THE WORLDWIDE BURDEN OF INFANT MENTAL AND EMOTIONAL DISORDER: REPORT OF THE TASK FORCE OF THE WORLD ASSOCIATION FOR INFANT MENTAL HEALTH

Children worldwide experience mental and emotional disorders. Mental disorders occurring among young children, especially infants (birth –3 years), often go unrecognized. Prevalence rates are difficult to determine because of lack of awareness and difficulty assessing and diagnosing young children. Existing data, however, suggest that rates of disorders in young children are comparable to those of older children and adolescents (von Klitzing, Dohnert, Kroll, & Grube, 2015 ). The lack of widespread recognition of disorders of infancy is particularly concerning due to the unique positioning of infancy as foundational in the developmental process. Both the brain and behavior are in vulnerable states of development across the first 3 years of life, with potential for enduring deviations to occur in response to early trauma and deprivation. Intervention approaches for young children require sensitivity to their developmental needs within their families. The primacy of infancy as a time of unique foundational risks for disorder, the impact of trauma and violence on young children's development, the impact of family disruption on children's attachment, and existing literature on prevalence rates of early disorders are discussed. Finally, global priorities for addressing these disorders of infancy are highlighted to support prevention and intervention actions that may alleviate suffering among our youngest world citizens.     

1993~2013年常驻高海拔地区军人心理健康状态的横断历史研究

研究为探索常驻高海拔地区军人心理健康水平如何随社会年代变迁而改变,运用了横断历史元分析的方法,对1993年至2013年38篇采用90项症状自评量表(SCL-90)的文献调查数据进行分析,考察了11454名常驻高海拔地区军人在该量表上9个因子得分随年代变化的趋势.结果发现:(1)SCL-90的7个因子均值与年代负相关,且不受期刊类型等的影响.20年来,7个因子下降了5%~15%不等.其中,强迫变化最大,抑郁、焦虑、人际敏感、偏执和精神病性均变化明显.这说明,常驻高海拔地区军人心理健康虽有所波动但整体水平逐步提升,变化幅度大致属于中等程度.(2)当年军费占GDP比值、居民消费水平指数与SCL-90部分因子均值负相关显著;5年前的居民消费水平指数与7个因子显著负相关.这说明,国防建设的经济投入和居民消费水平可能是影响常驻高海拔地区军人心理健康水平的重要因素.     

Spatial But Not Oculomotor Information Biases Perceptual Memory: Evidence From Face Perception and Cognitive Modeling

Recent research put forward the hypothesis that eye movements are integrated in memory representations and are reactivated when later recalled. However, “looking back to nothing” during recall might be a consequence of spatial memory retrieval. Here, we aimed at distinguishing between the effect of spatial and oculomotor information on perceptual memory. Participants’ task was to judge whether a morph looked rather like the first or second previously presented face. Crucially, faces and morphs were presented in a way that the morph reactivated oculomotor and/or spatial information associated with one of the previously encoded faces. Perceptual face memory was largely influenced by these manipulations. We considered a simple computational model with an excellent match (4.3% error) that expresses these biases as a linear combination of recency, saccade, and location. Surprisingly, saccades did not play a role. The results suggest that spatial and temporal rather than oculomotor information biases perceptual face memory.     

Does Parent-Child Interaction Therapy Reduce Maternal Stress,Anxiety, and Depression Among Mothers of Children with Autism Spectrum Disorder?

Maternal stress, anxiety, and depression are associated with ineffective parenting strategies for families of children with Autism Spectrum Disorders (ASD). We present the use of Parent-Child Interaction Therapy (PCIT) with three mother-child dyads to reduce maternal stress, anxiety, and depression and child disruptive behavior in children with ASD. Results included increases in positive parenting skills, and decreases in maternal anxiety, depression, and stress, as well as child behavior problems. PCIT is a promising alternative to more intensive and costly interventions, both at reducing disruptive behaviors and improving maternal health. Implications of PCIT for dyads affected by ASD are discussed.     

Adjustment modes in the trajectory of progressive multiple sclerosis: a qualitative study and conceptual model

Objective: We examined cognitive and behavioural challenges and adaptations for people with progressive multiple sclerosis (MS) and developed a preliminary conceptual model of changes in adjustment over time.

Design: Using theoretical sampling, 34 semi-structured interviews were conducted with people with MS. Participants were between 41 and 77 years of age. Thirteen were diagnosed with primary progressive MS and 21 with secondary progressive MS. Data were analysed using a grounded theory approach.

Results: Participants described initially bracketing the illness off and carrying on their usual activities but this became problematic as the condition progressed and they employed different adjustment modes to cope with increased disabilities. Some scaled back their activities to live a more comfortable life, others identified new activities or adapted old ones, whereas at times, people disengaged from the adjustment process altogether and resigned to their condition. Relationships with partners, emotional reactions, environment and perception of the environment influenced adjustment, while people were often flexible and shifted among modes.

Conclusions: Adjusting to a progressive condition is a fluid process. Future interventions can be tailored to address modifiable factors at different stages of the condition and may involve addressing emotional reactions concealing/revealing the condition and perceptions of the environment.     

How have people who have stopped or reduced their alcohol consumption incorporated this into their social rituals?

Objective: Limiting alcohol consumption is beneficial for health, but can be challenging given the role alcohol plays in the rituals of many social occasions. We examined how people who stopped or reduced their alcohol consumption incorporated this change within their social rituals.

Design: We conducted 16 semi-structured one-on-one interviews with adults aged 25–65 years, who lived in Australia and had stopped or significantly reduced their alcohol consumption in the previous year.

Results: Through thematic analysis, we identified four approaches to adapting drinking rituals: replacing alcohol with other drinks, replacing drinking with other social activities, changing the meaning of drinking rituals and replacing drinking occasions with activities that achieve different goals. These approaches varied in the extent to which they reflected a low or high change in the meanings and/or behaviours attached to the ritual. Approaches involving little change, such as using alternative drinks, were more readily accepted by participants’ social companions than approaches involving more substantial changes such as replacing drinking with activities achieving different goals.

Conclusions: Considering both the role and meaning alcohol carries in social interactions, and how else these might be achieved, may assist people to stop or reduce their drinking, without sacrificing their social lives.     

Change in subjective social status following HIV diagnosis and associated effects on mental and physical health among HIV-positive gay men in Australia

Objective: This study investigates the impact of HIV diagnosis on subjective social status and if changes are linked to health outcomes.

Design: Two measures of subjective social status, socio-economic and standing in the community were examined in 342 Australian HIV-positive gay men in 2014. Participants recalled ratings at diagnosis were compared with current ratings.

Main outcome measures: Self-reported mental (psychological distress, self-esteem, positive mental health and satisfaction with life) and physical health (self-rated health, CD4 count, viral load).

Results: Half of the participants reported improvements in subjective socio-economic status (59%) or standing in the community (52%) since diagnosis, yet one quarter reported socio-economic status (25%) or standing in the community had decreased (23%). Increases in either measure of subjective social status were linked to higher self-esteem, positive mental health, satisfaction with life and better self-rated health. Decreases in subjective social status, however, were strongly linked to poorer outcomes on all mental health measures. Decreases in standing in the community were also associated with poorer physical self-rated health.

Conclusion: Most participants reported their subjective social status were the same or better since diagnosis. Changes in subjective social status following diagnosis were strongly linked to mental health outcomes. Those who reported a decrease in subjective social status were particularly vulnerable to mental health problems.     

Action: a bridge between vocational and mental health counselling*

A theory of goal-directed action is proposed as a conceptual link between vocational and mental health counselling. Originally emerging from the vocational counselling field, contextual action theory is presented as a critical conceptual link not only between mental health and occupational life but also between counselling practices in these domains. This specific application of goal-directed action to vocational and mental health counselling is addressed by describing counselling as goal-directed action, the five tasks of counselling it invites, and tools for supporting client goals, such as the self-confrontation interview.     

Borderline personality disorder in an intermediate psychological therapies service

The intermediate psychological therapies service is provided for individuals referred with common mental health problems within the primary care psychological therapies service, but whose difficulties are longstanding and/or complex. The prevalence of borderline personality disorder (BPD) in intermediate psychological therapy services has not been researched to-date. The current study aimed to measure the prevalence of BPD amongst patients attending intermediate psychological therapies (n?=?63). The prevalence of BPD was established by identifying the number of patients who met DSM-IV criteria. BPD prevalence amongst patients attending an intermediate psychological therapy service was 37%. The high proportion of patients presenting with BPD indicates the potential need for staff training and supervision in how to manage such high levels of need at this service level. This is the first study to report prevalence rates of BPD specifically in an intermediate care psychological therapy service.     

Dealing with Big Numbers: Representation and Understanding of Magnitudes Outside of Human Experience

Being able to estimate quantity is important in everyday life and for success in the STEM disciplines. However, people have difficulty reasoning about magnitudes outside of human perception (e.g., nanoseconds, geologic time). This study examines patterns of estimation errors across temporal and spatial magnitudes at large scales. We evaluated the effectiveness of hierarchical alignment in improving estimations, and transfer across dimensions. The activity was successful in increasing accuracy for temporal and spatial magnitudes, and learning transferred to the estimation of numeric magnitudes associated with events and objects. However, there were also a number of informative differences in performance on temporal, spatial, and numeric magnitude measures, suggesting that participants possess different categorical information for these scales. Educational implications are discussed.