Medicine and Health Sciences Commons^™

Socioeconomic-Status And Mental Health In A Personality Disorder Sample: The Importance Of Neighborhood Factors, Zach Walsh, M. Tracie Shea, Shirley Yen, Emily B. Ansell, Carlos M. Grilo, Thomas H. Mcglashan, Robert L. Stout, Donna S. Bender, Andrew E. Skodol, Charles A. Sanislow, Leslie C. Morey, John G. Gunderson

Charles A. Sanislow, Ph.D.

This cross-sectional study examined the associations between neighborhood-level socioeconomic-status (NSES), and psychosocial functioning and personality pathology among 335 adults drawn from the Collaborative Longitudinal Personality Disorders Study. Participants belonged to four personality disorder (PD) diagnostic groups: Avoidant, Borderline, Schizotypal, and Obsessive Compulsive. Global functioning, social adjustment, and PD symptoms were assessed following a minimum two-year period of residential stability. Residence in higher-risk neighborhoods was associated with more PD symptoms and lower levels of functioning and social adjustment. These relationships were consistent after controlling for individual-level socioeconomic-status and ethnicity; however, the positive association between neighborhood-level socio-economic risk and PD symptoms was …

The Concomitant Relationship Shared By Sleep Disturbances And Type 2 Diabetes: Developing Telemedicine As A Viable Treatment Option, Pennie S. Seibert, Jennifer Valerio, Codieann Dehaas

Pennie S. Seibert

Individually, sleep disturbances and type 2 diabetes pose pervasive challenges to health. In addition, the negative symptomology associated with each condition is exacerbated further when presenting concomitantly. This relationship formulates a destructive loop wherein those with diabetes experience decreased sleep quality, which, in turn, worsens a wide range of health threats experienced by those with diabetes, including obesity and glucose intolerance. Because major lifestyle changes and daily care are needed to effectively manage both diabetes and sleep disturbances, an efficient and timely modality of treatment is essential. Advanced technology incorporating telemedicine and telehealth has the potential to enhance treatment by …

The Impact Of Worksite Weight-Related Social Norms On Associated Behaviors, Stephenie C. Lemon, Qin Liu, Robert P. Magner, Kristin L. Schneider, Lori Pbert

Qin Liu

Objective: To assess the association between descriptive social norms for weight and weight-related behaviors and associated behaviors at the worksite. Design and Sample: Baseline data from site-randomized trial of a worksite ecological intervention for weight control; 12 public high schools in central Massachusetts; Sample of 844 employees enrolled (~ 2/3 of all employees). Conclusions: Associations of weight loss and eating social norms with behavior; Unique from social support; No association of physical activity social norms with physical activity; May be little opportunity for and therefore little exposure to physical activity during the workday; Results support the development of weight loss …

Core Competencies For Clinical Supervisors, David Kalman, Stephanie Rodrigues

Stephanie Rodrigues

This chapter provides useful strategies that will help guide clinical supervisors who oversee and support the work of MISSION-VET Case Managers and Peer Support Specialists. It includes an overview of the MISSION-VET supervisor’s role and a description of each team member’s primary area of responsibility within the MISSION-VET program. The remainder of the chapter describes key strategies that MISSION-VET supervisors will need in order to establish productive working relationships with MISSION Case Managers and Peer Support Specialists. These strategies, which are designed to foster a strong supervisory alliance and assure that services are being delivered with fidelity to the MISSION-VET …

Extending The Revelation Effect To Faces: Haven’T We Met Before?, Brian H. Bornstein, Jeffrey R. Wilson

Jeffrey L. Wilson

The revelation effect is an episodic memory phenomenon where participants are more likely to report that they recognized an item when it is judged after an interpolated task than when it is not. Although this effect is very robust, nearly all of the extant research has used verbal or readily verbalizable stimuli. The present two experiments examined whether a revelation effect could be produced with non-verbal stimuli such as faces. A revelation effect was found in both experiments, for both targets and lures, using faces as stimuli. The findings are integrated into the prevailing empirical frameworks for the revelation effect …

Methodological Considerations In Pretrial Publicity Research: Is The Medium The Message?, Jeffrey R. Wilson, Brian H. Bornstein

Jeffrey L. Wilson

Two methodological issues within the pretrial publicity (PTP) literature were examined in the present experiment: the effect of emotional versus factual PTP and the effect of presenting PTP through different media. Emotional and factual PTP were constructed that differed in level of emotionality, but produced the same degree of bias. The PTP was presented in either a videotaped or written format. Although there was a significantly biasing effect of PTP overall compared to a control condition, no significant difference was found either between factual and emotional PTP or between video and written PTP.

Progressive Levels Of Physical Dependence To Tobacco Coincide With Changes In The Anterior Cingulum Bundle Microstructure, Wei Huang, Joseph R. Difranza, David N. Kennedy, Nanyin Zhang, Douglas M. Ziedonis, W. W. Sanouri A. Ursprung, Jean A. King

Douglas M. Ziedonis

BACKGROUND: The tobacco withdrawal syndrome indicates the development of neurophysiologic dependence. Clinical evidence indicates that neurophysiologic dependence develops through a set sequence of symptom presentation that can be assessed with a new 3-item survey measure of wanting, craving, and needing tobacco, the Level of Physical Dependence (PD). This study sought to determine if advancing neurophysiologic dependence as measured by the Level of PD correlates with characteristics of white matter structure measured by Fractional Anisotropy (FA).

METHODS: Diffusion-MRI based FA and diffusion tensor imaging probabilistic tractography were used to evaluate 11 smokers and 10 nonsmokers. FA was also examined in relation …

Outcomes Of Peginterferon Alfa-2a And Ribavirin Combination Therapy In A Resident-Initiated, Multidisciplinary, Hepatitis C Clinic, Nicole M. Agostino Do, Erini Vasiliadis Do, K Nadeem Ahmed Md, Suzanne J. Templer Do, Edward R. Norris Md, Fapa, Fapm, Charles M. Brooks Md, Eric J. Gertner Md, Mph, Joseph L. Yozviak Do, Facp

Edward R Norris MD, FAPA, FAPM

No abstract provided.

Growing Organizational Capacity To Facilitate The Streamlining Of Patients With Psychiatric Disorders In A Community Academic Health Network; An Eight Year Review, Edward R. Norris Md, Fapa, Fapm, Michael W. Kaufmann Md, David B. Burmeister Do, Muhamad Aly Rifai Md, Laurence P. Karper Md, Ralph A. Primelo Md

Edward R Norris MD, FAPA, FAPM

No abstract provided.

Using Portable Computers To Increase The Efficiency Of Evaluating Psychiatric Emergencies – A Pilot Program, Anthony Buchman Lcsw, Edward R. Norris Md, Fapa, Fapm, Rosanne Teders Lcsw, Michael Kaufmann Md

Edward R Norris MD, FAPA, FAPM

No abstract provided.

The Impact Of A Mental Health-Related Diagnosis On Readmission Rates For Heart Failure, Ronald S. Freudenberger Md, Carol A. Foltz Phd, Lou Lukas Md, Donna F. Petruccelli Crnp, Hannah D. Paxton Rn, Mph, Victoria Sabella Bsn

Ronald S Freudenberger MD

No abstract provided.

Resolving Instructor Challenges In The Online Classroom, Patt R. Elison-Bowers, Kimberly Henderson, Jaime Sand, Linda Osgood

Jaime Sand

The rapid growth of online education has led to expanded opportunities for students while introducing instructors to new teaching challenges inherent to virtual learning environments. The practical responsibilities, once confined to the traditional classroom, such as handling student records, class size, teaching assistants, and instructional material now require a new mind set as well as sufficient technical knowledge. The online instructor faces additional opportunities and challenges once the class is online and students have enrolled. How to merge the best of the traditional classroom including teaching and practical responsibilities with the best of an online teaching opportunity become paramount to …

Strategies For Managing Large Online Classes, Patt Elison-Bowers, Jaime Sand, M. Rose Barlow, Thomas J. Wing

Jaime Sand

Online classroom instruction is an exciting technology and continues to draw the attention of students, instructors and administrators working or studying in educational settings. Large numbers of faculty are currently involved in teaching online or hybrid courses within their educational institutions. At the present time, "very large" online classes are usually defined as 150 students and above. Many instructors are now experimenting with making online learning options available to even larger audiences and online class sizes are increasing rapidly. This paper presents guidelines for managing large online courses. Among key elements important in meeting the needs of the distant learner …

Welcome To The Journal Of Evolution And Health, Aaron Blaisdell, Paul Jaminet, David C. Pendergrass

Aaron P Blaisdell

Welcome to the first issue of the Journal of Evolution and Health! The Journal of Evolution and Health is the peer-reviewed, open-access journal of the Ancestral Health Society, a community of scientists, healthcare professionals, and laypersons who collaborate to understand health challenges from an evolutionary perspective.

Benefits And Constraints Of Telepsychiatry Utilization In The United States, Bruce A. Stec, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

This conference presentation describes the benefits and constraints of utilizing telemedicine primarily focusing on the field of psychiatry in the United States with the current system of healthcare. The utilization of telemedicine in the field of psychiatry is believed to provide better access, quality and care to the patients who necessitate psychiatric care in their overall medical care. Telemedicine has been a successfully integrated program into psychiatric facilities reaching rural, prisons or city facilities based on that it has increased the volume of patients in which physicians can reach out to and diagnose, as well as treat patients with limitations …

Convergent And Incremental Predictive Validity Of Clinician, Self-Report, And Structured Interview Diagnoses For Personality Disorders Over 5 Years, Douglas B. Samuel, Charles A. Sanislow, Christopher J. Hopwood, M. Tracie Shea, Andrew E. Skodol, Leslie C. Morey, Emily B. Ansell, John C. Markowitz, Mary C. Zanarini, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

OBJECTIVE: Research has demonstrated poor agreement between clinician-assigned personality disorder (PD) diagnoses and those generated by self-report questionnaires and semistructured diagnostic interviews. No research has compared prospectively the predictive validity of these methods. We investigated the convergence of these 3 diagnostic methods and tested their relative and incremental validity in predicting independent, multimethod assessments of psychosocial functioning performed prospectively over 5 years.

METHOD: Participants were 320 patients in the Collaborative Longitudinal Personality Disorders Study diagnosed with PDs by therapist, self-report, and semistructured interview at baseline. We examined the relative incremental validity of therapists' naturalistic ratings relative to these other diagnostic …

Does Practice Make Perfect? A Randomized Control Trial Of Behavioral Rehearsal On Suicide Prevention Gatekeeper Skills, Wendi F. Cross, David Seaburn, Danette Gibbs, Karen Schmeelk-Cone, Ann Marie White, Eric D. Caine

Danette Gibbs

Suicide is the third leading cause of death among 10-24-year-olds and the target of school-based prevention efforts. Gatekeeper training, a broadly disseminated prevention strategy, has been found to enhance participant knowledge and attitudes about intervening with distressed youth. Although the goal of training is the development of gatekeeper skills to intervene with at-risk youth, the impact on skills and use of training is less known. Brief gatekeeper training programs are largely educational and do not employ active learning strategies such as behavioral rehearsal through role play practice to assist skill development. In this study, we compare gatekeeper training as usual …

Depression In Parkinson Disease, Kevin J. Black

Kevin J. Black, MD

Dissemination Of Evidence-Based Atypical Antipsychotic Information To Nursing Homes, Celeste A. Lemay, Jennifer Tjia, Kathleen M. Mazor, Terry S. Field, Abir O. Kanaan, Jennifer L. Donovan, Jerry H. Gurwitz

Jennifer Tjia

Background: Accumulating evidence demonstrates minimal benefit and increased risk of off-label use of atypical antipsychotic medications for dementia-related behaviors. Optimal strategy for disseminating evidence-based guides to nursing home (NH) stakeholders is unclear. Our objective is to describe the impact of differing dissemination efforts in Connecticut NHs.

Methods: Forty-three Connecticut NHs were randomized to one of 3 arms receiving incrementally intensive dissemination strategies of the Agency for Healthcare Research and Quality Comparative Effectiveness Review Summary Guide on the off-label use of atypical antipsychotic drugs, which was included in a toolkit informed by a needs assessment of NHs. All NHs received the …

Understanding Antipsychotic Drug Use In The Nursing Home Setting, Celeste A. Lemay, Alice F. Bonner, Christina Compher, Terry S. Field, Jonathan Freedlander, Susan Joslin, Kathleen M. Mazor, Jennifer Tjia, Jerry H. Gurwitz

Jennifer Tjia

Introduction: The increasing prevalence of antipsychotic medication use in residents of nursing homes (NH) in the absence of psychiatric diagnoses is concerning. To address these concerns, it is essential to explore how these medications are being prescribed and managed in the NH setting. Our objectives were to understand the decision-making process that influences prescribing and factors that trigger administration of antipsychotic medications to residents with dementia in NHs and to explore why residents remain on antipsychotic medications over an extended period of time.

Methods: Interviews with prescribers, caregivers, and family members, on-site observations in study facilities, and review of NH …

Statin Discontinuation Among Nursing Home Residents With Advanced Dementia, Jennifer Tjia, Sarah L. Cutrona, Daniel J. Peterson, Becky A. Briesacher

Jennifer Tjia

Background: Statin use in elderly individuals with life-limiting illness such as advanced dementia is controversial.

Objective: To describe factors associated with statin discontinuation and estimate impact of discontinuation on 28-day hospitalizations in nursing home (NH) residents with advanced dementia.

Methods: Retrospective cohort study of NH residents ≥ 65 years with recent progression to advanced dementia from 5 large U.S. states drawn from the 2007-2008 Minimum Data Set 2.0. We identified residents using statins. Clinical characteristics and 28-day hospitalization risk were compared for residents discontinuing and continuing statins. Multivariable Cox proportional hazard models identified factors associated with time to statin discontinuation …

Barriers And Facilitators To Addressing Perinatal Depression In Obstetric Settings, Nancy Byatt, Kathleen Biebel, Liz Friedman, Gifty Debordes-Jackson, Jeroan J. Allison, Douglas M. Ziedonis

Kathleen Biebel

Background: Perinatal depression is common and can cause suffering for mother, fetus/child and family. The perinatal period is an ideal time to detect and treat depression due to regular contact between mothers and health professionals. Despite the opportune time and setting, depression is under-diagnosed and under-treated in the obstetric setting. Caring and committed providers are frustrated and confused, and mothers do not feel heard or understood by their providers.

Objectives: (1) Identify postpartum women’s perspective on how perinatal depression is addressed in obstetric settings; (2) Identify strategies for improvement of the delivery of depression care in OB/Gyn settings; and, (3) …

Hcv Behavioral Health Preparation Of The Racial/Ethnic Minority: Measurement Development Of A Hcv Treatment Readiness Tool In Spanish And English, Michele Vella, Joseph L. Yozviak Do, Facp, Judith Lash Rn

Joseph L Yozviak DO, FACP

No abstract provided.

Outcomes Of Peginterferon Alfa-2a And Ribavirin Combination Therapy In A Resident-Initiated, Multidisciplinary, Hepatitis C Clinic, Nicole M. Agostino Do, Erini Vasiliadis Do, K Nadeem Ahmed Md, Suzanne J. Templer Do, Edward R. Norris Md, Fapa, Fapm, Charles M. Brooks Md, Eric J. Gertner Md, Mph, Joseph L. Yozviak Do, Facp

Joseph L Yozviak DO, FACP

No abstract provided.

Cognitive, Affective And Social Processes Involved In Help-Negation After Critical Suicidal Thoughts, Coralie Wilson

Coralie J Wilson

Help-negation is defined as the process of help withdrawal or avoidance found among those currently experiencing clinical and subclinical levels of different forms of psychological distress, including low and critical levels of suicidal ideation (Wilson, Bushnell, Caputi, 2011). Understanding the determinants of help-negation in suicidal samples that have not yet come to treatment provides a potent opportunity to target prevention and early intervention strategies to facilitate appropriate and timely help-seeking. Over 20 help-negation studies have ruled out variables that might explain the withdrawal process associated with suicidal thoughts. These results now point to biological and neurological underpinnings working together with …

Preventing Help-Negation For Suicidal Ideation: Implications For Social Network Size And Frequency Of Social Interaction, Coralie J. Wilson

Coralie J Wilson

Help-negation is seen when the severity of an individual’s suicidal ideation increases and they become less likely to seek help as a result of their condition. Research has implicated distorted affect regulation and perceptual processes related to social support in the development of help-negation among suicidal individuals (Wilson et al., 2013). Future research needs to focus on psycho-social factors that can be linked to neurological processes that differentiate suicidal individuals from controls and are directly implicated in the help-negation processes associated with suicidal ideation. As suicidal individuals have interpersonal needs rejected they may cease to seek or accept help. The …

Help-Negation Among Telephone Crisis Support Workers: Impact On Personal Wellbeing And Worker Performance, Coralie J. Wilson

Coralie J Wilson

Telephone crisis supporters (TCSs) provide front line mental health support to callers in crisis. TCSs often support callers with suicidal thoughts, depression and anxiety, and the caller’s experience of the call will influence whether they will seek help from a crisis support service in the future. Despite their important role, little information on TCSs’ mental health and help-seeking behaviour exists – a structured literature search returned only 2 studies. This paper presents the results of the first study in a national research program that is aiming to inform the future training, preparation, supervision, and support of frontline health professionals who …

The Collaboration Particle; Applying The Formalism Of Quantum Theory To Cognition., Kelsey E. Landis, Hontas F. Farmer

Hontas F Farmer

We propose that collaboration between two people can be thought of as a quantum cognitive process wherein the relevant reality to be comprehended is an idea being communicated from one person to the other. Through a combination of writing center pedagogy and quantum theory, supported by mathematical evidence, we assert that collaboration can be effectively and equally established in both face-to-face and online writing tutoring sessions through conscious, active meditation to harness what can be thought of as a particle. Included is an analysis of writing center scholarship to show how collaboration is traditionally considered in a writing center context, …

Dsm V: Hope Or Hype?, Amresh Srivastava

Amresh Srivastava

DSM V: HOPE OR HYPE?

Amresh Shrivastava,

MD,MPM,MRCPsych,FRCPC

Associate professor of Psychiatry

Western University

London, Ontario

Since more than 50 years psychiatric diagnostic is being developed by a number of organisations. As research has advanced in understanding mental illnesses,need for a common language has been felt in order to provide best possible care to our patients.

The process of psychiatric diagnosis has evolved significantly. WHO as well APA both have made significant advances in developing diagnostic systems. DSM 5 recently approved by board of trustees by Americal psychiatric Association is scheduled to be released on 18th of May. This document …

Individuals With Single Versus Multiple Suicide Attempts Over 10 Years Of Prospective Follow-Up, Christina L. Boisseaua, Shirley Yen, John C. Markowitz, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Mary C. Zanarini, Andrew E. Skodol, John G. Gunderson, Leslie C. Morey, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Background: The study attempted to identify characteristics that differentiate multiple suicide attempters from single attempters in individuals with personality disorders (PDs) and/or major depression.

Method: Participants were 431 participants enrolled in the Collaborative Longitudinal Study of Personality Disorders from July 1996 to June 2008. Suicide attempts were assessed with the Longitudinal Interval Follow-up Evaluation at 6 and 12months, then yearly through 10years. Logistic regression was used to compare single attempters to multiple attempters on Axis I and II psychiatric disorders and personality trait variables.

Results: Twenty-one percent of participants attempted suicide during the 10years of observation, with 39 (9.0%) reporting …