THINKING Young children understand the relation between objects and events in a functional manner, such that the first object is seen to go with or to operate on the second object. Complementarity criteria are an integral component of their thinking. Older children and young adults, by contrast, tend to use similarity criteria. In old age, however, the use of complementarity criteria has been found to increase once again (Reese & Rodeheaver, 1985). The reversal to complementarity in old age is thought to be caused by environmental factors rather than being attributable to changes in competence. Young children as well as the elderly are rarely required to state their thoughts in a specifically prescribed way, and complementary categorization therefore seems more natural, since such categorization groups occur naturally in time and space. Older adults do not neces-

The encyclopedia of aging

Neuropsychological correlates of negative, disorganized and psychotic symptoms in schizophrenia

As part of a community-based survey of 529 homeless adults, the authors analyzed factors associated with their use of mental health services. Homeless persons who had had a previous psychiatric hospitalization were the least likely to sleep in an emergency shelter, had been homeless nearly twice as long as the rest of the sample, had the worst mental health status, used alcohol and drugs the most, and were the most involved in criminal activities. The majority had not made an outpatient mental health visit in 5 years. It is suggested that diverse systems of care are needed for homeless persons.

Mental health, alcohol and drug use, and criminal history among homeless adults

Increasingly, the mental health needs of populations are measured using large-sample surveys with standardized measures and methods. Such efforts, however, rarely include sufficient number of smaller, culturally defined populations to draw defensible conclusions about their needs. Furthermore, without some adaptation, the standardized methods and measures may yield invalid results in such populations. Using a recently completed psychiatric epidemiology and services study with American Indian populations as a case example, this paper outlines issues facing epidemiologists working in such culturally diverse contexts. The issues discussed include the following: (1) persuading the scientific community and potential sponsors that work with distinct or culturally defined populations is important; (2) framing research questions and activities to meet the needs of communities; (3) defining a population of inference; (4) balancing the needs for comparability and cultural specificity; (5) maximizing scientific validity in light of the challenges in sample acquisition; and (6) developing and implementing data collection methods that uphold scientific standards but are also realistic given the context. The authors draw on their experiences—most recently in the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP)—to illustrate these issues and suggest ways to address each. A goal of this paper is to challenge those invested in conducting culturally valid epidemiologic work in such populations to better articulate the nature of these efforts.

Cultural specificity and comparison in psychiatric epidemiology: walking the tightrope in American Indian research.

The purpose of this phenomenological study was to identify commonly occurring factors in filicide-suicide offenders, to describe this phenomenon better, and ultimately to enhance prevention of child murder. Thirty families' files from a county coroner's office were reviewed for commonly occurring factors in cases of filicide-suicide. Parental motives for filicide-suicide included altruistic and acutely psychotic motives. Twice as many fathers as mothers committed filicide-suicide during the study period, and older children were more often victims than infants. Records indicated that parents frequently showed evidence of depression or psychosis and had prior mental health care. The data support the hypothesis that traditional risk factors for violence appear different from commonly occurring factors in filicide-suicide. This descriptive study represents a step toward understanding filicide-suicide risk.

http://jaapl.org/content/jaapl/33/4/496.full.pdf

Filicide-Suicide: Common Factors in Parents Who Kill Their Children and Themselves

This paper describes murder-suicide in the United States from 1990 through 1995, using the cases reported in six major newspapers. Spousal murder-suicide was the predominant type with a range of 42%–57%; familicide-suicide was the second predominant type with a range of 22%–47%. The perpetrators were predominantly males; the victims were female sexual partners or consanguineous relatives. Firearms (guns) were used in 90% of the cases. The author concludes that a national surveillance system that specifically identifies and codes this phenomenon, and multi disciplinary studies are necessary to hinder this phenomenon.

Violence in America: a survey of suicide linked to homicides.

Deinstitutionalization and criminalization: tinkering in the interstices.

Tardive dyskinesia (TD) is a well-described adverse effect of treatment with neuroleptics. Studies from non-western countries are sparse and those that exist are not well publicized. We analyzed prevalence data on TD, published in English or French, and carried out in countries in Africa and Asia through December 1993. The estimated prevalence of TD among African subjects was 24% and among Asian subjects 17.20%. Both rates are in the middle range when compared with the western prevalence rates of 10–50%. Long-term hospitalization and older age were risk factors associated with TD. Female gender did not emerge as a risk factor. Also, several Asian studies showed that subjects with TD were taking lower doses of neuroleptics than subjects without TD. Prospective and controlled cross-cultural studies of TD are recommended for better understanding of associated risk factors and primary prevention.

Tardive dyskinesia in non-western countries: A review

Schizophrenia is a heterogeneous and multidimensional disorder The different syndromes or dimensions of this disorder represent distinct pathophysiological processes Evidence is growing that each of the composite syndromes or dimensions of this disorder is associated with specific validators This article reviewed neurophysiological and neuropsychological studies in schizophrenia in order to determine the external validators of its syndromes The review reveals compelling findings in some instances and contradictory findings in other instances

Symptom Dimensions of Schizophrenia: A Selective Integration of Neurophysiological and Neuropsychological Correlates

Advances in psychiatric research have reestablished the importance of psychiatric community epidemiological studies. Psychiatric epidemiological surveys that used the same standardized diagnostic interview and classification system in different parts of the world were reviewed. The lifetime prevalence for any psychiatric morbidity ranged from 21 to 65%. The prevalence of psychiatric disorders was higher than that in the first- and second-generation community surveys. The relevance of these findings to clinical practice, public health, and the directions for future epidemiological research are discussed.

Yekeen A. Aderibigbe

Papers

Violence in America: a survey of suicide linked to homicides.

Deinstitutionalization and criminalization: tinkering in the interstices.

Tardive dyskinesia in non-western countries: A review

Symptom Dimensions of Schizophrenia: A Selective Integration of Neurophysiological and Neuropsychological Correlates

Psychiatric epidemiology in cross-cultural perspective: a review.