Exploring goal taxonomies using the goal-based outcome tool in children and young people's mental health settings

Formulating goals in therapy may facilitate young people and parents/carers' engagement in mental health support settings. A number of goal taxonomies have been developed, which involve organising goals set at the outset of therapy into themes. Goal taxonomies are considered useful for service planning and outcome purposes. In order to build on the knowledge about what young people choose as goals, and to best support good practice, it is important to explore the links and differences between the existing goal taxonomies. A systematic review was conducted to identify goal taxonomies based on goals set using the goal-based outcome (GBO) tool. Framework analysis was conducted to investigate the extracted goal taxonomies. Overall, four core concepts were identified: “Goals targeting specific issues, symptoms, emotions, and behaviours,” “Return and engage in activities,” “Personal growth goals” and “Interpersonal goals.” Goals regarding specific issues, personal growth and interpersonal relationships were present in most studies. Using these overarching core concepts could be useful for practitioner-level, or service-level organisation of goal data, for activities such as service planning and delivery.     

Remarks on Penrose’s “New Argument”

It is commonly agreed that the well-known Lucas–Penrose arguments and even Penrose’s ‘new argument’ in [Penrose, R. (1994): Shadows of the Mind, Oxford University Press] are inconclusive. It is, perhaps, less clear exactly why at least the latter is inconclusive. This note continues the discussion in [Lindström, P. (2001): Penrose’s new argument, J. Philos. Logic 30, 241–250; Shapiro, S.(2003): Mechanism, truth, and Penrose’s new argument, J. Philos. Logic 32, 19–42] and elsewhere of this question.     

The Role of the Child in Adult Development

This paper provides theoretical and empirical support for the view that children play a large and often underappreciated role in adult development. Fifty parents and teachers were asked to discuss occasions when they learned something valuable from a child or when a child changed them in some significant way. Adults reported that children can cause them to (a) shift their values or priorities, (b) integrate memories or experiences previously disowned or repressed, (c) become more creative and cognitively flexible, or (d) look at the world with more wonder, awe, or curiosity. Werner's concept of genetic stratification (H. Werner, 1957) and Labouvie-Vief, Chiodo, Goguen, Diehl, and Orwoll's concept of dynamic intersubjectivity (G. Labouvie-Vief, L. M. Chiodo, L. A. Goquen, M. Diehl, & L. Orwoll, 1995) are used to explain the results.     

Ethics,policy, and rare genetic disorders: the case of Gaucher disease in Israel

Gaucher disease is a rare, chronic,ethnic-specific genetic disorder affecting Jewsof Eastern European descent. It is extremelyexpensive to treat and presents difficultdilemmas for officials and patients in Israelwhere many patients live. First, high-cost,high-benefit, but low volume treatment forGaucher creates severe allocation dilemmas forpolicy makers. Allocation policies driven bycost effectiveness, age, opportunity or needmake it difficult to justify funding. Processoriented decision making based on terms of faircooperation or decisions invoking the ``rule ofrescue' risk discriminating against minoritieswho may already suffer from inequitabledistribution of heath care resources. Apartfrom cost, Gaucher disease prompts questionsabout abortion. Unlike severe geneticdisorders, Gaucher offers no grounds forabortion and, in many ways, is analogous togender based abortions that are prohibitedregardless of fetal age. Finally, Gaucherraises concerns about the disclosure of geneticinformation. These affect potential carriersasked to participate in population studies andcarriers and patients who must considerdisclosure to others. These concerns weigh theright to privacy against communal interests andbilateral commitments.     

Young adult follow-up of hyperactive children: self-reported psychiatric disorders,comorbidity, and the role of childhood conduct problems and teen CD

We report on the psychiatric disorders present at young adult follow-up (Mean age 20–21 years; 13 + year follow-up) and the comorbidity among them for a large sample of hyperactive (H; N = 147) and community control (CC; N = 71) children. The H group had a significantly higher risk for any nondrug psychiatric disorders than the CC group (59% vs. 36%). More of the H group met criteria for ADHD (5%); major depressive disorder (26%); and histrionic (12%), antisocial (21%), passive–aggressive (18%), and borderline personality disorders (14%) at follow-up than the CC group. Severity of childhood conduct problems contributed to the risk for passive–aggressive, borderline, and antisocial personality disorders. But it only affected risk for antisocial personality after controlling for severity of teen conduct disorder (CD), which also contributed to the risk for these same 3 disorders. Examination for comorbidity among these disorders indicated that presence of either borderline or antisocial personality disorder significantly increased the risk for major depression and the other significant personality disorders. More of the hyperactive group had received various forms of mental health treatment during and since leaving high school than the control group. Results suggest that hyperactive children are at significant risk for at least 1 nondrug disorder in young adulthood, principally major depression and several personality disorders, and that this risk is largely mediated by severity of CD at adolescence.     

What is the Revised Fear Survey Schedule for Children measuring?

The Fear Survey Schedule for Children-Revised (FSSC-R) is a widely used self-report questionnaire that purports to measure the number of fears and the overall level of fearfulness in children. A number of studies have shown that the ten most common childhood fears can be found on the Danger and Death subscale of the FSSC-R, with upwards of 50% of children endorsing such fears. However, some researchers (e.g., H. McCathie & S.H. Spence, 1991; Behaviour Research and Therapy, 29, 495-502) have questioned the validity of these findings, suggesting that these items do not reflect actual childhood fears that children have or experience on a daily or regular basis. Rather, they suggest that children are responding to these fear items as if they were actually occurring to them in the here and now. The current study examined the occurrence of five Danger and Death fears from the FSSC-R (i.e., "Not being able to breathe", "Being hit by a car or truck", "Falling from high places", "Bombing attacks or being invaded", and "Fire or getting burned") in a sample of normal school children aged eight to 12 years (N=102). More specifically, we used three different methods to asses these fears: (1). prevalence as determined by the standard FSSC-R procedure, (2). prevalence as determined by a fear list procedure, and (3). actual occurrence or prevalence of these fears in the past week, as determined by a diary method. Results indicated that while these fears ranked high when using the standard FSSC-R procedure, they were considerably less common when using the fear list procedure, and had a low probability of actual occurrence on a daily basis, as well as possessing a short duration and low intensity. Implications for the assessment of fears and the use of self-report measures like the FSSC-R are briefly discussed.     

Medicine and pharmacy — facts and myths about the development of an innovative pharmaceutical industry in Poland

Innovation is fundamental to the pharmaceutical industry and a key to improvements in healthcare. Its effectiveness depends on huge, constant investments in research. This innovative industry directly affects the course of studies in healthcare and medicine. Its efforts translate directly into the length and quality of our lives. For several years now, the progress underway in pharmaceutical industry has produced measurable benefits. Doctors have new pharmaceuticals at their disposal, including many types of antibiotics and anti-viral drugs, vaccines and a wide range of drugs which save lives or make them more comfortable. In the near future, ever more efficient cures for neoplastic, rheumatic, neurological, psychic, metabolic, circulatory or respiratory diseases can be expected. Innovation is necessary. The human population is ageing, and the task of an innovative pharmaceutical industry is to keep it in a good condition. The use of innovative drugs can translate directly into lowering the costs of illness. A continuous reduction in spending on healthcare has been observed. The costs of inventing an innovative drug are enormous though (US$ 800 million), and studies on a new drug last between 10 and 13 years. An essential element in recovering the incurred costs and ensuring funds needed for new research is protection by patent. Innovative pharmaceutical companies in Poland are committed to increasing the competitiveness and sustaining the development of not only the market, but also the entire pharmaceutical sector. It is a group of companies of crucial importance to the Polish healthcare system, as it influences improvement in the quality of medical services. Through their investments and spending on research and development, innovative companies accelerate economic growth. In Poland, the innovative pharmaceutical industry is represented by the Association of Pharmaceutical Companies Representatives in Poland (SPFFwP). An earlier version of this paper was presented at an international conference, “The Ethics of Intellectual Property Rights and Patents,” held in Warsaw, Poland on 23–24 April, 2004.     

The Child Behavior Checklist for Group Care Workers: A Study Regarding the Factor Structure

In this study we examined the factor structure of the Child Behavior Checklist (CBCL) filled out by group care workers. Group care workers' judgements were collected on 846 children and adolescents treated in various residential settings in The Netherlands. Using confirmatory factor analysis, we were able to show that the original CBCL factor model based on parental judgments of child behavior also fits for the judgments of group care workers. This means that the well known 8 narrow-band syndromes (Withdrawn, Somatic Complaints, etc.) as well as the 2 broad-band syndromes (Internalizing and Externalizing) can be used to interpret the CBCL scores of group care workers. This confirmation of the CBCL factor structure is a first step to add a group care worker version to the CBCL family. However, as a second step, normative data need to be gathered to further enhance the use of the CBCL for group care workers.     

Suppression of scientific research: Bahramdipity and Nulltiple scientific discoveries

The fairy tale The Three Princes of Serendip can be taken to be allegorical of not only chance discovery (serendipity) but of other aspects of scientific discovery as well. Just as Horace Walpole coined serendipity, so can the term bahramdipity be derived from the tale and defined as the cruel suppression of a serendipitous discovery. Suppressed, unpublished discoveries are designated nulltiples. Several examples are presented to make the case that bahramdipity is an existent aspect of scientific discovery. Other examples of non-ideal scientific research and discovery are provided in order to contrast and clarify the meaning and use of bahramdipity. Additional allegories of scientific discovery are taken from the tale and a hope for the strengthening of scientific integrity is expressed.     

转型期初中生心理健康与父母养育方式的研究

本研究采用《心理健康诊断量表》和《父母养育方式问卷》对196名初中生进行测量,探讨初中生心理健康与父母养育方式的影响因素及其相互之间的关系。结果表明,初中生的心理健康问题的检出率依次是自责倾向、恐怖倾向、冲动倾向和对人焦虑;性别因素只在心理健康的学习焦虑、养育方式上的父亲的惩罚、严厉、母亲的过干涉、过保护、父母的拒绝、否认等因素上表现出了显著差异;独生子女与非独生子女子女比较,在恐怖倾向以及惩罚、严厉的养育方式上存在显著差异;父母的文化程度、职业状况、离异、下岗等因素,只有母亲的职业状况因素对心理健康构成了影响;父母消极的教养方式将使学生的焦虑增加,母亲积极的教养方式将使学生的焦虑减少。