Aetiology of Coexisting Mental Health and Alcohol and Other Drug Disorders: Perspectives of Refugee Youth and Service Providers

In the general population, people with comorbid mental health (MH) and alcohol and other drug (AOD) disorders (comorbidity) have great difficulty accessing appropriate services, and poor outcomes. Little is known about comorbidity in resettled refugees in Australia. This study was designed to identify risk factors and patterns of comorbidity development in young people from refugee backgrounds living in a disadvantaged urban region of Adelaide, South Australia. This qualitative study utilised in‐depth semi‐structured interviews (n = 30) with resettled refugee youth and workers from MH, AOD, and refugee support services. Thematic analyses were conducted to investigate the aetiology of MH and AOD disorders in young refugees. Interviews with both groups revealed how the interrelated nature of risk factors may place young people from refugee backgrounds at heightened risk of experiencing MH and AOD problems. The situations and conditions described by both groups are discussed under six main themes: pre‐migration experiences of torture and trauma; familial factors of intergenerational conflict; post‐migration adjustment difficulties in terms of language, culture, education, and employment; exposure to and availability of substances; maladaptive coping strategies and self‐medication; and access to information and services. Implications for psychologists and MH professionals are identified, emphasising the need for clinicians to understand the complexities surrounding the aetiology of comorbidity in these youth. The initial assessment needs to be comprehensive, including pre‐ and post‐settlement experiences and cultural and family dimensions of their current situation. Treatment may often need to simultaneously address multiple contributing factors and involve culturally sensitive psycho‐education.     

Kant's Argument that Existence is not a Determination

In this paper, I examine Kant's famous objection to the ontological argument: existence is not a determination. Previous commentators have not adequately explained what this claim means, how it undermines the ontological argument, or how Kant argues for it. I argue that the claim that existence is not a determination means that it is not possible for there to be non‐existent objects; necessarily, there are only existent objects. I argue further that Kant's target is not merely ontological arguments as such but the larger ‘ontotheist’ metaphysics they presuppose: the view that God necessarily exists in virtue of his essence being contained in, or logically entailed by, his essence. I show that the ontotheist explanation of divine necessity requires the assumption that existence is a determination, and I show that Descartes and Leibniz are implicitly committed to this in their published versions of the ontological argument. I consider the philosophical motivations for the claim that existence is a determination and then I examine Kant's arguments in the Critique of Pure Reason against it.     

Targeted Prevention of Childhood Anxiety: Engaging Parents in an Underserved Community

Selective prevention programs hold the promise of alleviating child anxiety symptoms, decreasing the risk for emotional problems across the lifespan. Such programs have particular public health import for young children of poor, underserved communities. Identifying factors related to parent engagement, and methods to improve engagement, are paramount in the effort to develop anxiety‐focused, community prevention programs. This feasibility study investigated the effect of an enhanced recruitment strategy to maximize parent engagement, as well as factors related to attendance in a single session focused on anxiety prevention. Participants were poor, ethnic minority parents of children aged 11–71 months (n = 256) who completed a survey that assessed anxiety risk according to trauma exposure, child anxiety, or parent anxiety, as well as preferences for preventive services (phase 1). Those meeting risk criteria (n = 101) were invited to a preventive group session (phase 2). Half of parents received enhanced recruitment (ER), which included personalized outreach, matching parent preferences, and community endorsement. Other parents were invited by mail. Chi square analyses indicated that ER was associated with planning to attend (49 vs. 6 % of control). Parents receiving ER were 3.5 times more likely to attend. Higher sociodemographic risk was correlated with higher child anxiety symptoms but not attendance. Results highlight the need for improved strategies for engaging parents in preventive, community‐based interventions.     

The Low and Narrow: A Preliminary Test of the Association Between Depressive Symptoms and Deficits in Producing Divergent Inferences

Depression is associated with biased interpretations and beliefs that are resistant to change. This kind of cognitive rigidity may depend on two distinct factors—a reduced ability for processing information that conflicts with these interpretations and beliefs and a reduced ability for generating alternative representations. Although depressive symptoms are typically not associated with deficits in common divergent thinking tasks, these tasks may not be sensitive or specific enough to detect the rigid cognition associated with depression. Accordingly, a novel task was developed to assess divergent thinking in line with the level of construal and thematic contents typical of depressive cognition (the Divergent Inference Task—DIT). In a preliminary investigation using a nonclinical sample, depressive symptoms were correlated with deficits in producing divergent interpretations for realistic scenarios using the DIT. This finding may represent an important psychological mechanism that contributes to the persistence of biased interpretations and beliefs in depression.