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Item type:Publication, “We can't carry the weight of the whole world”: Illness experiences among Peruvian older adults with symptoms of depression and anxiety(BioMed Central Ltd, 2020-07-10)Despite the high levels of depression and anxiety symptoms in old age, the use of mental health services in this population is low. Help-seeking behaviors are shaped by how an individual perceives and experiences their illness. The objective of this study was to characterize the illness experiences of Peruvian older adults with depression and anxiety symptoms in order to lay the foundation for tailored community-based mental health interventions. Methods: In this qualitative study, we conducted in-depth interviews with a purposively selected sample of older adults (≥ 60 years) from peri-urban areas of Lima, Peru. We included individuals with only depressive symptoms (Patient Health Questionnaire-9 ≥ 10), only anxiety symptoms (Beck Anxiety Inventory ≥ 16), with depressive and anxiety symptoms, and older adults who mentioned they had received mental health treatment/care. The interview guide included the following topics: perceptions and experiences about depression and anxiety; perceptions about the relationship between physical chronic diseases and mental health; experiences with mental health professionals and treatments, and coping mechanisms. Data collection was conducted between October 2018 and February 2019. Results: We interviewed 38 participants (23 women, 15 men) with a mean age of 67.9 years. Participants' ideas and perceptions of depression and anxiety showed considerable overlap. Participants attributed depression and anxiety mainly to familial and financial problems, loneliness, loss of independence and past traumatic experiences. Coping strategies used by older adults included 'self-reflection and adaptation' to circumstances, 'do your part', and seeking 'emotional support' mainly from non-professionals (relatives, friends, acquaintances, and religion). Conclusions: Illness experiences of depression and anxiety set the pathway for tailored community-based mental health interventions for older adults. Overlapping narratives and perceptions of depression and anxiety suggest that these conditions should be addressed together. Mental health interventions should incorporate addressing areas related to depression and anxiety such as prevention of loss of independence, trauma, and loneliness. Good acceptability of receiving emotional support for non-professionals might offer an opportunity to incorporate them when delivering mental health care to older adults. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Does multidimensional poverty affect depression? Evidence from Peru(SAGE Publishing, 2021-11-13)The number of people in low- and middle-income countries who suffer from depression is increasing, and a significant proportion of people in these countries live in poverty. We estimated the effect of living in multidimensional poverty on experiencing symptoms associated with major depression using the 2018 Peruvian Demographic and Health Survey. We used an instrumental variables approach to overcome the potential endogeneity bias caused by the simultaneous relationship between multidimensional poverty and depression. We found that living in multidimensional poverty significantly increases depression symptom severity. This has urgent policy implications for low- and middle-income countries with limited provision of mental health services. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The relationship between age and mental health among adults in Iran during the COVID-19 pandemic(Springer Science+Business Media, 2021-06-22)The evidence on the predictors of mental health in the COVID-19 pandemic has revealed contradictory findings, which prevent effective screening for mental health assistance. This study aims to identify the predictors of mental health issues, specifically examining age as a nonlinear predictor. Based on a survey of 474 adults using snowball sampling under the COVID-19 pandemic during April 1th–10th, 2020, in Iran, we found that age had a curvilinear relationship with nonsomatic pain, depression, and anxiety. Specifically, it predicted pain, depression, and anxiety disorders, negatively among adults younger than 45 years, yet positively among seniors older than 70 years. Adults who were female, were unsure about their chronic diseases, or exercised less were more likely to have mental health issues. This study, being the first paper to examine age curvilinearly, suggests future research to pay more attention to nonlinear predictors of mental health disorders in the COVID-19 pandemic. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Emotional impact of COVID-19 and emotional eating and the risk of alcohol use disorder in Peruvian healthcare students(Multidisciplinary Digital Publishing Institute (MDPI), 2024-09-01)This study aimed to explore the association between the emotional impact of COVID-19 and emotional eating and the risk of alcohol use disorder among Peruvian health science students. Methods: We conducted a cross-sectional analytical study in which an online questionnaire was administered to 456 health science interns from four cities in Peru. We used the COVID-19 Emotional Impact Profile questionnaire, Mindful Eating Questionnaire, and Alcohol Use Disorders Identification Test. Spearman’s correlations were calculated and two multiple linear regression models were developed. Results: 68.4% of the participants were emotional eaters and 8.6% reported low-risk levels of alcohol use disorder. Based on the results of the first model, the overall emotional impact of COVID-19, being overweight or obese, depression and anxiety levels, and living with only one parent were factors associated with emotional eating. The results of the second model showed that the level of depression, living with just one parent, living alone, sex, and number of months as an intern were factors associated with the risk of alcohol use disorder. Conclusions: To reduce emotional eating and the risk of alcohol use disorder among interns, universities should implement interventions aimed at reducing the emotional impact of COVID-19 and provide nutritional counseling. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Economic inequalities in adolescents’ internalising symptoms: Longitudinal evidence from eight countries(Elsevier Ltd, 2024-11-01)Research, mainly conducted in Europe and North America, has shown an inequitable burden of internalising mental health problems among adolescents from poorer households. We investigated whether these mental health inequalities differ across a diverse range of countries and multiple measures of economic circumstances. Methods: In this longitudinal observational cohort study, we analysed data from studies conducted in eight countries (Australia, Ethiopia, India, Mexico, Peru, South Africa, the UK, and Viet Nam) across five global regions. All studies had self-reported measures of internalising symptoms using a validated scale at two timepoints in adolescence; a measure of household income, household consumption expenditure, or subjective wealth; and data collected between 2000 and 2019. Household income (measured in four countries), consumption expenditure (six countries), and adolescents’ subjective assessment of household wealth (five countries) were measured in mid-adolescence (14–17 years). The primary outcome (internalising symptoms, characterised by negative mood, affect, and anxiety) was measured later in adolescence between age 17 and 19 years. Analyses were linear regression models with adjustment. Effect estimates were added to random-effects meta-analyses to aid understanding of cross-country differences. Findings: The overall pooled sample of eight studies featured 18 910 adolescents (9568 [50·6%] female and 9342 [49·4%] male). Household income had a small or null association with adolescents’ internalising symptoms. Heterogeneity (I2 statistic) was 71·04%, falling to 39·71% after adjusting for baseline symptoms. Household consumption expenditure had a stronger association with internalising symptoms (decreases of 0·075 SD in Peru [95% CI –0·136 to –0·013], 0·034 SD in South Africa [–0·061 to –0·006], and 0·141 SD in Viet Nam [–0·202 to –0·081] as household consumption expenditure doubled). The I2 statistic was 74·24%, remaining similar at 74·83% after adjusting for baseline symptoms. Adolescents’ subjective wealth was associated with internalising symptoms in four of the five countries where it was measured. The I2 statistic was 57·09% and remained similar after adjusting for baseline symptoms (53·25%). We found evidence for cross-country differences in economic inequalities in adolescents’ internalising symptoms, most prominently for inequalities according to household consumption expenditure. Subjective wealth explained greater variance in symptoms compared with the objective measures. Interpretation: Our study suggests that economic inequalities in adolescents’ mental health are prevalent in many but not all countries and vary by the economic measure considered. Variation in the magnitude of inequalities suggests that the wider context within countries plays an important role in the development of these inequalities. Funding: Wellcome Trust. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COVID-19 pandemic-related emotional, social, and medical concerns of Latino patients with cancer: Perspectives of mental health providers(Lippincott Williams and Wilkins, 2024-01-01)Latino people with cancer might face additional health, emotional, and socioeconomic burdens of the COVID-19 pandemic.Methods:This study included data from two waves of (independent) assessments with providers of mental health services to Latino/Hispanic people with cancer from the United States, Spain, and Latin America (first wave: May-July 2020; second wave: March-July 2021) who completed a cross-sectional online survey with open-ended and closed-ended questions, including concerns of people with cancer with/without COVID-19.Results:The response rates were 15% for Wave 1 (N = 88) and 14% for Wave 2 (N = 115). For Wave 1, 74 surveys were completed by clinicians and included in the analyses; for Wave 2, 115 surveys were included. Providers (first [77%] and second [84%] waves) reported that most patients had concerns about stress/symptoms of anxiety, followed by concerns about COVID-19 exposure (first [74%] and second [82%] waves) and family members' exposure (second wave 75%), hospital visits or appointments (82%, 79%, respectively), treatment/testing delays (69%, 72%, respectively), general health (58%, 71%, respectively), and income/salary loss or reduction (60%, 50%, respectively). According to providers, concerns of patients diagnosed with COVID-19 included fear of death and dying, spreading the disease, getting worse, and lack of appropriate medical care.Conclusion:Our findings reveal the need to address health, emotional, and socioeconomic burdens of the COVID-19 pandemic throughout Latin America, Spain, and the United States for Latino people with cancer. Interventions targeting the health care access, emotional, and socioeconomic needs of Latino people with cancer are warranted. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Emotion Regulation Strategies and Psychological Health Across Cultures(American Psychological Association, 2023-11-16)Emotion regulation is important for psychological health and can be achieved by implementing various strategies. How one regulates emotions is critical for maximizing psychological health. Few studies, however, tested the psychological correlates of different emotion regulation strategies across multiple cultures. In a preregistered cross-cultural study (N = 3,960, 19 countries), conducted during the COVID-19 pandemic, we assessed associations between the use of seven emotion regulation strategies (situation selection, distraction, rumination, cognitive reappraisal, acceptance, expressive suppression, and emotional support seeking) and four indices of psychological health (life satisfaction, depressive symptoms, perceived stress, and loneliness). Model comparisons based on Bayesian information criteria provided support for cultural differences in 36% of associations, with very strong support for differences in 18% of associations. Strategies that were linked to worse psychological health in individualist countries (e.g., rumination, expressive suppression) were unrelated or linked to better psychological health in collectivist countries. Cultural differences in associations with psychological health were most prominent for expressive suppression and rumination and also found for distraction and acceptance. In addition, we found evidence for cultural similarities in 46% of associations between strategies and psychological health, but none of this evidence was very strong. Cultural similarities were most prominent in associations of psychological health with emotional support seeking. These findings highlight the importance of considering the cultural context to understand how individuals from diverse backgrounds manage unpleasant emotions. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The impact of different adverse childhood experiences on the dimensions of emotional dysregulation in adults with major depression(Frontiers Media, 2025-01-01)Introduction: Adverse childhood experiences adversely affect the development of emotional regulation, yet their differential impact on discrete dysregulation dimensions in major depressive disorder remains underexamined. This study examines the relationship between adverse childhood experiences and emotional dysregulation, as well as its five dimensions. Methods: A total of 120 out-patients meeting the BDI-II cutoff for MDD completed the Childhood Trauma Questionnaire-SF (CTQ-SF) and the Difficulties in Emotion Regulation Scale (DERS). We first tested sex differences on DERS subscales (none emerged), then ran a multivariate multiple regression using Pillai's trace to assess the joint effects of the five CTQ-SF dimensions on the five DERS dimensions. Six follow-up linear regressions predicted each DERS subscale and the total DERS score from the CTQ-SF dimensions. Results: Physical abuse was the only CTQ dimension with a significant multivariate effect. In univariate models, emotional abuse predicted higher overall dysregulation and increased emotional dyscontrol, everyday interference, and emotional inattention, whereas greater physical abuse was associated with reduced everyday interference. Discussion: Emotional abuse appears to be the principal driver of both global and facet-specific emotion-regulation difficulties in adults with MDD, suggesting that interventions emphasizing impulse control, emotion awareness, and reduction of functional interference may be particularly beneficial for this subgroup. Limitations: The cross-sectional, selfreport design precludes causal inferences and may be subject to recall bias; future work should employ longitudinal, multimethod approaches to elucidate mechanisms and resilience factors.1 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, How i would like to forget: Lived experiences of traumatic and stressful life events among older adults in Peru(Cambridge University Press, 2025-09-23)Traumatic and stressful life events can have lasting effects on mental health, particularly among older adults in low-resource settings. In Latin America, there is limited qualitative evidence capturing the lived experiences of these events. This study explores how older adults in Peru reflect on traumatic and stressful events throughout their lives, and how these experiences continue to shape their mental health in later life. This qualitative study was nested within the Global Excellence in COPD Outcomes (GECo) study in Lima, Peru. We conducted semi-structured, narrative-based interviews with 38 older adults (≥60 years) with moderate to severe symptoms of depression (Patient Health Questionnaire-9 ≥ 10), anxiety (Beck Anxiety Inventory ≥ 16) or a history of mental health treatment. Four main categories emerged: (1) violence (emotional, physical or sexual), (2) abandonment or loss of close relatives, (3) onset of severe illness or disability and (4) other miscellaneous life disruptions. Participants described their memories of past stressful events as deeply embedded in current thoughts and, in some cases, as shaping how they experience certain emotions in the present. Addressing trauma in older adults may improve well-being in low-resource settings. Recognizing the enduring impact of life-course stressors is crucial for culturally sensitive mental health interventions.1