Reviewers for Special Issue

Objective: An enhanced stress and coping model was used to explain depression among HIV‐positive women in healthcare and community settings where highly active anti‐retroviral treatment (HAART) was commonplace. Method: HIV‐infected women in four cities (N=978) were assessed, cross‐sectionally, for mental and physical health, stress, social support, and other background factors. Results: Self‐reported level of depressive symptomatology was high. Number of physical symptoms, illness intrusiveness, and perceived stress were positively associated with depressed mood, while coping self‐efficacy and social support were negatively associated. Stress mediated the effect of health status on depression and coping self‐efficacy mediated the effect of psychosocial resources on depression. Our enhanced stress and coping model accounted for 52% of variance in depressive symtpomatology. Conclusions: Interventions focused on improving coping self‐efficacy, bolstering social supports, and decreasing stress in the lives of HIV‐positive women may help to reduce the negative effects of HIV disease on mood.     

Cumulative psychosocial and medical risk as predictors of early infant development and parenting stress in an African-American preterm sample

The present study examined predictive linkages between cumulative psychosocial and medical risk, assessed neonatally, and infant development and parenting stress at 4 months of infant corrected age. Predominantly low-income, African-American mothers and their preterm infants served as participants. Cumulative psychosocial risk predicted early mental, but not motor development, while cumulative medical risk predicted both mental and motor development. Cumulative psychosocial risk, but not medical risk, predicted parenting stress. Few studies of preterm infants have reported links between cumulative psychosocial risk and infant development at such an early age, nor has earlier work found associations between cumulative psychosocial risk and mothers' perceptions of parenting. Results support the premise that early intervention should target both the medical and psychosocial needs of low-income families with preterm infants, and that addressing psychosocial stressors shortly after birth may improve developmental outcomes in infancy.     

“Almost There”...Why Clients Fail to Engage in Family Therapy: An Exploratory Study

A great deal of clinical research has sought to describe and suggest remedies for the client dropout phenomenon. However, few studies have addressed the equally pervasive, yet often ignored, non-engagement problem. An exploratory study was conducted to understand why many clients fail to engage in family therapy services after they have completed the initial intake. The results of the study suggest that therapist gender and experience level, clinic policies regarding videotaping sessions, family concerns, and changes in the presenting problem prior to the first session, had an impact on potential clients’ decision to engage in therapy. Implications and future research are discussed.Meng-ning Wang, MA, a doctoral student, and Jonathan Sandberg, PhD, a faculty member in the Marriage and Family Therapy Program at Syracuse University at Syracuse University are co-first authors. Amy Zavada, MA, Tziporah Rosenberg, MA, Aaron Jeffrey, MA, and Justin McPheters, MA, are doctoral students, and Mona Mittal, PhD, and Anne Gosling, PhD, are faculty in the same program.     

Health Locus of Control After Lung Transplantation: Implications for Managing Health

Health locus of control (HLC) beliefs may influence the health behaviors that patients perform on their own behalf. Likewise, the HLC beliefs that clinicians consider desirable may influence how active they encourage patients to be in managing health. It remains unclear how involved lung recipients want to be and how involved transplant clinicians believe they should be. The aims of this study were to describe HLC beliefs and behaviors manifested by recipients and clinicians in the setting of lung transplantation. Mixed-methods were used, including quantitative techniques to measure demographics, clinical characteristics, and HLC using the Multidimensional Health Locus of Control Scale (MHLC), and qualitative techniques to explore how HLC beliefs were manifest in the clinical setting. Nearly all participants manifested behaviors consistent with high internality and externality, highlighting the importance of holding ‘dual health locus of control’ beliefs for optimal health management and lending support for recipients and clinicians to share responsibility for managing post-transplant health.Funded by the Nursing & Social Sciences Council of the International Society of Heart and Lung Transplantation.     

Evolution of an Inpatient Pediatric Psychology Consultation Service: Issues Related to Reimbursement and the Use of Health and Behavior Codes

The purpose of this study was to evaluate an inpatient pediatric psychology consultation service, with particular focus on issues related to financial reimbursement for services. Information was gathered over a four year period (2001–2005) regarding number of consults, referral source and referral question, type of insurance, and reimbursement rates for health and behavior codes versus mental health codes. The financial impact of hiring an insurance verification specialist was also explored. Results indicated that reimbursement rates for health and behavior codes were higher than reimbursement rates for mental health codes. Health and behavior codes were rejected in 31% of cases that they were billed; the primary reason for rejection was that these codes were not a covered service by Medicaid. Hiring an insurance verification specialist was found to be a cost-effective method for improving the financial “bottom-line” for psychology services. Implications for practice are discussed.     

Development of a Biomedical Program of Research in the Blackfeet Community: Challenges and Rewards

American Indian (AI) communities have high levels of stress and trauma and are disproportionately affected by numerous preventable diseases. Here, we describe an academic–community partnership based on a collaboration between Blackfeet Community College students and faculty in Psychology and Immunology at Montana State University (MSU). The collaboration, which has spanned over 5 years, was sparked by community interest in the relationship between stress and disease on the Blackfeet reservation. Specifically, community members wanted to understand how the experience of psychological stress and trauma may affect disease risk in their community and identify factors that promote resilience. In doing so, they hoped to identify pathways through which health could be improved for individual community members. Here, we discuss all stages of the collaborative process, including development of measures and methods and themes of research projects, challenges for community members and non‐indigenous collaborators, future directions for research, and the lessons learned. Finally, we note the ways in which this partnership and experience has advanced the science of community engagement in tribal communities, with the hope that our experiences will positively affect future collaborations between indigenous community members and non‐indigenous scientists.     

Visual imagery: The past and future as seen by patients with Alzheimer’s disease

We investigated visual imagery for past and future thinking in Alzheimer’s Disease (AD). We invited AD patients and controls to retrieve past events and to imagine future events. Participants also provided a “Field” response if they see the event through their own eyes, or an “Observer” response if they see themselves in the scene as a spectator would. Less “Field” and more “Observer” responses were observed in AD participants than in controls during past and future thinking, suggesting a diminished ability to mentally visualize past and future events in AD. Results also demonstrated significant positive correlations between the production of “Field” responses and specificity during past and future thinking, suggesting a relationship between the ability to mentally visualize past and future events and autobiographical overgenerality in AD.     

Contentieux des professionnels de santé avec les caisses d’assurance maladie

This article examines current case law, emanating from the Cassation Court and the Courts of Appeal, and extending over the period from September 2018 to March 2019.     

Art-Making and its Interface With Dissociative Identity Disorder: No Words That Didn’t fit

Studies point to promising developments in expressive arts therapy work with clients who experience dissociation as one of a constellation of symptoms of trauma. Individuals diagnosed with Dissociative Identity Disorder, however, may be hesitant to engage with long-term therapy and its relationship. This article presents the case of one such individual, a participant in a narrative phenomenological study who was able to develop her own visual art-making practice. Reflections on this practice revealed that it offered a safe place for her to explore the voice of her “parts” hitherto silenced. Her narrative has implications for professionals working in the expressive and talking therapies.     

ICD-11 guidelines for psychotic,mood, anxiety and stress-related disorders in Mexico: Clinical utility and reliability

Background/Objective: The World Health Organization's diagnostic guidelines for ICD-11 mental and behavioural disorders must be tested in clinical settings around the world to ensure that they are clinically useful and genuinely global. The objective is evaluate the inter-rater reliability and clinical utility of ICD-11 guidelines for psychotic, mood, anxiety- and stress-related disorders in Mexican patients. Method: Adult volunteers exhibiting the selected symptoms were referred from the pre-consultation unit of a public psychiatric hospital to an interview by a pair of clinicians, who subsequently assigned independent diagnoses and evaluated the clinical utility of the diagnostic guidelines as applied to each particular case, on the basis of a scale developed for this purpose. Results: 23 clinicians evaluated 153 patients. Kappa scores were strong for psychotic disorders (.83), moderate for stress-related (.77) and mood disorders (.60) and week for anxiety and fear-related disorders (.43). A high proportion of clinicians considered all diagnostic guidelines to be quite to extremely useful as applied to their patients. Conclusions: ICD-11 guidelines for psychotic, stress-related and mood disorders allow adequate inter-rater consistency among Mexican clinicians, who also considered them as clinical useful tools.