Provider contact with families of adults with severe mental illness: taking a closer look

This exploratory study examined the frequency and nature of providers' contact with families of persons with severe mental illness. Fifty-nine providers in six community mental health programs completed a self-administered survey. A subsample of 8 providers also completed two in-depth interviews. Although most providers had some family contact, the contact was restricted to a small percent of their caseloads. The nature of contact that providers have with families is generally limited by their professional role. Best practice guidelines for the treatment of mental illness and agency administrators responsible for instituting these guidelines will need to clarify the types of providers who are expected to implement various aspects of family involvement.     

Development and Evaluation of a Telephone Communication Protocol for the Delivery of Personalized Melanoma Genomic Risk to the General Population

Communicating personalized genomic risk results for common diseases to the general population as a form of tailored prevention is novel and may require alternative genetic counseling service delivery models. We describe the development and evaluation of a communication protocol for disclosing melanoma genomic risk information to the asymptomatic general population and assess participants’ satisfaction and acceptability. Participants (n?=?117) were aged 22–69 years, living in New South Wales, Australia and unselected for family history. They provided a saliva sample and had genomic testing for melanoma for low to moderate penetrant melanoma susceptibility variants in 21 genes. Participants could choose to receive their results from a genetic counselor via telephone, followed by a mailed booklet or to receive their risk result via mailed booklet only with a follow-up call for those at high risk. A follow-up questionnaire was completed by 85% of participants 3-months later. Most participants (80%) elected to receive their result via telephone. Participants were highly satisfied with the delivery of results (mean 3.4 out of 4, standard deviation 0.5), and this did not differ by delivery mode, risk category, age or sex. On follow-up, 75% accurately recalled their risk category, 6% indicated a preference for a different delivery mode, either electronic or face-to-face. The process of disclosing genomic risk results to the general population over the telephone with accompanying written material was feasible and acceptable, and may be useful for communicating polygenic risk for common diseases in the context of increasing demands for genomic testing.     

Promoting Attachment and Mentalization for Parents and Young Children in the Foster Care System: Implementing a New Training and Treatment Approach in an Agency

The Building Blocks Program is an innovative psychodynamic treatment approach that was designed to fit within a social service agency structure. It is based on concepts of attachment, attunement, and mentalization and builds on the research of Beatrice Beebe (2003), Peter Fonagy and colleagues (2002), Arietta Slade (2005), Howard and Miriam Steele (2008), and Dan Stern (1985). The Building Blocks Program targets birth mothers and their young children under age 5 who have been or are in danger of being removed from their families. In the beginning of the program, the Building Blocks therapists faced many challenges. As noted (Remez, this issue), many of the therapists were unfamiliar with a Reflective Supervision model of learning. They were accustomed to a more traditional pedagogical approach that emphasized critiquing their work, with a focus on their clients’ pathology. The Building Blocks model focuses on therapist and client safety and support, prompting a paradigm shift in the therapists’ thinking about supervision and how to conduct therapy.     

Information Channels and Biomarkers of Disease

Current research in molecular epidemiology uses biomarkers to model the different disease phases from environmental exposure, to early clinical changes, to development of disease. The hope is to get a better understanding of the causal impact of a number of pollutants and chemicals on several diseases, including cancer and allergies. In a recent paper Russo and Williamson (Med Stud, 2012) address the question of what evidential elements enter the conceptualisation and modelling stages of this type of biomarkers research. Recent research in causality has examined Ned Hall’s distinction between two concepts of causality: production and dependence (Hall in Causation and counterfactuals. MIT Press, Cambridge, pp 225–276, 2004). In another recent paper, Illari (Philos Technol, p 20, 2011b) examined the relatively under-explored production approach to causality, arguing that at least one job of an account of causal production is to illuminate our inferential practices concerning causal linking. Illari argued that an informational account solves existing problems with traditional accounts. This paper follows up this previous work by investigating the nature of the causal links established in biomarkers research. We argue that traditional accounts of productive causality are unable to provide a sensible account of the nature of the causal link in biomarkers research, while an informational account is very promising.     

Stress and support as related to postpartum paternal mental health and perceptions of the infant

This study examined the relationship of stress and social support to psychological adjustment, attitudes towards the parental role, and perceptions of infant behavior in two groups of fathers: an index group of 50 men whose wives had a diagnosed postpartum depression, and a control group of 50 men whose wives had no such disorder. Fathers with more stress and less support had higher levels of psychological symptomatology. Index fathers reported more stress, particularly from work and economic pressures. Index fathers were also less likely than controls to report support from in-laws, other relatives, and friends. Stress, but not support, was associated with more negative perceptions of the marriage, the parental role, and infant behavior. Work-related stress was most likely to have an impact on paternal attitudes. These findings suggest the need to adopt a family focus when studying postpartum depression. © 1997 Michigan Association for Infant Mental Healt     

“But Others Do It!”: Do Misperceptions of Schoolmate Alcohol and Marijuana Use Predict Subsequent Drug Use Among Young Adolescents?

We examined the effects of perceived prevalence of drug use among same-age peers on adolescents' subsequent drug use. In 7^th grade, participants estimated prevalence of alcohol and marijuana use among 7^th-grade students in their school, reported own use of these drugs, receipt of offers to use these drugs, and frequency of contact with peers who use these drugs. In 8^th grade, participants reported their frequency of alcohol and marijuana use. Although perceived prevalence of drug use predicted subsequent alcohol and marijuana use when controlling for actual prevalence, these effects disappeared once participants' prior levels of drug use and proximal peer contacts were considered. Implications of findings for intervention programs aiming solely to increase accuracy of perceived prevalence estimates are discussed.     

Rank and reproduction among female langur monkeys: Aging and improvement (They're not just getting older,they're getting better)

An investigation of the social rank, reproduction, and ages of adult female Indian gray langur monkeys (Presbytis entellus) living in two colony social groups revealed that rank based on displacements is neither correlated with nor best predicted by female age or reproductive value. The hierarchy of female ranks is best conceptualized as a layered ranking system in which there are clusters of females of the same dominance rank forming layers within the structure. Statistical significance in frequencies of displacement differs between but not within these layered groups of females. Factors such as group composition, presence of uterine kin, reproductive state, and individual personality are hypothesized to predict changes in female rank far better than does reproductive value. Our data show that reproductive success increases with age. The infant survival record for the six oldest females in our colony was much better than for the five youngest adult females.