Are Hearing Voices Networks Compatible with Cognitive Behavioural Therapy for Psychosis?

The most extensively evaluated intervention for auditory hallucinations is Cognitive Behavioural Therapy for Psychosis (CBTp), which is usually delivered in statutory settings by experienced clinicians. In contrast, peer support networks, such as the Hearing Voices Network (HVN), operate informally using peers to normalise and manage voices. This article compares these two approaches to identify points of synergy and difference. Its analysis suggests the two approaches share many features, but also deviate in important ways that could compensate for each other. Instead of competing with each other as might first be thought, they may actually be complementary. Further, HVN may align comfortably with the values and principles of social work. Social workers seeking to engage with voice hearers may be advised to study the underlying principles of each approach to guide the way in which they can capitalise on intervention opportunities to better assist voice hearers.     

The effects of school desegregation on mixed-race births

We find a strong positive raw correlation between black exposure to whites in their school district and the prevalence of later mixed-race (black-white) births, consistent with the literature on residential segregation and endogamy. However, that relationship is significantly attenuated by the addition of a few control variables, suggesting that individuals with higher propensities to have mixed-race births are more likely to live in desegregated school districts. We exploit quasi-random variation from court-ordered school desegregation to estimate causal effects of school desegregation on mixed-race childbearing, finding small to moderate effects that are largely statistically insignificant. Because the upward trend across cohorts in mixed-race childbearing was substantial, separating the effects of desegregation plans from secular cohort trends is difficult; results are sensitive to how we specify the cohort trends and to the inclusion of Chicago/Cook County in the sample. The fact that the addition of a few control variables substantially weakens the cross-sectional relationship between lower levels of school segregation and higher rates of mixed-race childbearing suggests that a substantial portion of the observed correlation is likely due to who chooses to live in places with desegregated schools. Researchers should be cautious about interpreting raw correlations between segregation—whether residential or school—and other outcomes as causal. Our results also point to the need to carefully explore specification of cohort effects in quasi-experimental designs for treatments where cumulative exposure is important.     

Is Chinese National Health Insurance Effective in the Face of Severe Illness? A Perspective from Health Service Utilization and Economic Burden

Over the past decade, health insurance coverage has expanded dramatically in China. Health insurance benefits, however, remain shallow or ambiguous. This study examines the effect of Chinese national health insurance policy on health service utilization and economic burden in urban settings using the Urban Resident Basic Medical Insurance Household Survey. We employ the Heckman selection model to correct for selection bias among hospital inpatients, and find that compared to individuals without health insurance, those with health insurance are more likely to be admitted to the hospital when their physicians recommended them to enter the hospital as inpatients. Health insurance is also associated with about 45.6 % decrease in out-of-pocket inpatient expenditures. Individuals with urban employee basic medical insurance see the largest decrease in economic burden, followed by individuals with urban resident basic medical Insurance, and those with new rural cooperative medical insurance.     

Preliminary evaluation of contingent meals and telephone use to improve evidence-supported family therapy session attendance in mothers referred by Child Protective Services for substance abuse

Persons referred by Child Protective Services (CPS) for substance abuse evidence high rates of nonattendance to therapy sessions, taxing systems of care and exacerbating outcomes. This study examined the influence of two telephone-based incentive programs on therapy session attendance in mothers who were referred by CPS for substance abuse. After baseline therapy session attendance was established in an evidence-based clinic that incorporated a telephone engagement intervention (Phase I), participants were provided free cellular telephones with limited minutes and permitted to order free meals delivered by the therapist during upcoming sessions (Phase II). The third phase was similar to Phase II, but participants were provided unlimited minutes. Results indicated that participants’ attendance was significantly improved when meals and cellular telephone minutes were contingent on attendance. Although the percentage of sessions attended by participants during Phase III was higher than Phase II, unlimited minutes and meals did not significantly enhance attendance relative to limited minutes and meals. Session attendance for significant others of these participants was significantly higher during Phase III as compared with Phase I. Session attendance of significant others was statistically similar between Phase I and II and between Phase II and Phase III. Study implications and recommendations for future research and practice are discussed in light of the findings.     

Anabolic-Androgenic Steroids and Condom Use: Potential Mechanisms in Adolescent Males

Previous research has revealed a significant bivariate relationship between anabolic-androgenic steroid (AAS) use and reduced condom use among adolescent boys. However, to date, no known studies have explored the psychological mechanisms that may explain this relationship. Thus, the current study sought to examine two possible mediators in the association between AAS and condom use: depressive symptoms and substance use. Data were extracted from a nationally representative sample of U.S. adolescents. Participants were 3,780 U.S. high school boys who responded to self-report items assessing a number of health behaviors, including symptoms of depression, substance use, AAS use, and use of condoms during their most recent act of intercourse. Both depression and substance use were significant mediators in the relationship between AAS and condom use. However, when these effects were contrasted, the indirect effect of substance use was significantly stronger in magnitude than the effect of depression. Although AAS use was associated with sexual risk behaviors among adolescent boys, significant variance in this relationship was accounted for by elevated levels of depression and substance use, with substance use demonstrating a particularly salient pathway.     

Predictors of treatment outcome in a child and adolescent psychiatry clinic: A naturalistic exploration

We present data on predictors of treatment outcome for 3200 consecutive referrals to a child and adolescent psychiatry clinic. Using Reliable Change Index (RCI) methodology, we divided children into those who, between intake and discharge, improved, stayed the same, or got worse according to clinician-rated impairment. Most predictors of improvement were related to parent variables (marital status, maternal anxiety, and ethnicity), while those associated with deterioration were tied to child status (extent of psychiatric comorbidity, history of placement in a self-contained classroom, and a prior trial of psychotropic medications). The implications of these findings for data-driven program development, clinic management, treatment planning, and systems of care are discussed.     

Delirium: a very common problem you may not recognize

Older adults with multiple pre-existing conditions are admitted to hospitals with acute illnesses and injuries every day. Delirium is not recognized by clinicians across health care settings. With awareness of risk factors and knowledge of delirium, nurses can play a pivotal role in the early identification, treatment, and, most important, prevention of delirium in older adults. Nurses often display a lack of knowledge related to delirium and the complex symptoms that appear differently in the presence of other complicating co-morbid conditions in aging adults. Nurses play a crucial role in keeping patients safe and ensuring optimal outcomes, regardless of the setting. With the growing population of older adults and the expected increases in chronic illness and dementia, delirium is a problem nurses are likely to experience in all practice settings. Knowing what to look for facilitates recognizing the risk and acting early to minimize (or even prevent) delirium.     

Documenting Pornography Use in America: A Comparative Analysis of Methodological Approaches

Estimates of pornography use in the United States range widely. We explore the reasons for the variation in such estimates among U.S. adults using data from four different recent nationally representative samples—each of which asked a different type of question about pornography use. We attribute the notable variation in estimates to differences in question wording and answer options, and assert that a survey question asking respondents about their most recent use of pornography minimizes recall bias and is better poised to assess the overall prevalence of pornography in a population than is the more common approach of asking respondents about their historical general-use pattern. When we privileged the most-recent-use approach, survey data from 2014 reveal that 46% of men and 16% of women between the ages of 18 and 39 intentionally viewed pornography in a given week. These numbers are notably higher than most previous population estimates employing different types of questions. The results have ramifications for methods of surveying sensitive self-reported behaviors and for contextualizing scholars’ claims as well as popular conversations about the reach and implications of pornography use in the United States.