Resource Document on Access to Firearms by People with Mental Disorders

The American Psychiatric Association, (“APA”), with more than 36,000 members at present, is the Nation's leading organization of physicians who specialize in psychiatry. APA provides for education and advocacy and develops policy through Position Statements. It promotes enhanced knowledge of particular topics relevant to psychiatric practice and patient care through Resource Documents. Since 1993, the APA has developed various positions and resource materials related to firearms and mental illness, incorporating evolving themes as new issues emerge. This paper reflects the APA's 2014 Resource Document on “Access to Firearms by People with Mental Disorders.” This article is derived from work done on behalf of American Psychiatric Association and remains the property of APA. It has been altered only in response to the requirements of peer review. Copyright © 2015 American Psychiatric Association. Published with permission (original adopted by the American Psychiatric Association 2014).     

A Secondary Analysis of Integrated Pediatric Chronic Pain Services Related to Cost Savings

Youth with chronic pain have high healthcare utilization and associated costs. Research supports integrated treatment; though, it’s unclear which treatments are used and cost-effective. This study expands on work that found reduced service use and cost savings following participation in an outpatient integrated pediatric pain clinic. We explored which services were commonly used and which individual (psychotherapy, medication management, acupuncture, massage, biofeedback) and/or combinations of services were associated with service use reduction and cost savings. Medication management and psychotherapy were more common than complementary integrative medicine (CIM) services. Massage services were associated with reduced inpatient costs. There were trends of fewer emergency department visits for participants who received CIM services in addition to medication management and psychotherapy, and more visits for those with biofeedback. Findings suggest that a more detailed examination of service utilization is needed to better understand cost outcomes related to the integrated treatment of pediatric chronic pain.

     

Construction of a Hypercompetitive Attitude Scale

Theory testing in the area of hypercompetitiveness has been impeded by the lack of an adequate psychometric instrument. Four studies were conducted as part of an initial research program designed to remedy this deficiency by constructing an individual difference measure of general hypercompetitive attitude with satisfactory psychometric properties. In Studies 1 and 2, a 26-item scale was derived primarily through item-total correlational analysis; it demonstrated adequate internal and test-retest reliabilities. The remaining two studies were concerned with determining the construct validity of the scale. In line with theoretical expectations based on Horney's theory of neurosis, subjects who perceived themselves as hypercompetitive were less psychologically healthy. The potential usefulness of the scale in therapeutic, athletic, school, and business settings is discussed.     

Memory and learning for visual signals in time and space

Vision is often characterized as a spatial sense, but what does that characterization imply about the relative ease of processing visual information distributed over time rather than over space? Three experiments addressed this question, using stimuli comprising random luminances. For some stimuli, individual items were presented sequentially, at 8 Hz; for other stimuli, individual items were presented simultaneously, as horizontal spatial arrays. For temporal sequences, subjects judged whether each of the last four luminances matched the corresponding luminance in the first four; for spatial arrays, they judged whether each of the right-hand four luminances matched the corresponding left-hand luminance. Overall, performance was far better with spatial presentations, even when the entire spatial array was presented for just tens of milliseconds. Experiment 2 demonstrated that there was no gain in performance from combining spatial and temporal information within a single stimulus. In a final experiment, particular spatial arrays or temporal sequences were made to recur intermittently, interspersed among, non-recurring stimuli. Performance improved steadily as particular stimulus exemplars recurred, with spatial and temporal stimuli being learned at equivalent rates. Logistic regression identified several shortcut strategies that subjects may have exploited while performing our task.     

Trait valence and the better-than-average effect

People tend to regard themselves as having superior personality traits compared to their average peer. To test whether this "better-than-average effect" varies with trait valence, participants (N = 154 students) rated both themselves and the average student on traits constituting either positive or negative poles of five trait dimensions. In each case, the better-than-average effect was found, but trait valence had no effect. Results were discussed in terms of Kahneman and Tversky's prospect theory.     

The effects of social injustice and inequality on children's moral judgments and behavior: Towards a theoretical model

Our goal in this paper is to examine the potential origins of children's understanding of morally relevant transgressions, with a particular focus on how children's perceptions of both proximal and distal unfairness might influence their social reasoning and behavior. A preliminary theoretical model is presented that addresses connections among aggressive children's social cognitive biases, their attachment histories, and their working models of societal justice and fairness. It is argued that difficulties in early parent–child interactions in combination with hostile larger social environments act to undermine emotional reciprocity, empathy, and concern for others in ways likely to promote proactive, uncaring forms of victimization and harm. Furthermore, it is proposed that given sufficiently toxic social experiences, some children will develop beliefs that life does not primarily revolve around caring or fairness, but around power and domination. Discussion focuses on the potential implications of these non-normative but coherent moral beliefs for theory and intervention.     

Does natural law have non-normative foundations?

This paper addresses one aspect of the natural law theory of Germain Grisez. According to Grisez, practical reason identifies the goods of human life prior to the invocation of any moral or normative notions. It can thus provide a non-normative foundation for moral theory. I present Grisez’s position and argue that the apparently non-normative aspect of natural law cannot support the moral position built upon it. I argue, in particular, that practical principles, as Grisez understands them, are best understood as speech acts. If this is correct, it is possible to develop a sceptical challenge to Grisez’s position. I am grateful to Michael Frede, Robert George, Richard Holton, Philip Pettit, and two anonymous reviewers for many helpful comments on this paper. This paper was presented at a seminar in the Department of Philosophy at Princeton University in November 1987, and I am grateful for the comments I received from the audience—in particular, Germain Grisez—on that occasion.     

Measured Gene–Environment Interactions and Mechanisms Promoting Resilient Development

ABSTRACT— Childhood maltreatment elevates risk for antisocial behavior, depression, and other problems over the life span, but a subset of maltreated individuals avoids maladaptive development and shows resilience. Resilience reflects a dynamic confluence of factors that promotes positive adaptation despite exposure to adverse experiences. Recent replicated findings of gene–environment interactions (abbreviated G × E) involving maltreatment have identified two genes, monoamine oxidase A ( MAOA ) and serotonin transporter ( 5-HTT ), that moderate the association between childhood maltreatment and psychopathology. Accordingly, G × E raise new questions about potential biological mechanisms by which some individuals are able to cope adaptively and function relatively well despite experiencing early adversity. We summarize advances toward greater specification of G × E mechanisms, including genetic and environmental moderation of G × E effects and imaging genomics that provide clues regarding resilience processes in development.