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This chapter addresses the question of how we might best characterize the morale of mothers of children with disabilities. Views of this question have undergone substantial evolution over the past quarter century (Turnbull & Turnbull, 2002). Early writers on the topic emphasized negative impacts on the family. Farber (1959) characterized the birth of a mentally retarded child as a tragic crisis that over time impeded the family from developing normally. Olshansky (1962) described the typical reaction of parents to a child with mental retardation as long-term demoralization, which he termed “chronic sorrow.” These assertions were then followed by empirical studies suggesting high levels of depression in mothers of children with disabilities (Cummings et al., 1966; Gath, 1977). Gath (1977), for example, compared two groups of parents with and without children with disabilities on a researcher developed measure of psychological distress and found significantly higher levels in parents of children with disabilities. She titled her report, “The impact of an abnormal child upon the parents,” seeming to imply that emotional distress, perhaps even mental illness, was the most characteristic impact. This literature also appeared to imply that the cause of parental distress was univariate, that is, the child’s disability uniquely caused it. Early studies of parental distress selected child variables as the sole predictors of emotional distress (e.g. Beckman, 1983). Turnbull and Turnbull (2002) reviewed this literature and described this historical phase as pathogenic.

The NHS Improving Access to Psychological Therapies (IAPT) programme provides access to psychotherapy in England through a stepped care approach for adults with depression and anxiety disorders. This evaluation sought to investigate IAPT recovery and reliable change rates of those who scored severe on depression (PHQ-9), anxiety (GAD-7) or impaired functioning (WASA). The paper aims to discuss this issue.

This evaluation employed a within groups design: a single case evaluation follow-up. Routine service data (from services set-up in 2008-2009 to February 2012) from 25,034 patients treated at four IAPT services was analysed.

The analysis revealed that 29 per cent (n=7,059) of patients were assessed as being in the WASA severe range, 41 per cent (n=10,208) in the PHQ severe range, and 57 per cent (n=14,612) in the GAD-7 severe range; with 14 per cent (n=3,548) in the severe range on all three measures combined. There were significant falls on all three measures and a large effect size. The percentage of patients who recovered to a point below the recovery threshold was 30 per cent for depression, 34 per cent for anxiety, 18 per cent for impaired functioning, and for those presenting severe on all measures: recovery rates were 21 per cent for anxiety, 26 per cent for depression, and 15 per cent for impaired functioning. Reliable change for anxiety was found to be greater than IAPT patients overall.

The results show that IAPT enables approximately a third of people scoring severe to recover, lower than IAPT recovery rates overall. Reliable change may be a more effective measure of patient progress.

This study aims to examine the relationship between objective and subjective aspects of financial well-being, the role of family financial support and depression symptoms of Chinese older adults.

This study used two waves (2015 and 2018) of the Harmonized China Health and Retirement Longitudinal Study. Two financial ratios: the expenditure-to-income ratio and the financial assets ratio, were used to measure the objective aspect of financial well-being. Perceived money management difficulty was employed to measure the subjective aspect of financial well-being. Depression symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D) score. Three analytical models, including an ordinary least squares (OLS) model, an OLS model controlling for lagged depression and a random effects model using panel data, were used to examine the relationships between the objective and subject aspects of financial well-being and depression.

The results from the three models showed consistent relationships: the expenditure-to-income ratio was a positive contributor, while the financial assets ratio was a negative contributor to depression of older adults in China. The robustness check using binary-coded financial ratio thresholds showed that reaching the suggested thresholds was negatively associated with depression. Perceived money management difficulty contributed positively to depression. The robustness check using the fixed effects model showed no significance of the two ratios, while perceived money management difficulty was positively associated with depression. The insignificance might be due to data limitation (limited waves or rare changes across waves).

The findings indicate that both objective and subjective financial well-being matters in relation to depression symptoms and, therefore, to the overall mental health of the Chinese elderly. Developments in public policies are needed to promote accessible financial services, assistance programs, mental health services and facilities for the older population in China.

Rising rates of anxiety and depression and the varied costs of these conditions indicate a clear need to create learning environments in which graduate and professional students can more readily thrive. However, the absence of multi-institutional, multi-disciplinary evidence about mental health in graduate education has obscured a clear picture of which populations, contexts and social dynamics merit focused attention and resources. The purpose of this study is therefore to analyze prevalence and risk factors associated with anxiety and depression among a large sample of graduate students, with special attention to how graduate education environments and interactions may be associated with mental health.

This paper offers the first multi-institutional, multi-disciplinary analysis of depression and anxiety among US graduate and professional students. Using a sample of 20,888 students randomly sampled within 69 universities, the author compares depression and anxiety prevalence among fields of study with hierarchical cluster modeling. Then, using a conceptual framework that links social support, role strain and self-determination theories, the author estimates fixed effects multivariate logistic regressions to measure how depression and anxiety are associated with experiencing racial discrimination, support from friends and family, perceived competitiveness in one’s classes, and comfort speaking with one’s professors about mental health.

Graduate students who endure frequent racial discrimination have odds of screening positive for depression and anxiety that are 2.3 and 3.0 times higher, respectively, than those who never experience discrimination. Support from family and friends moderates these relationships and perceived competitiveness exacerbates them. LGBTQ students and students who self-report that finances are a struggle or tight also have higher odds of depression and anxiety. Students in the humanities, arts and architecture have significantly higher prevalence of depression and anxiety than the sample as a whole.

The paper offers broadest base of evidence to date about patterns that are usually experienced at the individual level or analyzed institution-by-institution and field-by-field. Specifically, the author identified social dynamics, fields of study and populations where attention to wellbeing may be especially warranted. The conceptual framework and multivariate results clarify how organizational and individual factors in graduate students’ mental health may be intertwined through competitive, discriminatory, or supportive interactions with peers, faculty, family and friends. Findings clarify a need for awareness of the contexts and interactions that graduate students experience as well as individual factors that are associated with student wellbeing.

Posttraumatic stress disorder (PTSD), an anxiety disorder with lifetime prevalence of 7.8%, is characterized by symptoms that develop following exposure to traumatic life events and that cause an immediate experience of intense fear, helplessness or horror. PTSD is marked by recurrent nightmares typified by the recall of intrusive experiences and by extended disturbance throughout sleep. Individuals with PTSD respond poorly to drug treatments for insomnia. The disadvantages of drug treatment for insomnia underline the importance of non-pharmacological alternatives. Thus, the present study had three aims: first, to compare the efficiency of two relaxation techniques (muscular relaxation and progressive music relaxation) in alleviating insomnia among individuals with PTSD using both objective and subjective measures of sleep quality; second, to examine whether these two techniques have different effects on psychological indicators of PTSD, such as depression and anxiety; and finally, to examine how initial PTSD symptom severity and baseline emotional measures are related to the efficiency of these two relaxation methods. Thirteen PTSD patients with no other major psychiatric or neurological disorders participated in the study. The study comprised one seven-day running-in, no-treatment period, followed by two seven-day experimental periods. The treatments constituted either music relaxation or muscle relaxation techniques at desired bedtime. These treatments were randomly assigned. During each of these three experimental periods, subjects' sleep was continuously monitored with a wrist actigraph (Ambulatory Monitoring, Inc.), and subjects were asked to fill out several questionnaires concerned with a wide spectrum of issues, such as sleep, depression, and anxiety. Analyses revealed a significant increase in objective and subjective sleep efficiency and a significant reduction in depression level following music relaxation. Moreover, following music relaxation, a highly significant negative correlation was found between improvement in objective sleep efficiency and reduction in depression scale. The study‘s findings provide evidence that music relaxation at bedtime can be used as treatment for insomnia among individuals with PTSD.

The effects of stigmatisation regarding sex abuse and rape crimes have rarely been studied. This present study explores the effects of social stigma by examining coping style, thought suppression, depression and anxiety in those falsely accused of sex crimes compared with those convicted of sex crimes. A total of 60 males volunteered to complete a questionnaire. The questionnaires were given to participants from organisations that support people falsely accused and people who have been found guilty of sexual offending. The findings indicate that falsely accused individuals employ an emotion‐focused coping strategy significantly more than convicted sex offenders.

This study explores the social, biological, and genetic determinants of depression in later life. It adds complexity to the idea that later life depression is a natural outgrowth of vascular impairment, antagonistic pleiotropy, or compromised neuroanatomical structures, arguing instead for the importance of education as a fundamental cause.

The study uses the NAS-NRC Twin Registry of World War II Veterans. The use of twins permits the exploration of gene-environment interplay. A recent survey instrument associated with the registry contains numerous indicators of health, including a measure of depression.

The results show that education has a strong negative relationship with depression among those in their 70s and early 80s. Although this relationship is partly explained by lower rates of cardiovascular disease and diabetes among the well-educated, the relationship between education and many common physical illnesses is quite small. Most people of this age experience at least one chronic illness. The relationship between education and depression is explained, instead, by how education reduces impairments in activities of daily living. These impairments are not an inevitable outgrowth of declining health. The well-educated are better able to moderate the impact of poor health on daily functioning. Moreover, the well-educated are able to avoid the otherwise strong genetic risks for depression in later life. Gene × environment models show a high heritability for later life depression on average, but also reveal that this heritability declines with increasing education. Among those with a four-year college degree, the heritability of depression is very small.

These patterns are interpreted in light of compensatory gene × environment interactions, which emphasize the importance of especially enriched environments for overcoming genetic risk.

School bullying is an important social problem with serious consequences. Many studies suggest that involvement in bullying (as a perpetrator or a victim) is associated with undesirable short‐term effects on the physical and psychological health of children and with undesirable long‐term effects on their future psychosocial adjustment as adults. The purpose of this paper is to investigate whether bullying perpetration predicts later criminal offending and whether bullying victimization predicts later depression.

The paper analyses data from the Pittsburgh Youth Study in which 503 boys who were originally assessed at age 6‐7 years have been followed up to age 19, with yearly or half‐yearly assessments.

Bullying perpetration in one age range, according to boys and mothers, predicted delinquency (reported by boys) in a later age range, and this relationship held up after controlling for ten major risk factors measured in an earlier age range. Bullying perpetration, according to boys, was the stronger predictor of delinquency. Bullying victimization (being bullied) in one age range predicted depression (reported by boys, mothers and teachers) in a later age range, and this relationship also held up after controlling for ten earlier risk factors. Bullying victimization according to mothers was the stronger predictor of depression.

The paper provides useful evidence which leads to the conclusion that bullying perpetration is followed by an increased risk of delinquency, and that bullying victimization is followed by an increased risk of depression.

The methods of coping and their relationship to disease severity, cognitive function, depression and health‐related quality of life (HRQoL) were examined in 79 Parkinson's disease (PD) patients and their carers. The coping methods of the PD patients were not associated with disease severity, cognitive function, or depression. In general the majority of correlations were weak. However, patients who used avoidance and cognitive coping methods reported improved HRQoL. Impaired cognitive function, poorer HRQoL and increased disease severity were associated with depression in patients. In carers, avoidance coping was associated with depression and cognitive impairment in the patient being cared for. These findings demonstrate the complex relationship in PD between impairment, quality of life, depression, cognitive function and the coping styles adopted by patients and carers. The study also highlights the difficulties in measuring these interactions with quantitative outcome measures.

Information and communication technology (ICT) usage is pervasive among present day youth, with about 95% of youth ages 12–17 years reporting use of the Internet. Due to the proliferation of ICT use among this generation, it is important to understand the impacts of ICT usage on well-being. The goal of this study was to determine the impact of ICT usage on psychological well-being among a sample of urban, predominately African American youth.

Paper and pencil surveys were administered to fourth and fifth grade students enrolled in 27 elementary schools in the southeastern United States. Relationships between hours using various types of ICTs and the frequency of Internet activities on depression, hopelessness, self-esteem, and belonging were examined using Ordinary Least Squares (OLS) regression.

Results indicate that ICT usage has both positive and negative implications for psychological well-being, depending upon the type of ICT use and outcome being examined.

The proliferation of ICT usage among present day youth may actually lessen its impact on psychological well-being. Since the amount of ICT usage does not seem to influence psychological well-being, future research should examine the impact of ICT content on psychological well-being.