Irina MACSINGA* West University of Timisoara, Timisoara, Romania Abstract Stereotypes of mental illness related to dangerousness, handicap and lack of control lead to negative emotional reactions and discriminatory behavior. While there is a growing literature on mental illness perception among adults, less is known about how adolescents view mentally ill people. This study investigated […]
ADOLESCENT DOSE AND RATINGS OF AN INTERNET-BASED DEPRESSION PREVENTION PROGRAM: A RANDOMIZED TRIAL OF PRIMARY CARE PHYSICIAN BRIEF ADVICE VERSUS A MOTIVATIONAL INTERVIEW
Internet-based interventions for education and behavior change have proliferated, but most adolescents may not be sufficiently motivated to engage in Internet-based behavior change interventions. We sought to determine how two different forms of primary care physician engagement, brief advice (BA) versus motivational interview (MI), could enhance participation outcomes in an Internet-based depression prevention intervention.
Eighty-three adolescents at risk for developing major depression were recruited by screening in primary care and randomized to two groups: BA (1-2 minutes) + Internet program versus MI (10-15 minutes) + Internet program. We compared measures of participation and satisfaction for the two groups for a minimum of 12 months after enrollment.
Both groups engaged the site actively (MI: 90% versus BA: 78%, p=0.12). MI had significantly higher levels of engagement than BA for measures including total time on site (143.7 minutes versus 100.2 minutes, p=0.03), number of sessions (8.16 versus 6.00, p=0.04), longer duration of session activity on Internet site (46.2 days versus 29.34 days, p=0.04), and with more characters typed into exercises (3532 versus 2004, p=0.01). Adolescents in the MI group reported higher trust in their physician (4.18 versus 3.74, p=0.05) and greater satisfaction with the Internet-based component (7.92 versus 6.66, p=0.01).
Our results indicate that primary care engagement, particularly using motivational interviewing, may increase Internet use dose, and some elements enhance and intensify adolescent use of an Internet-based intervention over a one to two month period. Primary care engagement may be a useful method to facilitate adolescent involvement in preventive mental health interventions.
The main objective of this study was to propose a model, which includes personal and social factors associated to health-related quality of Life (HRQoL) in children and in adolescents.
A sample of 3195 children and adolescents was randomly selected from 5th and 7th graders, in Portuguese public schools. The Portuguese versions of KIDSCREEN-52, Harter’s SPPS, LOT-R, SSSS and HBSC (selected items) were used to evaluate personal and social factors and health behaviors.
Various structural equation models were developed in association with gender, age, socioeconomic status (SES) and using the global sample. The studied models presented good adjustment indexes, which suggest a good fit for the hypothesized model.
The psychosocial variables have a strong impact in the HRQoL. Consequently, health promotion programs for children and adolescents should include the psychosocial approach. Based on our results, we discuss and propose strategies to develop HRQoL in children and adolescents, in schools and in families.
ANXIETY, DEPRESSION AND COPING STRATEGIES: IMPROVING THE EVALUATION AND THE UNDERSTANDING OF THESE DIMENSIONS DURING PRE-ADOLESCENCE AND ADOLESCENCE
The aim of this study is to investigate and refine three different scales which measure depression, anxiety and coping strategies. The relation between these scales is also verified in a non-clinical school population of pre-adolescents and adolescents. Lastly, the moderating effects of age, gender, grade failure and family type are tested. This study used depression, anxiety and coping strategy scales to check moderating effects. The sample consisted of 916 Portuguese pupils, 54.3% females, aged 10 to 22 (M = 14, 44). The participants were randomly selected from the 5th to the 12th grades of public schools. The CDI (Kovacs, 1981), the MASC (March, 1997) and the CRY-Y (Moos, 1993) were used. Scales revealed a good internal consistency and suggested that girls are more anxious than boys are and that older students are more depressed, but use more coping strategies than younger learners. A set of exploratory factorial analyses (EFA) was then carried out with the objective of getting the most representative factor from the anxiety (MASC), the depression /CDI) and the coping (CRY-Y) scales. Reduced scales were identified and they strongly correlated with the previous measures, but better differentiate between a set of moderators. A confirmatory model (CPA) was carried out. Also, adjustment indexes suggested a good fit for the model, but consider both genders separately and the two age groups independently. An analysis of the items retained provided suggestions for school based interventions.
A group of highly-suggestible adolescents (n=25) and a group of adolescents with low suggestibility (n=25) followed a hypnotic induction procedure, during which a suggestion of posthypnotic amnesia was given, with the purpose of assessing its influence on autobiographical memory and of investigating if hypnosis-induced amnesia shares the same characteristics as functional amnesia. Statistical analysis confirmed the results of previous studies in the field and, surprisingly, pointed out that even less suggestible participants can be influenced by the suggestion of posthypnotic amnesia. In their case, however, trance levels were more superficial than in the case of highly-suggestible participants.