Treatment Of Psychopathology Research Articles

Prevalence and characteristics of psychotropic drug use in institutionalized children and adolescents with mild intellectual disability

Psychotropic drugs are a cornerstone in the treatment of psychopathology and/or behavioral problems in children with intellectual disability (ID), despite concerns about efficacy and safety. Studies on the prevalence of psychotropic drug use have mainly been focused on adults with ID or children without ID. Therefore the aim of this cross sectional study was to assess the prevalence and characteristics of psychotropic drug use in children with mild ID who were institutionalized in specialized inpatient treatment facilities in The Netherlands. Demographic data, psychiatric diagnoses, the nature of the behavioral problems, level of intellectual functioning, and medication data were extracted from medical records using a standardized data collection form. Adjusted relative risks (ARR) for the association between patient characteristics and psychotropic drug use were estimated with Cox regression analysis. Of the 472 included children, 29.4% (n=139) used any psychotropic drug, of which 15.3% (n=72) used antipsychotics (mainly risperidone), and 14.8% (n=70) used psychostimulants (mainly methylphenidate). Age, sex, and behavioral problems were associated with psychotropic drug use. Boys had a 1.7 (95%CI 1.1-2.4) higher probability of using psychotropic drugs, compared to girls adjusted for age and behavioral problems. Having any behavioral problem was associated with psychotropic drug use with an ARR of 2.1 (95%CI 1.3-3.3), adjusted for sex and age. The high prevalence of psychotropic drug use in children with ID is worrisome because of the lack of evidence of effectiveness (especially for behavioral problems) at this young age, and the potential of adverse drug reactions.

Exploring the Impact of Parental Psychopathology and Emotion Regulation on Evidence-Based Parenting Interventions: A Transdiagnostic Approach to Improving Treatment Effectiveness

Parenting interventions, particularly those categorized as parent management training (PMT), have a large evidence base supporting their effectiveness with most families who present for treatment of childhood behavior problems. However, data suggest that PMTs are not effective at treating all families who seek services. Parental psychopathology has been identified as one important factor moderating their effectiveness, yet few PMTs pay explicit attention to the role of parental psychopathology in treatment. Given growing support for a transdiagnostic model of psychopathology, which posits that disruptions in emotions and emotion regulation (ER) may underlie various forms of psychopathology, one way to address the impact of parental psychopathology on PMT may be by targeting parental ER. This paper will review the available literature on PMT and parental psychopathology, as well as existing evidence on relations between ER and both parental psychopathology and parenting behaviors. The limited research on PMTs that include explicitly parent-focused components will be reviewed, and suggestions for augmenting existing PMT curricula by including intervention around parental ER will be presented.

Lemons Into Lemonade: Development and Validation of an Inventory to Assess Dispositional Thriving

Research indicates that health and disorder are polar opposites of the same continuum of vulnerability. Research has focused almost exclusively upon one end of this continuum, namely disorder. As such, instruments that assess adaptive dispositions (e.g., “thriving”, or post-trauma growth) have rarely been developed. The purpose of this study was to develop and validate an instrument that assesses dispositional thriving. Undergraduate students (N = 289) were asked to complete the dispositional thriving inventory (DTI), in addition to a number of other instruments designed to assess adaptive (e.g., optimism, acceptance, planning, etc.) and maladaptive (depression, dysfunctional attitudes, etc.) constructs. Factor analysis revealed four orthogonal factors comprising the DTI. Results indicated that the 26-item scale is reliable (α = .88) and valid. Scores on the DTI positively correlated with optimism, and adaptive coping, and negatively correlated with depression and dysfunctional attitudes. There is some evidence that the DTI is a reliable and valid instrument. The construct of thriving has wide implications upon the onset and treatment of psychopathology.

Narrative overview of systematic reviews and meta-analyses: evidence on many treatments for psychopathology in people with developmental disabilities is limited

Narrative overview of systematic reviews and meta-analyses: evidence on many treatments for psychopathology in people with developmental disabilities is limited

Refugee Children: Mental Health and Effective Interventions

The mental health consequences of war and other forms of organized violence for children represent a serious global public health issue. Much of the research on the mental health of war-affected civilians has focused on refugees who have sought asylum in high-income countries and face the dual stress of a traumatic past and resettlement. This review will focus on the mental health of refugee children who have fled war as well as interventions to both prevent and treat adverse mental health outcomes. While war can have devastating mental health consequences, children raised in the midst of armed conflict also display resilience. Effective interventions for refugee children will be discussed both in terms of prevention and treatment of psychopathology, with a focus on recent developments in the field.

Relationship discord and the prevalence, incidence, and treatment of psychopathology

This paper provides a selective review of the literature on the association between poor relationship adjustment (i.e., relationship discord) and the prevalence, incidence, and treatment of psychopathology. Relationship discord has been shown to covary with a variety of psychiatric disorders and predict the incidence of mood, anxiety, and substance use disorders and increases in depressive symptoms. The association between relationship discord and psychopathology is moderated by several individual difference variables, including variables that have been shown to increase risk for psychopathology. Relationship discord is associated with poorer outcome to individual-based treatments for several common psychiatric disorders, and couple-based interventions have been shown to reduce depression and substance use as well as improve relationship discord.

Treatment of Psychopathology in People with Intellectual and other Disabilities

To review the psychosocial, pharmacological, and other treatments of psychopathology in people with intellectual disabilities (IDs), autism, and other developmental disabilities (DDs). Systematic reviews and meta-analyses of psychosocial, pharmacological, and other treatments for people with DDs are reviewed. There is strong evidence for applied behaviour analysis (ABA) and other behavioural treatments of some forms of psychopathology. There is little good evidence to support the effectiveness of cognitive-behavioural therapy, cognitive therapy, sensory interventions, and other forms of psychosocial interventions. Recently, more randomized controlled trials (RCTs) of psychopharmacology have been published, especially with people with autism spectrum disorders. Most RCTs were for externalizing behaviour problems, rather than for psychopathology. These RCTs offer only preliminary support for the effectiveness of pharmacotherapy. No evidence was found for the effectiveness of other biological treatments. Current research supports the use of ABA and other behavioural interventions for some forms of psychopathology. Evidence for the effectiveness of other interventions is limited or absent.

Couple‐based interventions for psychopathology

Relationship functioning and psychopathology are strongly associated with one another. In this article we provide a selective review of the literature on relationship discord and the presence, incidence and individual‐based treatment of psychiatric disorders. We then present a model for conceptualizing couple‐based interventions with couples in which one partner has a psychiatric disorder, distinguishing between partner‐assisted interventions, disorder‐specific interventions and couple therapy interventions. Finally, we provide examples of how to employ these interventions with several psychiatric disorders (obsessive‐compulsive disorder, anorexia nervosa and depression) and selectively review the efficacy of couple‐based interventions in the treatment of psychopathology.

Review: Psychopathology in childhood epilepsy.

Population-based studies of psychopathology are important in childhood epilepsy given that there is a spectrum of severity with regard to the impact of epilepsy and associated behavioural/psychiatric difficulties. Population-based studies in childhood epilepsy which have focused on global measures of psychopathology and rates of specific behavioural and psychiatric disorders were reviewed with respect to prevalence of disorders and possible correlates of difficulties. Clinic-based studies and meta-analyses were reviewed where they added to an understanding of the correlates or treatment of psychopathology in childhood epilepsy. The systematic review methodology was based on a search of PubMed from January 1980 to June 2011. Children with epilepsy are at significantly higher risk for a range of behavioural and psychiatric disorders including attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), depressive and anxiety disorders. Available evidence suggests that these difficulties are under-recognised and there have been few studies focussing on interventions to treat these behavioural and psychiatric issues in childhood epilepsy. Population-based studies suggest high rates of psychopathology in childhood epilepsy. As a result children with epilepsy need close monitoring with regard to the presence of behavioural difficulties. There is a need for studies on how such difficulties can be best managed so that affected children and their families can maximise their quality of life.

Alan E. Kazdin: Award for Distinguished Scientific Applications of Psychology.

Presents Alan E. Kazdin, the 2011 winner of the American Psychological Association Award for Distinguished Scientific Applications of Psychology. "For outstanding and pathbreaking contributions to the understanding of the development, assessment, and treatment of psychopathology. Alan E. Kazdin's theoretically innovative, methodologically rigorous, and scientifically informed research has significantly advanced knowledge of child and adolescent psychopathologies such as depression and conduct problems. His writings on research strategies and methods have set a high standard for rigor in the field. His work and his ideas have had an enormous impact on the science, practice, and teaching of psychology, and his research has strengthened assessment and treatment of children and adolescents in scientific and clinical settings. His passion, energy, wisdom, and wit have inspired countless colleagues and students over the years, and his work will no doubt continue to do so for many generations to come." (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Binge Eating Disorder and Obesity

Binge eating disorder (BED) is included into eating disorders that are not otherwise specified in DSM-IV. It is more common among overweight women applied to treatment. In the conducted researches it was found that there was high level psychiatric comorbidity in patients with BED. In addition, it has been emphasized that depression caused relapses after BED treatment. In this article, a case of a young woman that failed obesity treatment and therefore referred to psychiatry clinic has been presented. In her treatment fluoxetine and BDT were used and effective results have been obtained. The patient at the same time followed the diet program given by dietician and was controlled by internal medicine department. Multidisciplinary approach is important in the treatment of obesity. Successful results have been obtained with psychiatric evaluation and with the treatment of psychopathologies.

Publication Opportunity in the Journal of Psychopathology and Behavioral Assessment

This issue marks the beginning of the third year and volume of Journal of Psychopathology and Behavioral Assessment. The journal remains committed to the presentation of key developments in the science and practice of psychopathology and assessment, broadly conceived. As the journal has progressed, there has been new knowledge put forth on the general psychometric properties of existing measures. Moreover, new measures have been developed and introduced to the broader community of psychologists and mental health professionals via the journal. A great deal of knowledge has been acquired on psychopathology, assessment and its treatment. All of these studies have provided rich journal content. The journal remains dedicated to promoting the dissemination of knowledge of diverse facets of the profession of psychopathology and assessment. The journal is also committed to research on the treatment of psychopathology and especially articles that pertain to the measurement of change (i. e., reductions in psychopathology). It remains a goal of the journal to reflect the mastery of the assessment, psychopathology, and treatment areas for which authors are studying. In order to continue the flow of high quality manuscripts that have been submitted to the journal, I highlight several issues that I am hopeful will remain an important focus of the journal.

Clinical, Demographic, and Familial Correlates of Bipolar Spectrum Disorders Among Offspring of Parents With Bipolar Disorder

Despite increased risk, most offspring of parents with bipolar disorder (BP) do not manifest BP. The identification of risk factors for BP among offspring could improve preventive and treatment strategies. We examined this topic in the Pittsburgh Bipolar Offspring Study (BIOS). Subjects included 388 offspring, ages 7-17 years, of 233 parents with BP-I or BP-II (via the Structured Clinical Interview for DSM-IV). Offspring diagnoses were determined using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Present and Lifetime version (KSADS-PL). Analyses focused on the 41 offspring who were diagnosed with BP-I (N = 9), BP-II (N = 5), or BP-NOS (N = 27). Offspring with BP had proband parents who were significantly younger at the time of their birth, were more likely to be female, and had lower socio-economic status, versus proband parents of offspring without BP. Parental clinical variables and obstetric variables were not significantly associated with BP among offspring. History of physical and/or sexual abuse, exposure to antidepressants, and exposure to stimulants was significantly greater among offspring with versus without BP. There was significantly greater prevalence of attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, oppositional defiant disorder/conduct disorder (ODD/CD), and exposure to stimulants and antidepressants among offspring with versus without BP. Variables significantly associated with BP among offspring in regression analyses were as follows: older offspring age, younger parent age at birth, offspring anxiety disorders and ODD/CD, and biological coparent with BP. History of anxiety and/or disruptive behavior disorders, as well as presence of bi-lineal parental BP, is associated with elevated risk of bipolar spectrum disorders among offspring. If replicated prospectively, these findings could have implications for the diagnosis and treatment of psychopathology among BP offspring.

In This Issue/Abstract Thinking: Personalized Medicine And Pharmacogenomics in Child Psychiatry

Work presented in this month's Journal explores a variety of environmental and genetic influences on the development and treatment of psychopathology. This issue highlights advances in our understanding of factors that modify expectations related to diagnoses, treatment, and outcomes in children.

Hormones in the Mentally Disturbed Brain: Steroids and Peptides in the Development and Treatment of Psychopathology

One of the more fascinating recent discoveries in neuroscience is the widespread influence of hormones on brain regions and functions underlying pathological behaviors. A story is unfolding that points to critical roles played by hypothalamic - pituitary - gonadal (HPG) and hypothalamic - pituitary - adrenal (HPA) axes on a startling array of mental disorders, from depression to dementia. The influence of peptides and steroids does not end with hormones released from the two axes, however. It is now clear that the brain has adapted, "highjacked" is more descriptive, HPG and HPA hormones for uses unrelated to their original functions in reproduction and responses to stress. Findings of neuromodulatory effects of HPA and HPG hormones on monoamine, GABA, glutamate and opioid pathways and of hormone receptors and enzymes involved in hormone synthesis, particularly of steroids, in the hippocampus, amygdala and other subcortical brain regions provide the brain with multiple evolutionary means to adapt to new functions. The complexity of the metabolic cascade for the steroids also leaves open mechanisms by which endogenous errors and exogenous chemicals could be involved in the etiology of psychopathologies. The planned review will examine the recent literature for evidence of steroidal and peptidergic influences on basic biological functions and on mood disorders, anxiety and PTSD, schizophrenia, substance abuse and dementia. Emphasis will be placed on animal models, although findings with patient populations will be prominently included. Special attention will be paid to novel pathways by which the precursors and metabolites of sex steroids can influence psychopathologies. We also will speculate on promising treatments with hormone modulators that may be useful in mollifying the symptomology of the mental disorders.

Psychology: Pythagoras to present

Certain ideas have preoccupied thinkers since ancient times: the nature of mind, the sources of knowledge and belief, the nature of the self, ethics and the best way to lead our lives, the question of free will. In this book, John Malone examines these ideas in the writings of thinkers from antiquity to the present day and argues for their importance not just as precursors of modern views but as ideas that are frequently better than current ones. We can get good advice, he writes, from the writings of the best thinkers of the past. Pythagoras, Thales, Plato, Protagoras, Aristotle, Diogenes, and Epictetus all offer tried and tested ideas on how we should lead our lives and on the treatment of psychopathology--as do Berkeley, Hume, John Stuart Mill, Johann Friedrich Herbart, Wilhelm Wundt, William James, Sigmund Freud, and B. F. Skinner. Malone begins with the naturalistic and mystical strains of early Greek thought, moves on to Platonism and the world of Forms (and considers parallels between the thought of Plato and Freud), and discusses Ancient Self-Help Therapies (including Epicureanism). He investigates the psychological insights of Enlightenment thinkers including Francis Bacon and Galileo, Locke's and Kant's theories of experience, and Darwin's evolutionary thinking. He charts the rise of modern psychology and the beginning of biological psychology. He examines the work of Wundt, Titchener, Freud, Peirce, and James, among others, and describes the ideas of behaviorism, Gestalt psychology, and cognitive science. Malone's history offers both breadth and depth, an engaging style and rigorous scholarship, demonstrating vividly the relevance of the great historical psychological thinkers.

Sociology and nursing: Role performance in a psychiatric setting

The role of sociology in nursing continues to cast new light on many aspects of health and illness. Over the last 20 years, nursing practice has seen sociological theory become a valuable clinical tool, both in the diagnosis and prognosis of a wide range of illnesses and long-term conditions. Nevertheless, of these, the sociological examination of mental health problems and its impact upon nursing practitioners has received little coverage, simply because, as a discipline, mental health nursing has historically been wedded to a biomedical model, one which continues to embrace psychiatry/psychology as the driving force in the diagnosis and treatment of psychopathology. Adopting a sociological approach, this paper brings to light previously unexplored insights into the way nurses interact with patients experiencing mental health problems. Drawing on social interactionist methodology, this paper considers depression and other mental health problems in relation to current psychiatric nursing practice. Specifically, the paper focuses on aspects of role performance and interpersonal care in a psychiatric setting, and the impact the individual role may have on the wider aspects of institutional and official practices. The paper concludes by making a number of recommendations/observations for nursing practice.

Introduction to Special Issue: Evidence-based Assessment in Pediatric Psychology

Introduction to Special Issue: Evidence-based Assessment in Pediatric Psychology

Beyond Survivorship: Achieving a Harmonious Dynamic Equilibrium Using a Chinese Medicine Framework in Health and Mental Health

SUMMARY In working with clients who are experiencing major difficulties in life, the more traditional, psychopathology-oriented approach is often content with symptom reduction and adaptive functioning. This article proposes that therapists can aim higher, going beyond survivorship. Inspired by Chinese medicine's holistic model, the authors develop the Eastern body-mind-spirit approach with the primary therapy goal being the facilitation of harmonious dynamic equilibrium within oneself, as well as between oneself and the natural and social environment. To achieve that, multimodal interventions are employed, including vitalizing body work, such as simplified Tai Chi and Qigong exercises, acupressure, body scan, breathing meditation, and mindful tea drinking and eating, as well as vibrant mind and spirit process, such as the acknowledgement and acceptance of impermanence and unpredictability, regaining self-control by letting go of control, the appreciation and affirmation of life, the fostering of loving kindness and forgiveness. The spiral application of these multimodal interventions activates the interconnected body-mind-spirit systems to rebalance among themselves and arrive at a new harmonious dynamic equilibrium. The benefits of the approach are multidimensional—a multimodal approach can access and engage more clients; its focus on strength can avoid over-elaborated psychopathology treatment; and transformed clients are change catalysts, both inside and outside the therapeutic group.

Psychosis and Agitation in Dementia: Should General Psychiatrists Care?

Article AbstractBecause this piece has no abstract, we have provided for your benefit the first 3 sentences of the full text.Why read an article addressing whether a medicationcalled memantine might or might not help people with Alzheimer's ? Isn†t Alzheimer's a rare disorder,and a diagnosis of exclusion?†‹