Comprehensive psychiatry最新文献

{"title":"A comparison of firefighter mental health education programs: A descriptive thematic analysis of firefighter experiences","authors":"Sara M. Stretton ,&nbsp;Joy C. MacDermid ,&nbsp;Margaret Lomotan ,&nbsp;Shannon C. Killip","doi":"10.1016/j.comppsych.2024.152547","DOIUrl":"10.1016/j.comppsych.2024.152547","url":null,"abstract":"<div><h3>Background</h3><div>In response to the inherent critical incident exposures experienced by firefighters, various mental health education programs have been developed. The purpose of this study was to explore the perceptions of firefighters who took such programs to understand differences/similarities across these programs.</div></div><div><h3>Methods</h3><div>We recruited 14 participants, who had taken or delivered two or more programs for firefighters (Resilient Minds (RM), Road to Mental Readiness (R2MR), and Before Operational Stress (BOS)). Participants participated in semi-structured interviews, which explored information that they learned, recalled, used, and their preferences. Data was analysed using thematic analysis.</div></div><div><h3>Results</h3><div>Participants believed that all programs had some shared teaching methods, goals, skills, and topics; however, each program had key focuses/distinctive features. RM was said to be largely group participation and focused on assisting yourself, peers, and citizens. R2MR and BOS was said to be largely lecture style with a focus on the self. 70 % of participants who took RM (<em>n</em> = 7) and one other course preferred RM due to the specificity of training to firefighters, more active teaching methods, and focus on practical skill development. Others (43 %) had no program preference. Participants suggest that a tiered approach to mental health education would benefit firefighters.</div></div><div><h3>Conclusions</h3><div>All programs were seen as helpful. Despite some congruency in goals and content, most firefighters preferred RM because the content was fire-specific, and the pedagogical approach was seen as more active and engaging. Program characteristics are important to facilitate appropriate program selection, as such, programs should be explicit about these aspects.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152547"},"PeriodicalIF":4.3,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability, tolerability and safety of the BRIGhTMIND trial: Connectivity-guided intermittent theta-burst stimulation versus F3- repetitive transcranial magnetic stimulation for treatment-resistant depression","authors":"Lucy Webster ,&nbsp;Clement Boutry ,&nbsp;Louise Thomson ,&nbsp;Mohamed Abdelghani ,&nbsp;Shaun Barber ,&nbsp;Paul M. Briley ,&nbsp;Micheal Kurkar ,&nbsp;Sudheer Lankappa ,&nbsp;R. Hamish McAllister-Williams ,&nbsp;Ana Suazo Di Paola ,&nbsp;Richard Morriss ,&nbsp;BRIGhTMIND study and LEAP team","doi":"10.1016/j.comppsych.2024.152544","DOIUrl":"10.1016/j.comppsych.2024.152544","url":null,"abstract":"<div><h3>Background</h3><div>The BRIGhTMIND study was a double-blind RCT comparing repetitive transcranial magnetic stimulation at a standard simulation site (the “F3” location given by the International 10–20 system, F3-rTMS) versus connectivity-guided intermittent theta burst stimulation (cgiTBS) for treatment-resistant depression. This present study reports the acceptability, safety, and tolerability of F3-rTMS versus cgiTBS.</div></div><div><h3>Methods</h3><div>The present study used quantitative and qualitative methods. Two hundred fifty-four participants were included in the quantitative BRIGhTMIND acceptability and safety analysis (<em>n</em> = 126 F3-rTMS, <em>n</em> = 128 cgiTBS). Qualitative analysis included interviews for 15 participants (<em>n</em> = 7 F3-rTMS, <em>n</em> = 8 cgiTBS) and 582 written comments made by any participant randomised to the BRIGhTMIND trial regarding their experience of TMS and the study. Statistical analyses were used to explore differences between F3-rTMS and cgiTBS, as well as associations between acceptability, impression of change and safety. Qualitative data was analysed using an inductive thematic framework approach.</div></div><div><h3>Outcomes</h3><div>Acceptability, TMS benefits/negative effects and impression of improvement ratings did not differ across the two treatment protocols, with ratings maintained long-term (71.4 % rated TMS acceptable, 48.8 % indicated benefits of TMS outweighed negative effects and 52.2 % feeling somewhat or much better at 26 week follow-up <em>n</em> = 203). Impression of improvement was positively associated with acceptability and TMS benefits. Qualitative themes included participants' TMS experience, TMS response variability, and lay theories of effectiveness. Safety profiles were comparable between F3-rTMS and cgiTBS, with 74.5 % of participants (<em>n</em> = 190/254) experiencing at least one adverse event possibly, probably, or definitely related to TMS. The majority of adverse events were transient and mild, with a sizeable number requiring simple treatments or small adjustments to TMS intensity and coil positioning. The F3-rTMS group had a significantly greater proportion of participants that required small adjustments to TMS to tolerate treatment compared to the cgiTBS group. Serious adverse events were rare, with one serious event in each treatment arm possibly related to TMS (F3-rTMS- psychotic episode, cgiTBS-manic episode).</div></div><div><h3>Conclusion</h3><div>F3-rTMS and cgiTBS are comparably safe, tolerable and highly acceptable interventions for treatment-resistant depression. BRIGhTMIND systematically collected data from a large sample, providing evidence to meet the information needs of patients, clinicians and policy makers.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152544"},"PeriodicalIF":4.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise moderates longitudinal group psychopathology networks in individuals with eating disorders","authors":"David R. Kolar ,&nbsp;Christina Ralph-Nearman ,&nbsp;Trevor Swanson ,&nbsp;Cheri A. Levinson","doi":"10.1016/j.comppsych.2024.152543","DOIUrl":"10.1016/j.comppsych.2024.152543","url":null,"abstract":"<div><div>Individuals with eating disorders (EDs) often engage in exercise no matter potential negative long-term outcomes (e.g., weight loss, injury). Yet exercising may temporarily attenuate ED symptoms, but whether exercise also affects network structure and pairwise associations of ED symptoms remained unclear. We used a novel approach called Moderated Multilevel Graphical Vector Autoregression to estimate changes in psychopathology networks from before to after exercising in ecological momentary assessment data from 102 individuals with EDs across multiple days (<em>M</em> = 22.14, <em>SD</em> = 5.40; range: 6–22 days) at 4 times daily. Between-person and within-person temporal networks were computed, obtaining stable centrality coefficients for temporal networks only. In those, autoregressive effects of several symptoms, including binge-eating, overeating, or weighing oneself, were attenuated when participants previously exercised. Exercise mostly downregulated temporal effects of ED symptoms on other symptoms, including effects of binge eating and other compensatory behaviors on feeling guilty after the most recent meal, vomiting on weighing oneself, and overeating on fear of weight gain. Our study highlights the complex dynamic effects of exercise on ED symptoms in daily life and calls for novel studies investigating mechanisms of exercise to inform treatments targeting detrimental long-term effects of exercise in EDs.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152543"},"PeriodicalIF":4.3,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The deer mouse (Peromyscus maniculatus bairdii) as a model organism to explore the naturalistic psychobiological mechanisms contributing to compulsive-like rigidity: A narrative overview of advances and opportunities","authors":"Vasti Theron ,&nbsp;Chrstine Lochner ,&nbsp;Dan J. Stein ,&nbsp;Brian H Harvey ,&nbsp;De Wet Wolmarans","doi":"10.1016/j.comppsych.2024.152545","DOIUrl":"10.1016/j.comppsych.2024.152545","url":null,"abstract":"<div><div>Deer mice <em>(Peromyscus maniculatus bairdii)</em>, a wildtype species native to North America, have been investigated for their spontaneous compulsive-like behaviour. The repetitive and persistence nature of three unique compulsive-like phenotypes in deer mice, i.e., high stereotypy (HS), large nesting behaviour (LNB) and high marble burying (HMB), are characterized by behavioural and cognitive rigidity. In this narrative review, we summarize key advances in the model's application to study obsessive-compulsive disorder (OCD), emphasizing how it may be used to investigate neurobiological and neurocognitive aspects of rigidity. Indeed, deer mice provide the field with a unique naturalistic and spontaneous model system of behavioural and cognitive rigidity that is useful for investigating the psychobiological mechanisms that underpin a range of compulsive-like phenotypes. Throughout the review, we highlight new opportunities for future research.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152545"},"PeriodicalIF":4.3,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying factors strongest associated with clinical, societal and personal recovery in people with psychosis with a long duration of illness","authors":"Stynke Castelein ,&nbsp;Ellen Visser ,&nbsp;PHAMOUS-investigators ,&nbsp;Maarten F. Brilman ,&nbsp;Klaas J. Wardenaar ,&nbsp;Jojanneke Bruins","doi":"10.1016/j.comppsych.2024.152540","DOIUrl":"10.1016/j.comppsych.2024.152540","url":null,"abstract":"<div><h3>Introduction</h3><div>Most studies on recovery of psychotic disorders focus on first-episode populations using premorbid and baseline data to predict recovery. However, many patients experience a long duration of illness and many factors are dynamic and change during life.</div></div><div><h3>Aims</h3><div>To investigate factors strongest associated with clinical, societal and personal recovery, and recovery change scores in people with a long duration of illness using current data measured at the same assessment.</div></div><div><h3>Methods</h3><div>Least absolute shrinkage and selection operator regression analyses with cross-validation were used to identify the correlates of (changes in) clinical (<em>N</em> = 1054), societal (<em>N</em> = 1145) and personal recovery (<em>N</em> = 1187) in people with psychotic disorders. Subsequently, the identified associated factors were included in separate linear regression models, examining the associative strength of the identified variables and overall fit of the models.</div></div><div><h3>Results</h3><div>Better clinical recovery was associated with better societal and personal recovery, experiencing fewer problems with daily functioning and social relations. Participants had a better societal recovery when they were employed, had fewer problems in daily life, less negative symptoms, had a life partner and better clinical recovery. Personal recovery was associated with greater satisfaction with life in general, no depressive mood and increased clinical recovery. Change scores were small with minimal fluctuation and no significant associations with change scores were detected.</div></div><div><h3>Conclusions</h3><div>Recovery domains strongly influence each other in people with a long illness duration of psychosis and should therefore have an equally important focus during treatment.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152540"},"PeriodicalIF":4.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates of risk-taking behaviour and suicidality among humanitarian aid workers","authors":"Frédérique Vallières ,&nbsp;Hamed Seddighi ,&nbsp;Áine Travers ,&nbsp;Peter Varah ,&nbsp;Nana Wiedemann ,&nbsp;Cecilie Dinesen ,&nbsp;Kinan Aldamman ,&nbsp;James Lee ,&nbsp;Bonnix Kayabu ,&nbsp;Philip Hyland","doi":"10.1016/j.comppsych.2024.152541","DOIUrl":"10.1016/j.comppsych.2024.152541","url":null,"abstract":"<div><div>In an era of high need for humanitarian assistance, humanitarian aid workers face increased exposure to potentially traumatic events and, correspondingly, a greater risk of psychological distress (e.g., anxiety, depression, posttraumatic stress disorder [PTSD], and burnout). Less studied among humanitarian workers, however, are other known correlates of trauma-exposure: complex PTSD, risk-taking behaviours, and suicidality. The current study examined levels of trauma exposure and rates of trauma-related mental health disorders, risk-taking behaviour, and levels of suicidality among a sample (<em>N</em> = 232) of humanitarian workers located across 52 countries. Multiple linear regression analysis was used to determine which demographic (i.e., sex, age, cadre, years working as an aid worker), psychological (i.e., social support, personality traits), and trauma-related (trauma exposure, complex posttraumatic stress disorder [CPTSD] symptoms, and dissociation) variables were uniquely associated with risk-taking behaviours and suicidality. Overall, 12.9 % (95 % CI = 8.5 %, 17.2 %) of humanitarian workers met the diagnostic requirements for PTSD, and 8.6 % (95 % CI = 5.0 %, 12.2 %) met requirements for CPTSD. Higher risk-taking behaviours were significantly associated with being male, an international worker, greater trauma exposure, extraversion, neuroticism, and CPTSD symptoms. Suicidality was significantly associated with being an international staff member and higher levels of dissociation. Results are consistent with previous studies citing a high risk of psychological distress among humanitarian workers. Humanitarian aid agencies have a duty of care to their workers - both professional and volunteer - and greater safeguarding measures are necessary to mitigate the risk to mental health brought on by humanitarian work-related stressors.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152541"},"PeriodicalIF":4.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prospective associations between problematic gaming and phubbing among Chinese adolescents: Insights from a cross-lagged panel network model","authors":"Yingying Su ,&nbsp;Yan Chen ,&nbsp;Qian Gai ,&nbsp;Xiangfei Meng ,&nbsp;Tingting Gao","doi":"10.1016/j.comppsych.2024.152542","DOIUrl":"10.1016/j.comppsych.2024.152542","url":null,"abstract":"<div><h3>Background and aims</h3><div>Previous studies are limited in addressing the directionality of temporal relationships between problematic gaming and phubbing symptoms by exploring cross-sectional studies. Therefore, we estimated the longitudinal relationships between individual behavioral addictive symptoms including problematic gaming and phubbing in adolescence, and explored potential sex differences in these relationships.</div></div><div><h3>Methods</h3><div>This study included 3296 participants in Shandong Province, China. Data were collected from November 2021 (mean [SD] age: 15.17 [1.44] years) to May 2023 (mean [SD] age: 17.50 [1.18] years), with females comprising 54.5 % of the sample. Problematic gaming and phubbing were assessed using validated scales at each wave. We construct cross-sectional networks and cross-lagged panel networks (CLPN) to explore the contemptuous and temporal relationships between problematic gaming and phubbing.</div></div><div><h3>Results</h3><div>Contemporaneous networks revealed significant differences in problematic gaming and phubbing networks between males and females. Additionally, temporal network analyses indicated that among male adolescents, feeling anxious when unable to play games was the most influential predictor of subsequent behavioral addictive symptoms. For female adolescents, fantasizing about gaming had the most significant associations with future addictive behaviors. The strongest bridge symptom linking problematic gaming and phubbing for both sexes was focusing on phones rather than engaging in conversation.</div></div><div><h3>Discussion and conclusions</h3><div>The study applied network modeling to panel data from a large, population-based cohort of adolescents, identifying unique longitudinal relationships between problematic gaming and phubbing across symptom domains. It provides valuable insights into the characterization of behavioral addictive symptoms among adolescents and the potential predictive relationships among these symptoms among different sexes, guiding sex-specific targeted interventions for adolescents.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152542"},"PeriodicalIF":4.3,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicidal thoughts and behaviors in adults with hoarding disorder","authors":"Dariana Gil-Hernández ,&nbsp;Elizabeth McCarthy ,&nbsp;Tatevik Avanesyan ,&nbsp;Pavithra Mukunda ,&nbsp;Marcos Ortiz ,&nbsp;Randy O. Frost ,&nbsp;Peter J. van Roessel ,&nbsp;Michele S. Berk ,&nbsp;Carolyn I. Rodriguez","doi":"10.1016/j.comppsych.2024.152539","DOIUrl":"10.1016/j.comppsych.2024.152539","url":null,"abstract":"<div><h3>Background</h3><div>Hoarding disorder (HD) is characterized by difficulty discarding possessions and clutter that impairs daily functioning. Previous research has demonstrated a high correlation between hoarding behaviors and suicidal thoughts and behaviors; however, there is limited research on suicidal thoughts and behaviors in individuals meeting Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for HD. Our aim in this study was to report our findings about suicidal thoughts and behaviors in a HD sample.</div></div><div><h3>Methods</h3><div>We used existing data from participants meeting DSM-5 criteria for HD (<em>n</em> = 99). Data about suicidal thoughts and behaviors was collected using a structured instrument, the Columbia-Suicide Severity Rating Scale (C-SSRS).</div></div><div><h3>Results</h3><div>Among the 99 participants, 49.5 % and 26.3 % had passive and active suicidal ideation (SI), respectively. Of those with active ideation, 11 participants endorsed thinking about overdose during their most severe SI. 13 participants reported attempting suicide at least once in their lifetime.</div></div><div><h3>Conclusions</h3><div>To our knowledge, this is the first study examining suicidal thoughts and behaviors in HD using the structured assessment C-SSRS. In this HD data set, participants reported suicidal thoughts and behaviors at higher rates than the general U.S. population. Our study highlights the importance of screening for suicidal thoughts and behaviors in individuals with HD.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"136 ","pages":"Article 152539"},"PeriodicalIF":4.3,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role models in gaming: Wishful identification and maladaptive daydreaming mediate the association between desire for fame and game engagement","authors":"Rita Horváth ,&nbsp;Ágnes Buvár ,&nbsp;Róbert Urbán ,&nbsp;Zsolt Demetrovics ,&nbsp;Ágnes Zsila","doi":"10.1016/j.comppsych.2024.152538","DOIUrl":"10.1016/j.comppsych.2024.152538","url":null,"abstract":"<div><h3>Background</h3><div>The popularity of video games has considerably increased in recent years, with approximately 3.24 billion players worldwide in 2021. Empirical evidence suggests that the quality of engagement in video games can determine whether a gaming activity is associated with psychological distress (i.e., problematic gaming) or self-enhancing outcomes (i.e., esports career pursuits). This study investigates the role of influential gaming role models and other external factors relating to fame appeal in gamers' different ways of engagement.</div></div><div><h3>Methods</h3><div>A total of 803 adolescent and adult gamers (89.29 % male, <em>M</em>age = 24.90 years, <em>SD</em> = 6.13) were recruited through an online questionnaire.</div></div><div><h3>Results</h3><div>A path analysis was constructed demonstrating that wishful identification partially mediated the relationship between desire for fame and esports career planning. Moreover, maladaptive daydreaming fully mediated the association between desire for fame and gaming disorder symptoms. Wishful identification with gaming role models predicted both esports career planning and gaming disorder symptoms.</div></div><div><h3>Conclusions</h3><div>The findings shed light on the importance of considering the role of gaming role models in predicting healthy and problematic gaming patterns.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"135 ","pages":"Article 152538"},"PeriodicalIF":4.3,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parenting and mental health in protracted refugee situations: a systematic review","authors":"Qusai Khraisha ,&nbsp;Nadeen Abujaber ,&nbsp;Sadhbh Carpenter ,&nbsp;Robert J. Crossen ,&nbsp;Johanna Kappenberg ,&nbsp;Ronan Kelly ,&nbsp;Cameron Murphy ,&nbsp;Orla Norton ,&nbsp;Sophie Marleen Put ,&nbsp;Kate Schnoebelen ,&nbsp;Azza Warraitch ,&nbsp;Stella Roney ,&nbsp;Kristin Hadfield","doi":"10.1016/j.comppsych.2024.152536","DOIUrl":"10.1016/j.comppsych.2024.152536","url":null,"abstract":"<div><h3>Background</h3><div>Refugees' parenting behaviour is profoundly influenced by their mental health, which is, in turn, influenced by their situation of displacement. Our research presents the first systematic review on parenting and mental health in protracted refugee situations, where 78% of all refugees reside.</div></div><div><h3>Methods</h3><div>We pre-registered our protocol and screened documents in 22 languages from 10 electronic databases, reports by 16 international humanitarian organisations and region-specific content from the top 100 websites for each of the 72 countries that ‘host’ protracted refugees. Our criteria were empirical papers reporting parenting and parental mental health data on refugees who are in a protracted refugee situation. Studies including only internally displaced or stateless persons were excluded.</div></div><div><h3>Results</h3><div>A total of 18,125 documents were screened and 30 studies were included. We identified a universal pathway linking macro-level stressors in protracted refugee situations, such as movement restrictions and documentation issues, to symptoms of depression and anxiety, which, in turn, led to negative parenting practices. Addtionally, culture-specific pathways were observed in the way parental mental health and parenting were expressed. Situational (e.g., overcrowding) and relational factors (e.g., spousal dynamics) modulated both of these pathways. Biases in the research included the over-representation of specific protracted refugee situations, overreliance on self-reported data, and a heavy focus on mothers while neglecting fathers and other caregivers. Longitudinal research is needed to clarify the directionality and causality between specific macro-level stressors in a given protracted refugee situation and parental mental health and practices. Refugees were rarely consulted or involved in the design of research about their parenting and parental mental health.</div></div><div><h3>Conclusion</h3><div>In recognising the existing links between protracted refugee situations, parental mental health, and parenting, our systematic review calls for a shift in thinking: from focusing solely on the micro aspects that affect ‘refugee parenting’ to understanding and tackling the broader macro-level stressors that drive them. We urge for larger and long-term research efforts that consider diverse protracted refugee situations, greater investment in science communication and diplomacy with governments, and stronger implementation of durable solutions by states to alleviate the roots of refugee parents' distress and negative parenting practices.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"135 ","pages":"Article 152536"},"PeriodicalIF":4.3,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}