Search Results (174)

Background: Incarcerated men experience disproportionately high levels of health inequities shaped by social determinants, including poverty, violence, family adversity, trauma, and limited access to healthcare. These long-standing disadvantages, added to the adverse conditions experienced in prisons, may be associated with elevated rates of suicidality in this population. This study examined the prevalence of suicidal ideation and lifetime suicide attempts among men deprived of liberty in Southern Brazil and investigated the role of cumulative adversities and current protective factors in these outcomes. Methods: A cross-sectional study was conducted with 496 incarcerated men. Participants completed a sociodemographic and background questionnaire assessing lifetime adversity (e.g., hunger, homelessness, sexual abuse, domestic violence, family substance dependence) and current protective factors in prison (e.g., family visits, education, leisure, physical activity, religion, positive self-perception). Cumulative adversity and protective factors were operationalized as composite indices. Logistic regression models tested whether cumulative adversities and protective factors were independently associated with suicidal ideation and suicide attempts. Results: Lifetime prevalence was 9.6% for suicidal ideation and 10.8% for suicide attempts. Cumulative adversities were associated with higher odds of both suicidal ideation (OR = 1.43; 95% CI = 1.11–1.84; p = 0.006) and suicide attempts (OR = 1.94; 95% CI = 1.50–2.52; p < 0.001). Protective factors were associated with lower likelihood of suicidal ideation (OR = 0.74; 95% CI = 0.58–0.96; p = 0.020) but were not significantly associated with suicide attempts. No significant interaction effects were observed, indicating that protective factors did not moderate the impact of adversity. Conclusions: Suicidal tendencies among incarcerated men were associated with cumulative structural and psychosocial adversities. Protective factors in prison were associated with lower odds of ideation but not attempts. These associations may inform person-centered and equity-oriented approaches and are consistent with the relevance of social determinants to mental health, although causal inferences are not supported by this project. Full article

Background: Bullying in university settings is a significant yet understudied contributor to psychological distress. Differentiating the sources of victimization, may reveal distinct risk profiles associated with mental health and substance use outcomes. Objective: To evaluate the frequency and risk factors associated with bullying victimization among medical students, and to identify associations with mental disorders and substance use. Methods: A nested case–control cohort study was conducted with 124 medical students. Participants completed nine validated psychometric instruments evaluating neurobehavioral traits, emotional distress, substance use, and scholar bullying. Bivariate and multivariate regression models were used to estimate coefficients and odds ratios for key outcomes. Results: 42.7% of the students reported victimization, with teacher harassment (37.1%) more frequent than peer harassment (27.4%); 22.6% experienced both. Teacher harassment was primarily characterized by intentional harm (78%); peer harassment involved abuse of authority (63%). ADHD, severe stress, and substance use were associated with teacher-related victimization, while peer victimization was linked to ADHD, stress, impulsivity, and suicide risk. Childhood abuse, high stress levels, and non-heterosexual orientation as predictors of teacher harassment (p < 0.05). Notably, students with a non-heterosexual orientation were over six times more likely to report teacher harassment, highlighting the disproportionate vulnerability of sexual minorities within academic power dynamics. Conclusions: Teacher- and peer-related harassment are prevalent and often co-occur, with teacher-perpetrated bullying emerging as both more frequent and more strongly associated with mental health and identity-based vulnerabilities. Students with ADHD, high stress levels, and non-heterosexual orientation are at significantly greater risk. These findings emphasize the need for institutional accountability, inclusive academic policies, and targeted mental health support to protect vulnerable students and prevent harm within educational environments. Full article

Background/Objectives: The variation in the treatment outcomes of extended-release naltrexone (XR-NTX) including the potential role of genetic factors are poorly understood. This study aimed to explore the potential association between the catechol-O-methyltransferase (COMT) rs4680 and mu-opioid receptor (OPRM₁) rs1799971 genotypes and XR-NTX treatment outcomes in patients with opioid use disorder (OUD) specifically focusing on treatment retention, relapse to opioids, number of days of opioid use, and opioid cravings. Methods: This was a 24-week, open-label clinical prospective, exploratory study involving patients with OUD who chose treatment with monthly injections of intramuscular XR-NTX. Men and women aged 18–65 years with OUD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, were included. The participants were interviewed using the European Addiction Severity Index. Survival analyses and linear mixed models were used to analyze the data. Results: Of the 162 participants included in this study, 138 (21% female) initiated treatment with XR-NTX, with 88 genotyped for COMT rs4680 and 86 for OPRM₁ rs1799971. Heterozygous Met/Val carriers of COMT rs4680 were less likely to relapse to opioids compared with those with the COMT rs4680 Met/Met genotype. No significant association was observed for the OPRM₁ polymorphism. Conclusions: Patients with the COMT rs4680 Met/Val genotype exhibit a reduced risk of relapse to opioids and may therefore derive greater benefit from XR-NTX treatment compared with those with the COMT rs4680 Met/Met genotype. Future studies should be conducted with a larger number of participants and possibly include other genetic variants and treatment outcomes. The trial is registered at ClinicalTrials.gov (#NCT03647774) and the EU Clinical Trial Register (#2017-004706-18). Full article

The New Jersey Safe Schools Program (NJSS) provides required training for secondary school career–technical education work-based learning (WBL) supervision, allowing certified teachers to supervise students in school-sponsored work placements. During each training’s virtual live session day, a new activity for teachers to use to connect the U.S. Substance Abuse and Mental Health Services Administration’s (SAMHSA) “Eight Dimensions of Wellness” model (8DW) to individual young workers was conducted. NJSS implemented an optional “Eight Dimensions of Young Worker Wellness” activity with 67 volunteer participants (44% response rate) in February–November 2024. Using Mentimeter, teachers were given a student worker scenario and asked how aspects of the scenario pertained to each of the 8DW (emotional, environmental, financial, intellectual, occupational, physical, social, spiritual). A qualitative, inductive content analysis of open responses collected via Mentimeter was conducted. Most teachers selected emotional and social dimensions of 8DW when asked to select the two most important for young workers to incorporate into their work lives. This new NJSS activity encouraged teachers to examine different aspects of their own health, and potentially they could then apply it to the health, safety, and wellness of their students and co-workers, as a proactive approach to promote comprehensive wellness. Full article

Background: The use of electronic cigarettes (ECs) has become a significant public health problem, especially among young people. EC use has been associated with increased nicotine exposure and other toxic substances, increasing the risk of early addiction and health problems. Recently, attention has focused on understanding the interplay between psychosocial stressors, exposure to violence, psychological distress, and an increased propensity to experiment with nicotine. Hence, the aim of this study was to estimate the prevalence of EC use in the previous month and its associated factors. Methods: This is a cross-sectional study based on secondary data analysis of a nationwide survey conducted to monitor risk and protective factors for the health of school-aged adolescents (52.89% males; 55.97% aged up to 15 years old). Specifically, we analyzed data from adolescents aged 13–17 years who answered questions on EC use (n = 36,659). Results: The results show that the prevalence of EC use in this sample was 11.23% (IC95%: 11.23, 11.87). Logistic regression revealed several factors that increased the likelihood of EC use, such as alcohol use by friends, alcohol use in the past month, gender (male), intentional binge drinking, higher mental health symptoms, living in urban areas, experience of abuse at home, report of other drug use, and smoking friends, with the latter exerting a higher influence. Conclusion: Findings show the interplay of peers, family and environmental influences on youth risk behavior. Prevention strategies should therefore include school- and family-based interventions, trauma-informed approaches and anti-marketing campaigns to dispel misconceptions regarding EC. Full article

Gender-based violence is a pervasive social and public health issue that severely impacts women’s mental health, often leading to conditions such as anxiety, depression, post-traumatic stress disorder, and substance abuse. Identifying the combination of these various mental health conditions could then point to someone who is a victim of gender-based violence. While speech-based artificial intelligence tools appear as a promising solution for mental health screening, their performance often deteriorates when encountering speech from previously unseen speakers, a sign that speaker traits may be confounding factors. This study introduces a speaker-agnostic approach to detecting the gender-based violence victim condition—defined as self-identified survivors who exhibit pre-clinical PTSD symptom levels—from speech, aiming to develop robust artificial intelligence models capable of generalizing across speakers. By employing domain-adversarial training, we reduce the influence of speaker identity on model predictions, and we achieve a 26.95% relative reduction in speaker identification accuracy while improving gender-based violence victim condition classification accuracy by 6.37% (relative). These results suggest that our models effectively capture paralinguistic biomarkers linked to the gender-based violence victim condition, rather than speaker-specific traits. Additionally, the model’s predictions show moderate correlation with pre-clinical post-traumatic stress disorder symptoms, supporting the relevance of speech as a non-invasive tool for mental health monitoring. This work lays the foundation for ethical, privacy-preserving artificial intelligence systems to support clinical screening of gender-based violence survivors. Full article

Objectives: Latinx Americans represent the largest ethnic minority group (nearly 19% of the U.S. population). Their behavioral health has received increasing attention as they exhibit elevated prevalence rates of anxiety (ANX), depression (DEP), and substance use disorders (SUDs). The National Latino and Asian American Study (NLAAS) is the first national population-based mental health study of Latinx Americans and is the most comprehensive resource for understanding their behavioral health. This systematic review aims to synthesize peer-reviewed publications using the NLAAS dataset to identify psychosocial determinants of the three key outcomes. Method: We followed PRISMA to search for English peer-reviewed articles published in EBSCO, Embase, PsycINFO, Web of Science, and PubMed. Inclusion criteria were as follows: (1) Latinx in the NLAAS database; (2) ANX, DEP, or SUD; (3) risk or protective factors; and (4) peer-reviewed publications in English. Search terms such as Latino, Latina, anxiety, depressive symptoms, substance abuse, and NLAAS were used to search for relevant articles. Two authors screened the articles independently and extracted data from each study. Results: Thirty-two studies published between 2007 and 2024 were included in our final review. Among them, 12 studies investigated ANX, and 17 studies examined DEP and SUD, respectively. Sixteen studies assessed protective factors. Ten articles assessed multiple key outcomes. All risk factors were grouped into three categories: Trauma and negative relationships (e.g., childhood maltreatment, negative family relationship, traumatic life experience), acculturation- and immigration-related factors (e.g., nativity, acculturation experience, English proficiency, discrimination), and sociodemographic and social participation factors (e.g., gender, education, income level). Protective factors such as family cohesion, religious activity, gender, and education were also identified. Conclusion: This first systematic review provided comprehensive NLAAS findings on multifaceted cultural, social, and intrapersonal factors that were either negatively or positively associated with three behavioral health outcomes within the U.S. Latinx population. Potential mechanisms by which risk and protective factors influence their mental health, as well as limitations of this review, were discussed. Findings of this review can inform culturally responsive prevention strategies and interventions to reduce behavioral health disparities and to improve mental health outcomes among Latinx Americans. Full article

Depression is one of the most prevalent mental health conditions in middle and late adulthood, contributing substantially to morbidity, mortality, and reduced quality of life. However, limited research has examined the mechanisms linking genetic predisposition and early protective environments to long-term mental health trajectories. Guided by a life course health development perspective, this study investigated how depression polygenic scores (G) and protective childhood family environments (E) interplay to shape depressive symptom trajectories from mid- to late adulthood. We analyzed longitudinal data of 14 waves from the Health and Retirement Study (1994–2020; N = 4817), estimating linear mixed-effects models of depressive symptoms using the validated CES-D scale. Early protective environments were measured by indicators of family structure stability, non-abusive and substance-free parenting, positive parent–child relationships, and parental support. Results showed that genetic predisposition and protective family environments jointly influence depression trajectories across the life course. Specifically, individuals with both low genetic risk and high environmental protection had the lowest depressive symptoms over time. Importantly, when only one favorable factor was present, protective family environments offered a stronger lifelong benefit than low genetic risk. These findings extend prior research by demonstrating that supportive childhood environments can mitigate genetic vulnerability, shaping healthier long-term mental health trajectories. This work underscores the need for early family-based interventions to reduce depression risk, enhance resilience, and promote longevity. Full article

The British From Harm to Hope drugs strategy seems limited in gender responsiveness. Evidence is presented from a West Midlands case study where a qualitative participatory methodology with thematic analysis was employed. The project was co-designed by academics, women with lived-experience and third-sector research leaders. To identify community drug and alcohol treatment issues and solutions, interviews and focus groups were conducted with female service users (N = 28), a range of drug and alcohol workers and managers, and women’s sector practitioners (N = 17). Frontline professionals (N = 9) also took part in an online-adapted world café to enrich understanding and ascertain solutions. The study found that many women using illicit drugs have trauma and mental health issues linked to (1) adverse childhood experiences, (2) child removal by local authorities, (3) domestic abuse and sexually exploitative relationships, and (4) criminal justice system engagement. Based on findings, the study recommends that women’s public health pertaining to substance use, mental health and the interplay with childhood and adulthood abuse and violence needs better addressing in policy and practice. This paper highlights the need to better address women’s health through developing drug and alcohol services with improved referral pathways to domestic violence and mental health services. Full article

This study evaluated emergency preparedness, covering knowledge, challenges, and culturally and linguistically appropriate resources among five resettled refugee communities in Central Ohio: Afghan, Bhutanese, Congolese, Ethiopian/Eritrean, and Somali. It also explored youth perceptions of community engagement and the effectiveness of current crisis support initiatives. A mixed-methods approach was used, consisting of a cross-sectional quantitative survey of 266 adults and a qualitative 60-min focus group discussion with 10 youth from the resettled communities. Quantitative data was analyzed with descriptive statistics and Chi-square tests assessing differences in preparedness across communities. Quantitative findings showed that the Bhutanese group reported the highest familiarity with preparedness concepts (33.3%), while Afghan and Congolese communities showed significant gaps. Of the 266 overall respondents, only 39.5% had an emergency plan, and 15.8% felt extremely confident in handling emergencies. Language barriers were major challenges, along with those related to race and ethnic identity, religious practices, and cultural norms. Effective platforms for engagement included community meetings, religious sites, and social media, with text messages and phone calls preferred for emergency communication. Youth discussion highlighted key public health concerns, particularly gun violence, substance abuse, and mental health crises, with stigma and limited resources further hindering preparedness efforts. Participants emphasized the need for culturally relevant interventions and stronger community engagement. Full article

Adverse childhood experiences (ACEs) are critical determinants of long-term psychological and physiological health outcomes. Transgender and gender nonconforming (TGNC) individuals are at increased risk for ACEs, including family rejection, peer victimization, and systemic discrimination. Despite the growing body of research on this topic, an updated synthesis of recent literature is needed to understand the evolving landscape of ACE-related risks and protective factors in TGNC populations. This systematic review, conducted according to PRISMA guidelines, examined studies published between 2020 and 2024 that were related to the association between ACEs and mental health outcomes in TGNC individuals. A comprehensive database search yielded 6124 articles, 42 of which met the inclusion criteria. Data extraction focused on the type of ACEs reported, associated mental health outcomes, resilience factors, and clinical implications. The results showed that TGNC individuals are significantly more likely to experience childhood maltreatment, including emotional, physical, and sexual abuse, as well as transphobia-specific ACEs such as forced gender conformity and identity denial. These experiences are associated with an increased risk of depression, PTSD, suicidality, and substance use disorders. Family rejection was found to be a critical risk factor, while social support, gender-specific care, and self-efficacy showed protective effects. The reviewed studies emphasize the urgent need for trauma-informed and gender-affirming mental health interventions to mitigate the effects of ACEs on TGNC individuals. Limitations and future research directions are discussed. Full article

Objectives: Social isolation is an important public health issue that is becoming increasingly prevalent among adolescents today. Recognizing the risk of social isolation in children and adolescents during their developmental years can contribute to the prevention of depression and anxiety disorders, as well as risky behaviors such as suicide and substance abuse. Valid and reliable measurement tools are needed to assess social isolation in adolescents. There is a lack of surveys to identify gaps in social isolation among Turkish adolescents. This study aims to adapt the Social Isolation Questionnaire (QIS) scale, which was developed for adolescents, to Turkish culture and to evaluate its psychometric properties. Methods: This descriptive and methodological study was conducted between July and November 2024 with 1922 adolescents. Data were collected using an introductory information form, the QIS, and the UCLA Loneliness Scale. In the evaluation of the data, explanatory and confirmatory factor analysis, Cronbach’s alpha, split-half, item–total score correlation, and test–retest analysis were used. Results: The average age of the adolescents was 13.97 ± 1.67 years (min = 12, max = 17). A total of 50.6% of the adolescents were male and 49.4% were female. A total of 81.2% of the adolescents had a nuclear family structure. Exploratory factor analysis revealed a three-factor structure explaining 55.97% of the variance. The factor loadings were greater than 0.30, and all fit indices were greater than 0.90. The total Cronbach’s α value of the scale was 0.83, while the values for the subdimensions ranged from 0.73 to 0.75. Conclusions: The Turkish version of the QIS is a valid and reliable measurement tool for assessing social isolation in adolescents. This questionnaire can be used by health professionals and researchers to identify adolescents at risk of social isolation and plan appropriate mental health interventions. This questionnaire can be used in studies focusing on adolescent mental health and well-being, contributing to the development and implementation of strategies in line with the Sustainable Development Goals. Full article

This study aimed to map the literature on the clinical role of pharmacists in the care of incarcerated people at correctional facilities and to identify gaps in this field. A scoping review was conducted on 30 July 2024, using the PubMed, Scopus, and LILACS databases. Gray literature was searched via Google Scholar, and references of included studies were manually reviewed. Primary studies of any design reporting pharmacists’ clinical services and/or activities for incarcerated individuals were eligible. Study selection and data extraction were performed independently by two reviewers, with a third resolving disagreements. The search yielded 894 records, from which 27 studies were included. Most studies were conducted in the United States (n = 16; 59%) and France (n = 7; 26%). Eleven (41%) focused exclusively on male populations, and one (4%) on female inmates. Most studies addressed pharmacists’ clinical roles in mental health conditions and substance use disorders (n = 9; 33%), infectious diseases (n = 5; 19%), and diabetes (n = 4; 15%). Clinical services and/or activities related to direct patient care were the most frequently reported (n = 18; 67%). Process measures were reported in 18 studies (67%), and clinical outcomes were the most common type of outcome (n = 13; 48%). This review highlights the pharmacist’s clinical role in treating mental health conditions and substance abuse, infectious diseases, and diabetes in incarcerated care. It underscores the need for further research in low- and middle-income countries, on women’s health, and on other prevalent conditions. Full article

Despite the increasing adoption of a syndemic approach in HIV research, few health communication campaigns have used a syndemic approach in messaging to improve health outcomes for persons living with HIV (PWH). This paper introduces a framework for practitioners and researchers developing health communication messages in support of a syndemic approach to HIV care for PWH in the United States. Grounded in insights from a review of counseling and psychosocial interventions that demonstrated significant positive effects on HIV clinical outcomes, the C4H Framework emphasizes four components: compassion, comprehensive messaging, capacity-building, and coordination. Compassion ensures that messages resonate with individuals experiencing the intertwined challenges of HIV, substance abuse, and mental health issues. Comprehensive messaging integrates a holistic view of the barriers faced by PWH. Capacity-building empowers individuals to effectively engage with and act upon health information. Coordination promotes alignment between stakeholders and resources to ensure consistent and supportive messaging. The C4H Framework bridges the gap between research and practice, offering a foundation for crafting effective communication messages that resonate with individuals facing the complex challenges inherent in HIV syndemics. Future research should explicitly test the effectiveness and acceptability of messages developed using the C4H Framework with people living with HIV. Full article

This paper presents the development and validation of the Transgender Health, Resilience, Inner Well-Being, Vitality, and Empowerment (THRIVE) Scale. It offers insights into the well-being of transgender and gender-diverse (TGD) individuals, by considering their unique experiences and challenges. TGD individuals often experience significant health disparities, including mental health issues, substance abuse, physical health problems, and difficulty with providers knowing about their needs. A comprehensive quality-of-life assessment could aid in identifying contributions to poor quality of life (QOL) and knowing which resources are needed to address this effectively. Assessments attempting to address these challenges often have not been studied adequately and/or have limitations of being for one-time use, surgery-focused, lengthy, emotionally taxing, and not inclusive of non-binary individuals’ specific needs. Validated among a sample of TGD individuals (N = 61), the THRIVE scale displayed good internal consistency reliability (α = 0.87), as well as convergent and divergent validity. It had significant negative correlations with measures of psychological symptoms and identity distress and positive correlations with measures of life satisfaction and well-being. The THRIVE scale represents a critical advancement in assessing the QOL of TGD individuals and could be an effective tool for individualized care, research, and conversation with these populations. Full article