Mutual Help Groups for Mental Health Problems: A Review of Effectiveness Studies

This paper reviews empirical studies on whether participating in mutual help groups for people with mental health problems leads to improved psychological and social functioning. To be included, studies had to satisfy four sets of criteria, covering: (1) characteristics of the group, (2) target problems, (3) outcome measures, and (4) research design. The 12 studies meeting these criteria provide limited but promising evidence that mutual help groups benefit people with three types of problems: chronic mental illness, depression/anxiety, and bereavement. Seven studies reported positive changes for those attending support groups. The strongest findings come from two randomized trials showing that the outcomes of mutual help groups were equivalent to those of substantially more costly professional interventions. Five of the 12 studies found no differences in mental health outcomes between mutual help group members and non-members; no studies showed evidence of negative effects. There was no indication that mutual help groups were differentially effective for certain types of problems. The studies varied in terms of design quality and reporting of results. More high-quality outcome research is needed to evaluate the effectiveness of mutual help groups across the spectrum of mental health problems.     

Narrative accounts of illness in schizophrenia: association of different forms of awareness with neurocognition and social function over time

Awareness of illness in schizophrenia reflects complex storied understanding of the impact of the disorder upon one’s life. Individuals may be aware of their illness in different ways and this may be related to their functioning. A total of 76 adults with schizophrenia were assessed for their awareness of illness, neurocognition, social cognition, and social function concurrently and social function was also assessed at three later time points. A cluster analysis revealed 3 groups: generally full awareness, generally limited awareness, and superficial awareness. Comparisons between these profiles revealed the superficial group had poorer executive function, emotion recognition ability, and capacity for social relationships than the full awareness group, yet had better verbal memory and more social contacts than the limited awareness group. These results suggest assessing the narrative qualities of awareness of illness may reveal unique links with cognition and function, and this may have implications for interventions.     

Child Psychosocial Adjustment and Parenting in Families Affected by Maternal HIV/AIDS

Child adjustment and parenting were examined in twenty-three 9–16-year-old youth from families affected by maternal HIV infection and 20 same-age peers whose mothers were not infected. Children whose mothers were seropositive reported significantly more externalizing problems. Infected mothers reported less age-appropriate supervision/monitoring relative to non-infected mothers. Better mother-child relationship quality and less impairment in parental supervision/monitoring of age-appropriate youth behaviors were associated with fewer externalizing difficulties among the HIV-positive group only. Similarly, only among HIV-infected mothers was refraining from engaging in inconsistent disciplinary tactics associated with lower reports of internalizing and externalizing problems. These data highlight the promise of programs targeting parenting skills to prevent or ameliorate child difficulties.     

心理疾病内隐污名述评

心理疾病内隐污名是个体无法内省或精确识别的与心理疾病有关的痕迹, 它潜在地调节着个体对心理疾病患者的观念和行为。心理疾病内隐污名的主要测量方法包括内隐联想测验、简式内隐联想测验、启动任务和生理心理测量。当前该研究领域集中在内隐污名的成分、公众内隐污名、自我内隐污名、去污名化评估等方面。未来研究可从心理疾病内隐污名的构成与结构、认知神经基础、测量整合和本土化等角度做进一步探讨。     

Ethical Considerations for Providing In-Home Mental Health Services for Homebound Individuals

The number of homebound individuals in the United States is on the rise, causing health-care professionals to expand in-home health services to help meet the increased demand. Due to the prevalence of feelings of isolation and depression in this population, it is imperative that mental health professionals join this effort to increase access to mental health services. Delivering psychotherapy in clients’ homes presents many advantages to these homebound individuals, but there is a dearth of literature addressing how therapists should handle unique ethical issues that arise in this type of setting. This article addresses ethical considerations and guidelines for in-home provision of mental health services. General ethical issues related to home-based psychotherapy include boundaries, confidentiality and privacy, competency, insurance coverage, and autonomy. Issues pertaining to different categories of homebound individuals, including persons with agoraphobia, chronic illnesses, and older adults, are then discussed in turn. Recommendations on how to best manage these issues by applying the American Psychological Association’s, the American Counseling Association’s, and the National Association of Social Workers’ Ethics Codes are provided.     

Prime and prejudice: Brief stereotypical media representations can increase prejudicial attitudes and behaviour towards people with schizophrenia

Prejudice against people with mental illnesses remains a significant problem in the United Kingdom and in many other countries despite sustained efforts by governments and charities. This is particularly so for people with schizophrenia, who are seen as dangerous and unpredictable. The present study investigated the effect of brief, casual, stereotypical representations on prejudice and behavioural intentions towards people with schizophrenia. Participants viewed Halloween costumes in an online environment under the guise of product research. In the experimental condition, they were exposed to a “Psycho Ward” Halloween outfit identical to one sold online by a leading supermarket chain in the United Kingdom. Participants in the control condition saw a neutral “pumpkin” Halloween costume. Exposure to the Psycho Ward outfit resulted in more negative behavioural intentions towards people with schizophrenia, mediated by increased prejudice. These findings confirm and extend earlier research that implicates adverse media stereotypes in the persistence of prejudice against people with mental illness. More research is warranted on the relative effects of different influences on community attitudes to mental illness.     

Demarcating depression

How to draw the line between depression‐as‐disorder and non‐pathological depressive symptoms continues to be a contested issue in psychiatry. Relatively few philosophers have waded into this debate, but the tools of philosophical analysis are quite relevant to it. In this paper, I defend a particular answer to this question, the Contextual approach. On this view, depression is a disorder if and only if it is a disproportionate response to a justifying cause or else is unconnected to any justifying cause. I present four objections to this approach and then defend it from them. Along the way, I explain why it matters whether we get this question right.     

Pilot Effectiveness of a Stress Management Program for Sheltered Homeless Adults With Mental Illness: A Two-Group Controlled Study

This study examined the effectiveness of a stress management intervention for sheltered homeless adults with mental illness. Twelve intervention participants received a 6-week, 1-hour psychoeducation group combined with a 20-minute meditation. Eleven matched pairs did not receive intervention and served as controls. At 1 week post study, intervention participants reported a statistically significant reduction in perceived stress (Z=??2.285, p < .02, d=??1.176) compared to controls. No differences were found at 1 week post study between intervention and control participants on reported quality of life. This study provides pilot data on the effectiveness of an occupation-based stress management program for sheltered homeless adults and warrants further study.     

基于语义差异量表的心理疾病外显与内隐污名的结构及关系

采用语义差异法编制心理疾病污名语义差异量表,用于测量外显污名,并用语义差异量表的词对作为单类内隐联想测验的材料,测量内隐污名,用这两类材料研究外显污名与内隐污名的结构及关系。结果表明：外显污名的三维度模型具有良好的拟合度（χ²/df=2.99, RMSEA=0.075, CFI=0.918, TLI=0.902）;内隐污名的三维度模型也具有良好的拟合度（χ²/df=2.272, RMSEA=0.071, CFI=0.857, TLI=0.833）,且与外显污名的结构相同,都由认知评价、情感体验、行为反应三维度构成;心理疾病污名的外显认知评价与内隐认知评价存在显著相关（r=0.436）,外显污名与内隐污名的其它维度之间均不存在显著相关。     

19世纪西方医学对精神疾病诊治的影响

精神疾病是现代困扰人类的主要疾病之一。通过总结19世纪西方医学对精神疾病的认识及主要治疗方法,拟展现这个世纪中治疗方法随观念变化和实践深入而发展的轨迹,旨在说明19世纪是西医精神病学发展史上的重要时期,并揭示其与现代精神疾病治疗的历史传承性。