Who uses community mental health centres? A study of one health district

A caseload analysis was undertaken to investigate those clients seen by five community mental health centre teams within one healthcare district. The 985 clients are described in terms of demographic and clinical features and questions relating to service provision are discussed.     

Consumer decisions in relationships

Most research on consumer choice assumes that decisions are usually made by individuals, and that these decisions are based on an individual's personal attitudes, beliefs, and preferences. Yet, much consumer behavior—from joint decisions to individual choices—is directly or indirectly shaped by people with whom we have some relationship. In this target article, we examine how each member in a relationship can affect how consumer decisions are made. After reviewing foundational work in the area, we introduce a powerful and statistically sophisticated methodology to study decisions within relationships—a dyadic framework of decision-making. We then discuss how the study of consumer decisions in relationships can be informed by different theories in the relationships field, including attachment, interdependence, social power, communal/exchange orientations, relationship norms, and evolutionary principles. By building on the seminal foundations of prior joint-decision making research with theories and methods from contemporary relationship science, we hope to facilitate the integration of the consumer and relationships literature to better understand and generate novel hypotheses about consumer decisions in relationships.     

Impulse Control Disorders in Parkinson’s Disease: A Psychosocial Perspective

Parkinson's disease (PD) is a progressive neurodegenerative disease primarily characterised by motor symptoms. However, another feature of PD which is receiving increasing attention is the phenomenon of impulse control disorders (ICDs), such as pathological gambling. To date, research into ICDs in PD has centred on a biomedical model of cause, related to the effects of dopamine replacement therapy. However, there are several areas of discrepancy in the current biomedical account of ICDs in PD. In addition, we argue that social and psychological factors also need to be considered to achieve a more complete understanding of the phenomenon. We present a novel conceptual model which combines biomedical and psychosocial factors in the genesis of ICDs in PD and use the model to identify a number of potential treatment intervention points and to highlight important outstanding questions concerning the inter-relationship between psychosocial and biomedical factors in the genesis of ICDs in PD.     

Attitudes about psychotherapy: A qualitative study of introductory psychology students who have never been in psychotherapy and the influence of attachment style

Design: Interviews about attitudes about psychotherapy with 12 undergraduate students who had never been in psychotherapy were analysed using consensual qualitative research. Results: Participants believed that the client role is to disclose, be receptive, and be motivated; that the therapist role is to listen, support, and give advice; and that the therapeutic relationship should be close and personal. Participants had ideas about the benefits (a healing therapeutic relationship, personal and interpersonal changes) and the barriers (self‐stigma and public stigma, difficulty revealing, need to solve problems on own, cost) associated with seeking therapy, and they disliked the idea of being diagnosed. In contrast with participants who were securely attached, those who were insecurely attached more often wanted a professional therapeutic relationship, wanted the therapist to ask questions, mentioned fewer benefits to therapy, and thought that they would have difficulty disclosing to a therapist. Discussion: Implications for changing attitudes about psychotherapy and improving training programs for practitioners are discussed.     

Decreased aggressive and locomotor behaviors in Betta splendens after exposure to fluoxetine

The failure of sewage treatment plants to remove pharmaceuticals such as fluoxetine from waste water has become a concern given that these products are being detected in the surface waters of many countries of the world. The effects of fluoxetine in sub-lethal doses on the neural systems and behaviors of aquatic life are worthy of investigation. This study investigated the effects of sub-lethal amounts fluoxetine dissolved in water on the aggressive and locomotor behaviors of 44 male Betta splendens. Fish treated with 705 microg/l of fluoxetine and 350 microg/l of fluoxetine generally demonstrated significant decreases in locomotion and number of aggressive attacks compared to 0 microg/l of fluoxetine (controls) on Days 11 and 19 of drug exposure and persisted for at least 13 days after removal of fluoxetine. Consistent with decreases in the number of aggressive attacks, there was a significant increase in aggression-response time to a perceived intruder for treated males on Days 11 and 19 and persisted for 6 days following removal of fluoxetine. However, the differences in aggressive and locomotor behaviors seen in the fluoxetine-treated groups were indistinguishable from controls three weeks following drug removal.     

The perceptual span during foveally-demanding visual target localization

Foveally-induced processing load deteriorates target localization performance in vision-guided tasks. Here, participants searched for a target embedded among coded distractors. High processing load was effected by instructing some participants to use the coded distractors to guide their search for the target. Other participants (in the low processing load condition) were not apprised of the code. The experiment examined whether increased processing load alters the span of effective processing (i.e. perceptual span) by (a) reducing its size, (b) altering its shape, or (c) reducing its size and altering its shape. The results demonstrated a reduction in the size of the perceptual span, with no significant change to its shape. It is argued that when distractors are processed beyond simply rejecting them as non targets, the perceptual span shrinks with increasing processing load. The findings are discussed in contrast to a general interference theory that predicts a change in vision-guided performance without a shrinking of the perceptual span.     

Body image, shape, and volumetric assessments using 3D whole body laser scanning and 2D digital photography in females with a diagnosed eating disorder: preliminary novel findings

We piloted three-dimensional (3D) body scanning in eating disorder (ED) patients. Assessments of 22 ED patients (including nine anorexia nervosa (AN) patients, 12 bulimia nervosa (BN) patients, and one patient with eating disorder not otherwise specified) and 22 matched controls are presented. Volunteers underwent visual screening, two-dimensional (2D) digital photography to assess perception and dissatisfaction (via computerized image distortion), and adjunctive 3D full-body scanning. Patients and controls perceived themselves as bigger than their true shape (except in the chest region for controls and anorexia patients). All participants wished to be smaller across all body regions. Patients had poorer veridical perception and greater dissatisfaction than controls. Perception was generally poorer and dissatisfaction greater in bulimia compared with anorexia patients. 3D-volume:2D-area relationships showed that anorexia cases had least tissue on the torso and most on the arms and legs relative to frontal area. The engagement of patients with the scanning process suggests a validation study is viable. This would enable mental constructs of body image to be aligned with segmental volume of body areas, overcoming limitations, and errors associated with 2D instruments restricted to frontal (coronal) shapes. These novel data could inform the design of clinical trials in adjunctive treatments for eating disorders.     

Preventing suicide through improved training in suicide risk assessment and care: an American Association of Suicidology Task Force report addressing serious gaps in U.S. mental health training

There are twice as many suicides as homicides in the United States, and the suicide rate is rising. Suicides increased 12% between 1999 and 2009. Mental health professionals often treat suicidal patients, and suicide occurs even among patients who are seeking treatment or are currently in treatment. Despite these facts, training of most mental health professionals in the assessment and management of suicidal patients is surprisingly limited. The extant literature regarding the frequency with which mental health professionals encounter suicidal patients is reviewed, as is the prevalence of training in suicide risk assessment and management. Most importantly, six recommendations are made to address the longstanding insufficient training within the mental health professions regarding the assessment and management of suicidal patients.     

Attachment and the management of empathic accuracy in relationship-threatening situations

The current studies tested how attachment orientations are related to empathic accuracy (i.e., the accuracy with which one infers a partner's private thoughts and feelings) during attachment-relevant discussions. In Study 1, married couples were videotaped discussing a severe or a less severe relationship issue that involved intimacy or jealousy. In Study 2, dating couples were videotaped trying to resolve a relationship conflict. Consistent with the revised empathic accuracy model, highly avoidant individuals were less empathically accurate in both studies. Relative to less anxious persons, highly anxious individuals were more empathically accurate when discussing intimacy issues that posed a potential threat to their relationship (in Study 1) and when they were rated as more distressed when discussing a relationship conflict (in Study 2). The findings are discussed in terms of how highly anxious and highly avoidant people differentially manage empathic accuracy to regulate negative affect and facilitate their interpersonal goals.