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43 result(s) for "Koutra, Katerina"
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Antenatal and postnatal maternal mental health as determinants of infant neurodevelopment at 18 months of age in a mother–child cohort (Rhea Study) in Crete, Greece
Purpose A growing body of evidence links poor maternal mental health with negative outcomes on early child development. We examined the effect of antenatal and postnatal maternal mental health on infant neurodevelopment at age 18 months in a population-based mother–child cohort (Rhea Study) in Crete, Greece. Methods Self-reported measures of maternal depression (EPDS), trait anxiety (STAI-Trait) and personality traits (EPQ-R) were assessed in a sample of women during pregnancy and at 8 weeks postpartum ( n  = 223). An additional sample of 247 mothers also completed the EPDS scale at 8 weeks postpartum ( n  = 470). Neurodevelopment at 18 months was assessed with the use of Bayley Scales of Infant and Toddler Development (3rd edition). Results Multivariable linear regression models adjusted for confounders revealed that antenatal depressive symptoms (EPDS ≥ 13) were associated with decrease in cognitive development independently of postnatal depression. High trait anxiety and extraversion were associated with decrease and increase, respectively, in social–emotional development. Also, high trait anxiety and neuroticism had a positive effect on infants’ expressive communication. Finally, postpartum depressive symptoms (EPDS ≥ 13) were associated with decrease in cognitive and fine motor development independently of antenatal depression. Conclusions These findings suggest that antenatal and postnatal maternal psychological well-being has important consequences on early child neurodevelopment.
The Costs of Caring: Prevalence and Associated Factors of Burnout, Compassion Fatigue, and Compassion Satisfaction Among Mental Health Professionals in Greece
Burnout and work-related stress are extensively studied among mental health professionals (MHPs) in countries around the world, but there is a paucity of research emanating from Greece’s hybrid healthcare system. In Greece, MHPs may encounter unique challenges with economic obstacles and in putting ongoing community-oriented mental healthcare policies into practice. This study aims, first, to assess the prevalence of burnout, compassion fatigue, and compassion satisfaction among Greek MHPs; and second, to examine the sociodemographic and work-related factors influencing these dimensions of professional quality of life. A total of 287 Greek MHPs (25.4% male, 74.6% female; M = 39.85 years, SD = 9.52) completed the Maslach Burnout Inventory (MBI) and the Professional Quality of Life Scale-5 (ProQOL-5). Sociodemographic and occupational data were also collected. Findings revealed that 11.8% of participants reported high emotional exhaustion, 19.9% high depersonalization, and 35.9% a high risk of reduced personal accomplishment. Almost half of the participants (48.8%) reported high levels of compassion satisfaction, suggesting that many MHPs continue to find fulfillment in their work. Notably, none of the participants reported high levels of compassion fatigue. Sociodemographic characteristics, such as gender, ethnicity, and marital status, as well as work-related factors, including employment sector, specialization, and years of experience, were related to MHPs’ professional quality of life. These results highlight the need for targeted strategies to address burnout and promote positive professional experiences among MHPs in Greece. Interventions should support well-being and enhance the rewarding aspects of mental health practice.
From Early Stress to Adolescent Struggles: How Maternal Parenting Stress Shapes the Trajectories of Internalizing, Externalizing, and ADHD Symptoms
Background/Objectives: Parenting stress, the emotional strain resulting from the demands of child-rearing, can profoundly affect both parental well-being and children’s emotional and behavioral development. This study examined the impact of maternal parenting stress during early childhood on the longitudinal progression of children’s internalizing, externalizing, and attention deficit hyperactivity disorder (ADHD) symptoms, from early childhood through adolescence. Methods: The study included 406 mother–child pairs from the Rhea mother–child cohort in Crete, Greece. Maternal parenting stress was assessed at age 4 using the Parental Stress Scale (PSS). Children’s symptoms were evaluated at ages 4 (Strengths and Difficulties Questionnaire, ADHD Test), 6, 11, and 15 years (Child Behavior Checklist, Conners’ Parent Rating Scale) through maternal reports. Multivariate mixed regression models, incorporating a random intercept for each child and a random slope for age at follow-up, were used to analyze the trajectories of symptoms from ages 4 to 15. Group-based trajectory modeling was applied to identify trajectory groups from 4 to 15 years, and multinomial logistic regression models were implemented to examine the associations between parental stress and group trajectories. Results: The results revealed that higher parental stress at age 4 was significantly associated with increased internalizing (b = 0.94, 95% CI: 0.68, 1.21), externalizing (b = 1.03, 95% CI: 0.75, 1.30), and ADHD symptoms (b = 0.86, 95% CI: 0.58, 1.14) over the study period. Notably, the impact of parenting stress on behavioral problems decreased with age (interaction with age, p = 0.032). Additionally, higher parenting stress at age 4 was linked to a greater likelihood of belonging to adverse symptom trajectories, including high decreasing, low increasing, and stable high trajectories for both internalizing and externalizing problems. Conclusions: These findings underscore the importance of early maternal parenting stress as a predictor of long-term emotional and behavioral difficulties in children, emphasizing the need for early intervention programs that support maternal mental health and children’s emotional development.
The Influence of Positive and Negative Aspects of Perfectionism on Psychological Distress in Emerging Adulthood: Exploring the Mediating Role of Self-Compassion
Perfectionism constitutes a multidimensional personality trait. According to the diathesis–stress model, perfectionism may predispose individuals to experience increased psychological distress during stressful periods. Since self-compassion is considered as a protective factor within the context of mental health difficulties, the primary objective of this study was to explore the mediating function of self-compassion in the relationship between positive (i.e., high standards and order) and negative (i.e., discrepancy) aspects of perfectionism and psychological distress among Greek emerging adults. The sample consisted of 410 university students (47.6% males and 52.4% females), with a mean age of 20.61 ± 1.88 years. The Almost Perfect Scale-Revised (APS-R), the Self-Compassion Scale (SCS), and the General Health Questionnaire-28 (GHQ-28) were used to assess perfectionism, self-compassion, and psychological distress, respectively. The results indicated that self-compassion mediated the association between positive and negative aspects of perfectionism and different dimensions of psychological distress (i.e., somatic symptoms, anxiety/insomnia, social dysfunction, and severe depression). Specifically, discrepancy and increased levels of high standards were related to lower levels of self-compassion, thus leading to greater endorsement of psychological distress. In contrast, order was associated with higher levels of self-compassion, thus leading to lower levels of psychological distress. The findings of the present study highlight that self-compassion is an overall important area to examine in nonclinical populations. These findings have implications for the effectiveness of cognitive behavioral therapy (CBT) in enhancing individuals’ self-acceptance and awareness of their perfectionistic tendencies, as well as compassion-focused therapy (CFT) in elevating self-compassion, mindfulness, and overall psychological well-being while reducing psychological distress.
Breastfeeding duration and cognitive, language and motor development at 18 months of age: Rhea mother–child cohort in Crete, Greece
Background Breast feeding duration has been associated with improved cognitive development in children. However, few population-based prospective studies have evaluated dose–response relationships of breastfeeding duration with language and motor development at early ages, and results are discrepant. Methods The study uses data from the prospective mother–child cohort (‘Rhea’ study) in Crete, Greece. 540 mother–child pairs were included in the present analysis. Information about parental and child characteristics and breastfeeding practices was obtained by interview-administered questionnaires. Trained psychologists assessed cognitive, language and motor development by using the Bayley Scales of Infant Toddler Development (3rd edition) at the age of 18 months. Results Duration of breast feeding was linearly positively associated with all the Bayley scales, except of gross motor. The association persisted after adjustment for potential confounders with an increase of 0.28 points in the scale of cognitive development (β=0.28; 95% CI 0.01 to 0.55), 0.29 points in the scale of receptive communication (β=0.29; 95% CI 0.04 to 0.54), 0.30 points in the scale of expressive communication (β=0.30; 95% CI 0.04 to 0.57) and 0.29 points in the scale of fine motor development (β=0.29; 95% CI 0.02 to 0.56) per accumulated month of breast feeding. Children who were breast fed longer than 6 months had a 4.44-point increase in the scale of fine motor development (β=4.44; 95% CI 0.06 to 8.82) compared with those never breast fed. Conclusions Longer duration of breast feeding was associated with increased scores in cognitive, language and motor development at 18 months of age, independently from a wide range of parental and infant characteristics. Additional longitudinal studies and trials are needed to confirm these results.
Impact of prenatal exposure to cadmium on cognitive development at preschool age and the importance of selenium and iodine
The evidence regarding a potential link of low-to-moderate iodine deficiency, selenium status, and cadmium exposure during pregnancy with neurodevelopment is either contradicting or limited. We aimed to assess the prenatal impact of cadmium, selenium, and iodine on children's neurodevelopment at 4 years of age. The study included 575 mother—child pairs from the prospective \"Rhea\" cohort on Crete, Greece. Exposure to cadmium, selenium and iodine was assessed by concentrations in the mother's urine during pregnancy (median 13 weeks), measured by ICPMS. The McCarthy Scales of Children's Abilities was used to assess children's general cognitive score and seven different sub-scales. In multivariable-adjusted regression analysis, elevated urinary cadmium concentrations (≥0.8 μg/L) were inversely associated with children's general cognitive score [mean change: —6.1 points (95 % CI — 12; —0.33) per doubling of urinary cadmium; corresponding to ~0.4 SD]. Stratifying by smoking status (p for interaction 0.014), the association was restricted to smokers. Urinary selenium was positively associated with children's general cognitive score [mean change: 2.2 points (95 % CI —0.38; 4.8) per doubling of urinary selenium; ~0.1 SD], although the association was not statistically significant. Urinary iodine (median 172 μg/L) was not associated with children's general cognitive score. In conclusion, elevated cadmium exposure in pregnancy of smoking women was inversely associated with the children's cognitive function at pre-school age. The results indicate that cadmium may adversely affect neurodevelopment at doses commonly found in smokers, or that there is an interaction with other toxicants in tobacco smoke. Additionally, possible residual confounding cannot be ruled out.
Breaking Barriers: Unraveling the Connection between Mental Health Literacy, Attitudes towards Mental Illness, and Self-Stigma of Psychological Help-Seeking in University Students
Despite the high prevalence of mental health difficulties during the period of emerging adulthood and the availability of mental health resources, young adults are reluctant to seek professional psychological help. A significant contributor to this treatment gap is the inadequate levels of mental health literacy (MHL). The present study aimed to investigate the association between MHL with attitudes toward mental illness and the self-stigma of seeking psychological treatment among university students. The sample consisted of 485 university students (24.5% males, 75.5% females) with a mean age of 19.54 years (SD = 1.45) drawn from a regional university in Greece. MHL, attitudes towards severe mental illness, and self-stigma of help-seeking were assessed using the Mental Health Literacy Scale (MHLS), the Attitudes towards Severe Mental Illness (ASMI), and the Self-Stigma of Seeking Help Scale (SSOSH), respectively. MHLS was positively correlated with three out of four subscales of ASMI, namely stereotyping, optimism, and coping, and negatively related to SSOSH. Multivariate linear regression analysis adjusting for various confounders showed that students with higher MHL were more likely to report non-stigmatizing attitudes towards mental illness and lower self-stigma of help-seeking from mental health professionals. According to our findings, higher MHL was related to more positive views regarding mental illness and lower self-stigma of help-seeking. To lessen the self-stigma of seeking professional help, MHL must be addressed as an important component of psychoeducational interventions at universities aiming to support students’ help-seeking intentions and practices.
Emotion regulation in relation with resilience in emerging adults: The mediating role of self-esteem
The transitional period of emerging adulthood can cause a lot of stress to the individuals due to the multiple life changes and the social pressure. Efficient emotion regulation and resilience can be proven important qualities in the face of stressors during this period. The aim of the present study was to test a path analytic model accounting for emerging adults’ resilience that takes into account emotion regulation strategies (e.g., cognitive reappraisal and expressive suppression) and self-esteem. Also, two alternative models with reverse ordering of the variables to examine the theoretical possibility of reverse causation were formulated and tested. The sample consisted of 390 university students (70.8% females and 29.2% males) with mean age 20.64 years (± 1.83). The Emotion Regulation Questionnaire (ERQ), the Rosenberg Self-Esteem Scale (RSES), and the Connor-Davidson Resilience Scale (CD-RISC) were used to assess emotion regulation, self-esteem, and resilience, respectively. The results indicated that resilience was correlated positively with cognitive reappraisal and negatively with expressive suppression. Self-esteem partially mediated the relationship between cognitive reappraisal and resilience, and fully mediated the association of expressive suppression with resilience. Thus, cognitive reappraisal had a positive direct and indirect effect on resilience through the mechanism of self-esteem, while expressive suppression had a negative indirect effect on resilience through the mechanism of self-esteem. Alternative directions of causality with reverse ordering of the variables were not supported. These findings suggest that efficient regulation of emotions can boost self-esteem, which in turn makes individuals capable of responding adaptively to stress. Implications for enhancing self-esteem among individuals experiencing multiple stressors during emerging adulthood are discussed.
Suicide rates in Crete, Greece during the economic crisis: the effect of age, gender, unemployment and mental health service provision
Background Recently, suicides in Greece have drawn national and international interest due to the current economic crisis. According to published reports, suicides in Greece have increased up to 40% and Crete has been highlighted as an area with the sharpest increase. Aim To investigate the suicide mortality rates in Crete between 1999 and 2013 and their association with the economic crisis. Methods Data on suicides were selected from the Department of Forensic Medicine files of the University of Crete. Results Our analysis showed that (1) Crete, has the highest suicide mortality rate in Greece, however no significant increase was observed between 1999 and 2013, (2) there were opposing trends between men and women, with women showing a decrease whereas men showed an increase in that period, (3) there was a significant increase of suicides in middle-aged men (40–64 yrs) and elderly, although the highest unemployment rates were observed in young men and women, and (4) finally, there was a regional shift of suicides with a significant decrease in Western Crete and a significant increase in Eastern Crete. Conclusions Although, Crete has the highest suicide mortality rates in Greece, we did not observe an overall increase during the last 15 years, including the period of economic crisis. Furthermore, there was an increase in middle-aged and elderly men, whereas young men and women showed oppositional trends during the years of austerity. This may be related to the culturally different expectations for the two genders, as well as that younger individuals may find refuge to either strong family ties or by immigrating abroad. Finally, the relative increase of suicides in Eastern Crete may be explained by factors, such as the lack of community mental health services in that area.
Early Childhood Exposure to Endocrine Disrupting and Neurotoxic Chemicals: Associations with Internalizing and Externalizing Difficulties from Childhood to Adolescence in the Rhea Cohort, Crete, Greece
Many common chemicals are known or suspected to harm brain development, and children are particularly vulnerable, yet research on their long-term effects on mental health is limited. This study investigated the associations of early childhood exposure to endocrine disrupting and neurotoxic chemicals with the development of internalizing, externalizing, and attention-deficit/hyperactivity disorder (ADHD) symptoms from early childhood through adolescence in 387 children from the Rhea cohort in Crete, Greece. At age 4, serum concentrations of 3 organochlorine pesticides and 14 polychlorinated biphenyls, and urinary concentrations of 7 phthalate metabolites and 6 dialkyl phosphate metabolites were measured. Children’s symptoms were assessed via maternal reports at ages 4, 6, 11 and 15 years. Using generalized estimating equation models, the study found that early exposure to hexachlorobenzene (HCB) and dichlorodiphenyldichloroethylene (DDE) was associated with increased externalizing symptoms across ages in girls [beta (95% CI): 0.20 (0.04, 0.37) and 0.11 (0.01, 0.21), respectively]. Among girls, low molecular weight (LMW) phthalates were also linked to elevated internalizing and externalizing symptoms, as well as ADHD-related difficulties [beta (95% CI): 0.15 (0.04, 0.26), 0.13 (0.01, 0.25), and 0.13 (0.02, 0.24), respectively]. Additionally, exposure to organophosphate pesticides was associated with increased externalizing and ADHD symptoms [beta (95% CI): 0.13 (0.04, 0.22) and 0.12 (0.04, 0.20), respectively]. The findings suggest that early childhood exposure to environmental chemicals may have long-term effects on emotional and behavioral development, with pronounced effects observed only in girls.