Showing papers on "Mental health published in 1981"

National Institute of Mental Health diagnostic interview schedule: Its history, characteristics, and validity.

Abstract: • A new interview schedule allows lay interviewers or clinicians to make psychiatric diagnoses according to DSM-III criteria, Feighner criteria, and Research Diagnostic Criteria. It is being used in a set of epidemiological studies sponsored by the National Institute of Mental Health Center for Epidemiological Studies. Its accuracy has been evaluated in a test-retest design comparing independent administrations by psychiatrists and lay interviewers to 216 subjects (inpatients, outpatients, ex-patients, and nonpatients).

Scaling Community Attitudes Toward the Mentally Ill

Abstract: The measurement of public attitudes toward the mentally ill has taken on new significance since the introduction of communitybased mental health care. Previous attitude scales have been constructed and applied primarily in a professional context. This article discusses the development and application of a new set of four scales explicitly designed to measure community attitudes toward the mentally ill. The scales represent dimensions included in previous instruments, specifically, authoritarianism, benevolence, social restrictiveness, and community mental health ideology, but are expressed in terms of an almost completely new set of items that emphasize community contact with the mentally ill and mental health facilities. Data from a study of community attitudes about neighborhood mental health facilities in Toronto are used to test the internal and external validity of the scales. Results of the analysis provide strong support for the validity of the scales and demonstrate their usefulness as explanatory and predictive variables for studying community response to mental health facilities.

A model of mental health, life events, and social supports applicable to general populations

Abstract: This research addresses measurement issues, derives a model of the effects of life events on mental health, and tests hypotheses regarding the role of social supports in modifying these effects over time. Analyses were based on a longitudinal study of persons (N = 2,234) sampled from a general population in Seattle, Washington, as part of Rands Health Insurance Experiment. In addition to sociodemographic variables, measures of physical limitations, mental health, social supports, and stressful life events were fielded twice (one year apart), using previously validated measures. Data for a random half of the sample were analyzed to evaluate different approaches to defining and scoring life events and social supports and to fit a model of the main and interactive effects of these variables on mental health. The best-fitting model was then crossvalidated, using the remaining half of the sample. Results support the following conclusions: (1) Social supports predict improvements in mental health over time, (2) life events and physical limitations predict a deterioration in mental health over time, (3) the negative effects of life events and physical limitations on mental health do not vary according to amount of social support, and (4) differences in measurement strategies for life events and social supports produce some variance in results, but not in conclusions about whether effects on mental health are additive or interactive. This paper presents a longitudinal analysis

Living alone, social integration, and mental health.

Abstract: This study is an examination of the effects of living alone on mental health, mental well-being, and maladaptive behaviors. The findings may be summarized in three basic points. First, there is no ...

Defining and counting the chronically mentally ill.

Abstract: The shifts in the pattern and locus of mental health care arising from the deinstitutionalization movement have resulted in a lack of definitive information on the scope of the problem of chronic mental illness. In addition, there is a lack of consensus on the boundaries that define the chronically mentally ill population, boundaries that can guide national policy-makers in a more scientific assessment of needs. In a national study following up the recommendations of the President's Commission on Mental Health, the authors developed a detailed definition of the chronically mentally ill population based on diagnosis, disability, duration of illness, and the institutional and community settings in which chronic mental patients may be found. They used prevalence data from a number of sources to arrive at a national estimate of between 1.7 million and 2.4 million in the target population, including 900,000 in institutions.

The Epidemiologic Catchment Area Program of the National Institute of Mental Health.

Abstract: We hope that the ECA Program can make a significant, and perhaps unique, contribution to the field of psychiatric epidemiology and to mental health services research. If the Program provides total true prevalence data on mental disorders according to the latest diagnostic criteria, that in itself will be a significant contribution. Such data should be of enormous benefit to those interested in etiology as well as those interested in health services research. For researchers interested in etiology, the data can be used to identify, by comparison, high-risk groups; for those interested in health services research, the results can serve as a health planning guide that does not depend on the presence or absence of treatment facilities in a given area. Incidence data will be the second major contribution of the ECA Program. Its two-wave design enhances the study of incidence, etiology, and the natural history of disorders and also allows study of the social behavior of persons entering treatment for mental disorders--a subject important to health planners. Finally, a significant result of the ECA Program may be the establishment of a viable standardized methodology for the epidemiologic study of mental disorders by means of which demonstrably replicable results can be produced. Once we demonstrate the equivalence of method and results, then the stage is set for comparative studies of all sorts.

Normal and abnormal behavior in Chinese culture

Abstract: Section I: Historical and Cultural Background of Beliefs and Norms Governing Behavior.- 1. Selfhood and Authority in Neo-Confucian Political Culture.- 2. Suicide and the Family in Pre-modern Chinese Society.- 3. Normal and Deviant Drinking in Rural Taiwan.- 4. In the Presence of Authority: Hierarchical Roles in Chinese Spirit Medium Cults.- 5. Insanity in Imperial China: A Legal Case Study.- 6. Traditional Chinese Medical Beliefs and Their Relevance for Mental Illness and Psychiatry.- Section II: Child Development and Childhood Psychopathology.- 7. Conformity and Deviance Regarding Moral Rules in Chinese Society: A Socialization Perspective.- 8. Childhood Psychopathology: A Dialogue with Special Reference to Chinese and American Cultures.- 9. Sex Difference in School Adjustment in Taiwan.- Section III: Family Studies.- 10. Deviant Marriage Patterns in Chinese Society.- 11. Family and Community in the People's Republic.- 12. The Effect of Family Pathology on Taipei's Juvenile Delinquents.- Section IV: Psychiatric Studies: Epidemiological and Clinical.- 13. Overview of Mental Disorders in Chinese Cultures: Review of Epidemiological and Clinical Studies.- 14. Sex Roles, Social Status, and Psychiatric Symptoms in Urban Hong Kong.- 15. Mental Health Status of Chinese in the United States.- 16. The American Experience of the Chinese Student: On Being Normal in an Abnormal World.- 17. Mental Illness and Psychosocial Aspects of Medical Problems in China.- 18. Shen-K'uei Syndrome: A Culture-Specific Sexual Neurosis in Taiwan.- 19. Culture-Bound Syndromes among Overseas Chinese.- 20. Love, Denial and Rejection: Responses of Chinese Families to Mental Illness.- Epilogue.- List of Contributors.- Citation Index.

A longitudinal field study of group work redesig

Abstract: The paper describes an action research project on group work redesign which involved blue-collar employees in a confectionery company. A theoretical framework, derived from previous research on semi-autonomous work groups and the Job Characteristics Model modified to apply to group working (Hackman, 1977), was used as a guide to diagnosis, redesign and evaluation. Hie findings, based on a short term evaluation after six months and a longer term evaluation after eighteen months, reveal that substantial increases in group autonomy and group work identity were achieved, and were followed, as predicted, by increased work motivation, performance, job satisfaction and mental health, as well as reduced labour turnover. Of particular interest to subsequent theoretical development is the sensitivity of mental health as an outcome variable, and the existence of differential rates of change in the dependent variables.

Childhood mental disorders in primary health care: results of observations in four developing countries. A report from the WHO collaborative Study on Strategies for Extending Mental Health Care.

Abstract: To ascertain the frequency of mental disorders in Sudan, Philippines, India, and Columbia, 925 children attending primary health care facilities were studied. Rates of between 12% and 29% were found in the four study areas. The range of mental disorders diagnosed was similar to the encountered in industrialized countries. The research procedure involved a two-stage screening in which a ten-item "reporting questionnaire" constituted the first stage. The study has shown that mental disorders are common among children attending primary health care facilities in four developing countries and that accompanying adults (usually the mothers) readily recognize and report common psychologic and behavioral symptoms when these are solicited by means of a simple set of questions. Despite this, the primary health workers themselves recognized only between 10% and 22% of the cases of mental disorder. The result have been used to design appropriate brief training courses in childhood mental disorders for primary health workers in the countries participating in the study.

The city and the child

Abstract: The incidence of psychosocial problems of various kinds tends to be much higher in the inner cities than in areas of small towns or in rural communities. This paper explores the mechanisms likely to contribute to this difference, and considers the implications for mental health practitioners and policy makers.

Network Structure, Social Support, and Psychological Well-Being in the Single-Parent Family.

Abstract: This research examines the relationships among network structure, social support, and psychological well-being in the single-parent family. Three network types are identified: the family of origin network, the extended network, and the conjugal network. Findings indicate that network structure is associated with type of support, and that effects ofstructure and support on psychological well-being are mediated by a third variable, role orientation of the mother. Theoretical and methodological implications for research on stress and psychological distress as well as practical implications fbr community mental health services are suggested.

Natural history of male psychological health, X: Work as a predictor of positive mental health.

Abstract: A sample of 456 inner city men was prospectively followed from age 14 until age 47. Rates blind to adult outcome assessed the men's childhood success at tasks reflecting Erikson's fourth developmental stage, industry versus inferiority. Childhood assessments were made on the parenting the men received and other psychosocial variables, including social class and IQ, and were compared with independent judgments of these men's mental health and career success at age 47. Capacity to work in childhood predicted the success of these underprivileged men at work in adult life and surpassed social class, multiproblem-family membership, and all other childhood variables in predicting adult mental health and capacity for interpersonal relationships.

Sociology of mental disorder

Abstract: 1. The Problem of Mental Disorder. 2. Types of Mental Disorders. 3. Mental Disorder: Concepts of Causes and Cures. 4. Mental Disorder as Deviant Behavior. 5. Mental Disorder: Social Epidemiology. 6. Mental Disorder: Social Class. 7. Mental Disorder: Age, Gender, and Marital Status. 8. Mental Disorder: Urban versus Rural Living and Migration. 9. Mental Disorder: Race. 10. Help-Seeking Behavior and the Prepatient Experience. 11. Acting Mentally Disordered: The Example of Schizophrenia, Anxiety, and Depression. 12. The Mental Hospital Patient. 13. Residing in the Community. 14. Community Care and Public Policy. 15. Mental Disorder and the Law. 16. Mental Disorder and Public Policy in Selected Countries. References. Index.

Survivors: outreach to a reluctant population.

Abstract: Following a devastating fire at the Beverly Hills Supper Club, mental health professionals developed an outreach program to identify survivors at risk for long-term impairment and to offer preventive services. Differences among four outreach modes, in terms of impairment and efficiency of effort, are discussed in the context of a general survivors' reluctance to utilize mental health resources.

The Mental Health Professional's Concept of the Normal Adolescent

Abstract: • This article presents empirical evidence, based on the Offer Self-Image Questionnaire, comparing the self-image of normal adolescents, psychiatrically disturbed adolescents, and juvenile delinquents, with adolescent self-image as seen by 62 mental health professionals. The latter group was asked to complete the test the way they believed a normal, mentally healthy adolescent would complete it. Similar data were gathered from graduate students in psychology. In seven of ten scales, the mental health professionals viewed the normal adolescent as significantly more disturbed than the normal adolescent views himself or herself. The professionals saw the normal adolescents as having more problems than were reported either by the psychiatrically disturbed or the delinquent adolescents. These findings are important in terms of psychodynamic theory of adolescence and diagnostic problems encountered in work with adolescents.

Shift Work Related to Job Attitudes, Social Participation and Withdrawal Behavior: A Study of Nurses and Industrial Workers.

Abstract: The present study investigates the relationship between shift schedules and mental health, job satisfaction, social participation, organizational commitment, anticipated turnover, absenteeism and tardiness among nurses (N=440) in two hospitals and among rank-and-file workers (N=383) in a manufacturing organization. Results are generally supportive of the model which projected that workers on fixed work schedules (high routine-oriented) would be better off than workers on rotating work schedules (low routine-oriented) in terms of mental health, job satisfaction, organizational commitment and social participation. In addition, workers on fixed shift schedules are found to be lower on anticipated turnover, absenteeism and tardiness than workers on rotating shift schedules. Six potential moderators: age, marital status, place of socialization, cultural background, seniority and respondent's sex, were measured and their association with these relationships analyzed. Results are discussed in the light of the previous empirical evidence.

The New Chronic Patient and the System of Community Care

Abstract: Deinstitutionalization has created a new type of patient—the new young chronic—who has received most or all of his treatment during brief hospital stays and through extended contact with outpatient community care programs. A one-year study of 119 new chronic patients entering treatment in New York City between 1977 and 1979 casts light on their living arrangements, use of mental health services, social functioning, criminal activity, suicide attempts, and symptomatology.

Mental Health Law

Abstract: Modern mental health law was conceived when courts and commentators recognized that psychiatrists and other mental health professionals often promised society-and the legal system-far more than they were able to deliver (Kittrie, 1971; Szasz, 1963; cf. In re Gault, 1966). That era was typified by the legal profession's deferring to psychiatry with respect to the content of the law and its administration (e.g., civil commitment, effectuated by a "two-physician certificate" rather than by a hearing). Today, by contrast, mental health law emphasizes matters such as procedural protections (due process hearings, assigned lawyers) for persons facing civil commitment. When liberty is at stake, the law is now gene rally wary of dispensing with procedural safeguards simply because the ultimate disposition may be regarded as therapeutic rather than punitive (cf. Allen v. Illinois, 1986). In essence, modern mental health law esche ws the "medical model" and the "psychiatrization" of the law that was so prominent in the 1950s. The law's civil libertarian concern is to be applauded (Wexler, 1972). Because of its recent history and its antagonism toward psychiatry and related disciplines, however, modern mental health law has not profited from truly interdisciplinary cooperation and interchange-from having the knowledge, theories, and insights of the mental health disciplines help shape the law, the legal system, and the behavior of legal actors, just as economic principles have been used to inform legal development in certain other areas of the law, such as antitrust. But the law's ignorance of the mental health disciplines should no longer be excused. First, courts already do occasionally consider (or purport to consider) the anticipated therapeutic outcomes of their rulings, so it is best to focus scholarly attention on such matters to assist courts in reaching correct results. For example, in deciding that juveniles could constitutionally be involuntarily hospitalized without the necessity of a civil commitment hearing, the Supreme Court noted that "it is appropriate to inquire into how such a hearing would contribute to the successful long-range treatment of the patient" (Parham v. J.R., 1979, p. 2508; compare Perlin, 1981). Moreover, we are now developing an impressive body of scholarship-known as "social science in law" (Monahan & Walker, 1985)-to aid the law in evaluating (not deferring to) the contributions of the behavioral sciences (see, e.g., Davis, 1987; Monahan & Walker, 1986; Perry & Melton, 1983-1984; Walker & Monahan, 1987). Ifmental health information, a subset of the behavioral sciences, is looked to by the law with a healthy skepticism, we ought to be able to profit from some of that information without having the law succumb to passing psychological fads. Thus, mental health law is now in a reasonably good position both to evaluate mental health information and, because of the law's historical origin and consequent "rights" orientation, to appreciate the crucial import-

Inequality and women's mental health: an overview

Abstract: Complex processes of sex bias and sex-role stereotyping continue to detract from the quality of mental health services to both sexes, but particularly to women because of their disadvantaged status. Understanding how such processes can simultaneously create barriers to service access and facilitate inappropriate treatment is essential to ensuring quality mental health services. Ameliorating the problems of women as providers and consumers in the mental health delivery system will require a sophisticated understanding of the nature of those problems and a firm commitment to creative solutions. The ethical mandate to address the institutional structures of inequality extends to all persons who are part of the mental health delivery system.