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.     

Neural mechanisms of affective interference in schizotypy

Negatively valenced stimuli foster cognitive impairment in schizotypy and schizophrenia. To identify relevant brain mechanisms, the authors had 16 positive-schizotypy and 16 control participants perform an emotional Stroop task, judging the ink color of negative and neutral words during functional magnetic resonance imaging (fMRI) of regional brain activity. Schizotypy individuals showed increased right and decreased left activity in dorsolateral prefrontal cortex, indicating a deficit in maintenance of attentional set in the presence of negative emotional distractors. They also showed abnormal activity in ventral limbic areas, including decreased activity in nucleus accumbens and increased activity in hippocampus and amygdala, a circuit involved in the integration of cognitive and affective processes. These results indicate that aspects of emotion-cognition processes and the brain mechanisms that implement them are similar in schizotypy and schizophrenia.     

Audio-visual simultaneity judgments

The relative spatiotemporal correspondence between sensory events affects multisensory integration across a variety of species; integration is maximal when stimuli in different sensory modalities are presented from approximately the same position at about the same time. In the present study, we investigated the influence of spatial and temporal factors on audio-visual simultaneity perception in humans. Participants made unspeeded simultaneous versus successive discrimination responses to pairs of auditory and visual stimuli presented at varying stimulus onset asynchronies from either the same or different spatial positions using either the method of constant stimuli (Experiments 1 and 2) or psychophysical staircases (Experiment 3). The participants in all three experiments were more likely to report the stimuli as being simultaneous when they originated from the same spatial position than when they came from different positions, demonstrating that the apparent perception of multisensory simultaneity is dependent on the relative spatial position from which stimuli are presented.     

Emotional and deliberative reactions to a public crisis: Mad Cow disease in France

Although most theories of choice are cognitive, recent research has emphasized the role of emotions. We used a novel context--the Mad Cow crisis in France--to investigate how emotions alter choice even when consequences are held constant. A field study showed that individuals reduced beef consumption in months after many newspaper articles featured the emotional label "Mad Cow," but beef consumption was unaffected after articles featured scientific labels for the same disease. The reverse pattern held for the disease-related actions of a government bureaucracy. A lab study showed that the Mad Cow label induces people to make choices based solely on emotional reactions, whereas scientific labels induce people to consider their own probability judgments. Although the Mad Cow label produces less rational behavior than scientific labels, it is two to four times more common in the environment.     

Learning from Communities: Overcoming Difficulties in Dissemination of Prevention and Promotion Efforts

The model of prevention science advocated by the Institute of Medicine (P. J. Mrazek & R. J. Haggerty, 1994) has not lead to widespread adoption of prevention and promotion programs for four reasons. The model of dissemination of programs to communities fails to consider community and organizational capacity to implement programs, ignores the need for congruence in values between programs and host sites, displays a pro-innovation bias that undervalues indigenous practices, and assumes a simplistic model of how community organizations adopt innovations. To address these faults, researchers should locate, study, and help disseminate successful indigenous programs that fit community capacity and values. In addition, they should build on theoretical models of how locally developed programs work to make existing programs and polices more effective.     

Sexual victimization in relation to perceptions of risk: mediation, generalization, and temporal stability

There is evidence that personal experience with trauma is associated with increases in both personal and comparative risk perception. This study investigates this relation in terms of sexual victimization among women, focusing on three potential mediators: perceived control over sexual assault, perceived similarity to a typical sexual assault victim, and psychological distress. Mediational analyses were investigated using structural equation modeling. Although victimization experience was not related to comparative risk perception, it was associated with greater personal risk perception. This relation was mediated by perceived similarity to a typical sexual assault victim. Prospective analyses indicated that personal risk perception does change in response to sexual victimization but also indicated that heightened risk perception may be an accurate assessment of risk that actually precedes victimization experience. Implications for the meaning of perceived similarity and perceptions of risk for sexual assault victims are discussed.     

An extended comparator hypothesis account of superconditioning

Three conditioned taste aversion experiments with rats investigated superconditioning. In each experiment, alternate exposures of 2 flavor compounds with a common element (i.e., AB/AS) were administered to establish an inhibitory relationship between the 2 unique elements, B and S, and prior to testing, S was paired with lithium chloride (LiCl). In Experiment 1, pairings of a neutral cue (X) with S in compound with B after the AB/AS exposures resulted in superconditioning between X and S. Extinction of the common element (A) just before the S-LiCl pairing attenuated both the inhibitory relationship between B and S (Experiment 2) and superconditioning between X and S (Experiment 3). These observations suggest that superconditioning consists of enhanced performance rather than enhanced associative acquisition.     

Competition between antecedent and between subsequent stimuli in causal judgments

In the analysis of stimulus competition in causal judgment, 4 variables have been frequently confounded with respect to the conditions necessary for stimuli to compete: causal status of the competing stimuli (causes vs. effects), temporal order of the competing stimuli (antecedent vs. subsequent) relative to the noncompeting stimulus, directionality of training (predictive vs. diagnostic), and directionality of testing (predictive vs. diagnostic). In a factorial study using an overshadowing preparation, the authors isolated the role of each of these variables and their interactions. The results indicate that competition may be obtained in all conditions. Although some of the results are compatible with various theories of learning, the observation of stimulus competition in all conditions calls for a less restrictive reformulation of current learning theories that allows similar processing of antecedent and subsequent events, as well as of causes and effects.     

Adolescent Suicidality: Who Will Ideate,Who Will Act?

Responses to the 1999 Youth Risk Behavior Survey including suicide ideation, attempt, medically treated attempt, and six problem behaviors were analysed. Youth across the spectrum ideated. Overwhelmingly, the 17% of youth with more than three problem behaviors were the youth who acted; they accounted for 60% of medically treated suicidal acts. Compared to adolescents with zero problem behaviors, the odds of a medically treated suicide attempt were 2.3 times greater among respondents with one, 8.8 with two, 18.3 with three, 30.8 with four, 50.0 with five, and 227.3 with six. A count of problem behaviors offers a reliable way to identify suicide risk.