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Background: The psychometric properties of an online test are not necessarily identical to its paper and pencil original. The aim of this study is to test whether the factor structure of the Community Assessment of Psychic Experiences (CAPE) is measurement invariant with respect to online vs. paper and pencil assessment. Method: The factor structure of CAPE items assessed by paper and pencil (N = 796) was compared with the factor structure of CAPE items assessed by the Internet (N = 21,590) using formal tests for Measurement Invariance (MI). The effect size was calculated by estimating the Signed Item Difference in the Sample (SIDS) index and the Signed Test Difference in the Sample (STDS) for a hypothetical subject who scores 2 standard deviations above average on the latent dimensions. Results: The more restricted Metric Invariance model showed a significantly worse fit compared to the less restricted Configural Invariance model (χ2(23) = 152.75, p<0.001). However, the SIDS indices appear to be small, with an average of −0.11. A STDS of −4.80 indicates that Internet sample members who score 2 standard deviations above average would be expected to score 4.80 points lower on the CAPE total scale (ranging from 42 to 114 points) than would members of the Paper sample with the same latent trait score. Conclusions: Our findings did not support measurement invariance with respect to assessment method. Because of the small effect sizes, the measurement differences between the online assessed CAPE and its paper and pencil original can be neglected without major consequences for research purposes. However, a person with a high vulnerability for psychotic symptoms would score 4.80 points lower on the total scale if the CAPE is assessed online compared to paper and pencil assessment. Therefore, for clinical purposes, one should be cautious with online assessment of the CAPE. [ABSTRACT FROM AUTHOR]

This paper discusses why and how the operation of power is a central part of the Power Threat Meaning Framework (PTMF). Following a brief review of evidence linking social context to psychological distress and troubling behavior, and of psychology and psychiatry's limited engagement with this evidence, the paper focuses on the different approach adopted in the PTMF. It reviews conceptual resources drawn on in examining the nature and role of power and key ways in which the operation of power is central to the development and maintenance of troubling experiences and behavior which may be encountered in mental health systems and beyond. [ABSTRACT FROM AUTHOR]

Eating disorders are mental illnesses that can have a significant and persistent physical impact, especially for those who are not treated early in their disease trajectory. Although many persons with eating disorders may make a full recovery, some may not; this is especially the case when it comes to persons with severe and enduring anorexia nervosa (SEAN), namely, those who have had anorexia for between 6 and 12 years or more. Given that persons with SEAN are less likely to make a full recovery, a different treatment philosophy might be ethically warranted. One potential yet scarcely considered way to treat persons with SEAN is that of a harm reduction approach. A harm reduction philosophy is deemed widely defensible in certain contexts (e.g. in the substance use and addictions domain), and in this paper we argue that it may be similarly ethically defensible for treating persons with SEAN in some circumstances. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Contemporary mental health policy stipulates consumer participation in all aspects of mental health services including service evaluation and other forms of mental health research.Research is identified as underpinning quality mental health services, and therefore, consumers researchers could enhance the mental health sector by contributing to the quality, credibility and relevance of mental health research. What this paper adds to existing knowledge?: Non‐consumer researchers generally supported the concept of a consumer expert reference group for researchers at the individual and institutional level.A consumer expert reference group should reflect diversity and offer expertise relevant to the topic of research and may represent one way to normalize partnerships with consumer researchers and realize the benefits they can bring to research. What are the implications for practice?: Quality mental health services are underpinned by robust research evidence. It is crucial that consumers are active participants in research activity.The availability of a consumer expert reference group could facilitate collaborations between consumer and non‐consumer researchers and contribute to a stronger consumer focus embedded in mental health research. Introduction: Contemporary mental health policy identifies consumers as active participants in all aspects of mental health services from design to evaluation. Consumer researchers should be actively involved in mental health research and contribute to quality service delivery. Aim: To gain a snapshot of mental health researcher views on strategies for increasing research by or with consumers in mental health through the establishment of an Expert Consumer Researcher Group (ECRG). Methods: Cross‐sectional survey of 41 non‐consumer mental health researchers from Australia or New Zealand. Results: The introduction of an ECRG was considered an effective strategy for linking consumer and non‐consumer researchers and providing specialist advice on research design and methodology. The most suitable location for this group was identified as within consumer advocacy agencies (71%), universities (66%) or research funding bodies (66%). Participants rated their likelihood of seeking advice from the ECRG as high. Discussion: Research participants supported the value of an ECRG. They emphasized the importance of ensuring the group reflected a diversity of views and offered specialized expertise related to the specific topic. The ECRG could benefit both individual researchers and larger research organizations. Implications for practice: An ECRG could facilitate collaborations with consumer researchers and in turn enhance the quality of mental health research. [ABSTRACT FROM AUTHOR]

An editorial is presented on the Editorial Advisory Group for the British Psychological Society (BPS) journals has delighted to present this special issue of landmark papers. Topics include the many different spheres of influence of psychological knowledge, the opportunity to delve outside of your immediate area of interest and read the whole spectrum of papers, and the emphasis on theoretical enhancement and of presenting theoretical interpretations of empirical findings.

Purpose -- The purpose of this paper is to critically discuss how the psy-sciences have been, and continue to be, typified by some critics, as colonizers and are credited with Imperialistic motivations. However, rarely are these critiques developed beyond a pejorative characterisation. Design/methodology/approach -- This paper reviews the criticisms of psychiatry as colonial and outlines the tensions in taking different frames of reference in the mental health field, before going on to suggest theoretical and research perspectives arising from postcolonial theory that might advance these critical positions more coherently and the implications of doing so. Findings -- This study suggests an engagement with humanities-based methods and fields such as postcolonial scholarship. Social implications -- This argument is timely, especially given recent controversies over the publication of DSM5, the scaling up agenda for mental health in the Global South and increased attention to the agenda of Big Pharma. Originality/value -- Postcolonial intersections with psy-science remains a relatively undeveloped area in the critical literature. [ABSTRACT FROM AUTHOR]

Background: In a highly technical civilization like ours, in which the interest in human communication transcends academic barriers and clinical practice, it seems necessary to look back to Ruesch’s work in psychiatry. The main reason of it rests upon the idea that he was one of the few truly outstanding clinicians, researchers, and theoretical in the field of normal and abnormal communication. In fact, he did not only present a wealth of observational and clinical data; more importantly, he used these data to formulate creative hypotheses about the conflict between man and other human beings. Aim/Objective: The main purpose of this article is to pay tribute to Dr. Jurgen Ruesch (1909-1995), distinguished psychiatrist, communications experts and psychotherapist. For that reason, here we want to pay tribute to the enormous value of his work for the promotion of mental health and the clinical assessment of normal and pathological communication behavior. Methods: In working out his theoretical stance toward communication, all Ruesch’s works here have been reviewed. In line with this, the author also mentions similarities between Ruesch and other psychiatric/psychotherapeutic authors. Also similarities have been established between Ruesch and Frank on “non specific factors in psychotherapy”, and tensions within contemporary training of psychiatrists, almost predicted by Ruesch. Results and Conclusions: While some of Ruesch’s ideas about the nature and origins of communication has been discounted, many of his preoccupations are now part of the mainstream, and it is to here that we should look for evidence of his legacy. In fact, he has been the author of rich and fruitful ideas, which are essential to clinical understanding of mental diseases and their treatments. It is not surprising, therefore, that Ruesch’s burning interest in the clinical assessment of normal and pathological communicative behavior finds a significant echo in today’s proliferation of books, papers, and conferences on communication. For all that, we should honor him. [ABSTRACT FROM AUTHOR]

Background: Augmentative and Alternative Communication (AAC) is used for treating children with severe disorders of speech-language production and/or comprehension. Various strategies are used, but research and debate on their efficacy have remained limited to a specific area and have rarely reached the general medical community. Objective: To systematically evaluate outcomes of AAC interventions in children with limited speech or language skills. Methods: Searches were conducted (up to December 2012) in the MEDLINE, EMBASE, PsycINFO, CINAHL, DARE, and Cochrane Library databases. Furthermore, relevant journals were searched by hand. References from identified studies were examined. Only RCTs were considered. Trial quality was assessed according to a standardized and validated set of criteria. Results: Fourteen of 1661 retrieved papers met inclusion criteria. A total of 666 children were included in the review and 7 papers involved only children <5 years old. Papers were of average quality and all but one had been published during the previous 10 years by one of 8 research groups, 5 of which from the United States. Seven studies directly addressed AAC use by children with different disabilities. Seven studies enrolled typically developing children: 5 evaluated the use of AAC technologies by children without disabilities in order to obtain results that could be used to improve interventions in peers with disabilities, and 2 evaluated peers’ attitudes towards children who used AAC. Both interventions and outcome measures varied widely between studies. Overall findings demonstrate the effectiveness of the AAC interventions considered, but the focus on RCTs alone appears too restrictive. Conclusions: Solid evidence of the positive effects of AAC interventions in children with severe communication disorders must be generated, and different methods are needed besides RCTs. Moreover, it is important that knowledge, research, and debate extend to the medical community in order to ensure clinically effective AAC provision for these children (and their parents). [ABSTRACT FROM AUTHOR]

Objective: The Hospital Anxiety and Depression Scale (HADS) is widely used to screen for anxiety and depression. A large literature is citable in support of its validity, but difficulties are increasingly being identified, such as inexplicably discrepant optimal cutpoints and inconsistent factor-structures. This article examines whether these problems could be due to the construction of the HADS that poses difficulties for translation and cross-cultural use. Methods: Authors’ awareness of difficulties translating the HADS were identified by examining 20% of studies using the HADS, obtained by a systematic literature search in Pubmed and PsycINFO in May 2012. Reports of use of translations and validation studies were recorded for papers from non-English speaking countries. Narrative and systematic reviews were examined for how authors dealt with different translations. Results: Of 417 papers from non-English speaking countries, only 45% indicated whether a translation was used. Studies validating translations were cited in 54%. Seventeen reviews, incorporating data from diverse translated versions, were examined. Only seven mentioned issues of language and culture, and none indicated insurmountable problems in integrating results from different translations. Conclusion: Initial decisions concerning item content and response options likely leave the HADS difficult to translate, but we failed to find an acknowledgment of problems in articles involving its translation and cross-cultural use. Investigators’ lack of awareness of these issues can lead to anomalous results and difficulties in interpretation and integration of these results. Reviews tend to overlook these issues and most reviews indiscriminately integrate results from studies performed in different countries. Cross-culturally valid, but literally translated versions of the HADS may not be attainable, and specific cutpoints may not be valid across cultures and language. Claims about rates of anxiety and depression based on integrating cross-cultural data or using the same cutpoint across languages and culture should be subject to critical scrutiny. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic trends herald what many describe as the Asian Century, whereby Asian economic, political and cultural influence is in global ascendency. Broadening relevant ties between Australia and Asia is evident and logical and may include strengthening alliances in mental health systems. Aim: We argue the importance of strengthening Asian mental health systems and some of the roles Australian mental health workers could have in promoting strengthening the Asian mental health system. Methods: This paper is a narrative review which sources data from reputable search databases. Results: A well-articulated Australian strategy to support strengthening the mental health system in Asia is lacking. While there are active initiatives operating in this space, these remain fragmented and underdeveloped. Coordinated, collaborative and culturally respectful efforts to enhance health education, research, policy, leadership and development assistance are key opportunities. Conclusion: Psychiatrists and other mental health professionals have a unique opportunity to contribute to improved mental health outcomes in Asia. [ABSTRACT FROM AUTHOR]

Objective: Psychiatrists may become involved in circumstances where a child is seeking termination of pregnancy. Potential roles include capacity advice and advocacy, but ethical and legal uncertainties abound. This paper uses illustrative cases, in an Australian jurisdiction, to exemplify the issues.Conclusion: Termination of pregnancy at the youthful extreme raises unique challenges for all involved. [ABSTRACT FROM AUTHOR]

This conceptual, perspective and review paper on Indian scales and inventories begins with clarification on the historical and contemporary meanings of psychometry before linking itself to the burgeoning field of clinimetrics in their applications to the practice of clinical psychology and psychiatry. Clinimetrics is explained as a changing paradigm in the design, administration, and interpretation of quantitative tests, techniques or procedures applied to measurement of clinical variables, traits and processes. As an illustrative sample, this article assembles a bibliographic survey of about 105 out of 2582 research papers (4.07%) scanned through 51 back dated volumes covering 185 issues related to clinimetry as reviewed across a span of over fifty years (1958-2009) in the Indian Journal of Psychiatry. A content analysis of the contributions across distinct categories of mental measurements is explained before linkages are proposed for future directions along these lines. [ABSTRACT FROM AUTHOR]

Celebrity followers of the Church of Scientology have recently used their public forum to attack the modern practice of mental health. The practice of Scientology is rooted in the religious writings of its founder, L. Ron Hubbard. This paper will review the religious writings of L Ron Hubbard to understand Scientology’s position on mental health. This paper reviews four of the major religious books written by L Ron Hubbard, in addition to a comprehensive overview of Scientology compiled by Scientology staff. Hubbard’s theory of mind borrowed heavily from the earlier writings of Freud, until Hubbard’s psychological theory extended to include a spiritual existence that goes beyond the material world. The goal of Hubbard’s psychology and religion were to optimize the freedom of the individual, and he viewed psychiatry and psychology as inherently anti-spiritual and opposed to personal freedom and self-realization. Ultimately Hubbard presents a world view of potential nuclear world cataclysm, fueled by the geopolitical climate and mental health theories that dominated the mid 20th century. Hubbard’s writings mirrored the times in which he lived. His views that mental health practices are inherently anti-religious, freedom-inhibiting, and brain damaging do not reflect the modern-day practices of mental health. [ABSTRACT FROM AUTHOR]

This paper is based on the Bruce Burns Memorial Trust Lecture, Terrorism and Mental Health, presented in October 2005, in Birmingham. In addition to written sources, it is informed by the author's experience and contact with military and police experts in this arena over 28 years as a member of the British Army. The diagnosis and treatment of post traumatic mental disorders are not addressed in this paper. The author explores the general phenomenon of terrorism, in an endeavour to inform understanding of terrorist acts. He stresses the need for contextualisation of acts of terror, their perpetrators, their effects on populations and individuals, and attention to the psychology of groups. The author aims to invite and inform further thought and debate on the subject by raising a wide range of issues which do not sit comfortably within a strict psychiatric, research-based paradigm. The author covers a brief history of terrorism; organisational requirements of terror groups and the process of recruiting personnel to them; the means, motives and opportunities terrorists exploit in their work; the need for communication with terror groups; sacrificial death; governmental responses to terrorist acts and fear and mental health. The author proposes that terrorist organisations perform some of the functions of a family; that acts of terror are 'propaganda by deed'; that terrorism, or more precisely the media's treatment of it, breeds 'formless fears' which may directly lead to the development of fear-based symptoms and illness within societies. He notes that terrorism is an enterprise from which many players ('experts', media, politicians, etc.) benefit; that terrorism has its shadow in counter-terrorism, which may range from benign to malignant and that psychiatry could, in this context, acknowledge its bias towards individual psychologies and rectify its lack of understanding of groups and the behaviours of individuals within them. [ABSTRACT FROM AUTHOR]

This is the introductory paper to the special issue on ethics in psychiatry. We introduce the other papers that follow and set them in a context. Inevitably, they represent only a thin slice of the work going on in psychiatric ethics. But they serve to show two unique features of this discipline. First, it has a tendency to dig deep and to make connections with other philosophical concepts. So, for example, in a number of ways the papers that follow touch on the nature of personhood. We examine this notion. Second, psychiatric ethics, because of its content and its embededness in the real world, tends to hit upon diverse and sometimes conflicting values. We introduce the idea of values-based medicine, which provides both a theoretical framework and a practical approach to the common dilemmas of psychiatric practice. The need to think deeply, but also clearly and coherently, combined with the need to engage with the hurly-burly of the world of patients, users and carers, suggests the reasons why psychiatric ethics offers a paradigm for practical ethics generally. [ABSTRACT FROM AUTHOR]

In a recent paper, it was argued forcefully by Thomas Szasz that it is crucial to the scientific credibility of psychiatry that it abandon talk of the behaviour of the mentally "ill" in terms of causes: such behaviour is not caused by their condition--it simply has reasons, which are discounted by the medical model. It is argued in this paper that Szasz's theory is incomplete for two reasons: first, in assuming that reasons are radically different from causes, it cannot account for the possibility that "sane" behaviour might be just as much caused as "insane"; and second, it tacitly assumes that the origin of behaviour always lies with the agent--a view that arguably is an accident of grammar. Hence while there is no mental illness, this is because there is nothing that could be ill--and this means that there is no such thing as mental "health" either. [ABSTRACT FROM AUTHOR]

Taking as its starting point a series of traditional divisions and debates, this paper approaches issues of 'mental' health through the specific lens of the emotions. Key themes and organising principles here include the following: (i) reason versus emotion (ii) biology versus society (iii) the micro and the macro divide, and finally (iv) the medicalisation-demedicalisation of society. Each of these divisions is critically assessed and some 'new' ways forward provided through a commitment to the emotions, their relationship to 'mental' health and to rationality and, more generally, to their 'fate' in late 20th century Western society. The paper concludes with some further reflections on these and related emotional health matters, including a critique of the very notion of 'mental' health as a contradiction in terms. [ABSTRACT FROM AUTHOR]

Seldom is the work of philosophers invoked by health professionals when examining aspects of care from a philosophical perspective. Instead, students of health care, especially nurses, have been introduced to ‘philosophies’ which are often superficially examined and poorly understood. This practice fails to develop in students an appreciation of the work of philosophers or to acquire the art of critical thinking. The introduction of models and theories of nursing in the past three decades has alerted nurses to the importance of possessing critical skills in order to identify sound theory and implement good practice. This paper goes beyond mere philosophising and examines aspects of mental health care from the perspectives of one of nineteenth century Europe’s most notable philosophers, Friedrich Nietzsche. It argues that understanding his work can enhance one’s ability to reflect on nursing practice, as well as bringing a new dimension to how we analyse ‘mental health’ problems. His work provides many insights into how we can improve our understanding of the effect of mental illness and mental health care on the individual, and how we conceptualise the process of care. This paper provides an overview of his life’s work, his impact on the history of ideas and develops some of the more provocative implications of his work for mental health care. [ABSTRACT FROM AUTHOR]

Content and Focus: Research publications often adopt two major forms. Firstly the generic edition, which publishes all work that has met a certain threshold of quality. The second type of offering is the special edition, a collection of papers held together with a common theme running through it. Such strategies can be viewed as 'rural' or 'urban' in nature, with the latter reflecting the more collectivised commonalities and the former reflecting the every person stands for her/himself strategy. This editorial extends this urban/rural analogy to consider how such a strategy fits in relation to counselling psychology training in the UK. In particular it raises a number of strengths and weaknesses in both approaches and proposes that a more urban research strategy would enhance the profession of counselling psychology and strengthen its voice within the world of applied psychology. Following on from the predominant thrust of this editorial, the papers within this particular edition of Counselling Psychology Review are introduced in turn (and, as you will see, the edition is more rural in nature). [ABSTRACT FROM AUTHOR]

Background: Doctors, lawyers and criminal justice agencies need methods to assess vulnerability to violent radicalization. In synergy, public health interventions aim to prevent the emergence of risk behaviours as well as prevent and treat new illness events. This paper describes a new method of assessing vulnerability to violent radicalization, and then investigates the role of previously reported causes, including poor self-reported health, anxiety and depression, adverse life events, poverty, and migration and socio-political factors. The aim is to identify foci for preventive intervention. Methods: A cross-sectional survey of a representative population sample of men and women aged 18–45, of Muslim heritage and recruited by quota sampling by age, gender, working status, in two English cities. The main outcomes include self-reported health, symptoms of anxiety and depression (common mental disorders), and vulnerability to violent radicalization assessed by sympathies for violent protest and terrorist acts. Results: 2.4% of people showed some sympathy for violent protest and terrorist acts. Sympathy was more likely to be articulated by the under 20s, those in full time education rather than employment, those born in the UK, those speaking English at home, and high earners (>£75,000 a year). People with poor self-reported health were less likely to show sympathies for violent protest and terrorism. Anxiety and depressive symptoms, adverse life events and socio-political attitudes showed no associations. Conclusions: Sympathies for violent protest and terrorism were uncommon among men and women, aged 18–45, of Muslim heritage living in two English cities. Youth, wealth, and being in education rather than employment were risk factors. [ABSTRACT FROM AUTHOR]

Background: A recent paper reported the outcomes of a study examining a new self-guided internet-delivered treatment, the Wellbeing Course, for symptoms of anxiety or depression. This study found the intervention resulted in significant symptom reductions. It also found that automated emails increased treatment completion and clinical improvements in a subsample with elevated anxiety and depression. Aims: To examine the clinical outcomes and the effect of automated emails at 12 months post-treatment. Method: Participants, who were randomly allocated to a Treatment Plus Automated Emails Group (TEG; n = 100), a standard Treatment Group (TG; n = 106) or delayed-treatment Waitlist Control Group (Control; n = 51), were followed up at 12 months post-treatment. Eighty-one percent, 78% and 87% of participants in the TEG, TG and treated Waitlist Control Group provided symptom data at 12-month follow-up, respectively. The primary outcome measures were the Patient Health Questionnaire-9 Item Scale (PHQ-9) and the Generalized Anxiety Disorder-7 Item Scale (GAD-7). Results: Significant improvements in symptoms of anxiety and depression were observed over time in both the TEG and TG (Fs >69, ps <.001) these were sustained from post-treatment to 12-month follow-up (ps >.05), and were associated with large effect sizes. No statistically significant differences in symptoms were found between the TEG and TG at post-treatment, 3-month or 12-month follow-up. Previously reported symptom differences between TEG and TG participants with comorbid symptoms were no longer present at 12-month follow-up (ps >.70). Conclusions: The overall benefits of the Wellbeing Course were sustained at 12-month follow-up. Although automated emails facilitated Course completion and reductions in symptoms for participants with comorbid anxiety and depression from pre-post treatment, these differences were no longer observed at 12-month follow-up. The results indicate that automated emails promote more rapid treatment response for people with elevated and comorbid symptoms, but may not improve longer term outcomes. Trial Registration: Australian and New Zealand Clinical Trials Registry ACTRN12610001058066 [ABSTRACT FROM AUTHOR]

Background: Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs) to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda) participating in the PRogramme for Improving Mental health carE (PRIME). The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care. Methods: A situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts. Results: The PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care. Conclusions: The low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential for sustainable delivery of quality mental health care integrated into primary care. [ABSTRACT FROM AUTHOR]

Background: Evidence about relevant outcomes is required in the evaluation of clinical interventions for children with autism spectrum disorders (ASD). However, to date, the variety of outcome measurement tools being used, and lack of knowledge about the measurement properties of some, compromise conclusions regarding the most effective interventions. Objectives: This two-stage systematic review aimed to identify the tools used in studies evaluating interventions for anxiety for high-functioning children with ASD in middle childhood, and then to evaluate the tools for their appropriateness and measurement properties. Methods: Electronic databases including Medline, PsychInfo, Embase, and the Cochrane database and registers were searched for anxiety intervention studies for children with ASD in middle childhood. Articles examining the measurement properties of the tools used were then searched for using a methodological filter in PubMed, and the quality of the papers evaluated using the COSMIN checklist. Results: Ten intervention studies were identified in which six tools measuring anxiety and one of overall symptom change were used as primary outcomes. One further tool was included as it is recommended for standard use in UK children's mental health services. Sixty three articles on the properties of the tools were evaluated for the quality of evidence, and the quality of the measurement properties of each tool was summarised. Conclusions: Overall three questionnaires were found robust in their measurement properties, the Spence Children's Anxiety Scale, its revised version – the Revised Children's Anxiety and Depression Scale, and also the Screen for Child Anxiety Related Emotional Disorders. Crucially the articles on measurement properties provided almost no evidence on responsiveness to change, nor on the validity of use of the tools for evaluation of interventions for children with ASD. PROSPERO Registration number: CRD42012002684. [ABSTRACT FROM AUTHOR]

The aim of this paper is to provide information and data sourced from the National Data Set (NDS) provided by the National Occupational Health and Safety Commission (NOHSC). This information reflects the most current available information on the number, incidence and frequency rate of stress related data for Australia involving 5 days or more time lost based on workers compensation statistics. However, it does not include data on injury costs. The most recent information available at the time of reporting was the 1999-2000 data sets. This report is meant to be read as a companion paper to the "Jurisdictional Stress Initiatives Paper" published in Comparisons of Workers Compensation Arrangements in Australian Jurisdictions July 20011 which discusses both regulatory and non-regulatory approaches to claims that were used by Australian and New Zealand jurisdictions as of July 2000. [ABSTRACT FROM AUTHOR]

Background: This paper reports day-to-day data for from a one-week intervention phase, part of a 9-weeks randomised parallel study with patient having major depression (data from weekly visits have been reported). Wake therapy (sleep deprivation) has an established antidepressant effect with onset of action within hours. Deterioration on the following night’s sleep is, however, common, and we used daily light therapy and sleep time stabilisation as a preventive measure. In particular, we evaluated the day-to-day acute effect of and tolerance to sleep deprivation and examined predictors of response. Methods: Patients were assessed at psychiatric inpatient wards. In the wake group (n = 36), patients did three wake therapies in combination with light therapy each morning together with sleep time stabilisation. In the exercise group (n = 38), patients did daily exercise. Hamilton subscale scores were primary outcome (not blinded), secondary outcome was self-assessment data from the Preskorn scale and sleep. Results: Patients in the wake therapy group had an immediate, large, stable, and statistically significant better antidepressant effect than patients in the exercise group with response rates at day5 of 75.0%/25.1% and remission rates of 58.6%/6.0%, respectively. The response and remission rates were diminished at day8 with response rates of 41.9%/10.1% and remission rates of 19.4%/4.7%, respectively. Patients and ward personnel found the method applicable with few side effects. Positive diurnal variation (mood better in the evening) predicted a larger response to wake therapy. In the wake group napping on days after intervention predicted greater deterioration on day8. Conclusions: The intervention induced an acute antidepressant response without relapse between wake nights but with a diminishing effect after intervention. Development is still needed to secure maintenance of response. Avoiding napping in the days after wake therapy is important. Trial Registration: Clinical trials.gov NCT00149110 [ABSTRACT FROM AUTHOR]

Aim: To investigate the personality in very preterm individuals (VPT; gestational age, GA, <32 weeks) at adult age in two cohorts born in 1974–76 and 1980–82, respectively, and to illuminate the effect of increased survival rates and the clinical implications of deviations in personality. Method: Demographic data were extracted for all individuals born in Denmark in 1974–76 and 1980–82. From each period one index-group each comprising 150 individuals with the lowest gestational age was selected. Thereafter two control groups born at term were matched by gender, age and residential area. Personality was assessed with the short version of NEO PI-R, and psychiatric diagnoses were obtained from the Danish Psychiatric Central Research Register. Results: Of all the individuals born <32 weeks of gestation in 1980–82 67% were alive in 2006 vs. 43% of those born in 1974–76 (p<0.0001). A total of 433 individuals participated in the study, 76% of the VPT groups (n = 227, mean GA = 27.9) and 69% of the control groups (n = 206). There were no significant differences on personality scores between the two VPT groups. Compared to the control groups, the combined VPT groups scored higher on neuroticism (p = 0.005) and agreeableness (p = 0.012), but lower on extraversion (p = 0.002). Psychiatric disorder was strongly associated with higher scores on neuroticism and lower scores on extraversion. Interpretation: Improved survival of VPT infants was not associated with increased deviances in the personality as adults. The personality traits in VPT individuals differ moderately from those of term born controls. High scores in neuroticism and low scores in extraversion were associated with increased risk psychiatric disorders. VPT adults also showed signs of positive adaptation in the form of an agreeable and confident attitude towards others. What this paper adds: The much improved survival rate in very preterm infants during the early years of active neonatology was not associated with increased risk of personality deviation. There are signs of positive adaptation in the form of increased agreeableness in young adults born very preterm. [ABSTRACT FROM AUTHOR]

Depression is a type of complex psychiatric disorder with long-term, recurrent bouts, and its etiology remains largely unknown. Here, an integrated approach utilizing 1H NMR and UPLC-Q-TOF/MS together was firstly used for a comprehensive urinary metabonomics study on chronic unpredictable mild stress (CUMS) treated rats. More than twenty-nine metabolic pathways were disturbed after CUMS treatment and thirty-six potential biomarkers were identified by using two complementary analytical technologies. Among the identified biomarkers, nineteen (10, 11,16, 17, 21–25, and 27–36) were firstly reported as potential biomarkers of CUMS-induced depression. Obviously, this paper presented a comprehensive map of the metabolic pathways perturbed by CUMS and expanded on the multitude of potential biomarkers that have been previously reported in the CUMS model. Four metabolic pathways, including valine, leucine and isoleucine biosynthesis; phenylalanine, tyrosine and tryptophan biosynthesis; tryptophan metabolism; synthesis and degradation of ketone bodies had the deepest influence in the pathophysiologic process of depression. Fifteen potential biomarkers (1–2, 4–6, 15, 18, 20–23, 27, 32, 35–36) involved in the above four metabolic pathways might become the screening criteria in clinical diagnosis and predict the development of depression. Moreover, the results of Western blot analysis of aromatic L-amino acid decarboxylase (DDC) and indoleamine 2, 3-dioxygenase (IDO) in the hippocampus of CUMS-treated rats indicated that depletion of 5-HT and tryptophan, production of 5-MT and altered expression of DDC and IDO together played a key role in the initiation and progression of depression. In addition, none of the potential biomarkers were detected by NMR and LC-MS simultaneously which indicated the complementary of the two kinds of detection technologies. Therefore, the integration of 1H NMR and UPLC-Q-TOF/MS in metabonomics study provided an approach to identify the comprehensive potential depression-related biomarkers and helpful in further understanding the underlying molecular mechanisms of depression through the disturbance of metabolic pathways. [ABSTRACT FROM AUTHOR]

In the network approach to psychopathology, disorders are conceptualized as networks of mutually interacting symptoms (e.g., depressed mood) and transdiagnostic factors (e.g., rumination). This suggests that it is necessary to study how symptoms dynamically interact over time in a network architecture. In the present paper, we show how such an architecture can be constructed on the basis of time-series data obtained through Experience Sampling Methodology (ESM). The proposed methodology determines the parameters for the interaction between nodes in the network by estimating a multilevel vector autoregression (VAR) model on the data. The methodology allows combining between-subject and within-subject information in a multilevel framework. The resulting network architecture can subsequently be analyzed through network analysis techniques. In the present study, we apply the method to a set of items that assess mood-related factors. We show that the analysis generates a plausible and replicable network architecture, the structure of which is related to variables such as neuroticism; that is, for subjects who score high on neuroticism, worrying plays a more central role in the network. Implications and extensions of the methodology are discussed. [ABSTRACT FROM AUTHOR]

Background: Mental disorders may be reducible to sets of symptoms, connected through systems of causal relations. A clinical staging model predicts that in earlier stages of illness, symptom expression is both non-specific and diffuse. With illness progression, more specific syndromes emerge. This paper addressed the hypothesis that connection strength and connection variability between mental states differ in the hypothesized direction across different stages of psychopathology. Methods: In a general population sample of female siblings (mostly twins), the Experience Sampling Method was used to collect repeated measures of three momentary mental states (positive affect, negative affect and paranoia). Staging was operationalized across four levels of increasing severity of psychopathology, based on the total score of the Symptom Check List. Multilevel random regression was used to calculate inter- and intra-mental state connection strength and connection variability over time by modelling each momentary mental state at t as a function of the three momentary states at t-1, and by examining moderation by SCL-severity. Results: Mental states impacted dynamically on each other over time, in interaction with SCL-severity groups. Thus, SCL-90 severity groups were characterized by progressively greater inter- and intra-mental state connection strength, and greater inter- and intra-mental state connection variability. Conclusion: Diagnosis in psychiatry can be described as stages of growing dynamic causal impact of mental states over time. This system achieves a mode of psychiatric diagnosis that combines nomothetic (group-based classification across stages) and idiographic (individual-specific psychopathological profiles) components of psychopathology at the level of momentary mental states impacting on each other over time. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to clarify the symptomatology of the eating disorders examining the prefrontal function and activity associated with self-regulation among participants with or without eating disorders. Methods: Ten patients with anorexia nervosa, fourteen with bulimia nervosa, and fourteen healthy control participants performed two cognitive tasks assessing self-regulatory functions, an auditorily distracted word fluency task and a rock-paper-scissors task under the measurements on prefrontal oxyhemoglobin concentration with near infrared spectroscopy. The psychiatric symptoms of patient groups were assessed with several questionnaires. Results: Patients with bulimia nervosa showed decreased performances and prefrontal hyper activation patterns. Prefrontal activities showed a moderate negative correlation with task performances not in the patient groups but only in the healthy participants. The prefrontal activities of the patient groups showed positive correlations with some symptom scale aspects. Conclusions: The decreased cognitive abilities and characteristic prefrontal activation patterns associated with self-regulatory functions were shown in patients with bulimia nervosa, which correlated with their symptoms. These findings suggest inefficient prefrontal self-regulatory function of bulimia nervosa that associate with its symptoms. [ABSTRACT FROM AUTHOR]

The psychological consequences of sexual abuse are generally serious and enduring, particularly when the perpetrator is known and trusted by the survivor. This paper explores the experiences of five contemplative nuns who were sexually abused by priests and the spiritual journeys that followed. In the context of an ethnographic study of contemplative practice, participant observation and in-depth interviews were used to examine the ways that the nuns sought to make sense of their experiences through a long process of solitary introspection. The pursuit of meaning was shaped by religious beliefs relating to forgiveness, sacrifice, and salvation. Thus, trauma was transformed into a symbolic religious narrative that shaped their sense of identity. They were able to restructure core beliefs and to manage their current relationships with priests more securely. They described regaining their spiritual well-being in ways that suggest a form of posttraumatic spiritual growth. We conclude by discussing the findings in the light of the existing literature on the interaction of trauma and spirituality. [ABSTRACT FROM PUBLISHER]

Background: Depression is a common, recurrent, and debilitating problem and Internet delivered cognitive behaviour therapy (iCBT) could offer one solution. There are at least 25 controlled trials that demonstrate the efficacy of iCBT. The aim of the current paper was to evaluate the effectiveness of an iCBT Program in primary care that had been demonstrated to be efficacious in two randomized controlled trials (RCTs). Method: Quality assurance data from 359 patients prescribed the Sadness Program in Australia from October 2010 to November 2011 were included. Results: Intent-to-treat marginal model analyses demonstrated significant reductions in depressive symptoms (PHQ9), distress (K10), and impairment (WHODAS-II) with medium-large effect sizes (Cohen's d = .51–1.13.), even in severe and/or suicidal patients (Cohen's d = .50–1.49.) Secondary analyses on patients who completed all 6 lessons showed levels of clinically significant change as indexed by established criteria for remission, recovery, and reliable change. Conclusions: The Sadness Program is effective when prescribed by primary care practitioners and is consistent with a cost-effective stepped-care framework. [ABSTRACT FROM AUTHOR]

The biopsychosocial model of physical and mental health problems has developed a strong legitimacy in the academy. It is put forward episodically as a laudable holistic rationale for the study of health and as a useful bridge between psychology and medicine. It has a very strong appeal in health psychology because it is a realist paradigm (and so is consistent with the traditional objectivist aspirations of the discipline). This paper provides a critical analysis of the current status of the model, attending to its potential alignment with General Systems Theory but also drawing attention to its continuing problem with medical, especially psychiatric, constructs. [ABSTRACT FROM AUTHOR]

The articles that appeared in Indian Journal of Psychiatry were related to different areas of psychotherapy. Case reports dealt with a wide variety of cases. The review papers focused on the suitability of psychotherapy in the Indian context, different approaches in psychotherapy, psychotherapy training and supervision. Psychotherapy has been viewed very close to faith orientation. There were attempts to identify the indigenous concepts that are applicable to psychotherapy. Empirical studies are low in number. Concerted effort is needed to generate interest in psychotherapy, conduct more research on evidence-based therapies as well as on psychotherapeutic process variables. [ABSTRACT FROM AUTHOR]

Objectives: Conversations between anthropologists and psychiatrists have led to new theoretical trajectories, research agendas and clinical practices as social scientists and medical practitioners forged new understandings about the interaction of culture, personhood and illness. However, the demands of global mental health, coupled with health service provision requirements, mean that mental health interventions set up with the best intentions can fail to take into account the knowledge and expertise that social sciences can contribute to a programme's success. In this paper, I reflect on conversations between an anthropologist and mental health professionals in direct reference to data analysis of an AusAID mental health capacity-building programme undertaken in the Pacific region.Conclusions: Social and cultural perspectives embedded within programmes can provide richer, more contextualised interventions. In drawing on the combined expertise of anthropology and psychiatry, new taken-for-granted reference points embedding cultural approaches form the basis for delivery of global mental health programmes. These perspectives include: Locating mental health programmes within development critiques. Situating the subjects of development within contextualised settings, acknowledging and respecting local knowledge, understandings and practices. A focus on interdisciplinarity as the basis for future practice in global mental health projects. [ABSTRACT FROM AUTHOR]

The purpose of the paper is to reflect on value dilemmas in mental health consumer-run organizations and to discuss implications for research, policy, and practice. We review the roots of consumer-run organizations in the self-help movement and the psychiatric survivor liberation movement, focusing on the distinctive values espoused by consumer-run organizations. We also discuss evidence-based and value-based approaches to mental health policy formulation and mental health reform, noting the particular importance of value-based approaches and the role that consumer-run organizations can play in mental health reform. Based on our experiences conducting a participatory action research study of four mental health consumer-run organizations, we identify and examine several value dilemmas, discuss the lessons that we learned about these value dilemmas, and note their implications for future directions in research, policy, and practice [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder is characterized by severe and persistent pattern of hyperactivity and/or inattention, which is harmful. The correct assessment may be influenced by comorbidity and difficult of characterization. This paper evaluated the contribution of psychologist and psychiatrists on a correct avaliation and treatment elaboration. Ten psychologist and eight psychiatrists take part on semi-structured interview. The analysis was descriptive and qualitative. After comparing them we found that the psychologies and psychiatries of this sample contribute to the diagnostic in their specific ways and that the junctions of knowledge throw interdisciplinary work allows a better disorder comprehension and the development of a more efficient intervention plan. [ABSTRACT FROM AUTHOR]

AbstractControlled efficacy/effectiveness trials throughout the world have reached a high standard from a methodological stance, but what do we regard as the ideal or elegant intervention in clinical psychology? This paper presents six key points as the gold standards of psychosocial interventions by which treatment efficacy/effectiveness research with children, adolescents and adults might be evaluated: (1) Theoretical rationale and conceptualization of clinical dysfunction; (2) Clear problem identification and target client group; (3) Program features such as realistic goal setting, flexibility, and time limited interventions; (4) Manual based treatments; (5) Research support including clinically significant outcomes; and (6) Acceptability/social validation of clients and society. Sound case formulation and therapeutic alliance are crucial to assessment-treatment interface. Finally, we discuss the usefulness of such a framework for mental health professionals and clinical-researchers. [ABSTRACT FROM AUTHOR]

The emerging concept of recovery in mental health is often only loosely defined, but appears to be influenced more by specific human values and beliefs, than scientific research and 'evidence'. As a contribution to the further development of the philosophical basis of the concept of recovery, this paper reviews the discrete assumptions of the Tidal Model, describes the development of the Model's value base - the 10 Commitments - and illustrates the 20 Tidal Competencies, which aim to generate practice-based evidence for the process of recovery. [ABSTRACT FROM AUTHOR]

The thrust of this paper is to argue that Habermasian theory can provide useful insight and understanding to inform participatory research in the area of forensic mental health care. Habermasian theory about communication, participation, and democracy is used to explore retrospectively the relatively free discussions that took place within a user-led research project evaluating forensic mental health care. We (the academics within the research project team) first describe the stages of the research project, outlining how it opened up space for discussion about service users' experiences of the forensic mental health care they had received. Habermas's distinction between 'strategic action' (orientated towards getting things done) and 'communicative action' (interaction orientated towards freely agreeing consensual understanding) is then explored in a re-analysis of users' accounts of the interactions they recalled having with service providers. We then offer an account of interactions between service user researchers presenting their work at academic forums and their audiences of service providers. In particular, we look at the communication that occurred and, again using Habermasian theory, consider the issues that arose about open discussion and similarities and differences between therapy and participatory research. [ABSTRACT FROM AUTHOR]

A commentary on the Special Issue papers on the Scientist-Practitioner Model is presented. Based on the authors' recollections, a senior scholar uses a contextual approach to describe the historical and social sources of the evolution of the S-P model. It is recommended that the S-P perspective not be restricted to a philosophy of training nor a particular kind of scientific methodology, but include a historical and social understanding of the unfolding instantiations of the model. [ABSTRACT FROM AUTHOR]

Freud's philosophical anthropology is in fact little more than an amplified psychiatry. For Freud, the human being is in essence a sick animal. In this paper, I discuss the possibility of founding this ‘anthropological turn’ on evolutionary biology. On the one hand, it is shown that Freud's own attempted ‘evolutionary psychiatry’ failed because of his very limited knowledge of Darwinism and his awe for Haeckel and Lamarck. On the other hand, I argue that more recent attempts to reconcile psychoanalysis and evolutionary biology do not always provide a solid biological foundation for the Freudian philosophical project, despite the fact that they are—from a Darwinian point of view—tenable. This is so because, generally speaking, these theories consider psychopathologies either as adaptations or as accidental disorders, and not as inevitable but dysfunctional parts of human nature, like Freud did. [ABSTRACT FROM AUTHOR]

There is a lack of knowledge about the incidence of personality disorders and their consequences among peacekeepers. Moreover, most studies are follow-up studies in which, if at all, personality traits are screened for after the soldiers have left their service abroad. The aim of this paper was to study personality disorders in a longitudinal perspective. The method used was to screen the personnel in a Swedish mechanized battalion serving in Bosnia from March until October 1996 on four occasions: before deployment, immediately after deployment, 6 months after deployment and 1 year after deployment. Serving in the battalion were 724 individuals of whom 516 took part in the survey. The screening instrument used was the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q). The result shows that the rate of personality disorders were on the same level, or a little bit lower, than in the general population. Moreover, personality disorders were related to impaired general mental health and to reported traumatic experiences. Personality disorders also seemed to contribute to poor mental health 1 year after returning home from a mission abroad. The implications of these results for the future selection of peacekeepers are discussed. [ABSTRACT FROM AUTHOR]

The present paper uses an adaptational-continuum model of personality, based on health psychology model integrating Eysenck personality factors and coping style, to provide a context for examining the relationship between forgiveness and mental health. Three hundred and twenty respondents completed measures of personality, coping style, forgiveness (forgiveness of self, others, likelihood, presence of positive forgiveness, absence of negative forgiveness), general health, stress, positive and negative affect and life satisfaction. Among respondents, all measures of forgiveness, bar one, load negatively on a neuroticism-coping factor. The remaining measure of forgiveness (presence of positive forgiveness) loaded on an extraversion-coping factor. The relationship of the neuroticism-coping-forgiveness factor was associated with poorer mental health, suggesting forgiveness is associated with better mental health within the context of this personality-coping factor. Significant positive relationships were found between the extraversion-coping-forgiveness factor and two measures of positive mental health outcomes (positive affect and life satisfaction) suggesting forgiveness is associated with some aspects of mental health within the context of this personality-coping factor. The present findings suggest that forgiveness, or failure to forgive, can be conceptualised within an adaptational-continuum model of personality. [Copyright &y& Elsevier]

This paper explores the representation of emotional health and healing in traditional Chinese literature, and the holistic relationship between traditional Chinese mental medicine and literature as well as philosophy. The philosophical, moral and aesthetic significance assigned to emotional health and healing not only inspired but also mandated the representation of these subjects in Chinese literature. For many Chinese readers, emotional health is more than a medical concern but is integral to their moral and spiritual wholesomeness, the attainment of which necessarily involves the edifying role of literature. The literary representation of emotional health and healing gave rise to a subculture of emotional health and a medical dilettantism in Chinese society. The mutual inclusivity of the professional and the amateurish is peculiar to traditional Chinese mental medicine. While facilitating popular appreciation of emotional health and helping to validate the legitimacy and efficacy of emotional healing, such a phenomenon also caused a certain degree of charlatanization that undercut the rationality and validity of mental medicine. An investigation into the relationship between traditional Chinese literature and mental medicine provides an interdisciplinary perspective from which to examine the latter's history, theory, and practice, thus shedding a cross-cultural light on modern psychology and psychiatry. [ABSTRACT FROM AUTHOR]

This paper describes the results and implications of an 8-year audit cycle concerning premature termination of treatment in a population with severe personality disorder treated within a specialist residential setting. The results of the first audit showed (a) a high early dropout rate, (b) a significant difference in early dropout rates between the two clinical programmes (one-stage and step-down) offered by the unit, and (c) a higher attrition of non-borderline personality disorders compared to borderline type disorder. Qualitative analysis of interviews with early dropout patients helped to identify deficiencies in practice, which may have contributed to dropout. Discussion of results amongst the team led to corrective measures that allowed reduction of early dropout in the one-stage programme over the subsequent years. The implications of the results are discussed. [ABSTRACT FROM AUTHOR]

Why has there been a very rapid elaboration of the category of personality disorder within psychiatric classifications over the last 20 years? Personality disorder is the site of considerable psychiatric controversy. Its classification, diagnosis, and treatment are disputed not only within psychiatry, but also in closely related fields of forensic and psychological work. For severe cases, the Home Secretary in Britain has recently suggested that pre-emptive incarceration is justified, and many psychiatrists feel that personality disorder is not amenable to treatment. This paper seeks to make a contribution to the sociology of psychiatric knowledge, drawing both on recent work on the sociology of science and technology, and on the relationship between psychiatric practice and government in the late 20th century. [ABSTRACT FROM AUTHOR]

Discusses developments in the "International Journal of Methods in Psychiatric Research. Tool for publications on methods in clinical and basic neuropsychiatry, clinical psychology, epidemiology and other mental health domains; Publication of the U.S. National Institutes of Health-sponsored series of papers describing the National Comorbidity Survey Replication.

Background: The growing concern about cannabis use, the most commonly used illicit drug worldwide, has led to a significant increase in the number of human studies using neuroimaging techniques to determine the effect of cannabis on brain structure and function. We conducted a systematic review to assess the evidence of the impact of chronic cannabis use on brain structure and function in adults and adolescents. Methods: Papers published until August 2012 were included from EMBASE, Medline, PubMed and LILACS databases following a comprehensive search strategy and pre-determined set of criteria for article selection. Only neuroimaging studies involving chronic cannabis users with a matched control group were considered. Results: One hundred and forty-two studies were identified, of which 43 met the established criteria. Eight studies were in adolescent population. Neuroimaging studies provide evidence of morphological brain alterations in both population groups, particularly in the medial temporal and frontal cortices, as well as the cerebellum. These effects may be related to the amount of cannabis exposure. Functional neuroimaging studies suggest different patterns of resting global and brain activity during the performance of several cognitive tasks both in adolescents and adults, which may indicate compensatory effects in response to chronic cannabis exposure. Limitations: However, the results pointed out methodological limitations of the work conducted to date and considerable heterogeneity in the findings. Conclusion: Chronic cannabis use may alter brain structure and function in adult and adolescent population. Further studies should consider the use of convergent methodology, prospective large samples involving adolescent to adulthood subjects, and data-sharing initiatives. [ABSTRACT FROM AUTHOR]