Epidemiologic Reviews最新文献_第10页

Risks and Targeted Interventions: Firearms in Intimate Partner Violence. 风险和针对性干预:亲密伴侣暴力中的枪支。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2016-01-01 DOI: 10.1093/epirev/mxv007

A. Zeoli, Rebecca Malinski, Brandon S. Turchan

{"title":"Risks and Targeted Interventions: Firearms in Intimate Partner Violence.","authors":"A. Zeoli, Rebecca Malinski, Brandon S. Turchan","doi":"10.1093/epirev/mxv007","DOIUrl":"https://doi.org/10.1093/epirev/mxv007","url":null,"abstract":"The use of firearms in intimate partner violence (IPV) is widely recognized as an important public health threat. However, what we know about the risks of firearm access on IPV outcomes is limited. Therefore, we conducted a systematic review to determine the state of knowledge on 1) the risks of firearm access and use in IPV and 2) the effectiveness of interventions designed specifically to reduce firearm violence in intimate relationships. Only studies published in English in peer-reviewed journals from 1990 through 2014 were included. Results of the review suggest that, when violent intimates have access to firearms, IPV increases in severity and deadliness; however, increases in severity may not be due to firearm use. Additionally, statutes prohibiting persons under domestic violence restraining orders from accessing firearms are associated with reductions in intimate partner homicide, but certain provisions of these laws and their enforcement may impact their effectiveness. Future research should focus on elucidating the link between firearm access and increased IPV severity and on investigating whether and which specific provisions of domestic violence restraining order laws impact the laws' effectiveness. Additionally, more evaluations of initiatives designed to improve the enforcement of domestic violence restraining order firearm prohibitions are needed.","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"38 1 1","pages":"125-39"},"PeriodicalIF":5.5,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/epirev/mxv007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60827212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 70

Effectiveness of Interventions to Promote Safe Firearm Storage. 促进枪支安全储存的干预措施的有效性。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2016-01-01 DOI: 10.1093/epirev/mxv006

A. Rowhani-Rahbar, J. Simonetti, F. Rivara

{"title":"Effectiveness of Interventions to Promote Safe Firearm Storage.","authors":"A. Rowhani-Rahbar, J. Simonetti, F. Rivara","doi":"10.1093/epirev/mxv006","DOIUrl":"https://doi.org/10.1093/epirev/mxv006","url":null,"abstract":"Despite supportive evidence for an association between safe firearm storage and lower risk of firearm injury, the effectiveness of interventions that promote such practices remains unclear. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, we conducted a systematic review of randomized and quasi-experimental controlled studies of safe firearm storage interventions using a prespecified search of 9 electronic databases with no restrictions on language, year, or location from inception through May 27, 2015. Study selection and data extraction were independently performed by 2 investigators. The Cochrane Collaboration's domain-specific tool for assessing risk of bias was used to evaluate the quality of included studies. Seven clinic- and community-based studies published in 2000-2012 using counseling with or without safety device provision met the inclusion criteria. All 3 studies that provided a safety device significantly improved firearm storage practices, while 3 of 4 studies that provided no safety device failed to show an effect. Heterogeneity of studies precluded conducting a meta-analysis. We discuss methodological considerations, gaps in the literature, and recommendations for conducting future studies. Although additional studies are needed, the totality of evidence suggests that counseling augmented by device provision can effectively encourage individuals to store their firearms safely.","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"38 1 1","pages":"111-24"},"PeriodicalIF":5.5,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/epirev/mxv006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60827202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 127

Risk factors for homelessness among US veterans. 美国退伍军人无家可归的危险因素。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2015-01-01 Epub Date: 2015-01-16 DOI: 10.1093/epirev/mxu004

Jack Tsai, Robert A Rosenheck

{"title":"Risk factors for homelessness among US veterans.","authors":"Jack Tsai, Robert A Rosenheck","doi":"10.1093/epirev/mxu004","DOIUrl":"10.1093/epirev/mxu004","url":null,"abstract":"Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. ","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"37 ","pages":"177-95"},"PeriodicalIF":5.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/epirev/mxu004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32982226","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}

引用次数: 188

Alcohol and drug misuse, abuse, and dependence in women veterans. 女性退伍军人的酒精和药物滥用、滥用和依赖。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2015-01-01 Epub Date: 2015-01-21 DOI: 10.1093/epirev/mxu010

Katherine J Hoggatt, Andrea L Jamison, Keren Lehavot, Michael A Cucciare, Christine Timko, Tracy L Simpson

{"title":"Alcohol and drug misuse, abuse, and dependence in women veterans.","authors":"Katherine J Hoggatt, Andrea L Jamison, Keren Lehavot, Michael A Cucciare, Christine Timko, Tracy L Simpson","doi":"10.1093/epirev/mxu010","DOIUrl":"https://doi.org/10.1093/epirev/mxu010","url":null,"abstract":"We conducted a systematic literature review on substance misuse, abuse, and dependence in women veterans, including National Guard/reserve members. We identified 837 articles published between 1980 and 2013. Of 56 included studies, 32 reported rates of alcohol misuse, binge drinking, or other unhealthy alcohol use not meeting diagnostic criteria for abuse or dependence, and 33 reported rates of drug misuse or diagnosed alcohol or drug use disorders. Rates ranged from 4% to 37% for alcohol misuse and from 7% to 25% for binge drinking; among Veterans Health Administration (VA) health-care system outpatients, rates ranged from 3% to 16% for substance use disorder. Studies comparing women veterans and civilians reported no clear differences in binge or heavy drinking. Substance misuse rates were generally lower among women veterans than men veterans. Substance misuse was associated with higher rates of trauma, psychiatric and medical conditions, and increased mortality and suicide rates. Most studies included only VA patients, and many used only VA medical record data; therefore, the reported substance misuse rates likely do not reflect true prevalence. Rates also varied by assessment method, source of data, and the subgroups studied. Further efforts to develop epidemiologically valid prevalence estimates are needed to capture the true health burden of substance misuse in women veterans, particularly those not using VA care. ","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"37 ","pages":"23-37"},"PeriodicalIF":5.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/epirev/mxu010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32992612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 61

Aggressive and violent behavior among military personnel deployed to Iraq and Afghanistan: prevalence and link with deployment and combat exposure. 部署到伊拉克和阿富汗的军事人员的攻击性和暴力行为:患病率及其与部署和战斗暴露的联系。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2015-01-01 Epub Date: 2015-01-22 DOI: 10.1093/epirev/mxu006

Deirdre MacManus, Roberto Rona, Hannah Dickson, Greta Somaini, Nicola Fear, Simon Wessely

{"title":"Aggressive and violent behavior among military personnel deployed to Iraq and Afghanistan: prevalence and link with deployment and combat exposure.","authors":"Deirdre MacManus, Roberto Rona, Hannah Dickson, Greta Somaini, Nicola Fear, Simon Wessely","doi":"10.1093/epirev/mxu006","DOIUrl":"https://doi.org/10.1093/epirev/mxu006","url":null,"abstract":"A systematic review and meta-analyses were conducted on studies of the prevalence of aggressive and violent behavior, as well as of violent offenses and convictions, among military personnel following deployment to Iraq and/or Afghanistan; the relationship with deployment and combat exposure; and the role that mental health problems, such as post-traumatic stress disorder (PTSD), have on the pathway between deployment and combat to violence. Seventeen studies published between January 1, 2001, and February 12, 2014, in the United States and the United Kingdom met the inclusion criteria. Despite methodological differences across studies, aggressive behavior was found to be prevalent among serving and formerly serving personnel, with pooled estimates of 10% (95% confidence interval (CI): 1, 20) for physical assault and 29% (95% CI: 25, 36) for all types of physical aggression in the last month, and worthy of further exploration. In both countries, rates were increased among combat-exposed, formerly serving personnel. The majority of studies suggested a small-to-moderate association between combat exposure and postdeployment physical aggression and violence, with a pooled estimate of the weighted odds ratio = 3.24 (95% CI: 2.75, 3.82), with several studies finding that violence increased with intensity and frequency of exposure to combat traumas. The review's findings support the mediating role of PTSD between combat and postdeployment violence and the importance of alcohol, especially if comorbid with PTSD. ","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"37 ","pages":"196-212"},"PeriodicalIF":5.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/epirev/mxu006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33326281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 116

Prevalence of mental health disorders among justice-involved veterans. 参与司法的退伍军人中精神健康障碍的患病率。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2015-01-01 Epub Date: 2015-01-19 DOI: 10.1093/epirev/mxu003

Janet C Blodgett, Tigran Avoundjian, Andrea K Finlay, Joel Rosenthal, Steven M Asch, Natalya C Maisel, Amanda M Midboe

{"title":"Prevalence of mental health disorders among justice-involved veterans.","authors":"Janet C Blodgett, Tigran Avoundjian, Andrea K Finlay, Joel Rosenthal, Steven M Asch, Natalya C Maisel, Amanda M Midboe","doi":"10.1093/epirev/mxu003","DOIUrl":"https://doi.org/10.1093/epirev/mxu003","url":null,"abstract":"Justice-involved veterans are a special population with unique mental health needs compared with other veterans or justice-involved adults. Prevalence estimates of mental health concerns of justice-involved veterans across 18 samples of these veterans (1987-2013), including both incarcerated and community samples, were identified through a systematic literature search of published studies supplemented by Department of Veterans Affairs Veterans Justice Programs data. Despite heterogeneity across samples and measures used, the review highlights several prominent mental health concerns among veterans. Many justice-involved veterans have likely experienced at least one traumatic event, and many have post-traumatic stress disorder (prevalence from 4% to 39% across samples). At least half of justice-involved veterans have an alcohol and/or drug use disorder (estimates as high as 71% and 65%, respectively), and other psychiatric disorders, such as depression (14%-51%) and psychotic disorders (4%-14%), are common. Justice-involved veterans with comorbid substance use and psychiatric disorders are at increased risk of negative outcomes, including homelessness and violent behavior. Overall, comparisons of justice-involved veterans with other justice-involved adults found a slightly higher rate of mental health concerns among justice-involved veterans, with some indication that intravenous drug use is more prevalent. Compared with other veterans, justice-involved veterans have consistently higher rates of mental health concerns, particularly substance use disorders. ","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"37 ","pages":"163-76"},"PeriodicalIF":5.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/epirev/mxu003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33314684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 61

Hearing impairment and tinnitus: prevalence, risk factors, and outcomes in US service members and veterans deployed to the Iraq and Afghanistan wars. 听力障碍和耳鸣:在伊拉克和阿富汗战争中服役的美国军人和退伍军人的患病率、风险因素和结果。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2015-01-01 Epub Date: 2015-01-19 DOI: 10.1093/epirev/mxu005

Sarah M Theodoroff, M Samantha Lewis, Robert L Folmer, James A Henry, Kathleen F Carlson

{"title":"Hearing impairment and tinnitus: prevalence, risk factors, and outcomes in US service members and veterans deployed to the Iraq and Afghanistan wars.","authors":"Sarah M Theodoroff, M Samantha Lewis, Robert L Folmer, James A Henry, Kathleen F Carlson","doi":"10.1093/epirev/mxu005","DOIUrl":"https://doi.org/10.1093/epirev/mxu005","url":null,"abstract":"Hearing loss and tinnitus are the 2 most prevalent service-connected disabilities among veterans in the United States. Veterans of Operations Enduring Freedom, Iraqi Freedom, and New Dawn have been exposed to multiple hazards associated with these conditions, such as blasts/explosions, ototoxic chemicals, and most notably high levels of noise. We conducted a systematic literature review of evidence on 1) prevalence of, 2) risk and protective factors for, and 3) functional and quality-of-life outcomes of hearing impairment and tinnitus in US Operations Enduring Freedom, Iraqi Freedom, and New Dawn veterans and military personnel. We identified studies published from 2001 through 2013 using PubMed, PsycINFO, REHABDATA, Cochrane Library, pearling, and expert recommendation. Peer-reviewed English language articles describing studies of 30 or more adults were included if they informed one or more key questions. A total of 839 titles/abstracts were reviewed for relevance by investigators trained in critical analysis of literature; 14 studies met inclusion criteria. Of these, 13 studies presented data on prevalence and 4 on risk/protective factors, respectively. There were no included studies reporting on outcomes. Findings from this systematic review will help inform clinicians, researchers, and policy makers on future resource and research needs pertaining to hearing impairment and tinnitus in this newest generation of veterans. ","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"37 ","pages":"71-85"},"PeriodicalIF":5.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/epirev/mxu005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33314685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 81

Mental health among reserve component military service members and veterans. 预备役军人和退伍军人的心理健康状况。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2015-01-01 Epub Date: 2015-01-16 DOI: 10.1093/epirev/mxu007

Gregory H Cohen, David S Fink, Laura Sampson, Sandro Galea

{"title":"Mental health among reserve component military service members and veterans.","authors":"Gregory H Cohen, David S Fink, Laura Sampson, Sandro Galea","doi":"10.1093/epirev/mxu007","DOIUrl":"https://doi.org/10.1093/epirev/mxu007","url":null,"abstract":"Since 2001, the US military has increasingly relied on National Guard and reserve component forces to meet operational demands. Differences in preparation and military engagement experiences between active component and reserve component forces have long suggested that the psychiatric consequences of military engagement differ by component. We conducted a systematic review of prevalence and new onset of psychiatric disorders among reserve component forces and a meta-analysis of prevalence estimates comparing reserve component and active component forces, and we documented stage-sequential drivers of psychiatric burden among reserve component forces. We identified 27 reports from 19 unique samples published between 1985 and 2012: 9 studies reporting on the reserve component alone and 10 reporting on both the reserve component and the active component. The pooled prevalence for alcohol use disorders of 14.5% (95% confidence interval: 12.7, 15.2) among the reserve component was higher than that of 11.7% (95% confidence interval: 10.9, 12.6) among the active component, while there were no component differences for depression or post-traumatic stress disorder. We observed substantial heterogeneity in prevalence estimates reported by the reserve component. Published studies suggest that stage-sequential risk factors throughout the deployment cycle predicted alcohol use disorders, post-traumatic stress disorder and, to a lesser degree, depression. Improved and more standardized documentation of the mental health burden, as well as study of explanatory factors within a life-course framework, is necessary to inform mitigating strategies and to reduce psychiatric burden among reserve component forces. ","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"37 ","pages":"7-22"},"PeriodicalIF":5.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/epirev/mxu007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32982227","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}

引用次数: 61

Airborne hazards exposure and respiratory health of Iraq and Afghanistan veterans. 伊拉克和阿富汗退伍军人的空气危害暴露和呼吸健康。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2015-01-01 Epub Date: 2015-01-14 DOI: 10.1093/epirev/mxu009

Michael J Falvo, Omowunmi Y Osinubi, Anays M Sotolongo, Drew A Helmer

{"title":"Airborne hazards exposure and respiratory health of Iraq and Afghanistan veterans.","authors":"Michael J Falvo, Omowunmi Y Osinubi, Anays M Sotolongo, Drew A Helmer","doi":"10.1093/epirev/mxu009","DOIUrl":"https://doi.org/10.1093/epirev/mxu009","url":null,"abstract":"More than 2.6 million military personnel have been deployed to recent conflicts in Iraq and Afghanistan and were likely exposed to a variety of airborne hazards during deployment. Despite several epidemiologic reports of increased respiratory symptoms, whether or not these respiratory illnesses lead to reductions in lung function and/or specific pulmonary disease is unclear. We reviewed data published from 2001 to 2014 pertaining to respiratory health in military personnel deployed to Iraq and Afghanistan and found 19 unique studies. Study designs were primarily retrospective and observational in nature with patient symptom reporting and medical encounter data as primary outcome measures. Two case series reported on rare respiratory diseases, and one performed a standardized evaluation of new-onset respiratory symptoms. Respiratory outcomes in relation to proximity to a specific air pollution source (i.e., smoke from burning trash and sulfur mine fire) were described in 2 separate studies. Only 2 longitudinal investigations were identified comparing pre- and postdeployment measurement of exercise capacity. In summary, published data based on case reports and retrospective cohort studies suggest a higher prevalence of respiratory symptoms and respiratory illness consistent with airway obstruction. However, the association between chronic lung disease and airborne hazards exposure requires further longitudinal research studies with objective pulmonary assessments. ","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"37 ","pages":"116-30"},"PeriodicalIF":5.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/epirev/mxu009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32974983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 49

Stigma as a barrier to seeking health care among military personnel with mental health problems. 耻辱是有心理健康问题的军人寻求医疗保健的障碍。

IF 5.5 2区医学

Epidemiologic Reviews Pub Date : 2015-01-01 Epub Date: 2015-01-16 DOI: 10.1093/epirev/mxu012

Marie-Louise Sharp, Nicola T Fear, Roberto J Rona, Simon Wessely, Neil Greenberg, Norman Jones, Laura Goodwin

{"title":"Stigma as a barrier to seeking health care among military personnel with mental health problems.","authors":"Marie-Louise Sharp, Nicola T Fear, Roberto J Rona, Simon Wessely, Neil Greenberg, Norman Jones, Laura Goodwin","doi":"10.1093/epirev/mxu012","DOIUrl":"https://doi.org/10.1093/epirev/mxu012","url":null,"abstract":"Approximately 60% of military personnel who experience mental health problems do not seek help, yet many of them could benefit from professional treatment. Across military studies, one of the most frequently reported barriers to help-seeking for mental health problems is concerns about stigma. It is, however, less clear how stigma influences mental health service utilization. This review will synthesize existing research on stigma, focusing on those in the military with mental health problems. We conducted a systematic review and meta-analysis of studies between 2001 and 2014 to examine the prevalence of stigma for seeking help for a mental health problem and its association with help-seeking intentions/mental health service utilization. Twenty papers met the search criteria. Weighted prevalence estimates for the 2 most endorsed stigma concerns were 44.2% (95% confidence interval: 37.1, 51.4) for \"My unit leadership might treat me differently\" and 42.9% (95% confidence interval: 36.8, 49.0) for \"I would be seen as weak.\" Nine studies found no association between anticipated stigma and help-seeking intentions/mental health service use and 4 studies found a positive association. One study found a negative association between self-stigma and intentions to seek help. Counterintuitively, those that endorsed high anticipated stigma still utilized mental health services or were interested in seeking help. We propose that these findings may be related to intention-behavior gaps or methodological issues in the measurement of stigma. Positive associations may be influenced by modified labeling theory. Additionally, other factors such as self-stigma and negative attitudes toward mental health care may be worth further attention in future investigation. ","PeriodicalId":50510,"journal":{"name":"Epidemiologic Reviews","volume":"37 ","pages":"144-62"},"PeriodicalIF":5.5,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/epirev/mxu012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32980260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 295