Longitudinal Predictors of Self-Reliance for Coping with Mental Health Problems in the Military

Military personnel encounter occupational hazards that make them vulnerable to developing mental health symptoms; however, many soldiers who experience a problem do not seek treatment. A major barrier to treatment is self-reliance, a preference to manage problems oneself rather than seek help from a professional. In the present study, we sought a more comprehensive understanding of factors that contribute to self-reliance. Active-duty soldiers (N = 485) were surveyed at two time points. The sample was 93% male, 67% Caucasian, and most were aged 20-24 (49%). The survey included: factors that affect treatment-seeking, deployment experiences, and mental health symptoms. Results indicated that stigmatizing beliefs about those who seek treatment and negative beliefs about treatment at Time 1 were related to higher preferences for self-reliance at Time 2, while positive beliefs about treatment at Time 1 were related to lower self-reliance. Combat exposure, mental health symptoms, social support for treatment-seeking, and stigma from others were not significant predictors. These results demonstrate that self-reliance may not be unique to combat soldiers and may not diminish as symptoms become severe. Instead one’s views of treatment and others who seek treatment may be more impactful, and should be the target of interventions to encourage treatment-seeking

Prevalence and risk of psychiatric disorders as a function of variant rape histories: results from a national survey of women

Abstract Purpose Rape is an established risk factor for mental health disorders, such as posttraumatic stress disorder (PTSD), major depressive episodes (MDE), and substance use disorders. The majority of studies have not differentiated substance-involved rape or examined comorbid diagnoses among victims. Therefore, the aim of the present study was to estimate the prevalence of common traumarelated psychiatric disorders (and their comorbidity) in a national sample of women, with an emphasis on distinguishing between rape tactics. A secondary objective was to estimate the risk for psychiatric disorders among victims of variant rape tactics, in comparison to non-victims. Methods A nationally representative population-based sample of 3,001 non-institutionalized, civilian, English or Spanish speaking women (aged 18-86 years) participated in a structured telephone interview assessing rape history and DSM-IV criteria for PTSD, MDE, alcohol abuse (AA), and drug abuse (DA). Descriptive statistics and multivariate logistic regression analyses were employed. Results Women with rape histories involving both substance facilitation and forcible tactics reported the highest current prevalence of PTSD (36%), MDE (36%), and AA (20%). Multivariate models demonstrated that this victim group was also at highest risk for psychiatric disorders, after controlling for demographics and childhood and multiple victimization history. Women with substancefacilitated rapes reported higher prevalence of substance abuse in comparison to women with forcible rape histories. Comorbidity between PTSD and other psychiatric disorders was higher among rape victims in comparison to nonrape victims. Conclusions Researchers and clinicians should assess substance-facilitated rape tactics and attend to comorbidity among rape victims. Empirically supported treatments are needed to address the complex presentations observed among women with variant rape histories

Risk Factors Associated with Cognitive Decline after Cardiac Surgery: A Systematic Review

Modern day cardiac surgery evolved upon the advent of cardiopulmonary bypass machines (CPB) in the 1950s. Following this development, cardiac surgery in recent years has improved significantly. Despite such advances and the introduction of new technologies, neurological sequelae after cardiac surgery still exist. Ischaemic stroke, delirium, and cognitive impairment cause significant morbidity and mortality and unfortunately remain common complications. Postoperative cognitive decline (POCD) is believed to be associated with the presence of new ischaemic lesions originating from emboli entering the cerebral circulation during surgery. Cardiopulmonary bypass was thought to be the reason of POCD, but randomised controlled trials comparing with off-pump surgery show contradictory results. Attention has now turned to the growing evidence that perioperative risk factors, as well as patient-related risk factors, play an important role in early and late POCD. Clearly, identifying the mechanism of POCD is challenging. The purpose of this systematic review is to discuss the literature that has investigated patient and perioperative risk factors to better understand the magnitude of the risk factors associated with POCD after cardiac surgery