Targeting Insight in First Episode Psychosis: A Case Study of Metacognitive Reflection Insight Therapy (MERIT)

One aspect of schizophrenia contributing to its complexity is the lack of insight individuals often have into their illness. While poor insight is prevalent throughout the course of the illness, more severe levels are associated with first-episode psychosis (FEP). Interventions addressing insight are necessary but current treatments have been shown to have limited effectiveness. Thus, a novel intervention, Metacognitive Reflection and Insight Therapy (MERIT), is being studied for its efficacy of improving insight in individuals with schizophrenia spectrum disorders. MERIT is an integrative metacognitive therapy consisting of eight elements to assist clients in improving their ability to form complex ideas about themselves and others and to use this knowledge to respond to psychological problems. The present study is a case illustration of the implementation of MERIT to improve insight in FEP. Clinical outcomes were assessed and results showed that the client improved in both metacognition and insight. With replication, these results suggest that integrative metacognitive psychotherapy may serve as an intervention that improves insight in FEP, which marks an important step toward improved interventions for individuals with psychosis.     

An integrated model for guiding the selection of treatment components for problem behavior maintained by automatic reinforcement

We evaluated the usefulness of 2 assessments to guide treatment selection for individuals whose prior functional analysis indicated that automatic reinforcement maintained their problem behavior. In the 1st assessment, we compared levels of problem behavior during a noncontingent play condition and an alone or ignore condition. In the 2nd, we assessed participants’ relative preferences for automatic reinforcement and social reinforcers in a concurrent‐operants arrangement. We used the results of these 2 assessments to assign 5 participants to a treatment based on noncontingent access to social reinforcers or to a treatment based on differential access to social reinforcers. We conducted monthly probes with the participants over 10 to 12 months to evaluate the effects of the treatment procedures. All participants showed reductions in problem behavior over this period.     

Precocious quantitative cognition in monkeys

Basic quantitative abilities are thought to have an innate basis in humans partly because the ability to discriminate quantities emerges early in child development. If humans and nonhuman primates share this developmentally primitive foundation of quantitative reasoning, then this ability should be present early in development across species and should emerge earlier in monkeys than in humans because monkeys mature faster than humans. We report that monkeys spontaneously make accurate quantity choices by 1 year of age in a task that human children begin to perform only at 2.5 to 3 years of age. Additionally, we report that the quantitative sensitivity of infant monkeys is equal to that of the adult animals in their group and that rates of learning do not differ between infant and adult animals. This novel evidence of precocious quantitative reasoning in infant monkeys suggests that human quantitative reasoning shares its early developing foundation with other primates. The data further suggest that early developing components of primate quantitative reasoning are constrained by maturational factors related to genetic development as opposed to learning experience alone.     

Criminally Involved Parents Who Misuse Substances and Children’s Odds of Being Arrested as a Young Adult: Do Drug Treatment Courts Mitigate the Risk?

This paper examined (1) the association between parents who are convicted of a substance-related offense and their children’s probability of being arrested as a young adult and (2) whether or not parental participation in an adult drug treatment court program mitigated this risk. The analysis relied on state administrative data from North Carolina courts (2005–2013) and from birth records (1988–2003). The dependent variable was the probability that a child was arrested as a young adult (16–21). Logistic regression was used to compare groups and models accounted for the clustering of multiple children with the same mother. Findings revealed that children whose parents were convicted on either a substance-related charge on a non-substance-related charge had twice the odds of being arrested as young adult, relative to children whose parents had not been observed having a conviction. While a quarter of children whose parents participated in a drug treatment court program were arrested as young adults, parental completion this program did not reduce this risk. In conclusion, children whose parents were convicted had an increased risk of being arrested as young adults, irrespective of whether or not the conviction was on a substance-related charge. However, drug treatment courts did not reduce this risk. Reducing intergenerational links in the probability of arrest remains a societal challenge.     

Negotiating motherhood as a refugee: experiences of loss,love, survival and pain in the context of forced migration

The mental health of refugees has been an increasingly researched area, but has been criticised for having an individualised and symptom-focused approach to understanding the experience of forced migration. This paper attempts to respond to calls to address this culturally limited and incomplete way of conceptualising responses to experiences of persecution and terror bound up within global hegemony and power inequalities. Interpretative phenomenological analysis was employed to analyse semi-structured interviews undertaken with six refugee mothers, with the aim of exploring how participants made sense of, and created meaning around parenting and family life in the UK. Three main themes emerged from the data analysis (a) loss as a constant companion to parenting; (b) a shifting view of the self as a mother; and (c) taking the good with the bad in family life. Methodological limitations, as well as implications for future research and clinical practice are discussed.     

Between Opportunity and Constraint: Understanding the Onward Migration of Highly Educated Iranian Refugees from Sweden

In the 1980s and early 1990s, more than 50,000 Iranian refugees moved to Sweden. The Swedish state attended to their immediate needs, providing housing, language training, and other types of support. Moreover, these migrants had almost immediate access to all the benefits of the Swedish welfare state including affordable healthcare, unemployment insurance, and free education up to and including the tertiary level. Despite the opportunities available to them in Sweden, many Iranian refugees have faced challenges, especially when trying to secure meaningful work. One of the strategies they have used to overcome barriers to entering the labor market is to leave Sweden for onward destinations which are seen as having relatively more to offer. This study explores the onward migration of Iranians from Sweden by way of a two-step mixed methods approach: in the first step, population register data is used to determine how onward migrants differ from those Iranians who stay in Sweden. In the second step, information from life history interviews conducted with onward migrants in London and Toronto is used to understand what motivates individuals to leave Sweden. Overall, the study finds that highly educated Iranians who have struggled to find employment in Sweden are the most likely to move on. Their precise motivations for doing so, however, are nuanced and complex and relate to more than just economic factors.