Psychiatry Commons^™

Developing And Testing An Intervention To Prevent Homelessness Among Individuals Discharged From Psychiatric Wards To Shelters And ‘No Fixed Address’, Cheryl Forchuk, S. Macclure, M. Van Beers, C. Smith, Rick Csiernik, J. Hoch, E. Jensen

Rick Csiernik

Shelter data in a recent study revealed discharges from psychiatric facilities to shelters or the street occurred at least 194 times in 2002 in London, Ontario, Canada. This problem must be addressed to reduce the disastrous effects of such discharge, including re-hospitalization and prolonged homelessness. An intervention was developed and tested to prevent homelessness associated with discharge directly to no fixed address. A total of 14 participants at-risk of being discharged without housing were enrolled, with half randomized into the intervention group. The intervention group was provided with immediate assistance in accessing housing and assistance in paying their first and …

Do Antipsychotic Dose Reduction Trials Result In Worsening Behavior Among Nursing Home Residents With Dementia: A Systematic Review Of The Literature, Jennifer Tjia, Abir O. Kanaan, Jennifer L. Donovan

Jennifer Tjia

Background: While federal regulations require gradual dose reduction trials of antipsychotics prescribed for behavior management in nursing home (NH) residents with dementia, widespread concern about precipitating behavioral disturbances limits implementation. We conducted a systematic review of clinical trials reducing antipsychotic drug use in NH residents to determine best dose reduction practices and risk of behavior escalation.

Methods: A comprehensive literature search was conducted in MEDLINE, EMBASE, and International Pharmaceutical Abstracts between January 1970 and October 2011 using the terms “antipsychotic agent or neuroleptic agent,” “dementia,” “nursing homes,” and “withdrawal.” One investigator reviewed abstracts for inclusion based on: English-language, …

Gender Differences In The Fagerström Test For Nicotine Dependence In Korean Americans, Sun Kim, (Julia) Hua Fang, Joseph R. Difranza, Douglas M. Ziedonis, Grace X. Ma

Hua Julia Fang

Introduction: This study was conducted to compare gender differences in the psychometric properties of the Fagerström Test for Nicotine Dependence (FTND).

Methods: The sample comprised 334 Korean immigrants (97 women and 237 men) who reported daily smoking for the past 6 months. Item-by-item responses and exploratory factor analyses (EFA) were compared by gender. Promax rotation was selected based on findings from previous studies suggesting correlated factors.

Results: Compared with men, women smoked fewer cigarettes per day, were more likely to smoke when ill in bed, and were less likely to smoke frequently in the morning. The entire sample and men …

Prospective Investigation Of A Ptsd Personality Typology Among Individuals With Personality Disorders, Meghan E. Mcdevitt-Murphy, M. Tracie Shea, Shirley Yen, Carlos M. Grilo, Charles A. Sanislow, John C. Markowitz, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

This study investigated the replicability of a previously proposed personality typology of posttraumatic stress disorder (PTSD, and explored stability of cluster membership over a 6-month period. Participants with current PTSD (n = 156) were drawn from the Collaborative Longitudinal Personality Disorders Study (CLPS). The CLPS project tracked a large sample of individuals who met criteria for 1 of 4 target diagnoses (borderline, schizotypal, avoidant, and obsessive-compulsive) and a contrast group of individuals who met criteria for depression but no personality disorder. A cluster analysis using scales from the Schedule of Nonadaptive and Adaptive Personality yielded 3 clusters: “internalizing,” “externalizing,” and …

Medical Oxymoron Or Necessary Prevention Of Repeat Sex Offenses: An Examination Of The Appropriateness Of Existing Chemical Castration Statutes, Robert Watters

Robert Watters

The current chemical castration statutes in six states are full of logical constitutional, medical and ethical questions and concerns. The basis for the criticism can be traced to how the schemes were developed compared to the those used in Europe. The castration statutes enacted after long trial and error periods are, therefore, easily discernible from those signed into law quickly as a reaction to some outside event.

Stigma: Quantification Of Stigma For Clinical Assessment: A Paradigm Shift In Anti-Stigma Intervention., Amresh Srivastava

Amresh Srivastava

Title: Stigma: Quantification of Stigma for clinical assessment: A paradigm shift in anti-stigma intervention.

Author

Amresh Shrivastava 1 *, Yves Bureau 2, Nitika Riwari 3, Cheryl Forchuk 4, Ranjith Chandrasena 5

Affiliation

1,4,5, .Associate Professor of Psychiatry, The University of Western Ontario, 2,3 Lawson Health Research Institute . . * Presenting author

Abstract: Stigma is a clinical risk and a barrier to treatment. It is one of the factor closely related to suicide, violence and delayed intervention. We present finding of a working group on ‘measurement of stigma in day to day clinical setting to minimize the risk and improve …

Ab Deposition In Idiopathic And Dup15q11.2-Q13 Autism Spectrum Disorders, J Wegiel, Janusz Frackowiak, Bozena Mazur-Kolecka, N Carolyn Schanen, Edwin H. Cook Jr, Marian Sigman, Ted Brown, Izabela Kuchna, Jarek Wegiel, Krzysztof Nowicki, Humi Imaki, Shuang Yong Ma, Abha Chauhan, Ved Chauhan, David L. Miller, Pankaj D. Mehta, Michael Flory, Ira L. Cohen, Eric London, Barry Reisberg, Mony J. De Leon, Thomas Wisnieski

N C Schanen

Background: It has been shown that amyloid ß (Ab), a product of proteolytic cleavage of the amyloid b precursor protein (APP), accumulates in neuronal cytoplasm in non-affected individuals in a cell type–specific amount.

Methodology/Principal Findings: In the present study, we found that the percentage of amyloid-positive neurons increases in subjects diagnosed with idiopathic autism and subjects diagnosed with duplication 15q11.2-q13 (dup15) and autism spectrum disorder (ASD). In spite of interindividual differences within each examined group, levels of intraneuronal Ab load were significantly greater in the dup(15) autism group than in either the control or the idiopathic autism group in 11 …

Long-Stay Patients In State Psychiatric Hospitals At The End Of The 20th Century, William Fisher, Paul Barreira, Jeffrey Geller, Andrew White, Alisa Lincoln, Marylou Sudders

Alisa Lincoln

OBJECTIVES: The purpose of this study was to assess the characteristics of long-stay patients in contemporary state psychiatric hospitals and to identify factors representing possible barriers to alternative placements for these patients. METHODS: All patients in inpatient units of the Massachusetts Department of Mental Health who had been hospitalized for at least three years as of April 1, 1999, were assessed by their treatment teams with a standardized data collection instrument. Domains assessed included medical problems, need for nursing care, psychiatric diagnosis, and history of problematic behaviors. RESULTS: The 330 individuals identified as long-stay patients had an array of medical …

Insurance Status And Length Of Stay For Involuntarily Hospitalized Patients, William Fisher, Paul Barreira, Alisa Lincoln, Lorna Simon, Andrew White, Kristen Roy-Bujnowski, Marylou Sudders

Alisa Lincoln

General and private psychiatric hospitals are becoming increasingly common as sites for involuntary hospitalization. Unlike the public facilities that these settings are supplanting, these hospitals must pay strict attention to issues associated with reimbursement, insurance status, and managed care. This article examines the effects of insurance status on length of stay for involuntarily hospitalized patients in general and private hospitals in Massachusetts. Using a two-stage sampling procedure, data on episodes of involuntary hospitalization were gathered and assessed using multiple regression. The primary effect was found between patients with Medicare, who had the longest stays, and individuals who were uninsured, who …

Avoidant Personality Disorder, Traits, And Type, Charles A. Sanislow, Katelin Da Cruz, May O. Gianoli, Elizabeth M. Reagan

Charles A. Sanislow, Ph.D.

In this chapter, the evolution of the avoidant personality disorder (AVPD) diagnosis, its current status, and future possibilities are reviewed. AVPD is a chronic and enduring condition involving a poor sense of self and anxiety in social situations, and it is marked by fears of rejection and a distant interpersonal stance. AVPD may be conceptualized at the severe end of a continuum of social anxiety. In the extreme, traits, mechanisms, and symptoms become integral to chronic dysfunction in personality and interpersonal style. While AVPD is a valid diagnostic construct, the optimal organization of AVPD criteria for the diagnosis, and the …

Building The Foundation For The Family Options Project, Joanne Nicholson, Kathleen Biebel, Valerie Williams, Karen Albert

Joanne Nicholson

This article describes how the long-standing partnership between Employment Options, Inc., a psychosocial rehabilitation agency in Marlborough, MA, and the University of Massachusetts Medical School's (UMMS) Center for Mental Health Services Research led to the development of the Family Options program.

Mothers With Severe Mental Illness Caring For Children, Carla White, Joanne Nicholson, William Fisher, Jeffrey Geller

Joanne Nicholson

This research identifies and describes the Massachusetts population of Department of Mental Health (DMH) case-managed women with severe mental illness who are caretakers of their minor children (N = 314), and compares their demographic and clinical characteristics and service utilization with those of a matched, randomly selected group of DMH case-managed noncaretaking women (N = 328) using the Client Tracking System database. Caretakers were significantly younger, had less formal education, and had higher rates of marriage than did noncaretakers. They are diagnosed more often with major affective disorders and less often with psychotic disorders. Caretakers demonstrate higher levels of functioning …

Mothers With Mental Health Disorders: Mental Health Promotion In The Context Of Parenting, Joanne Nicholson, Elizabeth Aaker, Michael Agar, Karen Albert, Steven Banks, Kathleen Biebel, Bernice Gershenson, Antonia Seligowski, Valerie Williams, Brenda Warren, Sierra Williams, Katherine Woolsey

Joanne Nicholson

Parenting is a meaningful role for the majority of American women, including those with mental health disorders. Success in this role, particularly for women with mental health disorders, would seem to be intimately related to mental health promotion, the recovery process, and successful functioning in other major life domains (e.g., employment, community living, and personal health and well-being). The achievement of maximum social participation for women with mental health disorders may hinge on addressing the challenges they face as parents. Presented at Margins to Mainstream: World Congress on Mental Health Promotion and Prevention. Melbourne, Victoria, Australia, September 2008.

Critical Issues For Parents With Mental Illness And Their Families, Joanne Nicholson, Kathleen Biebel, Beth Hinden, Alexis Henry, Lawrence Stier

Joanne Nicholson

This report discusses the outcomes of a study that investigated the impact of parents who have mental illness on children and families. The report discusses the scope of the issue and the experiences of parents with mental illness, federal and State policies impacting policies and practices relating to parents with mental illness, current programs for parents with mental illness and their families, and recommended steps for improving and expanding services. Prepared for the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, MD.

The Invisible Children’S Project: A Family-Centered Intervention For Parents With Mental Illness, Beth Hinden, Kathleen Biebel, Joanne Nicholson, Liz Mehnert

Joanne Nicholson

Citation: Hinden, B., Biebel, K., Nicholson, J., & Mehnert, (2002) The Invisible Children’s Project: A family-centered intervention for parents with mental illness. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. This report describes an evaluation of the Invisible Children's Project (ICP), a program in Orange County, New York, that provides home-based, family-centered case management services for parents with mental illness. Policy implications and program recommendations are also discussed. Prepared for the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Office of Policy, Planning and Administration, Rockville, MD.

Children Of Parents With Mental Illnesses, Joanne Nicholson, Janice Cooper, Rachel Freed, Mareasa Isaacs

Joanne Nicholson

Citation: Nicholson, J., Cooper, J., Freed, R., & Isaacs, M. (2008) Children of parents with mental illnesses. In Gullotta, T.P. & Blau, G. (Eds.) Family influences on childhood behavior and development. New York: Routledge, pp. 231-266. ISBN 0415965322, 9780415965323. This chapter of Family Influences on Childhood Behavior and Development: Evidence-Based Prevention and Treatment Approaches explores the risks faced by children living with parents with mental illness. Individual, family, and community factors influencing risk and resiliency are considered, along with evidence-based treatment interventions, psychopharmacology recommendations, strategies for preventing psychopathology in children, and recommended best practices for clinicians. Limited preview available via …

Why Not Support(Ed) Parenting, Joanne Nicholson, William Deveney

Joanne Nicholson

No abstract provided.

A Survey Of Programs For Parents With Mental Illness And Their Families: Identifying Common Elements To Build The Evidence Base, Beth Hinden, Kathleen Biebel, Joanne Nicholson, Alexis Henry, Judith Katz-Leavy

Joanne Nicholson

Little is known about the effectiveness of interventions for families living with parental mental illness. Existing interventions offer information about successfully implemented treatments, which may demonstrate effectiveness in research. In the current study, directors of programs for parents with mental illness and their families were interviewed. Qualitative analyses revealed noteworthy similarities with respect to target population; funding; community context; agency context; mission, theoretical orientation, and assumptions; locus of care and essential services; desired outcomes; and moderators. Program similarities were identified to provide parameters for research, and to contribute to the development of testable hypotheses. Family-centered, strengths-based approaches were identified across …

Outcomes Of Father Involvement In Pregnancy And Birth, Joanne Nicholson, Nancy Gist, Robert Klein, Kay Standley

Joanne Nicholson

No abstract provided.

Privatized Medicaid Managed Care In Massachusetts: Disposition In Child And Adolescent Mental Health Emergencies, Joanne Nicholson, Stephen Young, Lorna Simon, William Fisher, Anne Bateman

Joanne Nicholson

Data from child and adolescent emergency mental health screening episodes prior and subsequent to privatized Medicaid managed care in Massachusetts are used to investigate the relationship between payer source and disposition and to compare the match between clinical need and disposition level of care. Having Medicaid as the payer in the post-Medicaid managed care period decreased the odds of hospitalization by nearly 60%. None of the clinical need variables that contributed to hospitalization for Medicaid episodes in the pre-Medicaid managed care period were significant in the post-Medicaid managed care period. Multiple forces shaping professional standards, decision making, and quality of …

Fathers With Severe Mental Illness: Characteristics And Comparisons, Joanne Nicholson, Margaret Nason, Anne Calabresi, Regina Yando

Joanne Nicholson

Among patients with severe mental illness attending a large, urban, outpatient mental health clinic, fathers are described and compared with nonfathers and with mothers on demographic, clinical, and child-related characteristics, and on resources and service needs. While fathers and nonfathers with mental illness differed significantly on most variables, fathers and mothers with mental illness were remarkably similar except on child-related characteristics. Issues regarding fathers' experiences and service needs are discussed.

A Qualitative Study Of Programs For Parents With Serious Mental Illness And Their Children: Building Practice-Based Evidence, Joanne Nicholson, Beth Hinden, Kathleen Biebel, Alexis Henry, Judith Katz-Leavy

Joanne Nicholson

The rationale for the development of effective programs for parents with serious mental illness and their children is compelling. Using qualitative methods and a grounded theory approach with data obtained in site visits, seven existing programs for parents with mental illness and their children in the United States are described and compared across core components: target population, theory and assumptions, funding, community and agency contexts, essential services and intervention strategies, moderators, and outcomes. The diversity across programs is strongly complemented by shared characteristics, the identification of which provides the foundation for future testing and the development of an evidence base. …

Parents With Severe Mental Illness And Their Children: The Need For Human Services Integration, Andrea Blanche, Joanne Nicholson, James Purcell

Joanne Nicholson

This article presents the findings and recommendations of a statewide interagency task force on parents with mental illness who have young children. Based on testimony from consumers, providers, and advocates, the task force concluded that this is a substantial and neglected public policy issue requiring an intergovernmental, services integration approach. Recommendations were made in the areas of services, policies and procedures, and service coordination.

Exploring The Concept Of “Young Carer” In Families Living With Parental Mental Illness, Antonia Seligowski, Peter Mcnamee, Karen Albert, Valerie Williams, Joanne Nicholson

Joanne Nicholson

Background Information: The concept of “young carers” has been framed in the literature as children providing care and assuming household responsibilities when parents have physical and/or mental disabilities (Aldridge & Becker, 2003). In the United Kingdom, young carers have been studied extensively, leading to increased access to services and supports (Dearden & Becker, 2004). Our goal is to explore the concept of young carers in the U.S.

Aims: 1) To describe the care giving and household responsibilities of children and youth living with parents with mental illnesses, how often they are performed, and the feelings of children and youth about …

A Historical Perspective On Victimization, Jeffrey Geller, Joanne Nicholson

Joanne Nicholson

Citation: Geller, J. L., Nicholson, J. & Traverso, A. (1997) A Historical Perspective on Victimization. In Harris, M. (Ed.) Sexual abuse trauma in the lives of women. Amsterdam: Harwood Academic Publishers, p. 139-160. ISBN 9057025051, 9789057025051. Limited preview available via Google Book Search.

Achieving The Goal Of Evidence-Based Psychiatric Rehabilitation Practices For Mothers With Mental Illnesses, Joanne Nicholson, Alexis Henry

Joanne Nicholson

There is a growing commitment to evidence-based practices in mental health. There is no well-articulated evidence base for interventions for mothers with mental illnesses. Parenthood is common among women with mental illnesses. Women themselves report motherhood is an important role. The risks of parental mental illness to children have been demonstrated; the challenges that motherhood brings to people with mental illnesses have been described. Because outcomes for both children and adults are multiply determined, there are many intervention opportunities. Recommendations for intervention are drawn from a focus group study and from the existing literature on parent training and support, exemplary …

Programs For Families With Parental Mental Illness: Results Of A Us National Survey, Joanne Nicholson, Beth Hinden, Kathleen Biebel, Alexis Henry, Lawrence Stier

Joanne Nicholson

Citation: Nicholson, J., Hinden, B., Biebel, K., Henry, A., & Stier, L. (2004). Programs for families with parental mental illness. Visions: British Columbia Mental Health and Addictions Journal, 2(2), 27-29. Available at: http://www.heretohelp.bc.ca/publications/visions/parenting. Summary: Survey of programs in the U.S. for parents with mental illness.

A Multi-Disciplinary, Whole-Of-Family Approach To Supporting Parents With Mental Illness, Joanne Nicholson

Joanne Nicholson

Summary: Family members are likely to have multiple and overlapping needs & roles – individuals with mental illness, carers & siblings. There are many opportunities & strategies for intervention. The best care requires the engagement of multiple stakeholders working in partnership. Citation: Nicholson, J. (2010, November). A multi-disciplinary, whole-of-family approach to supporting parents with mental illness. Presented as a plenary at the Developing Strength and Resilience in Children conference of Voksne for Barn, Oslo, Norway.

Parenting, Joanne Nicholson, Laura Miller

Joanne Nicholson

Citation: Nicholson, J. & Miller, L.J. (2008) Parenting. In Mueser, K. & Jeste, D.V. (Eds.) The clinical handbook of schizophrenia. New York: The Guilford Press, pp. 471-480. ISBN 1593856520, 9781593856526. Limited preview available via Google Book Search.

The Internet, Health Promotion, And Community Participation, Joanne Nicholson, Armando Rotondi

Joanne Nicholson

No abstract provided.