A Qualitative Study Exploring the Causes of Boredom for Men with a Psychosis in a Forensic Setting

Boredom is a problem in forensic mental health settings and is believed to increase levels of violence and be detrimental to health and recovery. There were 8 men in a forensic unit, all diagnosed with a psychotic disorder, that were interviewed regarding their experiences of boredom. A thematic analysis was used to identify emergent themes. These included: Mental health and motivation; Restrictive environment; Responsibilities; and Nothing to do. These findings provide a greater understanding of factors which may contribute to boredom within forensic settings and can guide occupational therapy interventions to address them.     

‘There and then’, ‘here and now’, ‘when and if’: The relationship of present,past and future in the consulting room

This paper revolves around the question of the patient’s inhabiting of time. Where is the main focus of the patient’s indwelling in time – the past, the present or the future – and what are the qualitative aspects of such indwelling? Of equal significance, is the patient able to move freely between past, present and future events and preoccupations and make links between them, or is he or she caught in a ‘time warp’? These questions are explored within a context of both psychodynamic and existential theory, drawing on the one hand on the work of Winnicott, Bick, Bion and Turp and on the other of Heidegger, Van den Berg, Merleau-Ponty, Kemp and Scheffler. The themes addressed are illustrated with clinical examples.     

Narrative exposure therapy for political imprisonment-related chronic posttraumatic stress disorder and depression

The psychological consequences of traumatic stress may last even into old age. In persons in their 60s and 70s who had been victims of political detention and torture four decades ago, we compared the outcome of narrative exposure therapy (NET) to that of psychoeducation (PED) only. From a group of 59 former political detainees, 18 who fulfilled the full PTSD criteria according to the Composite International Diagnostic Interview (CIDI) were offered and accepted participation in the treatment study. The participants were randomly assigned to either one session of PED (n=9) or five sessions of NET (n=9). Symptoms of PTSD (CIDI) and depression (Beck Depression Inventory, BDI) were assessed prior to treatment and after a 6-month follow-up. NET but not PED produced a significant reduction in post-traumatic symptoms and depression scores. Four out of 9 of those who completed NET, compared to 8/9 of those within the PED group, still had PTSD 6 months after the treatment had ended. These results indicate that NET may lead to the alleviation of post-traumatic and depression symptoms even when the conditions persist for excessive time periods.     

Executive and motivational inhibition: Associations with self-report measures related to inhibition

Inhibition involves the withholding or suppressing of attention or responses to irrelevant or distracting stimuli. We examined the relationship between five experimental tasks of inhibition, represented by two measures of executive, intentional control inhibition and three measures of motivational inhibition characterized by bottom-up interruption of affective and reward/punishment sensitive mechanisms. Associations between these experimental tasks with three self-report measures related to inhibition were also examined. Correlational analyses indicated a small but significant association between the measures in the executive domain (stop task and Stroop task), but a lack of associations between the measures in the motivational domain (emotional Stroop task, a card playing task involving rewards and punishments, and a gambling task). Both measures of executive and motivational inhibition entered as significant predictors on the self-report measures related to inhibition in simultaneous regression analyses, but not consistently in the expected direction. The results suggest that inhibition is not a unitary construct, and demonstrate an association between experimental measures of inhibition and self-report measures related to inhibition.     

Analyzing the scientific foundation of Child Sexual Abuse Accommodation Syndrome: A reply to Lyon et al.

The issue before the New Jersey Supreme Court in the Frye hearing New Jersey v. J.L.G. (2018) was whether the scientific community agreed that Summit's (1983) Child Sexual Abuse Accommodation Syndrome rested on a firm scientific foundation. Lyon et al. (this issue) critique our approach to describing child sexual abuse disclosure, which involved extrapolating rates from children who came to the attention of authorities. Lyon et al. claim that our conclusions are marred by sampling biases resulting from what they term the ground truth problem, suspicion bias and substantiation bias. The points Lyon et al. claim we “fell victim to” were the very points we acknowledge are inherent difficulties in estimating the extent to which children will come forward to tell others about sexual maltreatment. Lyon et al. offer an alternative solution to the inherent difficulties in studying a difficult-to-identify population, relying in large part on 21 papers published mostly in the 1960s and 1970s. We argue that the method they propose has more flaws than the one it is intended to replace. Points of agreement and disagreement, along with suggestions for future research, are discussed. Moving forward, we argue that studies are needed that embrace both validity and generalizability in order to foster data-driven theories rather than invoking the intuitive suppositions of Summit's (1983) syndromal evidence.     

Evidence for a General ADHD Factor from a Longitudinal General School Population Study

Recent factor analytic studies in Attention-Deficit/Hyperactivity Disorder (ADHD) have shown that hierarchical models provide a better fit of ADHD symptoms than correlated models. A hierarchical model includes a general ADHD factor and specific factors for inattention, and hyperactivity/impulsivity. The aim of this 12-month longitudinal study was to test the generalizability of the hierarchical models of ADHD within an elementary school population of 6–9 year old children (250 boys, 260 girls). Examination of differences as a function of informant (parent vs. teacher ratings), sex, and time was conducted. Six potential factor structures for the 18 items of the SWAN (Strengths and Weaknesses of ADHD-symptoms and Normal-behavior) scale were tested using confirmatory and exploratory factor analyses. Hierarchical models with a general ADHD factor and two or three specific factors best accounted for parent and teacher reports of symptoms for both boys and girls and at two time points separated by a 12-month interval. Findings indicate that the 18 SWAN items measure a common latent trait as well as orthogonal factors or dimensions of inattention and hyperactivity/impulsivity.     

Use of Integrity Tests May Reduce Workers’ Compensation Losses

Purpose  

The purpose of this study was to examine whether the use of integrity tests in personnel selection would reduce the cost of worker’s compensation claims in organizations representing four different industries.     

Evidence for a general factor model of ADHD in adults

Objective: To examine factor structures of Diagnostic and Statistical Manual of Mental Disorders (4th ed.) symptoms of ADHD in adults. Method: Two sets of models were tested: (a) models with inattention and hyperactivity/impulsivity as separate but correlated latent constructs and (b) hierarchical general factor models with a general factor for all symptoms and separate specific factors for inattention and hyperactivity/impulsivity. Participants were 751 adults with ADHD. Two models with correlated factors and two general factor models of ADHD symptoms were tested. Results: The general factor model provided a better fit of the data than the correlated models. The general factor model with one general and three (inattention, motoric, and verbal hyperactivity/impulsivity) specific factors best accounted for the adults' symptoms. Conclusion: These results suggest a unitary component to ADHD symptoms as well as dimensional specific factors. The replication of a general factor in adults suggests continuity of symptom presentation from childhood into adulthood. Clinical implications are discussed.