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Variation exists in our attitude and behaviour towards food and exercise, resulting in different degrees of health and ill health. Cultural and economic factors contribute to this, alongside personal choices, leading to a spectrum from normative eating, through disordered eating to the extremes of eating disorders (EDs). Understanding the intricate interplay between biological, psychological, and sociocultural factors to eating, exercise and body image is paramount to understand the current state regarding EDs and to deliver/develop multifaceted and individualised treatments. Significant service developments have occurred following the launch of the Irish Health Service Executive Model of Care for EDs in 2018. However, incomplete roll out and surge in EDs referrals post Covid-19 require generic child and adolescent mental health services (CAMHS) to be competent in assessment of EDs, and to keep abreast of clinical updates in order to offer effective treatment.
This review provides an evidenced based update on eating related difficulties, outlines a useful assessment framework, offers information on appropriate clinical management, and highlights exciting clinically relevant research developments.
Virtual reality (VR) for mental health promotion remains understudied in low-income humanitarian settings. We examined the effectiveness of VR in reducing depression with urban refugee youth in Kampala, Uganda. This randomized controlled trial assessed VR alone (Arm 1), VR followed by Group Problem Management Plus (GPM+) (Arm 2) and a control group (Arm 3), with a peer-driven and convenience sample of refugee youth aged 16–25 in Kampala. The primary outcome, depression, was measured with the Patient Health Questionnaire-9. Secondary outcomes included: mental health literacy, mental health stigma, self-compassion, mental well-being and adaptive coping. Analyses were conducted at three time points (baseline, 8 weeks, 16 weeks) using generalized estimating equations. Among participants (n = 335, mean age: 20.77, standard deviation: 3.01; cisgender women: n = 158, cisgender men: n = 173, transgender women: n = 4), we found no depression reductions for Arms 1 or 2 at 16 weeks compared with Arm 3. At 16 weeks, mental health literacy was significantly higher for Arm 2 compared with Arm 3, and self-compassion was significantly higher in Arm 1 and Arm 2 compared with Arm 3. VR alongside GPM+ may benefit self-compassion and MHL among urban refugee youth in Kampala, but these interventions were not effective in reducing depression.
This chapter demonstrates how young male Taiwanese elites turned to gendered masculinity in response to colonial redefinitions of women within the family and marriage from the 1920s onward. Taiwanese masculinity derived from the mixture of Han Chinese tradition and Japanese colonialism. Chinese men had developed their masculinity on sociocultural standings and power in and outside of the household. Meanwhile, male Taiwanese elites often received higher education in Japan, and they built Taiwanese nationalism on calls for regulating or ending the practices of bride prices, daughter adoption, and premarital sex among ordinary Taiwanese men and women. In those top-down calls, Taiwanese elites defined themselves as men in terms of their ability to facilitate individual willpower and liberalize society. Far from being personal, their masculinity made it necessary for the elites to work with the colonial authorities to materialize family reforms in the late 1920s. To shore up their sociopolitical standing, those elites held women responsible for obstructing family reforms and painted them in a negative light, constructing masculinity while assigning additional gendered burdens.
In June 2020, the largest democracy movement in a generation emerged in Thailand. The movement began with three demands: the current PM must resign, a new constitution must be drafted, and the state must stop threatening dissidents. In August 2020, a fourth demand was added: the monarchy must be reformed. This demand is where the transformative power of the movement came from, but also led to a swift crackdown in the form of police violence and prosecutions. This may appear to be a particularly egregious illustration of the rule-by-law regimes favored by autocrats, but close examination indicates that the law is being used to criminalize peaceful dissent and the mere questioning of how power is exercised. By examining several key cases, this chapter shows how the Thai regime aims to reshape both the rule of law and the polity through the arbitrary exercise of repressive power.
This chapter explores inclusions and exclusions embedded within the Omani economy as experienced by citizens and foreigners. The chapter shows, first, that contestations around labour market belonging and experiences emerge within the local structures of segmentation and the global nature of Oman’s labour market. Second, in order to understand economic belonging and citizenship in the Gulf, class has to take a central role. The production of difference and competing identities of local regionalism, tribal and community affiliation, religion, interior and coastal cultures, race, heritage, and gender all matter but need to be understood alongside the intervening variable of class. The subjectivity of experiences and perceptions of inclusion and exclusion exposes how the politics and practice of difference in global capitalism produces tensions, value, and forms of power that manifest in labour and class relations. These dynamics also generate resistance and contestation around the boundaries of inclusion and exclusion.
The chapter introduces the book, its main claims, and arguments. It is concerned with setting the agenda for how to take labour seriously in Gulf development discourses and the value of centring labour from the margins. The book argues that Oman’s labour market is global and that Omani labour needs to be understood globally and relationally within and beyond the segmentations that divide the labour market. The chapter situates youth and their economic dreams and experiences at the heart of the story of development, discusses how to understand labour within the rentier state, and lays out the framework and empirical analysis to follow.
This chapter examines the promotion of entrepreneurship and business startups in Oman and its rhetorical targeting of youth and women. Although innovation is part of the promotion agenda, entrepreneurship is often focused on encouraging citizens to create their own private sector job. The chapter focuses on the experiences of young people in internalising entrepreneurship promotion discourses and in starting personal businesses. It illustrates two key tensions – first, the tension between rentierism embedded within authoritarian governing structures, on the one hand, and the logic of neoliberal capitalism, on the other; and second, the tensions between rhetoric and realities of youth and female empowerment narratives. Entrepreneurship is expressed and promoted as an empowering activity, and at times is experienced as such, but can also be used to legitimise or reconstitute patriarchal and authoritarian structures to accommodate the market. The space of entrepreneurship promotion is both a key tactic of labour market bandaging, and a distinct illustration of rentier neoliberalism
Humanitarian aid, including food aid, has increasingly shifted towards the provision of cash assistance over in-kind benefits. This paper examines whether food security mediates the relationship between receipt of humanitarian cash transfers and subjective wellbeing among Syrian refugee youth in Jordan.
Design:
Secondary analysis of the 2020–21 Survey of Young People in Jordan, which is nationally representative of Syrian youth aged 16–30. We employ stepwise model building and structural equation models.
Setting:
Jordan.
Participants:
Syrian refugee youth aged 16–30 (n 1572).
Results:
While 92 % of Syrian households with youth received cash transfers from a UN agency, 78 % of households were food insecure using the Food Insecurity Experience Scale. Fifty-one percent of youth suffered from poor wellbeing using the WHO-5 subjective wellbeing scale. Household food insecurity was associated with poorer youth wellbeing. Receiving larger cash transfer amounts was associated with better wellbeing among Syrian youth in unadjusted models. The relationship between receipt of cash transfers and youth wellbeing was not mediated by food security.
Conclusion:
We do not find support for the hypothesis that food security is a mediator of the association between cash transfers and subjective wellbeing for this population.
This chapter introduces the main arguments of the book by exploring the case of Kizito Mihigo, a well-known popular singer who was imprisoned, was released, and later died while in police custody. It discusses the idiom of the heart – or, more particularly, the need to transform the heart – as key to understanding post-genocide social life and urban young people’s attempts to navigate a difficult political terrain. Instead of reproducing theoretical binaries – resistance–domination, sound–silence, past–present – this chapter proposes looking to popular culture and Pentecostalism in order to understand the different ways young people in Kigali attempt to assert agency and make ‘noise’ despite a wider context of silence.
Pentecostal charismatic churches that preach prosperity gospel in Zimbabwe have attracted a youthful membership. In the context of a deeply uncertain economic future, young Pentecostal Christians devise performativity strategies for optimizing their chances of converting prosperity gospel into material prosperity. These strategies include sartorial elegance in adorning counterfeit suits, the performance of obedience, and the use of social media technologies. The picture that emerges is a complex and at times contradictory one in which the potential realization of upward spiritual and social mobility rests, ultimately, on the transformative and volatile nature of value. Data for this project was collected in Harare through ethnographic research and interviews over a year-long period.
Statistical discrimination offers a compelling narrative on gender wage gaps among younger workers. Employers could reduce women's wages to adjust for expected costs linked to child-bearing. If this is the case, then trends toward delayed fertility should reduce the gender wage gap among young workers. We provide a novel collection of adjusted gender wage gap (AGWG) estimates among young workers from 56 countries spanning four decades and use it to test the conjecture that delayed fertility reduces gender wage inequality. We employ instrumental variables, and find that one year postponement of the first birth reduces AGWG by two percentage points (15% of the AGWG). We benchmark this estimate with the help of time-use data.
Youth, Pentecostalism, and Popular Music in Rwanda offers fascinating insight into the lived experiences of young people in Rwanda through ethnographic analysis of the ambiguities and ambivalences that have accompanied the country's rapid post-genocide development. Andrea Mariko Grant considers how Pentecostalism and popular music offer urban young people ways to craft themselves and their futures; to imagine alternative ways to 'be' Rwandan and inhabit the city in the post-genocide era. Exploring the idiom of the heart – and efforts to transform it – this book offers a richly nuanced perspective of urban young people's everyday lives, their aspirations and disappointments, at a political moment of both great promise and great constraint. Rather than insist on a resistance-dominance binary, Grant foregrounds the possibilities of agency available to young people, their ability to make 'noise', even when it may lead to devastating consequences.
There is a high prevalence of depression among refugee youth in low- and middle-income countries, yet depression trajectories are understudied. This study examined depression trajectories, and factors associated with trajectories, among urban refugee youth in Kampala, Uganda.
Methods
We conducted a longitudinal cohort study with refugee youth aged 16–24 in Kampala, Uganda. We assessed depression using the Patient Health Questionnaire-9 and conducted latent class growth analysis (LCGA) to identify depression trajectories. Sociodemographic and socioecological factors were examined as predictors of trajectory clusters using multivariable logistic regression.
Results
Data were collected from n = 164 participants (n = 89 cisgender women, n = 73 cisgender men, n = 2 transgender persons; mean age: 19.9, standard deviation: 2.5 at seven timepoints; n = 1,116 observations). Two distinct trajectory clusters were identified: “sustained low depression level” (n = 803, 71.9%) and “sustained high depression level” (n = 313, 28.1%). Sociodemographic (older age, gender [cisgender women vs. cisgender men], longer time in Uganda), and socioecological (structural: unemployment, food insecurity; interpersonal: parenthood, recent intimate partner violence) factors were significantly associated with the sustained high trajectory of depression.
Conclusions
The chronicity of depression highlights the critical need for early depression screening with urban refugee youth in Kampala. Addressing multilevel depression drivers prompts age and gender-tailored strategies and considering social determinants of health.
Engaging with personal mental health stories has the potential to help people with mental health difficulties by normalizing distressing experiences, imparting coping strategies and building hope. However, evidence-based mental health storytelling platforms are scarce, especially for young people in low-resource settings.
Objective
This paper presents an account of the co-design of ‘Baatcheet’ (‘conversation’ in Hindi), a peer-supported, web-based storytelling intervention aimed at 16–24-year-olds with depression and anxiety in New Delhi, India.
Methods
Development comprised three stages: (1) establishing a logic model through consultations with a Young People’s Advisory Group (N = 11) and a stakeholder reference group (N = 20); (2) elaborating intervention guiding principles and components through focus group discussions and co-design workshops (N = 42); and (3) user-testing of prototypes.
Results
The developmental process identified key stakeholder preferences for an online, youth-focused mental health storytelling intervention. Baatcheet uses an interactive storytelling website containing a repository of personal stories about young people’s experiences of depression and anxiety. This is offered alongside brief support from a peer.
Conclusions
There are few story-based interventions addressing depression and anxiety for young people, especially in low-resource settings. Baatcheet has the potential to deliver engaging, accessible and timely mental health support to young people. A pilot evaluation is underway.
Markers of inflammation and cannabis exposure are associated with an increased risk of mental disorders. In the current study, we investigated associations between cannabis use and biomarkers of inflammation.
Methods
Utilizing a sample of 914 participants from the Avon Longitudinal Study of Parents and Children, we investigated whether interleukin-6 (IL-6), tumor necrosis factor α (TNFα), C-reactive protein (CRP), and soluble urokinase plasminogen activator receptor (suPAR) measured at age 24 were associated with past year daily cannabis use, less frequent cannabis use, and no past year cannabis use. We adjusted for a number of covariates including sociodemographic measures, body mass index, childhood trauma, and tobacco smoking. We found evidence of a strong association between daily or near daily cannabis use and suPAR.
Results
We did not find any associations between less frequent cannabis use and suPAR. We did not find evidence of an association between IL-6, TNFα or CRP, and cannabis use.
Conclusions
Our finding that frequent cannabis use is strongly associated with suPAR, a biomarker of systemic chronic inflammation implicated in neurodevelopmental and neurodegenerative processes is novel. These findings may provide valuable insights into biological mechanisms by which cannabis affects the brain and impacts the risk of serious mental disorders.
Adolescents with a history of conduct problems (CP) are at heightened risk of increased service utilization as they develop. While the mechanisms underlying this association are unclear, early CP have also been linked with peer victimization and internalizing problems. The goals of the current study were: (1) to examine peer victimization and internalizing problems as potential serial mediators explaining increased medical and psychiatric service use in adolescents with a history of childhood CP, and; (2) to explore whether the proposed mediation models vary by sex.
Methods
Participants (N = 744; 53% boys, Mage = 8.39 years) from an ongoing longitudinal study that began in 2008 in Québec, Canada were recruited and assessed for CP, service use, and other behaviours via self-, parent- and teacher-reported questionnaires. Serial mediation analyses were conducted to examine the effects of peer victimization and internalizing problems on the association between childhood CP and adolescent medical and psychiatric service use, controlling for sex and household income.
Results
Adolescents with childhood CP reported higher medical and psychiatric service use than non-CP peers. Peer victimization and internalizing problems significantly mediated this association in both general medical and psychiatric service use models. The models did not vary by sex.
Conclusions
Findings support higher levels of service use in adolescents with a history of CP, mediated by peer victimization and internalizing problems. Specifically, results highlight the importance of examining peer and socioemotional factors that may explain the increased service usage observed among youth with CP, to support better health outcomes.
The aim of this study was to understand how and why relational welfare works to support young people who are not in employment, education or training (NEET). It builds on research discussing the limitations of work-first and human capital strategies in social policy while responding to calls for theory-driven insights into initiatives that move beyond employability and rapid employment. The material for this realist evaluation includes programme documents, fieldnotes and 75 interviews with practitioners and participants in community-based multicomponent initiatives delivered by Swedish municipalities. These data were scrutinised against programme theories while integrating literature on relational welfare as underpinned by co-creation and capability approaches. The results illustrate how flexible, challenging and coordinated programming strengthen beings and doings of young people in NEET situations while improving their wellbeing by overcoming isolation and forming a future orientation. The study provides guidance for supporting NEET-situated young people through a relational approach to welfare. It also offers a model against which local initiatives provided to a youth group high on the policy agenda can be mapped.
During the COVID-19 pandemic, collecting data online was the only option for many researchers. This chapter describes the barriers to, advantages of, and key lessons learned in conducting online interviews during the pandemic. We draw on a qualitative study focusing on employment experiences during the pandemic among youth with and without disabilities. Thirty interviews were conducted synchronously via Zoom. Barriers to conducting online interviews included technical difficulties and some challenges with building rapport. Benefits of conducting online interviews included greater efficiency and flexibility, technical advantages, and perceived anonymity and privacy. Key lessons learned in conducting online interviews included testing equipment in advance and having a back-up recorder, giving participants questions in advance or having it on the shared screen, and providing technical information to participants in an easy-to-understand format.
This chapter documents our experiences of pivoting research on sexual and gender minority youth towards an online protocol using digital methods. Digital diaries presented an opportunity to conduct virtual longitudinal qualitative research on how youth describe their experiences of living through the COVID-19 pandemic in Vancouver, Canada. Our digital diary process, supplemented with remote interviews, allowed us to capture shifting health-related patterns and trends, establish capacity to identify and explore unanticipated areas of inquiry, and evaluate participants’ impressions of the method itself. While going digital allowed us to overcome some immediate constraints to participation, it also introduced new uncertainties, including equity concerns and issues around consistent, secure and safe digital access for research participants. We describe how features of young people’s lives remain important factors associated with their ability to participate in digital and remote research. We offer solutions to the challenges and conclude that to counteract the inequities arising from the shift to digital methods, we need flexible, adaptive and population-tailored digital and remote approaches to data collection.
Youth in sub-Saharan Africa (SSA) face limited access to professional mental health resources. A comprehensive assessment of the prevalence of mental disorders would build an understanding of the scope of the need.
We conducted systematic searches in PsycInfo, Pubmed, AfriBib and Africa Journals Online to identify prevalence rates for five disorders (anxiety, depression, conduct disorder, attention problems and post-traumatic stress) among SSA youth with a mean age of less than 19 years. We calculated a random-effects pooled prevalence for each disorder and assessed possible moderators.
The meta-analysis included 63 studies with 55,071 participants. We found the following pooled prevalence rates: 12.53% post-traumatic stress disorder (PTSD), 15.27% depression, 6.55% attention-deficit hyperactivity disorder, 11.78% anxiety and 9.76% conduct disorder. We found high heterogeneity across the studies, which may have resulted from differences in samples or measurement tools. Reported prevalence rates were not explained by the sample (i.e., special or general population), but whether the psychometric tool was validated for SSA youth affected the reported prevalence of PTSD and anxiety. In a meta-regression, prevalence rates were associated with the disorder type, with a higher prevalence of depression and PTSD. We found the mean age significantly moderated the prevalence in univariate meta-regression, with increased age correlated with greater prevalence.
Our findings suggest there is a need to explore reasons for varying prevalence rates further and to develop interventions that support youth mental health in SSA, particularly interventions for depression and PTSD. Limitations included a lack of standardization in psychometric tools and limited reporting on research methods, which influenced quality rating. Importantly, the search only considered studies published in English and was conducted 2 years ago. Although recent estimates reported slightly higher than our prevalence estimates, these reviews together highlight the prevalence and importance of youth mental health difficulties in SSA.