Tracking children's mental states while solving algebra equations.

PubMed

Anderson, John R; Betts, Shawn; Ferris, Jennifer L; Fincham, Jon M

2012-11-01

Behavioral and function magnetic resonance imagery (fMRI) data were combined to infer the mental states of students as they interacted with an intelligent tutoring system. Sixteen children interacted with a computer tutor for solving linear equations over a six-day period (days 0-5), with days 1 and 5 occurring in an fMRI scanner. Hidden Markov model algorithms combined a model of student behavior with multi-voxel imaging pattern data to predict the mental states of students. We separately assessed the algorithms' ability to predict which step in a problem-solving sequence was performed and whether the step was performed correctly. For day 1, the data patterns of other students were used to predict the mental states of a target student. These predictions were improved on day 5 by adding information about the target student's behavioral and imaging data from day 1. Successful tracking of mental states depended on using the combination of a behavioral model and multi-voxel pattern analysis, illustrating the effectiveness of an integrated approach to tracking the cognition of individuals in real time as they perform complex tasks. Copyright © 2011 Wiley Periodicals, Inc.

The Cambridge Mindreading (CAM) Face-Voice Battery: Testing complex emotion recognition in adults with and without Asperger syndrome.

PubMed

Golan, Ofer; Baron-Cohen, Simon; Hill, Jacqueline

2006-02-01

Adults with Asperger Syndrome (AS) can recognise simple emotions and pass basic theory of mind tasks, but have difficulties recognising more complex emotions and mental states. This study describes a new battery of tasks, testing recognition of 20 complex emotions and mental states from faces and voices. The battery was given to males and females with AS and matched controls. Results showed the AS group performed worse than controls overall, on emotion recognition from faces and voices and on 12/20 specific emotions. Females recognised faces better than males regardless of diagnosis, and males with AS had more difficulties recognising emotions from faces than from voices. The implications of these results are discussed in relation to social functioning in AS.

Nurse Practitioner Independent Practice Authority and Mental Health Service Delivery in U.S. Community Health Centers.

PubMed

Yang, Bo Kyum; Trinkoff, Alison M; Zito, Julie Magno; Burcu, Mehmet; Safer, Daniel J; Storr, Carla L; Johantgen, Mary E; Idzik, Shannon

2017-10-01

Little is known about how nurse practitioner independent practice authority (NP-IPA) influences patient care. This study examined the effect of NP-IPA on patterns of mental health-related visits provided by NPs in U.S. community health centers (CHCs). State NP regulatory information was linked to National Ambulatory Medical Care Survey data on NP- and physician-provided visits (N=61,457) in CHCs from 2006 through 2011. The proportion of NP-provided versus physician-provided mental health-related visits in states with NP-IPA was compared with the proportion in states without NP-IPA. The adjusted odds of mental health-related visits in CHCs provided by NPs in states with and without NP-IPA were compared by using multiple logistic regression models while accounting for the complex survey design. Between 2006 and 2011, the odds of NP- versus physician-provided mental health-related visits in CHCs were more than two times greater in states with NP-IPA than in states with no NP-IPA (adjusted odds ratio [OR]= 2.43, 95% confidence interval [CI]=1.12-4.60). In contrast, no significant difference between states with and without NP-IPA was noted in non-mental health-related CHC visits provided by NPs. Among all mental health-related visits, the odds of visits in which psychotropic medications were prescribed by an NP were more than three times higher in states with NP-IPA than in those without NP-IPA (adjusted OR=3.14, CI=1.50-6.54). Compared with physicians, NPs provided proportionally more CHC mental health-related visits in states with NP-IPA than in states without NP-IPA.

Attractor concretion as a mechanism for the formation of context representations

PubMed Central

Rigotti, Mattia; Ben Dayan Rubin, Daniel; Morrison, Sara E.; Salzman, C. Daniel; Fusi, Stefano

2010-01-01

Complex tasks often require the memory of recent events, the knowledge about the context in which they occur, and the goals we intend to reach. All this information is stored in our mental states. Given a set of mental states, reinforcement learning (RL) algorithms predict the optimal policy that maximizes future reward. RL algorithms assign a value to each already-known state so that discovering the optimal policy reduces to selecting the action leading to the state with the highest value. But how does the brain create representations of these mental states in the first place? We propose a mechanism for the creation of mental states that contain information about the temporal statistics of the events in a particular context. We suggest that the mental states are represented by stable patterns of reverberating activity, which are attractors of the neural dynamics. These representations are built from neurons that are selective to specific combinations of external events (e.g. sensory stimuli) and pre-existent mental states. Consistent with this notion, we find that neurons in the amygdala and in orbito-frontal cortex (OFC) often exhibit this form of mixed selectivity. We propose that activating different mixed selectivity neurons in a fixed temporal order modifies synaptic connections so that conjunctions of events and mental states merge into a single pattern of reverberating activity. This process corresponds to the birth of a new different mental state that encodes a different temporal context. The concretion process depends on temporal contiguity, i.e. on the probability that a combination of an event and mental states follows or precedes the events and states that define a certain context. The information contained in the context thereby allows an animal to assign unambiguously a value to the events that initially appeared in different situations with different meanings. PMID:20100580

Dynamics of Entropy in Quantum-like Model of Decision Making

NASA Astrophysics Data System (ADS)

Basieva, Irina; Khrennikov, Andrei; Asano, Masanari; Ohya, Masanori; Tanaka, Yoshiharu

2011-03-01

We present a quantum-like model of decision making in games of the Prisoner's Dilemma type. By this model the brain processes information by using representation of mental states in complex Hilbert space. Driven by the master equation the mental state of a player, say Alice, approaches an equilibrium point in the space of density matrices. By using this equilibrium point Alice determines her mixed (i.e., probabilistic) strategy with respect to Bob. Thus our model is a model of thinking through decoherence of initially pure mental state. Decoherence is induced by interaction with memory and external environment. In this paper we study (numerically) dynamics of quantum entropy of Alice's state in the process of decision making. Our analysis demonstrates that this dynamics depends nontrivially on the initial state of Alice's mind on her own actions and her prediction state (for possible actions of Bob.)

Using Fiction to Assess Mental State Understanding: A New Task for Assessing Theory of Mind in Adults

PubMed Central

Dodell-Feder, David; Lincoln, Sarah Hope; Coulson, Joseph P.; Hooker, Christine I.

2013-01-01

Social functioning depends on the ability to attribute and reason about the mental states of others – an ability known as theory of mind (ToM). Research in this field is limited by the use of tasks in which ceiling effects are ubiquitous, rendering them insensitive to individual differences in ToM ability and instances of subtle ToM impairment. Here, we present data from a new ToM task – the Short Story Task (SST) - intended to improve upon many aspects of existing ToM measures. More specifically, the SST was designed to: (a) assess the full range of individual differences in ToM ability without suffering from ceiling effects; (b) incorporate a range of mental states of differing complexity, including epistemic states, affective states, and intentions to be inferred from a first- and second-order level; (c) use ToM stimuli representative of real-world social interactions; (d) require participants to utilize social context when making mental state inferences; (e) exhibit adequate psychometric properties; and (f) be quick and easy to administer and score. In the task, participants read a short story and were asked questions that assessed explicit mental state reasoning, spontaneous mental state inference, and comprehension of the non-mental aspects of the story. Responses were scored according to a rubric that assigned greater points for accurate mental state attributions that included multiple characters’ mental states. Results demonstrate that the SST is sensitive to variation in ToM ability, can be accurately scored by multiple raters, and exhibits concurrent validity with other social cognitive tasks. The results support the effectiveness of this new measure of ToM in the study of social cognition. The findings are also consistent with studies demonstrating significant relationships among narrative transportation, ToM, and the reading of fiction. Together, the data indicate that reading fiction may be an avenue for improving ToM ability. PMID:24244736

Automatic Detection of Student Mental Models Based on Natural Language Student Input during Metacognitive Skill Training

ERIC Educational Resources Information Center

Lintean, Mihai; Rus, Vasile; Azevedo, Roger

2012-01-01

This article describes the problem of detecting the student mental models, i.e. students' knowledge states, during the self-regulatory activity of prior knowledge activation in MetaTutor, an intelligent tutoring system that teaches students self-regulation skills while learning complex science topics. The article presents several approaches to…

Individual differences in the spontaneous recruitment of brain regions supporting mental state understanding when viewing natural social scenes.

PubMed

Wagner, Dylan D; Kelley, William M; Heatherton, Todd F

2011-12-01

People are able to rapidly infer complex personality traits and mental states even from the most minimal person information. Research has shown that when observers view a natural scene containing people, they spend a disproportionate amount of their time looking at the social features (e.g., faces, bodies). Does this preference for social features merely reflect the biological salience of these features or are observers spontaneously attempting to make sense of complex social dynamics? Using functional neuroimaging, we investigated neural responses to social and nonsocial visual scenes in a large sample of participants (n = 48) who varied on an individual difference measure assessing empathy and mentalizing (i.e., empathizing). Compared with other scene categories, viewing natural social scenes activated regions associated with social cognition (e.g., dorsomedial prefrontal cortex and temporal poles). Moreover, activity in these regions during social scene viewing was strongly correlated with individual differences in empathizing. These findings offer neural evidence that observers spontaneously engage in social cognition when viewing complex social material but that the degree to which people do so is mediated by individual differences in trait empathizing.

Privatized managed care and forensic mental health services.

PubMed

Packer, I K

1998-01-01

Managed care for mental health services, which began in the private, commercial sector, has spread over the past few years to the public mental health sector as well. Recently, states have begun considering whether to include the forensic population within their privatized managed care systems. This article explores some of the complexities and special challenges unique to forensic services and notes some of the problems that might be incurred if the forensic population were included in a managed care system.

An experimental investigation of mentalization ability in borderline personality disorder.

PubMed

Petersen, Robyn; Brakoulias, Vlasios; Langdon, Robyn

2016-01-01

Deficits in mentalization ability have been theorized to underlie borderline personality disorder (BPD) and have led to mentalization-based treatments. Yet there has been little empirical investigation into whether mentalization deficits do differentiate the BPD population from healthy controls, and the specific nature of these differences. Five pre-existing Theory of Mind (ToM) tasks that assessed simple to complex mentalization capacity in both the affective and cognitive domains were administered to the same groups of age and gender matched patients with BPD and controls. Self-report measures assessed cognitive and affective empathy and childhood trauma and abuse. The BPD group did not differ significantly from the healthy control group on basic cognitive false-belief picture-sequencing tasks, or on overall accuracy when discriminating mental states from viewing images of eyes, and attributing emotions based on social events. They were, however, significantly less accurate in identifying positive mental states on the Reading the Mind in the Eyes (RME) task and showed significantly more mentalization errors on affective and cognitive understanding of faux pas (faux pas total score p<.01) and on a Joke Appreciation task (p=.01), that required integration of multiple perspectives. They also self-reported less empathic perspective taking (p<.01). Observation of patterns of performance hinted at specific underlying biases (e.g. a default tendency to use superficial black-and-white attributions to others, such as, "he is mean", when explaining behavior). It was also found that as childhood experiences of punishment increased, adulthood mentalization ability decreased on all affective ToM tasks and on the cognitive and affective components of understanding faux pas. The BPD group was as capable as controls in undertaking simple mentalization. However, deficits in mentalization capacity became evident when mentalization tasks became more complex and required the integration of multiple perspectives. Increasing childhood experiences of punishment were related to decreasing mentalization ability in adulthood. Findings support the use of treatments to improve mentalization skills in BPD, however, further research is needed to better specify the nature of underlying mentalizing biases in this population. Copyright © 2015 Elsevier Inc. All rights reserved.

Anomalous subjective experience and psychosis risk in young depressed patients.

PubMed

Szily, Erika; Kéri, Szabolcs

2009-01-01

Help-seeking young people often display depressive symptoms. In some patients, these symptoms may co-exist with clinically high-risk mental states for psychosis. The aim of this study was to determine differences in subjective experience and social perception in young depressed patients with and without psychosis risk. Participants were 68 young persons with major depressive disorder. Twenty-six patients also met the criteria of attenuated or brief limited intermittent psychotic symptoms according to the Comprehensive Assessment of At Risk Mental States (CAARMS) criteria. Subjective experiences were assessed with the Bonn Scale for the Assessment of Basic Symptoms (BSABS). Recognition of complex social emotions and mental states was assessed using the 'Reading the Mind in the Eyes' test. Perplexity, self-disorder, and diminished affectivity significantly predicted psychosis risk. Depressed patients without psychosis risk displayed impaired recognition performance for negative social emotions, whereas patients with psychosis risk were also impaired in the recognition of cognitive expressions. In the high-risk group, self-disorder was associated with impaired recognition of facial expressions. These results suggest that anomalous subjective experience and impaired recognition of complex emotions may differentiate between young depressed patients with and without psychosis risk. 2009 S. Karger AG, Basel.

[Double diagnosis and forensic psychiatric opinion].

PubMed

Kocur, Józef; Trendak, Wiesława

2009-01-01

Addiction to alcohol or any other psychoactive substance can run parallel with other diseases or mental disorders. One can then observe co-occurrence and mutual interaction of dysfunctions typical of addiction and of other mental disorders that accompany addiction. That is why, clinical pictures of such states (double diagnosis) are usually less unique, have an unusual course and cause diagnostic and therapeutic difficulty. The problem of forensic psychiatric opinion and treatment of people with a double diagnosis is another aspect of these difficulties. It is caused by the fact that forensic psychiatric assessment of the mental state of such people requires taking into consideration a very complex clinical and legal situation triggered by the interference of various ethiopathogenetic and clinical disorders. It leads to the need for complex evaluation and reference to sanity or other signs of functioning within the current law should result, first of all, from the analyses directly pertaining to the influence of the diagnosed disorders on the state of patients with double diagnosis. The forensic psychiatric aspect of disorders connected with double diagnosis is particularly significant as there is a relatively high risk of behaviours posing a threat to public order in this group of patients.

Perceptions of Intentionality for Goal-Related Action: Behavioral Description Matters

PubMed Central

Monroe, Andrew E.; Reeder, Glenn D.; James, Lauren

2015-01-01

Perceptions of intentionality critically guide everyday social interactions, though the literature provides diverging portraits of how such judgments are made. One view suggests that people have an "intentionality bias," predisposing them toward labeling behaviors as intentional. A second view focuses on a more complex pattern of reasoning whereby judgments of intentionality are shaped by information about social context and mental states. Drawing on the theory of action-identification, we attempt to integrate these two perspectives. We propose that people parse intentionality into two categories: judgments about concrete, low-level behaviors and judgments about relatively more abstract, high-level behaviors. Evidence from five studies supports this distinction. Low-level behaviors were perceived as intentional regardless of mental state information, supporting the “intentionality bias” view. In contrast, judgments about the intentionality of high-level behaviors varied depending on social context and mental states, supporting the systematic view of intentionality. PMID:25781315

When will Little Red Riding Hood become scared? Children's attribution of mental states to a story character.

PubMed

Ronfard, Samuel; Harris, Paul L

2014-01-01

As children listen to a simple action-based narrative, they construct a dynamic representation of the protagonist's movements, visual perspective, and goal-directed thoughts. We examined children's representations of more complex narratives in which the protagonist will encounter an unexpected outcome upon reaching his or her goal. Three studies involving 105 children between 3 and 6 years of age showed that children shifted in the mental states they attributed depending on the distance of the protagonist from the unexpected outcome. Even though children consistently recognized that the protagonist did not know about the surprise at any point, they increasingly attributed feelings and thoughts consistent with the surprise. The studies highlight the degree to which children's mental state attributions are dynamic rather than fixed by their current theory of mind. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Foster and Adoptive Parent Perspectives on Needs and Services: a Mixed Methods Study.

PubMed

Barnett, Erin R; Jankowski, Mary K; Butcher, Rebecca L; Meister, Catherine; Parton, Rebecca R; Drake, Robert E

2018-01-01

Caring for children with complex needs severely stresses foster and adoptive parents, but few studies have examined their perspectives on needs and services. To examine parental views, the authors analyzed four focus groups (n = 27 participants) and one state-wide survey (n = 512 respondents, 42% of 1206 contacted) of foster and adoptive parents in one state. Results highlighted inadequate communication between providers and families, cultural and legal barriers, needs for parent training and preparation, the importance of several types of parent supports, and needs for specialized mental health treatment for the children. Surveyed parents identified children's behavior problems as their top challenge, and over half rated the availability of mental health providers who treat attachment and family as insufficient. The findings suggest specific areas in which state leaders could enhance training and supports for child welfare staff and foster and adoptive parents and improve mental health services for children in foster and adoptive care.

Are plants sentient?

PubMed

Calvo, Paco; Sahi, Vaidurya Pratap; Trewavas, Anthony

2017-11-01

Feelings in humans are mental states representing groups of physiological functions that usually have defined behavioural purposes. Feelings, being evolutionarily ancient, are thought to be coordinated in the brain stem of animals. One function of the brain is to prioritise between competing mental states and, thus, groups of physiological functions and in turn behaviour. Plants use groups of coordinated physiological activities to deal with defined environmental situations but currently have no known mental state to prioritise any order of response. Plants do have a nervous system based on action potentials transmitted along phloem conduits but which in addition, through anastomoses and other cross-links, forms a complex network. The emergent potential for this excitable network to form a mental state is unknown, but it might be used to distinguish between different and even contradictory signals to the individual plant and thus determine a priority of response. This plant nervous system stretches throughout the whole plant providing the potential for assessment in all parts and commensurate with its self-organising, phenotypically plastic behaviour. Plasticity may, in turn, depend heavily on the instructive capabilities of local bioelectric fields enabling both a degree of behavioural independence but influenced by the condition of the whole plant. © 2017 John Wiley & Sons Ltd.

Gun Violence, mental health, and Connecticut physicians.

PubMed

Dodds, Peter R; Anderson, Caitlyn O; Dodds, Jon H

2014-01-01

While there is a public perception that gun violence is associated with mental illness we present evidence that it is a complex public health problem which defies simple characterizations and solutions. Only a small percentage of individuals with mental illness are at risk for extreme violence and they account for only a small percentage of gun-related homicides. Individuals who are at risk for gun violence are difficult to identify and successfully treat. The incidence, and perhaps the demographics, of gun violence vary substantially from state to state. We make a case for Connecticut physicians to study gun violence at the state level. We recommend that Connecticut physicians promote and expand upon the American Academy of Pediatrics' recommendation for creating a "safe home environment. "We suggest that guns be secured in all homes in which there are children. In addition we suggest that guns be voluntarily removed from homes in which there are individuals with a history of violence, threats of violence, depression, drug and/or alcohol abuse, and individuals with major mental illnesses who are not cooperating with therapy.

Exploring the underlying structure of mental disorders: cross-diagnostic differences and similarities from a network perspective using both a top-down and a bottom-up approach.

PubMed

Wigman, J T W; van Os, J; Borsboom, D; Wardenaar, K J; Epskamp, S; Klippel, A; Viechtbauer, W; Myin-Germeys, I; Wichers, M

2015-08-01

It has been suggested that the structure of psychopathology is best described as a complex network of components that interact in dynamic ways. The goal of the present paper was to examine the concept of psychopathology from a network perspective, combining complementary top-down and bottom-up approaches using momentary assessment techniques. A pooled Experience Sampling Method (ESM) dataset of three groups (individuals with a diagnosis of depression, psychotic disorder or no diagnosis) was used (pooled N = 599). The top-down approach explored the network structure of mental states across different diagnostic categories. For this purpose, networks of five momentary mental states ('cheerful', 'content', 'down', 'insecure' and 'suspicious') were compared between the three groups. The complementary bottom-up approach used principal component analysis to explore whether empirically derived network structures yield meaningful higher order clusters. Individuals with a clinical diagnosis had more strongly connected moment-to-moment network structures, especially the depressed group. This group also showed more interconnections specifically between positive and negative mental states than the psychotic group. In the bottom-up approach, all possible connections between mental states were clustered into seven main components that together captured the main characteristics of the network dynamics. Our combination of (i) comparing network structure of mental states across three diagnostically different groups and (ii) searching for trans-diagnostic network components across all pooled individuals showed that these two approaches yield different, complementary perspectives in the field of psychopathology. The network paradigm therefore may be useful to map transdiagnostic processes.

Self-Processing and the Default Mode Network: Interactions with the Mirror Neuron System

PubMed Central

Molnar-Szakacs, Istvan; Uddin, Lucina Q.

2013-01-01

Recent evidence for the fractionation of the default mode network (DMN) into functionally distinguishable subdivisions with unique patterns of connectivity calls for a reconceptualization of the relationship between this network and self-referential processing. Advances in resting-state functional connectivity analyses are beginning to reveal increasingly complex patterns of organization within the key nodes of the DMN – medial prefrontal cortex and posterior cingulate cortex – as well as between these nodes and other brain systems. Here we review recent examinations of the relationships between the DMN and various aspects of self-relevant and social-cognitive processing in light of emerging evidence for heterogeneity within this network. Drawing from a rapidly evolving social-cognitive neuroscience literature, we propose that embodied simulation and mentalizing are processes which allow us to gain insight into another’s physical and mental state by providing privileged access to our own physical and mental states. Embodiment implies that the same neural systems are engaged for self- and other-understanding through a simulation mechanism, while mentalizing refers to the use of high-level conceptual information to make inferences about the mental states of self and others. These mechanisms work together to provide a coherent representation of the self and by extension, of others. Nodes of the DMN selectively interact with brain systems for embodiment and mentalizing, including the mirror neuron system, to produce appropriate mappings in the service of social-cognitive demands. PMID:24062671

Epilepsy, Mental Health Disorder, or Both?

PubMed Central

Beletsky, Vadim; Mirsattari, Seyed M.

2012-01-01

Temporal lobe epilepsy (TLE), a subset of the seizure disorder family, represents a complex neuropsychiatric illness, where the neurological presentation may be complemented by varying severity of affective, behavioral, psychotic, or personality abnormalities, which, in turn, may not only lead to misdiagnosis, but also affect the management. This paper outlines a spectrum of mental health presentations, including psychosis, mood, anxiety, panic, and dissociative states, associated with epilepsy that make the correct diagnosis a challenge. PMID:22934158

State of science: mental workload in ergonomics.

PubMed

Young, Mark S; Brookhuis, Karel A; Wickens, Christopher D; Hancock, Peter A

2015-01-01

Mental workload (MWL) is one of the most widely used concepts in ergonomics and human factors and represents a topic of increasing importance. Since modern technology in many working environments imposes ever more cognitive demands upon operators while physical demands diminish, understanding how MWL impinges on performance is increasingly critical. Yet, MWL is also one of the most nebulous concepts, with numerous definitions and dimensions associated with it. Moreover, MWL research has had a tendency to focus on complex, often safety-critical systems (e.g. transport, process control). Here we provide a general overview of the current state of affairs regarding the understanding, measurement and application of MWL in the design of complex systems over the last three decades. We conclude by discussing contemporary challenges for applied research, such as the interaction between cognitive workload and physical workload, and the quantification of workload 'redlines' which specify when operators are approaching or exceeding their performance tolerances.

Unravelling the differences between complexity and frailty in old age: findings from a constructivist grounded theory study.

PubMed

McGeorge, S J

2011-02-01

UK health policy has used the terms 'frailty' and 'complexity' synonymously but there is no common definition for either. Understanding these concepts is important if demand for health care created by the increasing number of older people in society is to be managed effectively. This paper explores some findings from a study into how mental health nurses who work with older people construct and operationalize the concept of 'age-related complexity'. Constructivist grounded theory was used. Audio-taped interviews were undertaken with 13 registered nurses and were analysed using a constant comparative method. This paper addresses the relationship between frailty and complexity, which was identified as a theme within the category 'dynamic complexity'. The findings suggest that nurses understand important differences between the two concepts. Frailty is exclusively used to describe physical states while complexity is a more encompassing term that has resonance and relevance in mental health services. The dynamic nature of complexity means that older people can become both more and less complex and this has implications for nursing practice that require further study. © 2010 Blackwell Publishing.

Public mental health crisis management and Section 136 of the Mental Health Act.

PubMed

O'Brien, Aileen; Sethi, Faisil; Smith, Mark; Bartlett, Annie

2018-05-01

The interface between mental health services and the criminal justice system presents challenges both for professionals and patients. Both systems are stressed and inherently complex. Section 136 of the Mental Health Act is unusual being both an aspect of the Mental Health Act and a power of arrest. It has a long and controversial history related to concerns about who has been detained and how the section was applied. More recently, Section 136 has had a public profile stemming from the use of police cells as places of safety for young, mentally disturbed individuals. This paper explores the current state of health of this piece of legislation. Specifically, we consider whether alternative approaches are more suitable for those individuals in crisis and/or distress who come into contact with the police. This requires careful thought as to the proper role of both health and criminal justice professionals who are daily grappling with an ethically contentious domain of multiagency work. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Neural Correlates of Emotional Prosody Comprehension: Disentangling Simple from Complex Emotion

PubMed Central

Alba-Ferrara, Lucy; Hausmann, Markus; Mitchell, Rachel L.; Weis, Susanne

2011-01-01

Background Emotional prosody comprehension (EPC), the ability to interpret another person's feelings by listening to their tone of voice, is crucial for effective social communication. Previous studies assessing the neural correlates of EPC have found inconsistent results, particularly regarding the involvement of the medial prefrontal cortex (mPFC). It remained unclear whether the involvement of the mPFC is linked to an increased demand in socio-cognitive components of EPC such as mental state attribution and if basic perceptual processing of EPC can be performed without the contribution of this region. Methods fMRI was used to delineate neural activity during the perception of prosodic stimuli conveying simple and complex emotion. Emotional trials in general, as compared to neutral ones, activated a network comprising temporal and lateral frontal brain regions, while complex emotion trials specifically showed an additional involvement of the mPFC, premotor cortex, frontal operculum and left insula. Conclusion These results indicate that the mPFC and premotor areas might be associated, but are not crucial to EPC. However, the mPFC supports socio-cognitive skills necessary to interpret complex emotion such as inferring mental states. Additionally, the premotor cortex involvement may reflect the participation of the mirror neuron system for prosody processing particularly of complex emotion. PMID:22174872

Animal health and welfare: equivalent or complementary?

PubMed

Nicks, B; Vandenheede, M

2014-04-01

The concepts of 'health' and 'welfare', whether applied to humans or animals, are increasingly becoming linked. But are they really indissociable, or even synonymous? Although human health is generally defined as a complete state of physical, mental and social well-being, animal health is still considered as simply the absence of disease. However, recent advances in scientific knowledge are forcing us to revise our ideas about the mental complexity of animals and to recognise their ability to feel emotions and to have needs and a degree of consciousness. The precise objective of animal welfare science is to study their mental states and their ability to adapt to domestication. Pending a global application of this concept of health, including mental health, to animals as well as to humans, the idea of welfare remains an important element in addition to traditional health concerns. More generally, this linkage fuels the ethical debate about the ways in which people use animals, prompting society to change its stance on some aspects of the issue.

Brain mechanisms underlying the impact of attachment-related stress on social cognition

PubMed Central

Nolte, Tobias; Bolling, Danielle Z.; Hudac, Caitlin M.; Fonagy, Peter; Mayes, Linda; Pelphrey, Kevin A.

2013-01-01

Mentalizing, in particular the successful attribution of complex mental states to others, is crucial for navigating social interactions. This ability is highly influenced by external factors within one's daily life, such as stress. We investigated the impact of stress on the brain basis of mentalization in adults. Using a novel modification of the Reading the Mind in the Eyes Test (RMET-R) we compared the differential effects of two personalized stress induction procedures: a general stress induction (GSI) and an attachment-related stress induction (ASI). Participants performed the RMET-R at baseline and after each of the two inductions. Baseline results replicated and extended previous findings regarding the neural correlates of the RMET-R. Additionally, we identified brain regions associated with making complex age judgments from the same stimuli. Results after stress exposure showed that the ASI condition resulted in reduced mentalization-related activation in the left posterior superior temporal sulcus (STS), left inferior frontal gyrus and left temporoparietal junction (TPJ). Moreover, the left middle frontal gyrus and left anterior insula showed greater functional connectivity to the left posterior STS after the ASI. Our findings indicate that attachment-related stress has a unique effect on the neural correlates of mentalization. PMID:24348364

Heartbeat Complexity Modulation in Bipolar Disorder during Daytime and Nighttime.

PubMed

Nardelli, Mimma; Lanata, Antonio; Bertschy, Gilles; Scilingo, Enzo Pasquale; Valenza, Gaetano

2017-12-20

This study reports on the complexity modulation of heartbeat dynamics in patients affected by bipolar disorder. In particular, a multiscale entropy analysis was applied to the R-R interval series, that were derived from electrocardiographic (ECG) signals for a group of nineteen subjects comprised of eight patients and eleven healthy control subjects. They were monitored using a textile-based sensorized t-shirt during the day and overnight for a total of 47 diurnal and 27 nocturnal recordings. Patients showed three different mood states: depression, hypomania and euthymia. Results show a clear loss of complexity during depressive and hypomanic states as compared to euthymic and healthy control states. In addition, we observed that a more significant complexity modulation among healthy and pathological mood states occurs during the night. These findings suggest that bipolar disorder is associated with an enhanced sleep-related dysregulation of the Autonomic Nervous System (ANS) activity, and that heartbeat complex dynamics may serve as a viable marker of pathological conditions in mental health.

A controlled trial of implementing a complex mental health intervention for carers of vulnerable young people living in out-of-home care: the ripple project.

PubMed

Herrman, Helen; Humphreys, Cathy; Halperin, Stephen; Monson, Katherine; Harvey, Carol; Mihalopoulos, Cathrine; Cotton, Susan; Mitchell, Penelope; Glynn, Tony; Magnus, Anne; Murray, Lenice; Szwarc, Josef; Davis, Elise; Havighurst, Sophie; McGorry, Patrick; Tyano, Sam; Kaplan, Ida; Rice, Simon; Moeller-Saxone, Kristen

2016-12-07

Out-of-home care (OoHC) refers to young people removed from their families by the state because of abuse, neglect or other adversities. Many of the young people experience poor mental health and social function before, during and after leaving care. Rigorously evaluated interventions are urgently required. This publication describes the protocol for the Ripple project and notes early findings from a controlled trial demonstrating the feasibility of the work. The Ripple project is implementing and evaluating a complex mental health intervention that aims to strengthen the therapeutic capacities of carers and case managers of young people (12-17 years) in OoHC. The study is conducted in partnership with mental health, substance abuse and social services in Melbourne, with young people as participants. It has three parts: 1. Needs assessment and implementation of a complex mental health intervention; 2. A 3-year controlled trial of the mental health, social and economic outcomes; and 3. Nested process evaluation of the intervention. Early findings characterising the young people, their carers and case managers and implementing the intervention are available. The trial Wave 1 includes interviews with 176 young people, 52% of those eligible in the study population, 104 carers and 79 case managers. Implementing and researching an affordable service system intervention appears feasible and likely to be applicable in other places and countries. Success of the intervention will potentially contribute to reducing mental ill-health among these young people, including suicide attempts, self-harm and substance abuse, as well as reducing homelessness, social isolation and contact with the criminal justice system. Australian New Zealand Clinical Trials Registry ACTRN12615000501549 . Retrospectively registered 19 May 2015.

Neural imaging to track mental states while using an intelligent tutoring system.

PubMed

Anderson, John R; Betts, Shawn; Ferris, Jennifer L; Fincham, Jon M

2010-04-13

Hemodynamic measures of brain activity can be used to interpret a student's mental state when they are interacting with an intelligent tutoring system. Functional magnetic resonance imaging (fMRI) data were collected while students worked with a tutoring system that taught an algebra isomorph. A cognitive model predicted the distribution of solution times from measures of problem complexity. Separately, a linear discriminant analysis used fMRI data to predict whether or not students were engaged in problem solving. A hidden Markov algorithm merged these two sources of information to predict the mental states of students during problem-solving episodes. The algorithm was trained on data from 1 day of interaction and tested with data from a later day. In terms of predicting what state a student was in during a 2-s period, the algorithm achieved 87% accuracy on the training data and 83% accuracy on the test data. The results illustrate the importance of integrating the bottom-up information from imaging data with the top-down information from a cognitive model.

Sex differences in mental rotation with polygons of different complexity: Do men utilize holistic processes whereas women prefer piecemeal ones?

PubMed

Heil, Martin; Jansen-Osmann, Petra

2008-05-01

Sex differences in mental rotation were investigated as a function of stimulus complexity with a sample size of N = 72. Replicating earlier findings with polygons, mental rotation was faster for males than for females, and reaction time increased with more complex polygons. Additionally, sex differences increased for complex polygons. Most importantly, however, mental rotation speed decreased with increasing complexity for women but did not change for men. Thus, the sex effects reflect a difference in strategy, with women mentally rotating the polygons in an analytic, piecemeal fashion and men using a holistic mode of mental rotation.

[Terrorism and mental health (problem's scale, population tolerance, management of care)].

PubMed

Iastrebov, V S

2004-01-01

The consequences of terrorist threat and terrorist acts for mental health of the individual, groups of individuals and community in general are analyzed. Mental disorders emerging in the victims of terrorism is described. The problem of terrorist threats use as a psychic weapon is discussed. Tolerance of population to terrorism can be divided into two types--psychophysiological and socio-psychological. The ways for elevating tolerability to terrorist threat and terrorist acts are suggested. Help in the centers of terrorist act must be of the complex character, being provided by different specialists including psychologists and psychiatrists. The importance of state structures and community support in this work is emphasized.

Law & psychiatry: mental retardation and the death penalty: after Atkins.

PubMed

Appelbaum, Paul S

2009-10-01

In Atkins v. Virginia the U.S. Supreme Court declared execution of persons with mental retardation to constitute cruel and unusual punishment, and thus to be unconstitutional under the Eighth Amendment. However, the Court left all considerations regarding how to implement the decision explicitly to the states. Since Atkins was decided in 2002, legislatures, courts, and mental health experts have struggled with its implementation, highlighting the complexities that can arise when the courts base legal rules on clinical findings. This column reviews the Atkins case and considers the challenges associated with a clinical determination that can have life-or-death consequences for capital defendants.

Preventing Persons Affected by Serious Mental Illnesses from Obtaining Firearms: The Evolution of Law, Policy, and Practice in Massachusetts.

PubMed

Silver, James; Fisher, William H; Silver, Emily

2015-06-01

A history of commitment to a mental health facility disqualifies applicants for gun licenses. Identifying such a history has become increasingly complex as the locus of confinement has become more diversified and privatized. In Massachusetts, prior to 2014, the databases used to identify individuals who would be disqualified on such grounds had not contemporaneously matched the evolution of the state's mental health systems. A survey of Massachusetts police chiefs, who, as in many jurisdictions, are charged with certifying qualification, indicates that some have broadened the scope of their background checks to include the experience of their officers with respect to certain applicants. The survey identifying these patterns, conducted in 2014, preceded by one month significant legislative reforms that mandate the modification of the reporting into a centralized database commitments to all types of mental health and substance use facilities, thus allowing identification of all commitments occurring in the state. The anticipated utilization of a different database mechanism, which has parallels in several other states, potentially streamlines the background check process, but raises numerous concerns that need to be addressed in developing and using such databases. Copyright © 2015 John Wiley & Sons, Ltd.

Bridging consciousness and cognition in memory and perception: evidence for both state and strength processes.

PubMed

Aly, Mariam; Yonelinas, Andrew P

2012-01-01

Subjective experience indicates that mental states are discrete, in the sense that memories and perceptions readily come to mind in some cases, but are entirely unavailable to awareness in others. However, a long history of psychophysical research has indicated that the discrete nature of mental states is largely epiphenomenal and that mental processes vary continuously in strength. We used a novel combination of behavioral methodologies to examine the processes underlying perception of complex images: (1) analysis of receiver operating characteristics (ROCs), (2) a modification of the change-detection flicker paradigm, and (3) subjective reports of conscious experience. These methods yielded converging results showing that perceptual judgments reflect the combined, yet functionally independent, contributions of two processes available to conscious experience: a state process of conscious perception and a strength process of knowing; processes that correspond to recollection and familiarity in long-term memory. In addition, insights from the perception experiments led to the discovery of a new recollection phenomenon in a long-term memory change detection paradigm. The apparent incompatibility between subjective experience and theories of cognition can be understood within a unified state-strength framework that links consciousness to cognition across the domains of perception and memory.

Bridging Consciousness and Cognition in Memory and Perception: Evidence for Both State and Strength Processes

PubMed Central

Aly, Mariam; Yonelinas, Andrew P.

2012-01-01

Subjective experience indicates that mental states are discrete, in the sense that memories and perceptions readily come to mind in some cases, but are entirely unavailable to awareness in others. However, a long history of psychophysical research has indicated that the discrete nature of mental states is largely epiphenomenal and that mental processes vary continuously in strength. We used a novel combination of behavioral methodologies to examine the processes underlying perception of complex images: (1) analysis of receiver operating characteristics (ROCs), (2) a modification of the change-detection flicker paradigm, and (3) subjective reports of conscious experience. These methods yielded converging results showing that perceptual judgments reflect the combined, yet functionally independent, contributions of two processes available to conscious experience: a state process of conscious perception and a strength process of knowing; processes that correspond to recollection and familiarity in long-term memory. In addition, insights from the perception experiments led to the discovery of a new recollection phenomenon in a long-term memory change detection paradigm. The apparent incompatibility between subjective experience and theories of cognition can be understood within a unified state-strength framework that links consciousness to cognition across the domains of perception and memory. PMID:22272314

Personality and its Relation to Mental and Psychosocial Health in Emerging Adult Sexual Minority Men: The P18 Cohort Study.

PubMed

D'Avanzo, Paul A; Barton, Staci C; Kapadia, Farzana; Halkitis, Perry N

2017-01-01

Personality disorder and personality pathology encompass a dimension of psychological dysfunction known to severely impact multiple domains of functioning. However, there is a notable dearth of research regarding both the pervasiveness and correlates of personality pathology among young sexual minority males who themselves experience heightened mental health burdens. Using the self-report version of the Standardized Assessment of Personality-Abbreviated Scale we tested associations between distinct personality characteristics with sociodemographic and psychosocial factors as well as mental health states in a sample of 528 young (aged 21-25 years) sexual minority men. In multivariate analysis, personality traits varied significantly by race/ethnicity. Personality traits were also positively associated with psychosocial states, specifically, internalized anti-homosexual bias, level of connection with the gay community, and male body dissatisfaction, as well as mental health in the form of recent depressive and anxious symptomatology. These findings support the complex synergy which exists between personality characteristics, psychosocial conditions, and mental health burdens present among sexual minority men and support the need for an all-encompassing approach to both the study and care of this population that addresses the influences of both internal and external factors on well-being.

Intraocular pressure is sensitive to cumulative and instantaneous mental workload.

PubMed

Vera, Jesús; Jiménez, Raimundo; García, José Antonio; Cárdenas, David

2017-04-01

We used a repeated-measures design to assess the impact of mental-task complexity on intraocular pressure (IOP). Fourteen participants performed three continuous 11-min blocks of a mental-workload task (3-back) and an oddball version of this task. Also, heart-rate variability (HRV), cognitive-performance scores, and subjective measure of mental load (NASA-TLX) were determined. IOP was taken before each block and afterwards as well as after recovery from mental tasks. We found that IOP increased during heavy mental workloads (p < 0.01). Consistent with this finding, the autonomic control (HRV) and the cognitive performance were significantly lower (p < 0.045, and p < 0.01, respectively), and the NASA-TLX scores were higher during the 3-back task (p < 0.01). We conclude that IOP is sensitive to mental workload, and it could provide a novel neuroergonomic tool to assess mental workload. Our study highlights a potential association between IOP and the nervous system's state of activation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ethnic differences in mental illness and mental health service use among Black fathers.

PubMed

Doyle, Otima; Joe, Sean; Caldwell, Cleopatra H

2012-05-01

We have presented nationally representative data on the prevalence and correlates of mental illness and mental health service use among African American and Caribbean Black (US-born and foreign-born) fathers in the United States. We have reported national estimates of lifetime and 12-month prevalence rates of mental illness, correlates, and service use among African American (n = 1254) and Caribbean Black (n = 633) fathers using data from the National Survey of American Life, a national household survey of Black Americans. We used bivariate cross-tabulations and Cox proportional hazards regression approaches and adjusted for the National Survey of American Life's complex sample design. The prevalence of mental illness, sociodemographic correlates, and service use among Black fathers varied by ethnicity and nativity. US-born Caribbean Black fathers had alarmingly high rates of most disorders, including depression, anxiety, and substance disorders. Mental health service use was particularly low for African American and foreign-born Caribbean Black fathers. These results demonstrate the need for more research on the causes and consequences of mental illness and the help-seeking behavior of ethnically diverse Black fathers.

Moral Development, HIV/AIDS Knowledge, and Attitude toward HIV/AIDS among Counseling Students in the United States

ERIC Educational Resources Information Center

Joe, J. Richelle; Foster, Victoria A.

2017-01-01

People living with HIV/AIDS will likely require services from mental health professionals to address the complex psychosocial effects of the illness. In the United States, counseling students are not likely to be well prepared to serve clients affected by HIV/AIDS, and little is known about their HIV-related knowledge and attitudes. The present…

Mental Capacity Assessments Among Inpatients Referred to the Consultation-Liaison Psychiatry Unit at a University Hospital in Bangkok, Thailand.

PubMed

Pariwatcharakul, Pornjira; Singhakant, Supachoke

2017-03-01

Clinicians routinely assess patients' mental capacity on a daily basis, but a more thorough assessment may be needed in complex cases. We aimed to identify the characteristics of inpatients in a general hospital, who were referred to a liaison psychiatry service for mental capacity assessment, reasons for the referrals, and the factors associated with their mental capacity. A 6-year retrospective study (2008-2013) was conducted using data collected routinely (e.g., age, gender, diagnosis, Thai Mental State Examination score, reasons for the referral, and the outcome of capacity assessment) on referrals for mental capacity assessment to a Consultation-liaison Psychiatry Unit at a university hospital in Thailand. Among 6194 consecutive referrals to the liaison-psychiatry services, only 0.6 % [n = 37, mean age (SD), 59.83 (20.42)] were referred for capacity assessment, 43.24 % of which lacked mental capacity. The most common requests from referring physicians were for assessment of testamentary capacity (15 assessed, 53.33 % lacking capacity), financial management capacity (14 assessed, 50 % lacking capacity), and capacity to consent to treatment (9 assessed, 22.22 % lacking capacity). Delirium, rather than dementia or other mental disorders, was associated with mental incapacity (p < 0.001) and being more dependent during the admission (p = 0.048). There were no significant differences for mean age (p = 0.257) or Thai Mental State Examination score (p = 0.206). The main request from referring clinicians was to assess testamentary capacity. Delirium and being more dependent during the admission were associated with lack of mental capacity, whereas age and dementia were not.

Self-transcending meditation is good for mental health: why this should be the case.

PubMed

Hankey, Alex; Shetkar, Rashmi

2016-06-01

A simple theory of health has recently been proposed: while poor quality regulation corresponds to poor quality health so that improving regulation should improve health, optimal regulation optimizes function and optimizes health. Examining the term 'optimal regulation' in biological systems leads to a straightforward definition in terms of 'criticality' in complexity biology, a concept that seems to apply universally throughout biology. Criticality maximizes information processing and sensitivity of response to external stimuli, and for these reasons may be held to optimize regulation. In this way a definition of health has been given in terms of regulation, a scientific concept, which ties into detailed properties of complex systems, including brain cortices, and mental health. Models of experience and meditation built on complexity also point to criticality: it represents the condition making self-awareness possible, and is strengthened by meditation practices leading to the state of pure consciousness-the content-free state of mind in deep meditation. From this it follows that healthy function of the brain cortex, its sensitivity,y and consistency of response to external challenges should improve by practicing techniques leading to content-free awareness-transcending the original focus introduced during practice. Evidence for this is reviewed.

Acculturation and Self-Rated Mental Health Among Latino and Asian Immigrants in the United States: A Latent Class Analysis.

PubMed

Bulut, Elif; Gayman, Matthew D

2016-08-01

This study assesses variations in acculturation experiences by identifying distinct acculturation classes, and investigates the role of these acculturation classes for self-rated mental health among Latino and Asian immigrants in the United States. Using 2002-2003 the National Latino and Asian American Study, Latent Class Analysis is used to capture variations in immigrant classes (recent arrivals, separated, bicultural and assimilated), and OLS regressions are used to assess the link between acculturation classes and self-rated mental health. For both Latinos and Asians, bicultural immigrants reported the best mental health, and separated immigrants and recent arrivals reported the worst mental health. The findings also reveal group differences in acculturation classes, whereby Latino immigrants were more likely to be in the separated class and recent arrivals class relative to Asian immigrants. While there was not a significant group difference in self-rated mental health at the bivariate level, controlling for acculturation classes revealed that Latinos report better self-rated mental health than Asians. Thus, Latino immigrants would actually have better self-rated mental health than their Asian counterparts if they were not more likely to be represented in less acculturated classes (separated class and recent arrivals) and/or as likely to be in the bicultural class as their Asian counterparts. Together the findings underscore the nuanced and complex nature of the acculturation process, highlighting the importance of race differences in this process, and demonstrate the role of acculturation classes for immigrant group differences in self-rated mental health.

Current Military Perinatal Mental Health Treatment Models

DTIC Science & Technology

2016-03-03

Form 3039, 20 131018 Page 3 of 3 CHAPTER 12 PRENATAL ASSESSMENT AND INTERVENTION Pregnancy is a marvelment that researchers struggle to understand...The physiological and psychological changes brought about with pregnancy are so complex that in the 6th ed ition of the Williams obstetrical...textbook (Shears & Williams, 1928) it was stated that " pregnancy begins with a striking and wonderful phenomenon which in the present state of our

Complex Networks - A Key to Understanding Brain Function

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sporns, Olaf

2008-01-23

The brain is a complex network of neurons, engaging in spontaneous and evoked activity that is thought to be the main substrate of mental life.  How this complex system works together to process information and generate coherent cognitive states, even consciousness, is not yet well understood.  In my talk I will review recent studies that have revealed characteristic structural and functional attributes of brain networks, and discuss efforts to build computational models of the brain that are informed by our growing knowledge of brain anatomy and physiology.

Complex Networks - A Key to Understanding Brain Function

ScienceCinema

Sporns, Olaf

2017-12-22

The brain is a complex network of neurons, engaging in spontaneous and evoked activity that is thought to be the main substrate of mental life.  How this complex system works together to process information and generate coherent cognitive states, even consciousness, is not yet well understood.  In my talk I will review recent studies that have revealed characteristic structural and functional attributes of brain networks, and discuss efforts to build computational models of the brain that are informed by our growing knowledge of brain anatomy and physiology.

‘My Virtual Dream’: Collective Neurofeedback in an Immersive Art Environment

PubMed Central

Kovacevic, Natasha; Ritter, Petra; Tays, William; Moreno, Sylvain; McIntosh, Anthony Randal

2015-01-01

While human brains are specialized for complex and variable real world tasks, most neuroscience studies reduce environmental complexity, which limits the range of behaviours that can be explored. Motivated to overcome this limitation, we conducted a large-scale experiment with electroencephalography (EEG) based brain-computer interface (BCI) technology as part of an immersive multi-media science-art installation. Data from 523 participants were collected in a single night. The exploratory experiment was designed as a collective computer game where players manipulated mental states of relaxation and concentration with neurofeedback targeting modulation of relative spectral power in alpha and beta frequency ranges. Besides validating robust time-of-night effects, gender differences and distinct spectral power patterns for the two mental states, our results also show differences in neurofeedback learning outcome. The unusually large sample size allowed us to detect unprecedented speed of learning changes in the power spectrum (~ 1 min). Moreover, we found that participants' baseline brain activity predicted subsequent neurofeedback beta training, indicating state-dependent learning. Besides revealing these training effects, which are relevant for BCI applications, our results validate a novel platform engaging art and science and fostering the understanding of brains under natural conditions. PMID:26154513

Rediscovering the Concept of Asylum for Persons with Serious Mental Illness.

PubMed

Lamb, H Richard; Weinberger, Linda E

2016-03-01

Treating persons with serious mental illness is a complex and challenging endeavor. One intervention that has received little attention in recent years is the need for asylum. Asylum means a sanctuary, a place that lowers levels of stress and provides protection, safety, security, and social support, as well as an array of treatment services. The concept of "asylum" may have lost favor because it was equated with the abysmal conditions found in the state psychiatric hospitals of the past. Among the reasons persons with serious mental illness have been arrested and incarcerated is society's failure to provide adequate levels of asylum. With the release of tens of thousands of mentally ill inmates from state and federal jails and prisons, it is time to revisit this concept, not only for these persons but for those who have not been criminalized. Asylum can be found in various settings, including with family in the patient's home, in a board-and-care facility, or in a psychiatric hospital if necessary. Not all persons with a major mental illness are capable of achieving high levels of social and vocational functioning; however, living in a place that provides asylum can promote a higher quality of life. The value of asylum for many persons with serious mental illness should not be underestimated. © 2016 American Academy of Psychiatry and the Law.

Unmet mental health care needs in U.S. children with medical complexity, 2005-2010.

PubMed

An, Ruopeng

2016-03-01

Children with special healthcare needs (CSHCN) are those who have or are at elevated risk for a chronic physical, developmental, behavioral or emotional condition and need healthcare services of a type or quantity beyond that required by children generally. Within CSHCN, a small group of children with medical complexity have medical vulnerability and intensive care needs that are not easily met by existing healthcare models. This study estimated the national prevalence of unmet mental healthcare needs among CSHCN with and without medical complexity. Secondary data analysis (N=80,965) based on the National Survey of CSHCN 2005-2006 and 2009-2010 waves. During 2005-2010, 7.66% of CSHCN in the U.S. were with medical complexity. The prevalence of unmet needs for mental healthcare services among CSHCN increased from 3.71% in 2005-2006 to 5.62% in 2009-2010. In 2005-2006 the prevalence of unmet mental healthcare needs among children with medical complexity was 9.92%, tripling the prevalence among CSHCN without medical complexity of 3.10%. The prevalence of unmet mental healthcare needs among children with medical complexity further increased to 13.71% in 2009-2010, whereas that among CSHCN without medical complexity increased to 5.07%. Among CSHCN with medical complexity, older children and children living in poorer households were more likely to have an unmet need for mental healthcare services. Substantial disparities in access to mental healthcare services between CSHCN with and without medical complexity were present, and the prevalence of unmet mental healthcare needs among both groups had noticeably increased during 2005-2010. Copyright © 2016 Elsevier Inc. All rights reserved.

Complexity of GPs' explanations about mental health problems: development, reliability, and validity of a measure

PubMed Central

Cape, John; Morris, Elena; Burd, Mary; Buszewicz, Marta

2008-01-01

Background How GPs understand mental health problems determines their treatment choices; however, measures describing GPs' thinking about such problems are not currently available. Aim To develop a measure of the complexity of GP explanations of common mental health problems and to pilot its reliability and validity. Design of study A qualitative development of the measure, followed by inter-rater reliability and validation pilot studies. Setting General practices in North London. Method Vignettes of simulated consultations with patients with mental health problems were videotaped, and an anchored measure of complexity of psychosocial explanation in response to these vignettes was developed. Six GPs, four psychologists, and two lay people viewed the vignettes. Their responses were rated for complexity, both using the anchored measure and independently by two experts in primary care mental health. In a second reliability and revalidation study, responses of 50 GPs to two vignettes were rated for complexity. The GPs also completed a questionnaire to determine their interest and training in mental health, and they completed the Depression Attitudes Questionnaire. Results Inter-rater reliability of the measure of complexity of explanation in both pilot studies was satisfactory (intraclass correlation coefficient = 0.78 and 0.72). The measure correlated with expert opinion as to what constitutes a complex explanation, and the responses of psychologists, GPs, and lay people differed in measured complexity. GPs with higher complexity scores had greater interest, more training in mental health, and more positive attitudes to depression. Conclusion Results suggest that the complexity of GPs' psychosocial explanations about common mental health problems can be reliably and validly assessed by this new standardised measure. PMID:18505616

The long and complex road in the search for treatment for mental disorders: An analysis of the process in five groups of patients.

PubMed

Del Valle, Gema; Belloch, Amparo; Carrió, Carmen

2017-07-01

Seeking treatment for mental-health problems is a complex process, with different underlying motives in each stage. However, the entire process and these motives have hardly been investigated. This study aims to analyze the different stages of the help-seeking process and their underlying motives in five groups of patients with different mental disorders. In all, 156 patients seeking treatment in outpatient mental health clinics were individually interviewed: 71 had Obsessive-Compulsive Disorder (OCD), 21 had Agoraphobia (AGO), 18 had Major Depressive Disorder (MDD), 20 had Anorexia Nervosa (AN), and 22 had Cocaine Dependence (COC). The AGO and MDD patients delayed significantly less time in recognizing their mental health symptoms. Moreover, MDD patients disclosed their symptoms and searched for professional help faster than the other groups. The most relevant variables in the recognition of disorders were the loss of control over the symptoms, the interference produced by these symptoms, and their negative impact on the person's emotional state. The most frequent barriers to seeking treatment were related to minimizing the symptoms and fear of stigma. Finally, the most important motivator for seeking treatment was the awareness that minimizing the symptoms did not help to reduce them, lessen their interference, or make them disappear. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Population health management in integrated physical and mental health care.

PubMed

Sieck, Cynthia J; Wickizer, Thomas; Geist, Laurel

2014-01-01

Individuals suffering from serious mental illness (SMI) face many challenges of navigating a complex and often fragmented health care system and may die significantly earlier from co-morbid physical health conditions. Integrating mental and physical health care for individuals with SMI is an emerging trend addressing the often-neglected physical health care needs of this population to better coordinate care and improve health outcomes. Population Health Management (PHM) provides a useful friamework for designing integrated care programs for individuals with SMI. This paper examines the structure and evolution of the integrated care program in Missouri in the context of PHM, highlighting particular elements of PHM that facilitate and support development of an integrated mental and physical health care program. As health care reform provides external motivation to provide integrated care, this study can be useful as other states attempt to address this important issue.

Exploring the mental health effects of political trauma with newly arrived refugees.

PubMed

Shannon, Patricia J; Wieling, Elizabeth; McCleary, Jennifer Simmelink; Becher, Emily

2015-04-01

We explored the mental health effects of war trauma and torture as described by 111 refugees newly arrived in the United States. We used ethnocultural methodologies to inform 13 culture-specific focus groups with refugees from Bhutan (34), Burma (23), Ethiopia (27), and Somalia (27). Contrary to the belief that stigma prevents refugees from discussing mental health distress, participants readily described complex conceptualizations of degrees of mental health distress informed by political context, observation of symptoms, cultural idioms, and functional impairment. Recommendations for health care providers include assessment processes that inquire about symptoms in their political context, the degree of distress as it is culturally conceptualized, and its effect on functioning. Findings confirm the cross-cultural recognition of symptoms associated with posttraumatic stress disorder; however, refugees described significant cultural variation in expressions of distress, indicating the need for more research on culture-bound disorders and idioms of distress. © The Author(s) 2014.

Medical and Psychological Determinants on the Development in Aged Persons.

ERIC Educational Resources Information Center

Schmitz-Scherzer, R.

The relationships between somatic and sociological-psychological variables are complex. Each mental change which occurs in aging is more or less closely accompanied by somatic changes. The reverse is also true. The objective state of health and the subjective feeling of well-being are linked. Both can exert an influence over behavior and…

Affect Response to Simulated Information Attack during Complex Task Performance

DTIC Science & Technology

2014-12-02

AND FRUSTRATION ........................ 42 FIGURE 27. TASK LOAD INDEX OF MENTAL DEMAND, TEMPORAL DEMAND, AND PHYSICAL DEMAND...situational awareness, affect, and trait characteristics interact with human performance during cyberspace attacks in the physical and information...Operator state was manipulated using emotional stimulation portrayed through the presentation of video segments. The effect of emotions on

Discrimination and Mental Health Among Lesbian, Gay, and Bisexual Adults in the United States

PubMed Central

Bostwick, Wendy B.; Boyd, Carol J.; Hughes, Tonda L.; West, Brady

2014-01-01

Health disparities among sexual minority groups, particularly mental health disparities, are well-documented. Numerous studies have demonstrated heightened prevalence of depressive and anxiety disorders among lesbian, gay, and bisexual groups as compared to heterosexuals. Some authors posit that these disparities are the result of the stress that prejudice and perceived discrimination can cause. The current study extends previous research by examining the associations between multiple types of discrimination, based on race/ethnicity, gender, and sexual orientation, and past year mental health disorders in a national sample of self-identified lesbian, gay and bisexual women and men (n=577). Findings suggest that different types of discrimination may be differentially associated with past year mental health disorders. Notably, sexual orientation discrimination was associated with higher odds of a past year disorder only in combination with other types of discrimination. These findings point to the complexity of the relationship between discrimination experiences and mental health, and suggest that further work is needed to better explicate the interplay between multiple marginalized identities, discrimination and mental health. PMID:24826824

Discrimination and mental health among lesbian, gay, and bisexual adults in the United States.

PubMed

Bostwick, Wendy B; Boyd, Carol J; Hughes, Tonda L; West, Brady T; McCabe, Sean Esteban

2014-01-01

Health disparities among sexual minority groups, particularly mental health disparities, are well-documented. Numerous studies have demonstrated heightened prevalence of depressive and anxiety disorders among lesbian, gay, and bisexual groups as compared with heterosexuals. Some authors posit that these disparities are the result of the stress that prejudice and perceived discrimination can cause. The current study extends previous research by examining the associations between multiple types of discrimination, based on race or ethnicity, gender, and sexual orientation, and past-year mental health disorders in a national sample of self-identified lesbian, gay, and bisexual women and men (n = 577). Findings suggest that different types of discrimination may be differentially associated with past-year mental health disorders. Notably, sexual orientation discrimination was associated with higher odds of a past-year disorder only in combination with other types of discrimination. These findings point to the complexity of the relationship between discrimination experiences and mental health, and suggest that further work is needed to better explicate the interplay among multiple marginalized identities, discrimination, and mental health. (c) 2014 APA, all rights reserved.

Acquisition of Complex Systemic Thinking: Mental Models of Evolution

ERIC Educational Resources Information Center

d'Apollonia, Sylvia T.; Charles, Elizabeth S.; Boyd, Gary M.

2004-01-01

We investigated the impact of introducing college students to complex adaptive systems on their subsequent mental models of evolution compared to those of students taught in the same manner but with no reference to complex systems. The students' mental models (derived from similarity ratings of 12 evolutionary terms using the pathfinder algorithm)…

An Exploration of Secondary Students' Mental States When Learning about Acids and Bases

ERIC Educational Resources Information Center

Liu, Chia-Ju; Hou, I-Lin; Chiu, Houn-Lin; Treagust, David F.

2014-01-01

This study explored factors of students' mental states, including emotion, intention, internal mental representation, and external mental representation, which can affect their learning performance. In evaluating students' mental states during the science learning process and the relationship between mental states and learning…

Interaction without intent: the shape of the social world in Huntington’s disease

PubMed Central

Rickards, Hugh E.

2015-01-01

Huntington’s disease (HD) is an inherited neurodegenerative condition. Patients with this movement disorder can exhibit deficits on tasks involving Theory of Mind (ToM): the ability to understand mental states such as beliefs and emotions. We investigated mental state inference in HD in response to ambiguous animations involving geometric shapes, while exploring the impact of symptoms within cognitive, emotional and motor domains. Forty patients with HD and twenty healthy controls described the events in videos showing random movements of two triangles (i.e. floating), simple interactions (e.g. following) and more complex interactions prompting the inference of mental states (e.g. one triangle encouraging the other). Relationships were explored between animation interpretation and measures of executive functioning, alexithymia and motor symptoms. Individuals with HD exhibited alexithymia and a reduced tendency to spontaneously attribute intentions to interacting triangles on the animations task. Attribution of intentions on the animations task correlated with motor symptoms and burden of pathology. Importantly, patients without motor symptoms showed similar ToM deficits despite intact executive functions. Subtle changes in ToM that are unrelated to executive dysfunction could therefore feature in basal ganglia disorders prior to motor onset. PMID:25680992

Subjective Experience, Heterophenomenology, or Neuroimaging? A Perspective on the Meaning and Application of Mental Disorder Terms, in Particular Major Depressive Disorder.

PubMed

Schleim, Stephan

2018-01-01

Increasing research efforts try to identify biological markers in order to support or eventually replace current practices of diagnosing mental disorders. Inasmuch as these disorders refer to subjective mental states, such efforts amount to their objectification. This gives rise to conceptual as well as empirical challenges: What kind of things are mental disorders? And how to deal with situations where subjective reports, clinical decisions, and brain scans contradict each other? The present paper starts out with a discussion of recent efforts to objectify beauty. Such attempts to quantify and localize psychological constructs in the brain are compared to earlier examples from the history of psychology. The paper then discusses personal and social implications of the objectification of subjective mental states, including mental disorders. The construct of Major Depressive Disorder, one of the most prevalent mental disorders, is then analyzed in more detail. It turns out that this is a very complex construct probably associated with highly heterogeneous actual instances of the disorder. It is then shown that it is unlikely to replace these symptoms' descriptions with patterns of brain activations, at least in the near future, given these patterns' empirical lack of specificity. The paper then discusses which of the disorder's core symptoms are more or less amenable to behavioral or neuroscientific investigation and analyses whether the heterophenomenological method can solve the problem. The conclusion is that the disorder construct is neither entirely subjective, nor completely objectifiable, and that clinical experts do well by continuing to take a pragmatical stance.

Subjective Experience, Heterophenomenology, or Neuroimaging? A Perspective on the Meaning and Application of Mental Disorder Terms, in Particular Major Depressive Disorder

PubMed Central

Schleim, Stephan

2018-01-01

Increasing research efforts try to identify biological markers in order to support or eventually replace current practices of diagnosing mental disorders. Inasmuch as these disorders refer to subjective mental states, such efforts amount to their objectification. This gives rise to conceptual as well as empirical challenges: What kind of things are mental disorders? And how to deal with situations where subjective reports, clinical decisions, and brain scans contradict each other? The present paper starts out with a discussion of recent efforts to objectify beauty. Such attempts to quantify and localize psychological constructs in the brain are compared to earlier examples from the history of psychology. The paper then discusses personal and social implications of the objectification of subjective mental states, including mental disorders. The construct of Major Depressive Disorder, one of the most prevalent mental disorders, is then analyzed in more detail. It turns out that this is a very complex construct probably associated with highly heterogeneous actual instances of the disorder. It is then shown that it is unlikely to replace these symptoms’ descriptions with patterns of brain activations, at least in the near future, given these patterns’ empirical lack of specificity. The paper then discusses which of the disorder’s core symptoms are more or less amenable to behavioral or neuroscientific investigation and analyses whether the heterophenomenological method can solve the problem. The conclusion is that the disorder construct is neither entirely subjective, nor completely objectifiable, and that clinical experts do well by continuing to take a pragmatical stance. PMID:29867668

Theory of Mind in the Wild: Toward Tackling the Challenges of Everyday Mental State Reasoning

PubMed Central

Wertz, Annie E.; German, Tamsin C.

2013-01-01

A complete understanding of the cognitive systems underwriting theory of mind (ToM) abilities requires articulating how mental state representations are generated and processed in everyday situations. Individuals rarely announce their intentions prior to acting, and actions are often consistent with multiple mental states. In order for ToM to operate effectively in such situations, mental state representations should be generated in response to certain actions, even when those actions occur in the presence of mental state content derived from other aspects of the situation. Results from three experiments with preschool children and adults demonstrate that mental state information is indeed generated based on an approach action cue in situations that contain competing mental state information. Further, the frequency with which participants produced or endorsed explanations that include mental states about an approached object decreased when the competing mental state information about a different object was made explicit. This set of experiments provides some of the first steps toward identifying the observable action cues that are used to generate mental state representations in everyday situations and offers insight into how both young children and adults processes multiple mental state representations. PMID:24069160

Social disorder and diagnostic order: the US Mental Hygiene Movement, the Midtown Manhattan study and the development of psychiatric epidemiology in the 20th century.

PubMed

March, Dana; Oppenheimer, Gerald M

2014-08-01

Recent scholarship regarding psychiatric epidemiology has focused on shifting notions of mental disorders. In psychiatric epidemiology in the last decades of the 20th century and the first decade of the 21st century, mental disorders have been perceived and treated largely as discrete categories denoting an individual's mental functioning as either pathological or normal. In the USA, this grew partly out of evolving modern epidemiological work responding to the State's commitment to measure the national social and economic burdens of psychiatric disorders and subsequently to determine the need for mental health services and to survey these needs over time. Notably absent in these decades have been environmentally oriented approaches to cultivating normal, healthy mental states, approaches initially present after World War II. We focus here on a set of community studies conducted in the 1950s, particularly the Midtown Manhattan study, which grew out of a holistic conception of mental health that depended on social context and had a strong historical affiliation with: the Mental Hygiene Movement and the philosophy of its founder, Adolf Meyer; the epidemiological formation of field studies and population surveys beginning early in the 20th century, often with a health policy agenda; the recognition of increasing chronic disease in the USA; and the radical change in orientation within psychiatry around World War II. We place the Midtown Manhattan study in historical context--a complex narrative of social institutions, professional formation and scientific norms in psychiatry and epidemiology, and social welfare theory that begins during the Progressive era (1890-1920) in the USA. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

IQ and mental health are vital predictors of work drop out and early mortality. Multi-state analyses of Norwegian male conscripts

PubMed Central

Tveito, Torill H.; Reme, Silje E.; Eriksen, Hege R.

2017-01-01

Background Disability benefits and sick leave benefits represents huge costs in western countries. The pathways and prognostic factors for receiving these benefits seen in recent years are complex and manifold. We postulate that mental health and IQ, both alone and concurrent, influence subsequent employment status, disability benefits and mortality. Methods A cohort of 918 888 Norwegian men was followed for 16 years from the age of 20 to 55. Risk for health benefits, emigration, and mortality were studied. Indicators of mental health and IQ at military enrolment were used as potential risk factors. Multi-state models were used to analyze transitions between employment, sick leave, time limited benefits, disability benefits, emigration, and mortality. Results During follow up, there were a total of 3 908 397 transitions between employment and different health benefits, plus 12 607 deaths. Men with low IQ (below 85), without any mental health problems at military enrolment, had an increased probability of receiving disability benefits before the age of 35 (HRR = 4.06, 95% CI: 3.88–4.26) compared to men with average IQ (85 to 115) and no mental health problems. For men with both low IQ and mental health problems, there was an excessive probability of receiving disability benefits before the age of 35 (HRR = 14.37, 95% CI: 13.59–15.19), as well as an increased probability for time limited benefits and death before the age of 35 compared to men with average IQ (85 to 115) and no mental health problems. Conclusion Low IQ and mental health problems are strong predictors of future disability benefits and early mortality for young men. PMID:28683088

IQ and mental health are vital predictors of work drop out and early mortality. Multi-state analyses of Norwegian male conscripts.

PubMed

Lie, Stein Atle; Tveito, Torill H; Reme, Silje E; Eriksen, Hege R

2017-01-01

Disability benefits and sick leave benefits represents huge costs in western countries. The pathways and prognostic factors for receiving these benefits seen in recent years are complex and manifold. We postulate that mental health and IQ, both alone and concurrent, influence subsequent employment status, disability benefits and mortality. A cohort of 918 888 Norwegian men was followed for 16 years from the age of 20 to 55. Risk for health benefits, emigration, and mortality were studied. Indicators of mental health and IQ at military enrolment were used as potential risk factors. Multi-state models were used to analyze transitions between employment, sick leave, time limited benefits, disability benefits, emigration, and mortality. During follow up, there were a total of 3 908 397 transitions between employment and different health benefits, plus 12 607 deaths. Men with low IQ (below 85), without any mental health problems at military enrolment, had an increased probability of receiving disability benefits before the age of 35 (HRR = 4.06, 95% CI: 3.88-4.26) compared to men with average IQ (85 to 115) and no mental health problems. For men with both low IQ and mental health problems, there was an excessive probability of receiving disability benefits before the age of 35 (HRR = 14.37, 95% CI: 13.59-15.19), as well as an increased probability for time limited benefits and death before the age of 35 compared to men with average IQ (85 to 115) and no mental health problems. Low IQ and mental health problems are strong predictors of future disability benefits and early mortality for young men.

Moving science into state child and adolescent mental health systems: Illinois' evidence-informed practice initiative.

PubMed

Starin, Amy C; Atkins, Marc S; Wehrmann, Kathryn C; Mehta, Tara; Hesson-McInnis, Matthew S; Marinez-Lora, A; Mehlinger, Renee

2014-01-01

In 2005, the Illinois State Mental Health Authority embarked on an initiative to close the gap between research and practice in the children's mental health system. A stakeholder advisory council developed a plan to advance evidence informed practice through policy and program initiatives. A multilevel approach was developed to achieve this objective, which included policy change, stakeholder education, and clinician training. This article focuses on the evidence-informed training process designed following review of implementation research. The training involved in-person didactic sessions and twice-monthly telephone supervision across 6 cohorts of community based clinicians, each receiving 12 months of training. Training content initially included cognitive behavioral therapy and behavioral parent training and was adapted over the years to a practice model based on common element concepts. Evaluation based on provider and parent report indicated children treated by training clinicians generally showed superior outcomes versus both a treatment-as-usual comparison group for Cohorts 1 to 4 and the statewide child population as a whole after 90 days of care for Cohorts 5 to 6. The results indicated primarily moderate to strong effects for the evidence-based training groups. Moving a large public statewide child mental health system toward more effective services is a complex and lengthy process. These results indicate training of community mental health providers in Illinois in evidence-informed practice was moderately successful in positively impacting child-level functional outcomes. These findings also influenced state policy in committing resources to continuing the initiative, even in difficult economic times.

Quantum-like dynamics applied to cognition: a consideration of available options

NASA Astrophysics Data System (ADS)

Broekaert, Jan; Basieva, Irina; Blasiak, Pawel; Pothos, Emmanuel M.

2017-10-01

Quantum probability theory (QPT) has provided a novel, rich mathematical framework for cognitive modelling, especially for situations which appear paradoxical from classical perspectives. This work concerns the dynamical aspects of QPT, as relevant to cognitive modelling. We aspire to shed light on how the mind's driving potentials (encoded in Hamiltonian and Lindbladian operators) impact the evolution of a mental state. Some existing QPT cognitive models do employ dynamical aspects when considering how a mental state changes with time, but it is often the case that several simplifying assumptions are introduced. What kind of modelling flexibility does QPT dynamics offer without any simplifying assumptions and is it likely that such flexibility will be relevant in cognitive modelling? We consider a series of nested QPT dynamical models, constructed with a view to accommodate results from a simple, hypothetical experimental paradigm on decision-making. We consider Hamiltonians more complex than the ones which have traditionally been employed with a view to explore the putative explanatory value of this additional complexity. We then proceed to compare simple models with extensions regarding both the initial state (e.g. a mixed state with a specific orthogonal decomposition; a general mixed state) and the dynamics (by introducing Hamiltonians which destroy the separability of the initial structure and by considering an open-system extension). We illustrate the relations between these models mathematically and numerically. This article is part of the themed issue `Second quantum revolution: foundational questions'.

The Affordable Care Act, Accountable Care Organizations, and Mental Health Care for Older Adults: Implications and Opportunities.

PubMed

Bartels, Stephen J; Gill, Lydia; Naslund, John A

2015-01-01

The Patient Protection and Affordable Care Act (ACA) represents the most significant legislative change in the United States health care system in nearly half a century. Key elements of the ACA include reforms aimed at addressing high-cost, complex, vulnerable patient populations. Older adults with mental health disorders are a rapidly growing segment of the population and are among the most challenging subgroups within health care, and they account for a disproportionate amount of costs. What does the ACA mean for geriatric mental health? We address this question by highlighting opportunities for reaching older adults with mental health disorders by leveraging the diverse elements of the ACA. We describe nine relevant initiatives: (1) accountable care organizations, (2) patient-centered medical homes, (3) Medicaid-financed specialty health homes, (4) hospital readmission and health care transitions initiatives, (5) Medicare annual wellness visit, (6) quality standards and associated incentives, (7) support for health information technology and telehealth, (8) Independence at Home and 1915(i) State Plan Home and Community-Based Services program, and (9) Medicare-Medicaid Coordination Office, Center for Medicare and Medicaid Innovation, and the Patient-Centered Outcomes Research Institute. We also consider potential challenges to full implementation of the ACA and discuss novel solutions for advancing geriatric mental health in the context of projected workforce shortages and the opportunities afforded by the ACA.

The Affordable Care Act, Accountable Care Organizations, and Mental Health Care for Older Adults: Implications and Opportunities

PubMed Central

Bartels, Stephen J.; Gill, Lydia; Naslund, John A.

2015-01-01

Abstract The Patient Protection and Affordable Care Act (ACA) represents the most significant legislative change in the United States health care system in nearly half a century. Key elements of the ACA include reforms aimed at addressing high-cost, complex, vulnerable patient populations. Older adults with mental health disorders are a rapidly growing segment of the population and are among the most challenging subgroups within health care, and they account for a disproportionate amount of costs. What does the ACA mean for geriatric mental health? We address this question by highlighting opportunities for reaching older adults with mental health disorders by leveraging the diverse elements of the ACA. We describe nine relevant initiatives: (1) accountable care organizations, (2) patient-centered medical homes, (3) Medicaid-financed specialty health homes, (4) hospital readmission and health care transitions initiatives, (5) Medicare annual wellness visit, (6) quality standards and associated incentives, (7) support for health information technology and telehealth, (8) Independence at Home and 1915(i) State Plan Home and Community-Based Services program, and (9) Medicare-Medicaid Coordination Office, Center for Medicare and Medicaid Innovation, and the Patient-Centered Outcomes Research Institute. We also consider potential challenges to full implementation of the ACA and discuss novel solutions for advancing geriatric mental health in the context of projected workforce shortages and the opportunities afforded by the ACA. PMID:25811340

Pure state consciousness and its local reduction to neuronal space

NASA Astrophysics Data System (ADS)

Duggins, A. J.

2013-01-01

The single neuronal state can be represented as a vector in a complex space, spanned by an orthonormal basis of integer spike counts. In this model a scalar element of experience is associated with the instantaneous firing rate of a single sensory neuron over repeated stimulus presentations. Here the model is extended to composite neural systems that are tensor products of single neuronal vector spaces. Depiction of the mental state as a vector on this tensor product space is intended to capture the unity of consciousness. The density operator is introduced as its local reduction to the single neuron level, from which the firing rate can again be derived as the objective correlate of a subjective element. However, the relational structure of perceptual experience only emerges when the non-local mental state is considered. A metric of phenomenal proximity between neuronal elements of experience is proposed, based on the cross-correlation function of neurophysiology, but constrained by the association of theoretical extremes of correlation/anticorrelation in inseparable 2-neuron states with identical and opponent elements respectively.

Heroes and Myths: On Davis Guggenheim's "Superman"

ERIC Educational Resources Information Center

Olorunda, Tolu

2011-01-01

David Guggenheim's latest documentary, "Waiting for 'Superman'," stops only an inch away from insisting upon the total razing of the public school system. Guggenheim stated that, with the release of this film, he was "trying to attack... this mental block that a lot of Americans have--which is that the problems with our schools are too complex,…

Balancing Student Privacy, Campus Security, and Public Safety: Issues for Campus Leaders. Perspectives, Winter 2008

ERIC Educational Resources Information Center

McBain, Lesley

2008-01-01

The complex issues of promoting student mental health, privacy and public safety, and the balance among them, weigh on the minds of institutional leaders, educational policymakers, and local, state and federal officials. American campuses have a proud history of intellectual freedom, openness and public accessibility to their communities. However,…

42 CFR 483.108 - Relationship of PASARR to other Medicaid processes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... mental health or mental retardation authorities cannot be countermanded by the State Medicaid agency... of this part may overturn a PASARR determination made by the State mental health or mental retardation authorities. (b) In making their determinations, however, the State mental health and mental...

42 CFR 483.108 - Relationship of PASARR to other Medicaid processes.

Code of Federal Regulations, 2011 CFR

2011-10-01

... mental health or mental retardation authorities cannot be countermanded by the State Medicaid agency... of this part may overturn a PASARR determination made by the State mental health or mental retardation authorities. (b) In making their determinations, however, the State mental health and mental...

Ongoing neural development of affective theory of mind in adolescence

PubMed Central

Weigelt, Sarah; Döhnel, Katrin; Smolka, Michael N.; Kliegel, Matthias

2014-01-01

Affective Theory of Mind (ToM), an important aspect of ToM, involves the understanding of affective mental states. This ability is critical in the developmental phase of adolescence, which is often related with socio-emotional problems. Using a developmentally sensitive behavioral task in combination with functional magnetic resonance imaging, the present study investigated the neural development of affective ToM throughout adolescence. Eighteen adolescent (ages 12–14 years) and 18 young adult women (aged 19–25 years) were scanned while evaluating complex affective mental states depicted by actors in video clips. The ventromedial prefrontal cortex (vmPFC) showed significantly stronger activation in adolescents in comparison to adults in the affective ToM condition. Current results indicate that the vmPFC might be involved in the development of affective ToM processing in adolescence. PMID:23716712

[Dangerous states and mental health disorders: perceptions and reality].

PubMed

Tassone-Monchicourt, C; Daumerie, N; Caria, A; Benradia, I; Roelandt, J-L

2010-01-01

Image of Madness was always strongly linked with the notion of "dangerousness", provoking fear and social exclusion, despite the evolution of psychiatric practices and organisation, and the emphasis on user's rights respect. Mediatization and politicization of this issue through news item combining crime and mental illness, reinforce and spread out this perception. This paper presents a review of the litterature on social perceptions associating "dangerousness", "Insanity" and "mental illness", available data about the link between "dangerous states" and "psychiatric disorders", as well as the notion of "dangerousness" and the assessment of "dangerous state" of people suffering or not from psychiatric disorders. MAPPING OF SOCIAL REPRESENTATIONS: The French Survey "Mental Health in General Population: Images and Realities (MHGP)" was carried out between 1999 and 2003, on a representative sample of 36.000 individuals over 18 years old. It aims at describing the social representations of the population about "insanity/insane" and "mental illness/mentally ill". The results show that about 75% of the people interviewed link "insanity" or "mental illness" with "criminal or violent acts". Young people and those with a high level of education more frequently categorize violent and dangerous behaviours in the field of Mental illness rather than in that of madness. CORRELATION BETWEEN DANGEROUS STATE AND PSYCHIATRIC DISORDERS: in the scientific literature, all experts reject the hypothesis of a direct link between violence and mental disorder. Besides, 2 tendencies appear in their conclusions: on one hand, some studies establish a significative link between violence and severe mental illness, compared with the general population. On the other hand, results show that 87 to 97% of des aggressors are not mentally ills. Therefore, the absence of scientific consensus feeds the confusion and reinforce the link of causality between psychiatric disorders and violence. OFFICIAL FIGURES BY THE MINISTRY OF JUSTICE: according to the French Ministry of Justice, there is a lack of significative data in general population, that would allow the accurate evaluation of the proportion of authors of crimes and offences presenting a "dangerous state", either of criminological order or related to a psychiatric disorder. FROM "DANGEROUSNESS" TO "DANGEROUS STATE": the vagueness of the notion of "dangerousness" aggravates the confusion and reinforce the negative social representations attached to subjects labelled as "mentally ills". A way to alleviate this stigmatisation would be to stop using the word "dangerous", and rather use those of "dangerous states". Assessment of dangerous states is complex and needs to take into account several heterogeneous factors (circumstances of acting, social and family environment...). Besides, it is not a linear process for a given individual. Those risk factors of "dangerous state" lead to the construction of evaluation or prediction scales, which limits lay in the biaises of over or under predictive value. The overestimation of dangerousness is harmful, not only to individuals wrongly considered as "dangerous", but also to the society which, driven by safety concerns, agrees on the implementation of inaccurate measures. A FEW TRACKS FOR REMEDIATION: the representations linking "mental illness" and "dangerousness" are the major vectors of stigma, and deeply anchored in the collective popular imagination. They are shared by all population categories, with no distinction of age, gender, professional status or level of education. To overcome those prejudices, one has to carefully study their basis, their criteria, document them with statistical data, look for consistency and scientific rigour, in the terminology as well as in the methodology. Moreover, one has to encourage exchanges about this topic, between users, relatives, carers, local elected, politicians, media and health professional. Copyright 2010 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

Mental health services conceptualised as complex adaptive systems: what can be learned?

PubMed

Ellis, Louise A; Churruca, Kate; Braithwaite, Jeffrey

2017-01-01

Despite many attempts at promoting systems integration, seamless care, and partnerships among service providers and users, mental health services internationally continue to be fragmented and piecemeal. We exploit recent ideas from complexity science to conceptualise mental health services as complex adaptive systems (CASs). The core features of CASs are described and Australia's headspace initiative is used as an example of the kinds of problems currently being faced. We argue that adopting a CAS lens can transform services, creating more connected care for service users with mental health conditions.

How social cognition can inform social decision making.

PubMed

Lee, Victoria K; Harris, Lasana T

2013-12-25

Social decision-making is often complex, requiring the decision-maker to make inferences of others' mental states in addition to engaging traditional decision-making processes like valuation and reward processing. A growing body of research in neuroeconomics has examined decision-making involving social and non-social stimuli to explore activity in brain regions such as the striatum and prefrontal cortex, largely ignoring the power of the social context. Perhaps more complex processes may influence decision-making in social vs. non-social contexts. Years of social psychology and social neuroscience research have documented a multitude of processes (e.g., mental state inferences, impression formation, spontaneous trait inferences) that occur upon viewing another person. These processes rely on a network of brain regions including medial prefrontal cortex (MPFC), superior temporal sulcus (STS), temporal parietal junction, and precuneus among others. Undoubtedly, these social cognition processes affect social decision-making since mental state inferences occur spontaneously and automatically. Few studies have looked at how these social inference processes affect decision-making in a social context despite the capability of these inferences to serve as predictions that can guide future decision-making. Here we review and integrate the person perception and decision-making literatures to understand how social cognition can inform the study of social decision-making in a way that is consistent with both literatures. We identify gaps in both literatures-while behavioral economics largely ignores social processes that spontaneously occur upon viewing another person, social psychology has largely failed to talk about the implications of social cognition processes in an economic decision-making context-and examine the benefits of integrating social psychological theory with behavioral economic theory.

How social cognition can inform social decision making

PubMed Central

Lee, Victoria K.; Harris, Lasana T.

2013-01-01

Social decision-making is often complex, requiring the decision-maker to make inferences of others' mental states in addition to engaging traditional decision-making processes like valuation and reward processing. A growing body of research in neuroeconomics has examined decision-making involving social and non-social stimuli to explore activity in brain regions such as the striatum and prefrontal cortex, largely ignoring the power of the social context. Perhaps more complex processes may influence decision-making in social vs. non-social contexts. Years of social psychology and social neuroscience research have documented a multitude of processes (e.g., mental state inferences, impression formation, spontaneous trait inferences) that occur upon viewing another person. These processes rely on a network of brain regions including medial prefrontal cortex (MPFC), superior temporal sulcus (STS), temporal parietal junction, and precuneus among others. Undoubtedly, these social cognition processes affect social decision-making since mental state inferences occur spontaneously and automatically. Few studies have looked at how these social inference processes affect decision-making in a social context despite the capability of these inferences to serve as predictions that can guide future decision-making. Here we review and integrate the person perception and decision-making literatures to understand how social cognition can inform the study of social decision-making in a way that is consistent with both literatures. We identify gaps in both literatures—while behavioral economics largely ignores social processes that spontaneously occur upon viewing another person, social psychology has largely failed to talk about the implications of social cognition processes in an economic decision-making context—and examine the benefits of integrating social psychological theory with behavioral economic theory. PMID:24399928

[Beijing college students' self-consciousness: its level, structure and relationship with mental health].

PubMed

Fan, Zhiwei; He, Shuchang

2013-11-01

To investigate Beijing college students' self-consciousness and its relationship with mental health. Convenient samples of 928 college students from five universities in Beijing were inquired and assessed with the self-consciousness scale and the Kessler 10 psychological distress scale. Confirmatory factor analysis and structural equation modeling were used to analyze the data. College students' scores of self-consciousness did not differ in sex, age, grade and major type. 83.5% of the participants had relatively low scores (10-24) of psychological distress, but those of the students of liberal arts were higher (P < 0.05). The measurement data of self-consciousness supported Mittal and Balasubramanian' s five-factor structure. Self-reflectiveness was positively correlated with depression (P < 0.05). Internal state awareness was negatively associated with both anxiety and depression (P < 0.05). Style consciousness was positively correlated with both of them (P < 0.001). Beijing college students' self-consciousness is relatively high and has a relatively complex structure. While self-reflectiveness and style consciousness have negative effects, internal state awareness is good for mental health.

Neural correlates of naturalistic social cognition: brain-behavior relationships in healthy adults

PubMed Central

Rademacher, L.M.; Winkler, L.; Schultz, R.T.; Gründer, G.; Lammertz, S.E.

2016-01-01

Being able to infer the thoughts, feelings and intentions of those around us is indispensable in order to function in a social world. Despite growing interest in social cognition and its neural underpinnings, the factors that contribute to successful mental state attribution remain unclear. Current knowledge is limited because the most widely used tasks suffer from two main constraints: (i) They fail to capture individual variability due to ceiling effects and (ii) they use highly simplistic, often artificial stimuli inapt to mirror real-world socio-cognitive demands. In the present study, we address these problems by employing complex depictions of naturalistic social interactions that vary in both valence (positive vs negative) and ambiguity (high vs low). Thirty-eight healthy participants (20 female) made mental state judgments while brain responses were obtained using functional magnetic resonance imaging (fMRI). Accuracy varied based on valence and ambiguity conditions and women were more accurate than men with highly ambiguous social stimuli. Activity of the orbitofrontal cortex predicted performance in the high ambiguity condition. The results shed light on subtle differences in mentalizing abilities and associated neural activity. PMID:27496338

MENTAL STATE LANGUAGE DEVELOPMENT: THE LONGITUDINAL ROLES OF ATTACHMENT AND MATERNAL LANGUAGE.

PubMed

Becker Razuri, Erin; Hiles Howard, Amanda R; Purvis, Karyn B; Cross, David R

2017-05-01

Maternal mental state language is thought to influence children's mental state language and sociocognitive understanding (e.g., theory of mind), but the mechanism is unclear. The current study examined the longitudinal development of mental state language in mother-child interactions. The methodology included assessments of the child and/or mother-child dyad at six time points between 12 to 52 months of the child's age. Measures determined child's attachment style and language abilities, and mental state language used by mother and child during a block-building task. Results showed that (a) mental state talk, including belief and desire language, increased over time; (b) there were differences between the type of mental state words used by the mother in insecure versus secure dyads; (c) there were differences in patterns of mental state words used in both mothers and children in insecure versus secure dyads; and (d) attachment appeared to exert a consistent influence over time. © 2017 Michigan Association for Infant Mental Health.

Seeing mental states: An experimental strategy for measuring the observability of other minds

NASA Astrophysics Data System (ADS)

Becchio, Cristina; Koul, Atesh; Ansuini, Caterina; Bertone, Cesare; Cavallo, Andrea

2018-03-01

Is it possible to perceive others' mental states? Are mental states visible in others' behavior? In contrast to the traditional view that mental states are hidden and not directly accessible to perception, in recent years a phenomenologically-motivated account of social cognition has emerged: direct social perception. However, despite numerous published articles that both defend and critique direct perception, researchers have made little progress in articulating the conditions under which direct perception of others' mental states is possible. This paper proposes an empirically anchored approach to the observability of others' mentality - not just in the weak sense of discussing relevant empirical evidence for and against the phenomenon of interest, but also, and more specifically, in the stronger sense of identifying an experimental strategy for measuring the observability of mental states and articulating the conditions under which mental states are observable. We conclude this article by reframing the problem of direct perception in terms of establishing a definable and measurable relationship between movement features and perceived mental states.

The emerging mental health strategy of the European Union: a multi-level work-in-progress.

PubMed

Kelly, Brendan D

2008-01-01

Policy-making in the European Union (EU) is a complex process that can appear impenetrable and opaque. This paper examines the ongoing process of mental health policy-making in the EU. In 2005, the Health and Consumer Protectorate Director-General of the European Commission published a Green Paper and launched a consultation process aimed at mental health service-users, advocates, providers, business, social services and governments. While there were varying levels of participation between member states, a range of trans-national, national and infra-national actors made contributions. Based on these consultations, a 'Consultative Platform' was created and made 10 recommendations centered on the principles of partnership; establishing policy competencies; integrating mental health into national policies; involving stakeholders; and protecting human rights. This ongoing process illustrates many features of EU policy-making: (a) the European Commission generates an initiative; (b) policy focuses on EU standardization, with member states remaining central actors in service-delivery; (c) policy focuses on social inclusion; (d) the European Commission coordinates diverse networks of actors; and (e) there is 'multi-level' involvement, with direct interaction between trans-national, national and infra-national actors. An enhanced focus on epidemiological data and 'evidence-based policy' would increase rigor and focus further attention on this relatively neglected policy area.

Spatio-temporal models of mental processes from fMRI.

PubMed

Janoos, Firdaus; Machiraju, Raghu; Singh, Shantanu; Morocz, Istvan Ákos

2011-07-15

Understanding the highly complex, spatially distributed and temporally organized phenomena entailed by mental processes using functional MRI is an important research problem in cognitive and clinical neuroscience. Conventional analysis methods focus on the spatial dimension of the data discarding the information about brain function contained in the temporal dimension. This paper presents a fully spatio-temporal multivariate analysis method using a state-space model (SSM) for brain function that yields not only spatial maps of activity but also its temporal structure along with spatially varying estimates of the hemodynamic response. Efficient algorithms for estimating the parameters along with quantitative validations are given. A novel low-dimensional feature-space for representing the data, based on a formal definition of functional similarity, is derived. Quantitative validation of the model and the estimation algorithms is provided with a simulation study. Using a real fMRI study for mental arithmetic, the ability of this neurophysiologically inspired model to represent the spatio-temporal information corresponding to mental processes is demonstrated. Moreover, by comparing the models across multiple subjects, natural patterns in mental processes organized according to different mental abilities are revealed. Copyright © 2011 Elsevier Inc. All rights reserved.

Taking the Concept of Citizenship in Mental Health across Countries. Reflections on Transferring Principles and Practice to Different Sociocultural Contexts

PubMed Central

Eiroa-Orosa, Francisco José; Rowe, Michael

2017-01-01

Transferring principles and practices to different sociocultural and professional contexts in the field of mental health can be very complex. Previous research on public health policy points to difficulties in different areas such as the understanding the new concepts, their applicability in different health systems, and suitable approaches to its effective implementation. The purpose of this article is to describe and analyze the process of transferring the concept of Citizenship, from its United States origins in mental health outreach work with persons who are homeless to Catalonia, Spain. We define Citizenship as promoting the rights, responsibilities, roles, resources and relationships of persons with mental illnesses, along with a sense of belonging that is validated by other citizens. The process of this transition involves embedding Citizenship in the mental health “first-person” (internationally known as Consumer/Survivor/Peer) movement in Catalonia. The paper includes a discussion of the concept of transference, including a case example of the adoption of the concept of mental health recovery in different countries. Following this, we describe the United States Citizenship model and key elements of its development. We then turn to Spain and the evolution of its mental health system, and then to Catalonia for a brief case history of transference of the principles and practices of Citizenship to that region. The “take home message” of this work is that concepts being brought from one sociocultural and national context to another, must focus on contextualization in the ‘adoptee’s’ practices, including the balance between personal involvement and professional rigor, the involvement of key actors, and ongoing evaluation of actions taken. PMID:28680412

42 CFR 483.112 - Preadmission screening of applicants for admission to NFs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... NF services. For each NF applicant with MI or MR, the State mental health or mental retardation... determined to require a NF level of care, the State mental health or mental retardation authority (as... State mental health or mental retardation authority for screening. (See § 483.128(a) for discussion of...

42 CFR 483.112 - Preadmission screening of applicants for admission to NFs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... NF services. For each NF applicant with MI or MR, the State mental health or mental retardation... determined to require a NF level of care, the State mental health or mental retardation authority (as... State mental health or mental retardation authority for screening. (See § 483.128(a) for discussion of...

Seizing opportunities under the Affordable Care Act for transforming the mental and behavioral health system.

PubMed

Mechanic, David

2012-02-01

The Affordable Care Act, along with Medicaid expansions, offers the opportunity to redesign the nation's highly flawed mental health system. It promotes new programs and tools, such as health homes, interdisciplinary care teams, the broadening of the Medicaid Home and Community-Based Services option, co-location of physical health and behavioral services, and collaborative care. Provisions of the act offer extraordinary opportunities, for instance, to insure many more people, reimburse previously unreimbursed services, integrate care using new information technology tools and treatment teams, confront complex chronic comorbidities, and adopt underused evidence-based interventions. The Centers for Medicare and Medicaid Services and its Center for Medicare and Medicaid Innovation should work intensively with the states to implement these new programs and other arrangements and begin to fulfill the many unmet promises of community mental health care.

Functional classification of schizophrenia using feed forward neural networks.

PubMed

Jafri, Madiha J; Calhoun, Vince D

2006-01-01

In medicine, the nature of an illness is often determined through behavioral or biological markers. The process of diagnosis becomes difficult when dealing with mental disorders since they rely primarily on behavioral markers. Schizophrenia is an example of a complex mental disorder that relies on aberrant behavior such as auditory hallucinations, dampening of emotions, paranoia, etc. This research is an attempt to determine a biological marker for schizophrenia through the use of functional magnetic resonance imaging (fMRI). In this paper, we propose a method of classification of schizophrenia and healthy controls, using a neural network approach and functional brain 'modes'estimated from resting state data using independent component analysis. A reliable technique for discriminating schizophrenia based upon fMRI would be a significant advance and may also provide additional information about the biological implications of mental illness.

Confucian States and Learning Life: Making Scholar-Officials and Social Learning a Political Contestation

ERIC Educational Resources Information Center

Han, SoongHee

2013-01-01

This paper describes how the way the concept of learning is identified and managed in a societal context can provide a crucial clue to explaining how a form of culture as a complex mental organism is constructed and interwoven. Specifically, I argue the point by illustrating that the discourse of Confucianism has fabricated a specific form of…

Authenticity, creativity and a love of the job: experiences of grassroots leaders of mental health nursing in queensland.

PubMed

McAllister, Margaret; Happell, Brenda; Bradshaw, Julie

2013-09-01

The strength of mental health nursing and its potential contribution to improved consumer outcomes depends upon strong and clearly articulated leadership. However, studies of leadership have tended to focus on nurses holding senior positions rather than exploring the leadership embedded in clinical work. A qualitative exploratory study was undertaken with identified mental health nurse leaders in one Australian state, in order to explore their experiences and what they found to be most meaningful in their work. This article reports the findings from this study. The data was analysed thematically to yield insights significant to mental health nursing and identity. The findings suggest these leaders find intrinsic rewards in the role; aspire to making authentic connections with consumers; appreciate the position of trust that they hold in bearing witness to individuals' distress; and use creative means to solve problems and achieve therapeutic outcomes. Sharing these themes builds knowledge on values that are embedded in mental health nursing practice and offers scope for integrating leadership attributes into the education, supervision and development of all mental health nurses. These findings also reveal the complexity of mental health nursing as a profession and the difficulties that might be encountered in attempts to define it in terms of its component tasks and functions.

Parental quality of life in complex paediatric neurologic disorders of unknown aetiology.

PubMed

van Nimwegen, K J M; Kievit, W; van der Wilt, G J; Schieving, J H; Willemsen, M A A P; Donders, A R T; Verhaak, C M; Grutters, J P C

2016-09-01

Complex paediatric neurology (CPN) patients generally present with non-specific symptoms, such as developmental delay, impaired movement and epilepsy. The diagnostic trajectory in these disorders is usually complicated and long-lasting, and may be burdensome to the patients and their parents. Additionally, as caring for a chronically ill child can be stressful and demanding, parents of these patients may experience impaired health-related quality of life (HRQoL). This study aims to assess parental HRQoL and factors related to it in CPN. Physical and mental HRQoL of 120 parents was measured and compared to the general population using the SF-12 questionnaire. Parents also completed this questionnaire for the measurement of patient HRQoL. Additional questionnaires were used to measure parental uncertainty (Visual Analogue Scale) and worry phenomena (Penn State Worry Questionnaire), and to obtain socio-demographic data. A linear mixed model with random effect was used to investigate which of these variables were associated with parental HRQoL. As compared to the general population, HRQoL of these parents appeared diminished. Fathers showed both lowered physical (51.76, p < 0.05) and mental (49.41, p < 0.01) HRQoL, whereas mothers only showed diminished mental (46.46, p < 0.01) HRQoL. Patient HRQoL and parental worry phenomena were significantly correlated with overall and mental parental HRQoL. The reduction in parental mental HRQoL is alarming, also because children strongly rely on their parents and parental mental health is known to influence children's health. Awareness of these problems among clinicians, and supportive care if needed are important to prevent exacerbation of the problems. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Survey of recognition and treatment of at-risk mental state by Japanese psychiatrists.

PubMed

Tsujino, Naohisa; Tagata, Hiromi; Baba, Yoko; Kojima, Akiko; Yamaguchi, Taiju; Katagiri, Naoyuki; Nemoto, Takahiro; Mizuno, Masafumi

2018-02-27

The importance of early intervention in psychiatry is widely recognized among psychiatrists. However, it is unknown whether precise knowledge of at-risk mental state has been disseminated. With this survey, we aimed to reveal how Japanese psychiatrists diagnose patients with at-risk mental state and prescribe treatment strategies for them. Using fictional case vignettes, we conducted a questionnaire survey of psychiatrists (n = 1399) who worked in Tokyo. We mailed study documents to all eligible participants in November 2015 with a requested return date in December. Two hundred and sixty (19.3%) psychiatrists responded to the survey. Their correct diagnosis rates for the patients in the at-risk mental state vignettes were low (14.6% for the vignette describing at-risk mental state with attenuated positive symptom syndrome; 13.1% for the vignette describing at-risk mental state with brief intermittent psychotic syndrome). Many psychiatrists selected pharmacotherapy and antipsychotics to treat patients in the at-risk mental state vignettes. The psychiatrists who correctly diagnosed patients in the at-risk mental state vignettes had significantly fewer years of clinical psychiatric experience than did those who diagnosed them as having a non-at-risk mental state (12.5 years vs 22.7 years for the vignette describing at-risk mental state with attenuated positive symptom syndrome, P < 0.01; 14.3 years vs 22.2 years for the vignette describing at-risk mental state with brief intermittent psychotic syndrome, P < 0.01). This study suggests that precise knowledge of at-risk mental state has not been disseminated among Japanese psychiatrists. © 2018 The Authors. Psychiatry and Clinical Neurosciences © 2018 Japanese Society of Psychiatry and Neurology.

42 CFR 431.620 - Agreement with State mental health authority or mental institutions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Agreement with State mental health authority or mental institutions. 431.620 Section 431.620 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... GENERAL ADMINISTRATION Relations With Other Agencies § 431.620 Agreement with State mental health...

42 CFR 431.620 - Agreement with State mental health authority or mental institutions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Agreement with State mental health authority or mental institutions. 431.620 Section 431.620 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... GENERAL ADMINISTRATION Relations With Other Agencies § 431.620 Agreement with State mental health...

42 CFR 431.620 - Agreement with State mental health authority or mental institutions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Agreement with State mental health authority or mental institutions. 431.620 Section 431.620 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... GENERAL ADMINISTRATION Relations With Other Agencies § 431.620 Agreement with State mental health...

42 CFR 431.620 - Agreement with State mental health authority or mental institutions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Agreement with State mental health authority or mental institutions. 431.620 Section 431.620 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... GENERAL ADMINISTRATION Relations With Other Agencies § 431.620 Agreement with State mental health...

42 CFR 431.620 - Agreement with State mental health authority or mental institutions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Agreement with State mental health authority or mental institutions. 431.620 Section 431.620 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... GENERAL ADMINISTRATION Relations With Other Agencies § 431.620 Agreement with State mental health...

Ongoing neural development of affective theory of mind in adolescence.

PubMed

Vetter, Nora C; Weigelt, Sarah; Döhnel, Katrin; Smolka, Michael N; Kliegel, Matthias

2014-07-01

Affective Theory of Mind (ToM), an important aspect of ToM, involves the understanding of affective mental states. This ability is critical in the developmental phase of adolescence, which is often related with socio-emotional problems. Using a developmentally sensitive behavioral task in combination with functional magnetic resonance imaging, the present study investigated the neural development of affective ToM throughout adolescence. Eighteen adolescent (ages 12-14 years) and 18 young adult women (aged 19-25 years) were scanned while evaluating complex affective mental states depicted by actors in video clips. The ventromedial prefrontal cortex (vmPFC) showed significantly stronger activation in adolescents in comparison to adults in the affective ToM condition. Current results indicate that the vmPFC might be involved in the development of affective ToM processing in adolescence. © The Author (2013). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Differential recruitment of theory of mind brain network across three tasks: An independent component analysis.

PubMed

Thye, Melissa D; Ammons, Carla J; Murdaugh, Donna L; Kana, Rajesh K

2018-07-16

Social neuroscience research has focused on an identified network of brain regions primarily associated with processing Theory of Mind (ToM). However, ToM is a broad cognitive process, which encompasses several sub-processes, such as mental state detection and intentional attribution, and the connectivity of brain regions underlying the broader ToM network in response to paradigms assessing these sub-processes requires further characterization. Standard fMRI analyses which focus only on brain activity cannot capture information about ToM processing at a network level. An alternative method, independent component analysis (ICA), is a data-driven technique used to isolate intrinsic connectivity networks, and this approach provides insight into network-level regional recruitment. In this fMRI study, three complementary, but distinct ToM tasks assessing mental state detection (e.g. RMIE: Reading the Mind in the Eyes; RMIV: Reading the Mind in the Voice) and intentional attribution (Causality task) were each analyzed using ICA in order to separately characterize the recruitment and functional connectivity of core nodes in the ToM network in response to the sub-processes of ToM. Based on visual comparison of the derived networks for each task, the spatiotemporal network patterns were similar between the RMIE and RMIV tasks, which elicited mentalizing about the mental states of others, and these networks differed from the network derived for the Causality task, which elicited mentalizing about goal-directed actions. The medial prefrontal cortex, precuneus, and right inferior frontal gyrus were seen in the components with the highest correlation with the task condition for each of the tasks highlighting the role of these regions in general ToM processing. Using a data-driven approach, the current study captured the differences in task-related brain response to ToM in three distinct ToM paradigms. The findings of this study further elucidate the neural mechanisms associated with mental state detection and causal attribution, which represent possible sub-processes of the complex construct of ToM processing. Published by Elsevier B.V.

Sleep and circadian rhythm disruption in social jetlag and mental illness.

PubMed

Foster, Russell G; Peirson, Stuart N; Wulff, Katharina; Winnebeck, Eva; Vetter, Céline; Roenneberg, Till

2013-01-01

Sleep and wake represent two profoundly different states of physiology that arise within the brain from a complex interaction between multiple neural circuits and neurotransmitter systems. These neural networks are, in turn, adjusted by three key drivers that collectively determine the duration, quality, and efficiency of sleep. Two of these drivers are endogenous, namely, the circadian system and a homeostatic hourglass oscillator, while the third is exogenous-our societal structure (social time). In this chapter, we outline the neuroscience of sleep and highlight the links between sleep, mood, cognition, and mental health. We emphasize that the complexity of sleep/wake generation and regulation makes this behavioral cycle very vulnerable to disruption and then explore this concept by examining sleep and circadian rhythm disruption (SCRD) when the exogenous and endogenous drivers of sleep are in conflict. SCRD can be particularly severe when social timing forces an abnormal pattern of sleep and wake upon our endogenous sleep biology. SCRD is also very common in mental illness, and although well known, this association is poorly understood or treated. Recent studies suggest that the generation of sleep and mental health shares overlapping neural mechanisms such that defects in these endogenous pathways result in pathologies to both behaviors. The evidence for this association is examined in some detail. We conclude this review by suggesting that the emerging understanding of the neurobiology of sleep/wake behavior, and of the health consequences of sleep disruption, will provide new ways to decrease the conflict between biological and societal timing in both the healthy and individuals with mental illness. © 2013, Elsevier Inc. All Rights Reserved.

Behavioral health benefits for public employees: effect of mental health parity legislation.

PubMed

Borzi, P C; Rosenbaum, S

2001-04-01

With the passage of the Mental Health Parity Act of 1996 (MHPA), Congress took an important first step toward equalizing treatment under medical plans between physical and mental illnesses by requiring parity in annual and lifetime dollar limits between physical and mental illness. But the Act was limited in scope: it did not mandate mental health benefits nor prohibit other common types of differentials between physical and mental illnesses, such as higher cost-sharing or lower limits on outpatient visits or inpatient treatments. Before Congress' action in 1996, a few of the states had adopted some type of parity requirement. Since 1996, state parity activity has accelerated.Recently, the Center for Health Services Research and Policy through a grant from the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services, examined contracts providing for mental health benefits for state employees in eight states to assess whether legislative attempts to require parity between physical and mental illnesses resulted in noticeable differences in behavioral health benefits for state employees. We concluded that, except in states that have mandated full parity for some or all types of mental illnesses, behavioral health benefits for state employees have not changed significantly as a result of the state parity laws, since they still remain subject to traditional restrictions, such as higher cost-sharing and greater limitations on outpatient visits and inpatient treatment days, than those imposed on physical illnesses. Thus the considerable state activity surrounding mental health parity may have little effect on state employees' access to mental health services, since although state laws required parity in dollar limitations, they generally permitted the continuation of other plan design features that are more restrictive for mental health coverage. However, many of the contracts we examined were multi-year contract and may not have fully reflected recent state activity. Moreover, if Congress renews the Mental Health Parity Act when it expires in September, 2001, and expands the scope of the Act to cover some of these other plan design features, states with more limited parity laws are likely to follow. In that case, perhaps state employees with mental illnesses may see significant change in the future.

Number line estimation and complex mental calculation: Is there a shared cognitive process driving the two tasks?

PubMed

Montefinese, Maria; Semenza, Carlo

2018-05-17

It is widely accepted that different number-related tasks, including solving simple addition and subtraction, may induce attentional shifts on the so-called mental number line, which represents larger numbers on the right and smaller numbers on the left. Recently, it has been shown that different number-related tasks also employ spatial attention shifts along with general cognitive processes. Here we investigated for the first time whether number line estimation and complex mental arithmetic recruit a common mechanism in healthy adults. Participants' performance in two-digit mental additions and subtractions using visual stimuli was compared with their performance in a mental bisection task using auditory numerical intervals. Results showed significant correlations between participants' performance in number line bisection and that in two-digit mental arithmetic operations, especially in additions, providing a first proof of a shared cognitive mechanism (or multiple shared cognitive mechanisms) between auditory number bisection and complex mental calculation.

Affective Aspects of Perceived Loss of Control and Potential Implications for Brain-Computer Interfaces.

PubMed

Grissmann, Sebastian; Zander, Thorsten O; Faller, Josef; Brönstrup, Jonas; Kelava, Augustin; Gramann, Klaus; Gerjets, Peter

2017-01-01

Most brain-computer interfaces (BCIs) focus on detecting single aspects of user states (e.g., motor imagery) in the electroencephalogram (EEG) in order to use these aspects as control input for external systems. This communication can be effective, but unaccounted mental processes can interfere with signals used for classification and thereby introduce changes in the signal properties which could potentially impede BCI classification performance. To improve BCI performance, we propose deploying an approach that potentially allows to describe different mental states that could influence BCI performance. To test this approach, we analyzed neural signatures of potential affective states in data collected in a paradigm where the complex user state of perceived loss of control (LOC) was induced. In this article, source localization methods were used to identify brain dynamics with source located outside but affecting the signal of interest originating from the primary motor areas, pointing to interfering processes in the brain during natural human-machine interaction. In particular, we found affective correlates which were related to perceived LOC. We conclude that additional context information about the ongoing user state might help to improve the applicability of BCIs to real-world scenarios.

Affective Aspects of Perceived Loss of Control and Potential Implications for Brain-Computer Interfaces

PubMed Central

Grissmann, Sebastian; Zander, Thorsten O.; Faller, Josef; Brönstrup, Jonas; Kelava, Augustin; Gramann, Klaus; Gerjets, Peter

2017-01-01

Most brain-computer interfaces (BCIs) focus on detecting single aspects of user states (e.g., motor imagery) in the electroencephalogram (EEG) in order to use these aspects as control input for external systems. This communication can be effective, but unaccounted mental processes can interfere with signals used for classification and thereby introduce changes in the signal properties which could potentially impede BCI classification performance. To improve BCI performance, we propose deploying an approach that potentially allows to describe different mental states that could influence BCI performance. To test this approach, we analyzed neural signatures of potential affective states in data collected in a paradigm where the complex user state of perceived loss of control (LOC) was induced. In this article, source localization methods were used to identify brain dynamics with source located outside but affecting the signal of interest originating from the primary motor areas, pointing to interfering processes in the brain during natural human-machine interaction. In particular, we found affective correlates which were related to perceived LOC. We conclude that additional context information about the ongoing user state might help to improve the applicability of BCIs to real-world scenarios. PMID:28769776

Institutions, Politics, and Mental Health Parity

PubMed Central

Hernandez, Elaine M.; Uggen, Christopher

2013-01-01

Mental health parity laws require insurers to extend comparable benefits for mental and physical health care. Proponents argue that by placing mental health services alongside physical health services, such laws can help ensure needed treatment and destigmatize mental illness. Opponents counter that such mandates are costly or unnecessary. The authors offer a sociological account of the diffusion and spatial distribution of state mental health parity laws. An event history analysis identifies four factors as especially important: diffusion of law, political ideology, the stability of mental health advocacy organizations and the relative health of state economies. Mental health parity is least likely to be established during times of high state unemployment and under the leadership of conservative state legislatures. PMID:24353902

Humans' perceptions of animal mentality: ascriptions of thinking.

PubMed

Rasmussen, J L; Rajecki, D W; Craft, H D

1993-09-01

On rating scales, 294 students indicated whether it was reasonable to say that a dog, cat, bird, fish, and school-age child had the capacity for 12 commonplace human mental operations or experiences. Factor analysis of responses identified 2 levels of attributions, simple thinking and complex thinking. The child and all animals were credited with simple thinking, but respondents were much more likely to ascribe complex thinking to the child. (A pilot study with 8 animal-behavior professionals generally replicated these results.) Certain mental categories (e.g., emotion) were judged by students to be simple for all target types; others (e.g., conservation) were judged to be universally complex. Further factoring revealed articulate ascriptions for key mental categories. Play and imagine was seen as simple in the animals but complex for the child, but enumeration and sorting and dream were seen as simple in the child but complex for the animals.

When There Is No Blueprint: The Provision of Mental Health Services in Alternative School Programs for Suspended and Expelled Youth

ERIC Educational Resources Information Center

Goldenson, Julie

2011-01-01

A variety of alternative programs are being implemented in Canada and the United States for students who have exhibited conduct problems and who are suspended or expelled from their schools. Given the complexity of issues that these students frequently face, treatment must be multifaceted, wrap-around, delivered by trained professionals and be…

There Is More to Mind Reading than Having Theory of Mind Concepts: New Directions in Theory of Mind Research

ERIC Educational Resources Information Center

Samson, Dana; Apperly, Ian A.

2010-01-01

For more than 30 years, researchers have focused on the important transition that children undergo between the ages of 3 and 5, when they start to solve mind-reading problems that require reasoning about complex mental states, such as beliefs. The main question for debate has been whether, during that transition, children acquire new concepts…

A PCA aided cross-covariance scheme for discriminative feature extraction from EEG signals.

PubMed

Zarei, Roozbeh; He, Jing; Siuly, Siuly; Zhang, Yanchun

2017-07-01

Feature extraction of EEG signals plays a significant role in Brain-computer interface (BCI) as it can significantly affect the performance and the computational time of the system. The main aim of the current work is to introduce an innovative algorithm for acquiring reliable discriminating features from EEG signals to improve classification performances and to reduce the time complexity. This study develops a robust feature extraction method combining the principal component analysis (PCA) and the cross-covariance technique (CCOV) for the extraction of discriminatory information from the mental states based on EEG signals in BCI applications. We apply the correlation based variable selection method with the best first search on the extracted features to identify the best feature set for characterizing the distribution of mental state signals. To verify the robustness of the proposed feature extraction method, three machine learning techniques: multilayer perceptron neural networks (MLP), least square support vector machine (LS-SVM), and logistic regression (LR) are employed on the obtained features. The proposed methods are evaluated on two publicly available datasets. Furthermore, we evaluate the performance of the proposed methods by comparing it with some recently reported algorithms. The experimental results show that all three classifiers achieve high performance (above 99% overall classification accuracy) for the proposed feature set. Among these classifiers, the MLP and LS-SVM methods yield the best performance for the obtained feature. The average sensitivity, specificity and classification accuracy for these two classifiers are same, which are 99.32%, 100%, and 99.66%, respectively for the BCI competition dataset IVa and 100%, 100%, and 100%, for the BCI competition dataset IVb. The results also indicate the proposed methods outperform the most recently reported methods by at least 0.25% average accuracy improvement in dataset IVa. The execution time results show that the proposed method has less time complexity after feature selection. The proposed feature extraction method is very effective for getting representatives information from mental states EEG signals in BCI applications and reducing the computational complexity of classifiers by reducing the number of extracted features. Copyright © 2017 Elsevier B.V. All rights reserved.

Electrophysiological difference between mental state decoding and mental state reasoning.

PubMed

Cao, Bihua; Li, Yiyuan; Li, Fuhong; Li, Hong

2012-06-29

Previous studies have explored the neural mechanism of Theory of Mind (ToM), but the neural correlates of its two components, mental state decoding and mental state reasoning, remain unclear. In the present study, participants were presented with various photographs, showing an actor looking at 1 of 2 objects, either with a happy or an unhappy expression. They were asked to either decode the emotion of the actor (mental state decoding task), predict which object would be chosen by the actor (mental state reasoning task), or judge at which object the actor was gazing (physical task), while scalp potentials were recorded. Results showed that (1) the reasoning task elicited an earlier N2 peak than the decoding task did over the prefrontal scalp sites; and (2) during the late positive component (240-440 ms), the reasoning task elicited a more positive deflection than the other two tasks did at the prefrontal scalp sites. In addition, neither the decoding task nor the reasoning task has no left/right hemisphere difference. These findings imply that mental state reasoning differs from mental state decoding early (210 ms) after stimulus onset, and that the prefrontal lobe is the neural basis of mental state reasoning. Copyright © 2012 Elsevier B.V. All rights reserved.

Treatment Disparities among African American Men with Depression: Implications for Clinical Practice

PubMed Central

Hankerson, Sidney H.; Suite, Derek; Bailey, Rahn K.

2015-01-01

A decade has passed since the National Institute of Mental Health initiated its landmark Real Men Real Depression public education campaign. Despite increased awareness, depressed African American men continue to underutilize mental health treatment and have the highest all-cause mortality rates of any racial/ethnic group in the United States. We review a complex array of socio-cultural factors, including racism and discrimination, cultural mistrust, misdiagnosis and clinician bias, and informal support networks that contribute to treatment disparities. We identify clinical and community entry points to engage African American men. We provide specific recommendations for frontline mental health workers to increase depression treatment utilization for African American men. Providers who present treatment options within a frame of holistic health promotion may enhance treatment adherence. We encourage the use of multidisciplinary, community-based participatory research approaches to test our hypotheses and engage African American men in clinical research. PMID:25702724

Treatment disparities among African American men with depression: implications for clinical practice.

PubMed

Hankerson, Sidney H; Suite, Derek; Bailey, Rahn K

2015-02-01

A decade has passed since the National Institute of Mental Health initiated its landmark Real Men Real Depression public education campaign. Despite increased awareness, depressed African American men continue to underutilize mental health treatment and have the highest all-cause mortality rates of any racial/ethnic group in the United States. We review a complex array of socio-cultural factors, including racism and discrimination, cultural mistrust, misdiagnosis and clinician bias, and informal support networks that contribute to treatment disparities. We identify clinical and community entry points to engage African American men. We provide specific recommendations for frontline mental health workers to increase depression treatment utilization for African American men. Providers who present treatment options within a frame of holistic health promotion may enhance treatment adherence. We encourage the use of multidisciplinary, community-based participatory research approaches to test our hypotheses and engage African American men in clinical research.

The use of logistic regression to enhance risk assessment and decision making by mental health administrators.

PubMed

Menditto, Anthony A; Linhorst, Donald M; Coleman, James C; Beck, Niels C

2006-04-01

Development of policies and procedures to contend with the risks presented by elopement, aggression, and suicidal behaviors are long-standing challenges for mental health administrators. Guidance in making such judgments can be obtained through the use of a multivariate statistical technique known as logistic regression. This procedure can be used to develop a predictive equation that is mathematically formulated to use the best combination of predictors, rather than considering just one factor at a time. This paper presents an overview of logistic regression and its utility in mental health administrative decision making. A case example of its application is presented using data on elopements from Missouri's long-term state psychiatric hospitals. Ultimately, the use of statistical prediction analyses tempered with differential qualitative weighting of classification errors can augment decision-making processes in a manner that provides guidance and flexibility while wrestling with the complex problem of risk assessment and decision making.

How to determine decisional capacity in critically ill patients. Presume the patient can make decisions unless proven otherwise.

PubMed

Fleming, C; Momin, Z A; Brensilver, J M; Brandstetter, R D

1995-03-01

Decisional capacity includes ability to comprehend information, to make an informed choice, and to communicate that choice; it is specific to the decision at hand. Presume a patient has decisional capacity; an evaluation of incapacity must be justified. Administer a standardized mental status test to help assess alertness, attention, memory, and reasoning ability. A patient scoring below 10 on the Folstein Mini-Mental State Examination (maximum score, 30) probably does not have decisional capacity; one scoring from 10 to 15 probably can designate a proxy but not make complex health care decisions. Obtain psychiatric consultations for a patient who exhibits psychological barriers to decision making.

A Morpholino Strategy to Assess TSC Gene Function in Zebrafish

DTIC Science & Technology

2006-11-01

ABSTRACT Tuberous sclerosis complex (TSC) is a genetic disorder associated with severe neurological symptoms including mental retardation, autism ...ABSTRACT Tuberous sclerosis complex (TSC) is a genetic disorder associated with severe neurological symptoms including mental retardation, autism ...devastating autosomal dominant disease that results in severe neurological symptoms including mental retardation, autism , and seizures (DiMario, 2004

The Development of Social Cognition: Preschoolers' Use of Mental State Talk in Peer Conflicts

ERIC Educational Resources Information Center

Comparini, Lisa; Douglas, Edith M.; Perez, Sara N.

2014-01-01

Research Findings: This research examines preschoolers' use of mental state terms in naturally occurring peer conflicts in the classroom to determine how children use mental state terms for organizing their social interactions. Analyses focus on the types, frequencies, and social interactive functions of mental state terms. Utterances (N = 166)…

Maternal Mental State Language and Preschool Children's Attachment Security: Relation to Children's Mental State Language and Expressions of Emotional Understanding

ERIC Educational Resources Information Center

Mcquaid, Nancy; Bigelow, Ann E.; McLaughlin, Jessica; MacLean, Kim

2008-01-01

Mothers' mental state language in conversation with their preschool children, and children's preschool attachment security were examined for their effects on children's mental state language and expressions of emotional understanding in their conversation. Children discussed an emotionally salient event with their mothers and then relayed the…

The Relationships of Mental States and Intellectual Processes in the Learning Activities of Students

ERIC Educational Resources Information Center

Prokhorov, Alexander O.; Chernov, Albert V.; Yusupov, Mark G.

2016-01-01

Investigation of the interaction of mental states and cognitive processes in the classroom allows us to solve the problem of increasing the effectiveness of training by activating cognitive processes and management of students' mental states. This article is concerned with the most general patterns of interaction between mental state and…

[Dynamic paradigm in psychopathology: "chaos theory", from physics to psychiatry].

PubMed

Pezard, L; Nandrino, J L

2001-01-01

For the last thirty years, progress in the field of physics, known as "Chaos theory"--or more precisely: non-linear dynamical systems theory--has increased our understanding of complex systems dynamics. This framework's formalism is general enough to be applied in other domains, such as biology or psychology, where complex systems are the rule rather than the exception. Our goal is to show here that this framework can become a valuable tool in scientific fields such as neuroscience and psychiatry where objects possess natural time dependency (i.e. dynamical properties) and non-linear characteristics. The application of non-linear dynamics concepts on these topics is more precise than a loose metaphor and can throw a new light on mental functioning and dysfunctioning. A class of neural networks (recurrent neural networks) constitutes an example of the implementation of the dynamical system concept and provides models of cognitive processes (15). The state of activity of the network is represented in its state space and the time evolution of this state is a trajectory in this space. After a period of time those networks settle on an equilibrium (a kind of attractor). The strength of connections between neurons define the number and relations between those attractors. The attractors of the network are usually interpreted as "mental representations". When an initial condition is imposed to the network, the evolution towards an attractor is considered as a model of information processing (27). This information processing is not defined in a symbolic manner but is a result of the interaction between distributed elements. Several properties of dynamical models can be used to define a way where the symbolic properties emerge from physical and dynamical properties (28) and thus they can be candidates for the definition of the emergence of mental properties on the basis of neuronal dynamics (42). Nevertheless, mental properties can also be considered as the result of an underlying dynamics without explicit mention of the neuronal one (47). In that case, dynamical tools can be used to elucidate the Freudian psychodynamics (34, 35). Recurrent neuronal networks have been used to propose interpretation of several mental dysfunctions (12). For example in the case of schizophrenia, it has been proposed that troubles in the cortical pruning during development (13) may cause a decrease in neural network storage ability and lead to the creation of spurious attractors. Those attractors do not correspond to stored memories and attract a large amount of initial conditions: they were thus associated to reality distorsion observed in schizophrenia (14). Nevertheless, the behavior of these models are too simple to be directly compared with real physiological data. In fact, equilibrium attractors are hardly met in biological dynamics. More complex behaviors (such as oscillations or chaos) should thus to be taken into account. The study of chaotic behavior have lead to the development of numerical methods devoted to the analysis of complex time series (17). These methods may be used to characterise the dynamical processes at the time-scales of both the cerebral dynamics and the clinical symptoms variations. The application of these methods to physiological signals have shown that complex behaviors are related to healthy states whereas simple dynamics are related to pathology (8). These studies have thus confirmed the notion of "dynamical disease" (20, 21) which denotes pathological conditions characterised by changes in physiological rhythms. Depression has been studied within this framework (25, 32) in order to define possible changes in brain electrical rhythms related to this trouble and its evolution. It has been shown that controls' brain dynamics is more complex than depressive one and that the recovery of a complex brain activity depends on the number of previous episodes. In the case of the symptoms time evolution, several studies have demonstrated that non-linear dynamical process may be involved in the recurrence of symptoms in troubles such as manic-depressive illness (9) or schizophrenia (51). These observations can contribute to more parcimonious interpretation of the time course of these illnesses than usual theories. In the search of a relationship between brain dynamics and mental troubles, it has been shown in three depressed patients an important correlation between the characteristics of brain dynamics and the intensity of depressive mood (49). This preliminary observation is in accordance with the emergence hypothesis according which changes in neuronal dynamics should be related to changes in mental processes. We reviewed here some theoretical and experimental results related to the use of "physical" dynamical theory in the field of psychopathology. It has been argued that these applications go beyond metaphor and that they are empirically founded. Nevertheless, these studies only constitute first steps on the way of a cautious development and definition of a "dynamical paradigm" in psychopathology. The introduction of concepts from dynamics such as complexity and dynamical changes (i.e. bifurcations) permits a new perspective on function and dysfunction of the mind/brain and the time evolution of symptoms. Moreover, it offers a ground for the hypothesis of the emergence of mental properties on the basis of neuronal dynamics (42). Since this theory can help to throw light on classical problems in psychopathology, we consider that a precise examination of both its theoretical and empirical consequences is requested to define its validity on this topic.

Connection to mental health care upon community reentry for detained youth: a qualitative study

PubMed Central

2014-01-01

Background Although detained youth evidence increased rates of mental illness, relatively few adolescents utilize mental health care upon release from detention. Thus, the goal of this study is to understand the process of mental health care engagement upon community reentry for mentally-ill detained youth. Methods Qualitative interviews were conducted with 19 youth and caregiver dyads (39 participants) recruited from four Midwest counties affiliated with a state-wide mental health screening project. Previously detained youth (ages 11–17), who had elevated scores on a validated mental health screening measure, and a caregiver were interviewed 30 days post release. A critical realist perspective was used to identify themes on the detention and reentry experiences that impacted youth mental health care acquisition. Results Youth perceived detention as a crisis event and having detention-based mental health care increased their motivation to seek mental health care at reentry. Caregivers described receiving very little information regarding their child during detention and felt “out of the loop,” which resulted in mental health care utilization difficulty. Upon community reentry, long wait periods between detention release and initial contact with court or probation officers were associated with decreased motivation for youth to seek care. However, systemic coordination between the family, court and mental health system facilitated mental health care connection. Conclusions Utilizing mental health care services can be a daunting process, particularly for youth upon community reentry from detention. The current study illustrates that individual, family-specific and systemic issues interact to facilitate or impair mental health care utilization. As such, in order to aid youth in accessing mental health care at detention release, systemic coordination efforts are necessary. The systematic coordination among caregivers, youth, and individuals within the justice system are needed to reduce barriers given that utilization of mental health care is a complex process. PMID:24499325

42 CFR 483.106 - Basic rule.

Code of Federal Regulations, 2011 CFR

2011-10-01

... mental health or mental retardation authority must conduct an annual resident review within 40 calendar... State mental health authority and be based on an independent physical and mental evaluation performed by a person or entity other than the State mental health authority; and (2) For individuals with mental...

42 CFR 483.106 - Basic rule.

Code of Federal Regulations, 2010 CFR

2010-10-01

... mental health or mental retardation authority must conduct an annual resident review within 40 calendar... State mental health authority and be based on an independent physical and mental evaluation performed by a person or entity other than the State mental health authority; and (2) For individuals with mental...

42 CFR 483.106 - Basic rule.

Code of Federal Regulations, 2014 CFR

2014-10-01

... State mental health or intellectual disability authority must conduct an annual resident review within... State mental health authority and be based on an independent physical and mental evaluation performed by a person or entity other than the State mental health authority; and (2) For individuals with...

42 CFR 483.106 - Basic rule.

Code of Federal Regulations, 2013 CFR

2013-10-01

... State mental health or intellectual disability authority must conduct an annual resident review within... State mental health authority and be based on an independent physical and mental evaluation performed by a person or entity other than the State mental health authority; and (2) For individuals with...

42 CFR 483.106 - Basic rule.

Code of Federal Regulations, 2012 CFR

2012-10-01

... State mental health or intellectual disability authority must conduct an annual resident review within... State mental health authority and be based on an independent physical and mental evaluation performed by a person or entity other than the State mental health authority; and (2) For individuals with...

Attachment and mentalization in female patients with comorbid narcissistic and borderline personality disorder.

PubMed

Diamond, Diana; Levy, Kenneth N; Clarkin, John F; Fischer-Kern, Melitta; Cain, Nicole M; Doering, Stephan; Hörz, Susanne; Buchheim, Anna

2014-10-01

We investigated attachment representations and the capacity for mentalization in a sample of adult female borderline patients with and without comorbid narcissistic personality disorder (NPD). Participants were 22 borderline patients diagnosed with comorbid NPD (NPD/BPD) and 129 BPD patients without NPD (BPD) from 2 randomized clinical trials. Attachment and mentalization were assessed on the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1996). Results showed that as expected, compared with the BPD group, the NPD/BPD group was significantly more likely to be categorized as either dismissing or cannot classify on the AAI, whereas the BPD group was more likely to be classified as either preoccupied or unresolved for loss and abuse than was the NPD/BPD group. Both groups of patients scored low on mentalizing, and there were no significant differences between the groups, indicating that both NPD/BPD and BPD individuals showed deficits in this capacity. The clinical implications of the group differences in AAI classification are discussed with a focus on how understanding the attachment representations of NPD/BPD patients helps to illuminate their complex, contradictory mental states. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Neural correlates of naturalistic social cognition: brain-behavior relationships in healthy adults.

PubMed

Deuse, L; Rademacher, L M; Winkler, L; Schultz, R T; Gründer, G; Lammertz, S E

2016-11-01

Being able to infer the thoughts, feelings and intentions of those around us is indispensable in order to function in a social world. Despite growing interest in social cognition and its neural underpinnings, the factors that contribute to successful mental state attribution remain unclear. Current knowledge is limited because the most widely used tasks suffer from two main constraints: (i) They fail to capture individual variability due to ceiling effects and (ii) they use highly simplistic, often artificial stimuli inapt to mirror real-world socio-cognitive demands. In the present study, we address these problems by employing complex depictions of naturalistic social interactions that vary in both valence (positive vs negative) and ambiguity (high vs low). Thirty-eight healthy participants (20 female) made mental state judgments while brain responses were obtained using functional magnetic resonance imaging (fMRI). Accuracy varied based on valence and ambiguity conditions and women were more accurate than men with highly ambiguous social stimuli. Activity of the orbitofrontal cortex predicted performance in the high ambiguity condition. The results shed light on subtle differences in mentalizing abilities and associated neural activity. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

A case report using the mental state examination scale (MSES): a tool for measuring change in mental state.

PubMed

Fernando, Irosh; Carter, Gregory

2016-02-01

There is a need for a simple and brief tool that can be used in routine clinical practice for the quantitative measurement of mental state across all diagnostic groups. The main utilities of such a tool would be to provide a global metric for the mental state examination, and to monitor the progression over time using this metric. We developed the mental state examination scale (MSES), and used it in an acute inpatient setting in routine clinical work to test its initial feasibility. Using a clinical case, the utility of MSES is demonstrated in this paper. When managing the patient described, the MSES assisted the clinician to assess the initial mental state, track the progress of the recovery, and make timely treatment decisions by quantifying the components of the mental state examination. MSES may enhance the quality of clinical practice for clinicians, and potentially serve as an index of universal mental healthcare outcome that can be used in clinical practice, service evaluation, and healthcare economics. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Uncivilizing "Mental Illness": Contextualizing Diverse Mental States and Posthuman Emotional Ecologies within The Icarus Project.

PubMed

Fletcher, Erica Hua

2018-03-01

This article argues humans should not be defined strictly at their physical boundaries with clear distinctions between anatomical bodies, mental states, and the rest of the world. Rather, diverse mental states, which are often diagnosed as "mental illness," take shape within greater environmental forces and flows, including those that are constructed online. Drawing from a multi-sited ethnography of The Icarus Project, a radical mental health community, the author situates online narratives written by two of its members within posthuman emotional ecologies in which the exchange of ideas online affects mental states in a profound way. These narratives can be seen as a new type of psychiatric resistance based in new technologies, one that "uncivilizes" mental illness by searching for alternative frameworks and metaphors to understand lived experiences with mental distress. This ethnographic perspective differs significantly from traditional bio-psychiatric models and interventions and can offer both patients and mental healthcare providers with an alternative language to frame mental health.

Car driving in schizophrenia: can visual memory and organization make a difference?

PubMed

Lipskaya-Velikovsky, Lena; Kotler, Moshe; Weiss, Penina; Kaspi, Maya; Gamzo, Shimrit; Ratzon, Navah

2013-09-01

Driving is a meaningful occupation which is ascribed to functional independence in schizophrenia. Although it is estimated that individuals with schizophrenia have two times more traffic accidents, little research has been done in this field. Present research explores differences in mental status, visual working memory and visual organization between drivers and non-drivers with schizophrenia in comparison to healthy drivers. There were three groups in the study: 20 drivers with schizophrenia, 20 non-driving individuals with schizophrenia and 20 drivers without schizophrenia (DWS). Visual perception was measured with Rey-Osterrieth Complex Figure test and a general cognitive status with Mini-Mental State Examination. The general cognitive status predicted actual driving situation in people with schizophrenia. No statistically significant differences were found between driving and non-driving persons with schizophrenia on any of the visual parameters tested, although these abilities were significantly lower than those of DWS. The research demonstrates that impairment of visual abilities does not prevent people with schizophrenia from driving and emphasizes the importance of general cognitive status for complex and multidimensional everyday tasks. The findings support the need for further investigation in the field of car driving for this population - a move that will considerably contribute to the participation and well-being. Implication for Rehabilitation Unique approach for driving evaluation in schizophrenia should be designed since direct applications of knowledge and practice acquired from other populations are not reliable. This research demonstrates that visual perception deficits in schizophrenia do not prevent clients from driving, and general cognitive status appeared to be a valid determinant for actual driving. We recommended usage of a general test of cognition such as Mini-Mental State Examination, or conjunction number of cognitive factors such as executive functions (e.g., Trail Making Test) and attention (e.g., Continuous Performance Test) in addition to spatial-visual ability tests (e.g., Rey-Osterrieth Complex Figure test) for considering driving status in schizophrenia.

Mind What Teachers Say: Kindergarten Teachers' Use of Mental State Language during Picture Story Narration

ERIC Educational Resources Information Center

Misailidi, Plousia; Papoudi, Despina; Brouzos, Andreas

2013-01-01

The study focuses on the mental state language kindergarten teachers use when narrating picture stories. The aims were to examine (a) individual differences in the frequency with which kindergarten teachers use mental state terms, (b) the types of mental state terms (e.g., emotion, desire, belief terms) teachers use most frequently, and (c) the…

Mental health policy development in the States: the piecemeal nature of transformational change.

PubMed

Garfield, Rachel L

2009-10-01

Transformation--systemic, sweeping changes to promote recovery and consumerism--is a pervasive theme in discussions of U.S. mental health policy. State systems are a fundamental component of national transformation plans. However, it is not clear how the vision of transformation will be balanced against the idiosyncratic political forces that traditionally characterize state policy making. This article examines the development of state mental health policy to assess whether and how it reflects the broader context of transformation versus political forces. Analysis used qualitative evidence collected from semistructured interviews in four states (California, Massachusetts, New Jersey, and New Mexico), which were chosen to capture variation in geography and population, health systems, and political environment. Interviewees included 35 key mental health officials, directors of principal mental health consumer and family advocacy groups, and executives of major mental health provider groups. Interviews were conducted between May 2007 and March 2008. Many recent state policy priorities in mental health are consistent with the overall goals of transformation, but some are particular to a state's circumstance. The case studies showed that these priorities are largely shaped by executive control, stakeholder interests, and crises. There is mixed evidence on whether these drivers of state priorities reflect an underlying transformative process. States' mental health policies are largely guided by the problems and resources of the states: sometimes these forces dovetail with nationwide transformation goals and processes, and sometimes they are idiosyncratic to a particular state. Thus, although states can play an integral role in forwarding transformation, their own mental health policy agendas are not eclipsed by this nationwide movement.

Resilience concepts in psychiatry demonstrated with bipolar disorder.

PubMed

Angeler, David G; Allen, Craig R; Persson, Maj-Liz

2018-02-09

The term resilience describes stress-response patterns of subjects across scientific disciplines. In ecology, advances have been made to clearly distinguish resilience definitions based on underlying mechanistic assumptions. Engineering resilience (rebound) is used for describing the ability of subjects to recover from adverse conditions (disturbances), and is the rate of recovery. In contrast, the ecological resilience definition considers a systemic change: when complex systems (including humans) respond to disturbances by reorganizing into a new regime (stable state) where structural and functional aspects have fundamentally changed relative to the prior regime. In this context, resilience is an emergent property of complex systems. We argue that both resilience definitions and uses are appropriate in psychology and psychiatry, but although the differences are subtle, the implications and uses are profoundly different. We borrow from the field of ecology to discuss resilience concepts in the mental health sciences. In psychology and psychiatry, the prevailing view of resilience is adaptation to, coping with, and recovery (engineering resilience) from adverse social and environmental conditions. Ecological resilience may be useful for describing vulnerability, onset, and the irreversibility patterns of mental disorders. We discuss this in the context of bipolar disorder. Rebound, adaptation, and coping are processes that are subsumed within the broader systemic organization of humans, from which ecological resilience emanates. Discerning resilience concepts in psychology and psychiatry has potential for a mechanistically appropriate contextualization of mental disorders at large. This might contribute to a refinement of theory and contextualize clinical practice within the broader systemic functioning of mental illnesses.

Moving From Static to Dynamic Models of the Onset of Mental Disorder: A Review.

PubMed

Nelson, Barnaby; McGorry, Patrick D; Wichers, Marieke; Wigman, Johanna T W; Hartmann, Jessica A

2017-05-01

In recent years, there has been increased focus on subthreshold stages of mental disorders, with attempts to model and predict which individuals will progress to full-threshold disorder. Given this research attention and the clinical significance of the issue, this article analyzes the assumptions of the theoretical models in the field. Psychiatric research into predicting the onset of mental disorder has shown an overreliance on one-off sampling of cross-sectional data (ie, a snapshot of clinical state and other risk markers) and may benefit from taking dynamic changes into account in predictive modeling. Cross-disciplinary approaches to complex system structures and changes, such as dynamical systems theory, network theory, instability mechanisms, chaos theory, and catastrophe theory, offer potent models that can be applied to the emergence (or decline) of psychopathology, including psychosis prediction, as well as to transdiagnostic emergence of symptoms. Psychiatric research may benefit from approaching psychopathology as a system rather than as a category, identifying dynamics of system change (eg, abrupt vs gradual psychosis onset), and determining the factors to which these systems are most sensitive (eg, interpersonal dynamics and neurochemical change) and the individual variability in system architecture and change. These goals can be advanced by testing hypotheses that emerge from cross-disciplinary models of complex systems. Future studies require repeated longitudinal assessment of relevant variables through either (or a combination of) micro-level (momentary and day-to-day) and macro-level (month and year) assessments. Ecological momentary assessment is a data collection technique appropriate for micro-level assessment. Relevant statistical approaches are joint modeling and time series analysis, including metric-based and model-based methods that draw on the mathematical principles of dynamical systems. This next generation of prediction studies may more accurately model the dynamic nature of psychopathology and system change as well as have treatment implications, such as introducing a means of identifying critical periods of risk for mental state deterioration.

Mental capacity assessments among general hospital inpatients referred to a specialist liaison psychiatry service for older people.

PubMed

Mujic, Fedza; Von Heising, Maite; Stewart, Robert J; Prince, Martin J

2009-08-01

Mental capacity has been little studied among older general hospital inpatients. A retrospective analysis was undertaken of routinely collected data (age, gender, ethnicity, admission diagnosis, psychiatric diagnosis, Mini-mental State Examination score, whether capacity was assessed, the outcome of that assessment, and discharge destination) on referrals to a liaison psychiatry service for older people (2003-2006) from medical and surgical teams at a large London teaching hospital. 1267 patients were referred to the service, of whom 379 (30%) were assessed for capacity. The most common mental capacity issues were placement (303 assessed of whom 54% lacked capacity), treatment (86 assessed, 59% lacking capacity) and finances (70 assessed, 79% lacking capacity). Cognitive impairment, dementia and delirium, rather than mental disorders were associated with incapacity. Those assessed and deemed to lack capacity for placement decisions were twice as likely to be placed in a care home, and four times as likely to be placed in an elderly mentally ill (EMI) facility, independent of dementia diagnosis and cognitive functioning. Referrals to a liaison psychiatry service for older people for assessment of mental capacity are common. The main mental capacity issues in older people were those linked to discharge planning. The relatively high proportion of those found to have capacity when capacity had been queried by referring clinicians attests to the important role of specialist liaison teams, particularly in complex cases, in protecting the autonomy of vulnerable older people, and avoiding institutionalization.

10-Minute Delayed Recall from the Modified Mini-Mental State Test Predicts Alzheimer’s Disease Pathology

PubMed Central

Lyness, Scott A.; Lee, Ae Young; Zarow, Chris; Teng, Evelyn L.; Chui, Helena C.

2014-01-01

We compared the sensitivity and specificity of two delayed recall scores from the Modified Mini-Mental State (3MS) test with consensus clinical diagnosis to differentiate cognitive impairment due to Alzheimer’s disease (AD) versus non-AD pathologies. At a memory disorders clinic, 117 cognitively impaired patients were administered a baseline 3MS test and received a contemporaneous consensus clinical diagnosis. Their brains were examined after death about 5 years later. Using logistic regression with forward selection to predict pathologically defined AD versus non-AD, 10-min delayed recall entered first (p = 0.001), followed by clinical diagnosis (p = 0.02); 1-min delayed recall did not enter. 10-min delayed recall scores ≤4 (score range = 0–9) were 87% sensitive and 47% specific in predicting AD pathology; consensus clinical diagnosis was 82% sensitive and 45% specific. For the 57 patients whose initial Mini-Mental State Examination scores were ≥19 (the median), 3MS 10-min delayed recall scores ≤4 showed some loss of sensitivity (80%) but a substantial gain in specificity (77%). In conclusion, 10-min delayed recall score on the brief 3MS test distinguished between AD versus non-AD pathology about 5 years before death at least as well as consensus clinical diagnosis that requires much more comprehensive information and complex deliberation. PMID:24240637

10-minute delayed recall from the modified mini-mental state test predicts Alzheimer's disease pathology.

PubMed

Lyness, Scott A; Lee, Ae Young; Zarow, Chris; Teng, Evelyn L; Chui, Helena C

2014-01-01

We compared the sensitivity and specificity of two delayed recall scores from the Modified Mini-Mental State (3MS) test with consensus clinical diagnosis to differentiate cognitive impairment due to Alzheimer's disease (AD) versus non-AD pathologies. At a memory disorders clinic, 117 cognitively impaired patients were administered a baseline 3MS test and received a contemporaneous consensus clinical diagnosis. Their brains were examined after death about 5 years later. Using logistic regression with forward selection to predict pathologically defined AD versus non-AD, 10-min delayed recall entered first (p = 0.001), followed by clinical diagnosis (p = 0.02); 1-min delayed recall did not enter. 10-min delayed recall scores ≤4 (score range = 0-9) were 87% sensitive and 47% specific in predicting AD pathology; consensus clinical diagnosis was 82% sensitive and 45% specific. For the 57 patients whose initial Mini-Mental State Examination scores were ≥19 (the median), 3MS 10-min delayed recall scores ≤4 showed some loss of sensitivity (80%) but a substantial gain in specificity (77%). In conclusion, 10-min delayed recall score on the brief 3MS test distinguished between AD versus non-AD pathology about 5 years before death at least as well as consensus clinical diagnosis that requires much more comprehensive information and complex deliberation.

Intersystem return on investment in public mental health: Positive externality of public mental health expenditure for the jail system in the U.S.

PubMed

Yoon, Jangho; Luck, Jeff

2016-12-01

This study examines the extent to which increased public mental health expenditures lead to a reduction in jail populations and computes the associated intersystem return on investment (ROI). We analyze unique panel data on 44 U.S. states and D.C. for years 2001-2009. To isolate the intersystem spillover effect, we exploit variations across states and over time within states in per capita public mental health expenditures and average daily jail inmates. Regression models control for a comprehensive set of determinants of jail incarcerations as well as unobserved determinants specific to state and year. Findings show a positive spillover benefit of increased public mental health spending on the jail system: a 10% increase in per capita public inpatient mental health expenditure on average leads to a 1.5% reduction in jail inmates. We also find that the positive intersystem externality of increased public inpatient mental health expenditure is greater when the level of community mental health spending is lower. Similarly, the intersystem spillover effect of community mental health expenditure is larger when inpatient mental health spending is lower. We compute that overall an extra dollar in public inpatient mental health expenditure by a state would yield an intersystem ROI of a quarter dollar for the jail system. There is significant cross-state variation in the intersystem ROI in both public inpatient and community mental health expenditures, and the ROI overall is greater for inpatient mental health spending than for community mental health spending. Copyright © 2016. Published by Elsevier Ltd.

Service providers' experiences of using a telehealth network 12 months after digitisation of a large Australian rural mental health service.

PubMed

Newman, Lareen; Bidargaddi, Niranjan; Schrader, Geoffrey

2016-10-01

Despite evidence of benefits of telehealth networks in increasing access to, or providing, previously unavailable mental health services, care providers still prefer traditional approaches. For psychiatric assessment, digital technology can offer improvements over analog systems for the technical and, subsequently, the social quality of provider-client interaction. This is in turn expected to support greater provider uptake and enhanced patient benefits. Within the framework of Innovation Diffusion Theory, to study service providers' experiences of an existing regional telehealth network for mental health care practice twelve months after digitisation in order to identify the benefits of digital telehealth over an analog system for mental health care purposes in rural Australia. Qualitative interviews and focus groups were conducted with over 40 service providers from June to September 2013 in South Australia, ranging from the metropolitan central operations to health providers located up to 600km away in rural and remote areas of the same state. Participants included rural mental health teams, directors of nursing at rural hospitals, metropolitan-based psychiatrists and registrars, the metropolitan-based mental health team dedicated to rural provider support, rural GPs, administrative staff, and the executive group of the state rural health department. Fieldwork was conducted 12 months after the analog system was digitised. The interview and focus group data were analysed using thematic analysis, focusing on three key areas of innovation diffusion theory: relative advantage, technical complexity and technical compatibility. Five themes with 11 sub-themes were identified: (1) "Existing Uses", with three sub-themes: current mental health use, use by GPs, and use for staff support; (2) "Relative Advantage", with four sub-themes: improved technical quality, improved clinical practice, time and cost benefits for providers, and improved patient care; (3) "Technical Complexity"; (4) "Technical Compatibility" with two sub-themes: technical-clinical and technical-administrative; and (5) "Broader Organisational Culture", with two sub-themes: organizational policy support and 'digital telehealth' culture. The digitised telehealth network was generally well received by providers and adopted into clinical practice. Compared with the previous analog system, staff found advantages in better visual and audio quality, more technical stability with less "drop-out", less time delay to conversations and less confusion for clients. Despite these advantages, providers identified a range of challenges to starting or continuing use and they recommended improvements to increase uptake among mental health service providers and other providers (including GPs), and to clinical uses other than mental health. To further increase uptake and impact of telehealth-mediated mental health care in rural and remote areas, even with a high quality digital system, future research must design innovative care models, consider time and cost incentives for providers to use telehealth, and must focus not only on technical training but also how to best integrate technology with clinical practice and must develop an organization-wide digital telehealth culture. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

An empirical analysis of mental state talk and affect regulation in two single-cases of psychodynamic child therapy.

PubMed

Halfon, Sibel; Bekar, Ozlem; Gürleyen, Büşra

2017-06-01

Literature has shown the importance of mentalizing techniques in symptom remission and emotional understanding; however, no study to date has looked at the dynamic relations between mental state talk and affect regulation in the psychotherapy process. From a psychodynamic perspective, the emergence of the child's capacity to regulate affect through the therapist's reflection on the child's mental states is a core aspect of treatment. In an empirical investigation of 2 single cases with separation anxiety disorder, who were treated in long-term psychodynamic play therapy informed with mentalization principles, the effect of therapists' and children's use of mental state talk on children's subsequent capacity to regulate affect in play was assessed. One case was a positive outcome case, whereas the other did not show symptomatic improvement at the end of treatment. Children's and therapists' utterances in the sessions were coded using the Coding System for Mental State Talk in Narratives, and children's play was coded by Children's Play Therapy Instrument, which generated an index of children's "affect regulation." Time-series Granger Causality tests showed that even though both therapists' use of mental state talk significantly predicted children's subsequent affect regulation, the association between child's mental state talk and affect regulation was only supported for the child who showed clinically significant symptom reduction. This study provided preliminary support that mental state talk in psychodynamic psychotherapy facilitates emotion regulation in play. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Story Discourse and Use of Mental State Language between Mothers and School-Aged Children with and without Visual Impairment

ERIC Educational Resources Information Center

Tadic, Valerija; Pring, Linda; Dale, Naomi

2013-01-01

Background: Lack of sight compromises insight into other people's mental states. Little is known about the role of maternal language in assisting the development of mental state language in children with visual impairment (VI). Aims: To investigate mental state language strategies of mothers of school-aged children with VI and to compare…

Do US Medical Licensing Applications Treat Mental and Physical Illness Equivalently?

PubMed

Gold, Katherine J; Shih, Elizabeth R; Goldman, Edward B; Schwenk, Thomas L

2017-06-01

State medical licensing boards are responsible for evaluating physician impairment. Given the stigma generated by mental health issues among physicians and in the medical training culture, we were interested in whether states asked about mental and physical health conditions differently and whether questions focused on current impairment. Two authors reviewed physician medical licensing applications for US physicians seeking first-time licensing in 2013 in the 50 states and the District of Columbia. Questions about physical and mental health, as well as substance abuse, were identified and coded as to whether or not they asked about diagnosis and/or treatment or limited the questions to conditions causing physician impairment. Forty-three (84%) states asked questions about mental health conditions, 43 (84%) about physical health conditions, and 47 (92%) about substance use. States were more likely to ask for history of treatment and prior hospitalization for mental health and substance use, compared with physical health disorders. Among states asking about mental health, just 23 (53%) limited all questions to disorders causing functional impairment and just 6 (14%) limited to current problems. While most state medical licensing boards ask about mental health conditions or treatment, only half limited queries to disorders causing impairment. Differences in how state licensing boards assess mental health raise important ethical and legal questions about assessing physician ability to practice and may discourage treatment for physicians who might otherwise benefit from appropriate care.

Immigration Policies and Mental Health Morbidity among Latinos: A State-Level Analysis

PubMed Central

Hatzenbuehler, Mark L.; Prins, Seth; Flake, Morgan; Philbin, Morgan; Frazer, Somjen; Hagen, Daniel; Hirsch, Jennifer

2017-01-01

Rationale Despite abundant state-level policy activity in the U.S. related to immigration, no research has examined the mental health impact of the overall policy climate for Latinos, taking into account both inclusionary and exclusionary legislation. Objective To examine associations between the state-level policy climate related to immigration and mental health outcomes among Latinos. Methods We created a multi-sectoral policy climate index that included 14 policies in four domains (immigration, race/ethnicity, language, and agricultural worker protections). We then examined the relation of this policy climate index to two mental health outcomes (days of poor mental health and psychological distress) among Latinos from 31 states in the 2012 Behavioral Risk Factor Surveillance System (BRFSS), a population-based health survey of non-institutionalized individuals aged 18 years or older. Results Individuals in states with more exclusionary immigration policies had higher rates of poor mental health days than participants in states with less exclusionary policies (RR: 1.05, 95% CI: 1.00, 1.10). The association between state policies and the rate of poor mental health days was significantly higher among Latinos versus non-Latinos (RR for interaction term: 1.03, 95% CI: 1.01, 1.06). Furthermore, Latinos in states with more exclusionary policies had 1.14 (95% CI: 1.04, 1.25) times the rate of poor mental health days than Latinos in states with less exclusionary policies. Results were robust to individual- and state-level confounders. Sensitivity analyses indicated that results were specific to immigration policies, and not indicators of state political climate or of residential segregation. No relationship was observed between the immigration policy index and psychological distress. Conclusion These results suggest that restrictive immigration policies may be detrimental to the mental health of Latinos in the United States. PMID:28043019

"It's not that straightforward": when family support is challenging for mothers living with mental illness.

PubMed

Perera, Dinali N; Short, Liz; Fernbacher, Sabin

2014-09-01

Mental health service providers often have limited or problematic understanding of parents' support needs or experiences and family relationships. Moreover, the impact of family life and relationships for mothers with mental illness, and whether these relationships are experienced as positive or negative, have been largely underinvestigated. This article aims to increase understanding about the complexity of family relationships and support for mothers. Findings may be useful for services when considering family involvement, and for how to better meet the needs of mothers with mental illness and support their recovery. Semistructured interviews were conducted with 8 mothers with mental illness and 11 mental health service providers. This article presents a grounded theory analysis of the complexity of family relationships and support for mothers with mental illness. Family relationships of mothers with mental illness can be complex, potentially difficult, and challenging. Problems in relationships with partners and families, and experiences of abuse, can have harmful consequences on parenting, on mothers' and children's well-being, and on the support mothers receive. This project highlights a need to recognize and work with positive aspects and difficulties in family relationships as part of mental health service provision. Policies can be reviewed to increase the likelihood that mental health care will combine family-sensitive practice with practice that acknowledges difficult family relationships and experiences of family violence in order to maximize support to mothers with mental illness and their children. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

The Effect of Oxygen Enrichment on Cardiorespiratory and Neuropsychological Responses in Workers With Chronic Intermittent Exposure to High Altitude (ALMA, 5,050 m)

PubMed Central

Moraga, Fernando A.; López, Iván; Morales, Alicia; Soza, Daniel; Noack, Jessica

2018-01-01

It is estimated that labor activity at high altitudes in Chile will increase from 60,000 to 120,000 workers by the year 2020. Oxygenation of spaces improves the quality of life for workers at high geographic altitudes (<5,000 m). The aim of this study was to determine the effect of a mobile oxygen module system on cardiorespiratory and neuropsychological performance in a population of workers from Atacama Large Millimeter/submillimeter Array (ALMA, 5,050 m) radiotelescope in the Chajnantor Valley, Chile. We evaluated pulse oximetry, systolic and diastolic arterial pressure (SAP/DAP), and performed neuropsychological tests (Mini-Mental State examination, Rey-Osterrieth Complex Figure test) at environmental oxygen conditions (5,050 m), and subsequently in a mobile oxygenation module that increases the fraction of oxygen in order to mimic the higher oxygen partial pressure of lower altitudes (2,900 m). The use of module oxygenation at an altitude of 5,050 m, simulating an altitude of 2,900 m, increased oxygen saturation from 84 ± 0.8 to 91 ± 0.8% (p < 0.00001), decreased heart rate from 90 ± 8 to 77 ± 12 bpm (p < 0.01) and DAP from 96 ± 3 to 87 ± 5 mmHg (p < 0.01). In addition, mental cognitive state of workers (Mini-Mental State Examination) shown an increased from 19 to 31 points (p < 0.02). Furthermore, the Rey-Osterrieth Complex Figure test (memory) shown a significant increase from 35 to 70 (p < 0.0001). The results demonstrate that the use of an oxygen module system at 5,050 m, simulating an altitude equivalent to 2,900 m, by increasing FiO2 at 28%, significantly improves cardiorespiratory response and enhances neuropsychological performance in workers exposed to an altitude of 5,050 m. PMID:29628892

Heuristics in Managing Complex Clinical Decision Tasks in Experts’ Decision Making

PubMed Central

Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

2016-01-01

Background Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. Objective The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. Method After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. Results We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Conclusion Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Application Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design. PMID:27275019

Heuristics in Managing Complex Clinical Decision Tasks in Experts' Decision Making.

PubMed

Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

2014-09-01

Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design.

State Level Programs to Prepare and Use Mental Health Manpower in a State Mental Health Agency.

ERIC Educational Resources Information Center

Southern Regional Education Board, Atlanta, GA.

To assist mental health agency leaders and others concerned with state mental health manpower development, these guidelines (presented in ten sections) explore various issues and approaches and indications for using one approach over another. The first three sections focus on designing and conducting manpower studies, making long range projections…

Teachers' Language in Interactions: An Exploratory Examination of Mental State Talk in Early Childhood Education Classrooms

ERIC Educational Resources Information Center

King, Elizabeth; La Paro, Karen

2015-01-01

Research Findings: This study examined 34 Head Start teachers' use of four categories of mental state talk (verbalizations of mental processes using emotion terms, cognition terms, desire terms, and perception terms) during naturally occurring classroom interactions. Transcriptions from classroom videos were coded for mental state talk…

Meeting the challenge of Hawaii's mental health crisis: new opportunities and innovations in the state mental health system for the 1990s.

PubMed

Lewin, J C

1989-03-01

Recently, Hawaii's mental health care system has been in the news because of its alleged infamy as one of the poorest systems in the United States of America today. Hawaii has not always been considered a state with a conspicuously poor commitment to mental health. The Department of Health (DOH), the oldest department of health in the United States of America, was formed in 1850 by King Kamehameha III. In fact, Kamehameha III, recognizing the importance of developing programs in mental health, was one of the earliest political leaders in history to support government-sponsored mental health services.

Estimating the number of adults with severe and persistent mental illness who have complex, multi-agency needs.

PubMed

Whiteford, Harvey; Buckingham, Bill; Harris, Meredith; Diminic, Sandra; Stockings, Emily; Degenhardt, Louisa

2017-08-01

A population health approach to mental health service planning requires estimates that align interventions with the needs of people with mental illness. The primary objective was to estimate the number of people in Australia living with severe and persistent mental illness who have complex, multi-agency needs. The secondary objective was to describe the possible service needs of individuals with severe mental illness. We disaggregated the estimated 12-month prevalence of adults with severe mental illness into needs-based sub-groups, using multiple data sources. Possible service needs of 1825 adults with psychotic disorders and 334 adults with severe past-year affective and/or anxiety disorders were described using data from the 2010 Survey of High Impact Psychosis and 2007 National Survey of Mental Health and Wellbeing, respectively. Using best available data, we estimated that 3.3% of adults experience a severe mental illness each year, of whom one-third (1.1% of adults) experience a persistent mental illness that requires ongoing services to address residual disability. Among those with severe and persistent mental illness, one-third of adults (0.4% or 59,000 adults in 2015) have complex needs requiring multi-agency support to maximise their health, housing, social participation and personal functioning. Survey of High Impact Psychosis data indicated that among adults with psychotic disorders, use of accommodation (40%), non-government (30%) services and receipt of income support (85%) services were common, as were possible needs for support with socialising, personal care and employment. National Survey of Mental Health and Wellbeing data indicated that among individuals with severe affective and anxiety disorders, receipt of income support (37%) was common (information on accommodation and non-government support services was not available), as were possible needs for financial management and employment support. Agreed indicators of complex, multi-agency needs are required to refine these estimates. Closer alignment of information collected about possible service needs across epidemiological surveys is needed.

Criticism and Depression among the Caregivers of At-Risk Mental State and First-Episode Psychosis Patients

PubMed Central

Hamaie, Yumiko; Ohmuro, Noriyuki; Katsura, Masahiro; Obara, Chika; Kikuchi, Tatsuo; Ito, Fumiaki; Miyakoshi, Tetsuo; Matsuoka, Hiroo; Matsumoto, Kazunori

2016-01-01

Expressed emotion (EE), especially criticism, is an important predictor of outcomes for the patient for a wide range of mental health problems. To understand complex links between EE and various relevant variables in early phase psychosis, this study examined criticism, distress of caregivers, other patients’, and caregivers’ variables, and links between criticism and these variables in those with at-risk mental state (ARMS) for psychosis and first-episode psychosis (FEP). The participants were 56 patients (mean age 18.8 ± 4.2 years) with ARMS and their caregivers (49.4 ± 5.8 years) and 43 patients (21.7 ± 5.2 years) with FEP and their caregivers (49.3 ± 7.4 years). We investigated criticisms made by caregivers using the Japanese version of the Family Attitude Scale and caregiver depressive symptoms via the self-report Beck Depression Inventory. We also assessed psychiatric symptoms and functioning of the patients. Approximately one-third of caregivers of patients with ARMS or FEP had depressive symptoms, predominately with mild-to-moderate symptom levels, whereas only a small portion exhibited high criticism. The level of criticism and depression were comparable between ARMS and FEP caregivers. The link between criticism, caregivers’ depression, and patients’ symptoms were observed in FEP but not in ARMS caregivers. These findings imply that the interaction between criticism and caregivers’ and patients’ mental states may develop during or after the onset of established psychosis and interventions for the caregivers should be tailored to the patient’s specific stage of illness. Interventions for FEP caregivers should target their emotional distress and include education about patient’s general symptoms. PMID:26918629

Effects of consumption of sucromalt, a slowly digestible carbohydrate, on mental and physical energy questionnaire responses.

PubMed

Dammann, Kristen W; Bell, Margie; Kanter, Mitch; Berger, Alvin

2013-03-01

To evaluate whether consumption of the low-glycemic index (GI) carbohydrate sucromalt improves healthy adults' perceptions of mental and physical energy and fatigue compared to dextrose (glucose), a high GI control. In this double-blind, randomized, cross-over study, subjects (n = 44 healthy adults) consumed a standardized dinner, and following an overnight fast, ingested 75 g of either sucromalt or glucose in solution at 7:30 AM the next day. Subjects completed validated questionnaires that assessed mental and physical energy, and fatigue, hunger, and sleepiness at baseline and hourly until 12:30 PM for a total of five post-consumption time points. Within-subject differences adjusted for baseline for individual questions and composite scores (Mental Energy State, Mental Fatigue State, Physical Energy State, and Physical Fatigue State) were analyzed using repeated measures analysis of variance. Mental Energy State, Physical Energy State, and Physical Fatigue State results favored sucromalt compared to glucose, with significant differences emerging particularly after 4-5 hours (P < 0.050). A trend toward a delay in Mental Fatigue State was also observed with sucromalt compared to glucose (P < 0.100). Minimal differences in ratings of hunger and sleepiness were observed between the beverages. Sucromalt may help attenuate the perceived decline in mental and physical energy and rise in mental and physical fatigue that can occur 4-5 hours after ingestion of a high GI beverage. Trials examining effects of sucromalt on cognitive and physical performance are of future interest.

Understanding the Effects of Team Cognition Associated with Complex Engineering Tasks: Dynamics of Shared Mental Models, Task-SMM, and Team-SMM

ERIC Educational Resources Information Center

Lee, Miyoung; Johnson, Tristan E.

2008-01-01

This study investigates how shared mental models (SMMs) change over time in teams of students in a manufacturing engineering course. A complex ill-structured project was given to each team. The objective of the team project was to analyze, test, and propose ways to improve their given manufactured product. Shared mental models were measured in…

Neuroreductionism about Sex and Love.

PubMed

Savulescu, Julian; Earp, Brian D

2014-01-01

"Neuroreductionism" is the tendency to reduce complex mental phenomena to brain states, confusing correlation for physical causation. In this paper, we illustrate the dangers of this popular neuro-fallacy, by looking at an example drawn from the media: a story about "hypoactive sexual desire disorder" in women. We discuss the role of folk dualism in perpetuating such a confusion, and draw some conclusions about the role of "brain scans" in our understanding of romantic love.

Linguistic and pragmatic aspects of narration in Finnish typically developing children and children with specific language impairment.

PubMed

Mäkinen, Leena; Loukusa, Soile; Laukkanen, Päivi; Leinonen, Eeva; Kunnari, Sari

2014-06-01

This study investigates narratives of Finnish children with specific language impairment (SLI) from linguistic and pragmatic perspectives, in order to get a comprehensive overview of these children's narrative abilities. Nineteen children with SLI (mean age 6;1 years) and 19 typically developing age-matched children participated in the study. Their picture-elicited narrations were analysed for linguistic productivity and complexity, grammatical and referential accuracy, event content, the use of mental state expressions and narrative comprehension. Children with SLI showed difficulties in every aspect of narration in comparison to their peers. Only one measure of productivity, the number of communication units, did not reach statistical significance. Not only was linguistic structure fragile but also pragmatic aspects of storytelling (referencing, event content, mental state expressions and inferencing) were demanding for children with SLI. Results suggest that pragmatic aspects of narration should be taken into account more often when assessing narrative abilities of children with SLI.

Measuring mental workload with the NASA-TLX needs to examine each dimension rather than relying on the global score: an example with driving.

PubMed

Galy, Edith; Paxion, Julie; Berthelon, Catherine

2018-04-01

The distinction between several components of mental workload is often made in the ergonomics literature. However, measurements used are often established from a global score, notably with several questionnaires that originally reflect several dimensions. The present study tested the effect of driving situation complexity, experience and subjective levels of tension and alertness on each dimension of the NASA-TLX questionnaire of workload, in order to highlight the potential influence of intrinsic, extraneous and germane load factors. The results showed that, in complex situation, mental, temporal and physical demand (load dimensions) increased, and that novice drivers presented high physical demand when subjective tension was low on performance. Moreover, increase of mental and physical demand increased effort. It thus, appears essential to distinguish the different components of mental workload used in the NASA-TLX questionnaire. Practitioner Summary: Currently, global score of NASA-TLX questionnaire is used to measure mental workload. Here, we considered independently each dimension of NASA-TLX, and results showed that mental load factors (driving situation complexity, experience, subjective tension and alertness) had a different effect on dimensions, questioning global score use to evaluate workload.

Children's Developing Understanding of Mental Verbs: Remember, Know, and Guess.

ERIC Educational Resources Information Center

Johnson, Carl Nils; Wellman, Henry M.

1980-01-01

Preschoolers interpreted mental verbs with respect to their mental state in contrast to external state. These children were nontheless ignorant of definitive distinctions between the mental verbs, completely confusing cases of remembering, knowing, and guessing. (Author/RH)

Mental states inside out: switching costs for emotional and nonemotional sentences that differ in internal and external focus.

PubMed

Oosterwijk, Suzanne; Winkielman, Piotr; Pecher, Diane; Zeelenberg, René; Rotteveel, Mark; Fischer, Agneta H

2012-01-01

Mental states-such as thinking, remembering, or feeling angry, happy, or dizzy-have a clear internal component. We feel a certain way when we are in these states. These internal experiences may be simulated when people understand conceptual references to mental states. However, mental states can also be described from an "external" perspective, for example when referring to "smiling." In those cases, simulation of visible outside features may be more relevant for understanding. In a switching costs paradigm, we presented semantically unrelated sentences describing emotional and nonemotional mental states while manipulating their internal or external focus. The results show that switching costs occur when participants shift between sentences with an internal and an external focus. This suggests that different forms of simulation underlie understanding these sentences. In addition, these effects occurred for emotional and nonemotional mental states, suggesting that they are grounded in a similar way-through the process of simulation.

States of mind: Emotions, body feelings, and thoughts share distributed neural networks

PubMed Central

Oosterwijk, Suzanne; Lindquist, Kristen A.; Anderson, Eric; Dautoff, Rebecca; Moriguchi, Yoshiya; Barrett, Lisa Feldman

2012-01-01

Scientists have traditionally assumed that different kinds of mental states (e.g., fear, disgust, love, memory, planning, concentration, etc.) correspond to different psychological faculties that have domain-specific correlates in the brain. Yet, growing evidence points to the constructionist hypothesis that mental states emerge from the combination of domain-general psychological processes that map to large-scale distributed brain networks. In this paper, we report a novel study testing a constructionist model of the mind in which participants generated three kinds of mental states (emotions, body feelings, or thoughts) while we measured activity within large-scale distributed brain networks using fMRI. We examined the similarity and differences in the pattern of network activity across these three classes of mental states. Consistent with a constructionist hypothesis, a combination of large-scale distributed networks contributed to emotions, thoughts, and body feelings, although these mental states differed in the relative contribution of those networks. Implications for a constructionist functional architecture of diverse mental states are discussed. PMID:22677148

[Mental Health: Concepts, Measures, Determinants].

PubMed

Doré, Isabelle; Caron, Jean

Objectives This article aims to situate the concept of mental health in a historical perspective. This article presents the most commonly used measurement tools in Canada and elsewhere in the world to assess specific and multiple dimensions of mental health; when available, psychometric properties are discussed. Finally, research findings on quality of life and mental health determinants are presented.Methods A literature review of concepts, measurement and determinants of mental health is presented in this paper. The selection of measurement scales presented is based on the findings of the research reports conducted by the second author, an expert on mental health measures, for Health Canada and Statistics Canada.Results Mental health is more than the absence of mental illness; rather it is a state of complete well-being, which refers to our ability to enjoy life and deal with the challenges we face. Accordingly, mental health and mental illness are not extremes of the same continuum, but distinct yet correlated concepts. The traditional conceptualization suggesting that mental health represents simply the absence of mental illness has been replaced, in the last few decades, by a more holistic characterization, which directly concerns public health. The components of mental health include emotional well-being/quality of life (QOL) and psychological and social well-being. Mental health influences the personal and social functioning of individuals, justifying the importance of intervening upstream to promote mental health. Specific scales are relevant for obtaining a detailed measure of one aspect of well-being in particular (emotional/quality of life, psychological or social well-being); however, to account for the global mental health status, measurement tools that integrate all three forms of well-being (emotional, psychological and social) should be privileged. A diversity of determinants at the individual, social and neighbourhood levels influence quality of life and well-being. These determinants are interrelated, and the complex and cumulative interaction of these determinants involves the use of comprehensive strategies for mental health promotion.Conclusion We hope this article provides the reader with information to become familiar with the concepts and tools that aim at informing research, public health surveillance, public policy and programs for mental health promotion.

Sterilization of the Mentally Ill and the Mentally Retarded.

ERIC Educational Resources Information Center

National Association of State Mental Health Program Directors, Washington, DC.

Reported were the results of a survey on the sterilization of the mentally ill and the mentally retarded. Thirty-three states responded to the survey. It was found that 17 states have a sterilization statute, but the existence of the statute was explained not to mean that the procedure was used. Sixteen states responded that they did not have a…

Personality disorder is an excess risk factor for physical multimorbidity among women with mental state disorders.

PubMed

Quirk, Shae E; Stuart, Amanda L; Berk, Michael; Pasco, Julie A; Brennan Olsen, Sharon L; Koivumaa-Honkanen, Heli; Honkanen, Risto; Lukkala, Pyry S; Chanen, Andrew M; Kotowicz, Mark; Williams, Lana J

2017-11-01

We examined whether mental state disorders (lifetime mood, anxiety, eating, substance misuse) with comorbid personality disorder are associated with physical multimorbidity in a population-based sample of women. Mental state and personality disorders were assessed using semi-structured diagnostic interviews. Clinical measures were performed and medical conditions, medication use and lifestyle factors were documented by questionnaire. Mental state disorders were associated with higher odds of physical multimorbidity; risk was especially high for those with comorbid personality disorder. These findings suggest that mental state and physical comorbidity might be worsened by the additional comorbidity of personality disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

A Different Trolley Problem: The Limits of Environmental Justice and the Promise of Complex Moral Assessments for Transportation Infrastructure.

PubMed

Epting, Shane

2016-12-01

Transportation infrastructure tremendously affects the quality of life for urban residents, influences public and mental health, and shapes social relations. Historically, the topic is rich with social and political controversy and the resultant transit systems in the United States cause problems for minority residents and issues for the public. Environmental justice frameworks provide a means to identify and address harms that affect marginalized groups, but environmental justice has limits that cannot account for the mainstream population. To account for this condition, I employ a complex moral assessment measure that provides a way to talk about harms that affect the public.

Mental workload measurement for emergency operating procedures in digital nuclear power plants.

PubMed

Gao, Qin; Wang, Yang; Song, Fei; Li, Zhizhong; Dong, Xiaolu

2013-01-01

Mental workload is a major consideration for the design of emergency operation procedures (EOPs) in nuclear power plants. Continuous and objective measures are desired. This paper compares seven mental workload measurement methods (pupil size, blink rate, blink duration, heart rate variability, parasympathetic/sympathetic ratio, total power and (Goals, Operations, Methods, and Section Rules)-(Keystroke Level Model) GOMS-KLM-based workload index) with regard to sensitivity, validity and intrusiveness. Eighteen participants performed two computerised EOPs of different complexity levels, and mental workload measures were collected during the experiment. The results show that the blink rate is sensitive to both the difference in the overall task complexity and changes in peak complexity within EOPs, that the error rate is sensitive to the level of arousal and correlate to the step error rate and that blink duration increases over the task period in both low and high complexity EOPs. Cardiac measures were able to distinguish tasks with different overall complexity. The intrusiveness of the physiological instruments is acceptable. Finally, the six physiological measures were integrated using group method of data handling to predict perceived overall mental workload. The study compared seven measures for evaluating the mental workload with emergency operation procedure in nuclear power plants. An experiment with simulated procedures was carried out, and the results show that eye response measures are useful for assessing temporal changes of workload whereas cardiac measures are useful for evaluating the overall workload.

Mental Contrasting of a Negative Future with a Positive Reality Regulates State Anxiety

PubMed Central

Brodersen, Gunnar; Oettingen, Gabriele

2017-01-01

Mental contrasting of a desired future with impeding reality is a self-regulatory strategy fostering goal pursuit. However, there is little research on mental contrasting of a negative future with a positive reality. We conducted two experiments, each with four experimental conditions, investigating the effects of mental contrasting a negative future with a positive reality on state anxiety: participants who mentally contrasted a negative future regarding a bacterial epidemic (Study 1, N = 199) or an idiosyncratic negative event (Study 2, N = 206) showed less state anxiety than participants who imagined the negative future only or who reverse contrasted; participants who mentally elaborated on the positive reality also showed less state anxiety. Our findings suggest that mental contrasting of a negative future helps people reduce disproportional anxiety regarding a negative future. PMID:28979223

42 CFR 483.130 - PASARR determination criteria.

Code of Federal Regulations, 2011 CFR

2011-10-01

... criteria. (a) Basis for determinations. Determinations made by the State mental health or mental... determinations by category. Advance group determinations by category developed by the State mental health or... records, physician's evaluations, election of hospice status, records of community mental health centers...

Transitions Study of predictors of illness progression in young people with mental ill health: study methodology.

PubMed

Purcell, R; Jorm, A F; Hickie, I B; Yung, A R; Pantelis, C; Amminger, G P; Glozier, N; Killackey, E; Phillips, L; Wood, S J; Mackinnon, A; Scott, E; Kenyon, A; Mundy, L; Nichles, A; Scaffidi, A; Spiliotacopoulos, D; Taylor, L; Tong, J P Y; Wiltink, S; Zmicerevska, N; Hermens, Daniel; Guastella, Adam; McGorry, P D

2015-02-01

An estimated 75% of mental disorders begin before the age of 24 and approximately 25% of 13-24-year-olds are affected by mental disorders at any one time. To better understand and ideally prevent the onset of post-pubertal mental disorders, a clinical staging model has been proposed that provides a longitudinal perspective of illness development. This heuristic model takes account of the differential effects of both genetic and environmental risk factors, as well as markers relevant to the stage of illness, course or prognosis. The aim of the Transitions Study is to test empirically the assumptions that underpin the clinical staging model. Additionally, it will permit investigation of a range of psychological, social and genetic markers in terms of their capacity to define current clinical stage or predict transition from less severe or enduring to more severe and persistent stages of mental disorder. This paper describes the study methodology, which involves a longitudinal cohort design implemented within four headspace youth mental health services in Australia. Participants are young people aged 12-25 years who have sought help at headspace and consented to complete a comprehensive assessment of clinical state and psychosocial risk factors. A total of 802 young people (66% female) completed baseline assessments. Annual follow-up assessments have commenced. The results of this study may have implications for the way mental disorders are diagnosed and treated, and progress our understanding of the pathophysiologies of complex mental disorders by identifying genetic or psychosocial markers of illness stage or progression. © 2013 Wiley Publishing Asia Pty Ltd.

[Mental health in the immigrant population in Spain].

PubMed

Collazos Sánchez, Francisco; Ghali Bada, Khalid; Ramos Gascón, Mar; Qureshi Burckhardt, Adil

2014-01-01

The relationship between migration of people and the impact on their mental health is a complex issue, and its study implies multiple variables at stake. The objective is to describe the state of the mental health of the immigrant population in Spain. scoping Review of the literature published in the period 1998-2012. Articles in Spanish or English developed in Spain and that fulfil the definition of immigrant from the International Organization for Migration were selected. The literature search was performed in Medline and MEDES. The main characteristics of the articles are described. The period of maximum production is between 2004 and 2011. The country of origin is the most common way of classifying immigrants. Most of the studies reviewed have a social and epidemiological approach, making many references to the socio-economic conditions of the inmigrant collective. Work and psychosocial factors are crucial to the mental health of immigrants. The migration process is a risk factor itself, and if personal, social or familial vulnerability is added, all of which may promote the development of mental disorders. The main results of the studies conducted in this field are inconsistent, if not contradictory. Lack of consistency in the results reveals how this field is still in a very early stage.

Mental Illness Discrimination in Mental Health Treatment Programs: Intersections of Race, Ethnicity, and Sexual Orientation.

PubMed

Holley, Lynn C; Tavassoli, Kyoko Y; Stromwall, Layne K

2016-04-01

People with mental illnesses (PWMI) who are of color and/or lesbian, gay, or bisexual (LGB) experience mental health disparities, including within mental health treatment programs (MHTPs). Informed by a critical framework with attention to intersectionality and microaggressions, this qualitative study asked 20 PWMI and family members who also are of color and/or LGB whether they had experienced mental illness discrimination in MHTPs, a possible factor in disparities. We also asked participants about aspects of MHTPs that supported recovery. Participants reported that they were ignored/not listened to, not viewed as complex individuals, experienced condescension/lack of respect and violations of privacy or other rights, and were presumed to lack intelligence. In addition, identifying mental illness discrimination was complex due to intersections of identities. Despite these perceptions of discrimination, participants described supportive aspects of MHTPs. Implications for practice and research are offered.

Prader-Willi syndrome mental health research strategy workshop proceedings: the state of the science and future directions.

PubMed

Schwartz, Lauren; Holland, Anthony; Dykens, Elisabeth; Strong, Theresa; Roof, Elizabeth; Bohonowych, Jessica

2016-09-29

This paper reports on the 'Prader-Willi Syndrome (PWS) Mental Health Research Strategy Workshop' that took place in March 2015. PWS is characterized by a complex phenotype affecting multiple systems with a high prevalence of maladaptive behaviours, and neuropsychiatric illness. Prader Willi syndrome results from the absence of paternally derived alleles located at the imprinted chromosomal locus, 15q11-13. The goal of the workshop was to highlight the state of the science of the mental health of people with this rare neurodevelopmental disorder. Mental ill health and maladaptive behaviors significantly impact quality of life for persons with PWS and their caregivers. Effective treatments and further research into this area are critically needed. A multidisciplinary group of scientists and health care professionals were brought together to discuss the mental health and behavioral needs of people with PWS. The workshop strategy was to integrate established work on PWS with other relevant areas of study. The meeting also focused on two neurobiological systems that research had suggested were relevant to understanding the broader mental health aspects of PWS: the autonomic nervous system and oxytocin/vasopressin pathways. Other relevant topics were considered and recommendations made. The workshop presentations and working group discussions revealed that no one approach was sufficient to fully conceptualize the mental health challenges in PWS. Workshop discussions pointed to the need for theoretically informed studies focused on clinical characterization, measurement, and the probing of specific neurobiological systems through pharmaceutical or other interventions. Future studies in this area should explore the use of advanced neuroimaging protocols, as well as molecular studies using iPS cells in order to create more informed theories. Within this framework, workshop participants identified and prioritized key research questions, and highlighted current opportunities. Recommendations were made with respect to the development of specific resources and tools for furthering mental health research such as The Global PWS Registry, the development of effective endpoints, the use of animal models and iPS cells to aid understanding of the neurobiological underpinnings. Additionally, collaborative opportunities across disciplines and syndromes were highlighted and targeted research initiatives focused on psychological/behavioral interventions modified for use in PWS were recommended.

Levels of Information Processing in a Fitts law task (LIPFitts)

NASA Technical Reports Server (NTRS)

Mosier, K. L.; Hart, S. G.

1986-01-01

State-of-the-art flight technology has restructured the task of human operators, decreasing the need for physical and sensory resources, and increasing the quantity of cognitive effort required, changing it qualitatively. Recent technological advances have the most potential for impacting a pilot in two areas: performance and mental workload. In an environment in which timing is critical, additional cognitive processing can cause performance decrements, and increase a pilot's perception of the mental workload involved. The effects of stimulus processing demands on motor response performance and subjective mental workload are examined, using different combinations of response selection and target acquisition tasks. The information processing demands of the response selection were varied (e.g., Sternberg memory set tasks, math equations, pattern matching), as was the difficulty of the response execution. Response latency as well as subjective workload ratings varied in accordance with the cognitive complexity of the task. Movement times varied according to the difficulty of the response execution task. Implications in terms of real-world flight situations are discussed.

Organizational determinants of efficiency and effectiveness in mental health partial care programs.

PubMed Central

Schinnar, A P; Kamis-Gould, E; Delucia, N; Rothbard, A B

1990-01-01

The use of partial care as a treatment modality for mentally ill patients, particularly the chronically mentally ill, has greatly increased. However, research into what constitutes a "good" program has been scant. This article reports on an evaluation study of staff productivity, cost efficiency, and service effectiveness of adult partial care programs carried out in New Jersey in fiscal year 1984/1985. Five program performance indexes are developed based on comparisons of multiple measures of resources, service activities, and client outcomes. These are used to test various hypotheses regarding the effect of organizational and fiscal variables on partial care program efficiency and effectiveness. The four issues explored are: auspices, organizational complexity, service mix, and fiscal control by the state. These were found to explain about half of the variance in program performance. In addition, partial care programs demonstrating midlevel performance with regard to productivity and efficiency were observed to be the most effective, implying a possible optimal level of efficiency at which effectiveness is maximized. PMID:2113046

Emergency department utilization among Medicaid beneficiaries with schizophrenia and diabetes: The consequences of increasing medical complexity

PubMed Central

Shim, Ruth S.; Druss, Benjamin G.; Zhang, Shun; Kim, Giyeon; Oderinde, Adesoji; Shoyinka, Sosunmolu; Rust, George

2014-01-01

Objective Individuals with both physical and mental health problems may have elevated levels of emergency department (ED) service utilization either for index conditions or for associated comorbidities. This study examines the use of ED services by Medicaid beneficiaries with comorbid diabetes and schizophrenia, a dyad with particularly high levels of clinical complexity. Methods Retrospective cohort analysis of claims data for Medicaid beneficiaries with both schizophrenia and diabetes from fourteen Southern states was compared with patients with diabetes only, schizophrenia only, and patients with any diagnosis other than schizophrenia and diabetes. Key outcome variables for individuals with comorbid schizophrenia and diabetes were ED visits for diabetes, mental health-related conditions, and other causes. Results Medicaid patients with comorbid diabetes and schizophrenia had an average number of 7.5 ED visits per year, compared to the sample Medicaid population with neither diabetes nor schizophrenia (1.9 ED visits per year), diabetes only (4.7 ED visits per year), and schizophrenia only (5.3 ED visits per year). Greater numbers of comorbidities (over and above diabetes and schizophrenia) were associated with substantial increases in diabetes-related, mental health-related and all-cause ED visits. Most ED visits in all patients, but especially in patients with more comorbidities, were for causes other than diabetes or mental health-related conditions. Conclusion Most ED utilization by individuals with diabetes and schizophrenia is for increasing numbers of comorbidities rather than the index conditions. Improving care in this population will require management of both index conditions as well as comorbid ones. PMID:24380780

Mental Health Services for Children and Youth: Strengthening the Promise of the Future. Human Services Series.

ERIC Educational Resources Information Center

Craig, Rebecca T.

1988-01-01

Many mentally ill children, especially those who are seriously disturbed, are not receiving the mental health care they need. Although the federal government offers financing to the states for child and adolescent mental health programming, the primary responsibility for financing mental health services has been assumed by state governments. At…

The intersection of physician wellbeing and clinical application of diabetes guidelines.

PubMed

Seehusen, Dean A; Deavers, Justin; Mainous, Arch G; Ledford, Christy J W

2018-05-01

Prediabetes (preDM) and diabetes are complex conditions that place significant strain on medical providers. This can have a negative impact on providers' wellbeing and could impact clinical decisions. We investigated the interplay of caring for patients with prediabetes, physician mental wellbeing, and clinical care. Using the theory of planned behavior, we conducted a secondary analysis to evaluate physicians' self-reported provision of care to patients with preDM. We evaluated the effect of mental wellbeing and perceived barriers to caring for patients with preDM. Among 1015 academic physicians, a greater perception of barriers to care and a higher percentage of patients seen with preDM were both significantly associated with a less positive physician state of mind. Physician state of mind was not associated with self-reported clinical behavior. Physician perception of patient barriers has a positive correlation with their likelihood of prescribing metformin for preDM. Caring for a larger proportion of patients with preDM is associated with worse mental wellbeing. Physician attitudes and subjective norms may predict adherence to guidelines, while physician attitudes and wellbeing affect self-reported prescribing behavior. Future research should evaluate ways to lessen the psychological burden of caring for patients with diabetes and preDM. Published by Elsevier B.V.

How are you feeling?: A personalized methodology for predicting mental states from temporally observable physical and behavioral information.

PubMed

Tuarob, Suppawong; Tucker, Conrad S; Kumara, Soundar; Giles, C Lee; Pincus, Aaron L; Conroy, David E; Ram, Nilam

2017-04-01

It is believed that anomalous mental states such as stress and anxiety not only cause suffering for the individuals, but also lead to tragedies in some extreme cases. The ability to predict the mental state of an individual at both current and future time periods could prove critical to healthcare practitioners. Currently, the practical way to predict an individual's mental state is through mental examinations that involve psychological experts performing the evaluations. However, such methods can be time and resource consuming, mitigating their broad applicability to a wide population. Furthermore, some individuals may also be unaware of their mental states or may feel uncomfortable to express themselves during the evaluations. Hence, their anomalous mental states could remain undetected for a prolonged period of time. The objective of this work is to demonstrate the ability of using advanced machine learning based approaches to generate mathematical models that predict current and future mental states of an individual. The problem of mental state prediction is transformed into the time series forecasting problem, where an individual is represented as a multivariate time series stream of monitored physical and behavioral attributes. A personalized mathematical model is then automatically generated to capture the dependencies among these attributes, which is used for prediction of mental states for each individual. In particular, we first illustrate the drawbacks of traditional multivariate time series forecasting methodologies such as vector autoregression. Then, we show that such issues could be mitigated by using machine learning regression techniques which are modified for capturing temporal dependencies in time series data. A case study using the data from 150 human participants illustrates that the proposed machine learning based forecasting methods are more suitable for high-dimensional psychological data than the traditional vector autoregressive model in terms of both magnitude of error and directional accuracy. These results not only present a successful usage of machine learning techniques in psychological studies, but also serve as a building block for multiple medical applications that could rely on an automated system to gauge individuals' mental states. Copyright © 2017 Elsevier Inc. All rights reserved.

Identifying and addressing sexual health in serious mental illness: Views of mental health staff working in two National Health Service organizations in England.

PubMed

Hughes, Elizabeth; Edmondson, Amanda J; Onyekwe, Ijeoma; Quinn, Chris; Nolan, Fiona

2018-06-01

People with serious mental illness (service users) have needs related to sexual health and sexuality, yet these have been poorly addressed in mental health services. In the present study, we report the current practice of mental health professionals in relation to sexual health. Focus groups conducted in two mental health trusts explored routine practice in relation to discussing, assessing, and planning care in relation to sexual health. A thematic analysis identified seven themes: (i) sexual health provision is a complex issue; (ii) mental health staff are aware of sexual health needs; (iii) current provision regarding sexual health is 'neglected'; (iv) barriers to sexual health provision; (v) enabling a discussion around sexual health; (vi) sexual health provision is a role for mental health professionals; and (vii) training needs. Mental health staff are aware of complex issues related to sexual health for service users, but this is mainly seen through the lens of risk management and safeguarding. We need to develop the mental health workforce to be able to incorporate sexual health into routine health care. © 2017 Australian College of Mental Health Nurses Inc.

The neural architecture of expert calendar calculation: a matter of strategy?

PubMed

Fehr, Thorsten; Wallace, Gregory L; Erhard, Peter; Herrmann, Manfred

2011-08-01

Savants and prodigies are individuals with exceptional skills in particular mental domains. In the present study we used functional magnetic resonance imaging to examine neural correlates of calendar calculation in two individuals, a savant with Asperger's disorder and a self-taught mathematical prodigy. If there is a modular neural organization of exceptional performance in a specific mental domain, calendar calculation should be reflected in a considerable overlap in the recruitment of brain circuits across expert individuals. However, considerable individual differences in activation patterns during calendar calculation were noted. The present results indicate that activation patterns produced by complex mental processing, such as calendar calculation, seem to be influenced strongly by learning history and idiosyncratic strategy usage rather than a modular neural organization. Thus, well-known individual differences in complex cognition play a major role even in experts with exceptional abilities in a particular mental domain and should in particular be considered when examining the neural architecture of complex mental processes and skills.

Recent changes in Medicaid policy and their possible effects on mental health services.

PubMed

Buck, Jeffrey A

2009-11-01

As Medicaid has emerged as the primary funder of public mental health services, its character has affected the organization and delivery of such services. Recent changes to the program, however, promise to further affect the direction of changes in states' mental health service systems. One group of changes will further limit the flexibility of Medicaid mental health funding, while increasing provider accountability and the authority of state Medicaid agencies. Others will increase incentives for deinstitutionalization and community-based care and promote person-centered treatment principles. These changes will likely affect state mental health systems, mental health providers, and the nature of service delivery.

Mental state attribution in schizophrenia: what distinguishes patients with "poor" from patients with "fair" mentalising skills?

PubMed

Brüne, M; Schaub, D

2012-07-01

Although many patients with schizophrenia are impaired in mental states attribution abilities, a significant number perform within normal or near-normal ranges in mental state attribution tasks. No studies have analysed cognitive or behavioural differences between patients with - to some extent - preserved mental state attribution skills and those with poor mentalising abilities. To examine characteristics of "poor" and "fair" mentalisers, 58 patients with schizophrenia performed a mental state attribution task, a test of general intelligence, and two executive functioning tests. "Poor" and "fair" mentalising skills were defined according to a median-split procedure; the median score in the patient group was also within two standard deviations of the control group. In addition, patients' social behavioural skills and psychopathological profiles were rated. Patients performing within normal or near normal ranges on the mental state attribution task had fewer social behavioural abnormalities than patients with poor mentalising abilities (even when controlled for intelligence), but did not differ in executive functioning. Fair mental state performers showed less disorganisation and excitement symptoms than poor performers. The degree of disorganisation mediated the influence of mental state attribution on social behavioural skills. Schizophrenia patients with (partially) preserved mentalising skills have fewer behavioural problems in the social domain than patients with poor mentalising abilities. Conceptual disorganisation mediates the prediction of social behavioural skills through mentalising skills, suggesting that disorganised patients may require special attention regarding social-cognitive skills training. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Aspects of Theory of Mind that attenuate the relationship between persecutory delusions and social functioning in schizophrenia spectrum disorders.

PubMed

Phalen, Peter L; Dimaggio, Giancarlo; Popolo, Raffaele; Lysaker, Paul H

2017-09-01

Despite the apparent relevance of persecutory delusions to social relationships, evidence linking these beliefs to social functioning has been inconsistent. In this study, we examined the hypothesis that theory of mind moderates the relationship between persecutory delusions and social functioning. 88 adults with schizophrenia or schizoaffective disorder were assessed concurrently for social functioning, severity of persecutory delusions, and two components of theory of mind: mental state decoding and mental state reasoning. Mental state decoding was assessed using the Eyes Test, mental state reasoning using the Hinting Task, and social functioning assessed with the Social Functioning Scale. Moderation effects were evaluated using linear models and the Johnson-Neyman procedure. Mental state reasoning was found to moderate the relationship between persecutory delusions and social functioning, controlling for overall psychopathology. For participants with reasoning scores in the bottom 78th percentile, persecutory delusions showed a significant negative relationship with social functioning. However, for those participants with mental state reasoning scores in the top 22nd percentile, more severe persecutory delusions were not significantly associated with worse social functioning. Mental state decoding was not a statistically significant moderator. Generalizability is limited as participants were generally men in later phases of illness. Mental state reasoning abilities may buffer the impact of persecutory delusions on social functioning, possibly by helping individuals avoid applying global beliefs of persecution to specific individuals or by allowing for the correction of paranoid inferences. Published by Elsevier Ltd.

Four States, Four Projects, One Mission: Collectively Enhancing Mental and Behavioral Health Capacity Throughout the Gulf Coast.

PubMed

Langhinrichsen-Rohling, Jennifer; Osofsky, Howard; Osofsky, Joy; Rohrer, Glenn; Rehner, Timothy

The 2010 Deepwater Horizon oil spill triggered numerous concerns regarding the health and well-being of citizens within the already vulnerable Gulf Coast region. Four Mental and Behavioral Health Capacity Projects (MBHCPs) united to form the Quad-State MBHCP component of the Gulf Region Health Outreach Program (GRHOP). Their shared mission was to increase mental and behavioral health (MBH) capacity within coastal counties of Louisiana, Mississippi, Alabama, and the Florida Panhandle. To describe strategies used to collectively enhance the impact of the 4 state-specific MBHCPs and to share lessons learned from a multistate collaborative flexibly designed to meet a shared mission. Archival materials were assessed. They included attendance sheets/notes from regularly scheduled group meetings, GRHOP quarterly and annual reports, and state-specific MBHCP logic models. Nationally available data on MBH services provided in project-relevant primary care sites were also examined. Three strategies were found to be effective facilitators of collective success: (i) reciprocal participation in the backbone organization (GRHOP); (ii) creation and comparison of state-specific MBHCP logic models and activities; and (iii) cross-fertilization among the MBHCP state-specific logic models, a unified Quad-State, and the GRHOP-wide logic model to generate additional synergistic endeavors and measureable outcomes. Examples of region-wide MBHCP success, such as uptake in integrated health services in health care clinics across the jurisdiction of investment, are presented. Isolated approaches to complex issues are, at times, ineffective. The Collective Impact (CI) model, with an emphasis on coordination among existing organizations, stakeholders, and the public, can serve as a guidepost to facilitate sustainable change even when used in a modified form. Strategies discussed herein for maximizing the 5 prescribed CI conditions provide an important roadmap for how to interface among multidisciplinary projects seeking to address the same, large-scale public health problem.

Differential involvement of the posterior temporal cortex in mentalizing but not perspective taking

PubMed Central

Aumann, Carolin; Santos, Natacha S.; Bewernick, Bettina H.; Eickhoff, Simon B.; Newen, Albert; Shah, N. Jon; Fink, Gereon R.; Vogeley, Kai

2008-01-01

Understanding and predicting other people's mental states and behavior are important prerequisites for social interactions. The capacity to attribute mental states such as desires, thoughts or intentions to oneself or others is referred to as mentalizing. The right posterior temporal cortex at the temporal–parietal junction has been associated with mentalizing but also with taking someone else's spatial perspective onto the world—possibly an important prerequisite for mentalizing. Here, we directly compared the neural correlates of mentalizing and perspective taking using the same stimulus material. We found significantly increased neural activity in the right posterior segment of the superior temporal sulcus only during mentalizing but not perspective taking. Our data further clarify the role of the posterior temporal cortex in social cognition by showing that it is involved in processing information from socially salient visual cues in situations that require the inference about other people's mental states. PMID:19015120

State and non-state mental health service collaboration in a South African district: a mixed methods study.

PubMed

Janse van Rensburg, André; Petersen, Inge; Wouters, Edwin; Engelbrecht, Michelle; Kigozi, Gladys; Fourie, Pieter; van Rensburg, Dingie; Bracke, Piet

2018-05-01

The Life Esidimeni tragedy in South Africa showed that, despite significant global gains in recognizing the salience of integrated public mental health care during the past decade, crucial gaps remain. State and non-state mental health service collaboration is a recognized strategy to increase access to care and optimal use of community resources, but little evidence exist about how it unfolds in low- to middle-income countries. South Africa's Mental Health Policy Framework and Strategic Plan 2013-20 (MHPF) underlines the importance of collaborative public mental health care, though it is unclear how and to what extent this happens. The aim of the study was to explore the extent and nature of state and non-state mental health service collaboration in the Mangaung Metropolitan District, Free State, South Africa. The research involved an equal status, sequential mixed methods design, comprised of social network analysis (SNA) and semi-structured interviews. SNA-structured interviews were conducted with collaborating state and non-state mental health service providers. Semi-structured interviews were conducted with collaborating partners and key stake holders. Descriptive network analyses of the SNA data were performed with Gephi, and thematic analysis of the semi-structured interview data were performed in NVivo. SNA results suggested a fragmented, hospital centric network, with low average density and clustering, and high authority and influence of a specialist psychiatric hospital. Several different types of collaborative interactions emerged, of which housing and treatment adherence a key point of collaboration. Proportional interactions between state and non-state services were low. Qualitative data expanded on these findings, highlighting the range of available mental health services, and pointed to power dynamics as an important consideration in the mental health service network. The fostering of a well-integrated system of care as proposed in the MHPF requires inter-institutional arrangements that include both clinical and social facets of care, and improvements in local governance.

States of mind: emotions, body feelings, and thoughts share distributed neural networks.

PubMed

Oosterwijk, Suzanne; Lindquist, Kristen A; Anderson, Eric; Dautoff, Rebecca; Moriguchi, Yoshiya; Barrett, Lisa Feldman

2012-09-01

Scientists have traditionally assumed that different kinds of mental states (e.g., fear, disgust, love, memory, planning, concentration, etc.) correspond to different psychological faculties that have domain-specific correlates in the brain. Yet, growing evidence points to the constructionist hypothesis that mental states emerge from the combination of domain-general psychological processes that map to large-scale distributed brain networks. In this paper, we report a novel study testing a constructionist model of the mind in which participants generated three kinds of mental states (emotions, body feelings, or thoughts) while we measured activity within large-scale distributed brain networks using fMRI. We examined the similarity and differences in the pattern of network activity across these three classes of mental states. Consistent with a constructionist hypothesis, a combination of large-scale distributed networks contributed to emotions, thoughts, and body feelings, although these mental states differed in the relative contribution of those networks. Implications for a constructionist functional architecture of diverse mental states are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

Do Adults with High Functioning Autism or Asperger Syndrome Differ in Empathy and Emotion Recognition?

PubMed

Montgomery, Charlotte B; Allison, Carrie; Lai, Meng-Chuan; Cassidy, Sarah; Langdon, Peter E; Baron-Cohen, Simon

2016-06-01

The present study examined whether adults with high functioning autism (HFA) showed greater difficulties in (1) their self-reported ability to empathise with others and/or (2) their ability to read mental states in others' eyes than adults with Asperger syndrome (AS). The Empathy Quotient (EQ) and 'Reading the Mind in the Eyes' Test (Eyes Test) were compared in 43 adults with AS and 43 adults with HFA. No significant difference was observed on EQ score between groups, while adults with AS performed significantly better on the Eyes Test than those with HFA. This suggests that adults with HFA may need more support, particularly in mentalizing and complex emotion recognition, and raises questions about the existence of subgroups within autism spectrum conditions.

Neuroreductionism about Sex and Love

PubMed Central

SAVULESCU, JULIAN; EARP, BRIAN D.

2014-01-01

“Neuroreductionism” is the tendency to reduce complex mental phenomena to brain states, confusing correlation for physical causation. In this paper, we illustrate the dangers of this popular neuro-fallacy, by looking at an example drawn from the media: a story about “hypoactive sexual desire disorder” in women. We discuss the role of folk dualism in perpetuating such a confusion, and draw some conclusions about the role of “brain scans” in our understanding of romantic love. PMID:25309130

The Effects of Day-to-Day Variability of Physiological Data on Operator Functional State Classification

DTIC Science & Technology

2013-03-01

fMRI data (e.g. Kamitami & Tong, 2005). This approach has been remarkably successful in classifying mental workload in complex tasks (Berka, et al...1991). These previous studies relied upon spectral comparison rather than classification. In previous research examining the stability of fMRI ...chose to focus on electrophysiology, as the collection conditions may be more carefully controlled across days than fMRI and it is more amenable to

[The cinema as a device for teaching complexity in mental health].

PubMed

Delego, Adriana; Carroll, Hugo

2013-01-01

This article proposes the use of Cinema as an instrument for a complex approach to Teaching in the field of Clinical Psychiatry and Psychopathology in Mental Health. With this aim, intends a different look that pretends the approach not only to the conceptual structures on Psychopathology, but also to the complexity involved, choosing Cinema as a powerful way of "empathic recreation". Based on previous work by several authors, the theoretical framework that supports this modality is presented in the philosophical, cognitive, pedagogical-didactic aspects and their consequences into teaching within Mental Health. This task also implies addressing the historical evolution of the representation of subjectivity in fiction. In this way, a new perspective to those working in the field of mental health, as subjects involved in continuous learning processes, is presented. This perspective emphasizes the interactions underlying psychic problematical.

42 CFR 483.108 - Relationship of PASARR to other Medicaid processes.

Code of Federal Regulations, 2014 CFR

2014-10-01

... mental health or intellectual disability authorities cannot be countermanded by the State Medicaid agency... of this part may overturn a PASARR determination made by the State mental health or intellectual disability authorities. (b) In making their determinations, however, the State mental health and intellectual...

42 CFR 483.108 - Relationship of PASARR to other Medicaid processes.

Code of Federal Regulations, 2012 CFR

2012-10-01

... mental health or intellectual disability authorities cannot be countermanded by the State Medicaid agency... of this part may overturn a PASARR determination made by the State mental health or intellectual disability authorities. (b) In making their determinations, however, the State mental health and intellectual...

42 CFR 483.108 - Relationship of PASARR to other Medicaid processes.

Code of Federal Regulations, 2013 CFR

2013-10-01

... mental health or intellectual disability authorities cannot be countermanded by the State Medicaid agency... of this part may overturn a PASARR determination made by the State mental health or intellectual disability authorities. (b) In making their determinations, however, the State mental health and intellectual...

Structural stigma in state legislation.

PubMed

Corrigan, Patrick W; Watson, Amy C; Heyrman, Mark L; Warpinski, Amy; Gracia, Gabriela; Slopen, Natalie; Hall, Laura L

2005-05-01

This article discusses examples of structural stigma that results from state governments' enactment of laws that diminish the opportunities of people with mental illness. To examine current trends in structural stigma, the authors identified and coded all relevant bills introduced in 2002 in the 50 states. Bills were categorized in terms of their effect on liberties, protection from discrimination, and privacy. The terms used to describe the targets of bills were examined: persons with "mental illness" or persons who are "incompetent" or "disabled" because of mental illness. About one-quarter of the state bills reviewed for this survey related to protection from discrimination. Within that category, half the bills reduced protections for the targeted individuals, such as restriction of firearms for people with current or past mental illness and reduced parental rights among persons with a history of mental illness. Half the bills seemed to expand protections, such as those that required mental health funding at the same levels provided for other medical conditions and those that disallowed use of mental health status in child custody cases. Legislation frequently confuses "incompetence" with "mental illness." Examples of structural stigma uncovered by surveys such as this one can inform advocates for persons with mental illness as to where an individual state stands in relation to the number of bills that affect persons with mental illness and whether these bills expand or contract the liberties of this stigmatized group.

Psychology of knowledge representation.

PubMed

Grimm, Lisa R

2014-05-01

Every cognitive enterprise involves some form of knowledge representation. Humans represent information about the external world and internal mental states, like beliefs and desires, and use this information to meet goals (e.g., classification or problem solving). Unfortunately, researchers do not have direct access to mental representations. Instead, cognitive scientists design experiments and implement computational models to develop theories about the mental representations present during task performance. There are several main types of mental representation and corresponding processes that have been posited: spatial, feature, network, and structured. Each type has a particular structure and a set of processes that are capable of accessing and manipulating information within the representation. The structure and processes determine what information can be used during task performance and what information has not been represented at all. As such, the different types of representation are likely used to solve different kinds of tasks. For example, structured representations are more complex and computationally demanding, but are good at representing relational information. Researchers interested in human psychology would benefit from considering how knowledge is represented in their domain of inquiry. For further resources related to this article, please visit the WIREs website. The author has declared no conflicts of interest for this article. © 2014 John Wiley & Sons, Ltd.

Self-perceived coping resources of middle-aged and older adults - results of a large population-based study.

PubMed

Boehlen, Friederike H; Herzog, Wolfgang; Schellberg, Dieter; Maatouk, Imad; Saum, Kai-Uwe; Brenner, Hermann; Wild, Beate

2017-12-01

Psychosocial resources (personal resources, social resources, and other) are important for coping with aging and impairment. The aim of this study was to describe the resources of older adults and to compare subgroups with frailty, complex health care needs, and/or mental disorders. At the third follow-up of the large population-based German ESTHER study, 3124 elderly persons (aged 55-85) were included. Psychosocial resources were assessed during a home visit by trained study doctors by using a list of 26 different items. Resources were described for the total group, separated by sex, and for the three subgroups of persons with frailty, complex health care needs, and mental disorders. Family, self-efficacy, and financial security were the most frequently reported resources of older adults. Women and men showed significant differences in their self-perceived resources. Personal resources (self-efficacy, optimism, mastery), social resources, and financial security were reported significantly less frequently by frail persons, persons with complex health care needs, and mentally ill older adults compared to non-impaired participants. Apart from external support, patients who experienced complex health care needs reported resources less frequently compared to frail and mentally ill patients. Coping resources in older adults are associated with sex and impairment. Evaluation and support of personal resources of frail or mentally ill persons or individuals with complex health care needs should be integrated in the therapeutic process.

Individuals with Mental Retardation and the Criminal Justice System: The View from States' Attorneys General.

ERIC Educational Resources Information Center

McAfee, James K.; Gural, Michele

1988-01-01

Results of a survey of state attorneys general (N=46) found that, with few exceptions, identification of persons with mental retardation in criminal justice is neither systematic nor probable. Protections lie in statutes pertaining to mental illness rather than to mental retardation. (Author/DB)

Effects of training on short- and long-term skill retention in a complex multiple-task environment.

PubMed

Sauer, J; Hockey, G R; Wastell, D G

2000-12-01

The paper reports the results of an experiment on the performance and retention of a complex task. This was a computer-based simulation of the essential elements of a spacecraft's life support system. It allowed the authors to take a range of measures, including primary and secondary task performance, system intervention and information sampling strategies, mental model structure, and subjective operator state. The study compared the effectiveness of two methods of training, based on low level (procedure-based) and high level (system-based) understanding. Twenty-five participants were trained extensively on the task, then given a 1-h testing session. A second testing session was carried out 8 months after the first (with no intervening practice) with 17 of the original participants. While training had little effect on control performance, there were considerable effects on system management strategies, as well as in structure of operator's mental model. In the second testing session, the anticipated general performance decrement did not occur, though for complex faults there was an increase in selectivity towards the primary control task. The relevance of the findings for training and skill retention in real work environments is discussed in the context of a model of compensatory control.

Estimation of Subjective Mental Work Load Level with Heart Rate Variability by Tolerance to Driver's Mental Load

NASA Astrophysics Data System (ADS)

Yokoi, Toshiyuki; Itoh, Michimasa; Oguri, Koji

Most of the traffic accidents have been caused by inappropriate driver's mental state. Therefore, driver monitoring is one of the most important challenges to prevent traffic accidents. Some studies for evaluating the driver's mental state while driving have been reported; however driver's mental state should be estimated in real-time in the future. This paper proposes a way to estimate quantitatively driver's mental workload using heart rate variability. It is assumed that the tolerance to driver's mental workload is different depending on the individual. Therefore, we classify people based on their individual tolerance to mental workload. Our estimation method is multiple linear regression analysis, and we compare it to NASA-TLX which is used as the evaluation method of subjective mental workload. As a result, the coefficient of correlation improved from 0.83 to 0.91, and the standard deviation of error also improved. Therefore, our proposed method demonstrated the possibility to estimate mental workload.

The impact of mental health insurance laws on state suicide rates.

PubMed

Lang, Matthew

2013-01-01

In the 1990s and early 2000s, a number of states passed laws requiring mental health benefits to be included in health insurance coverage. The variation in the characteristics and enactment date of the laws provides an opportunity to measure the impact of increasing access to mental health care on mental health outcomes, as evidenced by state suicide rates. In contrast with previous research, results show that when states enact laws requiring insurance coverage to include mental health benefits at parity with physical health benefits, the suicide rate decreases significantly by 5%. The findings are robust to a number of specifications and falsification tests. Copyright © 2011 John Wiley & Sons, Ltd.

Expanding the Role of Psychiatric Mental Health Nurse Practitioners in a State Psychiatric System: The New Hampshire Experience.

PubMed

de Nesnera, Alexander; Allen, Diane E

2016-05-01

Psychiatric mental health nurse practitioners (PMHNPs) are assuming increasing clinical responsibilities in the treatment of individuals with mental illness as the shortage of psychiatrists and their maldistribution continues to persist in the United States. States vary widely in their statutes and administrative rules delineating PMHNP's scope of practice. This column describes the legislative process of incremental changes in New Hampshire statute and rules changes over the past 15 years that have significantly expanded PMHNP's ability to treat individuals with mental illnesses in the state mental health system. PMHNPs have worked closely with physician leaders and policy makers to allow this to occur.

Causation, constitution and context. Comment on "Seeing mental states: An experimental strategy for measuring the observability of other minds" by Cristina Becchio et al.

NASA Astrophysics Data System (ADS)

Zahavi, Dan

2018-03-01

In their new article [1], Becchio and her colleagues argue that recent claims concerning the possibility of directly perceiving other people's mental states will remain speculative as long as one has failed to demonstrate the availability of mentalistic information in observable behavior [p. 4]. The ambitious goal of the authors is then to outline an experimental setup that will permit one to determine whether and to what extent a mental state is observable. Drawing on Becchio's previous work on how regularities in the kinematic patterns specify the mental states of the agent, the authors suggest that a similar approach can be adopted to probe the observability of any mental state instantiated in behavioral patterns [p. 19].

Exploring the social brain in schizophrenia: left prefrontal underactivation during mental state attribution.

PubMed

Russell, T A; Rubia, K; Bullmore, E T; Soni, W; Suckling, J; Brammer, M J; Simmons, A; Williams, S C; Sharma, T

2000-12-01

Evidence suggests that patients with schizophrenia have a deficit in "theory of mind," i.e., interpretation of the mental state of others. The authors used functional magnetic resonance imaging (MRI) to investigate the hypothesis that patients with schizophrenia have a dysfunction in brain regions responsible for mental state attribution. Mean brain activation in five male patients with schizophrenia was compared to that in seven comparison subjects during performance of a task involving attribution of mental state. During performance of the mental state attribution task, the patients made more errors and showed less blood-oxygen-level-dependent signal in the left inferior frontal gyrus. To the authors' knowledge, this is the first functional MRI study to show a deficit in the left prefrontal cortex in schizophrenia during a socioemotional task.

What Is Infant Mental Health?

ERIC Educational Resources Information Center

Osofsky, Joy D.; Thomas, Kandace

2012-01-01

Unfortunately, the term "infant mental health" can be confusing for some people because it may be understood as translating into "mental illness." Others may not appreciate that babies and toddlers have the capacity to experience complex emotions. The Guest Editors of this issue of the Journal explore the meaning of infant mental health.

Right to property, inheritance, and contract and persons with mental illness.

PubMed

Bhugra, Dinesh; Pathare, Soumitra; Joshi, Rajlaxmi; Nardodkar, Renuka; Torales, Julio; Tolentino, Edgardo Juan L; Dantas, Rubens; Ventriglio, Antonio

2016-08-01

Discrimination against people with mental illness is rife across the globe. Among different types of discrimination is the policy in many countries where persons with mental illness are forbidden to inherit property, and they are not able to enter into a contract in a large number of countries. Using various databases, legislations dealing with law of contract, law of succession/inheritance, and law relating to testamentary capacity (wills) of all UN Member states (193 countries) were studied. With respect to federal countries, the laws of the most populous state as a representative state in the respective country were studied. Only 40 Member States (21%) recognize/allow persons with mental health problems to enter into contracts. Of these, however, only 16 Member States (9%) recognize the right of persons with mental health problems to enter into a contract without any restrictions. The remaining 24 Member States (12%) allow a contract entered into by a person with mental health problems to be invalidated under certain conditions. These countries also make the validity of the contract subject to the capacity to consent or based on the level of understanding of the person with mental health problems. They may allow persons with mental health problems to enter into contracts only for transactions of an insignificant nature or of personal rights. Only 9% of the countries allow people with mental illness to enter into contracts in an unrestricted way. Furthermore, there remain variations between high income and low income states. In spite of international laws in many countries, laws remain discriminatory.

Mothers’ perspectives on their child’s mental illness as compared to other complex disorders in their family: Insights to inform genetic counseling practice

PubMed Central

Lautenbach, Denise M.; Hiraki, Susan; Campion, MaryAnn W.; Austin, Jehannine C.

2013-01-01

To facilitate the development of a therapeutic alliance in genetic counseling, it is important that the counselor understands how families might perceive the condition that constitutes the reason for the referral. Through training and professional practice, genetic counselors develop a thorough understanding of families’ perceptions of the conditions that are common indications for genetic counseling. But, for referral indications that are less frequent, like serious mental illnesses, genetic counselors may feel less confident in their understanding of the family’s experience, or in their ability to provide psychosocial support when serious mental illness is reported in a family history. This may impede the establishment of a therapeutic alliance. As research shows that most referrals for genetic counseling related to serious mental illness are for female first-degree family members of affected individuals, we sought to explore how this group perceives serious mental illness. To provide a frame of reference with which genetic counselors may be more familiar, we explored how women perceived serious mental illness compared to other common complex disorders in their family. We conducted semi-structured interviews with women who had a child with a serious mental illness (schizophrenia, schizoaffective disorder, bipolar disorder) and a first-degree relative with another common complex disorder (diabetes, heart disease, cancer). Interviews were transcribed and subjected to thematic analysis. Saturation was reached when nine women had participated. Serious mental illness was perceived as being more severe and as having a greater impact on the family than diabetes, heart disease, or cancer. Themes identified included guilt, stigma, and loss. Some of the most important issues that contribute to mothers’ perceptions that serious mental illness is more severe than other common complex disorders could be effectively addressed in genetic counseling. Developing a heightened awareness of how family members experience a relative’s mental illness may help genetic counselors to be better able to provide psychosocial support to this group, whether serious mental illness constitutes the primary reason for referral or appears in the family history during counseling for a different referral reason. PMID:22089936

Rhythms of Mental Performance

ERIC Educational Resources Information Center

Valdez, Pablo; Reilly, Thomas; Waterhouse, Jim

2008-01-01

Cognitive performance is affected by an individual's characteristics and the environment, as well as by the nature of the task and the amount of practice at it. Mental performance tests range in complexity and include subjective estimates of mood, simple objective tests (reaction time), and measures of complex performance that require decisions to…

Using a Team Approach to Meet Complex Family Needs

ERIC Educational Resources Information Center

Njorge, Wanijiku F. M.

2011-01-01

Mental health clinicians who work with families with infants and toddlers often face complex challenges that require collaboration among many professionals and disciplines. A team approach to addressing infant mental health is critical to successful intervention. In this articles, a fractured family dealing with interpersonal violence and maternal…

Electroencephalographic monitoring of complex mental tasks

NASA Technical Reports Server (NTRS)

Guisado, Raul; Montgomery, Richard; Montgomery, Leslie; Hickey, Chris

1992-01-01

Outlined here is the development of neurophysiological procedures to monitor operators during the performance of cognitive tasks. Our approach included the use of electroencepalographic (EEG) and rheoencephalographic (REG) techniques to determine changes in cortical function associated with cognition in the operator's state. A two channel tetrapolar REG, a single channel forearm impedance plethysmograph, a Lead I electrocardiogram (ECG) and a 21 channel EEG were used to measure subject responses to various visual-motor cognitive tasks. Testing, analytical, and display procedures for EEG and REG monitoring were developed that extend the state of the art and provide a valuable tool for the study of cerebral circulatory and neural activity during cognition.

[Changes in the work capacity of the operators of command-measuring systems during daily duty].

PubMed

Novikov, V S; Lustin, S I; Blaginin, A A; Kozlov, V P

1997-06-01

Through 12 hours of work the operators of command-measuring complexes had initial signs of exhaustion, showed them-self by decrease of health state, activity, mood, increase of latent period of simple sensorimotor reaction. These changes of a functional condition had no effect on quality of fulfillment of target problems. At the end of daily duty exhaustion, described by deterioration of health state, increase of operators' anxiousness, rapid pulse, reduction of time of delay of breath, increase of time of instability of sensorimotor reactions, amount of faulty actions, reduction of speed of mental processes and distribution of attention were developed.

Translating Disparities Research to Policy: A Qualitative Study of State Mental Health Policymakers' Perceptions of Mental Health Care Disparities Report Cards

PubMed Central

Valentine, Anne; DeAngelo, Darcie; Alegría, Margarita; Cook, Benjamin L.

2014-01-01

Report cards have been used to increase accountability and quality of care in health care settings, and to improve state infrastructure for providing quality mental health care services. However, to date, report cards have not been used to compare states on racial/ethnic disparities in mental health care. This qualitative study examines reactions of mental health care policymakers to a proposed mental health care disparities report card generated from population-based survey data of mental health and mental health care utilization. We elicited feedback about the content, format, and salience of the report card. Interviews were conducted with nine senior advisors to state policymakers and one policy director of a national non-governmental organization from across the U.S. Four primary themes emerged: fairness in state-by-state comparisons; disconnect between the goals and language of policymakers and researchers; concerns about data quality and; targeted suggestions from policymakers. Participant responses provide important information that can contribute to making evidence-based research more accessible to policymakers. Further, policymakers suggested ways to improve the structure and presentation of report cards to make them more accessible to policymakers and to foster equity considerations during the implementation of new health care legislation. To reduce mental health care disparities, effort is required to facilitate understanding between researchers and relevant stakeholders about research methods, standards for interpretation of research-based evidence and its use in evaluating policies aimed at ameliorating disparities. PMID:25383993

T.D. v. New York State Office of Mental Health.

PubMed

1995-02-28

The New York Supreme Court for New York County determined that a state regulation allowing substituted consent to research on mentally ill individuals by a spouse, parent, adult child or sibling, guardian, or authorized committee did not apply to nonfederally funded research. The court was asked by a group of involuntary state mental patients to decide on the validity of state regulations concerning participation in potentially high risk experimentation without consent. The patients, who were incapable of giving informed consent, claimed that their right to refuse treatment based on autonomy, privacy, due process, and equal protection was violated by provisions allowing substituted consent by third party decision makers. The court interpreted federal regulations on research and state regulations on public health and mental health as they applied to both federally funded and nonfederally funded, possibly therapeutic and nontherapeutic, research using non-FDA approved psychotropic drugs that could cause stroke, heart attack, convulsions, hallucinations, or death. The court found first, that the state mental health regulations covered the care, treatment, and rehabilitation of the mentally ill generally; second, that the state public health regulations specifically governed research on human subjects; and third, that the federal regulations controlled federally funded research unless state or local law provides additional protection. But in this case the state public health regulations did not apply to the federally funded research due to an exemption by the state legislature, but did apply to the nonfederally funded research, because not all the federal requirements had been met. The state mental health regulation on substituted consent was enacted without authority and thus was found to be invalid.

Conversations about mental states and theory of mind development during middle childhood: A training study.

PubMed

Bianco, Federica; Lecce, Serena; Banerjee, Robin

2016-09-01

Despite 30years of productive research on theory of mind (ToM), we still know relatively little about variables that influence ToM development during middle childhood. Recent experimental studies have shown that conversations about the mind affect ToM abilities, but they have not explored the mechanisms underlying this developmental effect. In the current study, we examined two potential mechanisms through which conversations about mental states are likely to influence ToM: an increased frequency of references to mental states when explaining behavior and an increased accuracy of mental-state attributions. To this aim, we conducted a training study in which 101 children were assigned to either an intervention condition or a control condition. The conversation-based intervention was made up of four sessions scheduled over 2weeks. Children completed a battery of assessments before and after the intervention as well as 2months later. The groups were equivalent at Time 1 (T1) for age, family affluence, vocabulary, and executive functions. The ToM group showed an improvement in ToM skills (as evaluated on both the practiced tasks and a transfer task). Mediation analyses demonstrated that the accuracy of mental-state attributions, but not the mere frequency of mental-state references, mediated the positive effect of conversations about the mind on ToM development. Our results indicate that conversational experience can enhance mental-state reasoning not by simply drawing children's attention to mental states but rather by scaffolding a mature understanding of social situations. Copyright © 2015 Elsevier Inc. All rights reserved.

Social disorder and diagnostic order: the US Mental Hygiene Movement, the Midtown Manhattan study and the development of psychiatric epidemiology in the 20th century

PubMed Central

March, Dana; Oppenheimer, Gerald M

2014-01-01

Recent scholarship regarding psychiatric epidemiology has focused on shifting notions of mental disorders. In psychiatric epidemiology in the last decades of the 20th century and the first decade of the 21st century, mental disorders have been perceived and treated largely as discrete categories denoting an individual’s mental functioning as either pathological or normal. In the USA, this grew partly out of evolving modern epidemiological work responding to the State’s commitment to measure the national social and economic burdens of psychiatric disorders and subsequently to determine the need for mental health services and to survey these needs over time. Notably absent in these decades have been environmentally oriented approaches to cultivating normal, healthy mental states, approaches initially present after World War II. We focus here on a set of community studies conducted in the 1950s, particularly the Midtown Manhattan study, which grew out of a holistic conception of mental health that depended on social context and had a strong historical affiliation with: the Mental Hygiene Movement and the philosophy of its founder, Adolf Meyer; the epidemiological formation of field studies and population surveys beginning early in the 20th century, often with a health policy agenda; the recognition of increasing chronic disease in the USA; and the radical change in orientation within psychiatry around World War II. We place the Midtown Manhattan study in historical context—a complex narrative of social institutions, professional formation and scientific norms in psychiatry and epidemiology, and social welfare theory that begins during the Progressive era (1890-1920) in the USA. PMID:25031047

Norms Inform Mental State Ascriptions: A Rational Explanation for the Side-Effect Effect

ERIC Educational Resources Information Center

Uttich, Kevin; Lombrozo, Tania

2010-01-01

Theory of mind, the capacity to understand and ascribe mental states, has traditionally been conceptualized as analogous to a scientific theory. However, recent work in philosophy and psychology has documented a "side-effect effect" suggesting that moral evaluations influence mental state ascriptions, and in particular whether a behavior is…

Public and Private Language Games as Mental States: Wittgenstein's Contribution to the Qualitative Research Tradition.

ERIC Educational Resources Information Center

Washington, Ernest D.

An interpretation is provided of the philosopher L. Wittgenstein's analyses of mental states. The theoretical implications of these analyses for cognitive development and qualitatively oriented researchers are discussed. The mental states examined are: (1) pain; (2) remembering; (3) calculating/adding; (4) following a rule; and (5) reading.…

42 CFR 483.112 - Preadmission screening of applicants for admission to NFs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... NF services. For each NF applicant with MI or IID, the State mental health or intellectual disability... is determined to require a NF level of care, the State mental health or intellectual disability... part, to the State mental health or intellectual disability authority for screening. (See § 483.128(a...

42 CFR 483.112 - Preadmission screening of applicants for admission to NFs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... NF services. For each NF applicant with MI or MR, the State mental health or intellectual disability... is determined to require a NF level of care, the State mental health or intellectual disability... part, to the State mental health or intellectual disability authority for screening. (See § 483.128(a...

Implications of State Policy Changes on Mental Health Service Models for Students with Disabilities

ERIC Educational Resources Information Center

Lawson, Janelle E.; Cmar, Jennifer L.

2016-01-01

For over 25 years, students with disabilities in California received educationally related mental health services through interagency collaboration between school districts and county mental health agencies. After a major change in state policy that eliminated state-mandated interagency collaboration, school districts in California are now solely…

Computerization of Mental Health Integration Complexity Scores at Intermountain Healthcare

PubMed Central

Oniki, Thomas A.; Rodrigues, Drayton; Rahman, Noman; Patur, Saritha; Briot, Pascal; Taylor, David P.; Wilcox, Adam B.; Reiss-Brennan, Brenda; Cannon, Wayne H.

2014-01-01

Intermountain Healthcare’s Mental Health Integration (MHI) Care Process Model (CPM) contains formal scoring criteria for assessing a patient’s mental health complexity as “mild,” “medium,” or “high” based on patient data. The complexity score attempts to assist Primary Care Physicians in assessing the mental health needs of their patients and what resources will need to be brought to bear. We describe an effort to computerize the scoring. Informatics and MHI personnel collaboratively and iteratively refined the criteria to make them adequately explicit and reflective of MHI objectives. When tested on retrospective data of 540 patients, the clinician agreed with the computer’s conclusion in 52.8% of the cases (285/540). We considered the analysis sufficiently successful to begin piloting the computerized score in prospective clinical care. So far in the pilot, clinicians have agreed with the computer in 70.6% of the cases (24/34). PMID:25954401

Bodily Sensory Inputs and Anomalous Bodily Experiences in Complex Regional Pain Syndrome: Evaluation of the Potential Effects of Sound Feedback

PubMed Central

Tajadura-Jiménez, Ana; Cohen, Helen; Bianchi-Berthouze, Nadia

2017-01-01

Neuroscientific studies have shown that human's mental body representations are not fixed but are constantly updated through sensory feedback, including sound feedback. This suggests potential new therapeutic sensory approaches for patients experiencing body-perception disturbances (BPD). BPD can occur in association with chronic pain, for example in Complex Regional Pain Syndrome (CRPS). BPD often impacts on emotional, social, and motor functioning. Here we present the results from a proof-of-principle pilot study investigating the potential value of using sound feedback for altering BPD and its related emotional state and motor behavior in those with CRPS. We build on previous findings that real-time alteration of the sounds produced by walking can alter healthy people's perception of their own body size, while also resulting in more active gait patterns and a more positive emotional state. In the present study we quantified the emotional state, BPD, pain levels and gait of twelve people with CRPS Type 1, who were exposed to real-time alteration of their walking sounds. Results confirm previous reports of the complexity of the BPD linked to CRPS, as participants could be classified into four BPD subgroups according to how they mentally visualize their body. Further, results suggest that sound feedback may affect the perceived size of the CRPS affected limb and the pain experienced, but that the effects may differ according to the type of BPD. Sound feedback affected CRPS descriptors and other bodily feelings and emotions including feelings of emotional dominance, limb detachment, position awareness, attention and negative feelings toward the limb. Gait also varied with sound feedback, affecting the foot contact time with the ground in a way consistent with experienced changes in body weight. Although, findings from this small pilot study should be interpreted with caution, they suggest potential applications for regenerating BDP and its related bodily feelings in a clinical setting for patients with chronic pain and BPD. PMID:28798671

Preschool-aged children’s understanding of gratitude: Relations with emotion and mental state knowledge

PubMed Central

Nelson, Jackie A.; de Lucca Freitas, Lia Beatriz; O’Brien, Marion; Calkins, Susan D.; Leerkes, Esther M.; Marcovitch, Stuart

2016-01-01

Developmental precursors to children’s early understanding of gratitude were examined. A diverse group of 263 children were tested for emotion and mental state knowledge at ages 3 and 4, and their understanding of gratitude was measured at age 5. Children varied widely in their understanding of gratitude, but most understood some aspects of gratitude-eliciting situations. A model-building path analysis approach was used to examine longitudinal relations among early emotion and mental state knowledge and later understanding of gratitude. Children with a better early understanding of emotions and mental states understand more about gratitude. Mental state knowledge at age 4 mediated the relation between emotion knowledge at age 3 and gratitude understanding at age 5. The current study contributes to the scant literature on the early emergence of children’s understanding of gratitude. PMID:23331105

An audience research study to disseminate evidence about comprehensive state mental health parity legislation to US State policymakers: protocol.

PubMed

Purtle, Jonathan; Lê-Scherban, Félice; Shattuck, Paul; Proctor, Enola K; Brownson, Ross C

2017-06-26

A large proportion of the US population has limited access to mental health treatments because insurance providers limit the utilization of mental health services in ways that are more restrictive than for physical health services. Comprehensive state mental health parity legislation (C-SMHPL) is an evidence-based policy intervention that enhances mental health insurance coverage and improves access to care. Implementation of C-SMHPL, however, is limited. State policymakers have the exclusive authority to implement C-SMHPL, but sparse guidance exists to inform the design of strategies to disseminate evidence about C-SMHPL, and more broadly, evidence-based treatments and mental illness, to this audience. The aims of this exploratory audience research study are to (1) characterize US State policymakers' knowledge and attitudes about C-SMHPL and identify individual- and state-level attributes associated with support for C-SMHPL; and (2) integrate quantitative and qualitative data to develop a conceptual framework to disseminate evidence about C-SMHPL, evidence-based treatments, and mental illness to US State policymakers. The study uses a multi-level (policymaker, state), mixed method (QUAN→qual) approach and is guided by Kingdon's Multiple Streams Framework, adapted to incorporate constructs from Aarons' Model of Evidence-Based Implementation in Public Sectors. A multi-modal survey (telephone, post-mail, e-mail) of 600 US State policymakers (500 legislative, 100 administrative) will be conducted and responses will be linked to state-level variables. The survey will span domains such as support for C-SMHPL, knowledge and attitudes about C-SMHPL and evidence-based treatments, mental illness stigma, and research dissemination preferences. State-level variables will measure factors associated with C-SMHPL implementation, such as economic climate and political environment. Multi-level regression will determine the relative strength of individual- and state-level variables on policymaker support for C-SMHPL. Informed by survey results, semi-structured interviews will be conducted with approximately 50 US State policymakers to elaborate upon quantitative findings. Then, using a systematic process, quantitative and qualitative data will be integrated and a US State policymaker-focused C-SMHPL dissemination framework will be developed. Study results will provide the foundation for hypothesis-driven, experimental studies testing the effects of different dissemination strategies on state policymakers' support for, and implementation of, evidence-based mental health policy interventions.

Working atmosphere, job satisfaction and individual characteristics of community mental health professionals in integrated care.

PubMed

Goetz, Katja; Kleine-Budde, Katja; Bramesfeld, Anke; Stegbauer, Constance

2018-03-01

Working requirements of community mental healthcare professionals in integrated care are complex. There is a lack of research concerning the relation of job satisfaction, working atmosphere and individual characteristics. For the current study, a survey evaluating job satisfaction and working atmosphere of mental healthcare professionals in integrated care was performed. About 321 community mental healthcare professionals were included in the survey; the response rate was 59.5%. The professional background of community mental healthcare professionals included nursing, social work and psychology. Community mental healthcare professionals reported the highest satisfaction with colleagues and the lowest satisfaction with income. Moreover, it could be shown that more responsibility, more recognition and more variety in job tasks lead to an increase of overall job satisfaction. Healthcare for mentally ill patients in the community setting is complex and requires well-structured care with appropriate responsibilities within the team. A co-operative relationship among colleagues as well as clearly defined responsibilities seem to be the key for the job satisfaction of community mental healthcare professionals in integrated care. © 2017 John Wiley & Sons Ltd.

Dual Frequency Head Maps: A New Method for Indexing Mental Workload Continuously during Execution of Cognitive Tasks

PubMed Central

Radüntz, Thea

2017-01-01

One goal of advanced information and communication technology is to simplify work. However, there is growing consensus regarding the negative consequences of inappropriate workload on employee's health and the safety of persons. In order to develop a method for continuous mental workload monitoring, we implemented a task battery consisting of cognitive tasks with diverse levels of complexity and difficulty. We conducted experiments and registered the electroencephalogram (EEG), performance data, and the NASA-TLX questionnaire from 54 people. Analysis of the EEG spectra demonstrates an increase of the frontal theta band power and a decrease of the parietal alpha band power, both under increasing task difficulty level. Based on these findings we implemented a new method for monitoring mental workload, the so-called Dual Frequency Head Maps (DFHM) that are classified by support vectors machines (SVMs) in three different workload levels. The results are in accordance with the expected difficulty levels arising from the requirements of the tasks on the executive functions. Furthermore, this article includes an empirical validation of the new method on a secondary subset with new subjects and one additional new task without any adjustment of the classifiers. Hence, the main advantage of the proposed method compared with the existing solutions is that it provides an automatic, continuous classification of the mental workload state without any need for retraining the classifier—neither for new subjects nor for new tasks. The continuous workload monitoring can help ensure good working conditions, maintain a good level of performance, and simultaneously preserve a good state of health. PMID:29276490

Here, there and everywhere: emotion and mental state talk in different social contexts predicts empathic helping in toddlers.

PubMed

Drummond, Jesse; Paul, Elena F; Waugh, Whitney E; Hammond, Stuart I; Brownell, Celia A

2014-01-01

A growing body of literature suggests that parents socialize early-emerging prosocial behavior across varied contexts and in subtle yet powerful ways. We focus on discourse about emotions and mental states as one potential socialization mechanism given its conceptual relevance to prosocial behavior and its known positive relations with emotion understanding and social-cognitive development, as well as parents' frequent use of such discourse beginning in infancy. Specifically, we ask how parents' emotion and mental state talk (EMST) with their toddlers relates to toddlers' helping and how these associations vary by context. Children aged 18- to 30-months (n = 38) interacted with a parent during book reading and joint play with toys, two everyday contexts that afford parental discussion of emotions and mental states. Children also participated in instrumental and empathic helping tasks. Results revealed that although parents discuss mental states with their children in both contexts, the nature of their talk differs: during book reading parents labeled emotions and mental states significantly more often than during joint play, especially simple affect words (e.g., happy, sad) and explanations or elaborations of emotions; whereas they used more desire talk and mental state words (e.g., think, know) in joint play. Parents' emotion and mental state discourse related to children's empathic, emotion-based helping behavior; however, it did not relate to instrumental, action-based helping. Moreover, relations between parent talk and empathic helping varied by context: children who helped more quickly had parents who labeled emotion and mental states more often during joint play and who elicited this talk more often during book reading. As EMST both varies between contexts and exhibits context-specific associations with empathic prosocial behavior early in development, we conclude that such discourse may be a key form of socialization in emerging prosociality.

Preparation of Mental Health Clinicians to Work with Children with Co-Occurring Autism Spectrum Disorders and Mental Health Needs

ERIC Educational Resources Information Center

Williams, Marian E.; Haranin, Emily C.

2016-01-01

Up to 70% of children with autism spectrum disorders (ASD) have a co-occurring mental health disorder; however, many clinicians feel unprepared to serve children with complex co-occurring conditions. This study surveyed 64 mental health clinicians working in 21 publically-funded mental health agencies in a large urban setting to explore their…

Detection of Mental State and Reduction of Artifacts Using Functional Near Infrared Spectroscopy (FNIRS)

NASA Technical Reports Server (NTRS)

Harrivel, Angela (Inventor); Hearn, Tristan (Inventor)

2017-01-01

fNIRS may be used in real time or near-real time to detect the mental state of individuals. Phase measurement can be applied to drive an adaptive filter for the removal of motion artifacts in real time or near-real time. In this manner, the application of fNIRS may be extended to practical non-laboratory environments. For example, the mental state of an operator of a vehicle may be monitored, and alerts may be issued and/or an autopilot may be engaged when the mental state of the operator indicates that the operator is inattentive.

Health and Functioning of Families of Children With Special Health Care Needs Cared for in Home Care, Long-term Care, and Medical Day Care Settings.

PubMed

Caicedo, Carmen

2015-06-01

To examine and compare child and parent or guardian physical and mental health outcomes in families with children with special health care needs who have medically complex technology-dependent needs in home care, long-term care (LTC), and medical day care (MDC) settings. The number of children requiring medically complex technology-dependent care has grown exponentially. In this study, options for their care are home care, LTC, or MDC. Comparison of child and parent/guardian health outcomes is unknown. Using repeated measures data were collected from 84 dyads (parent/guardian, medically complex technology-dependent child) for 5 months using Pediatric Quality of Life Inventory Generic Core Module 4.0 and Family Impact Module Data analysis: χ(2), RM-ANCOVA. There were no significant differences in overall physical health, mental health, and functioning of children by care setting. Most severely disabled children were in home care; moderately disabled in MDC; children in vegetative state LTC; however, parents perceived children's health across care setting as good to excellent. Parents/guardians from home care reported the poorest physical health including being tired during the day, too tired to do the things they like to do, feeling physically weak, or feeling sick and had cognitive difficulties, difficulties with worry, communication, and daily activities. Parents/guardians from LTC reported the best physical health with time and energy for a social life and employment. Trends in health care policy indicate a movement away from LTC care to care in the family home where data indicate these parents/guardians are already mentally and functionally challenged.

Rapid Growth In Mental Health Telemedicine Use Among Rural Medicare Beneficiaries, Wide Variation Across States.

PubMed

Mehrotra, Ateev; Huskamp, Haiden A; Souza, Jeffrey; Uscher-Pines, Lori; Rose, Sherri; Landon, Bruce E; Jena, Anupam B; Busch, Alisa B

2017-05-01

Congress and many state legislatures are considering expanding access to telemedicine. To inform this debate, we analyzed Medicare fee-for-service claims for the period 2004-14 to understand trends in and recent use of telemedicine for mental health care, also known as telemental health. The study population consisted of rural beneficiaries with a diagnosis of any mental illness or serious mental illness. The number of telemental health visits grew on average 45.1 percent annually, and by 2014 there were 5.3 and 11.8 telemental health visits per 100 rural beneficiaries with any mental illness or serious mental illness, respectively. There was notable variation across states: In 2014 nine had more than twenty-five visits per 100 beneficiaries with serious mental illness, while four states and the District of Columbia had none. Compared to other beneficiaries with mental illness, beneficiaries who received a telemental health visit were more likely to be younger than sixty-five, be eligible for Medicare because of disability, and live in a relatively poor community. States with a telemedicine parity law and a pro-telemental health regulatory environment had significantly higher rates of telemental health use than those that did not. Project HOPE—The People-to-People Health Foundation, Inc.

What Can Parents Do? A Review of State Laws Regarding Decision Making for Adolescent Drug Abuse and Mental Health Treatment

PubMed Central

Kerwin, MaryLouise E.; Kirby, Kimberly C.; Speziali, Dominic; Duggan, Morgan; Mellitz, Cynthia; Versek, Brian; McNamara, Ashley

2013-01-01

This study examined US state laws regarding parental and adolescent decision-making for substance use and mental health inpatient and outpatient treatment. State statues for requiring parental consent favored mental health over drug abuse treatment and inpatient over outpatient modalities. Parental consent was sufficient in 53%–61% of the states for inpatient treatment, but only for 39% – 46% of the states for outpatient treatment. State laws favored the rights of minors to access drug treatment without parental consent, and to do so at a younger age than for mental health treatment. Implications for how these laws may impact parents seeking help for their children are discussed. PMID:25870511

Mental health surveillance among children--United States, 2005-2011.

PubMed

Perou, Ruth; Bitsko, Rebecca H; Blumberg, Stephen J; Pastor, Patricia; Ghandour, Reem M; Gfroerer, Joseph C; Hedden, Sarra L; Crosby, Alex E; Visser, Susanna N; Schieve, Laura A; Parks, Sharyn E; Hall, Jeffery E; Brody, Debra; Simile, Catherine M; Thompson, William W; Baio, Jon; Avenevoli, Shelli; Kogan, Michael D; Huang, Larke N

2013-05-17

Mental disorders among children are described as "serious deviations from expected cognitive, social, and emotional development" (US Department of Health and Human Services Health Resources and Services Administration, Maternal and Child Health Bureau. Mental health: A report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, and National Institutes of Health, National Institute of Mental Health; 1999). These disorders are an important public health issue in the United States because of their prevalence, early onset, and impact on the child, family, and community, with an estimated total annual cost of $247 billion. A total of 13%-20% of children living in the United States experience a mental disorder in a given year, and surveillance during 1994-2011 has shown the prevalence of these conditions to be increasing. Suicide, which can result from the interaction of mental disorders and other factors, was the second leading cause of death among children aged 12-17 years in 2010. Surveillance efforts are critical for documenting the impact of mental disorders and for informing policy, prevention, and resource allocation. This report summarizes information about ongoing federal surveillance systems that can provide estimates of the prevalence of mental disorders and indicators of mental health among children living in the United States, presents estimates of childhood mental disorders and indicators from these systems during 2005-2011, explains limitations, and identifies gaps in information while presenting strategies to bridge those gaps.

Story discourse and use of mental state language between mothers and school-aged children with and without visual impairment.

PubMed

Tadić, Valerija; Pring, Linda; Dale, Naomi

2013-01-01

Lack of sight compromises insight into other people's mental states. Little is known about the role of maternal language in assisting the development of mental state language in children with visual impairment (VI). To investigate mental state language strategies of mothers of school-aged children with VI and to compare these with mothers of comparable children with typically developing vision. To investigate whether the characteristics of mother-child discourse were associated with the child's socio-communicative competence. Mother-child discourse with twelve 6-12-year-old children with VI was coded during a shared book-reading narrative and compared with 14 typically sighted children matched in age and verbal ability. Mothers of children with VI elaborated more and made significantly more references to story characters' mental states and descriptive elaborations than mothers of sighted children. Mental state elaborations of mothers in the VI group related positively with the level produced by their children, with the association remaining after mothers' overall verbosity and children's developmental levels were controlled for. Frequency of maternal elaborations, including their mental state language, was related to socio-communicative competence of children with VI. The findings offer insights into the potential contribution of maternal verbal scaffolding to mentalistic language and social-communicative competences of children with VI. © 2013 Royal College of Speech and Language Therapists.

Story discourse and use of mental state language between mothers and school-aged children with and without visual impairment

PubMed Central

Tadić, Valerija; Pring, Linda; Dale, Naomi

2013-01-01

Background Lack of sight compromises insight into other people’s mental states. Little is known about the role of maternal language in assisting the development of mental state language in children with visual impairment (VI). Aims To investigate mental state language strategies of mothers of school-aged children with VI and to compare these with mothers of comparable children with typically developing vision. To investigate whether the characteristics of mother–child discourse were associated with the child’s socio-communicative competence. Methods & Procedures Mother–child discourse with twelve 6–12-year-old children with VI was coded during a shared book-reading narrative and compared with 14 typically sighted children matched in age and verbal ability. Outcomes & Results Mothers of children with VI elaborated more and made significantly more references to story characters’ mental states and descriptive elaborations than mothers of sighted children. Mental state elaborations of mothers in the VI group related positively with the level produced by their children, with the association remaining after mothers’ overall verbosity and children’s developmental levels were controlled for. Frequency of maternal elaborations, including their mental state language, was related to socio-communicative competence of children with VI. Conclusions & Implications The findings offer insights into the potential contribution of maternal verbal scaffolding to mentalistic language and social–communicative competences of children with VI. PMID:24165364

Effects of user mental state on EEG-BCI performance.

PubMed

Myrden, Andrew; Chau, Tom

2015-01-01

Changes in psychological state have been proposed as a cause of variation in brain-computer interface performance, but little formal analysis has been conducted to support this hypothesis. In this study, we investigated the effects of three mental states-fatigue, frustration, and attention-on BCI performance. Twelve able-bodied participants were trained to use a two-class EEG-BCI based on the performance of user-specific mental tasks. Following training, participants completed three testing sessions, during which they used the BCI to play a simple maze navigation game while periodically reporting their perceived levels of fatigue, frustration, and attention. Statistical analysis indicated that there is a significant relationship between frustration and BCI performance while the relationship between fatigue and BCI performance approached significance. BCI performance was 7% lower than average when self-reported fatigue was low and 7% higher than average when self-reported frustration was moderate. A multivariate analysis of mental state revealed the presence of contiguous regions in mental state space where BCI performance was more accurate than average, suggesting the importance of moderate fatigue for achieving effortless focus on BCI control, frustration as a potential motivating factor, and attention as a compensatory mechanism to increasing frustration. Finally, a visual analysis showed the sensitivity of underlying class distributions to changes in mental state. Collectively, these results indicate that mental state is closely related to BCI performance, encouraging future development of psychologically adaptive BCIs.

Mental Health and Special Educational Needs: Exploring a Complex Relationship

ERIC Educational Resources Information Center

Rose, Richard; Howley, Marie; Fergusson, Ann; Jament, Johnson

2009-01-01

The relationship between mental health and special educational needs is both complex and misunderstood. In this article, Richard Rose, Professor of Special and Inclusive Education, Marie Howley, Senior Lecturer, Ann Fergusson, Senior Lecturer, and Johnson Jament, a PhD student, all from the Centre for Special Needs Education and Research directed…

Use of Movement Imagery in Neurorehabilitation: Researching Effects of a Complex Intervention

ERIC Educational Resources Information Center

Braun, Susy M.; Wade, Derick T.; Beurskens, Anna J. H. M.

2011-01-01

Since the beginning of the new millennium, the use of mental practice and movement imagery within several medical professions in rehabilitation and therapy has received an increased attention. Before this introduction in healthcare, the use of movement imagery was mainly researched in sports science. Mental practice is a complex intervention. When…

A Case Study of Multimethod Evaluation of Complex School Mental Health Promotion and Prevention: The Mindmatters Evaluation Suite

ERIC Educational Resources Information Center

Rowling, Louise; Mason, Jo

2005-01-01

There are a number of challenges and debates surrounding the implementation of mental health interventions in schools. These include recognising the complexity of influencing factors and the interdependency of key components; the critical importance of monitoring school-based implementation in particular contexts; employing multimethod evaluation…

Modeling life course pathways from adverse childhood experiences to adult mental health.

PubMed

Jones, Tiffany M; Nurius, Paula; Song, Chiho; Fleming, Christopher M

2018-06-01

Although the association between adverse childhood experiences (ACEs) and adult mental health is becoming well established, less is known about the complex and multiple pathways through which ACEs exert their influence. Growing evidence suggests that adversity early in life conveys not only early impacts, but also augments risk of stress-related life course cascades that continue to undermine health. The present study aims to test pathways of stress proliferation and stress embodiment processes linking ACEs to mental health impairment in adulthood. Data are from the 2011 Behavioral Risk Factor Surveillance Survey, a representative sample of Washington State adults ages 18 and over (N = 14,001). Structural equation modeling allowed for testing of direct and indirect effects from ACEs though low income status, experiences of adversity in adulthood, and social support. The model demonstrated that adult low income, social support and adult adversity are in fact conduits through which ACEs exert their influence on mental health impairment in adulthood. Significant indirect pathways through these variables supported hypotheses that the effect of ACEs is carried through these variables. This is among the first models that demonstrates multiple stress-related life course pathways through which early life adversity compromises adult mental health. Discussion elaborates multiple service system opportunities for intervention in early and later life to interrupt direct and indirect pathways of ACE effects. Copyright © 2018 Elsevier Ltd. All rights reserved.

CalMHSA Student Mental Health Campus-Wide Survey. 2013 Summary Report

ERIC Educational Resources Information Center

Sontag-Padilla, Lisa; Roth, Elizabeth; Woodbridge, Michelle W.; Kase, Courtney Ann; Osilla, Karen Chan; D'Amico, Elizabeth; Jaycox, Lisa H.; Stein, Bradley D.

2014-01-01

Mental Health Problems among college and university students represent a significant public health issue in the United States. Mental disorders account for nearly one-half of the disease burden for young adults in the United States (World Health Organization, 2008), and most lifetime mental disorders have first onset by age 24 (Kessler et al.,…

Image, imagination, and reality: on effectiveness of introductory work with vocalists.

PubMed

Gullaer, Irene; Walker, Robert; Badin, Pierre; Lamalle, Laurent

2006-01-01

Fifty-four sung tokens, each consisting of eight images were generated with the help of magnetic resonance imaging (MRI) technique to demonstrate the work of intrapharyngeal muscles when singing and speaking, and to help the educational process. The MRI images can be used as a part of a visualization feed-back method in vocal education and contribute to creation of proper mental images. The use of visualization (pictures, drafts, graphs, spectra, MRI images, etc.), along with mental images, facilitates simplification and acceleration of the process of understanding and learning how to master the basics of vocal technique, especially in the initial period of study. It is shown that work on muscle development and use of imagination should progress with close interaction between the two. For higher effectiveness and tangible results, mental images used by a vocal pedagogue should correspond to the technical and emotional level of a student. Therefore, mental images have to undertake the same evolution as articulation technique-from simplified and comprehensible to complex and abstract. Our integrated approach suggests continuing the work on muscle development and use of imagination in singing classes, employing the experience of voice-speech teachers. Their exercises are modified using the empirical method and other techniques developed creatively by singing teachers. In this method, sensitivity towards the state of the tissues becomes increasingly refined; students acquire a conscious control over the muscle work, students gain full awareness of both sensation and muscle activity. As a result, a complex of professional conditioned reflexes is being developed. A case study of the New Zealand experience was conducted with groups of Maori and European students. Unique properties and trends in the voices of Maori people are discussed.

Mental Condition Requirement in Competency to Stand Trial Assessments.

PubMed

Reisner, Andrew D; Piel, Jennifer L

2018-03-01

In Ohio, a criminal defendant is incompetent to stand trial only if "a present mental condition" renders him unable to understand the nature and objectives of the proceedings against him or to assist in his defense. Some forensic mental health evaluators have treated the mental-condition requirement as synonymous with, or similar to, the psychiatric condition required in the state's insanity criteria, which requires a "severe mental disease or defect." Yet the term mental condition does not appear in other areas of the state's criminal code or in the state's definition of a mental illness for purposes of civil commitment. Moreover, Ohio's adjudicative competency statute does not explain what conditions or symptoms constitute a mental condition sufficient to render a defendant incompetent. This article is a review of the mental condition requirement in competence to stand trial laws, using Ohio as an example, and how this term has been interpreted (or misinterpreted) by mental health evaluators and the legal system. Suggestions for practicing forensic evaluators are offered. © 2018 American Academy of Psychiatry and the Law.

Mother and Infant Talk about Mental States Relates to Desire Language and Emotion Understanding

ERIC Educational Resources Information Center

Taumoepeau, Mele; Ruffman, Ted

2006-01-01

This study assessed the relation between mother mental state language and child desire language and emotion understanding in 15--24-month-olds. At both times point, mothers described pictures to their infants and mother talk was coded for mental and nonmental state language. Children were administered 2 emotion understanding tasks and their mental…

A Cognitive Approach to the Education of Retarded Children

ERIC Educational Resources Information Center

Haywood, H. Carl

1977-01-01

Moderately mentally retarded children can acquire the necessary basic mental operations through a proper progression of mediated learning experiences; once the basic mental operations have been acquired, complex learning can occur because the necessary cognitive tools are present. (JD)

Preschool-aged children's understanding of gratitude: relations with emotion and mental state knowledge.

PubMed

Nelson, Jackie A; de Lucca Freitas, Lia Beatriz; O'Brien, Marion; Calkins, Susan D; Leerkes, Esther M; Marcovitch, Stuart

2013-03-01

Developmental precursors to children's early understanding of gratitude were examined. A diverse group of 263 children was tested for emotion and mental state knowledge at ages 3 and 4, and their understanding of gratitude was measured at age 5. Children varied widely in their understanding of gratitude, but most understood some aspects of gratitude-eliciting situations. A model-building path analysis approach was used to examine longitudinal relations among early emotion and mental state knowledge and later understanding of gratitude. Children with a better early understanding of emotions and mental states understand more about gratitude. Mental state knowledge at age 4 mediated the relation between emotion knowledge at age 3 and gratitude understanding at age 5. The current study contributes to the scant literature on the early emergence of children's understanding of gratitude. © 2012 The British Psychological Society.

Mental state attribution and the gaze cueing effect.

PubMed

Cole, Geoff G; Smith, Daniel T; Atkinson, Mark A

2015-05-01

Theory of mind is said to be possessed by an individual if he or she is able to impute mental states to others. Recently, some authors have demonstrated that such mental state attributions can mediate the "gaze cueing" effect, in which observation of another individual shifts an observer's attention. One question that follows from this work is whether such mental state attributions produce mandatory modulations of gaze cueing. Employing the basic gaze cueing paradigm, together with a technique commonly used to assess mental-state attribution in nonhuman animals, we manipulated whether the gazing agent could see the same thing as the participant (i.e., the target) or had this view obstructed by a physical barrier. We found robust gaze cueing effects, even when the observed agent in the display could not see the same thing as the participant. These results suggest that the attribution of "seeing" does not necessarily modulate the gaze cueing effect.

Egosyntonic and egodystonic: accounting for continuities and discontinuities between personality traits and personality disorders.

PubMed

Paris, Joel

2015-02-01

Egosyntonic and egodystonic features describe differences between trait-based and state-based mental disorders. Many diagnoses, most particularly personality disorder (PD), show both features. These complex forms of psychopathology are an amalgam of traits and symptoms in which both egosyntonicity and egodystonicity can be present but vary in prominence. This distinction might help resolve the long-standing controversy as to whether PDs are best classified using dimensions or categories. Narrative review. PDs in which egosyntonic features tend to predominate can be understood as amplified trait profiles. PDs associated with highly egodystonic clinical symptoms that more closely resemble major mental disorders may be usefully classified using both categories and dimensions. PDs with stronger egosyntonic features are more suitable for dimensional diagnosis. When egodystonic symptoms are more prominent, categorical diagnoses can be useful.

An open clinical trial assessing a novel training program for social cognitive impairment in schizophrenia.

PubMed

Marsh, Pamela; Langdon, Robyn; McGuire, Jonathan; Harris, Anthony; Polito, Vince; Coltheart, Max

2013-04-01

Social cognition is profoundly impaired in patients with schizophrenia. This study describes 'Mental-State Reasoning Training for Social Cognitive Impairment' (SoCog-MSRT), a 5-week program developed to improve social cognition in patients with schizophrenia. We aimed to investigate the feasibility of implementing SoCog-MSRT in a rehabilitation setting and to evaluate whether our training methods produced improvements. METHOD The feasibility and benefits of SoCog-MSRT were evaluated in an open clinical trial with 14 participants with schizophrenia or schizoaffective disorder. Training comprised 10 twice-weekly sessions, for 5 weeks, with a pre- and post-training assessment. There were significant improvements on: (a) a classic false-belief test of Theory of Mind (ToM); (b) inferring complex mental states from the eyes; and (c) a self-reported measure of social understanding. Some of these improvements were associated with baseline levels of working memory and premorbid Intelligence Quotient (IQ). CONCLUSIONS SoCog-MSRT can improve ToM abilities and social understanding, but individuals with poorer working memory and lower premorbid IQ may be less able to benefit from this type of training.

Using Technology to Improve the Objectivity of Criminal Responsibility Evaluations.

PubMed

Vitacco, Michael J; Gottfried, Emily D; Batastini, Ashley B

2018-03-01

Criminal responsibility (or insanity) evaluations require forensic clinicians to reconstruct a defendant's decision-making abilities, behavioral control, and emotional state at the time of the criminal act. Forensic evaluators are ultimately tasked to evaluate whether an individual had the capacity to understand right from wrong, and in some jurisdictions, determine whether the defendant lacked substantial capacity to conform his behavior to the requirements of the law as a result of a threshold condition (e.g., mental illness). Insanity evaluations are inherently complex, because they require the clinician to determine someone's mental state at some point in the past (weeks, months, or even years). Recent research on insanity evaluations underscores significant problems with the reliability and validity of these evaluations. However, technological advances including social media (e.g., Facebook and Twitter), mandating that law enforcement videotape interrogations, and the use of body and dashboard cameras can aid clinicians in improving the precision and quality of insanity evaluations. This article discusses practical guidelines and ethics-related concerns regarding the use of technology to improve the objectivity of criminal responsibility evaluations. © 2018 American Academy of Psychiatry and the Law.

Mental Health Literacy: A Conceptual Framework for Future Inquiry into Child and Youth Care Professionals' Practice with Suicidal Adolescents

ERIC Educational Resources Information Center

Ranahan, Patti

2010-01-01

Knowledge and beliefs about mental disorders; attitudes that promote help-seeking; knowledge of risk factors and causes, treatments and self-help, and professional help available are all elements of mental health literacy. The complexities of practice with suicidal adolescents and young people suffering from mental health concerns require…

Variation in outpatient mental health service utilization under capitation.

PubMed

Chou, Ann F; Wallace, Neal; Bloom, Joan R; Hu, Teh-Wei

2005-03-01

To improve the financing of Colorado's public mental health system, the state designed, implemented, and evaluated a pilot program that consisted of three reimbursement models for the provision of outpatient services. Community mental health centers (CMHCs), the primary providers of comprehensive mental health services to Medicaid recipients in Colorado, had to search for innovative ways to provide cost-effective services. This study assessed outpatient service delivery to Medicaid-eligible consumers under this program. This paper is among the first to study variations in the delivery of specific types of outpatient mental health services under capitated financing systems. This study uses claims data (1994-1997) from Colorado's Medicaid and Mental Health Services Agency. The fee-for-service (FFS) model served as the comparison model. Two capitated models under evaluation are: (i) direct capitation (DC), where the state contracts with a non-profit entity to provide both the services and administers the capitated financing, and (ii) managed behavioral health organization (MBHO), which is a joint venture between a for-profit company who manages the capitated financing and a number of non-profit entities who deliver the services. A sample of severely mentally ill patients who reported at least one inpatient visit was included in the analysis. Types of outpatient services of interest are: day-treatment visits, group therapy, individual therapy, medication monitoring, case management, testing, and all other services. Comparisons were set up to examine differences in service utilization and cost between FFS and each of the two capitated models, using a two-part model across three time periods. Results showed differences in service delivery among reimbursement models over time. Capitated providers had higher initial utilization in most outpatient service categories than their FFS counterparts and as a result of capitation, outpatient services delivered under these providers decreased to converge to the FFS pattern. Findings also suggest substitution between group therapy and individual psychotherapy. Overall, more service integration was observed and less complex service packages were provided post capitation. IMPLICATION FOR HEALTH CARE PROVISION AND POLICIES: Financing models and organizational arrangements have an impact on mental health service delivery. Changes in utilization and costs of specific types of outpatient services reflect the effects of capitation. Understanding the mechanism for these changes may lead to more streamlined service delivery allowing extra funding for expanding the range of cost-effective treatment alternatives. These changes pose implications for improving the financing of public mental health systems, coordination of mental health services with other healthcare and human services, and provision of services through a more efficient financing system.

Uncovering the cognitive processes underlying mental rotation: an eye-movement study.

PubMed

Xue, Jiguo; Li, Chunyong; Quan, Cheng; Lu, Yiming; Yue, Jingwei; Zhang, Chenggang

2017-08-30

Mental rotation is an important paradigm for spatial ability. Mental-rotation tasks are assumed to involve five or three sequential cognitive-processing states, though this has not been demonstrated experimentally. Here, we investigated how processing states alternate during mental-rotation tasks. Inference was carried out using an advanced statistical modelling and data-driven approach - a discriminative hidden Markov model (dHMM) trained using eye-movement data obtained from an experiment consisting of two different strategies: (I) mentally rotate the right-side figure to be aligned with the left-side figure and (II) mentally rotate the left-side figure to be aligned with the right-side figure. Eye movements were found to contain the necessary information for determining the processing strategy, and the dHMM that best fit our data segmented the mental-rotation process into three hidden states, which we termed encoding and searching, comparison, and searching on one-side pair. Additionally, we applied three classification methods, logistic regression, support vector model and dHMM, of which dHMM predicted the strategies with the highest accuracy (76.8%). Our study did confirm that there are differences in processing states between these two of mental-rotation strategies, and were consistent with the previous suggestion that mental rotation is discrete process that is accomplished in a piecemeal fashion.

42 CFR 483.130 - PASARR determination criteria.

Code of Federal Regulations, 2012 CFR

2012-10-01

... criteria. (a) Basis for determinations. Determinations made by the State mental health or intellectual... determinations by category. Advance group determinations by category developed by the State mental health or... records, physician's evaluations, election of hospice status, records of community mental health centers...

42 CFR 483.130 - PASARR determination criteria.

Code of Federal Regulations, 2013 CFR

2013-10-01

... criteria. (a) Basis for determinations. Determinations made by the State mental health or intellectual... determinations by category. Advance group determinations by category developed by the State mental health or... records, physician's evaluations, election of hospice status, records of community mental health centers...

Child Obesity and Mental Health: A Complex Interaction.

PubMed

Small, Leigh; Aplasca, Alexis

2016-04-01

Prevalence rates of childhood obesity have risen steeply over the last 3 decades. Given the increased national focus, the frequency of this clinical problem, and the multiple mental health factors that coexist with it, make obesity a public health concern. The complex relationships between mental health and obesity serve to potentiate the severity and interdependency of each. The purpose of this review is to create a contextual connection for the 2 conditions as outlined by the research literature and consider treatment options that affect both health problems. Copyright © 2016 Elsevier Inc. All rights reserved.

Body weight, self-perception and mental health outcomes among adolescents.

PubMed

Ali, Mir M; Fang, Hai; Rizzo, John A

2010-06-01

The prevalence of childhood obesity in the United States has increased three-fold over the last thirty years. During the same period, the prevalence of depressive symptoms in children also rose significantly. Previous literature suggests an association between actual body weight and mental health, but there is little evidence on self-perception of weight and mental health status. To examine the relationship between actual body weight, self-perception of body weight and mental health outcomes among adolescents. Using data for a nationally-representative sample of adolescents in the United States, we ascertain the effect of body weight status on depressive symptoms by estimating endogeneity-corrected models including school-level fixed effects to account for bi-directionality and unobserved confounders. Actual body weight status was calculated using interviewer-measured height and weight. We also used a measure of self-perceived weight status to compare how actual versus self-perceived weight status affects mental health. The Rosenberg Self-Esteem (RSE) Scale, Center for Epidemiologic Studies Depression (CES-D) Scale, and a dichotomous version of self-reported indicator for depression were utilized as mental health indicators. Potential mediators between mental health and weight status such as levels of physical activity, participation in risky health behaviors and parental characteristics were also controlled for in the analysis. The analytical sample consisted of 13,454 adolescents aged 11 to 18. After accounting for a wide array of relevant characteristics, we did not find a direct and significant association between actual weight status and mental health outcomes. Instead, our analysis revealed a strongly negative and significant relationship between self-perceived weight status and mental health. The negative relationship between self-perceived weight and depressive symptoms was more pronounced among females. The RSE scale was particularly correlated with body weight perceptions, suggesting a potentially important link between weight perception and self esteem. While the data set has rich detail on body weight and mental health outcomes, it lacks information on weight stigmatization. The complex relationships between actual body weight, self-perception of weight and weight stigmatization also limit determination of causality. The results from this study highlight the role of body weight perceptions in influencing mental health outcomes independent of actual weight status, especially among female adolescents. This suggests that policies aimed at improving mental health outcomes among adolescents might benefit from a focus on increasing awareness about healthy attitudes towards weight. Recent studies have found evidence that weight stigmatization and body dissatisfaction are predictors of depressive symptoms. It may be that the causal pathway between perceived weight status and depression occurs through weight stigmatization and body dissatisfaction. Future studies should investigate this causal mechanism further.

Assessing Child Mental Health Services in New York: A Report on Three Focus Groups, Winter 2003.

ERIC Educational Resources Information Center

Koyanagi, Chris; Semansky, Rafael

In 2002, the Bazelon Center for Mental Health Law investigated the impact of expanding child mental health services in Medicaid on the actual availability of services to children. To assess family satisfaction, focus groups were held in two states: Oregon and New York. Both states have a comprehensive Medicaid mental health benefit for children…

Do the Eyes Have It? Inferring Mental States from Animated Faces in Autism

ERIC Educational Resources Information Center

Back, Elisa; Ropar, Danielle; Mitchell, Peter

2007-01-01

The ability of individuals with autistic spectrum disorders (ASD) to infer mental states from dynamic and static facial stimuli was investigated. In Experiment 1, individuals with ASD (10- to 14-year olds; N = 18) performed above chance but not as well as controls. Accuracy scores for mental states did not differ between dynamic and static faces.…

Theory of Mind and Mental State Discourse during Book Reading and Story-Telling Tasks

ERIC Educational Resources Information Center

Symons, Douglas K.; Peterson, Candida C.; Slaughter, Virginia; Roche, Jackie; Doyle, Emily

2005-01-01

This article presents three studies conducted in Canada and Australia that relate theory of mind (ToM) development to mental state discourse. In Study 1, mental state discourse was examined while parents and their 5-7-year-old children jointly read a storybook which had a surprise ending about the identity of the main character. Comments specific…

Modeling the Mental Health Workforce in Washington State: Using State Licensing Data to Examine Provider Supply in Rural and Urban Areas

ERIC Educational Resources Information Center

Baldwin, Laura-Mae; Patanian, Miriam M.; Larson, Eric H.; Lishner, Denise M.; Mauksch, Larry B.; Katon, Wayne J.; Walker, Edward; Hart, L. Gary

2006-01-01

Context: Ensuring an adequate mental health provider supply in rural and urban areas requires accessible methods of identifying provider types, practice locations, and practice productivity. Purpose: To identify mental health shortage areas using existing licensing and survey data. Methods: The 1998-1999 Washington State Department of Health files…

Applying the World Health Organization Mental Health Action Plan to evaluate policy on addressing co-occurrence of physical and mental illnesses in Australia.

PubMed

Happell, Brenda; Platania-Phung, Chris; Webster, Stephanie; McKenna, Brian; Millar, Freyja; Stanton, Robert; Galletly, Cherrie; Castle, David; Furness, Trentham; Liu, Dennis; Scott, David

2015-09-01

The aim of the present study was to document Australian policies on the physical health of people with mental illness and evaluate the capacity of policy to support health needs. A search of state and federal policies on mental and physical illness was conducted, as well as detailed analysis of policy content and the relationships between policies, by applying the World Health Organization Mental Health Action Plan 2013-2020 as an evaluative framework. National policy attention to the physical health of people with mental illness has grown, but there is little interconnection at the national and state levels. State policies across the country are inconsistent, and there is little evidence of consistent policy implementation. A coherent national health policy framework on addressing co-occurring physical and mental illnesses that includes healthcare system reforms and ensuring the interconnectedness of other relevant services should be prioritised.

The role of state mental health authorities in managing change for the implementation of evidence-based practices.

PubMed

Isett, Kimberley Roussin; Burnam, M Audrey; Coleman-Beattie, Brenda; Hyde, Pamela S; Morrissey, Joseph P; Magnabosco, Jennifer L; Rapp, Charles; Ganju, Vijay; Goldman, Howard H

2008-06-01

The evidence-based practice demonstration for services to adults with serious mental illness has ended its pilot stage. This paper presents the approaches states employed to combine traditional policy levers with more strategic/institutional efforts (e.g., leadership) to facilitate implementation of these practices. Two rounds of site visits were completed and extensive interview data collected. The data were analyzed to find trends that were consistent across states and across practices. Two themes emerged for understanding implementation of evidence-based practices: the support and influence of the state mental health authority matters and so does the structure of the mental health systems.

Vital Signs: Trends in State Suicide Rates - United States, 1999-2016 and Circumstances Contributing to Suicide - 27 States, 2015.

PubMed

Stone, Deborah M; Simon, Thomas R; Fowler, Katherine A; Kegler, Scott R; Yuan, Keming; Holland, Kristin M; Ivey-Stephenson, Asha Z; Crosby, Alex E

2018-06-08

Suicide rates in the United States have risen nearly 30% since 1999, and mental health conditions are one of several factors contributing to suicide. Examining state-level trends in suicide and the multiple circumstances contributing to it can inform comprehensive state suicide prevention planning. Trends in age-adjusted suicide rates among persons aged ≥10 years, by state and sex, across six consecutive 3-year periods (1999-2016), were assessed using data from the National Vital Statistics System for 50 states and the District of Columbia. Data from the National Violent Death Reporting System, covering 27 states in 2015, were used to examine contributing circumstances among decedents with and without known mental health conditions. During 1999-2016, suicide rates increased significantly in 44 states, with 25 states experiencing increases >30%. Rates increased significantly among males and females in 34 and 43 states, respectively. Fifty-four percent of decedents in 27 states in 2015 did not have a known mental health condition. Among decedents with available information, several circumstances were significantly more likely among those without known mental health conditions than among those with mental health conditions, including relationship problems/loss (45.1% versus 39.6%), life stressors (50.5% versus 47.2%), and recent/impending crises (32.9% versus 26.0%), but these circumstances were common across groups. Suicide rates increased significantly across most states during 1999-2016. Various circumstances contributed to suicides among persons with and without known mental health conditions. States can use a comprehensive evidence-based public health approach to prevent suicide risk before it occurs, identify and support persons at risk, prevent reattempts, and help friends and family members in the aftermath of a suicide.

Mental Health Assessment and Intervention for People with Complex Communication Needs Associated with Developmental Disabilities

ERIC Educational Resources Information Center

Di Marco, Mark; Iacono, Teresa

2007-01-01

This paper addresses the issues of assessment and psychological interventions of mental health in people with complex communication needs of people with intellectual disability and/or cerebral palsy. The literature indicates that research data have been lacking in this area, with a dearth of appropriate assessment tools and information on how to…

The Experiences of Licensed Mental Health Professionals Who Have Encountered and Navigated through Compassion Fatigue

ERIC Educational Resources Information Center

Jorgensen, Louise B.

2012-01-01

The purpose of this dissertation study was to increase understanding of licensed mental health professionals' experiences as they have encountered and navigated through compassion fatigue (CF). CF is a complex construct with an attendant constellation of secondary stress responses. In order to examine the complex and varying factors…

Legal frameworks and key concepts regulating diversion and treatment of mentally disordered offenders in European Union member states.

PubMed

Dressing, Harald; Salize, Hans Joachim; Gordon, Harvey

2007-10-01

There is only limited research on the various legal regulations governing assessment, placement and treatment of mentally ill offenders in European Union member states (EU-member states). To provide a structured description and cross-boundary comparison of legal frameworks regulating diversion and treatment of mentally disordered offenders in EU-member states before the extension in May 2004. A special focus is on the concept of criminal responsibility. Information on legislation and practice concerning the assessment, placement and treatment of mentally ill offenders was gathered by means of a detailed, structured questionnaire which was filled in by national experts. The legal regulations relevant for forensic psychiatry in EU-member states are outlined. Definitions of mental disorders given within these acts are introduced and compared with ICD-10 diagnoses. Finally the application of the concept of criminal responsibility by the law and in routine practice is presented. Legal frameworks for the processing and placement of mentally disordered offenders varied markedly across EU-member states. Since May 2004 the European Union has expanded to 25 member states and in January 2007 it will reach 27. With increasing mobility across Europe, the need for increasing trans-national co-operation is becoming apparent in which great variation in legal tradition pertains.

The Neural Bases of Directed and Spontaneous Mental State Attributions to Group Agents

PubMed Central

Jenkins, Adrianna C.; Dodell-Feder, David; Saxe, Rebecca; Knobe, Joshua

2014-01-01

In daily life, perceivers often need to predict and interpret the behavior of group agents, such as corporations and governments. Although research has investigated how perceivers reason about individual members of particular groups, less is known about how perceivers reason about group agents themselves. The present studies investigate how perceivers understand group agents by investigating the extent to which understanding the ‘mind’ of the group as a whole shares important properties and processes with understanding the minds of individuals. Experiment 1 demonstrates that perceivers are sometimes willing to attribute a mental state to a group as a whole even when they are not willing to attribute that mental state to any of the individual members of the group, suggesting that perceivers can reason about the beliefs and desires of group agents over and above those of their individual members. Experiment 2 demonstrates that the degree of activation in brain regions associated with attributing mental states to individuals—i.e., brain regions associated with mentalizing or theory-of-mind, including the medial prefrontal cortex (MPFC), temporo-parietal junction (TPJ), and precuneus—does not distinguish individual from group targets, either when reading statements about those targets' mental states (directed) or when attributing mental states implicitly in order to predict their behavior (spontaneous). Together, these results help to illuminate the processes that support understanding group agents themselves. PMID:25140705

Towards psychologically adaptive brain-computer interfaces

NASA Astrophysics Data System (ADS)

Myrden, A.; Chau, T.

2016-12-01

Objective. Brain-computer interface (BCI) performance is sensitive to short-term changes in psychological states such as fatigue, frustration, and attention. This paper explores the design of a BCI that can adapt to these short-term changes. Approach. Eleven able-bodied individuals participated in a study during which they used a mental task-based EEG-BCI to play a simple maze navigation game while self-reporting their perceived levels of fatigue, frustration, and attention. In an offline analysis, a regression algorithm was trained to predict changes in these states, yielding Pearson correlation coefficients in excess of 0.45 between the self-reported and predicted states. Two means of fusing the resultant mental state predictions with mental task classification were investigated. First, single-trial mental state predictions were used to predict correct classification by the BCI during each trial. Second, an adaptive BCI was designed that retrained a new classifier for each testing sample using only those training samples for which predicted mental state was similar to that predicted for the current testing sample. Main results. Mental state-based prediction of BCI reliability exceeded chance levels. The adaptive BCI exhibited significant, but practically modest, increases in classification accuracy for five of 11 participants and no significant difference for the remaining six despite a smaller average training set size. Significance. Collectively, these findings indicate that adaptation to psychological state may allow the design of more accurate BCIs.

Women Prisoners' Mental Health: Vulnerabilities, Risks and Resilience.

ERIC Educational Resources Information Center

Martin, Margaret E.; Hesselbrock, Michie N.

2001-01-01

Studies 49 incarcerated women to examine the complex relationship among women's criminal history, victimization, relational supports, personal strengths and their mental health. A cluster analysis produced four typologies shaping recommendations for assessment and treatment. Findings suggest that women with the greatest mental health needs have…

Psychiatric genetic research at the National Institute of Mental Health

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berg, K.; Mullican, C.; Maestri, N.

For some time it has been known through the results of family, twin, and adoption studies that hereditary appears to play a significant casual role in many mental disorders, including schizophrenia, bipolar disorder, and other mood disorders, Alzheimer`s Disease, panic disorder, obsessive compulsive disorder, autism, dyslexia, and Tourette`s syndrome. The precise patterns of inheritance of these complex disorders have not been determined, nor have the relevant genes been localized or cloned. Because the genetics are complex and because there is also clearly an environmental contribution to behavior, we expect the analysis of the genetics of mental illness to be arduousmore » and not quickly resolved. There are several compelling reasons to continue to focus our attention on uncovering the genetic factors for severe mental illness. Prominent among these are the implications for better treatment of mental disorders. The National Institute of Mental Health supports a wide range of studies on psychiatric genetic research. 16 refs.« less

Towards a system-paced near-infrared spectroscopy brain-computer interface: differentiating prefrontal activity due to mental arithmetic and mental singing from the no-control state.

PubMed

Power, Sarah D; Kushki, Azadeh; Chau, Tom

2011-12-01

Near-infrared spectroscopy (NIRS) has recently been investigated as a non-invasive brain-computer interface (BCI) for individuals with severe motor impairments. For the most part, previous research has investigated the development of NIRS-BCIs operating under synchronous control paradigms, which require the user to exert conscious control over their mental activity whenever the system is vigilant. Though functional, this is mentally demanding and an unnatural way to communicate. An attractive alternative to the synchronous control paradigm is system-paced control, in which users are required to consciously modify their brain activity only when they wish to affect the BCI output, and can remain in a more natural, 'no-control' state at all other times. In this study, we investigated the feasibility of a system-paced NIRS-BCI with one intentional control (IC) state corresponding to the performance of either mental arithmetic or mental singing. In particular, this involved determining if these tasks could be distinguished, individually, from the unconstrained 'no-control' state. Deploying a dual-wavelength frequency domain near-infrared spectrometer, we interrogated nine sites around the frontopolar locations (International 10-20 System) while eight able-bodied adults performed mental arithmetic and mental singing to answer multiple-choice questions within a system-paced paradigm. With a linear classifier trained on a six-dimensional feature set, an overall classification accuracy of 71.2% across participants was achieved for the mental arithmetic versus no-control classification problem. While the mental singing versus no-control classification was less successful across participants (62.7% on average), four participants did attain accuracies well in excess of chance, three of which were above 70%. Analyses were performed offline. Collectively, these results are encouraging, and demonstrate the potential of a system-paced NIRS-BCI with one IC state corresponding to either mental arithmetic or mental singing.

Towards a system-paced near-infrared spectroscopy brain-computer interface: differentiating prefrontal activity due to mental arithmetic and mental singing from the no-control state

NASA Astrophysics Data System (ADS)

Power, Sarah D.; Kushki, Azadeh; Chau, Tom

2011-10-01

Near-infrared spectroscopy (NIRS) has recently been investigated as a non-invasive brain-computer interface (BCI) for individuals with severe motor impairments. For the most part, previous research has investigated the development of NIRS-BCIs operating under synchronous control paradigms, which require the user to exert conscious control over their mental activity whenever the system is vigilant. Though functional, this is mentally demanding and an unnatural way to communicate. An attractive alternative to the synchronous control paradigm is system-paced control, in which users are required to consciously modify their brain activity only when they wish to affect the BCI output, and can remain in a more natural, 'no-control' state at all other times. In this study, we investigated the feasibility of a system-paced NIRS-BCI with one intentional control (IC) state corresponding to the performance of either mental arithmetic or mental singing. In particular, this involved determining if these tasks could be distinguished, individually, from the unconstrained 'no-control' state. Deploying a dual-wavelength frequency domain near-infrared spectrometer, we interrogated nine sites around the frontopolar locations (International 10-20 System) while eight able-bodied adults performed mental arithmetic and mental singing to answer multiple-choice questions within a system-paced paradigm. With a linear classifier trained on a six-dimensional feature set, an overall classification accuracy of 71.2% across participants was achieved for the mental arithmetic versus no-control classification problem. While the mental singing versus no-control classification was less successful across participants (62.7% on average), four participants did attain accuracies well in excess of chance, three of which were above 70%. Analyses were performed offline. Collectively, these results are encouraging, and demonstrate the potential of a system-paced NIRS-BCI with one IC state corresponding to either mental arithmetic or mental singing.

Stepping Stones to Others' Minds: Maternal Talk Relates to Child Mental State Language and Emotion Understanding at 15, 24, and 33 Months

ERIC Educational Resources Information Center

Taumoepeau, Mele; Ruffman, Ted

2008-01-01

This continuation of a previous study (Taumoepeau & Ruffman, 2006) examined the longitudinal relation between maternal mental state talk to 15- and 24-month-olds and their later mental state language and emotion understanding (N = 74). The previous study found that maternal talk about the child's desires to 15-month-old children uniquely predicted…

Reading Minds: The Relation between Children's Mental State Knowledge and Their Metaknowledge about Reading

ERIC Educational Resources Information Center

Lecce, Serena; Zocchi, Silvia; Pagnin, Adriano; Palladino, Paola; Taumoepeau, Mele

2010-01-01

The relation between children's mental state knowledge and metaknowledge about reading was examined in 2 studies. In Study 1, 196 children (mean age = 9 years) were tested for verbal ability (VA), metaknowledge about reading, and mental state words in a story task. In Study 2, the results of Study 1 were extended by using a cross-lagged design and…

Brief Report: Conveying Subjective Experience in Conversation: Production of Mental State Terms and Personal Narratives in Individuals with High Functioning Autism

ERIC Educational Resources Information Center

Bang, Janet; Burns, Jesse; Nadig, Aparna

2013-01-01

Mental state terms and personal narratives are conversational devices used to communicate subjective experience in conversation. Pre-adolescents with high-functioning autism (HFA, n = 20) were compared with language-matched typically-developing peers (TYP, n = 17) on production of mental state terms (i.e., perception, physiology, desire, emotion,…

Therapeutic Jurisprudence in Health Research: Enlisting Legal Theory as a Methodological Guide in an Interdisciplinary Case Study of Mental Health and Criminal Law.

PubMed

Ferrazzi, Priscilla; Krupa, Terry

2015-09-01

Studies that seek to understand and improve health care systems benefit from qualitative methods that employ theory to add depth, complexity, and context to analysis. Theories used in health research typically emerge from social science, but these can be inadequate for studying complex health systems. Mental health rehabilitation programs for criminal courts are complicated by their integration within the criminal justice system and by their dual health-and-justice objectives. In a qualitative multiple case study exploring the potential for these mental health court programs in Arctic communities, we assess whether a legal theory, known as therapeutic jurisprudence, functions as a useful methodological theory. Therapeutic jurisprudence, recruited across discipline boundaries, succeeds in guiding our qualitative inquiry at the complex intersection of mental health care and criminal law by providing a framework foundation for directing the study's research questions and the related propositions that focus our analysis. © The Author(s) 2014.

Parsing the Behavioral and Brain Mechanisms of Third-Party Punishment

PubMed Central

Bonnie, Richard J.; Hoffman, Morris B.; Shen, Francis X.; Simons, Kenneth W.

2016-01-01

The evolved capacity for third-party punishment is considered crucial to the emergence and maintenance of elaborate human social organization and is central to the modern provision of fairness and justice within society. Although it is well established that the mental state of the offender and the severity of the harm he caused are the two primary predictors of punishment decisions, the precise cognitive and brain mechanisms by which these distinct components are evaluated and integrated into a punishment decision are poorly understood. Using fMRI, here we implement a novel experimental design to functionally dissociate the mechanisms underlying evaluation, integration, and decision that were conflated in previous studies of third-party punishment. Behaviorally, the punishment decision is primarily defined by a superadditive interaction between harm and mental state, with subjects weighing the interaction factor more than the single factors of harm and mental state. On a neural level, evaluation of harms engaged brain areas associated with affective and somatosensory processing, whereas mental state evaluation primarily recruited circuitry involved in mentalization. Harm and mental state evaluations are integrated in medial prefrontal and posterior cingulate structures, with the amygdala acting as a pivotal hub of the interaction between harm and mental state. This integrated information is used by the right dorsolateral prefrontal cortex at the time of the decision to assign an appropriate punishment through a distributed coding system. Together, these findings provide a blueprint of the brain mechanisms by which neutral third parties render punishment decisions. SIGNIFICANCE STATEMENT Punishment undergirds large-scale cooperation and helps dispense criminal justice. Yet it is currently unknown precisely how people assess the mental states of offenders, evaluate the harms they caused, and integrate those two components into a single punishment decision. Using a new design, we isolated these three processes, identifying the distinct brain systems and activities that enable each. Additional findings suggest that the amygdala plays a crucial role in mediating the interaction of mental state and harm information, whereas the dorsolateral prefrontal cortex plays a crucial, final-stage role, both in integrating mental state and harm information and in selecting a suitable punishment amount. These findings deepen our understanding of how punishment decisions are made, which may someday help to improve them. PMID:27605616

Parsing the Behavioral and Brain Mechanisms of Third-Party Punishment.

PubMed

Ginther, Matthew R; Bonnie, Richard J; Hoffman, Morris B; Shen, Francis X; Simons, Kenneth W; Jones, Owen D; Marois, René

2016-09-07

The evolved capacity for third-party punishment is considered crucial to the emergence and maintenance of elaborate human social organization and is central to the modern provision of fairness and justice within society. Although it is well established that the mental state of the offender and the severity of the harm he caused are the two primary predictors of punishment decisions, the precise cognitive and brain mechanisms by which these distinct components are evaluated and integrated into a punishment decision are poorly understood. Using fMRI, here we implement a novel experimental design to functionally dissociate the mechanisms underlying evaluation, integration, and decision that were conflated in previous studies of third-party punishment. Behaviorally, the punishment decision is primarily defined by a superadditive interaction between harm and mental state, with subjects weighing the interaction factor more than the single factors of harm and mental state. On a neural level, evaluation of harms engaged brain areas associated with affective and somatosensory processing, whereas mental state evaluation primarily recruited circuitry involved in mentalization. Harm and mental state evaluations are integrated in medial prefrontal and posterior cingulate structures, with the amygdala acting as a pivotal hub of the interaction between harm and mental state. This integrated information is used by the right dorsolateral prefrontal cortex at the time of the decision to assign an appropriate punishment through a distributed coding system. Together, these findings provide a blueprint of the brain mechanisms by which neutral third parties render punishment decisions. Punishment undergirds large-scale cooperation and helps dispense criminal justice. Yet it is currently unknown precisely how people assess the mental states of offenders, evaluate the harms they caused, and integrate those two components into a single punishment decision. Using a new design, we isolated these three processes, identifying the distinct brain systems and activities that enable each. Additional findings suggest that the amygdala plays a crucial role in mediating the interaction of mental state and harm information, whereas the dorsolateral prefrontal cortex plays a crucial, final-stage role, both in integrating mental state and harm information and in selecting a suitable punishment amount. These findings deepen our understanding of how punishment decisions are made, which may someday help to improve them. Copyright © 2016 Ginther et al.

The Global Mental Health movement and its impact on traditional healing in India: A case study of the Balaji temple in Rajasthan.

PubMed

Sood, Anubha

2016-12-01

This article considers the impact of the global mental health discourse on India's traditional healing systems. Folk mental health traditions, based in religious lifeways and etiologies of supernatural affliction, are overwhelmingly sought by Indians in times of mental ill-health. This is despite the fact that the postcolonial Indian state has historically considered the popularity of these indigenous treatments regressive, and claimed Western psychiatry as the only mental health system befitting the country's aspirations as a modern nation-state. In the last decade however, as global mental health concerns for scaling up psychiatric interventions and instituting bioethical practices in mental health services begin to shape India's mental health policy formulations, the state's disapproving stance towards traditional healing has turned to vehement condemnation. In present-day India, traditional treatments are denounced for being antithetical to global mental health tenets and harmful for the population, while biomedical psychiatry is espoused as the only legitimate form of mental health care. Based on ethnographic research in the Hindu healing temple of Balaji, Rajasthan, and analysis of India's mental health policy environment, I demonstrate how the tenor of the global mental health agenda is negatively impacting the functioning of the country's traditional healing sites. I argue that crucial changes in the therapeutic culture of the Balaji temple, including the disappearance of a number of key healing rituals, are consequences of global mental health-inspired policy in India which is reducing the plural mental health landscape.

Public and nonprofit funding for research on mental disorders in France, the United Kingdom, and the United States.

PubMed

Chevreul, Karine; McDaid, David; Farmer, Carrie M; Prigent, Amélie; Park, A-La; Leboyer, Marion; Kupfer, David J; Durand-Zaleski, Isabelle

2012-07-01

To document the investments made in research on mental disorders by both government and nonprofit nongovernmental organizations in France, the United Kingdom, and the United States. An exhaustive survey was conducted of primary sources of public and nonprofit organization funding for mental health research for the year 2007 in France and the United Kingdom and for fiscal year 2007-2008 in the United States, augmented with an examination of relevant Web sites and publications. In France, all universities and research institutions were identified using the Public Finance Act. In the United Kingdom, we scrutinized Web sites and hand searched annual reports and grant lists for the public sector and nonprofit charitable medical research awarding bodies. In the United States, we included the following sources: the National Institutes of Health, other administrative entities within the Department of Health and Human Services (eg, Centers for Disease Control and Prevention), the Department of Education, the Department of Veterans Affairs, the Department of Defense, and the National Science Foundation and, for nonprofit funding, The Foundation Center. We included research on all mental disorders and substance-related disorders using the same keywords. We excluded research on mental retardation and dementia and on the promotion of mental well-being. We used the same algorithm in each country to obtain data for only mental health funding in situations in which funding had a broader scope. France spent $27.6 million (2%) of its health research budget on mental disorders, the United Kingdom spent $172.6 million (7%), and the United States spent $5.2 billion (16%). Nongovernmental funding ranged from 1% of total funding for mental health research in France and the United States to 14% in the United Kingdom. Funding for research on mental disorders accounts for low proportions of research budgets compared with funding levels for research on other major health problems, whereas the expected return on investment is potentially high. © Copyright 2012 Physicians Postgraduate Press, Inc.

Conceptual and Developmental Analysis of Mental Models: An Example with Complex Change Problems.

ERIC Educational Resources Information Center

Poirier, Louise

Defining better implicit models of children's actions in a series of situations is of paramount importance to understanding how knowledge is constructed. The objective of this study was to analyze the implicit mental models used by children in complex change problems to understand the stability of the models and their evolution with the child's…

Fast and Careless or Careful and Slow? Apparent Holistic Processing in Mental Rotation Is Explained by Speed-Accuracy Trade-Offs

ERIC Educational Resources Information Center

Liesefeld, Heinrich René; Fu, Xiaolan; Zimmer, Hubert D.

2015-01-01

A major debate in the mental-rotation literature concerns the question of whether objects are represented holistically during rotation. Effects of object complexity on rotational speed are considered strong evidence against such holistic representations. In Experiment 1, such an effect of object complexity was markedly present. A closer look on…

Poverty, social stress & mental health.

PubMed

Kuruvilla, A; Jacob, K S

2007-10-01

While there is increasing evidence of an association between poor mental health and the experience of poverty and deprivation, the relationship is complex. We discuss the epidemiological data on mental illness among the different socio-economic groups, look at the cause -effect debate on poverty and mental illness and the nature of mental distress and disorders related to poverty. Issues related to individual versus area-based poverty, relative poverty and the impact of poverty on woman's and child mental health are presented. This review also addresses factors associated with poverty and the difficulties in the measurement of mental health and illness and levels/impact of poverty.

Financing mental health services for adolescents: a background paper.

PubMed

Kapphahn, Cynthia; Morreale, Madlyn; Rickert, Vaughn I; Walker, Leslie

2006-09-01

Good mental health provides an essential foundation for normal growth and development through adolescence and into adulthood. Many adolescents, however, experience mental health problems that significantly impede the attainment of their full potential. The majority of these adolescents do not receive needed mental health services, in part because of financial obstacles to care. This article reviews the magnitude and impact of mental health problems during adolescence and highlights the importance of insurance coverage in assuring access to mental health services for adolescents. Significant limitations in private health insurance coverage of mental health services are outlined. Recent federal and state efforts to move toward parity in private insurance coverage between mental and physical health services are discussed, including an explanation of the role of Medicaid and the State Children's Health Insurance Program (SCHIP) in providing access to mental health services for adolescents. Finally, other elements that would facilitate financial access to essential mental health services for adolescents are presented.

Perceiving expressions of emotion: What evidence could bear on questions about perceptual experience of mental states?

PubMed

Butterfill, Stephen A

2015-11-01

What evidence could bear on questions about whether humans ever perceptually experience any of another's mental states, and how might those questions be made precise enough to test experimentally? This paper focusses on emotions and their expression. It is proposed that research on perceptual experiences of physical properties provides one model for thinking about what evidence concerning expressions of emotion might reveal about perceptual experiences of others' mental states. This proposal motivates consideration of the hypothesis that categorical perception of expressions of emotion occurs, can be facilitated by information about agents' emotions, and gives rise to phenomenal expectations. It is argued that the truth of this hypothesis would support a modest version of the claim that humans sometimes perceptually experience some of another's mental states. Much available evidence is consistent with, but insufficient to establish, the truth of the hypothesis. We are probably not yet in a position to know whether humans ever perceptually experience others' mental states. Copyright © 2015 Elsevier Inc. All rights reserved.

Introduction: Applying Clinical Psychological Science to Practice.

PubMed

Cha, Christine B; DiVasto, Katherine A

2017-05-01

Mental illness is a prevalent and extraordinarily complex phenomenon. Psychologists have developed distinct approaches toward understanding and treating mental illness, rooted in divergent epistemology. This introduction to the Special Issue on Clinical Psychological Science and Practice provides a brief overview of the scientist-practitioner gap, and explores one step (of many) toward bridging this divide. Seven compelling case illustrations featured in this Special Issue apply empirical findings to case formulation, treatment selection, and assessment across complex and varied clinical presentations. This issue thereby demonstrates the feasibility of integrating research and clinical expertise in mental healthcare. © 2017 Wiley Periodicals, Inc.

Functionalism and consciousness.

PubMed

Shoemaker, S

1993-01-01

It is widely held that a mental state and the subject's introspective belief about it are always 'distinct existences' and only contingently connected. This suggests that for each sort of mental state there could be a creature that is introspectively 'blind' with respect to states of that sort, meaning that while it is capable of having such states, and of conceiving of itself as having them, it is totally without introspective access to its states of that sort. It is argued here that introspective blindness with respect to many sorts of mental states, in particular beliefs and sensory states, is not a possibility, because it is incompatible with requirements of rationality that are internal to the functional roles that are constitutive of these states. Introspective accessibility is essential to the functional roles of such mental states when the conceptual and cognitive resources of the subject of those states are sufficiently rich to make beliefs and thoughts about them a possibility. This is a version of the view that such states are necessarily self-intimating and is incompatible with the perceptual model of introspection favoured by some functionalists as well as by many non-functionalists.

Using Medicaid to Help Young Children and Parents Access Mental Health Services: Results of a 50-State Survey. Updated

ERIC Educational Resources Information Center

Smith, Sheila; Granja, Maribel; Ekono, Mercedes; Robbins, Taylor; Nagarur, Mahathi

2017-01-01

As states work to strengthen supports for young children's mental health, often with the goal of reducing the incidence of costly conditions at later ages, they face the question of how to finance new or expanded services. This brief examines states' use of Medicaid as a key source of funding for early childhood mental health (ECMH) services. It…

Mental State Decoding in Adolescent Boys with Major Depressive Disorder versus Sex-Matched Healthy Controls.

PubMed

Mellick, William; Sharp, Carla

2016-01-01

Several adult depression studies have investigated mental state decoding, the basis for theory of mind, using the Reading the Mind in the Eyes Test. Findings have been mixed, but a comprehensive study found a greater severity of depression to be associated with poorer mental state decoding. Importantly, there has yet to be a similar study of adolescent depression. Converging evidence suggests that atypical mental state decoding may have particularly profound effects for psychosocial functioning among depressed adolescent boys. Adolescent boys with major depressive disorder (MDD, n = 33) and sex-matched healthy controls (HCs, n = 84) completed structured clinical interviews, self-report measures of psychopathology and the Child Eyes Test (CET). The MDD group performed significantly better than HCs on the CET overall (p = 0.002), underscored by greater accuracy for negatively valenced items (p = 0.003). Group differences on items depicting positive (p = 0.129) and neutral mental states (p = 0.081) were nonsignificant. Enhanced mental state decoding among depressed adolescent boys may play a role in the maintenance of and vulnerability to adolescent depression. Findings and implications are discussed. Limitations of this study include a reliance on self-report data for HC boys, as well as a lack of 'pure' depression among the boys with MDD. © 2016 S. Karger AG, Basel.

Emotion understanding, parent mental state language, and behavior problems in internationally adopted children.

PubMed

Tarullo, Amanda R; Youssef, Adriana; Frenn, Kristin A; Wiik, Kristen; Garvin, Melissa C; Gunnar, Megan R

2016-05-01

Internationally adopted postinstitutionalized (PI) children are at risk for lower levels of emotion understanding. This study examined how postadoption parenting influences emotion understanding and whether lower levels of emotion understanding are associated with behavior problems. Emotion understanding and parent mental state language were assessed in 3-year-old internationally adopted PI children (N = 25), and comparison groups of children internationally adopted from foster care (N = 25) and nonadopted (NA) children (N = 36). At 5.5-year follow-up, PI children had lower levels of emotion understanding than NA children, a group difference not explained by language. In the total sample, parent mental state language at age 3 years predicted 5.5-year emotion understanding after controlling for child language ability. The association of parent mental state language and 5.5-year emotion understanding was moderated by adoption status, such that parent mental state language predicted 5.5-year emotion understanding for the internationally adopted children, but not for the NA children. While postadoption experience does not erase negative effects of early deprivation on emotion understanding, results suggest that parents can promote emotion understanding development through mental state talk. At 5.5 years, PI children had more internalizing and externalizing problems than NA children, and these behavioral problems related to lower levels of emotion understanding.

State mental health policy: Maryland's shared leadership approach to mental health transformation: partnerships that work.

PubMed

Semansky, Rafael M

2012-07-01

In 2005, Maryland received a mental health transformation grant from the Substance Abuse and Mental Health Services Administration. Maryland's transformation efforts have differed from those in other grantee states and have evolved into a shared leadership approach that harnesses the power of leaders from all sectors of the community. This column describes Maryland's reform efforts, focusing in particular on the development of the position of a peer employment specialist to improve placement of consumers in employment. This shared leadership approach has the potential to enhance long-term sustainability of reform initiatives and uses fewer state resources.

Mental Models: Knowledge in the Head and Knowledge in the World.

ERIC Educational Resources Information Center

Jonassen, David H.; Henning, Philip

1999-01-01

Explores the utility of mental models as learning outcomes in using complex and situated learning environments. Describes two studies: one aimed at eliciting mental models in the heads of novice refrigeration technicians, and the other an ethnographic study eliciting knowledge and models within the community of experienced refrigeration…

Mental Simulation of Visceral States Affects Preferences and Behavior

PubMed Central

Steinmetz, Janina; Tausen, Brittany M.; Risen, Jane L.

2017-01-01

Preferences and behavior are heavily influenced by one’s current visceral experience, yet people often fail to anticipate such effects. Although research suggests that this gap is difficult to overcome—to act as if in another visceral state—research on mental simulation has demonstrated that simulations can substitute for experiences, albeit to a weaker extent. We examine whether mentally simulating visceral states can impact preferences and behavior. We show that simulating a specific visceral state (e.g., being cold or hungry) shifts people’s preferences for relevant activities (Studies 1a-2) and choices of food portion sizes (Study 3). Like actual visceral experiences, mental simulation only affects people’s current preferences but not their general preferences (Study 4). Finally, people project simulated states onto similar others, as is the case for actual visceral experiences (Study 5). Thus, mental simulation may help people anticipate their own and others’ future preferences, thereby improving their decision making. PMID:29161953

Development and neurophysiology of mentalizing.

PubMed Central

Frith, Uta; Frith, Christopher D

2003-01-01

The mentalizing (theory of mind) system of the brain is probably in operation from ca. 18 months of age, allowing implicit attribution of intentions and other mental states. Between the ages of 4 and 6 years explicit mentalizing becomes possible, and from this age children are able to explain the misleading reasons that have given rise to a false belief. Neuroimaging studies of mentalizing have so far only been carried out in adults. They reveal a system with three components consistently activated during both implicit and explicit mentalizing tasks: medial prefrontal cortex (MPFC), temporal poles and posterior superior temporal sulcus (STS). The functions of these components can be elucidated, to some extent, from their role in other tasks used in neuroimaging studies. Thus, the MPFC region is probably the basis of the decoupling mechanism that distinguishes mental state representations from physical state representations; the STS region is probably the basis of the detection of agency, and the temporal poles might be involved in access to social knowledge in the form of scripts. The activation of these components in concert appears to be critical to mentalizing. PMID:12689373

Mental models: an alternative evaluation of a sensemaking approach to ethics instruction.

PubMed

Brock, Meagan E; Vert, Andrew; Kligyte, Vykinta; Waples, Ethan P; Sevier, Sydney T; Mumford, Michael D

2008-09-01

In spite of the wide variety of approaches to ethics training it is still debatable which approach has the highest potential to enhance professionals' integrity. The current effort assesses a novel curriculum that focuses on metacognitive reasoning strategies researchers use when making sense of day-to-day professional practices that have ethical implications. The evaluated trainings effectiveness was assessed by examining five key sensemaking processes, such as framing, emotion regulation, forecasting, self-reflection, and information integration that experts and novices apply in ethical decision-making. Mental models of trained and untrained graduate students, as well as faculty, working in the field of physical sciences were compared using a think-aloud protocol 6 months following the ethics training. Evaluation and comparison of the mental models of participants provided further validation evidence for sensemaking training. Specifically, it was found that trained students applied metacognitive reasoning strategies learned during training in their ethical decision-making that resulted in complex mental models focused on the objective assessment of the situation. Mental models of faculty and untrained students were externally-driven with a heavy focus on autobiographical processes. The study shows that sensemaking training has a potential to induce shifts in researchers' mental models by making them more cognitively complex via the use of metacognitive reasoning strategies. Furthermore, field experts may benefit from sensemaking training to improve their ethical decision-making framework in highly complex, novel, and ambiguous situations.

Mother and Infant Talk about Mental States: Systemic Emergence of Psychological Lexicon and Theory of Mind Understanding

NASA Astrophysics Data System (ADS)

Rollo, D.; Buttiglieri, F.

In recent years, a number of studies that have examined how social experiences are related to children's theory of mind development, have found that: (1) the frequency of mothers' mental state utterances used in mother-child picture-book reading, is correlated with children's theory of mind abilities; (2) mothers' use of cognitive terms is related more strongly to children's theory of mind performances than the mothers' references to other mental states, such as desires or emotions (Adrian, Clemente, Villanueva, Rieffe, 2005; Ruffman, Slade, Crowe, 2002; Taumoepeau, Ruffman, 2006; Dunn, 2002). Despite the evidence for the role of mothers' language, there is disagreement over how exactly it improves children's theory of mind development. In short, mentalistic comments contain distinctive words, grammatical constructions and pragmatic features. The question is, however, which factor is critical (de Rosnay, Pons, Harris, Morrell, 2004). The present study addresses this issue and focuses on relationship between mothers' mental state terms and children's performances in theory of mind tasks (emotion understanding and false belief tasks). Mothers were asked to read some pictures to 10 children between 3;0 and 5;0. Among the different mental state references (perceptual, emotional, volitional, cognitive, moral and communicative), it was found that the frequency and variety of mothers' mental state words were significantly associated with children's mental lexicon. In addition, emotional terms correlated positively with children's false belief performance. Kind of emotional words that are used by the mothers with reference to the Italian language will be discussed.

Spatial Complexity Due to Bulk Electronic Liquid Crystals in Superconducting Dy-Bi2212

NASA Astrophysics Data System (ADS)

Carlson, Erica; Phillabaum, Benjamin; Dahmen, Karin

2012-02-01

Surface probes such as scanning tunneling microscopy (STM) have detected complex electronic patterns at the nanoscale in many high temperature superconductors. In cuprates, the pattern formation is associated with the pseudogap phase, a precursor to the high temperature superconducting state. Rotational symmetry breaking of the host crystal (i.e. from C4 to C2) in the form of electronic nematicity has recently been proposed as a unifying theme of the pseudogap phase [Lawler Nature 2010]. However, the fundamental physics governing the nanoscale pattern formation has not yet been identified. Here we use universal cluster properties extracted from STM studies of cuprate superconductors to identify the funda- mental physics controlling the complex pattern formation. We find that due to a delicate balance between disorder, interactions, and material anisotropy, the rotational symmetry breaking is fractal in nature, and that the electronic liquid crystal extends throughout the bulk of the material.

Towards successful Dissemination of Psychological First Aid: a study of provider training preferences.

PubMed

Hambrick, Erin P; Rubens, Sonia L; Vernberg, Eric M; Jacobs, Anne K; Kanine, Rebecca M

2014-04-01

Dissemination of Psychological First Aid (PFA) is challenging considering the complex nature of disaster response and the various disaster mental health (DMH) trainings available. To understand challenges to dissemination in community mental health centers (CMHCs), interviews were conducted with nine DMH providers associated with CMHCs. Consensual qualitative analysis was used to analyze data. Interviews were targeted toward understanding organizational infrastructure, DMH training requirements, and training needs. Results clarified challenges to DMH training in CMHCs and factors that may promote buy-in for trainings. For example, resources are limited and thus allocated for state and federal training requirements. Therefore, including PFA in these requirements could promote adoption. Additionally, a variety of training approaches that differ in content, style, and length would be useful. To conclude, a conceptual model for ways to promote buy-in for the PFA Guide is proposed.

Health-Related Quality of Life Among US Workers: Variability Across Occupation Groups.

PubMed

Shockey, Taylor M; Zack, Matthew; Sussell, Aaron

2017-08-01

To examine the health-related quality of life among workers in 22 standard occupation groups using data from the 2013-2014 US Behavioral Risk Factor Surveillance System. We examined the health-related quality of life measures of self-rated health, frequent physical distress, frequent mental distress, frequent activity limitation, and frequent overall unhealthy days by occupation group for 155 839 currently employed adults among 17 states. We performed multiple logistic regression analyses that accounted for the Behavioral Risk Factor Surveillance System's complex survey design to obtain prevalence estimates adjusted for potential confounders. Among all occupation groups, the arts, design, entertainment, sports, and media occupation group reported the highest adjusted prevalence of frequent physical distress, frequent mental distress, frequent activity limitation, and frequent overall unhealthy days. The personal care and service occupation group had the highest adjusted prevalence for fair or poor self-rated health. Workers' jobs affect their health-related quality of life.

Specialized mechanisms for theory of mind: are mental representations special because they are mental or because they are representations?

PubMed

Cohen, Adam S; Sasaki, Joni Y; German, Tamsin C

2015-03-01

Does theory of mind depend on a capacity to reason about representations generally or on mechanisms selective for the processing of mental state representations? In four experiments, participants reasoned about beliefs (mental representations) and notes (non-mental, linguistic representations), which according to two prominent theories are closely matched representations because both are represented propositionally. Reaction times were faster and accuracies higher when participants endorsed or rejected statements about false beliefs than about false notes (Experiment 1), even when statements emphasized representational format (Experiment 2), which should have favored the activation of representation concepts. Experiments 3 and 4 ruled out a counterhypothesis that differences in task demands were responsible for the advantage in belief processing. These results demonstrate for the first time that understanding of mental and linguistic representations can be dissociated even though both may carry propositional content, supporting the theory that mechanisms governing theory of mind reasoning are narrowly specialized to process mental states, not representations more broadly. Extending this theory, we discuss whether less efficient processing of non-mental representations may be a by-product of mechanisms specialized for processing mental states. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

Medical Licensure Questions and Physician Reluctance to Seek Care for Mental Health Conditions.

PubMed

Dyrbye, Liselotte N; West, Colin P; Sinsky, Christine A; Goeders, Lindsey E; Satele, Daniel V; Shanafelt, Tait D

2017-10-01

To determine whether state medical licensure application questions (MLAQs) about mental health are related to physicians' reluctance to seek help for a mental health condition because of concerns about repercussions to their medical licensure. In 2016, we collected initial and renewal medical licensure application forms from 50 states and the District of Columbia. We coded MLAQs related to physicians' mental health as "consistent" if they inquired only about current impairment from a mental health condition or did not ask about mental health conditions. We obtained data on care-seeking attitudes for a mental health problem from a nationally representative convenience sample of 5829 physicians who completed a survey between August 28, 2014, and October 6, 2014. Analyses explored relationships between state of employment, MLAQs, and physicians' reluctance to seek formal medical care for treatment of a mental health condition because of concerns about repercussions to their medical licensure. We obtained initial licensure applications from 51 of 51 (100%) and renewal applications from 48 of 51 (94.1%) medical licensing boards. Only one-third of states currently have MLAQs about mental health on their initial and renewal application forms that are considered consistent. Nearly 40% of physicians (2325 of 5829) reported that they would be reluctant to seek formal medical care for treatment of a mental health condition because of concerns about repercussions to their medical licensure. Physicians working in a state in which neither the initial nor the renewal application was consistent were more likely to be reluctant to seek help (odds ratio, 1.21; 95% CI, 1.07-1.37; P=.002 vs both applications consistent). Our findings support that MLAQs regarding mental health conditions present a barrier to physicians seeking help. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

The status of states' policies to support evidence-based practices in children's mental health.

PubMed

Cooper, Janice L; Aratani, Yumiko

2009-12-01

This study examined the efforts of states' mental health authorities to promote the use of evidence-based practices through policy. Data were drawn from three components of a national study, including a survey of state children's mental health directors (N=53), which was developed using a three-step process that involved stakeholders. Data from the directors' survey revealed that over 90% of states are implementing strategies to support the use of evidence-based practices. The scope of these efforts varies, with 36% reporting statewide reach. Further, states' strategies for implementing evidence-based practices are often not accompanied by comparable efforts to enhance information systems, even though enhancing such systems can bolster opportunities for successful implementation. Variability in the adoption of evidence-based practices, poor attention to information systems, and inconsistent fiscal policies threaten states' efforts to improve the quality of children's mental health services.

Energy management system optimization for on-site facility staff - a case history of the New York State Office of Mental Health

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bagdon, M.J.; Martin, P.J.

1997-06-01

In 1994, Novus Engineering and EME Group began a project for the New York State Office of Mental Health (OMH) to maximize the use and benefit of energy management systems (EMS) installed at various large psychiatric hospitals throughout New York State. The project, which was funded and managed by the Dormitory Authority of the State of New York (DASNY), had three major objectives: (1) Maximize Energy Savings - Novus staff quickly learned that EMS systems as set up by contractors are far from optimal for generating energy savings. This part of the program revealed numerous opportunities for increased energy savings,more » such as: fine tuning proportional/integral/derivative (PID) loops to eliminate valve and damper hunting; adjusting temperature reset schedules to reduce energy consumption and provide more uniform temperature conditions throughout the facilities; and modifying equipment schedules. (2) Develop Monitoring Protocols - Large EMS systems are so complex that they require a systematic approach to daily, monthly and seasonal monitoring of building system conditions in order to locate system problems before they turn into trouble calls or equipment failures. In order to assist local facility staff in their monitoring efforts, Novus prepared user-friendly handbooks on each EMS. These included monitoring protocols tailored to each facility. (3) Provide Staff Training - When a new EMS is installed at a facility, it is frequently the maintenance staffs first exposure to a complex computerized system. Without proper training in what to look for, staff use of the EMS is generally very limited. With proper training, staff can be taught to take a pro-active approach to identify and solve problems before they get out of hand. The staff then realize that the EMS is a powerful preventative maintenance tool that can be used to make their work more effective and efficient. Case histories are presented.« less

Improving access to psychosocial interventions for common mental health problems in the United Kingdom: narrative review and development of a conceptual model for complex interventions

PubMed Central

2012-01-01

Background In the United Kingdom and worldwide, there is significant policy interest in improving the quality of care for patients with mental health disorders and distress. Improving quality of care means addressing not only the effectiveness of interventions but also the issue of limited access to care. Research to date into improving access to mental health care has not been strongly rooted within a conceptual model, nor has it systematically identified the different elements of the patient journey from identification of illness to receipt of care. This paper set out to review core concepts underlying patient access to mental health care, synthesise these to develop a conceptual model of access, and consider the implications of the model for the development and evaluation of interventions for groups with poor access to mental health care such as older people and ethnic minorities. Methods Narrative review of the literature to identify concepts underlying patient access to mental health care, and synthesis into a conceptual model to support the delivery and evaluation of complex interventions to improve access to mental health care. Results The narrative review adopted a process model of access to care, incorporating interventions at three levels. The levels comprise (a) community engagement (b) addressing the quality of interactions in primary care and (c) the development and delivery of tailored psychosocial interventions. Conclusions The model we propose can form the basis for the development and evaluation of complex interventions in access to mental health care. We highlight the key methodological challenges in evaluating the overall impact of access interventions, and assessing the relative contribution of the different elements of the model. PMID:22889290

Electroencephalographic Fractal Dimension in Healthy Ageing and Alzheimer’s Disease

PubMed Central

Cottone, Carlo; Cancelli, Andrea; Rossini, Paolo Maria; Tecchio, Franca

2016-01-01

Brain activity is complex; a reflection of its structural and functional organization. Among other measures of complexity, the fractal dimension is emerging as being sensitive to neuronal damage secondary to neurological and psychiatric diseases. Here, we calculated Higuchi’s fractal dimension (HFD) in resting-state eyes-closed electroencephalography (EEG) recordings from 41 healthy controls (age: 20–89 years) and 67 Alzheimer’s Disease (AD) patients (age: 50–88 years), to investigate whether HFD is sensitive to brain activity changes typical in healthy aging and in AD. Additionally, we considered whether AD-accelerating effects of the copper fraction not bound to ceruloplasmin (also called “free” copper) are reflected in HFD fluctuations. The HFD measure showed an inverted U-shaped relationship with age in healthy people (R2 = .575, p < .001). Onset of HFD decline appeared around the age of 60, and was most evident in central-parietal regions. In this region, HFD decreased with aging stronger in the right than in the left hemisphere (p = .006). AD patients demonstrated reduced HFD compared to age- and education-matched healthy controls, especially in temporal-occipital regions. This was associated with decreasing cognitive status as assessed by mini-mental state examination, and with higher levels of non-ceruloplasmin copper. Taken together, our findings show that resting-state EEG complexity increases from youth to maturity and declines in healthy, aging individuals. In AD, brain activity complexity is further reduced in correlation with cognitive impairment. In addition, elevated levels of non-ceruloplasmin copper appear to accelerate the reduction of neural activity complexity. Overall, HDF appears to be a proper indicator for monitoring EEG-derived brain activity complexity in healthy and pathological aging. PMID:26872349

State Laws on Emergency Holds for Mental Health Stabilization.

PubMed

Hedman, Leslie C; Petrila, John; Fisher, William H; Swanson, Jeffrey W; Dingman, Deirdre A; Burris, Scott

2016-05-01

Psychiatric emergency hold laws permit involuntary admission to a health care facility of a person with an acute mental illness under certain circumstances. This study documented critical variation in state laws, identified important questions for evaluation research, and created a data set of laws to facilitate the public health law research of emergency hold laws' impact on mental health outcomes. The research team built a 50-state, open-source data set of laws currently governing emergency holds. A protocol and codebook were developed so that the study may be replicated and extended longitudinally, allowing future research to accurately capture changes to current laws. Although every state and the District of Columbia have emergency hold laws, state law varies on the duration of emergency holds, who can initiate an emergency hold, the extent of judicial oversight, and the rights of patients during the hold. The core criterion justifying an involuntary hold is mental illness that results in danger to self or others, but many states have added further specifications. Only 22 states require some form of judicial review of the emergency hold process, and only nine require a judge to certify the commitment before a person is hospitalized. Five states do not guarantee assessment by a qualified mental health professional during the emergency hold. The article highlights variability in state law for emergency holds of persons with acute mental illness. How this variability affects the individual, the treatment system, and law enforcement behavior is unknown. Research is needed to guide policy making and implementation on these issues.

A Macro-Level Analysis of SRL Processes and Their Relations to the Acquisition of a Sophisticated Mental Model of a Complex System

ERIC Educational Resources Information Center

Greene, Jeffrey Alan; Azevedo, Roger

2009-01-01

In this study, we used think-aloud verbal protocols to examine how various macro-level processes of self-regulated learning (SRL; e.g., planning, monitoring, strategy use, handling of task difficulty and demands) were associated with the acquisition of a sophisticated mental model of a complex biological system. Numerous studies examine how…

75 FR 21314 - Medicaid Program; Final FY 2008, Revised Preliminary FY 2009, and Preliminary FY 2010...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... Federal share) IMD and other mental health facility DSH expenditures applicable to the State's FY 1995 DSH... State's total computable DSH expenditures attributable to the FY 1995 DSH allotment for mental health... DSH expenditures (mental health facility plus inpatient hospital) applicable to the FY 1995 DSH...

Development of Services for Elderly Persons with Mental Retardation in a Rural State.

ERIC Educational Resources Information Center

Cotten, Paul D.; Spirrison, Charles L.

1988-01-01

A model demonstration project to meet the needs of elderly mentally retarded individuals in a rural state was designed as a complementary, collaborative endeavor among service providers from the aging, mental retardation, and generic service system networks in Mississippi. Continuous training of staff members across networks was emphasized. (JW)

Evaluation of Community Residential Programs for Mentally Retarded Persons.

ERIC Educational Resources Information Center

Minnesota State Office of the Legislative Auditor, St. Paul. Program Evaluation Div.

The report evaluates how Minnesota plans, regulates, and finances residential services for mentally retarded persons. The first chapter reviews descriptive findings about the mentally retarded population in the state and notes that despite a decline in the number of state hospital residents, the total number of retarded persons in long-term care…

PUBLIC PROVISION FOR THE MENTALLY RETARDED IN THE UNITED STATES.

ERIC Educational Resources Information Center

BEST, HARRY

WRITTEN FROM THE STANDPOINT OF THE SOCIOLOGIST OR SOCIAL SCIENTIST, THIS BOOK REPORTS DATA OBTAINED FROM STATISTICAL RESEARCH ON MENTAL RETARDATES. ITS CHIEF PURPOSE IS THE SCIENTIFIC STUDY OF THE MENTALLY RETARDED AND PROVISIONS MADE FOR THEM IN THE UNITED STATES. DISCUSSION OF THE GENERAL CONDITION COVERS DEFINITION AND CLASSIFICATION, ETIOLOGY,…

42 CFR 483.116 - Residents and applicants determined to require NF level of services.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Individuals needing NF services. If the State mental health or mental retardation authority determines that a... individual. (b) Individuals needing NF services and specialized services. If the State mental health or... 42 Public Health 5 2011-10-01 2011-10-01 false Residents and applicants determined to require NF...

42 CFR 483.116 - Residents and applicants determined to require NF level of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Individuals needing NF services. If the State mental health or mental retardation authority determines that a... individual. (b) Individuals needing NF services and specialized services. If the State mental health or... 42 Public Health 5 2010-10-01 2010-10-01 false Residents and applicants determined to require NF...

Mutations in the gene encoding the Sigma 2 subunit of the adaptor protein 1 complex, AP1S2, cause X-linked mental retardation.

PubMed

Tarpey, Patrick S; Stevens, Claire; Teague, Jon; Edkins, Sarah; O'Meara, Sarah; Avis, Tim; Barthorpe, Syd; Buck, Gemma; Butler, Adam; Cole, Jennifer; Dicks, Ed; Gray, Kristian; Halliday, Kelly; Harrison, Rachel; Hills, Katy; Hinton, Jonathon; Jones, David; Menzies, Andrew; Mironenko, Tatiana; Perry, Janet; Raine, Keiran; Richardson, David; Shepherd, Rebecca; Small, Alexandra; Tofts, Calli; Varian, Jennifer; West, Sofie; Widaa, Sara; Yates, Andy; Catford, Rachael; Butler, Julia; Mallya, Uma; Moon, Jenny; Luo, Ying; Dorkins, Huw; Thompson, Deborah; Easton, Douglas F; Wooster, Richard; Bobrow, Martin; Carpenter, Nancy; Simensen, Richard J; Schwartz, Charles E; Stevenson, Roger E; Turner, Gillian; Partington, Michael; Gecz, Jozef; Stratton, Michael R; Futreal, P Andrew; Raymond, F Lucy

2006-12-01

In a systematic sequencing screen of the coding exons of the X chromosome in 250 families with X-linked mental retardation (XLMR), we identified two nonsense mutations and one consensus splice-site mutation in the AP1S2 gene on Xp22 in three families. Affected individuals in these families showed mild-to-profound mental retardation. Other features included hypotonia early in life and delay in walking. AP1S2 encodes an adaptin protein that constitutes part of the adaptor protein complex found at the cytoplasmic face of coated vesicles located at the Golgi complex. The complex mediates the recruitment of clathrin to the vesicle membrane. Aberrant endocytic processing through disruption of adaptor protein complexes is likely to result from the AP1S2 mutations identified in the three XLMR-affected families, and such defects may plausibly cause abnormal synaptic development and function. AP1S2 is the first reported XLMR gene that encodes a protein directly involved in the assembly of endocytic vesicles.

Electroencephalography Based Analysis of Working Memory Load and Affective Valence in an N-back Task with Emotional Stimuli

PubMed Central

Grissmann, Sebastian; Faller, Josef; Scharinger, Christian; Spüler, Martin; Gerjets, Peter

2017-01-01

Most brain-based measures of the electroencephalogram (EEG) are used in highly controlled lab environments and only focus on narrow mental states (e.g., working memory load). However, we assume that outside the lab complex multidimensional mental states are evoked. This could potentially create interference between EEG signatures used for identification of specific mental states. In this study, we aimed to investigate more realistic conditions and therefore induced a combination of working memory load and affective valence to reveal potential interferences in EEG measures. To induce changes in working memory load and affective valence, we used a paradigm which combines an N-back task (for working memory load manipulation) with a standard method to induce affect (affective pictures taken from the International Affective Picture System (IAPS) database). Subjective ratings showed that the experimental task was successful in inducing working memory load as well as affective valence. Additionally, performance measures were analyzed and it was found that behavioral performance decreased with increasing workload as well as negative valence, showing that affective valence can have an effect on cognitive processing. These findings are supported by changes in frontal theta and parietal alpha power, parameters used for measuring of working memory load in the EEG. However, these EEG measures are influenced by the negative valence condition as well and thereby show that detection of working memory load is sensitive to affective contexts. Unexpectedly, we did not find any effects for EEG measures typically used for affective valence detection (Frontal Alpha Asymmetry (FAA)). Therefore we assume that the FAA measure might not be usable if cognitive workload is induced simultaneously. We conclude that future studies should account for potential context-specifity of EEG measures. PMID:29311875

Electroencephalography Based Analysis of Working Memory Load and Affective Valence in an N-back Task with Emotional Stimuli.

PubMed

Grissmann, Sebastian; Faller, Josef; Scharinger, Christian; Spüler, Martin; Gerjets, Peter

2017-01-01

Most brain-based measures of the electroencephalogram (EEG) are used in highly controlled lab environments and only focus on narrow mental states (e.g., working memory load). However, we assume that outside the lab complex multidimensional mental states are evoked. This could potentially create interference between EEG signatures used for identification of specific mental states. In this study, we aimed to investigate more realistic conditions and therefore induced a combination of working memory load and affective valence to reveal potential interferences in EEG measures. To induce changes in working memory load and affective valence, we used a paradigm which combines an N-back task (for working memory load manipulation) with a standard method to induce affect (affective pictures taken from the International Affective Picture System (IAPS) database). Subjective ratings showed that the experimental task was successful in inducing working memory load as well as affective valence. Additionally, performance measures were analyzed and it was found that behavioral performance decreased with increasing workload as well as negative valence, showing that affective valence can have an effect on cognitive processing. These findings are supported by changes in frontal theta and parietal alpha power, parameters used for measuring of working memory load in the EEG. However, these EEG measures are influenced by the negative valence condition as well and thereby show that detection of working memory load is sensitive to affective contexts. Unexpectedly, we did not find any effects for EEG measures typically used for affective valence detection (Frontal Alpha Asymmetry (FAA)). Therefore we assume that the FAA measure might not be usable if cognitive workload is induced simultaneously. We conclude that future studies should account for potential context-specifity of EEG measures.

Effect of physical effort on mental workload of cyclists in real traffic in relation to age and use of pedelecs.

PubMed

Boele-Vos, M J; Commandeur, J J F; Twisk, D A M

2017-08-01

To improve cycling safety, insight is required into the factors that contribute to road safety of older cyclists. From the wide range of possible factors, this paper addresses the role of physical effort on mental workload of cyclists with the aim to investigate whether physical effort affects mental workload of cyclists in real traffic in a field experiment. Two instrumented bicycles, a conventional bicycle and a pedelec, were used. Mental workload of cyclists in two age groups - 30-45 years and 65 years and over - was measured by means of a secondary cognitive task requiring the detection and reaction to visual stimuli on a cycle route that varied in physical effort and task complexity. We expected physical effort to impair performance on the secondary task in complex traffic sections and not in simple sections, and that this impairment would be greater for older cyclists because of age related reduced muscle strength than for younger cyclists. We expected this impairment to be smaller if a pedelec was used. If such would be the case, this would indicate pedelecs to be beneficial for this older age group, because of a lower mental workload. Our study confirmed that increased physical effort in complex traffic sections deteriorated the detection of relevant stimuli in both age groups. Overall, older cyclists had longer reaction times and lower hit rates than younger cyclists. Mental workloads of cyclists are basically the same when cycling on a conventional bicycle or on a pedelec. In theory, pedelecs may be beneficial to reduce physical effort in cycling in order to maintain enough mental capacity to handle complex traffic situations. However, this study did not demonstrate these benefits. As pedelecs are often used for longer trips, by elderly with low muscle strength, future studies should also explore the effect of higher physical effort over longer periods of time, and also specifically in elderly with low muscle strength. Copyright © 2016 Elsevier Ltd. All rights reserved.

Outpatient care programs of mental health organizations, United States, 1988.

PubMed

Redick, R W; Witkin, M J; Atay, J E; Manderscheid, R W

1991-09-01

In 1988, 2,989 (60 percent) of the 4,961 mental health organizations in the United States (including the territories) offered outpatient care programs. A total of 5.8 million patient care episodes were generated by these organized outpatient programs. These episodes included 3.1 million outpatient additions, produced 54 million outpatient visits, and represented 67 percent of all patient care episodes in mental health organizations in 1988. Although the number of mental health organizations with outpatient care programs increased by less than one percent between 1986 and 1988, the number of outpatient additions showed an 11 percent gain during this period. Multiservice mental health organizations were the primary locus of outpatient care in 1988, accounting for 41 percent of the 2,989 mental health organizations providing this care. Ranking next in this respect, were free-standing psychiatric outpatient clinics, and the separate psychiatric outpatient services in non-Federal general hospitals, with 25 and 16 percent, respectively, of the total outpatient care programs. In general, these three organization types had similar rankings with respect to the volume of the outpatient caseload. By definition, all of the freestanding psychiatric outpatient clinics provided outpatient care, and almost all of the VA mental health programs and multiservice mental health organizations also offered this care (99 and 92 percent, respectively). In contrast, psychiatric outpatient care was available in only 37 percent of non-Federal general hospitals with separate psychiatric services, 36 percent of private psychiatric hospitals, 29 percent of State mental hospitals, and 22 percent of RTCs for emotionally disturbed children. Outpatient care was available in mental health organizations in all States in 1988, with every State having at least two or more organization types providing this service. In general, the most populous States had the largest number and the greatest variety of mental health organizations with outpatient care programs. Of the 2.87 million clients receiving outpatient care in mental health organizations at the end of 1988, 23 percent were under 18 years of age, 68 percent were 18 to 64, and 9 percent were 65 and older. Male outpatient clients slightly outnumbered female clients. The majority (77 percent) of the outpatient clients were white, with blacks representing 21 percent; native Americans and Asians/Pacific Islanders, the remaining two percent. Eleven percent of the total client population were reported to be of Hispanic origin.(ABSTRACT TRUNCATED AT 400 WORDS)

Mental health of nurses after the Fukushima complex disaster: a narrative review

PubMed Central

Nukui, Hiroshi; Midorikawa, Sanae; Murakami, Michio; Maeda, Masaharu; Ohtsuru, Akira

2018-01-01

Abstract Work-related mental health impairment is recognized as a real problem in the context of helping responders, including health professionals, due to adverse health outcomes after a severe disaster. The Great East-Japan Earthquake, which occurred on 11 March 2011, was an unprecedented complex disaster that caused a nuclear accident at the Fukushima Daiichi Nuclear Power Plant (NPP). In addition to disaster stress and daily work, medical and health-care professionals, particularly nurses, provided counseling services to residents concerned about radiation health risks or mental health issues. This review focuses on the psychological aspects of the complex nuclear disaster, which was a combined artificial nuclear accident and natural disaster, and we investigated the psychological effects on hospital nurses associated with their experiences during the disaster. We looked at several investigations into the mental health of nurses after a nuclear disaster and in other situations. It was shown that mental health of nurses is impacted, not only after nuclear disasters but also in other circumstances. Furthermore, we noted the effects of extended periods of a heavy workload and daily life. Regarding anxiety about radiation exposure, nurses who had more knowledge of radiation tended to have better mental health, suggesting that education about the health risks of radiation exposure is important for health-care professionals. In summary, it is essential that nurses are provided with education about radiation exposure and its associated health risks, and also that there is a comprehensive approach to mental health care for nurses during the chronic phase of a disaster. PMID:29668971

Mental health of nurses after the Fukushima complex disaster: a narrative review.

PubMed

Nukui, Hiroshi; Midorikawa, Sanae; Murakami, Michio; Maeda, Masaharu; Ohtsuru, Akira

2018-04-01

Work-related mental health impairment is recognized as a real problem in the context of helping responders, including health professionals, due to adverse health outcomes after a severe disaster. The Great East-Japan Earthquake, which occurred on 11 March 2011, was an unprecedented complex disaster that caused a nuclear accident at the Fukushima Daiichi Nuclear Power Plant (NPP). In addition to disaster stress and daily work, medical and health-care professionals, particularly nurses, provided counseling services to residents concerned about radiation health risks or mental health issues. This review focuses on the psychological aspects of the complex nuclear disaster, which was a combined artificial nuclear accident and natural disaster, and we investigated the psychological effects on hospital nurses associated with their experiences during the disaster. We looked at several investigations into the mental health of nurses after a nuclear disaster and in other situations. It was shown that mental health of nurses is impacted, not only after nuclear disasters but also in other circumstances. Furthermore, we noted the effects of extended periods of a heavy workload and daily life. Regarding anxiety about radiation exposure, nurses who had more knowledge of radiation tended to have better mental health, suggesting that education about the health risks of radiation exposure is important for health-care professionals. In summary, it is essential that nurses are provided with education about radiation exposure and its associated health risks, and also that there is a comprehensive approach to mental health care for nurses during the chronic phase of a disaster.

Student Cognitive Difficulties and Mental Model Development of Complex Earth and Environmental Systems

NASA Astrophysics Data System (ADS)

Sell, K.; Herbert, B.; Schielack, J.

2004-05-01

Students organize scientific knowledge and reason about environmental issues through manipulation of mental models. The nature of the environmental sciences, which are focused on the study of complex, dynamic systems, may present cognitive difficulties to students in their development of authentic, accurate mental models of environmental systems. The inquiry project seeks to develop and assess the coupling of information technology (IT)-based learning with physical models in order to foster rich mental model development of environmental systems in geoscience undergraduate students. The manipulation of multiple representations, the development and testing of conceptual models based on available evidence, and exposure to authentic, complex and ill-constrained problems were the components of investigation utilized to reach the learning goals. Upper-level undergraduate students enrolled in an environmental geology course at Texas A&M University participated in this research which served as a pilot study. Data based on rubric evaluations interpreted by principal component analyses suggest students' understanding of the nature of scientific inquiry is limited and the ability to cross scales and link systems proved problematic. Results categorized into content knowledge and cognition processes where reasoning, critical thinking and cognitive load were driving factors behind difficulties in student learning. Student mental model development revealed multiple misconceptions and lacked complexity and completeness to represent the studied systems. Further, the positive learning impacts of the implemented modules favored the physical model over the IT-based learning projects, likely due to cognitive load issues. This study illustrates the need to better understand student difficulties in solving complex problems when using IT, where the appropriate scaffolding can then be implemented to enhance student learning of the earth system sciences.

Triumph and adversity: Exploring the complexities of consumer storytelling in mental health nursing education.

PubMed

Happell, Brenda; Bennetts, Wanda

2016-12-01

Consumer participation in the education of health professionals is increasing, particularly in mental health nursing education and storytelling remains the most frequent approach to consumer involvement. The use of story has tended to be accepted as a legitimate educational tool with limited critique or consideration of its potential consequences presented within the academic literature. A qualitative exploratory research study was undertaken with mental health nurse academics (n = 34) and consumer educators and academics (n = 12), to investigate the perceptions and experiences of mental health nurses and consumers regarding the involvement of consumers in mental health nursing education. Data were analysed thematically. Story was a major theme to emerge from consumer participants and received some attention from nurse academics. Consumers and nurses both referred to the power of story to convey the human experience of mental illness diagnosis and service use; and the vulnerability that can result from storytelling. Consumers also described: story as expectation; preparation and support; and the politics of story. All participants supported the value of storytelling in mental health nursing education. Consumers had considered the complexities in far greater detail. The ongoing value of story as an educational technique requires further research. Equally important is considering a broader range of educational roles for mental health consumers. © 2016 Australian College of Mental Health Nurses Inc.

From Community to Meta-Community Mental Health Care.

PubMed

Bouras, Nick; Ikkos, George; Craig, Thomas

2018-04-20

Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although community mental health care has been positive for many service users, it has also had severe shortcomings. Expectations that it would lead to fuller social integration have not been fulfilled and many service users remain secluded in sheltered or custodial environments with limited social contacts and no prospect of work. Others receive little or no service at all. In today’s complex landscape of increasingly specialised services for people with mental health problems, the number of possible interfaces between services is increasing. Together with existing uneven financing systems and a context of constant change, these interfaces are challenging us to develop effective care pathways adjusted to the needs of service users and their carers. This discussion paper reviews the developments in community mental health care over the recent years and puts forward the concept of “Meta-Community Mental Health Care”. “Meta-Community Mental Health Care” embraces pluralism in understanding and treating psychiatric disorders, acknowledges the complexities of community provision, and reflects the realities and needs of the current era of care.

From Community to Meta-Community Mental Health Care

PubMed Central

Bouras, Nick; Ikkos, George; Craig, Thomas

2018-01-01

Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although community mental health care has been positive for many service users, it has also had severe shortcomings. Expectations that it would lead to fuller social integration have not been fulfilled and many service users remain secluded in sheltered or custodial environments with limited social contacts and no prospect of work. Others receive little or no service at all. In today’s complex landscape of increasingly specialised services for people with mental health problems, the number of possible interfaces between services is increasing. Together with existing uneven financing systems and a context of constant change, these interfaces are challenging us to develop effective care pathways adjusted to the needs of service users and their carers. This discussion paper reviews the developments in community mental health care over the recent years and puts forward the concept of “Meta-Community Mental Health Care”. “Meta-Community Mental Health Care” embraces pluralism in understanding and treating psychiatric disorders, acknowledges the complexities of community provision, and reflects the realities and needs of the current era of care. PMID:29677100

The impact of mental state disorder and personality on social functioning in patients engaged in community mental health care.

PubMed

Newton-Howes, Giles

2014-02-01

The aim of this study was to assess the degree to which mental state disorder and personality disorder impact on social functioning in patients engaged in secondary mental health care in New Zealand. Patients were interviewed using peer-reviewed instruments able to provide an indication of severity to assess their social functioning, personality status and diagnosis. Univariate correlations and linear regression was used to identify the association between social functioning, mental state disorder and personality. Using simple correlations all diagnostic categories associated with declines in social functioning. In the regression analysis depression and personality dysfunction accounted for 48% of the variance in social functioning. For patients engaged in secondary care, depression and personality dysfunction are significantly associated with poorer social functioning.

Automatic Detection of Student Mental Models during Prior Knowledge Activation in MetaTutor

ERIC Educational Resources Information Center

Rus, Vasile; Lintean, Mihai; Azevedo, Roger

2009-01-01

This paper presents several methods to automatically detecting students' mental models in MetaTutor, an intelligent tutoring system that teaches students self-regulatory processes during learning of complex science topics. In particular, we focus on detecting students' mental models based on student-generated paragraphs during prior knowledge…

Do You Hear Voices? Problems in Assessment of Mental Status in Deaf Persons with Severe Language Deprivation

ERIC Educational Resources Information Center

Glickman, Neil

2007-01-01

When mental health clinicians perform mental status examinations, they examine the language patterns of patients because abnormal language patterns, sometimes referred to as language dysfluency, may indicate a thought disorder. Performing such examinations with deaf patients is a far more complex task, especially with traditionally underserved…

Functional Connectivity of the Precuneus in Female University Students with Long-Term Musical Training.

PubMed

Tanaka, Shoji; Kirino, Eiji

2016-01-01

Conceiving concrete mental imagery is critical for skillful musical expression and performance. The precuneus, a core component of the default mode network (DMN), is a hub of mental image processing that participates in functions such as episodic memory retrieval and imagining future events. The precuneus connects with many brain regions in the frontal, parietal, temporal, and occipital cortices. The aim of this study was to examine the effects of long-term musical training on the resting-state functional connectivity of the precuneus. Our hypothesis was that the functional connectivity of the precuneus is altered in musicians. We analyzed the functional connectivity of the precuneus using resting-state functional magnetic resonance imaging (fMRI) data recorded in female university students majoring in music and nonmusic disciplines. The results show that the music students had higher functional connectivity of the precuneus with opercular/insular regions, which are associated with interoceptive and emotional processing; Heschl's gyrus (HG) and the planum temporale (PT), which process complex tonal information; and the lateral occipital cortex (LOC), which processes visual information. Connectivity of the precuneus within the DMN did not differ between the two groups. Our finding suggests that functional connections between the precuneus and the regions outside of the DMN play an important role in musical performance. We propose that a neural network linking the precuneus with these regions contributes to translate mental imagery into information relevant to musical performance.

Functional Connectivity of the Precuneus in Female University Students with Long-Term Musical Training

PubMed Central

Tanaka, Shoji; Kirino, Eiji

2016-01-01

Conceiving concrete mental imagery is critical for skillful musical expression and performance. The precuneus, a core component of the default mode network (DMN), is a hub of mental image processing that participates in functions such as episodic memory retrieval and imagining future events. The precuneus connects with many brain regions in the frontal, parietal, temporal, and occipital cortices. The aim of this study was to examine the effects of long-term musical training on the resting-state functional connectivity of the precuneus. Our hypothesis was that the functional connectivity of the precuneus is altered in musicians. We analyzed the functional connectivity of the precuneus using resting-state functional magnetic resonance imaging (fMRI) data recorded in female university students majoring in music and nonmusic disciplines. The results show that the music students had higher functional connectivity of the precuneus with opercular/insular regions, which are associated with interoceptive and emotional processing; Heschl’s gyrus (HG) and the planum temporale (PT), which process complex tonal information; and the lateral occipital cortex (LOC), which processes visual information. Connectivity of the precuneus within the DMN did not differ between the two groups. Our finding suggests that functional connections between the precuneus and the regions outside of the DMN play an important role in musical performance. We propose that a neural network linking the precuneus with these regions contributes to translate mental imagery into information relevant to musical performance. PMID:27445765

42 CFR 483.118 - Residents and applicants determined not to require NF level of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... provision of specialized services for the mental illness or mental retardation. (2) Short term residents... provision of, specialized services for the mental illness or mental retardation. (3) For the purpose of...) Applicants who do not require NF services. If the State mental health or mental retardation authority...

Peer Interaction Does Not Always Improve Children’s Mental State Talk Production in Oral Narratives. A Study in 6- to 10-Year-Old Italian Children

PubMed Central

Pinto, Giuliana; Tarchi, Christian; Bigozzi, Lucia

2016-01-01

Joint narratives are a mean through which children develop and practice their Theory of Mind (ToM), thus they represent an ideal means to explore children’s use and development of mental state talk. However, creating a learning environment for storytelling based on peer interaction, does not necessarily mean that students will automatically exploit it by engaging in productive collaboration, thus it is important to explore under what conditions peer interaction promotes children’s ToM. This study extends our understanding of social aspects of ToM, focusing on the effect of joint narratives on school-age children’s mental state talk. Fifty-six Italian primary school children participated in the study (19 females and 37 males). Children created a story in two different experimental conditions (individually and with a partner randomly assigned). Each story told by the children, as well as their dialogs were recorded and transcribed. Transcriptions of narratives were coded in terms of text quality and mental state talk, whereas transcriptions of dialogs were coded in terms of quality of interaction. The results from this study confirmed that peer interaction does not always improve children’s mental state talk performances in oral narratives, but certain conditions need to be satisfied. Peer interaction was more effective on mental state talk with lower individual levels and productive interactions, particularly in terms of capacity to regulate the interactions. When children were able to focus on the interaction, as well as the product, they were also exposed to each other’s reasoning behind their viewpoint. This level of intersubjectivity, in turn, allowed them to take more in consideration the contribution of mental states to the narrative. PMID:27826283

A Comparison of Children's Ability to Read Children's and Adults' Mental States in an Adaptation of the Reading the Mind in the Eyes Task

PubMed Central

van der Meulen, Anna; Roerig, Simone; de Ruyter, Doret; van Lier, Pol; Krabbendam, Lydia

2017-01-01

The ability to read mental states from subtle facial cues is an important part of Theory of Mind, which can contribute to children's daily life social functioning. Mental state reading performance is influenced by the specific interactions in which it is applied; familiarity with characteristics of these interactions (such as the person) can enhance performance. The aim of this research is to gain insight in this context effect for mental state reading in children, assessed with the Reading the Mind in the Eyes (RME) task that originally consists of pictures of adults' eyes. Because of differences between children and adults in roles, development and frequency of interaction, children are more familiar with mental state reading of other children. It can therefore be expected that children's mental state reading depends on whether this is assessed with children's or adults' eyes. A new 14 item version of the RME for children was constructed with pictures of children instead of adults (study 1). This task was used and compared to the original child RME in 6–10 year olds (N = 718, study 2) and 8–14 year olds (N = 182, study 3). Children in both groups performed better on the new RME than on the original RME. Item level findings of the new RME were in line with previous findings on the task and test re-test reliability (in a subgroup of older children, n = 95) was adequate (0.47). This suggests that the RME with children's eyes can assess children's daily life mental state reading and supplement existing ToM tasks. PMID:28491043

Mental health, concurrent disorders, and health care utilization in homeless women.

PubMed

Strehlau, Verena; Torchalla, Iris; Kathy, Li; Schuetz, Christian; Krausz, Michael

2012-09-01

This study assessed lifetime and current prevalence rates of mental disorders and concurrent mental and substance use disorders in a sample of homeless women. Current suicide risk and recent health service utilization were also examined in order to understand the complex mental health issues of this population and to inform the development of new treatment strategies that better meet their specific needs. A cross-sectional survey of 196 adult homeless women in three different Canadian cities was done. Participants were assessed using DSM-IV-based structured clinical interviews. Current diagnoses were compared to available mental health prevalence rates in the Canadian female general population. Current prevalence rates were 63% for any mental disorder, excluding substance use disorders; 17% for depressive episode; 10% for manic episode; 7% for psychotic disorder; 39% for anxiety disorders, 28% for posttraumatic stress disorder; and 19% for obsessive-compulsive disorder; 58% had concurrent substance dependence and mental disorders. Lifetime prevalence rates were notably higher. Current moderate or high suicide risk was found in 22% of the women. Participants used a variety of health services, especially emergency rooms, general practitioners, and walk-in clinics. Prevalence rates of mental disorders among homeless participants were substantially higher than among women from the general Canadian population. The percentage of participants with moderate or high suicide risk and concurrent disorders indicates a high severity of mental health symptomatology. Treatment and housing programs need to be accompanied by multidisciplinary, specialized interventions that account for high rates of complex mental health conditions.

How Do Thoughts, Emotions, and Decisions Align? A New Way to Examine Theory of Mind in Middle Childhood and Beyond

PubMed Central

Lagattuta, Kristin Hansen

2016-01-01

The current study examined 4- to 10-year-olds’ and adults’ (N = 280) tendency to connect people’s thoughts, emotions, and decisions into valence-matched mental state triads (thought valence = emotion valence = decision valence; such as, anticipate something bad + feel worried + avoid) and valence-matched mental state dyads (thought-emotion, thought-decision, and emotion-decision). Participants heard vignettes about focal characters who re-encountered individuals who had previously harmed them twice, helped them twice, or both harmed and helped them. Baseline trials involved no past experience. Children and adults predicted the focal characters’ thoughts (anticipate something good or bad), emotions (feel happy or worried), and decisions (go near or stay away). Results showed significant increases between 4 and 10 years in the formation of valence-matched mental state triads and dyads, with thoughts and emotions most often aligned by valence. We also documented age-related improvement in awareness that uncertain situations elicit less valence-consistent mental states than more certain situations, with females expecting weaker coherence among characters’ thoughts, emotions, and decisions than males. Controlling for age and sex, individuals with stronger executive function (working memory and inhibitory control) predicted more valence-aligned mental states. These findings add to the emerging literature on development and individual differences in children’s reasoning about mental states and emotions during middle childhood and beyond. PMID:27017060

The felt presence of other minds: Predictive processing, counterfactual predictions, and mentalising in autism.

PubMed

Palmer, Colin J; Seth, Anil K; Hohwy, Jakob

2015-11-01

The mental states of other people are components of the external world that modulate the activity of our sensory epithelia. Recent probabilistic frameworks that cast perception as unconscious inference on the external causes of sensory input can thus be expanded to enfold the brain's representation of others' mental states. This paper examines this subject in the context of the debate concerning the extent to which we have perceptual awareness of other minds. In particular, we suggest that the notion of perceptual presence helps to refine this debate: are others' mental states experienced as veridical qualities of the perceptual world around us? This experiential aspect of social cognition may be central to conditions such as autism spectrum disorder, where representations of others' mental states seem to be selectively compromised. Importantly, recent work ties perceptual presence to the counterfactual predictions of hierarchical generative models that are suggested to perform unconscious inference in the brain. This enables a characterisation of mental state representations in terms of their associated counterfactual predictions, allowing a distinction between spontaneous and explicit forms of mentalising within the framework of predictive processing. This leads to a hypothesis that social cognition in autism spectrum disorder is characterised by a diminished set of counterfactual predictions and the reduced perceptual presence of others' mental states. Copyright © 2015 Elsevier Inc. All rights reserved.

From Exploitation to Industry: Definitions, Risks, and Consequences of Domestic Sexual Exploitation and Sex Work Among Women and Girls

PubMed Central

Gerassi, Lara

2015-01-01

In the last 15 years, terms such as prostitution, sex trafficking, sexual exploitation, modern-day slavery, and sex work have elicited much confusion and debate as to their definitions. Consequently several challenges have emerged for both law enforcement in the prosecution of criminals and practitioners in service provision. This article reviews the state of the literature with regard to domestic, sexual exploitation among women and girls in the United States and seeks to (1) provide definitions and describe the complexity of all terms relating to domestic sexual exploitation of women and girls in the United States, (2) explore available national prevalence data according to the definitions provided, and (3) review the evidence of mental health, social, and structural risk factors at the micro-, mezzo-, and macrolevels. PMID:26726289

From Exploitation to Industry: Definitions, Risks, and Consequences of Domestic Sexual Exploitation and Sex Work Among Women and Girls.

PubMed

Gerassi, Lara

In the last 15 years, terms such as prostitution, sex trafficking, sexual exploitation, modern-day slavery, and sex work have elicited much confusion and debate as to their definitions. Consequently several challenges have emerged for both law enforcement in the prosecution of criminals and practitioners in service provision. This article reviews the state of the literature with regard to domestic, sexual exploitation among women and girls in the United States and seeks to (1) provide definitions and describe the complexity of all terms relating to domestic sexual exploitation of women and girls in the United States, (2) explore available national prevalence data according to the definitions provided, and (3) review the evidence of mental health, social, and structural risk factors at the micro-, mezzo-, and macrolevels.

State of mental healthcare systems in Eastern Europe: do we really understand what is going on?

PubMed Central

Winkler, Petr

2016-01-01

The article examines the current state of mental healthcare systems in countries of Eastern Europe and derives implications for future research and service development. Analysis of available statistics from the World Health Organization’s Mental Health Atlas suggests the need for better-quality data collection. Nonetheless, there appear to be insufficient resources allocated to mental health, lack of involvement of service users in policy-making and, to a large extent, systems continue to rely on mental hospitals. Based on the data presented, a set of directions for future reforms was drafted. PMID:29093919

Perceived task complexity of trunk stability exercises.

PubMed

McPhee, Megan; Tucker, Kylie J; Wan, Alan; MacDonald, David A

2017-02-01

Perceived task complexity can impact participation in an exercise programme and the level of skill acquisition resulting from participation. Although trunk stability exercises are commonly included in the management of people with low back pain, potential differences in perceived task complexity between those exercises have not been investigated previously. To investigate the perceived task complexity following first time instruction of two common stability exercises: the abdominal brace and abdominal hollow. Cross-sectional. Twenty-four naïve healthy participants received instruction in the performance of an abdominal brace and an abdominal hollow with feedback. Participants rated their perceived task complexity (mental, physical, and temporal demand, performance, effort, frustration) for each exercise on the NASA-Task Load Index. The abdominal hollow was associated with higher perceived mental demand than the abdominal brace (p = 0.01), and required more time to learn (p < 0.01). The abdominal brace was associated with greater mental demand and frustration when performed after the abdominal hollow than before. This study has provided the first evidence for differences in perceived task complexity between two commonly used trunk stability exercises. Those differences in perceived task complexity may influence the selection of exercises intended to enhance the robustness of spinal stability. Copyright © 2016 Elsevier Ltd. All rights reserved.

The 2010 Haiti earthquake response.

PubMed

Raviola, Giuseppe; Severe, Jennifer; Therosme, Tatiana; Oswald, Cate; Belkin, Gary; Eustache, Eddy

2013-09-01

This article presents an overview of the mental health response to the 2010 Haiti earthquake. Discussion includes consideration of complexities that relate to emergency response, mental health and psychosocial response in disasters, long-term planning of systems of care, and the development of safe, effective, and culturally sound mental health services in the Haitian context. This information will be of value to mental health professionals and policy specialists interested in mental health in Haiti, and in the delivery of mental health services in particularly resource-limited contexts in the setting of disasters. Copyright © 2013 Elsevier Inc. All rights reserved.

Contemporary Perspectives on Spirituality and Mental Health

PubMed Central

Sharma, Pulkit; Charak, Ruby; Sharma, Vibha

2009-01-01

The paper strives to elucidate the complex yet intimate relation between spirituality and mental health from contemporary perspectives. The diverse and constantly evolving views that spiritualists and mental health professionals have held toward each other over last century are discussed with special accent on the transpersonal spiritual framework within psychology. The role of spirituality in promoting mental health and alleviating mental illness is highlighted. The paper is concluded with an increasing need to integrate spirituality within the mental health field albeit there are several impediments in achieving the same, which need to be worked through circumspectly. PMID:21938086

Mental Health Insurance Parity and Provider Wages.

PubMed

Golberstein, Ezra; Busch, Susan H

2017-06-01

Policymakers frequently mandate that employers or insurers provide insurance benefits deemed to be critical to individuals' well-being. However, in the presence of private market imperfections, mandates that increase demand for a service can lead to price increases for that service, without necessarily affecting the quantity being supplied. We test this idea empirically by looking at mental health parity mandates. This study evaluated whether implementation of parity laws was associated with changes in mental health provider wages. Quasi-experimental analysis of average wages by state and year for six mental health care-related occupations were considered: Clinical, Counseling, and School Psychologists; Substance Abuse and Behavioral Disorder Counselors; Marriage and Family Therapists; Mental Health Counselors; Mental Health and Substance Abuse Social Workers; and Psychiatrists. Data from 1999-2013 were used to estimate the association between the implementation of state mental health parity laws and the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act and average mental health provider wages. Mental health parity laws were associated with a significant increase in mental health care provider wages controlling for changes in mental health provider wages in states not exposed to parity (3.5 percent [95% CI: 0.3%, 6.6%]; p<.05). Mental health parity laws were associated with statistically significant but modest increases in mental health provider wages. Health insurance benefit expansions may lead to increased prices for health services when the private market that supplies the service is imperfect or constrained. In the context of mental health parity, this work suggests that part of the value of expanding insurance benefits for mental health coverage was captured by providers. Given historically low wage levels of mental health providers, this increase may be a first step in bringing mental health provider wages in line with parallel health professions, potentially reducing turnover rates and improving treatment quality.

Virtual reality and paranoid ideations in people with an 'at-risk mental state' for psychosis.

PubMed

Valmaggia, Lucia R; Freeman, Daniel; Green, Catherine; Garety, Philippa; Swapp, David; Antley, Angus; Prescott, Corinne; Fowler, David; Kuipers, Elizabeth; Bebbington, Paul; Slater, Mel; Broome, Matthew; McGuire, Philip K

2007-12-01

Virtual reality provides a means of studying paranoid thinking in controlled laboratory conditions. However, this method has not been used with a clinical group. To establish the feasibility and safety of using virtual reality methodology in people with an at-risk mental state and to investigate the applicability of a cognitive model of paranoia to this group. Twenty-one participants with an at-risk mental state were assessed before and after entering a virtual reality environment depicting the inside of an underground train. Virtual reality did not raise levels of distress at the time of testing or cause adverse experiences over the subsequent week. Individuals attributed mental states to virtual reality characters including hostile intent. Persecutory ideation in virtual reality was predicted by higher levels of trait paranoia, anxiety, stress, immersion in virtual reality, perseveration and interpersonal sensitivity. Virtual reality is an acceptable experimental technique for use with individuals with at-risk mental states. Paranoia in virtual reality was understandable in terms of the cognitive model of persecutory delusions.

Promoting mental wellbeing: developing a theoretically and empirically sound complex intervention.

PubMed

Millar, S L; Donnelly, M

2014-06-01

This paper describes the development of a complex intervention to promote mental wellbeing using the revised framework for developing and evaluating complex interventions produced by the UK Medical Research Council (UKMRC). Application of the first two phases of the framework is described--development and feasibility and piloting. The theoretical case and evidence base were examined analytically to explicate the theoretical and empirical foundations of the intervention. These findings informed the design of a 12-week mental wellbeing promotion programme providing early intervention for people showing signs of mental health difficulties. The programme is based on the theoretical constructs of self-efficacy, self-esteem, purpose in life, resilience and social support and comprises 10 steps. A mixed methods approach was used to conduct a feasibility study with community and voluntary sector service users and in primary care. A significant increase in mental wellbeing was observed following participation in the intervention. Qualitative data corroborated this finding and suggested that the intervention was feasible to deliver and acceptable to participants, facilitators and health professionals. The revised UKMRC framework can be successfully applied to the development of public health interventions. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Gaps and Barriers in Services for Children in State Mental Health Plans

ERIC Educational Resources Information Center

Gould, Sara R.; Beals-Erickson, Sarah E.; Roberts, Michael C.

2012-01-01

Significant gaps exist in children's mental healthcare, and barriers prevent access to existing services. Current federal initiatives call for state governmental agencies to recognize and resolve deficits in their systems of care. Previous work has acknowledged some of the problems in meeting the mental health needs of children within a system of…

School-Based Mental Health Programs in the United States: Present Status and a Blueprint for the Future.

ERIC Educational Resources Information Center

Pfeiffer, Steven I.; Reddy, Linda A.

1998-01-01

Provides overview of sociocultural and political factors in the United States that have influenced recent interest in school-based health and mental health programs. Describes four well-known programs and presents a new framework, the Tripartite Model of School-Based Mental Health Interventions, to stimulate thinking on future programs. Addresses…

Mental Health and Social Services: Results from the School Health Policies and Programs Study 2006

ERIC Educational Resources Information Center

Brener, Nancy D.; Weist, Mark; Adelman, Howard; Taylor, Linda; Vernon-Smiley, Mary

2007-01-01

Background: Schools are in a unique position not only to identify mental health problems among children and adolescents but also to provide links to appropriate services. This article describes the characteristics of school mental health and social services in the United States, including state- and district-level policies and school practices.…

Prevalence of Intestinal Parasite Infections among Individuals with Mental Retardation in New York State.

ERIC Educational Resources Information Center

Schupf, Nicole; And Others

1995-01-01

Prevalence of intestinal parasite infection among program participants of the New York State Office of Mental Retardation and Developmental Disabilities for 1986-87 was estimated at 7.3%, suggesting that management of parasitic infection is improving. Males and individuals with severe/profound mental retardation were twice as likely to have…

The Connecticut Mental Health Center: Celebrating 50 Years of a Successful Partnership Between the State and Yale University.

PubMed

Steiner, Jeanne L; Anez-Nava, Luis; Baranoski, Madelon; Cole, Robert; Davidson, Larry; Delphin-Rittmon, Miriam; Dike, Charles; DiLeo, Paul J; Duman, Ronald S; Kirk, Thomas; Krystal, John; Malison, Robert T; Rohrbaugh, Robert M; Sernyak, Michael J; Srihari, Vinod; Styron, Thomas; Tebes, Jacob K; Woods, Scott; Zonana, Howard; Jacobs, Selby C

2016-12-01

September 28, 2016, marked the 50th anniversary of the Connecticut Mental Health Center, a state-owned and state-operated joint venture between the state and Yale University built and sustained with federal, state, and university funds. Collaboration across these entities has produced a wide array of clinical, educational, and research initiatives, a few of which are described in this column. The missions of clinical care, research, and education remain the foundation for an organization that serves 5,000 individuals each year who are poor and who experience serious mental illnesses and substance use disorders.

A Model of Mental State Transition Network

NASA Astrophysics Data System (ADS)

Xiang, Hua; Jiang, Peilin; Xiao, Shuang; Ren, Fuji; Kuroiwa, Shingo

Emotion is one of the most essential and basic attributes of human intelligence. Current AI (Artificial Intelligence) research is concentrating on physical components of emotion, rarely is it carried out from the view of psychology directly(1). Study on the model of artificial psychology is the first step in the development of human-computer interaction. As affective computing remains unpredictable, creating a reasonable mental model becomes the primary task for building a hybrid system. A pragmatic mental model is also the fundament of some key topics such as recognition and synthesis of emotions. In this paper a Mental State Transition Network Model(2) is proposed to detect human emotions. By a series of psychological experiments, we present a new way to predict coming human's emotions depending on the various current emotional states under various stimuli. Besides, people in different genders and characters are taken into consideration in our investigation. According to the psychological experiments data derived from 200 questionnaires, a Mental State Transition Network Model for describing the transitions in distribution among the emotions and relationships between internal mental situations and external are concluded. Further more the coefficients of the mental transition network model were achieved. Comparing seven relative evaluating experiments, an average precision rate of 0.843 is achieved using a set of samples for the proposed model.

The Effects of Romantic Love on Mentalizing Abilities

PubMed Central

Wlodarski, Rafael; Dunbar, Robin I. M.

2015-01-01

The effects of the human pair-bonded state of “romantic love” on cognitive function remain relatively unexplored. Theories on cognitive priming suggest that a state of love may activate love-relevant schemas, such as mentalizing about the beliefs of another individual, and may thus improve mentalizing abilities. On the other hand, recent functional MRI (fMRI) research on individuals who are in love suggests that several brain regions associated with mentalizing may be “deactivated” during the presentation of a love prime, potentially affecting mentalizing cognitions and behaviors. The current study aimed to investigate experimentally the effect of a love prime on a constituent aspect of mentalizing—the attribution of emotional states to others. Ninety-one participants who stated they were “deeply in love” with their romantic partner completed a cognitive task involving the assessment of emotional content of facial stimuli (the Reading the Mind in the Eyes task) immediately after the presentation of either a love prime or a neutral prime. Individuals were significantly better at interpreting the emotional states of others after a love prime than after a neutral prime, particularly males assessing negative emotional stimuli. These results suggest that presentation of a love stimulus can prime love-relevant networks and enhance subsequent performance on conceptually related mentalizing tasks. PMID:26167112

New measures of mental state and behavior based on data collected from sensors, smartphones, and the Internet.

PubMed

Glenn, Tasha; Monteith, Scott

2014-12-01

With the rapid and ubiquitous acceptance of new technologies, algorithms will be used to estimate new measures of mental state and behavior based on digital data. The algorithms will analyze data collected from sensors in smartphones and wearable technology, and data collected from Internet and smartphone usage and activities. In the future, new medical measures that assist with the screening, diagnosis, and monitoring of psychiatric disorders will be available despite unresolved reliability, usability, and privacy issues. At the same time, similar non-medical commercial measures of mental state are being developed primarily for targeted advertising. There are societal and ethical implications related to the use of these measures of mental state and behavior for both medical and non-medical purposes.

Bad risk? An overview of laws prohibiting possession of firearms by individuals with a history of treatment for mental illness.

PubMed

Simpson, Joseph R

2007-01-01

For nearly 40 years, federal law has barred certain individuals with a history of mental health treatment from purchasing, receiving, or possessing firearms. State laws are a patchwork of different regulations, some much more inclusive than the federal statute, others that parallel it closely. In some states, such laws are nonexistent. For the past 20 years, it has been possible to petition for relief from the federal prohibition; however, this is not the case with all state laws. The mechanisms for relief under state laws, when present, vary significantly, and not all require the input of a mental health professional or even of any physician. This article provides an overview of federal and state laws, a discussion of implications of these laws for mental health clinicians and forensic practitioners, and suggestions of directions for future research.

Maternal discussions of mental states and behaviors: relations to emotion situation knowledge in European American and immigrant Chinese children.

PubMed

Doan, Stacey N; Wang, Qi

2010-01-01

This study examined in a cross-cultural context mothers' discussions of mental states and external behaviors in a story-telling task with their 3-year-old children and the relations of such discussions to children's emotion situation knowledge (ESK). The participants were 71 European American and 60 Chinese immigrant mother-child pairs in the United States. Mothers and children read a storybook together at home, and children's ESK was assessed. Results showed that European American mothers made more references to thoughts and emotions during storytelling than did Chinese mothers, who commented more frequently on behaviors. Regardless of culture, mothers' use of mental states language predicted children's ESK, whereas their references to behaviors were negatively related to children's ESK. Finally, mothers' emphasis on mental states over behaviors partially mediated cultural effects on children's ESK. © 2010 The Authors. Child Development © 2010 Society for Research in Child Development, Inc.

Toward Family and Community: Mental Retardation Services in Massachusetts, New England, and the United States.

ERIC Educational Resources Information Center

Braddock, David; Hemp, Richard

1997-01-01

Current trends in mental retardation services in Massachusetts were investigated using the New England region, the state of Michigan, and the United States as comparative frames of reference. Massachusetts' movement toward reducing reliance on state institutions, reallocating funding, and developing community services and family support is…

Prevention and treatment of long-term social disability amongst young people with emerging severe mental illness with social recovery therapy (The PRODIGY Trial): study protocol for a randomised controlled trial.

PubMed

Fowler, David; French, Paul; Banerjee, Robin; Barton, Garry; Berry, Clio; Byrne, Rory; Clarke, Timothy; Fraser, Rick; Gee, Brioney; Greenwood, Kathryn; Notley, Caitlin; Parker, Sophie; Shepstone, Lee; Wilson, Jon; Yung, Alison R; Hodgekins, Joanne

2017-07-11

Young people who have social disability associated with severe and complex mental health problems are an important group in need of early intervention. Their problems often date back to childhood and become chronic at an early age. Without intervention, the long-term prognosis is often poor and the economic costs very large. There is a major gap in the provision of evidence-based interventions for this group, and therefore new approaches to detection and intervention are needed. This trial provides a definitive evaluation of a new approach to early intervention with young people with social disability and severe and complex mental health problems using social recovery therapy (SRT) over a period of 9 months to improve mental health and social recovery outcomes. This is a pragmatic, multi-centre, single blind, superiority randomised controlled trial. It is conducted in three sites in the UK: Sussex, Manchester and East Anglia. Participants are aged 16 to 25 and have both persistent and severe social disability (defined as engaged in less than 30 hours per week of structured activity) and severe and complex mental health problems. The target sample size is 270 participants, providing 135 participants in each trial arm. Participants are randomised 1:1 using a web-based randomisation system and allocated to either SRT plus optimised treatment as usual (enhanced standard care) or enhanced standard care alone. The primary outcome is time use, namely hours spent in structured activity per week at 15 months post-randomisation. Secondary outcomes assess typical mental health problems of the group, including subthreshold psychotic symptoms, negative symptoms, depression and anxiety. Time use, secondary outcomes and health economic measures are assessed at 9, 15 and 24 months post-randomisation. This definitive trial will be the first to evaluate a novel psychological treatment for social disability and mental health problems in young people presenting with social disability and severe and complex non-psychotic mental health problems. The results will have important implications for policy and practice in the detection and early intervention for this group in mental health services. Trial Registry: International Standard Randomised Controlled Trial Number (ISRCTN) Registry. ISRCTN47998710 (registered 29/11/2012).

Estimating mental fatigue based on electroencephalogram and heart rate variability

NASA Astrophysics Data System (ADS)

Zhang, Chong; Yu, Xiaolin

2010-01-01

The effects of long term mental arithmetic task on psychology are investigated by subjective self-reporting measures and action performance test. Based on electroencephalogram (EEG) and heart rate variability (HRV), the impacts of prolonged cognitive activity on central nervous system and autonomic nervous system are observed and analyzed. Wavelet packet parameters of EEG and power spectral indices of HRV are combined to estimate the change of mental fatigue. Then wavelet packet parameters of EEG which change significantly are extracted as the features of brain activity in different mental fatigue state, support vector machine (SVM) algorithm is applied to differentiate two mental fatigue states. The experimental results show that long term mental arithmetic task induces the mental fatigue. The wavelet packet parameters of EEG and power spectral indices of HRV are strongly correlated with mental fatigue. The predominant activity of autonomic nervous system of subjects turns to the sympathetic activity from parasympathetic activity after the task. Moreover, the slow waves of EEG increase, the fast waves of EEG and the degree of disorder of brain decrease compared with the pre-task. The SVM algorithm can effectively differentiate two mental fatigue states, which achieves the maximum classification accuracy (91%). The SVM algorithm could be a promising tool for the evaluation of mental fatigue. Fatigue, especially mental fatigue, is a common phenomenon in modern life, is a persistent occupational hazard for professional. Mental fatigue is usually accompanied with a sense of weariness, reduced alertness, and reduced mental performance, which would lead the accidents in life, decrease productivity in workplace and harm the health. Therefore, the evaluation of mental fatigue is important for the occupational risk protection, productivity, and occupational health.

Voting pattern of mental patients in a community state hospital.

PubMed

Klein, M M; Grossman, S A

1967-06-01

The voting pattern of mental patients in a community-based state hospital was studied. Patients were polled on the New York City mayoralty race. A comparison to the vote of the general population revealed that the hospital sample vote resembled most closely the election results of the hospital district. The results highlight the advantage of community-centered mental health facilities, which undertake the treatment and rehabilitation of mental patients under conditions that maintain ties with family and community.

Williams syndrome as a model of genetically determined right-hemisphere dominance.

PubMed

Bogdanov, N N; Solonichenko, V G

1997-01-01

Studies were carried out on the dermatoglyphics (skin ridge marks) on the hands of children with Williams syndrome; this is an inherited disease with cardiovascular pathology and a characteristic facial phenotype ("elf" facies), along with specific mental and cognitive disturbances. The results suggest a characteristic dermatoglyphic type with the presence of complex whorls on the fingers and a clear predominance of marks of greater complexity on the left hand; this is a very rare trait in normal people and in those with other inherited nervous system disorders. The features of the dermatoglyphic pattern serve as a characteristic marker of a genetically determined state of the human central nervous system, and suggests directions for neurophysiological studies of children with Williams syndrome as a unique model for analysis of higher nervous function in humans.

A framework for current public mental health care practice in South Africa.

PubMed

Janse Van Rensburg, A B

2007-11-01

One of the main aims of the new Mental Health Care Act, Act No. 17 of 2002 (MHCA) is to promote the human rights of people with mental disabilities in South Africa. However, the upholding of these rights seems to be subject to the availability of resources. Chapter 2 of the MHCA clarifies the responsibility of the State to provide infrastructure and systems. Chapters 5, 6 and 7 of the Act define and regulate the different categories of mental health care users, clarify the procedures around these categories and spell out mental health practitioners' roles and responsibilities in this regard. Also according to the National Health Act No. 61 of 2003, the State remains the key role player in mental health care provision, being responsible for adequate mental health infrastructure and resource allocation. Due to "limited resources" practitioners however often work in environments where staff ratios may be fractional of what should be expected and in units of which the physical structure and security is totally inadequate. The interface between professional responsibility of clinical workers versus the inadequacy of clinical interventions resulting from infrastructure and staffing constraints needs to be defined. This paper considered recent legislation currently relevant to mental health care practice in order to delineate the legal, ethical and labour framework in which public sector mental health practitioners operate as state employees. These included the Mental Health Care Act, No.17 of 2002; the National Health Act, No. 61 of 2003 and the proposed Traditional Health Practitioners Act, No. 35 of 2004. Formal legal review of and advice on this legislation as it pertains to public sector mental health practitioners as state employees, is necessary and should form the basis of the principles and standards for care endorsed by organized mental health care practitioner groups such as the South African Society of Psychiatrists (SASOP).

Undergraduate Nursing Students' Attitudes toward Mental Illness and Mental Health Nursing

ERIC Educational Resources Information Center

Konzelman, Lois

2017-01-01

Historically, nurses have lacked recognition for the work they do, especially in the area of mental health. There is a shortage of qualified mental health nurses to meet the demand for services. Many rural areas in the United States have few or no mental health services to offer communities. Encouraging positive attitudes toward mental health…

Enrollment of Specialty Mental Health Clinics in a State Medicaid Program to Promote Physical Health Services

PubMed Central

Breslau, Joshua; Yu, Hao; Horvitz-Lennon, Marcela; Leckman-Westin, Emily; Scharf, Deborah M.; Connor, Kathryn; Finnerty, Molly T.

2016-01-01

OBJECTIVE To promote integrated physical health care for individuals with serious mental illness, the New York State Office of Mental Health (NYOMH) established regulations allowing specialty mental health clinics to provide Medicaid-reimbursable health monitoring (HM) and health physicals (HP). This paper examines clinics’ enrollment in this program to understand its potential to reach individuals with serious mental illness. METHODS Information on enrollment and clinic characteristics (N=500) were drawn from NYOMH administrative databases. Clinic enrollment in the HM/HP program was examined from the program’s first five years (2010–2015). Logistic regression models accounting for the clustering of multiple clinics within agencies were used to examine characteristics associated with enrollment. RESULTS Two-hundred ninety one of 500 clinics (58%) enrolled in the HM/HP program, potentially reaching 62.5% of all Medicaid enrollees with serious mental illness seen in specialty mental health clinics in the state. State-operated clinics were required to participate, and had 91.8% enrollment. Over half of hospital-affiliated and freestanding mental health clinics elected to enroll in the program (52.6% and 53.7% respectively). In adjusted models, enrollment was higher among freestanding clinics relative to hospital-affiliated clinics, higher in larger relative to smaller clinics, and higher in county-operated relative to private non-profit clinics. CONCLUSIONS The high level of enrollment in the HM/HP program indicates strong interest among mental health clinics in providing physical health care services. However, supplemental policies may be needed to extend the program to areas of the mental health system where barriers to physical health care services are highest. PMID:27524372

Twelve-month use of herbal medicines as a remedy for mental health problems in Japan: A cross-national analysis of World Mental Health Survey data.

PubMed

Iwanaga, Mai; Iwanaga, Hiroo; Kawakami, Norito

2017-09-01

The purpose of this study was to clarify the frequencies and sociodemographic and other characteristics around use of herbal medicine as a remedy for mental health problems in Japan. Data from the World Mental Health Japan (WMHJ) Survey and US National Comorbidity Survey Replications were analyzed. The WMHJ was conducted in 2002 to 2006, with 4129 respondents. National Comorbidity Survey Replications was conducted in 2002 to 2003, with 9282 respondents. The interview asked the respondents about their use of several types of herbs for mental health problems. Frequencies of use of herbal medicine were compared between Japan and the United States. Multiple logistic regression analyses were conducted to determine sociodemographic and mental health-related correlates of 12-month herbal medicine use. Relevant sampling weights were used to adjust for the sampling designs. The proportion for use of herbal medicines as a remedy for mental health problems in the past 12 months was lower (0.4%) in Japan than that in the United States (3.7%). Low education in both countries (P < .05) was significantly associated with nonuse of herbal medicine. Any anxiety disorder in Japan was significantly associated with herbal medicine use (P < .01), while any mental disorder categories were significantly associated in the United States (P < .01). The frequency for use of herbal medicine among patients with mental health problems in the past 12 months was much lower in Japan compared to the United States. Persons with high educational attainment and anxiety disorders used herbal medicine as a remedy for mental health problems more frequently in Japan. © 2017 John Wiley & Sons Australia, Ltd.

Mental Health Care: Licensing and Certification Requirements for Staff in State Hospitals. Fact Sheet for the Honorable Daniel K. Inouye, United States Senate.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of Human Resources.

The Office of United States Senator Daniel Inouye requested information on state minimum licensing and certification requirements for physicians, psychiatrists, psychologists, social workers, and nurses who work directly with patients in state mental hospitals. To obtain this information, the General Accounting Office called the offices of the…

A model to investigate intention understanding in autism?. Comment on "Seeing mental states: An experimental strategy for measuring the observability of other minds" by Cristina Becchio et al.

NASA Astrophysics Data System (ADS)

Forbes, Paul A. G.; Hamilton, Antonia F. de C.

2018-03-01

Becchio et al. [2] specify the conditions under which mental states are observable in the kinematics of other agents. Given that autistic people display differences in their understanding of other's mental states [1] and show an insensitivity to the kinematics of co-actors' movements [5,10], what are the implications of Becchio et al.'s strategy for the study of autism?

Child Abuse and Neglect in New York State Office of Mental Health and Office of Mental Retardation and Developmental Disabilities Residential Programs. A Review of Reports Filed October 1, 1986-September 30, 1989.

ERIC Educational Resources Information Center

New York State Commission on Quality of Care for the Mentally Disabled, Albany.

This report summarizes a 3-year review of reports of child abuse and neglect in New York State's mental hygiene facilities. The study determined that greater efforts are required to ensure protection of those children who were "repeat" alleged victims and who, as a group, were involved in 400 of the 850 reports to the State Central…

Coping Among Victims of Relationship Abuse: A Longitudinal Examination

PubMed Central

Taft, Casey T.; Resick, Patricia A.; Panuzio, Jillian; Vogt, Dawne S.; Mechanic, Mindy B.

2010-01-01

This longitudinal study examined the associations between relationship abuse, coping variables, and mental health outcomes among a sample of battered women obtained from shelter and nonresidential community agencies (N = 61). Sexual aggression was a stronger predictor of poorer mental health than was physical assault. Engagement coping strategies were generally predictive of positive mental health, and disengagement coping strategies were generally predictive of poorer mental health. Results highlight the complexity of the associations between different forms of relationship abuse, coping strategies, and mental health among this population. PMID:17691549

Mental well-being in settings of 'complex emergency': an overview.

PubMed

Almedom, Astier M; Summerfield, Derek

2004-07-01

The mental state of people affected by war and other disasters has been a subject of special interest to academic researchers and practitioners in humanitarian assistance and public health for over two decades. The last decade in particular has seen a rise in the number of papers published in scholarly journals around the Post-Traumatic Stress Disorder (PTSD) debate. Anthropologists have rarely engaged in this debate. Nevertheless, some of the most illuminating contributions have come from socio-medical anthropology (Last, 2000). This volume brings together a wide range of disciplines in the human sciences to address some of the key questions that bear upon the mental health and well-being of populations affected by war and displacement, with contributions from applied biosocial and medical anthropology (Almedom; Lewando-Hundt et al.); applied psychology/public health and social psychiatry (Carballo et al.; Snider et al.; Fullilove et al.); social work (Ahearn & Noble); and political sciences (Pupavac). The four themes that run through this set of papers (outlined below) remain topical areas of contention in contemporary humanitarianism. Scholars and practitioners in the biosocial sciences may wish to engage in the empirical study of human (if not humanitarian) responses to disaster focusing on questions as yet unanswered.

The Interaction of Same-Sex Marriage Access With Sexual Minority Identity on Mental Health and Subjective Wellbeing.

PubMed

Tatum, Alexander K

2017-01-01

Previous psychological and public health research has highlighted the impact of legal recognition of same-sex relationships on individual identity and mental health. Using a sample of U.S. sexual minority (N = 313) and heterosexual (N = 214) adults, participants completed a battery of mental health inventories prior to the nationwide legalization of same-sex marriage. Analyses of covariance (ANCOVAs) examining identity revealed sexual minority participants living in states where same-sex marriage was banned experienced significantly higher levels of internalized homonegativity than sexual minority participants living in states where same-sex marriage was legal, even after controlling for state-level political climate. Mental health ANCOVAs revealed sexual minority participants residing in states without same-sex marriage experienced greater anxiety and lower subjective wellbeing compared to sexual minority participants residing in states with same-sex marriage and heterosexual participants residing in states with or without same-sex marriage. Implications for public policy and future research directions are discussed.

A Feedback Learning and Mental Models Perspective on Strategic Decision Making

ERIC Educational Resources Information Center

Capelo, Carlos; Dias, Joao Ferreira

2009-01-01

This study aims to be a contribution to a theoretical model that explains the effectiveness of the learning and decision-making processes by means of a feedback and mental models perspective. With appropriate mental models, managers should be able to improve their capacity to deal with dynamically complex contexts, in order to achieve long-term…

Pauses in the Narratives Produced by Autistic, Mentally Retarded, and Normal Children as an Index of Cognitive Demand.

ERIC Educational Resources Information Center

Thurber, Christopher; Tager-Flusberg, Helen

1993-01-01

The production of speech pauses and repairs in story narratives produced by autistic, mentally retarded, and normal children, matched on verbal mental age, was analyzed. Children with autism produced fewer nongrammatical pauses, and their nongrammatical pausing was correlated with measures of story length and complexity, suggesting that their…

An Examination of New York State's Integrated Primary and Mental Health Care Services for Adults with Serious Mental Illness.

PubMed

Scharf, Deborah M; Breslau, Joshua; Hackbarth, Nicole Schmidt; Kusuke, Daniela; Staplefoote, B Lynette; Pincus, Harold Alan

2014-12-30

The poor physical health of adults with serious mental illnesses is a public health crisis. Greater integration of mental health and primary medical care services at the clinic and system levels could address this need. In New York state, there are several ongoing initiatives that promote integrated care for adults with serious mental illness, provided or coordinated by community mental health center staff. This study examines three initiatives. Data were collected by RAND through site visits and surveys of mental health clinic administrators and associated professionals. Results showed that Primary and Behavioral Health Care Integration grantees developed infrastructure that supported a broad scope of primary and preventive health care services; these broad changes appeared to contribute to clinic-wide culture shifts toward integration and shared accountability for consumers' "whole person" health. Clinics participating in the Medicaid Incentive tended to implement only those services for which they could bill, which resulted in newly identified consumer physical health care needs but did not help consumers to connect to physical health care services. Finally, while administrators and providers were optimistic that Medicaid Health Homes have potential to improve access to care for adults with serious mental illness, the newness of the initiative made it difficult to assess the degree to which Health Home networks would meet these goals. We conclude with recommendations to state policymakers, clinical providers, and technical assistance providers and recommendations for future research, all designed to strengthen New York state's integrated care initiatives for adults with serious mental illness.

Incentives in financing mental health care in Austria.

PubMed

Zechmeister, Ingrid; Oesterle, August; Denk, Peter; Katschnig, Heinz

2002-09-01

In Austria, financing health care -and even more so mental health care- is characterized by a mix of federal and provincial responsibilities, lack of uniformity in service provision and service providers, and diverse funding arrangements. The division between financing structures for health care and social care makes the situation even more complex. This state of affairs results in various, partly counterproductive and sometimes paradoxical financial incentives and disincentives for the providers, recipients and financiers of mental health services. In several provinces of Austria, recent reform plans in mental health care have focused strongly on establishing community-based and patient-oriented mental health care. One of the main challenges in implementing this new policy is the re-allocation of resources. The authors hypothesize that the existing structure of mental health care financing, with its incentives and disincentives, constitutes an obstacle to patient-oriented community-based mental health care. Analyzing the characteristics of the overall mental health care financing system in one Austrian province, Lower Austria, will provide a better understanding of actor-relationships and inherent incentives and highlight implications for the process of deinstitutionalization. The authors used an analytical framework based on the principal-agent theory, empirical evidence, and information on financial, organizational and legal structures to identify the characteristics of actor-relationships and the position of single actors within the system. The article shows how incentives are linked to existing constellations of actors involved in mental health care financing and identifies significant power relations. As a consequence, incentives and disincentives within the financing system result in hospital- centered and supply-oriented mental health care in Lower Austria. The current system of financing mental health care provides an obstacle to the provision of patient-oriented and community-based mental care. This is due to existing constellations and power relations among the actors where, most importantly, patients are the weakest party in the patient-payer-provider triangle. Balancing power relations will be a significant prerequisite for alternative financing systems. IMPLICATIONS FOR HEALTH POLICIES AND FURTHER RESEARCH: If a community and needs-based mental health care system is to be established in Austria, the financing structures have to be changed accordingly. Applying a principal-agent framework is useful for identifying key aspects in mental health care financing in relation to the provision of services. Further research is needed to help develop alternative financing mechanisms that support community-based and patient-oriented mental health care systems.

Harmonic Brain Modes: A Unifying Framework for Linking Space and Time in Brain Dynamics.

PubMed

Atasoy, Selen; Deco, Gustavo; Kringelbach, Morten L; Pearson, Joel

2018-06-01

A fundamental characteristic of spontaneous brain activity is coherent oscillations covering a wide range of frequencies. Interestingly, these temporal oscillations are highly correlated among spatially distributed cortical areas forming structured correlation patterns known as the resting state networks, although the brain is never truly at "rest." Here, we introduce the concept of harmonic brain modes-fundamental building blocks of complex spatiotemporal patterns of neural activity. We define these elementary harmonic brain modes as harmonic modes of structural connectivity; that is, connectome harmonics, yielding fully synchronous neural activity patterns with different frequency oscillations emerging on and constrained by the particular structure of the brain. Hence, this particular definition implicitly links the hitherto poorly understood dimensions of space and time in brain dynamics and its underlying anatomy. Further we show how harmonic brain modes can explain the relationship between neurophysiological, temporal, and network-level changes in the brain across different mental states ( wakefulness, sleep, anesthesia, psychedelic). Notably, when decoded as activation of connectome harmonics, spatial and temporal characteristics of neural activity naturally emerge from the interplay between excitation and inhibition and this critical relation fits the spatial, temporal, and neurophysiological changes associated with different mental states. Thus, the introduced framework of harmonic brain modes not only establishes a relation between the spatial structure of correlation patterns and temporal oscillations (linking space and time in brain dynamics), but also enables a new dimension of tools for understanding fundamental principles underlying brain dynamics in different states of consciousness.

Comparing Strategies for Providing Child and Youth Mental Health Care Services in Canada, the United States, and The Netherlands.

PubMed

Ronis, Scott T; Slaunwhite, Amanda K; Malcom, Kathryn E

2017-11-01

This paper reviews how child and youth mental health care services in Canada, the United States, and the Netherlands are organized and financed in order to identify systems and individual-level factors that may inhibit or discourage access to treatment for youth with mental health problems, such as public or private health insurance coverage, out-of-pocket expenses, and referral requirements for specialized mental health care services. Pathways to care for treatment of mental health problems among children and youth are conceptualized and discussed in reference to health insurance coverage and access to specialty services. We outline reforms to the organization of health care that have been introduced in recent years, and the basket of services covered by public and private insurance schemes. We conclude with a discussion of country-level opportunities to enhance access to child and youth mental health services using existing health policy levers in Canada, the United States and the Netherlands.

Sculpting the Intrinsic Modular Organization of Spontaneous Brain Activity by Art.

PubMed

Lin, Chia-Shu; Liu, Yong; Huang, Wei-Yuan; Lu, Chia-Feng; Teng, Shin; Ju, Tzong-Ching; He, Yong; Wu, Yu-Te; Jiang, Tianzi; Hsieh, Jen-Chuen

2013-01-01

Artistic training is a complex learning that requires the meticulous orchestration of sophisticated polysensory, motor, cognitive, and emotional elements of mental capacity to harvest an aesthetic creation. In this study, we investigated the architecture of the resting-state functional connectivity networks from professional painters, dancers and pianists. Using a graph-based network analysis, we focused on the art-related changes of modular organization and functional hubs in the resting-state functional connectivity network. We report that the brain architecture of artists consists of a hierarchical modular organization where art-unique and artistic form-specific brain states collectively mirror the mind states of virtuosos. We show that even in the resting state, this type of extraordinary and long-lasting training can macroscopically imprint a neural network system of spontaneous activity in which the related brain regions become functionally and topologically modularized in both domain-general and domain-specific manners. The attuned modularity reflects a resilient plasticity nurtured by long-term experience.

Sculpting the Intrinsic Modular Organization of Spontaneous Brain Activity by Art

PubMed Central

Lin, Chia-Shu; Liu, Yong; Huang, Wei-Yuan; Lu, Chia-Feng; Teng, Shin; Ju, Tzong-Ching; He, Yong; Wu, Yu-Te; Jiang, Tianzi; Hsieh, Jen-Chuen

2013-01-01

Artistic training is a complex learning that requires the meticulous orchestration of sophisticated polysensory, motor, cognitive, and emotional elements of mental capacity to harvest an aesthetic creation. In this study, we investigated the architecture of the resting-state functional connectivity networks from professional painters, dancers and pianists. Using a graph-based network analysis, we focused on the art-related changes of modular organization and functional hubs in the resting-state functional connectivity network. We report that the brain architecture of artists consists of a hierarchical modular organization where art-unique and artistic form-specific brain states collectively mirror the mind states of virtuosos. We show that even in the resting state, this type of extraordinary and long-lasting training can macroscopically imprint a neural network system of spontaneous activity in which the related brain regions become functionally and topologically modularized in both domain-general and domain-specific manners. The attuned modularity reflects a resilient plasticity nurtured by long-term experience. PMID:23840527

The Effects of Supplementation with a Vitamin and Mineral Complex with Guaraná Prior to Fasted Exercise on Affect, Exertion, Cognitive Performance, and Substrate Metabolism: A Randomized Controlled Trial.

PubMed

Veasey, Rachel C; Haskell-Ramsay, Crystal F; Kennedy, David O; Wishart, Karl; Maggini, Silvia; Fuchs, Caspar J; Stevenson, Emma J

2015-07-27

Exercise undertaken in a fasted state can lead to higher post-exercise mental fatigue. The administration of a vitamin and mineral complex with guaraná (MVM + G) has been shown to attenuate mental fatigue and improve performance during cognitively demanding tasks. This placebo-controlled, double-blind, randomized, balanced cross-over study examined the effect of MVM + G consumed prior to morning exercise on cognitive performance, affect, exertion, and substrate metabolism. Forty active males (age 21.4 ± 3.0 year; body mass index (BMI) 24.0 ± 2.4 kg/m2; maximal oxygen consumption (V̇O2max) 57.6 ± 7.3 mL/min/kg) completed two main trials, consuming either MVM + G or placebo prior to a 30-min run at 60% V̇O2max. Supplementation prior to exercise led to a small but significant reduction in Rating of Perceived Exertion (RPE) during exercise compared to the placebo. The MVM + G combination also led to significantly increased accuracy of numeric working memory and increased speed of picture recognition, compared to the placebo. There were no significant effects of supplementation on any other cognitive or mood measures or on substrate metabolism during exercise. These findings demonstrate that consuming a vitamin and mineral complex containing guaraná, prior to exercise, can positively impact subsequent memory performance and reduce perceived exertion during a moderate-intensity run in active males.

The Effects of Supplementation with a Vitamin and Mineral Complex with Guaraná Prior to Fasted Exercise on Affect, Exertion, Cognitive Performance, and Substrate Metabolism: A Randomized Controlled Trial

PubMed Central

Veasey, Rachel C.; Haskell-Ramsay, Crystal F.; Kennedy, David O.; Wishart, Karl; Maggini, Silvia; Fuchs, Caspar J.; Stevenson, Emma J.

2015-01-01

Exercise undertaken in a fasted state can lead to higher post-exercise mental fatigue. The administration of a vitamin and mineral complex with guaraná (MVM + G) has been shown to attenuate mental fatigue and improve performance during cognitively demanding tasks. This placebo-controlled, double-blind, randomized, balanced cross-over study examined the effect of MVM + G consumed prior to morning exercise on cognitive performance, affect, exertion, and substrate metabolism. Forty active males (age 21.4 ± 3.0 year; body mass index (BMI) 24.0 ± 2.4 kg/m2; maximal oxygen consumption (V̇O2max) 57.6 ± 7.3 mL/min/kg) completed two main trials, consuming either MVM + G or placebo prior to a 30-min run at 60% V̇O2max. Supplementation prior to exercise led to a small but significant reduction in Rating of Perceived Exertion (RPE) during exercise compared to the placebo. The MVM + G combination also led to significantly increased accuracy of numeric working memory and increased speed of picture recognition, compared to the placebo. There were no significant effects of supplementation on any other cognitive or mood measures or on substrate metabolism during exercise. These findings demonstrate that consuming a vitamin and mineral complex containing guaraná, prior to exercise, can positively impact subsequent memory performance and reduce perceived exertion during a moderate-intensity run in active males. PMID:26225993

The Role of Control Functions in Mentalizing: Dual-Task Studies of Theory of Mind and Executive Function

ERIC Educational Resources Information Center

Bull, Rebecca; Phillips, Louise H.; Conway, Claire A.

2008-01-01

Conflicting evidence has arisen from correlational studies regarding the role of executive control functions in Theory of Mind. The current study used dual-task manipulations of executive functions (inhibition, updating and switching) to investigate the role of these control functions in mental state and non-mental state tasks. The "Eyes"…

Mental Illness and/or Mental Health? Investigating Axioms of the Complete State Model of Health

ERIC Educational Resources Information Center

Keyes, Corey L. M.

2005-01-01

A continuous assessment and a categorical diagnosis of the presence (i.e., flourishing) and the absence (i.e., languishing) of mental health were proposed and applied to the Midlife in the United States study data, a nationally representative sample of adults between the ages of 25 and 74 years (N = 3,032). Confirmatory factor analyses supported…

The Role of Language Games in Children's Understanding of Mental States: A Training Study

ERIC Educational Resources Information Center

Ornaghi, Veronica; Brockmeier, Jens; Grazzani Gavazzi, Ilaria

2011-01-01

In this study the authors investigated whether training preschool children in the use of mental state lexicon plays a significant role in bringing about advanced conceptual understanding of mental terms and improved performance on theory-of-mind tasks. A total of 70 participants belonging to two age groups (3 and 4 years old) were randomly…

The Consequences of Official Labels: An Examination of the Rights Lost by the Mentally Ill and Mentally Incompetent Since 1989.

PubMed

Walker, Andrea M; Klein, Michael S; Hemmens, Craig; Stohr, Mary K; Burton, Velmer S

2016-04-01

This study presents a survey of state statutes which restrict the civil rights of persons with a mental illness or who have been declared mentally incompetent. Five civil rights (voting, holding public office, jury service, parenting, and marriage) are examined. The results of this study are compared with the results of studies conducted in 1989 and 1999 to determine what changes have occurred over time in the restriction of civil rights of those suffering from mental health problems. This comparison reveals that states continue to restrict the rights of the mentally ill and incompetent, and that there is a trend towards increased restriction of political rights, including the right to vote and hold public office.

The reconstruction of narrative identity during mental health recovery: a complex adaptive systems perspective.

PubMed

Kerr, Douglas J R; Crowe, Trevor P; Oades, Lindsay G

2013-06-01

1) to understand the reconstruction of narrative identity during mental health recovery using a complex adaptive systems perspective, 2) to address the need for alternative approaches that embrace the complexities of health care. A narrative review of published literature was conducted. A complex adaptive systems perspective offers a framework and language that can assist individuals to make sense of their experiences and reconstruct their narratives during an often erratic and uncertain life transition. It is a novel research direction focused on a critical area of recovery and addresses the need for alternative approaches that embrace the complexities of health care. A complexity research approach to narrative identity reconstruction is valuable. It is an accessible model for addressing the complexities of recovery and may underpin the development of simple, practical recovery coaching tools. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Trends in Residential Services for Mentally Retarded People: 1977-1982. Brief #23.

ERIC Educational Resources Information Center

Hill, B. K.; Lakin, K. C.

In 1977 a survey was conducted of all state-licensed, state-contracted, and state-operated residential facilities serving mentally retarded people in the United States. The survey was replicated in 1982 and this report summarizes and compares the results of the two surveys. Results indicate that the overall size of the residential service system…

Public Expenditures for Mental Retardation and Developmental Disabilities in the United States: Analytical Summary. (A Working Paper).

ERIC Educational Resources Information Center

Braddock, David; And Others

The report summarizes results from a mental retardation/developmental disabilities (MR/DD) expenditure analysis study. Three parts comprised the study: (1) the state government expenditure analysis which covered fiscal years (FY) 1977 through 1984, and dealt primarily with state general fund expenditures of the principal MR/DD state agency, the…

Rethinking the Psychogenic Model of Complex Regional Pain Syndrome: Somatoform Disorders and Complex Regional Pain Syndrome

PubMed Central

Hill, Renee J.; Chopra, Pradeep; Richardi, Toni

2012-01-01

Abstract Explaining the etiology of Complex Regional Pain Syndrome (CRPS) from the psychogenic model is exceedingly unsophisticated, because neurocognitive deficits, neuroanatomical abnormalities, and distortions in cognitive mapping are features of CRPS pathology. More importantly, many people who have developed CRPS have no history of mental illness. The psychogenic model offers comfort to physicians and mental health practitioners (MHPs) who have difficulty understanding pain maintained by newly uncovered neuro inflammatory processes. With increased education about CRPS through a biopsychosocial perspective, both physicians and MHPs can better diagnose, treat, and manage CRPS symptomatology. PMID:24223338

States Pass Diverse Slate of Mental Health Legislation in 2013. Mental Health: 2013 Legislative Session

ERIC Educational Resources Information Center

Thomsen, Jennifer

2014-01-01

Recent violence in schools and on college campuses has brought into sharp focus the need to address mental health issues in educational settings. Getting students with mental health problems the help they need, without stigmatizing mental illness, may help prevent future tragedies. Children with mental health problems face a host of challenges,…

National mental health programme: Manpower development scheme of eleventh five-year plan.

PubMed

Sinha, Suman K; Kaur, Jagdish

2011-07-01

Mental disorders impose a massive burden in the society. The National Mental Health Programme (NMHP) is being implemented by the Government of India to support state governments in providing mental health services in the country. India is facing shortage of qualified mental health manpower for District Mental Health Programme (DMHP) in particular and for the whole mental health sector in general. Recognizing this key constraint Government of India has formulated manpower development schemes under NMHP to address this issue. Under the scheme 11 centers of excellence in mental health, 120 PG departments in mental health specialties, upgradation of psychiatric wings of medical colleges, modernization of state-run mental hospitals will be supported. The expected outcome of the Manpower Development schemes is 104 psychiatrists, 416 clinical psychologists, 416 PSWs and 820 psychiatric nurses annually once these institutes/ departments are established. Together with other components such as DMHP with added services, Information, education and communication activities, NGO component, dedicated monitoring mechanism, research and training, this scheme has the potential to make a facelift of the mental health sector in the country which is essentially dependent on the availability and equitable distribution mental health manpower in the country.

National mental health programme: Manpower development scheme of eleventh five-year plan

PubMed Central

Sinha, Suman K.; Kaur, Jagdish

2011-01-01

Mental disorders impose a massive burden in the society. The National Mental Health Programme (NMHP) is being implemented by the Government of India to support state governments in providing mental health services in the country. India is facing shortage of qualified mental health manpower for District Mental Health Programme (DMHP) in particular and for the whole mental health sector in general. Recognizing this key constraint Government of India has formulated manpower development schemes under NMHP to address this issue. Under the scheme 11 centers of excellence in mental health, 120 PG departments in mental health specialties, upgradation of psychiatric wings of medical colleges, modernization of state-run mental hospitals will be supported. The expected outcome of the Manpower Development schemes is 104 psychiatrists, 416 clinical psychologists, 416 PSWs and 820 psychiatric nurses annually once these institutes/ departments are established. Together with other components such as DMHP with added services, Information, education and communication activities, NGO component, dedicated monitoring mechanism, research and training, this scheme has the potential to make a facelift of the mental health sector in the country which is essentially dependent on the availability and equitable distribution mental health manpower in the country. PMID:22135448

Development of Mental Health Indicators in Korea

PubMed Central

Han, Hyeree; Ahn, Dong Hyun; Song, Jinhee; Hwang, Tae Yeon

2012-01-01

Objective Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea. Methods This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries. Results We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders. Conclusion Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation. PMID:23251193

Use of State Mental Health Centers in Training Teachers of Children with Behavior Disorders

ERIC Educational Resources Information Center

Anderson, Robert M.; Kauffman, James M.

1970-01-01

Community oriented state mental health facilities can provide invaluable practicum experiences for undergraduate and graduate students in training to become teachers of behaviorally disordered children. (Author/CJ)

40 CFR 62.5100 - Identification of plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... acid mist from sulfuric acid plants, submitted by the Secretary of Health and Mental Hygiene, State of..., submitted by the Secretary of Health and Mental Hygiene, State of Maryland on January 26, 1984. (c...

State of the Nigerian child - neglect of child and adolescent mental health: a review.

PubMed

Atilola, O; Ayinde, O O; Emedoh, C T; Oladimeji, O

2015-05-01

As most child health initiatives in Nigeria lack a child and adolescent mental health (CAMH) strategy, CAMH issues have remained obscure to the country's policy-makers. The lack of current and representative epidemiological data on the mental health of Nigerian children continues to be a barrier to advocacy for CAMH policy initiatives. In view of the importance of CAMH to national development, there must be a continued search for ways of bringing the state of CAMH in Nigeria to the attention of policy-makers. To use information from UNICEF's State of the World's Children as proxy data to speculate on the state of child mental health in Nigeria. With a view to discussing its CAMH implications, social and health indicators in the Nigerian child were extracted from UNICEF's 2012 edition. Most of the social and health indicators assessed reflect significant mental health risks. Up to 65% of households live on less than US$1·25 per day, child malnutrition is evident in up to 40% of children, and the primary and secondary school net enrolment ratios are only 63% and 25%, respectively. In addition, the rate of attendance for antenatal care was 45%, and only 39% of deliveries were supervised by skilled birth attendants. Child labour and under-age marriage is very common. A literature review demonstrates that children living in these circumstances are at significant risk of mental health problems. Current data on the state of Nigerian children contain indices that can serve as proxy information for the state of CAMH in the country. Policy-makers need to invest more in pre-emptive child health initiatives as a way of preserving the physical and mental health of children.

How do thoughts, emotions, and decisions align? A new way to examine theory of mind during middle childhood and beyond.

PubMed

Lagattuta, Kristin Hansen; Elrod, Noel M; Kramer, Hannah J

2016-09-01

The current study examined 4- to 10-year-olds' and adults' (N=280) tendency to connect people's thoughts, emotions, and decisions into valence-matched mental state triads (thought valence=emotion valence=decision valence; e.g., anticipate something bad+feel worried+avoid) and valence-matched mental state dyads (thought-emotion, thought-decision, and emotion-decision). Participants heard vignettes about focal characters who re-encountered individuals who had previously harmed them twice, helped them twice, or both harmed and helped them. Baseline trials involved no past experience. Children and adults predicted the focal characters' thoughts (anticipate something good or bad), emotions (feel happy or worried), and decisions (go near or stay away). Results showed significant increases between 4 and 10years of age in the formation of valence-matched mental state triads and dyads, with thoughts and emotions most often aligned by valence. We also documented age-related improvement in awareness that uncertain situations elicit less valence-consistent mental states than more certain situations, with females expecting weaker coherence among characters' thoughts, emotions, and decisions than males. Controlling for age and sex, individuals with stronger executive function (working memory and inhibitory control) predicted more valence-aligned mental states. These findings add to the emerging literature on development and individual differences in children's reasoning about mental states and emotions during middle childhood and beyond. Copyright © 2016 Elsevier Inc. All rights reserved.

Clinician burnout and satisfaction with resources in caring for complex patients.

PubMed

Whitebird, Robin R; Solberg, Leif I; Crain, A Lauren; Rossom, Rebecca C; Beck, Arne; Neely, Claire; Dreskin, Mark; Coleman, Karen J

To describe primary care clinicians' self-reported satisfaction, burnout and barriers for treating complex patients. We conducted a survey of 1554 primary care clinicians in 172 primary care clinics in 18 health care systems across 8 states prior to the implementation of a collaborative model of care for patients with depression and diabetes and/or cardiovascular disease. Of the clinicians who responded to the survey (n=709; 46%), we found that a substantial minority (31%) were experiencing burnout that was associated with lower career satisfaction (P<.0001) and lower satisfaction with resources to treat complex patients (P<.0001). Less than 50% of clinicians rated their ability to treat complex patients as very good to excellent with 21% rating their ability as fair to poor. The majority of clinicians (72%) thought that a collaborative model of care would be very helpful for treating complex patients. Burnout remains a problem for primary care clinicians and is associated with low job satisfaction and low satisfaction with resources to treat complex patients. A collaborative care model for patients with mental and physical health problems may provide the resources needed to improve the quality of care for these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Passive BCI in Operational Environments: Insights, Recent Advances, and Future Trends.

PubMed

Arico, Pietro; Borghini, Gianluca; Di Flumeri, Gianluca; Sciaraffa, Nicolina; Colosimo, Alfredo; Babiloni, Fabio

2017-07-01

This minireview aims to highlight recent important aspects to consider and evaluate when passive brain-computer interface (pBCI) systems would be developed and used in operational environments, and remarks future directions of their applications. Electroencephalography (EEG) based pBCI has become an important tool for real-time analysis of brain activity since it could potentially provide covertly-without distracting the user from the main task-and objectively-not affected by the subjective judgment of an observer or the user itself-information about the operator cognitive state. Different examples of pBCI applications in operational environments and new adaptive interface solutions have been presented and described. In addition, a general overview regarding the correct use of machine learning techniques (e.g., which algorithm to use, common pitfalls to avoid, etc.) in the pBCI field has been provided. Despite recent innovations on algorithms and neurotechnology, pBCI systems are not completely ready to enter the market yet, mainly due to limitations of the EEG electrodes technology, and algorithms reliability and capability in real settings. High complexity and safety critical systems (e.g., airplanes, ATM interfaces) should adapt their behaviors and functionality accordingly to the user' actual mental state. Thus, technologies (i.e., pBCIs) able to measure in real time the user's mental states would result very useful in such "high risk" environments to enhance human machine interaction, and so increase the overall safety.

A national survey of U.S. juvenile mental health courts.

PubMed

Callahan, Lisa; Cocozza, Joseph; Steadman, Henry J; Tillman, Sheila

2012-02-01

The authors surveyed U.S. juvenile mental health courts (JMHCs). Forty-one were identified in 15 states, and 34 returned surveys; one was completed on the basis of published information. Topics included the court's history, youths served, inclusion and exclusion criteria, the court process, and services provided. Half (51%) reported that the juvenile court was responsible for the program; for 11% the probation agency had the responsibility, and 17% reported shared responsibility by these entities. Fifty-one percent reported that all youths with any mental disorder diagnosis are eligible. The most commonly reported participant diagnoses are bipolar disorder (27%), depression (23%), and attention-deficit hyperactivity disorder (16%). Seventy percent currently include participants with felony offenses, and 91% with misdemeanors; 67% exclude status offenses, and 21% exclude violent offenses. A guilty plea was required by 63%. Incentives to participate included dismissal of charges (40%), reduction in court hearings (43%), praise by the judge and probation officer (60%), reduction in curfew restrictions (23%), and gift cards or gifts (71%). Sanctions for not participating included increased supervision or hearings (60%), performing community service (54%), and placement in residential detention (60%). Most JMHCs reported use of a multidisciplinary team to coordinate community-based services to prevent protracted justice system involvement. JMHCs are being developed in the absence of systematically collected outcome data. Although they resemble adult mental health courts, they have unique features that are specific to addressing the complex needs of youths with mental disorders involved in the justice system. These include diagnostic and treatment challenges and issues related to involving families and schools.

Effects of complex aural stimuli on mental performance.

PubMed

Vij, Mohit; Aghazadeh, Fereydoun; Ray, Thomas G; Hatipkarasulu, Selen

2003-06-01

The objective of this study is to investigate the effect of complex aural stimuli on mental performance. A series of experiments were designed to obtain data for two different analyses. The first analysis is a "Stimulus" versus "No-stimulus" comparison for each of the four dependent variables, i.e. quantitative ability, reasoning ability, spatial ability and memory of an individual, by comparing the control treatment with the rest of the treatments. The second set of analysis is a multi-variant analysis of variance for component level main effects and interactions. The two component factors are tempo of the complex aural stimuli and sound volume level, each administered at three discrete levels for all four dependent variables. Ten experiments were conducted on eleven subjects. It was found that complex aural stimuli influence the quantitative and spatial aspect of the mind, while the reasoning ability was unaffected by the stimuli. Although memory showed a trend to be worse with the presence of complex aural stimuli, the effect was statistically insignificant. Variation in tempo and sound volume level of an aural stimulus did not significantly affect the mental performance of an individual. The results of these experiments can be effectively used in designing work environments.

DIRECTORY OF RESIDENTIAL CAMPS SERVING THE MENTALLY RETARDED.

ERIC Educational Resources Information Center

National Association for Retarded Children, New York, NY.

PREPARED BY THE NATIONAL ASSOCIATION FOR RETARDED CHILDREN FROM A QUESTIONNAIRE SENT TO STATE AND LOCAL ORGANIZATIONS, THE DIRECTORY (1967) LISTS RESIDENT CAMPS SERVING THE MENTALLY RETARDED THROUGHOUT THE UNITED STATES. CAMPS ARE ENTERED ALPHABETICALLY ACCORDING TO GEOGRAPHIC LOCATION WITHIN EACH STATE. TYPES OF CHILDREN SERVED INCLUDE MENTALLY…

'Treading water but drowning slowly': what are GPs' experiences of living and working with mental illness and distress in England? A qualitative study.

PubMed

Riley, Ruth; Spiers, Johanna; Chew-Graham, Carolyn A; Taylor, Anna K; Thornton, Gail A; Buszewicz, Marta

2018-05-03

This paper provides an in-depth account of general practitioners' (GPs) experiences of living and working with mental illness and distress, as part of a wider study reporting the barriers and facilitators to help-seeking for mental illness and burn-out, and sources of stress/distress for GP participants. Qualitative study using in-depth interviews with 47 GP participants. The interviews were audio recorded, transcribed, anonymised and imported into NVivo V.11 to facilitate data management. Data were analysed using a thematic analysis employing the constant comparative method. England. A purposive sample of GP participants who self-identified as: (1) currently living with mental distress, (2) returning to work following treatment, (3) off sick or retired early as a result of mental distress or (4) without experience of mental distress. Interviews were conducted face to face or over the telephone. The findings report GP participants' in-depth experiences of distress and mental illness with many recollecting their distressing experiences and significant psychological and physical symptoms relating to chronic stress, anxiety, depression and/or burn-out, and a quarter articulating thoughts of suicide. Many talked about their shame, humiliation and embarrassment at their perceived inability to cope with the stresses of their job and/or their symptoms of mental illness. These findings paint a concerning picture of the situation affecting primary care doctors, with participants' accounts suggesting there is a considerable degree of mental ill health and reduced well-being among GPs. The solutions are complex and lie in prevention and provision. There needs to be greater recognition of the components and cumulative effect of occupational stressors for doctors, such as the increasing workload and the clinical and emotional demands of the job, as well as the need for a culture shift within medicine to more supportive and compassionate work environments. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

What Does Mental Health Parity Really Mean for the Care of People with Serious Mental Illness?

PubMed

Bartlett, John; Manderscheid, Ron

2016-06-01

Parity of mental health and substance abuse insurance benefits with medical care benefits, as well as parity in their management, are major ongoing concerns for adults with serious mental illness (SMI). The Mental Health Parity and Addiction Equity Act of 2008 guaranteed this parity of benefits and management in large private insurance plans and privately managed state Medicaid plans, but only if the benefits were offered at all. The Patient Protection and Affordable Care Act of 2010 extended parity to all persons receiving insurance through the state health insurance marketplaces, through the state Medicaid Expansions, and through new individual and small group plans. This article presents an analysis of how accessible parity has become for adults with SMI at both the system and personal levels several years after these legislative changes have been implemented. Copyright © 2016 Elsevier Inc. All rights reserved.

NeuroPlace: Categorizing urban places according to mental states

PubMed Central

2017-01-01

Urban spaces have a great impact on how people’s emotion and behaviour. There are number of factors that impact our brain responses to a space. This paper presents a novel urban place recommendation approach, that is based on modelling in-situ EEG data. The research investigations leverages on newly affordable Electroencephalogram (EEG) headsets, which has the capability to sense mental states such as meditation and attention levels. These emerging devices have been utilized in understanding how human brains are affected by the surrounding built environments and natural spaces. In this paper, mobile EEG headsets have been used to detect mental states at different types of urban places. By analysing and modelling brain activity data, we were able to classify three different places according to the mental state signature of the users, and create an association map to guide and recommend people to therapeutic places that lessen brain fatigue and increase mental rejuvenation. Our mental states classifier has achieved accuracy of (%90.8). NeuroPlace breaks new ground not only as a mobile ubiquitous brain monitoring system for urban computing, but also as a system that can advise urban planners on the impact of specific urban planning policies and structures. We present and discuss the challenges in making our initial prototype more practical, robust, and reliable as part of our on-going research. In addition, we present some enabling applications using the proposed architecture. PMID:28898244

["Lex Kendra" in New York, United States. Homicide, "revolving door psychiatry" and political response].

PubMed

Röttgers, H R; Nedjat, S

2001-03-01

The history, motivation and consequences of the New York State "Kendra's Law" as of August 1999 are reviewed. "Kendra's Law" was the consequence of the killing of a young woman, Kendra W., by a schizophrenic patient later convicted for second degree murder. Before, he had been repeatedly rejected when he sought treatment in state-run psychiatric facilities and was expelled several times from long-term hospitals despite a long history of violent behaviour when untreated. "Kendra's Law" now entitles physicians, case workers, roommates and families of untreated mentally ill persons to seek a court order forcing a patient to comply with treatment and, at the same time, compelling mental health institutions to grant this treatment. Additionally, the law and another bill signed in November 1999 provided for additional funding for the underfinanced state-run mental health system. "Kendra's Law" illustrates a bidirectional attempt to cope with the revolving door treatment situation of mentally ill in the State of New York by additional funding and additional possibilities to enforce treatment. The law illustrates the fundamental conflict between individual autonomy and the need for treatment of people suffering from severe mental illness.

Firearm laws: a primer for psychiatrists.

PubMed

Price, Marilyn; Norris, Donna Marie

2010-01-01

Persons with mental illness or substance abuse have been perceived by the public to pose an increased risk of violence to themselves and others. As a result, federal and state laws have restricted the right of certain categories of persons with mental illness or substance abuse to possess, register, license, retain, or carry a firearm. Clinicians should be familiar with the specific firearm statutes of their own states, which describe the disqualifying mental health/substance abuse history and the role and responsibility of the psychiatrist in the process. State statutes vary widely in terms of the definitions of, and reporting requirements relating to, prohibited persons with mental illness or substance abuse. States also vary in the duration of the prohibition and in the timing of the appeals process. Some of the statutes have specific provisions for the removal of a firearm when a prohibited person is identified. States may maintain a mental health database that is used to determine firearm eligibility and may forward information to the National Instant Criminal Background Check System. The National Instant Criminal Background Check System Improvement Amendments Act of 2007 will likely increase the number of persons identified as belonging to the prohibited class.

Motes v. Hall County.

PubMed

1983-09-07

In a challenge to Georgia's involuntary sterilization statute, the state Supreme Court ruled that the standard of evidence required by the statute before granting a state-initiated sterilization petition did not meet constitutional requirements. Recognizing procreation as a fundamental right, the court held that authorization of involuntary sterilization of mental incompetents must be based on the elevated standard of "clear and convincing evidence" that the person is irreversibly and incurably mentally incompetent, whether by mental retardation or brain damage, and is unable to care for a child without causing serious mental of physical harm to the child.

Significance and costs of complex biopsychosocial health care needs in elderly people: results of a population-based study.

PubMed

Wild, Beate; Heider, Dirk; Maatouk, Imad; Slaets, Joris; König, Hans-Helmut; Niehoff, Dorothea; Saum, Kai-Uwe; Brenner, Hermann; Söllner, Wolfgang; Herzog, Wolfgang

2014-09-01

To improve health care for the elderly, a consideration of biopsychosocial health care needs may be of particular importance-especially because of the prevalence of multiple conditions, mental disorders, and social challenges facing elderly people. The aim of the study was to investigate significance and costs of biopsychosocial health care needs in elderly people. Data were derived from the 8-year follow-up of the ESTHER study-a German epidemiological study in the elderly population. A total of 3124 participants aged 57 to 84 years were visited at home by trained medical doctors. Biopsychosocial health care needs were assessed using the INTERMED for the Elderly (IM-E) interview. Health-related quality of life (HRQOL) was measured by the 12-Item Short-Form Health Survey, and psychosomatic burden was measured by the Patient Health Questionnaire. The IM-E correlated with decreased mental (mental component score: r = -0.38, p < .0001) and physical HRQOL (physical component score: r = -0.45, p < .0001), increased depression severity (r = 0.53, p < .0001), and costs (R = 0.41, p < .0001). The proportion of the participants who had an IM-E score of at least 21 was 8.2%; according to previous studies, they were classified as complex patients (having complex biopsychosocial health care needs). Complex patients showed a highly reduced HRQOL compared with participants without complex health care needs (mental component score: 37.0 [10.8] versus 48.7 [8.8]; physical component score: 33.0 [9.1] versus 41.6 [9.5]). Mean health care costs per 3 months of complex patients were strongly increased (1651.1 &OV0556; [3192.2] versus 764.5 &OV0556; [1868.4]). Complex biopsychosocial health care needs are strongly associated with adverse health outcomes in elderly people. It should be evaluated if interdisciplinary treatment plans would improve the health outcomes for complex patients.

[Mentalization based treatment and borderline personality disorder].

PubMed

De Oliveira, C; Rahioui, H; Smadja, M; Gorsane, M A; Louppe, F

2017-08-01

The borderline personality disorder is a complex psychiatric disorder that represents a high number of patients in a psychiatric adult service. Even if some therapies have shown to be effective in the therapeutic care of the borderline personality disorder they only target certain symptoms (e.g. anxiety, sadness, self-mutilation). The aim of this paper is to introduce a therapeutic model little known in France: the mentalization based therapy (MBT) developed in 2004 by Bateman and Fonagy. This therapeutic model apprehends the borderline personality disorder in all its complexity and is based on two main concepts: Bowlby's attachment theory and the concept of mentalization. The MBT is based on the hypothesis that a deficit of mentalization leads to the development of borderline disorder. The capacity of mentalization, also known as reflexive function, is acquired in infancy through interpersonal relationships, in particular those of attachment, and is the ability to understand the mental state (emotions, needs, thoughts, etc.) of oneself and others which underlies explicit behaviour. This reflexive capacity is of a better quality when the person has a secure attachment style. Indeed, borderline patients have, mainly, a deficit of mentalization capacity associated with an insecure attachment style. Thus, the main objective of the Bateman and Fonagy approach is to develop and reinforce the mentalization capacity through a therapeutic relationship as a secure base, a group therapy and the concept of insight. Classically, MBT is structured over a period of 18 months divided into 3 distinct phases distributed in two therapeutic axes: group and individual therapy. The initial phase aims to engage the patient in the therapy by evaluating attachment style, mentalization's ability, interpersonal functioning; providing psychoeducation about borderline disorder and establishing a therapeutic contract. To evaluate attachment style, the authors strongly recommend the use of the Relationship Scales Questionnaire. During the second phase, which includes individual and group therapy, the aim is to stimulate the capacity of mentalization through different techniques according to the patient's attachment style. These include therapeutic relationship, empathy, affect clarification and elaboration, positive and negative reinforcement. The final phase serves to review the patient's improvement and to prepare him progressively for the end of the therapy which can be experienced as an abandonment. Effectiveness of MBT in treating borderline disorder has been shown in several studies with short and long term benefits. It can be adapted for other personality disorders and specific populations such as adolescents. This article introduces the key concepts and aims of mentalization based treatment. The therapy is briefly described in its different phases and the various techniques are discussed. Clinical trials have shown that MBT is effective in treating borderline disorder in adolescent and adult populations. Despite the effectiveness of this therapy, it is difficult to set up and requires substantial resources. Interpersonal therapy based on attachment provides a therapeutic model focused on problematic areas which can offer an alternative therapy and reduce the fields of investigations. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Promotion of mental health in children of parents with a mental disorder.

PubMed

Verrocchio, Maria Cristina; Ambrosini, Alessandra; Fulcheri, Mario

2013-01-01

Mental disorders are associated with many difficulties in the activities of daily living, work, relationships and family, and they determine high social and economic costs that represent an important public health problem. The literature has shown that children of parents with mental disorders grow up in environments that are potentially harmful to their mental health and are at risk of neglect and maltreatment. Interventions to prevent mental disorders and psychological symptoms of children of parents with mental disorders are effective but supporting these families is a complex task which requires both cooperation between departments and an interdisciplinary knowledge. A greater knowledge of the responses provided to assist families with dependent children and a mentally ill parent, could stimulate reflections on critical issues and government actions aimed at promoting and protecting the mental health of children.

42 CFR 410.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

...— Community mental health center (CMHC) means an entity that— (1) Provides outpatient services, including... residents of its mental health service area who have been discharged from inpatient treatment at a mental... patients being considered for admission to State mental health facilities to determine the appropriateness...

42 CFR 410.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

...— Community mental health center (CMHC) means an entity that— (1) Provides outpatient services, including... residents of its mental health service area who have been discharged from inpatient treatment at a mental... patients being considered for admission to State mental health facilities to determine the appropriateness...

42 CFR 410.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

...— Community mental health center (CMHC) means an entity that— (1) Provides outpatient services, including... residents of its mental health service area who have been discharged from inpatient treatment at a mental... patients being considered for admission to State mental health facilities to determine the appropriateness...

42 CFR 410.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

...— Community mental health center (CMHC) means an entity that— (1) Provides outpatient services, including... residents of its mental health service area who have been discharged from inpatient treatment at a mental... patients being considered for admission to State mental health facilities to determine the appropriateness...

Collaboratively reframing mental health for integration of HIV care in Ethiopia†

PubMed Central

Wissow, Lawrence S.; Tegegn, Teketel; Asheber, Kassahun; McNabb, Marion; Weldegebreal, Teklu; Jerene, Degu; Ruff, Andrea

2015-01-01

Background Integrating mental health with general medical care can increase access to mental health services, but requires helping generalists acquire a range of unfamiliar knowledge and master potentially complex diagnostic and treatment processes. Method We describe a model for integrating complex specialty care with generalist/primary care, using as an illustration the integration of mental health into hospital-based HIV treatment services in Ethiopia. Generalists and specialists collaboratively developed mental health treatments to fit the knowledge, skills and resources of the generalists. The model recognizes commonalities between mental health and general medical care, focusing on practical interventions acceptable to patients. It was developed through a process of literature review, interviews, observing clinical practice, pilot trainings and expert consultation. Preliminary evaluation results were obtained by debriefing generalist trainees after their return to their clinical sites. Results In planning interviews, generalists reported discomfort making mental health diagnoses but recognition of symptom groups including low mood, anxiety, thought problems, poor child behaviour, seizures and substance use. Diagnostic and treatment algorithms were developed for these groups and tailored to the setting by including possible medical causes and burdens of living with HIV. First-line treatment included modalities familiar to generalists: empathetic patient–provider interactions, psychoeducation, cognitive reframing, referral to community supports and elements of symptom-specific evidence-informed counselling. Training introduced basic skills, with evolving expertise supported by job aides and ongoing support from mental health nurses cross-trained in HIV testing. Feedback from trainees suggested the programme fit well with generalists’ settings and clinical goals. Conclusions An integration model based on collaboratively developing processes that fit the generalist setting shows promise as a method for incorporating complex, multi-faceted interventions into general medical settings. Formal evaluations will be needed to compare the quality of care provided with more traditional approaches and to determine the resources required to sustain quality over time. PMID:25012090

Collaboratively reframing mental health for integration of HIV care in Ethiopia.

PubMed

Wissow, Lawrence S; Tegegn, Teketel; Asheber, Kassahun; McNabb, Marion; Weldegebreal, Teklu; Jerene, Degu; Ruff, Andrea

2015-07-01

Integrating mental health with general medical care can increase access to mental health services, but requires helping generalists acquire a range of unfamiliar knowledge and master potentially complex diagnostic and treatment processes. We describe a model for integrating complex specialty care with generalist/primary care, using as an illustration the integration of mental health into hospital-based HIV treatment services in Ethiopia. Generalists and specialists collaboratively developed mental health treatments to fit the knowledge, skills and resources of the generalists. The model recognizes commonalities between mental health and general medical care, focusing on practical interventions acceptable to patients. It was developed through a process of literature review, interviews, observing clinical practice, pilot trainings and expert consultation. Preliminary evaluation results were obtained by debriefing generalist trainees after their return to their clinical sites. In planning interviews, generalists reported discomfort making mental health diagnoses but recognition of symptom groups including low mood, anxiety, thought problems, poor child behaviour, seizures and substance use. Diagnostic and treatment algorithms were developed for these groups and tailored to the setting by including possible medical causes and burdens of living with HIV. First-line treatment included modalities familiar to generalists: empathetic patient-provider interactions, psychoeducation, cognitive reframing, referral to community supports and elements of symptom-specific evidence-informed counselling. Training introduced basic skills, with evolving expertise supported by job aides and ongoing support from mental health nurses cross-trained in HIV testing. Feedback from trainees suggested the programme fit well with generalists' settings and clinical goals. An integration model based on collaboratively developing processes that fit the generalist setting shows promise as a method for incorporating complex, multi-faceted interventions into general medical settings. Formal evaluations will be needed to compare the quality of care provided with more traditional approaches and to determine the resources required to sustain quality over time. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Investigating the validity and usability of an interactive computer programme for assessing competence in telephone-based mental health triage.

PubMed

Sands, Natisha; Elsom, Stephen; Keppich-Arnold, Sandra; Henderson, Kathryn; King, Peter; Bourke-Finn, Karen; Brunning, Debra

2016-02-01

Telephone-based mental health triage services are frontline health-care providers that operate 24/7 to facilitate access to psychiatric assessment and intervention for people requiring assistance with a mental health problem. The mental health triage clinical role is complex, and the populations triage serves are typically high risk; yet to date, no evidence-based methods have been available to assess clinician competence to practice telephone-based mental health triage. The present study reports the findings of a study that investigated the validity and usability of the Mental Health Triage Competency Assessment Tool, an evidence-based, interactive computer programme designed to assist clinicians in developing and assessing competence to practice telephone-based mental health triage. © 2015 Australian College of Mental Health Nurses Inc.

Physical Disabilities Related to the Depressive Mental States of Japanese Patients with Subacute Myelo-optico-neuropathy.

PubMed

Konishi, Tetsuro

2018-05-18

Objective The aim of this study was to clarify the clinical conditions related to the depressive mental states in Japanese patients with subacute myelo-optico-neuropathy (SMON), caused by clioquinol intoxication more than 40 years previously. Materials and methods The changes in the mental states with aging were investigated in 25 Japanese SMON patients (mean age: 77.2 years old, range: 53-90) using a Japanese version of the Zung Self-rating Depression Scale (J-SDS) questionnaires with supportive interviews by the clinical psychotherapist and medical checkup records. These mental and medical examinations were repeated more than twice within 2 to 11 years' interval. The J-SDS questionnaires were also examined in 25 age-matched non-SMON elderly people. Results The total J-SDS scores of most of the SMON patients decreased with age without significant changes in the mean Barthel index scores during this study period. The mean J-SDS scores at the first and latest studies were significantly higher than in the age-matched healthy elderly people. The total J-SDS scores of the latest study were significantly correlated with the degree of physical disability, such as the inverse total Barthel index scores, severity of SMON or gait disturbance, but not with the age. Conclusion The total J-SDS scores of most of the SMON patients tended to decrease with age. Repeating mental supportive interviews and medical examinations by experts helped to improve the depressive mental state and revealed close relationship between the mental state and the physical disabilities of the SMON patients.

Books reconsidered: Emile Durkheim, Le Suicide.

PubMed

Robertson, Michael

2006-12-01

To reappraise Emile Durkheim's taxonomy of suicide in Le Suicide in the light of recent experience. While Durkheim's scientific method and argument are fundamentally flawed, some of his concepts have instrumental value in attempting to understand the complex origins of suicidal behaviour. Durkheim's baseless dismissal of mental illness as a key determinant of suicidal behaviour weakens his thesis significantly. However, his conceptualization of anomic, egoistic and altruistic suicide provides a means of comprehending recent trends in suicidal behaviour in the former Soviet states and a possible window into the psyche of the suicides of religious and political extremists.

Brainstem response and state-trait variables

NASA Technical Reports Server (NTRS)

Gilliland, Kirby

1988-01-01

A series of investigations are summarized from a personality research program that have relevance for mental state estimation. Of particular concern are those personality variables that are believed to have either a biological or perceptual basis and their relationship to human task performance and psychophysiology. These variables are among the most robust personality measures and include such dimensions as extraversion-introversion, sensation seeking, and impulsiveness. These dimensions also have the most distinct link to performance and psychophysiology. Through the course of many of these investigations two issues have emerged repeatedly: these personality dimensions appear to mediate mental state, and mental state appears to influence measures of performance or psychophysiology.

EEG Brain Activity in Dynamic Health Qigong Training: Same Effects for Mental Practice and Physical Training?

PubMed

Henz, Diana; Schöllhorn, Wolfgang I

2017-01-01

In recent years, there has been significant uptake of meditation and related relaxation techniques, as a means of alleviating stress and fostering an attentive mind. Several electroencephalogram (EEG) studies have reported changes in spectral band frequencies during Qigong meditation indicating a relaxed state. Much less is reported on effects of brain activation patterns induced by Qigong techniques involving bodily movement. In this study, we tested whether (1) physical Qigong training alters EEG theta and alpha activation, and (2) mental practice induces the same effect as a physical Qigong training. Subjects performed the dynamic Health Qigong technique Wu Qin Xi (five animals) physically and by mental practice in a within-subjects design. Experimental conditions were randomized. Two 2-min (eyes-open, eyes-closed) EEG sequences under resting conditions were recorded before and immediately after each 15-min exercise. Analyses of variance were performed for spectral power density data. Increased alpha power was found in posterior regions in mental practice and physical training for eyes-open and eyes-closed conditions. Theta power was increased after mental practice in central areas in eyes-open conditions, decreased in fronto-central areas in eyes-closed conditions. Results suggest that mental, as well as physical Qigong training, increases alpha activity and therefore induces a relaxed state of mind. The observed differences in theta activity indicate different attentional processes in physical and mental Qigong training. No difference in theta activity was obtained in physical and mental Qigong training for eyes-open and eyes-closed resting state. In contrast, mental practice of Qigong entails a high degree of internalized attention that correlates with theta activity, and that is dependent on eyes-open and eyes-closed resting state.

State planning of mental health services.

PubMed

Sauber, S R

1976-03-01

Planning is the vital process that links needs to solutions. The interorganizational field of human services constitutes a "turbulent environment," a condition of rapid change, and there needs to be greater receptivity toward comprehensive planning on the part of state departments of mental health. Increased overlap with various welfare and educational service, advances in scientific knowledge, and shifts in general attitudes and social philosophy lead to demands for new and different types of service and require changes in approach and method. Generalized findings of a study of 14 state departments of mental health are presented.

Annual report on health care for children and youth in the United States: national estimates of cost, utilization and expenditures for children with mental health conditions.

PubMed

Torio, Celeste Marie; Encinosa, William; Berdahl, Terceira; McCormick, Marie C; Simpson, Lisa A

2015-01-01

To examine national trends in hospital utilization, costs, and expenditures for children with mental health conditions. The analyses of children aged 1 to 17 are based on AHRQ's 2006 and 2011 Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS) databases, and on AHRQ's pooled 2006 to 2011 Medical Expenditure Panel Survey (MEPS). All estimates are nationally representative, and standard errors account for the complex survey designs. Although overall all-cause children's hospitalizations did not increase between 2006 and 2011, hospitalizations for all listed mental health conditions increased by nearly 50% among children aged 10 to 14 years, and by 21% for emergency department (ED) visits. Behavioral disorders experienced a shift in underlying patterns between 2006 and 2011: inpatient stays for alcohol-related disorders declined by 44%, but ED visits increased by 34% for substance-related disorders and by 71% for impulse control disorders. Inpatient visits for suicide, suicidal ideation, and self-injury increased by 104% for children ages 1 to 17 years, and by 151% for children ages 10 to 14 years during this period. A total of $11.6 billion was spent on hospital visits for mental health during this period. Medicaid covered half of the inpatient visits, but with 50% to 30% longer length of stays in 2006 and 2011, respectively, than private payers. Medicaid's overall share of the ED visits increased from 45% in 2006 to 53% in 2011. These alarming trends highlight the renewed need for research on mental health care for children. This study also provides a baseline for evaluating the impact of the Affordable Care Act and the mental health parity legislation on mental health utilization and expenditures for children. Published by Elsevier Inc.

Using workshops to develop theories of change in five low and middle income countries: lessons from the programme for improving mental health care (PRIME)

PubMed Central

2014-01-01

Background The Theory of Change (ToC) approach has been used to develop and evaluate complex health initiatives in a participatory way in high income countries. Little is known about its use to develop mental health care plans in low and middle income countries where mental health services remain inadequate. Aims ToC workshops were held as part of formative phase of the Programme for Improving Mental Health Care (PRIME) in order 1) to develop a structured logical and evidence-based ToC map as a basis for a mental health care plan in each district; (2) to contextualise the plans; and (3) to obtain stakeholder buy-in in Ethiopia, India, Nepal, South Africa and Uganda. This study describes the structure and facilitator’s experiences of ToC workshops. Methods The facilitators of the ToC workshops were interviewed and the interviews were recorded, transcribed and analysed together with process documentation from the workshops using a framework analysis approach. Results Thirteen workshops were held in the five PRIME countries at different levels of the health system. The ToC workshops achieved their stated goals with the contributions of different stakeholders. District health planners, mental health specialists, and researchers contributed the most to the development of the ToC while service providers provided detailed contextual information. Buy-in was achieved from all stakeholders but valued more from those in control of resources. Conclusions ToC workshops are a useful approach for developing ToCs as a basis for mental health care plans because they facilitate logical, evidence based and contextualised plans, while promoting stakeholder buy in. Because of the existing hierarchies within some health systems, strategies such as limiting the types of participants and stratifying the workshops can be used to ensure productive workshops. PMID:24808923

Mental workload in decision and control

NASA Technical Reports Server (NTRS)

Sheridan, T. B.

1979-01-01

This paper briefly reviews the problems of defining and measuring the 'mental workload' of aircraft pilots and other human operators of complex dynamic systems. Of the alternative approaches the author indicates a clear preference for the use of subjective scaling. Some recent experiments from MIT and elsewhere are described which utilize subjective mental workload scales in conjunction with human decision and control tasks in the laboratory. Finally a new three-dimensional mental workload rating scale, under current development for use by IFR aircraft pilots, is presented.

[Functional state of the visual analyzer in the conditions of the use of traditional and LED light sources].

PubMed

Kaptsov, V A; Sosunov, N N; Shishchenko, I I; Viktorov, V S; Tulushev, V N; Deynego, V N; Bukhareva, E A; Murashova, M A; Shishchenko, A A

2014-01-01

There was performed the experimental work on the study of the possibility of the application of LED lighting (LED light sources) in rail transport for traffic safety in related professions. Results of 4 series of studies involving 10 volunteers for the study and a comparative evaluation of the functional state of the visual analyzer, the general functional state and mental capacity under the performing the simulated operator activity in conditions of traditional light sources (incandescent, fluorescent lamp) and the new LED (LED lamp, LED panel) light sources have revealed changes in the negative direction. This was pronounced in a some decrease of functional stability to color discrimination between green and red cone signals, as well as an increase in response time in complex visual--motor response and significant reduction in readiness for emergency action of examinees.

Phobias of attachment-related inner states in the psychotherapy of adult survivors of childhood complex trauma.

PubMed

Liotti, Giovanni

2013-11-01

The clinical case described in this article illustrates the value of taking into account the dynamics of disorganized attachment in the assessment of attachment-related phobias (phobia of attachment and phobia of attachment loss) during the psychotherapy of chronically traumatized patients. These seemingly opposite phobias typically coexist in the same patient, appear as phobias of both inner states (affect phobias) and relational experiences, and are linked to dissociated representations of self-with-other. Theory and research on attachment disorganization provide a clinician-friendly conceptual framework for capturing both the intrapsychic (e.g., intrusive and nonintegrated mental states) and the relational (e.g., dramatic unsolvable dilemmas in interpersonal exchanges) aspects of the attachment-related phobias. The therapeutic strategy and the key interventions that logically follow from a case formulation based on this conceptual framework are examined. © 2013 Wiley Periodicals, Inc.

Situational analysis: preliminary regional review of the Mental Health Atlas 2014.

PubMed

Gater, R; Chew, Z; Saeed, K

2015-09-28

The WHO comprehensive Mental Health Action Plan 2013-2020 established goals and objectives that Member States have agreed to meet by 2020. To update the Atlas of Mental Health 2011, specific indicators from the Mental Health Action Plan and additional indicators on service coverage were incorporated into the questionnaire for the Atlas 2014. The data will help facilitate improvement in information gathering and focus efforts towards implementation of the Mental Health Action Plan. The questionnaire was completed by the national mental health focal point of each country. This preliminary review seeks to consolidate data from the initial response to the Atlas 2014 questionnaire by Member States in the Eastern Mediterranean Region. Data for this review were analysed for the whole Region, by health systems groupings and by individual countries. Where possible, data are compared with the Mental Health Atlas 2011 to give a longitudinal perspective.

Factors influencing korean international students' preferences for mental health professionals: a conjoint analysis.

PubMed

Lee, Eun-Jeong; Chan, Fong; Ditchman, Nicole; Feigon, Maia

2014-01-01

Asian students comprise over half of all international students in the United States, yet little is known about their help-seeking behaviors and preferences for mental health professionals. The purpose of this study was to use conjoint analysis to examine characteristics of mental health professionals influencing Korean international students' preferences when choosing a mental health professional. Korean international students from three universities in the United States were recruited on a volunteer basis to participate in this study (N = 114). Results indicated that mental health professional characteristics, including ethnicity, age, professional identity, and training institution, were significant factors in students' preference formation; however, gender of the mental health professional was not found to be a significant factor in the present study. Ethnic similarity was the most powerful predictor of preference formation. Implications for promoting help-seeking and mental health service utilization among Asian international students are discussed.

Current limitations into the application of virtual reality to mental health research.

PubMed

Huang, M P; Alessi, N E

1998-01-01

Virtual Reality (VR) environments have significant potential as a tool in mental health research, but are limited by technical factors and by mental health research factors. Technical difficulties include cost and complexity of virtual environment creation. Mental health research difficulties include current inadequacy of standards to specify needed details for virtual environment design. Technical difficulties are disappearing with technological advances, but the mental health research difficulties will take a concerted effort to overcome. Some of this effort will need to be directed at the formation of collaborative projects and standards for how such collaborations should proceed.

Policy reform dilemmas in promoting employment of persons with severe mental illness.

PubMed

Noble, J H

1998-06-01

Recent evaluations by the U.S. General Accounting Office and the National Alliance for the Mentally Ill of reemployment efforts of the federal-state vocational rehabilitation program found that services offered by state vocational rehabilitation agencies do not produce long-term earnings for clients with emotional or physical disabilities. This paper examines reasons for these poor outcomes and the implications of recent policy reform recommendations. Congress must decide whether to take action at the federal level to upgrade programs affecting persons with severe mental illnesses or to continue to rely on state decision making. The federal-state program largely wastes an estimated $490 million annually on time-limited services to consumers with mental illnesses. Rechanneled into a variety of innovative and more appropriate integrated services models, the money could buy stable annual vocational rehabilitation funding for 62,000 to 90,000 consumers with severe mental illnesses. Larger macrosystem problems involve the dynamics of the labor market that limit job opportunities and the powerful work disincentives for consumers with severe disabilities now inherent in Social Security Disability Insurance, Supplemental Security Income, Medicare, and Medicaid.

Rural Mental Health

MedlinePlus

... Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning Tools Testing New Approaches Rural Health IT ... Mental Health Professional Shortage in the United States reports that higher levels of unmet need for mental ...

Fee-for-Service Revenue for School Mental Health through a Partnership with an Outpatient Mental Health Center

ERIC Educational Resources Information Center

Lever, Nancy A.; Stephan, Sharon Hoover; Axelrod, Jennifer; Weist, Mark D.

2004-01-01

School mental health programs are increasingly prominent in the United States and in other countries, but funding remains tentative. This article describes a partnership between a school mental health program and an outpatient mental health center, and considers the larger goal of promoting sustainability and increasing revenue. Issues related to…

Prediction of Client Success with Vocational Rehabilitation in a State Mental Hospital

ERIC Educational Resources Information Center

Aiduk, Robert; Langmeyer, Daniel

1972-01-01

In the present study, biographical and demographic variables obtained from case files of a vocational rehabilitation agency at a state mental hospital were found not to be related individually to rehabilitation outcome. (Author)

Provision of mental healthcare for children and adolescents: a worldwide view.

PubMed

Rocha, Thiago Botter-Maio; Graeff-Martins, Ana Soledade; Kieling, Christian; Rohde, Luis Augusto

2015-07-01

There has been increased attention towards the burden imposed by mental disorders on children and adolescents. The present overview explores the current state of child and adolescent mental healthcare provision around the globe. Current research indicates a concerning gap in the provision of care for the child and adolescent population. The disparities between need, demand and access to youth mental healthcare are likely to be even greater in low and- middle-income countries (LAMIC), where the proportion of children and adolescents in the population is higher. The scarcity of available resources for youth mental healthcare, especially in LAMIC, represents a major obstacle to decreasing the impact of mental disorders across the lifespan. Our review highlights the discrepancy between demands and availability of mental healthcare for youth populations throughout the world. We describe some of the potential contributors to the current state of youth mental healthcare, such as problematic access to services, implementation deficiencies and inadequacy of policies. Recent innovative strategies to reduce these barriers are also presented.

"How Dark a World It Is … Where Mental Health Is Poorly Treated": Mental Illness Frames in Sermons Given After the Sandy Hook Shootings.

PubMed

Olufowote, James O; Matusitz, Jonathan

2016-12-01

In the aftermath of the Newtown, CT, massacre, the United States is engaging in public deliberations that will reshape future mental healthcare policies, practices, and systems. We know little about the clergy's contributions to these deliberations. Clergy, as with psychiatrists and mental health specialists, are members of the helping professions and are regarded as front-line mental health workers and gatekeepers to mental health services. To consider clergy contributions, we drew on Entman's framing perspective to study sermons given in the state of Connecticut after the Sandy Hook shootings. We examined 73 posted full-text sermons and performed the constant comparative method on 20 that made references to mental illness. We discovered clergy used "social support" and "social system" frames. Upon developing these frames, we discuss the study's contributions by considering clergy silence, their use of frames to delineate between the secular and the spiritual, their mitigation and promotion of mental illness stigma, and their incomplete social system frame.

Emotion Regulation and Mentalization in People at Risk for Food Addiction.

PubMed

Innamorati, Marco; Imperatori, Claudio; Harnic, Désirée; Erbuto, Denise; Patitucci, Eleonora; Janiri, Luigi; Lamis, Dorian A; Pompili, Maurizio; Tamburello, Stella; Fabbricatore, Mariantonietta

2017-01-01

Researchers investigated the association among food addiction, difficulties in emotion regulation, and mentalization deficits in a sample of 322 Italian adults from the general population. All participants were administered the Italian versions of the Yale Food Addiction Scale (I-YFAS), the Difficulties in Emotion Regulation Scale, the Mentalization Questionnaire, the Binge Eating Scale, and the Michigan Alcohol Screening Test. Of respondents, 7.1% reported high food-addiction symptoms (ie, 3 or more symptoms of food addiction on the I-YFAS). In bivariate analyses, high food-addiction symptoms were associated with more difficulties in emotion regulation and mentalization deficits. In the multivariate analysis, high food-addiction symptoms remained independently associated with mentalization deficits, but not with difficulties in emotion regulation. Our data suggest that mentalization may play an important role in food addiction by making it difficult for an individual to understand his or her own inner mental states as well as the mental states of others, especially when powerful emotions arise.

Trends In News Media Coverage Of Mental Illness In The United States: 1995–2014

PubMed Central

McGinty, Emma E.; Kennedy-Hendricks, Alene; Choksy, Seema; Barry, Colleen L.

2016-01-01

The United States is engaged in ongoing dialogue around mental illness. To assess trends in this national discourse, we studied the volume and content of a random sample of 400 news stories about mental illness from the period 1995–2014. Compared to news stories in the first decade of the study period, those in the second decade were more likely to mention mass shootings by people with mental illnesses. The most frequently mentioned topic across the study period was violence (55 percent overall) divided into categories of interpersonal violence or self-directed (suicide) violence, followed by stories about any type of treatment for mental illness (47 percent). Fewer news stories, only 14 percent, described successful treatment for or recovery from mental illness. The news media’s continued emphasis on interpersonal violence is highly disproportionate to actual rates of violence among those with mental illnesses. Research suggests that this focus may exacerbate social stigma and decrease support for public policies that benefit people with mental illnesses. PMID:27269031

Neural evidence that three dimensions organize mental state representation: Rationality, social impact, and valence

PubMed Central

Tamir, Diana I.; Thornton, Mark A.; Contreras, Juan Manuel; Mitchell, Jason P.

2016-01-01

How do people understand the minds of others? Existing psychological theories have suggested a number of dimensions that perceivers could use to make sense of others’ internal mental states. However, it remains unclear which of these dimensions, if any, the brain spontaneously uses when we think about others. The present study used multivoxel pattern analysis (MVPA) of neuroimaging data to identify the primary organizing principles of social cognition. We derived four unique dimensions of mental state representation from existing psychological theories and used functional magnetic resonance imaging to test whether these dimensions organize the neural encoding of others’ mental states. MVPA revealed that three such dimensions could predict neural patterns within the medial prefrontal and parietal cortices, temporoparietal junction, and anterior temporal lobes during social thought: rationality, social impact, and valence. These results suggest that these dimensions serve as organizing principles for our understanding of other people. PMID:26621704

Maternal Discussions of Mental States and Behaviors: Relations to Emotion Situation Knowledge in European American and Immigrant Chinese Children

PubMed Central

Doan, Stacey N.; Wang, Qi

2010-01-01

This study examined in a cross-cultural context mothers’ discussions of mental states and external behaviors in a story-telling task with their 3-year-old children and the relations of such discussions to children’s emotion situation knowledge (ESK). The participants were 71 European American and 60 Chinese immigrant mother-child pairs in the U.S. Mothers and children read a storybook together at home, and children’s ESK was assessed. Results showed that European American mothers made more references to thoughts and emotions during storytelling than did Chinese mothers, who commented more frequently on behaviors. Regardless of culture, mothers’ use of mental states language predicted children’s ESK, whereas their references to behaviors were negatively related to children’s ESK. Finally, mothers’ emphasis on mental states over behaviors partially mediated cultural effects on children’s ESK. PMID:20840236

Emotion, Cognition, and Mental State Representation in Amygdala and Prefrontal Cortex

PubMed Central

Salzman, C. Daniel; Fusi, Stefano

2011-01-01

Neuroscientists have often described cognition and emotion as separable processes implemented by different regions of the brain, such as the amygdala for emotion and the prefrontal cortex for cognition. In this framework, functional interactions between the amygdala and prefrontal cortex mediate emotional influences on cognitive processes such as decision-making, as well as the cognitive regulation of emotion. However, neurons in these structures often have entangled representations, whereby single neurons encode multiple cognitive and emotional variables. Here we review studies using anatomical, lesion, and neurophysiological approaches to investigate the representation and utilization of cognitive and emotional parameters. We propose that these mental state parameters are inextricably linked and represented in dynamic neural networks composed of interconnected prefrontal and limbic brain structures. Future theoretical and experimental work is required to understand how these mental state representations form and how shifts between mental states occur, a critical feature of adaptive cognitive and emotional behavior. PMID:20331363

Theory of mind and central coherence in adults with high-functioning autism or Asperger syndrome.

PubMed

Beaumont, Renae; Newcombe, Peter

2006-07-01

The study investigated theory of mind and central coherence abilities in adults with high-functioning autism (HFA) or Asperger syndrome (AS) using naturalistic tasks. Twenty adults with HFA/AS correctly answered significantly fewer theory of mind questions than 20 controls on a forced-choice response task. On a narrative task, there were no differences in the proportion of mental state words between the two groups, although the participants with HFA/AS were less inclined to provide explanations for characters' mental states. No between-group differences existed on the central coherence questions of the forced-choice response task, and the participants with HFA/AS included an equivalent proportion of explanations for non-mental state phenomena in their narratives as did controls. These results support the theory of mind deficit account of autism spectrum disorders, and suggest that difficulties in mental state attribution cannot be exclusively attributed to weak central coherence.

AIDS: Legal Tools Helpful for Mental Health Counseling Interventions.

ERIC Educational Resources Information Center

Friedman, Ann Lorentson; Hughes, Rosemary B.

1994-01-01

Complex HIV and AIDS related legal issues confronting mental health professionals are addressed, specifically: living will, statutes, durable power of attorney, durable power of attorney for health care, rational suicide, euthanasia, workplace discrimination, and laws affecting minors. (JBJ)

Preparing for Complexity and Wicked Problems through Transformational Learning Approaches

ERIC Educational Resources Information Center

Yukawa, Joyce

2015-01-01

As the information environment becomes increasingly complex and challenging, Library and Information Studies (LIS) education is called upon to nurture innovative leaders capable of managing complex situations and "wicked problems." While disciplinary expertise remains essential, higher levels of mental complexity and adaptive…

Relationship Among Body Image, Anthropometric Parameters and Mental Health in Physical Education Students

PubMed Central

Legey, Sandro; Lamego, Murilo Khede; Lattari, Eduardo; Campos, Carlos; Paes, Flávia; Sancassiani, Federica; Mura, Gioia; Carta, Mauro Giovanni; Rocha, Nuno Barbosa F.; Nardi, Antônio Egídio; José de Oliveira, Aldair; Neto, Geraldo Maranhão; Murillo-Rodriguez, Eric; Arias-Carrión, Oscar; Budde, Henning; Machado, Sergio

2016-01-01

Background The prevalence of body image dissatisfaction (BID) is currently high. Given that psychological well-being is associated with the body measurements imposed by esthetic standards, BID is an important risk factor for mental disorders. Objective Identify the prevalence of BID, and compare anthropometric and mental health parameters between individuals satisfied and dissatisfied with their body image. Method A total of 140 university students completed the silhouette scale to screen for BID. Anthropometric measures, body mass index (BMI), waist circumference (WC) and body fat percentage (BFP) were used. To investigate mental health, The State-Trait Anxiety Inventories (STAI-S and STAI-T), Profile of Mood States (POMS) scale and Quality of Life (QOL-36) questionnaire were used to investigate mental health. The Student’s t-test was applied to compare anthropometric and mental health parameters. Results 67.1% of university students exhibited BID. There was a significant difference (p = 0.041) in BF and WC (p = 0.048) between dissatisfied and satisfied individuals. With respect to mood states, significant differences were observed for anger (p = 0.014), depression (p = 0.011), hostility (p = 0.006), fatigue (p = 0.013), mental confusion (p = 0.021) and total mood disturbance (TMD) (p = 0.001). The mental aspect of QOL was significantly higher (p = 0.001) in satisfied university students compared to their dissatisfied counterparts. Conclusion BID was high and it seems to be influenced by anthropometric measures related to the amount and distribution of body fat. This dissatisfaction may have a negative effect on the quality of life and mood state of young adults. PMID:28217145

School Mental Health: The Impact of State and Local Capacity-Building Training

ERIC Educational Resources Information Center

Stephan, Sharon; Paternite, Carl; Grimm, Lindsey; Hurwitz, Laura

2014-01-01

Despite a growing number of collaborative partnerships between schools and community-based organizations to expand school mental health (SMH) service capacity in the United States, there have been relatively few systematic initiatives focused on key strategies for large-scale SMH capacity building with state and local education systems. Based on a…

Mental Health: Funds Needed for Future Planning Activities.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of Human Resources.

The United States General Accounting Office undertook an assessment of whether additional federal funds are needed to assist states, the District of Columbia, Puerto Rico, and the United States territories in completing the development of the comprehensive mental health services plans required by law. To assess need, officials at the Department of…

Intellectual Disabilities and Mental Health: United States-Based Research

ERIC Educational Resources Information Center

Charlot, Lauren; Beasley, Joan B.

2013-01-01

In the United States, research directed specifically at improving our understanding of the psychiatric assessment and treatment of individuals with intellectual disabilities (ID) has grown, yet lags far behind efforts for typically developing children and adults. In the United States, a lack of a national approach to the mental health problems of…

The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study

PubMed Central

2012-01-01

Background Evidence-based practices have not been routinely adopted in community mental health organizations despite the support of scientific evidence and in some cases even legislative or regulatory action. We examined the association of clinician attitudes toward evidence-based practice with organizational culture, climate, and other characteristics in a nationally representative sample of mental health organizations in the United States. Methods In-person, group-administered surveys were conducted with a sample of 1,112 mental health service providers in a nationwide sample of 100 mental health service institutions in 26 states in the United States. The study examines these associations with a two-level Hierarchical Linear Modeling (HLM) analysis of responses to the Evidence-Based Practice Attitude Scale (EBPAS) at the individual clinician level as a function of the Organizational Social Context (OSC) measure at the organizational level, controlling for other organization and clinician characteristics. Results We found that more proficient organizational cultures and more engaged and less stressful organizational climates were associated with positive clinician attitudes toward adopting evidence-based practice. Conclusions The findings suggest that organizational intervention strategies for improving the organizational social context of mental health services may contribute to the success of evidence-based practice dissemination and implementation efforts by influencing clinician attitudes. PMID:22726759

Suicidal Ideation and Mental Health of Bhutanese Refugees in the United States.

PubMed

Ao, Trong; Shetty, Sharmila; Sivilli, Teresa; Blanton, Curtis; Ellis, Heidi; Geltman, Paul L; Cochran, Jennifer; Taylor, Eboni; Lankau, Emily W; Lopes Cardozo, Barbara

2016-08-01

Refugee agencies noticed a high number of suicides among Bhutanese refugees resettled in the United States between 2009 and 2012. We aimed to estimate prevalence of mental health conditions and identify factors associated with suicidal ideation among Bhutanese refugees. We conducted a stratified random cross-sectional survey and collected information on demographics, mental health conditions, suicidal ideation, and post-migration difficulties. Bivariate logistic regressions were performed to identify factors associated with suicidal ideation. Prevalence of mental health conditions were: depression (21 %), symptoms of anxiety (19 %), post-traumatic stress disorder (4.5 %), and suicidal ideation (3 %), significant risk factors for suicidal ideation included: not being a provider of the family; perceiving low social support; and having symptoms of anxiety and depression. These findings suggest that Bhutanese refugees in the United States may have a higher burden of mental illness relative to the US population and may benefit from mental health screening and treatment. Refugee communities and service providers may benefit from additional suicide awareness training to identify those at highest risk.

Of Atkins and men: deviations from clinical definitions of mental retardation in death penalty cases.

PubMed

Blume, John H; Johnson, Sheri Lynn; Seeds, Christopher

2009-01-01

Under Atkins v. Virginia, the Eighth Amendment exempts from execution individuals who meet the clinical definitions of mental retardation set forth by the American Association on Intellectual and Developmental Disabilities and the American Psychiatric Association. Both define mental retardation as significantly subaverage intellectual functioning accompanied by significant limitations in adaptive functioning, originating before the age of 18. Since Atkins, most jurisdictions have adopted definitions of mental retardation that conform to those definitions. But some states, looking often to stereotypes of persons with mental retardation, apply exclusion criteria that deviate from and are more restrictive than the accepted scientific and clinical definitions. These state deviations have the effect of excluding from Atkins's reach some individuals who plainly fall within the class it protects. This article focuses on the cases of Roger Cherry, Jeffrey Williams, Michael Stallings, and others, who represent an ever-growing number of individuals inappropriately excluded from Atkins. Left unaddressed, the state deviations discussed herein permit what Atkins does not: the death-sentencing and execution of some capital defendants who have mental retardation.

UNITED STATES DENTAL PROFESSIONALS’ PERCEPTIONS OF DENTAL ANXIETY AND NEED FOR SEDATION IN PATIENTS WITH MENTAL ILLNESS

PubMed Central

Heaton, Lisa J.; Hyatt, Halee A.; Huggins, Kimberly Hanson; Milgrom, Peter

2012-01-01

Dental fear is a barrier to receiving dental care, particularly for those patients who also suffer from mental illnesses. The current study examined United States dental professionals’ perceptions of dental fear experienced by patients with mental illness, and frequency of sedation of patients with and without mental illness. Dentists and dental staff members (n = 187) completed a survey about their experiences in treating patients with mental illness. More participants agreed (79.8%) than disagreed (20.2%) that patients with mental illness have more anxiety regarding dental treatment (p < .001) than dental patients without mental illness. Further, significantly more participants reported mentally ill patients’ anxiety is “possibly” or “definitely” a barrier to both receiving (96.8%; p < .001) and providing (76.9%; p < .01) dental treatment. Despite reporting more fear in these patients, there were no significant differences in frequency of sedation procedures between those with and without mental illness, regardless of type of sedation (p’s > .05). This lack of difference in sedation for mentally ill patients suggests hesitancy on the part of dental providers to sedate patients with mental illness and highlights a lack of clinical guidelines for this population in the US. Suggestions are given for the assessment and clinical management of patients with mental illness. PMID:24876662

Decoding emotion of the other differs among schizophrenia patients and schizoaffective patients: A pilot study.

PubMed

Tadmor, Hagar; Levin, Maya; Dadon, Tzameret; Meiman, Meital E; Ajameeh, Alaa; Mazzawi, Hosam; Rigbi, Amihai; Kremer, Ilana; Golani, Idit; Shamir, Alon

2016-09-01

The deficit in ability to attribute mental states such as thoughts, beliefs, and intentions of another person is a key component in the functional impairment of social cognition in schizophrenia. In the current study, we compared the ability of persons with first episode schizophrenia (FE-SZ) and individuals with schizophrenia displaying symptomatic remission (SZ-CR) to decode the mental state of others with healthy individuals and schizoaffective patients. In addition, we analyzed the effect of dopamine-related genes polymorphism on the ability to decode the mental state of another, and searched for different genetic signatures. Our results show that overall, individuals with schizophrenia performed worse in the "Reading the Mind in the Eyes" (eyes) test, a simple well-defined task to infer the mental state of others than healthy individuals. Within the schizophrenia group, schizoaffective scored significantly higher than FE-SZ, SZ-CR, and healthy individuals. No difference was observed in performance between FE-SZ and SZ-CR subjects. Interestingly, FE-SZ and SZ-CR, but not schizoaffective individuals, performed worse in decoding negative and neutral emotional valance than the healthy control group. At the genetic level, we observed a significant effect of the DAT genotype, but not D4R genotype, on the eyes test performance. Our data suggest that understanding the mental state of another person is a trait marker of the illness, and might serve as an intermediate phenotype in the diagnostic process of schizophrenia disorders, and raise the possibility that DA-related DAT gene might have a role in decoding the mental state of another person.

Psychosis, Socioeconomic Disadvantage, and Health Service Use in South Australia: Findings from the Second Australian National Survey of Psychosis

PubMed Central

Sweeney, Shaun; Air, Tracy; Zannettino, Lana; Galletly, Cherrie

2015-01-01

The association between mental illness and poor physical health and socioeconomic outcomes has been well established. In the twenty-first century, the challenge of how mental illnesses, such as psychosis, are managed in the provision of public health services remains complex. Developing effective clinical mental health support and interventions for individuals requires a coordinated and robust mental health system supported by social as well as health policy that places a priority on addressing socioeconomic disadvantage in mental health cohorts. This paper, thus, examines the complex relationship between socioeconomic disadvantage, family/social supports, physical health, and health service utilization in a community sample of 402 participants diagnosed with psychosis. The paper utilizes quantitative data collected from the 2010 Survey of High Impact Psychosis research project conducted in a socioeconomically disadvantaged region of Adelaide, SA, Australia. Participants (42% female) provided information about socioeconomic status, education, employment, physical health, contact with family and friends, and health service utilization. The paper highlights that socioeconomic disadvantage is related to increased self-reported use of emergency departments, decreased use of general practitioners for mental health reasons, higher body mass index, less family contact, and less social support. In particular, the paper explores the multifaceted relationship between socioeconomic disadvantage and poor health confronting individuals with psychosis, highlighting the complex link between socioeconomic disadvantage and poor health. It emphasizes that mental health service usage for those with higher levels of socioeconomic disadvantage differs from those experiencing lower levels of socioeconomic disadvantage. The paper also stresses that the development of health policy and practice that seeks to redress the socioeconomic and health inequalities created by this disadvantage be an important focus for mental health services. Such health policy would provide accessible treatment programs and linked pathways to illness recovery and diminish the pressure on the delivery of health services. Consequently, the development of policy and practice that seeks to redress the socioeconomic and health inequalities created by disadvantage should be an important focus for the improvement of mental health services. PMID:26636059

Mental Retardation: Prevention Strategies That Work.

ERIC Educational Resources Information Center

President's Committee on Mental Retardation, Washington, DC.

The report by the President's Committee on Mental Retardation reviews the current state of knowledge in the area of biological and environmental prevention of mental retardation and describes programs on the frontiers of research or service delivery. Section I examines programs that are effectively preventing mental retardation through biomedical…

The genetics of mental illness: implications for practice.

PubMed Central

Hyman, S. E.

2000-01-01

Many of the comfortable and relatively simple models of the nature of mental disorders, their causes and their neural substrates now appear quite frayed. Gone is the idea that symptom clusters, course of illness, family history and treatment response would coalesce in a simple way to yield valid diagnoses. Also too simple was the concept, born of early pharmacological successes, that abnormal levels of one or more neurotransmitters would satisfactorily explain the pathogenesis of depression or schizophrenia. Gone is the notion that there is a single gene that causes any mental disorder or determines any behavioural variant. The concept of the causative gene has been replaced by that of genetic complexity, in which multiple genes act in concert with non-genetic factors to produce a risk of mental disorder. Discoveries in genetics and neuroscience can be expected to lead to better models that provide improved representation of the complexity of the brain and behaviour and the development of both. There are likely to be profound implications for clinical practice. The complex genetics of risk should reinvigorate research on the epidemiology and classification of mental disorders and explain the complex patterns of disease transmission within families. Knowledge of the timing of the expression of risk genes during brain development and of their function should not only contribute to an understanding of gene action and the pathophysiology of disease but should also help to direct the search for modifiable environmental risk factors that convert risk into illness. The function of risk genes can only become comprehensible in the context of advances at the molecular, cellular and systems levels in neuroscience and the behavioural sciences. Genetics should yield new therapies aimed not just at symptoms but also at pathogenic processes, thus permitting the targeting of specific therapies to individual patients. PMID:10885164

The Impact of Specific and Complex Trauma on the Mental Health of Homeless Youth.

PubMed

Wong, Carolyn F; Clark, Leslie F; Marlotte, Lauren

2016-03-01

This study investigates the relative impact of trauma experiences that occurred prior to and since becoming homeless on depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and self-injurious behaviors among a sample of homeless youth (N = 389). Youth (aged 13 to 25) who had been homeless or precariously housed in the past year completed a survey about housing history, experiences of violence and victimization, mental health, and service utilization. In addition to examining the impact associated with specific trauma types, we also considered the effect of "early-on" poly-victimization (i.e., cumulative number of reported traumas prior to homelessness) and the influence of a compound sexual trauma variable created to represent earlier complex trauma. This created-variable has values ranging from no reported trauma, single trauma, multiple non-sexual traumas, and multiple traumas that co-occurred with sexual abuse. Multivariate analyses revealed that specific traumatic experiences prior to homelessness, including sexual abuse, emotional abuse/neglect, and adverse home environment, predicted greater mental health symptoms. Poly-victimization did not add to the prediction of mental health symptoms after the inclusion of specific traumas. Results with early compound sexual trauma revealed significant differences between lower-order trauma exposures and multiple-trauma exposures. Specifically, experience of multiple traumas that co-occurred with sexual trauma was significantly more detrimental in predicting PTSD symptoms than multiple traumas of non-sexual nature. Findings support the utility of an alternate/novel conceptualization of complex trauma, and support the need to carefully evaluate complex traumatic experiences that occurred prior to homelessness, which can impact the design and implementation of mental health care and services for homeless youth. © The Author(s) 2014.

Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care

PubMed Central

Lake, James; Turner, Mason Spain

2017-01-01

Current treatments and the dominant model of mental health care do not adequately address the complex challenges of mental illness, which accounts for roughly one-third of adult disability globally. These circumstances call for radical change in the paradigm and practices of mental health care, including improving standards of clinician training, developing new research methods, and re-envisioning current models of mental health care delivery. Because of its dominant position in the US health care marketplace and its commitment to research and innovation, Kaiser Permanente (KP) is strategically positioned to make important contributions that will shape the future of mental health care nationally and globally. This article reviews challenges facing mental health care and proposes an agenda for developing a collaborative care model in primary care settings that incorporates conventional biomedical therapies and complementary and alternative medicine approaches. By moving beyond treatment delivery via telephone and secure video and providing earlier interventions through primary care clinics, KP is shifting the paradigm of mental health care to a collaborative care model focusing on prevention. Recommendations are to expand current practices to include integrative treatment strategies incorporating evidence-based biomedical and complementary and alternative medicine modalities that can be provided to patients using a collaborative care model. Recommendations also are made for an internal research program aimed at investigating the efficacy and cost-effectiveness of promising complementary and alternative medicine and integrative treatments addressing the complex needs of patients with severe psychiatric disorders, many of whom respond poorly to treatments available in KP mental health clinics. PMID:28898197

Automatically Characterizing Sensory-Motor Patterns Underlying Reach-to-Grasp Movements on a Physical Depth Inversion Illusion.

PubMed

Nguyen, Jillian; Majmudar, Ushma V; Ravaliya, Jay H; Papathomas, Thomas V; Torres, Elizabeth B

2015-01-01

Recently, movement variability has been of great interest to motor control physiologists as it constitutes a physical, quantifiable form of sensory feedback to aid in planning, updating, and executing complex actions. In marked contrast, the psychological and psychiatric arenas mainly rely on verbal descriptions and interpretations of behavior via observation. Consequently, a large gap exists between the body's manifestations of mental states and their descriptions, creating a disembodied approach in the psychological and neural sciences: contributions of the peripheral nervous system to central control, executive functions, and decision-making processes are poorly understood. How do we shift from a psychological, theorizing approach to characterize complex behaviors more objectively? We introduce a novel, objective, statistical framework, and visuomotor control paradigm to help characterize the stochastic signatures of minute fluctuations in overt movements during a visuomotor task. We also quantify a new class of covert movements that spontaneously occur without instruction. These are largely beneath awareness, but inevitably present in all behaviors. The inclusion of these motions in our analyses introduces a new paradigm in sensory-motor integration. As it turns out, these movements, often overlooked as motor noise, contain valuable information that contributes to the emergence of different kinesthetic percepts. We apply these new methods to help better understand perception-action loops. To investigate how perceptual inputs affect reach behavior, we use a depth inversion illusion (DII): the same physical stimulus produces two distinct depth percepts that are nearly orthogonal, enabling a robust comparison of competing percepts. We find that the moment-by-moment empirically estimated motor output variability can inform us of the participants' perceptual states, detecting physiologically relevant signals from the peripheral nervous system that reveal internal mental states evoked by the bi-stable illusion. Our work proposes a new statistical platform to objectively separate changes in visual perception by quantifying the unfolding of movement, emphasizing the importance of including in the motion analyses all overt and covert aspects of motor behavior.

Mitochondrial Dysfunction in Schizophrenia: Determination of Mitochondrial Respiratory Activity in a Two-Hit Mouse Model.

PubMed

Monpays, Cécile; Deslauriers, Jessica; Sarret, Philippe; Grignon, Sylvain

2016-08-01

Schizophrenia is a chronic mental illness in which mitochondrial dysfunction has been suggested. Our laboratory recently developed a juvenile murine two-hit model (THM) of schizophrenia based on the combination of gestational inflammation, followed by juvenile restraint stress. We previously reported that relevant behaviors and neurochemical disturbances, including oxidative stress, were reversed by the antioxidant lipoic acid (LA), thereby pointing to the central role played by oxidative abnormalities and prompting us to investigate mitochondrial function. Mitochondrial activity was determined with the MitoXpress® commercial kit in two schizophrenia-relevant regions (prefrontal cortex (PFC) and striatum). Measurements were performed in state 3, with substrates for complex I- and complex II-induced respiratory activity (IRA). We observed an increase in complex I IRA in the PFC and striatum in both sexes but an increase in complex II activity only in males. LA treatment prevented this increase only in complex II IRA in males. Expression levels of the different respiratory chain complexes, as well as fission/fusion proteins and protein carbonylation, were unchanged. In conclusion, our juvenile schizophrenia THM shows an increase in mitochondrial activity reversed by LA, specifically in complex II IRA in males. Further investigations are required to determine the mechanisms of these modifications.

Associations Between Motivation and Mental Health in Sport: A Test of the Hierarchical Model of Intrinsic and Extrinsic Motivation

PubMed Central

Sheehan, Rachel B.; Herring, Matthew P.; Campbell, Mark J.

2018-01-01

Motivation has been the subject of much research in the sport psychology literature, whereas athlete mental health has received limited attention. Motivational complexities in elite sport are somewhat reflected in the mental health literature, where there is evidence for both protective and risk factors for athletes. Notably, few studies have linked motivation to mental health. Therefore, the key objective of this study was to test four mental health outcomes in the motivational sequence posited by the Hierarchical Model of Intrinsic and Extrinsic Motivation: motivational climate → basic psychological needs → motivation → mental health outcomes. Elite team-sport athletes (140 females, 75 males) completed seven psychometric inventories of motivation-related and mental health variables. Overall, the athletes reported positive motivational patterns, with autonomous motivation and task climate being more prevalent than their less adaptive counterparts. Elevated depressive symptoms and poor sleep quality affected nearly half of the cohort. Structural equation modeling supported pathways between motivational climate, basic needs, motivation, and mood, depressive symptoms, sleep quality, and trait anxiety. Specifically, a task climate was positively associated with the three basic psychological needs, and an ego climate was positively associated with competence. Autonomy and relatedness had positive and negative associations with autonomous and controlled forms of motivation, respectively. Controlled motivation regulations were positively associated with the four mental health outcomes. Integrated regulation had a negative association with anxiety, and intrinsic regulation had a positive association with depressive symptoms. These findings highlight the complexities of and interrelations between motivation and mental health among athletes, and support the importance of considering mental health as an outcome of motivation. PMID:29867672

Associations Between Motivation and Mental Health in Sport: A Test of the Hierarchical Model of Intrinsic and Extrinsic Motivation.

PubMed

Sheehan, Rachel B; Herring, Matthew P; Campbell, Mark J

2018-01-01

Motivation has been the subject of much research in the sport psychology literature, whereas athlete mental health has received limited attention. Motivational complexities in elite sport are somewhat reflected in the mental health literature, where there is evidence for both protective and risk factors for athletes. Notably, few studies have linked motivation to mental health. Therefore, the key objective of this study was to test four mental health outcomes in the motivational sequence posited by the Hierarchical Model of Intrinsic and Extrinsic Motivation: motivational climate → basic psychological needs → motivation → mental health outcomes. Elite team-sport athletes (140 females, 75 males) completed seven psychometric inventories of motivation-related and mental health variables. Overall, the athletes reported positive motivational patterns, with autonomous motivation and task climate being more prevalent than their less adaptive counterparts. Elevated depressive symptoms and poor sleep quality affected nearly half of the cohort. Structural equation modeling supported pathways between motivational climate, basic needs, motivation, and mood, depressive symptoms, sleep quality, and trait anxiety. Specifically, a task climate was positively associated with the three basic psychological needs, and an ego climate was positively associated with competence. Autonomy and relatedness had positive and negative associations with autonomous and controlled forms of motivation, respectively. Controlled motivation regulations were positively associated with the four mental health outcomes. Integrated regulation had a negative association with anxiety, and intrinsic regulation had a positive association with depressive symptoms. These findings highlight the complexities of and interrelations between motivation and mental health among athletes, and support the importance of considering mental health as an outcome of motivation.

In This Issue: Opiates, Tobacco, Social Determinants of Health, Social Accountability for Non-Profit Hospitals, More on PCMH, and Clinical Topics.

PubMed

Bowman, Marjorie A; Victoria Neale, Anne; Seehusen, Dean A

2017-01-01

This issue contains several articles about the factors contributing to the complex and deadly interplay between social determinants of health, pain, mental illness, and addictive substances such as opioids and tobacco. One article clearly is a call to action: more than half of opioid prescriptions in the United States are given to patients with mental health problems. Two articles report work on the next steps for social determinants of health in health care settings. Social accountability based on community health needs assessments required of community hospitals should lead to the creation of more family medicine residency positions. Patient-centered medical home (PCMH) recognition can be costly. A new typology for PCMHs is proposed. Other topics include group advance care planning visits, the interaction of dental and primary care, free clinics, a fix for a squeaking wrist, adherence to latent tuberculosis treatment, and more. © Copyright 2017 by the American Board of Family Medicine.

Forward progress of scientific inquiry into the early father-child relationship: introduction to the special issue on very young children and their fathers.

PubMed

Bocknek, Erika L; Hossain, Ziarat; Roggman, Lori

2014-01-01

Research on fathering and the father-child relationship has made substantial progress in the most recent 15 years since the last special issue of the Infant Mental Health Journal on fathers and young children. This special issue on fathers and young children contains a series of papers exemplifying this progress, including advances in methodology-more direct assessment and more observational measures-in addition to the increasing dynamic complexity of the conceptual models used to study fathers, the diversity of fathers studied, and the growth of programs to support early father involvement. In assessing the current state of the field, special attention is given to contributions made by the papers contained in this special issue, and two critical areas for continued progress are addressed: (1) methodological and measurement development that specifically address fathers and fathering relationships and (2) cross-cultural and ecologically valid research examining the diversity of models of fathering. © 2014 Michigan Association for Infant Mental Health.

The sequential structure of brain activation predicts skill.

PubMed

Anderson, John R; Bothell, Daniel; Fincham, Jon M; Moon, Jungaa

2016-01-29

In an fMRI study, participants were trained to play a complex video game. They were scanned early and then again after substantial practice. While better players showed greater activation in one region (right dorsal striatum) their relative skill was better diagnosed by considering the sequential structure of whole brain activation. Using a cognitive model that played this game, we extracted a characterization of the mental states that are involved in playing a game and the statistical structure of the transitions among these states. There was a strong correspondence between this measure of sequential structure and the skill of different players. Using multi-voxel pattern analysis, it was possible to recognize, with relatively high accuracy, the cognitive states participants were in during particular scans. We used the sequential structure of these activation-recognized states to predict the skill of individual players. These findings indicate that important features about information-processing strategies can be identified from a model-based analysis of the sequential structure of brain activation. Copyright © 2015 Elsevier Ltd. All rights reserved.

The evaluative imaging of mental models - Visual representations of complexity

NASA Technical Reports Server (NTRS)

Dede, Christopher

1989-01-01

The paper deals with some design issues involved in building a system that could visually represent the semantic structures of training materials and their underlying mental models. In particular, hypermedia-based semantic networks that instantiate classification problem solving strategies are thought to be a useful formalism for such representations; the complexity of these web structures can be best managed through visual depictions. It is also noted that a useful approach to implement in these hypermedia models would be some metrics of conceptual distance.

What are specialist mental health clinician attitudes to guideline recommendations for the treatment of depression in young people?

PubMed

Hetrick, Sarah E; Simmons, Magenta; Thompson, Andrew; Parker, Alexandra G

2011-11-01

We sought to examine potential barriers to the use of evidence-based guidelines for youth depression in a tertiary specialist mental health service, as part of an initiative to implement evidence based practice within the service. This was a qualitative study adopting a social constructionist perspective using focus groups. The focus groups, conducted with all clinicians (medical and allied health), were audiotaped, transcribed and thematic analysis was undertaken. Clinicians were asked about the barriers to implementing four key recommendations from the National Institute for Health and Clinical Excellence (NICE) guidelines. Barriers existed at (i) the individual clinician level; (ii) the clinical level in terms of the presentation of young people; and (iii) the service level. The key individual clinician level barrier was a stated belief that the guidelines were not relevant to the young people presenting to the service, with little evidence to guide practice. Related, the main barrier with regard to the clinical presentation was the severity and complexity of this presentation, often making the delivery of interventions like cognitive behavioural therapy (CBT) difficult. At the service level, a lack of integration with primary and secondary level care meant sequencing interventions according to guideline recommendations was difficult. There is a clear imperative to develop the evidence base to ensure that effective treatments for young people aged up to 25 years with severe and complex disorders that include comorbid conditions, suicide risk and psychosocial difficulties are investigated and disseminated. Furthermore, this work has highlighted the need for greater investment in models of care that ensure integration between existing primary and secondary care and enhanced specialist early intervention mental health services for young people.

The Legal Framework for Care and Treatment of the Mentally Ill. Staff Brief 86-7.

ERIC Educational Resources Information Center

Russell, Pam

This report was prepared for the Wisconsin State Legislative Council's Special Committee on Mental Health Issues. It summarizes legal issues and procedures relating to the admission, commitment, and treatment of the mentally ill in Wisconsin. Part I sets forth legal definitions of certain key mental health terms, including mental illness as it is…

Proceedings of the Conference on Nutrition and Mental Retardation (Ann Arbor, Michigan, February 10-11, 1971).

ERIC Educational Resources Information Center

Springer, Ninfa Saturnino, Ed.

The conference, planned primarily for nutritionists and dieticians, dealt with the role of nutrition in the prevention and management of mental retardation. Proceedings include an overview of mental retardation, an examination of nutrition manpower needs in the fields of mental health and mental retardation on both the national and state levels,…

Effectiveness of Universal School-Based Mental Health Awareness Programs among Youth in the United States: A Systematic Review

ERIC Educational Resources Information Center

Salerno, John P.

2016-01-01

Background: Stigmatizing attitudes toward mental illness and low mental health literacy have been identified as links to social adversity, and barriers to seeking and adhering to treatment among adolescents suffering from mental illness. Prior research has found that it is possible to improve these outcomes using school-based mental health…

Empathy and aversion: the neural signature of mentalizing in Tourette syndrome.

PubMed

Eddy, C M; Cavanna, A E; Hansen, P C

2017-02-01

Previous studies suggest that adults with Tourette syndrome (TS) can respond unconventionally on tasks involving social cognition. We therefore hypothesized that these patients would exhibit different neural responses to healthy controls in response to emotionally salient expressions of human eyes. Twenty-five adults with TS and 25 matched healthy controls were scanned using fMRI during the standard version of the Reading the Mind in the Eyes Task which requires mental state judgements, and a novel comparison version requiring judgements about age. During prompted mental state recognition, greater activity was apparent in TS within left orbitofrontal cortex, posterior cingulate, right amygdala and right temporo-parietal junction (TPJ), while reduced activity was apparent in regions including left inferior parietal cortex. Age judgement elicited greater activity in TS within precuneus, medial prefrontal and temporal regions involved in mentalizing. The interaction between group and task revealed differential activity in areas including right inferior frontal gyrus. Task-related activity in the TPJ covaried with global ratings of the urge to tic. While recognizing mental states, adults with TS exhibit greater activity than controls in brain areas involved in the processing of negative emotion, in addition to reduced activity in regions associated with the attribution of agency. In addition, increased recruitment of areas involved in mental state reasoning is apparent in these patients when mentalizing is not a task requirement. Our findings highlight differential neural reactivity in response to emotive social cues in TS, which may interact with tic expression.

Attitudes toward mental illness in adults by mental illness-related factors and chronic disease status: 2007 and 2009 Behavioral Risk Factor Surveillance System.

PubMed

Kobau, Rosemarie; Zack, Matthew M

2013-11-01

We examined how attitudes toward mental illness treatment and its course differ by serious psychological distress, mental illness treatment, chronic disease, and sociodemographic factors using representative state-based data. Using data from jurisdictions supporting the Behavioral Risk Factor Surveillance System's Mental Illness and Stigma Module (35 states, the District of Columbia, and Puerto Rico), we compared adjusted proportions of adults agreeing that "Treatment can help people with mental illness lead normal lives" (treatment effectiveness) and that "People are generally caring and sympathetic to people with mental illness" (supportive environment), by demographic characteristics, serious psychological distress, chronic disease status, and mental illness treatment. Attitudes regarding treatment effectiveness and a supportive environment for people with mental illness varied within and between groups. Most adults receiving mental illness treatment agreed that treatment is effective. Fewer adults with serious psychological distress than those without such distress agreed that treatment is effective. Fewer of those receiving treatment, those with psychological distress, and those with chronic disease perceived the environment as supportive. These data can be used to target interventions for population subgroups with less favorable attitudes and for surveillance.

Pediatric and adolescent mental health emergencies in the emergency medical services system.

PubMed

Dolan, Margaret A; Fein, Joel A

2011-05-01

Emergency department (ED) health care professionals often care for patients with previously diagnosed psychiatric illnesses who are ill, injured, or having a behavioral crisis. In addition, ED personnel encounter children with psychiatric illnesses who may not present to the ED with overt mental health symptoms. Staff education and training regarding identification and management of pediatric mental health illness can help EDs overcome the perceived limitations of the setting that influence timely and comprehensive evaluation. In addition, ED physicians can inform and advocate for policy changes at local, state, and national levels that are needed to ensure comprehensive care of children with mental health illnesses. This report addresses the roles that the ED and ED health care professionals play in emergency mental health care of children and adolescents in the United States, which includes the stabilization and management of patients in mental health crisis, the discovery of mental illnesses and suicidal ideation in ED patients, and approaches to advocating for improved recognition and treatment of mental illnesses in children. The report also addresses special issues related to mental illness in the ED, such as minority populations, children with special health care needs, and children's mental health during and after disasters and trauma.

Affective mentalizing and brain activity at rest in the behavioral variant of frontotemporal dementia.

PubMed

Caminiti, Silvia P; Canessa, Nicola; Cerami, Chiara; Dodich, Alessandra; Crespi, Chiara; Iannaccone, Sandro; Marcone, Alessandra; Falini, Andrea; Cappa, Stefano F

2015-01-01

bvFTD patients display an impairment in the attribution of cognitive and affective states to others, reflecting GM atrophy in brain regions associated with social cognition, such as amygdala, superior temporal cortex and posterior insula. Distinctive patterns of abnormal brain functioning at rest have been reported in bvFTD, but their relationship with defective attribution of affective states has not been investigated. To investigate the relationship among resting-state brain activity, gray matter (GM) atrophy and the attribution of mental states in the behavioral variant of fronto-temporal degeneration (bvFTD). We compared 12 bvFTD patients with 30 age- and education-matched healthy controls on a) performance in a task requiring the attribution of affective vs. cognitive mental states; b) metrics of resting-state activity in known functional networks; and c) the relationship between task-performances and resting-state metrics. In addition, we assessed a connection between abnormal resting-state metrics and GM atrophy. Compared with controls, bvFTD patients showed a reduction of intra-network coherent activity in several components, as well as decreased strength of activation in networks related to attentional processing. Anomalous resting-state activity involved networks which also displayed a significant reduction of GM density. In patients, compared with controls, higher affective mentalizing performance correlated with stronger functional connectivity between medial prefrontal sectors of the default-mode and attentional/performance monitoring networks, as well as with increased coherent activity in components of the executive, sensorimotor and fronto-limbic networks. Some of the observed effects may reflect specific compensatory mechanisms for the atrophic changes involving regions in charge of affective mentalizing. The analysis of specific resting-state networks thus highlights an intermediate level of analysis between abnormal brain structure and impaired behavioral performance in bvFTD, reflecting both dysfunction and compensation mechanisms.

Investigation of Mentalizing and Visuospatial Perspective Taking for Self and Other in Asperger Syndrome

ERIC Educational Resources Information Center

David, Nicole; Aumann, Carolin; Bewernick, Bettina H.; Santos, Natacha S.; Lehnhardt, Fritz-G.; Vogeley, Kai

2010-01-01

Mentalizing refers to making inferences about other people's mental states, whereas visuospatial perspective taking refers to inferring other people's viewpoints. Both abilities seem vital for social functioning; yet, their exact relationship is unclear. We directly compared mentalizing and visuospatial perspective taking in nineteen adults with…

Mothers' use of cognitive state verbs in picture-book reading and the development of children's understanding of mind: a longitudinal study.

PubMed

Adrián, Juan E; Clemente, Rosa Ana; Villanueva, Lidón

2007-01-01

Mothers read stories to their children (N=41) aged between 3.3 years and 5.11 years old, and children then completed two false-belief tasks. One year later, mothers read a story to 37 of those children who were also given four tasks to assess their advanced understanding of mental states. Mothers' early use of cognitive verbs in picture-book reading correlated with their children's later understanding of mental states. Some pragmatic aspects of maternal input correlated with children's later outcomes. Two different factors in mothers' cognitive discourse were identified, suggesting a zone of proximal development in children's understanding of mental states.

Thinking about Seeing: perceptual sources of knowledge are encoded in the theory of mind brain regions of sighted and blind adults

PubMed Central

Koster-Hale, Jorie; Bedny, Marina; Saxe, Rebecca

2014-01-01

Blind people's inferences about how other people see provide a window into fundamental questions about the human capacity to think about one another's thoughts. By working with blind individuals, we can ask both what kinds of representations people form about others’ minds, and how much these representations depend on the observer having had similar mental states themselves. Thinking about others’ mental states depends on a specific group of brain regions, including the right temporo-parietal junction (RTPJ). We investigated the representations of others’ mental states in these brain regions, using multivoxel pattern analyses (MVPA). We found that, first, in the RTPJ of sighted adults, the pattern of neural response distinguished the source of the mental state (did the protagonist see or hear something?) but not the valence (did the protagonist feel good or bad?). Second, these neural representations were preserved in congenitally blind adults. These results suggest that the temporo-parietal junction contains explicit, abstract representations of features of others’ mental states, including the perceptual source. The persistence of these representations in congenitally blind adults, who have no first-person experience with sight, provides evidence that these representations emerge even in the absence of first-person perceptual experiences. PMID:24960530

Thinking about seeing: perceptual sources of knowledge are encoded in the theory of mind brain regions of sighted and blind adults.

PubMed

Koster-Hale, Jorie; Bedny, Marina; Saxe, Rebecca

2014-10-01

Blind people's inferences about how other people see provide a window into fundamental questions about the human capacity to think about one another's thoughts. By working with blind individuals, we can ask both what kinds of representations people form about others' minds, and how much these representations depend on the observer having had similar mental states themselves. Thinking about others' mental states depends on a specific group of brain regions, including the right temporo-parietal junction (RTPJ). We investigated the representations of others' mental states in these brain regions, using multivoxel pattern analyses (MVPA). We found that, first, in the RTPJ of sighted adults, the pattern of neural response distinguished the source of the mental state (did the protagonist see or hear something?) but not the valence (did the protagonist feel good or bad?). Second, these neural representations were preserved in congenitally blind adults. These results suggest that the temporo-parietal junction contains explicit, abstract representations of features of others' mental states, including the perceptual source. The persistence of these representations in congenitally blind adults, who have no first-person experience with sight, provides evidence that these representations emerge even in the absence of relevant first-person perceptual experiences. Copyright © 2014 Elsevier B.V. All rights reserved.

Neurophysiological basis of creativity in healthy elderly people: a multiscale entropy approach.

PubMed

Ueno, Kanji; Takahashi, Tetsuya; Takahashi, Koichi; Mizukami, Kimiko; Tanaka, Yuji; Wada, Yuji

2015-03-01

Creativity, which presumably involves various connections within and across different neural networks, reportedly underpins the mental well-being of older adults. Multiscale entropy (MSE) can characterize the complexity inherent in EEG dynamics with multiple temporal scales. It can therefore provide useful insight into neural networks. Given that background, we sought to clarify the neurophysiological bases of creativity in healthy elderly subjects by assessing EEG complexity with MSE, with emphasis on assessment of neural networks. We recorded resting state EEG of 20 healthy elderly subjects. MSE was calculated for each subject for continuous 20-s epochs. Their relevance to individual creativity was examined concurrently with intellectual function. Higher individual creativity was linked closely to increased EEG complexity across higher temporal scales, but no significant relation was found with intellectual function (IQ score). Considering the general "loss of complexity" theory of aging, our finding of increased EEG complexity in elderly people with heightened creativity supports the idea that creativity is associated with activated neural networks. Results reported here underscore the potential usefulness of MSE analysis for characterizing the neurophysiological bases of elderly people with heightened creativity. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.