Young refugees talk about well-being: a qualitative analysis of refugee youth mental health from three states

[Abstract]: Young people from refugee backgrounds face enormous challenges in the settlement process within Australia. They must locate themselves within a new social, cultural, geographic and adult space, yet also try to find security within the spaces of their own families and ethnic communities. Traumas of the past can mix with painful experiences of the present. The stresses on the lives of these young people can be both complex and diverse. This paper explores the nature of the stresses among young people from refugee backgrounds living in Australia. It is based on in-depth interviews with 76 young people from refugee backgrounds now living in Brisbane, Adelaide and Perth. A qualitative analysis of the impact of these stressors as well as the coping strategies employed are discussed. It is argued that trauma exists within a life continuum and that approaches to supporting young people in these circumstances should be wary of limiting their focus to biomedical categories such as Post- Traumatic Stress Disorder or Acculturation Stress and instead focus on a wider social context

Chinese mental illness narratives: Controlling the spirit

Through analysis of local level narrative themes and linguistic features and their attendant narrative ‘domains’ and emotive content, this study explicates the discursive forms of Chinese personal narratives about mental illness published in a psychoeducational volume in mainland China. The cultural phenomena underpinning the explicated discursive forms are considered. The study finds that the Chinese mental illness narratives emphasize the problematic nature of the illness experience for the individual concerned, as well as the importance of gaining control over the personal and social disembodiment that mental illness brings about. The language of medicine presents as a dominant linguistic feature of the texts. Narrative authors appear to respond to their illness experience by negotiating and utilizing social relationships and support structures and through active medical intercession. As such, their narratives appear deeply culturally marked despite their psychoeducational intent and institutional context of publication. The study findings bear out the call for more attention to be given to the cultural dimension when analysing illness narratives

A comparative study of sertraline dosages, plasma concentrations, efficacy and adverse reactions in Chinese versus Caucasian patients

This prospective 6-week study examined the differences in dosage and steady state plasma concentrations of sertraline in Chinese versus Caucasian depressed patients. Two groups of Chinese patients from different geographical sites and a group of Caucasian patients were evaluated with clinical measures during an initial dose of 50 mg/day, with subsequent doses adjusted clinically. The results of 17 Australian Chinese (ACHI), 13 Malaysian Chinese (MCHI) and 15 Australian Caucasians (AC) were analysed. Despite controlling for weight, the AC subjects received a significantly higher dose than both the ACHI (P=0.002) and the MCHI groups (P=0.012). However, the mean sertraline concentration to dose ratios at weeks 1 and 6 were not significantly different between the three groups. Sertraline was effective and well tolerated in both ethnic groups with few adverse events. Although there was a lack of difference between groups in the pharmacokinetic results, Chinese depressed patients appeared to require lower dosages with consequently lower plasma concentrations of sertraline compared to Caucasian patients to achieve clinical efficacy. Further studies of the dosages, kinetics and adverse effects of selective serotonin reuptake inhibitors linked with genotyping are necessary

Parent–child relationships and adolescents’ life satisfaction across the first decade of the new millennium

This is the peer reviewed version of the following article: Antonia Jiménez-Iglesias, Irene GarcÍa-Moya, and Carmen Moreno, ‘Parent–Child Relationships and Adolescents' Life Satisfaction Across the First Decade of the New Millennium’, Family Relations, Vol. 66 (3): 512-526, July 2017, which has been published in final form at: https://doi.org/10.1111/fare.12249. Under embargo until 31 July 2018. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.Objective: To examine whether changes occurred in parent–child relationships (maternal and paternal affection, ease of communication with the mother and father, maternal and paternal knowledge, and family activities) between 2002 and 2010 in boys and girls and to examine the contributions of these family dimensions to life satisfaction. Background: Although parent–child relationships may be affected by social change, there are few investigations of change in parent–child relationships over time. Method: The sample consisted of 46,593 adolescents between 11 to 18 years of age who participated in the 2002, 2006, or 2010 editions of the Health Behaviour in School-aged Children (HBSC) study in Spain. Trend analysis including univariate analyses of variance (ANOVAs) and factorial ANOVAs were conducted separately for boys and girls, and effect size tests were calculated. Results: Communication with fathers and family activities statistically increased across HBSC editions and parent–child relationships were positively associated with life satisfaction across the examined period. Conclusion: There were small positive changes in some family dimensions, and some of them were increasingly important for adolescent life satisfaction over time. Implications: Interventions for strengthening parent-child relationships and promoting adolescent well-being should include mothers and fathers and emphasize affection, communication, and family activities.Peer reviewedFinal Accepted Versio

Does cultural integration explain a mental health advantage for adolescents?

BACKGROUND: A mental health advantage has been observed among adolescents in urban areas. This prospective study tests whether cultural integration measured by cross-cultural friendships explains a mental health advantage for adolescents. METHODS: A prospective cohort of adolescents was recruited from 51 secondary schools in 10 London boroughs. Cultural identity was assessed by friendship choices within and across ethnic groups. Cultural integration is one of four categories of cultural identity. Using gender-specific linear-mixed models we tested whether cultural integration explained a mental health advantage, and whether gender and age were influential. Demographic and other relevant factors, such as ethnic group, socio-economic status, family structure, parenting styles and perceived racism were also measured and entered into the models. Mental health was measured by the Strengths and Difficulties Questionnaire as a 'total difficulties score' and by classification as a 'probable clinical case'. RESULTS: A total of 6643 pupils in first and second years of secondary school (ages 11-13 years) took part in the baseline survey (2003/04) and 4785 took part in the follow-up survey in 2005-06. Overall mental health improved with age, more so in male rather than female students. Cultural integration (friendships with own and other ethnic groups) was associated with the lowest levels of mental health problems especially among male students. This effect was sustained irrespective of age, ethnicity and other potential explanatory variables. There was a mental health advantage among specific ethnic groups: Black Caribbean and Black African male students (Nigerian/Ghanaian origin) and female Indian students. This was not fully explained by cultural integration, although cultural integration was independently associated with better mental health. CONCLUSIONS: Cultural integration was associated with better mental health, independent of the mental health advantage found among specific ethnic groups: Black Caribbean and some Black African male students and female Indian students

Illness causal beliefs in Turkish immigrants

<p>Abstract</p> <p>Background</p> <p>People hold a wide variety of beliefs concerning the causes of illness. Such beliefs vary across cultures and, among immigrants, may be influenced by many factors, including level of acculturation, gender, level of education, and experience of illness and treatment. This study examines illness causal beliefs in Turkish-immigrants in Australia.</p> <p>Methods</p> <p>Causal beliefs about somatic and mental illness were examined in a sample of 444 members of the Turkish population of Melbourne. The socio-demographic characteristics of the sample were broadly similar to those of the Melbourne Turkish community. Five issues were examined: the structure of causal beliefs; the relative frequency of natural, supernatural and metaphysical beliefs; ascription of somatic, mental, or both somatic and mental conditions to the various causes; the correlations of belief types with socio-demographic, modernizing and acculturation variables; and the relationship between causal beliefs and current illness.</p> <p>Results</p> <p>Principal components analysis revealed two broad factors, accounting for 58 percent of the variation in scores on illness belief scales, distinctly interpretable as natural and supernatural beliefs. Second, beliefs in natural causes were more frequent than beliefs in supernatural causes. Third, some causal beliefs were commonly linked to both somatic and mental conditions while others were regarded as more specific to either somatic or mental disorders. Last, there was a range of correlations between endorsement of belief types and factors defining heterogeneity within the community, including with demographic factors, indicators of modernizing and acculturative processes, and the current presence of illness.</p> <p>Conclusion</p> <p>Results supported the classification of causal beliefs proposed by Murdock, Wilson & Frederick, with a division into natural and supernatural causes. While belief in natural causes is more common, belief in supernatural causes persists despite modernizing and acculturative influences. Different types of causal beliefs are held in relation to somatic or mental illness, and a variety of apparently logically incompatible beliefs may be concurrently held. Illness causal beliefs are dynamic and are related to demographic, modernizing, and acculturative factors, and to the current presence of illness. Any assumption of uniformity of illness causal beliefs within a community, even one that is relatively culturally homogeneous, is likely to be misleading. A better understanding of the diversity, and determinants, of illness causal beliefs can be of value in improving our understanding of illness experience, the clinical process, and in developing more effective health services and population health strategies.</p

Do schools differ in suicide risk? the influence of school and neighbourhood on attempted suicide, suicidal ideation and self-harm among secondary school pupils

&lt;br&gt;Background: Rates of suicide and poor mental health are high in environments (neighbourhoods and institutions) where individuals have only weak social ties, feel socially disconnected and experience anomie - a mismatch between individual and community norms and values. Young people spend much of their time within the school environment, but the influence of school context (school connectedness, ethos and contextual factors such as school size or denomination) on suicide-risk is understudied. Our aim is to explore if school context is associated with rates of attempted suicide and suicide-risk at age 15 and self-harm at age 19, adjusting for confounders.&lt;/br&gt; &lt;br&gt;Methods: A longitudinal school-based survey of 1698 young people surveyed when aged 11, (primary school), 15 (secondary school) and in early adulthood (age 19). Participants provided data about attempted suicide and suicide-risk at age 15 and deliberate self-harm at 19. In addition, data were collected about mental health at age 11, social background (gender, religion, etc.), and at age 15, perception of local area (e.g. neighbourhood cohesion, safety/civility and facilities), school connectedness (school engagement, involvement, etc.) and school context (size, denomination, etc.). A dummy variable was created indicating a religious 'mismatch', where pupils held a different faith from their school denomination. Data were analysed using multilevel logistic regression.&lt;/br&gt; &lt;br&gt;Results: After adjustment for confounders, pupils attempted suicide, suicide-risk and self-harm were all more likely among pupils with low school engagement (15-18% increase in odds for each SD change in engagement). While holding Catholic religious beliefs was protective, attending a Catholic school was a risk factor for suicidal behaviours. This pattern was explained by religious 'mismatch': pupils of a different religion from their school were approximately 2-4 times more likely to attempt suicide, be a suicide-risk or self-harm.&lt;/br&gt; &lt;br&gt;Conclusions: With several caveats, we found support for the importance of school context for suicidality and self-harm. School policies promoting school connectedness are uncontroversial. Devising a policy to reduce risks to pupils holding a different faith from that of their school may be more problematic.&lt;/br&gt

Children's perceptions of parental emotional neglect and control and psychopathology

&lt;b&gt;Background:&lt;/b&gt; Parental emotional neglect is linked to psychiatric disorder. This study explores the associations between children’s perceptions of parental emotional neglect and future psychopathology. &lt;b&gt;Methods:&lt;/b&gt; In a school-based longitudinal study of nearly 1700 children aged 11-15 we explored children’s perceptions of parenting, as measured by the parental bonding instrument (PBI) at age 11, and their associations with later psychiatric diagnosis at age 15, as measured by computerized psychiatric interview. Rather than using the traditional four category approach to the PBI, we identified groups of children, classified according to their perceptions of parenting, using latent class analysis. &lt;b&gt;Results:&lt;/b&gt; A small group of children (3%) perceived their parents as almost always emotionally neglectful and controlling. This group had an increased odds of psychiatric disorder (OR 2.14; 95% CI 1.29-4.50), increased overall (standardised) psychiatric symptom scores (B = 0.46; 95% CI 0.16-0.75) and increased scores in all psychiatric subscales except substance-use at age 15, despite no increase in psychiatric referral at age 11. Analyses controlled for key potential confounders (e.g. socioeconomic status). &lt;b&gt;Conclusions:&lt;/b&gt; Although our findings are limited by having no objective evidence that children’s perceptions of emotional neglect are directly associated with actual neglect, children’s perceptions of neglect and control are associated with over twice the odds of psychiatric disorder at age 15. Children’s perceptions that parents are emotionally neglectful and controlling are independently associated with later psychiatric disorder and should be taken seriously as a risk factor for future psychopathology

‘How people from Chinese backgrounds make sense of and respond to experiences of mental distress: Thematic analysis

This is the peer reviewed version of the following article: E. Y. W. Yeung, F. Irvine, and K. M. S. Tsang, ‘How people from Chinese backgrounds make sense of and respond to the experiences of mental distress: Thematic analysis’, Journal of Psychiatric and Mental Health Nursing, Vol. 24 (8): 589-599, October 2017, which has been published in final form at https://doi.org/10.1111/jpm.12406. Under embargo. Embargo end date: 3 August 2018. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.Introduction: Late presentation and low utilisation of mental health services are common among Chinese populations. An understanding of their journey towards mental health care helps to identify timely and appropriate intervention. Aim: We aimed to examine how Chinese populations make sense of the experiences of mental distress, and how this understanding influences their pathways to mental health care. Method: We undertook in-depth interviews with fourteen people with mental health problems and sixteen family members. Thematic analysis was used to analyse data. Results / Discussions: Different conceptualisation of mental distress and the stigma attached to mental health problems explained why most participants accessed services at crisis points. Because of mental illness stigma, they were reluctant to seek help outside of the family. Participants used a pragmatic pluralistic approach to incorporate ritual healing and western interventions to manage mental distress as they travelled further on the pathway journey. Families play a key role in the journey and are prepared to visit different parts of the world to seek traditional healers. Implications for practice: Mental health nurses need to adopt a transcultural working approach to address mental health issues so that family will get the support needed to continue their caring role.Peer reviewe