Universal parental support for parents of adolescents: Who wants municipality‐based parental support and in what form?

Parenting a child through adolescence can be a challenge for many parents; adolescents go through notable developmental, physical, and psychological changes that affect the relationships around them. Most parents find parental support during these years important. These young people's relationships with their parents are important to their mental health, but although parental support is universally available to parents of younger children, it is still scarce for parents of adolescents. The aim of this study was to explore what factors are associated with interest in universal parental support through telephone interviews and questionnaires with 223 parents of 13‐ to 17‐year‐olds. Parents’ interest in parental support was linked to their own anxious mood, their lower perceived parental capacity, their perception of the child as having psychiatric problems, the parents’ perception of their adolescents’ openness about things and their perception of the adolescent's overall difficulties in daily life due to psychiatric symptoms. The results show that lighter forms of support such as lectures or seminars were more appealing to parents with higher social status. Offering community‐based individual counseling and leader‐led parent training groups therefore has the potential to reach parents with difficulties more equally, while offering support only through lectures and seminars could increase the inequality between parents in different social situations.     

Religiousness and Mental Health: Systematic Review Study

Many people use religious beliefs and practices to cope with stressful life events and derive peace of mind and purpose in life. The goal of this paper was to systematically review the recent psychological literature to assess the role of religion in mental health outcomes. A comprehensive literature search was conducted using medical and psychological databases on the relationship between religiosity and mental health. Seventy-four articles in the English and Arabic languages published between January 2000 and March 2012 were chosen. Despite the controversial relationship between religion and psychiatry, psychology, and medical care, there has been an increasing interest in the role which spirituality and religion play in mental health. The findings of past research showed that religion could play an important role in many situations, as religious convictions and rules influence the believer’s life and health care. Most of the past literature in this area reported that there is a significant connection between religious beliefs and practices and mental health.     

A Couple-Based Psychological Treatment for Chronic Pain and Relationship Distress

Chronic pain impacts individuals with pain as well as their loved ones. Yet, there has been little attention to the social context in individual psychological treatment approaches to chronic pain management. With this need in mind, we developed a couple-based treatment, “Mindful Living and Relating,” aimed at alleviating pain and suffering by promoting couples’ psychological and relational flexibility skills. Currently, there is no integrative treatment that fully harnesses the power of the couple, treating both the individual with chronic pain and the spouse as two individuals who are each in need of developing greater psychological and relational flexibility to improve their own and their partners’ health. Mindfulness, acceptance, and values-based action exercises were used to promote psychological flexibility. The intervention also targets relational flexibility, which we define as the ability to interact with one’s partner, fully attending to the present moment, and responding empathically in a way that serves one’s own and one’s partner’s values. To this end, the intervention also included exercises aimed at applying psychological flexibility skills to social interactions as well as emotional disclosure and empathic responding exercises to enhance relational flexibility. The case presented demonstrates that healthy coping with pain and stress may be most successful and sustainable when one is involved in a supportive relationship with someone who also practices psychological flexibility skills and when both partners use relational flexibility skills during their interactions.     

Group Activities to Promote Early Rehabilitation in an Acute Psychiatric Ward: A Relationship-Based Approach Focusing on Movies

Our Psychiatry Institute has a long-standing tradition of providing training in the importance of relational and emotional skills and helping relationships. Here we describe techniques that are routinely used on our psychiatric ward (Maggiore della Carità Hospital, Novara, Italy) to promote early rehabilitation of acute psychiatric inpatients. We focus on the Cinema group, which is typical of our approach to informal, therapeutic group activity. Targeting social and relational issues as adjunct to treatment as usual is useful in acute settings and can begin at an early stage of hospitalization. Our intervention is designed to improve patients’ coping strategies, relational and communication skills, and overall quality of life.     

A critical engagement with the DSM-5 and psychiatric diagnosis

Classifications in psychiatry can result in the reification of hypothetical approaches, arbitrary categorisation and social injustice. This article applies a social constructivist approach to critique the DSM-5 as a neurobiological model of psychiatric diagnosis which ignores psychosocial factors such as poverty, unemployment and trauma as causes of mental distress. It challenges the universality of psychiatric diagnosis and proposes that cultural psychiatry's framing of ‘culture-bound syndromes,’ or ‘cultural case formulation’ guidelines, is oversimplified. Use of the DSM in the South African context risks perpetuating injustice by labelling and stigmatising people who have in the past been racially stigmatised by apartheid. In culturally diverse South Africa, psychiatric diagnosis should take into account alternative explanatory models that provide a more balanced view of the complex and dynamic relationship between biological and sociocultural forces in the manifestation of psychopathology.     

Madness versus badness: the ethical tension between the recovery movement and forensic psychiatry

The mental health recovery movement promotes patient self-determination and opposes coercive psychiatric treatment. While it has made great strides towards these ends, its rhetoric impairs its political efficacy. We illustrate how psychiatry can share recovery values and yet appear to violate them. In certain criminal proceedings, for example, forensic psychiatrists routinely argue that persons with mental illness who have committed crimes are not full moral agents. Such arguments align with the recovery movement’s aim of providing appropriate treatment and services for people with severe mental illness, but contradict its fundamental principle of self-determination. We suggest that this contradiction should be addressed with some urgency, and we recommend a multidisciplinary collaborative effort involving ethics, law, psychiatry, and social policy to address this and other ethical questions that arise as the United States strives to implement recovery-oriented programs.     

Children’s mental health: Time to stop using psychiatric diagnosis

Hegemonic mental health service approaches stress the need for ‘accurate’ diagnosis in order to understand what the correct ‘treatment’ should be. I review the evidence on how far diagnosis in psychiatry has helped advance scientific knowledge and clinical practice and conclude that it hasn’t. I then examine how National Institute for Health and Care Excellence (NICE) guidelines in relation to children’s behaviour problems reflects the lack of progress that results from adopting a diagnostic approach. Taking mental health practice beyond reliance on narrow non-evidence-based diagnostic algorithms can be developed by adopting existing projects such as the Partners for Change Outcome Management Systems project.     

Long Term Posttraumatic Growth After Breast Cancer: Prevalence,Predictors and Relationships with Psychological Health

This study evaluated the prevalence and predictors of long term posttraumatic growth (PTG) after breast cancer, and relationships of PTG with psychological health in a random sample of 307 currently disease-free women 5–15 years after diagnosis. This cross-sectional study reveals long term posttraumatic growth scores comparable to those found in shorter term studies. Prevalence of a better appreciation of life is especially noteworthy. With the exception of perceived current sequelae of disease associated in a somewhat curvilinear fashion with PTG, demographic and medical variables are poor predictors of the issue. On the contrary, dispositional positive affectivity and adaptative coping of positive, active, relational, religious and to some extent denial coping have a strong effect on growth. Finally, PTG is slightly associated with mental quality of life and happiness. Findings are discussed in the light of posttraumatic growth theory.     

No more psychiatric labels: Why formal psychiatric diagnostic systems should be abolished

This article argues that psychiatric diagnoses are not valid or useful. The use of psychiatric diagnosis increases stigma, does not aid treatment decisions, is associated with worsening long-term prognosis for mental health problems, and imposes Western beliefs about mental distress on other cultures. This article reviews the evidence base focusing in particular on empirical findings in relation to the topics of: aetiology, validity, reliability, treatment and outcome, prognosis, colonialism, and cultural and public policy impact. This evidence points toward diagnostic based frameworks for understanding and intervening in mental health difficulties being unable to either improve our scientific knowledge or improve outcomes in clinical practice and suggests that we need to move away from reliance on diagnostic based approaches for organising research and service delivery. Alternative evidence-based models for organising effective mental health care are available. Therefore formal psychiatric diagnostic systems such as the mental health section of the International Classification of Diseases Tenth Edition (ICD-10) and Diagnostic Statistical Manual Fifth Edition (DSM 5) should be abolished.     

Family Management of Pediatric Cancer: Links with Parenting Satisfaction and Psychological Distress

Research has long acknowledged the disruptions posed by pediatric cancer diagnosis and treatment to family life. Nonetheless, the mechanisms through which the family response influences parents’ mental health in this adverse context are not fully understood. The main goal of the present study was to examine the direct and indirect links, via parenting satisfaction, between family condition management and psychological distress of parents of children with cancer. Participants were 201 parents (86.6% mothers) of children/adolescents diagnosed with cancer who completed self‐report questionnaires assessing family condition management (family life difficulty and parental mutuality), parenting satisfaction, and psychological distress (anxiety and depression). Structural equation modeling was used to test the proposed mediation model. The results showed that parenting satisfaction mediated the association between both the family condition management dimensions (family life difficulty and parental mutuality) and depression. Specifically, greater family life difficulties and lower parental mutuality were associated with lower parenting satisfaction, which, in turn, was associated with higher levels of depression. Additionally, greater family life difficulties and lower parental mutuality were directly linked to higher levels of anxiety. Multigroup analyses suggested that the model was valid across patient age groups (children vs. adolescents) and treatment status (on vs. off‐treatment). These findings reinforce the need for family‐ and parent‐based interventions in the pediatric oncology field. Interventions that target families’ difficulties and promote their resources are likely to foster parenting satisfaction and psychological adjustment.     

诠释与转换：积极心理健康及其当代理解

积极心理健康是积极心理学理论系统的一个重要组成部分,也是积极心理学理论本身在心理健康领域的一种应用。积极心理健康以积极为核心观念,以人的积极品质为研究对象,注重人的个体差异的研究思路,引领和推动传统心理健康从关注人的消极品质转向人的积极潜力,从而使心理健康的主题既符合时代潮流又具有深厚的思想底蕴。     

INTERNISTS OF THE MIND OR PHYSICIANS OF THE SOUL: DOES PSYCHIATRY NEED A PUBLIC PHILOSOPHY?

Although psychiatry is interested in what both body and mind contribute to behavior, it sometimes emphasizes one more than the other. Since the early 1980s, American psychiatry has shifted its interest from mind and psyche to body and brain. Neuroscience and psychopharmacology are increasingly at the core of psychiatry. Some experts claim that psychiatry is no longer interested in problems in living and positive goals such as mental health, happiness, and morality but rather has narrowed its focus to mental disorders addressed with psychotropic drugs. In view of this trend, psychiatry needs to confront two questions in social philosophy. If it is no longer directly concerned with health and happiness, how does it relate to these positive goals? And how does it relate as a medical institution to religious institutions, schools, and other organizations that directly promote health, happiness, morality, and the purposes of life? It is not enough for psychiatry to renounce its moral role; its practices still shape cultural values. Psychiatry should take more responsibility for developing a public philosophy that addresses these issues.     

On Being Sane in an Insane Place – The Rosenhan Experiment in the Laboratory of Plautus’ Epidamnus

Plautus’ Roman comedy Menaechmi (The Two Menaechmuses) of c. 200 BC anticipates in fictional form the famous Rosenhan experiment of 1973, a landmark critique of psychiatric diagnosis. An analysis of the scenes of feigned madness and psychiatric examination suggests that the play (and the earlier Greek play from which it was adapted) offers two related ethical reflections, one on the validity of psychiatric diagnoses, the other on the validity of the entire medical model of insanity—that is, of the popular notion and political truth that mental illness is a (bodily) disease “like any other.” This essay is offered as a contribution to the interpretation of the play as well as to the history of psychiatry.     

The Mental Health Benefits and Costs of Sabbath Observance Among Orthodox Jews

This study aimed to examine the perceived psychological costs and benefits of Sabbath (Shabbos) observance among 13 practising Jews, 9 UK residents and 4 US residents. Emerging themes were as follows: Shabbos as a special day, giving time to contemplate on profound issues, withdrawal and rest from mundane concerns, and deepening relationships. These aspects can potentially improve feelings of mental well-being, and were indeed often said to do so. Some difficulties were described: some found they were prone to worry more on Shabbos because of the freedom from distractions, and there were reports of the difficulties of explaining to non-Jewish work colleagues the religious need to be free from work commitments. These findings were related to the literature on religious ritual observance and generally accord with other work in anthropology and psychology of religion examining the psychological impact of ritual. Work on the mental health implications of ritual observance needs to be expanded. It has received only limited attention, and understanding has been constrained by a misleading confusion between ritual and obsessionality. Other impacts of religion on mental health are better documented and understood, and religious ritual and its impact needs further documentation and attention.     

Correlates and predictors of positive mental health for school going children

The relationship between positive mental health and well-being was examined in 604 North Indian high school and secondary high school going children aged 11–18 years. The study employed various scales such as Mental Health Continuum-Short Form (MHC-SF; Keyes, 2005), Scale of Positive and Negative Experiences (SPANE) and Flourishing Scale (FS; Diener et al., 2010), World Health Organization Quality of Life-BREF (WHOQOL-BREF, 1996) and Personal Well-being Index Scale-School Going Children (PWI-SC; Cummins & Lau, 2005). The MHC-SF predicted the positive mental health and the various predictors used in this study were SPANE, FS, WHOQOL-BREF and PWI-SC. Positive mental health was found positively correlated with SPANE P, life satisfaction, personal well-being, flourishing and all four domains of quality of life (physical health, psychological well-being, social relationships and environmental health) and negatively correlated with SPANE N. Well-being measures of flourishing, SPANE P, SPANE-N, all four domains of quality of life (physical health, psychological well-being, social relationships and environmental health) significantly predicted children’s positive mental health (49% of variance) and its dimensions like emotional well-being (41% of variance), social well-being (24% of variance) and psychological well-being (47% of variance).     

Mental health care and the politics of inclusion: A social systems account of psychiatric deinstitutionalization

This paper provides an interpretation, based on the social systems theory of German sociologist Niklas Luhmann, of the recent paradigmatic shift of mental health care from an asylum-based model to a community-oriented network of services. The observed shift is described as the development of psychiatry as a function system of modern society and whose operative goal has moved from the medical and social management of a lower and marginalized group to the specialized medical and psychological care of the whole population. From this theoretical viewpoint, the wider deployment of the modern social order as a functionally differentiated system may be considered to be a consistent driving force for this process; it has made asylum psychiatry overly incompatible with prevailing social values (particularly with the normative and regulative principle of inclusion of all individuals in the different functional spheres of society and with the common patterns of participation in modern function systems) and has, in turn, required the availability of psychiatric care for a growing number of individuals. After presenting this account, some major challenges for the future of mental health care provision, such as the overburdening of services or the overt exclusion of a significant group of potential users, are identified and briefly discussed.     

Significance of nature in a clinical setting and its perceived therapeutic value from patients’ perspective

The effect that nature can have on the development of mental health and the implications for recovery is important for understanding the impact nature has on humans, as well as delineating possible alternative venues for treating psychological problems. The present qualitative study examined how individuals understand the significance of nature in relation to their mental health and treatment. A total of 12 participants in residential treatment for varying nonpsychotic mental health issues were interviewed about previous and present experiences with nature and the meaning these experiences have for them in recovery. Thematic analysis resulted in the creation of two main themes: «being human in nature», which included three sub-themes ‘experience of nature’, ‘effects on focus and attention’ and ‘change and the transformative in nature’, and «nature, the patient and treatment», with two sub-themes ‘nature as therapy’ and ‘nature and therapy’. Participants describe a feeling of coming closer to themselves, to their problems and existential meanings when in nature. In addition, they report being able to make new relational experiences with other patients, and that some experiences in nature can function as symbolic tools in therapy. The study underlines the complex interrelationships between nature and humans and points to new lines for future research.     

The Psychiatrization of Poverty: Rethinking the Mental Health–Poverty Nexus

The positive association between ‘mental illness’ and poverty is one of the most well established in psychiatric epidemiology. Yet, there is little conclusive evidence about the nature of this relationship. Generally, explanations revolve around the idea of a vicious cycle, where poverty may cause mental ill health, and mental ill health may lead to poverty. Problematically, much of the literature overlooks the historical, social, political, and cultural trajectories of constructions of both poverty and ‘mental illness’. Laudable attempts to explore the social determinants of mental health sometimes take recourse to using and reifying psychiatric diagnostic categories that individualize distress and work to psychiatrically reconfigure ‘symptoms’ of oppression, poverty, and inequality as ‘symptoms’ of ‘mental illness’. This raises the paradoxical issue that the very tools that are used to research the relationship between poverty and mental health may prevent recognition of the complexity of that relationship. Looking at the mental health–poverty nexus through a lens of psychiatrization (intersecting with medicalization, pathologization, and psychologization), this paper recognizes the need for radically different tools to trace the messiness of the multiple relationships between poverty and distress. It also implies radically different interventions into mental health and poverty that recognize the landscapes in which lived realities of poverty are embedded, the political economy of psychiatric diagnostic and prescribing practices, and ultimately to address the systemic causes of poverty and inequality.     

年轻男同性恋者自我概念清晰性与生命意义感的关系及作用机制

通过网络抽样法对405名年轻男同性恋者进行问卷调查,考察年轻男同性恋者自我概念清晰性与生命意义感的关系,并探讨内化同性恋嫌恶和应对自我效能感在其间的作用机制。结果表明：（1）年轻男同性恋者自我概念清晰性与生命意义感呈显著正相关。（2）内化同性恋嫌恶、应对自我效能感在自我概念清晰性与生命意义感间起链式中介作用。（3）应对自我效能感在自我概念清晰性与生命意义感间起中介作用。     

Introduction: Reflections on mothering and on reexperiencing the early relationship experience

As President of the World Association for Infant Psychiatry and Allied Disciplines the Editor has invited me to introduce this issue, which continues with papers from the Stockholm Congress. Advances in developmental biology and medical genetics make it clear that the future of psychiatric and mental health research will be centered in preventive intervention. This prospect highlights the need for more knowledge about environmental/individual interactions. The caregiving relationship experience is a crucial aspect of these interactions and frames the later development of strength or disorder. Several papers in this issue focus on the caregiving experience and provide me an opportunity to offer some reflections on the nature of experiencing and reexperiencing. Propositions that seem important include the following: The experience of caregiving involves a reexperiencing of earlier represented relationships; reexperiencing in this sense involves other past relationships that had a similar role relationship context; reexperiencing involves a dynamic interplay on both sides of a represented role relationship (that is, self and other interacting); early formative relationships are apt to be represented as affective prototypes such that reexperiencing occurs mainly without conscious awareness. Understanding such affective representations can guide infant psychiatry as it opens new opportunities for brief interventions. These can benefit infants and caregivers through the medium of the infant-caregiver relationship experience. Activating formative aspects of that experience can promote health and the strengths of individuality and provide a buffer against illness and self-defeating attitudes.