Use of Psychiatric Medications in Juvenile Detention Facilities and the Impact of State Placement Policy

The use of psychotropic medications is a significant factor in the overall effort to respond to detained youth with mental illness, yet there are very few studies of psychotropic medication use in juvenile detention settings. It is important to understand the factors that influence the use of mental health services and psychoactive medications in these settings since youth with emotional problems are overrepresented in them. This paper addresses the proportion of youth in these settings who receive mental health services and psychoactive medications. In addition, the impact of a major statewide policy change—the shift of juvenile placement responsibility from the state to local government—on these proportions was examined using 8 years of publicly available data from county probation departments. Multivariate regression analyses of 1,760 observations of quarterly reports from 55 counties showed that the use of both mental health services and psychoactive medications in detention facilities increased concurrently with the policy change. While these proportions had already been gradually increasing in these facilities, it appears that after the policy change they increased even more. This contradicts the aim of most juvenile justice planners—to divert non-violent youth offenders with emotional problems away from incarceration settings and towards community based treatment alternatives. If adequately available, these support services could provide diversion alternatives to prevent inappropriate detentions, and to provide post-detention treatment to prevent lapses in continuity of care and, ultimately, to prevent reoffending.     

Grandiose Narcissism Predicts Willingness to Behave Badly,Without Proportional Tolerance for Others’ Bad Behavior

Narcissists characteristically behave badly; our study investigated how they respond to experiencing others’ bad behavior. After completing the Narcissistic Personality Inventory, a measure of grandiose narcissism, participants reported their willingness to engage in different inconsiderate or unethical common behaviors. Then they reported how bothered they would feel in response to experiencing each of the same bad behaviors—perpetrated by someone else. Participants overall reported feeling bothered by others’ bad behavior, but narcissism was unrelated to intolerance judgments. Narcissists are often highly reactive when their inflated self-views are challenged, but our study suggests that narcissists are not uniquely bothered by everyday minor offenses. However, when viewed from a different angle, narcissists’ level of intolerance could be interpreted as unjustly high, because they reported more willingness to engage in behavior that could bother others, yet did not show proportional tolerance for others’ bothersome behavior.     

A Puzzle Concerning Gratitude and Accountability

P.F. Strawson’s account of moral responsibility in “Freedom and Resentment” has been widely influential. In both that paper and in the contemporary literature, much attention has been paid to Strawson’s account of blame in terms of reactive attitudes like resentment and indignation. The Strawsonian view of praise in terms of gratitude has received comparatively little attention. Some, however, have noticed something puzzling about gratitude and accountability. We typically understand accountability in terms of moral demands and expectations. Yet gratitude does not express or enforce moral demands or expectations. So, how is it a way to hold an agent accountable? In a more general manner, we might ask if there is even sense to be made of the idea that agents can be accountable—i.e., “on the hook”—in a positive way. In this paper, I clarify the relationship between gratitude and moral accountability. I suggest that accountability is a matter of engaging with others in a way that is basically concerned with their feelings and attitudes rather than solely a matter of moral demands. Expressions of gratitude are a paradigmatic form of this concerned engagement. I conclude by defending my view from the objection that it leads to an overly generous conception of holding accountable and suggest in reply that moral responsibility skeptics may not help themselves to as many moral emotions as they might have thought.

     

Jung's Erotic Phenomenology: I. A New Translation

In the introduction to The Psychology of the Transference (1946), Carl Jung sketched out a theory of “erotic phenomenology” which condenses his teaching about sexuality and romantic love into a very concise summary. But the meaning of this passage is obscured in the English translation given in the Collected Works of C. G. Jung. I propose here a new translation which makes Jung’s meaning clearer, along with a commentary which explains it in the context of Freudian drive theory and German 19^th century philosophy. Invoking the concepts of instinct, mind, and Eros (both the passion and the divine figure), Jung’s theory says that male sexual desire can be cultivated or repressed in four distinct ways, each associated with a female symbolic figure or anima image: Eve, Helen, Mary and Sophia.     

Perceptions and use of empirically-supported psychotherapies among eating disorder professionals

Despite growing support for the dissemination of empirically-supported treatments (ESTs), treatment providers have been slow to take up using ESTs. This study explored eating disorders (EDs) professionals' views of empirical support for psychotherapies for EDs and the role of empirical evidence in ED treatment selection. We distributed a web-based survey to members of two international organizations of ED practitioners and researchers; 402 members (32.7%) were eligible and participated. Most providers reported they used ESTs in treating EDs, but these ESTs were often folded into eclectic approaches rather than used in forms that had been evaluated in research trials. Use of ESTs and perceptions of empirical support for psychotherapies differed between participants who were and were not recently involved in research. We conclude that perceptions of available research evidence may be important to target in efforts to increase the uptake of ESTs in clinical practice and to help close the research-practice gap.     

A brief assessment tool for body image in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) may adversely affect body image in multitude ways. Development and validation of a brief and valid SLE specific body image tool were undertaken. Eleven items were identified on interview of 21 SLE patients for the Body Image Lupus Scale (BILS v1.0). The tool was administered to 70 SLE patients. Based on analysis, feedback, and refinement of items, the final iteration BILS v1.2 with five items was administered to 233 SLE patients along with validated body image measures (Situational Inventory of Body Image Dysphoria and Body Image Quality of Life Inventory) and health-related quality of life measures for a subsample. The BILS scores' had an internal consistency reliability of .94. It correlated with both the referent body image measures, and with health-related quality of life. It differentiated participants by health status and disease activity. Test-retest reliability estimates exceeded .90. These results support the psychometric properties of BILS.