WOMEN'S PSYCHOLOGICAL ADJUSTMENT FOLLOWING EMERGENCY CESAREAN VERSUS VAGINAL DELIVERY

The present study was designed to investigate possible differences in psychological adjustment and satisfaction between women delivering vaginally and those delivering by emergency cesarean section. Women's satisfaction with the birth experience was distinguished from postpartum psychological adjustment, as measured by depression, anxiety, and confidence in mothering ability. Twenty-two women who delivered vaginally and twenty-two women who delivered by emergency cesarean section were selected according to stringent criteria, to control for factors known to be associated with positive cesarean outcomes. Significant differences were found in level of satisfaction, with cesarean mothers reporting less satisfaction with the delivery than vaginal mothers. However, no differences were found between the groups on the three measures of psychological adjustment. Under optimal conditions, cesarean deliveries are not associated with adverse early postpartum psychological adjustment.     

Head Start Children at Third Grade: Preliminary Special Education Identification and Placement of Children with Emotional, Learning, and Related Disabilities

Although children in Head Start are at risk for emotional or behavioral problems, little is known about their later need for special education. There is evidence that children at risk for emotional disturbance are underidentified or misidentified in other special education categories. We examined special education identification rates for Head Start children at risk for emotional disturbance, learning disabilities, speech or language impairments, and mental retardation as they complete third grade. Two cohorts of 4136 children across 30 sites were followed as part of a larger study on transition. Diagnosis of each child as being at risk for emotional disturbance or related disabilities was made using clinical cut-offs on teacher ratings and individual testing completed in the spring of third grade. Special education eligibility of these children was determined from school records. Only 31.8% of children considered to be at risk, based on research diagnostic criteria, were actually identified by the schools, and fewer than 6% of children at risk for ED were identified in the school category of ED. Comparisons were made between school-identified and nonidentified children in gender, ethnicity, and school variables; and findings were discussed in relation to underidentification or misidentification of children with emotional disturbance.     

Suicide After Evaluation for Involuntary Psychiatric Commitment—Who Gets Them and What Influences Survival Time?

Although involuntary psychiatric hospitalizations are associated with suicide risk, little is known about the relationship between evaluation for involuntary detention and suicide. We analyzed data on 10,082 suicides from 2000 to 2011 to examine demographics related to evaluation for detention and the association between demographics and evaluation dispositions on survival time. Evaluation preceded 11% of suicides; 53.8% of deaths occurred within 365 days, 6.5 times the expected rate. Males and older individuals were least likely to have been evaluated. Minority status and referral disposition influence 30‐day survival time. Risk is highly concentrated in the first year following evaluation.     

The Evolving Position of the American Psychiatric Association on Firearm Policy (1993–2014)

Before the Supreme Court's 2008 decision in District of Columbia v. Heller, the American Psychiatric Association's position on gun policy reflected the strong gun control perspective championed by the nation's public health establishment. After Heller declared that an individual's right to bear arms is constitutionally protected, the APA refocused its attention on the specific aspects of firearm policy that implicate the interests and rights of persons with mental illness. Psychiatrists are mindful of the need to curtail firearm access by persons with mental disorders that elevate the risk of suicide or violence to others, but they are also opposed to stigmatization, discrimination, and unfair treatment of individuals based on mental illness. Although civil commitment is an acceptable basis for prohibiting access to firearms, other adjudications of conduct indicative of elevated risk should also be included. Every state should provide a fair and reasonable process for restoring firearm rights after a suitable waiting period based on individualized assessment of whether the person remains at an elevated risk. However, restricting firearm rights of persons solely on the basis of a diagnosis of a mental disorder or voluntary treatment, whether in-patient or outpatient, discourages treatment and would be counterproductive. Copyright © 2015 John Wiley & Sons, Ltd. (original adopted by the American Psychiatric Association 2014).     

Can Perfectionism Affect Career Development? Exploring Career Thoughts and Self‐Efficacy

This study identified relationships among career‐specific barriers (i.e., perfectionism, negative career thoughts, career decision‐making self‐efficacy) in a sample of 300 college students. The authors found relationships among the constructs of interest, prediction of variance in career decision‐making self‐efficacy, and differences among groups of perfectionists on endorsements of negative career thoughts and career decision‐making self‐efficacy. The findings suggest that interventions addressing maladaptive perfectionism and dysfunctional career thinking may enhance clients’ confidence in decision making.