Effects of involuntary outpatient commitment on subjective quality of life in persons with severe mental illness

Recent evidence suggests that involuntary outpatient commitment (OPC), when appropriately applied, can improve adherence with psychiatric treatment, decrease hospital recidivism and arrests, and lower the risk of violent behavior in persons with severe mental illness. Presumably these are benefits that improve quality of life (QOL); however, insofar as OPC involves legal coercion, the undesirable aspects of OPC could also exert a negative effect on quality of life, thus offsetting clinical benefits. Involuntarily hospitalized subjects, awaiting discharge under outpatient commitment, were randomly assigned to be released or continue under outpatient commitment in the community after hospital discharge, and were followed for one year. Quality of life was measured at baseline and 12 months follow-up. Treatment characteristics and clinical outcomes were also measured.Subjects who underwent longer periods of outpatient commitment had significantly greater quality of life as measured at the end of the 1 year study. Multivariable analysis showed that the effect of OPC on QOL was mediated by greater treatment adherence and lower symptom scores. However, perceived coercion moderated the effect of OPC on QOL. Involuntary outpatient commitment, when sustained over time, indirectly exerts a positive effect on subjective quality of life for persons with SMI, at least in part by improving treatment adherence and lowering symptomatology.     

Self-coded indirect memory associations and

Indirect memory associations for substance use predict both the concurrent and prospective levels of substance use. These methods assess spontaneous, possibly implicit, and easily accessible associations that predict substance use over direct (explicit) methods of assessment (e.g., outcome expectancies). The present study tested and expanded the application of a coding method for alcohol and marijuana associations on the basis of self-coding of indirect responses (Frigon & Krank, 2009). College students generated free associates to (1) ambiguous words (e.g., draft or weed), (2) situations (e.g., at a party, hanging out with friends), and (3) emotions (having fun, feeling dreamy). Later, participants were shown their responses and were asked to code their responses according to both nonrisk and risk activities, such as alcohol and marijuana use. Self-coded scores were higher than researcher-coded scores, captured the same variance, and improved the prediction of substance use. Self-coding of indirect memory associations provides accurate and efficient prediction of the level of alcohol and marijuana. Self-coding is efficient and may be useful for reducing ambiguities in coding of many different kinds of open-ended responses.     

Object-based warping: an illusory distortion of space within objects

Visual objects are high-level primitives that are fundamental to numerous perceptual functions, such as guidance of attention. We report that objects warp visual perception of space in such a way that spatial distances within objects appear to be larger than spatial distances in ground regions. When two dots were placed inside a rectangular object, they appeared farther apart from one another than two dots with identical spacing outside of the object. To investigate whether this effect was object based, we measured the distortion while manipulating the structure surrounding the dots. Object displays were constructed with a single object, multiple objects, a partially occluded object, and an illusory object. Nonobject displays were constructed to be comparable to object displays in low-level visual attributes. In all cases, the object displays resulted in a more powerful distortion of spatial perception than comparable non-object-based displays. These results suggest that perception of space within objects is warped.     

Predicting preference for items during periods of extended access based on early response allocation

Top‐ranked items were identified during 30‐min free‐operant preference assessments for 9 individuals. Data from each session were analyzed to identify the item (a) that was engaged with first in each session and (b) to which the most responding was allocated after 5 min, 10 min, 15 min, 20 min, and 25 min had elapsed in each session. The results indicated that the first‐engaged item and the 5‐min high‐allocation item predicted the top‐ranked item in 55% and 62% of the sessions, respectively. The results also showed that engagement with the top‐ranked item from the first session decreased across subsequent sessions for 6 of the 9 participants. The implications of the results for brief versus extended stimulus preference assessments are discussed.     

Subjective and Objective Risks of Carrying a BRCA1/2 Mutation in Individuals of Ashkenazi Jewish Descent

This repeated measures study examines (1) the change in subjective risk of mutations pre- to postcounseling, (2) the accuracy of BRCAPRO estimates of mutations, and (3) the discrepancy between subjective risk and BRCAPRO estimates of mutations before and after genetic counseling. Ninety-nine Ashkenazi Jewish individuals pursued testing for BRCA1/2 mutations. Most had a personal cancer history (N = 51; family only: N = 48); and received uninformative negative results (N = 66; positives: N = 23; informative negative: N = 10). The coping strategy of defensive pessimism predicts that individuals will believe the worst case scenario to better cope with a potential negative outcome. Consistent with this, most felt they would have a mutation, if not mutations in both genes. The BRCAPRO model appeared to overestimate risk of having a mutation in this sample (p < .001). BRCAPRO overestimates notwithstanding, genetic counseling increased accuracy of subjective risk (p < .01). Individuals with a family-only cancer history had the least accurate estimates of risk (p < .05) and may need further intervention to either manage anxiety or improve knowledge.     

Perceived Peer and Family Relationships,Hopelessness and Locus of Control as Factors in Adolescent Suicide Attempts

ABSTRACT: Thirty hospitalized suicidal adolescents were compared with thirty-four hospitalized nonsuicidal teenagers and thirty-five nonhospitalized coping youngsters (controls) on the extent of their problems, their perceptions of peer and family relationships, degree of hopelessness, and locus of control. Suicidals were found to experience the greatest total number of problems, nonsuicidals the next most, and controls the fewest. Significantly more peer problems differentiated the suicidals from the other two groups, while serious family problems discriminated the three groups from each other. The controls viewed their families as the most well-adjusted, followed by the nonsuicidals, while the suicidals felt their families were the most maladjusted. Suicide attempters experienced a significantly greater degree of hopelessness than all the nonattempters, and significantly more external locus of control than the controls. Some sex differences emerged in the study.     

Selective attention modulates implicit learning

The effect of selective attention on implicit learning was tested in four experiments using the "contextual cueing" paradigm (Chun & Jiang, 1998, 1999). Observers performed visual search through items presented in an attended colour (e.g., red) and an ignored colour (e.g., green). When the spatial configuration of items in the attended colour was invariant and was consistently paired with a target location, visual search was facilitated, showing contextual cueing (Experiments 1, 3, and 4). In contrast, repeating and pairing the configuration of the ignored items with the target location resulted in no contextual cueing (Experiments 2 and 4). We conclude that implicit learning is robust only when relevant, predictive information is selectively attended.