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.     

Developing Measures of Community-Relevant Outcomes for Violence Prevention Programs: A Community-Based Participatory Research Approach to Measurement

Community-Based Participatory Research is a research paradigm that encourages community participation in designing and implementing evaluation research, though the actual outcome measures usually reflect the “external” academic researchers’ view of program effect and the policy-makers’ needs for decision-making. This paper describes a replicable process by which existing standardized psychometric scales commonly used in youth-related intervention programs were modified to measure indicators of program success defined by community partners. This study utilizes a secondary analysis of data gathered in the context of a community-based youth violence prevention program. Data were retooled into new measures developed using items from the Alabama Parenting Questionnaire, the Hare Area Specific Self-Esteem Scale, and the Youth Asset Survey. These measures evaluated two community-defined outcome indicators, “More Parental Involvement” and “Showing Kids Love.” Results showed that existing scale items can be re-organized to create measures of community-defined outcomes that are psychometrically reliable and valid. Results also show that the community definitions of parent or parenting caregivers exemplified by the two indicators are similar to how these constructs have been defined in previous research, but they are not synonymous. There are nuanced differences that are important and worthy of better understanding, in part through better measurement.     

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.     

Early processing of emotional faces in children with autism: An event-related potential study

Social deficits are one of the most striking manifestations of autism spectrum disorders (ASDs). Among these social deficits, the recognition and understanding of emotional facial expressions has been widely reported to be affected in ASDs. We investigated emotional face processing in children with and without autism using event-related potentials (ERPs). High-functioning children with autism (n = 15, mean age = 10.5 ± 3.3 years) completed an implicit emotional task while visual ERPs were recorded. Two groups of typically developing children (chronological age-matched and verbal equivalent age-matched [both ns = 15, mean age = 7.7 ± 3.8 years]) also participated in this study. The early ERP responses to faces (P1 and N170) were delayed, and the P1 was smaller in children with autism than in typically developing children of the same chronological age, revealing that the first stages of emotional face processing are affected in autism. However, when matched by verbal equivalent age, only P1 amplitude remained affected in autism. Our results suggest that the emotional and facial processing difficulties in autism could start from atypicalities in visual perceptual processes involving rapid feedback to primary visual areas and subsequent holistic processing.     

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 persistence of implicit behavioral associations for moms and dads

While the concept of the “new involved father” has gained popularity in the media and academic circles, it is unclear to what extent behavioral expectations of moms and dads today reflect gender equality. Using a Go/No-Go Task, Study 1 examined implicit associations between behavioral images indicative of childcare versus the professional world with (a) parent roles (dads versus moms) and (b) gender categories (males versus females). Both evidenced strong persistence of traditional stereotypes. Moreover, females were more strongly associated with the role mom than males were with dad. In Study 2, individual variation in the strength of these implicit associations predicted differences in judgments of how best to resolve work—family conflicts along traditional stereotypic lines. Implicit associations tying mom to childcare and dad to the professional world likely contribute to greater experienced conflict for women than men in striving to be both a parent and a professional.