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Suicide among American Muslims is understudied, despite recent research highlighting increased suicide attempts among this population. While suicide is forbidden in Islam, formal guidelines for addressing and responding to suicide within Muslim communities did not exist until recently. The Stanford Muslim Mental Health and Islamic Psychology Lab has responded to a number of suicides in Muslim communities across North America and implemented an original model for suicide response and community healing. This approach incorporates Islamic principles and values to create a culturally and religiously congruent response to suicide that can support loss survivors and steer impacted communities toward healing. The Muslim Postvention Community Healing session described in this paper aims to provide a safe space for individuals impacted by suicide to come together and process their emotions, while also using Islamic teachings to guide the healing process. This unique model has the potential to serve as a valuable resource for Muslim communities across North America, and beyond, in addressing and responding to suicide. [ABSTRACT FROM AUTHOR]

Mental health and mental illness have been contested concepts for decades, with a wide variety of models being proposed. To date, there has been no exhaustive review that provides an overview of existing models. To conduct a quasi-systematic review of theoretical models of mental health problems. We searched academic databases, reference lists, and an electronic bookshop for literature that proposed, endorsed, reviewed, or critiqued such models. Papers, book chapters, and books were included with material by researchers, clinicians, non-medical professions, and service users writing between 2000 to June 2020 being considered. The study was registered with the Open Science Framework (No. osf.io/r3tjx). Based on 110 publications, we identified 34 different models which were grouped into five broader categories. Many models bridged two or more categories. Biological and psychological approaches had the largest number of models while social, consumer and cultural models were less diversified. Due to the non-empirical nature of the publications, several limitations in terms of search and quality appraisal apply. We conclude that mental health care needs to acknowledge the diversity of theoretical models on mental health problems. [ABSTRACT FROM AUTHOR]

This paper examines how an intersection of critical cultural disability studies and rhetorical studies can inform a critical education on 'mental health (problems)' for psychology students. Building on cultural theories of disability/impairment, a conception of 'mental health (problems)' as culturally constituted is introduced. We propose the rhetorical perspective as a particularly relevant analytical and pedagogical approach to enable students to critically reflect on the cultural assumptions underpinning various (professional) understandings of 'mental health (problems)'. Our contribution is based on a research project in which clinical psychology students rhetorically analysed cultural constructions of 'mental health (problems)' in a graphic novel on 'bipolar disorder'. Based on a qualitative analysis of students' reflective reports, we argue that rhetorical perspectives enable students to develop reflexive stances towards the different cultural logics, and the ethical and political ramifications of these logics, in which psychological practice and knowledge on 'mental health (problems)' are inevitably embedded. This article argues that clinical psychology students need to think critically about the language they use to think and talk about mental health problems because this language has an impact on their beliefs, attitudes and actions towards people experiencing mental health problems. Educators can support students in this endeavour by introducing them to stories that challenge some of the dominant ways society thinks and talks about mental health problems, for example by working with stories or art work of survivors. In this study, clinical psychology students read an autobiographical graphic novel on 'bipolar disorder'. The graphic novel made students reflect on how the main character in the novel experiences mental health problems, on their personal and professional assumptions about mental health problems, and on dominant societal assumptions about mental health problems and their impact. [ABSTRACT FROM AUTHOR]

Psychosomatic conditions are generally discussed in broad and general terms that are difficult to conceptualize and have neither specific identified etiological factors nor consensus for treatment. This paper was written as a broad overview of psychosomatic conditions in order to provide clarity to the topic. Several databases were searched including Medline and PsychInfo and reference lists from relevant publications. Literature was sought out f or psychosomatic conditions, somatoform disorders, and medical illnesses with psychosomatic components. A general description of psychosomatic conditions and overarching themes were identified which include: lack of a universal definition, poor compatibility between psychological diagnoses and diagnoses outside of psychology, unclear etiology, psychosomatic factors occur in many illnesses, holistic perspective is preferred, poor patient insight regarding symptoms, strong family influence, and pediatric-liaison teams are strongly encouraged in diagnosis and treatment. Treatment is often highly individualized utilizing cognitive behavioral therapy, pharmacotherapy and pediatric-liaison teams with a biopsychosocial focus. [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]

Recent reviews on placebo treatments in clinical trials and clinical practice have reported to help patients with many diseases. Yet the quality of the evidence supporting this finding has not been rigorously evaluated. Therefore, the aim of the present study is to investigate the placebo effect as compared to active medication and whether, it has a different impact on physical health compared to mental health. In this research paper, research objectives include a comprehensive clarification of the origin of placebo effect, function, process and uses. The important models underlying the placebo effect have been explored in great detail and how a negative perception of a placebo treatment can result in the "nocebo effect" The results suggest that placebo interventions work more effectively on physical diseases than on mental disorders. However the placebo effect is not more effective than active medication. [ABSTRACT FROM AUTHOR]

Although Islam is the world's second-largest religion, there continues to be misconceptions and an overall lack of awareness regarding the religious and social worlds that make up the global Muslim community. This is particularly concerning when examining notions of mental ill-health, where a lack of cultural awareness, understanding, and sensitivity can impede adequate treatment. As a global religion, Islam is practiced within various cultural milieus, and, given the centrality of faith amongst Muslim communities, a conflation of religion and culture can occur when attempting to understand mental health paradigms. Whilst much of the discourse regarding Muslim mental health centres on cultural formulations, this article discusses how, historically, conceptualisations relating to medicine and mental health were ensconced within the particular medical paradigm of the day. Specifically, it considers the frameworks within which mental health and illness were understood within the medieval Muslim medical tradition and their relevance to contemporary debates in psychology and psychiatry. In sum, this paper seeks to demonstrate that cultural formulations of mental illness, often viewed as "Islamic", are distinct from historical Islamic approaches to mental health which employed contemporaneous medical discourse and which act as the reference marker for the emergent revivalist Islamic psychology movement seen today. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to determine the relation between quality of life (QoL), mental illness, challenging behaviour and institutionalisation in an adult population with intellectual disabilities (ID).Design/methodology/approach The study assessed the QoL and its conditioning factors in 142 subjects with different degrees of ID. The GENCAT and Quality of Life in Late Stage Dementia scale were used to evaluate QoL, the Psychiatric Assessment Schedule for Adults with Developmental Disability and Diagnostic Assessment for the Severely Handicapped-II scale to assess mental illness and the Inventory for Client and aetiology Planning scale to assess challenging behaviour.Findings Individuals who live in residential care homes were found to have significantly impaired QoL (<0.001). Individuals with challenging behaviour presented significantly lower QoL, regardless of ID aethiology and degree, while psychiatric disorders did not seem to have a direct influence on individual QoL.Originality/value This paper provides new insight into the importance of challenging behaviour and psychiatric disorders in the QoL of individuals with ID. [ABSTRACT FROM AUTHOR]

Background: First generation migrants are reportedly at higher risk of mental ill-health compared to the settled population. This paper systematically reviews and synthesizes all reviews on the mental health of first generation migrants in order to appraise the risk factors for, and explain differences in, the mental health of this population.Methods: Scientific databases were searched for systematic reviews (inception-November 2015) which provided quantitative data on the mental ill-health of first generation migrants and associated risk factors. Two reviewers screened titles, abstracts and full text papers for their suitability against pre-specified criteria, methodological quality was assessed.Results: One thousand eight hundred twenty articles were identified, eight met inclusion criteria, which were all moderate or low quality. Depression was mostly higher in first generation migrants in general, and in refugees/asylum seekers when analysed separately. However, for both groups there was wide variation in prevalence rates, from 5 to 44 % compared with prevalence rates of 8-12 % in the general population. Post-Traumatic Stress Disorder prevalence was higher for both first generation migrants in general and for refugees/asylum seekers compared with the settled majority. Post-Traumatic Stress Disorder prevalence in first generation migrants in general and refugees/ asylum seekers ranged from 9 to 36 % compared with reported prevalence rates of 1-2 % in the general population. Few studies presented anxiety prevalence rates in first generation migrants and there was wide variation in those that did. Prevalence ranged from 4 to 40 % compared with reported prevalence of 5 % in the general population. Two reviews assessed the psychotic disorder risk, reporting this was two to three times more likely in adult first generation migrants. However, one review on the risk of schizophrenia in refugees reported similar prevalence rates (2 %) to estimates of prevalence among the settled majority (3 %). Risk factors for mental ill-health included low Gross National Product in the host country, downward social mobility, country of origin, and host country.Conclusion: First generation migrants may be at increased risk of mental illness and public health policy must account for this and influencing factors. High quality research in the area is urgently needed as is the use of culturally specific validated measurement tools for assessing migrant mental health. [ABSTRACT FROM AUTHOR]

Despite increasing mental health promotion and advocacy, stigma persists and poses a significant threat to the healthy functioning at the macro and micro-sociological levels. Stigma is gradually evolving with the incorporation of broader social contexts at the micro and macro levels in which individuals, institutions and larger cultural constructs shape and influence the perception of what is different and therefore stigmatized. This theoretical paper based on literature underscores how mental health stigma discourages individuals from getting proper mental health treatment. The interface of mental illness, stigma, and mental health treatment has ethical and potentially moral implications. [ABSTRACT FROM AUTHOR]

Current research on return to work (RTW) for employees with common mental disorders suffers from two limitations. First, research mostly focuses on the influence of resources during the absence period ignoring the resources which may facilitate sustainable RTW, i.e. employees continuing to work and thrive at work post-return. Second, research tends to view the work and non-work domains separately and fails to consider the interaction of resources at the individual, group, leader and organisational levels, once back at work. In the present position paper, we present an integrated framework and a preliminary definition of sustainable RTW. Based on current occupational health psychology theory and existing research on RTW, we develop ten propositions for the resources in and outside work, which may promote sustainable RTW. In addition to the individual, group, leader, and organisational levels, we also argue for the importance of the overarching context, i.e. the societal context and the culture and legislation that may promote sustainable RTW. Our framework raises new questions that need to be addressed to enhance our understanding of how key stakeholders can support employees with common mental health disorders staying and thriving at work. [ABSTRACT FROM AUTHOR]

This essay is in part a response to a cluster of papers from the conference in Norway. Utilising these as a springboard to expand certain ideas, some latent, some more manifest in the papers, regarding the history and the terrain concerning the mental health issues in our culture. Fundamentally, this proposes that there is an unrelenting tension between two polarities: one reactionary and authoritarian, fixated on a concern with outcomes, propped up by closed systems of thought, managerial, habitually linked to adaptation and conformity; the other more romantically seen as revolutionary, unhandcuffing madness from mental illness, facilitating more expansive, freewheeling possibilities within all our lives. Much of this pays tribute to some of the major figures in the history of ‘anti-psychiatry’ (Basaglia, Cooper and Laing), with the costs involved, and goes on to trace out the genesis and consequences of the two predominant ‘clouds’ permeating our world, the paranoid and the digital … all converging on a naturalisation of our culture of surveillance, and an insistence on control. Otherwise known as a culture of fear. [ABSTRACT FROM PUBLISHER]

Purpose Interactions between individuals experiencing mental health (MH) problems and the police are complex and may affect the way in which both parties react to and experience the interactions. The purpose of this paper is to examine three commonly used interventions to improve these interactions.Design/methodology/approach Mixed methods were used to examine embedded MH professionals in command and control rooms, Liaison and Diversion Teams and Street Triage. The authors also reviewed the use of Section 136 (s136) of the Mental Health Act 1983 (2007) during the period these interventions were deployed.Findings There was strong support for these interventions but also gaps, resource and operational issues that need to be addressed if they are to have optimal effect on delivering appropriate diversion from the justice system, reduce reoffending and improve MH outcomes for individuals. The use of s136 remained relatively constant.Originality/value Despite a recent increase in the level of investment related to these interventions the evidence base remains limited. This study provides baseline of research evidence for those who commission and provide services for individuals experiencing mental ill health and who are in contact with the justice system. [ABSTRACT FROM AUTHOR]

The mental health consumer movement initiated the development of the recovery approach, in which self-determination, human rights and the living of a hopeful life superseded merely symptom management for people living with mental illnesses and addictions. To what degree has this reimagined path to recovery shaped social work practice? In this paper we analyse the perspectives of eleven social workers doing child protection work in Aotearoa New Zealand. We examine also the accounts of thirteen parents living with mental illness or addiction who have been involved in child custody investigations in Aotearoa New Zealand. We ask whether the social workers understand recovery as possible for such parents, and if so, how they see it occurring. We found that there is a substantial difference between the way the social workers and the parents conceived of such ‘recovery’. While parents' descriptions of recovery reflected those of the mental health consumer movement, social workers tended to operate with a focus on clinical intervention, symptom and risk management. [ABSTRACT FROM AUTHOR]

Purpose: The main purpose of this paper is to examine geographic variation in unmet need for mental health care among racially/ethnically diverse adults with psychiatric disorders in the US.Methods: Drawn from the Collaborative Psychiatric Epidemiology Surveys (CPES; 2001-2003), adults with any past year psychiatric disorder diagnosis (n = 3211) from diverse racial/ethnic backgrounds were selected for analyses. Using weighted data, descriptive analyses and logistic regression analyses were conducted.Results: Two-thirds of the total sample had unmet mental health care need, which differed significantly by race/ethnicity (p < .001). Logistic regression analyses show regional variation of the effect of race/ethnicity in unmet need: after adjusting for covariates, Latinos in the South, Blacks and Latinos in the Midwest, and Latinos and Asians in the West had higher unmet need than non-Hispanic Whites, whereas no significant racial/ethnic effects were found in the Northeast.Conclusions: Findings suggest that geographic region plays an important role in the sufficient use of mental health services among racial/ethnic minorities. Further research should elucidate reasons for geographic disparities in mental health care among racial/ethnic minority adults to reduce disparities. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore the ways in which "mental health" difficulties are approached in low-income countries, using a case study of Uganda focus down upon the issues. Design/methodology/approach – The study involved two phases. The first was the collection and analysis of documentary evidence and interviews with policy makers in Uganda. The second involved interviews with health staff, traditional healers and the public in the Buganda Kingdom of Uganda. Interviews were conducted in English or Luganda and translated as necessary. No external sources of funding to declare. Findings – There are differing perceptions of mental health and illness in Uganda and there exists culturally accepted sources of support for distress. This highlights the important role of traditional healers and the paper argues that they should be recognised for their work in mental health care. Research limitations/implications – The paper is a small-scale study of one area of Uganda (Buganda Kingdom), the extent to which it can be generalised is therefore very limited. However, the research is sufficient to indicate the benefits of traditional healers in mental health care and supports an argument towards a public mental health model. Practical implications – The paper argues for a move in priority away from a focus upon a biomedical model of mental health support towards a public health model and the meaningful engagement of traditional healers. This would also necessitate a refocus of spending in the wider society. Originality/value – The paper poses a challenge to the Global Public Health movement and questions the relevance of expanding biomedical psychiatry in low-income countries. The paper also adds weight to emerging literature on the value of a public health approach to mental health and illness, especially in the developing world. [ABSTRACT FROM AUTHOR]

Background: Research in emergencies is needed to understand the prevalence of mental health and psychosocial problems and strengthen the evidence base for interventions. All research - including operational needs assessments, programme monitoring and evaluation, and formal academic research - must be conducted ethically. While there is broad consensus on fundamental principles codified in research ethics guidelines, these do not address the ethical specificities of conducting mental health and psychosocial support (MHPSS) research with adults in emergencies. To address this gap, this paper presents a review of multidisciplinary literature to identify specific ethical principles applicable to MHPSS research in emergencies.Discussion: Fifty-nine sources meeting the literature review inclusion criteria were analysed following a thematic synthesis approach. There was consensus on the relevance of universal ethical research principles to MHPSS research in emergencies, including norms of participant informed consent and protection; ensuring benefit arises from research participation; researcher neutrality, accountability, and safety; and the duty to ensure research is well designed and accounts for contextual factors in emergency settings. We go onto discuss unresolved issues by highlighting six current debates relating to the application of ethics in emergency settings: (1) what constitutes fair benefits?; (2) how should informed consent be operationalised?; (3) is there a role for decision making capacity assessments?; (4) how do risk management approaches impact upon the construction of ethical research?; (5) how can ethical reflection best be achieved?, and (6) are ethical review boards sufficiently representative and equipped to judge the ethical and scientific merit of emergency MHPSS research? Underlying these debates is a systemic tension between procedural ethics and ethics in practice. In summary, underpinning the literature is a desire to ensure the protection of participants exposed to emergencies and in need of evidence-based MHPSS. However, there is a lack of agreement on how to contextualise guidelines and procedures to effectively maximise the perspectives of researchers, participants and ethical review boards. This is a tension that the field must address to strengthen ethical MHPSS research in emergencies. [ABSTRACT FROM AUTHOR]

Background: In-patient suicide prevention is a high priority in many countries, but its practice remains poorly understood. Patients in a suicidal crisis who receive psychiatric care can provide valuable insight into understanding and improving patient safety. The aim of this paper was therefore to summarize the qualitative literature regarding suicidal patients' in-patient care experiences. The following question guided the review: How can we describe suicidal patients' experiences regarding safety during psychiatric in-patient care?Methods: Systematic searches were conducted in the MEDLINE, Academic Search Premier, CINAHL, SOCINDEX and PsycINFO databases, identifying 20 qualitative studies on suicidal patients and their psychiatric in-patient care experiences. These studies were systematically reviewed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, synthesized via thematic analysis and subjected to quality appraisals.Results: Patients described safety as "feeling safe", and three components, i.e., connection, protection and control, were vital to their experiences of safety. Fulfilling these needs was essential to patients recovering from suicidal crises, feeling safe during encounters with health care professionals and feeling safe from suicidal impulses. Unmet needs for connection, protection and control left patients feeling unsafe and increased their suicidal behaviour.Conclusion: Our review addresses the importance of adopting a wider perspective of patient safety than considering safety solely in technical and physical terms. Safety for the suicidal patient is highly dependent on patients' perceptions of their psychological safety and the fulfilment of their needs. The three patient-identified factors mentioned above - connection, protection and control - should be considered an integral part of patient safety practices and should form the basis of future efforts to understand the safety of suicidal patients during psychiatric in-patient care. [ABSTRACT FROM AUTHOR]

Background: Substance abuse treatment following a natural disaster is often met with challenges. If treatment is available, facilities may be unequipped to service an influx of patients or provide specialized care for unique populations. Objectives: This paper seeks to evaluate trends in substance abuse treatment over time and assess changes pre- and post-Hurricane Katrina. Methods: Substance abuse treatment admission data (N = 42,678) from New Orleans, Louisiana, for years 2000 through 2012 were obtained from the Treatment Episode Data Set. Admissions were examined to evaluate demographic, socioeconomic, psychiatric, and criminality trends in substance abuse treatment and assess changes following Hurricane Katrina. Results: Treatment admissions have decreased from 2000 to 2012. About one in five admissions had a psychiatric illness in addition to a substance abuse problem. A staggering 76% of admissions with a psychiatric illness were referred by the criminal justice system post-Katrina as compared to pre-Katrina. Rates of alcohol and marijuana admissions have remained stable from 2000 to 2012. Cocaine/crack admissions have declined and admissions who abused heroin have increased over time. Conclusions: Treatment admissions stabilized following Hurricane Katrina; however, since 2009, they have begun to decline. Targeted exploration of factors affecting admission to treatment in New Orleans with populations such as the homeless, those with a psychiatric illness in addition to a substance abuse problem, and those referred by the criminal justice system is essential. The results of this study assist in identifying variations in substance abuse treatment characteristics for those admitted to treatment in New Orleans. [ABSTRACT FROM AUTHOR]

Background: Reader Groups (RGs) involve a skilled facilitator reading aloud complex literature in a group setting, followed by group discussion of the text. This paper explores the experience of eight individuals with mental health problems participating in general community RGs, relating this to making sense of life experiences and relationships inside and outside the group. Method: Semi-structured interviews were transcribed and analysed using interpretative phenomenological analysis. Results: Five master themes emerged from the analysis: Boundaries and Rules of Engagement, Literature as an Intermediary Object, Self as Valued, Worthy, Capable, Community and Togetherness in Relational Space, and Changing View of Self, World, Others. Conclusion: The findings are discussed in relation to existing research and psychological theory, highlighting the literature as a key mediator in psychological processes involved in participants' experiences of RGs. [ABSTRACT FROM AUTHOR]

Accessible summary • The deployment of British troops to Afghanistan as part of the 'war on terror', has put the Armed Forces under strain and resulted in growing pressure to address the mental health consequences among service personnel. • This paper examined lots of research papers and other articles to find out what we know about the effects of war on soldiers mental health and what help they can receive. • Themes emerging from the literature were: the mental health of current and ex-service personnel, young service personnel, responses to the mental health needs of soldiers and barriers to care. • There are higher rates of homelessness, alcohol abuse, domestic violence, relationship breakdown and criminality among former military personnel with untreated mental health problems. • Poor mental health is associated with increased risk of social exclusion on leaving the services, which further exacerbates mental health problems. An increasing number of ex-service personnel are expected to develop stress-related mental health problems in the future. The aim of this paper was to explore how a military career may affect the mental health of serving and ex-service personnel, to identify the accessibility and helpfulness of support (both during and after military service) and to make recommendations for change. A literature search was undertaken using the MetaFind meta search engine with keywords: mental health, psychological health, emotional health, soldier, British army, army, ex-army, military, military personnel, armed forces, resettlement, impact, family relationship, divorce, health, support services. The search was applied to the following databases: EBSCO Host, CINAHL, Cochrane Library, Ingenta Connect, Medline, PsyArticles, PubMed, Web of Knowledge, together with the specific journals American Journal of Psychiatry, British Journal of Psychiatry and ProQuest Nursing journals. 110 relevant publications were identified and from these 61 papers were retrieved for further analysis. Poor mental health is associated with increased risk of social exclusion on leaving the services, which further exacerbates mental health problems. An increasing number of ex-service personnel are expected to develop stress-related mental health problems in the future. [ABSTRACT FROM AUTHOR]

This paper is an invited response to Kashdan, Biswas-Diener, & King (2008) and to Waterman's (2008) commentary. Kashdan et al. assert that the distinction between hedonic and eudaimonic well-being is unwarranted philosophically and scientifically. We disagree, because a correct understanding of Aristotle refutes Kashdan et al.'s claims, and we refute three specific claims made about the definition, measurements, and overlap of kinds of subjective well-being. We re-analyze data from Keyes' (2005b) paper on mental health, and find that nearly half (48.5%) of the MIDUS national sample has high hedonic well-being. However, only 18% are flourishing, which requires a high level of hedonic and eudaimonic well-being. The remaining 30.5% with high hedonic well-being but moderate eudaimonic well-being has nearly twice the rate of mental illness as flourishing individuals. Costs are incurred, we conclude, by science and citizens when we do not distinguish and achieve both kinds of well-being. [ABSTRACT FROM AUTHOR]

This paper describes selected findings from a research study exploring the use of a basic literacy/creative writing course provided in a community setting for adults with long-term mental health difficulties. It explores one case in particular, where long-term mental illness coupled with limited verbal articulation and low levels of literacy presented significant barriers to learning, creativity and the construction of narrative. However, whilst little movement or development could be discerned in some participant cases where recognisable barriers were less formidable, the case study selected illustrates a resilience and agency on the part of one individual which enabled incremental but significant development. The paper suggests that seeking the creative in the writing, or the meaning in the words was to overlook the actual creative act, which was the resilient, reparative process of coming to terms with a new identity and a new self narrative. [ABSTRACT FROM AUTHOR]

The purpose of this article is to illustrate how neurobiological deficits and subcortical structures contribute to psychodynamic processes. Specifically, this paper seeks to enhance our clinical understanding of the consequence of such contributions by clarifying how a person might select and maintain dysfunctional behaviors or responses. Viewing the brain from an evolutionary perspective, with physical and mental survival as the goal of evolved brain function, specific dysfunctional behaviors are shown to be context and time dependent regulatory or modulatory procedures, which compensate for missing neural connections. This paper describes two courses of treatment with the same patient, first for procrastination and later for perversion. In each treatment deficits are identified and compensatory skills are discussed. [ABSTRACT FROM AUTHOR]

This article takes as its starting point a paper by Hugo Bleichmar presented at the 2003 Joseph Sandler Research Conference on Depression. The author argues in favour of viewing depression in a broad perspective. The Freudian prototype of "guilty depression" represents only one of many pathways leading to depressive states. Psychoanalytic understanding of depression should represent a multidimensional approach, characterised by interacting determinants, both internal and external. In clinical practice, this would imply an attitude of greater freedom and flexibility in the analyst. The paper compares the psychoanalytic account of depression with that given by the cognitive approach. It is argued that within a diverse research field, where depression is studied from different angles - as a disorder of the brain and in terms of cognitive deficits - the contribution of psychoanalysis is that depression is most usefully studied at the level of psychological causation. The psychoanalytic understanding of depressive states in terms of unconscious interpretation and meaning of experience represents a distinct contribution. Implications of viewing depression as an "illness" are discussed. [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]

Introduction: Burn care innovations have vastly reduced mortality rates and improved prognoses, fostering the need for multi-disciplinary input in holistic recovery. Consequently psychological and social considerations post-burn are included in National Burn Care Standards and have featured increasingly in burns literature.Aim: To identify the key findings of the rapidly expanding literature base for psychosocial adjustment post-burn, highlighting the most important knowledge and future directions for both practice and research.Method: MEDLINE, CINAHL, EMBASE, PsycINFO, BNI, HMIC databases were searched from January 2003 to September 2013 using search terms regarding psychosocial adjustment post-burn. After exclusions 24 papers underwent critical appraisal.Results: Studies were categorised by the element of adjustment that they examined; psychopathology, quality of life, return to work, interpersonal, post-traumatic growth. Strengths, weaknesses, and significant findings within each category were presented.Discussion: Although psychopathology and quality of life were well-researched compared to other categories, all would benefit from methodological improvements such as sample size or dropout rates. Coping strategies, premorbid psychopathology, and personality consistently featured as predictors of adjustment, although research should now move from identifying predictors, to clarifying the concept and parameters of psychosocial adjustment while developing and evaluating interventions to improve outcomes. [ABSTRACT FROM AUTHOR]

When children with special educational needs are excluded from school, it should raise the concern that these children are not receiving adequate help and support. This systematic review aims to identify the prevalence of psychiatric disorder or impairing psychopathology among children who are excluded from school compared to children who are not excluded from school. The review follows the guidelines set out by the Centre of Research and Dissemination (Centre for Reviews and Dissemination, 2009). We used broad search terms (across 16 databases) in order to avoid missing papers, our initial screening stage involved 3712 titles and abstracts. Five studies finally met our inclusion criteria. The results from these studies suggest that the odds of children who have been excluded from school having some kind of impairing psychological or behavioural impairment is increased in comparison to children who have not been excluded (odds ratios ranging from 1.13–31.9). However, the paucity of primary research in this area, combined with methodological weaknesses in the identified studies makes it difficult to draw firm conclusions. The need for education and mental health professionals to work together to provide the appropriate support for all children at risk of exclusion is of great and immediate concern. [ABSTRACT FROM PUBLISHER]

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]

People with intellectual disabilities have poorer health than their non-disabled peers. They are also more likely to be exposed to a wide range of environmental adversities in childhood. Research undertaken in the general population has demonstrated that exposure to environmental adversity in childhood can have an adverse impact on health and well-being across the life course. Recently, research in this area has added new breadth and depth to our understanding of: (1) the extent to which cumulative exposure to environmental adversities across the life course, but especially in early childhood, can reduce health and well-being; (2) the social, psychological and biological mediating pathways through which environmental adversities may impair health; (3) the processes associated with resilience and vulnerability in the face of exposure to adversity; and (4) the social significance of these effects in accounting for the magnitude of the inequalities in health that are apparent both between and within populations. This new knowledge is making a significant contribution to the development of social policies that seek to combine health gain with the reduction in health inequalities. This paper attempts to apply this knowledge to research aimed at understanding and improving the health and well-being of people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

This paper describes the intersection of converging lines of research on the social structural, psychosocial, and physiological factors involved in the production of stress and implications for the field of mental health. Of particular interest are the stress sensitization consequences stemming from exposure to adversity over the life course. Contemporary stress sensitization theory provides important clinical utility in articulating mechanisms through which these multiple levels exert influence on mental health. Stress sensitization models (a) extend understanding of neurobiological and functional contexts within which extreme stressors operate and (b) make clear how these can influence psychologically traumatic outcomes. The value of interventions that are sensitive to current contexts as well as life course profiles of cumulative stress are illustrated through recent treatment innovations. [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]

Purpose - This pilot study aimed to investigate whether adults with mild/moderate intellectual disabilities could accurately self-report their attachment style. It explored whether there is a relationship between attachment style and challenging behaviour and/or mental health problems. Additionally, the paper examines the distribution of attachment styles in people with intellectual disabilities, based on the hypothesis that it might be different to that of the general population.Design/methodology/approach - Adults with intellectual disabilities (n = 60) and people who supported them (n = 39) completed questionnaires based on Hazan and Shaver's attachment categories and mental health diagnoses. Supporters also provided information about challenging behaviour.Findings - People with mild/moderate intellectual disabilities show the same range of attachment styles as the general population. Links between challenging behaviour and insecure attachment were found, and there was an association between depression and insecure-avoidant attachment.Originality/value - Applications of attachment theory in individual therapy and at a policy level are explored in light of the findings, as well as directions for future research. There appears to be a relationship between insecure attachment and depression in people with intellectual disabilities. This has implications for the psychological treatment of people with intellectual disabilities and interventions should be developed that focus on attachment relationships. Attachment behaviour may not be linked to challenging behaviour as directly as has been previously suggested, certainly for people with mild moderate intellectual disabilities. [ABSTRACT FROM AUTHOR]

Abstract: Across all health care settings, certain patients are perceived as ‘difficult’ by clinicians. This paper’s aim is to understand how certain patients come to be perceived and labelled as ‘difficult’ patients in community mental health care, through mixed-methods research in The Netherlands between June 2006 and October 2009. A literature review, a Delphi-study among experts, a survey study among professionals, a Grounded Theory interview study among ‘difficult’ patients, and three case studies of ‘difficult’ patients were undertaken. Analysis of the results of these qualitative and quantitative studies took place within the concept of the sick role, and resulted in the construction of a tentative explanatory model. The ‘difficult’ patient-label is associated with professional pessimism, passive treatment and possible discharge or referral out of care. The label is given by professionals when certain patient characteristics are present and a specific causal attribution (psychological, social or moral versus neurobiological) about the patient’s behaviours is made. The status of ‘difficult’ patient is easily reinforced by subsequent patient and professional behaviour, turning initial unusual help-seeking behaviour into ‘difficult’ or ineffective chronic illness behaviour, and ineffective professional behaviour. These findings illustrate that the course of mental illness, or at least the course of patients’ contact with mental health professionals and services, is determined by patient and professional and reinforced by the social and mental health care system. This model adds to the broader sick role concept a micro-perspective in which attribution and learning principles are incorporated. On a practical level, it implies that professionals need to look into their own role in the perpetuation of difficult behaviours as described here. [Copyright &y& Elsevier]

Objective: In Australia it has been estimated that mental health symptoms result in a loss of $ AU2.7 billion in employee productivity. To date, however, there has been only one study quantifying employee productivity decrements due to mental disorders when treatment-seeking behaviours are considered. The aim of the current paper was to estimate employee work productivity by mental health symptoms while considering different treatment-seeking behaviours. Method: A total of 60 556 full-time employees responded to the World Health Organization Health and Work Performance Questionnaire. This questionnaire is designed to monitor the work productivity of employees for chronic and acute physical and mental health conditions. Contained within the questionnaire is the Kessler 6, a scale measuring psychological distress along with an evaluation of employee treatment-seeking behaviours for depression, anxiety and any other emotional problems. A univariate analysis of variance was performed for employee productivity using the interaction between Kessler 6 severity categories and treatment-seeking behaviours. Results: A total of 9.6% of employees have moderate psychological distress and a further 4.5% have high psychological distress. Increasing psychological distress from low to moderate then to high levels is associated with increasing productivity decrements (6.4%, 9.4% and 20.9% decrements, respectively) for employees in current treatment. Combining the prevalence of Kessler 6 categories with treatment-seeking behaviours, mean 2009 salaries and number of Australian employees in 2009, it is estimated that psychological distress produces an $ AU5.9 billion reduction in Australian employee productivity per annum. Conclusions: The estimated loss of $ AU5.9 billion in employee productivity due to mental health problems is substantially higher than previous estimates. This finding is especially pertinent given the global economic crisis, when psychological distress among employees is likely to be increasing. Effective treatment for mental health problems yields substantial increases in employee productivity and would be a sound economic investment for employers. [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]

In this paper, we discuss a problem in qualitative interviewing labeled by Bourdieu as 'false, collusive objectification'. As described by Bourdieu, interviews where this occurs appear authentic because they often echo social science concepts and terminology and therefore may please the interviewer; however, they are actually unusable. We evaluate Bourdieu's claim for the existence of 'false' interviews in light of the predominant postmodern position in qualitative research, offer examples from our own research on people diagnosed with mental illness and raise the issue of whether, when and how qualitative researchers should concern themselves with the shortcomings of interviews. We conclude with suggestions derived from Bourdieu's view on how to address the problem he described. [ABSTRACT FROM AUTHOR]

In relation to treatment-related research in the United States, there is relatively little systematic effort focused on the combination of risk and prevention for anxiety pathology. This article broadly discusses risk factor research and prevention program development for anxiety psychopathology. The authors also specifically discuss papers in this special issue that are focused on these topics. Risk factor research should be used by clinical researchers to inform prevention programs, and reciprocally, prevention knowledge should be effectively utilized to drive new, clinically focused risk factor 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]

Posttraumatic stress disorder (PTSD) factor analytic research to date has not provided a clear consensus on the structure of posttraumatic stress symptoms. Seven hypothesized factor structures were evaluated using confirmatory factor analysis of the Posttraumatic Stress Disorder Checklist, a paper-and-pencil measure of posttraumatic stress symptom severity, in a sample of 1,218 women who experienced a broad range of workplace sexual harassment. The model specifying correlated re-experiencing, effortful avoidance, emotional numbing, and hyperarousal factors provided the best fit to the data. Virtually no support was obtained for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; American Psychiatric Association, 1994) three-factor model of re-experiencing, avoidance, and hyperarousal factors. Different patterns of correlations with external variables were found for the avoidance and emotional numbing factors, providing further validation of the supported model. [ABSTRACT FROM AUTHOR]

Serious mental illness is associated with substantial personal and interpersonal distress and life disruption for the sufferer and for his/her family. A common response to having and caring for a family member with a serious mental illness is feeling loss and grief. This paper presents a representative narrative that attempts to capture the essence of the experience as conveyed by 22 parents of adult children with a serious mental illness. The implication of the narrative is examined. [ABSTRACT FROM AUTHOR]

Background. The German National Health Interview and Examination Survey (GHS) is the first government mandated nationwide study to investigate jointly the prevalence of somatic and mental disorders within one study in the general adult population in Germany. This paper reports results from its Mental Health Supplement (GHS-MHS) on 4-week 12-month, and selected lifetime prevalence of a broad range of DSM-IV mental disorders, their co-morbidity and correlates in the community. Methods. The sample of the GHS-MHS (n=4181; multistage stratified random sample drawn from population registries; conditional response rate: 87·6%) can be regarded as representative for the German population aged 18–65. Diagnoses are based on fully structured computer assisted clinical interviews (M-CIDI), conducted by clinically trained interviewers. Results. 12-month prevalence for any DSM-IV study disorder is 31% (lifetime: 43%; 4-week: 20%) with anxiety disorders, mood disorders and somatoform syndromes being the most frequent diagnoses. Retrospective age of onset information reveals that most disorders begin early in life. Co-morbidity rates among mental disorders range from 44% to 94%. Correlates of increased rates of mental disorders and co-morbidity were: female gender (except for substance disorders), not being married, low social class, and poor somatic health status. Health care utilization for mental disorders depended on co-morbidity (30% in ‘pure’, 76% in highly co-morbid cases) and varied from 33% for substance use disorders to 75% for panic disorder. Conclusions. Results confirm and extend results from other national studies using the same assessment instruments with regard to prevalence, co-morbidity and sociodemographic correlates, covering a broader range of DSM-IV disorders [i.e. somatoform disorders, all anxiety disorders (except PTSD), mental disorders due to substance or general medical factor, eating disorders]. Intervention rates were higher than in previous studies, yet still low overall. [ABSTRACT FROM AUTHOR]

This paper evaluated the quality of life (QOL) of people with multiple sclerosis (MS) and people from the general population. Gender differences between the 2 groups of respondents and the influence of coping style on adjustment were also evaluated. The participants were 381 (144 males, 237 females) people with MS, and 291 (101 males, 190 females) people from the general population. The results demonstrated that people with MS experienced lower levels of QOL than people from the general population for both the objective and subjective dimensions of all domains (physical health, psychological adjustment, social relationships, environmental adjustment). All coping strategies (problem-focused, focusing on the positive, detachment, wishful thinking, seeking social support) were important predictors of QOL for both males and females with MS, with wishful thinking being the strongest predictor of poor QOL. These results are discussed in terms of the various factors that impact on QOL among people with MS, and the types of coping strategies that are most adaptive in improving the QOL of people with this illness. [ABSTRACT FROM AUTHOR]

A great deal of research has been conducted over recent years in the field of occupational stress and its relationship to physical and mental illness. This paper attempts to provide a framework for examining this work, with the dual objectives of broadening the existing psychological literature with the extensive medical data available and also highlighting the research gaps in this area. By emphasizing the medical evidence it is hoped that we may encourage greater interdisciplinary work in the growing field of stress at work. [ABSTRACT FROM AUTHOR]