Why Clinical Psychology Needs to Engage in Community‐Based Approaches to Mental Health

The aim of this article is to advocate for clinical psychology to engage with community‐based approaches to mental health. This engagement will be challenging given community work is antithetical to the individualism that defines much of clinical psychology. It would also result in a direct challenge to the core tenets of our profession, including an emphasis on individualism, psychopathology, and expert‐driven intervention. We need clinical psychology, however, to decolonise itself to respond to the needs of Aboriginal communities and those from non‐Western collectivist cultures. We also need clinical psychology to consider the sociopolitics of human distress and lend itself to social action for complex problems. Specific examples of community‐based practices will be provided, focusing specifically on those that relate to mental health. Implication for the reform of research methodologies and classroom pedagogies will also be discussed.     

Do Geographic Regions with Higher Suicide Rates also have Higher Rates of Nonfatal Intentional Self‐Harm?

Fatal and nonfatal intentional self‐harm events in eight U.S. states were compared using emergency department, hospital, and vital statistics data. Nonfatal event rates increased by an estimated 24.20% over 6 years. Case fatality ratios varied widely, but two northeastern states' total event rates (fatal plus nonfatal) were very high (New Hampshire 206.5/100,000 person years; Massachusetts 166.7/100,000). Geographic context did not uniformly impact the likelihood of self‐harm across event types. The state‐level public health burden posed by such acts cannot, therefore, be accurately estimated from either mortality or morbidity data alone.     

CONTINGENT PAYMENT PROCEDURES FOR SMOKING REDUCTION AND CESSATION

We assessed the ability of a combined contingent reinforcement and intensive monitoring procedure to promote and sustain temporary smoking cessation among 34 hired research volunteers, and the ability of a smoking reduction test to predict the subsequent initiation of abstinence. During the 5-day cutdown test, subjects were paid from $0 to $6 per day depending on the extent of reduction from baseline CO levels. During the abstinence test, breath samples were obtained three times daily and subjects were paid $4 for each CO reading ≤11 ppm. Sixty-eight percent of subjects initiated abstinence. Of the breath samples collected during the abstinence test (91% of scheduled samples), 96.5% were ≤11 ppm and 80.5% were ≤8 ppm. Subjects who earned more money during the cutdown test were more likely to abstain (r = ?0.51, p < .001). Contingent reinforcement and intensive monitoring procedures appear to have usefulness for analog studies of smoking reduction and cessation.     

A noninvasive method for delivering controlled doses of nicotine via cigarette smoke

A cigarette-smoke delivery system is described in which nicotine dosage was delimited by having the subject inhale a measured amount of smoke to a predetermined depth and duration of inhalation. A plastic syringe was used to “inject” a specified amount of cigarette smoke into the subject’s mouth, and an airbag containing 1 liter of air was used to provide a “chaser” with a fixed volume of inhalation for the smoke. Using plasma nicotine boost as an indicator, dose control was found to be nearly linear for the three dose levels employed; in the high-dose condition, plasma nicotine levels were moderately consistent within subjects over three successive administrations. Between-subject variability was considerably greater than within-subject variability, however, suggesting that each smoker obtained a characteristic nicotine boost that reflected individual differences in nicotine pharmacokinetics in addition to nicotine intake per se.     

Exploring the Meaning and Usefulness of Measures of Subjective Goal Difficulty1

Despite the critical role of the goal difficulty construct in predicting the effects of goals on task performance, the choice of goal difficulty measure(s) has not played a prominent role in goal setting research. The current laboratory study, using 92 college students, examines three operationalizations of the goal difficulty construct: assigned goal level (objective or direct measure), self-referenced goal difficulty perception. and an externally-referenced goal difficulty perception. The results clearly demonstrated that the choice of a goal difficulty measure matters in relation to other constructs in goal setting theory. Furthermore, it was found that the externally-referenced goal difficulty perception measure corresponded best with assigned goal level.     

Do childhood anxiety measures measure anxiety?

The Fear Survey Schedule for Children-Revised (FSSC-R), Revised-Children's Manifest Anxiety Scale (RCMAS), and the Modified State-Trait Anxiety Inventory for Children (STAIC-M) are three widely used self-report measures of childhood anxiety. While previous studies have established the reliability of these measures, their validity in discriminating anxious from non-anxious youngsters remains to be established. The present study examines the discriminant validity of the three measures by comparing clinic referred samples of boys with an anxiety disorder (n=105) or ADHD (n=59) with a community sample of never-psychiatrically-ill boys (n=49). Results indicated that the two patient groups differed significantly from the never-psychiatrically-ill group on the RCMAS and STAIC-M, but the anxious and ADHD groups did not differ from each other. None of the three groups differed on the FSSC-R. The implications of these findings for the assessment of childhood anxiety disorders are discussed.     

Idiomatic processing: Syntactic frozenness and subjective familiarity

Summary Four experiments are reported that investigated idiomatic processing. Two experiments collected subjects' ratings of frozenness, familiarity, and meaningfulness for a set of idioms. The ratings obtained were used to assess the contributions of these dimensions to performance in two experiments that utilized a phoneme-identification task. Ambiguous and unambiguous phoneme targets occurred as the initial sound in the final word in idiomatic and neutral carrier phrases. Subjects' phoneme identifications were biased in the labeling of ambiguous segments in that identification responses in the idiom context tended to form an idiomatic phrase, more so than those in the neutral carrier phrase. Additional correlational analyses suggested that an idiom's degree of influence on identification depended on the rated syntactic frozenness. For subjects who knew the idioms, familiarity did not account for the biasing effect of idiomatic contexts. The experiments are discussed in terms of theories of auditory word recognition and the representation of frozenness in the mental lexicon.This research was supported by NIDCD Grant R29 NS26 587 to the first author.