Praxis makes perfect: Illness as a bridge between biological concepts of disease and social conceptions of health

Analyses of biological concepts of disease and social conceptions of health indicate that they are structurally interdependent. This in turn suggests the need for a bridge theory of illness. The main features of such a theory are an emphasis on the logical properties of value terms, close attention to the features of the experience of illness, and an analysis of this experience as action failure, drawing directly on the internal structure of action. The practical applications of this theory are outlined for a number of problems in each of the three main practical areas, clinical work, teaching and research. In each case the resources of the theory suggest new models and generate new results. The full practical significance of the theory, however, is shown to consist in the way in which it ties together biological and social theories into an integrated picture of the conceptual structure of medicine as a whole. It is argued, finally, that practical efficiency of this kind is a test of theory not only in the philosophy of medicine but also in general philosophy.     

Does medics' social identification increase handicap for mentally retarded patients?

Briefs about mentally retarded people are more negative than briefs about other social categories; professionals, such as medical doctors evaluate them most negatively of all. It was hypothesized (a) that medics' beliefs about mentally retarded people are mediated by psychological salience of their clinical social identification, rather than by personal characteristics that medics happen to share and (b) that such beliefs will bias decisions, rather than enhance accuracy. Forty-five doctors and medical students were randomly assigned to conditions designed to enhance salience of their shared clinical social identification or individual self-perceptions. Subjects completed semantic differentials about mentally retarded people and distinguished between slides of ‘mentally retarded’ and ‘normal’ children. Beliefs of subjects in the medical condition were significantly more negative than those in the personal condition. A signal detection analysis revealed no difference between conditions in subjects' ability to distinguish between children but showed that subjects in the medical condition were significantly more likely to judge a child ‘mentally retarded’ when in doubt. Results were discussed within an information processing framework and supported the idea that a salient clinical social identity can mediate beliefs that are likely to handicap patients.     

Reliability of self-reported service use: Test-retest consistency of children's responses to the Child and Adolescent Services Assessment (CASA)

This paper reports on the reliability of children's responses on the Child and Adolescent Services Assessment (CASA) — a self-report instrument for use with 8– to 18-year-olds that gathers information about services used to address mental health problems. Findings were based on interviews completed by 77 children at a one week test-retest interval. Results showed that reports of lifetime service use were as reliable as were reports of service use in the preceding three months. Children reported restrictive and intrusive services more reliably than services that were provided in their natural environment. Reliability appeared to be associated more strongly with characteristics of the type of service than with characteristics of the child. Children also could report reliably on some details about their encounters with service providers (e.g., length of stay, number of visits, and onset of service use).     

Evaluating children's mental health service systems: An analysis of critical behaviors and events

A lack of studies which evaluate system change by tracking client outcomes is noted in the children's mental health area. This deficit may be a result of the inability of researchers to define outcomes and to draw conclusions about which measures reflect the efficacy of services and service delivery systems. This paper reviews five social validation surveys which examined children's mental health outcome measures. Based on the results of the five surveys, a model of critical behaviors and events is presented. This model will assist evaluators and researchers in understanding which critical events and behaviors should be measured to assess the impact of community-based mental health services for children.     

中国背景下自我效能感与心理健康的元分析

社会认知理论指出自我效能感对心理健康具有重要意义,但两者的关系在以往的研究中尚不一致。当前研究采用元分析技术分析自我效能感对心理健康影响的主效应,并重点考察各调节变量在两者关系中的调节效应。通过文献检索和筛查,最终符合元分析纳入标准的文献有117篇。结果表明,自我效能感与心理健康积极因素呈显著正相关,而与心理健康消极因素呈显著负相关。此外自我效能感与心理健康的关系受自我效能感层级、社会发展和性别的调节;而年龄阶段仅调节了自我效能感与心理健康积极因素的关系。以上结果说明,高自我效能感个体的心理健康水平更高,同时还要考虑年龄阶段、自我效能感层级、社会发展和性别在两者关系中的作用。     

Different Disgust Domains Specifically Relate to Mental and Contact Contamination Fear in Obsessive-Compulsive Disorder: Evidence From a Path Analytic Model in an Italian Clinical Sample

Both contact contamination (CC) and mental contamination (MC) fears—which combined represent the most common manifestation of obsessive-compulsive disorder (OCD)—have been widely associated with disgust propensity. However, extant research explored this relationship using measures assessing only pathogen-related disgust, not taking into account the potential role played by sexual and moral disgust, despite literature about MC suggesting that this might be particularly relevant. In Study 1, the psychometric properties of the Italian version of the Three Domains of Disgust Scale (TDDS) were assessed in a large Italian community sample. Exploratory and confirmatory factor analyses confirmed the three-factor structure of the TDDS. The scale also showed good internal consistency and construct validity. In Study 2, the differential patterns of relationships between CC and MC and the three disgust domains were explored in an Italian clinical OCD sample using a path analytic approach. The TDDS-Pathogen subscale was a unique predictor of CC while the TDDS-Sexual subscale was a unique predictor of MC, after controlling for anxiety and depression. Surprisingly, the TDDS-Moral subscale was not a predictor of either domain of contamination fear. Limitations and clinical implications are discussed.     

Socially Valued Roles,Self‐Determination,and Community Participation among Individuals Living with Serious Mental Illnesses

Decades after deinstitutionalization, individuals living with serious mental illnesses remain isolated, socially disengaged, and devalued members of communities. Burgeoning research and services need conceptual clarity to improve such social conditions. This qualitative inquiry used grounded theory and participatory approaches to conduct an in‐depth exploration of community participation for individuals living with serious mental illnesses based on key stakeholder perspectives (n = 45). Results revealed that community participation is a multifaceted construct with layers of meaning for individuals living with serious mental illnesses. Overarching themes are contextualized in Self‐Determination Theory and presented with deidentified illustrations. Implications for services, research, and policy are discussed.     

Utility of the REDFLAGS Model for Supporting Community College Students’ Mental Health: Implications for Counselors

The counseling literature is lacking in research on supporting the mental health needs of the growing community college student population. A number of past investigators have demonstrated the utility of mental health literacy for supporting college students’ mental health on 4‐year universities. The present researchers examined the validity of the REDFLAGS model (a theoretical model for promoting mental health literacy) with a national stratified random sample (N = 640, stratified by age, gender, and ethnicity) of community college students. Collectively, the results of the confirmatory factor analysis, hierarchical logistic regression, and factorial analysis of variance supported the use of the model with community college students. Implications for enhancing counseling practice as well as directions for future research are provided.     

A Limited Information Estimator for Dynamic Factor Models

Structural equation modeling (SEM) is an increasingly popular method for examining multivariate time series data. As in cross-sectional data analysis, structural misspecification of time series models is inevitable, and further complicated by the fact that errors occur in both the time series and measurement components of the model. In this article, we introduce a new limited information estimator and local fit diagnostic for dynamic factor models within the SEM framework. We demonstrate the implementation of this estimator and examine its performance under both correct and incorrect model specifications via a small simulation study. The estimates from this estimator are compared to those from the most common system-wide estimators and are found to be more robust to the structural misspecifications considered.