Transforming mental health care for children and their families

In April 2002, the President's New Freedom Commission on Mental Health was created by executive order to study the mental health care delivery system in our nation and to make recommendations for improvements so that individuals with serious mental disorders can live, work, learn, and fully participate in their homes and communities. In its report, "Achieving the Promise: Transforming Mental Health Care in America," the commission provided strategies to address critical infrastructure, practice, and research issues. This article focuses on the work of the commission's Subcommittee on Children and Families, describing its vision for mental health service delivery for children and providing suggestions for strengthening community-based care for youths with or at risk of behavioral health disorders. Training, research, practice, and policy implications for psychologists are discussed.     

Characteristics of auditory agnosia in a child with severe traumatic brain injury: a case report

We present a case that is unusual in many respects from other documented incidences of auditory agnosia, including the mechanism of injury, age of the individual, and location of neurological insult. The clinical presentation is one of disturbance in the perception of spoken language, music, pitch, emotional prosody, and temporal auditory processing in the absence of significant deficits in the comprehension of written language, expressive language production, or peripheral auditory function. Furthermore, the patient demonstrates relatively preserved function in other aspects of audition such as sound localization, voice recognition, and perception of animal noises and environmental sounds. This case study demonstrates that auditory agnosia is possible following traumatic brain injury in a child, and illustrates the necessity of assessment with a wide variety of auditory stimuli to fully characterize auditory agnosia in a single individual.     

Implementation of a comprehensive schoolwide behavioral intervention: The ABC program

The Academic and Behavioral Competencies (ABC) Program, a schoolwide program to reduce classroom disruption and encourage rule following, academic task completion, and homework completion, is described. The program was initially developed and implemented in an elementary school with a high-risk population. Data from teachers, parents, and children indicate high levels of satisfaction with the program. In addition, unobtrusive measures of program impact, reported as reductions in referrals to the principal's office, suspensions, and increases in homework completion rates relative to the year prior to implementation of the program, suggest a preliminary positive impact of the program. A replication is reported for another school district, with teacher evaluations of satisfaction and effectiveness reported, supporting the flexibility and adaptability of the program. Although the present article does not constitute a systematic evaluation of the ABC Program, it presents preliminary data on the process of implementation and stakeholder satisfaction.     

A replication of the MMPI-A PSY-5 scales and development of facet subscales

McNulty, Harkness, Ben-Porath and Williams recently developed Personality Psychopathology Five (PSY-5) scales for the Minnesota Multiphasic Personality Inventory-A (MMPI-A). This study examined these new scales in a sample of 545 adolescents receiving inpatient psychiatric treatment. Item-level principal components analyses were employed to determine the internal structure of each PSY-5 scale and to aid in the creation of facet subscales for each PSY-5 scale. Results suggest that the MMPI-A PSY-5 scales display adequate internal consistency and our findings generally replicate the original work of McNulty et al. but also extend this work by showing that several of the PSY-5 scales may also be subdivided into meaningful lower level dimensions. These facet subscales for each of the MMPI-A PSY-5 scales are offered for further study.     

An examination and replication of the psychometric properties of the Massachusetts Youth Screening Instrument--second edition (MAYSI-2) among adolescents in detention settings

There is a high prevalence of psychological disorders among adolescents in detention facilities. The need for a simple, effective screening tool led to the development of the Massachusetts Youth Screening Instrument (MAYSI) and its successor, the MAYSI-2. This study evaluated the MAYSI-2 psychometric properties based on the records of 704 youths evaluated at intake to detention facilities. In addition to factor structure, the study evaluated test-retest reliability and concurrent external validity. Results were generally encouraging in terms of the use of MAYSI-2 in detention facilities, and directions for future research are discussed.     

Neural synergy between kinetic vision and touch

Ambiguous visual information often produces unstable visual perception. In four psychophysical experiments, we found that unambiguous tactile information about the direction of rotation of a globe whose three-dimensional structure is ambiguous significantly influences visual perception of the globe. This disambiguation of vision by touch occurs only when the two modalities are stimulated concurrently, however. Using functional magnetic resonance imaging, we discovered that touching the rotating globe, even when not looking at it, reliably activates the middle temporal visual area (MT+), a brain region commonly thought to be crucially involved in registering structure from motion. Considered together, our results show that the brain draws on somatosensory information to resolve visual conflict.     

Treatment of pharmacotherapy-refractory posttraumatic stress disorder among Cambodian refugees: a pilot study of combination treatment with cognitive-behavior therapy vs sertraline alone

Cambodian refugees with posttraumatic stress disorder (PTSD) represent a cohort in severe need of treatment, but little information is available to guide treatment choices. We selected a sample of pharmacotherapy-refractory individuals to test the efficacy of combination treatment with sertraline and cognitive-behavior therapy (CBT) for treating PTSD. Participants in this pilot study were ten Khmer-speaking women who had been at a mean age of 22-26 years during the Pol Pot period (1975-1979). These patients were randomly assigned to either sertraline alone or combined treatment. We found that combined treatment offered additional benefit in the range of medium to large effect sizes for PTSD and associated symptoms. Our findings indicate that substantial gains can be achieved by adding CBT to pharmacotherapy for PTSD, and that a program of CBT emphasizing information, exposure, and cognitive-restructuring can be successfully modified for Khmer-speaking refugees.     

Picture interpretation and Jungian typology

This study examined a Jungian picture interpretation schema, which utilizes a specific quadrant method. This proposed schema, which is used in training at the C. G. Jung Institute in Zürich, attaches significance to specific areas of a drawing. The upper left of a drawing is associated with the father; the lower left with the unconscious; the lower right with the mother; and the upper right with the future. Three questions served as the foci of this study: Is the schema valid? Do certain types within Jung's personality theory respond better than others to the schema? Does the schema work best when it elicits a strong affective response from the person who created the picture? Subjects took one of two tests: a space domain test, or a colour associative test. The results revealed only two significant effects: a positive association (in the space domain test) between unconscious material with the unconscious quadrant and a negative association (in the colour associative test) of mother material with the mother quadrant. These results suggest that the Jungian quadrant schema used to interpret drawings is invalid and of minimal practical utility. Other methods of picture interpretation are discussed as well as suggestions for future research that would be helpful to this field.     

Providing social support may be more beneficial than receiving it: results from a prospective study of mortality

This study examines the relative contributions of giving versus receiving support to longevity in a sample of older married adults. Baseline indicators of giving and receiving support were used to predict mortality status over a 5-year period in the Changing Lives of Older Couples sample. Results from logistic regression analyses indicated that mortality was significantly reduced for individuals who reported providing instrumental support to friends, relatives, and neighbors, and individuals who reported providing emotional support to their spouse. Receiving support had no effect on mortality once giving support was taken into consideration. This pattern of findings was obtained after controlling for demographic, personality, health, mental health, and marital-relationship variables. These results have implications for understanding how social contact influences health and longevity.