Service users’ perceptions of shared agency in mental health services

Objective: The concept of shared agency is used in examining the collaboration between the service user and the professionals. The study aims to find out what kind of experiences on shared agency mental health service users have.

Method: The study was based on interviews of 19 service users. The data set was formed of those parts of the interviews that dealt with shared aims, being heard, collaboration and joint planning and decision-making. Typical methods of inductive content analysis were applied.

Results: Three domains of shared agency were found: emotional, communicative and supportive ones. The emotional domain included elements of becoming heard and building confidence. In the communicative one, the main features were mutual information sharing, finding words to describe the chaos and reconstructing harmony. The supportive domain included encouragement and giving support. Experiences on non-shared agency were also found.

Conclusion: Many experiences on shared agency were found. Joint planning and working with life goals were, however, seldom reported. This result, together with experiences of non-shared agency, sets a challenge for mental health services.     

Interpersonal psychotherapy for eating disorders with co-morbid depression: A pilot study

Objective: Patients with eating disorders (ED) often suffer from co-morbid depression, which may complicate the ED treatment. Previous studies have found that ED interventions seem to have limited capacity to reduce depressive symptoms. Several studies of interpersonal psychotherapy (IPT), have found that when patients have been treated for depression, co-morbid symptoms have diminished. As depression and EDs are commonly co-occurring conditions, this pilot study aimed to examine the effect of an IPT treatment for these conditions, with the focus on the depressive symptoms.

Method: In this multi-centre study, 16 patients with EDs and co-occurring major depression received 16 weeks of depression-focused IPT.

Results: Significant improvements with substantial effect sizes were found for both depression (d = 1.48) and ED (d = .93). Symptom reduction in the two syndromes were strongly correlated (r = .625, p = .004). Patients with a restrictive ED did not improve on either depression or ED symptoms.

Conclusion: These findings point to the usefulness of IPT for concurrent depression and ED with a bingeing/purging symptomatology. Working with negative affect and problem-solving related to current interpersonal problems may alleviate general psychological distress among these patients.     

Male and female psychoneuroendocrine response to examination stress: A case report

Urinary catecholamine levels were investigated in one female and one male Ph.D. candidate during public defense of their Ph.D. theses as well as during 2 weeks preceding and 1 week following these examinations. Although females, in comparison to males, usually tend to show a weak adrenaline response to mental stress, a threefold increase was observed in both subjects. The results support the assumption that sex differences in adrenal-medullary responsiveness to stress is not determined by sex-specific biological factors alone and that a “male” responsiveness may be observed in achievement-oriented females exposed to a challenging real-life situation. Effects on urinary measures of cortisol obtained from the male subject resembled effects on adrenaline, showing that this kind of real-life stressor affects the sympathetic-adrenal medullary and the pituitary-adrenocortical systems similarly.     

Decreasing motor stereotypy in leisure contexts: Analysis of stimulus control with response interruption and redirection

Noncontingent access to preferred stimuli and activities may decrease stereotypic behavior in individuals with autism or other developmental disorders. However, prompted engagement, response interruption and redirection (RIRD), and/or contingent access to stereotypy may be required to achieve clinically significant reductions in stereotypy. Antecedent stimuli may also be manipulated during intervention to establish stimulus control by signaling when stereotypy will receive programmed consequences. The purpose of the current project was to replicate prior research in this area by a) evaluating the effectiveness of RIRD on motor stereotypy in an adolescent with autism and b) providing contingent access to stereotypy as a function of successively longer intervals without stereotypic behavior. We also assessed the extent that these procedures gained acceptable stimulus control. Results from this project suggest RIRD and contingent access to stereotypy may effectively decrease motor stereotypy in leisure contexts, though consistent inhibitory stimulus control may be difficult to establish.     

Interaction of sex-related psychological characteristics and psychoneuroendocrine stress responses

Sex-related psychological characteristics of male and female engineering students were examined and correlated with measures of sympathetic-adrenal medullary hormones. Self-ratings showed that both males and females perceived themselves as equally high in characteristics generally viewed as masculine and feminine. Retrospective reports of play activities in childhood reflected the traditional sex-role patterns, whereas ratings of adult interests, hobbies, and job preferences showed that the two gender groups had moved in a more androgynous direction, with the increase in females' cross-sex interests being greater than that of males. The intellectual performance profiles showed the well-documented sex difference, with males excelling in visuospatial abilities and females in verabl abilities and perceptual speed. Correlations between measures of intellectual performance and catecholamine excretion were mainly positive in the male group and negative in the female group, which is consistent with findings from previous studies.     

Timing of Early Maternal Mental Health and Child Cortisol Regulation

Maternal mental health problems can negatively impact children's physiological stress regulation. Yet, little is known of their long‐term effects, especially related to the timing of maternal symptoms. We examined how maternal mental health problems during pregnancy versus in the early postpartum period predict children's cortisol levels and diurnal patterns at 10–12 years. Participants were a selection (N = 102) of an original sample of 805 Finnish families, who were followed from the second trimester of pregnancy (T1) to child's age of 2 months (T2) and 12 months (T3), and again at child's age of 10–12 years (T4). Based on the timing of psychological distress and depressive symptoms (T1–T3), the mothers could be assigned to three distinct mental health trajectory groups: mothers with prenatal mental health problems (n = 15), mothers with early postpartum mental health problems (n = 15) and mothers without mental health problems (n = 72). Children's cortisol (T4) was measured by saliva samples through five within‐1‐day assessments. The results show that maternal prenatal mental health problems predicted a relatively steep increase of child cortisol from awakening to 1 h later, indicating an intensified cortisol awakening response (CAR). Mothers' early postpartum mental health problems instead predicted a reduced CAR. Both maternal prenatal and postnatal mental health problems thus predicted children's later stress regulation, but in unique ways. We discuss the specific roles of direct biochemical effects during pregnancy and postpartum mother–infant interaction quality as modifiers of the hypothalamic–pituitary–adrenal system. Copyright © 2015 John Wiley & Sons, Ltd.     

Modeling the categorical perception of speech sounds: A step toward biological plausibility

Our native language has a lifelong effect on how we perceive speech sounds. Behaviorally, this is manifested as categorical perception, but the neural mechanisms underlying this phenomenon are still unknown. Here, we constructed a computational model of categorical perception, following principles consistent with infant speech learning. A self-organizing network was exposed to a statistical distribution of speech input presented as neural activity patterns of the auditory periphery, resembling the way sound arrives to the human brain. In the resulting neural map, categorical perception emerges from most single neurons of the model being maximally activated by prototypical speech sounds, while the largest variability in activity is produced at category boundaries. Consequently, regions in the vicinity of prototypes become perceptually compressed, and regions at category boundaries become expanded. Thus, the present study offers a unifying framework for explaining the neural basis of the warping of perceptual space associated with categorical perception.     

Changes in studying abilities as perceived by students attending psychotherapy

In rehabilitative psychotherapy, the goal is to support and improve the person's working and studying capacity and to secure his/her staying in or entering the workforce. In this qualitative study, the aim was to describe the changes students experienced in their studying ability and the advancement of their studies as a result of the therapy process. The results of this study showed many kinds of positive changes in the psychological resources and studying ability of students participating in psychotherapy. The results also show that when psychotherapy is arranged with the aim to support the study process, good connections between psychotherapy, study tutoring and career guidance are needed.