Reasons for substance use among people with psychotic disorders: method triangulation approach

Substance use disorders (SUD) are common among people with psychotic disorders and are associated with many negative consequences. Understanding the reasons for substance use in this population may allow for the development of more effective prevention and intervention strategies. We examined reasons for tobacco, alcohol, or cannabis use among people with psychotic disorders. Sixty-four participants with a diagnosed psychotic disorder completed a self-report reasons for use questionnaire. A subset of eight participants completed semi-structured qualitative interviews. Both the qualitative and quantitative data indicated that reasons for use of tobacco, alcohol, and cannabis differed considerably. Tobacco was primarily used for coping motives, alcohol for social motives, and cannabis for pleasure enhancement motives. Prevention and intervention strategies targeting coexisting psychotic disorders and SUD may improve in effectiveness if they address the perceived beneficial effects of tobacco use, the strong social pressures influencing alcohol use and if they encourage cannabis users to seek alternative pleasurable activities.     

The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.     

Integrating sport psychology and sports medicine in research: The dilemmas

Abstract

The recent acceleration of interest in conducting sport psychology research within sports medicine settings has prompted an introspection on the stringency of sport injury-focused research protocols and methodology. Much of the literature relating to the psychology of sport injury is anecdotal, comprised of conjecture, or is an extrapolation from allied psychological study. In addition, retrospective studies, involving the recall of an unpleasant event (i.e., sport injury) proliferate the literature. Quality research that integrates sport psychology and sports medicine presents a unique challenge because of the multifactorial nature of sport injury and the necessity for sound interpretation of research outcomes relative to the nature of psychology. sport, and injury. Confounding and complicating aspects of this integrated research include definition of injury variables, timing of data collection. evaluation of pain. and the physiological sequelae of injury. Research and methodological issues relating to sport psychology and sport injury are discussed.     

The Effects of Spatial Frequency and Temporal Waveform on Three Measures of Temporal Processing

The effects of spatial frequency and temporal transition of sine-wave grating onset and offset were assessed using measures of reaction time, visual persistence, and temporal order judgments. The stimuli were lateralized fields, separated by 1° of visual angle. Slow temporal transition resulted in significantly poorer performance than did abrupt onset and offset, but spatial frequency had a minimal effect. Thus, the latency, temporal resolution, and temporal ordering of events are mediated by a mechanism that is sensitive to abrupt temporal transients. The stimulus conditions employed did not result in a shift in the point of subjective simultaneity.     

Infant-led innovations in a mother-baby therapy group

A mother-baby therapy group for mothers and infants in their first year who are experiencing difficulties is described. In a literature review no comparable group where the infants are seen as members in their own right has been found. Themes in the mothers' material are outlined, followed by the infants' evolving interactive and internal processes. Some therapeutic factors, in particular interactions between the infants and interventions on the part of the therapists, are then illustrated with clinical material. Some infant-led innovations are described, such as the way the infants' activity is used as a basis for making ‘group as a whole’ interpretations, and in particular how the therapists' actions towards the infants have come to be viewed as a non-verbal form of interpretation. The role of attuned play in direct work with infants is discussed further.     

A Direct Method of Assessing Underlying Cognitive Risk for Adolescent Depression

An enduring tendency towards negative thinking is thought to increase vulnerability for future depression. However, it has not been possible to assess this tendency in non-depressed mood states. We examined if response latency to endorse dysfunctional attitudes is associated with depressive outcomes in a longitudinal study. A sample of young people at familial risk of depression (N?=?252, aged 10–19, 56.3 % female) completed a computer-administered dysfunctional attitude scale. The main outcome measure was the difference in reaction time to agree versus disagree with dysfunctional attitudes. Cross-sectional differences between current and previous depression and no psychiatric disorder groups as well as longitudinal associations with depressive symptoms were examined. Young people with current and previous depression were quicker to agree with dysfunctional attitudes than those without disorder. In young people free from depressive disorder, faster agreements with dysfunctional attitudes were specifically associated with increased depressive symptoms over time. Self-reported dysfunctional attitudes did not differentiate the formerly depressed and no disorder groups and showed a longitudinal association with depressive symptoms for older adolescents only. Reaction time to endorse dysfunctional attitudes may indicate changes in affective processing that represent an early risk for future depression that is not indexed by self-report measures of negative thought.