Troubled Individuals Research Articles

Organizational resistance through organizing principles: the case of gender equality in the military

PurposePrevious studies show that the implementation of gender equality encounters resistance in military organizations, but it is often invisible or seen as confined to anonymous structures or troubled individuals. This paper aims to show how the Swedish Armed Forces (SAF) use organizational principles to resist implementing gender equality measures.Design/methodology/approachThe study is a qualitative analysis of discursive strategies in the SAF’s 2013–2018 annual reports to government.FindingsThe organizing principles of instrumentality and distance, while existing in parallel with gender equality efforts, actually pursue logics that prevents the SAF from implementing gender equality. The principle of instrumentality in this context means that gender equality in the SAF is of secondary interest to organizational members. The principle of distancing from the problem includes strategies that alienate female from male officers.Originality/valueThe contribution of this paper is the finding that the use of organizing principles represents conscious organizational resistance to gender equality efforts. This kind of use needs to be revealed and criticized to change military organizations.

“Wonder boys” book vs movie comparison: do wonder boys wander through joys?

Comparisons between books and movies tend to instigate intense conversations. Adapting a film is no simple task, but contrasting the two products can also be an erratic process, regardless of how much one tries to gather all of their ideas together. A mere observation can bring about diverse opinions or daring suggestions on how readers / viewers would have portrayed a certain scene or a small but crucial detail. In the end, it comes down to the charm of taking on the active role of a “critic” and analyzing the choices that were made alongside possible alternatives. The respective article will talk about how the novel “Wonder Boys”, written by Michael Chabon, came to be interpreted in a different medium, as a comedy-drama film from 2000, directed by Curtis Hanson. “Wonder Boys” may be perceived as a world of freedom from various outlooks. In 1995, Chabon – already ahead of his time – produced a small universe in his novel, where his characters could express themselves candidly. In 2000, Hanson went from being a reader to an avid interpreter and creator of his own “Wonder Boys”. Up until today, fortunate people, who come across the book and the film, can spot the director’s ingenious approach, accompanied by his constant loyalty to the writer’s concepts. We are dealing with a piece of work which should be discussed more frequently in classrooms or university lectures, due to its representative teacher-student bonding, the twisted realistic world – in which troubled individuals can still become inspirations for others – and its quality to be replicated in such inventive ways.

Threat assessment as a school violence prevention strategy

Research SummaryThis paper describes the immense difficulty of predicting that someone is going to carry out a school shooting and then turns to threat assessment as a more promising violence prevention strategy. In schools, a multidisciplinary threat assessment team investigates reported threats and develops responses that are calibrated to the seriousness of the threat and the student's educational needs. Researchers have found that school teams have been able to resolve thousands of student threats with no serious acts of violence, yet permitting the majority of students to return to school. Controlled studies have found that schools using this approach can have reductions in the use of school suspension and improvements in student and teacher perceptions of school climate.Policy ImplicationsThreat assessment represents a fundamental shift in the risk assessment field away from the pursuit of predictive accuracy toward a broader approach to the prevention of violence by helping troubled individuals. Threat assessment offers schools a proactive alternative to reactive practices such as zero tolerance discipline and costly investment in building security measures.

Is promoting war trauma such a good idea?

A well‐known medical journal, The Lancet, recently published an important systematic review and meta‐analysis of mental disorder estimates in conflict settings, advocating for the scaling up of mental health interventions in such contexts. However, there is an assumption that the introduction of such treatments has no significant impact, except from a therapeutic one, in the settings they have been imported to. The authors' research in post‐conflict northern Uganda analyzed the social impact of mental health interventions addressing post‐traumatic stress disorder (PTSD) and showed that promoting trauma has had considerable socio‐economic ramifications on the wider society. The introduction of trauma narratives has created a market where some are able to thrive, but many deeply troubled individuals remain invisible. The authors found no social benefits from promoting trauma, and few positive effects for individuals. Arguments for urgently upscaling mental health interventions of the kinds highlighted by the review in The Lancet, and which the authors have observed on the ground, should be treated with caution.

The Fish Can Sing by Halldór Laxness: Holding fast against vanity and illusion

SummaryIn his early novels, the Icelandic Nobel laureate Halldór Laxness portrayed troubled individuals beset by familial, societal and economic challenges within an unpredictable and often unforgiving landscape; his later work addressed humanistic concerns regarding a well-lived life and the harmony of individual and environment. His 1957 novel The Fish Can Sing lies at the cusp of these preoccupations. Laxness contrasts the economic privations experienced by hard-pressed Icelanders with the ostentatious displays of their Danish colonial overloads; he also portrays individuals afflicted by psychosis, alcohol use disorders and medically unexplained physical symptoms, and delineates the path towards a ‘celebrity’ suicide. The novel warns against self-deceptive vanity and community-endorsed illusions, and celebrates the persistent benefits of nurturing relationships, all within a lyric contemplation of individual adaptive resilience and quotidian domestic pleasures.

Psychological health, trauma, dissociation, absorption, and fantasy proneness among Danish spiritual practitioners.

Groups of spiritual practitioners (P) (n = 38), long-term residents in a center offering spiritual courses (R) (n = 8), and matched control groups from a general, population sample for P (CP) (n = 45) and for R (CR) (n = 14) were compared. P had high levels of education and tended to be in a committed relationship and belong to the Danish National Church, whereas R had a lower level of education and were unlikely to be in a committed relationship or belong to the Church, suggesting social marginality. All groups completed the Brief Symptom Inventory-53 (BSI-53), a measure of psychological distress. P did not differ from the control groups in the Global Severity scale (GSI) or the other subscales of the BSI-53 except for scoring lower on the phobic anxiety subscale. In contrast, R scored higher in the GSI and most BSI-53 subscales than P and the control groups, and published norms for Danish and US populations. P and R did not differ in the subscales of somatization or interpersonal sensitivity. These two groups also filled out measures of dissociation, general and severe trauma, absorption, and fantasy proneness. R scored higher than P in dissociation, severe trauma, and absorption. The GSI correlated with dissociation, a history of serious trauma and (weakly) with absorption, but not with general trauma or fantasy-proneness. Overall, the results do not support the view that most spiritual practitioners have higher psychological distress or are socially marginal, although there is a subset of more troubled individuals. (Less)

Classification of offenders with mental health problems and problematic substance use using the Addiction Severity Index version 6: analysis of three-year follow-up data and predictive validity

Previous research is scarce on the problems and needs of the “triply troubled” – among offenders with mental health problems and problematic substance use. Classifying this population into clusters based on problem profiles may provide information about individual needs for treatment. In a previous study, we identified four clusters of triply troubled: less troubled, severely triply troubled, triply troubled with medical problems, and working triply troubled. The present study explored the stability and predictive validity of these clusters in a naturalistic design. In total, 125 triply troubled individuals included in any of the four clusters were followed for approximately three years with regard to their inpatient and outpatient treatment participation. They were also interviewed with the 6th version of the Addiction Severity Index, the Psychopathy Checklist–Revised, and the World Health Organization Quality of Life–Bref. The main finding of the study was that on average the participants of all four cl...

Concerns about the dissemination and implementation of evidence-based psychotherapies in the Veterans Affairs health care system.

Comments on the article by B. E. Karlin and G. Cross (see record 2013-31043-001). The present authors have concerns stemming primarily from how the Department of Veterans Affairs (VA) defines evidence-based psychotherapies (EBPs). The article by Karlin and Cross alluded to some of the controversies surrounding EBPs and why they have not been broadly implemented in many settings. For example, EBP guidelines often are perceived as mechanistic and only appropriate for certain patient populations; and, indeed, for many troubled individuals, EBPs do not work or require adjustment. A group of 19 current and recent past presidents of three APA divisions (12, 29, and 50) and the North American and International Societies for Psychotherapy Research has identified several questions, the answers to which may be important to increase the optimization of such guidelines.

It is our moral obligation and the time is now

The recent outbreaks of violence in the United States that took lives by gunfire and bombings have stimulated numerous commentaries and concerns. Local and Federal officials have rushed to create new laws to limit the availability of firearms, both rifles and handguns. Such laws in the past have had limited effect on violence as attributed to in my native Chicago, which has perhaps the most restrictive such laws and still has one of the most violent, if not the most violent murder rates by handguns in the United States. Also such laws do not hinder bombers. The other major resulting concern has been with the medical community. Lay people do not understand why such troubled individuals, some of who have been under Psychiatric care, have not been recognized as potentially violent and handled accordingly. Their concerns are realistic and important, but the reality is that there are not well documented guidelines Psychiatrically regarding the diagnosis and effective treatments in such individuals. The Diagnostic and Statistical Manual of Mental Disorders, the official guide for diagnosis and treatment used by Psychiatrists, is constantly being changed. There is a clear need for a review of the problem and development of scientifically based solutions. The issue needs a broader view than Psychiatry alone. During the past 15 years there has been a significant research surge in both basic and clinical brain science, especially in intricate and dynamic imaging of the nervous system. All these areas are highly specialized and complicated. It seems logical then that the complex issue of mental illness and potential violence is best evaluated by a multidisciplinary approach that includes the basic brain scientists, anatomists, physiologists, chemists, and now nanotechnologists, clinical experts, Neurologists and Neurosurgeons, and Psychiatrists and Forensic Psychologists. There are a number of Forensic Psychologists practicing, but the singular work of Robert Hare, PhD stands out in this matter; his publications, The Psychopathy Checklist Revised and Without Conscience are landmarks. Funding of such an effort will be important. Initial funding could come through the scholarly societies that guide each subspecialty and when the group is established, funding could then come through the local, regional or State Law Enforcement Agencies using the service of the group. Such a group would also shed light on the mental functioning of terrorists that hound the civilized world today and might well contribute ways to deal with that massive problem.

Identification of dysfunctional cooperative learning teams and troubled individuals

AbstractIn cooperative learning, students work together as a team to maximize the academic success of all the team members. The failure of even a single member can compromise the success of the entire team. Thus, to evaluate the functioning of the team reliably, it is necessary to consider both the performance of the individual team members and the interactions among them. In this study, a method was developed for identifying dysfunctional teams and troubled individuals by examining the correlation between the team scores obtained in sequential tests and the correlation between the scores obtained by the different team members. The effectiveness of the proposed method was evaluated via field experiments. Forty‐eight students were randomly assigned to cooperative learning teams and their learning performance assessed by four‐unit tests. The results indicated that the proposed method can identify the most troubled individuals in a team even when the team performance/grouping information is not taken explicitly into account. Furthermore, when the team information is considered, the method can identify both the dysfunctional teams and the troubled individuals within the teams. Therefore, the proposed method provides a useful basis for the development of computer‐assisted solutions for assessing the performance of cooperative learning teams.

Framing Islam: An Analysis of U.S. Media Coverage of Terrorism Since 9/11

Since 9/11 there have been 11 terrorist events on U.S. soil that occurred or were stopped on the planned day of attack. This study of news coverage of those terrorist events revealed a thematic pattern of terrorism coverage in which fear of international terrorism is dominant, particularly as Muslims/Arabs/Islam working together in organized terrorist cells against a “Christian America,” while domestic terrorism is cast as a minor threat that occurs in isolated incidents by troubled individuals.

Treating the "Untreatable": Healing in the Realms of Madnessby Steinman Ira . London Karnac Books , 2009 , 240 pp., $35.00.

Back to table of contents Previous article Next article This article has been corrected | View Correction Book ForumFull AccessTreating the "Untreatable": Healing in the Realms of MadnessLloyd Sederer, M.D.Lloyd SedererSearch for more papers by this author, M.D.Published Online:1 Mar 2010https://doi.org/10.1176/appi.ajp.2009.09091339AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail by SteinmanIra. LondonKarnac Books, 2009, 240pp., $35.00There are many roads to recovery, I grant you that. But some have been shown to have a far greater likelihood of success than others; we call those evidence-based practices. For example, we know with confidence that the use of medication for people with schizophrenia reduces the risk of hospitalization fivefold, and that a comprehensive treatment of medication, family psychoeducation, case management, skill building, and problem-solving approaches reduces 1-year relapse rates from near certain to 14%. If my family member were ill, I would sure want to reduce the risks. Isn't all health care about reducing risks?But not Dr. Steinman, I guess. His approach, presented through 12 case studies of individuals he treated over a long career, instead holds that psychodynamic therapy, provided multiple times per week over the course of years, is an effective treatment for "the most disturbed and psychotic patients" (p. xiii). He proposes that what these individuals need is "a working through of underlying psychological issues and emotions that have been warded off" (p. xiv). But he does not stop there; in fact, he claims that we in psychiatry have "lost our way…following psychiatric department chairmen who emphasise the ‘scientific' approach" (pp. 187–188). On a roll, he adds that psychiatry has "adopted a cult-like attitude to the benefits of antipsychotic medications and supportive psychotherapy," which includes cognitive therapies in his lexicon of treatments.The cases themselves are an admixture of troubled individuals experiencing psychotic, dissociative, and mood disorders, which he seems to blend together as if they were all the same and thus amenable to his singular form of treatment. The author has a tendency to accept whatever the patient says as fact (as if memory, even childhood memory, were invariably accurately reported) and to blame parents for the ills of their children. Whenever a patient does better, he attributes their success to his work, even though that same person may have left a long-stay hospital for the community or had time to recover from what appeared to be a psychosis fostered by the use of "psychedelic" drugs.I am all for talking with patients, and some of the case material is nicely framed examples of how we all resort to defensive psychological maneuvers to avoid emotional pain and conflict, but where has Dr. Steinman been? Donald Winnicott and the object relations school of dynamic therapy of psychoses have not stood the test of time (nor have they achieved any more than anecdotal support). The author need not create dialectic between handholding and intensive dynamic therapy; after all, we have learned some things since the 1930s. No wonder he says, "I am left with a question…why did these patients not get appropriate treatment?" If he read the Surgeon General's report on mental health, he would know something about the "science to practice gap" that bedevils medicine, including psychiatry, and would be considering ways to improve access and provide effective treatments to people in need, rather than proposing an intervention that at best should be coupled with the interventions we know to work, and at worst can itself produce regression, more years of dysfunction, and tragically missed opportunities to have a life.New York, N.Y.The author reports no financial relationships with commercial interests. FiguresReferencesCited byDetailsCited ByThe Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, Vol. 39, No. 2 Volume 167Issue 3 March 2010Pages 356-357 Metrics PDF download History Accepted 1 September 2009 Published online 1 March 2010 Published in print 1 March 2010

Elvin V. Semrad (1909-1976): Experiencing the Heart and Core of Psychotherapy Training

Elvin Semrad was among the most influential and beloved teachers of psychotherapy in his generation. His legacy as a clinician, teacher, and mentor is still felt today, even among those who never knew him directly. What and how he taught remains as relevant as ever in the psychotherapeutic care of troubled individuals. His was primarily a psychiatry of affects and bodily feelings, and he focused uncannily and empathically on the patient's experience. The basis of his rich, heartfelt, wise, and inimitable approach was not just classically psychoanalytic, or existential, or ego-oriented, or self-psychological, or interpersonal-relational, or even humanistic or adaptational. Rather, it was all of these in a uniquely "Semradian" integration geared toward elucidating patients' experience that had arrested them during their life course and their avoidance of "acknowledging, bearing, and putting into perspective" what they were up against. This paper describes who he was and gives a personal perspective on his influence--how and what he taught and why he had such an effect on those who knew him.

Choosing psychotherapy as a career: Beyond “I want to help people”

This article briefly considers the career determinants of mental health professionals and then introduces the contents of the Journal of Clinical Psychology: In Session issue devoted to "why I became a psychotherapist." Psychotherapists are assuredly a special sort because the average person prefers to minimize the psychic sufferings of fellow humans and to avoid extensive contact with troubled individuals. Although the most frequent and conscious reason for becoming a psychotherapist is a desire to "help others," the decision is more complex and multidetermined than that. The multiple, intertwined motives are partly unconscious, impacted by chance encounters, and probably not well understood into late in one's career.

Heightened vulnerability and increased risk-taking among adolescent chat room users: results from a statewide school survey

Purpose To profile adolescent Internet chat room users in terms of demographic characteristics, psychological and environmental factors, and behavioral risk factors. Methods The study sample was drawn from respondents to an anonymous statewide survey of 50,168 9th-grade public school students and included 40,376 students who reported Internet access at home and 19,511 who accessed chat rooms. Data were collected by the Minnesota Student Survey (MSS), a survey that has been administered triennially by the state's education department to public school students in grades 6, 9, and 12 since 1989. The MSS includes more than 117 questions (300 variables) addressing attitudinal, behavioral, and environmental issues. Data analysis consisted of comparing the odds of a particular characteristic or behavior for chat room users with that of nonusers. Analyses were run separately for boys and girls. The homogeneity of odd ratios was tested with the Breslow-Day statistic using SPSS for Windows. Results For boys and girls, use of Internet chat rooms was associated with psychological distress, a difficult living environment, and a higher likelihood of risky behaviors. Although most chat room users did not report serious problems, this group included a disproportionate number of troubled individuals. Conclusions Because chat room use serves as an indicator of heightened vulnerability and risk-taking, parents and others need to be aware of potential dangers posed by online contact between strangers and youth.

Integration in Psychotherapy: Models and Methods

Article AbstractBecause this piece does not have an abstract, we have provided for your benefit the first 3 sentences of the full text.In today's rapidly expanding world of psychiatric knowledge, hardly a day passes without discussion of some new psychotropic agent. Research presses forward with urgency, the goals of eradicating, or at least keeping at bay, debilitating psychiatric symptoms stemming from an openness about psychiatric illness that didn†t exist years ago. But as clinicians whose "raison d†etre" is to understand the meaning of human behavior and whose goal is to help troubled individuals effect meaningful life changes, it is crucial for us to also explore the various psychotherapies that enable our patients to make these changes. This book reminds us that "all therapies rely on a purposeful collaboration between patient and therapist" (p.13).

Reconciling Divergent Perspectives: Judith Wallerstein, Quantitative Family Research, and Children of Divorce

Although Judith Wallerstein's research on children with divorced parents has been influential, many quantitative family scholars have criticized her methods and conclusions. Wallerstein claims that children with divorced parents often reach adulthood as psychologically troubled individuals who find it difficult to maintain stable and satisfying relationships with others. Consistent with Wallerstein's claims, quantitative research suggests that parental divorce increases the risk of experiencing psychological problems, having a discordant marriage, seeing one's own marriage end in divorce, and having weak ties to parents (especially fathers) in adulthood. The accumulated evidence, however, reveals that the estimated effects of divorce are not as strong as Wallerstein appears to claim. I provide examples from the Marital Instability Over the Life Course study to illustrate the magnitude of divorce effects. I conclude with a call for a rapprochement between Wallerstein and her critics.

Colleagues Reflect on Va. Psychiatrist’s Tenure as MH Inspector General

Back to table of contents Previous article Next article Members in the NewsFull AccessColleagues Reflect on Va. Psychiatrist’s Tenure as MH Inspector GeneralJoan Arehart-TreichelJoan Arehart-TreichelSearch for more papers by this authorPublished Online:2 May 2003https://doi.org/10.1176/pn.38.9.0019aNot surprisingly, Virginia psychiatrists are quite pleased that government officials have created an office of inspector general for Virginia’s public mental health system. “I think it is good to have somebody in the field of medicine and psychiatry, someone like Dr. Anita Everett, who can look objectively at very emotional issues and recommend good system fixes,” Jorge Cortina, M.D., a geriatric psychiatrist with the Veterans Affairs Medical Center in Hampton, Va., told Psychiatric News.“It was certainly a good idea that such a position was created,” J. Gregory Fisher, M.D., a Lynchburg, Va., psychiatrist and president-elect of the Psychiatric Society of Virginia, said in an interview, “because unfortunately Virginia’s state mental hospitals, like those in a lot of states, have had a checkered history. I think the state has worked hard to improve the mental health system and get above board, but I think the position of inspector general has helped with that process significantly.”Virginia psychiatrists are quite pleased with Everett’s performance as inspector general. “She has done an excellent job,” opined Charles Davis, M.D., medical director of Central State Hospital in Petersburg, Va., which is one of the public mental health facilities under Everett’s purview. “It is a demanding and difficult role. The state hospitals are where the most troubled individuals go. And many times they are prone to behaviors that may be injurious to themselves or others, which are difficult for the public to understand. . . .”“She fills a vital function in terms of people knowing that their system is being looked at by someone who insists that a good job must be done, but who is also on their side,” asserted John Shemo, M.D., a Charlottesville, Va., psychiatrist and a district branch representative to the APA Assembly. “She doesn’t have any agenda other than having the system work better. . . .”“Although I do not work in the state mental health system, I do know that I am reading less about our state mental hospitals in the newspapers than I was several years ago,” Fisher said. “That indicates that Dr. Everett has made a positive difference.”Virginia psychiatrists have a list of objectives that they would like Everett to achieve in the time that she has left as inspector general.“I would like to see more coordination or tightening of relations between the public and private mental health sectors,” Fisher said. “I’m not sure how she could achieve that in her position. However, there is currently a lack of working together between the two sectors, and anything that could be done on either side to ameliorate the situation would be of value.”“I hope that she’ll be able to influence the dumping of patients out of the state mental hospitals,” Shemo asserted. “There are a lot of patients in our state, as in every state, who either end up in the prison system or in poorly funded domiciles where there is no real care or protection. I know that Anita feels strongly about these issues. In the APA Assembly, she was able to help get a block of five action papers passed, all of which specifically addressed the needs of the severely and persistently mentally ill.”“I think that the people with power in our state—the governor, legislature, department of mental health—are pleased with her work,” David Markowitz, M.D., a Richmond, Va., psychiatrist and president of the Psychiatric Society of Virginia, opined. “So I don’t think there is anyone who would like to see the position of inspector general go. But at the same time, everybody protects their own piece of the pocketbook. So I wish that she could find some way to transition her position into a permanent one to help the public mental health system.” ▪ ISSUES NewArchived

From the valley of the shadow of death: a group model for borderline patients.

Describes a pastoral group for patients with borderline personality disorder. Offers a theoretical justification for providing such troubled individuals with access to spiritual as well as to traditional biopsychosocial treatment resources.

On Becoming a Counselor: A Basic Guide for Non-Professional Counselors

Since its first publication in 1977, Eugene Kennedy and Sara Charles's 'On Becoming a Counsellor' has become the one, indispensable resource for all those who, without extensive psychological training, must deal with troubled individuals - the confused, the grieving, the suffering, the immature, who so often turn to teachers, doctors, nurses, lawyers, clergy, and frequently to old friends. This new and completely revised edition will bring this already popular book up-to-date with the medical and psychological advances over the past ten years, and continue to provide non-professional as well as professional counsellors with all the essential tools they need to respond to people's problems with intelligence and compassion. The authors set forth the basic rules of sound, effective counselling in such areas as anxiety, neurosis, depression, obsession, marriage, death, bereavement, suicide, schizophrenia, alcoholism and drugs. The meaning and symptoms of real emergencies are explored, as are the aspects of interviewing, diagnosis, referral and emotional involvement.