Psychosocial work factors, physical work load and associated musculoskeletal symptoms among home care workers

This study was based on a questionnaire and included a group of home care workers (HCW) (n = 305) and a reference group of municipal employees (n = 694). The relationship between the work environment and musculoskeletal symptoms was analysed. The HCW were less satisfied with their control over their work and stimulus from their work and had a higher physical work load and prevalence of musculoskeletal symptoms, compared with the reference group. The Rate Ratio (RR) of neck and shoulder symptoms among HCW was 83 and 54 %, respectively, higher among those reporting a "high" psychological work load compared with those reporting a "low" load. The highest RR for a single risk indicator was 2.5, and this concerned low-back symptoms among HCW who often worked with twisted postures. A combination of "poor" psychosocial work environment and "high" physical work load produced the highest RR for work-related neck (RR = 2.57) and shoulder (RR = 2.13) symptoms.     

Evaluating the vermont system of care: Outcomes associated with community-based wraparound services

Evaluation of innovative community-based interventions is becoming a high priority for child and adolescent mental health service system research. The present study examined outcomes for a sample of Vermont children (N=27) experiencing emotional and behavioral problems and receiving individualized, wraparound services. One year after initiation of wraparound care, incidence of negative behaviors rated as placing a child at risk of removal from the community had decreased significantly, compliance behavior had increased, and a significant decline in Total Problem Behavior scores on the Child Behavior Checklist was observed. In addition, though 70% of the participants had previously required inpatient or residential treatment, 89% were maintained in the community after one year of services, and the total cost of services was less than that of out-of-state residential care. Although further comparative research is needed, this study suggests that for many of these children, wraparound services may be a more efficient intervention than long-term psychiatric hospitalization or residential treatment.     

APPLYING BEHAVIOR ANALYSIS TO CLINICAL PROBLEMS: REVIEW AND ANALYSIS OF HABIT REVERSAL

This article provides a review and analysis of habit reversal, a multicomponent procedure developed by Azrin and Nunn (1973, 1974) for the treatment of nervous habits, tics, and stuttering. The article starts with a discussion of the behaviors treated with habit reversal, behavioral covariation among habits, and functional analysis and assessment of habits. Research on habit reversal and simplified versions of the procedure is then described. Next the article discusses the limitations of habit reversal and the evidence for its generality. The article concludes with an analysis of the behavioral processes involved in habit reversal and suggestions for future research.     

Comorbidity of drug abuse treatment

Research has suggested that comorbidity, the concurrence of substance abuse disorders with other psychiatric disorders, may have prognostic value and important implications for the treatment of substance abuse. Knowledge of the prevalence of comorbid disorder is important because it will enable treatment services to be appropriately configured and designed for clinical drug treatment populations. The form and duration of comorbidity may be influenced by a variety of factors, which include the class of drug being abused, the duration of drug use, the individual sensitivity to drug effects, and whether the drug effects are acute or due to withdrawal or residual conditions. This paper addresses three important scientific questions: (1) What is the prevalence of comorbid disorders in a drug abuser population? (2) What is the stability of psychiatric diagnoses in a drug abuser population? (3) Does the existence of a comorbid disorder influence the outcome of drug abuse treatment?     

Adult Outcomes of Child Conduct Problems: A Cohort Study

The present study assessed the mental health and criminal records of 6,449 males and 6,268 females who presented conduct problems as children by examining an unselected birth cohort followed up to age 30. Conduct problems were defined by teacher ratings of behavior problems and/or antisocial behavior in the community. There was little overlap in the children identified by teachers and by the community. These two groups of children were at differential risk for adult mental disorder. Seventy-six percent of the males and 30% of females with childhood conduct problems had either a criminal record, a mental disorder, or both by age 30. Risk ratios for adult criminality and/or mental disorders, however, were greater for females than for males with a history of childhood conduct problems. Almost all of the mental disorders were severe substance abuse. Mental disorders and crime were strongly associated among males with a history of childhood conduct problems.     

Presidential Address: Are the Obsessive-Compulsive Related Disorders Related to Obsessive-Compulsive Disorder? A Critical Look at DSM-5’s New Category

The 5^th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) includes a new class of obsessive-compulsive and related disorders (OCRDs) that includes obsessive-compulsive disorder (OCD) and a handful of other putatively related conditions. Although this new category promises to raise awareness of underrecognized and understudied problems, the empirical validity and practical utility of this new DSM category is questionable. This article critically examines the arguments underlying the new OCRD class, illuminates a number of problems with this class, and then discusses implications for clinicians and researchers.     

Deficit in phonological processes: a characteristic of the neuropsychological profile of children with NF1

Learning disabilities are one of the most frequent complications of neurofibromatosis type 1 (NF1) in children. Studies of the effects of the neurocognitive deficit on academic performance are relatively rare, owing to the small size of the populations concerned. However, research is needed to develop effective rehabilitation programs. In the present study, we explored the impact of a possible phonological deficit on the reading abilities of children with NF1. A multicenter, cross-sectional study was conducted in France on two groups of 75 children with or without NF1 aged 8–12 years, matched for age, sex, handedness, and reading level. All participants underwent a neuropsychological evaluation to assess their general cognitive level, reading skills, phonological processes, visuoperceptual abilities, and attentional capacity. Phonological skills were assessed by means of two phonological awareness tasks and one short-term memory task. In the group of children with NF1, 41% had reading difficulties. Phonological processes were impaired in this group, compared with the children without NF1. Similar differences were found for a phoneme deletion task after adjustment for reading difficulties, IQ level, and visuoperceptual abilities. Phonological awareness, but not phonological short-term memory, was impaired in children with NF1, and not just those whose reading was impaired. Results suggest that children with NF1 have a phonological awareness deficit, whatever their reading level. Identification of reduced phonological skills may warrant the implementation of a specific rehabilitation program before early reading difficulties emerge.     

Alliance rupture and repair processes in borderline personality disorder: A case study using dialogical sequence analysis

Objective: This study examined alliance rupture and repair processes in borderline personality disorder (BPD) and how the content of sessions interacts with the quality of the alliance.

Design: A mixed methods single case study design was employed incorporating quantitative and qualitative measures of process and outcome.

Methods: This case study examined a 22-year-old female with BPD who received 16 sessions of Cognitive Analytic Therapy. Measures of alliance, symptoms and global functioning were taken across multiple time-points. Selected sessions were analysed using dialogical sequence analysis (DSA), a theory-driven method of psychotherapy research that analyses utterances according to their author, addressee and referential object.

Results: Quantitative data indicated symptom reduction without functional improvement. DSA demonstrated that the first exchanges in therapy were reflective of key relational themes. The case suggests that, rather than simply negotiating tasks and goals, repairing ruptures involves systematically linking the manifest topic to the client’s core problems.

Conclusions: This case study points to the mediating role that the content of sessions has on alliance quality. Results underline the importance of the therapist stance, the need for a shared formulation to make sense of relational processes and the use of responsively timed interventions to decrease desperation and improve self-reflection.     

Women’s Perspectives Related to Occupational Performance Following Participation in Substance Use Recovery Programs

Very little research has examined how substance abuse programs affect occupational performance. The progression of addiction and its etiology for women are still under-reported. This study aimed to explore perceived effects of substance use and participation in peer-based programs on women’s occupational performance. Qualitative semi-structured interviews were completed with seven women. Four themes were identified: (1) substance use did not markedly inhibit participation in daily life; (2) recovery was supported by replacing substance related occupations with non-substance related occupations; (3) perceived value of shared perspectives and experiences with others; and (4) the embracing of new perspectives as part of recovery.     

Pathological Dissociation and Its Relationships with Aggression and Delinquency in a College Student Sample in Hong Kong

Pathological dissociation is widely regarded as a cross-culturally occurring condition related to trauma and adversity and is an important construct in the mental health field. Yet, the frequency of pathological dissociation in both clinical and nonclinical populations in Hong Kong remains unknown. In addition, the relationship of pathological dissociation with aggression and delinquency requires further investigation. To investigate these relationships, we administered the Dissociative Experiences Scale-Taxon (DES-T), the 5-item Somatoform Dissociation Questionnaire (SDQ-5), selected sections from the Self-Report Version of the Dissociative Disorders Interview Schedule (SR-DDIS), the Reactive–Proactive Aggression Questionnaire (RPQ), and a delinquent behaviors checklist to 177 college students in Hong Kong. The findings suggest that pathological dissociation is not as rare as it is traditionally believed to be in Hong Kong. In our sample, 4.52% of the participants may have a DSM-5 dissociative disorder (including other specified dissociative disorder) while 9.60% met the DSM-5 diagnostic criteria for borderline personality disorder (BPD). Our findings indicate that the RPQ total score and delinquency may be more characteristic of BPD than of pathological dissociation. In addition, while reactive aggression was related to pathological dissociation and BPD symptoms in both genders, proactive aggression was related to pathological dissociation and BPD symptoms only in females. Although the findings of this study are preliminary and the results should be interpreted with caution, the study provides the first data regarding pathological dissociation and its relationship with aggression and delinquency in Hong Kong. Some implications for research and practice are highlighted. Further investigation of pathological dissociation in Hong Kong is necessary. In addition, more studies are essential to further examine the relationships between pathological dissociation, aggression, and delinquency in both clinical and nonclinical populations.