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There is a proven link between healthy socioemotional development and academic success (SAMHSA in SAMHSA's concept of trauma and guidance for a trauma-informed approach. Substance Abuse and Mental Health Services Administration, Rockville, 2014; Alisic et al. in J Clin Psychiatry 69:1455-1461, 2008; Landolt et al. in J Trauma Stress 26:209-216, 2013). In order to achieve academic success, school systems serving children who have been exposed to trauma must deal with the unique challenge that comes with resultant activation of the brain's stress response (Perry in J Calif Alliance Ment III 11(1):48-51, 2000; Ford in Treatment of complex trauma: a sequenced, relationship-based approach. Guilford Press, New York, 2013; Schore in Infant Mental Health J 22(1&2):7-66, 2001). This warrants an alteration in how our educational system understands and responds to the needs of youth exposed to trauma (Bailey in I love you rituals. Harper Collins, New York, 2000; Stein and Kendall in Psychological trauma and the developing brain. Haworth Press, Binghamton, 2004; Badenoch in Being a brain-wise therapist: A practical guide to interpersonal neurobiology. WW Norton & Company, Inc., New York, 2008). Within the City of New Haven, the pressure to meet national expectations coupled with the reality that many schools within the city are impacted by the ripple effects of community-wide chronic stress creates added challenges. The New Haven Trauma Coalition was created to address the negative mental health and social effects of adversity, trauma, and chronic stress on families and school-aged children in the New Haven area. This paper reviews the process of implementing a trio of Direct Services in one public pilot school in the City of New Haven. It provides recommendations on how to successfully implement trauma-informed practices during the first year of implementation and utilizes a mixed-methods approach to outline findings obtained during implementation of three separate Direct Service components: Services Professional Development, Care Coordination, and Clinical Services.

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Purpose: Assessment of distress and well-being of patients with cancer is not always documented or addressed in a clinical visit, reflecting a need for improved psychosocial screening., Methods: A multidisciplinary team completed process mapping for emotional distress assessment in two clinics. Barriers were identified through cause-and-effect analysis, and an intervention was chosen. Patient-reported outcomes were collected over 6 months using the validated National Comprehensive Cancer Network Emotional Distress Thermometer (EDT) paper tool. The American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) measures were compared before and after intervention., Results: During 6 months, a total of 864 tools were collected from 1,344 patients in two ambulatory clinics (64%). Electronic medical record documentation of distress increased from 19.2% to 34% during the 6 months before and after intervention. QOPI measures showed an increase in emotional well-being documentation. Of 29 new and 835 return patients, 62% indicated mild distress (EDT, 0 to 3), 18% moderate (EDT, 4 to 6), and 11% severe (EDT, 7 to 10). The average distress score of new patients was significantly higher than that of return patients (5.39 [n = 26] v 2.52 [n = 754]; P < .001). The top problems for patients with moderate and severe distress were worry, fatigue, pain, and nervousness; depression and sadness were particularly noted in patients reporting severe distress. Eleven percent of patients were referred to the social worker on site., Conclusion: A pilot intervention collecting Patient-reported outcomes in two ambulatory clinics led to increase in psychosocial distress screening followed by sustained improvement, indicated by both process and QOPI measures., (Copyright © 2015 by American Society of Clinical Oncology.)

Young expecting parents face a great deal of challenges as they transition into parenthood. This paper sought to identify racial and gender differences in the relationship between general discrimination, neighborhood problems, neighborhood cohesion, and social support on the depressive and stress symptoms among young expecting couples. Results indicated perceived general discrimination and less social support was associated with increased stress and depression. More neighborhood problems were related to increased depression and more neighborhood cohesion was related to less stress. Moderator analyses showed that the influence of general discrimination and stress was stronger for women than men. In addition, neighborhood cohesion was protective on stress for Blacks and Whites but not for Hispanics. These results indicate the need to address the broader social context for young expectant couples. [ABSTRACT FROM AUTHOR]

Background: The experiences and perceived support needs of harm reduction workers in the USA have been understudied. While previous research has explored staff burnout and role-related stress, there is a research gap around potential supports for staff wellbeing and individual longevity in their roles. This is especially critical given the growing overdose crisis and the need for sustainable harm reduction programming. Thus, we sought to describe the experiences of harm reduction staff and identify the perceived support that could empower harm reduction staff to successfully navigate their roles. Methods: Purposive sampling methods were used to recruit harm reduction staff working in Connecticut. Seventeen semi-structured, one-on-one interviews were conducted between December 2022 and March 2023. Participants were asked about their experiences with role-related stressors and supports. Informed by the Social-Ecological Model, transcripts were coded using both inductive and deductive codes, and themes were developed using thematic analysis approaches. Results: Study participants described their experiences working in harm reduction and the numerous ways they already are or could be receiving support in their roles. These experiences were organized into eight themes according to the levels of the Social-Ecological Model. At the individual level, participants explained that support could help them navigate the variability of the physical environment, boundary setting, and self-care. Relationships between clients and co-workers were both identified as means of support at the interpersonal level, helping participants navigate difficult situations and feelings of stress. At the organizational level, study participants explained how they look to their organization to provide sufficient support by way of training, staffing, compensation, and benefits. Additionally, participants stressed the importance of having supervisors who valued their work and provided emotional support. Lastly, at the community level, participants discussed how support was needed to help them navigate complex systems while working with a stigmatized population in an often-stigmatized field. Conclusions: To best support harm reduction staff in their day-to-day roles, our findings underscore the need for support on multiple levels. Future research could explore how the provision of support to harm reduction staff impacts not only staff perceptions of support but also the success of clients accessing harm reduction services. [ABSTRACT FROM AUTHOR]

Individuals with serious mental illness are vulnerable to extreme heat due to biological, social, and place-based factors. We examine the spatial correlation of prevalence of individuals treated at a community mental health center to heat vulnerability. We applied a heat vulnerability index (HVI) to the catchment of the Connecticut Mental Health Center in New Haven, Connecticut. Geocoded addresses were mapped to correlate patient prevalence with heat vulnerability of census tracts. Census tracts closer to the city center had elevated vulnerability scores. Patient prevalence was positively correlated with HVI score (Pearson's r(44) = 0.67, p < 0.01). Statistical significance persists after correction for spatial autocorrelation (modified t-test p < 0.01). The study indicates that individuals treated at this community mental health center are more likely to live in census tracts with high heat vulnerability. Heat mapping strategies can help communicate risk and target resources at the local scale. [ABSTRACT FROM AUTHOR]

Adolescents who engage in non-opioid substance misuse and/or experience mental health symptoms are at greater risk of misusing opioids and/or developing opioid use disorder. Adolescence is a critical developmental period to both prevent the initiation of opioid misuse and target mental health. To date, there are no digital health games targeting both conditions. We describe the protocol for a randomized controlled trial designed to assess the efficacy of an original digital health game, PlaySmart. Five hundred and thirty-two adolescents aged 16–19 years old, who are at greater risk for initiating opioid misuse are recruited from 10 Connecticut school-based health sites. Participants are randomized to PlaySmart or a set of time/attention control videogames. Randomization was stratified by sex at birth and school grade. Participants play their assigned game or games for up to six weeks (300 minutes) and complete assessment questions over a 12-month period (baseline, post-gameplay, 3, 6, and 12 months). The primary outcome is perception of risk of harm of opioid misuse at 3 months. Secondary outcome measures specific to opioid misuse include intentions, self-efficacy, attitudes, knowledge, and perceived norms. Mental health outcomes include measures of depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7), help-seeking behaviors, stigma, measures of self-regulation, self-efficacy to seek professional help for mental health, and knowledge around coping skills. PlaySmart has the potential to significantly reduce the risk of initiation of opioid misuse, improve mental health outcomes, and given its high levels of engagement and accessibility, holds the promise for extensive reach, scale, and impact for adolescents. Trial registration: ClinicalTrials.gov: NCT04941950. Registered on 23 June 2021. [ABSTRACT FROM AUTHOR]

Background: Psilocybin may help treat obsessive-compulsive disorder (OCD). To date, only one open-label study of psilocybin for OCD exists, necessitating further investigation with a randomized controlled design. The neural correlates of psilocybin's effects on OCD have also not been studied. Objectives: This first-of-its-kind trial aims to evaluate the feasibility, safety, and tolerability of psilocybin in the treatment of OCD, provide preliminary evidence on the effects of psilocybin on OCD symptoms, and elucidate neural mechanisms that may mediate psilocybin's effects on OCD. Design: We use a randomized (1:1), double-blind, placebo-controlled, noncrossover design to examine the clinical and neural effects of either a single dose of oral psilocybin (0.25 mg/kg) or active placebo-control agent (250 mg of niacin) on OCD symptoms. Methods and analysis: We are enrolling 30 adult participants at a single site in Connecticut, USA who have failed at least one trial of standard care treatment (medication/psychotherapy) for OCD. All participants will also receive unstructured, non-directive psychological support during visits. Aside from safety, primary outcomes include OCD symptoms over the past 24 h, assessed by the Acute Yale-Brown Obsessive-Compulsive Scale and Visual Analog Scale ratings. These are collected by blinded, independent raters at baseline and the primary endpoint of 48 h post-dosing. Total follow-up is 12 weeks post-dosing. Resting state neuroimaging data will be collected at baseline and primary endpoint. Participants randomized to placebo will be offered the chance to return for an open-label dose of 0.25 mg/kg. Ethics statement: All participants will be required to provide written informed consent. The trial (protocol v. 5.2) was approved by the institutional review board (HIC #2000020355) and registered with ClinicalTrials.gov (NCT03356483). Discussion: This study may represent an advance in our ability to treat refractory OCD, and pave the way for future studies of neurobiological mechanisms of OCD that may respond to psilocybin. [ABSTRACT FROM AUTHOR]

Youth homelessness is a significant problem in most United States communities. Health problems are both a contributor to and a consequence of homelessness. Responses to youth homelessness are typically fragmentary. Different agencies deal with various causes and consequences of the problem. Stakeholders in Connecticut sought a more coherent approach. This article describes the development and use of a system dynamics simulation model as a decision-support tool that: (1) brings stakeholders together from diverse service sectors and allows them to see the system as a whole, (2) enables them to explore how delivery systems interact to affect homeless and unstably housed youth, (3) lets them test the impact of different intervention alternatives on reducing the problem, and (4) helps develop insights about coherent approaches to youth homelessness. The model's development is described as a phased process including stakeholder engagement, causal mapping, and creation of the quantitative simulation model. The resulting model is presented along with an interface that enables stakeholders to use the model in a Learning Lab setting. Results of an initial set of Learning Labs are presented, including types of insights gained by participants from using the simulation model. Conclusions include limitations of the model and plans for its future use. [ABSTRACT FROM AUTHOR]

This is a preliminary report on relationships between changes in life events and changes in psychiatric symptomatology in a community sample of 720 adults in New Haven, Connecticut. Over a two-year period it was found that the greater the net change in life events the more likely was the individual's mental status to have changed. A net increase in life events was associated with a worsening of symptoms, while a net decrease resulted in improvement. Similar patterns were found for most of the 64 individual life events [or which information was gathered as well as for events categorized according to type of social activity, changes in the respondent's social field, and degree of desirability. [ABSTRACT FROM AUTHOR]

Graduate school environments are recognized for contributing to elevated stress levels among student populations. Purpose: The objective was to test whether a behavioral intervention, delivered through an online course on behavior change, is effective in preventing declining mental health. Methods: Data were collected via a quasi-experimental longitudinal study to observe the effect of self-directed behavioral interventions on mental health. Participants included students enrolled in a course on Health Behavior Change at the Yale School of Public Health (n = 45) and a control group (n = 33) of students in the same graduate program. Analyses were conducted to evaluate differences at post-intervention and at a 12-week follow-up assessment in indicators of mental and general health. Results: Enrolled students reported significantly improved mental health outcomes as compared to the control students. At follow-up, multiple differences persisted, with participants who had completed the course reporting sustained improvements in general and mental health. Discussion: Self-directed behavior change interventions are effective in promoting mental and physical health among graduate student populations. Translation to Health Education Practice: This curriculum-based intervention can support student wellbeing in a variety of academic programs. [ABSTRACT FROM AUTHOR]

While there is a public perception that gun violence is associated with mental illness we present evidence that it is a complex public health problem which defies simple characterizations and solutions. Only a small percentage of individuals with mental illness are at risk for extreme violence and they account for only a small percentage of gun-related homicides. Individuals who are at risk for gun violence are difficult to identify and successfully treat. The incidence, and perhaps the demographics, of gun violence vary substantially from state to state. We make a case for Connecticut physicians to study gun violence at the state level. We recommend that Connecticut physicians promote and expand upon the American Academy of Pediatrics' recommendation for creating a "safe home environment." We suggest that guns be secured in all homes in which there are children. In addition we suggest that guns be voluntarily removed from homes in which there are individuals with a history of violence, threats of violence, depression, drug and/or alcohol abuse, and individuals with major mental illnesses who are not cooperating with therapy. [ABSTRACT FROM AUTHOR]

Studies of relatively recently resettled refugees have noted social disconnection, linked to various physical and mental health outcomes, as a concern. Limited studies have examined whether social disconnection and its effects persists within refugee populations resettled more than 3 decades prior. The relationship between social disconnection and self-reported health was explored in a secondary analysis of a cross-sectional needs assessment survey with a snowball sample of 100 Cambodian refugees residing in Connecticut. Social disconnectedness and comorbid health conditions were prevalent. Lack of religious and community engagement were associated with poor health outcomes, while individuals with a lack of ethnic engagement reported better overall health. This study underscores the importance of understanding the specific risks that social disconnection poses to refugees who have resettled many years before and their offspring that may assist in better serving currently settling refugees within the United States. [ABSTRACT FROM AUTHOR]

Four days after the Sandy Hook tragedy, the schools of Newtown, Connecticut reopened. The author discusses his work as a leader of a mental health team which supported the students, teachers, and parents in one elementary school. The goal was not just to restore the school system in its educational role, but also sustain it as a source of psychological and emotional support. The author illustrates the step by step process by which clinical and supportive services were developed and provided. Specific issues related to managing affect in an institution are demonstrated, and the special psychological demands on teaching staff are highlighted as is the significance of tapping into community resilience. The importance of a responsive empathic approach broadly applied and attuned to both community and individual needs is emphasized. [ABSTRACT FROM AUTHOR]

Objective: Individuals with mental illness and substance use disorders smoke at elevated rates and tend to have greater difficulty quitting smoking as compared to the general population. Some believe that e-cigarettes may reduce harm associated with smoking, but little is known about e-cigarette use, perceptions, and motivations for their use among individuals with mental health and/or substance use disorders. Methods: Rates and correlates of e-cigarette use, perceptions, and sources of information about e-cigarettes among smokers seeking mental health and/or substance use services (N = 188) at the VA Connecticut Healthcare System were assessed via a brief survey. The Pearson χ2 test of independence was used to compare veterans who currently used e-cigarettes with those who did not. Logistic regression was used to examine independent attitudinal differences controlling for potentially confounding variables. Results: Participants were generally male (90%), Caucasian (54%), and older than 50 (69%), with high rates of at least one mental health condition (82%), at least one substance use disorder (73%), and comorbid mental health and substance use disorders (55%). A relatively high proportion of the sample (30.9%) used e-cigarettes. These participants, compared to those who did not use e-cigarettes, were more likely to have a mental health disorder and less likely to have a substance use disorder, started smoking later in life, spent less money on smoking, and were more likely to have tried to quit "cold turkey." Knowledge of e-cigarettes originated most often from TV, radio, or personal contacts. Respondents held generally positive perceptions and motivations regarding e-cigarette use (i.e., it is socially acceptable, may help reduce/quit smoking, less harmful to others). Despite positive attributions, rates of dual use of e-cigarettes and traditional cigarettes was high (86.2%), and very few people using e-cigarettes (6.9%) indicated that e-cigarettes actually helped them quit smoking, suggesting little related harm reduction. Conclusions: E-cigarettes are commonly used by smokers with mental health conditions and/or substance use disorders, a high-risk group that feels positive about e-cigarettes. However, positive regard of e-cigarettes did not appear to translate to ability to reduce or quit cigarette smoking. Safety and effectiveness research on e-cigarettes is urgently needed. [ABSTRACT FROM AUTHOR]

The existence of a workforce crisis in behavioral health has been recognized for decades. However, workforce problems often have been viewed as too large, too complex, and too daunting for individual states to tackle. This article reviews the progress of one state in systematically strengthening its workforce as part of a federally supported effort to transform mental health services. The workforce priorities in Connecticut are identified and the specific workforce transformation projects and their impact are described. The success in sustaining these initiatives after cessation of federal support is reviewed. The authors conclude by offering five recommendations to guide comprehensive state workforce development. This work has particular salience for the many states across the nation that have identified behavioral health service and workforce needs as obstacles to comprehensive health care reform. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated financial challenges, satisfaction with financial-management supports, and interest in additional or alternative supports among clients of a mental health center.Methods: Six focus groups were held with 39 clients of an urban community mental health center who reported having difficulty with their finances. Five focus groups were held with direct-care staff who provided services to the clients. Investigators used an inductive analytical approach to distill themes from notes taken during the focus groups.Results: Clients emphasized the challenges of living in poverty and described using complex strategies to sustain themselves, including negotiating benefits systems, carefully planning purchases, and developing and relying on social relationships. They spoke of having uneven access to tools and services for managing their money, such as advice from direct-care staff, representative payees, and bank accounts, and had varying opinions about their value. Noting concerns similar to those of clients, direct-care staff expressed frustration at the lack of support services for helping clients manage their finances. Both clients and staff expressed the need for more services to help clients with their finances.Conclusions: Findings suggest a need for more services to support people with mental illness to manage their finances, particularly a more flexible and broader range of options than are provided by current representative-payee mechanisms. [ABSTRACT FROM AUTHOR]

We conducted an exploratory research study looking at fathering interactions as they relate to the wraparound care given by the Partnership for Kids or PARK Project, a school-based system of care in Bridgeport, Connecticut. The questions posed by our research focused on how fathers' positive interaction measured by their levels of engagement and accessibility can moderate the effect of the school-based system of care intervention on the mental health outcomes of children with serious emotional disturbances. We found that, although not statistically significant, children's access to their father did have a moderating effect on CBCL scores for internalizing behaviors and total problems. There was very small change in CBCL scores for externalizing behaviors. Further, the moderating effect of father accessibility and father engagement had a lasting effect as a moderator through 12 months into the intervention, especially with regard to internalizing behavior scores. [ABSTRACT FROM AUTHOR]

Human societies are unique in that our behavior is regulated by learned norms and influenced by cultural standards. The present article addresses one of the aspects of how normative culture affects individual's mental life. This study specifically examined the role of norm internalization in cultural consonance and individual psychological flourishing. The data, collected in New England in the winter of 2012, contained measures of individual's (n= 189) knowledge about a cultural model of a good, worthy life, the degree of internalization of the corresponding normative ideas, and self-reported information about each informant's lifestyle and individual mental health status. The results suggest that while stronger internalizers tend to have slightly better levels of psychological flourishing on average, they also suffer greater losses in positive mental health when they think that they are not conforming to the norms embedded in a cultural model. [ABSTRACT FROM PUBLISHER]

Little research has been conducted on the prevalence of physical health problems in Cambodian refugees and the relationship between their mental and physical health. We identified the relationship between mental and physical health problems and barriers to healthcare access in Cambodian refugee adults. We used a cross-sectional survey design with a snowball sample of 136 Cambodian refugee adult residents of Connecticut and Western Massachusetts. 61 % reported being diagnosed with three or more physical conditions and 73 % with depression, posttraumatic stress disorder (PTSD) or both. Language and transportation problems were the primary barriers to accessing care. Participants with probable comorbid PTSD and depression had 1.850 times more physical health problems than those without either condition ( p > .001; CI 1.334-2.566). Age moderated this relationship. Participants who had been diagnosed with both depression and PTSD reported a consistent number of health conditions across the age span while those who had no mental health conditions or only one of the two reported fewer health conditions when they were younger and more when they were older. These two groups were significantly different from the group reporting both. There is a significant relationship between chronic comorbid mental and physical health diseases affecting Cambodian refugees resettled in the US Having comorbid depression and PTSD puts Cambodian refugees at risk for physical health problems no matter their age. It is vital that those treating Cambodian genocide survivors identify and treat their prevalent comorbid health conditions. Language and transportation barriers must be addressed to improve access to mental and physical health care in this population. [ABSTRACT FROM AUTHOR]

Mental health problems among Southeast Asian refugees have been documented. However, longer term health consequences of mass violence as re-settled refugees age are less well described. This study investigated relationships among trauma symptoms, self-reported health outcomes, and barriers to healthcare among Cambodian and Vietnamese persons in Connecticut. An internet phone directory was used to generate a list of names that was compared to 2000 census data to estimate the proportion of the population in each group. From these lists, 190 telephone listings were selected at random. Interviewers telephoned selected listings to screen for eligible participants and obtain an appointment for interview. Surveys were administered through face-to-face interviews during home visits conducted in Khmer or Vietnamese. The Harvard Trauma Questionnaire assessed trauma symptoms. Questions regarding the presence of physician diagnosed heart disease, hypertension, diabetes, and chronic pain were adapted as written from the Health Interview Survey. Healthcare access and occurrence were measured with questions regarding cost and access, patient-provider understanding, and interpretive services. Hierarchical modeling was used to account for respondent nesting within family. Analyses controlled for age, sex, and country of origin. Individuals who reported greater trauma symptoms were more likely to report heart disease by a factor of 1.82, hypertension by a factor of 1.41, and total count of diseases by a factor of 1.22, as well as lower levels of subjective health. Greater trauma symptoms were also associated with greater lack of understanding, cost and access problems, and the need for an interpreter. Although the majority of Southeast Asian immigrants came to the United States as refugees approximately 20–30 years ago, there continues to be high levels of trauma symptoms among this population which are associated with increased risk for disease and decreased access to healthcare services. [ABSTRACT FROM AUTHOR]

Objective. To examine the association of perceived discrimination and health-related quality of life using cross-sectional survey. Methods. We measured perceived discrimination using a nine-item discrimination scale and measured health-related quality of life with the mental component summary (MCS) and physical component summary (PCS) scores of the Short Form-12 questionnaire. The sample was drawn from adult members of an East Coast American Indian Tribe. Results. After adjusting for age, sex, marital status, education, and smoking status, perceived discrimination scores greater than the sample median were associated with higher odds of poor mental functioning (odds ratio = 2.25, 95% CI = 1.03 - 4.91) but not with poor physical functioning (odds ratio = 1.18, 95% CI = 0.53 - 2.63). Conclusions. Our findings support results from previous studies linking perceived discrimination to worse mental health outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This case study describes and reports one university's occupational therapy (OT) curriculum design regarding the utilization of clinical fieldwork level II experiences to promote mental health as a core to the education of occupational therapists. PARTICIPANTS AND METHODS: Graduates (190) of a Connecticut University were queried through a survey to determine the influence of OT fieldwork level II on student development of knowledge pertaining to psychological and social aspects of mental health. The respondents also provided feedback on the efficacy of such an experience in preparing for practice across all practice settings. RESULTS: Quantitative and qualitative themes indicate that University alumni recognize significant educational benefits acquired through the experience of a mental health/psychological-social fieldwork level II experience. CONCLUSIONS: Mental health concepts as represented by psychological and social aspects are embedded in all domains of occupational therapy. Beginning with its strong foundational influence to the profession, there has been of late, a recent resurgence of knowledge and practice implications as noted by various official professional publications. The major finding of the study was that graduates indicated that a clinical experience in mental health did contribute significantly to their holistic practice skills. Recognizing the potential benefits of a psychosocial fieldwork level II experience with new, accentuated methods for student learning, may foster the development of mental health skills for utilization across all practice settings. [ABSTRACT FROM AUTHOR]

This prescriptive article considers five major areas of concern for juvenile justice and mental health professionals-juvenile therapeutic jurisprudence, disproportionate minority contact, psychopharmacology and psychiatry, rehabilitation, and culture in the context of political contraindications for progress. It proposes that institutions that are instrumental in advancing the welfare of urban minority youth will not realize their transformative potential in these areas if they work in isolation. Public systems in the business of promoting healthy well-being for urban minority adolescents must share a cooperative work and responsibility ethic. To date, no model provides instruction on how to effectively promote and implement partnerships between the mental health and juvenile justice systems. A collaborative control governance framework is offered as a formal method to foster interorganizational cooperation from a client-centered perspective for urban ethnic minority youth in at-risk environments. [ABSTRACT FROM AUTHOR]

The fundamental assertion of worldview-based models of posttraumatic stress disorder (PTSD) is that trauma symptoms result when traumatic experiences cannot be readily assimilated into previously held worldviews. In two studies, we test the anxiety buffer disruption hypothesis, which states that trauma symptoms result from the disruption of normal death anxiety–buffering functions of worldviews. In Study 1, participants with trauma symptoms greater than the cutoff for PTSD evinced greater death thought accessibility than those with subclinical or negligible symptoms after a reminder of death. In Study 2, participants with clinically significant trauma symptoms showed no evidence of worldview defense though death thoughts were accessible. These results support the anxiety buffer disruption hypothesis and suggest an entirely new approach to experimental PTSD research. [ABSTRACT FROM AUTHOR]

Background: To obtain prevalence estimates and identify factors associated with psychological problems and receipt of help by a geographically proximate population in which some persons had direct exposure but the overall prevalence of direct exposure was low, 5-15 months after the September 11th, 2001 terrorist incidents.Method: Telephone survey data from the Behavioral Risk Factor Surveillance System (BRFSS) (Connecticut Module) with a randomly selected cohort of 2741 women and 1899 men aged 18 and older were examined using bivariate Chi Square and multivariate logistic regression analyses of weighted data.Results: One in three respondents reported 9/11-related psychological problems, 26% of whom reported receiving formal services or peer support. Risk factors for reporting psychological problems included being surveyed earlier, female gender, age 64 or younger, Hispanic ethnicity, disability, recent depression, and reporting one day or more in the past 30 of poor mental health, sleep problems or worry. Poor mental health was associated with receipt of formal services, and increased alcohol use was associated with receipt of peer support.Conclusion: In the post-impact recovery period following mass trauma, psychological problems by persons with ongoing mental health conditions or increased alcohol use warrant continuing public and professional attention. Women, Hispanics, and disabled adults also may be under-served. [ABSTRACT FROM AUTHOR]

This descriptive study surveyed the ways in which trauma survivor needs have been addressed within the public mental health system in one sector of Connecticut. Information was obtained about the prevalence of traumatic history among consumers, the existence of policy related to trauma, trauma screening and cross-referral mechanisms, and trauma-related supervision and education. The study maps current service system functioning related to the provision of trauma-specific services at both the agency and the clinician level. The study data indicate a need for service enhancement and increased service system collaboration and integration to permit access to a full range of trauma interventions. The data also indicate a need for increased clinician education and supervision specific to trauma both across agencies and among individual clinicians. [ABSTRACT FROM AUTHOR]

This article summarizes a study in which before and after interviews and questionnaires were administered to 73 women who had registered for feminist conciousness-raising groups in the state of Connecticut, and three groups were observed over a period of 10 to 16 weeks, in order to explore the unintended psychological benefits of participation. The results show that consciousness raising may help women to increase their sense of control and externalize their attributions of blame, and may consequently increase self-esteem and reduce depression among participants. The article concludes with a discussion relating these results to studies on race and class differences in mental health, and comparing consciousness raising to psychotherapy. [ABSTRACT FROM AUTHOR]

Objectives. This study was designed to identify factors associated with service use for child psychopathology in three settings: mental health, general health, and school. Methods. Subjects were 2519 children, 6 to 11 years of age, assessed in two cross-sectional Connecticut surveys in the late 1980s. Three groups of variables (sociodemographics, child's illness profile, and parental attitudes) were examined through multivariate logistic regression. Results. Most sociodemographics showed moderate associations with all settings, although some previously reported effects (e.g., birth order, sibship size) were not observed. Of the illness profile measures, only Child Behavior Checklist total scores predicted use in the final model (odds ratio [OR| = 1.6, 95% confidence interval [CI] = 1.1, 2.3). Health problems were associated with increased use in all settings (OR = 1.5, 95% CI = 1.3, 1.9), while academic problems were associated only with increased school service use (OR = 5.2, 95% CI = 3.9, 7.0). Parental belief that the child needed help was most strongly associated with service use (common OR for all settings = 5.3, 95% CI = 4.1, 6.8). Conclusions. Sociodemographics, parental attitudes, and children's illness profiles independently influence service use for psychopathology in school-aged children. [ABSTRACT FROM AUTHOR]

Background: To date, research on mental health in HIV- affected children (children who have an HIV-positive caregiver or live with the virus themselves) has focused on risk factors associated with the disease. However, simultaneous identification of factors that contribute to resilience in the face of risks is also needed. A greater understanding of modifiable protective processes that contribute to resilience in the mental health of children affected by HIV can inform the design of interventions that bolster naturally occurring supports and contribute to early prevention or better management of risks. Methods: We reviewed the recent literature on mental health and resilience in children and adolescents affected by HIV/AIDS. Literature searches of PsycInfo and PubMed were conducted during July-December 2011 consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Qualitative and quantitative studies were included for review if primary research questions pertained to mental health and coping or protective processes in children and families affected by HIV/AIDS. All studies subject to full review were evaluated for quality using a modified Systematic Assessment of Quality in Observational Research (SAQOR) rating system. Results: One hundred and seventy one unique studies were returned from online searches of the literature and bibliography mining. Of these, 29 were evaluated as pertaining directly to mental health and resilience in families and children living with HIV/AIDS. Eight studies presented qualitative analyses. Ten quantitative studies examined individual resources contributing to child resilience and four quantitative studies looked at family-level resources. Ten studies also investigated community level interactions. Four presented findings from resilience-focused interventions. Conclusions: There is a clear need for rigorous research on mental health and resilience in HIV-affected children and adolescents. The evidence base would greatly benefit from more standardized and robust approaches to thinking about resilience from an ecological perspective inclusive of resources at multiple levels and their interactions. [ABSTRACT FROM AUTHOR]