Adult Attachment Patterns Modify the Association Between Social Support and Psychological Distress

Introduction: Social support is an important protective factor for psychological distress, and adult attachment patterns—which are the basis of human relationships—may modify the association between social support and psychological distress. The objective of this study was to investigate whether adult attachment patterns modify the association between social support and psychological distress.Methods: A commercial online survey service was used to collect data from 1648 men and women of 30–69 years of age in Japan. We assessed the association between social support and psychological distress, as measured by the Kessler Psychological Distress Scale (K6), and stratified it by adult attachment patterns using multiple linear models. Adjustments were made for age, sex, presence of a spouse and child in the household, level of education, employment, and household income.Results: There was a significant interaction effect between social support score and a dismissing attachment pattern on psychological distress (p = 0.015); social support was associated with reduced level of psychological distress only in participants with a secure attachment pattern (β:−0.86, 95% CI: −1.56 to −0.16), whereas the point estimate was of opposite sign in participants with a dismissing attachment pattern (β:1.02, 95% CI: −0.32 to 2.37).Conclusions: Higher social support reduced the risk of distress among participants with secure attachment. On the contrary, social support can be harmful for those with a dismissing attachment pattern. Our results suggest that further assessment of adult attachment patterns is needed to maximize the positive effects of social support to prevent psychological distress

Impact of conflict on infant immunisation coverage in Afghanistan: a countrywide study 2000–2003

<p>Abstract</p> <p>Background</p> <p>Infant immunisation is an effective public health intervention to reduce the morbidity and mortality of vaccine preventable diseases. However, some developing countries fail to achieve desirable vaccination coverage; Afghanistan is one such country. The present study was performed to evaluate the progress and variation in infant immunisation coverage by district and region in Afghanistan and to assess the impact of conflict and resource availability on immunisation coverage.</p> <p>Results</p> <p>This study analysed reports of infant immunisation from 331 districts across 7 regions of Afghanistan between 2000 and 2003. Geographic information system (GIS) analysis was used to visualise the distribution of immunisation coverage in districts and to identify geographic inequalities in the process of improvement of infant immunisation coverage. The number of districts reporting immunisation coverage increased substantially during the four years of the study. Progress in Bacillus Calmette-Guerin (BCG) immunisation coverage was observed in all 7 regions, although satisfactory coverage of 80% remained unequally distributed. Progress in the third dose of Diphtheria-Pertussis-Tetanus (DPT3) immunisation differed among regions, in addition to the unequal distribution of immunisation coverage in 2000. The results of multivariate logistic regression analysis indicated a significant negative association between lack of security in the region and achievement of 80% coverage of immunisation regardless of available resources for immunisation, while resource availability showed no relation to immunisation coverage.</p> <p>Conclusion</p> <p>Although progress was observed in all 7 regions, geographic inequalities in these improvements remain a cause for concern. The results of the present study indicated that security within a country is an important factor for affecting the delivery of immunisation services.</p

Parental Time of Returning Home From Work and Child Mental Health Among First-Year Primary School Students in Japan: Result From A-CHILD Study

Introduction: Child mental health is known to be influenced by parental work hours. Although literature suggests that parent-child interaction mediates the association, few studies have directly measured the parental time of returning home from work. We analyzed data from a school-based survey to examine the association between parental time of returning home from work and child mental health.Methods: We used a sample of 2,987 first-year primary school students derived from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study that examined the impact of family environment and lifestyle on child health in Adachi City, Tokyo, Japan. We analyzed the associations between reported parental time of returning home and the continuous Strengths and Difficulties Questionnaire (SDQ) scores using multivariable regression modeling.Results: Children whose parents both returned home late (later than 6 p.m. for the mother and later than 8 p.m. for the father), or at irregular times, had higher scores in total difficulties (β = 1.20, 95% CI: 0.55 to 1.85), the “conduct problems” subscale (β = 0.37, 95% CI: 0.13 to 0.60), and the hyperactivity/inattention subscale (β = 0.53, 95% CI: 0.24 to 0.82) compared with children whose parents both returned home earlier. Mediation analyses indicated that the percentage of the total association between parental time of returning home and the SDQ scores, which was mediated by parent-child interaction, was 20% (95% CI: 10 to 46) for total difficulties, 17% (95% CI: 7 to 49) for conduct problems, and 23% (95% CI: 11 to 52) for hyperactivity/inattention.Conclusions: Late or irregular returning home times for both parents had an adverse effect on child mental health, and the relationship was partly mediated by reduced frequency of parent-child interaction

Factors associated with the health and nutritional status of children under 5 years of age in Afghanistan: family behaviour related to women and past experience of war-related hardships

<p>Abstract</p> <p>Background</p> <p>The present study was performed to assess, beyond socio-economic factors, independent associations between the health and nutritional status of children under 5 years old and (1) family behavioural factors related to women with regard to child care and (2) war-related experience by the household of hardships in Afghanistan.</p> <p>Methods</p> <p>The subjects were all children born during the previous 5 years from 1400 households in Kabul Province, Afghanistan and were selected by multistage sampling in March 2006. Height and weight measurements of the children and culturally sensitive interviews with their mothers were conducted by household visits. Child mortality, morbidity and nutritional status were evaluated. Four areas were assessed as variables for family behavioural factors related to women: education of mothers, child marriage of the mothers, maternal autonomy in obtaining healthcare for children and preference for a female physician. Hardships experienced by the family were examined by determining their satisfaction of basic material needs and by any experience of being forced to leave a preferred residence.</p> <p>Results</p> <p>A total of 2474 children from 1327 households completed the examinations and interviews; among them, 101 children were deceased by the time of the interview visits. Diarrhoea (32.5%) and acute respiratory infection (41.0%) were common child health problems and both emaciation (12.4%) and linear growth retardation (39.9%) were prevalent. Regardless of the influence of economic, demographic, family behavioural or hardships experience factors, a lack of maternal autonomy (79.1%) was associated with the occurrence of acute respiratory infection (odds-ratio = 1.72; 95% confidence interval = 1.23, 2.40), and linear growth retardation of children (odds-ratio = 1.38; 95% confidence interval = 1.01, 1.90); a lack of education of the mother (71.7%) and child marriage of the mothers (18.3%) were associated with diarrhoea (odds-ratio = 1.84; 95% confidence interval = 1.40, 2.41; odds-ratio = 1.46; 95% confidence interval = 1.08, 1.96, respectively); a shortage of basic material needs (59.1%) was associated with diarrhoea (odds-ratio = 1.35; 95% confidence interval = 1.08, 1.68); and migration inside the country (52.9%) was associated with underweight children (odds-ratio = 2.48; 95% confidence interval = 1.13, 5.44).</p> <p>Conclusion</p> <p>A lack of education of the mothers, child marriage, lack of maternal autonomy, shortage of basic material needs and internal displacement showed independent and significant negative associations with child health and nutritional variables in this country that has experienced a long period of conflict.</p

Association between Frequency of Conversations and Suicidal Ideation among Medical Students during COVID-19 Pandemic in Japan

To mitigate the spread of COVID-19, universities in Japan shifted from face-to-face to online classes, which might have reduced social interaction and increased psychiatric problems among students. A self-report questionnaire was administered to fourth-year medical students in Tokyo in May 2021, during the fourth wave of the COVID-19 outbreak, to examine the association between the frequency of conversations and suicidal thoughts. The questionnaire assessed the frequency of conversations and, using part of the Mini International Neuropsychiatric Interview, suicidal ideation. Of the 113 students, 98 (86.7%) responded, of whom 20 (20.4%) had suicidal ideation. Poisson regression analysis revealed that those with less than 1 conversation per week and no conversations at all had a significantly higher risk of suicidal ideation than those with 3 conversations per week or more, after adjusting for personality, family relationship, income level, living alone, number of friends, gender, and age. These results indicate that less frequent conversations increased the risk of suicidal ideation among medical students. Mental health support for students needs to be strengthened if universities suspend face-to-face classes during a pandemic

Does gender inequity increase the risk of intimate partner violence among women? Evidence from a national Bangladeshi sample.

BACKGROUND: Evidence from developing countries regarding the association between gender inequity and intimate partner violence (IPV) victimization in women has been suggestive but inconclusive. Using nationally representative population-based data from Bangladesh, we examined the association between multidimensional aspects of gender inequity and the risk of IPV. METHODS: We used data from the 2007 Bangladesh Demographic Health Survey. The analyses were based on the responses of 4,467 married women. The main explanatory variable was gender inequity, which reflects the multidimensional aspects of women's autonomy and the relationship inequality between women and their partner. The experience of physical and/or sexual IPV was the main outcome variable of interest. RESULTS: Over 53% of married Bangladeshi women experienced physical and/or sexual violence from their husbands. In the adjusted models, women who had a higher level of autonomy (adjusted odds ratio [AOR] 0.48; 99% confidence interval [CI] 0.37-0.61), a particularly high level of economic-decision-making autonomy (AOR 0.12; 99% CI 0.08-0.17), and a higher level of non-supportive attitudes towards wife beating or raping (AOR 0.61; 99% CI 0.47-0.83) were less likely to report having experienced IPV. Education level, age at marriage, and occupational discrepancy between spouses were also found to be significant predictors of IPV. CONCLUSIONS: In conclusion, dimensions of gender inequities were significant predictors of IPV among married women in Bangladesh. An investigation of the causal link between multidimensional aspects of gender inequity and IPV will be critical to developing interventions to reduce the risk of IPV and should be considered a public health research priority

Intimate partner violence and use of reproductive health services among married women: evidence from a national Bangladeshi sample

Abstract Background Data from a statewide survey in India and clinic-based studies in developed settings have previously suggested an association between maternal physical intimate partner violence (IPV) experiences and the low use of antenatal care (ANC). This study aimed to explore the association between maternal experiences of physical and sexual IPV and the use of reproductive health care services, using a large nationally representative data set from Bangladesh. Methods This paper used data from the 2007 Bangladesh Demographic Health Survey. The analyses were based on the responses of 2001currently married women living with at least one child younger than 5 years. Exposure was determined from maternal reports of physical and sexual IPV. The utilization of ANC according to amount and type of provider and utilization of delivery assistance according to provider type were used as proxy outcome variables for reproductive health care utilization. Descriptive statistics and multivariate logistic regression analysis used in the study. Results Approximately two out of four (48.2%) respondents had experienced physical IPV. Maternal experience of physical IPV was associated with low use of receiving sufficient ANC (adjusted odds ratio [AOR] 0.69; 95% confidence interval [CI] 0.49–0.96), lower likelihood of receiving ANC (AOR 0.69; 95% CI 0.53–0.89), and assisted deliveries from skilled provider (AOR 0.54; 95% CI 0.37–0.78). Women who had been sexually abused were significantly less likely to have visited a skilled ANC and delivery care provider. Furthermore, severity of physical IPV appeared to have more profound consequences on the outcome measured. Conclusions The association between exposure to IPV and use of reproductive health care services suggests that partner violence plays a significant role in lower utilization of reproductive health services among women in Bangladesh. Our findings suggest that, in addition to a wide range of socio-demographic factors, preventing maternal physical and sexual IPV need to be considered as an important psychosocial determinates for the higher utilization of reproductive health care services in Bangladesh.</p

Decline of supportive attitudes among husbands toward female genital mutilation and its association to those practices in Yemen.

OBJECTIVES: To elucidate the attitudes of women and their husband's towards female genital mutilation (FGM) and their associations with the continuation of FGM upon their daughters. METHODS: Subjects were 10,345 (in 1997) and 11,252 (in 2003) ever married women aged 15 to 49 years from the Yemen Demographic Health Surveys. Performances of FGM on the most-recently-born daughters were investigated. Attitudes of women and their husbands were assessed by their opinions on the continuation of FGM. The association between the attitudes of women and their husbands and performance of FGM on the most-recently-born daughters were investigated after adjusting for age and education of the women. FINDINGS: The percentage among the most-recently-born daughters who received FGM of women who had undergone FGM declined from 61.9% in 1997 to 56.5% in 2003 (p<0.001). The percentages of women who had undergone FGM and who supported the continuation of FGM and of husbands who also supported its continuation decreased from 78.2% and 60.1% in 1997 to 70.9% and 49.5% in 2003, respectively (both p<0.001). When the women or the husbands did not agree with FGM, it was less likely to be performed on their daughter than when the women or the husbands agreed in 1997 (odds ratio=0.11, 95% confidence interval 0.07-0.16 and odds ratio=0.07, 95% confidence interval 0.04-0.12, respectively) and in 2003 (odds ratio=0.12, 95% confidence interval 0.09-0.16 and odds ratio=0.11, 95% confidence interval 0.07-0.16, respectively). CONCLUSION: Non-supportive attitudes of women and their husbands towards the continuation of FGM have become common and were associated with their decision not to perform FGM upon their daughters