Violent behavior patterns on psychiatric wards

A study of 379 violent incidents between pairs of psychiatric inpatients during an eight-month period indicates a substantial number of patterned associations between assaulting patients and those struck. In addition, regularities are observed in these incidents between frequency of occurrence and spatiotemporal and other contextual factors. Taken in the aggregate, these relationships support enlargement of most current conceptualizations of the violent act in psychiatric settings, which focus almost exclusively upon physiologic and psychologic state changes within the identified initiator of violent acts.     

Integration of the pleasant events and activity restriction models: development and validation of a "PEAR" model of negative outcomes in Alzheimer's caregivers

This study examined an activity restriction/pleasurable activities mismatch model for psychosocial and health-related outcomes. A total of 108 spousal caregivers of patients with Alzheimer's Disease (AD) were assessed for their experience of social and recreational activities over the past month as well as their perception of how restricted they were for engaging in social and recreational activities. Participants were divided into three groups based on their reported activities and activity restriction: HPLR = High Pleasant Events + Low Activity Restriction (i.e., reference group; N = 28); HPHR/LPLR = Either High Pleasant Events + High Activity Restriction or Low Pleasant Events + Low Activity Restriction (N = 43); LPHR = Low Pleasant Events + High Activity Restriction (N = 37). We hypothesized that participants reporting low pleasant events combined with high activity restriction (LPHR) would demonstrate greater disturbance relative to other two groups in multiple outcome domains, including: (a) greater mood disturbance, (b) greater use of negative coping factors, (c) reduced use of positive coping strategies, (d) reduced report of psychological resource factors (e.g., personal mastery, self-efficacy), and (e) increased report of subjective health difficulties (e.g., sleep disturbance). Results generally supported our hypotheses, suggesting that assessment of both constructs is important for best predicting quality of well-being in AD caregivers, and potentially for establishing maximal effect in behavior therapy for caregivers.     

Specificity of cognitive and behavioral variables to Positive and Negative Affect

The Tripartite Model proposes that a combination of greater Negative Affect (NA) and reduced Positive Affect (PA) contributes to depressive symptoms. The purpose of this study was to test a model of affective experience in which cognitive variables (i.e., negative cognitions and appraisals) are uniquely related to NA but not PA, and in which behavioral variables (i.e., activity participation) are uniquely associated with PA but not NA. Participants included 88 spousal Alzheimer caregivers (mean age = 74 years). Multiple regression models, in which negative cognitions (i.e., helplessness, blames self, and negative appraisals) and activity participation (i.e., frequency of engaging in social and recreational activities) were used to predict depressive symptoms, PA and NA. Results indicated that while helplessness, blaming oneself, negative appraisals, and activity participation all significantly predicted depressive symptoms, only negative cognitive variables significantly predicted NA, and only activity participation significantly predicted PA. These data confirm that depressive experience consists of two relatively independent components - increased Negative Affect and reduced Positive Affect - which have unique correlates in negative cognitions and activity participation. If confirmed, the findings suggest the utility of focusing interventions on each of these components in the management of depressive symptoms.     

成人日常问题解决的老化研究

日常问题解决能力是近十几年来老年心理学中研究比较活跃的一个领域。本文介绍了有关日常问题解决研究的四种理论,即心理测量的智力内隐理论、形式后思维的辨证思维理论、信息加工理论和社会认知与智慧理论,及其初步的研究成果,并进一步指出在理论上整合和在实践中开展干预的研究方向。     

IQ and Scores on the Mini-Mental State Examination (MMSE)

The Mini-Mental State Examination (MMSE) and the Peabody Picture Vocabulary Test-Revised (PPVT-R) were administered to 217 Veterans Affairs (VA) Nursing Home patients, 104 of whom did not carry a diagnosis associated with brain impairment, and 113 who had a diagnosis associated with degenerative or cerebrovascular conditions. MMSE and IQ scores were significantly correlated in both groups, even controlling for the effects of education. It is suggested that although previous normative studies of the MMSE may provide good general clinical guidance, interpretation of “impaired” performance on the MMSE for those with IQ scores below 90 should be approached with caution. Average MMSE scores for Wechsler IQ classifications are provided.     

A Pilot Study of Acute Stress Symptoms in Parents and Youth Following Diagnosis of Type I Diabetes

The primary aims of this exploratory study were to determine the rate of occurrence of acute stress disorder (ASD) in children newly diagnosed with Type 1 diabetes and their parents, to examine relationships with demographic and psychosocial factors, and to examine the relationships between ASD symptom clusters and early adherence behavior (clinic attendance). The sample consisted of 102 parents of children ages 0–17 years and 40 youth ages 11–17 who were evaluated within three days of diabetes diagnosis. Eighteen percent of parents and 17% of youth reported subthreshold symptoms of ASD. Acute stress symptoms and demographic variables predicted clinic attendance, with a differential pattern evident in the responses of youth and their parents. These findings reinforce the importance of screening symptoms of ASD in youth with newly diagnosed diabetes and their parents to assist in identifying families who may be in need of additional support.     

Social anxiety in older adults: phenomenology, prevalence, and measurement

Although phobias represent the most common anxiety disorders among the elderly, little is known about their social nature. The present study provides information about the prevalence, measurement, and phenomenology of social anxiety in older adults (n = 283) and compares results to those of younger adults (n = 318). Analyses revealed that social anxiety is less prevalent in old age than it is within younger cohorts and is associated with different symptomatology. The psychopathological profile of those who reach clinical levels of social anxiety is however similar, irrespective of age. Results regarding the psychometric properties of the SPAI when used for the elderly were promising, but the questionnaire appears to be difficult for some older adults to complete. Results are discussed in terms of explanations for age differences in social anxiety, initial psychometrics of the SPAI in an older adult sample, and suggestions for future research.     

The Validity of a Brief Risk Assessment Tool for Predicting Suicidal Behavior in Veterans Utilizing VHA Mental Health Care

Suicide risk among military veterans is an important and ongoing concern. The Veterans Administration (VA) mandates suicide risk screening of all veterans seen for mental health issues, but little is known about the effectiveness of this screening. A retrospective chart review to examine all suicide risk screens at VA San Diego between October and December 2012 (n = 3,365) was conducted to assess whether results were associated with suicidal behavior over the subsequent 12 months. Patients judged to be at increased risk for suicide were 3 to 16 times more likely to attempt suicide and 7 to 25 times more likely to engage in self‐directed violence over the next 12 months compared with others. The screening tool may be a useful addition to clinical practice.