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.     

Using FMRI to test models of complex cognition

This article investigates the potential of fMRI to test assumptions about different components in models of complex cognitive tasks. If the components of a model can be associated with specific brain regions, one can make predictions for the temporal course of the BOLD response in these regions. An event-locked procedure is described for dealing with temporal variability and bringing model runs and individual data trials into alignment. Statistical methods for testing the model are described that deal with the scan-to-scan correlations in the errors of measurement of the BOLD signal. This approach is illustrated using a "sacrificial" ACT-R model that involves mapping 6 modules onto 6 brain regions in an experiment from Ravizza, Anderson, and Carter (in press) concerned with equation solving. The model's visual encoding predicted the BOLD response in the fusiform gyrus, its controlled retrieval predicted the BOLD response in the lateral inferior prefrontal cortex, and its subgoal setting predicted the BOLD response in the anterior cingulate cortex. On the other hand, its motor programming failed to predict anticipatory activation in the motor cortex, its representational changes failed to predicted the pattern of activity in the posterior parietal cortex, and its procedural component failed to predict an initial spike in caudate. The results illustrate the power of such data to direct the development of a theory of complex problem solving, both at the level of a specific task model as well as at the level of the cognitive architecture.     

生存质量在晚期肿瘤疗效评价中的思考

传统的肿瘤疗效评价方法多采用治愈率、生存率等指标来衡量。随着传统医学模式向生物一心理一社会医学模式转变,生存质量越来越受到重视。生存质量从一个新的角度评价治疗效果,更重视患者的主观感受,而不是仅将临床客观指标作为评价标准,能更客观地指导治疗方案的选择。     

干扰素治疗慢性乙型肝炎临床评价

干扰素治疗慢性乙型肝炎已有20多年历史,由于其抑制病毒复制和强大的免疫调节作用,以及具有疗程确定,不引起病毒变异耐药,显效后疗效持久的特点,是慢性乙型肝炎抗病毒治疗的首选药物之一。多项试验证明聚乙二醇化干扰素治疗慢性乙型肝炎的疗效优于普通干扰素和核苷类似物。本文就有关干扰素单用、联合核苷类似物和序贯疗法治疗慢性乙型肝炎的临床研究和HBV基因型对干扰素疗效的影响做简要综述。     

医院临床药学管理要注重药物经济学评价与研究

通过对医院临床药学管理的药物经济学评价与研究的重要性、药物经济学评价与研究的基本方法和技术的论述,提出在进行临床药学管理的同时,应注重和开展药物经济学评价与研究,使之成为医院临床药学管理重要方面。目前医院临床药物管理中需关注的评价与研究项目,包括医院药品费用评价和控制研究、医院用药目录评价和规范医生行为研究、药物的适用范围评价与科学合理性研究、患者选择药物行为评价和正确帮助择药研究。     

Caregiver Involvement in the Intensive Mental Health Program: Influence on Changes in Child Functioning

We examined behavioral markers of caregiver involvement and the ways in which family participation was related to treatment outcomes in 47 elementary school children with SED enrolled in a school-based intensive mental health program. Measures of caregiver involvement included therapeutic home visits, attendance at therapeutic meetings, completion of ratings on the daily point sheet, and extra communications with the therapeutic team on the point sheet. Greater initial impairment was associated with greater caregiver involvement. Greater caregiver involvement was linked to improvement in child thought processes, increased ability to provide emotional and social supports for the child, and greater overall child functioning at discharge. Our findings also reflected increased therapists’ attempts to provide additional in-home services in cases where caregivers demonstrated a decline in their ability to provide for their children’s physical and material needs, or in which therapists discovered that the family functioning was more impaired than what was initially assessed. We provide a case study that exemplifies many of these findings.     

Challenges of Evaluating Multilevel Interventions

This article uses the Comprehensive Mixed-Methods Participatory Evaluation (CMMPE; Nastasi and Hitchcock Transforming school mental health services: Population-based approaches to promoting the competency and wellness of children, Thousand Oaks, CA: Corwin Press with National Association of School Psychologists 2008; Nastasi et al. School-based mental health services: creating comprehensive and culturally specific programs. Washington, DC: American Psychological Association 2004) model as a framework for addressing the multiplicity of evaluation decisions and complex nature of questions related to program success in multilevel interventions. CMMPE defines program success in terms of acceptability, integrity, social or cultural validity, outcomes (impact), sustainability and institutionalization, thus broadening the traditional notions of program outcomes. The authors use CMMPE and an example of a community-based multilevel sexual risk prevention program with multiple outcomes to discuss challenges of evaluating multilevel interventions. The sexual risk program exemplifies what Schensul and Tricket (this issue) characterize as multilevel intervention–multilevel evaluation (M–M), with both intervention and evaluation at community, health practitioner, and patient levels. The illustration provides the context for considering several challenges related to M–M designs: feasibility of randomized controlled trials within community-based multilevel intervention; acceptability and social or cultural validity of evaluation procedures; implementer, recipient, and contextual variations in program success; interactions among levels of the intervention; unanticipated changes or conditions; multiple indicators of program success; engaging multiple stakeholders in a participatory process; and evaluating sustainability and institutionalization. The complexity of multilevel intervention and evaluation designs challenges traditional notions of evaluation research and experimental designs. Overcoming these challenges is critical to effective translation of research to practice in psychology and related disciplines.     

The evidence for relativism

The aim of this paper is to examine the kind of evidence that might be adduced in support of relativist semantics of a kind that have recently been proposed for predicates of personal taste, for epistemic modals, for knowledge attributions and for other cases. I shall concentrate on the case of taste predicates, but what I have to say is easily transposed to the other cases just mentioned. I shall begin by considering in general the question of what kind of evidence can be offered in favour of some semantic theory or framework of semantic theorizing. In other words, I shall begin with the difficult question of the empirical significance of semantic theorizing. In Sect. 2, I outline a relativist semantic theory, and in Sect. 3, I review four types of evidence that might be offered in favour of a relativistic framework. I show that the evidence is not conclusive because a sophisticated form of contextualism (or indexical relativism) can stand up to the evidence. However, the evidence can be taken to support the view that either relativism or the sophisticated form of contextualism is correct.     

Reactions to Different Types of Forced Distribution Performance Evaluation Systems

Purpose  We isolate and describe four key elements that distinguish different forms of forced distribution systems (FDS). These key elements are the consequences for low performers, differentiation of rewards for top performers, frequency of feedback, and comparison group size. We examine how these elements influence respondents’ attraction to FDS. Design/methodology/approach  Undergraduate students (n = 163) completed a policy capturing study designed to determine how these four FDS elements influence their attraction to FDS. We examine the relative importance of these elements that most influence attraction to different FDS, as well as individual attributes (i.e., cognitive ability, gender, and major) that may affect those preferences. Findings  Respondents were most attracted to systems with less stringent treatment of low performers, high differentiation of rewards, frequent feedback and large comparison groups. Consequences for low performers were nearly twice as influential as any other element. Respondents with higher cognitive ability favored high reward differentiation and males were less affected by stringent consequences for low performers. Implications  Before practitioners implement FDS, it would be prudent to consider all four elements examined in this study—with the treatment of low performers being the most salient issue. Future accounts of FDS should clarify the nature of these elements when reporting on FDS. Such precision will be useful in generating a knowledge base on FDS. Originality/value   We add precision to the discussion of FDS by identifying four key elements. This is one of the first studies to examine perceptions of FDS from a ratee perspective.

The susceptibility of mental accounting principles to evaluation mode effects

The present research shows that the predictions and outcomes of mental‐accounting tests depend on whether preferences are measured separately (one at a time) or jointly (comparatively). Across five studies, we show that joint evaluation weakens some decision biases (the theater ticket problem, the calculator and jacket problem), but exacerbates others (the basketball game problem). Joint evaluations serve as a check on whether people think the answers they give in separate evaluations make sense or require adjustment. We discuss how the findings impact (1) tests of mental accounting predictions (between vs. within subjects designs), and (2) the normative status of mental accounting. Copyright © 2008 John Wiley & Sons, Ltd.