The mental health experience of treatment-seeking military members and public safety personnel: a qualitative investigation of trauma and non-trauma-related concerns

Introduction: Paramedics, firefighters, police officers and other public safety personnel (PSP) as well as Canadian Armed Forces (CAF) members are frequently exposed to stressors and demanding work environments. Although their specific work-related tasks may vary, a commonality between these occupations is the significant likelihood of repeated exposure to potentially psychologically traumatic events (PPTE) over the course of their careers. Due in part to these repeated exposures, CAF members and PSP are at an elevated risk of mental health concerns including posttraumatic stress disor-der. The purpose of this study was to obtain a more in-depth understanding of the trauma-and non-trauma-related experiences of active or retired PSP and CAF members that may be implicated in mental health issues and resultant treatment and recovery. Methods: Study participants were recruited during inpatient treatment at a private mental health and addictions inpatient hospital in Canada. We conducted and audiotaped semistructured focus groups and transcribed the discussions. Interpretive phenomeno-logical analysis and thematic coding generated a coding scheme from which to identify concepts and linkages in the data. Results: Analysis generated four primary themes: interpersonal relationships, personal identity, mental health toll and potential moral injury. A variety of subthemes were identified, including family dynamics, inability to trust, feelings of professional/per-sonal betrayal, stigma within the CAF/PSP culture, increased negative emotions about self/others, and a reliance on comradery within the service. Conclusion: The information gathered is critical to understanding the perspectives of PSP and military members as the career stressors and related exposure to PPTE of these occupations are unique

Peer Victimization in British Columbia Youth

Peer victimization is an issue which has recently received considerable attention from the media, the school system, and academic literature. The present study examines a number of expected correlates, both risk factors and outcomes, of peer victimization through the use of the Adolescent Health Survey - II conducted by the McCreary Centre Society in the province of British Columbia. Approximately 25,800 youth, from grades 7 through 12, from various regions of the province completed the questionnaire. Potential risk factors, including gender, grade, age, age relative to classmates, appearing younger or older than classmates, ethnicity, family socioeconomic status, sexual orientation, disability, body weight, family relationships, peer relationships, teacher relationships and having moved recently, and outcome factors, including depression, suicidal ideation, suicide attempts, anxietylstress, physical health, drug use, body image, eating disorders, academic achievement and aspirations, school enjoyment and attendance, and school connectedness, were evaluated. Possible moderators between peer victimization and risk factors and between peer victimization and outcome factors were considered. Results indicated that most of the proposed risk factors were indeed associated with peer victimization. However, the effect sizes of these relationships were marginal. When gender and grade were considered as moderators between each of the risk factors and peer victimization they were found not to add predictive power. In regards to outcome factors, results again indicated that most factors were associated with peer victimization. Effect sizes were marginal. When gender, grade, family connectedness, teacher relationships, peer relationships, school connectedness, and academic achievement were considered as moderators between each of the outcome factors and peer victimization they were found not to add any predictive power. Findings of the present study expand on past literature by considering novel factors as well as considering effect sizes

School structure and experiences of aggression: school transitions and middle school

Social dominance theory, which argues that dominance in social hierarchies is established and maintained through the use of aggression, has been used to explain increases in aggression, bullying, and positive attitudes towards aggression following school transitions. School transitions are marked by a disruption in youths’ social networks, and they are thus faced with the task of establishing new social hierarchies. However, school transitions and age/grade level have typically been confounded in previous research, and thus it was unclear if the findings reflected a reaction to school transition, which can be explained by social dominance theory, or whether this pattern reflected naturally occurring developmental changes related to social functioning. The current study considered the relationship between school transition and reciprocated aggression (fighting), peer victimization (physical, verbal, and relational), and perceived attitudes of peers regarding aggression, while controlling for grade level. Other aspects of school structure, such as type of school (e.g., elementary, middle, secondary), school size, and the number of grade levels contained within a school, were also considered. The present study made use of the British Columbia Adolescent Health Survey of 2003. A subsample of 22,596 students, from Grades 7 through 12, attending 351 different schools, were selected for consideration in the present study. Youth in the same grade level – both those who were in a transition year, and those who were not – were found to report similar rates of reciprocated aggression and peer victimization, but youth in a transition year perceived their peers to be more accepting of aggression. Youth in smaller schools were more likely to have experienced peer victimization and to perceive their peers to be accepting of aggression. Although school type was not associated with reciprocated aggression or peer victimization, youth in elementary school perceived their peers to be more accepting of aggression than their same age peers in middle or secondary school. The number of grade levels within a school was not associated with reciprocated aggression, peer victimization, or perceived attitudes of peers regarding aggression. Findings were discussed in relation to social dominance theory and social development

Prediction of excess pregnancy weight gain using psychological, physical, and social predictors: A validated model in a prospective cohort study.

OBJECTIVE:To develop and validate a prediction model for excess pregnancy weight gain using early pregnancy factors. DESIGN:Prospective cohort study. SETTING:We recruited from 12 obstetrical, family medicine, and midwifery centers in Ontario, Canada. PARTICIPANTS:We recruited English-speaking women with singleton pregnancies between 8+0-20+6 weeks. Of 1296 women approached, 1050 were recruited (81%). Of those, 970 women had complete data (970/1050, 92%) and were recruited at a mean of 14.8 weeks. PRIMARY OUTCOME MEASURE:We collected data on psychological, physical, and social factors and used stepwise logistic regression analysis to develop a multivariable model predicting our primary outcome of excess pregnancy weight gain, with random selection of 2/3 of women for training data and 1/3 for testing data. RESULTS:Nine variables were included in the final model to predict excess pregnancy weight gain. These included nulliparity, being overweight, planning excessive gain, eating in front of a screen, low self-efficacy regarding pregnancy weight gain, thinking family or friends believe pregnant women should eat twice as much as before pregnancy, being agreeable, and having emotion control difficulties. Training and testing data yielded areas under the receiver operating characteristic curve of 0.76 (95% confidence interval, 0.72 to 0.80) and 0.62 (95% confidence interval 0.56 to 0.68), respectively. CONCLUSIONS:In this first validated prediction model in early pregnancy, we found that nine psychological, physical, and social factors moderately predicted excess pregnancy weight gain in the final model. This research highlights the importance of several predictors, including relatively easily modifiable ones such as appropriate weight gain plans and mindfulness during eating, and lays an important methodological foundation for other future prediction models