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.     

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.     

‘Hope givers’? A scoping review of new media and mental health in 27 Australian Christian organisations

This article explains a range of conceptual and methodological innovations in the use of new media for the clinical practice and public communication of mental health. Building on two current contexts – the emerging research area of new media and mental health, and major reform of the mental health system in Australia – this article presents a scoping review of the online communication of Christian organisations that offer mental health care in Australia. This article compares the websites of 27 Australian Christian mental health organisations, analysing these organisations’ configurations of mainstream and religious modalities of mental health care, their discursive and visual communication strategies, as well as their use of social media platforms.     

Computational model of enactive visuospatial mental imagery using saccadic perceptual actions

From the onset of cognitive revolution, the concept of mental imagery has been given different, many times opposing, theoretical accounts. Mental imagery appears to be a ubiquitous, yet wholly individual, easy to explain experience on the one hand, being hard to deal with scientifically on the other hand. The focus of this research is on an enactive approach to visuospatial mental imagery, inspired by Sima’s perceptual instantiation theory. We designed a hybrid computational model, composed of a forward model, an inverse model, both implemented as neural networks, and a memory/controller module, that grounds simple mental concepts, such as a triangle and a square, in perceptual actions, and is able to reimagine these objects by performing the necessary perceptual actions in a simulated humanoid robot. We tested the model on three tasks – salience-based object recognition, imagination-based object recognition and object imagination – and achieved very good results showing, as a proof of concept, that perceptual actions are a viable candidate for grounding the visuospatial mental concepts as well as the credible substrate of visuospatial mental imagery.     

从表征和认知过程上看表象与知觉、记忆的关系

表象、知觉和记忆是一个整合的认知系统。由于知觉和记忆提供了表象生成的材料,因而三者共享相似的表征,并激活广泛而相似的脑区。然而在认知加工过程上三者存在一定的差异。与知觉相比,表象的编码方式更抽象、更依赖过去经验的参与且处理细节能力更弱;与记忆相比,表象更容易受无关信息的干扰。未来对三者关系的研究应关注不同来源和不同类型的表象与知觉、记忆之间的关系,以及工作记忆在三者关系中所起的作用。     

Ecological Networks and Community Attachment and Support Among Recently Resettled Refugees

Interventions aimed at enhancing mental health are increasingly centered around promoting community attachment and support. However, few have examined and tested the specific ecological factors that give rise to these key community processes. Drawing from insights from the ecological network perspective, we tested whether spatial and social overlap in routine activity settings (e.g., work, school, childcare) with fellow ethnic community members is associated with individuals’ attachment to their ethnic communities and access to social resources embedded in their communities. Data on routine activity locations drawn from the Refugee Well‐Being Project (based in a city in the Southwestern United States) were used to reconstruct the ecological networks of recently resettled refugee communities, which were two‐mode networks that comprise individuals and their routine activity locations. Results indicated that respondents’ community attachment and support increased with their ecological network extensity—which taps the extent to which respondents share routine activity locations with other community members. Our study highlights a key ecological process that potentially enhances individuals’ ethnic community attachment that extends beyond residential neighborhoods.