Clinical Ecopsychology: The Mental Health Impacts and Underlying Pathways of the Climate and Environmental Crisis

Humankind is confronted with progressing climate change, pollution, environmental degradation, and/or destruction of the air, soil, water, and ecosystems. The climate and environmental crisis is probably one of the greatest challenges in the history of humankind. It not only poses a serious current and continuing threat to physical health, but is also an existing and growing hazard to the mental health of millions of people worldwide. This synergy of literature provides a current summary of the adverse mental health impacts of the climate and environmental crisis from the perspective of Clinical Psychology. Furthermore, it presents potential underlying processes, including biological, emotional, cognitive, behavioral, and social pathways. The existing data suggest that the climate and environmental crisis not only acts as a direct stressor, but can also exert a detrimental impact on the various pathways, with the potential to amplify an individual's biopsychosocial vulnerability to develop mental ill-health. This is a call for an increased investigation into this emerging research field of Clinical Ecopsychology by clinical psychologists and other researchers

Successful Treatment of PulmonaryInvasive Aspergillosis with Voriconazole in Patients who FailedConventional Therapy

Abstract.: Background: The incidence of fungal infections, including those due to Aspergillosis species has continued to increase in recent years. Invasive aspergillosis remains an important cause of morbidity and mortality, despite therapeutics interventions. Patients and Methods: We reported five cases of invasive pulmonary aspergillosis treated with voriconazole failing to respond to conventional treatments. Results: The clinical and radiological resolution of pulmonary aspergillosis reported in these cases following therapy with voriconazole is remarkable, considering the infections had proved refractory to standard antifungal therapies. Long-term therapy (in two cases ≥ 1 year, in one case 6 months) was very well tolerated by patients who were unable to tolerate other antifungal agents. Conclusion: Therapy with voriconazole offers a new therapeutic option for otherwise difficult-to-treat infections and the potential to significantly improve the management of Aspergillosis infection

Southern American University Undergraduates\u27 Attitudes toward Intrauterine Insemination Undertaken by Women of Differing Age, Marital Status and Sexual Orientation

Undergraduate college students in the southern U.S. were presented with vignettes about a fictional woman seeking to become pregnant via intrauterine insemination (IUI). Participants were randomly assigned to conditions in which the woman described was 26 or 41 years old, and single, married to a man, or married to a woman. After reading the vignettes, participants rated their expectations of the prospective mother’s preparedness for parenting, ability to provide quality of life for a child, risk for pregnancy complications and achieving a healthy pregnancy. Results yielded marginally significantly (p = .05) lower expectations of achieving a healthy pregnancy when the mother was over 40, and significantly (p \u3c .05) lower anticipation of preparedness for parenting and ability to provide quality of life when she was designated as single or married to a woman. We discuss findings in terms of bias favoring traditional families with a mother and father begun when the parents were in their twenties

Mental health resilience in Swiss older adult survivors of child welfare-related maltreatment

Minors affected by child welfare practices in Switzerland during the last century had a high risk for exposure to childhood trauma and maltreatment. Several studies with this cohort demonstrated substantially higher levels of clinically-relevant psychopathology in older adult survivors in comparison to non-affected control individuals. However, these studies also revealed that not all affected individuals developed mental health disorders over their lifespan. To date, this mental health resilience in survivors of an advanced age is still insufficiently understood. Therefore, this study aimed to assess and compare the resilience profiles of older adults who were formerly affected by child welfare-related trauma and maltreatment (risk group, RG; n = 132; Mage = 71 years) and non-affected, age-matched controls (control group, CG; n = 125). Within the RG, approximately one-third of the individuals had no current or lifetime DSM-5 mental health disorders. In comparison to the survivors with a history of mental ill-health, these individuals were older, had a higher income, and expressed a higher subjective satisfaction with their socio-economic status. Furthermore, they reported less early-life physical abuse, and had lower levels of neuroticism, as well as empathy-related characteristics. In addition, they showed higher levels of self-esteem and trait resilience. Group differences between the RG and CG highlight the importance of considering past adversity in the understanding of mental health resilience in later life

Salutary mechanisms in the relationship between stress and health: The mediating and moderating roles of Sense of Coherence-Revised

While chronic and acute stress are often associated with negative health, the sense of coherence-revised (SOC-R) is proposed to facilitate coping with stress and promote health. However, research is lacking on the specific mechanisms. Therefore, the current study aimed to investigate potential mediating and moderating mechanisms of SOC-R in the relationship between stress and health. Using a cross-sectional design, standardized questionnaires assessed SOC-R, acute (perceived) stress, early-life adversity (ELA; indicator for early-life chronic stress), mental and physical health, and satisfaction with life. Mediation and moderation analyses were conducted with N = 531 Irish adults (mean age: 59.5 years; 58.4% female). Regarding acute (perceived) stress, results showed that SOC-R and its Manageability subscale significantly mediated the association between perceived stress and mental health, and satisfaction with life. SOC-R and its Manageability subscale also significantly moderated the association between perceived stress and mental health. Regarding ELA, the Manageability subscale significantly mediated the association between ELA and mental health, and satisfaction with life; and the Balance subscale significantly mediated the association between ELA and physical health. SOC-R may provide a useful focus for stress-related research, with future longitudinal studies needed to examine SOC-R as a long-term modulating pathway between stress and health

Early-life adversity and later-life mental health: a conditional process analysis of sense of coherence and resilience-related resources

Objective While early-life adversity can have negative effects on health and wellbeing that persist across the lifespan, some individuals show indications of resilience. Resilience can be understood as a dynamic coping process involving the mobilization of resources in response to adversity exposure. Sense of coherence—revised (SOC-R), an ability linked to health maintenance in the face of adversity, may be influential in this process. However, research is lacking on the mechanisms underpinning SOC-R and resilience-related resources and their impact on the (mental) health of individuals exposed to early-life adversity. Therefore, this study examined the role of SOC-R and selected resilience-related resources in the relationship between early-life adversity and later-life health and wellbeing. Method Participants were N = 531 Irish (older) adults (58.2% female, mean age = 59.5 years, range = 50–86 years). Standardized questionnaires assessed retrospective reports of early-life adversity, as well as current physical and mental health, satisfaction with life, SOC-R, and resilience-related resources (self-efficacy, optimism, social support). A multiple mediation analysis tested the indirect effects of the resources and a moderated mediation tested for conditional dependence on SOC-R. Results For mental health and satisfaction with life, significant partial mediations were found for all three resources. Only optimism showed a significant partial mediation for physical health. In the moderated mediation, SOC-R significantly moderated the associations between early-life adversity and self-efficacy (b = .06, t = 3.65, p = .001), optimism (b = .04, t = 2.60, p = .009), and social support (b = .08, t = 3.75, p < .001). The indirect effects were larger at high rather than low SOC-R, indicating that the mediating effects of the resources were greater for individuals with a stronger SOC-R. Conclusion A strong SOC-R may have a beneficial influence on health and wellbeing by mitigating the detrimental effect of early-life adversity on the resources self-efficacy, optimism, and social support. Future avenues for research include the expanded assessment of resources and the potential role of SOC-R in successful ageing through the selection and adaptation of goals and resources into older age. SOC-R may represent a promising target for psychotherapeutic interventions promoting resilience in survivors of early-life adversity

Childhood adversity and later life prosocial behavior: A qualitative comparative study of Irish older adult survivors

Objective Although childhood adversity can have lasting effects into later life, positive adaptations have also been observed, including an increased tendency toward prosocial behavior. However, little is known about the link between childhood adversity and later life prosocial behavior, with a particular scarcity of research on intrafamilial childhood adversity. Therefore, this study aimed to examine older adult's experiences of childhood adversity and identify mechanisms linked to prosocial behavior. Two adversity contexts (intrafamilial and extrafamilial) were compared to explore individual, as well as broader cultural and contextual mechanisms linking childhood adversity and later life prosocial behavior. Method Semi-structured interviews (60–120 min) were conducted with N = 29 Irish (older) adult survivors of childhood adversity: n = 12 intrafamilial survivors (mean age: 58 years, range: 51–72), n = 17 institutional survivors (mean age: 61 years, range: 50–77). Interviews were analyzed using the framework analysis method, with reference to the conceptual model of altruism born of suffering. Results Five themes were identified on prosocial mechanisms, with three themes in both survivor groups (enhanced empathy, self-identity, amelioration), and two group-specific themes (compassion fatigue in intrafamilial survivors; denouncing detrimental social values in institutional survivors). Conclusion Results identified motivational processes and volitional factors linked to later life prosocial behavior. Connections to caring roles, (lack of) support, and social norms in childhood, as well as the need for a sense of purpose and meaning from the adversities in adulthood, highlight potential targets for psychotherapeutic intervention to promote prosocial responding and positive adaptation for childhood adversity survivors

The Effects of Social Support on ACEs and Mental Health in Ireland

The aim of this study is to determine the moderating effect of perceived social support on the relationships between ACEs and depression/anxiety, and CPTSD symptoms in older adults in Ireland. Moderated regression analysis was used to evaluate these relationships in a sample of 535 residents of Ireland, aged 50 or above. The results show statistically significant predictive relationships between ACEs and mental health outcomes as well as a significant moderating effect of perceived social support. These findings suggest that ACEs in Ireland should be considered and measures to increase perceived social support should be implemented

Internalizing Mental Health Disorders and Emotion Regulation: A Comparative and Mediational Study of Older Adults With and Without a History of Complex Trauma Exposure

Individuals with complex trauma exposure (CTE) in early life (i.e., childhood/adolescence) are at heightened risk for developing problems in various domains of functioning. As such, CTE has repeatedly been linked to internalizing mental health disorders, such as depression and anxiety, as well as emotion dysregulation across the lifespan. While these correlates of CTE are comparatively well studied up to middle adulthood, they are insufficiently studied in older adulthood. Therefore, this study aimed to (a) compare Swiss older adults with and without a CTE history regarding current and lifetime internalizing mental health disorders and emotion regulation strategies; and (b) to examine the potential mediating role of emotion regulation in the mental health disparities between these groups. A total of N = 257 participants (age = 49–95 years; 46.3% female) were assessed in a retrospective, cross-sectional study, using two face-to-face interviews. The CTE group (n = 161; M$_{age}$ = 69.66 years, 48.4% female) presented with significantly more current and lifetime internalizing mental health disorders than the non-affected (nCTE) group (n = 96; M$_{age}$ = 72.49 years, 42.7% female). The CTE group showed significantly higher emotion suppression and lower emotion reappraisal compared to the nCTE group. Mediation analysis revealed that the two emotion regulation strategies were significant mediators between CTE history and internalizing mental health disorders. Findings emphasize the relevance of emotion (dys-)regulation in understanding mental health disparities in older age and deciding about treatment strategies. Research and practice should pay more attention to the needs of this high-risk group of older individuals