Profession Differences in Family Focused Practice in the Adult Mental Health System

There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross‐sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices.     

Race-Related Differences in the Experiences of Family Members of Persons with Mental Illness Participating in the NAMI Family to Family Education Program

Families play an important role in the lives of individuals with mental illness. Coping with the strain of shifting roles and multiple challenges of caregiving can have a huge impact. Limited information exists regarding race-related differences in families’ caregiving experiences, their abilities to cope with the mental illness of a loved one, or their interactions with mental health service systems. This study examined race-related differences in the experiences of adults seeking to participate in the National Alliance on Mental Illness Family-to-Family Education Program due to mental illness of a loved one. Participants were 293 White and 107 African American family members who completed measures of problem- and emotion-focused coping, knowledge about mental illness, subjective illness burden, psychological distress, and family functioning. Multiple regression analyses were used to determine race-related differences. African American caregivers reported higher levels of negative caregiving experiences, less knowledge of mental illness, and higher levels of both problem-solving coping and emotion-focused coping, than White caregivers. Mental health programs serving African American families should consider targeting specific strategies to address caregiving challenges, support their use of existing coping mechanisms and support networks, and increase their knowledge of mental illness.     

Leveraged Resources and Systems Changes in Community Collaboration

Most models of community collaboration emphasize the ability of diverse partners to come together to enact systematic changes that improve the health of individuals and communities. The ability of these groups to leverage resources is thought to be an important marker of successful collaboration and eventual improvements in community health. However, there is a paucity of research addressing linkages between systems change activities and leveraged resources. This study used a sample of collaboratives (N = 157) that received technical assistance and funding through the Georgia Family Connection Partnership (GaFCP) between 2006 and 2007. Data were collected from collaborative report of activities and funding, member ratings of collaborative functioning, and characteristics of the communities served by the collaboratives drawn from US Census data. Cross-lagged regression models tested longitudinal associations between systems change activities and leveraged dollars. The results indicated that systems change activities predict increased leveraging of resources from state/federal and private partners. However, there was no evidence that systems changes were linked with leveraging resources from local groups and agencies. These findings have important implications for providing technical assistance and training to health partnerships. Furthermore, future research should consider the relative strength of different systems change activities in relation to the ability of coalitions to leverage resources.     

Axis I anxiety and mental health disorders among stuttering adolescents

PurposeThe purpose of this study was to evaluate anxiety and psychological functioning among adolescents seeking speech therapy for stuttering using a structured, diagnostic interview and psychological questionnaires. This study also sought to determine whether any differences in psychological status were evident between younger and older adolescents.MethodParticipants were 37 stuttering adolescents seeking stuttering treatment. We administered the Computerized Voice Version of the Diagnostic Interview Schedule for Children, and five psychometric tests. Participants were classified into younger (12–14 years; n = 20) and older adolescents (15–17 years; n = 17).ResultsThirty-eight percent of participants attained at least one diagnosis of a mental disorder, according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; APA, 2000), with the majority of these diagnoses involving anxiety. This figure is double current estimates for general adolescent populations, and is consistent with our finding of moderate and moderate–severe quality of life impairment. Although many of the scores on psychological measures fell within the normal range, older adolescents (15–17 years) reported significantly higher anxiety, depression, reactions to stuttering, and emotional/behavioral problems, than younger adolescents (12–14 years). There was scant evidence that self-reported stuttering severity is correlated with mental health issues. There are good reasons to believe these results are conservative because many participants gave socially desirable responses about their mental health status.DiscussionThese results reveal a need for large-scale, statistically powerful assessments of anxiety and other mental disorders among stuttering adolescents with reference to control populations.Educational Objectives: The reader will be able to: (a) explain the clinical importance of assessing for mental health with stuttering adolescents, (b) state the superior method for adolescent mental health assessment and (c) state a major issue with determining the genuineness of stuttering adolescent responses to psychological assessment.     

The Effects of Prior Learned Strategies on Updating an Opponent's Strategy in the Rock,Paper, Scissors Game

To explore how model building adapts to changing environments, we had participants play “rock‐paper‐scissors” against a computer that played a frequency bias or a player‐dependent bias and then switched. Participants demonstrated their use of prior experience in how quickly they recognized and exploited changes in the computer's play strategy; in general, the more similar the strategies, the more efficient the updating. These findings inform our understanding of previously reported updating impairments in right‐brain damaged patients.     

Psychopaths and blame: The argument from content

The recent debate over the moral responsibility of psychopaths has centered on whether, or in what sense, they understand moral requirements. In this paper, I argue that even if they do understand what morality requires, the content of their actions is not of the right kind to justify full-blown blame. I advance two independent justifications of this claim. First, I argue that if the psychopath comes to know what morality requires via a route that does not involve a proper appreciation of what it means to cause another harm or distress, the content of violations of rules against harm will be of a lower grade than the content of similar actions by normal individuals. Second, I argue that in order to intend a harm to a person—that is, to intend the distinctive kind of harm that can only befall a person—it is necessary to understand what personhood is and what makes it valuable. The psychopath's deficits with regard to mental time travel ensure that s/he cannot intend this kind of harm.     

Problematic,absent and stigmatizing diagnoses in current mental disorders classifications: Results from the WHO-WPA and WHO-IUPsyS Global Surveys

This study examined English- and Spanish-speaking psychologists’ and psychiatrists’ opinions regarding problematic, absent and stigmatizing diagnoses in current mental disorders classifications (ICD-10 and DSM-IV), and their perceived need for a national classification of mental disorders. Answers to open-ended questions included in WHO-WPA and WHO-IUPsyS surveys were examined using an inductive content-analysis method. A total of 3,222 participants from 35 countries were included. The most problematic diagnostic group was personality disorders, especially among psychiatrists, because of poor validity and lack of specificity. Complex posttraumatic stress disorder was the most frequent diagnosis suggested for inclusion, mainly by psychologists, to better account for the distinct processes and consequences of complex trauma. Schizophrenia was the diagnosis most frequently identified as stigmatizing, particularly by psychiatrists, due to lack of public understanding or knowledge about the diagnosis. Of the 14.4% of participants who perceived a need for a national classification system, two-thirds were from Africa or Latin America. The rationales provided were that mental disorders classifications should consider cultural and socio-historical diversity in the expression of psychopathology, differences in the perception of what is and is not pathological in different nations, and the existence of culture-bound syndromes. Implications for ICD-11 development and dissemination are discussed.     

Travailler dans un réseau de santé : effets sur la santé psychique au travail

The new needs as regards care taking charge of patients have contributed to the creation of health networks. As they are growing fast, they are an integral part of the French sanitation system. The impact, on the health professionals, of networking is, today, the object of contrasted research and results, but has little been studied as far as Social Psychology, Work and Organizations are concerned. This article follows a research project which had the objective, on the one hand, to describe the effects of the participation to a health network mental health at work and, on the other hand, to examine the variables and process accounting for the variability of these effects. This research privileges an approach to the health network as a place of socialization and personalization (Malrieu, 1979). The research on the ground is carried out in collaboration with the health network town-hospital Prevention and Taking charge of Pediatric Obesity Network (RéPPOP) Midi-Pyrénées. We have carried out semi-guided interviews with 20 private professionals (8 doctors, 8 dieticians, 3 psychologists, 1 physiotherapist) members of the RePPOP Midi-Pyrénées network. The main results show that the perception of positive and/or negative effects of networking on mental health varies according to the age of membership of the network and the processes of transfer of experience (from professional practice within the network to professional practice off-network and vice versa). Proposals are deduced in terms of continuing education within the network.     

Secret médical en santé au travail

The occupational physicians are obliged, like any doctor, to respect the ethical obligations imposed on their profession, including in the exercise of the missions specific to occupational medicine and contained in the Labor Code. The occupational physician is not isolated and works in a multidisciplinary team of a health service at work. He must communicate with other health professionals, but also with employers, representative bodies of staff. Medical confidentiality holds a special place in the triangular relationship between the occupational physician, the employee and the employer. The medical practice in the field of occupational health requires that many provisions of the Labor Code be followed, including the respect of the secret of manufacture and the position of advising employers and employees. The occupational physician must communicate with the employer in order to best achieve his mission, but in practice, it may be difficult for the occupational doctor to make his recommendations heard to improve the working conditions of employees without power, when he cannot argue his opinions on medical information.     

Stress perçu et santé physique des doctorants dans les universités françaises

Few studies have focused on PhD students in France despite the fact that this population appears to be particularly vulnerable to stress and often faces precariousness. This research investigated associations between socio-demographic factors, health behaviours, perceived stress and physical health in a wide sample of PhD students (n = 1923) in order to have a better understanding of this population's specificities. Our results indicated that stress is a critical issue among PhD candidates. Predictors of perceived stress were: gender, age, satisfaction with supervision, sleep quality and sports practice. Findings from this study confirm the relevance of the transactional model to investigate students’ health issues and suggest that physical activity and stress management should be encouraged through health promotion programs.