The community competence scale in the placement of the deinstitutionalized mentally ill

Little systematic research has been directed towards the determination of appropriate residential placements for deinstitutionalized psychiatric patients. A previous study suggested that the Community Competence Scale (CCS), a 124-item multiscale instrument, had potential utility for community placement decisions. In the present study, the CCS was administered to 52 deinstitutionalized patients placed in an urban boarding home, a rural boarding home, and urban apartments. No significant differences on the CCS occurred attributable to urban vs. rural setting; accordingly, the urban and rural boarding home groups were combined. The CCS discriminated between patients placed in boarding home and apartment settings after variability between the groups associated with age and diagnosis had been removed. The CCS discriminated more effectively between the groups than did prior hospitalization, subsequent rehospitalization, or the Social Competence Scale (SCS). The CCS was significantly positively correlated with the SCS and significantly negatively correlated with previous hospitalization and age.     

Locus of control among psychosomatically and chronically ill children and adolescents

In a matched group design, two groups of children suffering from a psychosomatic disease (bronchial asthma and ulcerative colitis) were compared with two groups of children suffering from other chronic illnesses affecting the same organ (cystic fibrosis and Crohn's disease) and with healthy subjects with regard to locus of control. With the exception of bronchial asthma, all clinical groups were characterized by greater internal locus of control. There were no significant relationships between the IE-dimension and further clinical parameters specific to each disease. Furthermore, there was an indication that psychiatric disturbance in general is related to external locus of control. The IE dimension did not contribute to a differentiation between the types of psychosomatic and chronic illness.     

Transition planning and recidivism among mentally ill juvenile offenders

OBJECTIVES: To determine the extent to which transition planning and community service would predict lower levels of recidivism among mentally ill juvenile offenders. DESIGN: Review of legal, medical and social service records including examination of 3-month period following community release. PARTICIPANTS: Juvenile offenders incarcerated for 6 months or more (N = 44) transitioning to community. MEASURES: Child and Adolescent Functional Assessment Scale (CAFAS), sum of different documented pre- and post-release discharge planning contacts, documented community service contacts. OUTCOMES: Re-offense during the first year post-release. RESULTS: Documented community service contacts in the 3 months following discharge were rare for mental health (20.5%), substance abuse (38.6%), financial assistance (29.5%), and school placement (34.1%). The average number of different pre-release and post-release discharge planning contacts was also low, M(SD)=1.86(1.68) and M(SD)= 2.34(1.71) respectively. Post-release discharge planning and the receipt of financial assistance and mental health services were all associated with lower levels of reoffending. CONCLUSIONS: Community transition planning, including the coordination and provision of community services, is an essential component of community reintegration for juvenile offenders and is associated with lower rates of recidivism during the first year post-discharge.     

Ernst Kris and the art of the mentally ill1

Ernst Kris, a gifted art historian as well as an eminent psychoanalyst, had little regard for the aesthetic value of the spontaneous artistic products of the mentally ill, considering them to be of interest only for the insight they might provide about the patient's psychopathology and unconscious conflicts. Recent scholarship and developments in the art world warrant a critical review of his position, which appears to have derived from his adherence to classical and Renaissance criteria. The works of two untrained and psychiatrically disturbed artists are offered as evidence of their potential aesthetic worth.     

Character and behavior in the mentally ill and well mother

The purpose of this study was to examine character and behavior in a group of mentally ill and well mothers. Mentally ill mothers differed from well mothers in mother-child interaction in their positive involvement in the feeding context and in overall optimal mothering during feeding. On measures of intrapsychic conflict and concern, mentally ill mothers demonstrated significantly more conflict in areas of trust, anger, self-esteem, mutuality and nurturance and more concern with issues of self-esteem, and giving and caring than well mothers. For the mentally ill mothers postpartum onset of illness and number of separations from her child were related to some aspects of character and behavior.     

Reactive and proactive control in incarcerated and community adolescents and young adults

This study compared the cognitive control skills of male incarcerated adolescents (n = 44), male control adolescents (n = 33), male incarcerated young adults (n = 41), and male control young adults (n = 35) using the AX-continuous performance test (AX-CPT). This test measures proactive control (the ability to maintain a mental representation of goal-related information in preparation for a behavioral response) and reactive control (the ability to activate goal-related information in response to an external trigger). Incarcerated individuals had more difficulty implementing proactive control, whereas control individuals had more difficulty implementing reactive control. Adolescents had more difficulty with both reactive and proactive control compared with young adults, suggesting that both skills improve with age. Additional analyses indicated that the effect of age on proactive control was due to the presence of attention-deficit/hyperactivity disorder, whereas the effect of age on reactive control appeared to be a natural developmental trend that could not be explained by other variables. These findings are considered in relation to the dual mechanisms of control theory [Braver, T. S., Gray, J. R., & Burgess, G. C. (2007). Explaining the many varieties of working memory variation: Dual mechanisms of cognitive control. In A. R. A. Conway, C. Jarrold, M. J. Kane, A. Miyake, & J. N. Towse (Eds.), Variation in Working Memory. New York: Oxford University Press.].     

Mental health needs of the chronically mentally ill elderly

The treatment histories and current social, financial, and clinical status of 111 chronically mentally ill (CMI) persons over the age of 60 were examined. Information was obtained from Ss, family, mental health records, and mental health professionals familiar with Ss. Psychiatric symptoms were observed in 74% of Ss. Many Ss experienced long periods without acute episodes of illness. Recurring episodes eventually appeared in most Ss, however, and ongoing deficits in daily functioning and social contacts were prototypical. Two thirds of the Ss were living in the community, relying heavily on family contacts; the rest lived primarily in nursing homes (23.4%) or psychiatric hospitals (7.2%). Social support was the best predictor of level of functioning. Findings suggest that failure of CMI elderly to use mental health services is not due to lack of need. Mental health services currently do not appear to be meeting the needs of this population.