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Borderline personality disorder (BPD) is a prevalent psychiatric illness that often first presents at college. If left untreated, BPD can lead to severe disability or fatality. While multiple evidence-based treatments for BPD exist, most are resource intensive and, therefore, difficult to implement at the typical college mental health center. However, general psychiatric management (GPM) is an evidence-based intervention for BPD that can be flexibly implemented in nonspecialized, resource-constrained environments. This principle-driven alternative to more intensive BPD-focused treatments provides a practical framework for treating college students with BPD. The aim of this article is to provide an introduction to the techniques of GPM within the college mental health setting. With a case vignette, we illustrate how GPM techniques might be brought to bear on such a treatment.

Objective: Blood-based biomarkers have received considerable attention for their diagnostic and prognostic value in the acute and postacute period following traumatic brain injury (TBI). The purpose of this study was to examine whether blood-based biomarker concentrations within the first 12 months of TBI can predict neurobehavioral outcome in the chronic phase of the recovery trajectory. Setting: Inpatient and outpatient wards from 3 military medical treatment facilities. Participants: A total of 161 service members and veterans classified into 3 groups: (a) uncomplicated mild TBI (MTBI; n = 37), (b) complicated mild, moderate, severe, penetrating TBI combined (STBI; n = 46), and (c) controls (CTRL; n = 78). Design: Prospective longitudinal. Main Measures: Participants completed 6 scales from the Traumatic Brain Injury Quality of Life (ie, Anger, Anxiety, Depression, Fatigue, Headaches, and Cognitive Concerns) within 12 months (baseline) and at 2 or more years (follow-up) post-injury. Serum concentrations of tau, neurofilament light, glial fibrillary acidic protein, and UCHL-1 at baseline were measured using SIMOA. Results: Baseline tau was associated with worse anger, anxiety, and depression in the STBI group at follow-up (R 2 = 0.101-0.127), and worse anxiety in the MTBI group (R 2 = 0.210). Baseline ubiquitin carboxyl-terminal hydrolase L1 (UCHL-1) was associated with worse anxiety and depression at follow-up in both the MTBI and STBI groups (R 2Δ = 0.143-0.207), and worse cognitive concerns in the MTBI group (R 2Δ = 0.223). Conclusions: A blood-based panel including these biomarkers could be a useful tool for identifying individuals at risk of poor outcome following TBI. [ABSTRACT FROM AUTHOR]

Key Points: Question: Are individuals with hypochondriasis at increased risk of death due to natural and unnatural causes? Findings: In this Swedish nationwide matched-cohort study of 4129 individuals with a diagnosis of hypochondriasis and 41 290 demographically matched individuals without hypochondriasis, those with hypochondriasis had an increased risk of death from both natural and unnatural causes, particularly suicide. Meaning: This study suggests that individuals with hypochondriasis have an increased risk of mortality, mainly from potentially preventable causes. Importance: Hypochondriasis, also known as health anxiety disorder, is a prevalent, yet underdiagnosed psychiatric disorder characterized by persistent preoccupation about having serious and progressive physical disorders. The risk of mortality among individuals with hypochondriasis is unknown. Objective: To investigate all-cause and cause-specific mortality among a large cohort of individuals with hypochondriasis. Design, Setting, and Participants: This Swedish nationwide matched-cohort study included 4129 individuals with a validated International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnosis of hypochondriasis assigned between January 1, 1997, and December 31, 2020, and 41 290 demographically matched individuals without hypochondriasis. Individuals with diagnoses of dysmorphophobia (body dysmorphic disorder) assigned during the same period were excluded from the cohort. Statistical analyses were conducted between May 5 and September 27, 2023. Exposure: Validated ICD-10 diagnoses of hypochondriasis in the National Patient Register. Main Outcome and Measures: All-cause and cause-specific mortality in the Cause of Death Register. Covariates included birth year, sex, county of residence, country of birth (Sweden vs abroad), latest recorded education, civil status, family income, and lifetime psychiatric comorbidities. Stratified Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) and 95% CIs of all-cause and cause-specific mortality. Results: Of the 4129 individuals with hypochondriasis (2342 women [56.7%]; median age at first diagnosis, 34.5 years [IQR, 26.3-46.1 years]) and 41 290 demographically matched individuals without hypochondriasis (23 420 women [56.7%]; median age at matching, 34.5 years [IQR, 26.4-46.2 years]) in the study, 268 individuals with hypochondriasis and 1761 individuals without hypochondriasis died during the study period, corresponding to crude mortality rates of 8.5 and 5.5 per 1000 person-years, respectively. In models adjusted for sociodemographic variables, an increased rate of all-cause mortality was observed among individuals with hypochondriasis compared with individuals without hypochondriasis (HR, 1.69; 95% CI, 1.47-1.93). An increased rate was observed for both natural (HR, 1.60; 95% CI, 1.38-1.85) and unnatural (HR, 2.43; 95% CI, 1.61-3.68) causes of death. Most deaths from unnatural causes were attributed to suicide (HR, 4.14; 95% CI, 2.44-7.03). The results were generally robust to additional adjustment for lifetime psychiatric disorders. Conclusions and Relevance: This cohort study suggests that individuals with hypochondriasis have an increased risk of death from both natural and unnatural causes, particularly suicide, compared with individuals from the general population without hypochondriasis. Improved detection and access to evidence-based care should be prioritized. This Swedish nationwide cohort study investigates all-cause and cause-specific mortality among a large cohort of individuals with hypochondriasis and a demographically matched cohort of individuals without hypochondriasis. [ABSTRACT FROM AUTHOR]

Evaluators use their eyes to see what is there, whether it is intended or not. But they use their test instruments to measure what is intended, whether it is there or not. Evaluators have been broadening their repertoire of instruments for years: curriculum-embedded tests, observer checklists, audiotape recorders, videotape recorders, unobtrusive measures, the critical incident technique, situational tests, peer ratings, projective tests, criterion-referenced tests, and on and on. Developing tests in field situations promises to enrich their repertoire still further. In this article, the author discusses how to develop an instrument that can measure as well as one's eyes. He discusses three test developments that would produce hard evidence which would coincide with soft evidence: (1) field-based test development; (2) goal-free test development; and (3) theory-based test development.

New Zealand's army education schemes were established in 1943, following overseas practice, with several objectives in mind. Those on active service often suffered from boredom, and the schemes' libraries, movies and study courses offered one means of boosting flagging spirits. At the same time, military personnel needed to be prepared for an eventual return to civilian life, and the educational programmes had an important role to play. Personnel could study a range of practical skills courses by correspondence, and engage in discussion groups on current affairs and the changing nation to which many of them would return. The army's study materials provide both an important source of contemporary social analysis and a means of acculturating servicemen and servicewomen into a new postwar citizenship. In this way, education and recreation were fused together in ways that dovetailed with individual needs on the one hand, and the New Zealand government's wish to foster aware and self-governing citizens on the other. (Contains 3 figures and 107 footnotes.)

Determination of neuropsychological impairment involves contrasting obtained performances with a comparison standard, which is often an estimate of premorbid IQ. M. R. Schoenberg, R. T. Lange, T. A. Brickell, and D. H. Saklofske (2007) proposed the Child Premorbid Intelligence Estimate (CPIE) to predict premorbid Full Scale IQ (FSIQ) using the Wechsler Intelligence Scale for Children-4th Edition (WISC-IV; Wechsler, 2003). The CPIE includes 12 algorithms to predict FSIQ, 1 using demographic variables and 11 algorithms combining WISC-IV subtest raw scores with demographic variables. The CPIE was applied to a sample of children with acquired traumatic brain injury (TBI sample; n = 40) and a healthy demographically matched sample (n = 40). Paired-samples t tests found estimated premorbid FSIQ differed from obtained FSIQ when applied to the TBI sample (ps [less than or equal to] 0.01). When applied to healthy peers, estimated and obtained FSIQ did not differ (ps greater than 0.02). The demographic only algorithm performed well at a group level, but estimates were restricted in range. Algorithms combining single subtest scores with demographics performed adequately. Results support the clinical application of the CPIE algorithms. However, limitations to estimating individual premorbid ability, including statistical and developmental factors, must be considered. (Contains 3 tables and 1 footnote.)

This paper explores the application of distributed cognition theory to educational contexts by examining a common learning interaction, the "Copy and Paste" function. After a discussion of distributed cognition and the role of mediating artefacts in real world cognitions, the "Copy and Paste" function is redesigned to embed an effective interaction strategy, based on encoding strategies, into the interface. The current affordances of the "Copy and Paste" interaction derived from its business heritage (speed and accuracy of reproduction) are contrasted with those needed for a learning interaction (the meaningful processing of content for understanding). An empirical study was conducted to test the efficacy of the redesigned function through an experimental treatment. The study examined the impact of an experimental treatment based on changes to the "Copy and Paste" function in terms of: (a) changes to interaction strategies employed by learners; (b) changes in learner familiarity with note taking and summarisation interaction strategies; and (c) changes to the features of the text produced by learners. The experimental task consisted of participants completing three short written assessment tasks based on multiple text resources using either: (i) Control treatment: standard notepad tools supplemented by a text-based resource outlining note-taking and summarisation strategies; or (ii) Experimental treatment: the modified notepad. The results of the study showed that participants in the experimental group spent significantly more time engaged in activities that indicated higher levels of cognitive processing and produced notes that contained text features that also indicated significantly higher levels of cognitive processing.

This essay examines the relationships between homosexuality and sex education in New Zealand during the 1970s. It argues that reading sex education debates and resources provides a useful way of exploring connections between the ontologies and politics of sexuality at that time. In particular, the advent of social movements concerned with sexual issues marked a turning point in homosexuality's appearance within formal and informal modes of sex education. During the 1970s, sex education and related debates became a key site at which various conceptualisations of homosexuality were constructed and contested. By analysing the struggles between radical and conservative perspectives, we can see how same-sex desire came to symbolise changing sexual mores, as well as broader ideas about social order and social change. (Contains 13 notes.)

The affordances of online learning technologies have enabled more widespread development of learning environments that facilitate the exploration and solving of complex and realistic problems. In this paper, we describe the design of a real world geography problem, embedded within a web environment that is facilitated by an onsite excursion for data collection. The learning environment has been designed to deliberately address known problems associated with the problem solving approach, specifically in regard to three issues, and uses scaffolding prompts and supports embedded within the environment to facilitate student learning. The paper describes the theoretical foundations for the approach, the design of the learning task, and specific scaffolding approaches used in the environment. (Contains 4 figures and 3 tables.)

Historical analysis of sex education materials, as well as of the debates that surround them, can shed light upon the construction of sexuality in particular contexts. This article examines some of these materials and debates as a window into the construction of "homosexuality" and "the homosexual" in mid-twentieth century New Zealand. It is argued that "the homosexual" as a category was not clearly demarcated during this period, and that "heterosexuality" "per se" did not appear in debates over "sex instruction" until the 1950s. Earlier notions of self-control were reasserted during the post-war moral panic over young people's sexuality, and homosexuality was sometimes regarded as a symptom of social rebellion and thus a universal potential as much as a characteristic of a fixed sexual minority. Contemporary psychology and responses to the war blurred the boundaries between "homosexuality" and "normal" sexuality, ensuring the ongoing instability of what has more recently been termed the "homo/hetero binary". (Contains 20 notes.)

Objective: To examine the relationship between service member/veteran (SM/V) traumatic brain injury (TBI) severity with caregiver health-related quality of life (HRQOL). Setting: Military treatment facility. Participants: Caregivers (N = 316) of SM/Vs following a TBI divided into 2 groups based on SM/V TBI severity: (1) caregivers of SM/Vs following an uncomplicated mild TBI (UnMTBI Caregiver group, n = 246), and (2) caregivers of SM//Vs following a complicated mild, moderate, severe, or penetrating TBI (STBI Caregiver group, n = 70). The STBI Caregiver group was further divided into 2 subgroups: Parent (n = 21) versus Intimate Partner (n = 49). The UnMTBI Caregiver group consisted of intimate partners. Design: Prospective cohort. Main Measures: Caregivers completed 15 HRQOL measures. Results: Using analysis of variance and chi-square analysis, the UnMTBI Caregiver group reported worse scores on 12 HRQOL measures and more clinically elevated scores for 6 of 15 comparisons than the STBI Caregiver group. The UnMTBI Caregiver group also reported worse scores on 10 HRQOL measures than intimate partners in the STBI Caregiver group and 5 measures than parents in the STBI Caregiver group. Parents reported worse scores on 3 measures than intimate partners in the STBI Caregiver group. The UnMTBI Caregiver group reported more clinically elevated scores for 7 of 15 comparisons than intimate partners in the STBI Caregiver group. Conclusion: Intimate partner caregivers of an SM/V following a remote uncomplicated MTBI reported worse HRQOL than intimate partners and parent caregivers of an SM/V following a more severe TBI, mostly likely due to SM/V physical and mental health comorbidities. Interventions that focus on the SM/V's TBI and other comorbidities, the caregiver's behavioral health problems, and the relationship and family factors that interact with each other will likely have the most success in improving individual and family outcomes for military families. [ABSTRACT FROM AUTHOR]