Defining Location in the Mental Health System: A Case Study of a Consumer-Run Agency

In this ethnographic study of a mental health service agency staffed by “consumers,” or fellow “recipients” of services for serious mental illness, the concept of community narrative provides the framework for examining how such an agency preserves its consumer identity while providing services dictated by the established service system. Locating the agency's narrative in its “origins tale,” analysis revealed five principles comprising the agency's identity: a normalizing view of mental illness, a commitment to helping, a dual-valued understanding of the mental health system, and beliefs in recovery and in the significance of employment as a criterion for recovery. Predicted consequences of narrative functioning emerged in social climate and staff expressions of cohesion and commitment. The local meaning of these narrative themes reveals the agency's view of the consumer element in its work and its solution to the dilemma of being both inside and outside of the mental health system.     

Environmental topography and postural control demands shape aging-associated decrements in spatial navigation performance

This study tests the hypothesis that aging-induced cognitive permeation of sensorimotor functions contributes to adult age differences in spatial navigation performance. Virtual maze-like museums were projected in front of a treadmill. Sixteen 20-30-year-old men and sixteen 60-70-year-old men performed a way-finding task in city-block or variable topographies while walking with or without support. Walking support attenuated age-related decrements in navigational learning. Navigation load increased trunk-angle variability for older adults only. Age differences in spatial knowledge persisted despite perfect place-finding performance. City-block topography was easier than variable topography for younger adults only, indicating age-related differences in reliance on spatial relational learning. Attempts at supporting older adults' navigation performance should consider sensorimotor/cognitive interactions and qualitative differences in navigational activity.     

Temperament, personality, and developmental psychopathology as childhood antecedents of personality disorders

To contribute to the case for a dimensional conceptualization of psychopathology in general and maladaptive personality or personality disorders in particular, the present paper reviews the evidence for a dimensional representation of childhood temperament and personality. The review of temperament and variable-centered as well as person-centered approaches to childhood personality leads us to propose five broadband dimensions that capture individual differences in children and adolescents: extraversion, emotional stability, agreeableness, conscientiousness, and openness/intellect. Our analysis of the CBCL (Achenbach, 1991) and the DIPSI (currently under development at Ghent University), two dimensional models for childhood psychopathology, suggests two common broadband factors, internalizing and externalizing. The relations between the dimensional representation of childhood temperament/personality and psychopathology are documented with data from general population and clinical samples of children and adolescents. The article concludes with a proposal on how the higher-order dimensions emerging from studies of adaptive and maladaptive individual differences in childhood could be integrated in a common dimensional model.     

Predictors of Young Adolescents’ Math Grades and Course Enrollment Intentions: Gender Similarities and Differences

Gender differences and similarities in the relations of key constructs in Eccles and colleagues (Wigfield & Eccles, 2000) model of achievement were examined as predictors of math grades and enrollment intentions for Grade 9 boys (n = 263) and girls (n = 277). A number of gender similarities were found, particularly in the prediction of math grades. There were, however, two gender-specific paths: for girls, a direct path from competence beliefs to enrollment intentions, and for boys, a direct path from prior math grades to enrollment intentions. In addition, for boys, the path from utility value to enrollment intentions was stronger than it was for girls. These differential predictive patterns were found even though girls and boys reported similar levels of math utility and girls had lower math competence beliefs. For girls, competence beliefs were a significant predictor of both intentions and current math grades, which indicates the central role of competence beliefs.     

Discounting and conditionalization

When people are asked to judge the strengths of two potential causes of an effect, they often demonstrate discounting--devaluing the strength of a target cause when it is judged in the presence of a strong (relative to a weak) alternative cause. Devaluing the target cause sometimes results from conditionalization--holding alternative causes constant while evaluating the target cause. Yet discounting not attributable to conditionalization also occurs. We sought to dissociate conditionalization and discounting (beyond that accounted for by conditionalization) by having subjects perform either a spatial or a verbal working memory task while learning a causal relation. Conditionalization was disrupted by the verbal task but not the spatial task; however, discounting was disrupted by the spatial task but not the verbal task. Conditionalization and discounting are therefore cognitively dissociable processes in human causal inference.     

A warm heart and a clear head. The contingent effects of weather on mood and cognition

Prior studies on the association between weather and psychological changes have produced mixed results. In part, this inconsistency may be because weather's psychological effects are moderated by two important factors: the season and time spent outside. In two correlational studies and an experiment manipulating participants' time outdoors (total N = 605), pleasant weather (higher temperature or barometric pressure) was related to higher mood, better memory, and "broadened" cognitive style during the spring as time spent outside increased. The same relationships between mood and weather were not observed during other times of year, and indeed hotter weather was associated with lower mood in the summer. These results are consistent with findings on seasonal affective disorder, and suggest that pleasant weather improves mood and broadens cognition in the spring because people have been deprived of such weather during the winter.     

Cystic Fibrosis Prenatal Screening in Genetic Counseling Practice: Recommendations of the National Society of Genetic Counselors

For over a decade, prenatal screening for cystic fibrosis (CF) has been considered a model for the integration of genetic testing into routine medical practice. Data from pilot studies and public policy discourse have led to recommendations by some professional organizations that CF screening should be offered or made available to pregnant women and their partners, and to couples planning a pregnancy. It is crucial that genetic counselors gain thorough understanding of the complexities of CF and the implications of positive test results, so that they may serve as a reliable, educated referral base and resource for health care providers and their patients. While not all pregnant women will be referred for genetic counseling prior to CF carrier testing, genetic counselors often will be asked to counsel clients after they have a positive test result, or who are found to be at increased risk. Genetic counselors can play an important role in providing accurate and current information as well as support for patients informed decisions. These recommendations were created by a multicenter working group of genetic counselors with expertise in CF and are based on personal clinical experience, review of pertinent English language medical articles, and reports of expert committees. The recommendations should not be construed as dictating an exclusive course of management, nor does the use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care providers professional judgment based on the clinical circumstances of a particular client.     

Genetic Evaluation and Counseling of Couples with Recurrent Miscarriage: Recommendations of the National Society of Genetic Counselors

The objective of this document is to provide recommendations for genetic evaluation and counseling of couples with recurrent miscarriage (RM). The recommendations are the opinions of the multidisciplinary Inherited Pregnancy Loss Working Group (IPLWG), with expertise in genetic counseling, medical genetics, maternal fetal medicine, internal medicine, infectious disease, cytogenetics, and coagulation disorders. The IPLWG defines RM as three or more clinically recognized consecutive or non-consecutive pregnancy losses occurring prior to fetal viability (<24 weeks gestation). These recommendations are provided to assist genetic counselors and other health care providers in clinical decision-making, as well as to promote consistency of patient care, guide the allocation of medical resources, and increase awareness of the psychosocial and cultural issues experienced by couples with RM. The IPLWG was convened with support from the March of Dimes Western Washington State Chapter and the University of Washington Division of Medical Genetics. The recommendations are U.S. Preventive Task Force Class III, and are based on clinical experiences, review of pertinent English-language published articles, and reports of expert committees. This document reviews the suspected causes of RM, provides indications for genetic evaluation and testing, addresses psychosocial and cultural considerations, and provides professional and patient resources. These recommendations should not be construed as dictating an exclusive course of medical management, nor does the use of such recommendations guarantee a particular outcome. The professional judgment of a health care provider, familiar with the circumstances of a specific case, should always supersede these recommendations.     

Use of the Conners-wells adolescent self-report scale (short form) with children

The short form of the Conners-Wells Adolescent Self-Report Scale (CASS:Short) is administered to 319 children and 844 adolescents to investigate whether the instrument can be used with respondents under the age of 12. Mothers of all respondents are asked to rate each child using a measure designed to assess a parallel set of problem behaviors. The factor structure of the CASS:Short is tested in both samples and is found to have good fit to the data. Mean levels of ADHD symptomatology are also examined for possible sex and age effects, as was the relationship between parent and self-report ratings. The overall results provide empirical support for the use of the CASS:Short with children ages 7 to 11.