Variations in the reported age of a patient: A source of bias in the diagnosis of depression and dementia.

The presence of bias in assessing organic vs depressive pathology in the elderly psychiatric population has been clinically observed in the apparent tendency to overattribute cognitive deficits to senile dementia. In the present study, 21 male and 15 female 26–49 yr old clinical psychologists were presented with a taped interview in which the age of a 64-yr-old male with depressive pseudodementia was varied (either 55 or 75 yrs). It was assumed that the ambiguity involved in determining the etiology of the patient's cognitive deficits would elicit a social or diagnostic bias related to his age. Results show the presence of a bias, with a greater attribution of organic symptoms reflective of senile dementia and fewer judgments of depression when the patient was described as elderly rather than middle-aged. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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Multifamily group treatment for veterans with traumatic brain injury.

A common clinical problem encountered by clinicians treating veterans who incurred traumatic brain injury (TBI) while serving in Afghanistan in support of Operation Enduring Freedom (OEF) or in Iraq in support of Operation Iraqi Freedom (OIF) is lack of knowledge about TBI on the part of the veterans' family members. Insufficient information can exacerbate marital or family conflict and lead to psychological distress and social isolation for the veteran and family, and suboptimal illness management for the veteran. To address this problem, we adapted Multifamily Group Treatment (MFGT), an evidence-based practice for treatment of serious mental illness (SMI), for treatment of OEF/OIF veterans with TBI and their families. We have implemented the adapted treatment (MFG-TBI) in four groups of veterans and families (N = 20 veterans and 20 family members) across two sites: the Durham VA Medical Center (VAMC) in North Carolina and the JJ Peters VAMC in the Bronx, New York. Adaptations focused on contents and format of the educational components, specification of a protocol for conjugal couples, and the addition of an ecomap to identify support systems during the joining (i.e. assessment) phase, a shorter (9 months) intervention duration, and a more active clinician role including use of motivational enhancement, intersession support, and coordination with other service providers. Biweekly group sessions were supervised and rated for adherence. We illustrate how MFG-TBI both educates and builds problem-solving skills with clinical examples. Suggestions for effective use of problem-solving skills with this population are offered. (PsycINFO Database Record (c) 2011 APA, all rights reserved)