Psychiatry and Psychology Commons^™

Big Five Personality Traits, Pathological Personality Traits, And Psychological Dysregulation: Predicting Aggression And Antisocial Behaviors In Detained Adolescents, Katherine S. L. Lau

University of New Orleans Theses and Dissertations

This study tested the utility of three different models of personality, namely the social and personality model, the pathological personality traits model, and the psychological dysregulation model, in predicting overt aggression, relational aggression, and delinquency in a sample of detained boys (ages 12 to 18; M age = 15.31; SD = 1.16). Results indicated that the three personality approaches demonstrated different unique associations with aggression and delinquency. The psychological dysregulation approach, composed of behavioral dysregulation, emotional dysregulation, and cognitive dysregulation, emerged as the overall best predictor of overt aggression, relational aggression, and delinquency. After controlling for the Big Five personality …

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 …

Euthanasia - An Act Of Love, David San Filippo Ph.D.

David San Filippo Ph.D.

Attitudes towards euthanasia are changing. According to a 2005 Gallup poll, 75% of the respondents believed that people should have the right to choose to die. A person in intractable pain with no hope of improvement may have the moral right to commit end her/his life.

Examining The Inner Experience Of Four Individuals With Bipolar Disorder Using Descriptive Experience Sampling, Johanah Kang

UNLV Theses, Dissertations, Professional Papers, and Capstones

Bipolar disorder is a lifelong mood disorder with diagnostic criteria that provide a description of expected experiences of individuals diagnosed with BD (e.g., elevated mood, sadness, difficulty concentrating). Despite these criteria, the inner experience of these individuals is largely unknown. Understanding the inner experience of individuals diagnosed with BD may prove essential in understanding and treating BD. The present study examined the inner experience of four individuals diagnosed with BD using the Descriptive Experience Sampling (DES) method (Hurlburt 1990, 1993, 2011). Results revealed all our participants had clear and prevalent experiences of sensory awareness. They also had difficulties apprehending and …

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.

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 …

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 …

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 …

Depression In Parkinson Disease, Kevin J. Black

Kevin J. Black, MD

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) …

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.

Potentially Inappropriate Use Of Antipsychotics In Community-Dwelling Adults With Dementia More Common In Those With Low Income, Jennifer Tjia

Jennifer Tjia

Comment on: The essential and potentially inappropriate use of antipsychotics across income groups: an analysis of linked administrative data. [Can J Psychiatry. 2012]

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.

Diagnostic Interaction: First-Person Patient Narratives On Hacking's Looping Effects And The Normative Status Of Psychiatric Nosology, Corinne Jager

Honors College Theses

What is the interaction between a psychiatric patient and their diagnosis? How do they respond to being classified? A number of philosophical theories attempt to explain the interaction between the diagnosed patient and their classification. Ian Hacking develops an account of interaction which holds that objects of human science classification are influenced by the awareness of the classification in a way that changes both the classification and its object. Hacking thinks that psychiatric patients are “interactive kinds” whose awareness of their classification causes changes in the individuals' experience of themselves, and thus changes in their classification. Hacking claims that these …

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 …

Norepinephrine Involvement In The Intermittent Swim Stress-Induced Deficit In Spatial Learning And Memory, Emily Elgert

Honors Theses and Capstones

Learning and memory impairments are often caused by stress disorders including depression. The present study investigated the involvement of norepinephrine in the swim stress-induced deficits of spatial learning and memory. Exposure to intermittent swim stress (ISS) followed by learning and memory tests in the Morris water maze (MWM) were used to investigate this relationship. The ISS paradigm consists of intermittent exposure to cold water, producing stress responses in rats. Reboxetine, a norepinephrine selective reuptake inhibitor (NSRI), was employed to investigate whether this compound reverses the ISS-induced deficit. In other words, rats exposed to the ISS, were hypothesized to experience impaired …

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 …

Magnetic Resonance Imaging Of Brain Tissue Abnormalities: Transverse Relaxation Time In Autism And Tourette Syndrome And Development Of A Novel Whole-Brain Myelin Mapping Technique, Yann Gagnon

Electronic Thesis and Dissertation Repository

The transverse relaxation time (T2) is a fundamental parameter of magnetic resonance imaging sensitive to tissue microstructure and water content, thus offering a non-invasive approach to evaluate abnormalities of brain tissue in-vivo. Prevailing hypotheses of two childhood psychiatric disorders were tested using quantitative T2 imaging and automated region of interest (ROI) analyses. In autism, the under-connectivity theory, which proposes aberrant connectivity within white matter (WM) was assessed, finding T2 to be eleveted in the frontal and parietal lobes, while dividing whole brain data into neurodevelopmentally relevant WM ROIs found increased T2 in bridging and radiate WM. In Tourette syndrome, tissue …

Age-Dependent Decrease And Alternative Splicing Of Methionine Synthase Mrna In Human Cerebral Cortex And An Accelerated Decrease In Autism, Christina R. Muratore, Nathaniel W. Hodgson, Malav S. Trivedi, Hamid M. Abdolmaleky, Antonio M. Persico, Carla Lintas, Suzanne De La Monte, Richard C. Deth

Richard Deth

The folate and vitamin B12-dependent enzyme methionine synthase (MS) is highly sensitive to cellular oxidative status, and lower MS activity increases production of the antioxidant glutathione, while simultaneously decreasing more than 200 methylation reactions, broadly affecting metabolic activity. MS mRNA levels in postmortem human cortex from subjects across the lifespan were measured and a dramatic progressive biphasic decrease of more than 400-fold from 28 weeks of gestation to 84 years was observed. Further analysis revealed alternative splicing of MS mRNA, including deletion of folate-binding domain exons and age-dependent deletion of exons from the cap domain, which protects vitamin B12 (cobalamin) …

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. …