Background Health inequities remain a public health concern. Chronic adversity such as discrimination or racism as trauma may perpetuate health inequities in marginalized populations. There is a growing body of the literature on trauma informed and culturally competent care as essential elements of promoting health equity, yet no prior review has systematically addressed trauma informed interventions. The purpose of this study was to appraise the types, setting, scope, and delivery of trauma informed interventions and associated outcomes. Methods We performed database searches— PubMed, Embase, CINAHL, SCOPUS and PsycINFO—to identify quantitative studies published in English before June 2019. Thirty-two unique studies with one companion article met the eligibility criteria. Results More than half of the 32 studies were randomized controlled trials (n = 19). Thirteen studies were conducted in the United States. Child abuse, domestic violence, or sexual assault were the most common types of trauma addressed (n = 16). While the interventions were largely focused on reducing symptoms of post-traumatic stress disorder (PTSD) (n = 23), depression (n = 16), or anxiety (n = 10), trauma informed interventions were mostly delivered in an outpatient setting (n = 20) by medical professionals (n = 21). Two most frequently used interventions were eye movement desensitization and reprocessing (n = 6) and cognitive behavioral therapy (n = 5). Intervention fidelity was addressed in 16 studies. Trauma informed interventions significantly reduced PTSD symptoms in 11 of 23 studies. Fifteen studies found improvements in three main psychological outcomes including PTSD symptoms (11 of 23), depression (9 of 16), and anxiety (5 of 10). Cognitive behavioral therapy consistently improved a wide range of outcomes including depression, anxiety, emotional dysregulation, interpersonal problems, and risky behaviors (n = 5). Conclusions There is inconsistent evidence to support trauma informed interventions as an effective approach for psychological outcomes. Future trauma informed intervention should be expanded in scope to address a wide range of trauma types such as racism and discrimination. Additionally, a wider range of trauma outcomes should be studied.
Objective: The purpose of this study is to identify whether dementia caregiving is associated with physical difficulty among informal caregivers. Methods: This cross-sectional retrospective cohort study design used data from the 2015 National Health and Aging Trends Study and the National Study of Caregiving. Binary logistic regression was used to examine the association between substantial physical difficulty and dementia caregiving among 1,871 caregivers. Results: Nearly 14% of the caregivers reported substantial physical difficulty. Dementia caregivers were 1.5 times more likely to report caregiving-related substantial physical difficulty (adjusted odds ratio [AOR] = 1.58, p = .04) than non-dementia caregivers. Factors associated with substantial physical difficulty included caregiver gender, self-rated health, depressive symptoms, pain, and caring for someone receiving assistance with three or more self-care or mobility activities. Discussion: Future studies should identify strategies to mitigate the physical demands on dementia caregivers. Early monitoring of caregivers’ self-rated health, depressive symptoms, and pain may identify those more likely to experience physical difficulty.
The aim of the current review is to describe the prevalence and demographic correlates of mental health disorders among undergraduate university students in the United States. A search strategy was built and conducted using PubMed, PsycINFO, and CINAHL to identify studies published between 2009 and 2019 on the prevalence of mental health disorders, as defined in the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders , in undergraduate students in the United States. A total of 12 studies were included in the final data extraction. The highest prevalence rates were identified in eating disorders, which ranged from 19% to 48%, followed by compulsive disorders (2% to 12.27%), depression (22%), posttraumatic stress disorder (8%), and sleep disorders (9.4% to 36%). The identified prevalence of mental health disorders is high, and the subsequent impact on this population is worrying. There is an urgent need to develop strategies for early screening and management of mental health services in university settings. [ Journal of Psychosocial Nursing and Mental Health Services, 59 (2), 17–24.]
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