Psychiatry and Psychology Commons^™

Drug Firms, The Codification Of Diagnostic Categories, And Bias In Clinical Guidelines, Lisa Cosgrove, Emily E. Wheeler

Counseling and School Psychology Faculty Publication Series

The profession of medicine is predicated upon an ethical mandate: first do no harm. However, critics charge that the medical profession’s culture and its public health mission are being undermined by the pharmaceutical industry’s wide-ranging influence. In this article, we analyze how drug firms influence psychiatric taxonomy and treatment guidelines such that these resources may serve commercial rather than public health interests. Moving beyond a conflict-of-interest model, we use the conceptual and normative framework of institutional corruption to examine how organized psychiatry’s dependence on drug firms has distorted science. We suggest that academic-industry relationships have led to the corruption of …

Research Brief: "Prospectively Assessed Post-Traumatic Stress Disorder And Associated Physical Activity", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the connection between physical activity and symptoms of post-traumatic stress disorder in veterans. In policy and practice, service members who experienced combat should have high levels of physical activity in order to reduce the possibility of developing PTSD, clinicians should mention the importance of physical activity for mental health to service members, as well as recommend alternatives for veterans who are unable to do high levels of physical activity. The VA should implement and promote fitness programs for service members and veterans to lower the possibility of developing PTSD, and policymakers should fund physical activity programs …

Conflicts Of Interest And The Quality Of Recommendations In Clinical Guidelines, Lisa Cosgrove, Allen F. Shaughnessy, Deborah R. Erlich, Emily E. Wheeler, Harold J. Bursztajn

Counseling and School Psychology Faculty Publication Series

Background: There is increasing concern that conflicts of interest affect the development process of clinical practice guidelines. We evaluated The American Psychiatric Association's Practice Guideline for the Treatment of Patients with Major Depressive Disorder to determine the existence of financial and intellectual conflicts of interest and examine their possible effects. We selected this guideline because of its influence on clinical practice and because this guideline recommends pharmacotherapy for all levels of depression, despite controversies over the evidence base.

Methods and Findings: We determined the number and type of financial conflicts of interest for members of the guideline development group as …

Research Brief: "Prevalence Of Childhood Trauma Among U.S. Army Soldiers With Suicidal Behavior", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the link between childhood trauma and servicemember suicide risk within the US Army. In policy and practice, communities should be willing to discuss abuse with servicemembers who experienced childhood trauma, healthcare providers should tell veterans and servicemembers about their treatment options, and family members should assist with the mental health treatment of veterans and servicemembers. Policymakers should create programs that encourage social networks and increase the number of veteran and military support groups. Suggestions for future research include using a different data source for the study, adding a control group, and broadening the sample of veterans …

Treatment Of Psychiatric Inpatients With Relationship Dysfunction Using A Short Term Cognitive Interpersonal Intervention: A Pilot Study, Tamra Rasberry

Doctoral Dissertations and Projects

Relationship conflict for the psychiatric patient can have significant detrimental effects. There are specific types of interactions that can increase conflict and predict the potential for relapse; these have been identified by research and designated as components of Expressed Emotion (EE). Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) have been very effective when targeting specific psychiatric diagnoses, but less effective when addressing relationship conflict. The majority of studies addressing relationship conflict have taken place in an outpatient, long-term setting. There is limited research that utilizes an inpatient short-term intensive therapy with relationship conflict as its sole focus, targeting areas …

Research Brief: "Supporting The Education Goals Of Post-9/11 Veterans With Self-Reported Ptsd Symptoms: A Needs Assessment", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This research undertook a needs assessment for educational support among post-9/11 service veterans with self-reported PTSD symptoms, and found a need for age relevant services that assist with: education planning and access, counseling for the G.I. Bill, accommodations for PTSD symptoms, and more. Administrators should work to ensure that educational services are customized to meet individual needs of student veterans, as well as policies that ensure veterans have access to peer mentors in their age group. This can provide social opportunities and support from veterans who have successfully transitioned from active duty to civilian life. Future research should include more …

Research Brief: "Suicide Among Patients In The Veterans Affairs Health System: Rural-Urban Differences In Rates, Risks, And Methods", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the differences between rural and urban veterans in risks and rates for suicide. In policy and practice, communities should implement support programs for rural veterans, and veteran families should educate themselves about the risk factors for suicide and support veterans in their families; policymakers should increase VA outreach programs in rural areas, as well as programs educating rural veterans about the importance of mental health treatment for those at risk for suicide. Suggestions for future research include looking at the impact of social context on suicide rates, determining the relationship between suicide risk for rural veterans …

Research Brief: "Anxiety, Social Support, And Physical Health In A Sample Of Spouses Of Oef/Oif Service Members", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study focused on anxiety disorders in military spouses and their comorbidity with physical health, identifying the potential for such a comorbidity to worsen over time. The study suggests the importance of recognizing, identifying, and supporting these members of the community. The future research proposed includes objectively measuring this study's outcomes, examining ALL of the military branches, and ways of treating these situations of anxiety disorders.

Finding Solutions To Institutional Corruption: Lessons From Cognitive Dissonance Theory, Lisa Cosgrove, Robert Whitaker

Counseling and School Psychology Faculty Publication Series

The American Psychiatric Association and academic psychiatry in the United States have two conflicts of interest that may affect their assessment of psychiatric drugs and their development of diagnostic and clinical care guidelines: payments from pharmaceutical companies and guild interests. Until recently, the proposed solution to industry-academic relationships has been transparency. However, cognitive dissonance research reveals that disclosure is not a solution because cognitive biases are commonplace and difficult to eradicate. Indeed, bias is most often manifest in subtle ways unbeknownst to the researcher or clinician, and thus is usually implicit and unintentional. Also, recent studies suggest that disclosure of …

Primary Care Clinicians’ Recognition And Management Of Depression: A Model Of Depression Care In Real-World Primary Care Practice, Seong-Yi Baik, Benjamin F. Crabtree, Junius Gonzales

Publications from Provost Junius J. Gonzales

BACKGROUND

Depression is prevalent in primary care (PC) practices and poses a considerable public health burden in the United States. Despite nearly four decades of efforts to improve depression care quality in PC practices, a gap remains between desired treatment outcomes and the reality of how depression care is delivered.

OBJECTIVE

This article presents a real-world PC practice model of depression care, elucidating the processes and their influencing conditions.

DESIGN

Grounded theory methodology was used for the data collection and analysis to develop a depression care model. Data were collected from 70 individual interviews (60 to 70 min each), three …

Research Brief: "Partnering With Communities To Address The Mental Health Needs Of Rural Veterans", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This research focuses on veterans in rural communities who have less access to mental health providers. The Yellow Ribbon Task Force program promoted and encouraged engagement in mental health care for veterans in rural communities, although future policies should enhance already existing clinical practices to increase standards for care. For further study, researchers should focus on evaluating initial program implementation and pilot testing in a variety of states and rural populations.

Anxiety Symptoms In Individuals With High Functioning Autism, Jane C. Kelleher

Honors Scholar Theses

Research indicates a complicated relationship between anxiety disorders and autism spectrum disorders (ASDs). The current study examined the relationship between anxiety symptoms and ASD in 30 Optimal Outcome (OO) individuals, 33 High Functioning Autism (HFA) individuals, and 34 Typically Developing (TD) individuals. The groups were compared on the K-SADS measure of anxiety symptoms. The HFA group presented greater anxiety than both the OO and TD groups, and the OO and TD groups only differed on one anxiety symptom. Across all three groups, there was a significant association between greater anxiety symptoms and a higher level of social and communicative impairment. …

Research Brief: "A Randomized Controlled Trial Of Supported Employment Among Veterans With Post-Traumatic Stress Disorder", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief focuses on some analyses of veterans with PTSD concerning supported employment programs, the Individual Placement and Support (IPS) program, and the evidence-based IPS program. This study's results showed IPS programs to be almost three times more effective than the traditional VRP, and they have a significant impact on employment outcomes for veterans with mental health diagnoses. Suggestions for future research include using a diverse, national sample of veterans to examine the success of the VRP program with different criteria.

Neuroinflammation And Psychiatric Illness, Souhel Najjar, Daniel M. Pearlman, Kenneth Alper, Amanda Najjar, Orrin Devinsky

Dartmouth Scholarship

Multiple lines of evidence support the pathogenic role of neuroinflammation in psychiatric illness. While systemic autoimmune diseases are well-documented causes of neuropsychiatric disorders, synaptic autoimmune encephalitides with psychotic symptoms often go under-recognized. Parallel to the link between psychiatric symptoms and autoimmunity in autoimmune diseases, neuroimmunological abnormalities occur in classical psychiatric disorders (for example, major depressive, bipolar, schizophrenia, and obsessive-compulsive disorders). Investigations into the pathophysiology of these conditions traditionally stressed dysregulation of the glutamatergic and monoaminergic systems, but the mechanisms causing these neurotransmitter abnormalities remained elusive. We review the link between autoimmunity and neuropsychiatric disorders, and the human and experimental evidence …

Warum Gesunde Menchen Immer Häufiger Fur Psychisch Krank Erklärt Werden, Lisa Cosgrove

Counseling and School Psychology Faculty Publication Series

zuerst einmal nicht schaden": Das ist der wohl wichtigste Grundsatz der Medizin. Aber diese Mission droht durch den Einfluss großer Pharmafirmen unterhöhlt zu werden. Der Vorwurf einer Verstrickung von Ärzten und Arzneimittelherstellern ist schon in fast allen medizinischen Fachrichtungen aufgekommen. Vor allem aber die Psychiatrie steckt in einer Glaubwürdigkeitskrise. Das zeigt sich in der aktuellen Debatte um die neue Auflage des "Diagnostischen und Statistischen Manual Psychischer Störungen" (DSM).

Dieses von der US-Psychiater-Vereinigung APA herausgegebene Handbuch definiert, was eine psychische Erkrankung ist. Die Bedeutung dieser Wertung geht weit über die USA hinaus - das Handbuch nimmt oft Definitionen der Weltgesundheitsorganisation vorweg. …

Industry’S Colonization Of Psychiatry: Ethical And Practical Implications Of Financial Conflicts Of Interest In The Dsm-5, Lisa Cosgrove, Emily E. Wheeler

Counseling and School Psychology Faculty Publication Series

The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for publication in May 2013 by the American Psychiatric Association (APA), has created a firestorm of controversy because of questions about undue industry influence. Specifically, concerns have been raised about financial conflicts of interest between DSM-5 panel members and the pharmaceutical industry. The authors argue that current approaches to the management of these relationships, particularly transparency of them, are insufficient solutions to the problem of industry’s capture of organized psychiatry. The conceptual framework of institutional corruption is used to understand psychiatry’s dependence on the pharmaceutical industry and …

蓬瀛仙館 : 探討患有「抑鬱症」長者的服務提供狀況 - 早期防治工作的成效評估, Asia-Pacific Institute Of Ageing Studies, Lingnan University 嶺南大學亞太老年學研究中心

APIAS Research Report 研究報告

是次計劃希望全面地評估蓬瀛仙館現時為長者所提供的抑鬱症前期服務，並提出服務建議，作日後改善及發展長者抑鬱症服務之參考，計劃目標如下：

一. 評估機構現時對長者抑鬱症前期服務提供的狀況；

二. 了解服務使用者對長者抑鬱症服務的期望與現時機構提供的前期服務兩者之間的差距，作為日後服務改進以及發展之參考；

三. 對機構提供之長者抑鬱症前期服務提出改善方案，以及為將來機構發展全方位的長者抑鬱症服務提供發展框架；

四. 為機構提供系統性之長者抑鬱症服務評估框架，以便機構日後作定期的服務評估。

Research Brief: "Accommodating Veterans With Post-Traumatic Stress Disorder Symptoms In The Academic Setting", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study examined specific barriers to education in a sample of seven student veterans, which included veterans with post-traumatic stress disorder (PTSD), and found some professional adjustment issues, social interactions, behavioral and emotional challenges, and life changes. In practice, student veterans expressed impairments in developing close relationships, concerns about feelings of isolation, and heightened anxiety when asked insensitive questions about their military service. In policy, educational policies regarding course transferability may need to be revisited so that veterans seeking to further their education can take steps to do so both during and after their military service without repeating coursework. Suggestions …

The Role Of Parent Psychopathology In The Developmental Trajectories Of Preschool Children With Behavior Problems, Rosanna P. Breaux

Masters Theses 1911 - February 2014

This study investigated associations among different parental psychopathology dimensions and child functioning. Mothers and fathers of preschoolers with behavior problems (n = 132) completed psychopathology questionnaires when children were 3 years old. Children’s externalizing, internalizing, and social problems, academic achievement, and cognitive ability were assessed at annual home visits from age 3 to 6. In general, maternal psychopathology symptoms were associated with mothers’ reports of externalizing, internalizing, and social problems at age 3 and 6. Additionally, paternal psychopathology symptoms were associated with fathers’ reports of externalizing and internalizing problems at age 3 and 6. Mothers with more elevated psychopathology …

United States: Mental Health Issues In An Adolescent Medicine Clinic Patient Population, Abdel Salous, Linah Al-Alem, Hatim A. Omar

Pharmacology and Nutritional Sciences Faculty Publications

The correlation between exposure to forms of violence and development of mental disorders in victims is well established. The purpose of this chapter was to identify mental health problems in an adolescent medicine clinic population in Lexington, Kentucky and to investigate potential correlation of mental disorders with psychosocial factors. Data were gathered from the charts of 169 adolescent clinic patients (age 10-22) seen in the clinic for mental health care and analyzed using Excel. Of the patient population, 68% were urban, whereas 32% were rural. In terms of gender, 40% of the patients were male and 60% were female, 80% …

Profile Of Alcohol And Drug Indicators For Hillsborough County, Florida, Kathleen A. Moore, M. Scott Young, Ellen Snelling

Mental Health Law & Policy Faculty Publications

Alcohol has the highest prevalence of use of any substance in Hillsborough County and throughout the nation. In 2011, Hillsborough County ranked first among all counties in alcohol-related fatalities. Although Hillsborough County DUI arrests decreased in 2011, Hillsborough still had more DUI arrests than any other Florida county. To address these concerns, the Hillsborough County Anti Drug Alliance (HCADA) and the Tampa Alcohol Coalition (TAC) have continued to support: DUI law enforcement operations, The Hillsborough County Sheriff’s Alcohol Vendor Enforcement program (SAVE), DUI Counterattack, DUI media coverage, alcohol awareness programs, improved alcohol policies and community coalitions’ collaborative efforts to reduce …

Prospective Memory In Schizophrenia: Relationship To Medication Management Skills, Neurocognition And Symptoms In Individuals With Schizophrenia [Pre-Print], Sarah Raskin, Jacqueline Maye, Alexandra Rogers, David Correll, Marta Zamroziewicz, Matthew Kurtz

Faculty Scholarship

Objective: Impaired adherence to medication regimens is a serious concern for individuals with schizophrenia
linked to relapse and poorer outcomes. One possible reason for poor adherence to medication is
poor ability to remember future intentions, labeled prospective memory skills. It has been demonstrated
in several studies that individuals with schizophrenia have impairments in prospective memory that are
linked to everyday life skills. However, there have been no studies, to our knowledge, examining the
relationship of a clinical measure of prospective memory to medication management skills, a key element
of successful adherence. Methods: In this Study 41 individuals with schizophrenia and …

Baker Act Receiving Facility Staff Perceptions Of Community Services, Steve Roggenbaum, Annette Christy, Mary R. Murrin

Mental Health Law & Policy Faculty Publications

No abstract provided.

Psychiatric Nursing Care For Patients With Cardiac Disease, Gail Stern Msn, Donna Petruccelli Msn, Crnp, Np-C, Jeanne Manavizadeh Bsn, Rn, Pccn

Patient Care Services / Nursing

No abstract provided.

A Good Enough Reason: Addiction, Agency And Criminal Responsibility, Stephen J. Morse

All Faculty Scholarship

The article begins by contrasting medical and moral views of addiction and how such views influence responsibility and policy analysis. It suggests that since addiction always involves action and action can always be morally evaluated, we must independently decide whether addicts do not meet responsibility criteria rather than begging the question and deciding by the label of ‘disease’ or ‘moral weakness’. It then turns to the criteria for criminal responsibility and shows that the criteria for criminal responsibility, like the criteria for addiction, are all folk psychological. Therefore, any scientific information about addiction must be ‘translated’ into the law’s folk …

Existential Concerns Of Individuals Living With Chronic Mental Illness In Guam, Christina Maria B. Dela Cruz

Antioch University Dissertations & Theses

Individuals living with chronic mental illness experience a host of challenges associated with the symptoms of their illness. In an effort to help restore healthy functioning, mental health treatment for individuals with chronic mental illness thus focuses primarily on symptom reduction and management. Recent research exploring the lived experience of individuals with chronic mental illness suggests that apart from their symptoms, these individuals also encounter existential issues related to the self, relationships with others, temporality, making meaning out of the illness experience, and managing life with the illness. At the same time, however, this research has tended to focus on …

It Doesn't Pass The Sell Test: Focusing On "The Facts Of The Individual Case" In Involuntary Medication Inquiries, Susan A. Mcmahon

Georgetown Law Faculty Publications and Other Works

Criminal defendants who are incompetent to stand trial have a significant liberty interest in refusing the antipsychotic medication that could restore their competency. The Supreme Court cautioned that instances of intrusion upon that right “may be rare,” and, in Sell v. United States, it laid out what it believed to be stringent criteria for when a defendant could be medicated against his will. Yet, since Sell, trial courts have ordered over sixty-three percent of defendants involuntarily medicated. These individuals did not pose a danger to themselves or others, and they were rarely accused of crimes that involved damage …