The prevalence of dental anxiety in patients of a university dental clinic

Dental anxiety remains a pervasive barrier to dental treatment for many individuals, including college-age patients. In this article, the author reviews dental anxiety and examines the usefulness of assessment instruments for identifying dental anxiety. Using 2 unique assessment instruments, he examines the prevalence of dental anxiety in his university dental clinic's patient population. The 2 assessment instruments were determined to be equally effective in identifying anxious dental patients. Both instruments revealed that the average patient surveyed had low-to-mild dental anxiety. The results of this survey concur with those of previous studies of college-populations.     

An Examination of Older Immigrants' Use of Dental Services in the United States

The recent influx of immigrants aged 65 and older in the United States triggers an increasing need to understand older immigrants' dental services use. This paper uses data (n = 9,617) from the 2004 and 2006 waves of the Health and Retirement Study to examine the dental services use of older Americans. In particular, this study focuses on differences in dental services use between immigrants and natives and potential contributing factors. Multivariate logistic regression analyses showed, contrary to expectation, that older immigrants were more likely to use dental services than older natives despite numerous barriers (odds ratio = 1.30 in 2004). The results in 2006 confirmed these findings. The results from 2004 and 2006 analyses showed dental insurance coverage, sex, and marital status were associated differently with dental services use for immigrants and natives. Implications for current oral health policies and future research of older Americans are discussed, as well as methods for meeting older immigrants' growing dental services needs.     

Depressive Symptoms,Stress, and Social Support Among Dental Students at a Historically Black College and University

Objective: The authors measured the prevalence of depressive symptoms among dental students at a historically black college in the United States to determine how depressive symptoms, stress, and social support influence each other within this student population. Participants: Dental students (n = 143) completed a self-administered survey to assess depressive symptoms, stress, and social support, using validated and reliable instruments. Participants also reported demographic variables. Methods: The authors used multivariable linear regression controlling for potential confounding. Results: The prevalence of depressive symptoms was 16.7%. There were significantly higher levels of stress for students with depressive symptoms compared with those without such symptoms (p < .01), and students with depressive symptoms had significantly lower levels of social support (p < .01). Results show higher levels of depressive symptomatology to be related to decreased social support at both high and low stress levels (p < .01). Conclusions: Stress and social support are associated with depressive symptoms among dental students.     

The Emergency Dental Service at Southern Illinois University/Carbondale

Abstract

The Student Emergency Dental Service (SEDS), a program of Allied Health and Public Services, Southern Illinois University at Carbondale (SIUC), began treating patients in January 1978. The purpose of the program is twofold. The main emphasis of SEDS is to treat patients with dental-related disorders of an emergency nature. The other purpose of SEDS is to help raise the level of dental knowledge among the student population so as to prevent the emergency situations from occurring.

The Student Emergency Dental Service is essentially an “emergency only” service, even though prevention is highlighted. Such an emergency service cannot compete with a comprehensive service in terms of providing total patient dental care. Hence, the SEDS program has some innate limitations a comprehensive service does not. It must work from certain guidelines. It cannot treat everyone, and the mode of treatment must be altered to aid the emergency patient. This creates dilemmas that will be addressed in this paper. The organization, accomplishments, and advantages and disadvantages of the SEDS program at Southern Illinois University are also discussed.     

Structured risk assessment procedures: instruments of abuse?

Child protection services in Australia and elsewhere face increasing internal and external demands. As a response to these pressures, in part at least, services are increasingly implementing some form of risk assessment procedures. This article examines the practice implications of the increasing use of risk assessment instruments in child protection services. It highlights the complexity of the concept of risk as the basis for a future‐oriented assessment activity. The authors suggest that this change of time frame (from what has happened to what might happen) may be detrimental to children. Through a critical review of the literature, the authors question whether risk prediction is possible and discuss the limitations of risk assessment instruments which omit some risk factors and may ignore the perspective of the child. The authors challenge the validity of risk assessment instruments in statutory settings and suggest that the protection of the organization may be a major objective in their implementation. Copyright © 1999 John Wiley & Sons, Ltd.     

Great Expectations: The Growing Divide between Students and Social Work Educators

This article examines and reflects upon initial findings from a longitudinal study evaluating the experiences and views of students on professional social work programmes across four higher education institutes in the North West of England, on the BA and the MA routes. The paper focuses on one aspect of this study; the students' experience of assessment. In particular it examines how students experienced the process of learning, assessment, support and feedback, which was found to be in part shaped by previous educational experiences. The range of assessment methods previously experienced by students was diverse, some of which were more helpful than others in preparing them for their professional training. Lack of foundation subject knowledge presented a challenge to students on both courses, in particular for MA students who were being assessed at ‘M’ level. Unmet expectations of both the amount and type of support created anxiety, frustration and even anger for some. The ‘search for certainty’ led to anxiety amongst many first year students who believed that academics could facilitate the assessment process by providing ‘the answer’. This exploration of assessment reveals, we believe, a growing divide in the expectations of social work students and their educators.     

Tell Me a Story: A Review of Narrative Assessments for Preschoolers

The use of narrative assessments in mental health research with young children has increased significantly over the last 15 years. This article reviews 13 empirically validated narrative assessments for preschool populations. The reviewed instruments assess children’s attachment relationships, moral values, separation anxiety, pro-social behavior, object relations and depression, among other constructs. The authors present an analysis of each instrument including a discussion of its methodological rigor, and point to needed directions in the field. These narrative assessment instruments provide researchers and clinicians with insight into the internal worlds of young children, offering windows into a difficult-to-assess population.     

Assessment and management of hospitalized suicidal patients

Suicide in inpatient psychiatric settings is a critical problem. A comprehensive literature review was performed to determine risk factors for inpatient suicide, instruments for assessing suicide, and treatment of hospitalized suicidal patients. Findings suggested that root causes of inpatient suicide were factors related to the treatment environment, failure to assess patient behavioral characteristics, and staff reliance on no-suicide contracts. Recommendations include assessing suicide risk regularly throughout hospitalization, including on admission, during changes in a patient's mental or physical status, after a change in observation level, and before discharge. Orientation and inservice education for all staff and additional research on the psychometric properties of available suicide assessment instruments are also essential.     

Risk assessment of sex offenders: the current position in the UK

This paper examines the various risk factors that are considered in the current risk assessments used with sex offenders, and the strengths and weaknesses of each. In addition, particular attention is given to the assessments that are currently employed within the prison and probation services. Static instruments, dynamic instruments and combined approaches are evaluated, as are clinical assessments of risk. In particular, the now commonly used joint Prison‐Probation Offender Assessment System risk prediction instrument (OASys) is considered, with an evaluation of the relevance of the factors included in making an assessment of risk and whether this is supported by research into recidivism amongst sex offenders. Copyright © 2006 John Wiley & Sons, Ltd.     

Effects of Social Anxiety on Nonverbal Accuracy and Response Time I: Facial Expressions

Cognitive models of social anxiety provide a basis for predicting that the ability to process nonverbal information accurately and quickly should be impaired during the experience of state anxiety. To test this hypothesis, we assigned participants to threatening and non-threatening conditions and asked them to label the emotions expressed in a series of faces. It was predicted that social anxiety would be positively associated with errors and response times in threatening conditions, but not in a non-threatening condition. It was also predicted that high social anxiety would be associated with more errors and longer response times when identifying similar expressions such as sadness, anger, and fear. The results indicate that social anxiety was not associated with errors in identifying facial expressions of emotion, regardless of the level of state anxiety experienced. However, social anxiety scores were found to be significantly related to response times to identify facial expressions, but the relationship varied depending on the level of state anxiety experienced. Methodological and theoretical implications of using response time data when assessing nonverbal ability are discussed.     

Multiple stories: Collaborative and generative possibilities for psychological evaluation

This paper explores a collaborative generative approach to psychological assessment employed in Puerto Rico, with children, adolescents, and adults. It begins with a critical reflection on how the dominant discourse of mental health, founded in the suppositions and practices of Euro-American-centred psychological knowledge, has been disseminated to the globalise south under the claim that its assertions are unaffected by social, ideological, or historical forces. It discusses how its claims of expert scientific knowledge have contributed, through classificatory instruments such as the DSM and the ICD, to the production and re-production of deficit narratives in our day-to-day life. It also examines how these practices have been applied in the use of assessment instruments in Puerto Rico. It then describes, how, through a collaborative approach and narrative theory, the established colonising practices and narratives of traditional forms of psychological assessment can be questioned, deconstructed, and transformed. This approach promotes the co-creation of dialogic and generative spaces that allow for the emergence of multiple stories and performances that give meaning to a person's identity and relational being. A brief clinical case exposition is used to illustrate how this collaborative, dialogic, and culturally sensitive approach to psychological assessment can help to undermine and disrupt deficit-based narratives and provide families with new generative possibilities for re-storying and re-performing their lives and particularly, the lives of their children.     

The effect of social anxiety,generalized anxiety,depression and substance abuse on child support payment compliance among non-custodial parents

Millions of children live with custodial parents (CPs) who have child support court orders for the non-custodial parent (NCP) to provide payments to the CP for care of the children. Unfortunately, less than half of CPs receives full child support. A key issue influencing the failure to pay child support is NCP unemployment. Despite a clear association between unemployment and several mental disorders, the nature and prevalence of mental disorders has not been investigated in the NCP population. The purpose of this study was to explore the association between mental health and substance use problems among non-custodial parents and their payment of child support. The study also investigated whether unemployment mediated the relationship between these variables.Surveys that included validated screening instruments to assess for generalized anxiety, social anxiety, depression, and substance use disorders were administered to a convenience sample of 633 NCPs. Survey respondents were matched with state support payment information.The results indicated that depression, generalized anxiety, social anxiety and substance use problems were present at a much higher rate than 12-month rates of these conditions found in the general population. This study also confirmed the strong association between child support payments and employment. Employment mediated the relationship between mental health problems and child support payments. The findings suggest that non-compliant NCPs, particularly those who are also unemployed, may experience clinically significant mental health conditions that contribute to unemployment and potentially, payment non-compliance. Future studies could explore if providing mental health assessment and employment-focused treatment for mental health-related barriers to employment may increase employment and child support compliance for NCPs, thereby improving children's economic stability and well-being.     

Use of standardized assessment instruments in couple therapy: the role of attitudes and professional factors

The study examined therapeutic approach, professional affiliation, training, seniority, and work setting as predictors of attitudes toward standardized instruments and their use in couple therapy. Data were gathered from 163 certified marriage and family therapists in Israel. Results showed that 27.6% of marital therapists used standardized instruments for assessment. More positive attitudes toward standardized instruments were associated with the extent of training in their use and with a structural-strategic approach. Logistic regression analysis indicated that positive attitudes, training, and work setting best predict the application of standardized assessment instruments. Reasons for the relative lack of use of standardized assessment instruments are discussed. It is recommended that more training in assessment instruments be included in marriage and family therapy training.     

The Impact of Childhood Sexual Abuse on Women's Dental Experiences

ABSTRACT

One hundred and thirty-two women with a history of sexual abuse and 49 reporting no such history were compared, using a pilot-tested Dental Experiences Questionnaire. A history of abuse, especially severity of abuse, was found to be predictive of different patterns in making and keeping dental appointments; stress-related dental problems; and PTSD-type symptoms while at the dentist. Physical proximity, tactile, and kinesthetic experiences were evocative and therefore particularly discomfitting. Strategies that increased dental patients' sense of control, provided a feeling of protection or safety, and allowed for empowerment were positively endorsed, especially by sexual abuse survivors.     

Examining needs of informal kinship families: Validating the family needs scale

Families who provide informal kinship care are a critical part of child welfare, yet our understanding of their needs is limited due to the challenges of identifying the population. The absence of validated and reliable instruments for kinship families is an additional barrier. This study tests the psychometric properties and construct validity of the Family Needs Scale. A sample of 303 informal kinship families recruited through local child welfare and social services completed the scale as part of a demonstration project. An eight-factor structure emerged from psychometric testing. The FNS is strongly associated with other predictors of the needs such as income and parenting stress, suggesting the instrument's potential as a need assessment tool for kinship families. Further replication and robust analyses of the FNS structure will build stronger support for the scale as a needs assessment for kinship families.     

Cognitive Risk Factors to the Development of Anxiety and Depressive Disorders in Adolescents

This exploratory study examines cognitive risk factors, anxiety sensitivity, and positive and negative affect, as related to the development of anxiety and depression. In a mailed survey, adolescents completed the Child Anxiety Sensitivity Index and the Positive and Negative Affectivity Scale. Previous research utilized the broad and unified variable of anxiety sensitivity as a predictor of anxiety. In this study, we separate and examine the four specific factors of anxiety sensitivity: mental incapacitation concerns, social concerns, disease concerns, and unsteady concerns, and relate it to specific anxiety disorders and depression. Results indicate good convergent validity and improved divergent validity when utilizing the four factors of anxiety sensitivity as compared to using it as one construct. Results also suggest: (1) OCD and GAD share numerous similarities and (2) the importance of the role of negative affectivity in anxiety and depression. Being aware of the components of anxiety sensitivity and how they relate to specific anxiety disorders can help a social worker when rendering a diagnosis. Part of the data presented in this article was from David A. Dia’s doctoral dissertation.     

Psychological Distress as an Indicator of Co-Occurring Psychopathology among Treatment-Seeking Disordered Gamblers

Disordered gamblers frequently present with concurrent anxiety, depressive, personality, and substance use disorders, which may complicate treatment. Although there is a need for a thorough assessment, some questionnaires may prove lengthy for clients and clinicians. Thus, there is a need for brief screens for identifying co-occurring psychopathology. The present study sought to examine whether a brief, self-report measure of psychological distress could indicate the presence of co-occurring psychopathology among an outpatient sample of disordered gamblers. At intake, 69 participants completed self-report measures of distress and gambling symptomatology, a personality inventory, and a structured interview for the diagnostic criteria for disordered gambling. Gamblers with greater elevations of psychological distress evidenced greater severity of gambling pathology. Clinically significant elevations were present for symptoms of depression, deviancy, and anxiety, but not substance abuse. Greater scores of psychological distress significantly predicted elevations of depression, deviancy, and anxiety. Sensitivity and specificity were evaluated and the findings supported that an average psychological distress score of 16 corresponded with the presence of co-occurring psychopathology. Clinicians treating disordered gamblers should consider screening for co-occurring psychopathology with brief, self-report measures of psychological distress.     

Understanding Policy Instruments for Steering Nonprofit Organizations in China: Only Carrots and Sticks?

Government–nonprofit relations in China have transformed over the past three decades. Building on policy instrument theory, this article explores which policy instruments have been used to steer nonprofits at the central level and how the use of policy instruments has changed over time. This article is based on a content analysis of 300 central-level policy documents for nonprofits using NVivo. The results show that 22 kinds of policy instruments have been used to steer nonprofits. A steep upward trend is evident in the use of four categories of policy instruments for nonprofits: authority, incentive, information, and organization. Policy instruments for nonprofits have advanced in diversity, emphasizing indirect control. The central government continues to show a significant predisposition toward regulatory instruments, which have evolved from ex ante regulation to process and ex post regulation. This article contributes to the public management literature by identifying which policy instruments governments use to shape government–nonprofit relations.

     

The Current State of Mental Health Research on Asian Americans

Summary

A review of research reveals that the prevalence rates of depression, somatization, and posttraumatic stress disorder among Asian Americans are at least as high as those for White Americans, and, in many cases, higher rates are exhibited. Findings with respect to anxiety have been equivocal. The conclusion that is best supported by research at this time is that Asian Americans are not extraordinarily well adjusted, in contrast to their stereotype as a model ethnic minority group. What has hindered researchers in determining the rates and distributions of mental disorders among Asian Americans has been methodological and conceptual problems. These problems involve (a) making cross-cultural comparisons using assessment instruments that have been standardized on one group and applied to another and (b) phenomena unique to Asian Americans, including their population size, heterogeneity, and rapid demographic changes. Suggestions for research directions are given.