Parent and peer attachment in early adolescent depression

Insecure attachment relations have been theorized to play a significant role in the development of depressogenic modes of adaptation and to thus form a vulnerability factor for the emergence of depressive disorder in children. This study examined security of parent and peer attachment among four groups of early adolescents: clinically depressed, nondepressed psychiatric controls, nonpsychiatric controls, and adolescents with resolved depression. Depressed adolescents reported significantly less secure parent attachment than either of the control groups, and less secure peer attachment than the nonpsychiatric control group. Attachment security of adolescents with resolved depression was on a par with the nonpsychiatric control group. Among all psychiatric patients, security of attachment to parents was negatively correlated with severity of depression according to interview and self-report ratings. Less secure attachment to parents, but generally not to peers, was also related to more maladaptive attributional styles, presence of separation anxiety disorder, and history of suicidal ideation.     

Assessing Dissimulation and Denial on the MMPI in a Sample of Maximum Security,Male Inmates

Comparisons were made between three groups of maximum security inmates thought to possess varying degrees of motivation to either exaggerate or suppress psychiatric symptomatology in their Minnesota Multiphasic Personality Inventory (MMPI) self-report. A group of individuals requesting single-cell placement (the group hypothesized to be motivated to exaggerate symptomatology) were found to score significantly higher on Scale F, the F-K Index, and a number of special MMPI scales (i.e., D-O, Hy-O, Pd-O, Pa-O, Ma-O, Dissimulation Scale, total number of Obvious Items, O:S Ratio) and significantly lower on scales K, Hy-S, Ma-S, and the total number of Subtle items relative to inmates undergoing parole evaluations (denial condition) or entering group therapy (neutral condition). Differences between the parole and group therapy conditions were relatively small, with only D-O, Hy-O, and the Dissimulation Scale producing statistically significant results. These findings tend to support use of the MMPI in assessing a respondent's test-taking attitude, particularly in cases where the subject is attempting to exaggerate psychiatric symptomatology.     

The effects of unstable clients in adolescent treatment: contagion versus continuity

This study examined the effects of integrating an unstable group of seriously disturbed adolescents into an existing day treatment program. Behavioral data were collected for an established group of subjects who were in treatment one year prior to and one year after the arrival of a new group of severely disturbed adolescents. It was found that the disruptive behavior displayed by the new admission subjects was not imitated by the subjects of the established group. Rather, there was a significant decrease in aggression and in the overall number of psychiatric events for the established group. The treatment milieu was seen to be resistant to the effects of the new admissions largely due to the structured form of treatment.     

Assessing dissimulation and denial on the MMPI in a sample of maximum security, male inmates

Comparisons were made between three groups of maximum security inmates thought to possess varying degrees of motivation to either exaggerate or suppress psychiatric symptomatology in their Minnesota Multiphasic Personality Inventory (MMPI) self-report. A group of individuals requesting single-cell placement (the group hypothesized to be motivated to exaggerate symptomatology) were found to score significantly higher on Scale F, the F-K Index, and a number of special MMPI scales (i.e., D-O, Hy-O, Pd-O, Pa-O, Ma-O, Dissimulation Scale, total number of Obvious Items, O:S Ratio) and significantly lower on scales K, Hy-S, Ma-S, and the total number of Subtle items relative to inmates undergoing parole evaluations (denial condition) or entering group therapy (neutral condition). Differences between the parole and group therapy conditions were relatively small, with only D-O, Hy-O, and the Dissimulation Scale producing statistically significant results. These findings tend to support use of the MMPI in assessing a respondent's test-taking attitude, particularly in cases where the subject is attempting to exaggerate psychiatric symptomatology.     

Umgang mit gefährlichen Straftätern in England und Wales

Forensic psychiatric institutions exist in all western European countries. Their organisation depends on a number of factors including the legal framework and societal attitudes towards mentally disordered offenders. This article describes and critically comments on the forensic psychiatric system in England and Wales, its legal framework and approaches to dealing with dangerous offenders. England and Wales have a long forensic psychiatric tradition with the first high security hospital, Broadmoor hospital, having been established in 1863. Evidence-based treatment approaches in forensic hospitals as well as in prisons, training of forensic psychiatrists and research in the field of forensic psychiatry have gained international recognition. However, there are some worrying aspects in the system of forensic psychiatric care and the criminal justice system more generally, in particular the high and still increasing number of prisoners in comparison with other European countries, the low age of criminal responsibility, long sentences, increasing length of stay in forensic care and the increasingly risk averse culture. A number of differences to the German system can be found; one such difference relates to the role of criminal responsibility which is irrelevant for decisions regarding commitment in England and Wales. Only the mental state and need for treatment at the time of trial (or later assessment in prison) determine whether an offender is admitted to psychiatric care or receives a prison sentence. A number of new initiatives have been launched in recent years resulting in an increasing number of individuals being detained in forensic psychiatric and criminal justice institutions, in particular the initiative for the detention and treatment of individuals with so-called dangerous and severe personality disorders, the sexual offenders register and the new sentence of indeterminate imprisonment for public protection. These initiatives have been the subject of a number of complaints to the European Court of Human Rights. Nevertheless, the trend towards a more and more risk averse culture continues.     

A Motivational Model of Authoritarianism: Integrating Personal and Situational Determinants

We describe and test a collective security model of authoritarianism. This model sees Right Wing Authoritarianism (RWA) as directly caused by collective security motivation (CSM), which is in turn influenced jointly by personality (with its effects mediated through group identification and dangerous world beliefs) and social threat (with its effects mediated through dangerous world beliefs). Two studies tested this model using student samples—one was correlational ( N =  218), while the other included an experimental manipulation of threat using future scenarios ( N =  136). Structural equation analyses partially supported the model suggesting that CSM fully mediated the effects of threat and group identification on RWA, but only partially mediated the effect of personality, which also had important direct effects.     

Do terrorist threat alerts increase perception of threat and legitimization of in‐group's wars? The moderating role of perceived in‐group homogeneity

This study examined the impact of external cues of (experimentally induced) terrorist threat or security on perceived threat and legitimization of the U.S.'s war in Iraq as a function of perceived in‐group homogeneity and in‐group identification. In‐group identification did not moderate the effects of external cues of threat or security. External cues of threat resulted in higher legitimization of war via heightened perceived threat, but only among participants who rated low or moderate in perceived in‐group homogeneity. By contrast, cues affirming the security of the in‐group resulted in lower legitimization of war among group members who viewed their in‐group to be homogeneous. These results draw attention to in‐group homogeneity's role in increasing perceived group's agency to cope with threats.     

Predicting treatment outcome and recidivism among patients in a maximum security token economy

The relationship between program performance and outcome for patients in maximum security token economy programs has not been previously studied. We examined variables related to success in a token economy program and to postrelease failure for 92 men in a maximum security psychiatric hospital. Point earnings later in the program were best predicted by earlier point earnings. Variables that best predicted postrelease failure, defined in various ways, were similar to those found in other studies; youthfulness, having spent more time in institutions, a diagnosis of personality disorder or retardation rather than psychosis, not having been found not guilty by reason of insanity or unfit to stand trial, and having been referred from another psychiatric hospital. That program variables were generally unrelated to later outcome suggests that treatment programs for patients in maximum security settings must emphasize skills that are relevant to postrelease success.     

Subjective social stress indicators and the level of reported psychopathology: The case of Israel

This study investigated (on the aggregate level) the relationship between the level of psychopathology in society (monthly rates of inpatient psychiatric admissions) and the population's perception of stress (expressions of worry or dissatisfaction regarding the general, economic, and security situation) and social support (national solidarity expressed as positive attitudes regarding relations between various segments of the population). The subjective indicators were derived from continuing surveys of representative samples of urban Israeli population during 1967-1979. Included were 12 stress indicators and 3 solidarity indicators. As predicted, general stress was positively related to psychiatric admissions, while security stress (due to its cohesive effect) and social solidarity were negatively related to these admissions. Contrary to prediction, economic subjective stress was negatively related to psychiatric admissions. Theoretical implications of the findings are discussed.     

Validation of distinct amnesic and executive type memory deficit in a psychiatric sample based on retrieval performance

Studies of localized brain dysfunctions have revealed connections between patterns of cognitive dysfunction and specific profiles of memory impairment. The amnesic type of memory impairment is defined by deficits in both free recall and recognition memory, whereas the dysexecutive memory impairment is characterized by retrieval deficits, i.e. a disproportional impairment in free recall relative to recognition memory. The present study tests whether classifications of psychiatric patients into recall impaired only (= RO group) and Recall and Recognition impaired (= RR group) correspond to the executive type and amnesic type of memory impairment. The alternative hypothesis is that the two groups merely differ in degree of neuropsychological and psychiatric disturbance. Forty-four subjects impaired on California Verbal Learning Test (CVLT) were selected from a larger database of 103 impaired and non-impaired subjects with schizophrenia or recurrent major depression. Subjects were classified into RO and RR groups and compared on measures of memory strategy (recency effect and interference on CVLT), overall neuropsychological function (Stroop Test and WAIS-R similarity) and psychiatric symptom load (positive and negative symptoms). Repeated measures ANOVA showed no effects of group, i.e. the RR group did not perform consistently below the RO group with regard to memory strategy, neuropsychological function or psychiatric symptom load. Two out of three analyses showed group x test interaction, supporting the dissociation of distinct executive and amnesic profiles among psychiatric patients. The RO group was more susceptible to interference but had better recency score than the RR group. The RO had higher negative symptoms while the RR group had higher positive symptoms.     

Personifying the Radical

This study examines relationships among individual dispositions, news framing of civil liberties restrictions, security concerns, and political tolerance. We theorize that news frames condition the effects of individual dispositions on security and tolerance attitudes. To explore these relationships, an online‐survey experiment was conducted with 650 respondents. This experiment presented alternative versions of news stories about domestic security policies following September 11, and the policies' implications for a fringe activist group. One factor was whether the activists targeted by the government advocated for a cause supported or opposed by the respondent; another factor was whether the story framed government actions against the activists at the individual or group level. Findings show that individual framing—as opposed to group framing—made participants less tolerant of radicals they opposed and more tolerant of radicals they supported. Similar effects were observed for political ideology. Implications of personification as a framing device are discussed.     

The relationship between maternal psychiatric disorder and very young children's coping behaviors

The coping behavior of high-risk infants aged 4 to 36 months was investigated. Two groups of infants (n = 60) (mothers with and without psychiatric disorders) were rated using the Early Coping Inventory (ECI), an observational measure. Results indicated that children whose mothers had chronic psychiatric disorders demonstrated significantly less effective coping behavior on all subscales of the ECI (Sensorimotor Organization, Reactive Behavior, and Self-Initiated Behavior) and on 47 of the 48 items. The at-risk children's behavior was found to be more “situationally effective”; that is, behavior used effectively in one type of situation was not generalized to other types of situations. The greatest discrepancy between the groups was in self-initiated behavior. No significant effects of demographic variables or type or severity of psychiatric disorder were found. Implications for treatment of this high-risk group are discussed. © 1997 Michigan Association for Infant Mental Health     

Job security and work performance in Chinese employees: The mediating role of organisational identification

This research focuses on investigating whether organisational identification mediates the effects of job security on in‐role behaviour and extra‐role behaviour and how these mediation mechanisms differ according to gender. Through analysing 212 supervisor‐subordinate dyads from a Chinese air transportation group, the research indicated that organisational identification partially mediated the effect of job security on in‐role behaviour and fully mediated the effect of job security on extra‐role behaviour. A multi‐group analysis also showed that there were significant differences between male and female employees in these relationships. In addition, moderated mediation analyses showed that gender moderated the indirect effects of job security on in‐role behaviour and extra‐role behaviour through organisational identification. Limitations and implications of these findings are discussed.     

Electrical stimulation of the brain for psychiatric disorders

Despite advances in therapies, there remain psychiatric patients who are extremely ill and cannot be helped by classic psychiatric treatments, including psychotherapy and drug therapy. Certain of these patients may be helped by use of bilateral brain lesioning. The complication rate of standard stereotactic psychosurgery techniques is very low. The main rationale for the continued experimental use of deep brain stimulation (DBS) in neurosurgery for mental disorders is its reversibility. This reversibility is not an advantage in terms of the benefits obtained, but rather if side effects emerge. In addition, electrical stimulation may provide patients with some autonomy for their treatment. The first, very preliminary results of electrical stimulation for obsessive-compulsive disorder and for a small heterogeneous group of patients with other psychiatric disorders have been published. Electrical stimulation of the brain for psychiatric disorders may become a new treatment option for certain intractable psychiatric disorders. Nevertheless, the mechanism of action of DBS in psychiatric disorders is unknown, and the experience with this modality is extremely limited. The first results look promising, but this treatment option may prove unusable for some time because of a lack of knowledge of appropriate brain stimulation targets and technical problems such as the availability of sufficient current supply.     

Personality Change from Life Experiences: Moderation Effect of Attachment Security

This study focused on effects of life experiences on change in personality and moderation effects of attachment security on the life experience influences. With a sample of Japanese university students (N = 1,000; 679 female; M = 19.72; SD = 1.26; age range, 18–25 years), the Big Five personality traits were assessed twice. The assessment interval was 20 weeks. Hierarchical linear modeling (HLM) analyses revealed that there were large between‐individual differences in change and stability of the Big Five personality traits, which were accounted for by the amount of daily positive and negative life experiences during the interval period. Moreover, multi‐group HLM analyses indicated that the life experience effects were moderated by participants' attachment security at Time 1. These findings suggest that the accumulation of small daily experiences may work for the personality development of university students and that environmental influences may vary by individual susceptibility to experiences, like attachment security.     

Les unités de soins intensifs psychiatriques (USIP) : expériences françaises et internationales

Psychiatric Intensive Care Units (PICU) propose a secure setting for patients with acute behavior disturbances who can not be managed in psychiatric general wards. Physical violence acts against patients or hospital staff, substance abuse, non-compliance for care and treatment, intensity of symptoms or absconding are frequent motives for admission. Patients are compulsorily detained in secure conditions. They are admitted from psychiatric facilities of a health area or by agreement between hospitals. Multidisciplinary working in psychiatric intensive care is essential, delivered by qualified staff. Care and treatment must be centered on the patient, multidisciplinary, intensive, comprehensive with an immediacy of response to critical situations. As length of stay should not exceed 2 months in duration, interface and liaison with original services of patients are important issues. In France, PICU exist notably at Cadillac, Lyon, Paris, Nice, Eygurande, Montpellier, Pau and Prémontré. These facilities appear as a missing level, an interesting alternative in mental health care system, between psychiatric general wards and maximum security hospitals. This paper reports the creation of a National Association of PICU in France, the existence of national minimum standards and international experiences.     

The Use of Psychoeducation for a Patient with Hepatitis C and Psychiatric Illness in Preparation for Antiviral Therapy: A Case Report and Discussion

The standard of care treatment for chronic hepatitis C viral infection (HCV) is a combination of pegylated interferon alfa and ribavirin for 24-48?weeks according to the virus genotype. This therapy is known to have multiple neuropsychiatric side effects. A major concern when evaluating a patient for HCV treatment with a known history of a psychiatric disorder is the risk that the patient's psychiatric disorder will flare or become unmanageable. The possibility of precipitating depression, confusion, mania, psychosis, hallucinations, or suicidal ideation or attempt is frequently an obstacle to treatment. We present the case of a 50?year-old man with HCV and an extensive psychiatric history involving alcoholism, depression, and suicidality who participated in a psychoeducation group to help prepare him for treatment with pegylated interferon alfa/ribavirin therapy. Though the patient derived much benefit from the psychoeducation group, by the time of evaluation for HCV treatment two months after the group ended he had relapsed back into a depressive episode with suicidal thoughts. His acute psychiatric status made him unacceptable for pegylated interferon alfa/ribavirin therapy. Psychoeducation groups show promise for helping patients with chronic medical illness to be ready for and endure intensive medical treatment that has substantial psychiatric side effects. The challenge is to help patients overcome barriers to treatment, particularly psychosocial problems, because available treatments are increasingly effective.     

Phyloanalysis: Theoretical and Practical Considerations on Burrow's Group Analytic and Socio-Therapeutic Method by W. Riese and H. Syz

Abstract

Women in an eating disorders partial hospital program and a psychiatric partial hospital program were compared on a self-report measure of group climate following a psychodynamic-interpersonal therapy group. Those with eating disorders experienced their groups as more engaged and as more avoiding than those in the psychiatric partial hospital group. Therapists may be able to use initial heightened engagement in eating disorder groups to counteract the tendency to avoid content.     

Clinical,Studies in Psychiatry by H. S. Sullivan

A structured group therapy approach for psychiatric inpatients is presented. After reviewing the literature indicating that insight-oriented approaches are not effective with severely disturbed patients, the data supporting an interpersonal, cognitive, problem-solving approach with such patients is reviewed. A rationale for combining this cognitive problem-solving approach and Yalom's interpersonal approach with psychiatric inpatients is then presented. This structured group therapy approach, called the problem-solving support group (PSSG) is discussed, defining the nature and composition, screening procedures, methods, and techniques of the PSSG. Its use with psychiatric patients is illustrated by therapy protocols depicting the nature of the therapeutic interactions during the group, while also demonstrating what the group appears to be accomplishing for its members.