Paul Wc Wong

Evaluation of a Web-Based Social Network Electronic Game in Enhancing Mental Health Literacy for Young People

Background Internet-based learning programs provide people with massive health care information and self-help guidelines on improving their health. The advent of Web 2.0 and social networks renders significant flexibility to embedding highly interactive components, such as games, to foster learning processes. The effectiveness of game-based learning on social networks has not yet been fully evaluated. Objectives The aim of this study was to assess the effectiveness of a fully automated, Web-based, social network electronic game on enhancing mental health knowledge and problem-solving skills of young people. We investigated potential motivational constructs directly affecting the learning outcome. Gender differences in learning outcome and motivation were also examined. Methods A pre/posttest design was used to evaluate the fully automated Web-based intervention. Participants, recruited from a closed online user group, self-assessed their mental health literacy and motivational constructs before and after completing the game within a 3-week period. The electronic game was designed according to cognitive-behavioral approaches. Completers and intent-to-treat analyses, using multiple imputation for missing data, were performed. Regression analysis with backward selection was employed when examining the relationship between knowledge enhancement and motivational constructs. Results The sample included 73 undergraduates (42 females) for completers analysis. The gaming approach was effective in enhancing young people’s mental health literacy (d=0.65). The finding was also consistent with the intent-to-treat analysis, which included 127 undergraduates (75 females). No gender differences were found in learning outcome (P=.97). Intrinsic goal orientation was the primary factor in learning motivation, whereas test anxiety was successfully alleviated in the game setting. No gender differences were found on any learning motivation subscales (P>.10). We also found that participants’ self-efficacy for learning and performance, as well as test anxiety, significantly affected their learning outcomes, whereas other motivational subscales were statistically nonsignificant. Conclusions Electronic games implemented through social networking sites appear to effectively enhance users’ mental health literacy.

Youth social withdrawal behavior (hikikomori): A systematic review of qualitative and quantitative studies:

Objective: Acute and/or severe social withdrawal behavior among youth was seen as a culture-bound psychiatric syndrome in Japan, but more youth social withdrawal cases in different countries have been discovered recently. However, due to the lack of a formal definition and diagnostic tool for youth social withdrawal, cross-cultural observational and intervention studies are limited. We aimed to consolidate existing knowledge in order to understand youth social withdrawal from diverse perspectives and suggest different interventions for different trajectories of youth social withdrawal. Method: This review examined the current available scientific information on youth social withdrawal in the academic databases: ProQuest, ScienceDirect, Web of Science and PubMed. We included quantitative and qualitative studies of socially withdrawn youths published in English and academic peer-reviewed journals. Results: We synthesized the information into the following categories: (1) definitions of youth social withdrawal, (2) developmental theories, (3) factors associated with youth social withdrawal and (4) interventions for socially withdrawn youths. Accordingly, there are diverse and controversial definitions for youth social withdrawal. Studies of youth social withdrawal are based on models that lead to quite different conclusions. Researchers with an attachment perspective view youth social withdrawal as a negative phenomenon, whereas those who adopt Erikson’s developmental theory view it more positively as a process of seeking self-knowledge. Different interventions for socially withdrawn youths have been developed, mainly in Japan, but evidence-based practice is almost non-existent. Conclusion: We propose a theoretical framework that views youth social withdrawal as resulting from the interplay between psychological, social and behavioral factors. Future validation of the framework will help drive forward advances in theory and interventions for youth social withdrawal as an emerging issue in developed countries.

The prevalence and correlates of severe social withdrawal (hikikomori) in Hong Kong: A cross-sectional telephone-based survey study

Background: Severe social withdrawal behaviors among young people have been a subject of public and clinical concerns. Aims: This study aimed to explore the prevalence of social withdrawal behaviors among young people aged 12–29 years in Hong Kong. Methods: A cross-sectional telephone-based survey was conducted with 1,010 young individuals. Social withdrawal behaviors were measured with the proposed research diagnostic criteria for hikikomori and were categorized according to the (a) international proposed duration criterion (more than 6 months), (b) local proposed criterion (less than 6 months) and (c) with withdrawal behaviors but self-perceived as non-problematic. The correlates of social withdrawal among the three groups were examined using multinomial and ordinal logistic regression analyses. Results: The prevalence rates of more than 6 months, less than 6 months and self-perceived non-problematic social withdrawal were 1.9%, 2.5% and 2.6%, respectively. In terms of the correlates, the internationally and locally defined socially withdrawn youths are similar, while the self-perceived non-problematic group is comparable to the comparison group. Conclusions: The study finds that the prevalence of severe social withdrawal in Hong Kong is comparable to that in Japan. Both groups with withdrawal behaviors for more or less than 6 months share similar characteristics and are related to other contemporary youth issues, for example, compensated dating and self-injury behavior. The self-perceived non-problematic group appears to be a distinct group and the withdrawal behaviors of its members may be discretionary.

Building a model for encouraging help-seeking for depression: a qualitative study in a Chinese society

BackgroundClinical depression has been increasingly prevalent in international health statistics but people are often found to be reluctant to seek help when they encounter depression. However, there is no general theory to explain how personal, social and cultural factors affect an individual’s help-seeking intention, nor to guide the design of preventive programmes for such intention once needed.MethodsDrawing on the theory of planned behavior, we deployed the illness narrative approach and interviewed 18 participants in Hong Kong.ResultsWith the diverse results we gathered from the interviews, a behavioral model was built to conceptualize the interplays of various factors in shaping one’s help-seeking intention and behavior for depression. Participants appeared to have a limited view of treatment options and had diverse views of the symptoms of depression, both of which profoundly affected their motivation to seek help.ConclusionsThe role of family and friends and a holistic approach to mental health education were found to be particularly important for encouraging help-seeking behavior in future campaigns concerning depression.

Withdrawal experience and possible way-outs from withdrawal behavior in young people

The term NEET (not in employment, education, or training) has been increasingly applied to young people in Europe not engaged in the three systems mentioned. Young people who seclude themselves at home and progress to social withdrawal can be considered a NEET subgroup—the “disengaged.” This phenomenon was first identified in Japan, where such reclusive individuals are referred to as hikikomori, but youth social withdrawal has also been reported in other countries, including South Korea and Hong Kong. Research on youth social withdrawal has mainly focused on describing and identifying contributing factors to this withdrawal behavior. Very few studies have examined the transitional processes from the initial self-seclusion to later help-seeking. Examining the mechanisms behind the engagement process for helping professionals is important to guide social work services for this unique group of young people. We conducted a qualitative study involving semi-structured interviews with 30 socially withdrawn young people in Hong Kong. Thematic analysis conceptualized their social withdrawal processes into three subthemes: private status, de-friending spiral, and suspension of experiences. Three reasons for changing their withdrawal behavior were also identified: rebalancing one’s ideal self with reality, reconnecting with tuned-in people, and regaining momentum in life. This study provides practical implications for social workers to develop approaches to engage withdrawn young people.

The effectiveness of psychosocial interventions implemented after the Indian Ocean Tsunami: A systematic review

Background: Currently, the number of natural disasters has increased sixfold when compared to the 1960s. The 2004 Indian Ocean Tsunami offered provided an opportunity for scientifically investigating the effectiveness of post-disaster programs across countries with diverse ethnic, religious and cultural backgrounds. Aim: This study aimed to assess the effectiveness of psychological interventions focused on the prevention or reduction in post-traumatic stress disorder (PTSD) symptoms and/or enhancement of psychological well-being implemented after the 2004 Tsunami. Methods: We systematically searched through MEDLINE, PsycINFO and The Published International Literature on Traumatic Stress (PILOTS) databases using the following keywords: ‘tsunami’ OR ‘Indian Ocean’, AND ‘intervention’. Results: Our systematic review included 10 studies which adopted 10 different psychological interventions. A total of 8 of the 10 studies reported positive results in reducing PTSD symptoms and most interventions showed high levels of cultural sensitivity. No significant harmful effects of the included interventions were identified although two studies used potentially harmful interventions. Conclusion: Evidence-based practice is a process of collaborative decision-making between the affected ones and interventionists. The practitioner assesses not only the availability of the level of evidence of the preferred interventions, but he or she also assesses his or her own expertise, the availability of resources, the surrounding context and the characteristics, values and preferences of relevant stakeholders.

Collective Intelligence for Suicide Surveillance in Web Forums

Internet users may see and comment on suicide expressions in the cyberspace that are not identified by helping professionals. The communication between the two parties is not well facilitated. In light of this situation, we present a system using collective intelligence from Internet users to efficiently and effectively identify suicidal people in order to provide timely intervention and promote better public health. We describe the system architecture involving information retrieval, affect analysis, and opinion summarization technique. The collective intelligence approach incorporates machine learning techniques and Internet users’ contributions to facilitate the automated identification of suicide expressions. The system will be examined and evaluated in lab settings and suicide prevention organizations.