Suchergebnisse

Abstract
It has been demonstrated that working with trauma-exposed children increases the risk for developing secondary traumatisation (ST) and burnout (BO). High correlations between ST and BO have been reported, suggesting an empirical overlap between the constructs. The purpose of the present review was to synthesise research investigating covariates of BO and ST to explore whether this overlap extends to covariates. Seven research databases were searched for studies investigating covariates of both BO and ST. Identified studies were screened in accordance with predefined inclusion and exclusion criteria, resulting in thirteen articles being included for further review. Fourteen covariates were examined in two or more of the included studies and were synthesised according to the 'levels of evidence approach'. Some individual and operational factors appeared to be equally related to BO and ST. There was a predominance of equivocal evidence for and against the salience of different covariates as well as an over-representation of demographic factors compared to organisational and operational factors in the current literature. More research investigating the nature of the overlap between BO and ST is needed, and future research would benefit from integrating covariates supported in the work and organisational literature with covariates from the psychotraumatological literature.

AbstractBackgroundTaking a trauma informed care approach has demonstrated positive outcomes for services for people in the general population. Given the increased vulnerability to psychological trauma for adults with an intellectual disability, this study explores what residential staff know about trauma and trauma informed care.MethodsThirty‐two staffs representing three staff groups: direct care staff; managers; and specialist practitioners, were interviewed using semi‐structured interviews, which were analysed following a structured framework.FindingsEach staff group held different perspectives in their knowledge of trauma and trauma informed care. Limitations were noted in staffs' knowledge of trauma, implementation of evidence‐based supports, and access to specialist services for adults with an intellectual disability. All participants highlighted their training needs regarding trauma.ConclusionIncreased training on recognising and responding to trauma is needed among community staff supporting those with a trauma history if organisations are to move towards trauma informed care.

Purpose: Emerging evidence suggests that ICD-11 CPTSD is a more common condition than PTSD in treatment seeking samples although no study has explored risk factors and comorbidities of PTSD and CPTSD in veteran populations. In this study risk factors and comorbidity between veterans meeting criteria for PTSD or CPTSD using the ICD-11 International Trauma Questionnaire (ITQ) were explored. Methods: A sample of help-seeking veterans who had been diagnosed with a mental health difficulty (n=177) was recruited. Participants completed a range of mental health and functioning measures. Multinomial logistic regression analysis was conducted to explore differences in the above factors between participants meeting case criteria for PTSD, CPTSD or another mental health disorder. Results: Those with CPTSD appeared to have taken longer to seek help, reported higher rates of childhood adversity and more experiences of emotional or physical bullying during their military careers. Further, participants with CPTSD reported a greater burden of co-morbid mental health difficulties including high levels of dissociation, anger, difficulties related to moral injury and common mental health difficulties and greater degree of impairment including social isolation, sleep difficulties and impaired functioning. Conclusions: Considering that CPTSD is a more debilitating condition than PTSD, there is now an urgent need to test the effectiveness of new and existing interventions in veterans with CPTSD.

BackgroundAntidepressant prescription rates in the United Kingdom (UK) are among the highest in Western Europe and prescription rates in Northern Ireland (NI) are significantly higher than the rest of the UK. Moreover, while prescription rates are climbing annually, rates of depression are not changing, and evidence suggests that a range of socio-economic and geographical factors may be responsible.
ObjectivesThe primary aim was to calculate the rates of antidepressant prescribing for the Northern Ireland population for years 2011 to 2015 and identify significant socio-demographic predictors.
Methods (including data)This Administrative Research Centre (Northern Ireland) study linked data from the 2011 census and prescribing records (Enhanced Prescribing Database). The British National Formulary codes was used to identify the four main antidepressant drug types.
FindingsResults indicated high levels of antidepressant prescribing for years 2011 to 2015 and significant associations were found with demographic, health, and economic variables.
ConclusionsNorthern Ireland has high levels of antidepressant prescribing compared to other parts of the UK and other European countries. This suggests that there is a need to extend the provision of social prescribing, where people can avail of local, non-clinical options to alleviate mental health problems.

AbstractPrevious research indicated a significant role of family variables (parental supervision and attachment) in the study of criminality. Social learning of criminal behaviour suggested that the intensity of criminal acts during adolescence is predicted by exposure to criminal peer groups. Based on a sample of recidivists (n = 312) incarcerated in a high‐security prison, this article investigates the direct and indirect effects of parental attachment, parental supervision, and peer relations on associations with criminal friends and subsequent criminal behaviour. Two alternative models of criminal behaviour were specified and estimated in Mplus 6 with restricted maximum likelihood estimation, using structural equation modelling. Results suggest that parental attachment has a significant, positive direct effect on parental supervision and relationships with peers, and an indirect effect on associations with criminal friends via parental supervision. Results also indicate a direct negative effect of parental supervision on criminal associations and a strong, positive effect of criminal associations with criminal friends on criminal behaviour. The only indirect predictor of criminal behaviour was parental supervision via associations with criminal friends. Further implications in relation to theory and previous studies are discussed.

ObjectiveAntimicrobial resistance (AMR) has become one of the most serious global public health threats. Concerns about AMR resulted in increased monitoring and evaluation of antibiotic prescribing, with primary care responsible for over 80% of these prescriptions. Through this study, we aim to analyse temporal trends and variations in antibiotic prescribing at GP practice level and investigate the association between antibiotic prescribing and demographic, clinical, geographic, and socio-economic characteristics in Northern Ireland.
MethodThe descriptive analyses are complemented by performing the multilevel modelling analysis to identify practice-level determinants of prescribing.
ResultsChanges in standardised antibiotic prescribing rates are evaluated using a linear mixed-effects model with a random intercept for each GP practice. We discuss the changes in antibiotic prescribing rates over time, between-GP practice variations in prescribing, differences in prescribing between urban and urban practices, and the impact of demographic and socio-economic factors on antibiotic prescribing rates
Conclusions and ImplicationsThis study contributes to the debate on determinants of antibiotic prescribing in primary care and provides actionable insights to policy makers responsible for antimicrobial stewardship and public health campaigns.

Abstract
Background
This study sought to describe the characteristics of unpaid carers in the UK and assess levels of depression, anxiety, and mental health treatment seeking behaviours in this population.

Methods
Data was derived from Wave 9 (n = 2790) of the COVID-19 Psychological Research Consortium (C19PRC) study, a longitudinal survey of adults in the UK. Logistic regression analyses were conducted to examine the characteristics of unpaid carers, association between caregiver status and psychological wellbeing, and caregiver-specific factors associated with risk of poor psychological wellbeing.

Results
Approximately 15% (n = 417) of the sample reported providing unpaid care. Younger age, having three or more children in the household, and lower income were identified as significant correlates of caregiver status. Unpaid caregivers were at increased risk of depression or anxiety and mental health help-seeking. Unpaid caregivers who were younger, lived in households with one or two children, and had a lower income were at greater risk of depression or anxiety and engaging in mental health help-seeking. Caring for an individual with a terminal illness, long-term illness, learning disability or difficulty, mental health problems, physical disability, and other were linked to increased risk of depression or anxiety, while caring for someone with a learning disability increased risk of mental health help-seeking.

Conclusions
This study indicates that at least one in eight people in the UK provide unpaid care, and that those who provide unpaid care have a far higher risk of experiencing depression or anxiety and seeking mental health treatment. The identification of risk factors associated with these mental health outcomes will facilitate the identification of those in most need of support.

Background: Veterans with PTSD typically report a poorer treatment response than those who have not served in the Armed Forces. A possible explanation is that veterans often present with complex symptoms of PTSD. ICD-11 PTSD and Complex PTSD (CPTSD) has not previously been explored in a military sample.Aim: This study aimed to validate the only measure of ICD-11 PTSD and CPTSD, the International Trauma Questionnaire (ITQ), and assess the rates of the disorder in a sample of treatment-seeking UK veterans.Method: A sample of help-seeking veterans (n=177) was recruited from a national charity in the UK that provides clinical services to veterans. Participants completed measures of ICD-11 PTSD and CPTSD as well as childhood and adult traumatic life events. Confirmatory factor analysis was used to assess the latent structure of PTSD and CPTSD symptoms, and rates of the disorders were estimated.Results: The majority of the participants (70.7%) reported symptoms consistent with a diagnosis of either PTSD or CPTSD. Results indicated presence of two separate disorders, with CPTSD being more frequently endorsed (56.7%) than PTSD (14.0%). CPTSD was more strongly associated with childhood trauma than PTSD.Conclusions: ITQ can adequately distinguish between PTSD and CPTSD within clinical samples of veterans. There is a need to explore the effectiveness of existing and new treatments for CPTSD in military personnel.

BackgroundVariability in prevalence estimation of intellectual disability has been attributed to heterogeneity in study settings, methodologies, and intellectual disability case definitions. Among studies based on national household survey data specifically, variability in prevalence estimation has partly been attributed to the level of specificity of the survey questions employed to determine the presence of intellectual disability.
Specific aims & methodUsing standardised difference scoring, and 'intellectual disability' survey data from the 2007 Northern Ireland Survey on Activity Limitation and Disability (NISALD) (N=23,689) and the 2011 Northern Ireland Census (N=1,770,217) the following study had two aims. First, we aimed to demonstrate the effects of survey question specificity on intellectual disability prevalence estimation. Second, we aimed to produce reliable estimates of the geographic variation of intellectual disability within private households in Northern Ireland while also assessing the socio-demographic, health-related and disability characteristics of this population.
FindingsPrevalence estimates generated using the more crudely classified intellectual disability Census data indicated a prevalence of 2% for the overall population, 3.8% for children aged between 0 and 15 years, and 1.5% for citizens aged 16 years or older. Intellectual disability prevalence estimates generated using the more explicitly defined 2007 NISALD data indicated a population prevalence of 0.5% for the overall population, 1.3% for children aged between 0 and 15 years, and 0.3% for citizens aged 16 years or older. The NISALD estimates were consistent with most recent international meta-analysis prevalence estimates. According to the NISALD data, the majority of those with an intellectual disability were male, lived outside Belfast, and experienced severe intellectual disability, with multiple comorbid health conditions.
DiscussionThe current findings highlight the importance of survey question specificity in the estimation of intellectual disability prevalence and provide reliable prevalence estimates of intellectual disability in Northern Ireland. The findings also demonstrate the utility of administrative data for detecting and understanding intellectual disability, and inform recommendations on how to maximise use of future intellectual disability Census data.