Genetic Studies of Pathological Gambling: A Review of Methodology and Analyses of Data from the Vietnam Era Twin Registry

Twin studies represent an important and powerful approach to estimating the relative contributions of environmental and genetic factors to the expression of psychiatric illnesses. In this article, we first explain the rationale for using large populations of monozygotic and dizygotic twin pairs to estimate genetic and environmental contributions to a disorder and the statistical modeling associated with this approach. We then review results from studies of the Vietnam Era Twin Registry that use this methodology to examine the etiology of pathological gambling (PG) behaviors. The results provide strong evidence for genetic contributions to the development of PG in men and set the foundation for future studies aimed at identifying the manner in which specific genes and environmental factors individually and in conjunction contribute to PG.     

Early assessment of implementing evidence-based brief therapy interventions among secondary service psychiatric therapists

This implementation study was part of the Ostrobothnia Depression Study, in Finland, which covered implementation of motivational interviewing (MI) and behavioral activation (BA) within regional public psychiatric secondary care. It aimed to evaluate the mid-term progress of implementation and related factors. Altogether, 80 therapists had been educated through the implementation program by the point of the mid-term evaluation. Eligible information for evaluation was gathered using two questionnaires (q1, q2) with a one-year interval.A total of 45 of the 80 therapists completed q1, 30 completed q2, and 24 completed both questionnaires. Professional education was the only background factor associated with adopting the interventions (q1: p = 0.059, q2: p = 0.023), with higher education indicating greater activity. On the basis of trends such as changes in overall usefulness score from q1 to q2, the most involved therapists were slightly more likely to adopt MI/BA. Our experience so far suggests that encouraging staff to begin using new interventions during education is very important. The Consolidated Framework for Implementation Research was found to be a useful tool for constructing the evaluation.     

Effectiveness of the Coral Tree Family Service family inpatient unit: a longitudinal study exploring change in family functioning

Child mental health disorders represent a major burden to public health in Australia due to high prevalence rates, the widespread impact across domains, and the potential for difficulties to persist into adolescence and adulthood. Extensive evidence exists for the use of parent management training and cognitive behavioural therapy to treat difficulties experienced by children; however, a proportion of children do not benefit as expected from these treatments. The use of complementary therapeutic approaches and variations to the mode and intensity of existing intervention is warranted; family inpatient units represent a unique example of this. The aim of this study is to evaluate the effectiveness of a well-established Australian inpatient unit that admits the whole family, for children aged 12 years and younger referred with mental health, behavioural, or emotional difficulties. This study's longitudinal within-subject study design utilised routinely collected outcome data from the systemic clinical outcome and routine evaluation, 15 item (SCORE-15)—a valid and reliable measure of family functioning—from a sample of 980 participants attending the Family Residential Program. This study reported significant improvement in family functioning across all outcome variables between baseline and post-intervention, with no variables returning to pre-intervention levels at follow-up. Clinically significant changes in overall family functioning showed that 37% of participant scores moved from the clinical range at baseline to the nonclinical range post-intervention. This study represents the first empirical evaluation of the Family Residential Program, and the reported results provide compelling evidence for the program to effect improvement in family functioning for families with long-standing and severe difficulties. Poor rates of questionnaire completion following intervention frequent the literature base of family inpatient units, with low post-intervention (56%) and follow-up (12%) rates evident in this study. This study uniquely contributes to the growing evidence base of family inpatient units using rigorous evaluation methods.     

What can Social Psychologists Learn from Architecture? The Asylum as Example

In this paper I argue for a stronger consideration of the possible relationship between social psychology and architecture and architectural history. After a brief review of some of the ways in which other social psychologists have sought to develop links between social psychology and history, I consider the utility of architecture in more depth, especially to the social psychologist interested in the development of knowledge and understanding. I argue that, especially when knowledge is institutionalised, the design and use of buildings might have a particular contribution to make to the way we can understand how phenomena have been understood and approached in the past. Although many examples are relevant, I consider the case of the psychiatric hospital (or “asylum”) in more detail.     

积极认知行为治疗的基本方法

积极认知行为治疗以调动患者的积极性和主动性为核心,在治疗师的积极引导下,指导患者自主完成思维记录和自我探索负性情绪对抗行为,并进行认知重建和行为矫正,以达到心理治疗的效果。积极认知行为治疗的操作程序包括四个阶段:首次会谈与诊断评估阶段、自我探索阶段、强化巩固阶段、效果评估和回归社会阶段。而自我探索阶段是整个治疗过程中的核心阶段,主要通过建立在患者问题概念化基础之上的"积极认知行为治疗记录"来分步完成。而六个核心治疗环节依次是:临床访谈、躯体和心理检查、对患者关于积极认知行为治疗表格记录和表中关系要素说明、对抗负性情绪行为模式的自我探索、非理性信念的批判及理性信念的建立、有效对抗负性情绪行为模式的确定和强化巩固。     

EMDR、适应性信息加工与个案概念化(下)

EMDR是一个整合性的、以咨客为中心的心理治疗方法。该方法用于治疗那些不是由器质性损伤为病理学基础的心理问题,它的治疗重点是处理大脑的信息加工系统中的痛苦记忆。EMDR既能处理那些引起困扰的经历和体验,也能帮助咨客获得达到更健康的心理状态所需要的经历和体验。综览EMDR的历史、发展和研究,它是一个主要以经验为支持的治疗方法。本文在阐述适应性信息加工模型之后,用一个延续的个案实例,来说明EMDR的个案概念化和8个阶段的治疗。EMDR技术主要是加工那些有病理学基础的早期记忆和引发不良功能的当前情境,并为未来适应性的行为提供模板,包括克服技能不足和(或)发展性的不足所需的知识与行为。整合的EMDR与家庭系统观点的好处是可以提供最综合的治疗效果。     

The story of Lucy: lessons learned,lessons taught

ABSTRACT

This article provides an extended case example highlighting the value of a supportive approach to practice, in addition to the importance of holding a psychodynamic developmental frame of reference. Concepts of repetition compulsion, the holding environment, and object constancy are applied to the clinical material. The case is underscored for its value as a teaching tool.     

Special Considerations in the Treatment of College Students With Bipolar Disorder

Abstract

Bipolar disorder is a relatively common mental disorder that often has its onset during the college years. This means that students simultaneously face both the challenge of late adolescent development and the challenge of adapting to a major mental illness. As a further complication, the college environment is not well suited to the kinds of lifestyle changes that add stability to the lives of people with bipolar disorder. Treatment involves establishing an alliance, education about lifestyle changes, aiding adaptation to the illness, careful medication to minimize side effects, and loosening the affective constriction that can result from fear of relapse. Both the health care provider and student can use the culture of learning and self-discovery in the college setting to the treatment's benefit. As well, the provider can use the time-limited nature of college to lessen ambivalence about making long-term changes.     

Psychiatric Symptoms and Perceived Need for Psychiatric Care After Divorce

Abstract

The study investigated level of psychiatric symptoms and perceived need for psychiatric care among recently divorced males and females. Furthermore, various demographic factors and characteristics of the marriage and divorce related to psychiatric symptoms and perceived need for psychiatric care, were identified. Six hundred fifty eight recently divorced males and females living in five different counties in Norway participated. Their level of psychiatric symptoms was compared with the general Norwegian population. Divorced individuals had substantially higher level of psychiatric symptoms as compared to the general population. No consistent gender differences were observed. For both males and females, level of conflict with the ex-spouse and being leaver or being left, were the variables being most strongly related to psychiatric symptoms and need of psychiatric care. However, the variables accounted for only a modest proportion of the variance in the mental health outcome.