Where Has All the Psyche Gone? Searching for Treatments That Focus on Psychological Issues

The field of psychotherapy can be aided by adopting an integrative model that follows a comprehensive biopsychosocial perspective. Unfortunately, recent advances in the field of psychopharmacology have appeared to overshadow the gains that can be made through psychotherapy. Psychotherapists need to protect the psyche that lies at the core of their treatment. Psychotherapy can promote changes in cognitive processes that help to reduce psychiatric symptoms and enhance adaptive functioning. Psychotherapists should not neglect the role of biological or social factors in the etiology or treatment of mental illness. Many clients benefit from a comprehensive biopsychosocial model and interdisciplinary collaboration among mental health professionals. Psychotherapists can maintain a strong emphasis on psychological functioning, while colleagues from other fields focus on the biological and social aspects of mental illness. Furthermore, it seems important for psychotherapists to emphasize the unique qualities of psychotherapy that are distinct from the social support that is provided from a close and confiding friendship.     

Advancing the Field of Psychotherapy Through Innovation and Integration in Scholarly Works

Published articles on psychotherapy often incorporate a combination of integration and innovation, helping to advance the field through scholarly work. Many useful papers help to integrate the biological, psychological, and social or cultural factors that often play a role in the etiology and treatment of specific forms of mental illness. In addition, quality papers strive to integrate theory, science, and clinical applications throughout the text. Authors can encourage a series of minor innovations that could gradually shift the field over time. Useful papers often focus on a narrow topic that has a broad appeal to many members of the field. Authors can explore new ideas, expressing their opinions while supporting the ideas through various types of evidence. When submitting papers for publication, authors should expect it will require multiple revisions in order to sharpen the thinking and improve the writing.     

Using Systems of Care to Reduce Incarceration of Youth with Serious Mental Illness

Youth with serious mental illness come into contact with juvenile justice more than 3 times as often as other youth, obliging communities to expend substantial resources on adjudicating and incarcerating many who, with proper treatment, could remain in the community for a fraction of the cost. Incarceration is relatively ineffective at remediating behaviors associated with untreated serious mental illness and may worsen some youths' symptoms and long-term prognoses. Systems of care represent a useful model for creating systems change to reduce incarceration of these youth. This paper identifies the systemic factors that contribute to the inappropriate incarceration of youth with serious mental illness, including those who have committed non-violent offenses or were detained due to lack of available treatment. It describes the progress of on-going efforts to address this problem including wraparound and diversion programs and others utilizing elements of systems of care. The utility of systems of care principles for increasing access to community-based mental health care for youth with serious mental illness is illustrated and a number of recommendations for developing collaborations with juvenile justice to further reduce the inappropriate incarceration of these youth are offered.     

The stigma of seeking help for mental health issues: mediating roles of support and coping and the moderating role of symptom profile

A key factor to the prevalence of mental illness might be the disinclination to seek help, perhaps owing to the stigma of mental illness. In two studies, the contribution of severity of depressive symptoms, social support, and unsupport, coping strategies, and salience of psychological versus biological features of depression in relation to perceived self‐ and other‐stigma of help‐seeking for mental health issues were examined. Participants were first year students experiencing a transitional stressor, namely entry to university. Together, the findings point to the contribution of social support and unsupportive interactions, and coping methods to the prediction of perceived stigma of seeking help, but that the framing of mental illness can limit or strengthen these relations.     

Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families

Despite the central role culture plays in racial and ethnic disparities in mental health among ethnic minority and immigrant children and families, existing measures of engagement in mental health services have failed to integrate culturally specific factors that shape these families’ engagement with mental health services. To illustrate this gap, the authors systematically review 119 existing instruments that measure the multi-dimensional and developmental process of engagement for ethnic minority and immigrant children and families. The review is anchored in a new integrated conceptualization of engagement, the culturally infused engagement model. The review assesses culturally relevant cognitive, attitudinal, and behavioral mechanisms of engagement from the stages of problem recognition and help seeking to treatment participation that can help illuminate the gaps. Existing measures examined four central domains pertinent to the process of engagement for ethnic minority and immigrant children and families: (a) expressions of mental distress and illness, (b) causal explanations of mental distress and illness, (c) beliefs about mental distress and illness, and (d) beliefs and experiences of seeking help. The findings highlight the variety of tools that are used to measure behavioral and attitudinal dimensions of engagement, showing the limitations of their application for ethnic minority and immigrant children and families. The review proposes directions for promising research methodologies to help intervention scientists and clinicians improve engagement and service delivery and reduce disparities among ethnic minority and immigrant children and families at large, and recommends practical applications for training, program planning, and policymaking.     

Mental Health Risk and Social Ecological Variables Associated with Educational Attainment for Gulf War Veterans: Implications for Veterans Returning to Civilian Life

This study examines how post-secondary educational attainment among young veterans of the first gulf war affects their mental health status. The all-volunteer military attracts recruits by offering them veterans’ educational benefits. Education should help veterans adjust to civilian life. Few studies have shown whether education following military service helps improve veterans’ mental health, however. Viewing resiliency, life span and life course, and social geography theories through the lens of social ecology, it is hypothesized that selected contextual factors in the personal, interpersonal, and organizational domains could mediate or moderate the relationship between education and veterans’ mental health. Informational social networks showed an association with obtaining mental illness treatment. Recent treatment for post-traumatic stress disorder (PTSD) showed an association with use of veterans’ educational benefits. Residing with a small nuclear family in conjunction with having higher levels of health and educational benefits and a higher family income was associated with higher educational attainment.     

Personal construct theory and the argument against mental illness

An attempt is made to integrate Thomas Szasz's 0974) theory of personal conduct and George Kelly's (1955) theory of personal constructs (PCT). It is argued that PCT provides an alternative to the void left behind by Szasz's negation of mental illness. Because PCT is concerned with psychological, rather than physiological, constructions of problems in living, it is not compatible with the biological model associated with Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic categories. Rather, it is in keeping with the views of Szasz. Kelly's and Szasz's writings are used to support this view. Kelly's transitive diagnosis approach to “mental illness”, wherein diagnosis and therapy are construed as process oriented as opposed to category driven, is described as an alternative to the biological model. A contextualist approach (Sarbin & Mancuso, 1980) is also discussed. These approaches not only empower clients and allow them to assert responsibility and control over their lives, but also provide an alternative system to the one rejected by Szasz.     

Social Support and Mental Health Outcomes Among U.S. Army Special Operations Personnel

Mental health disorders continue to plague service members and veterans; thus, new approaches are required to help address such outcomes. The identification of risk and resilience factors for these disorders in specific populations can better inform both treatment and prevention strategies. This study focuses on a unique population of U.S. Army Special Operations personnel to assess how specific avenues of social support and personal morale are related to mental health outcomes. The results indicate that, whereas personal morale and friend support reduce the relationship between combat experiences and posttraumatic stress disorder (PTSD), strong unit support exacerbates the negative effects of combat experiences in relation to PTSD. The study thus shows that although informal social support can lessen postdeployment mental health concerns, military populations with strong internal bonds may be at greater risk of PTSD because the support that they receive from fellow service members may heighten the traumatic impact of combat experiences.     

Comment on “The Self‐Care of Psychologists and Mental Health Professionals” (Dattilio, 2015)—Working With the Mentally Ill Is a Mental Health Hazard: What Can We Do About It?

It has been known for many decades that the risk of burnout, psychological distress, mental illness, or suicidal ideation is higher in mental health professionals (MHP) compared with many other professions and the general population; however, MHPs often disregard their own mental health for the sake of helping others, sometimes with fatal consequences. Paradoxically MHP tends to avoid seeking professional help for their own mental health issues. Apart from the serious risk to one's health that this poses, MHPs are now mandated to report any impairment that affects their ability to practice. The aim of this commentary is to emphasise the heightened risk of mental illness among MHP, and includes some risk factors associated with burnout, psychological distress, or mental illness in MHP. It explores some of the barriers to help seeking, including stigma, and highlights mindfulness as a self‐care strategy to prevent psychological distress and burnout. The commentary makes recommendations for inclusions into current psychology postgraduate as well as undergraduate curriculum. It concludes with recommendation for suitable support from professional bodies to help maintain good mental health and to help prevent mental illness among MHPs.     

Using cognitive dissonance to induce adolescents' escaping from the claw of online gaming: the roles of personal responsibility and justification of cost.

The negative impact of the Internet on adolescents has received much attention. How to reduce their pathological use of online gaming is also a critical issue. Based on cognitive dissonance theory, two experiments were conducted to examine whether personal responsibility and justification of cost may play crucial factors in impacting adolescent players' attitude change and their willingness to engage in attitude-discrepant behavior. The results of Experiment 1 revealed that adolescent players who felt a strong sense of responsibility appeared to exhibit greater attitude change. In Experiment 2, the findings indicated that players tended to employ justification of cost in order to reduce or eliminate the dissonance between their attitude toward online gaming and invested cost. Adolescent players who perceived a higher cost in online gaming were less willing to engage in attitude-discrepant behavior. Reducing adolescents ' overuse of online gaming can be appreciated through the perspective of cognitive dissonance.     

Psychoanalytic concepts of the etiology of severe mental illness

In this paper I challenge some prevalent psychoanalytic concepts of the etiology and pathogenesis of severe mental illness which I believe to be in need of revision. There is insufficient evidence to conclude that the etiology of the two major adult psychoses, schizophrenia and manic-depressive illness, can be attributed to failures in development or fixations during the earliest years of life. Furthermore, I believe it incorrect to ascribe these failures of development to deficiencies in the early maternal environment. I base my disagreements on three main considerations: the misinterpretation of the etiological significance of regression, the relevance of new biological data, and erroneous conclusions drawn from lack of diagnostic distinctions. I also challenge the generally held concept of etiologic phase specificity which proposes that failures during various early phases of development can be correlated with different kinds of adult psychopathology. In calling this concept into question, I argue that current psychoanalytic concepts of the etiology of the borderline group of disorders also need to be reevaluated.     

Life Experience Is Not a Disease or Why Medicalizing Madness Is Counterproductive to Recovery

Abstract

The author draws on her personal experience as the family member of an individual with mental illness, on her anthropological research and on that of others to argue that medicalizing madness can be counterproductive to recovery. The medical model is sometimes used in a way that strips away the meaning of the illness experience. Analogies drawn to diseases do not help the understanding of mental illness. Psychiatry is a social practice embedded in a social milieu and that renders it less than objective. It is useful to recognize that the experiences called symptoms have meaning and may have positive and pleasurable aspects.     

Explanatory models for mental illness endorsed by Christian clergymen: The development and use of an instrument in Singapore

Researchers have attempted to elicit the explanatory models used by different populations to understand mental illness, since these models can influence how populations use mental-health treatment. However, little effort has been made to understand the explanatory models used by Christian clergymen. This is despite their important role as providers of mental-health care in many Asian and Western societies. Neither are there suitable instruments to conduct such investigations. This study attempts to present a suitable instrument for such research and explore the belief structure of this population by administering a modified version of the Opinions about Psychological Problems to a representative sample of Singaporean Christian clergymen. Factor-analytic techniques revealed five factors which were explained as (1) a Traditional Christian and (2) a Deliverance etiology, both models implicating religious causes for mental illness, (3) a Poor Coping and (4) Internal Conflicts etiology, essentially being psychological explanations and an (5) Organic etiology model. The Traditional Christian model received the greatest endorsement, followed by the Poor Coping model, while the Organic model had the least acceptance. The belief structure used by nearly half of the respondents was noted to be complex, involving a combination of religious, psychological, and organic explanations.     

South African Muslim Psychologists' Perceptions of Mental Illness

This study explored perceptions of mental illness in a sample of 10 female Muslim psychologists in a South African city to determine the influences of religion (and Islam specifically) on their understanding of the aetiology and treatment of mental illness. Participants responded to a semi-structured interview. The data from the interviews were thematically analyzed. Four themes emerged from the analysis: mental illness as maladaptive coping, religion as a resource for wellbeing, influences of personal religiosity on therapy and openness to collaborative treatment     

An introduction to organic brain syndromes

Organic brain syndromes are of forensic interest for several reasons. First, patients with organic brain syndromes may require judicial determination of competence in any of a number of areas, e.g., testamentary capacity, need for financial guardianship, or competence to make medical decisions. Second, any patient whose mental state is of legal interest will need evaluation for contributing organic factors; uncovering these factors may have considerable medical and legal consequence. Third, the discovery of organic factors may be decisive in the outcome of a judicial proceeding, where “hard” biological data are often accorded more weight, and are thus more persuasive, than “soft” psychological data. This article provides an introductory overview of the organic brain syndromes. For each syndrome, the clinical features are described and are illustrated with a case vignette, the more common etiologies are presented, and selected aspects to the evaluation are highlighted. In addition, since the detectian of malingered mental illness is a key component in many forensic contexts, characteristics are described which help to distinguish actual from malingered mental illness.     

Utah youth suicide study: barriers to mental health treatment for adolescents

Forty-nine suicide cases were drawn from an original sample of 151 consecutive youth suicide deaths. We used information from 270 interviews with parents and other survivors to evaluate mental health treatment sought for and by the decedent and barriers to mental health treatment. Participants reported the same primary barriers for the decedent: belief that nothing could help, seeking help is a sign of weakness or failure, reluctance to admit to having mental health problems, denial of problems, and too embarrassed to seek help. It is suggested that the stigma of mental illness is a considerable barrier to mental health treatment.     

Personal responsibility and control over our bodies: when expectation exceeds reality

Good health has become more than a means to personal goals such as greater attractiveness and increased longevity. It symbolizes self-control, hard work, ambition, and success in life. Inherent in this symbolism is the concept that the individual controls behavior, which in turn controls health. Although control over one's life plays an important role in both physical and mental health, the concept of personal control also infers responsibility. Positive attributes are accorded to people who are healthy, but those who fall ill, or those with less than the perfect body, are blamed and are thought to be self-indulgent, lazy, or even irresponsible and immoral. There is a tendency to overstate the impact of personal behavior on health. However, biological realities shape the degree to which health is under the control of the individual. The positive effects of behavior change must be balanced with the limits imposed by biology.     

Erotomanie, pathologische Verliebtheit, kognitive Distorsionen: psychopathologische Übergänge beim Stalking

Stalking is a widespread phenomenon which can be caused by different motives and in rare cases can be considered as an expression of mental illness. Stalking can occur as a symptom of schizophrenia or erotomania. The criminal culpability of psychotic stalkers is diminished and appropriate treatment has to be administered. However, there are cases which are not clearly distinct from delusional disorders. Stalking may be driven by morbid infatuation which impairs cognitive and affective capability. As the boundaries between full criminal responsibility and diminished criminal responsibility according to German penal law are blurred, these cases require thorough forensic assessment.     

“You have to be mental to jump off a board any way”: Elite divers' conceptualizations and perceptions of mental health

ObjectivesMental health research in elite sport focuses predominantly on mental illness prevalence rates and help-seeking behaviours. Diving has been identified as a sport that generates particular challenges for maintaining mental health, yet has received scant attention from researchers. Therefore, purpose this paper explores what mental health and mental health related behaviours mean for a group of young, elite athletes as conditioned by their peculiar social context as elite athletes.MethodSemi-structured interviews were conducted with purposely sampled eight elite divers aged between 14 and 24 years with between 5 and 16 years of diving experience who have competed in international level diving competitions including Olympic, Common Wealth and World Cup competitions. Interviews were recorded, transcribed verbatim, and analyzed using inductive thematic analysis.ResultsAnalysis identified mental health literacy, experiences of mental health, risk factors, and opportunities for support as themes. Mental health generated negative connotations for participants attributable to knowledge development occurring through personal and vicarious experience of mental illness. Limited knowledge of symptoms of mental illnesses was evident. Participants identified a range of risk-factors inherent in their sport performance and culture revealing a performative and gendered dimension to mental health.ConclusionsOur results indicate the need to recognize the performative nature of mental health for elite divers and therefore social and cultural influences alongside biophysical. Greater efforts need to be made to help improve the overall mental health literacy of elite divers so they may be able to seek the support and treatment they need.