Browsing by Subject "Psychiatry"
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Item Open Access Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria(Global Mental Health, 2019) Kaiser, BN; Ticao, C; Anoje, C; Minto, J; Boglosa, J; Kohrt, BABackgroundThe Boko Haram insurgency has brought turmoil and instability to Nigeria, generating a large number of internally displaced people and adding to the country's 17.5 million orphans and vulnerable children. Recently, steps have been taken to improve the mental healthcare infrastructure in Nigeria, including revamping national policies and initiating training of primary care providers in mental healthcare. In order for these efforts to succeed, they require means for community-based detection and linkage to care. A major gap preventing such efforts is the shortage of culturally appropriate, valid screening tools for identifying emotional and behavioral disorders among adolescents. In particular, studies have not conducted simultaneous validation of screening tools in multiple languages, to support screening and detection efforts in linguistically diverse populations. We aim to culturally adapt screening tools for emotional and behavioral disorders for use among adolescents in Nigeria, in order to facilitate future validation studies.MethodsWe used a rigorous mixed-method process to culturally adapt the Depression Self Rating Scale, Child PTSD Symptom Scale, and Disruptive Behavior Disorders Rating Scale. We employed expert translations, focus group discussions (N = 24), and piloting with cognitive interviewing (N = 24) to achieve semantic, content, technical, and criterion equivalence of screening tool items.ResultsWe identified and adapted items that were conceptually difficult for adolescents to understand, conceptually non-equivalent across languages, considered unacceptable to discuss, or stigmatizing. Findings regarding problematic items largely align with existing literature regarding cross-cultural adaptation.ConclusionsCulturally adapting screening tools represents a vital first step toward improving community case detection.Item Open Access Allan McLane Hamilton.(The American journal of psychiatry, 2018-07) Davidson, JonathanItem Open Access Bayard Holmes (1852-1924) and Henry Cotton (1869-1933): Surgeon-psychiatrists and their tragic quest to cure schizophrenia.(Journal of medical biography, 2016-11) Davidson, JonathanEarly 20th-century medicine was dominated by the infectious theory of disease. Some leading physicians believed that infection or the accumulation of toxic substances from bacterial stasis caused a wide range of diseases, including schizophrenia. In the case of schizophrenia, one theory held that intestinal stasis lead to the bacterial production of toxins that affected brain function, resulting in psychotic illness. This theory predicted that clearing the stasis by drainage or by removal of the offending organ would be curative. Bayard Holmes and Henry Cotton, surgeon-psychiatrists, achieved notoriety for their efforts to cure schizophrenia surgically. Their endeavours were not only a failure but resulted in tragedy to their families and to a wider population. Treatment of their own sons also represented a violation of the ethics of their time. This account describes the life and career of Holmes and Cotton and reappraises their work in the light of recent developments.Item Open Access Correction: Progressive decline in hippocampal CA1 volume in individuals at ultra-high-risk for psychosis who do not remit: findings from the longitudinal youth at risk study.(Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2019-11) Ho, New Fei; Holt, Daphne J; Cheung, Mike; Iglesias, Juan Eugenio; Goh, Alex; Wang, Mingyuan; Lim, Joseph KW; de Souza, Joshua; Poh, Joann S; See, Yuen Mei; Adcock, R Alison; Wood, Stephen J; Chee, Michael WL; Lee, Jimmy; Zhou, JuanAn amendment to this paper has been published and can be accessed via a link at the top of the paper.Item Open Access Correlates of Parent-Child Physiological Synchrony and Emotional Parenting: Differential Associations in Varying Interactive Contexts(Journal of Child and Family Studies, 2019-04-01) Han, ZR; Gao, MM; Yan, J; Hu, X; Zhou, W; Li, X© 2019, The Author(s). Objectives: Parent-child synchrony during interaction might possess important features that underlie parenting processes throughout development. However, little is known regarding the association between parent-child physiological synchrony and emotional parenting behaviors during middle childhood. The main goal of the study was to examine whether emotional parenting was positively or negatively associated with parent-child physiological synchrony for school-age children. Methods: Adopting a biopsychosocial perspective, we incorporated the interbeat interval (IBI) and behavioral observation data of 150 parent-child dyads (child M age = 8.77, SD= 1.80) to explore the patterns of moment-to-moment dyadic physiological synchrony and to investigate whether these patterns were associated with two emotional parenting behaviors (psychological control and psychological unavailability). Results: Our findings provided some initial evidence that in low to moderately stressful situations that mimic daily parent-child interaction, parent-child physiological synchrony was indicative of different emotional parenting behaviors in various parent-child interactive situations. Specifically, in the collaborative context (parent-child working together to complete a task), parent-child physiological synchrony was indicative of less psychological unavailability, whereas in the competitive context (parent-child resolving disagreement with each other), parent-child physiological synchrony was indicative of less psychological control. The study implications and future research directions are discussed. Conclusions: Overall, our findings suggested that dyadic physiological synchrony, indexed by parent-child moment-to-moment matching of IBI, was associated with fewer negative emotional parenting behaviors.Item Open Access Corrigendum to "Concurrent use of methamphetamine, MDMA, LSD, ketamine, GHB, and flunitrazepam among American youths" [Drug and Alcohol Dependence 84 (1) (2006) 102-113] (DOI:10.1016/j.drugalcdep.2006.01.002)(Drug and Alcohol Dependence, 2007-01-12) Wu, LT; Schlenger, WE; Galvin, DMItem Open Access E-cigarette prevalence and correlates of use among adolescents versus adults: A review and comparison(Journal of Psychiatric Research, 2014) Carroll Chapman, SL; Wu, L-TPerceived safer than tobacco cigarettes, prevalence of electronic cigarette (e-cigarette) use is increasing. Analyses of cartridges suggest that e-cigarettes may pose health risks. In light of increased use and the potential for consequences, we searched Google Scholar and Pubmed in July of 2013 using keywords, such as e-cigarette and vaping, to compare differences and similarities in prevalence and correlates of e-cigarette use among adolescents (grades 6-12) versus adults (aged ≥18 years). Twenty-one studies focused on e-cigarette use. Ever-use increased among various age groups. In 2011, ever-use was highest among young adults (college students and those aged 20-28; 4.9%-7.0%), followed by adults (aged ≥18; 0.6%-6.2%), and adolescents (grades 6-12 and aged 11-19; <1%-3.3%). However, in 2012 adolescent ever-use increased to 6.8% and, among high school students, went as high as 10.0%. While the identified common correlate of e-cigarette use was a history of cigarette smoking, a notable proportion of adolescents and young adults who never smoked cigarettes had ever-used e-cigarettes. E-cigarette use was not consistently associated with attempting to quit tobacco among young adults. Adults most often reported e-cigarettes as a substitute for tobacco, although not always to quit. Reviewed studies showed a somewhat different pattern of e-cigarette use among young people (new e-cigarette users who had never used tobacco) versus adults (former or current tobacco users). Research is needed to better characterize prevalences, use correlates, and motives of use in different population groups, including how adolescent and young adult experimentation with e-cigarettes relates to other types of substance use behaviors. © 2014 Elsevier Ltd. All rights reserved.Item Unknown Engaging families to advance global mental health intervention research.(The lancet. Psychiatry, 2019-05) Hinton, Ladson; Kohrt, Brandon A; Kleinman, ArthurItem Unknown Global Mental Health: Five Areas for Value-Driven Training Innovation.(Acad Psychiatry, 2016-08) Kohrt, Brandon A; Marienfeld, Carla B; Panter-Brick, Catherine; Tsai, Alexander C; Wainberg, Milton LOBJECTIVE: In the field of global mental health, there is a need for identifying core values and competencies to guide training programs in professional practice as well as in academia. This paper presents the results of interdisciplinary discussions fostered during an annual meeting of the Society for the Study of Psychiatry and Culture to develop recommendations for value-driven innovation in global mental health training. METHODS: Participants (n = 48), who registered for a dedicated workshop on global mental health training advertised in conference proceedings, included both established faculty and current students engaged in learning, practice, and research. They proffered recommendations in five areas of training curriculum: values, competencies, training experiences, resources, and evaluation. RESULTS: Priority values included humility, ethical awareness of power differentials, collaborative action, and "deep accountability" when working in low-resource settings in low- and middle-income countries and high-income countries. Competencies included flexibility and tolerating ambiguity when working across diverse settings, the ability to systematically evaluate personal biases, historical and linguistic proficiency, and evaluation skills across a range of stakeholders. Training experiences included didactics, language training, self-awareness, and supervision in immersive activities related to professional or academic work. Resources included connections with diverse faculty such as social scientists and mentors in addition to medical practitioners, institutional commitment through protected time and funding, and sustainable collaborations with partners in low resource settings. Finally, evaluation skills built upon community-based participatory methods, 360-degree feedback from partners in low-resource settings, and observed structured clinical evaluations (OSCEs) with people of different cultural backgrounds. CONCLUSIONS: Global mental health training, as envisioned in this workshop, exemplifies an ethos of working through power differentials across clinical, professional, and social contexts in order to form longstanding collaborations. If incorporated into the ACGME/ABPN Psychiatry Milestone Project, such recommendations will improve training gained through international experiences as well as the everyday training of mental health professionals, global health practitioners, and social scientists.Item Unknown Identifying core curricular components for behavioral health training in internal medicine residency: Qualitative interviews with residents, faculty, and behavioral health clinicians.(International journal of psychiatry in medicine, 2019-05) Hemming, Patrick; Revels, Jessica A; Tran, Anh N; Greenblatt, Lawrence H; Steinhauser, Karen EObjective
Behavioral health services frequently delivered by primary care providers include care for mental health and substance abuse disorders and assistance with behavioral risk factor reduction. Internal medicine residencies in the United States lack formal expectations regarding training in behavioral health for residents. This qualitative study aimed to determine learners' and teachers' perceptions about appropriate behavioral health curricular components for internal medicine residents.Method
Focus groups and interviews were conducted with the following individuals from the Duke Outpatient Clinic: residents with continuity practice (n = 27), advanced practice providers (n = 2), internal medicine attending physicians (n = 4), internal medicine/psychiatry attending physicians (n = 2), and behavioral health clinicians (n = 4). A focus group leader asked regarding residents' successes and challenges in managing behavioral health issues and about specific learning components considered necessary to understand and manage these behavioral health conditions. Transcripts were coded using an editing analysis style to identify central themes and concordance/discordance between groups.Results
Regarding mental health management (Theme 1), residents emphasized a need for better care coordination with specialty mental health, while attendings and behavioral health clinicians gave priority to residents' skills in primary management of mental health. Residents, attendings, and behavioral health clinicians all emphasized advanced interviewing skills (Theme 2) with subthemes: eliciting the patient's perspective, managing time in encounters, improving patients' understanding, and patient counseling.Conclusions
Internal medicine residents, attendings, and behavioral health clinicians may differ significantly in their perceptions of primary care's role in mental health care. Future internal medicine behavioral health curricula should specifically address these attitudinal differences. Curricula should also emphasize interview skills training as an essential component of behavioral health learning.Item Unknown Key lessons learned from the INDIGO global network on mental health related stigma and discrimination.(World psychiatry : official journal of the World Psychiatric Association (WPA), 2019-06) Thornicroft, Graham; Bakolis, Ioannis; Evans-Lacko, Sara; Gronholm, Petra C; Henderson, Claire; Kohrt, Brandon A; Koschorke, Mirja; Milenova, Maria; Semrau, Maya; Votruba, Nicole; Sartorius, NormanItem Unknown Managing Stigma Effectively: What Social Psychology and Social Neuroscience Can Teach Us.(Acad Psychiatry, 2016-04) Griffith, James L; Kohrt, Brandon APsychiatric education is confronted with three barriers to managing stigma associated with mental health treatment. First, there are limited evidence-based practices for stigma reduction, and interventions to deal with stigma against mental health care providers are especially lacking. Second, there is a scarcity of training models for mental health professionals on how to reduce stigma in clinical services. Third, there is a lack of conceptual models for neuroscience approaches to stigma reduction, which are a requirement for high-tier competency in the ACGME Milestones for Psychiatry. The George Washington University (GWU) psychiatry residency program has developed an eight-week course on managing stigma that is based on social psychology and social neuroscience research. The course draws upon social neuroscience research demonstrating that stigma is a normal function of normal brains resulting from evolutionary processes in human group behavior. Based on these processes, stigma can be categorized according to different threats that include peril stigma, disruption stigma, empathy fatigue, moral stigma, and courtesy stigma. Grounded in social neuroscience mechanisms, residents are taught to develop interventions to manage stigma. Case examples illustrate application to common clinical challenges: (1) helping patients anticipate and manage stigma encountered in the family, community, or workplace; (2) ameliorating internalized stigma among patients; (3) conducting effective treatment from a stigmatized position due to prejudice from medical colleagues or patients' family members; and (4) facilitating patient treatment plans when stigma precludes engagement with mental health professionals. This curriculum addresses the need for educating trainees to manage stigma in clinical settings. Future studies are needed to evaluate changes in clinical practices and patient outcomes as a result of social neuroscience-based training on managing stigma.Item Unknown Patient and Health Care Professional Perspectives on Stigma in Integrated Behavioral Health: Barriers and Recommendations.(Annals of family medicine, 2023-02) Phelan, Sean M; Salinas, Manisha; Pankey, Tyson; Cummings, Gabrielle; Allen, Jay-Sheree P; Waniger, Anne; Miller, Nathaniel E; Lebow, Jocelyn; Dovidio, John F; van Ryn, Michelle; Doubeni, Chyke APurpose
Stigma related to mental health is well documented and a major barrier to using mental and physical health care. Integrated behavioral health (IBH) in primary care, in which behavioral/mental health care services are located within a primary care setting, may reduce the experience of stigma. The purpose of this study was to assess the opinions of patients and health care professionals about mental illness stigma as a barrier to engagement with IBH and to gain insight into strategies to reduce stigma, encourage discussion of mental health, and increase uptake of IBH care.Methods
We conducted semistructured interviews with 16 patients referred to IBH in a prior year and 15 health care professionals (12 primary care physicians and 3 psychologists). Interviews were transcribed and inductively coded separately by 2 coders for common themes and subthemes under the topic headings of barriers, facilitators, and recommendations.Results
We identified 10 converging themes from interviews with patients and the health care professionals, representing important complementary perspectives, with respect to barriers, facilitators, and recommendations. Barriers included professionals, families, and the public as sources of stigma, as well as self-stigma or avoidance, or internalizing negative stereotypes. Facilitators and recommendations included normalizing discussion of mental health and mental health care-seeking action, using patient-centered and empathetic communication strategies, sharing by health care professionals of their own experiences, and tailoring the discussion of mental health to patients' preferred understanding.Conclusions
Health care professionals can help reduce perceptions of stigma by having conversations with patients that normalize mental health discussion, use patient-centered communication, promote professional self-disclosure, and are tailored to patients' preferred understanding.Item Unknown Self-Regulation and Psychopathology: Toward an Integrative Translational Research Paradigm.(Annual review of clinical psychology, 2017-05) Strauman, Timothy JThis article presents a general framework in which different manifestations of psychopathology can be conceptualized as dysfunctions in one or more mechanisms of self-regulation, defined as the ongoing process of managing personal goal pursuit in the face of internal, interpersonal, and environmental forces that would derail it. The framework is based on the assertion that self-regulation is a critical locus for the proximal influence on motivation, cognition, emotion, and behavior of more distal factors such as genetics, temperament, socialization history, and neurophysiology. Psychological theories of self-regulation are ideal platforms from which to integrate the study of self-regulation both within and across traditional disciplines. This article has two related goals: to elucidate how the construct of self-regulation provides a unique conceptual platform for the study of psychopathology and to illustrate that platform by presenting our research on depression as an example.Item Unknown Suicide and substance use among female veterans: A need for research(Drug and Alcohol Dependence, 2013) Chapman, SLC; Wu, L-TBackground: The number of female veterans is increasing. Veterans Administration (VA) enrollment increased over 40% from past eras. However, little research has focused on their mental health. We reviewed literature to examine associations of substance use with suicide in female veterans, identify research gaps, and inform future studies. Methods: Google Scholar, Pub Med, and PsychINFO were searched using: substance use, female veteran, and suicide. Exclusion criteria (e.g., not discussing U.S. veterans) left 17 articles. Results: Nine studies examined completed suicide among veterans. In most recent years, rates of deaths were greater for veterans than nonveterans, including females. Completed suicide was associated with past trauma, young age, and a mental disorder. Studies have often not addressed substance use. Three studies examined completed suicide among VA treated veterans without examining substance use as an associated factor. Rates of completed suicides were also higher among veterans than nonveterans, including females. A large proportion of females also had a mental diagnosis. Five studies examined substance use and attempted or completed suicide among VA treated veterans. Veterans in poor mental health had increased odds of suicide mortality; women with a substance use disorder (SUD) had a higher hazard ratio for completed suicide than men with a SUD. Engagement in substance abuse treatment decreased odds of suicide attempt among veterans. Conclusion: Available data suggest that suicide rates are higher among female veterans than women in the general population. Substance use may increase the likelihood of suicidal behaviors among female veterans, particularly those with a mental diagnosis. © 2013 Elsevier Ireland Ltd. All rights reserved.Item Unknown The impact of the CONSORT statement on reporting of randomized clinical trials in psychiatry.(Contemporary clinical trials, 2009-03) Han, Changsu; Kwak, Kyung-phil; Marks, David M; Pae, Chi-Un; Wu, Li-Tzy; Bhatia, Kamal S; Masand, Prakash S; Patkar, Ashwin ATo determine whether the CONSORT recommendations influenced the quality of reporting of randomized controlled trials (RCTs) in the field of psychiatry, we evaluated the quality of clinical trial reports before and after the introduction of CONSORT statement. We selected seven high impact journals and retrieved the randomized, clinical trials in the field of psychiatry during the period of 1992-1996 (pre-CONSORT) and 2002-2007 (post-CONSORT). Among the total 5201 articles screened, 736 were identified and entered in our database. After critical review of the publications, 442 articles met the inclusion and exclusion criteria. The CONSORT Index (sum of 22 items of the checklist) during the post-CONSORT period was significantly higher than that during the pre-CONSORT period. However, over 40% of post-CONSORT studies did not adhere to CONSORT statement for reporting the process of randomization, and details of the process for obtaining informed consent were still insufficient. Furthermore, adherence to the CONSORT guidelines of reporting how blinding was accomplished and evaluated actually decreased after publication of the CONSORT statement. Although the overall quality of reporting on psychiatric RCTs generally improved after publication of the CONSORT statement, reporting the details of randomization, blinding, and obtaining informed consent remain insufficient.