Childhood maltreatment (CM) is linked to impairments in various domains of social functioning. Here, we argue that it is critical to identify factors that underlie impaired social functioning as well as processes that mediate the beneficial health effects of positive relationships in individuals exposed to CM. Key research recommendations are presented, focusing on: (1) identifying attachment-related alterations in specific inter- and intrapersonal processes (e.g., regulation of closeness and distance) that underlie problems in broader domains of social functioning (e.g., lack of perceived social support) in individuals affected by CM; (2) identifying internal (e.g., current emotional state) and external situational factors (e.g., cultural factors, presence of close others) that modulate alterations in specific social processes; and (3) identifying mechanisms that explain the positive health effects of intact social functioning. Methodological recommendations include: (1) assessing social processes through interactive and (close to) real-life assessments inside and outside the laboratory; (2) adopting an interdisciplinary, lifespan perspective to assess social processes, using multi-method assessments; (3) establishing global research collaborations to account for cultural influences on social processes and enable replications across laboratories and countries. The proposed line of research will contribute to globally develop and refine interventions that prevent CM and further positive relationships, which – likely through buffering the effects of chronic stress and corresponding allostatic load – foster resilience and improve mental and physical health, thereby reducing personal suffering and the societal and economic costs of CM and its consequences. Interventions targeting euthymia and psychological well-being are promising therapeutic concepts in this context.
IntroductionEstablishing structured peer support in mental health, particularly for people with schizophrenia, as a psychosocial intervention is early in low and middle-income countries like India. Before implementing and understanding the effectiveness of peer support service and which mode of peer support delivery will be suitable for our culture, our study aimed to understand if peer support would be accepted by the different participants like persons with schizophrenia, caregivers and mental health professionals in a tertiary care center in Chennai, India.MethodsThe study was conducted at the outpatient department (OPD) of a tertiary psychiatric care facility in Chennai, India. A cross-sectional study method was used. Consecutive persons diagnosed with schizophrenia and caregivers of persons with schizophrenia, who attended the outpatient department, and mental health professionals within and outside the facility who met the inclusion and exclusion criteria participated in the study. A structured questionnaire purposefully developed for the study was administered to the different study participants. Descriptive statistics were used to analyze the data. Categorical variables were expressed as frequency and percentages, while the continuous variables were expressed as mean and standard deviation.ResultsA total of 155 participants (52 persons with schizophrenia, 50 caregivers and 53 mental health professionals) completed the survey. The majority of the participants (90.4% of persons with schizophrenia, 86% caregivers and all mental health professionals) welcomed peer support interventions. The participants wanted peers to help persons with schizophrenia achieve personal goals to enhance their mental health and day to day living with an emphasis on independent living and interpersonal and social relationships and help them achieve medication and treatment-related goals toward recovery. Understanding the role of a peer support volunteer and transitioning from a “person with schizophrenia” to a “peer support volunteer” by persons with schizophrenia was thought most challenging.ConclusionThe results highlight the potential acceptability of peer support across several stakeholders in the care of schizophrenia in a low and middle-income country context. The results may guide the implementation of a peer support volunteer programme as an essential mechanism of delivering psychosocial interventions for persons with schizophrenia.
Background: Autism spectrum disorder (ASD) is one of the most common pervasive developmental disorder and present with varied severity and clinical presentation. The diagnosis of ASD in the children has a huge psychological impact among their primary caregivers, leading to distress and mental health issues. The aim of our study was to assess the association between the severity and repetitive behaviours in children with autism spectrum disorder and anxiety and depression levels among their primary caregivers. Materials and methods: Children with autism spectrum disorder and their primary caregivers were recruited from the child psychiatry unit of large tertiary children hospital in south India, after informed consent. Severity of ASD was assessed by Childhood Autism Rating Scale – 1 (CARS-1) and repetitive behaviour by Repetitive behaviour scale - Revised (RBS-R). Among the caregivers, anxiety levels were assessed by Hamilton rating scale for Anxiety (HAM-A) and depression levels were assessed by Hamilton rating scale for Depression (HAM-D). Results: We recruited 100 children with ASD and their mothers (primary caregivers) in the study. The prevalence of anxiety and depression among mothers of children with ASD was 44% and 30%. Statistically significant correlation was observed between CARS scores and HAM-A (p=0.002) and HAM-D (p less than 0.001) scores. Among the repetitive behaviours, self-injurious behaviour was found to be significantly associated with anxiety (p less than 0.001) and depression (p less than 0.001) scores, while stereotyped (P =0.002) and compulsive (p=0.004) behaviours were associated with depression scores. Conclusion: There is a significant association between severity of autism spectrum disorder and anxiety and depression among their mothers.
Background: Sleep disorders can act as risk factors and even aggravate underlying conditions. With prevalence of 17% in general population, hypertension is a leading cause of morbidity and mortality in India. Though hypertension has various well established risk factors like family history, sedentary lifestyle, poor diet, smoking and age, sleep is often an understudied and overlooked factor. Body mass index is another important risk factor for various physical conditions. Associations between sleep and body mass index have been documented in many studies around the world. Although a consensus is yet to be drawn, many studies highlight that BMI related disorders could be predicted by sleep duration and quality. Materials and Methods: Two hundred consecutive hypertensive patients who were attending the OPD for follow-up were included as participants in this study after obtaining an informed consent. A semi structured proforma was designed to elicit the socio demographic profile of the participants. Each participant was assessed for the presence of sleep disorders by sleep-50 questionnaire and quality of sleep by the Pittsburgh Sleep Quality Index (PSQI). Results: Results found that BMI was significantly correlated with sleep quality, sleep duration, and sleep disorder. Hypertension was not significantly correlated to sleep quality or duration but associated to sleep disorder. Conclusion: This study found that body mass index was significantly correlated with sleep variables such as sleep duration, sleep quality, and sleep disorders. Maintaining a healthy BMI could in fact impact the amount and quality of sleep an individual receives.
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