The Psychiatrization of Poverty: Rethinking the Mental Health–Poverty Nexus

The positive association between ‘mental illness’ and poverty is one of the most well established in psychiatric epidemiology. Yet, there is little conclusive evidence about the nature of this relationship. Generally, explanations revolve around the idea of a vicious cycle, where poverty may cause mental ill health, and mental ill health may lead to poverty. Problematically, much of the literature overlooks the historical, social, political, and cultural trajectories of constructions of both poverty and ‘mental illness’. Laudable attempts to explore the social determinants of mental health sometimes take recourse to using and reifying psychiatric diagnostic categories that individualize distress and work to psychiatrically reconfigure ‘symptoms’ of oppression, poverty, and inequality as ‘symptoms’ of ‘mental illness’. This raises the paradoxical issue that the very tools that are used to research the relationship between poverty and mental health may prevent recognition of the complexity of that relationship. Looking at the mental health–poverty nexus through a lens of psychiatrization (intersecting with medicalization, pathologization, and psychologization), this paper recognizes the need for radically different tools to trace the messiness of the multiple relationships between poverty and distress. It also implies radically different interventions into mental health and poverty that recognize the landscapes in which lived realities of poverty are embedded, the political economy of psychiatric diagnostic and prescribing practices, and ultimately to address the systemic causes of poverty and inequality.     

Gaming motivation and problematic video gaming: The role of needs frustration

Motivation is often used as a predictor of a problematic style of video game engagement, implying that individuals' gaming undermines optimal functioning. Drawing from recent advances in Self‐Determination Theory (SDT), the present study explores the links between gaming motivations, the daily frustration of basic psychological needs, and reports of problematic video gaming (PVG). A sample of 1029 participants (72.8% male; M = 22.96 years; SD = 4.13 years) completed items regarding their gaming engagement and gaming motivation as well as their experience of needs frustration and PVG symptoms. Results revealed positive associations between gaming motivations and PVG, and between daily needs frustration and PVG. Finally, after comparing several competing models, a mediational model whereby needs frustration explained the association between individuals' gaming motivation and PVG emerged as best fitting the data. The discussion addresses the theoretical and practical implications of these findings in the context of recent research.     

Effects of aging and depression on mnemonic discrimination ability

Aging and depression have been found to be associated with poorer performance in mnemonic discrimination. In the current study, a two-response format mnemonic similarity test, Cognitive Drug Research MST, was used to compare these effects. Seventy-six participants were tested; with 52 participants in the young group, aged 18–35 years, and 24 participants in the elderly group, aged 55 years or older. Twenty-two young participants and 10 elderly participants met DSM-IV criteria for MDD or dysthymia. Age-related deficits were found for lure identification and speed of response. Differences in speed of responses to lure images were found for younger depressed participants, and depressive symptom severity was found to be negatively associated with lure identification accuracy in the elderly. These findings may be viewed as putative behavioral correlates of decreased pattern separation ability, which may be indicative of altered hippocampal neurogenesis in aging and depression.     

Swing phase mechanics of healthy young and elderly men.

This study examined the effect of ageing on the swing phase mechanics of young and elderly gait. Sagittal plane marker trajectories and force plate data were collected while 10 young (24.9+/-0.9 years) and eight elderly (68.9+/-0.4 years) subjects walked at their preferred walking speeds. Comparison between young and elderly gait was made for a range of spatial-temporal, kinematic and kinetic variables with emphasis given to identifying possible differences at toe-off, minimum metatarsal-phalangeal joint clearance and heel contact. In order to control for the confounding effect of gait velocity on the dependent variables, a multivariate analysis of covariance was used to identify differences between the young and elderly subjects due to age. In contrast to studies that have reported lower preferred walking speeds in the elderly compared to the young [J.O. Judge, R.B. Davis III, S. Ounpuu, Step length reductions in advanced age: the role of ankle and hip kinetics, Journal of Gerontology: Medical Sciences 51 (1996) M303-312; D.C. Kerrigan, M.K. Todd, U. Della Croce, L.A. Lipsitz, J.J. Collins, Biomechanical gait alterations independent of speed in the healthy elderly: evidence for specific limiting impairments, Archives of Physical and Medical Rehabilitation 79 (1998) 317-322], no differences in walking speed nor in the spatial-temporal variables that determine walking speed were detected. The elderly were however, found to have a greater hip extension moment at the time of minimum metatarsal-phalangeal joint clearance, and a significantly higher anterior-posterior velocity heel contact velocity that was linked to a significantly higher shank and foot angular velocity at heel contact. Since many gait variables are highly correlated with walking speed [C. Kirtley, M.W. Whittle, R.J. Jefferson, Influence of walking speed on gait parameters, Journal of Biomechanical Engineering 7 (1985) 282-288; D.A. Winter, Biomechanical motor patterns in normal walking, Journal of Motor Behaviour 15 (1983) 302-330], differences between young and elderly gait found in the present study may therefore be attributed to ageing, rather than a secondary effect of differences in gait velocity.     

Traditional tests and job simulations: minority and majority performance and test validities.

Performance of 565 minority and 414 majority job applicants on traditional paper-and-pencil tests and on a telephone simulation that measured similar constructs was assessed. Models of the measurement characteristics of these 2 test batteries indicated larger subgroup mean differences on the traditional tests than on the simulation. Correlations between traditional tests were lower in the majority sample than in the minority sample, and the variance of the minority candidates' scores on the traditional tests was much larger than the variance of majority applicants' scores on the same measures. The validity of the simulation was lower than the validity of the traditional tests. This study replicates previous laboratory research that has indicated smaller subgroup differences on simulations than on paper-and-pencil tests and extends this research by providing evidence of the relative validity of these 2 types of measures.     

Adult attachment style and stress as risk factors for early maternal sensitivity and negativity

The current study examined the individual and joint effects of self‐reported adult attachment style, psychological distress, and parenting stress on maternal caregiving behaviors at 6 and 12 months of child age. We proposed a diathesis‐stress model to examine the potential deleterious effects of stress for mothers with insecure adult attachment styles. Data from 137 mothers were gathered by the longitudinal Durham Child Health and Development Study. Mothers provided self‐reports using C. Hazan and P. Shaver's ( 1987 ) Adult Attachment Style measure, the Brief Symptom Inventory (L.R. Derogatis & P.M. Spencer, 1982 ), and the Parent Stress Inventory (R.R. Abidin, 1995 ); observations of parenting data were made from 10‐min free‐play interactions. Consistently avoidant mothers were less sensitive with their infants than were consistently secure mothers; however, this effect was limited to avoidant mothers who experienced elevated levels of psychological distress. Results suggest that the association between insecure adult attachment style and insensitive parenting behavior is moderated by concurrent psychosocial stress. Clinical implications for these findings are discussed.     

A pilot study of a family‐focused intervention for children and families affected by maternal depression

A non‐experimental pilot study examined child, mother and family outcomes of a 10‐session multi‐family group intervention designed to reduce risk and promote resilience for mothers with depression and their families. Positive changes following the Keeping Families Strong intervention included mother‐reported decreases in child behaviour and emotional problems, improvements in the quality of family interactions and routines and improvements in their own well‐being and support from others. Children (9–16 years) reported decreased internalizing symptoms, improved coping, increased maternal warmth and acceptance and decreased stressful family events. Attendance and mother‐reported satisfaction were high, indicating the perceived value of the intervention.