Preventing hung juries about therapy studies.

Responds to N. S. Jacobson and S. D. Holland's (see record 1996-02770-007) argument in defense of drug–psychotherapy comparisons that do not include pill-placebo controls. Klein presents a series of arguments that emphasize the importance of comparatively evaluating psychotherapies with appropriate pharmacotherapy and pill placebo. National Institute of Mental Health (NIMH) Treatment of Depression Collaborative Research Program is critically discussed because this program incorporated the recommended design features but still led to substantial controversy. Klein contends that the inclusion of a pill-placebo arm in future therapeutic studies is most desirable. NIMH should initiate a funded program specifically for multisite, pill-placebo-controlled studies of psychotherapy, pharmacotherapy, and their combination, jointly sponsored and supervised by skilled psychopharmacologists and psychotherapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

National Institute of Mental Health goals for behavioral science.

Because all health conditions for which the National Institute of Mental Health (NIMH) is responsible manifest at the level of behavior, and all interventions must have an impact at the behavioral level, NIMH is firmly committed to the support of behavioral science. In an era in which research in areas that some view as reductionist—for example, genomics, genetics, functional genomics and proteomics, and molecular science—is especially promising, NIMH is striving to maintain a balance in its portfolio with studies that explore integrative aspects of biology, including behavior. Without this perspective, new information about fundamental processes will prove ultimately to be shallow. This commentary discusses how understanding of brain and behavior in mental illness and health calls for integrating bottom-up research that studies brain and behavior through genes and molecules, with top-down research that examines the impact of environment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health manpower policy: A perspective from the National Institute of Mental Health.

Provides a brief history of the US National Institute of Mental Health (NIMH) and its role in mental health manpower development. It is concluded that the mental health clinical training programs of NIMH have been essential to the academic mental health community and to the growth of the professions. Presently in psychology and social work, the shortage of funds to support students is the primary concern. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The training program of the National Institute of Mental Health: Its implications for mental health programs.

The year 1956 marked the tenth anniversary of the Training Grants Program of the National Institute of Mental Health (NIMH). From very meager beginnings in 1948 they had advanced to the very substantial position which they now occupy in fiscal year 1957. This article looks backward briefly to when the National Mental Health Act was passed with the goal of improving the mental health of our nation. It describes the objectives and growth of the NIMH mental health program, which was established to help attain this goal. The article also describes several ongoing public mental health programs that reflect NIMH training grant support and problems in program implementation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV prevention case management: current practice and future directions

The NIMH Genetics Initiative is a multi-site collaborative study designed to create a national resource for genetic studies of complex neuropsychiatric disorders. Schizophrenia pedigrees have been collected at three sites: Washington University, Columbia University, and Harvard University. This article-one in a series that describes the results of a genome-wide scan with 459 short-tandem repeat (STR) markers for susceptibility loci in the NIMH Genetics Initiative schizophrenia sample-presents results for African-American pedigrees. The African-American sample comprises 30 nuclear families and 98 subjects. Seventy-nine of the family members were considered affected by virtue of having received a DSMIII-R diagnosis of schizophrenia (n = 71) or schizoaffective disorder, depressed (n = 8). The families contained a total of 42 independent sib pairs. While no region demonstrated evidence of significant linkage using the criteria suggested by Lander and Kruglyak, several regions, including chromosomes 6q16-6q24, 8pter-8q12, 9q32-9q34, and 15p13-15q12, showed evidence consistent with linkage (P = 0.01-0.05), providing independent support of findings reported in other studies. Moreover, the fact that different genetic loci were identified in this and in the European-American samples, lends credence to the notion that these genetic differences together with differences in environmental exposures may contribute to the reported differences in disease prevalence, severity, comorbidity, and course that has been observed in different racial groups in the United States and elsewhere.     

Biomarker assessment of the effects of petroleum refinery contamination on channel catfish

A series of arguments are presented that emphasize the importance of comparatively evaluating psychotherapies with appropriate pharmacotherapy and pill placebo. The lack of a pill-placebo arm has rendered moot those studies that compared pharmacotherapy directly with psychotherapy because of the lack of an internal sample defining calibration with regard to medication responsivity. The National Institute of Mental Health (NIMH) Treatment of Depression Collaborative Research Program is critically discussed because this program incorporated the recommended design features but still led to substantial controversy. The inclusion of a pill-placebo arm in future therapeutic studies is most desirable. NIMH should initiate a funded program specifically for multisite, pill-placebo-controlled studies of psychotherapy, pharmacotherapy, and their combination, jointly sponsored and supervised by skilled psychopharmacologists and psychotherapists.     

Basic behavioral science research for mental health: A national investment.

Presents the National Institute of Mental Health (NIMH) Behavioral Science Task Force Report (BSTFR). The BSTFR is a result of the collective efforts of the National Advisory Mental Health Council, the Staff of the Division of the Neuroscience and Behavioral Science at NIMH, and a panel of 52 behavioral scientists in the field. The BSTFR is expected to provide guidance for the NIMH's basic research programs concerning behavioral and social factors that promote mental health or contribute to mental disorders. Research topics are highlighted, such as the use of animals in basic behavioral science research, comparisons across species and across cultures, and the bidirectionality of causation. Recommendations include strengthening basic behavioral science research, increasing support for investigator-initiated research, and preserving expert review of basic behavioral science. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychodynamic research perspectices on development, psychopathology, and treatment in later life.

Reports on a meeting held at the National Institute of Mental Health (NIMH). At this meeting, over 700 psychoanalysts and other mental health professionals and investigators gathered to consider research on the interplay of personality, biology, and society in shaping adaptation to aging. The convening of this meeting, co-sponsored by the Center for Studies of the Mental Health of the Aging and the Psychosocial Treatments Research Branch, marked the first time that NIMH had sponsored a conference in which the clinical and theoretical contributions of psychoanalysis to the study of normal and pathological development had been so explicitly recognized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research on psychotherapy integration: Recommendations and conclusions from an NIMH workshop.

Although the trend toward psychotherapy integration and eclecticism has gathered momentum, research on eclectic approaches to psychotherapy has lagged behind. To address this gap, the National Institute of Mental Health (NIMH) held a 2-day workshop in March 1986 on psychotherapy integration. Fourteen psychotherapy researchers were invited to consider the key issues associated with psychotherapy integration in order to advise the NIMH on guidelines for launching a program to stimulate relevant empirical research. Recommendations were developed to initiate such a research program that encompassed (a) conceptual clarification, (b) efficacy studies of systematic eclectic therapies, (c) the role of traditional psychotherapy process research, and (d) the training of integrative or eclectic therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health services for homeless mentally ill persons: Federal initiatives and current service trends.

Recent research suggests that approximately one third of the population of homeless single adults suffer from severe mental illnesses. Despite multiple health, mental health, and social welfare needs, this population is often unable to obtain necessary housing and community-based services. For this reason, since 1982, the National Institute of Mental Health (NIMH) has undertaken a number of federal initiatives to encourage research and assist states and localities in improving services focused on this vulnerable subgroup of the homeless population. This article describes the target population, NIMH research findings, and current mental health programs—with particular emphasis on two mental health programs established under the Stewart B. McKinney Homeless Assistance Act. Proposed future directions for federal research and evaluation efforts in this area are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reducing risks of mental disorders.

Presents views on the prevention of mental disorders, with a focus on the reports entitled Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research (P. J. Mrazek and R. J. Haggerty, 1994) and The Prevention of Mental Disorders: A National Research Agenda (NIMH Prevention Research Steering Committee, 1994), prepared by the Institute of Medicine (IOM) and the National Institute of Mental Health, respectively. Congress must work closely with NIMH to ensure that recommendations made by the IOM to advance the field of prevention of mental disorders are implemented. Also, the mental health community will need to be proactive with Congress to make a difference in critical decisions about financing for the treatment and prevention of mental disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reflections of a 40-year exploration. A scientific view on homosexuality

The author documents her experiences as she researched homosexual men. She discusses the adverse conditions that potentially threatened her achieving her research goals, including the demand of university officials that the research be conducted at the university. As confidentiality was imperative, the author insisted on conducting interviews at her home office. Starting in 1953 she received grants from the National Institute of Mental Health (NIMH) to research male homosexuality and in 1969 proposed an agenda outlining research and policy issues at NIMH. Hooker recently received a trust fund for almost a half million dollars from a gay man she had interviewed in the late 1950s to conduct research for the understanding of gay men and lesbians. The funds are now in the American Psychological Foundation under control of selected officers of Division 44. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consideration of conformational transitions and racemization during process development of recombinant glucagon-like peptide-1

This article summarizes the results of a combined analysis from two identical multicenter clinical trials that investigated the efficacy and safety of sertraline versus placebo for treating panic disorder. Patients with panic disorder who were treated with sertraline had a statistically significant reduction in the mean number of panic attacks per week (the primary efficacy measure) as compared with placebo (4.8 vs. 2.5, p < .001). Sertraline-treated patients also showed greater improvement that was statistically significant on several ratings of panic disorder symptomatology and functioning. The design characteristics, clinical rating measures, and outcome measures in these trials included most of the features deemed essential by Shear and Maser (1994) in their summary of the NIMH Consensus Conference for the development of standardized assessments for panic disorder. This suggests that the NIMH Consensus Conference played a key role in developing successful multicenter pharmacological treatment studies, such as this one that ultimately demonstrated that sertraline was an effective treatment for panic disorder.     

Psychology and mental health: An enduring partnership.

Discusses the relationship between psychology and the National Institute of Mental Health's (NIMH's) funding of research in the behavioral sciences and the diagnosis, treatment, and prevention of mental illness. It is pointed out that, despite the fears of biological reductionism, the NIMH is determined to maintain a balanced program across the broad spectrum of its efforts. The funding of current research efforts in a variety of areas is outlined. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Television and behavior: Research conclusions of the 1982 NIMH report and their policy implications.

Research on TV and behavior in the 1970's has recently been reviewed and evaluated in a 2-volume report from the National Institute of Mental Health (NIMH). The most widely publicized conclusion of the report was that violence on TV does lead to aggressive behavior by children. The TV networks' response to this conclusion has been one of denial. Research also documented that young children are often unable to relate a series of complex actions to their final consequence. Another area in the cognitive and affective aspects of TV concerns the effects of TV viewing on child development and on academic achievement. Findings suggest a need for increased emphasis on teaching children critical TV viewing skills. TV also has the potential to affect social beliefs and behaviors, such as beliefs about sex roles, minorities, prosocial behavior, and products advertised on TV. The impact of TV on social relations, especially familial relations, and on health is also addressed. The NIMH report demonstrates a need to see TV viewing as a continuing form of informal education. What is needed is more creativity on the part of the industry and more discrimination on the part of the viewer. The teaching of critical viewing skills and parental interest in what children watch are especially important. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A 1 year double-blind placebo-controlled fixed dose study of sertraline in the treatment of obsessive-compulsive disorder

The objective of this study was to evaluate the safety and efficacy, over a 1 year treatment period, of three dose levels of sertraline and placebo in the treatment of non-depressed adult out-patients with obsessive-compulsive disorder (OCD). Following 1 week of single-blind placebo washout, patients (n = 325) from 11 sites following identical protocols were randomly assigned to 12 weeks of double-blind treatment with one of three fixed doses of sertraline (50, 100 or 200 mg) or placebo. At the end of 12 weeks, treatment responders (including placebo patients) were offered an additional 40 weeks of double-blind treatment at their assigned doses. Efficacy measures were the Yale-Brown Obsessive Compulsive Scale, the NIMH Global Obsessive Compulsive Scale, Clinical Global Impressions of Severity of Illness and Global Improvement and the Maudsley Obsessive Compulsive Inventory. Patients in the pooled sertraline group showed greater improvement than placebo-treated patients on all efficacy measures, based on the endpoint analyses. Moreover, pairwise comparisons at endpoint revealed a significant effect on all three investigator-rated scales in patients receiving 50 or 200 mg of sertraline; in the 100 mg group, there was a significant effect on the NIMH Global Obsessive Compulsive Scale only. Patients completing 3 months of sertraline treatment exhibited excellent toleration and sustained improvement during an additional 40 weeks of therapy. Results support the safety, efficacy and tolerability of daily doses of 50-200 mg of sertraline in the long-term treatment of patients with OCD.     

Research in dynamic psychotherapy.

The Psychosocial Treatments Branch of NIMH held two conferences during 1982 and 1983 at which groups of experts in dynamic psychotherapy and research examined the feasability of mounting a special research program on dynamic psychotherapy. Recommendations regarding such a research program are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Betty Horenstein Pickett (1926–2008).

Presents an obituary for Betty Horenstein Pickett who was best known for her long-term service in the United States Public Health Service (USPHS) as an administrator in both the National Institute of Mental Health (NIMH) and the National Institute of Child Health and Human Development (NICHD). Described is her educational background as well as the positions she held and achievements throughout her career in government service. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Eating disorders: National Institute of Mental Health's perspective.

The mission of the National Institute of Mental Health (NIMH) is to reduce the burden of mental and behavioral disorders through research, and eating disorders embody an important fraction of this burden. Although past and current research has provided important knowledge regarding the etiology, classification, pathophysiology, and treatment of the eating disorders, there are still significant challenges that need to be addressed. This article briefly describes some of these challenges, recent NIMH-supported research and research-related activities directed at addressing these challenges, and approaches and areas of research that hold promise for furthering the understanding and treatment of eating disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)