Transforming mental health care for children and their families

In April 2002, the President's New Freedom Commission on Mental Health was created by executive order to study the mental health care delivery system in our nation and to make recommendations for improvements so that individuals with serious mental disorders can live, work, learn, and fully participate in their homes and communities. In its report, "Achieving the Promise: Transforming Mental Health Care in America," the commission provided strategies to address critical infrastructure, practice, and research issues. This article focuses on the work of the commission's Subcommittee on Children and Families, describing its vision for mental health service delivery for children and providing suggestions for strengthening community-based care for youths with or at risk of behavioral health disorders. Training, research, practice, and policy implications for psychologists are discussed.     

Developments in declarative memory

The second year of life is marked by changes in the robustness of recall memory. Both retrieval and storage processes have been implicated as the major source of age-related improvements in recall. Children 13 to 20 months of age were matched for levels of learning of laboratory events (thereby eliminating encoding as a source of developmental difference) and tested for recall after delays as long as 6 months. In Experiment 1, 16-month-olds evidenced less loss of information and more relearning than 13-month-olds. In Experiment 2, 20-month-olds evidenced less loss of information and more relearning than 16-month-olds. Patterns of performance across test trials and in relearning implicate a decline in susceptibility to storage failure as the primary source of the observed developmental trend.     

Developing a Community Science Research Agenda for Building Community Capacity for Effective Preventive Interventions

Research has shown that prevention programming can improve community health when implemented well. There are examples of successful prevention in local communities, however many continue to face significant challenges, demonstrating a gap between science and practice. Common strategies within the United States to address this gap are available (e.g., trainings), but lack outcomes. Building community capacity to implement high quality prevention can help communities achieve positive health outcomes, thereby narrowing the gap. While there is ample research on the efficacy of evidence-based programs, there is little on how to improve community capacity to improve prevention quality. In order to narrow the gap, a new model of research—one based in Community Science—is suggested that improves the latest theoretical understanding of community capacity and evaluates technologies designed to enhance it. In this article, we describe this model and suggest a research agenda that can lead to improved outcomes at the local level.     

Self-reported personality disorder in the children in the community sample: convergent and prospective validity in late adolescence and adulthood

Approximately 800 youths from the Children in the Community Study (Cohen & Cohen, 1996) have been assessed prospectively for over 20 years to study personality disorders (PDs) in adolescents and young adults. In this article we evaluate the Children in the Community Self-Report (CIC-SR) Scales, which were designed to assess DSM-IV PDs using self-reported prospective data from this longitudinal sample. To evaluate convergent validity, we assessed concordance between the CIC-SR Scales and the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II; First, Gibbon, Spitzer, Williams, & Benjamin, 1995) in 644 participants at mean age 33. To assess predictive validity, we used CIC-SR Scales at mean age 22 to predict subsequent CIC-SR and SCID-II Personality Questionnaire scores at mean age 33. In these analyses the CIC-SR Scales matched or exceeded benchmarks established in previous comparisons between self-report instruments and structured clinical interviews. Unlike other self-report scales, the CIC-SR did not appear to overestimate diagnoses when compared with SCID-II clinical diagnoses.     

Divergent trajectories in the aging mind: changes in working memory for affective versus visual information with age

Working memory mediates the short-term maintenance of information. Virtually all empirical research on working memory involves investigations of working memory for verbal and visual information. Whereas aging is typically associated with a deficit in working memory for these types of information, recent findings suggestive of relatively well-preserved long-term memory for emotional information in older adults raise questions about working memory for emotional material. This study examined age differences in working memory for emotional versus visual information. Findings demonstrate that, despite an age-related deficit for the latter, working memory for emotion was unimpaired. Further, older adults exhibited superior performance on positive relative to negative emotion trials, whereas their younger counterparts exhibited the opposite pattern.     

Factor structure and validity of the MacArthur Competence Assessment Tool-Criminal Adjudication

Examination of the available literature regarding the development of the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA) reveals 2 theoretical factor structures on which the MacCAT-CA was based: one in which 3 lower-order constructs are proposed (understanding, reasoning, appreciation) and one in which 2 higher-order constructs are proposed (competence to assist counsel and decisional competence). Confirmatory factor analyses were conducted with the MacCAT-CA's original normative sample (N = 729) to test both the relative fit of these 2 theoretical factor structures and models that combine the 2 factor structures. Analyses were also completed to examine the convergent and discriminant validity of the MacCAT-CA. Results are discussed in terms of the strengths and weaknesses of the nomothetic nature of the MacCAT-CA.     

Assessment and treatment of adult acute responses to traumatic stress following mass traumatic events

Assessment and treatment of acute responses to traumatic stress has received much attention since September 11, 2001. This article elucidates principles of early intervention with adults in the immediate (within 48 hours) and early recovery phase (within the first week). The principles have been drawn from research on risk and recover factors, stress and traumatic stress theory, and expert consensus recommendations. The debriefing model is discussed, and principle interventions of psychological first aid, pharmacology, and mass trauma systems are described. This article concludes with brief guidelines for longer-term interventions and recommendations for future research.     

Amygdala activation to sad pictures during high-field (4 tesla) functional magnetic resonance imaging

Fear-related processing in the amygdala has been well documented, but its role in signaling other emotions remains controversial. The authors recovered signal loss in the amygdala at high-field strength using an inward spiral pulse sequence and probed its response to pictures varying in their degree of portrayed sadness. These pictures were presented as intermittent task-irrelevant distractors during a concurrent visual oddball task. Relative to neutral distractors, sad distractors elicited greater activation along ventral brain regions, including the amygdala, fusiform gyrus, and inferior frontal gyrus. In contrast, oddball targets engaged dorsal sectors of frontal, parietal, and cingulate cortices. The amygdala's role in emotional evaluation thus extends to images of grief and despair as well as to those depicting violence and threat.     

Hopelessness as a risk factor for post-traumatic stress disorder symptoms among interpersonal violence survivors

Post-traumatic stress disorder often co-occurs with depression, and they may share common risk factors. One possible common cognitive risk factor is hopelessness. Thus, we examined whether hopelessness was related to symptoms of post-traumatic stress disorder. Participants were 202 female survivors of interpersonal violence. Relationships between self-reported and interviewer-rated measures of hopelessness gathered at 2 weeks post-trauma and self-reported and interviewer-rated symptoms of post-traumatic stress disorder gathered at 2 weeks and 3 months post-trauma were examined. Hierarchical, simultaneous regression analyses that co-varied trauma type revealed that hopelessness was related to self-reported symptoms of post-traumatic stress disorder, both concurrently and prospectively. Follow-up analyses revealed that relationships between hopelessness and symptoms of post-traumatic stress disorder were due almost entirely to shared variance with depression. No relationships were found between hopelessness and interviewer-rated symptoms of post-traumatic stress disorder.