Suicide and Disability: Three Different Analyses of a Nation-Wide Sample of American Adults

Suicidality is a major public health issue and is more common among people with disabilities. However, relatively little is known about the context and specifics of suicidality among adults with disabilities compared to their peers without disabilities. This dissertation presents three different analyses of suicidality and disability using a sample of American adults. Chapter I introduces the topic and dataset. Chapter II presents an analysis of the internal consistency, mean scores, and response patterns on the Suicidal Behavior Questionnaire—Revised (SBQ-R) by disability status in order to establish the internal of the measure in people with disabilities and explore the uniformity of suicidality in people with and without disabilities. Participants with disabilities tended to more frequently endorse response choices consistent with increased past, current, and perceived future suicidality. Chapter III presents an analysis of the relationship between suicidality, disability, and psychiatric disability. Disability remained a significant predictor of suicidality even when depressive symptoms were included in the analysis, and psychiatric disability predicted greater suicidality within the disability subsample, even when depressive symptoms were controlled for via statistical analysis. Chapter IV presents an analysis of suicidality and disability within the context of both depressive symptoms and sociodemographic risk and protective factors for suicidality. Participants with disabilities experienced more sociodemographic risk factors than participants without disabilities; however, disability status remained a significant predictor of suicidality even when sociodemographic risk and protective factors, as well as depressive symptoms, were included in the analysis. Chapter V summarizes and concludes the dissertation, including our consistent and major finding that disability is linked to significantly higher suicidality, even when depression and sociodemographic risk factor are accounted for in statistical analysis

Peer Victimization in Students who are Deaf and Hard of Hearing: Exploring Educational Placement

Forty-five American students who are Deaf/hard of hearing (SWD/HOH) in grades 5-12 completed a survey assessing their experiences with peer victimization. Almost four-fifths reported victimizing peers over the past two months, and almost 90% reported being the victim of peer victimization during that same timeframe. The most commonly reported types of peer victimization were verbal and relational aggression. Students who attended a Deaf-only campus reported greater mean victimization than those attending magnet programs located in general education schools. The results highlight the need for evidence-based programs that address peer victimization among SWD/HOH

Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa

Abstract Background The 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) is a depression screening tool that has been used in the South African National Income Dynamics Study (NIDS), a national household panel study. This screening tool has not yet been validated in South Africa. This study aimed to establish the reliability and validity of the CES-D-10 in Zulu, Xhosa and Afrikaans. The CES-D-10’s psychometric properties were also compared to the Patient Health Questionnaire (PHQ-9), a depression screening tool already validated in South Africa. Methods Stratified random samples of Xhosa, Afrikaans and Zulu-speaking participants aged 15 years or older (N = 944) were recruited from Cape Town Metro and Ethekwini districts. Face-to-face interviews included socio-demographic questions, the CES-D-10, Patient Health Questionnaire (PHQ-9), and WHO Disability Assessment Schedule 2.0 (WHODAS). Major depression was determined using the Mini International Neuropsychiatric Interview. All instruments were translated and back-translated to English. Construct validity was examined using exploratory factor analysis with varimax rotation. Receiver Operating Characteristics (ROC) curves were used to investigate the CES-D-10 and PHQ-9’s criterion validity, and compared using the DeLong method. Results Overall, 6.6, 18.0 and 6.9% of the Zulu, Afrikaans and Xhosa samples were diagnosed with depression, respectively. The CES-D-10 had acceptable internal consistency across samples (α = 0.69–0.89), and adequate concurrent validity, when compared to the PHQ-9 and WHODAS. The CES-D-10 area under the Receiver Operator Characteristic curve was good to excellent: 0.81 (95% CI 0.71–0.90) for Zulu, 0.93 (95% CI 0.90–0.96) for Afrikaans, and 0.94 (95% CI 0.89–0.99) for Xhosa. A cut-off of 12, 11 and 13 for Zulu, Afrikaans and Xhosa, respectively, generated the most balanced sensitivity, specificity and positive predictive value (Zulu: 71.4, 72.6% and 16.1%; Afrikaans: 84.6%, 84.0%, 53.7%; Xhosa: 81.0%, 95.0%, 54.8%). These were slightly higher than those generated for the PHQ-9. The CES-D-10 and PHQ-9 otherwise performed similarly across samples. Conclusions The CES-D-10 is a valid, reliable screening tool for depression in Zulu, Xhosa and coloured Afrikaans populations

Qualitative Exploration of Case Conferencing and Occupational Stress with Video Relay Interpreters

American Sign Language (ASL) interpreters working in Video Relay Service (VRS) call centers experience more occupational stress than interpreters working in community settings, leading to burnout, attrition, and loss of qualified interpreters for the Deaf and hard of hearing community. Case conferencing that incorporates the use of demand control schema (DC-S; Dean & Pollard, 2001) is an emergent strategy that may be effective in decreasing VRS interpreters’ stress and burnout but has yet to be thoroughly studied. The purpose of this exploratory, qualitative case study is to understand how participation in an adapted DC-S case conferencing group assisted VRS interpreters reducing occupational stress and attrition in VRS. Data from this study yielded four major themes: (1) reduction of occupational stress, (2) application of skills learned in groups, (3) integration into practice, and (4) retention in VRS. Although not a distinct theme, improvement in call center culture emerged as an additional finding. Our findings suggest that case conferencing is a helpful strategy to manage stressors that are unique to working in VRS and can promote interpreter retention

Early Experiences of Parents of Children who are Deaf or Hard of Hearing: Navigating through Identification, Intervention, and Beyond

Guidelines created by the Joint Committee on Infant Hearing ([JCIH], 2019) were designed to aid in the early identification of infant hearing loss. Despite these guidelines, a quarter of children who fail their initial screening are lost to the follow-up process and many more do not receive care in line with the 1-3-6 guidelines (Centers for Disease Control and Prevention [CDC], 2018; JCIH, 2019). To acquire more information about the experiences of families and identify specific barriers to timely diagnosis and intervention, interviews were conducted with 13 parents of children who are deaf or hard of hearing whose children were enrolled in a larger longitudinal study. These interviews revealed common themes regarding delayed identification, frustrations about timely intervention, and confusion when choosing communication modalities. Common themes amongst families who felt well-supported were also identified

Ex Vivo and In Vivo Noninvasive Imaging of Epidermal Growth Factor Receptor Inhibition on Colon Tumorigenesis Using Activatable Near-Infrared Fluorescent Probes

Near-infrared fluorescence (NIRF) imaging combined with enzyme-activatable NIRF probes has yielded promising results in cancer detection

Anomalous Pacific‐Antarctic Ridge volcanism precedes glacial Termination 2

We present results from a well‐dated sediment core on the Pacific‐Antarctic Ridge (PAR) that document a ∼15 cm thick layer of basaltic ash shards that precedes the penultimate deglaciation (Termination 2). The glasses have MORB composition consistent with an axial source and their morphologies are typical of pyroclastic deposits created by submarine volcanism. The ash layer was deposited ∼7 km from the PAR axis, a distance that implies buoyant plumes lofted debris high into the water column with subsequent fallout to the core location. We infer plume rise height using grain settling velocities, the water depth at the core site, and deep ocean current speeds from ARGO floats. Rise heights of 1.5 km or less require unrealistically large current speeds to transport grains to the core site. Instead, the data are consistent with a plume rise height of at least 2 km, implying that T2 was an interval of anomalous volcanism along this segment of the PAR. The timing and duration of the ash deposit is consistent with glacial‐interglacial modulation of ridge magmatism. Volcaniclastic records from additional locations will be necessary to assess whether the PAR record is a rare find or it is representative of mid‐ocean ridge volcanism during glacial terminations

Perinatal depressive symptoms among low-income South African women at risk of depression: trajectories and predictors

Abstract Background The aim of the study was to identify trajectories of perinatal depressive symptoms and their predictors among women living in a low-resource setting in South Africa, and who present with a risk of depression during pregnancy. Methods This is a secondary analysis of a randomised controlled trial among 384 women living in Khayelitsha, a low income setting in South Africa, recruited at their first antenatal visit if they scored 13 or above on the Edinburgh Postnatal Depression Scale, were at least 18 years of age, less than 29 weeks pregnant and spoke isiXhosa. Participants were followed up at 8 months gestation, 3 and 12 months postpartum. Latent trajectories of depressive symptoms were identified using growth mixture modelling, based on the Hamilton Depression Rating Scale (HDRS). There were no differences in HDRS scores between the control and intervention arms, so all participants were assessed together. Health, social and economic predictors of trajectories were investigated to identify high-risk groups with greater or more chronic depressive symptoms, using univariate logistic regression. Results Two trajectories were identified: antenatal only (91.4%), with moderate to severe symptoms at baseline which later subside; and antenatal and postnatal (8.6%), with severe depressive symptoms during pregnancy and later in the postpartum period, which subside temporarily to moderate levels at 3 months postpartum. Predictors for the antenatal and postnatal trajectory include severe food insecurity, intimate partner violence, lower social support, greater functional impairment, problematic drinking and suicide risk. Conclusions A small proportion of women who are at risk for depression antenatally remain at risk throughout the perinatal period, and can be differentiated from those who show a natural remission. Identification and referral strategies should be developed with these findings in mind, especially given the limited mental health resources in low-income settings