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The US National Comorbidity Survey Replication (NCS-R): Design and field procedures
International Journal of Methods in Psychiatric Research
Abstract
The National Comorbidity Survey Replication (NCS-R) is a survey of the prevalence and correlates of mental disorders in the US that was carried out between February 2001 and April 2003. Interviews were administered face-to-face in the homes of respondents, who were selected from a nationally representative multi-stage clustered area probability sample of households. A total of 9,282 interviews were completed in the main survey and an additional 554 short non-response interviews were completed with initial non-respondents. This paper describes the main features of the NCS-R design and field procedures, including information on fieldwork organization and procedures, sample design, weighting and considerations in the use of design-based versus model-based estimation. Empirical information is presented on non-response bias, design effect, and the trade-off between bias and efficiency in minimizing total mean-squared error of estimates by trimming weights.
... 2,3 When left untreated, ADHD is associated with increased morbidity and mortality, 4 low earning potential, 5 poor physical health, 6 relationship instability, 7 and elevated comorbid mental health conditions. 8 Untreated adult ADHD is often complex and comorbid with depression, anxiety, bipolar disorder, insomnia, substance use disorders, and trauma-related conditions. 8,9 Adult ADHD is associated with a 5-fold increased risk for anxiety disorders, a 4.5-fold increased risk for major depression, an 8.7-fold increased risk for bipolar disorder, and a 4.6-fold increased risk for substance use disorders. ...
... 8 Untreated adult ADHD is often complex and comorbid with depression, anxiety, bipolar disorder, insomnia, substance use disorders, and trauma-related conditions. 8,9 Adult ADHD is associated with a 5-fold increased risk for anxiety disorders, a 4.5-fold increased risk for major depression, an 8.7-fold increased risk for bipolar disorder, and a 4.6-fold increased risk for substance use disorders. 10 The risks and benefits of individualized ADHD treatment 11 must carefully be considered in these complex conditions 12 as ADHD and comorbid disorders present both diagnostic and treatment challenges. ...
... These RSS findings provide clinicians and policymakers with the first US national estimates on prevalence of current ADHD diagnosis and pharmacologic treatment among adults in more than 2 decades. 8,24 The RSS found that 6% of US adults had a current diagnosis of ADHD, with 8% of US adults reporting a past or present diagnosis. ...
... This study investigates the short-and long-term psychological self-reported impacts of lifetime gun violence exposure using a cross-sectional survey of 10,000 respondents designed to be representative of US adults administered online by YouGov in January 2024. Findings revealed that 20.1% of respondents reported a mass shooting in their community, 18.3% had been threatened with a rearm, and 2.2% and 2.4% were injured in mass and non-mass shootings, respectively. Between 58.6% and 94.4% reported mental health consequences across exposure types, with younger individuals and women particularly vulnerable. ...
... The majority of respondents reported psychological distress following gun violence exposure, with anxiety, depression and post-traumatic stress symptoms being the most commonly reported outcomes. While these mental health symptoms were self-reported, they were significantly higher than clinical prevalence rates for the general population, where rates of depression, anxiety, PTSD and panic disorder are 8.3%, 19.1%, 3.6% and 2.7%, respectively 18,19 . Notably, individuals injured in shootings were most affected, but even those not physically harmed-whether present during the incident or residents in communities affected by gun violence-experienced elevated levels of psychological symptoms. ...
Gun violence exposure is a major public health issue in the United States, yet
its mental health consequences remain insufficiently examined. This study
investigates the short- and long-term psychological self-reported impacts
of lifetime gun violence exposure using a cross-sectional survey of 10,000
respondents designed to be representative of US adults administered online
by YouGov in January 2024. Findings revealed that 20.1% of respondents
reported a mass shooting in their community, 18.3% had been threatened
with a firearm, and 2.2% and 2.4% were injured in mass and non-mass
shootings, respectively. Between 58.6% and 94.4% reported mental health
consequences across exposure types, with younger individuals and women
particularly vulnerable. While mass shootings corresponded with greater
psychological distress, the long-term impacts, including post-traumatic
stress, were reported at a higher rate following non-mass shootings. These
findings promote trauma-informed public health interventions tailored to
both individual and community-level needs in the aftermath of gun violence.
... In the United States about 10.5% of women have reported experiencing an episode of major depression (Centers for Disease Control and Prevention [CDC], 2022) and 23.4% of females in the country present with an anxiety disorder in their lifespan, which is double than the rate for males (Kessler et al., 2004). However, these rates are considerably elevated for mothers, with approximately 43% mothers of children between the ages of 18 months and 4 years old presenting with clinical depression while 32% present with symptoms of anxiety (Kessler et al., 2004). ...
... In the United States about 10.5% of women have reported experiencing an episode of major depression (Centers for Disease Control and Prevention [CDC], 2022) and 23.4% of females in the country present with an anxiety disorder in their lifespan, which is double than the rate for males (Kessler et al., 2004). However, these rates are considerably elevated for mothers, with approximately 43% mothers of children between the ages of 18 months and 4 years old presenting with clinical depression while 32% present with symptoms of anxiety (Kessler et al., 2004). ...
There is extensive evidence on the negative effects of maternal depression and parenting stress on child development. Specifically, there is a robust body of literature suggesting that depression and stress decrease maternal responsiveness which affects the mother-child interactions and relationship. This disruption in the dyad may hinder appropriate child self-regulation development which has been extensively linked to important outcomes (e.g., school readiness, academic achievement, social-emotional competence). However, most of this research work has focused on White European families which considerably differ from the rapidly growing Latino population in the United States. The present cross-sectional study sought to examine the associations among maternal distress (maternal depression and parenting stress), parenting behaviors, and child self-regulation while considering racial stress (stress of immigration and perceived racism) in a community sample of 150 Latina mother-child dyads across the country. This study also explored the moderating effects of cultural factors such as acculturation, ethnic identity, and social support on these associations. Latina mothers of preschool aged children participated remotely by completing a demographic questionnaire via phone call and filling out several self-report, standardized surveys assessing aspects of maternal distress, parenting, and child behavior. Several regression analyses were conducted. Findings from this study indicate that in a low-risk sample of Latina mother-child dyads higher levels of maternal distress were negatively associated with child self-regulation even when controlling for child sex. Results also showed that this relation may be partially mediated by negative parenting. Although in this sample racial stress was not significantly correlated with child self-regulation, it was positively correlated with maternal distress suggesting that culture specific stressors significantly contribute to reductions in maternal psychological well-being
... Symptom profiles are extremely heterogeneous and are often characterized as falling along different symptom dimensions, including contamination/washing, intrusive thoughts/checking and symmetry/ordering (Bloch et al., 2008;Mataix-Cols et al., 2005). The lifetime prevalence of OCD was estimated to be 1.3% worldwide (Fawcett et al., 2020) and 2.3% among adults in the United States (Kessler et al., 2004). OCD causes significant distress and debilitation to one's life, where over half of OCD patients report serious functional impairment (Kessler et al., 2004;Mancebo et al., 2008) and reduced life satisfaction ( Jacoby et al., 2014;Norberg et al., 2008). ...
... The lifetime prevalence of OCD was estimated to be 1.3% worldwide (Fawcett et al., 2020) and 2.3% among adults in the United States (Kessler et al., 2004). OCD causes significant distress and debilitation to one's life, where over half of OCD patients report serious functional impairment (Kessler et al., 2004;Mancebo et al., 2008) and reduced life satisfaction ( Jacoby et al., 2014;Norberg et al., 2008). OCD is notable in that even those with subclinical symptoms experience substantial interference in social, occupational and other important areas of daily functioning (Adam et al., 2012;Angst et al., 2004). ...
Objectives
Obsessive–compulsive disorder (OCD) is a debilitating mental disorder characterized by persistent and intrusive thoughts accompanied by repetitive mental or physical acts. While both intolerance of uncertainty and emotion‐related impulsivity have been consistently evidenced as cognitive risk factors of OCD, no studies have considered their joint effects. The current study examined the interaction between intolerance of uncertainty and two forms of emotion‐related impulsivity—including both a behavioural and cognitive form—in predicting OCD symptoms.
Design
Cross‐sectional data were collected online from community‐based adult participants.
Methods
Participants (N = 673) completed a battery of self‐report measures of OCD symptom severity, intolerance of uncertainty, and emotion‐related impulsivity.
Results
The behavioural form of emotion‐related impulsivity positively moderated the relationship between intolerance of uncertainty and OCD symptoms. Elevated levels of both factors predicted the most severe symptoms, particularly checking, washing, and obsessing. This interaction effect was not found for the cognitive form of emotion‐related impulsivity, which still emerged as a unique predictor of OCD symptom severity, specifically obsessing symptoms.
Conclusions
Current findings furthered the understanding of the link between intolerance of uncertainty and OCD symptoms by highlighting the role of emotion‐related impulsivity. When uncertainty triggers distress in individuals with high intolerance of uncertainty, the urge to behaviourally alleviate this distress could promote the use of maladaptive obsessions and compulsions, leading to greater OCD symptoms. Results also indicated the potentially differential effects from the behavioural versus cognitive forms of emotion‐related impulsivity on different symptom domains, and the mechanistic link here is worthy of further investigation.
... QC was defined as planned efforts to monitor, verify, and analyze the quality of data as it is being collected, thus enabling continuous quality improvement during data collection [2]. The World Mental Health (WMH) surveys implement a high standard of quality control [1, [3][4][5][6] to reduce errors and unacceptable practices including falsification in the data collection. In several countries where the WMH survey was conducted, such as the United States, China, Germany, Lebanon, New Zealand, and Spain, data falsifications were reported [1,4]. ...
... The World Mental Health (WMH) surveys implement a high standard of quality control [1, [3][4][5][6] to reduce errors and unacceptable practices including falsification in the data collection. In several countries where the WMH survey was conducted, such as the United States, China, Germany, Lebanon, New Zealand, and Spain, data falsifications were reported [1,4]. Falsifications included making up all or part of an interview, miscoding the answer, reporting the wrong case disposition, and interviewing a non-sampled individual [7]. ...
BACKGROUND
All World Mental Health (WMH) Surveys apply high standards of data quality. To date, most of the published quality control (QC) procedures for these surveys were in relation to face-to-face interviews. However, owing to the social restrictions that emerged from the COVID-19 pandemic, telephone interviews are the most effective alternative for conducting complex probability-based large-scale surveys.
OBJECTIVE
In this paper, we present the QC system implemented in the WMH Qatar Survey, the first WMH Survey conducted during the COVID-19 pandemic in the Middle East. The objective of the QC process was to acquire high data quality through the reduction of random errors and bias in data collection.
METHODS
The QC design and procedures in this study were adapted to the telephone survey mode in response to the COVID-19 pandemic. We focus on the design of the QC indicator system and its implementation, including the investigation process, monitoring interviewers’ performance during survey fielding and applying quality-informed interventions.
RESULTS
The study team investigated 11,035 flags triggered during the 2 waves of the survey data collection. The most triggered flags were related to short question administration duration and multiple visits to the same survey questions or responses. Live monitoring of the interviews helped in understanding why certain duration-related flags were triggered and the interviewing patterns of the interviewers. Corrective and preventive actions were taken against interviewers’ behaviors based on the investigation of triggered flags per interviewer and live call monitoring of interviews. Although, in most cases, the interviewers required refresher training sessions and feedback to improve their performance, several interviewers discontinued work because of low productivity and a high number of triggered flags.
CONCLUSIONS
The specific QC procedures implemented in the course of the WMH Qatar Survey were essential for successfully meeting the target number of interviews (N=5000). The QC strategies and the new indicators customized for telephone interviews contributed to the flag investigation and verification process. The QC data presented in this study shed light on the rigorous methods and quality monitoring processes in the course of conducting a large-scale national survey on sensitive topics during the COVID-19 pandemic.
... The school sample (N = 9,244) was randomly selected adolescents within a representative sample of middle, junior high, and high schools. The smaller household sample (N = 904) was adolescents residing in the households chosen in the National Comorbidity Survey Replication (Kessler et al., 2004), a similar prior study with adults. In the NCS-A, there were 25 youths (0.2%) identified as nonstudent participants in the household component of the study. ...
... Disorders within these blocks were then searched for individual symptom criteria related to sleep and irritability, which produced a table of candidate diagnostic categories for inclusion, as well as candidate irritability and sleep criteria within each one. From there, NCS-A itemlevel data used to screen or assess these symptoms were examined, and Ashley R. Karlovich and Spencer C. Evans collectively located items with 1:1 correspondence, following the DSM-5 and the NCS-A codebook (Kessler, 2001(Kessler, -2004. Analyses drew from all available data in the NCS-A adolescent household and school data set. ...
The Diagnostic and Statistical Manual of Mental Disorders (DSM) descriptive criterial approach to diagnosis has been criticized for contributing to comorbidity, heterogeneity within conditions, and nonspecificity across conditions. Much research has examined comorbidity and heterogeneity, but less is known about nonspecificity. Here, we examined two nonspecific symptoms: irritability and sleep disturbance. Both are common, clinically significant, and appear in several DSM disorder criteria sets, but their transdiagnostic prevalence is unknown. Leveraging a nationally representative epidemiological study of adolescents (n = 10,148; ages = 13–18), we first identified all instances where irritability or sleep disturbance appears in DSM-5-TR criteria for bipolar, depressive, anxiety, traumatic stress, or disruptive/impulse-control disorders; then found their DSM-IV equivalents in study variables; and finally estimated their prevalence individually and cumulatively across categories. Weighted lifetime prevalence estimates were 79.5% (95% CI [77.8, 81.2]) for irritability and 60.8% [58.7, 62.9] for sleep disturbance. Associations with age and gender were significant but small. Most youth reported multiple symptoms of irritability (weighted M = 3.04, Mdn = 2) and at least one symptom of sleep disturbance (weighted M = 1.61, Mdn = 1). Both problems were extremely common among individuals with specific disorders but were underestimated by the criteria for those conditions. Results suggest that the high prevalence of DSM-defined irritability and sleep problems may be obfuscated by these symptoms being scattered across diagnostic entities. There is a need for more research on assessing, treating, and understanding problems related to irritability and sleep in their own right, cutting across, rather than confined to, particular diagnoses.
... Mood disorders are a group of mental disorders marked by emotional disruptions such as severe lows (depression), extreme highs (mania), or both [1], and include major depressive disorder (MDD) and bipolar disorder. Estimates from the National Comorbidity Survey Replication (NCS-R) suggest that mood disorders are highly prevalent, with an estimated 9.7% of the US adult population diagnosed and an additional 21.4% experiencing mood disorders at some time in their lives [2]. Anxiety disorders, on the other hand, are a group of mental disorders characterized by unfocused worry, pathological anxiety, and behavioral disturbances [3], and include generalized anxiety disorder, post-traumatic stress disorder (PTSD), and phobias [4]. ...
... Anxiety disorders, on the other hand, are a group of mental disorders characterized by unfocused worry, pathological anxiety, and behavioral disturbances [3], and include generalized anxiety disorder, post-traumatic stress disorder (PTSD), and phobias [4]. Estimates suggest that 19.1% of adults in the US have been diagnosed with some form of anxiety disorder, with about 31% suffering from anxiety at some point in their life [2]. With the high prevalence of mood and anxiety disorders, it is no surprise that associated financial burdens are also high, with an annual estimated cost of $44 billion for mood disorders [5] and $42 billion for anxiety disorders [6]. ...
Mood and anxiety disorders are heterogeneous psychiatric diagnoses affecting millions. While the disease etiology is complex, various risk factors have been identified, such as stress. Stress is a neuroendocrine physiologic response to a stressor that promotes organism survival through adaptive processes and behavior. The central stress response, which drives behavioral and physiological change, is primarily mediated by activating the hypothalamic–pituitary–adrenal (HPA) axis. In addition to its effects on the HPA axis, stress activates the locus coeruleus (LC), a bilateral brainstem nucleus that projects broadly throughout the central nervous system and releases the catecholamine transmitter norepinephrine (NE). The combined activities of the LC–NE system and HPA axis work synergistically to produce timely adaptive physiological and behavioral responses to stress. While advantageous in the short term, chronic stress exposure can lead to HPA axis and LC dysregulation, which are thought to contribute to the etiology of several neuropsychiatric disease states. Notably, recent studies have also implicated neuroinflammation mediated by microglia as a risk factor in mood and anxiety disorders. Despite their combined association with mood and anxiety disorders, the potential links between stress and inflammation, and possible interactions between their respective signaling cascades, have not been well-explored. This brief review aims to summarize how LC is uniquely positioned to respond to both pro-stress and pro-inflammatory cues, and how their convergence in this site may contribute to the development of mood and anxiety disorders.
... Anxiety disorders are a major public health concern affecting an estimated 374 million people worldwide in 2020, making them the most common class of mental health disorder [1,2]. In the United States it has been estimated that 31.1% of adults are expected to experience any anxiety disorder in their lifetime [3,4]. Risk for anxiety disorders is influenced by complex genetic and environmental factors; a 2015 metaanalysis of over 2,500 twin studies estimated overall anxiety disorder heritability at about 49% [5], while more recent heritability estimates from GWAS are around 26% [6], though estimates differ by individual anxiety disorder. ...
Anxiety disorders are the most common class of psychiatric disorder. Risk for anxiety disorders is thought to be influenced by many genes, each contributing a small effect. The light-dark box behavioral assay was designed to measure anxiety-like behavior in rodents. Diversity Outbred (DO) mice were designed for high-resolution quantitative trait loci (QTL) mapping on a genetically-diverse background. Here, we studied a population of 518 male DO mice for anxiety-like and locomotor behaviors from a light-dark box assay. Multivariate analysis of behavioral data identified two major subgroups of animals differing in basal anxiety behavior and subsequent ethanol consumption patterns. Behavioral QTL analysis identified a significant locus on Chromosome 14 associated with 3 anxiety-like behavioral phenotypes. Haplotype analysis revealed an effect of C57BL/6J alleles at this locus, with mice carrying those alleles exhibiting more anxiety-like behavior. An additional 9 suggestive loci were identified. Genes located within the confidence intervals for the Chromosome 14 locus were analyzed for coding sequence polymorphisms, prefrontal cortex expression QTLs, human GWAS data, and additional data sets related to psychiatric conditions including substance use. Results prioritized two candidate genes, Tbc1d4 and Lmo7, for further study. These results represent the highest-resolution genetic mapping of light-dark box behaviors in mice to date, revealing insights into the complex biology of anxiety disorders. Additionally the studies identify striking subgroups of animals where basal anxiety-like behavior predicts eventual ethanol consumption phenotypes.
... Anxiety disorders are common and affect an estimated 31.1% of U.S. adults at some point in their lives (1). Despite the high prevalence of anxiety, acute exacerbations of anxiety are not a typical primary diagnosis in psychiatric hospitals. ...
... In general, women have a greater risk for stress-related disorders. Women are twice as likely to have depression, GAD, and post-traumatic stress disorder (PTSD) when compared to men, with this difference emerging after adolescence (Kessler et al., 2004;Morken et al., 2023). Sex differences in adolescent stress effects on affective behaviors could explain the sex differences in anxiety-like behavioral outcomes seen in our model. ...
Adverse childhood experiences have been associated with many neurodevelopmental and affective disorders including attention deficit hyperactivity disorder and generalized anxiety disorder, with more exposures increasing negative risk. Sex and genetic background are biological variables involved in adverse psychiatric outcomes due to early life trauma. Females in general have an increased prevalence of stress-related psychopathologies beginning after adolescence, indicative of adolescence being a female-specific sensitive period. To understand the underlying neuronal mechanisms potentially responsible for this relationship between genetic background, sex, stress/trauma, and cognitive/affective behaviors, we assessed behavioral and neuronal changes in a novel animal model of early life stress exposure. Male and female BALB/cJ mice that express elevated basal anxiety-like behaviors and differences in monoamine signaling-associated genes, were exposed to an early life variable stress protocol that combined deprivation in early life with unpredictability in adolescence. Stress exposure produced hyperlocomotion and attention deficits (5-choice serial reaction time task) in male and female mice along with female-specific increased anxiety-like behavior. These behavioral changes were paralleled by reduced excitability of locus coeruleus (LC) neurons, due to resting membrane potential hyperpolarization in males and a female-specific increase in action potential delay time. These data describe a novel interaction between sex, genetic background, and early life stress that results in behavioral changes in clinically relevant domains and potential underlying mechanistic lasting changes in physiological properties of neurons in the LC.
... Screeners assessed lifetime AUD severity using a measure developed for the National Comorbidity Survey Replication (NCS-R, Kessler et al., 2004). This measure is based on the World Mental Health Survey Initiative Version of the World Health Organization Composite International Diagnostic Interview (World Health Organization, 1993); including an item on craving and dropping an item on legal problems establishes consistency with the DSM-5 (American Psychiatric Association, 2013). ...
Background
Although studies are increasingly adopting online protocols, few such studies in the addiction field have comprehensively described their data review procedures and successes in detecting low‐quality/fraudulent data. The current study describes data collection protocols and outcomes of a large, longitudinal study (the PAL Study 2021) that implemented online design elements to study individuals seeking peer support for an alcohol use disorder.
Methods
In 2021, the PAL Study collaborated with mutual‐help group (MHG) partners and recovery‐related organizations to recruit individuals attending a 12‐step group, Women for Sobriety (WFS), LifeRing Secular Recovery, and/or SMART Recovery for an alcohol problem in‐person and/or online in the prior 30 days. Participation was solicited both online and in‐person. Individuals accessed baseline surveys via an open web link; follow‐ups occurred at 6 and 12 months. Analyses included calculating the proportion of surveys eliminated in data quality review; comparing MHG subsamples to internal survey (benchmark) data for Alcoholics Anonymous (AA), WFS, LifeRing, and SMART; and examining response rates and attrition.
Results
Although 93% of respondents who opened the baseline survey completed it, 87% of baseline surveys were eliminated in data quality review (final N = 531). Nonetheless, cleaned MHG subsamples were generally similar to benchmark samples on gender, age, race/ethnicity, and education. Follow‐up rates for the cleaned sample were 88% (6 months) and 85% (12 months). Analyses revealed some differences in attrition by gender, primary MHG, and lifetime drug problems, but there was no evidence of greater attrition among those in earlier/less stable recovery.
Conclusions
Study methods appear to have produced a valid, largely representative sample of the hard‐to‐reach target population that was successfully followed across 12 months. However, given the high survey elimination rate and need for extensive data review, we recommend that researchers avoid open‐link designs and include comprehensive data review when incorporating online design elements.
... 5 Mental health problems are common in the United States. Studies have found that slightly less than one half of respondents (46%) had a lifetime history of a mental health condition 6,7 and in any given year, one fourth of the population may have a mental health disorder. 8 These estimates exclude people living in institutions and the homeless, so the prevalence of mental health disorders in the United States is likely higher. ...
Background
The lifetime risk of mental health disorders is almost 50% and, in any year, about 25% of the population have a psychiatric disorder. Many of those people are cared for in primary care settings.
Research Objective
Measure access to mental health services, such as getting counselling or prescription mental health medications, using new patient survey questions that can be added to Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys.
Study Design
Surveys were conducted with a stratified probability sample of patients receiving primary care services in a single state in 2018–2019. Medicaid and privately insured patients were surveyed by mail or telephone, respectively.
Results
Approximately 14% of sampled patients responded to a survey. More than 10% of privately insured respondents and about 20% of Medicaid respondents got or tried to get appointments for mental health care. About 15% of privately insured respondents and 11% of Medicaid respondents reported problems getting appointments with counselors. Only 8%–9% of respondents seeking mental health medicines reported problems getting appointments for prescriptions. A composite measure combining access to counselors and prescribers of mental health medicines evidenced adequate internal consistency reliability. Group level reliability estimates were low.
Conclusions
Many respondents got or tried to get mental health services and a substantial number reported problems getting appointments or getting mental health prescriptions. The tested questions can be combined into an Access to Mental Health Care measure, which can be included in patient experience surveys for ambulatory care to monitor access to behavioral health care.
... Perceived Need. Perceived need for mental health services was measured with the following item from the National Comorbidity Survey Replication (Kessler et al., 2004): "Was there ever a time during the past 12 months when you felt that you might need to see a professional because of the problems with your emotions or nerves?" Responses were coded as 0 (no) or 1 (yes; α = not appropriate). ...
Mental illness is common, consequential, and increasing in prevalence. Despite this, most individuals do not seek professional help for mental health concerns. Research has begun to investigate the impact of personality on help seeking, but it has suffered from many limitations. As such, the purpose of this study was to establish the effects of the Big Five personality traits on public and self-stigma of seeking help, help-seeking attitudes, and help seeking intentions. We employed hierarchical regression models in a large cross-sectional sample (N = 5,712) to evaluate personality traits in the context of other established predictors of help seeking. Agreeableness had consistent protective effects across all models, and extraversion was especially protective regarding help-seeking intentions. In contrast to these beneficial effects, openness, conscientiousness, and neuroticism had complex relationships with help-seeking constructs. Our findings have implications for understanding the influence of the Big Five on which individuals may be unlikely to seek mental health services when needed. Through this understanding, we can begin to develop targeted strategies directed toward individuals at risk to not seek help for mental health concerns and increase help-seeking behavior.
... Social Stress was measured using items from the National Comorbidity Survey Replication (Kessler et al., 2004). The Social Stress subscale included four items, such as "Not including your partner, how often do your relatives make too many demands on you?". ...
Study of fathers has gained significant traction over recent decades. However, the experience for men over the transition to parenthood remains focused on high‐socioeconomic and socially advantaged fathers. Researchers have yet to thoroughly investigate how fathers may uniquely experience this transition period with a history of childhood maltreatment, given that childhood abuse is known to impact several components of development and relationship functioning into adulthood. The current study endeavored to fill this gap by evaluating the associations between fathers' childhood experiences of physical and emotional abuse and their relationship functioning over the transition to parenthood in terms of both the couple relationship and social adjustment in relationships with others. Using data from 399 fathers who participated in a randomized control trial during pregnancy, the results from stepwise regressions indicate fathers with a history of emotional abuse experience particular declines in their external relationships (reductions in social support and increases in social stress) from prenatal (Wave 1) to postpartum (Wave 2) reports. However, no significant association emerged between fathers' history of maltreatment and their relationship functioning with their partners. These results underscore the importance of investigating the impact of different types of abuse on men in fatherhood. Moreover, we emphasize the need to study further fathers' social adjustment over the transition to parenthood beyond the couple relationship and broad social support to address the needs of men with a history of maltreatment in their new role as fathers.
... However, SUDs vary widely in their occurrence and severity; most humans can use addictive substances such as alcohol or cocaine frequently without developing problematic use, while others develop substance use disorders. Specific proportions vary between substances and individual studies, but only 5-30 % of regular drug users eventually fulfill the diagnostic criteria for addiction [6][7][8][9]. Similar variability can be observed in laboratory rodents [10][11][12][13]. ...
... Age-associated psychological changes are marked remarkably by a decline in cognitive performance and mental health. Anxiety disorders, stress, depression, and dementia are seniors' most prevalent psychological illnesses that lead to lower quality of life [2]. Empirically, studies have profoundly proved the benefits of the natural environment's restorative effects on mental health-related outcomes, and well-being. ...
There was no significant difference between subject factors either in SCC or SAA. Within-subject factors showed an inverse result where SCC significantly declined from baseline to endline (p<0.001), while SAA increased (p<0-001). The quality of life, mainly in mental health components, rose considerably after a month of intervention.
... Therefore, the current analyses are limited to the Part II respondents who provided complete, valid responses for all measures included in one or more models (n = 5481). Composite probability weights accounting for Part I response and sampling characteristics (e.g., variation in geography, households, various strata) and Part II response rates was provided by the study authors (a comprehensive explanation of the weighting process can be found in Kessler, Berglund et al., 2004). All my analyses utilize these weights. ...
Access to firearms among individuals with mental health problems has been a source of protracted debate among policymakers, the media, and the public, writ large. At the center of this controversy are questions about the nature and consequences of gun access in the context of mental illness. The lack of substantial empirical evidence, due in part to limited access to quality data, plays a significant role in perpetuating ongoing debate. To address this problem, this study uses data from the National Comorbidity Survey Replication to evaluate the relative importance of several clinical, cultural, and criminological factors in explaining gun access and carrying among adults with and without mental illnesses. Multivariate analyses reveal that, whereas past year disorder (of any type or severity) and other clinical characteristics were unrelated to firearm access, several cultural factors such as childhood rurality (e.g., OR rural vs. urban : 3.59; 95% CI: 2.52, 5.12) and the criminological experience of early intimate partner violence (e.g., OR victim only vs. noexp : 1.84; 95% CI: 1.50, 2.26) were. None were predictive of carrying. Further, none of the relationships observed were conditioned on any of the clinical characteristics. These results indicate that people with mental illnesses likely own and carry guns for the same reasons and in the same contexts as others. Additional updated and quality data is needed to further explore these issues; however, these finding suggest that suicide and violence prevention efforts targeting people with mental illnesses need to be sensitive to the cultural and personal significance of guns.
... Adverse posttraumatic neuropsychiatric sequelae (APNS) such as posttraumatic stress disorder (PTSD), depression, and somatic symptoms are common after traumatic stress exposure [1][2][3][4][5][6]. Contemporary limitations in understanding the pathogenesis of APNS are a barrier to developing effective primary and secondary preventive interventions [1,7]. ...
Patients exposed to trauma often experience high rates of adverse post-traumatic neuropsychiatric sequelae (APNS). The biological mechanisms promoting APNS are currently unknown, but the microbiota-gut-brain axis offers an avenue to understanding mechanisms as well as possibilities for intervention. Microbiome composition after trauma exposure has been poorly examined regarding neuropsychiatric outcomes. We aimed to determine whether the gut microbiomes of trauma-exposed emergency department patients who develop APNS have dysfunctional gut microbiome profiles and discover potential associated mechanisms. We performed metagenomic analysis on stool samples (n = 51) from a subset of adults enrolled in the Advancing Understanding of RecOvery afteR traumA (AURORA) study. Two-, eight- and twelve-week post-trauma outcomes for post-traumatic stress disorder (PTSD) (PTSD checklist for DSM-5), normalized depression scores (PROMIS Depression Short Form 8b) and somatic symptom counts were collected. Generalized linear models were created for each outcome using microbial abundances and relevant demographics. Mixed-effect random forest machine learning models were used to identify associations between APNS outcomes and microbial features and encoded metabolic pathways from stool metagenomics. Microbial species, including Flavonifractor plautii, Ruminococcus gnavus and, Bifidobacterium species, which are prevalent commensal gut microbes, were found to be important in predicting worse APNS outcomes from microbial abundance data. Notably, through APNS outcome modeling using microbial metabolic pathways, worse APNS outcomes were highly predicted by decreased L-arginine related pathway genes and increased citrulline and ornithine pathways. Common commensal microbial species are enriched in individuals who develop APNS. More notably, we identified a biological mechanism through which the gut microbiome reduces global arginine bioavailability, a metabolic change that has also been demonstrated in the plasma of patients with PTSD.
... Substance use disorders (SUDs) list among the most serious mental illnesses. Lifetime prevalence ranges from 8.0 to 17.5% for alcohol-associated disorders and 1.8 to 3.0% for disorders associated with the use of illicit substances mainly in industrialised countries (Kessler et al. 2004(Kessler et al. , 2007Hasin et al. 2007;Merikangas and McClair 2012;Geschwind and Flint 2015). Purposes of consumption include social drinking, satisfaction of curiosity, recreational use, and maladaptive strategies of emotion regulation (Parks and Kennedy 2004;Terry-McElrath et al. 2009). ...
Rationale: Substance use disorders (SUDs) rank among the most severely debilitating psychiatric conditions. Among others, decreased response inhibition capacities could make it more difficult for patients to abstain from drug use and maintain abstinence. However, meta-analyses on the neural basis of response inhibition in SUDs yielded conflicting results.
Objective: In this study, we revisited the neuroimaging research field and summarized the existing fMRI literature on overt response inhibition (Go/NoGo and stop-signal paradigms) across different SUDs.
Methods: We performed a systematic literature review and an activation likelihood estimation (ALE) meta-analysis to investigate the actual convergence of functional deviations observed in SUD samples. Results were further supplied by consecutive robustness measures and a post-hoc random-effects meta-analysis of behavioural data.
Results: We identified k=21 eligible studies for our analysis. The ALE analysis indicated a significant cluster of convergence with its statistical peak in the right anterior insula. Consecutive analyses, however, indicated this result was not robust and susceptible towards publication bias. Additionally, a post-hoc random effects meta-analysis of the behavioural parameters of Go/Nogo and stop-signal paradigms reported by the included studies revealed no significant differences in task performance comparing SUD samples and controls.
Conclusion: We discuss that the role of task-based response inhibition may require some refinement as an overarching marker for SUD pathology. Finally, we give a few prospects for future research that should be further explored in this context.
... One advantage of PTSD research is that most authors used the standardized, validated Posttraumatic Stress Disorder Checklist (PCL) [82] or Diagnostic and Statistical Manual of Mental Disorders (DSM), although PTSD criteria were revised in the latest DSM edition [83]. Twelve-month PTSD prevalence for adults 60 years of age and older in the general population is 1%, and it tends to decrease over time [84,85]. There is no clear estimate of late-life post-disaster PTSD rates, although a recent systematic review indicated an all-age prevalence of up to 52% of survivors [86]. ...
Climate change is a major public health emergency. Natural disasters (earthquakes, floods, hurricanes, tornadoes, tsunamis, landslides, wildfires, and volcanic eruptions) have been increasing in frequency and severity and can cause lasting psychological sequelae. Older adults are highly vulnerable to the physical and mental health impacts of extreme weather and natural disasters. A narrative review was conducted to identify and summarize English-language articles focusing on the impact of climate change on older adults’ mental health. Sixty sources were identified. This review summarizes age-specific risk factors, clinical presentations (including anxiety, depressive, posttraumatic stress symptoms, and sleep disturbances), and management of psychiatric symptoms linked to climate change in the geriatric population. Older adults are highly vulnerable and can experience multiple mental health symptoms as a result of climate change. Clinicians should be aware and educated regarding the mental health impacts of climate change on older adults, so they can best support their patients.
... For instance, patients diagnosed with schizophrenia have higher rates of alcohol, nicotine, and illicit drug use compared to the general population [6,7]. It is estimated that 68% of psychiatric patients suffer from comorbid medical conditions, and 28% of those with a medical disorder have a comorbid mental health condition [8,9]. For example, in a study analyzing death records of 608 seriously mentally ill patients in Ohio public mental health hospitals, it was discovered that almost a quarter of the deceased (24%) had obesity (BMI>30), 22% suffered from hypertension, 12% had diabetes, 10% had COPD and related conditions, and 5% had asthma [10]. ...
SARS-CoV-2 (COVID-19) infection can be associated with significant medical complications. This risk could be even higher in psychiatric patients due to an increased risk of medical co-morbidity. In addition, psychiatric patients are also vulnerable to acquiring SARS-CoV2 infection due to homelessness, living in crowded areas, and poor adherence to recommended preventive measures. This retrospective study aims to compare two groups of patients, namely COVID-19 positive inpatient psychiatric patients with and without preexisting medical comorbidity on specific clinical and socio-demographic features and more importantly how many patients in the two groups subsequently developed medical complications. All COVID-19 positive psychiatric patients who were admitted to acute psychiatric inpatient units over a one-year period during the peri-pandemic phase were included for this study. Data was collected from the electronic medical records of 174 patients admitted to the inpatient psychiatric facility between January and December 2020.
Among the COVID-19 positive patients, twenty individuals out of eighty-nine in the WC (with pre-existing medical comorbidity) group and two individuals out of eighty-five in the WOC (without pre-existing medical comorbidity) group developed COVID-related pneumonia. Ten WC patients and two WOC patients required supplemental oxygen, while only one patient in the WC group developed critical illness and required ventilatory support. The WC group had longer stay in both psychiatric and medical units compared to the WOC group. Consistent with existing literature that patients with comorbid medical condition are higher risk of COVID-19 complications, this study replicates the finding that in psychiatric inpatients pre-existing comorbid medical conditions create a higher risk of experiencing COVID-19 related medical complications. More interestingly, however that increased risk of developing new medical complications was not significantly different from the published rates observed in the general population which is surprising given how vulnerable psychiatric patients are, both medical, psychiatrically and psychosocially. In fact, in some ways and for reasons as yet unclear, the medical complication rate was slightly better in the WC compared to published data in the general population groups.
... [42,43] The baseline expected prevalence of PTSD was presumed to be 5.2% in mothers and 1.8% in fathers based on the National Comorbidity Survey. [44] Because there is very limited data on how long depression, anxiety and PTSD persist in parents of MPS III children, the presumed length of disease was approximated to 25 years after onset of symptoms, regardless of MPS III subtype. ...
Introduction:
Sanfilippo syndrome is a rare disease and fatal genetic disorder in the United States with no FDA-approved treatment, and no comprehensive assessment of economic disease burden is available.
Objective
To develop a model to estimate the economic burden associated with Sanfilippo syndrome in the United States (US) using valued intangibles (disability-adjusted life years lost) and indirect burden (lost caregiver productivity) from 2023 onward.
Design and Setting:
A multistage comorbidity model was generated using publicly available literature on Sanfilippo syndrome disability, and 14 disability weights from the 2010 Global Burden of Disease Study. Attributable increase in caregiver mental health burden and caregiver productivity loss were also estimated using data from the CDC National Comorbidity Survey, retrospective studies on caregiver burden in Sanfilippo syndrome, and the Bureau of Labor Statistics. Monetary valuations were adjusted to USD 2023 and given a 3% discount rate from 2023 onward.
Main Outcomes and Measures:
Year-over-year incidence and prevalence of Sanfilippo syndrome was calculated for each age group in each year, and year-over-year disability-adjust life years (DALYs) lost due to patient disability was calculated by comparing to health-adjusted life expectancy (HALE), considering years of life lost (YLLs) due to premature mortality and years lived with disability (YLDs). Intangibles were valued in USD 2023, adjusted for inflation and discounted to provide economic burden of disease.
Results
From 2023–2043, overall economic burden in the US attributable to Sanfilippo syndrome was estimated to be 5.86 million present value from time of birth per child born with Sanfilippo syndrome. These figures are also a conservative estimate, since they do not consider direct cost associated with the disease, as extensive primary data on the direct healthcare cost of Sanfilippo syndrome does not currently exist in the literature.
Conclusions and Relevance:
Sanfilippo syndrome is a rare lysosomal storage disease, however the severe burden associated with the disease for individual families demonstrates a profound cumulative impact. Our model represents the first disease burden estimate associated with Sanfilippo syndrome. This underscores the substantial morbidity and mortality burden of Sanfilippo syndrome.
... The CIDI 15 is a fully structured diagnostic tool that diagnoses psychiatric disorders based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) 16 criteria. This tool is also utilized in various WHO-WMH surveys such as the National Survey of Mental Health and Wellbeing 17 from Australia, the US National Comorbidity Survey Replication (NCS-R), 18 and the World Mental Health Japan Survey, 19 allowing for national comparison studies. Moreover, numerous studies [20][21][22][23] have been conducted based on these data. ...
Objective:
Mental health is a global concern and needs to be studied more closely. We aimed to estimate the prevalence of mental disorders and their associated factors among the general population in Korea.
Methods:
The National Mental Health Survey of Korea 2021 was conducted between June 19 and August 31, 2021 and included 13,530 households; 5,511 participants completed the interview (response rate: 40.7%). The lifetime and 12-month diagnosis rates of mental disorders were made using the Korean version of the Composite International Diagnostic Interview 2.1. Factors associated with alcohol use disorder (AUD), nicotine use disorder, depressive disorder, and anxiety disorder were analyzed, and mental health service utilization rates were estimated.
Results:
The lifetime prevalence of mental disorders was 27.8%. The 12-month prevalence rates of alcohol use, nicotine use, depressive, and anxiety disorders were 2.6%, 2.7%, 1.7%, and 3.1%, respectively. The risk factors associated with 12-month diagnosis rates were as follows: AUD: sex and age; nicotine use disorder: sex; depressive disorder: marital status and job status; anxiety disorder: sex, marital status, and job status. The 12-month treatment and service utilization rates for 12-month AUD, nicotine use disorder, depressive disorder, and anxiety disorder were 2.6%, 1.1%, 28.2%, and 9.1%, respectively.
Conclusion:
Approximately 25% of adults in the general population were diagnosed with mental disorders during their lifetime. The treatment rates were substantially low. Future studies on this topic and efforts to increase the mental health treatment rate at a national level are needed.
... Traumatology research has documented widescale traumatic stressor events, including the COVID-19 pandemic, as triggering increased worry, fear, psychological distress, and symptoms of psychopathology (Galatzer Levy et al., 2018;Taylor & Asmundson, 2020). Therefore, some individuals will be at an increased risk for meeting clinical criteria for mental health disorders (Kessler et al., 2004;Uwadiale et al., 2021). Anxiety disorders are the most frequently diagnosed mental health disorders in the U.S., and research has demonstrated a sharp increase in Generalized Anxiety Disorder (GAD) among the U.S. adult population at the onset of the pandemic . ...
Objective: This study examined provisional prevalence rates of generalized anxiety disorder (GAD) along with psychosocial correlates among U.S. college students during the first year of the pandemic.
Participants: There were 1,793 undergraduate college student participants recruited from a public university.
Methods:Using the Patient Health Questionnaire for GAD (GAD-7), a provisional diagnosis of GAD was determined and participants with GAD (N = 347;19.4%) and without GAD (N = 1446; 80.6%) were compared on stress, coping, loneliness, individual strength, pandemic concerns, and substance use behaviors.
Results:Students with GAD symptomology reported significantly higher rates of perceived stress, greater loneliness, more fatigue, and more pandemic-related concerns. Further, those with GAD had a significant increase in substance use behaviors.
Conclusions: It is important for college mental health providers to be aware of GAD symptomology among college students, and to further recognize the importance of early screening and detection, especially during traumatic stressor events.
Aim
Most psychiatric and neurodevelopmental disorders are heterogeneous. Neural abnormalities in patients might differ in magnitude and kind, giving rise to distinct subtypes that can be partly overlapping (comorbidity). Identifying disorder‐related individual differences is challenging due to the overwhelming presence of disorder‐unrelated variation shared with healthy controls. Recently, Contrastive Variational Autoencoders (CVAEs) have been shown to separate disorder‐related individual variation from disorder‐unrelated variation. However, it is not known if CVAEs can also satisfy the other key desiderata for psychiatric research: capturing disease subtypes and disentangling comorbidity. In this paper, we compare CVAEs to other methods as a function of hyperparameters, such as model size and training data availability. We also introduce a new architecture for modeling comorbid disorders and test a novel training procedure for CVAEs that improves their reproducibility.
Methods
We use synthetic neuroanatomical MRI data with known ground truth for shared and disorder‐specific effects and study the performance of the CVAE and non‐contrastive baseline models at detecting disorder‐subtypes and disentangling comorbidity in brain images varying along shared and disorder‐specific dimensions.
Results
CVAE models consistently outperformed non‐contrastive alternatives as measured by correlation with disorder‐specific ground truth effects and accuracy of subtype discovery. The CVAE also successfully disentangled neuroanatomical loci of comorbid disorders, due to its novel architecture. Improved training procedure reduced variability in the results by up to 5.5×.
Conclusion
The results showcase how the CVAE can be used as an overall framework in precision psychiatry studies, enabling reliable detection of interpretable neuromarkers, discovering disorder subtypes and disentangling comorbidity.
There is consistent, strong evidence that both physical activity and exercise lowers risk of many diseases, yet the way physical activity and exercise are measured varies substantially. Physical activity epidemiologists use observational designs (such as cohort or case-control studies) to examine the relationship of physical activity exposures and outcomes including mortality, or disease-specific such as incident type 2 diabetes mellitus, cancer, cardiovascular disease, anxiety, or depression. These same observational designs can be used to examine the associations of prevalent disease in reducing symptom burden in those who are physically active compared to those who are not, specifically examining anxiety and depression. There is great statistical power and often large sample sizes in physical activity epidemiologic studies with valid and reliable assessment tools but known limitations such as measurement error or social desirability bias. Overall, physical activity epidemiology can be a useful tool to understand the influence of exercise and physical activity on risk of disease. In this chapter, we will explore the strength, consistency, and sources of evidence primarily using a physical activity epidemiology lens.
Objective
The Mental and Substance Use Disorders Prevalence Study (MDPS) builds upon previous epidemiologic studies to provide estimates of prevalence and treatment rates of mental and substance use disorders among adults aged 18–65 in the U.S. The study background and methods are described.
Method
The MDPS employed novel techniques such as the inclusion of household, prison, homeless and state psychiatric hospital populations, a semi‐structured clinical interview administered by trained clinical interviewers to assess disorders, the assessment of both past year and lifetime schizophrenia spectrum disorder (SSD) using full Diagnostic and Statistical Manual 5 criteria, as well as other mental and substance use disorders, and video‐based interviewing. Population specific and combined sample weights were developed to estimate nationally representative prevalence and treatment rates.
Results
Data collection was conducted between October 2020 and October 2022 resulting in 5679 clinical interviews. The statistical weighting and analytic plan are described. Weighted response rates and reasons for non‐response are provided for each study population.
Conclusions
The MDPS successfully developed and employed novel techniques to estimate the prevalence and treatment rates of mental and substance use disorders in both household and non‐household populations, including some of the most impairing disorders such as SSD.
Objective:
A growing evidence base supports stepped care interventions for the early treatment of posttraumatic stress disorder (PTSD) after physical injury. Few investigations have examined the characteristics of patients who do and do not respond to these interventions.
Method:
This investigation was a secondary analysis that used previously collected data from three randomized clinical trials of stepped care interventions (patient N = 498). The study hypothesized that a subgroup of patients would manifest persistent PTSD symptoms regardless of randomization to intervention or control conditions, and that characteristics present at the time of baseline injury hospitalization could distinguish patients who would develop persistent symptoms from potential treatment responders. Regression analyses identified baseline patient clinical and demographic characteristics that were associated with persistent PTSD symptoms over the 6-months post-injury. Additional analyses identified treatment attributes of intervention patients who were and were not likely to demonstrate persistent symptoms.
Results:
A substantial subgroup of patients (n = 222, 44.6%) demonstrated persistent PTSD symptoms over time. Greater numbers of pre-injury trauma, pre-injury PTSD symptoms, elevated early post-injury PTSD symptoms, unemployment, and non-White race identified patients with persistent symptoms. Patients with ≥3 of these baseline risk characteristics demonstrated diminished treatment responses when compared to patients with <3 characteristics. Intervention patients with ≥3 risk characteristics were less likely to engage in treatment and required greater amounts of interventionist time.
Conclusions:
Injured trauma survivors have readily identifiable characteristics at the time of hospitalization that can distinguish responders to PTSD stepped care interventions versus patients who may be treatment refractory.
Objective:
The Interpersonal Theory of Suicide posits that suicidal behavior results from thwarted belongingness, perceived burdensomeness, and capability for suicide. Considering that food insecurity (FI) may be linked to these constructs to differing extents based on severity of FI, this study examined cross-sectional associations between levels of FI and suicidal ideation, plans, and attempts in a nationally representative sample of adults in the United States.
Methods:
Data for this study were collected in 2001-2003 from 5,552 participants in the National Comorbidity Survey Replication (Mage=44.8 ± 0.5 years; 53.8% female). Prevalence ratios (PRs) and 95% confidence intervals (CIs) were generated using modified Poisson regression to examine past-year ideation, plans, and attempts with intent of lethality by past-year FI level (assessed with a modified version of the Short Form U.S. Household Food Security Scale).
Results:
After controlling for sociodemographic covariates, low food security was significantly associated with elevated prevalence of suicidal ideation, plans, and attempts (ideation: PR = 2.21, 95% CI 1.32-3.70; plans: PR = 5.42, 95% CI 2.71-10.83; attempts: PR = 5.35, 95% CI 2.38-12.03). Very low food security (i.e., more severe FI) exhibited stronger associations yet with suicidal ideation, plans, and attempts (ideation: PR = 6.99, 95% CI 4.10-11.92; plans: PR = 17.21, 95% CI 8.41-35.24; attempts: PR = 14.72, 95% CI 4.96-43.69).
Conclusions:
Findings indicative of a dose-response relationship between FI and suicidal ideation, plans, and attempts emphasize the need to increase reach of food assistance programs, increase availability of mental health services in food-insecure populations, and routinely screen for FI in mental health practice.
Presentazione del metodo d'indagine in psicanalisi dai punti di vista architetturale e logico.
Obiettivo della presentazione è fornire delle valutazioni di carattere epistemologico circa l’architettura e le ipotesi e regole logiche che sorreggono il metodo d’indagine freudiano. Per quanto riguarda l’architettura, si metterà in evidenza come il metodo si ispiri alla Teoria dei sistemi, in particolare alla messa in sequenza logico temporale di due Black Boxes dalle caratteristiche specifiche. Con riferimento all’aspetto logico, si mostrerà come il metodo faccia uso di ipotesi e regole sofisticate e rare che sorreggono l’intera architettura, quali la Negation as Failure e la Consequentia Mirabilis. Si concluderà mostrando come l’intero impianto metodologico sia di stampo falsificazionista e, specificatamente, trascendentale.
Background:
All World Mental Health (WMH) surveys apply high standards of data quality. Most published quality control procedures for these surveys to date were in relation to face-to-face interviews. However, due to the social restrictions that emerged from the COVID-19 pandemic, telephone interviews are the most effective alternative for conducting complex probability based large-scale surveys.
Objective:
In this paper, we present the quality control system implemented in the World Mental Health Qatar (WMHQ) survey - the first WMH survey conducted during the COVID-19 pandemic in the Middle East. The objective of the quality control process was to acquire high data quality through reduction in random errors and bias in data collection.
Methods:
The QC design and procedures in this study were adapted to telephone survey mode in response to the COVID-19 pandemic. We focus on the design of the quality control indicator system and its implementation including investigation process, monitoring interviewers' performance during survey fielding, and applying quality-informed interventions.
Results:
The study team investigated a total of 11,035 flags triggered during two waves of survey data collection. The most triggered flags were related to short question administration duration and multiple visits to the same survey questions or responses. Live monitoring of the interviews helped in understanding why certain duration-related flags were triggered and interviewing patterns of the interviewers. Corrective and preventive actions were taken against interviewers' behaviors based on the investigation of triggered flags per interviewer and live call monitoring of interviews. While in most cases, the interviewers required refresher training sessions and feedback for improving their performance, several interviewers discontinued work due to low productivity and high number of triggered flags.
Conclusions:
The specific QC procedures implemented in the course of the WMHQ survey were essential in successfully meeting the target number of interviews (N=5000). The QC strategies as well as the new indicators customized for the telephone interviews contributed to the flag investigation and verification process. The QC data presented here shed light on the rigorous methods and quality monitoring process in the course of conducting a large-scale national survey on a sensitive topic during the COVID-19 pandemic.
Objective: We examined whether meaningful subgroups of self-injurious behaviors (SIBs) would emerge within a pool of first-year college students already deemed at elevated risk. Participants: First-year undergraduates (N = 1,068) recruited in 2015-2018 Fall terms. Methods: Past-year nonsuicidal self-injury (NSSI) frequency, past-year number of NSSI methods used, lifetime suicide attempt (SA) history, and recency of SA were included in a latent profile analysis. Results: Four subgroups emerged: low SIB (n = 558, 52%), high NSSI only (n = 182, 17%), high SIB (n = 141, 13%), and high SA only (n = 187, 18%). Students in the high SIB group reported higher levels of suicidal ideation at baseline and follow-up in comparison to all groups. Those in the high NSSI only or high SIB groups had relatively higher levels of NSSI at baseline and follow-up. Conclusions: Findings highlight the amount of heterogeneity within a high-risk group, along with the importance of considering distal and proximal SIBs in university screening efforts.
Objective:
Research investigating cannabis use and sleep health is limited, and results are mixed. Few studies were nationally representative with racially-ethnically diverse samples or assessed potential modifiers. Our objective was to investigate cross-sectional associations between reported cannabis use and sleep disturbances by potential modifiers among non-Hispanic White, non-Hispanic Black, and Hispanic/Latino men and women in the United States.
Methods:
We used nationally representative National Comorbidity Survey-Replication data collected from 2001 to 2003 among 3929 adults. Poisson regression with robust variance estimated prevalence ratios (PR) and 95% confidence intervals of patterns of sleep disturbances identified through latent class analysis. Models adjusted for sociodemographic, health behavior, and clinical characteristics were stratified by race-ethnicity and by race-ethnicity along with sex/gender, and age, separately.
Results:
Over half of adults reported cannabis use (52%-ever/lifetime vs 48%-never). We identified two latent classes: multiple sleep disturbances with daytime sleepiness and no sleep disturbances with some daytime sleepiness. Prevalence of multiple sleep disturbances with daytime sleepiness was higher among participants reporting lifetime cannabis use (23% vs 20%). Associations did not vary by race-ethnicity or sex/gender. Lifetime vs never cannabis use was marginally associated with a higher prevalence of multiple sleep disturbances with daytime sleepiness only among adults aged 25-29years (PR=1.09 [95% confidence interval: 1.00-1.18]; eg, PRage 40+ years=1.00 [0.97-1.03], pinteraction=0.03).
Conclusions:
Associations between cannabis use and sleep may vary by age. Replication with more recent data and prospective studies that investigate intersectional identities among diverse populations with objective assessments are warranted.
I was a participant of the project organised for national statistical offices on 28 April 2022.
Objective: The COVID-19 outbreak has led to an increase in posttraumatic stress symptoms (PTSSs; Prout et al., 2020) for some individuals, whereas others appeared to be more resilient. It remains relatively unclear what characterizes these potentially different response trajectories (Chen & Bonanno, 2020). This study sought to (a) assess individuals’ PTSS levels at the start of the pandemic and at two subsequent timepoints 3 and 6 months later, (b) identify different trajectories of PTSSs over time, and (c) describe which individual characteristics influenced the likelihood of each of these different trajectories to occur. Method: A community sample (n = 317) responded to an online survey during the first weeks of the pandemic, 3 and 6 months later. Results: Among those who reported acute levels of PTSSs, latent class growth analyses identified three different resilience trajectories—resilient (low baseline PTSSs and a slight decrease over time), chronic (severe PTSSs at baseline and no change over time), and recovered (severe PTSSs at baseline but a sharp improvement over time). Baseline childhood adversity, depression, anxiety, defensive functioning, and somatization predicted trajectories. Demographics (age, gender, preexisting chronic illness) and COVID-related factors (knowing someone diagnosed with or who died of COVID-19) were unrelated to trajectories. Conclusions: Results suggest that although high PTSS levels decreased over time on average, heterogenous change trajectories can be identified based on baseline psychological characteristics. This implies that mental health, including past and present experiences, as well as adaptational mechanisms may shape individuals’ experiences with pandemic-related ongoing stress.
Purpose:
This study aims to provide an overview and quality appraisal of the current scientific evidence concerning the prevalence and characteristics of mental and physical disorders among sentenced female prisoners.
Design/methodology/approach:
A mixed-methods systematic literature review.
Findings:
A total of 4 reviews and 39 single studies met the inclusion criteria for the review. Mental disorders were the main area of investigation in the majority of single studies, with substance abuse, particularly drug abuse, as the most consistently gender biased disorder, with higher prevalence among women than men in prison. The review identified a lack of updated systematic evidence on the presence of multi-morbidity.
Originality/value:
This study provides an up-to-date overview and quality appraisal of the current scientific evidence concerning the prevalence and characteristics of mental and physical disorders among female prisoners.
Large-scale mental health surveys screen participants for the presence of the core diagnostic criteria of a mental disorder such as major depressive disorder (MDD). Only participants who screen positive are administered the full diagnostic module; the remainder "skip-out." Although this procedure adheres faithfully to the psychiatric classification of mental disorders, it limits the use of the resulting survey data for conducting high-quality research of importance to scientists, clinicians, and policymakers. Here, we conduct a series of exploratory analyses using the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders (VATSPSUD) data, a unique survey which suspended the skip-out procedure for assessing past-year MDD. Adult twins (N = 8,980) born between 1930 and 1974 were recruited from a multiple-birth record database established in 1980 and interviewed in mid-adulthood between 1987 and 1996. We compared the: (a) prevalence and levels of impairment of the diagnostic criteria (and disaggregated symptom items) of adults screening positive/negative and (b) patterns of associations between MDD diagnostic criteria (and disaggregated symptom items) under three conditions: (a) full data; (b) "skip-out" data substituted with zeros; and (c) "skip-out" data treated via listwise deletion. Important differences in the patterns of associations between diagnostic criteria and disaggregated symptom sets emerged which changed the statistical evidence regarding the dimensionality of the criteria/symptom items (i.e., Condition C). An ill-defined correlation matrix which was unsuitable for statistical analysis was produced (i.e., Condition B). Given the problems with these widely used approaches, we offer researchers and data analysts practical alternatives to using the skip-out procedure in future surveys. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Certain primary sampling units PSUs may be extremely innuential on survey estimates and consequently contribute disproportionately to their variance. We propose a general approach to estimation that downweights highly innuential PSUs. Our robust estimation strategy applies M-estimation to the empirical innuence of the PSUs. The method is motivated by a problem in census coverage estimation, and we illustrate it using data from the 1990 Post Enumeration Survey. In this context, an objective, prespeciied methodology for handling in-uential observations is essential to avoid having to justify judgemental post hoc adjustment of weights. In 1990, both extreme weights and large errors led to extreme innuence. We analysed these data using M-estimators based on the t distribution and the Huber-function, and estimated innuence by T aylor linearization of the estimator. As predicted by theory, the robust procedures greatly reduced the variance of estimated coverage rates, more so than truncation of weights. On the other hand, the procedure may i n troduce bias into survey estimates when the distributions of the innuence statistics are asymmetric. We consider the properties of the estimators in the presence of asymmetry and demonstrate techniques for assessing the bias-variance tradeoo, nding that mean squared error is reduced by applying the robust procedure to our dataset. We also suggest PES design improvements to reduce the impact of innuential clusters.
The rationale for the use of sample survey weights in a least squares regression analysis is examined with respect to four increasingly general specifications of the population regression model. The appropriateness of the weighted regression estimate depends on which model is chosen. A proposal is made to use the difference between the weighted and unweighted estimates as an aid in choosing the appropriate model and hence the appropriate estimator. When applied to an analysis of the familial and environmental determinants of the educational level attained by a sample of young adults, the methods lead to a revision of the initial additive model in which interaction terms between county unemployment and race, as well as between sex and mother's education, are included.
Surveys of risk behaviors have been hobbled by their reliance on respondents to report accurately about engaging in behaviors
that are highly sensitive and may be illegal. An audio computer-assisted self-interviewing (audio-CASI) technology for measuring
those behaviors was tested with 1690 respondents in the 1995 National Survey of Adolescent Males. The respondents were randomly
assigned to answer questions using either audio-CASI or a more traditional self-administered questionnaire. Estimates of the
prevalence of male-male sex, injection drug use, and sexual contact with intravenous drug users were higher by factors of
3 or more when audio-CASI was used. Increased reporting was also found for several other risk behaviors.
Certain clusters may be extremely influential on survey estimates from clustered samples and conse- quently contribute disproportionately to their vari- ance. We propose a general approach to down- weighting clusters using a robust estimation strategy based on M-estimation, using t-based weight func- tions. The method is motivated by a problem in census coverage estimation. In this context, both extreme weights and large errors can lead to ex- treme influence, and influence can be estimated by Taylor linearization. As predicted by theory, the robust procedure greatly reduces the variance of es- timated coverage rates, more so than truncation of weights. On the other hand, the procedure may in- troduce bias into survey estimates when the distri- butions of the influence statistics are asymmetric. We demonstrate techniques for assessing the bias- variance tradeoff and consider the properties of the estimators in the presence of asymmetry. We also suggest design improvements to reduce the impact of influential clusters.
The design of complex samples induces correlations between element values. In stratification negative correlation reduces the variance; but that gain is less for subclass means, and even less for their differences and for complex statistics. Clustering induces larger and positive correlations between element values. The resulting increase in variance is measured by the ratio deff, and is often severe. This is reduced but persists for subclass means, their differences, and for analytical statistics. Three methods for computing variances are compared in a large empirical study. The results are encouraging and useful.
As Monograph No. 4 in the Joint Commission on Mental Illness and Health series, this University of Michigan Survey Research Center report deals with the findings obtained from extensive interviews with a representative sample of 2460 Americans over 21 and living at home. Questions focused on how people indicate their life adjustment, their perceived problems, and how they have coped with their expressed needs. Following an introductory overview, individual chapters deal with varied aspects, including marriage, parenthood, job, symptom patterns, referrals and resources, and demographic characteristics. Questionnaire and technical data are appended. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Introduction General Conditions for the Randomization-Validity of Infinite-m Repeated-Imputation Inferences Examples of Proper and Improper Imputation Methods in a Simple Case with Ignorable Nonresponse Further Discussion of Proper Imputation Methods The Asymptotic Distribution of (Q̄m, Ūm, Bm) for Proper Imputation Methods Evaluations of Finite-m Inferences with Scalar Estimands Evaluation of Significance Levels from the Moment-Based Statistics Dm and Δm with Multicomponent Estimands Evaluation of Significance Levels Based on Repeated Significance Levels
This paper presents an overview of the World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) and a discussion of the methodological research on which the development of the instrument was based. The WMH-CIDI includes a screening module and 40 sections that focus on diagnoses (22 sections), functioning (four sections), treatment (two sections), risk factors (four sections), socio-demographic correlates (seven sections), and methodological factors (two sections). Innovations compared to earlier versions of the CIDI include expansion of the diagnostic sections, a focus on 12-month as well as lifetime disorders in the same interview, detailed assessment of clinical severity, and inclusion of information on treatment, risk factors, and consequences. A computer-assisted version of the interview is available along with a direct data entry software system that can be used to keypunch responses to the paper-and-pencil version of the interview. Computer programs that generate diagnoses are also available based on both ICD-10 and DSM-IV criteria. Elaborate CD-ROM-based training materials are available to teach interviewers how to administer the interview as well as to teach supervisors how to monitor the quality of data collection.
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Tu rner CF, Ku L, Rogers SM, Lindberg LD, Pleck JH,
Sonenstein FL. Adolescent sexual behavior, drug use,
and violence: increased reporting with computer survey
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Mark Olfson (Columbia University College of Physicians and Surgeons)
- Alden Tr Ust
Alden Tr ust. Collaborating investigators include Ronald
C. Kessler (Principal Investigator, Harvard Medical
School), Kathleen Merikangas (Co-Principal Investigator,
NIMH), James Anthony (Michigan State University),
William Eaton (The Johns Hopkins University), Meyer
Glantz (NIDA), Doreen Koretz (Harvard University), Jane
McLeod (Indiana University), Mark Olfson (Columbia
University College of Physicians and Surgeons), Harold
Pincus (University of Pittsburgh), Greg Simon (Group
Health Cooperative), Michael Von Korff (Group Health
Cooperative), Philip Wang (Harvard Medical School),
Kenneth Wells (UCLA), Elaine Wethington (Cornell
University) and Hans-Ulrich Wittchen (Institute of
Clinical Psychology, Te chnical University D resden
and Max Planck Institute of Psychiatry). The authors
appreciate the helpful comments on earlier drafts of
Jim Anthony, Doreen Koretz, Kathleen Merikangas,
Bedirhan Üstün, Michael von Korff, and Philip Wang.
- Rubin