Measuring Child Mental Health Status for Services Research

Epidemiological studies of the prevalence of mental health disorders typically contain multiple measures of mental health, using different instruments and different informants (child, parent, and interviewer). We used the Methods for the Epidemiology of Child and Adolescents Mental Disorder (MECA) study of U.S. youth to assess the effects of employing a range of these measures in mental health services research. We examined the effect of including various measures of mental health status in regressions of income on mental health service use. The estimated effect of income on service use varied widely, depending on the measure of mental health status used. Some measures of mental health status have little explanatory power in service use regressions. Measures of mental health status based on parental assessment of impairment or need, such as the Columbia Impairment Scale, are less costly to collect and also have good explanatory power, but are more strongly correlated with income. The Non-Clinician Child Global Assessment Scale (NC-CGAS) performs best in terms of explanatory power and correlation with income. Higher income parents appeared to judge behaviors differently from lower income parents, so analyses based on measures derived from parental report may lead to an understatement of the effect of income on service use.     

IUSAM-APdeBA: A higher education institute for psychoanalytic training

The history of the last century shows the almost constant presence of psychoanalysis in the academic setting and, simultaneously, the incredible absence of analytic training at the universities. This paper outlines the project of the Buenos Aires Psychoanalytic Association (APdeBA) to create a higher education institution of its own (IUSAM) specifically aimed at lodging psychoanalytic training within a university setting. The project was approved by the Argentine educational authorities in 2005 and received the economic support of the International Psychoanalytical Association (IPA). The academic structure of the university is described, whose goal is broadened to the interdisciplinary field of mental health with psychoanalysis as an integrating axis. Some of the characteristics of the traditional 'university model' as well as its relationship with psychoanalysis are pointed out. With the IUSAM, psychoanalytic training is not included as a part of an already established university, it rather creates a new one, with the support of a well-known psychoanalytical association (APdeBA) which endorses its activities and guarantees its identity. IPA's requirements for analytic training (didactic analysis, supervisions and seminars) have been fully preserved in this new context. Finally, some of the advantages and disadvantages of including analytic training into an academic environment are listed .     

ALTRUISM IN SUICIDE TERROR ORGANIZATIONS

In recent years, much has been learned about the strategic and organizational contexts of suicide attacks. However, motivations of the agents who commit them remain difficult to explain. In part this is because standard models of social learning as well as Durkheimian notions of sacrificial behavior are inadequate in the face of the actions of human bombers. In addition, the importance of organizational structures and practices in reinforcing commitment on the part of suicide recruits is an under-explored factor in many analyses. This essay examines the potential applicability of evolutionary models of altruism to the understanding of commitment to suicide on the part of terrorist organizational recruits. Three evolutionary models of sacrificial behavior in nonhuman species and many categories of human behavior are explored cross-organizationally: reciprocity, inclusive fitness theory, and induced altruism. Reciprocal altruism is unlikely to be a major motivator in suicide attacks because the costs exhibited by attackers are too high to be adequately compensated. However, the role of evolved self-deception in perceptions of personal death, and thus of rewards in the afterlife, is potentially illuminating. Inclusive fitness theory can help explain the motivations of attackers because rewards to kin often are offered by organizations to suicide recruits. However, suicide bombers also often act out of revenge for the loss of or injury to relatives, and inclusive fitness theory generally, as well as more specific theoretical models of retaliatory aggression, may not adequately account for the bombers' actions. Predictions from induced altruism theory appear to be well supported because suicide terror organizations tend to be tightly structured around practices intended to maintain and reinforce commitment though the manipulation of kinship-recognition cues.     

Risk behaviour and mental workload: Multimodal assessment techniques applied to motorbike riding simulation

We present data from an ongoing research project on the cognitive, emotional and neuropsychological basis of risk behaviour. The main aim of the project is to build a model of risk behaviour so that if we know certain cognitive, behavioural and emotional variables, we will be able to predict decisions made in the face of uncertainty and risk, with the final goal of designing programs for evaluating, preventing and controlling risk behaviour. The objective of the present study was to look for individual differences in hazard perception during a static riding simulation and their relationship with mental workload. We used a multidimensional methodology, including behavioural, subjective and physiological data. The behavioural measures were obtained in a static riding simulation during eight hazard situations. We evaluated whether eye activity measures correlated with cognitive workload and different types of risky behaviours. Eye movement parameters were measured using a video-based eye tracking system. We found that risk-prone individuals showed specific patterns of risky behaviours and that peak of saccadic velocity and subjective mental workload indexes were both reliable indicators of risk proneness. Mental workload was higher for participants showing attitudes to risk behaviours probably because of a lack of conscious awareness of specific cues indicating dangerous scenarios.     

Thin-Ideal Media and Women’s Body Dissatisfaction: Prevention using Downward Social Comparisons on Non-Appearance Dimensions

Exposure to thin-ideal media has adverse effects on the body satisfaction of women with higher levels of body image disturbance. In a study involving 109 UCLA female undergraduates, we examined the effectiveness of an intervention that was based on downward social comparison theory and the selection of alternative comparison dimensions. All participants had higher levels of body dissatisfaction and viewed pictures of fashion models; the intervention group compared downward with the models on non-appearance dimensions in writing, whereas the control group described the models in writing. We hypothesized that the intervention group would experience more positive shifts in body and weight satisfaction, anxiety about appearance, and desire to lose weight than would the control group. The results supported our hypotheses.     

Memory is not extinguished along with CS presentation but within a few seconds after CS-offset

Prior work with the crab's contextual memory model showed that CS-US conditioned animals undergoing an unreinforced CS presentation would either reconsolidate or extinguish the CS-US memory, depending on the length of the reexposure to the CS. Either memory process is only triggered once the CS is terminated. Based on these results, the following questions are raised. First, when is extinction memory acquired, if not along extinction training, and how long does it take? Second, can acquisition and consolidation of extinction memory be pharmacologically dissected? Here we address these questions performing three series of experiments: a first one aimed to study systematically the relationship between extinction and increasing periods of unreinforced CS presentations, a second one to determine the time boundaries of the extinction memory acquisition, and the third one to assay the requirement for protein synthesis and NMDA-like receptors of acquisition and consolidation of extinction memory. Our results confirm that it is CS-offset and not the mere retrieval (CS-onset) that triggers acquisition of extinction memory and that it is completed in less than 45 sec after CS-offset. In addition, protein synthesis is required for consolidation but not for acquisition of this memory and, conversely, NMDA-like receptor activity is required for its acquisition but not for its consolidation. Finally, we offer an interpretative scheme of our results and we discuss to what extent it could apply to multitrial extinction.     

Cognitive biases in human causal learning

The main aim of this work was to look for cognitive biases in human inference of causal relationships in order to emphasize the psychological processes that modulate causal learning. From the effect of the judgment frequency, this work presents subsequent research on cue competition (overshadowing, blocking, and super-conditioning effects) showing that the strength of prior beliefs and new evidence based upon covariation computation contributes additively to predict causal judgments, whereas the balance between the reliability of both, beliefs and covariation knowledge, modulates their relative weight. New findings also showed "inattentional blindness" for negative or preventative causal relationships but not for positive or generative ones, due to failure in codifying and retrieving the necessary information for its computation. Overall results unveil the need of three hierarchical levels of a whole architecture for human causal learning: the lower one, responsible for codifying the events during the task; the second one, computing the retrieved information; finally, the higher level, integrating this evidence with previous causal knowledge. In summary, whereas current theoretical frameworks on causal inference and decision-making usually focused either on causal beliefs or covariation information, the present work shows how both are required to be able to explain the complexity and flexibility involved in human causal learning.     

出院精神病患者的职业康复

精神病患者出院后的职业康复研究是目前西方精神疾病康复研究的热点。通过帮助出院后症状稳定的精神病患者就业,来帮助患者获得技能,获取收入,增强自信和自我认同,提升生活质量,较好地回归社会。文章从总体上介绍了职业康复的研究现状与进展,并着重阐述了较新的支持性就业、个体支持性就业、工作社交技能训练和综合性支持性就业等方法,旨在为我国的相关研究提供参考     

On the ethics of facial transplantation research

Transplantation continues to push the frontiers of medicine into domains that summon forth troublesome ethical questions. Looming on the frontier today is human facial transplantation. We develop criteria that, we maintain, must be satisfied in order to ethically undertake this as-yet-untried transplant procedure. We draw on the criteria advanced by Dr. Francis Moore in the late 1980s for introducing innovative procedures in transplant surgery. In addition to these we also insist that human face transplantation must meet all the ethical requirements usually applied to health care research. We summarize the achievements of transplant surgery to date, focusing in particular on the safety and efficacy of immunosuppressive medications. We also emphasize the importance of risk/benefit assessments that take into account the physical, aesthetic, psychological, and social dimensions of facial disfiguration, reconstruction, and transplantation. Finally, we maintain that the time has come to move facial transplantation research into the clinical phase.