The Anxiety Depression Pathway Among Men Following a Prostate Cancer Diagnosis: Cross-Sectional Interactions Between Anger Responses and Loneliness.

Anger has been a largely neglected emotion in prostate cancer research and intervention. This paper highlights the role of anger in the anxiety depression pathway among men with prostate cancer, and whether its impact is dependent on loneliness. Data are presented from a sample of men with prostate cancer (N = 105, M = 69.12 years, prostatectomy = 63.8%) and analysed using conditional process analysis. Dimensions of anger were evaluated as parallel mediators in bi-directional anxiety and depression pathways. Loneliness was evaluated as a conditional moderator of identified significant mediation relationships. Moderate severity depression (16.5%) was endorsed more frequently than moderate severity anxiety (8.6%, p = .008), with 19.1% of the sample reporting past two-week suicide ideation. Consistent with hypotheses, anger-related social interference (but not other dimensions of anger) significantly mediated the anxiety-depression pathway, but not the reverse depression-anxiety pathway. This indirect effect was conditional on men experiencing loneliness. Sensitivity analyses indicated the observed moderated mediation effect occurred for affective, but not somatic symptoms of depression. Findings support anger-related social interference (as opposed to anger frequency, intensity, duration or antagonism) as key to explaining the previously established anxiety-depression pathway. Results underscore the need for enhanced psychosocial supports for men with prostate cancer, with a particular focus on relational aspects. Supporting men with prostate cancer to adaptively process and manage their anger in ways that ameliorate negative social consequences will likely enhance their perceived social support quality, which may in turn better facilitate post-diagnosis recovery and emotional adjustment

Elevated urinary excretion of free pyridinoline in Friesian horses suggests a breed-specific increase in collagen degradation

Background: Friesian horses are known for their high inbreeding rate resulting in several genetic diseases such as hydrocephaly and dwarfism. This last decade, several studies focused on two other presumed hereditary traits in Friesian horses: megaoesophagus and aortic rupture. The pathogenesis of these diseases remains obscure but an important role of collagen has been hypothesized. The purpose of this study was to examine possible breed-related differences in collagen catabolism. Urinary specimens from Friesian (n = 17, median age 10 years old) and Warmblood horses (n = 17, median age 10 years old) were assessed for mature collagen cross-links, i.e. pyridinoline (PYD) (=hydroxylysylpyridinoline/HP) and deoxypyridinoline (DPD) (lysylpyridinoline /LP). Solid-phase extraction was performed, followed by reversed-phase ion-paired liquid chromatography prior to tandem mass spectrometry (MS/MS) detection. Results: Mean urinary concentrations of free PYD, expressed as fPYD/creatinine ratio, were significantly higher in Friesian horses compared to Warmblood horses (28.5 ± 5.2 versus 22.2 ± 9.6 nmol/mmol, p = 0.02) while mean fDPD/creatinine ratios were similar in both horse breeds (3.0 ± 0.7 versus 4.6 ± 3.7 nmol/mmol, p = 0.09). Conclusions: Since DPD is considered a specific bone degradation marker and PYD is more widely distributed in connective tissues, the significant elevation in the mean PYD/DPD ratio in Friesian versus Warmblood horses (9.6 ± 1.6 versus 5.7 ± 1.8, p < 0.0001) suggests a soft tissue origin for the increased fPYD levels. Considering that a previous study found no differences in total collagen content between Friesian and Warmblood horses for tendon and aortic tissue, this indicates a higher rate of collagen degradation. The latter might, at least in part, explain the predisposition of Friesians to connective tissue disorders

A systematic review of interventions to increase awareness of mental health and well-being in athletes, coaches and officials

Full search for the psychinfo database. (DOCX 16 kb

Men's Help-Seeking for Depression: Attitudinal and Structural Barriers in Symptomatic Men

Objective: Men with depression are known to have significant challenges with health service engagement. The current study sought to better understand attitudinal and structural mental health care barriers among those men identified as symptomatic for symptoms of major depression. Design: Cross-sectional study with data provided by Canadian men via a nationally representative online survey. Outcomes examined depression, suicide risk, and barriers to mental health services. Participants: A total of 117 men (mean age = 42.36 years) reporting symptoms of major depression consistent with moderate severity as identified by the Patient Health Questionnaire-Depression Module (PHQ-9). Results: In all, 51.3% of the sample reported previously receiving counselling or psychotherapy for mental health concerns. The majority (63.2%) reported past 2-week suicide or self-harm ideation; however, only a small proportion (8.5%) were currently engaged with professional mental health support. Logistic regression indicated that men's attitudinal barriers to mental health help-seeking had a greater predictive effect than structural barriers (33% vs 0% of items, respectively). In particular, lower likelihood of help-seeking was associated with men's reluctance to disclose mood-related symptoms to their physician/family doctor (adjusted odds ratio [AOR] = 0.37), a tendency for self-reliance and solving one's own problems (AOR = 0.34), and uncertainly about the process of psychotherapy (AOR = 0.29). Conclusion: Gender-transformative approaches to primary health care may be key to improving men's rates of disclosure and increasing detection for depression and suicide risk

Men’s Mental Health Services: The Case for a Masculinities Model

It is well understood that men are reticent in seeking help for mental health concerns. In the wake of government-funded campaigns across many Western nations that have sought to address this, noticeably absent have been the active development, promotion, dissemination, and rigorous evaluation of male-centered treatment styles. We argue that next-generation approaches must actively counteract unhelpful stereotypes, instead promoting diverse and healthy masculinities. The current article makes the case for the development of a masculinities model of mental health care, offering recommendations to advance clinical practice and research toward this goal. We propose that updated help-seeking campaigns and clinician training, gender-sensitive service provision, and comprehensive cost analyses will provide the groundwork for such a model to better target the diversity in men and reduce any reluctance to engage with mental health treatment

Engaging Men in Psychological Treatment: A Scoping Review

Tailoring psychological treatments to men's specific needs has been a topic of concern for decades given evidence that many men are reticent to seek professional health care. However, existing literature providing clinical recommendations for engaging men in psychological treatments is diffuse. The aim of this scoping review was to provide a comprehensive summary of recommendations for how to engage men in psychological treatment. Four electronic databases (MEDLINE, PubMed, CINAHL, PsycINFO) were searched for articles published between 2000 and 2017. Titles and abstracts were reviewed; data extracted and synthesized thematically. Of 3,627 citations identified, 46 met the inclusion criteria. Thirty articles (65%) were reviews or commentaries; 23 (50%) provided broad recommendations for working with all men. Findings indicate providing male-appropriate psychological treatment requires clinicians to consider the impact of masculine socialization on their client and themselves, and how gender norms may impact clinical engagement and outcomes. Existing literature also emphasized specific process micro-skills (e.g., self-disclosure, normalizing), language adaption (e.g., male-oriented metaphors) and treatment styles most engaging for men (e.g., collaborative, transparent, action-oriented, goal-focused). Presented are clinical recommendations for how to engage men in psychological treatments including paying attention to tapping the strengths of multiple masculinities coexisting within and across men. Our review suggests more empirically informed tailored interventions are needed, along with formal program evaluations to advance the evidence base

The Cost of Bottling It Up: Emotion Suppression as a Mediator in the Relationship Between Anger and Depression Among Men with Prostate Cancer

Background: Prostate cancer is a risk factor for major depressive disorder. Recent psycho-oncology research suggests a potential role for male-specific mood-related symptoms in this relationship. Gender socialisation experiences may reinforce men's anger and emotion suppression responses in times of distress, and anger and emotion suppression may be implicated in pathways to, and maintenance of depression in prostate cancer. Patients and Methods: Data were collected online from men with a self-reported diagnosis of prostate cancer (N=100; mean age 64.8 years). Respondents provided information regarding diagnosis and treatment, in addition to current experience of major depression and male-specific externalising symptoms. Results: Prostate cancer diagnosis in the last 12 months occurred for 35.4% of the sample. Elevated major depression symptoms were observed for 49% of respondents, with 14% endorsing past 2-week suicide ideation. Parallel mediation analysis (99% CIs) controlling for prostatectomy and active surveillance indicated men's emotion suppression mediated the relationship between anger and depression symptoms (R 2=0.580). Trichotimised emotion suppression scores with control variables yielded a large multivariate effect (p<0.001, partial η 2=0.199). Univariate moderate-sized effects were observed for emotion suppression comparisons for symptoms of depressed mood and sleep disturbance, and a large effect observed for guilt-proneness. Conclusion: Findings highlight the salience of anger in the experience of depression symptoms for men with prostate cancer. The mediating role of emotion suppression, which in turn was strongly linked to men's feelings of guilt, suggests potential assessment and intervention targets. Future work should examine the role of androgen deprivation therapy and other treatments including active surveillance on the relationship between anger and depression in men with prostate cancer. Consideration of interventions focused on emotion processing skills in psycho-oncology settings may help reduce men's reliance on emotion suppression as a strategy for coping with feelings of anger or guilt in the context of prostate cancer

Family-centered depression treatment for older men in primary care: a qualitative study of stakeholder perspectives

Abstract Background Family members often play important roles in the lives of depressed older men and frequently attend primary care visits with their loved ones, yet surprisingly little is known about how to most effectively engage and include family members in depression treatment. However, including family in depression treatment may be difficult due to several factors, such as depression stigma and family conflicts. The objective of this study was to describe challenges in engaging family members in older men’s depression treatment and potential strategies to overcome those challenges. Methods A cross-sectional, qualitative descriptive interview study was conducted in a safety-net, Federally Qualified Health Center in California’s Central Valley. A total of 37 stakeholders were recruited, including 15 depressed older (i.e. age ≥ 60) men, 12 family members, and 10 clinic staff. Depressed men were identified through mail outreach, waiting room screening, and referral. Depressed men identified family members who were later approached to participate. We also recruited a purposeful sample of clinic staff. Interviews explored stakeholder perspectives on family involvement in men’s depression treatment as part of a primary care intervention. Interviews were conducted using a semi-structured interview guide, tape-recorded, transcribed verbatim, and translated if the interview was conducted in Spanish. Results Four themes were identified representing core challenges: engaging men at the right time; preserving men’s sense of autonomy; managing privacy concerns; and navigating family tensions. Stakeholders also provided practical suggestions and advice about how each of these challenges might be addressed. Conclusions While engaging family is a promising approach to strengthen depression care for older men in primary care settings, several potential challenges exist. Family- centered depression intervention development and clinical practice need to anticipate these challenges and to develop approaches and guidelines to address them