Exploring young people’s perceptions of the effectiveness of text-based online counseling: mixed methods pilot study

Background: Young people aged 10-24 years are at the highest risk for mental health problems and are the least likely to seek professional treatment. Owing to this population’s high consumption of internet content, electronic mental (e-mental) health services have increased globally, with an aim to address barriers to treatment. Many of these services use text-based online counseling (TBOC), which shows promising results in supporting young people but also greater variance in outcomes compared with adult comparators. Objective: This pilot study qualitatively explored the characteristics of users aged 15-25 years accessing TBOC services, their motivations for access, and their perceptions about factors believed to influence the effectiveness of these modalities. Methods: E-surveys were administered naturalistically to 100 young service users aged 15-25 years who accessed webchat and email counseling services via an Australian e-mental health service. Thematic analysis of qualitative themes and quantitative descriptive and proportional data presented in electronic surveys were examined across the areas of user characteristics, motivations for selecting TBOC modalities, and their perceptions of TBOC effectiveness. Results: Participants were predominately female high school students of Caucasian or European descent from middle socioeconomic status, living with their parents in major cities. Four domains and various themes and subthemes were related to participants’ reasons for accessing TBOC and perceptions of its effectiveness: user characteristics (ie, physical and mental health syndrome and perceived social difficulties), selection factors (ie, safety, avoidance motivation, accessibility, and expectation), factors perceived to increase effectiveness (ie, general therapeutic benefits, positive modality and service factors, and persisting with counseling to increase benefit), and factors perceived to decrease effectiveness (ie, negative modality and service factors, and persisting with counseling despite benefit). Conclusions: Participants were motivated to use TBOC to increase their sense of safety in response to negative perceptions of their social skills and the response of the online counsellor to their presenting problem. By using TBOC services, they also sought to improve their access to mental health services that better met their expectations. Factors that increased effectiveness of TBOC were the counsellor’s interpersonal skills, use of text-based communication, and persisting with beneficial counseling sessions. Factors that reduced TBOC effectiveness were poor timeliness in response to service requests, experiencing no change in their presenting problem, not knowing what postcounseling action to take, and persisting with ineffective counseling sessions

Associations between teacher-reported school climate and depressive symptoms in Australian adolescents : a 5-year longitudinal study.

Adolescent depression is serious and common. As adolescents spend approximately 15,000 h in school, this setting is a logical place to seek etiological factors. Research suggests there are negative associations between school climate and adolescent depressive symptoms. However, such studies typically use student reports of both climate and depressive symptoms; this is problematic because common method variance results when the same individual provides information on all variables, contributing to overestimations of associations between depressive symptoms and school climate. Therefore, the purpose of this study is to examine the association between teacher-reported school climate and adolescent-reported depressive symptoms. Thus, 2545 Australian high school students participated in this 5-year longitudinal study. Students completed a measure of depressive symptoms annually; their teachers (N = 882) completed a questionnaire to evaluate the quality of the school environment (i.e., safe/orderly and supportive relationships). Multi-group latent growth models revealed that more positive teacher-reported school climate was cross-sectionally associated with fewer student-reported depressive symptoms in both boys and girls, although this association was significantly stronger for girls. Longitudinally, positive school climate was associated with lower depressive symptoms but a higher rate of change of symptoms for both boys and girls. The overall findings are consistent with previous findings with student-reported school climate. However, the gender difference and the directionality of the longitudinal association between school climate and depressive symptoms over time demonstrate that additional studies of mechanisms by which school climate is connected to adolescents’ depressive symptoms are needed

Associations between teacher-reported school climate and depressive symptoms in Australian adolescents : a 5-year longitudinal study.

Adolescent depression is serious and common. As adolescents spend approximately 15,000 h in school, this setting is a logical place to seek etiological factors. Research suggests there are negative associations between school climate and adolescent depressive symptoms. However, such studies typically use student reports of both climate and depressive symptoms; this is problematic because common method variance results when the same individual provides information on all variables, contributing to overestimations of associations between depressive symptoms and school climate. Therefore, the purpose of this study is to examine the association between teacher-reported school climate and adolescent-reported depressive symptoms. Thus, 2545 Australian high school students participated in this 5-year longitudinal study. Students completed a measure of depressive symptoms annually; their teachers (N = 882) completed a questionnaire to evaluate the quality of the school environment (i.e., safe/orderly and supportive relationships). Multi-group latent growth models revealed that more positive teacher-reported school climate was cross-sectionally associated with fewer student-reported depressive symptoms in both boys and girls, although this association was significantly stronger for girls. Longitudinally, positive school climate was associated with lower depressive symptoms but a higher rate of change of symptoms for both boys and girls. The overall findings are consistent with previous findings with student-reported school climate. However, the gender difference and the directionality of the longitudinal association between school climate and depressive symptoms over time demonstrate that additional studies of mechanisms by which school climate is connected to adolescents’ depressive symptoms are needed

“An Important Part of Who I am”: The Predictors of Dietary Adherence among Weight-Loss, Vegetarian, Vegan, Paleo, and Gluten-Free Dietary Groups

Weight-loss diets are notorious for their low adherence, which is a barrier to efforts to reduce population rates of overweight and obesity. However, there is some evidence that adherence is better among people on other kinds of diets, such as vegan and gluten free. This study aimed to explore the predictors of dietary adherence across five restrictive dietary patterns (vegan, vegetarian, paleo, gluten free, and weight loss). This study used both qualitative and quantitative methods among 292 adult community members who were following a restrictive dietary pattern. Personality, mental health, and motivational predictors of adherence were examined. Substantial differences in adherence were found between dietary groups, with vegans and vegetarians being particularly high in adherence and gluten-free and weight-loss dieters being comparably low. Four consistent predictors of adherence across different dietary patterns were supported in both the quantitative and qualitative analyses. Self-efficacy and social identification with one’s dietary group positively predicted adherence. Conversely, being motivated in one’s dietary choices by mood or by weight control negatively predicted adherence. These findings speak to the importance of social and motivational factors in determining adherence. The results also illustrate the utility of looking beyond weight-loss dieters and virtuous individual traits for insights into how adherence may be improved

Additive effectiveness of mindfulness meditation to a school-based brief cognitive-behavioral alcohol intervention for adolescents

This randomized controlled trial is the 1st study to evaluate the additive efficacy of mindfulness meditation to brief school-based universal cognitive behavior therapy (CBT + MM) for adolescent alcohol consumption. Previous studies have lacked strong controls for nonspecific effects, and treatment mechanisms remain unclear. The present study compared a CBT + MM condition to an active control CBT intervention with progressive muscle relaxation (CBT + PMR) for nonspecific effects and an assessment-only control (AoC).Cluster sampling was used to recruit Australian adolescents ( = 404; 62% female) ages 13-17 years ( = 14.99, = .66) of mostly Australian-New Zealand or European descent. School classes were randomized to 3 intervention conditions (CBT + PMR = 8 classes, CBT + MM = 7 classes, AoC = 7 classes), and adolescents completed preintervention, postintervention, and 3- and 6-month follow-up assessments, including measures of alcohol consumption, mindfulness, impulsivity, and the alcohol-related cognitions of alcohol expectancies and drinking refusal self-efficacy.Multilevel modeling analyses revealed that both intervention conditions reduced the growth of alcohol consumption compared to the AoC ( = -.18, = .014), although CBT + MM was no more effective than was CBT + PMR ( = -.06, = .484). Negative alcohol expectancies increased for adolescents in the intervention conditions compared to the AoC ( = 1.09, = .012), as did positive alcohol expectancies ( = 1.30, = .008). There was no effect of interventions on mindfulness, drinking refusal self-efficacy, or impulsivity.There was no evidence of mindfulness-specific effects beyond existing effects of CBT within a brief universal school-based CBT intervention. Hypothesized mechanisms of change were largely unsupported. (PsycINFO Database Record (c) 2019 APA, all rights reserved)

Problem-Solving Orientation and Attributional Style: Moderators of the Impact of Negative Life Events on the Development of Depressive Symptoms in Adolescence?

Followed up 733 adolescents, ages 12 to 14 years, from a community sample over a 1-year period. Depressive symptoms at 1-year follow-up, controlling for baseline depression levels, were predicted by negative life events (NLEs) in the previous 12 months, attributional style (AS), negative problem solving orientation (NPSO), and the interaction between NLEs and NPSO. In the presence, but not absence, of high NLEs, NPSO predicted increases in depressive symmptoms. In contrast, pessimistic AS predicted future increases in depression irrespective of the occurrence of NLEs. The findings supported a cognitive diathesis-stress model of the development of depression for NPSO but not AS

Who wants a slimmer body? The relationship between body weight status, education level and body shape dissatisfaction among young adults in Hong Kong

Background: Body shape dissatisfaction has been thought to have an indispensable impact on weight control behaviors. We investigated the prevalence of body shape dissatisfaction (BSD) and explored its association with weight status, education level and other determinants among young adults in Hong Kong. Methods. Information on anthropometry, BSD, and socio-demographics was collected from a random sample of 1205 young adults (611 men and 594 women) aged 18-27 in a community-based household survey. BSD was defined as a discrepancy between current and ideal body shape based on a figure rating scale. Cross-tabulations, homogeneity tests and logistic regression models were applied. Results: The percentages of underweight men and women were 16.5% and 34.9% respectively, and the corresponding percentages of being overweight or obese were 26.7% and 13.2% for men and women respectively. Three-quarters of young adults had BSD. Among women, 30.9% of those underweight and 75.5% of those with normal weight desired a slimmer body shape. Overweight men and underweight women with lower education level were more likely to have a mismatch between weight status and BSD than those with higher education level. After controlling for other determinants, underweight women were found to have a higher likelihood to maintain their current body shapes than other women. Men were found to be less likely to have a mismatch between weight status and BSD than women. Conclusions: Overweight and obesity in men and underweight in women were prevalent among Hong Kong young adults. Inappropriate body shape desire might predispose individuals to unhealthy weight loss or gain behaviors. Careful consideration of actual weight status in body shape desire is needed in health promotion and education, especially for underweight and normal weight women and those with a low education level. © 2011 Cheung et al; licensee BioMed Central Ltd.published_or_final_versio

A 7-year-old girl scratching holes in herself

Case scenario Emma is aged 7 years and lives with her mother and stepfather and her adored baby sister. She spends most weekends with her father who has moved back into the home of his elderly parents. Emma's mother brought her in to the surgery and confided that she was at her wit's end because Emma was recurrently scratching holes in herself. It appeared that a kind of ritual had developed where Emma started to rub a small area of her skin harder and harder until she was able to penetrate the skin with her fingernail and dig out a small lump of flesh. She had about seven or eight scabbed holes on her trunk and limbs and even a couple medial to her scapula, where she hoped her mother wouldn't see. Emma said that she tried not to do it but that she couldn't stop thinking about it. She initially said that a voice was telling her to do it. She appeared to be a very self-possessed little girl who was happy at school and had lots of friends. What help can Emma be offered to overcome this problem

Relative contributions of life events versus daily hassles to the frequency and intensity of headaches

This study investigated headache parameters (frequency and intensity) in relation to (the number and severity of) two types of psychosocial stress: major life events (as assessed by a revised Social Readjustment Rating Scale) and minor daily hassles (as assessed by a revised Hassles Scale). Subjects were 261 volunteers reporting headache. Results revealed that both headache frequency and intensity were significantly predicted by daily hassles, in particular, the average severity of these hassles, but there was a negligible relationship between headache parameters and any of the life event measures. Furthermore, a significant relationship emerged between life events and daily hassles themselves. This fits with recent findings that life events (while exerting little direct effect on headache) may trigger a succession of hassles which culminate in headaches. Also, it is not the number of hassles, but the perceived severity of these hassles that best predicts headache frequency and intensity. Finally, though significant as predictors, daily hassles explained - small portion of the variance in headache, thus pointing to the host of other possible biological and psychosocial contributions to headache

Why do diets fail?: an exploration of dieters' experiences using thematic analysis

Previous research has drawn on theoretical models and clinical observations to develop propositions regarding the mechanisms of diet failure, with only one study examining it directly from the perspective of dieters themselves. Furthermore, research to date has failed to provide an empirically validated, multi-factorial model of diet failure, despite the issue being recognised as a complex and multifaceted one. This study extended on previous research by examining themes of diet failure from the perspective of dieters (n = 22) and health professionals in the field (n = 5)