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.     

From “4Rs and 2Ss” to “Amaka Amasanyufu” (Happy Families): Adapting a U.S.-based Evidence-Based Intervention to the Uganda Context

In Uganda, one in five children presents mental health challenges, including disruptive behavior disorders (DBDs). DBDs can persist through adulthood and result in negative outcomes. Effective interventions for DBDs have been developed and tested in high-poverty communities in developed countries. Yet, most African countries, such as Uganda, lack such interventions. This paper describes the adaptation process of an evidence-based intervention of U.S. origin to optimize fit to context with intervention fidelity, as part of a randomized trial conducted with youth that exhibit behavioral challenges and their caregivers in 30 schools in Uganda. The process involved: initial meetings with headteachers and teachers to introduce the study and the main concepts of the intervention; initial manual review focusing on 4Rs and 2Ss content by the Uganda team; engagement of community stakeholders for additional feedback on content and cultural relevance; final revision of the manual; and collection of children’s drawings for the illustration of the manual. This paper describes both similarities and differences between the original and adapted intervention content and methods of delivery. The findings also highlight the importance of involving community stakeholders in the adaptation process.     

Mind,brain and body. Healing trauma: the way forward

The paper explores an interdisciplinary whole person approach to healing from trauma that conserves our rich inheritance from Jung but also takes on board insights from research in the areas of attachment, trauma and the neurobiology of emotion. It is now over 20 years since insights from neurobiology began to be used to inform clinical practice. The paper reviews key insights which have emerged, along with the ways they enable therapists to help mind, brain and body to heal and the ways in which they clarify why, in clinical practice, we do what we do. Traditionally the emphasis has been on words, interpretations, and meaning‐making. Currently there is greater appreciation of the affective, relational, embodied aspects of therapeutic work and the way in which these relate to traumatic early interactive experience that is held outside of human awareness. The ways in which knowledge of particular systems of connectivity inform understanding of the whole mind‐brain‐body relationship are examined. The way forward for clinical practice to become more focused in order to help clients to heal in mind and body is reviewed.     

The Associations between Mothers’ and Grandmothers’ Depressive Symptoms,Parenting Stress,and Relationship with Children: An Actor–Partner Interdependence Mediation Model

Three-generation households that include parents and grandparents raising children together have become increasingly common in China. This study examined the relations among depressive symptoms, parenting stress, and caregiver–child relationships in the mother–grandmother dyadic context. Participants were mothers and grandmothers from 136 three-generation households. Results from Actor–Partner Interdependence Mediation Modeling indicated that mothers’ depressive symptoms were indirectly related to mother–child conflict/closeness through own parenting stress; grandmothers’ depressive symptoms were indirectly related to grandmother–child conflict through own parenting stress. Mothers’ depressive symptoms were indirectly related to grandmothers’ conflict with children through grandmothers’ parenting stress, and grandmothers’ depressive symptoms were indirectly related to mothers’ conflict/closeness with children through mothers’ parenting stress. The relation between mothers’ parenting stress and mother–child closeness was stronger than the relation between grandmothers’ parenting stress and grandmother–child closeness. Findings highlight the implications of using a family system perspective and the dyadic approach in understanding and improving family functioning in Chinese three-generation households.     

Validación de la versión española del Child Abuse Potential Inventory

Resumen

Este estudio tuvo como objetivo realizar la adaptación y validación del Child Abuse Potential Inventory para su utilización en España. El Inventario CAP fue diseñado para evaluar el riesgo potencial que presenta un sujeto para perpetrar acciones de maltrato físico infantil. Consta de 160 items, agrupados en cuatro escalas: Abuso, Deseabilidad Social, Respuesta al Azar e Inconsistencia. Tras varios estudios preliminares en España, se procedió a su validación, aplicándolo a una muestra de 920 sujetos. La Escala de Respuesta al Azar fue modificada y quedó constituida por 12 items. La Escala de Deseabilidad Social, quedó compuesta por 10 items. Para realizar la validación de la Escala de Abuso se crearon dos grupos emparejados en las variables sociodemográficas: maltratadores físicos y población general. Se seleccionaron 73 items que discriminaban de manera estadísticamente significativa entre ambos grupos. Los análisis de regresión logística realizados con esta Escala de 73 items proporcionan porcentajes de clasificación correcta del 92.4%. Las puntuaciones directas de esta Escala proporcionan un porcentaje de clasificación correcta de sujetos maltratadores físicos y sujetos de la población general del 84.1%.     

Cómo predecir a algunas personas en algunas ocasiones: la búsqueda de consistencias transituacionales en la conducta

RESUMEN

La controversia, históricamente repetida, sobre la existencia de consistencias transituacionales er la conducta se mantiene debido a la discrepancia entre nuestras intuiciones, que afirman su existencia, y la investigación, que la niega. Se argumenta que los supuestos nomotéticos del paradigma tradicional de investigación son incorrectos y que, adoptando algunos de los supuestos indiográficos empleados en nuestras intuiciones, se pueden obtener mayores coeficientes de correlación transituacionales. Sepresenta un estudio que muestra que es posible identificar a priori a los individuos que serán consistentes tran- situacionalmente y aquellos que no lo serán, y se concluye que la evaluación de la personalidad debe atender no sólo a las situaciones—como recientemente se ha insistido—sino también a las personas.     

El lugar de la interferencia en la percepción de estímulos simultáneos

RESUMEN

En una amplia variedad de tareas de detección de objetivos auditivos y visuales, la ejecución era escasamente influida por el número de no-objetivos simultáneos, pero le afectaba si los objetivos simultáneos debían ser detectados por separado. Se ha sugerido que sólo los objetivos necesitan pasar por un sistema de capacidad limitada que conduce a la conciencia; los no-objetivos pueden ser identificados y rechazados por un procesamiento paralelo e inconsciente. Puesto que las palabras no- objetivo, por ejemplo, se pueden rechazar en base al significado, el estímulo debe ser completamente analizado antes de pasar por el sistema de capacidad limitada. De modo general, la disminución en la ejecución debida a la atención dividida es acusada siempre que la estimulación simultánea (psicofísica, verbal, etc.) se deba identificar por separado, puesto que bajo estas circunstancias cualquier estimulación debe pasar por un sistema de capacidad limitada hasta la conciencia.     

DC:0–5: DIAGNOSTIC CLASSIFICATION OF MENTAL HEALTH AND DEVELOPMENTAL DISORDERS OF INFANCY AND EARLY CHILDHOOD

The significant growth in the clinical literature on early childhood psychopathologysince the publication of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Zero to Three–Revised (DC:0–3R; ZERO TO THREE) in 2005 necessitated substantial revisions to the manual, which resulted in the publication of the DC:0–5: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Zero to Five (ZERO TO THREE) in 2016. In addition to the decision to extend the early childhood diagnoses to include children through age 5 years, significant revisions were made to many diagnoses, and new diagnostic categories were added such as the Relationship Specific Disorder of Infancy/Early Childhood. Other additions, such as guidance for the development of a Cultural Formulation for the young child and his or her family and the inclusion of functional impairment criteria also contribute to making the DC: 0–5a substantially more comprehensive and robust diagnostic framework than its predecessor.     

MATERNAL SELF‐REPORTED DEPRESSIVE SYMPTOMS AND MATERNAL CORTISOL LEVELS INTERACT TO PREDICT INFANT CORTISOL LEVELS

Three basic findings have emerged from research on maternal depressive symptoms and offspring hypothalamic–pituitary–adrenal functioning: (a) Mothers’ depressive symptoms are positively associated with their offsprings’ cortisol stress response, (b) numerous individual and interpersonal maternal characteristics moderate this association, and (c) maternal and infant cortisol levels are highly correlated. In combination, these findings have suggested that maternal cortisol levels may moderate the relation between maternal depressive symptoms and infant cortisol responsivity; the current study assessed this hypothesis. Participants were 297 mother–infant dyads who were recruited from the community. Maternal depressive symptoms were assessed via self‐report. Dyads participated in two differentially stressful infant challenges when infants were 16 and 17 months old. Mother and infant salivary cortisol was collected before and after challenges. Results indicate that maternal cortisol levels moderated associations between maternal depressive symptoms and infant cortisol levels across both challenges. Infants showed higher cortisol levels if their mothers had both higher depressive symptoms and higher cortisol levels, as compared to infants of mothers with higher depressive symptoms and lower cortisol, and to infants of mothers with lower depressive symptoms and either higher or lower cortisol levels. We discuss findings in relation to environmental and biological factors that may contribute to the intergenerational transmission of depressive symptoms.     

Personalidad,estrategias cognitivas y tiempo de Inspección

Resumen

En el presente trabajo se han empleado las medidas cronométricas de Tiempo de Inspección (TI) y Tiempo de Reacción (TR) para estudiar los efectos de las diferencias individuales en extroversion sobre una tarea de discriminación perceptual. Para ello se utilizaron dos grupos de sujetos que habían obtenido puntuaciones máximas y mínimas en la dimensión Extraversión del Test EPI de H. J. Eysenck. Se postuló que los extrovertidos obtendrían un TI más corto que los introvertidos y asimismo un TR también más corto, de acuerdo a los modelos de Brebner (1980) y Tous (1986). Los resultados indicaron que si bien existieron diferencias entre extrovertidos e introvertidos en cuanto a las medidas cronométricas, estas dit erencias dependieron del uso diferencial de estrategias de resolver la tarea que fueron utilizadas por estos sujetos.