Mental health, not social support, mediates the forgiveness-alcohol outcome relationship.

Religiousness and spirituality are important to most Americans, and evidence suggests that they may contribute to both addiction and recovery. Forgiveness is a specific dimension of religiousness and spirituality that may enhance recovery, but the mechanism(s) through which it operates is unknown. We hypothesized that higher levels of forgiveness would be associated with higher levels of mental health and social support, which, in turn, would be associated with improved alcohol-related outcomes. Baseline and 6-month longitudinal data from a sample of 149 individuals with alcohol use disorders seeking outpatient substance abuse treatment were analyzed through multiple-mediation statistical techniques. While previous research has shown direct associations among forgiveness, alcohol-related outcomes, mental health, and social support, this study found that the direct associations between forgiveness and alcohol-related outcomes were no longer significant when mental health and social support were analyzed as mediator variables. At baseline, for each alcohol-related outcome measured (alcohol-related problems, percent heavy drinking days, percent days abstinent, and drinks per drinking day), mental health individually played a role in the relationship with both forgiveness of self and forgiveness of others, fully mediating or operating through an indirect-only pathway. For alcohol-related problems only, mental health fully mediated the relationship with forgiveness of self at follow-up and operated through an indirect-only pathway with forgiveness of others longitudinally. Social support and feeling forgiven by God were nonsignificant variables at baseline, follow-up, and longitudinally. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Therapeutic effort, treatment outcome, and national health policy.

Contends that psychotherapy is seen as repairing or preventing emotional, social, and behavioral dysfunction. The therapeutic effort in the delivery of psychotherapy can be construed as containing 3 components: (1) the dosage of each element in the therapeutic effort; (2) the extent to which each therapeutic intervention restricts the patient's life; and (3) the cumulative costs, in terms of human and material resources invested, of the clinical episode. Dosage measures provide a means of assessing the differences in outcome that might result when 2 or more interventions are provided with the same dosage, or when the same intervention is provided at different dosage levels. Restrictiveness measures provide a means for assessing the differences in outcome that might result when 2 or more interventions seek to control the therapeutic environment in different ways. Cost measures can combine the issues raised in both dosage and restrictiveness studies to provide measures of their combined influences. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health outcome assessment: The new agenda.

Reviews the new market-driven demands for mental health outcomes research, summarizes issues pertaining to choice of outcome measures, describes the implementation of an outcome assessment system in a clinical environment, and suggests directions for the future. Rising health care costs and resulting reimbursement limitations imposed by 3rd-party payers have led to increased demands to justify mental health services. Profiling, report cards, instrument panels, and benchmarking have emerged as methods for understanding, documenting, and reporting quality and outcomes of treatment. Several national efforts are underway to achieve consensus on a core battery of measures to serve as a standard for a national mental health "report card." An example of an outcome assessment system within a clinical setting is presented along with outcome profiles for age, gender, and diagnostic subgroups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adaptationism, mental health, and therapeutic outcome.

Common views of psychotherapy and mental health regard improved ego adaptation as the predominant goal for therapy. These views originate in the individualism of major models of personality and in the individualistic and secular biases of modern Western culture. Because of its commitment to the self-interested ego as the ultimate unit of analysis, the adaptationist model of has made it difficult for psychotherapy to respond to some of the major sources of mental disorder today: isolation, meaninglessness, and the depersonaliazation of self and others. Therapy must make a special effort to attend and respond to the person's ethical participation in constitutive relationships of several kinds. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonpsychiatric medical comorbidity, health perceptions, and treatment outcome in patients with panic disorder.

Panic disorder is frequently complicated by high rates of co-occurring nonpsychiatric medical conditions. The present study examined the relationship between medical morbidity, perceived physical health, and treatment outcome in panic disorder Patients meeting the American Psychiatric Association's Diagnostic and Statistical Manual of mental disorders (1994) criteria for panic disorder (N?=?71) completed 12 sessions of cognitive-behavioral treatment and were assessed at posttreatment and 6-month follow-up. Medical comorbidity and perceived health were both found to be related to end-state functioning. Medical comorbidity did not uniquely predict outcome beyond its shared variance with perceived health. At posttreatment, 71% of patients who perceived their physical health as good met recovery criteria compared with only 35% of those who perceived their health as poor. At follow-up, 67% of those who perceived their physical health as good met composite recovery criteria compared with only 33% of those with perceived poor health. These findings offer preliminary support for the impact of physical health, both actual and perceived, on treatment outcome of patients with panic disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health technology.

Discusses the acute need for the development of viable technologies in social-behavioral areas, e.g., mental health. Technology is defined as anything that increases the efficiency of some work process, and has the potential for being based on science. By examining the nature and historical development of established technologies, some of their problems can hopefully be avoided. The field of mental health is essentially pretechnological, although, as is true of other social-behavioral areas, potential scientific data bases and directions for technological development are not lacking. 8 such areas are identified and briefly discussed. (15 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health care: Access, stigma, and effectiveness.

Discusses the lack of commitment by the US as a nation to ensure that high-quality mental health care will be provided to all who are in need. The mental health benefits under Medicare and Medicaid programs are meager at best. Psychologists and other nonphysician health care providers are not considered bona fide professionals. Prevention, program evaluation efforts, and the use of alternatives to traditional inpatient care, such as halfway houses and crisis intervention programs, are not treated under the current reimbursement system. An "efficacy proposal" created by US Senators D. K. Inouye and S. M. Matsunaga is described. The essence of the proposal was modeled after the current Food and Drug Administration requirements for safety and efficacy for all new drugs and medical devices. In addition to these 2 requirements, the notion of "appropriateness" or "cost-effectiveness" was added. This proposal, which was deleted in 1980, would have established an interdisciplinary commission comprised of representatives of both the scientific and clinical communities. The commission would have been charged with the responsibility for making recommendations as to what types of mental health services, and under what conditions, should be reimbursed under the Social Security Act. It is concluded that the establishment of an independent entity with the charge of seriously reviewing the "probably public benefit" of providing psychotherapy would be in the national interest of the US. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health practitioners and HIPAA.

The privacy and security of patients' medical records continue to challenge mental health practitioners in an ever-increasing electronic environment. Although practitioners were to be in compliance of the 1996 Health Insurance Portability and Accountability Act (HIPAA) by April 20, 2006, many practitioners still struggle to understand the nuances of the regulations. This article will cover the areas of HIPAA that relate specifically to the mental health practitioner who treats both adults and children. The article begins with important definitions such as “covered entity,” “individually identified health information,” and “electronic transactions.” Establishing that many mental health practitioners likely meet the definition of covered entities, the article details The Privacy Rule and The Security Rule. Included are issues concerning consents, authorizations, and objections along with enforcement of HIPAA. Also changes in enforcement to HIPAA by the Health Information Technology for Economic and Clinical Health Act (HITECH), a part of the American Recovery and Reinvestment Act of 2009 are discussed. Examples of violations and resulting enforcement will help practitioners better understand the regulations and how best to comply with these regulations. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Re: Mental health treatment in Ontario

A 2.5-year-old girl with neurogenic Gaucher's disease was transplanted with donor bone marrow from her HLA-compatible 12-year-old brother whose marrow was harvested 30 min post-mortem, after he suffered a severe head and neck injury. The marrow was stored in liquid nitrogen for 30 days prior to infusion. The post-transplantation period was uneventful with good engraftment and no signs of graft-versus-host disease. Currently, 6 months post-allogeneic bone marrow transplantation (alloBMT), analysis of both bone marrow and blood samples by PCR documented only cells of donor origin. This case demonstrates the feasibility of cadaveric marrow as a source of donor cells. To our knowledge, this patient is the only survivor of alloBMT from a cadaveric donor.     

Mental health manpower and institutional change.

"The greatest social need for mental health services today comes from the low-income groups and the poor. Meeting this need is not primarily a problem of manpower but [one] of ideology. The task is to develop concepts, methods, programs, and services that are appropriate, effective, and related to the life styles of low-income people and to their needs, in a way which will create an effective demand for them. This will require significant institutional changes. Whatever manpower problems do exist are inseparable from the problem of institutional change. The solutions to manpower problems can reinforce existing institutionalized mental health or they can constitute a strategy for promoting institutional change." (20 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health intensive outpatient programming: An outcome and satisfaction evaluation of a private practice model.

The current economic climate of mental health care requires an adaptation of traditional treatment paradigms for practitioners to succeed in the marketplace. Psychologists have not really capitalized on their training and expertise in developing outpatient treatment models for acute care. A private practice outpatient program, based in crisis intervention and group therapy, is described. The effectiveness of a mental health intensive outpatient program (IOP) in a private practice setting is demonstrated. IOPs represent an opportunity for private practice groups to collaborate with larger systems of care while providing clinically effective, consumer friendly, and safe treatment for acute patients in traditional outpatient settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Embodiment, agency, and attitude change.

Attitude embodiment effects occur when the position or movement of a person’s physical body changes the way the person evaluates an object. The present research investigated whether attitude embodiment effects depend more on biomechanical factors or on inferential cues to causal agency. Experiments 1 and 2 showed that actual movements of the physical body are not necessary to create attitude embodiment effects when inferential cues imply agency for another person’s physical movements. Experiment 3 showed that actual movements of the physical body are not sufficient to create attitude embodiment effects when inferential cues imply nonagency for those movements. In all 3 experiments, inferential cues to agency played a more important role in attitude embodiment effects than did actual agency, suggesting that theories of embodiment and attitude embodiment need to consider inferential cues to agency alongside biomechanical mechanisms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health symptoms in youth affected by Hurricane Katrina.

Natural disasters, such as hurricanes, may cause severe psychological impairment in children and adolescents, which may persist in youth who have survived hurricanes, their effects, or both. To better understand the needs of youth in the community after Hurricane Katrina, officials in St. Bernard Parish, LA, commissioned a youth needs assessment survey. The survey assessed how youth were coping approximately 2 years after Hurricane Katrina. The goal was to explore the prevalence and severity of depressive, anxious, and posttraumatic symptoms reported by youth. Based on retrospective reports from 43 youth, the prevalence of children’s mental health symptoms was 44–104% higher in the 2 years after Hurricane Katrina compared to pre-Katrina. The majority of mental health symptoms reported by youth had an onset after the hurricane, for example, 79% reported new onset of mental heath symptoms in the year after Katrina. The vast majority of these children (56%) continued to experience mental health difficulties 2 years after the disaster. Implications regarding post-Katrina mental health needs, service delivery, public response, and collaboration efforts are summarized and directions for future research are proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Priapism. Etiology, diagnosis and treatment

Priapism is a condition of prolonged penile erection which often causes pain and is unrelated to sexual desire. There is a high risk of impotence despite immediate intervention. The incidence has doubled since the introduction of intracorporeal injection therapy for impotence. Two subtypes of priapism have been described, depending on the underlying cause. The more common type, termed low flow, is characterised by inadequate venous outflow, leading to a hypoxic painful prolonged erection. The etiology is either idiopathic or related to intracorporeal injection therapy. Treatment consists of aspiration and instillation of a diluted alpha-adrenergic agent, or surgery, depending on the degree of hypoxia. The less common subtype, high flow, is arteriogenic, and causes less pain and no ischemia. Injury to a cavernous artery leads to a fistula between the artery and the corpora cavernosa. Treatment is either conservative with immediate ice pack and compression, or delayed selective embolization of the fistula.     

Mental health professionals' attitudes toward confidentiality, privilege, and third-party disclosure.

Describes a questionnaire survey of 64 mental health professionals in North Dakota examining their knowledge of and attitudes toward 3 important ethical-legal issues: confidentiality, privilege, and disclosure of information to 3rd parties. Results demonstrate agreement on the importance of confidentiality in the therapeutic relationship. With regard to privilege, a wider range of variance among respondents suggests that the ramifications of privilege statutes (as well as those professions included or not included) are blurred among mental health professions. Results also suggest the need for clients to be informed about the conditions under which exceptions to the general principle of confidentiality will occur. An appendix of means, standard deviations, and frequency tabulations of the questionnaire items is included. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)