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Categories, Dimensions, and Narratives for Person-Centered Diagnostic Assessment
No full textClassifications are multipurpose tools that have to deal with multiple epistemological constraints. In spite of the hopes they raised, the DSM-III, DSM-IV, and DSM-5 categorical models have shown their limitations in fostering effective diagnostic assessment processes. By discussing the person-centered integrative diagnosis (PID) this paper will consider how pluralistic descriptive procedures (Categories, Dimensions and Narratives) are essential for diagnostic assessment in person-centered medicine and psychiatry. It will stress the importance of the narratives of the patient and of the physician in this novel comprehensive diagnostic perspective
Social evaluation or simple association? Simple associations may explain moral reasoning in infants
No full textAre we born amoral or do we come into this world with a rudimentary moral compass? Hamlin and colleagues argue that at least one component of our moral system, the ability to evaluate other individuals as good or bad, is present from an early age. In their study, 6- and 10-month-old infants watched two social interactions - in one, infants observed the helper assist the climber achieve the goal of ascending a hill, while in the other, infants observed the hinderer prevent the climber from ascending the hill. When given a choice, the vast majority of infants picked the helper over the hinderer, suggesting that infants evaluated the helper as good and the hinderer as bad. Hamlin and colleagues concluded that the ability to evaluate individuals based on social interaction is innate. Here, we provide evidence that their findings reflect simple associations rather than social evaluations
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Frequency of infant stroking reported by mothers moderates the effect of prenatal depression on infant behavioural and physiological outcomes
No full textAnimal studies find that prenatal stress is associated with increased physiological and emotional reactivity later in life, mediated via fetal programming of the HPA axis through decreased glucocorticoid receptor (GR) gene expression. Post-natal behaviours, notably licking and grooming in rats, cause decreased behavioural indices of fear and reduced HPA axis reactivity mediated via increased GR gene expression. Post-natal maternal behaviours may therefore be expected to modify prenatal effects, but this has not previously been examined in humans. We examined whether, according to self-report, maternal stroking over the first weeks of life modified associations between prenatal depression and physiological and behavioral outcomes in infancy, hence mimicking effects of rodent licking and grooming. From a general population sample of 1233 first time mothers recruited at 20 weeks gestation we drew a stratified random sample of 316 for assessment at 32 weeks based on reported inter-partner psychological abuse, a risk to child development. Of these 271 provided data at 5, 9 and 29 weeks post delivery. Mothers reported how often they stroked their babies at 5 and 9 weeks. At 29 weeks vagal withdrawal to a stressor, a measure of physiological adaptability, and maternal reported negative emotionality were assessed. There was a significant interaction between prenatal depression and maternal stroking in the prediction of vagal reactivity to a stressor (p = .01), and maternal reports of infant anger proneness (p = .007) and fear (p = .043). Increasing maternal depression was associated with decreasing physiological adaptability, and with increasing negative emotionality, only in the presence of low maternal stroking. These initial findings in humans indicate that maternal stroking in infancy, as reported by mothers, has effects strongly resembling the effects of observed maternal behaviours in animals, pointing to future studies of the epigenetic, physiological and behavioral effects of maternal stroking
Child and Adolescent Psychiatry
No full textChild and Adolescent psychiatry, more than other areas of the field, has to take into account not only the current child’s mental health but also his future as an adult as well as nature–nurture questions and neurodevelopmental and environmental processes. In all these perspectives, child and adolescent psychiatry has to be particularly integrative in its approach of the patient and in the consideration it gives to the complexity of the person. The integrative dimension of Person Centered Psychiatry is particularly important to encompass the various aspects of this complexity. Child and Adolescent Psychiatry can then be seen as a good example of the usefulness of person-centered approaches in various care settings; to the point that it can be considered that, to be effective and faithful to clinical reality, childhood and adolescent mental heath care cannot be but person-centered. After examining the various clinical specificities of Child and Adolescent Psychiatry, this paper will consider the conceptual modifications needed to take them into account. This involves introducing more complexity in current classification systems and care planning to allow them to get closer and more responsive to clinical situations faced in child and adolescent psychiatry. Two examples will be provided on the conceptual and practical consequences of these considerations, i.e., the impact on health and well-being of early life experiences (such as adverse childhood events and impaired relationships) and the suitability of a person-centered health model for people with Intellectual Developmental Disorders
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Male suicide rates in German prisons and the role of citizenship
No full textPurpose: Prisoners are at a particularly high risk of suicide. In contrast to other psychosocial risk factors it remains unclear to what degree the risk of suicide differs between prisoners with local citizenship and foreigners. In order to provide more detailed information for suicide prevention in prisons, this study aims to compare suicide rates (SR) between these populations in German criminal custody.
Methods: Based on a German national database of completed suicide in custody, suicides by prisoners were analysed and compared with epidemiological data of the prison population and the general population, stratified for German and foreign citizenship. Data analysis was adjusted for differences in the age distribution of both populations by calculating standard mortality ratios (SMR) for suicide.
Results: SR were higher in prisoners with German citizenship than those with foreign citizenship (SR = 76.5 vs. SR = 42.8, P<0.01). This association was not specific to the prison population, as the higher SR in citizens compared to non-citizens (SR = 19.3 vs. SR = 9.0, P<0.01) were also found in the general population. The association between prison suicide and citizenship was comparable in juvenile and adult prisoners, indicating its relevance to both the juvenile and adult detention systems.
Conclusion: Imprisonment is associated with a substantially increased risk of suicide in both German and non-German citizens, a finding which needs to be taken into consideration by the justice system. The lower suicide risk in non-German citizens is independent of whether or not they are in custody
Adversity, emotion recognition, and empathic concern in high-risk youth.
Get PDFLittle is known about how emotion recognition and empathy jointly operate in youth growing up in contexts defined by persistent adversity. We investigated whether adversity exposure in two groups of youth was associated with reduced empathy and whether deficits in emotion recognition mediated this association. Foster, rural poor, and comparison youth from Swaziland, Africa identified emotional expressions and rated their empathic concern for characters depicted in images showing positive, ambiguous, and negative scenes. Rural and foster youth perceived greater anger and happiness in the main characters in ambiguous and negative images than did comparison youth. Rural children also perceived less sadness. Youth's perceptions of sadness in the negative and ambiguous expressions mediated the relation between adversity and empathic concern, but only for the rural youth, who perceived less sadness, which then predicted less empathy. Findings provide new insight into processes that underlie empathic tendencies in adversity-exposed youth and highlight potential directions for interventions to increase empathy
General trust impedes perception of self-reported primary psychopathy in thin slices of social interaction.
Get PDFLittle is known about people's ability to detect subclinical psychopathy from others' quotidian social behavior, or about the correlates of variation in this ability. This study sought to address these questions using a thin slice personality judgment paradigm. We presented 108 undergraduate judges (70.4% female) with 1.5 minute video thin slices of zero-acquaintance triadic conversations among other undergraduates (targets: n = 105, 57.1% female). Judges completed self-report measures of general trust, caution, and empathy. Target individuals had completed the Levenson Self-Report Psychopathy (LSRP) scale. Judges viewed the videos in one of three conditions: complete audio, silent, or audio from which semantic content had been removed using low-pass filtering. Using a novel other-rating version of the LSRP, judges' ratings of targets' primary psychopathy levels were significantly positively associated with targets' self-reports, but only in the complete audio condition. Judge general trust and target LSRP interacted, such that judges higher in general trust made less accurate judgments with respect to targets higher in primary and total psychopathy. Results are consistent with a scenario in which psychopathic traits are maintained in human populations by negative frequency dependent selection operating through the costs of detecting psychopathy in others
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