The hardest part is knowing I will survive: The use of music and creative mediums to enhance empathy and facilitate life-long distance learning in professionally qualified clinicians

© Redfame Publishing Inc.Music is an experience that can cross personal and professional domains alongside cultural, gender, age and generational boundaries; it can also enhance the learning process through emotional processing and connection. This paper focuses on the learning experience of qualified clinical psychologists (CPs) working in the United Kingdom. This group of CPs had experience of undertaking experiential learning and reflective writing during their professional training. It considers the potential to continue a learning process, 3 years post qualification, through long distance methods using vignette-based material. Empathising with, and understanding, the position of others from differing backgrounds is an important competency within the therapeutic work of CPs and this comes alongside acknowledging and understanding ones‟ own experiences, both past and present. CPs work with difficult life experiences and complex issues; connecting constantly can be exhausting and, perhaps, unrealistic. Yet, to truly empathise one must connect with, and understand, the lived experiences of others. We will consider what helps and hinders this process, and how music and other creative mediums can be effectively used in learning even via long distance methods. We will further consider how CPs may be well placed to enhance the learning about, and processing of, difficult emotional experiences for themselves, other clinicians and the people they might work with.Peer reviewe

Stigma as a fundamental hindrance to the United States opioid overdose crisis response.

Alexander Tsai and co-authors discuss the role of stigma in responses to the US opioid crisis

Novel methods in psychiatric epidemiology

status: publishe

Mid-Western Educational Researcher Call for Papers: Special Issue on Anti-Racist Education

Call for Paper

Increase in suicides the months after the death of Robin Williams in the US

Investigating suicides following the death of Robin Williams, a beloved actor and comedian, on August 11th, 2014, we used time-series analysis to estimate the expected number of suicides during the months following Williams’ death. Monthly suicide count data in the US (1999–2015) were from the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER). Expected suicides were calculated using a seasonal autoregressive integrated moving averages model to account for both the seasonal patterns and autoregression. Time-series models indicated that we would expect 16,849 suicides from August to December 2014; however, we observed 18,690 suicides in that period, suggesting an excess of 1,841 cases (9.85% increase). Although excess suicides were observed across gender and age groups, males and persons aged 30–44 had the greatest increase in excess suicide events. This study documents associations between Robin Williams’ death and suicide deaths in the population thereafter

Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis

Objective: To estimate the contributions of biological aging, historical trends, and birth cohort effects on trends in pre-eclampsia in the United States. Design: Population based retrospective study. Setting: National hospital discharge survey datasets, 1980-2010, United States. Participants: 120 million women admitted to hospital for delivery. Main outcome measures: Temporal changes in rates of mild and severe pre-eclampsia in relation to maternal age, year of delivery, and birth cohorts. Poisson regression as well as multilevel age-period-cohort models with adjustment for obesity and smoking were incorporated. Results: The rate of pre-eclampsia was 3.4%. The age-period-cohort analysis showed a strong age effect, with women at the extremes of maternal age having the greatest risk of pre-eclampsia. In comparison with women delivering in 1980, those delivering in 2003 were at 6.7-fold (95% confidence interval 5.6-fold to 8.0-fold) increased risk of severe pre-eclampsia. Period effects declined after 2003. Trends for severe pre-eclampsia also showed a modest birth cohort effect, with women born in the 1970s at increased risk. Compared with women born in 1955, the risk ratio for women born in 1970 was 1.2 (95% confidence interval 1.1 to 1.3). Similar patterns were also evident for mild pre-eclampsia, although attenuated. Changes in the population prevalence of obesity and smoking were associated with period and cohort trends in pre-eclampsia but did not explain the trends. Conclusions Rates of severe pre-eclampsia have been increasing in the United States and age-period-cohort effects all contribute to these trends. Although smoking and obesity have driven these trends, changes in the diagnostic criteria may have also contributed to the age-period-cohort effects. Health consequences of rising obesity rates in the United States underscore that efforts to reduce obesity may be beneficial to maternal and perinatal health

How healthy are survey respondents compared with the general population? Using survey-linked death records to compare mortality outcomes

Background: National surveys are used to capture US health trends and set clinical guidelines, yet the sampling frame often includes those in non-institutional households, potentially missing those most vulnerable for poor health. Declining response rates in national surveys also represent a challenge, and existing inputs to survey weights have limitations. We compared mortality rates between those who respond to surveys and the general population over time. Methods: Survey respondents from twenty waves of the National Health Interview Survey from 1990 through 2009 who have been linked to death records through 31 December 2011 were included. For each cohort in the survey, we estimated their mortality rates along with that cohort's mortality rate in the census population using vital statistics records and differences were examined using Poisson models. Results: In all years, survey respondents had lower mortality rates compared with the general population, when data were both weighted and unweighted. Among men, survey respondents in the weighted sample had 0.86 (95% C.I. 0.853-0.868) times the mortality rate of the general population (among women, RR=0.887; 95% C.I. 0.879-0.895). Differences in mortality are evident along all points of the life course. Differences have remained relatively stable over time. Conclusion: Survey respondents have lower death rates than the general US population, suggesting that they are a systematically healthier source population. Incorporating non-household samples and revised weighting strategies to account for sample frame exclusion and non-response may allow for more rigorous estimation of the US population's health

Role of Foreign-Born Status on Suicide Mortality in Spain Between 2000 and 2019: An Age-Period-Cohort Analysis

Objectives: To examine recent age-period-cohort effects on suicide among foreign-born individuals, a particularly vulnerable sociodemographic group in Spain. Methods: Using 2000-2019 mortality data from Spain's National Institute of Statistics, we estimated age-period-cohort effects on suicide mortality, stratified by foreign-born status (native- vs. foreign-born) and, among the foreign-born, by Spanish citizenship status, a proxy for greater socioeconomic stability. Results: Annual suicide mortality rates were lower among foreign- than native-born individuals. There was heterogeneity in age-period-cohort effects between study groups. After 2010, suicide mortality increased markedly among the foreign-born-especially for female cohorts born around 1950, and slightly among native-born women-especially among female cohorts born after the 1960s. Among native-born men, suicide increased linearly with age and remained stable over time. Increases in suicide among the foreign-born were driven by increases among individuals without Spanish citizenship-especially among cohorts born after 1975. Conclusion: After 2010, suicide in Spain increased markedly among foreign-born individuals and slightly among native-born women, suggesting an association between the downstream effects of the 2008 economic recession and increases in suicide mortality among socioeconomically vulnerable populations.This work was supported by the National Institute of Mental Health (Grant number R01-MH121410) and the Instituto de Salud Carlos III (Grant number FIS PI19CIII/00037). The funders had no role in the conception, design, or execution of the study.S

Did Medicaid Expansion Close African American-white Health Care Disparities Nationwide? A Scoping Review

Objectives: To investigate the impact of the Affordable Care Act’s (ACA) Medicaid expansion on African Americanwhite disparities in health coverage, access to healthcare, receipt of treatment, and health outcomes. Design: A search of research reports, following the PRISMA-ScR guidelines, identified twenty-six national studies investigating changes in health care disparities between African American and white non-disabled, non-elderly adults before and after ACA Medicaid expansion, comparing states that did and did not expand Medicaid. Analysis examined research design and findings. Results: Whether Medicaid eligibility expansion reduced African American-white health coverage disparities remains an open question: Absolute disparities in coverage appear to have declined in expansion states, although exceptions have been reported. African American disparities in health access, treatment, or health outcomes showed little evidence of change for the general population. Conclusions: Future research addressing key weaknesses in existing research may help to uncover sources of continuing disparities and clarify the impact of future Medicaid expansion on African American health care disparities

Burden of Mental Disorders and Suicide Attributable to Childhood Maltreatment

Importance: The proportion of mental disorders and burden causally attributable to childhood maltreatment is unknown. Objective: To determine the contribution of child maltreatment to mental health conditions in Australia, accounting for genetic and environmental confounding. Design, Setting, and Participants: This meta-analysis involved an epidemiological assessment accounting for genetic and environmental confounding between maltreatment and mental health and 3 cross-sectional national surveys: the Australian Child Maltreatment Study (ACMS) 2023, National Study of Mental Health and Well-being 2020-2022, and Australian Burden of Disease Study 2023. Causal estimates were derived on the association between childhood maltreatment and mental health conditions from a meta-analysis of quasi-experimental studies. This was combined with the prevalence of maltreatment from the ACMS to calculate the population attributable fraction (PAF). The PAF was applied to the number and burden of mental health conditions in Australia, sourced from 2 population-based, nationally representative surveys of Australians aged 16 to 85 years, to generate the number and associated burden of mental disorders attributable to child maltreatment. Exposure: Physical abuse, sexual abuse, emotional abuse, or neglect prior to age 18 years. Main Outcomes and Measures: Proportion and number of cases, years of life lost, years lived with disability, and disability-adjusted life-years of mental health conditions (anxiety, depression, harmful alcohol and drug use, self-harm, and suicide attempt) attributable to childhood maltreatment. Results: Meta-analytic estimates were generated from 34 studies and 54646 participants and applied to prevalence estimates of childhood maltreatment generated from 8503 Australians. Childhood maltreatment accounted for a substantial proportion of mental health conditions, ranging from 21% (95% CI, 13%-28%) for depression to 41% (95% CI, 27%-54%) of suicide attempts. More than 1.8 million cases of depressive, anxiety, and substance use disorders could be prevented if childhood maltreatment was eradicated. Maltreatment accounted for 66143 years of life lost (95% CI, 43313-87314), primarily through suicide, and 184636 disability-adjusted life-years (95% CI, 109321-252887). Conclusions and Relevance: This study provides the first estimates of the causal contribution of child maltreatment to mental health in Australia. Results highlight the urgency of preventing child maltreatment to reduce the population prevalence and burden of mental disorders.