The LORS-enabled dialogue: improving insight in psychotic illnesses

Patients often underestimate the degree of their psychiatric illness and consequently have difficulty effectively participating in interventions to optimize recovery. This problem of insight may be connected with neurological difficulties resulting in poor explicit memory; however, most interventions nurses use to help patients improve their understanding of illness rely on explicit memory. The discrepancy between clinician and patient scores on the Levels of Recovery from Psychotic Disorders Scale (LORS) has been correlated with measures of insight and psychopathology. This difference can be used in a therapeutic dialogue, the LORS-Enabled Dialogue (LED). This intervention engages patients' implicit memory, asking a series of open-ended questions and using motivational interviewing to help promote patients' attainment of life goals. Large-scale studies of this intervention are currently underway and should help better define questions about the effectiveness of the LED.     

User-centred responses to child sexual abuse: the way forward?

Two parallel surveys were carried out based in the north-east of England and Cumbria: one ascertaining statutory social work services provided for child and adult survivors of sexual abuse, the other drawing upon the perceptions of adult survivors of child sexual abuse about existing and desirable forms of provision for adults and children. The surveys indicate the need for greater genuine partnership between service users and statutory agencies in the field of child sexual abuse, similar to that which is being pioneered in the field of adult care and disability. A community-orientated response to sexual abuse, centred on service-users, is required if one of the largest social problems facing us today is to be effectively challenged.     

Traditional Support Systems: Are They Sufficient in a Culturally Diverse Academic Environment?

Correspondence to Dr Adital Ben-Ari School of Social Work, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel 31905. Summary The present study explores the relationship between perceivedsocial support and well-being among students of the three mainpopulations living in Israel: Israeli-born Jews, Israeli-bornArabs and Russian immigrants. More specifically, it comparesthe well-being of these three groups and examines to what extentperceived social support actually contributes to their well-being.The sample comprised 278 undergradute students in the schoolsof social work and nursing at one of the major universitiesin Israel. Three instruments were used. Well-being was measuredby both the Brief Symptoms Inventory Scale (Derogatis, 1979)and the Beck Depression Inventory (Beck and Steer, 1987). Perceivedsocial support was assessed by the Multidimensional Scale ofPerceived Social Support (Zimet et al., 1988). The findingsshow that the Arab students are significantly more distressedthan their Jewish and Russian counterparts on all measures ofwell-being. At the same time, their perceived social supportis significantly higher than that of the Jewish students (bothIsraeli-born Jews and Russian immigrants). Stepwise linear regressionanalysis revealed that while perceived social support was amajor contributor to the explanation of well-being among theIsraeli students, it did not surface as a significant explanatorypredictor of well-being among either Arabs or Russian immigrants.The significance of the findings is discussed within the theoreticalframeworks of stress and social support theories as well asmodernization and immigration processes.     

Projecting From Advance Data Using Propensity Modeling: An Application to Income and Tax Statistics

This article proposes and evaluates two new methods of reweighting preliminary data to obtain estimates more closely approximating those derived from the final data set. In our motivating example, the preliminary data are an early sample of tax returns, and the final data set is the sample after all tax returns have been processed. The new methods estimate a predicted propensity for late filing for each return in the advance sample and then poststratify based on these propensity scores. Using advance and complete sample data for 1982, we demonstrate that the new methods produce advance estimates generally much closer to the final estimates than those derived from the current advance estimation techniques. The results demonstrate the value of propensity modeling, a general-purpose methodology that can be applied to a wide range of problems, including adjustment for unit nonresponse and frame undercoverage as well as statistical matching.     

Impact of mental health on perception of relationship satisfaction and quality among female same-sex couples

Using data from both partners in female same-sex couples, individual and dyadic (individual/actor-partner) level analyses were conducted to determine the associations between couple members' global mental health, internalized homophobia, and perceptions of relationship qualities and satisfaction (N = 90). Findings at the dyadic level indicated that an individual's global mental health was uniquely associated with her partner's assessment of relationship satisfaction and qualities, beyond the effects of the individual's own mental health and internalized homophobia. Implications for further research on the strengths and challenges within female same-sex couple relationships are discussed.     

Associations between ongoing COVID-19 lockdown and the financial and mental health experiences of Australian families

In 2020, Australia's successful COVID-19 public health restrictions comprised a national “initial lockdown” (March–May) and “ongoing lockdown” (July–November) for metropolitan Victorian residents only. We evaluated associations between ongoing lockdown and family finances and mental health. In the June and September 2020 Royal Children's Hospital National Child Health Polls, caregivers of children in Victoria and New South Wales (NSW) reported the following: job/income loss; material deprivation (inability to pay for essential items); income poverty; mental health (Kessler-6); perceived impact on caregiver/child mental health; and caregiver/child coping. Data from caregivers (N = 1207/902) in June/September were analysed using difference-in-difference modelling (NSW provided the comparator). During Victoria's ongoing lockdown, job/income loss increased by 11% (95%CI: 3%–18%); Kessler-6 poor mental health by 6% (95%CI: −0.3%–12%) and perceived negative mental health impacts by 14% for caregivers (95%CI: 6%–23%) and 12% for children (95%CI: 4%–20%). Female (vs. male) caregivers, metropolitan (vs. regional/rural) families, and families with elementary school-aged children (vs. pre-/high-school) were the most affected. The ongoing lockdown was associated with negative experiences of mental health, employment and income, but not deprivation or poverty, likely because of government income supplements introduced early in the pandemic. Future lockdowns require planned responses to outbreaks and evidence-informed financial and mental health supports.     

Development of a framework for classifying threat and neglect in childhood: A qualitative study

Quantification of childhood adversity has typically involved a cumulative risk approach in which total number of discrete adversities serves as an index of overall risk. However, this approach fails to account for the growing evidence of differential outcomes following exposure to childhood adversities. An alternative approach adopts a dimensional perspective, with growing evidence for distinct developmental impacts associated with exposure to threat (violence/abuse) and deprivation (neglect). This study developed a framework for the classification of these dimensions through a thematic analysis of health practitioners' views and accounts of different forms of childhood adversity. Ten health practitioners experienced in working with children with challenging behaviours and neurodevelopmental disorders participated in semi-structured interviews regarding definitions and examples of six categories of adversity: physical/emotional/sexual abuse, physical/emotional neglect, and domestic and family violence. The qualitative analysis identified 23 themes across the six categories of adversity, along with two overarching themes regarding ambiguity of classifying exposures and non-specific outcomes of exposures. Themes were integrated to provide a framework and checklist for classifying indicators of exposure to threat and deprivation. The findings offer a framework and checklist for the assessment of threat and deprivation that will allow for further testing of the dimensional risk model.