Context An understudied crucial step in the help-seeking process is making prompt initial contact with a treatment provider after first onset of a mental disorder. Objective To provide data on patterns and predictors of failure and delay in making initial treatment contact after first onset of a mental disorder in the United States from the recently completed National Comorbidity Survey Replication. Design and Setting Nationally representative face-to-face household survey carried out between February 2001 and April 2003. Participants A total of 9282 respondents aged 18 years and older. Main Outcome Measures LifetimeDSM-IVdisorders were assessed with the World Mental Health (WMH) Survey Initiative version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI), a fully structured interview designed to be administered by trained lay interviewers. Information about age of first professional treatment contact for each lifetimeDSM-IV/WMH-CIDI disorder assessed in the survey was collected and compared with age at onset of the disorder to study typical duration of delay. Results Cumulative lifetime probability curves show that the vast majority of people with lifetime disorders eventually make treatment contact, although more so for mood (88.1%-94.2%) disorders than for anxiety (27.3%-95.3%), impulse control (33.9%-51.8%), or substance (52.7%-76.9%) disorders. Delay among those who eventually make treatment contact ranges from 6 to 8 years for mood disorders and 9 to 23 years for anxiety disorders. Failure to make initial treatment contact and delay among those who eventually make treatment contact are both associated with early age of onset, being in an older cohort, and a number of socio-demographic characteristics (male, married, poorly educated, racial/ethnic minority). Conclusions Failure to make prompt initial treatment contact is a pervasive aspect of unmet need for mental health care in the United States. Interventions to speed initial treatment contact are likely to reduce the burdens and hazards of untreated mental disorder.

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/208684/yoa40306.pdf

Failure and Delay in Initial Treatment Contact After First Onset of Mental Disorders in the National Comorbidity Survey Replication

BACKGROUND: Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology.

METHODS: The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members. On this basis they can either revise their views or make a case for their position. The statements are then revised based on panel feedback, and again rated by and commented on by the panel. In this study, feedback from a second round was used to prepare a final set of statements in narrative form. The panel included 57 individuals representing a range of professions and nationalities.

RESULTS: We achieved at least 78% agreement for 19 of 21 statements within two rounds of ratings. These were collapsed into 12 statements for the final consensus reported here. The term ‘Language Disorder’ is recommended to refer to a profile of difficulties that causes functional impairment in everyday life and is associated with poor prognosis. The term, ‘Developmental Language Disorder’ (DLD) was endorsed for use when the language disorder was not associated with a known biomedical aetiology. It was also agreed that (a) presence of risk factors (neurobiological or environmental) does not preclude a diagnosis of DLD, (b) DLD can co-occur with other neurodevelopmental disorders (e.g. ADHD) and (c) DLD does not require a mismatch between verbal and nonverbal ability.

CONCLUSIONS: This Delphi exercise highlights reasons for disagreements about terminology for language disorders and proposes standard definitions and nomenclature.

/pdf/phase-2-of-catalise-a-multinational-and-multidisciplinary-l687pezso3.pdf

Phase 2 of CATALISE: a multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology

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What It Is: Selected Poems

https://greatergood.berkeley.edu/images/uploads/Decety_DevCognNeuro2011.pdf

Putting together phylogenetic and ontogenetic perspectives on empathy.

Background
Physician empathy is an essential attribute of the patient–physician relationship and is associated with better outcomes, greater patient safety and fewer malpractice claims.

/pdf/empathy-training-for-resident-physicians-a-randomized-25wjozsbs7.pdf

Empathy training for resident physicians: a randomized controlled trial of a neuroscience-informed curriculum

The Red Book: Liber Novus

DOI:10.1097/YCO.0b013e32835fd6fb The diagnostic term ‘mental retardation’ is finally being eliminated in the upcoming international classifications of diseases and disorders. The term ‘mental retardation’ was introduced by the American Association on Mental Retardation in 1961 and soon afterwards was adopted by the American Psychiatric Association (APA) in its Diagnostic and Statistical Manual for Mental Disorders (DSM-5) [1,2]. Mental retardation replaced older terms such as feeblemindedness, idiocy, and mental subnormality that had become pejorative. Now, over 5 decades later, the term ‘mental retardation’ is being eliminated for similar reasons. The APA’s fifth revision of its DSM-5 [3] and the WHO in the 11th edition of the International Classification of Diseases (lCD-11) will revise their terminology [4]. This is consistent with the abandonment of the term by medical and educational professions and advocacy groups over recent years. The International Association for the Scientific Study of Mental Deficiency (IASSMD) has long been designated the International Association for the Scientific Study of Intellectual Disability (IASSID). The Journal of Mental Deficiency Research is now The Journal of Intellectual Disability Research and the federal advisory group The United States President’s Committee on Mental Retardation is now designated The President’s Committee for Persons With Intellectual Disabilities. In the United States, a federal statute (Public Law 111-256, Rosa’s law) replaces the term ‘mental retardation’ with ‘intellectual disability’ [5] and requires that person first language be used when referring to those affected in all federal laws. Rosa’s law is indicative of the sentiment for change. Rosa Marcellino, an 8-year-old girl with Down Syndrome from Maryland, was taunted frequently and pejoratively called ‘retard’ in a demeaning manner. With support from her state representative and US Senator Barbara Mikulski, legislation was initiated leading to the change in the law. Such change is important not only to deal with the pejorative use of the term, but also to emphasize that these are people with neurodevelopmental disorders requiring intervention early in the developmental period.

New terminology for mental retardation in DSM-5 and ICD-11.

A clinical lesson at the Salpêtrière.

The school's size, diverse programs and degree offerings, as well as facilities result in a fully configured art school within the largest university in the Southeast. The school, with the other units of the College of the Arts and the Harn Museum of Art, shares the mission of serving as an educational, professional and cultural resource in the visual arts for the campus, community, state and region.

The art of painting.

Introduction Mutual aid between and among members of a species may be the most potent force in evolution. This was the position taken by the Russian evolutionists who proposed that greater emphasis be placed on ‘mutual aid’ than on ‘survival of the fittest’ in the struggle for existence (Kropotkin, 1989; Todes, 1989). They noted that those species with the most highly evolved brains having the greatest brain weight and the most complex neocortical development show the greatest social cooperation and are the most sociable. MacLean's (1990) emphasis on integrated brain function in social adaptation is critical to understanding the evolution of empathy. He and his colleagues provide an ethological perspective on the study of empathy in their paleo-ethological and ethological studies of behaviour. Evolutionary steps toward sociability are highlighted in his studies of audiovocal communication and on the effects of brain lesions on behaviour in lizards ( Anolis carolinensis ), rodents and squirrel monkeys. An increase in social behaviour and social responsiveness accompanies the evolutionary transition from reptiles to mammal-like reptiles to early mammals to primates and humans. Preston and de Waal (2002) suggest that in this evolutionary transition there are proximate and ultimate bases for empathy. Proximately, the perception of an object's state activates the individual's corresponding representations, which activate somatic and autonomic responses. They propose a Perception-Action Model (PAM) that along with experience can predict empathetic behaviour or its absence.

James C. Harris

Papers

The Red Book: Liber Novus

New terminology for mental retardation in DSM-5 and ICD-11.

A clinical lesson at the Salpêtrière.

The art of painting.

The evolutionary neurobiology, emergence and facilitation of empathy