Pharmacotherapy of delusional disorders in the context of offending and the potential for compulsory treatment

Delusional disorder is an uncommon mental illness with an estimated prevalence of 0.03%. Its low prevalence has likely contributed to the paucity of research interest in this area, leading to substantial gaps in knowledge concerning its treatment and management. In the absence of a robust literature, most clinicians rely on their experience and guidelines for treating schizophrenia when treating patients with delusional disorder. This article reviews the available literature that is specific to the treatment of delusional disorder. In addition, it focuses on specific forensic and medicolegal aspects of managing patients with delusional disorder.     

An investigation of appearance motives for tanning: The development and evaluation of the Physical Appearance Reasons For Tanning Scale (PARTS) and its relation to sunbathing and indoor tanning intentions

Motives for UV exposure have been shown to be related to appearance concerns, yet little research has examined specific tan appearance attitudes. Given this lacuna, Study 1 involved the identification of six factors among college female tanners: general attractiveness, media influence, family/friends influence, physical fitness appearance, acne reasons, and skin aging concerns. In Study 2, a separate sample of college female tanners were used to validate a higher order factor model, which demonstrated acceptable fit. Additionally, the factors converged in the expected directions, with the general attractiveness and skin aging concerns being the best correlate of UV exposure and sun-protection intentions. The relevance of these findings to skin cancer prevention is discussed.     

Examination of emotional Stroop interference in obsessive-compulsive disorder

Previous research has produced conflicting findings on whether or not patients with subclinical or manifest obsessive-compulsive disorder (OCD) share an attentional bias for anxiety-related material. In the present study, 35 OCD patients were compared with 20 healthy controls on their performance in an emotional Stroop paradigm. Nine different stimulus conditions were compiled, including sets for depression-related and anxiety-related words as well as stimuli from two constructs with a potential relevance for the pathogenesis and maintenance of OCD symptomatology: responsibility and conscientiousness. Patients did not show enhanced interference for any of the conditions. Syndrome subtype and severity, avoidance and speed of information processing did not moderate results. The present study concurs with most prior research that OCD patients display no interference effect for general threat words. It deserves further consideration, that emotional interference effects in OCD as seen in other anxiety disorders occur when using idiosyncratic word material with a direct relation to the individual's primary concerns.     

Using modeling and vicarious reinforcement to produce more positive attitudes toward mental health treatment

In this study, the authors evaluated the effectiveness of a video, developed for this study and using principles of cognitive learning theory, to produce positive attitudinal change toward mental health treatment. The participants were 35 men and 45 women who were randomly assigned to watch either an experimental video, which included 3 positive 1st-person accounts of psychotherapy or a control video that focused on the psychological construct of self. Pre-intervention, post-intervention, and 2-week follow-up levels of attitude toward mental health treatment were measured using the Attitude Toward Seeking Professional Help Scale (E. H. Fischer & J. L. Turner, 1970). The experimental video group showed a significantly greater increase in positive attitude than did the control group. These results support the effectiveness of using the vicarious reinforcement elements of cognitive learning theory as a basis for changing attitudes toward mental health treatment.     

Neurocognitive impairment does not predict treatment outcome in obsessive-compulsive disorder

There is conflicting evidence pertaining to whether or not neurocognitive task performance at baseline predicts treatment response in obsessive-compulsive disorder (OCD). In the present study, we administered a set of executive neurocognitive tests with a putative sensitivity for treatment outcome to a sample of 138 OCD patients. Additionally, subjective neurocognitive dysfunction was determined via a questionnaire. All patients participated in a cognitive-behavioural treatment program (CBT). Results showed that responders (n = 73) did not differ from non-responders (n = 65) on any of the parameters except for decreased performance on the delayed alternation test (p < .1, effect size: .61). A subsidiary analysis revealed that slowing on the Trail-Making Test A and an enhanced rate of perserveration errors on the Wisconsin Card Sorting Test predicted poor outcome for the treatment of compulsions. It is concluded that neurocognitive impairment does not represent a reliable early warning sign for non-response to CBT.     

Timed picture naming in seven languages

Timed picture naming was compared in seven languages that vary along dimensions known to affect lexical access. Analyses over items focused on factors that determine cross-language universals and cross-language disparities. With regard to universals, number of alternative names had large effects on reaction time within and across languages after target-name agreement was controlled, suggesting inhibitory effects from lexical competitors. For all the languages, word frequency and goodness of depiction had large effects, but objective picture complexity did not. Effects of word structure variables (length, syllable structure, compounding, and initial frication) varied markedly over languages. Strong cross-language correlations were found in naming latencies, frequency, and length. Other-language frequency effects were observed (e.g., Chinese frequencies predicting Spanish reaction times) even after within-language effects were controlled (e.g., Spanish frequencies predicting Spanish reaction times). These surprising cross-language correlations challenge widely held assumptions about the lexical locus of length and frequency effects, suggesting instead that they may (at least in part) reflect familiarity and accessibility at a conceptual level that is shared over languages.     

Temporal stability and consistency of aesthetic judgments of beauty of formal graphic patterns

Temporal stability and consistency of nonartists' aesthetic judgments of beauty of formal graphic patterns was assessed. Temporal stability decreased markedly over several months. When items were repeated in an aesthetic judgment task participants responded consistently over trials rather than performing genuine repeated aesthetic judgments of beauty.     

An inexpensive,portable, printing event recorder for behavior studies

An inexpensive, field-portable event recorder for monitoring insect or other animal behavior is described. The recorder consists of a 16-key event code keyboard and a 99.99-min timer interfaced to a low-cost printing calculator. The event code number and the elapsed time (.01-min resolution) from the start of an observation period are printed whenever an event key is pressed. The recorder is operable over a temperature range of 0°C to 50°C, with a timing error of less than ±.05% of the 99.99-min full-scale timing range. Periods longer than 99.99 min can be monitored, provided the return to zero of the timer is noted and taken into consideration.     

Clinicians and supervisors' experiences with developing practices of open dialogue in network meetings in public mental health services

Open Dialogue is a dialogical approach focusing on the perspectives of patients and their social networks on treatment and recovery processes. As part of a larger research project, this prospective cohort study explores what promotes and hinders the development of Open Dialogue in network meetings (ODNM) based on the experiences of thirty-seven clinicians and seven supervisors. Multistage focus group interviews were used to collect data and were analysed thematically. We generated two main themes: (1) togetherness and isolation and (2) challenging and evolving. The findings show that ODNM can be developed in public mental healthcare, but this leads to both challenges and opportunities at the organisational level, such as conflicting perspectives, the difficulty of maintaining interest in ODNM, the need for committed and involved leaders, and the growing change in the traditional view of treatment, which has made clinicians collaborate more with patients and their relatives.