Building a bridge of trust: collaborative assessment with a person with serious mental illness

Collaborative assessment utilizes psychological testing to help people make positive changes in their lives. Limited research has evaluated the utility of collaborative assessment for persons with serious mental illness. This case example uses the Personality Assessment Inventory to illustrate the usefulness of collaborative assessment with a person with serious mental illness. This approach informed not only diagnostic considerations but also revealed the client's current level of distress, contributed to enhanced therapeutic alliance, and directly pointed to psychiatric rehabilitation strategies.     

VA Puget Sound Telemental Health Service to rural veterans: a growing program

The VA Puget Sound Health Care System Telemental Health program connects veterans with psychologists, psychiatrists, and social workers via live clinical video teleconferencing. Providers deliver care to veterans in rural Veteran Affairs medical centers, community-based outpatient clinics and residences, and thus, increase access to specialty mental health care for rural and medically underserved veteran communities.     

Children's evaluation of the certainty of another person's inductive inferences and guesses

In three studies, 5–10-year-old children and an adult comparison group judged another's certainty in making inductive inferences and guesses. Participants observed a puppet make strong inductions, weak inductions, and guesses. Participants either had no information about the correctness of the puppet's conclusion, knew that the puppet was correct, or knew that the puppet was incorrect. Children of all ages (but not adults) rated the puppet as more certain about statements the child knew to be correct than statements the child knew to be incorrect. When assessing another's certainty, children have difficulty inhibiting their own knowledge and focusing on the other's perspective. Children were more likely to differentiate between inductions and guesses when the puppet made an Incorrect Statement, but even the oldest children did not differentiate consistently. The distinction between induction and guessing appears to be only acquired gradually but is important as a contributor to more advanced forms of reasoning and epistemological understanding.     

Grasping with the eyes: The role of elongation in visual recognition of manipulable objects

Processing within the dorsal visual stream subserves object-directed action, whereas visual object recognition is mediated by the ventral visual stream. Recent findings suggest that the computations performed by the dorsal stream can nevertheless influence object recognition. Little is known, however, about the type of dorsal stream information that is available to assist in object recognition. Here, we present a series of experiments that explored different psychophysical manipulations known to bias the processing of a stimulus toward the dorsal visual stream in order to isolate its contribution to object recognition. We show that elongated-shaped stimuli, regardless of their semantic category and familiarity, when processed by the dorsal stream, elicit visuomotor grasp-related information that affects how we categorize manipulable objects. Elongated stimuli may reduce ambiguity during grasp preparation by providing a coarse cue to hand shaping and orientation that is sufficient to support action planning. We propose that this dorsal-stream-based analysis of elongation along a principal axis is the basis for how the dorsal visual object processing stream can affect categorization of manipulable objects.     

The Assessment and Diagnosis of Attention Deficit Hyperactivity Disorder in Adult Forensic Psychiatric Outpatients

The primary purpose of the present study was to examine the validity of commonly utilized ADHD rating scales within an adult forensic population. Participants were 120 patients assessed for dysfunctional anger and impulsive aggression at a hospital-based clinic. Two psychiatrists made independent diagnoses about the presence or absence of ADHD among individuals presenting with symptoms consistent with this disorder. Following the diagnoses, participants were assessed with multiple ADHD measures, including measures based on self-report, observer-report, or a computerized neuropsychological measure (IVA + Plus). With the exception of the IVA + Plus, the ADHD measures significantly differentiated individuals diagnosed with ADHD from individuals who were not so diagnosed. These measures also demonstrated good diagnostic utility via test specific parameters (sensitivity, specificity, positive predictive power, and negative predictive power). A sub-set of measures demonstrated particularly good classification accuracy, with high sensitivity (91 %) and good specificity (81 %). Implications of these findings for the effective assessment and diagnosis of ADHD in adult outpatient psychiatric settings are discussed.     

Tragedy and the art of questioning in depth psychotherapy

Abstract

This essay examines how the art of questioning is central to depth psychotherapy. Conceiving of depth psychotherapy as a tragic art suggests the kind of inquiry unique to psychotherapy is that oriented to pathos. To explicate the art of pathic inquiry, this essay draws upon Nietzsche's depiction of Greek tragedy as structured by the relations between the artistic deities Apollo and Dionysus. As a tragic art, the structure of pathic questioning is formed by the principles these gods embody: reason and passion. Their intertwining within a psychotherapeutic discourse stimulates a liberative self‐knowledge, exemplified here by the differing approaches of Eugene Gendlin and James Hillman.     

Design and Evaluation of a Decision Aid for Inviting Parents to Participate in a Fragile X Newborn Screening Pilot Study

The major objectives of this project were to develop and evaluate a brochure to help parents make an informed decision about participation in a fragile X newborn screening study. We used an iterative development process that drew on principles of Informed Decision Making (IDM), stakeholder input, design expertise, and expert evaluation. A simulation study with 118 women examined response to the brochure. An independent review rated the brochure high on informational content, guidance, and values. Mothers took an average of 6.5 min to read it and scored an average of 91.1 % correct on a knowledge test. Most women rated the brochure as high quality and trustworthy. When asked to make a hypothetical decision about study participation, 61.9 % would agree to screening. Structural equation modeling showed that agreement to screening and decisional confidence were associated with perceived quality and trust in the brochure. Minority and white mothers did not differ in perceptions of quality or trust. We demonstrate the application of IDM in developing a study brochure. The brochure was highly rated by experts and consumers, met high standards for IDM, and achieved stated goals in a simulation study. The IDM provides a model for consent in research disclosing complicated genetic information of uncertain value.