The refractory headache patient--I. Chronic, daily, high intensity headache

Two studies on patients with Chronic, Daily, High Intensity Headache (CDHIHA) are presented. In the first, their response to various self-regulatory (biofeedback, relaxation) treatments was compared to that of case controls matched for age, duration and Ad Hoc Committee diagnoses who had 1-2 headache-free days per week (Group II) and 3-5 headache-free days per week (Group III). The CDHIHA patients had a significantly poorer response to treatment (12.7 vs 49.8% improvement for Groups II and III combined). In the second study, the psychological profiles of an enlarged sample of CDHIHA patients were compared to matched case controls from Group II and Group III. The CDHIHA patients tended to be more anxious, more hysterical and to have more non-headache somatic complaints than Groups II and III combined.     

The relationship between assessment and psychotherapy

The many arguments, pro and con, about the usefulness and roles of diagnosis in general, and a psychological test battery in particular, can be settled only with reference to particular tests, a particular tester, particular patients, with reference to particular questions, in a particular context. Psychologists need to establish the usefulness of tests in cost-effective ways and demonstrate how tests provide a means of studying the mind. It follows that all psychotherapists should be able to use the tests, as all physiologists should be able to use a microscope. The rule of thumb that therapists should not give tests to their patients is unnecessary, though it is preferable that the tests be given early in the relationship, and that patients have the opportunity to explore their reactions to the procedure. To maximize the usefulness of tests given by someone who is not the patient's therapist, the test report should be designed as a means of persuasion toward therapeutic action more than a passive report of findings. An outline for test report writing is suggested. Finally, the use of tests helps elucidate the many factors that contribute to change through psychotherapy.     

Developmental retardation in infants as a concomitant of physical child abuse

The impact of child abuse on the developmental functioning of infants was investigated. Thirty verified cases of physically abused children were compared to a reference group of 30 nonabused children matched for age, sex, race, and socioeconomic status. Abused children scored significantly lower in terms of cognitive and motor development as measured by the Bayley Scales of Infant Development. Developmental delays on three of the four sectors of the Denver Developmental Screening Test, personal-social, language, and gross motor, were also found in the abused children. There were, however, relatively few item differences between the two groups on the 30 more general behavioral variables constituting the Bayley Infant Behavior Record. Results appear to confirm clinical observation of abused children as developmentally retarded with specific delays in the language and gross motor areas. Although methodologically complex, longitudinal studies are clearly indicated to assess the stability and/or reversibility of the present findings.The author is indebted to John E. Overall for statistical analysis of the data, and to Drs. Joan Hebeler, Margaret McNeese, Manon Brenner, and Sally Robinson for their invaluable assistance in obtaining children for this study, and to the M. D. Anderson Foundation for their support of this project.     

Restoration of Firearm Rights in New York

The National Instant Criminal Background Check System (NICS) Improvement Amendments Act of 2007 encouraged states to create processes by which individuals who have lost their rights to firearm possession for mental-illness-related reasons could receive relief from restrictions. Over 20 states have created relief processes for this sub-group, but there still exists considerable state-by-state heterogeneity. The spectrum ranges from states that require a physician's opinion regarding appropriateness for restoration to those that rely solely on judicial proceedings without input from psychiatrists or other mental health professionals. This article reviews the restoration process in New York State, a model in which psychiatrists participate in the process of assessing whether an individual's firearm rights can be restored. It discusses the legislative background of these regulations, the specific policies and procedures governing the restoration process, and clinical considerations for the forensic evaluation. Copyright © 2015 John Wiley & Sons, Ltd.     

Pygmalion in the genes? On the potentially negative impacts of polygenic scores for educational attainment

Social Psychology of Education - Polygenic scores for educational attainment and related variables, such as IQ and “mathematical ability” are now readily available via...     

Psychopharmacology and the Power of Narrative

This report offers recommendations to physicians who provide information or services through online sites. The recommendations maintain that physicians responsible for health-related information should ensure that it is accurate, timely, reliable, and scientifically sound. Also, advice to online users with whom physicians do not have preexisting relationships or the use of decision-support programs that generate personalized information directly transmitted to users should be consistent with general and specialty-specific standards. In particular, these standards should address truthfulness, protection of privacy, informed consent, and disclosures including limitations inherent in the technology. Finally, physicians who establish or are involved in health-related online sites must minimize conflicts of interest and commercial biases and, if patient specific information is transmitted, they must provide high-level security protections, as well as privacy and confidentiality safeguards.