Expanding Mental Health Services to Older High-Utilizing HMO Patients: A Pilot Study

Background: Expanded mental health benefits were offered to older HMO patients who were high medical utilizers. Outcomes of interest were use of services, subjective well-being, and psychopathology. Methods: Sixty-nine (25 male, 44 female) patients age 55 or above seeking frequent outpatient medical care completed the SF-36 health survey and the revised Symptom Check List (SCL-90-R). Patients were assigned to usual care, health education, or expanded mental health benefit conditions. Results: Patients showed high initial levels of psychopathology and distress. Over the 6 months of the study, patients in the expanded benefits group made a mean of 11.5 visits to mental health professionals versus a mean of 3.4 visits by usual care patients. Patients in the expanded benefits group showed significant improvement in SF-36 General Health and Mental Health well-being scores. Patients in the health education group showed no improvement. Patients in the usual care group showed improvements in Vitality scores. Psychopathology summary scores showed improvement for both usual care and enhanced benefit groups. Conclusions: Mental health treatment may improve well-being and reduce psychopathology in older high-utilizing patients. Creativity will be needed in expanding access to mental health services for this population.     

Home Versus School Environments and their Influences on the Affective and Behavioral States of African American,Hispanic, and Caucasian Juvenile Offenders

We examined and compared the influence of home and school environments to the affective (anxiety and depression) and behavioral (impulsivity and compliance) states of 626 African American, Caucasian, and Hispanic adjudicated juvenile offenders. African Americans showed the strongest relationship between their home environment and compliance. Caucasian and Hispanic males exhibited increased home and school environment problems associated with affective states. Among females, African American and Caucasian females exhibited the strongest relationships between their home environment and behavioral states, whereas Caucasian and Hispanic males revealed increased school environment problems related to affective states with Hispanic males showing the strongest relationships. In addition, the school environment was more predictive of the affective and behavioral states of the adolescents, particularly females.     

Beyond Harm and Fairness: A Study of Deviance and Morality

Using data from 1,429 students, we test whether a moral foundations approach focusing on both individual- and group-oriented measures of morality improves our ability to predict deviant behavior over and above the effects of individual-oriented measures alone. Results show that the emphasis individuals place on group-oriented moral concerns is inversely associated with a range of deviant behaviors. Moreover, these associations are stronger and more pervasive than the emphasis placed on individual-level moral concerns. Additionally, we find that a recently developed “moral identity” measure does not add to the prediction of deviant behavior over and above group-oriented measures.     

Effect of motivation on academic fluency performance in survivors of pediatric medulloblastoma

It has been proposed previously that extrinsic motivation may enable survivors of childhood medulloblastoma to significantly improve aspects of neurocognitive performance. In healthy populations, enhanced motivation has been shown to promote academic fluency, a domain likely more relevant to the educational outcomes of pediatric medulloblastoma survivors than academic skill development. The present study investigates the effect of enhanced extrinsic motivation on fluent (i.e., accurate and efficient) academic performance in pediatric medulloblastoma survivors. Participants were 36 children, ages 7–18, who had completed treatment for medulloblastoma. Participants completed a neuropsychological battery that included administration of equivalent tasks on Forms A and B of the Woodcock-Johnson III Tests of Achievement. Half were randomly assigned to an incentive condition prior to the administration of Form B. Provision of a performance-based incentive resulted in statistically significant improvement, but not normalization of function, in performance on measures of academic fluency. No demographic, treatment-related, academic, neuropsychological, or self-perception variables predicted response to incentive. Findings suggest that academic performance of survivors may significantly improve under highly motivating conditions. In addition to implications for educational services, this finding raises the novel possibility that decreased motivation represents an inherent neuropsychological deficit in this population and provides a rationale for further investigation of factors affecting individual differences in motivational processes. Further, by examining effort in a context where effort is not inherently suspect, present findings also significantly contribute to the debate regarding the effects of effort and motivation on neuropsychological performance.     

Integrating Web-Based Applications into Aged Care: Two Case Studies and Discussion

In anticipation of the growing need for adequate mental health care for older adults in residential aged care facilities, psychologists are challenged to overcome several barriers that impede the uptake and delivery of their services in such settings. Information and communication technologies (ICT) have strong potential to overcome some of these barriers by supporting the delivery of evidence-based psychosocial treatments for common psychogeriatric issues. This paper presents two case studies that illustrate when and how psychologists can use various ICT applications (e.g., tablet devices, web-based applications) integrated with cognitive behavioural and reminiscence-based therapies. Both case studies demonstrate that ICT can effectively support the therapeutic alliance, enhance therapeutic engagement, and individualize treatment delivery to accommodate the needs of elderly patients. It is hoped that these case studies will encourage clinicians to consider using ICT to augment therapy with their elderly patients.     

Frieda fromm-reichmann,loneliness and deafness

Abstract

This paper explores the rôle that Fromm-Reichmann's parents' adult-onset severe familial deafness may have played in the development of Fromm-Reichmann's career choice and of her charismatic style. She, too, became deaf. Her final paper, “Loneliness” is perhaps her most emotionally evocative work. Perhaps her own increasingly severe experience of loneliness motivated her writing on this theme. Just as she expected self-honesty from her Chestnut Lodge colleagues, this paper demonstrates that she held herself to this same standard. The author urges the deaf community to seek out the newly deaf and to encourage their learning to sign, thus ameliorating the newly deaf individual's loneliness.     

Predicting Prosocial Behavior Toward Sex-Trafficked Persons: The Roles of Empathy,Belief in a Just World,and Attitudes Toward Prostitution

Human trafficking has been identified as a global human rights violation. This study aimed to investigate the predictors of prosocial behaviors toward sex-trafficked persons. Participants were 223 undergraduates randomly assigned to read a vignette and answer follow-up questions along with measures of empathy, just world belief, attitudes toward prostitution, and proactive behavior. Empathy was highest for trafficked women, regardless of citizenship status. Trafficked foreign women received the highest empathy, and U.S. prostitutes received the least. Path analysis results indicate just world belief, beliefs about prostitutes, and family values relating to prostitution had direct effects on empathic concern; in turn, empathic concern had a direct effect on proactive behavior. Explanations for the results are discussed, along with educational and clinical implications.     

Intimate partner violence and preschoolers' explicit memory functioning.

This research examines whether parents' intimate partner physical violence (IPV) relates to their preschoolers' explicit memory functioning, whether children's symptoms of hyperarousal mediate this relation, and whether mothers' positive parenting moderates this relation. Participants were 69 mothers and their 4- or 5-year-old child (34 girls). Mothers completed measures of IPV, children's hyperarousal symptoms, parent-child aggression, and positive parenting. Measures of explicit memory functioning were administered to preschoolers. As expected, IPV correlated negatively with preschoolers' performance on explicit memory tasks, even after controlling for parent-child aggression and demographic variables related to preschoolers' memory functioning. Preschoolers' hyperarousal symptoms did not mediate the relation between IPV and explicit memory functioning, but mothers' positive parenting moderated this relation. Specifically, the negative relation between IPV and preschoolers' performance on 2 of the 3 explicit memory tasks was weaker when mothers engaged in higher levels of positive parenting. These findings extend research on IPV and children's adjustment difficulties to explicit memory functioning in preschoolers and suggest that mothers can ameliorate the influence of IPV on preschoolers' memory functioning via their parenting.