Computational psychiatry

Computational ideas pervade many areas of science and have an integrative explanatory role in neuroscience and cognitive science. However, computational depictions of cognitive function have had surprisingly little impact on the way we assess mental illness because diseases of the mind have not been systematically conceptualized in computational terms. Here, we outline goals and nascent efforts in the new field of computational psychiatry, which seeks to characterize mental dysfunction in terms of aberrant computations over multiple scales. We highlight early efforts in this area that employ reinforcement learning and game theoretic frameworks to elucidate decision-making in health and disease. Looking forwards, we emphasize a need for theory development and large-scale computational phenotyping in human subjects.     

Emotional support and counselling for people with visual impairment: Quantitative findings from a mixed methods pilot study

Aims: This paper reports on mainly quantitative findings from a mixed methods evaluation of a new model of emotional support and counselling for people with moderate visual impairment. Method: The CORE Outcome Measure was completed with service users at baseline and post‐intervention to assess the impact of the new service on psychological wellbeing and social functioning. Their perceived needs and expectations of the service were also explored. Results: Of the 35 individuals providing data at each assessment time, mean item scores on the CORE fell significantly (p<.001), taking the sample from within a clinical population before therapy, to a mean score below this following therapy. A more positive outlook accompanied this improvement in functioning. Discussion: Findings from the study augment the growing evidence that emotional support and counselling services can play an important role alongside and within related vision services. Implications for practice: The study indicates that therapeutic input for the visually impaired client group may need to target both wellbeing (feelings about oneself and the future) and problems (depression, anxiety, physical health, and trauma). Conclusions: Our findings suggest that a dual model of emotional support and counselling offers considerable benefit for people with visual impairment.     

Relations Between Parental Attachment,Empathy, and Bystander Help-Seeking Preference Following Peer Aggression

Journal of Child and Family Studies - This study aimed to examine the complex relations between two known predictors of bystander decisions in bullying incidents—empathy and family contextual...     

Can boundary crossings in clinical supervision be beneficial?

Published studies have addressed boundary violations by clinical supervisors, but boundary crossings, particularly those deemed positive by supervisees, have not received much attention. Eleven trainees in APA-accredited doctoral programs in clinical and counseling psychology were interviewed regarding positive boundary crossings (PBCs) they experienced with clinical supervisors. Interview data were analyzed using Consensual Qualitative Research. Examples of PBCs included socializing with supervisors outside the office, sharing car rides, and supervisor self-disclosure. Typically, supervisees did not discuss the PBC with their supervisors because they were uncomfortable doing so, felt that the PBC was normal, or felt that processing such issues was not part of the supervisor’s style. Most supervisees viewed the PBCs as enhancing the supervisory relationship and their clinical training; however, some participants reported that the PBCs created role confusion. The results suggest that there are legitimate reasons for supervisors to be scrupulous about their boundaries with supervisees; however, supervisors who hold rigid boundaries can deprive supervisees of deeper mentoring relationships or a more authentic emotional relationship that can be valuable to supervisees learning how to provide psychotherapy.     

Model-based and model-free Pavlovian reward learning: Revaluation,revision, and revelation

Evidence supports at least two methods for learning about reward and punishment and making predictions for guiding actions. One method, called model-free, progressively acquires cached estimates of the long-run values of circumstances and actions from retrospective experience. The other method, called model-based, uses representations of the environment, expectations, and prospective calculations to make cognitive predictions of future value. Extensive attention has been paid to both methods in computational analyses of instrumental learning. By contrast, although a full computational analysis has been lacking, Pavlovian learning and prediction has typically been presumed to be solely model-free. Here, we revise that presumption and review compelling evidence from Pavlovian revaluation experiments showing that Pavlovian predictions can involve their own form of model-based evaluation. In model-based Pavlovian evaluation, prevailing states of the body and brain influence value computations, and thereby produce powerful incentive motivations that can sometimes be quite new. We consider the consequences of this revised Pavlovian view for the computational landscape of prediction, response, and choice. We also revisit differences between Pavlovian and instrumental learning in the control of incentive motivation.     

Improving Treatment Plan Implementation in Schools: A Meta-analysis of Single Subject Design Studies

Twenty-nine peer-reviewed journal articles that analyzed intervention implementation in schools using single-case experimental designs were meta-analyzed. These studies reported 171 separate data paths and provided 3,991 data points. The meta-analysis was accomplished by fitting data extracted from graphs in mixed linear growth models. This analytic approach was adopted to provide a model whose assumptions were met and could model both level and trend. The extent to which interventions were implemented as planned in baseline was low with a downward trend. Performance feedback, performance feedback augmented with additional procedures, and self-monitoring with environmental supports were found to be highly effective for improving intervention implementation. Follow-up meetings without review of implementation data were ineffective. Maintenance data were positive across studies. Implications of the results for future research and practice are discussed.     

Trust and Goodwill as Attractors: Reflecting on a Complexity-Informed Inquiry

This article discusses a complexity-informed review and evaluation project. Complexity-informed methods and techniques are used to fashion understanding of the relationships and processes implicated between the service agencies constituting the Youth Accommodation Interagency—Nepean (YAIN) and their Resource Worker, the influence of these relationships and processes on the achievement of desired and required goals, and the potential for replication of these relationships and processes elsewhere. The article concludes with critical reflection regarding what was learnt from utilizing complexity in this qualitative inquiry.     

Equine-Facilitated Psychotherapy With Children and Adolescents: An Update and Literature Review

During the past several years, there has been a large increase in the number of studies of equine-facilitated psychotherapy (EFP) with children and adolescents. However, due to the diversity of methods, samples, and publication types represented in the literature, it may be difficult for EFP practitioners to synthesize the existing research into useful guidelines and treatment recommendations for patients. This article summarizes and tabulates investigation findings by methods, theoretical underpinnings, and treatment populations. This review of 47 recent publications suggests that EFP is a useful modality with children and adolescents. In the large majority of reviewed papers, benefits were found for a variety of presenting problems and disorders. The most often studied populations were “at-risk” youth and children with an Autism Spectrum Disorder diagnosis. Recommendations for counselors and directions of future EFP research are made.     

Concerns of Older Veteran Callers to the Veterans Crisis Line

When the Veterans Crisis Line (VCL) was implemented, it was uncertain if veterans, and particularly older male veterans, would utilize the service. We examined VCL use by a growing group of veterans at increased risk for suicide: those aged 60 and older. Real‐time clinical data were gathered from a weekly random sampling of calls. Approximately 25% of calls were from veterans aged 60 or older; over 80% reported benefit from the call. Several significant differences in presenting concerns between older and younger callers were found. Targeted outreach to encourage older veterans to use the VCL is suggested.