The interface between physical and mental disorders: The need to dismantle the biopsychosocialneuroimmunological model of disease

This article argues for the necessity of cognitive-behavioral assessment for a thorough understanding of how psychological factors mediate disease process across a wide range of diseases including coronary artery disease, breast cancer, and human immunodeficiency disease. Based on empirical data presented as part of the APA Presidential miniconvention, “To Your Health: Psychology through the Life Span,” the conclusion is that psychological treatment can help extend life. Stress management programs can positively influence adherence to treatment regimens and positively influence the human immune system response during the course of treatment and recovery from illness. Even in the face of life-threatening circumstances such as liver transplantation, Stage II and III breast cancer, and after HIV infection has been diagnosed, the quality of life can be remarkably improved. Physicians and psychologists must work together to produce the beneficial effects of the synergy between mind-body processes.     

Factors associated with respite care use by families with a child with disabilities

This paper reviews the literature on respite care utilization, describes a respite care program in Arkansas, and reports on a study of utilization initiated by the Arkansas Division of Mental Health Services (DMHS). Among the 89 families qualifying for respite services, 70 consented to participate, and 66 were surveyed in a phone interview. Users (n=54) and non-users (n=12) were compared relative to a variety of staff, child, geographic, and budget differences. Also, respite use was examined relative, to the aforementioned variables based on level of use, (i.e., none, low, moderate, high). There were no differences in use according to age, the number of family members, family income, or needs of the child. A larger percentage of non-use and low use of respite care was evident among those families receiving Tax Equity Fiscal Responsibility Act (TEFRA) benefits. There were no significant differences between races related to perceived barriers to care. Differences in expectations/experiences with respite care among rural and urban groups were limited with rural respondents expressing, concern about travel/distance issues. Overall, the program as a whole received positive ratings by parents, and no clear factors were found to be related to non-use in the small sample (n=12) who did not take advantage of respite services.     

The readability of educational materials written for parents of children with attention-deficit hyperactivity disorder

Health-care providers are relying increasingly on printed materials to educate patients and their families about varous aspects of their health or mental health conditions. For the target audience to be able to read and understand health brochures, they should be written at or about the 8th-grade level and incorporate variables that facilitate comprehension. The purpose of this study was to analyze brochures related to Attention-Deficit Hyperactivity Disorder to determine (a) if they were written at a level appropriate for the target audience, and (b) the extent to which they incorporated variables identified in the research literature as facilitating comprehension. The results showed that the brochures were written at a reading level beyond that of the target audience. Further, although the brochures incorporated a large number of variables which facilitate comprehension, many were not used to the extent necessary to ensure that readers would be able to understand the brochures. These results clearly indicated the need for health care materials to be written in such a way that they can be read and understood by the target audience.     

脑出血后智力障碍与局部脑血流量相关性研究

作者用长谷川智力测定量表法测定了６１例脑出血患者的智力,用ＳＰＥＣＴ定量测定法测定了双侧大脑半球各１５个脑区的局部血流量,并计算其比值。分析了脑出血、局部脑血流量、局部脑血流量比值与长谷川分数的关系。结果提示脑出血时,除由于病变直接破坏与智力有关的结构外,左半球（特别是左颞叶及左缘上回和角回）局部脑血流量下降,缘上回和角回、颞上回后部、颞中回后部、颞下回局部脑血流量比值失衡亦可能是造成智力下降的原因。     

Crisis for community mental health: The use of groups in the struggle for survival

The task of community mental health is to provide quality services to clients despite funding cutbacks. This paper describes the recent evolution in conceptualization and service delivery in one center. The outcomes are a philosophy that is customer oriented, and treatment that draws upon brief techniques, in group and long term contexts.     

Reimbursement for professional psychological services

A brief history of the professionalization of psychology precedes a section of how psychological services became reimbursable. Specific focus is placed on reimbursement for psychological services, especially the distinction between medical and psychiatric diagnoses as well as procedures or services. Specific guidelines for appropriate reimbursement are provided. Future directions for reimbursement for mental health and related services are considered.     

Prevention, solution-focused therapy, and the illusion of mental disorders

Therapy theorists' criticism of the lack of specific mechanisms in the prevention of mental disorders is examined from the perspective of solution-focused therapy (SFT), which argues that solutions can be unrelated to problems, and that it is not even necessary to know what a problem is in order to solve it. It is suggested that the shift of attention from problems to solutions in SFT offers a conceptual framework within which the criticism is not relevant, and from which theorists of therapy and prevention can share a common outlook. This outlook involves a focus on encouraging productive, useful, positive behavior, with a corresponding deemphasis on an skepticism about current conceptualizations of mental disorders.     

Primary Prevention Mental Health Programs: The Future is Exciting

Current outcome research on primary prevention mental health programs is encouraging and the future is exciting. Data continue to accumulate regarding the efficacy of preventive intervention. Exemplary programs can prevent multiple problems across different outcome domains suggesting the need for collaboration among preventionists across disciplines and research areas. The commentators on our review (Durlak and Wells, 1997) offered many useful suggestions to improve the next generation of research. Most recommendations fall broadly under the rubric of increasing the precision of theory, design, and program evaluation. If current recommendations for improving future research are followed, the next reviewers of primary prevention mental health programs for children and adolescents will have a more complete and useful database for analysis.     

The Experience of Caregiving Among Mothers of Adults Suffering from Psychotic Disorders: Factors Associated with Their Psychological Distress

To identify correlates of psychological distress among multiple indicators, 99 women with adult children suffering from a psychotic disorder were interviewed. The women, who were recruited through hospitals and self-help groups, represented different socioeconomic levels. A face-to-face standardized interview was conducted, mainly in the participants' homes. Multiple hierarchical regression analysis showed that dimensions of burden and social support were strongly associated with distress reported by the participants. The negative interactions that participants had with their main confidant or spouse constituted a more powerful correlate than their perception of the quality of this relationship. Furthermore, a perception of their own health as poorer is a strong correlate of their distress. Since no control group was studied simultaneously, these results suggest, but do not prove, the presence of differences between mothers of adults with psychotic disorders and other mothers.     

Psychological Distress and Help Seeking in Rural America

The implications of exposure to acute and chronic stressors, and seeking mental health care, for increased psychological distress are examined. Research on economic stress, psychological distress, and rural agrarian values each point to increasing variability within rural areas. Using data from a panel study of 1,487 adults, a model predicting changes in depressive symptoms was specified and tested. Results show effects by size of place for men but not for women. Men living in rural villages of under 2,500 or in small towns of 2,500 to 9,999 people had significantly greater increases in depressive symptoms than men living in the country or in larger towns or cities. Size of place was also related to level of stigma toward mental health care. Persons living in the most rural environments were more likely to hold stigmatized attitudes toward mental health care and these views were strongly predictive of willingness to seek care. The combination of increased risk and less willingness to seek assistance places men living in small towns and villages in particular jeopardy for continuing problems involving depressed mood.