Showing papers on "Mental health published in 1986"

Appraisal, coping, health status, and psychological symptoms.

Abstract: In this study we examined the relation between personality factors (mastery and interpersonal trust), primary appraisal (the stakes a person has in a stressful encounter), secondary appraisal (options for coping), eight forms of problem- and emotion-focused coping, and somatic health status and psychological symptoms in a sample of 150 community-residing adults. Appraisal and coping processes should be characterized by a moderate degree of stability across stressful encounters for them to have an effect on somatic health status and psychological symptoms. These processes were assessed in five different stressful situations that subjects experienced in their day-to-day lives. Certain processes (e.g., secondary appraisal) were highly variable, whereas others (e.g., emotion-focused forms of coping) were moderately stable. We entered mastery and interpersonal trust, and primary appraisal and coping variables (aggregated over five occasions), into regression analyses of somatic health status and psychological symptoms. The variables did not explain a significant amount of the variance in somatic health status, but they did explain a significant amount of the variance in psychological symptoms. The pattern of relations indicated that certain variables were positively associated and others negatively associated with symptoms.

The health of Hispanics in the southwestern United States: an epidemiologic paradox.

Abstract: Recent reports in the literature on the health status of southwestern Hispanics, most of whom are Mexican Americans, are reviewed critically. The review is organized into the following sections: infant mortality, mortality at other ages, cardiovascular diseases, cancer, diabetes, other diseases, interview data on physical health, and mental health. Despite methodological limitations of much of the research, it can be concluded with some certainty that the health status of Hispanics in the Southwest is much more similar to the health status of other whites than that of blacks although socioeconomically, the status of Hispanics is closer to that of blacks. This observation is supported by evidence on such key health indicators as infant mortality, life-expectancy, mortality from cardiovascular diseases, mortality from major types of cancer, and measures of functional health. On other health indicators, such as diabetes and infectious and parasitic diseases, Hispanics appear to be clearly disadvantaged relative to other whites. Factors explaining the relative advantages or disadvantages of Hispanics include cultural practices, family supports, selective migration, diet, and genetic heritage. The recently completed Hispanic Health and Nutrition Examination Survey will go a long way to provide answers to many questions regarding the health of Hispanics in the Southwest or elsewhere.

Age‐associated memory impairment: Proposed diagnostic criteria and measures of clinical change — report of a national institute of mental health work group

Abstract: (1986). Age‐associated memory impairment: Proposed diagnostic criteria and measures of clinical change — report of a national institute of mental health work group. Developmental Neuropsychology: Vol. 2, No. 4, pp. 261-276.

Depressive symptoms in relation to physical health and functioning in the elderly

Abstract: The associations between depressive symptoms and functional disability and chronic conditions are examined in an elderly cohort of 2,806 noninstitutionalized men and women living in New Haven, Connecticut who were interviewed in 1982 as a part of the Yale Health and Aging Project. The aim is to explore several potential sources of invalidity in using the Center for Epidemiologic Studies-Depression scale (CES-D) to measure depressive symptoms in elderly populations. In particular, the authors are concerned with the possibility that prevalent physical illnesses and disabilities may cause the older person to report many somatic complaints, a major component of most measures of depressive symptomatology, and thereby inflate his or her CES-D score. Mean CES-D scores are 4.86 for those without any disabilities and range to 13.51 for those with major functional disabilities. However, physical disability is significantly associated with virtually every item on the CES-D scale not just those somatically-oriented items. The addition of functional disability to a multivariate model including age subfactor analysis of responses from this elderly sample produces results almost identical to those reported by earlier investigators who studied younger and middle-aged adults. The authors conclude that physical disabilities among the elderly do not appear to be a major threat to the validity of the CES-D scale and that the strong associations between physical and mental health should be rigorously investigated.

Problem-solving therapy : a social competence approach to clinical intervention

Abstract: An introduction and guide for therapists and counselors in the mental health professions to the approach as a reliable clinical treatment, health maintenance strategy, and prevention program Includes a treating manual for increasing adaptive coping and behavioral competence and reducing daily stre

Clinical Gerontology: A Guide to Assessment and Intervention

Abstract: Contents Preface ASSESSMENT OF THE GERIATRIC PATIENT Reasons for Low Utilization of Mental Health Services by the Elderly Spatial Competence: Assessment of Route-Finding, Route-Learning, and Topographical Memory in Normal Aging The Halstead-Reitan Neuropsychological Test Battery and Aging The Clinical Use of Projective Techniques with the Aged: A Critical Review and Synthesis DEPRESSION SCALES FOR USE IN LATER LIFE Directions for Clinical-Psychosocial Assessment of Depression in the Elderly Use of the Center for Epidemiological Studies-Depression Scale with Older Adults Use of the Zung Self-Rating Depression Scale in the Elderly The Beck Depression Inventory and Older Adults: Review of Its Development and Utility Geriatric Depression Scale (GDS): Recent Evidence and Development of a Shorter Version A Brief MMPI Depression Screening Scale for the Elderly Assessment of Mood and Affect in the Elderly: The Depression Adjective Check List and the Multiple Affect Adjective Check List Assessment of Pessimism and Despair in the Elderly: A Geriatric Scale of Hopelessness THERAPY IN LATER LIFE Psychodynamic Therapy with the Aged: A Review Application of Gestalt Therapy to Group Work with the Aged Cognitive Therapy with Older Adults Group Therapy with Cognitively Impaired Older Adults Lithium Groups and Elderly Bipolar Outpatients Pet-Facilitated Therapies: A Review of the Literature and Clinical Implementation Considerations FAMILY THERAPY The Functional-Age Model of Intergenerational Therapy: A Social Casework Model The Techniques and Contexts of Multigenerational Therapy Understanding the Family Coping with Alzheimer's Disease: An Application of Theory to Intervention Support Groups for Male Caregivers of Alzheimer's Patients RELATED TOPICS Later Life Personality Model: Diagnosis and Treatment Post-Traumatic Stress Disorder: Hidden Syndrome in Elders Assessment and Management of Chronic Pain in the Elderly Clinical Application of Biofeedback Techniques for the Elderly Suicide in the Elderly: Assessment and Intervention Drug Effects in Alzheimer's Disease Some Ethical Issues in Dementia Care Index

Impact of maternal postnatal depression on cognitive development of young children.

Abstract: Ninety four women and their first born children took part in a longitudinal study of maternal mental health during pregnancy and after delivery. The children's cognitive functioning was assessed at age 4 using the McCarthy scales, without knowledge of the mothers' psychiatric history or current health. As expected girls performed slightly better than boys and children from middle class and professional families did better than children from working class homes, as did children whose mothers had achieved at least one A level at school. Significant intellectual deficits were found in the children whose mothers had suffered with depression, but only when this depression occurred in the first year of the child's life. Marital conflict and a history of paternal psychiatric problems were independently linked with lower cognitive test scores; together with a working class home background these were the only factors that contributed to the deleterious effect of maternal postnatal depression.

The Functional Status Questionnaire: reliability and validity when used in primary care.

Abstract: A comprehensive functional assessment requires thorough and careful inquiry, which is difficult to accomplish in most busy clinical practices. This paper examines the reliability and validity of the Functional Status Questionnaire (FSQ), a brief, standardized, self-administered questionnaire designed to provide a comprehensive and feasible assessment of physical, psychological, social and role function in ambulatory patients. The FSQ can be completed and computer-scored in minutes to produce a one-page report which includes six summated-rating scale scores and six single-item scores. The clinician can use this report both to screen for and to monitor patients’ functional status. In this study, the FSQ was administered to 497 regular users of Boston’s Beth Israel Hospital’ Healthcare Associates and 656 regular users of 76 internal medicine practices in Los Angeles. The data demonstrate that the FSQ produces reliable sub-scales with construct validity. The authors believe the FSQ addresses many of the problems behind the slow diffusion into primary care of systematic functional assessment.

A new perspective on the relationships among race, social class, and psychological distress.

Abstract: Over the past decade, a body of research has developed which purports to show that the well-established relationship between race and psychological distress is due entirely to social class. In our paper we demonstrate that this view is incorrect: Most prior research has assumed that the effects of race and social class are additive; our analysis shows that they are actually interactive. The form of interaction is such that the true effect of race is suppressed and the true effect of social class is magnified in a model that fails to take the interaction into consideration. An analysis of eight different epidemiologic surveys documents this result and shows that race differences in psychological distress are particularly pronounced among people with low incomes. On the basis of this result we callfor renewed interest in the effect of race on mental health.

Sexual abuse in childhood: Psychosocial outcomes and implications for social work practice.

Abstract: A study of the prevalence of serious sexual assualt in childhood (up to age 16) is reported in the context of a community mental health study in a random sample of 377 women in a large Canadian city. Twenty-two percent of women reported sexual abuse in childhoos. Sexually abused women were twice as likely to have poor mental health as women who were not abused. The implications are addressed for helping adults whose poor mental health reflects the complex interaction of negative childhood events, including sexual abuse.

Social networking, hardiness and immigrant's mental health.

Abstract: Previous investigations of immigrant mental hospitalization rates have accumulated inconclusive evidence in regard to native-foreign differentials. We attempt to examine factors that protect voluntary immigrants from psychological impairment. Unlike existing studies, which tend to regard immigrants as merely reactive to stressful life changes accompanying immigration, we assume immigration can be used as a vehicle for personal advancement. We hypothesize that the immigrant's activism in cultivating social networks in the receiving society, and hardiness in the personality repertoire, are the chief means of ameliorating strain. Also examined are issues related to (/) the nature of social networks, (2) ties to the immigrant community and to the host society, and (3) how these ties influence adaptation.

Causes and Effects of My Disturbing Little Book

Abstract: Review and reflection indicate that no more than 5% of what was written in the 1954 book entitled, Clinical Versus Statistical Prediction (Meehl, 1984), needs to be retracted 30 years later. If anything, these retractions would result in the book's being more actuarial than it was. Seven factors appear to account for the failure of mental health professionals to apply in practice the strong and clearly supported empirical generalizations demonstrating the superiority of actuarial over clinical prediction.

The Practice of Psychiatric Rehabilitation: Historical, Conceptual, and Research Base

Abstract: With the recognition that most psychiatric disorders are associated with severe and persisting disability and the development of effective procedures for improving the long-term outcome of patients, the term "psychiatric rehabilitation" is becoming routinely used in the mental health field. Psychiatric rehabilitation has begun to take its place as a viable, credible intervention approach, even infiltrating professionals' jargon and administrators' program descriptions. The field of psychiatric rehabilitation has progressed to the stage where its history can be traced; its conceptual base and treatment strategies described; its practice observed, monitored, and replicated; and its future growth anchored in a research foundation.

Social support and adaptation to stress by the elderly.

Abstract: The fiist of a two-phase project is reported that examined the prospective effects of stress and social support on the physical and mental health of the elderly. A sample of 50 elderly subjects was assessed at two points in time over a 6-month period. Results indicated that social support was a significant predictor of physical health status, whereas mental health was related to the Stress X Social Support interaction term. These latter results were consistent with the buffering hypothesis, in that high levels of social support served to reduce the negative impact of stress on mental health. Individuals who were in better mental health at the initial assessment experienced fewer stressful events and higher levels of social support over the subsequent 6-month period. The implications of these findings for research and theory regarding the relation between stress and social support are discussed. A consistent association has been found between negative life events and the onset of physical and mental health problems (e.g., Thoits, 1983). Recently, interest has focused on how positive resources, such as social support, may have beneficial effects on health in the context of stressful life experiences. Two different models of the relation between negative life events and social support have been proposed. The first, the buffering hypothesis, states that social support serves a protective role primarily during times of stress, through an enhancement of adaptive coping behavior (Cassel, 1976; Cobb, 1976, 1979). Thus, an interaction between stress and social support in predicting physical and mental health is hypothesized, with the role of social support differing depending on the level of stress. The second model views social support as having positive effects on health and well-being both in the presence and absence of stress. This latter model predicts that there will be a direct relation between social support and physical and mental health, independent of the effects of

An empirically validated hierarchy of defense mechanisms.

Abstract: • We empirically examined the validity of ego mechanisms of defense as an explanatory concept for psychological health in 307 middle-aged men who were prospectively followed up for 40 years. Assessed on the basis of a two-hour interview when the men were 47 years old, the maturity (health) of the men's defenses correlated highly with independently assessed outcome measures. Evidence is offered that defensive style provides an independent dimension of mental health. First, childhood variables significantly predicted midlife mental health but not midlife maturity of defenses. Second, the bleaker the childhood the stronger the association of maturity of defenses with adult mental health. Third, the Bond Defense Style Questionnaire, administered to 131 of the 307 men six to eight years after the interview, identified the same styles of defense that were identified earlier by clinical assessment.

Quantitative review of the only child literature: Research evidence and theory development.

Abstract: Six meta-analyses of the research literature on the only child were conducted in order to evaluate the status of the only child and to guide theory development in this area. The 117 studies included here generated enough information to justify six meta-analyses: Achievement Adjustment Character Intelligence Mental Illness and Sociability. Only children are "found to surpass all others except firstborns and people from two-child families in Achievement and Intelligence. They also surpassed people from three- or more child families in Adjustment and Character. A model of the one-child family [is] developed that integrates the explanatory mechanisms of parental attention parental anxiety and family economic resources and emphasizes the strength of the parent-child relationship in small families." (EXCERPT)

Medication noncompliance in schizophrenia: codification and update.

Abstract: Risk of relapse and recidivism makes the failure to take antipsychotic medication as prescribed a significant issue in forensic psychiatry. This question may arise in such contexts as the setting of bail, plea bargaining, the insanity defense, and sentencing. We have reviewed the literature on medication noncompliance in schizophrenia and present here the results, organized by topics relevant for the work of forensic mental health experts. Reported rates of noncompliance vary widely, reflecting major differences in the populations studied and the methods used as well as the complexities involved in defining noncompliant behavior. A noncompliance rate of 50 percent has been attributed globally to chronic patients, both medical and psychiatric. The tendency of significant factors to interact precludes a simple typology of noncompliance. However, environmental security and supportiveness correlate positively with adherence; whereas anxiety, paranoia, grandiosity, depression, and side effects correlate negatively. Clinicians' assessments of whether medication is being taken have proven to be unreliable. Although monitoring by chemical measurement, particularly a radioreceptor assay for urine samples, can be useful, depot injection ensures that prescribed medication is being taken. Less invasive means of promoting compliance are described; psychodynamic and ethical issues to be considered in the monitoring and promotion of compliance over extended time periods are presented. We also probe the link between medication noncompliance and behavioral relapse. The time between default and relapse is most often measured in weeks. Whether due to medication withdrawal or not, the relapse pattern of each individual tends to repeat, allowing its recognition before recidivism occurs. Restarting medication at this stage, especially with a dosage increase, is usually effective. In sum, the forensic mental health expert can now readily use a large and diverse literature to assist with a variety of significant issues.

Pathological Gambling: Psychosomatic, emotional and marital difficulties as reported by the Gambler

Abstract: Two parallel self-administered surveys were distributed at three conferences of Gamblers Anonymous One survey was for members of Gamblers Anonymous and the other was for members of GamAnon Approximately 500 respondents completed the surveys, with 215 having completed the questionnaire for the spouse This article is a report of some of the data from the spouse's survey This survey focused on two time periods of the spouse's life — during the “desperation” phase of the gambler's illness (Custer, 1982) and the phase following a period of abstinence from gambling Specific areas covered in this report focus on the psychosomatic problems and emotional difficulties encountered by the spouse, marital and familial estrangement, financial management, and the need for mental health services It is anticipated that some of these needs can be met through training or therapy sessions in professional gambling treatment centers and at Gamblers Anonymous conferences

Relationship of life events and social support with psychological dysfunction among adolescents.

Abstract: Relationships among major life events, perceived social support, and psychological disorder were assessed in a sample of older adolescents. Negative life events and satisfaction with social support were significantly and independently related to a range of psychological symptoms. Further, the relationship between negative events and disorder was moderated by gender, the types of events experienced, and anticipated change in the psychosocial environment. The importance of the use of standardized and psychometrically sound measures of life events, social support, and psychological disorder is highlighted.

The effects of culture-compatible intervention on the utilization of mental health services by minority clients

Abstract: This study examined the relationship between a culture-compatible approach to mental health service and utilization as measured by dropout and total number of outpatient visits. The sample (N = 300) was 23.5% Mexican, 22.8% White, 18.1% Black, 17.1% Vietnamese, 16.8% Pilipino, and 1.7% other ethnic group. A culture-compatible approach was found to be effective in increasing utilization. Three culture-compatibility components were the best predictors of dropout status: language match of therapists and clients, ethnic/racial match of therapists and clients, and agency location in the ethnic/racial community. Pharmacotherapy, education, previous treatment and a diagnosis of psychosis were significantly related to remaining in therapy.

Psychology of Work and Unemployment

Abstract: This book is directed at industrial psychologists, human resource managers, consultants and social scientists interested in the psychological effect of employment and unemployment on people. It is an integration of research and theories about this effect. As far as employment is concerned it emphasizes that a significant number of employees have jobs which do not fully use their skills or provide personal satisfaction, and that the long term effects of such jobs include deterioration of employees' self image, personal control, intellectual functioning and social adjustment. The psychological effects are similar in kind to those experienced by people in unemployment - stress, helplessness, fatalism, and the implications for efficiency and motivation at work are serious. The book seeks to do more than give an account of factors affecting or affected by work behaviour - it considers the whole experience of employment, underemployment and unemployment and reviews the current state of our understanding of employment, leisure and retirement, as it relates to work attitudes, goals and performance. The book offers a critique of job design theories and guidance on improving work performance and job satisfaction.

Primary care pediatrics and child psychopathology: a review of diagnostic, treatment, and referral practices.

Abstract: The quality of mental health care for children depends not only on specialist mental health services, but also on how effectively primary care providers identify, treat, and refer children with emotional and behavioral problems. Recent research has shown that primary care practitioners are the sole providers of mental health care to the majority of people with a mental disorder. For example, Regier et al1 calculated that in 1975 54.1% of persons with a mental disorder were treated only in a primary care or outpatient medical setting, with another 6% receiving care from both specialist mental health and primary care medical facilities. An additional 21.5% were not in treatment or received treatment from nonmedical agencies. If the data were extrapolated for all age groups, these rates would imply that only one child in five with a mental disorder is receiving specialist treatment, three are in the care of a pediatrician, and one is receiving no treatment. This would lead to the conclusion that pediatricians are, according to Regier et al,1 the de facto mental health service for most children in need of such care. It would lend support to the drive to increase pediatricians9 awareness of, and training for, the mental health component of their work.2 In this paper, we review the published evidence as it applies to children. SCOPE This review includes the published studies of mental health problems diagnosed by primary care pediatricians, family practitioners, or pediatric nurse practitioners working in outpatient settings in the United States. These include private pediatric practices, group practices, health maintenance organizations (HMOs), and other types of prepaid group practices. The questions addressed are: (1) What proportion of the children seen by primary care pediatricians and their colleagues are diagnosed by them as having a mental disorder? (2) What proportion of children are referred for specialist evaluation and treatment? (3) What risk factors are associated with a higher probability of receiving a diagnosis of psychopathology? (4) How accurate are primary care pediatricians9 diagnoses of mental health problems?

Self-esteem and the psychological impact of unemployment.

Abstract: The study examines the relationship between employment status and self-esteem among highly educated Israeli adults. The self-esteem of employed and unemployed individuals and other variables indicative of their psychological well-being were assessed by questionnaires at two points in time, six months apart. Cross-sectional comparisons and longitudinal analysis show that depressive affect, morale and anxiety are affected by employment status, but, contrary to conventional wisdom, self-esteem is neither sensitive to employment status nor to changes in employment status. It is further shown that self-esteem moderates the relationship between employment status and psychological well-being-the psychological well-being of low self-esteem individuals is more sensitive to employment status than that of high self-esteem individuals. Low self-esteem unemployed individuals also tend to be more flexible in some respects when considering job offers. These findings are more in line with self-consistency theory than with the socio-cognitive approach to the self-concept.

Measuring psychiatric disorder among Southeast Asian refugees.

Abstract: Four measures of mental health – Panic, Depression, Somatization and Well-Being – have been developed for use in a population of Southeast Asian refugees. The scales, a product of work with 1348 refugees, demonstrate conceptual significance, good reliability, concurrent validity and stability of structure across samples. They are culturally sensitive, enabling intra-cultural study as well as screening for clinical purposes. The measures also permit comparisons, for research purposes, with non-Asians.

Sexual Intimacy Between Therapists and Patients

Abstract: Foreword by Harold I. Lief Preface Varieties of Sexual Intimacy and How They Occur Attempts to Recognize, Define, and Address the Problem: Legal, Ethical, and Theoretical Conceptualizations Therapists at Risk Vulnerabilities of Patients Consequences of Therapist-Patient Sexual Intimacy Modalities of Support, Advocacy, Mediation, and Therapy Overall Structuring, Assessment, and the Initial Phase of Treatment Special Principles and Techniques of the Subsequent Therapy Problems and Prospects for Patients Filing Complaints Guidelines for Lawyers Working With Patients Therapist-Patient Sexual Intimacy on Trial: Mental Health Professionals as Expert Witnesses Preventing Therapist-Patient Sexual Involvement Appendix A: Therapists' Checklist Appendix B: Patients' Checklist References/Bibliography Index About the Authors