Narrative Understanding in Acute Psychosis

Hermeneutical premises are adequate in understanding the psychotic patient. It is more important to hear and try to understand the patient's story told by the latter as an equal partner in conversation than understand events through stories in which the meanings are already determined. Understanding is dependent on the unique way in which the feelings, thoughts, and actions of the patient are connected with those of the ward staff, i.e., mutual knowledge. In this way understanding conforms to the preunderstanding of the interpreter as well as adequately captures the intentions of its originator. These are the preconditions for the integration of the need-adapted approach to the treatment of schizophrenia.     

Assessing the Truthfulness of Witness Statements Made by Children (Aged 7--8, 10--11, and 13--14) Employing Scales Derived from Johnson and Raye's Model of Reality Monitoring

The goal of this study was to determine whether children's true and false witness statements could be differentiated using the model of reality monitoring. The effects of age and verbal ability on scales based on the model were also investigated. Children (N = 68) from three different age-groups (7--8, 10--11, and 13--14 years) made both a true and a false statement concerning a mildly traumatic event. The statements were analysed using the Revised Memory Characteristics Questionnaire. The vocabulary sub-scale of the WISC-R was also administered. True statements were found to contain more sensory information and expressions of time, and less affective information. Overall, 64% of the statements were correctly classified on the basis of the scales. Older children received higher scores on most of the reality monitoring scales compared to the youngest children regardless of the truthfulness of their statements. Furthermore, the verbal ability of the children was positively associated with scores on several of the scales. The classification accuracy suggests that the model should not be applied to individual cases of child testimony. Although the final decision concerning the usefulness of the scales should be based on ecologically valid field studies.     

Psychometric properties of the screen for child anxiety related emotional disorders (SCARED) among elementary school children in Finland

Anxiety disorders are the most common mental disorders in children and youth. Effective screening methods are needed to identify children in need of treatment. The Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire is a widely used tool to assess childhood anxiety. We aim toevaluate the psychometric properties of the SCARED questionnaire, test the SCARED factor structure, and evaluate the prevalence of anxiety symptoms in a community sample of Finnish elementary school children, based on both a child and parent report. The sample included all pupils (n = 1,165) in grades 2 through 6 (ages 8–13) in four elementary schools in the city of Turku, Finland. Children completed a Finnish translation of the SCARED questionnaire at school, with one parent report questionnaire per child completed at home. In total, 663 child‐parent dyads (56.9%) completed the questionnaire. Internal consistency was high for both child and parent reports on all subscales (0.71–0.92), except for school avoidance (0.57 child, 0.63 parent report). Inter‐rater reliability ranged from poor to fair across subscales (intraclass correlation 0.27–0.47). Self‐reported anxiety scores were higher than the parent reported scores. Females had significantly higher total scores than males based on the child reports (p = 0.003), but not the parent reports. In the confirmatory factor analysis, hypothesized models did not have a good fit with the data, and modification was needed. The Finnish SCARED questionnaire has good internal consistency. Low child‐parent agreement calls for the importance of including both child and parental reports in the assessment of anxiety symptoms.     

Mental Illness,Natural Death,and Non-Voluntary Passive Euthanasia

When it is considered to be in their best interests, withholding and withdrawing life-supporting treatment from non-competent physically ill or injured patients – non-voluntary passive euthanasia, as it has been called – is generally accepted. A central reason in support of the procedures relates to the perceived manner of death they involve: in non-voluntary passive euthanasia death is seen to come about naturally. When a non-competent psychiatric patient attempts to kill herself, the mental health care providers treating her are obligated to try to stop her. Yet it has been suggested that death by suicide can be a part of the natural course of a severe mental illness. Accordingly, if the perceived naturalness of the deaths occurring in connection with non-voluntary passive euthanasia speaks for their moral permissibility, it could be taken that a similar reason can support the moral acceptability of the suicidal deaths of non-competent psychiatric patients. In this article, I consider whether the suicidal death of a non-competent psychiatric patient would necessarily be less natural than those of physically ill or injured patients who die as a result of non-voluntary passive euthanasia. I argue that it would not.     

An empirical examination of the mechanisms mediating between high-performance work systems and the performance of Japanese organizations

The resource-based view of the firm and social exchange perspectives are invoked to hypothesize linkages among high-performance work systems, collective human capital, the degree of social exchange in an establishment, and establishment performance. The authors argue that high-performance work systems generate a high level of collective human capital and encourage a high degree of social exchange within an organization, and that these are positively related to the organization's overall performance. On the basis of a sample of Japanese establishments, the results provide support for the existence of these mediating mechanisms through which high-performance work systems affect overall establishment performance.     

Development of the letter identity span in reading: evidence from the eye movement moving window paradigm

By means of the moving window paradigm, we examined how many letters can be identified during a single eye fixation and whether this letter identity span changes as a function of reading skill. The results revealed that 8-year-old Finnish readers identify approximately 5 characters, 10-year-old readers identify approximately 7 characters, and 12-year-old and adult readers identify approximately 9 characters to the right of fixation. Comparison with earlier studies revealed that the letter identity span is smaller than the span for identifying letter features and that it is as wide in Finnish as in English. Furthermore, the letter identity span of faster readers of each age group was larger than that of slower readers, indicating that slower readers, unlike faster readers, allocate most of their processing resources to foveally fixated words. Finally, slower second graders were largely not disrupted by smaller windows, suggesting that their word decoding skill is not yet fully automatized.     

Job‐seeking,adaptation and re‐employment experiences of the unemployed: a 3‐year follow‐up

The aim was to find predictors of employment status (Employed, Active Job‐Seeker, Not a Job‐Seeker) with a 3‐year longitudinal design. Also predictors of the quality of re‐employment were studied. Initially unemployed Finnish men and women were followed‐up. Of the original sample (n=559), 318 (56.9%) responded to the questionnaire. Baseline health and participation in labour market interventions were not predictive of employment status. Passive baseline job‐seeking and female gender were predictive of being a passive job‐seeker 3 years later. Good vocational education was central for high‐quality re‐employment. Long duration of unemployment and high baseline level of psychological distress were predictive of a perceived need for adjustment in the new job. Copyright © 1999 John Wiley & Sons, Ltd.     

Narrative process modes as a bridging concept for the theory, research and clinical practice of systemic therapy

This article is concerned with the relationships which hold between the clinical practice and the theory of family therapy; and between these and academic research. These relationships are seen as tenuous and thin because, in the first place, there is a lack of rigorous theoretical underpinning; and second, the research methods employed do not fit in with current family therapy practice, and with the theory that underlies this practice. The role of the concept of narrative process modes is proposed as a bridging and mediating one. The external, internal and reflective narrative process modes are seen as relevant from the point of view of family therapy process research, and the clinical practice of marital and family therapy.     

Maternal and infant characteristics connected to shared pleasure in dyadic interaction

The aim of the study was to analyze which maternal factors (depressive symptoms, effect of life events, maternal sensitivity and structuring) and infant characteristics (temperament, social withdrawal symptoms, interactive behavior, genotype, gender) contribute to shared pleasure (SP) in parent–infant interaction. Participants were 113 mother–infant dyads. The mothers filled in the Edinburgh Postnatal Depression Scale, the Infant Behavior Questionnaire, and the Life Events Questionnaire. The dyads were videotaped in a free-play situation, and the videos were analyzed using the Alarm Distress Baby Scale and the Emotional Availability Scales. The infants were genotyped for four genes involved in emotion regulation. The occurrence and duration of SP (SP-MD) in mother–infant interactions were analyzed from the videotapes. Higher maternal sensitivity and depressive symptoms, better infant responsiveness, and the infant having the GG variant of the gene tryptophan hydroxylase isoform 2 (TPH2) -307 were associated with the occurrence of SP. Lower level depressive symptoms, better maternal structuring, and greater infant involvement were associated with the longer duration of SP. Those dyads where the mother and infant were best able to read each other's positive cues and to respond to them were more likely to experience mutual positive affect, as seen in SP.     

Dietary patterns are associated with the prevalence of alexithymia

Recent evidence supports the association between healthy dietary patterns and a reduced risk of depression. The objective was: (1) to examine the associations between dietary patterns and alexithymic features; and (2) investigate whether these possible associations are explained by depressive symptoms in a cross‐sectional study among the Finnish general population aged 25–65 years. The study population was a part of the population‐based Kuopio Depression Study (KUDEP) conducted in central‐eastern Finland (n = 1747). Dietary data were collected using a food frequency questionnaire and dietary patterns from 22 predefined food groups, which were extracted by factor analysis. Alexithymia was assessed using the 20‐item Toronto Alexithymia Scale (TAS‐20) and depression using the 21‐item Beck Depression Inventory (BDI‐21). Altogether, 173 of the study subjects (9.9%) were alexithymic. Three dietary patterns were identified: “prudent,” “Western” and “traditional.” Lower scores for a healthy prudent dietary pattern and higher scores for an unhealthy Western dietary pattern were associated with an increased likelihood of belonging to the alexithymic group among subjects with elevated depressive symptoms. Among subjects without depressive symptoms, alexithymia was associated with lower scores in the prudent dietary pattern, but also with higher scores in the traditional dietary pattern. General population subjects with alexithymic features may have unhealthier dietary patterns than non‐alexithymic subjects.