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.     

Habilidades de segmentación y aprendizaje de la lectura en las personas ciegas

Resumen

El objetivo de esta investigación es estudiar las habilidades metalingüísticas de las personas ciegas y su relación con el rendimiento lector en el contexto de la discusión de las relaciones entre la conciencia fonológica y la lectura. La muestra estaba formada por cuarenta y seis estudiantes ciegos agrupados según el nivel escolar. Las habilidades metalingüísticas se evaluaron a través de tres pruebas de segmentación (omisión, comparación y construcción). Para determinar el nivel de lectura se utilizaron cuatro índices: velocidad lectora, decodificación, habilidades inferenciales y un índice general de lectura.

Los resultados muestran que el patrón de adquisición y desarrollo de las habilidades de segmentación de estos niños coincide con el de los videntes. Igualmente se confirma la relación de estas habilidades con los procesos instrucciona les, mientras que se diluye el efecto cronológico. En los sujetos ciegos, igual que ocurría en videntes y en sordos, volvemos a encontrar una estrecha relación entre las habilidades de segmentación y el nivel lector. Específicamente los ciegos presentan retrasos importantes, siendo más acusados en lectura que en segmentación. Por último se presentan, a partir de estos resultados, implicaciones para la práctica educativa.     

Apocalyptic themes in times of trouble: when young men are deeply alienated

Boys and young men more frequently live out aspects of their psychic and social alienation online. This paper explores some of the risks and dangers that can arise from retreats into the two-dimensional world of cyberspace. It focuses more specifically on videogaming called MOBA, multi-player online battle arena games, in which players point and shoot at others. A case example emphasizes the clinical problems emerging from violent fantasies that seek a false form of containment in cyberspace. Themes of destructive fantasizing are further amplified through images of apocalypse, which are often prevalent in combat arena videogames. Textual sources from the Book of Revelation offer possible understanding for various elements of destructiveness as it appears in vulnerable male psyches. Therapeutic contact that combines a relational, containing approach and a broadly spiritual and soulful perspective can provide a path to healing such violent splits within the psyches of boys and young men.     

Changes in verbalizations during sandplay: an empirical study

This is a quantitative study of an 11-year-old boy diagnosed with major depression who in all but one session made a sandplay. A computerized system was used to analyse the written verbalizations on four dimensions of positive and negative: emotions, contracts (psychosocial agreements, relationships, etc.), performance (behaviour) and rewards. It was hypothesized that the verbalizations made by the patient (recorded by the therapist) would become more positive and less negative during the course of therapy. The positive and negative values of the four dimensions were correlated with the session number. This was supported on two (performance & contract) of the four positive dimensions (statistically significant). The hypothesis that the negative dimensions would become less negative was supported on all four dimensions (statistically significant). Thus, six of the eight hypotheses were supported. This uninvestigated area of research illustrates verbal interactions between patient and therapist were an important aspect of sandplay therapy. Through reanalysing the sessions for quantitative content, written recording of direct quotes and observation of behaviour, data was entered into a valid and reliable coding system to quantitatively analyze the verbalizations. This analysis of verbalizations of the patient and observations made by the therapist indicates sandplay therapy is multifaceted.