A Retrospective Examination of Child Protection Involvement Among Young Adults Accessing Homelessness Services

Childhood maltreatment is associated with a variety of young adult adversities including homelessness. This study used linked administrative records to develop a population‐level, epidemiological characterization of the child protection histories of young adults accessing homelessness services. The records of all 17‐ to 24‐year‐olds receiving homeless services between 2011 and 2014 in San Francisco County, California (n = 2241) were probabilistically linked to statewide child protective service (CPS) records. Findings document that 50.0% of young adults had been reported for maltreatment at least once during childhood, yet the prevalence of past CPS involvement varied across demographic and child welfare characteristics. Homeless female youth were significantly more likely to have a CPS history than male youth (58.1% vs. 41.5%). Nearly twice as many Black clients accessing homelessness services had a CPS history as did White clients (59.8% vs. 31.8%). Roughly half (47.3%) of those with a childhood history of reported maltreatment had been last reported for maltreatment in another California county. Targeting services that address past trauma and instability among homeless young adults may be justified given the prevalence of CPS history in this population.     

The Search for Non-Medical Treatment by Patients with Psychiatric Disorders

Patients in Turkey frequently seek help from non-physicians such as hodjas and fortune-tellers. The aim of this study is to assess the prevalence, reasons for and results of the search for non-medical help by patients with psychiatric disorders. It was determined that 42.2% of patients consulted a hodja or a fortune-teller, and many (23.1%) were either the subject of prayers or else were advised to pray themselves as treatment. Considering that a significant number of patients seek non-medical treatment, it is thought that people should be informed about psychiatric disorders, therapies, and how to obtain them.All of the authors are M.D.s at Ondokuz Mayis University in Samsun, Turkey. Dr. Peksen is a Professor and Dr. Sunter an Assistant Professor in the Faculty of Medicine, Department of Public Health. Dr. Ozkan is a Professor and Dr. Güz an Associate Professor in the Department of Psychiatry.     

Pseudocontingencies in Consumer Choice: Preference for Prevalent Product Categories Decreases with Decreasing Set Quality

Building on theorizing about contingency inferences, the present research deals with the impact of product category prevalence on consumer choice. We argue that a category's prevalence in the choice set can signal high quality, but the validity depends on the aggregate quality of the choice set. With ever more low‐quality products in the set, high prevalence should increasingly signal poor rather than high quality. When choosing from a poor‐quality set, choices should thus favor products from the rare category. In four experiments, we show that poor‐quality sets increase the proportion of consumers choosing products from a rare category. Furthermore, we show that these effects increase when base rates of a category and quality become more extreme. Finally, Experiment 4 shows that contingency inferences partly mediate the effect of set quality on choice. The results extend previous research on contingency inferences, indicating the adaptive use of base‐rate information in consumer decision making. Copyright © 2017 John Wiley & Sons, Ltd.     

城乡居民的就医选择差异研究

文章利用利用2008年中国居民医疗服务调查数据, 描述了居民的就医选择模式, 比较了城乡居民就医选择的差异。数据显示, 居民主要选择整体治疗水平高、口碑好, 方便且收费规范的医院和医德、医术兼顾的医生。在城乡差异方面, 城市居民主要选择那些有实力且环境舒适的医院, 村镇居民更希望医院有良好的服务和友好的态度。城市居民对医生的医德要求更高、更喜欢选专家看病, 但对专家有更多的质疑;而村镇居民则倾向于根据病情选医生, 也更为信任专家。     

Improving day-treatment services for adults with severe disabilities: a norm-referenced application of outcome management

We evaluated an outcome management program for working with staff to improve the performance of adults with severe disabilities in a congregate day-treatment setting. Initially, observations were conducted of student task involvement and staff distribution of teaching interactions across students in four program sites. Using recent normative data to establish objective goals for student performance, management intervention was warranted in two of the sites. A six-step outcome management program was then implemented in the two sites. The program involved defining desired student and staff outcomes, systematic monitoring of the outcomes, staff training, and supportive and corrective feedback. The outcome management program was accompanied by increases in student on-task behavior and staff distribution of teaching interactions in both sites. The increases brought the levels of on-task behavior above the normative average; on-task behavior was maintained above the baseline average for over 1 year in both sites. These results are discussed in terms of the benefits of relying on normative data for objectively evaluating and improving service delivery systems. Discussion of future research needs focuses on applying the outcome management program to other settings and services for people with disabilities.     

不同抑郁症状青少年调节不同强度情绪时策略选择的差异

最新研究发现,情绪强度会影响健康个体的情绪调节策略选择。然而,至今尚未有研究考察情绪强度对不同抑郁症状青少年策略选择的影响。对此,本研究通过流调中心用抑郁量表划分出无抑郁、阈下抑郁和抑郁症青少年,进而考察其在面对高-低强度积极-消极日常情绪事件时选择认知重评和认知沉浸的差异。结果发现：当面对高强度积极情绪、低强度积极情绪和低强度消极情绪时,三组被试的策略选择均无显著差异;当面对高强度消极情绪时,无抑郁青少年比阈下抑郁和抑郁症青少年更多选择认知重评而更少选择认知沉浸,但阈下抑郁和抑郁症青少年之间无显著差异。结果表明：不同抑郁症状青少年在面对不同强度和效价情绪时的情绪调节策略选择存在差异,表现为高强度消极情绪下抑郁症状越多的青少年越少选择认知重评而越多选择认知沉浸。这一发现有助于识别和干预青少年的抑郁症状。     

Psychiatric Diagnoses and Clinical Characteristics of Asian American Youth in Children's Services

This study examined the psychiatric diagnoses and clinical characteristics of the 981 Asian American children enrolled in the first phase of the Comprehensive Community Mental Health Services for Children and Their Families Program. Asian Americans were less likely than non- Asian Americans to receive diagnoses of depression and ADHD and more likely to receive diagnoses of anxiety and adjustment disorder. As compared to non-Asians, Asian Americans were significantly more likely to be rated with severe functional impairment in community role performance, self-harmful behavior, and thinking. There was also a trend for fewer externalizing behavior problems. Implications for research and practice are discussed.     

Understanding Respite Care Use by Families of Children Receiving Short-Term, In-Home Psychiatric Emergency Services

Respite care is widely believed to be an important support service for families raising a child with a disability. We report the findings of a respite care utilization study conducted within the context of a larger research and demonstration project examining three models of intensive, in-home services for children experiencing psychiatric crises. Respite care, both in-home and out-of-home, was a support service available to families in two of the three study conditions. Overall, 34% of 146 eligible families used in-home and or out-of-home respite care. Utilization was lower than the estimates developed prior to implementation, prompting an inquiry at the end of the first project year designed to maximize use and to gather more information on caregiver and service provider attitudes toward respite care. The inquiry included caregiver and provider focus groups, surveys, and enhanced data collection and analysis. Caregiver interviews indicated that many families did not fully understand what it meant to receive respite care or even that it was available to them. A comparative analysis of respite care users and non-users revealed that respite care users were more likely to have younger children, children who had a greater number of assessed functional impairments, and fewer social supports. Respite care users also reported greater difficulty managing their children's difficult behaviors.     

Duty of Care,Safety, Normalisation and the Mental Capacity Act: A Discourse Analysis of Staff Arguments about Facilitating Choices for People with Learning Disabilities in UK Services

The benefits of having choice and control for people with learning disabilities 1 are well documented, and front‐line carers often make efforts ensuring that these are facilitated. However, despite this, government policy reports that disempowerment within learning disability services in the UK is a persistent problem. Using critical discursive psychology, 15 interviews with support workers about empowering people with learning disabilities were analysed. Interpretative repertoires about ‘duty of care’, ‘safety’ and ‘normalisation’ and discursive strategies involving ‘comparative evaluations’ were found, which opened speaker positions of granting or withholding choice, assuming responsibility for those in care and constructing service users as lacking capacity. These resources also allowed speakers to regulate the choices of service users and to normalise limited choice in ways that undermined taking up more empowering practices. The findings may explain the persistence of disempowerment within services by indicating how such discourses are deeply entrenched in service talk and are invoked to justify disempowering practices. This is discussed in view of the implications for empowerment and also current legislative frameworks such as the Mental Capacity Act. Copyright © 2014 John Wiley & Sons, Ltd.     

时间知觉在老年人跨期选择中的作用

随着人口老龄化速度的加快,老年人的跨期选择问题受到越来越多的关注。时间知觉是影响跨期选择的重要因素之一。然而,目前从时间知觉的角度来探讨老年人跨期选择的研究比较有限。本文在总结国内外相关研究的基础之上,试图分析时间知觉的随龄变化如何影响老年人的跨期选择。具体而言,本文从时间长度知觉、时间成本知觉以及时间知觉相关心理动机三个方面进行探讨,并指出了时间知觉视角的局限性及今后的研究方向。     

Demographic Influences on Psychiatric Diagnoses Among Youth Served in California Systems of Care

We examined the influences of demographic factors on diagnostic assignment among youth served in California public mental health systems after adjusting for the effects of county characteristics and standardized symptom and functioning indices. The sample consisted of 12,106 youth with severe emotional disturbance being served in integrated and coordinated service systems in 13 counties of California. African Americans were overrepresented in the sample relative to the ethnic characteristics of the counties and Asian Americans were under-represented. Results from logistic regression analyses showed that gender, age, and ethnicity affected the assignment of eight categories of clinical diagnosis at admission. However, standardized measurement of clinical status and functioning had little relationship to clinicians' assignment of diagnosis. Whereas no significant gender and age differences were found on broadband CBCL syndromes, ethnically diverse youth differed on CBCL internalizing and externalizing scores. Youth's role functioning as assessed by the CAFAS also significantly differed by gender, age, and ethnicity.     

Use of response cards with a group of students with learning disabilities including those for whom English is a second language

The current study compared the effects of hand raising and response cards during a writing instruction class in a middle-school resource classroom with students who were learning English as their second language. Response cards increased the rate and accuracy of academic responding, increased weekly quiz scores, and had mixed effects on off-task behavior, but most students reported that they preferred hand raising.     

Abuse Experiences in a Community Sample of Young Adults: Relations with Psychiatric Disorders, Sexual Risk Behaviors, and Sexually Transmitted Diseases

This study documents significant associations among lifetime abuse experiences, psychiatric diagnoses, and sexual risk behaviors in a multiethnic community sample of young men and women (N = 1803) in South Florida. Self-report data were collected via structured interviews as part of a longitudinal follow-up of a larger school-based study. Participants were grouped according to extent of lifetime abuse experiences. Cumulative lifetime abuse experiences were associated with increased risk for a broad range of individual lifetime psychiatric disorders, as well as cumulative lifetime psychiatric disorders. Both cumulative abuse experiences and cumulative psychiatric disorders were independently associated with (a) higher levels of sexual risk behaviors and (b) higher risk for lifetime sexually transmitted diseases (STDs). Implications for selective prevention of sexual risk behaviors and STDs among young adults with histories of abuse and psychiatric disorders are discussed.     

成人学习不良的筛查与诊断

西方（以美国为代表）逐步形成了一套符合自身特点的成人学习不良筛查与诊断模式。文章讨论了筛查与诊断的关系,介绍了成人学习不良筛查与诊断的基本环节,以及筛查与诊断工具的选择与评估标准,并在对西方成人学习不良筛查与诊断模式特点的分析基础上,对建立我国成人学习不良测评体系提出了建议。     

A Case for Greater Risk Tolerance in Internet Use by Adults with Intellectual Disabilities: A Comment on Chalghoumi et al.

This comment argues for increased tolerance of privacy risks in the Internet activity of adults with intellectual disabilities. Excessive caution about such risks denies those individuals not only the great benefits of Internet use but also the difficult but valuable experiences of loss, disappointment, and hurt associated with those risks. A level of risk-aversion appropriate for small children will be disrespectful for adults with intellectual disabilities. To the extent that additional safeguards are justified, they are better achieved through individualized security and privacy settings than through caregiver oversight.     

Increasing pretend toy play of toddlers with disabilities in an inclusive setting

We evaluated a program for increasing pretend toy play of 2-year-old children with disabilities in an inclusive classroom. Classroom personnel implemented the program, which involved choices of classroom centers containing toys that tend to occasion pretend play in toddlers without disabilities, along with prompting and praise. Increases occurred in independent pretend-play rates among all 5 participating toddlers. Results are discussed regarding the importance of promoting toy play of very young children with disabilities that is similar to the type of play of their nondisabled peers, and the need to identify critical program components that are applicable in inclusive settings. DESCRIPTORS: pretend play, young children with disabilities     

Detection of a Psychiatric Diagnosis in Heart Transplant Candidates with the MBHI

The utility of the Millon Behavioral Health Inventory (MBHI) in screening for the formal diagnosis of a psychiatric disorder was investigated in a sample of 90 heart transplant candidates, a population at risk for psychiatric disturbance. Psychiatric disorders were identified in 71% of patients, the majority being adjustment disorder. Sensitivity and specificity rates of >70% were determined in discriminant function analyses, for presence or absence of a psychiatric condition. When Axis I conditions were differentiated as mild (adjustment reaction only) or severe (all other Axis I conditions, including comorbid Axis II disorders), the MBHI correctly identified every severe case as a probable psychiatric diagnosis. The rate of clinically significant elevations on certain MBHI scales and severity of Axis I psychiatric condition was also significantly associated. These findings suggest that the MBHI may have potential utility in identifying high-risk patients with diagnosable psychiatric conditions and help justify mental health consultation referrals at a time when managed care entities are vigorously rationing ancillary services with medically ill populations.     

胃癌患者影像检查技术的合理选择

随着X线钡餐造影、计算机断层扫描、磁共振成像、超声检查及正电子发射体层摄影等技术的不断发展,各种影像检查方法在胃癌的诊断、术前分期及术后评价等方面被广泛应用,但各种检查技术都有各自的优缺点,我们应该根据胃癌患者的实际情况为其选择正确合理的影像检查技术。     

Randomized Effectiveness Trial of an Internet,Pure Self-Help,Cognitive Behavioral Intervention for Depressive Symptoms in Young Adults

This study evaluated an Internet-delivered, cognitive behavioral skills training program versus a treatment-as-usual (TAU) control condition targeting depression symptoms in young adults aged 18 to 24 years. Potential participants were mailed a recruitment brochure; if interested, they accessed the study website to complete an online consent and baseline assessment. Intervention participants could access the website at their own pace and at any time. Reminder postcards were mailed periodically to encourage return use of the intervention. The pure self-help intervention was delivered without contact with a live therapist. The primary depression outcome measure was the Patient Health Questionnaire, administered at 0, 5, 10, 16, and 32 weeks after enrollment. A small but significant between-group effect was found from Week 0 to Week 32 for the entire sample (N = 160, d = .20, 95% confidence interval [CI] 0.00–0.50), with a moderate effect among women (n = 128, d .42, 95%C1 = 0.09–0.77). Greater depression reduction was associated with two measures of lower website usage, total minutes, and total number of page hits. Although intervention effects were modest, they were observed against a background of substantial TAU depression pharmacotherapy and psychosocial services. Highly disseminable, low-cost, and self-help interventions such as this have the potential to deliver a significant public health benefit.