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Although augmentative and alternative communication (AAC) strategies are often used by autistic youth, little is known about the use of AAC in inpatient psychiatric settings. This study evaluated how demographic and clinical factors (e.g., language level, IQ) related to AAC use in a well-characterized sample of 527 autistic youth (78.7% male, mean age 12.94) who participated in the Autism Inpatient Collection. AAC use was common, with 42.5% of caregivers reporting at least one form of AAC. White children were more likely to use AAC than non-white children at the bivariate level. In regression analyses, young children were more likely to use AAC than older children. These results suggest the importance of provider training and improved equitable access to AAC.

Objectives: The purpose of this study was to investigate the impacts of using scaffolded clinical simulations on nursing students' confidence in clinical reasoning, clinical judgment, and critical thinking skills. Next, we also attempted to gain insights into students' perceptions of the benefits of scaffolded clinical simulations. Method: We used a mixed-methods research design to investigate the impacts of using scaffolded clinical simulations on 133 second-semester baccalaureate nursing students' confidence in clinical reasoning, clinical judgment, and critical thinking skills. Results: Findings from this study indicate that students who perceived the benefits of scaffolded simulation activities (i.e., peer observations, debriefings, and self-reflections) were more likely to engage in this deep learning process, which in turn led to their higher confidence in clinical reasoning, clinical judgment, and critical thinking skills. Conclusions: This study demonstrates that scaffolded simulations in psychiatric clinical settings, coupled with the novice to expert model in nursing education, are a valuable tool for preparing nursing students for the rigors of clinical practice, despite decreased in-person client experiences in nursing programs. Implications: This study has implications for designing and implementing scaffolded clinical simulations that foster clinical judgment and help students perform tasks with which they are already familiar, while new responsibilities are introduced throughout the semester.

Deploying a Lacanian conceptual framework, this article interrogates the psychoanalytic underpinnings of Paulo Freire's dialogical method of critical pedagogy. The paper advances the claim that the transformative efficacy of Freirean dialogue is rooted in its unique ability to confront and engage the repressed element of trauma, or what Lacan calls the "real." The author suggests that the locus of trauma stands as the elusive, yet central and constitutive axis around which Freire's dialogical engagement turns. Following psychoanalysis' attention to biography, the paper first examines how Freire's personal experience of exile informs his philosophical orientation to being, politics, and education. Turning to a specific classroom event Freire outlines in "Pedagogy of Hope," the paper then develops a new interpretation of Freire's idea of naming, and through Lacanian analysis, extends Freire's insight on the relationship between psyche, ideology, and social antagonism. Pushing the idea of class subjectivity in Freire beyond its familiar determinants (namely as an 'identity'), the paper resituates the notion of radical subjectivity in critical pedagogy as the effect of a traumatic loss or gap in the sociosymbolic order of being. The author argues that the 'naming event' in Freire is formally rooted in an encounter with this unconscious gap. To conclude, the paper offers critical educators some new points of departure for conceptualizing the transformative labor of problem-posing dialogue.

Objective: Few studies have investigated the maintenance of skills acquired in classroom-based clinician education. Using an advanced simulation-based clinical communication skill training program for postgraduate psychiatry education (ComPsych), we aimed to investigate skill acquisition through assessing changes in competence (abilities) and performance (practice). Methods: Forty trainee psychiatrists (15 males; age range 26-48) participated. Video-recorded Standardized Patient Assessments (SPAs) were delivered twice pre- and post-training to assess learning. Skills were coded by independent psychologists using the Core Communication Skills (CCS) coding system. Simulated patients (SPs) rated trainees' communication performance using the Sim-Patient SPA checklist. Paired t-tests, linear mixed models and logistic mixed models assessed changes in communication skills over time. Results: For SPAs, reliability of coder ratings was deemed acceptable (ICC range 0.67 to 0.87). Mean post-training communication performance significantly increased for skills in agenda setting (p < 0.001), information organization (p < 0.001), empathic skills (p = 0.046), and overall skills performance (p = 0.001). Significant decreases for questioning skills were indicative of reduced reliance on these skills post-training. SPs rated all skillsets higher post-training. A modest relationship was detected between frequency (coded) and (SP-rated) quality of communication skills. Improvements in agenda setting and information organisation skills were retained ~ 6 weeks post-training. Conclusions: Training improved patient-centered communication skills in psychiatry trainees, particularly skills in agenda setting and information organization, with skills retained ~ 6 weeks post-training. There was reduced reliance on questioning skills, which are well utilised generally. The study supports the benefits of this method of communication skills training into postgraduate psychiatry education.

This paper mobilises the psychoanalytic concepts of desire and enjoyment to better understand how processes of education aimed at extending and defending democratic life might respond to and engage with populist politics. I approach this task by engaging with a particular vector of Mouffe and Laclau's political philosophy, moving from a critique of liberal democracy's rationalist pretensions to their insistence that left populism and its passionate construction of a 'people' is the central task facing radical politics. This attention to the libidinal basis of political identification locates them in a community of Left Lacanian thinkers who reframe the problems of democratic politics in terms of desire and enjoyment rather than miseducation or its lack. Whilst this position might suggest a binary choice between different analytical frames, I inquire into what insights are generated by theorising left populism as an 'education of desire'. The paper is organised into four main parts: the opening discussion clarifies my understanding of education by engaging with the literature on educational agonism. The second section lays the groundwork for a critique of the way in which education is fetishized, in different ways, by liberals and radicals as a panacea for populist politics. The third section reframes democratic crisis as an enjoyment problem in order to better grasp the relationship between the liberal democratic disavowal of its own irrationality and the structure of right-wing populist enjoyment. The fourth section applies these insights to develop a critical analysis of what is at stake when we explicitly consider the left populist construction of a 'people' as an educational task. I conclude by drawing together and summarising the main features and considerations of left populism understood as an education of desire.

Background: Psychiatrists prescribe the psychotropic medication that is used to manage behaviors of concern (BOC) in people with intellectual disability (ID) (i.e., chemical restraint), and their attitudes and perceptions towards this treatment are important topics for study. Methods: 133 Queensland psychiatrists and psychiatry trainees completed a survey on attitudes and perceptions of ID and psychotropic medication. Exploratory cluster analysis was performed on 14 Likert items from this survey to detect groupings within the data. Results: Cluster analysis indicated the existence of two distinct clusters. While both groups were willing to be involved in the treatment of adults with ID, Cluster 1 held attitudes that showed inconsistencies with human rights principles and with international guidelines regarding psychotropic medication use for BOC. Conclusions: Our study highlights that the attitudes and perceptions of a significant subgroup of psychiatrists may contribute to the overprescribing of psychotropics for BOC.

Virtual patients are increasingly used in undergraduate psychiatry education. This article reports on a systematic review aimed at providing an overview of different approaches in this context, describing their effectiveness, and thematically comparing learning outcomes across different undergraduate programs. The authors searched PubMed, PsycInfo, CINAHL, and Scopus databases for articles published between 2000 and January 2021. Quantitative and qualitative studies that reported on outcomes related to learners' knowledge, skills, and attitudes following an intervention with virtual patients in undergraduate psychiatry education were reviewed. Outcomes were thematically compared, and a narrative synthesis of the different outcomes and effectiveness was provided. Of 7856 records identified, 240 articles were retrieved for full-text review and 46 articles met all inclusion criteria. There were four broad types of virtual patient interventions: case-based presentation (n = 17), interactive virtual patient scenarios (n = 14), standardized virtual patients (n = 10), and virtual patient videogames (n = 5). The thematic analysis revealed that virtual patients in psychiatry education have been used for learners to construe knowledge about symptomatology and psychopathology, develop interpersonal and clinical communicative skills, and to increase self-efficacy and decrease stigmatizing attitudes towards psychiatric patients. In comparison with no intervention, traditional teaching, and text-based interventions, virtual patients were associated with higher learning outcomes. However, the results did not indicate any superiority of virtual patients over non-technological simulation. Virtual patients in psychiatry education offer opportunities for students from different health disciplines to build knowledge, practice skills, and improve their attitudes towards individuals with mental illness. The article discusses methodological shortcomings in the reviewed literature. Future interventions should consider the mediating effects of the quality of the learning environment, psychological safety, and level of authenticity of the simulation.

Aim: This project sought to ascertain views and experiences of people with intellectual disabilities, their carers', and specialist intellectual disability psychiatrists as to use of telepsychiatry consultations. Background: During the COVID-19 pandemic specialist psychiatrists in intellectual disability services in the United Kingdom (UK) have explored and adopted use of telepsychiatry for psychiatric consultations. Method: An easy-read co-designed questionnaire was sent to potential respondents N = 590 potential respondents (N = 280 patients, N = 280 carers), and a separate questionnaire was sent electronically to N = 30 specialist intellectual disability psychiatrists. Findings: Responses were received from N = 192 respondents (N = 68 (24%) patients, N = 98 (35%) carers, and N = 26 (90%)) psychiatrists. Advantages of telepsychiatry cited were flexibility, and it being less disruptive to patients' routines, offering convenient practice and saving travel time and cost. Disadvantages reported included loss of rapport and relationship with patients, and an inability to conduct an effective mental state examination. Conclusion: This survey has produced equivocal evidence as to acceptability of telepsychiatry for all people with intellectual disabilities, carers and psychiatrists cannot be assumed. Some patients may need significant support to enable them to engage with such an approach.

We examine a Twitter attack against our phEmaterialist pedagogy during a UK-wide COVID-19 lockdown. We explore how trolls swarmed together in a collective mocking and ridiculing of images of colorful Play-doh genital models posted as part of a Master's module we teach. The session explored "clitoral validity" as a feminist pedagogical concept to disrupt phallocentric sexuality education through the modeling of the vulva and clitoris. We focus on a sub-sample of the attack, tweets that explicitly refer to clitoral validity, vulvas, and penises. We develop an analytical frame of networked affect and affective homophily in combination with psychoanalytical concepts to map affective circuits of misogyny and hate. To conclude, we use this episode to shed light on what is at stake for scholars working in feminism and/or gender and sexuality studies using creative, participatory, and arts-based methods and we both trouble and reclaim a position of bad feminist researchers/pedagogues.

This paper explores the intricate interplay of racism, trauma, and identity in Toni Morrison's novel, "The Bluest Eye." It delves into the challenges faced by African Americans within a predominantly white society by utilizing current trauma theory and black feminist concepts. The theoretical framework includes cultural trauma theories, including the contributions from Schreiber and insights from feminist thinkers like Bell Hooks and Patricia Hill Collins. Moreover, through an intersectional analysis, this study scrutinizes how gender, racial, class, and generational trauma intertwine to mold individuals' experiences and self-perception. Therefore, by amalgamating trauma theories with feminist perspectives, this paper provides valuable insights into the struggles of the characters and the societal dynamics portrayed in Morrison's novel, "The Bluest Eye."

This paper diffracts Deleuze and quantum physics through Winnicott's work to argue for an enrichment to playing. The roots of the play-cognitive hierarchy in Freudian psychoanalysis makes visible that progression and the stages that a child must pass en route to rationality continue to feed educational assumptions that a child must leave playing behind in order to learn. Addressing critiques of Freud's psychosexual theory of child development, I introduce Winnicott's work on playing as creative activity and transitional phenomena which cast playing in a positive light. I then turn to Deleuze's critique of Freud's foundational concepts of child development influenced by Newtonian physics to argue that a Deleuzian concept of energy aligns with quantum physics, which unsettles the binary play-cognition hierarchy. I introduce a vignette to illustrate a rich array of concepts involved in playing that are read through Winnicott. In the final step, I argue that Winnicott's transitional object provides a juncture with Deleuze's concept of the partial/virtual object paving the way to graft an alternative and more processual ontology onto Winnicott's work on playing that acts beside cognitive connections in ways that bring learning alive and liberate teachers to enter less constrained relationships with children.

In educational systems around the world, there is a long tradition of using psychiatric diagnoses when providing support in the special educational field. For instance, many countries have special schools and special classes for students with psychiatric diagnoses such as Attention-Deficit Hyperactivity Disorder, Autism spectrum disorder and general learning disabilities. This case study draws on data from Denmark and investigates how this organising principle is currently being challenged. The study shows that a main challenge to the widespread use of diagnoses is a shift in how the psychiatric system diagnoses students. Factors affecting the current situation are that a) an increasing proportion of students receive more than one diagnosis, and b) children with social problems are more likely to be diagnosed with a psychiatric condition as well. The outcome is that the institutional tradition of distinguishing between support to be provided for different diagnoses comes under pressure, and a paradoxical situation occurs where the growing complexity of children's psychiatric diagnoses leads to practices where more differentiated special needs are taught within the same classrooms. The situation has led the Danish school system to search for alternative ways of organising support for students. The study investigates these new emerging methods of providing support.

"Speculative Realism in Environmental Education and the Philosophy of Education" was a joint research symposium for the networks on Environmental and Sustainability Education (NW 30) and Philosophy of Education (NW 13), held at the European Conference of Education Research (ECER), 25 August, 2023, in Glasgow, Scotland. The symposium aimed to open up discussion on renewed interest in realisms in the field of philosophy, and what that might mean for education research and the field of environmental education research in particular. As backdrop, environmental education harbours strong democratic traditions as well as recognitions of relationships to a world that is composed by more than human positions and desires. The symposium then forms part of an ongoing discussion of how these positions are understood and intermingle in a rapidly changing world. The expectation of the event was to broaden discussion about the voices present in environmental education, human and otherwise, and sharpen engagement with established traditions within the field. In brief, three paper presentations and discussion by Graham Harman probed questions of: (a) the lightness and darkness of the objects of education, (b) who visibly desires which object in/as education, and (c) the risks of literalisms and correlationalisms in, for example, what is alluring to, and pursued by, educators. In other words, what we care about "in" and "as" environmental and sustainability education, what is perceived/treated as peculiar, and what is treated as normal and perverse to the realities of education in the Anthropocene, all matter to the work of speculative realism.

In this paper we respond to this special issue's critical focus on mental health in education by considering the medicalised and homogenising approaches to the mental health of young people and the severely negative consequences for young people. Our argument is underpinned by the need to destabilise the hegemony of the current dominant discourses and practices of mental health used in education. The problem with these discourses and practices, informed by particular forms of psychiatry and psychology, is precisely their dominance and their popularised proxy take-up of these. We firstly outline this problem, explore the emergence and saturation of a 'damaged self' in education and consider the impact on young people. We offer counter-narratives that involve a reframing of the self in relation to ethics, politics, capability and the arts and can assist in countering the psy-dominance in education. The paper concludes with some reflections on how teachers might work against the damaging effects of the psy-disciplines and instead support young people in finding their counter-narrative selves.

This research started as an effort to recover lost childhood memories. I (Emilio Bassail) used the film-making apparatus as a device that allowed me to excavate, elaborate and produce representations based on the small fragments of memory I had left. After creating an archive of reconstructed memories, I started questioning the images I had unearthed. This position allowed me to interrogate and challenge the discourses behind the images. What I discovered is that forgetfulness was in fact an effect of the suppression of potentially subversive discourses. I had not really forgotten, but rather I had chosen not to remember (since the hidden childhood memories defied the internalised discourses of power and structure). To be able to remember and therefore to create, first I had to debilitate the discourses of the power structures that prevented me from going forward in my research. Following Suely Rolnik's (2019).

Managing health and well-being issues can be challenging for college students. Alternative supports, such as online programs, have been identified as cost-effective and efficient methods of providing inclusive support to college students, removing numerous barriers to health and well-being promotion. The article summarized a novel, evidence-based approach to developing an online health and well-being program. The program is based on Cognitive Behavioral Therapy (CBT), the positive emotion, engagement, relationships, meaning, and accomplishments (PERMA) construct, and the analysis, design, development, implementation, and evaluation (ADDIE) model. It discusses future directions in the evaluation, assessment, and documentation of the fitness-for-purpose process.

Telepsychiatry has been rapidly adopted to help control the spread of coronavirus. Clinicians have raised concerns over this for individuals diagnosed with autism spectrum disorder. The remote delivery of psychological interventions in particular requires further attention as their in-person delivery has autism spectrum disorder--associated challenges which overlap with the challenges of telepsychiatry broadly (i.e. beyond autism spectrum disorder). Autistic service-users (aged 15-18 years, n = 6) and clinicians working with this client group (n = 8) were therefore interviewed about their experience of remote psychological interventions during the pandemic. The sample size was determined using preregistered thematic saturation calculations. Thematic analysis of responses identified challenges/barriers, benefits, facilitators, and factors perceived to cause variability in experiences of remote delivery. These broadly echoed those identified in existing literature, but their underlying reasons had not been explored before and some were novel. Novel findings mostly surrounded difficulties navigating a new social system online, and the intensity of the social interaction feeling reduced remotely. Themes were broadly the same between young people and clinicians, aside from subtle differences. For example, young people provided distinct reasons for some of the perceived benefits. Most participants advocated for the provision of hybrid delivery post-pandemic. Implications of findings are discussed.

Autistic adults are at risk of stress-related psychiatric disorders and reduced life quality due to social, cognitive, and perceptual challenges. Mental health interventions adapted to autistic adults are scarce. Acceptance and commitment therapy has preliminarily indicated health benefits in autistic adults, although it has not been robustly evaluated. Overall, 39 adults (21 males; 21-72 years) with autism spectrum disorder and normal intellectual ability (IQ M = 108.5; SD = 13.5) were randomized to 14 weeks of adapted acceptance and commitment therapy group treatment (NeuroACT) or treatment as usual. The intervention was feasible. Perceived stress and quality of life (primary outcomes), alongside psychological inflexibility, cognitive fusion, cognitive and behavioral avoidance, and autistic mannerism were statistically significantly improved in NeuroACT compared with treatment as usual (d = 0.70-0.90). Clinically significant changes in perceived stress and quality of life were in favor of NeuroACT. Between-group altered depression, anxiety, sleep problems, one quality of life measure, functional impairment, social aspects of autism, and executive difficulties were statistically non-significant. Dropout was slightly higher in NeuroACT. NeuroACT may be a promising treatment for autistic adults with co-existing stress and reduced quality of life. More extensive studies are warranted to evaluate NeuroACT further.

Intellectual impairments in preschoolers have been widely studied. A regularity that emerges is that children's intellectual impairments have an important impact on later adjustments in life. However, few studies have looked at the intellectual profiles of young psychiatric outpatients. This study aimed to describe the intelligence profile of preschoolers referred to psychiatry for various cognitive and behavioral problems in terms of verbal, nonverbal, and full-scale IQ and to examine their association with diagnoses. Three hundred four clinical records from young children aged under 7 years and 3 months who consulted at an outpatient psychiatric clinic and who had one intellectual assessment with a Wechsler Preschool and Primary Scale of Intelligence were reviewed. Verbal IQ (VIQ), Nonverbal IQ (NVIQ), and Full-scale IQ (FSIQ) were extracted. Hierarchical cluster analysis using Ward's method was employed to organize data into groups. The children had, on average, a FSIQ of 81, which is significantly lower than that expected in the general population. Four clusters were identified by the hierarchical clusters analysis. Three were characterized by low, average, and high intellectual ability. The last cluster was characterized by a verbal deficit. Findings also revealed that children's diagnoses were not related to any specific cluster, except for children with an intellectual disability with, as expected, low abilities. Children referred to an intellectual assessment in an early childhood mental health clinic showed an altered intellectual development, more specifically in the verbal domain.

Background: Overprescribing of off-licence psychotropic medications, particularly antipsychotics, for challenging behaviours in people with intellectual disabilities without a psychiatric disorder is a significant public health concern. In the United Kingdom, the National Health Service England launched an initiative in 2016, 'STopping Over-Medication of People with learning disabilities, autism or both (STOMP)', to address this concern. STOMP is supposed to encourage psychiatrists in the United Kingdom and elsewhere to rationalise psychotropic medication use in people with intellectual disabilities. The current study aims to gather UK psychiatrists' views and experience of implementing the STOMP initiative. Methods: An online questionnaire was sent to all UK psychiatrists working in the field of intellectual disabilities (estimated 225). Two open-ended questions allowed participants to write comments in response to these questions in the free text boxes. One question asked about the challenges psychiatrists faced locally to implement STOMP, and the other asked for examples of successes and positive experiences from the process. The free text data were analysed using a qualitative method with the help of the NVivo 12 plus software. Results: Eighty-eight (estimated 39%) psychiatrists returned the completed questionnaire. The qualitative analysis of free-text data has shown variation within services in the experience and views of the psychiatrists. In areas with good support for STOMP implementation provided through adequate resources, psychiatrists reported satisfaction in the process with successful antipsychotic rationalisation, better local multi-disciplinary and multi-agency working, and increased awareness of STOMP issues among the stakeholders such as people with intellectual disabilities and their caregivers and multidisciplinary teams, and improved quality of life caused by reduced medication-related adverse events in people with intellectual disabilities. However, where resource utilisation is not optimum, psychiatrists seemed dissatisfied with the process with little success in medication rationalisation. Conclusions: Whereas some psychiatrists are successful and enthusiastic about rationalising antipsychotics, others still face barriers and challenges. Much work is needed to achieve a uniformly positive outcome throughout the United Kingdom.

Autism spectrum disorder and intellectual disability are associated with psychiatric comorbidities, yet a 2009 study of US child and adolescent psychiatry program directors indicated that psychiatry residents receive insufficient training in autism spectrum disorder/intellectual disability. This follow-up study surveyed child and adolescent psychiatry and general psychiatry program directors to assess (1) the current extent of residency training in autism spectrum disorder/intellectual disability, (2) program director perceptions of educational topics and resident competency in autism spectrum disorder/intellectual disability, and (3) preferred resources to strengthen autism spectrum disorder/intellectual disability training. As in 2009, many child and adolescent psychiatry program directors reported few lecture hours, although current child and adolescent psychiatry residents saw slightly more patients with autism spectrum disorder but not intellectual disability. General psychiatry program directors reported fewer lecture hours in autism spectrum disorder/intellectual disability and fewer patients with autism spectrum disorder than child and adolescent psychiatry program directors. Both child and adolescent psychiatry and general psychiatry program directors recognized the importance of a range of educational topics in autism spectrum disorder/intellectual disability. Child and adolescent psychiatry program directors reported higher resident competency, and lecture hours and patients seen moderately correlated with resident competency. Program directors indicated that online videos and other resources would help improve autism spectrum disorder/intellectual disability training in their programs. Collectively, these findings suggest minimal improvements in autism spectrum disorder/intellectual disability training over the past decade and highlight the urgent need to advance psychiatry training in this field through dissemination of resources.

Aim: This Quality Improvement Project sought to improve communication between patients with intellectual disabilities and their psychiatrists by sharing medical information using an easy read letter format following psychiatric review. Background: Writing directly to patients is in keeping with good medical practice. Previous studies have shown patients with intellectual disabilities prefer letters tailored to meet their needs. Method: An easy read letter was used by nine psychiatrists who handed them to 100 consecutive patients after review. Feedback of acceptability to patients was obtained using a three-item facial rating scale and the use of free text. Feedback of acceptability was obtained from participating psychiatrists. Results: Patients found the easy read letter helpful and felt it should be used routinely. Psychiatrists felt this approach was beneficial as well as aiding patient understanding of review. Conclusions: The easy read letter was reported to improve communication following psychiatric review. Limitations are acknowledged but it is concluded that an easy read letter should be adopted as routine practice following psychiatric review, for people with intellectual disabilities.

In this paper I call for an emotional confrontation with our traumatic, racist, and often unacknowledged history. I share ideas, experiences, and pedagogical strategies with which to engage difficult dialogue about difficult knowledge, in such a way as to disarm defense and, potentially inspire anti-racist activism in education and beyond. The first strategy is to develop psychoanalytic sensibilities in education. I argue that this will help us begin to invite the "freedom to feel" into classrooms that customarily prioritize freedom of thought. The second strategy is to insist that a confrontation with traumatic elements of untold history, and unacknowledged racial (and other) injustices in our current reality, will be uncomfortable. I emphasize that we must work on our capacity to tolerate discomfort and develop our capacities to mourn (loss of cherished belief, loss of innocence, loss of privilege, among other forms of loss). Third, I argue that "knowing ignorance" can be a powerful antidote to the structural ignorance that has hindered our capacities to think critically and creatively in solidarity with different others. I conclude by suggesting that engagement with narrative fiction in film and literature, is a promising pedagogical approach that enables transformative dialogue to take place. I share a few of my favorite films and short stories that have yielded fruitful conversations in my own social justice-oriented classrooms.

Securing clinical locations for Bachelor of Nursing Science (BSN) programs is always a complex challenge, particularly when clinical experiences are focused on vulnerable populations such as pediatric psychiatric patients. To provide students with a meaningful clinical experience during the first weeks of the COVID-19 pandemic, we developed a telehealth simulation centered on a pediatric psychiatric patient with unfolding adolescent depression and suicidal ideation. This case study uses qualitative data analysis of student debriefing sessions as well as a pre/posttest design to explore the effectiveness of the simulation. Results suggest that simulations can be useful for presenting unique patient scenarios focused on therapeutic communication in psychiatric assessment, particularly for vulnerable patient populations. Quantitative data analysis showed BSN students improved their understanding of communication needs of adolescents and retained their knowledge over time; qualitative comments showed that students felt the simulation was a valuable learning experience and achieved key learning outcomes.

Public participation and survivor research in mental health are widely recognized as vital to the field. At the same time, contributions of patient collaborators can present unique challenges to determining authorship. Using an unresolved dispute around research contributions to the American Psychiatric Association's "Psychiatric Services" journal, authorship and contribution are addressed. Recommendations are suggested to prevent dilemmas and achieve responsible research credit inclusion, especially among researchers with different backgrounds and asymmetric power relations. Researchers and publishers can prepare proactively for conflict through consensus on authorship criteria, prior agreements around author inclusion, arrangement for third party dispute resolution, transparency in communication and contracts, notification to prospective publications of pending disputes, a contributor-guarantor model of contribution, journal editor "expressions of concern" when authorship disputes go unresolved, and expectation of conflict as generative.

Background: We examined whether a series of variables were related to the number of psychiatric inpatients using publicly available data about English psychiatric bed utilisation and NHS workforce. Method: Using linear regression, with auto-regressive errors, we examined relationships between variables over time using data from December 2013 to March 2021. Results: Over time, the number of inpatients reduced by either 6.58 or 8.07 per month depending upon the dataset utilised, and the number of community nurses and community nursing support staff reduced by 7.43 and 2.14 nurses per month, respectively. Increasing numbers of consultant psychiatrists were associated with fewer inpatients over time. More care and treatment reviews (CTRs) were associated with more admissions over time, while more post-admission CTRs were associated with increased discharges over time. Conclusions: Future studies should examine whether psychiatric bed utilisation elsewhere within the NHS by people with intellectual disabilities has increased.

Objective: To identify differences in preferences related to telepsychiatry among college students who have and have not been diagnosed with a mental health condition in the last year. Participants: Students (n = 537) at a medium-sized Midwestern university (M[subscript age] = 21 years; 71% female). Methods: A quantitative, causal-comparative design using an adapted version of the National College Health Assessment (NCHA). Differences in preferences among groups were analyzed by chi-square and Cramer's "V" analyses with a 95% confidence interval. Results: Students did not differ in their preferences or perceptions (confidentiality, time, cost, effectiveness) of face-to-face in-person compared to telecommunication treatment environments despite their mental health history. A majority of students (76%) would prefer seeing their regular provider if using telepsychiatry in the future. Conclusions: Implementing a higher education telepsychiatry model, especially within college health centers, could help students' access much-needed services while breaking down barriers such as transportation and wait lists.

This article reviews the implications of many of the major schools in the history of psychology for understanding giftedness and its inner workings: operationist, psychometric, psychoanalytic, associationist, behaviorist, Gestalt, cognitive, humanistic/positive psychology, functionalist/pragmatic/constructivist, cultural, and biological. Each paradigm has elucidated different aspects of human nature and functioning, and each has somewhat different implications for how we can understand giftedness. No one paradigm can provide complete understanding of giftedness. Rather, the paradigms should be viewed as different windows toward understanding giftedness, all of which together tell us much more than any individual one. It is regrettable that so many theorists and practitioners have locked themselves into an operationist paradigm, which simply accepts current measurement operations as sufficient for identifying and developing giftedness. The operationist paradigm is wholly insufficient to meet the challenges of the world of the 21st century.

This paper examines the changes in infant homes for children under the age of three in West Germany after the Second World War by combining two research perspectives. First, it will show that the increase in institutional care in the decade after 1945 was not simply dictated by a growing number of orphans. Instead, it primarily resulted from the way how authorities dealt with single mothers and their children. In a second step, the adverse influence of "Maternal Care and Mental Health," the WHO report by British psychiatrist and psychoanalyst John Bowlby, will be analysed. It will become clear that this monograph from 1951 was enormously influential within West German infant home education, such that institutional care for children under the age of three was almost completely abolished only a few years later. Thus, the paper contributes to the historization of residential childcare and of attachment theory.

Background: Some data call into question the persistence of developmental language disorders (DLDs) identified during the preschool period. For this reason, speech-language pathologists (SLPs) often reassess children. However, it is unclear if the instability of the profiles documented in community sample studies is present in children referred to specialized clinics. Given the scarcity of SLP resources, is re-evaluating the language skills of these children a good use of clinical time? Aim: To examine the stability of the findings from two SLP assessments in a sample of Canadian preschool children referred to a tertiary clinic between the ages of 2 and 6 years. It was hypothesized that children under the age of 4 years at first assessment and children with less severe initial deficits would show less stability of DLD diagnosis. Methods & Procedures: The clinical files of children referred to an early childhood psychiatric clinic in Canada were reviewed. For 149 children with two SLPs assessment reports, persistence of language deficits was documented and tested with McNemar's statistics. Differences between preschoolers under the age of 4 versus 4 years and over, as well as between mildly and severely impaired children, were examined. Outcomes & Results: High level of agreement (94%) and McNemar's test (p = 0.180) supported the stability of initial diagnosis. The stability for children assessed before the age of 4 (n = 64) was 100%, and was significantly different from older children's (n = 85) stability of 89% (Fisher's exact test, p = 0.01; bilateral). The stability for children with mild impairments (n = 18) was 78%, which was significantly lower than the stability (97%) in children with severe impairments (n = 114) (Fisher's exact test, p = 0.007; bilateral). Conclusions & Implications: No instability of language status was observed in children assessed before 4 years of age, which could be related to the significant severity of the difficulties that children in this age group presented and be specific to this type of clinical sample. The great stability of language status observed in preschoolers referred to a specialized clinic suggests that clinicians should limit reassessments to devote available resources to intervention efforts.

Developmental theorists use their research to generate philosophies on children's development. They organize and interpret data based on a scheme to develop their theory. A theory refers to a systematic statement of principles related to observed phenomena and their relationship to each other. A theory of child development looks at the children's growth and behavior and interprets it. It suggests elements in the child's genetic makeup and the environmental conditions that influence development and behavior and how these elements are related. Many developmental theories offer insights about how the performance of individuals is stimulated, sustained, directed, and encouraged. Psychologists have established several developmental theories. Many different competing theories exist, some dealing with only limited domains of development, and are continuously revised. This article describes the developmental theories and their founders who have had the greatest influence on the fields of child development, early childhood education, and care. The following sections discuss some influences on the individuals' development, such as theories, theorists, theoretical conceptions, and specific principles. It focuses on five theories that have had the most impact: maturationist, constructivist, behavioral, psychoanalytic, and ecological. Each theory offers interpretations on the meaning of children's development and behavior. Although the theories are clustered collectively into schools of thought, they differ within each school.

The purpose of this article is to further the methodological cross-fertilization between qualitative social science researchers and psychoanalytic theoreticians by outlining and demonstrating a method of intertextual psychoanalytic-intersubjective analysis (IPIA) in qualitative research. The authors believe that such a bridge between the psychoanalytic intersubjective approach and qualitative research will facilitate creativity and intellectual insights in qualitative studies, particularly in the data analysis stage. Similarly, they suggest that this methodological bridge may draw psychoanalytic practitioners and scholars to conduct qualitative research that will benefit from their clinical skills.

This paper reflects on a research-creation project that investigates the ways in which surveillance is experienced by youth as an embodiment that might be difficult to articulate in words but rather expressed affectively, through emotion and social practice. Our argument is that the aesthetic intervention provoked by research-creation can instantiate encounters that capture surveillance as an ineffable experience of everyday life. We situate our methodological claims in a concrete case study that considers youth engagement with a commissioned contemporary art project. Drawing on the writings of child and youth psychoanalyst W. D. Winnicott, we theorize the importance of a facilitating environment to create the conditions for young people to freely and playfully express meanings they make in their encounters with art. Research-creation suggests a perspective of resistance and failure as productive and constitutive of the possibilities of coming to know, both for the research subjects and ultimately for the authors in their orientation to research inquiry.

We developed and validated a self-report scale for screening pathological traits of dependent personality disorder (DPD) from the Hierarchical Taxonomy of psychopathology (HiTOP) perspective. The sample was 693 adults who answered the new scale, the Dimensional Clinical Personality Inventory DPD (IDCP-DPD), the PID-5, the FFDI, and the FFBI. The IDCP-DPD was composed of six factors grouped in one general score. The scores showed associations with external measures in the expected direction, and the means comparisons showed large differences. Our findings indicated the IDCP-DPD as a useful clinical measure, and the structure observed confirms the spectrum level of the HiTOP.

Clerkships are defining experiences for medical students in which students integrate basic science knowledge with clinical information as they gain experience in diagnosing and treating patients in a variety of clinical settings. Among the basic sciences, there is broad agreement that anatomy is foundational for medical practice. Unfortunately, there are longstanding concerns that student knowledge of anatomy is below the expectations of clerkship directors and clinical faculty. Most allopathic medical schools require eight "core" clerkships: internal medicine (IM), pediatrics (PD), general surgery (GS), obstetrics and gynecology (OB), psychiatry (PS), family medicine (FM), neurology (NU), and emergency medicine (EM). A targeted needs assessment was conducted to determine the anatomy considered important for each core clerkship based on the perspective of clinicians teaching in those clerkships. A total of 525 clinical faculty were surveyed at 24 United States allopathic medical schools. Participants rated 97 anatomical structure groups across all body regions on a 1-4 Likert-type scale (1 = not important, 4 = essential). Non-parametric ANOVAs determined if differences existed between clerkships. Combining all responses, 91% of anatomical structure groups were classified as "essential" or "more important." Clinicians in FM, EM, and GS rated anatomical structures in most body regions significantly higher than at least one other clerkship (p = 0.006). This study provides an evidence-base of anatomy content that should be considered important for each core clerkship and may assist in the development and/or revision of preclinical curricula to support the clinical training of medical students.

Background: Patients with schizophrenia present with both cognitive impairment as well as language difficulties. There are similarities in the language output of patients with schizophrenia and patients with aphasia, thus a differential diagnosis of patients who present with a question of dual diagnoses can be a clinical challenge. This case report highlights the importance of an interdisciplinary approach to a patient with schizophrenia who benefitted from intervention from both psychiatry and speech--language pathology services due to the patient's unique verbal output. Aims: The primary aim of this case report is to highlight the critical importance of interdisciplinary collaboration in this patient population. The secondary aim is to disseminate an interesting and unique clinical phenomenon whereby the patient demonstrated an awareness of two distinct speech patterns and the unique ability to 'code switch' between them, something not commonly appreciated in this clinical population. Methods & Procedures: This case report describes a patient seen as part of routine clinical care. Information shared was solely observational and involved dissemination of information regarding case history, assessment and treatment plan. No interventions were implemented as a part of this study. Outcomes & Results: Interprofessional communication was critical in order to diagnose a patient with schizophrenia with an atypical speech pattern. The patient's language output did not manifest as a true aphasia but rather as two distinct language patterns that the patient could use at will. This ability to 'code switch' between languages is a unique clinical profile that is atypical of patients with schizophrenia.

Examining the still underexplored elements in educational theorist Paulo Freire's work, this essay begins from his claim that problem-posing pedagogy works as a "kind of psychoanalysis." Situating Freire between the critical philosophical and psychoanalytic traditions, Alex Armonda offers a new reading of the problem-posing dialectic, mapping parallels between Freirean pedagogy and psychoanalysis on the nature of the subject/object relation, while thinking new connections across the philosophical-analytical divide on questions of being, subjectivity, and politics. First, he discusses the onto-epistemic specificity of "the human" in Freire and situates it in relation to the split subject of the unconscious in Lacanian psychoanalysis. Second, he presents the subject/object encounter in Freire, demonstrating that a similar notion of the unconscious informs Freire's account and plays a central role in his understanding of the banking and problem-posing pedagogical experiences. Advancing a Lacanian reading of the problem-posing encounter, Armonda concludes by reflecting on key differences between the dialectical-materialist and psychoanalytical interpretations of Freire, and how the latter opens new perspectives on "reality" as an inconsistent space of contest, generating alternative ways of conceiving political subjectivity and the possibility of radical social transformation in the present.

Diversity in terms of class, sexual identity and migration background among medical students in high income countries has increased greatly in recent decades. Some research into the experiences of these new groups of doctors has been performed. However, no previous research into the experiences of psychiatry residents specifically, is known. This qualitative study investigates how psychiatry residents, from these minoritized groups, experience their training regarding inclusion. Inclusion is defined as the degree to which one's needs for connection and for being valued in one's uniqueness, is satisfied. In-depth interviews with 16 psychiatry residents were conducted. These interviews were transcribed and coded using MaxQDA software. Initial themes that were constructed, were explored further in subsequent interviews and linked to literature. Finally, the developed themes were ordered in a model conceptualizing inclusion. Participants reported high belongingness within psychiatry training. Their experienced value in uniqueness, however, was generally quite low. Participants reported to experience little interest in and sensitivity for their perspectives and lived experiences from their co-workers. When faced with stigmatization and discrimination, participants reported lack of support from their colleagues. Assimilation was found to be the most frequently used coping strategy in dealing with diversity. Participants seemed to conform to the 'neutral' norm and experienced barriers in expressing themselves. Through this mechanism of assimilation, the added value that participants might bring with their unique knowledge and lived experiences was not used, both in patient care and in creating an inclusive climate within the organization. Moreover, assimilation is associated with psychological strain.

The objective of our research is to analyse career dissatisfaction through the psychoanalytical lens of Jacques Lacan. Taking a multiple-case study approach, semi-structured interviews were conducted with seven male, senior managers working in the highly competitive technology industry. We found that respondents are defining satisfaction against a socially constructed career system that obliterates the concept of an agentic self. By grounding our qualitative investigation in the research fields of career and career dissatisfaction in the under-researched realm of Lacanian theory, we extend career theory to include a psychodynamic lens. We also contribute to practice by providing an alternative approach to career counselling that encourages the client to co-construct a sense of liberation and empowerment.

In 2020, a nationwide shift to telepsychiatry occurred in the wake of the Coronavirus Disease 2019 (COVID-19) pandemic and lockdowns. To assess the rates of telepsychiatry appointment attendance pre- and post-lockdown, we conducted a national, multi-site survey of appointments in 2020 compared to a similar time period in 2019, at outpatient child psychiatry clinics that specialize in the treatment of patients with Autism Spectrum Disorder (ASD) and/or Developmental Disabilities (DD). ASD/DD clinics rapidly shifted to telepsychiatry, returning to pre-pandemic appointment numbers and completion rates within months. We advocate for the continued funding of this care model, discuss the substantial benefits physicians, patients and families have found in using telepsychiatry, and suggest ways to improve future access for ASD/DD telepsychiatry.

Coherent with mental health literacy curricula, mental health assessment and referral is embedded in Canadian educational contexts. Mental health literacy excludes the substantial scholarly critique of mental health produced by psychiatry, the disciplinary base of the field of mental health. In-school student referrals to mental health professionals may similarly omit important critical information. Key critical areas of concern include scientific evidence, psychiatric drugs, psychiatric diagnosis, misinformation, and potential for harm. Professional ethics codes call for full disclosure of risk and open access to any relevant information needed for informed decision-making. Some mental health interventions commonly take place on an implied consent basis within first-time consult appointments. Consequently, parents and students require access to critical mental health knowledge before or during referral processes. Beyond aligning mental health referral with the ethical principle of informed consent, professional ethics require institutional divestment from any mental health premises and practices that cause harm and lack scientific, intellectual, and ethical integrity.

The concept of evidence, the demand for evidence-based practice and decision-making has for years dominated educational research. Concomitantly, the randomized controlled trials (RCT) that originally gained ground within the field of medicine have become the gold standard for empirical research and political reform within educational sciences, at least in Scandinavia. Nevertheless, proponents of such an approach have not fully explored the consequences of evidence-based methods, in particular the double-blind, placebo-controlled clinical trial. What is the equivalent to the placebo-effect in education and how does research in educational sciences deal with this effect? The concept of placebo is arguably as close as medicine gets to acknowledging the psychoanalytic concept of the unconscious and unconscious knowledge. With the concept of transference, psychoanalysis offers a useful exploration of the processes and mechanisms leading to the placebo effects.

At the end of 2016, the Oxford English Dictionary announced 'post-truth' as word of the year, and since then, the concept has been invoked around the world to describe the growing anxieties surrounding the current crisis in truth, wherein emotion appears to have replaced fact in the shaping of public opinion. Society is witnessing what seems to be an unprecedented increase in the spread of fake news, alternative facts, and "affective feedback loops" that have hate on the rise, increasing left/right divides. There has been groundbreaking research across disciplinary divides that clearly identifies the targeting of emotions via personalized social media messaging as the new frontier of propaganda. However, despite the fact that the relationship between digital propaganda and manipulated emotion has come to public awareness, not enough attention is being drawn to the need for critical media literacy projects in education that include understandings of how emotions are being targeted and manipulated. Because psychoanalysis sees emotional life as the most significant resource for learning to think, and in learning to think differently, in this article, Jennifer Logue explores what psychoanalytic theory can bring to the "truthiness" table. She suggests that psychoanalytic insight can be extremely helpful in the creation of new pedagogies that enables people to better navigate the current climate of hate and fear, and the epidemic of "affective information warfare" people currently find themselves in.