Editor-in-Chief: John A. Talbott, MD
ISSN: 0022-3018
Online ISSN: 1539-736X
Frequency: 12 issues / year
Ranking: Psychiatry 51/120
Impact Factor: 1.812
Article Summaries
 

April 2015 Article Summaries

 

REVIEW ARTICLE

1. INSUFFICIENT DOLLARS AND QUALIFIED PERSONNEL TO MEET UNITED STATES MENTAL HEALTH NEEDS

Thomas P. Weil, PhD. 

The American populace currently supports the need for providing additional mental health services for: adolescents who express anger and mood instability; veterans or military personnel still on duty diagnosed with PTSD, depression, or combat-related disabilities; prisoners with substance abuse in need of medically-related rehabilitative services; and the senior citizens who experience dementia and depression. The problems outlined are too limited monies; effective therapies are often lacking; and a shortage of qualified mental health personnel except in upscale urban and suburban areas. These problems are so immense that even with enhanced prioritization, they are still not entirely solvable.

COMMENTARY

2. DESPAIR OR HOPE:  THE FUTURE OF MENTAL HEALTH SERVICE DELIVERY IN THE UNITED STATES

Steven Sharfstein, MD.

Weil paints a very grim picture for mental health care in the United States. He concludes “the overall evidence seems to be that most people in the U.S. with mental disorders remain either untreated or poorly treated, leaving the mental health system with less than a stellar reputation and, as a result, has difficulty in receiving additional funding.” Contrary to Dr. Weil, I believe there is hope at federal, state, and local levels in both the public and private sectors. The Affordable Care Act, as well as the Murphy bill, spurs the movement to integrate mental health services with general health services, particularly at the primary care level. With the expanded access, stigma is decreasing.

ORIGINAL ARTICLES

3. RELIGIOUS VERSUS CONVENTIONAL COGNITIVE-BEHAVIORAL THERAPY FOR MAJOR DEPRESSION IN PERSONS WITH CHRONIC MEDICAL ILLNESS: A PILOT RANDOMIZED TRIAL

Harold G. Koenig, MD, Michelle J. Pearce, PhD, Bruce Nelson, MA, Sally F. Shaw, PhD, Clive J. Robins, PhD, Noha S. Daher, DrPH, Harvey Jay Cohen, MD, Lee S. Berk, DrPH, Denise L. Bellinger, PhD, Kenneth I. Pargament, PhD, David H. Rosmarin, PhD, Sasan Vasegh, MD, Jean Kristeller, PhD, Nalini Juthani, MD, Douglas Nies, PhD, and Michael B. King, PhD.

We examine the efficacy of conventional CBT (CCBT) vs. religiously integrated CBT (RCBT) in persons with major depression and chronic medical illness. Participants were randomized to either CCBT (n=67) or RCBT (n=65). The intervention in both groups consisted of ten 50-minute sessions delivered remotely over 12 weeks. The intention-to-treat analysis at 12 weeks indicated no significant difference in outcome between the two groups. Response rates and remission rates were also similar.  These preliminary findings suggest that CCBT and RCBT are equivalent treatments for major depression in persons with chronic medical illness. Efficacy, as well as adherence, may be affected by client religiosity.

4. THE DSM-5 ALTERNATIVE MODEL OF PERSONALITY DISORDERS FROM THE PERSPECTIVE OF ADULT ATTACHMENT: A STUDY IN COMMUNITY DWELLING ADULTS

Andrea Fossati, PhD, Robert F. Krueger, PhD, Kristian E. Markon, PhD, Serena Borroni, PhD, Cesare Maffei, PhD, Antonella Somma, MSc.

480 Italian nonclinical adults were administered the Personality Inventory for DSM-5 (PID-5) and the Attachment Style Questionnaire (ASQ). In order to evaluate the uniqueness of the associations between the PID-5 scales and ASQ scales, participants were also administered the Big Five Inventory (BFI). Multiple regression analyses showed that the ASQ scales significantly predicted both PID-5 domain scales and BFI scales; however, the relationships were different both qualitatively and quantitatively. With the exception of PID-5 Risk Taking scale (adjusted R2value=.02), all other PID-5 trait scale were significantly predicted by the ASQ scales, median adjusted R2 value=.25, all ps<.001. Our findings suggest that the maladaptive personality domains and traits listed in the DSM-5 Alternative Model of Personality Disorders show meaningful associations with adult attachment styles.

5. STIGMATISING ATTITUDES AND BELIEFS TOWARDS BULIMIA NERVOSA: THE IMPORTANCE OF KNOWLEDGE AND EATING DISORDER SYMPTOMS

Rachel F. Rodgers, PhD, Susan J. Paxton, PhD, Siân A. McLean, Bsc, Robin Massey, BA,  Jonathan M. Mond, PhD,  Phillipa J. Hay, PhD, Bryan Rodgers, PhD. 

A community sample of 1,828 adults aged 18 to 70 completed a survey assessing stigmatising attitudes and beliefs towards bulimia nervosa, knowledge and familiarity with the disorder and levels of eating disorder symptoms. Knowledge of bulimia nervosa was negatively associated with 3 dimensions of stigmatisation, Personal Responsibility (ρ = -.28), Unreliability (ρ = -.19), and Advantages of Bulimia Nervosa (ρ = -.23). Familiarity revealed no association with stigmatisation. Both men and women with high levels of eating disorder symptoms perceived bulimia nervosa as less serious than participants with low levels of symptomatology. Increasing community knowledge about bulimia may help mitigate stigmatisation and perceived barriers to treatment.

6. THE COMPLEX ROLE OF PERSONALITY IN CANCER TREATMENT: IMPACT OF DEPENDENCY-DETACHMENT ON HEALTH STATUS, DISTRESS, AND PHYSICIAN-PATIENT RELATIONSHIP

John H. Porcerelli, PhD, ABPP, Robert F. Bornstein, PhD, Daniel Porcerelli, BS, V. Elayne Arterbery, MD, MHSA. 

Fifty adults undergoing radiation treatment for a variety of cancers completed measures of dependency and detachment, doctor-patient relationship, physical health, somatization, anxiety, and depression. Overdependence scores were positively and significantly correlated with patients' anxiety and negatively and significantly correlated with the physician-patient relationship. Detachment scores were positively and significantly correlated with pain, somatization, depression, and anxiety, and marginally associated with lower health related quality of life. These preliminary findings support the construct validity and clinical utility of trait dependency and detachment with oncology patients, and suggest that detachment is associated with poorer quality of life and higher psychological distress, while dependency is associated with poorer doctor-patient relationships following a cancer diagnosis.

7. SUICIDAL IDEATION AND SEX DIFFERENCES IN RELATION TO 18 MAJOR PSYCHIATRIC DISORDERS IN COLLEGE AND UNIVERSITY STUDENTS: ANONYMOUS WEB-BASED ASSESSMENT

Larry A. Tupler, PhD, Jennifer Y. Hong, BS, Ron Gibori, MBA, Timothy F.  Blitchington, BS, K. Ranga R. Krishnan, MBChB.

We report frequencies of 18 DSM-IV-TR disorders and suicidal ideation (SI) acquired anonymously from a website receiving 113,181 visits from over 1,500 predominantly USA colleges/universities. SI occurred in 47.1% of students, with women evidencing somewhat stronger findings than men, and was more associated with substance, bipolar, and panic disorders than depression. Self-reported emotional volatility exceeded thoughts of self-harm for all disorders.  Results support two subtypes of suicide risk: dysphoric premeditators and those primarily angry and/or impulsive.  Clinicians and researchers should therefore consider suicide as an independent psychopathological phenomenon that includes emotional volatility as a risk factor and thoroughly evaluate psychiatric disorders potentially conferring greater suicidal propensity than depression.

8. AN EXPLORATION OF REPORTED COGNITIONS DURING AN EARTHQUAKE AND ITS AFTERSHOCKS: DIFFERENCES ACROSS AFFECTED COMMUNITIES AND ASSOCIATIONS WITH PSYCHOLOGICAL DISTRESS

Lee Kannis-Dymand, PhD, PGDipClinPsych, Martin J. Dorahy, PhD, Rosemary Crake, MAppPsy (Clinical), BPsych, Peter Gibbon, PhD, Rhys Luckey, MSc, BSc.

Cognitive themes in two communities differentially affected by the September 2010 Christchurch Earthquake and aftershocks were investigated. Participants (N = 124) completed questions about their thoughts during the earthquake and aftershocks, and measures of acute stress, anxiety and depression. Cognitions were qualitatively analyzed into themes. The cognitive theme of worry and concern was the most frequently occurring for the earthquake and aftershocks across the whole sample and for the more affected suburb. Current threat was the most frequent theme for the earthquake in the less affected suburb, while worry and concern was most evident in this group for aftershocks. The superordinate theme of threat was significantly related to higher acute stress disorder scores in the more affected suburb for earthquake-reported cognitions.

9. CORRELATES OF COGNITIVE FLEXIBILITY IN VETERANS SEEKING TREATMENT FOR PTSD

Jessica Keith, PhD, Rodrigo Velezmoro, PhD, Carol O’Brien, PhD. 

This study examined the association between cognitive flexibility and variables that may be associated with treatment outcome for 579 Veterans seeking VA treatment for PTSD secondary to combat or sexual trauma. Factors associated with severity of PTSD (level of PTSD symptoms, guilt cognitions) and factors associated with PTSD prognosis (posttraumatic growth, optimistic expectations for the future) were examined. Regression analyses revealed that cognitive flexibility was associated with lower levels of PTSD symptoms and fewer guilt cognitions. Cognitive flexibility was positively associated with posttraumatic growth and optimistic expectations for the future.

10. PROGNOSIS AND PSYCHOSOCIAL OUTCOMES OF ATTEMPTED SUICIDE BY EARLY ADOLESCENCE: A 6- YEAR FOLLOW-UP OF SCHOOL STUDENTS INTO EARLY ADULTHOOD

Latha Nrugham, PhD, Are Holen, MD, PhD, Anne Mari Sund, MD, PhD.

Adulthood psychiatric and psychosocial outcomes of early adolescence suicidal acts were studied. A representative sample of school adolescents was followed up a year later with the same questionnaire (T2). High scorers of depression were matched with low- or-moderate scorers and interviewed using K-SADS-PL. They were reassessed after 5 years. Those who attempted suicide before the age 14 and repeated suicidal acts between ages 14 and 15 had worse prognostic profiles than incident cases between ages 14 to 15 years. Male attempters had better psychiatric prognosis than female attempters.  Attempters were more likely to have contacted child protection services, but not mental health services.

LETTERS

CORRECTING ERRORS IN TURKINGTON ET AL. (2014): TAKING CRITICISM SERIOUSLY
Tim Smits, PhD, Daniel Lakens, PhD, Stuart Ritchie, PhD, Keith Laws, PhD. 

COGNITIVE BEHAVIORAL TECHNIQUES FOR PSYCHOSIS: A BIOSTATISTICIAN’S PERSPECTIVE
Dom Cicchetti, PhD.

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Dr. Talbott and Lippincott Williams & Wilkins
wish to thank the
University of Maryland School of Medicine
Department of Psychiatry
for their support of
The Journal of Nervous and Mental Disease 

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