are selectively intensified and are the most intense bands. For the cerium double-decker, the most intense vibration also acting as the marker Raman band of Nc2− appears at 1497 cm−1 with contributions from both pyrrole CC and aza CN stretches. The same vibrational modes show weak to medium intensity scattering at 1506–1509 cm−1 for MIII(TBPP)(Nc) and this is the marker Raman band of Nc•− when thus excited. The scatterings due to the Nc breathings, ring radial vibration, aza group stretchings, naphthalene stretchings, benzoisoindole stretchings and the coupling of pyrrole CC and aza CN stretchings in MIII(TBPP)(Nc) are all slightly blue shifted along with the decrease in rare earth ionic radius, confirming the effects of increased ring–ring interactions on the Raman characteristics of naphthalocyanine in the mixed ring double-deckers.