bluuebunny/crossref_metadata_2025 huggingface dataset:
Ärztinnen und Ärzte an der Schnittstelle zum nicht-medizinischen Hilfs- und Unterstützungssektor für Menschen mit Demenz
Authors: Cording Linda , Beyer Annette , Boettcher Aisha , Schattschneider Ralf , Busch Susanne
Published: June 2017

Ziel Im Rahmen der Studie wurde die Schnittstellenfunktion von Ärztinnen und Ärzten zwischen dem medizinischen und nicht-medizinischen Hilfs- und Unterstützungssektor in der ambulanten Versorgung von Menschen mit Demenz konkret für die Stadt Hamburg untersucht. Differenziert beleuchtet wurden aus ärztlicher Perspektive die Ist-Situation des eigenen Umgangs mit Aspekten der nicht-medizinischen Hilfe und Unterstützung sowie Vorstellungen über Optimierungsbedarfe.

Methodik Auf Grundlage einer qualitativen Vorstudie (mit 6 Ärzten) wurde ein standardisierter Fragebogen entwickelt. Mithilfe dessen konnten in einer explorativen Querschnittstudie Daten von 177 in Hamburg niedergelassenen Haus- sowie Fachärztinnen/-ärzten (Fachrichtungen Nervenheilkunde, Neurologie, Psychiatrie, Psychotherapie und Psychotherapeutische Medizin) erhoben und deskriptiv analysiert werden.

Ergebnisse Die Studie zeigt, dass der Großteil (88,1%) der Haus- als auch Fachärztinnen/-ärzte Menschen mit Demenz und ihre Angehörigen über bzw. zu nicht-medizinischer Hilfe und Unterstützung informiert/berät. Die Information/Beratung weist dabei inhaltlich deutliche Unterschiede auf. Am häufigsten wird hinsichtlich ‚häuslicher Pflege‘, am wenigsten hinsichtlich ‚Leistungen für Pflegepersonen‘ informiert/beraten. Optimierungsmöglichkeiten der Ist-Situation werden vor allem in der Aufbereitung von Informationsmaterialien sowie der Bereitstellung einer professionellen Kontaktstelle für Ärztinnen/Ärzte gesehen.

Schlussfolgerung Die Ergebnisse bieten eine Grundlage für eine Weiterentwicklung und Verbesserung der derzeitigen Versorgungslandschaft. Diskutiert werden muss die monoperspektivische Datenerhebung aus ärztlicher Sicht. Für die konkrete Ableitung von Implikationen ist u. a. die Frage nach dem Zusammenführen mit den Perspektiven von Betroffenen sowie weiteren Stakeholdern aus der multiprofessionellen Versorgungslandschaft zu beantworten.
Mikronährstoffe und Demenzerkrankungen: Omega-3-Fettsäuren und B-Vitamine
Authors: Bayer Wolfgang , Schmidt Karlheiz
Published: June 2017

Die zunehmende Alterung unserer Bevölkerung rückt Demenzerkrankungen immer stärker in den Vordergrund.
Nach den vorliegenden Daten ist damit zu rechnen, dass bei über 90-Jährigen mehr als 40 % an einer Demenz
erkranken werden. Im Rahmen der Prävention von Demenzerkrankungen können nutritive Faktoren eine wichtige
Rolle spielen. Dabei liegt ein besonderer Fokus auf den mehrfach ungesättigten Omega-3-Fettsäuren sowie
auf den B-Vitaminen. Die Wirkung der B-Vitamine dürfte dabei zumindest teilweise auf eine
Homocysteinsenkung zurückzuführen sein. Besonders interessant sind die Interaktionen von mehrfach
ungesättigten Omega-3-Fettsäuren mit B-Vitaminen. Dabei haben neuere Studien gezeigt, dass positive
Wirkungen der B-Vitamine zu Inzidenz und Verlauf von Demenzerkrankungen von einer optimalen Versorgung
mit Omega-3-Fettsäuren abhängig sind. Dieses Beispiel zeigt den erforderlichen Wandel in der
Betrachtungsweise – weg von den präventiven und therapeutischen Wirkungen einzelner Mikronährstoffe hin
zu einer stärkeren Berücksichtigung komplexer Wechselwirkungen mehrerer Komponenten.
Musikalische Fähigkeiten bei Kindern mit auditiver Verarbeitungs- und Wahrnehmungsstörung
Authors: Scheffner Evgenia , Vorwerk Wilma , Vorwerk Ulrich
Published: June 2017

Hintergrund In der klinischen Praxis wurden bei Kindern mit auditiven Verarbeitungs- und Wahrnehmungsstörungen (AVWS) Schwierigkeiten
bei der Lösung musikalischer Aufgaben beobachtet. Musikalität bei AVWS ist bisher wenig erforscht.

Material und Methoden 15 AVWS-Patienten im Alter zwischen 6 und 11 Jahren wurden mit der Messung musikalischer Fähigkeiten (MMF)
untersucht und mit 15 Kontrollprobanden verglichen.

Ergebnisse AVWS-Patienten zeigen statistisch signifikante Defizite in den Aufgaben zur Tonhöhendifferenzierung, Reproduktion von
Rhythmen und Melodien. Zusammenhänge zwischen sprachlichen und musikalischen Leistungen bei AVWS-Patienten wurden nachgewiesen.

Schlussfolgerungen Musikalische Fähigkeiten sollten in der AVWS-Diagnostik mehr Beachtung finden. Positive Transfereffekte
musikalischen Trainings auf die Sprachentwicklung und allgemeine kognitive Fähigkeiten wurden in zahlreichen Studien nachgewiesen. Bei
Vorliegen musikalischer Defizite sollte musikalische Förderung als Therapiemethode bei AVWS diskutiert werden.
Variability of the IGF2 locus in the Suino Nero Lucano pig population and its effects on meat quality
Authors: Simonetti Amalia , Rando Andrea , Di Gregorio Paola , Valluzzi Carmelisa , Perna Annamaria , Gambacorta Emilio
Published: June 2017

The aim of this study was to analyse the polymorphisms in the two promoter regions, P1 and P2, of the porcine Insulin-like Growth Factor 2 (IGF2) gene and to investigate the effect of IGF2 genotypes on meat quality traits in the Italian autochthonous Suino Nero Lucano pig. Three polymorphic sites were analysed and only two of the eight potential haplotypes were observed in the Suino Nero Lucano pig population: A haplotype (–366A – –225G – –182C), and B haplotype (–366G – –225C – –182T). Muscle mass and meat quality characteristics were analysed in 30 castrated pigs (10 for each of the three IGF2 genotypes: A/A, A/B, and B/B). According to the results, B/B animals, at the same carcass weight, showed the highest Longissimus lumborum and Psoas weight (P < 0.05), whereas A/A animals showed a higher intramuscular fat percentage and lower Warner–Bratzler shear force, drip loss, and polyunsaturated fatty acids content. Meat from B/B animals showed also a higher L* value and myoglobin and deoxymyoglobin percentage compared with meat from A/A ones (P < 0.05).
The Miscellaneous Group—Description of the Clinical Group Comprising the Smallest Number in the Total Sample
Authors: Robins Eli
Published: June 2017

This chapter focuses on the members of the smallest diagnostic group, which was comprised of ‘miscellaneous’ diagnoses, including organic brain syndrome, schizophrenia, drug dependence, and terminal medical illness. It presents diagnostic criteria, and symptoms shown by members of this diagnostic group, before presenting study records and case notes of each member of the group.
Assessment of Older Adults
Authors: Gallagher-Thompson Dolores , Thompson Larry W.
Published: June 2017

Assessment of cognitive, emotional, and functional status is recommended prior to beginning CBT with an older client. This provides a clearer understanding of the client’s main problems and enables the therapist to determine whether or not the client is a suitable candidate for CBT. This chapter outlines preparation for assessment, the CBT model for older adults, assessment of alcohol or other substance abuse, depression and anxiety, suicide ideation, medical history, and social support.
Module 2: Identifying Target Complaints and Setting Goals
Authors: Gallagher-Thompson Dolores , Thompson Larry W.
Published: June 2017

This chapter describes the second module of CBT for late-life depression, which focuses on the identification of target complaints and setting goals. It includes a review of home practice, before identifying and prioritizing target complaints, translating target complaints into goals, progress towards goals, and home practice exercises.
Module 7: Termination
Authors: Gallagher-Thompson Dolores , Thompson Larry W.
Published: June 2017

This chapter describes the seventh module of CBT for late-life depression, which covers termination and the therapy ending processes. It includes scheduling the therapy conclusion process, maintenance of achievements, review of skills learned, planning for future stressful situations, and warning signs.
The Foundation
Authors: Safren Steven A. , Sprich Susan E. , Perlman Carol A. , Otto Michael W.
Published: June 2017

This chapter provides basic information about setting goals for treatment. It focuses on helping the client with adult ADHD to come up with goals for therapy that are both specific and within his or her control. The modular structure of this treatment program is explained. The chapter covers the foundational skills that will allow the client to get started with a task list and calendar system. There is a discussion of how to identify and try to resolve potential pitfalls or challenges that may arise during treatment. The chapter concludes with a discussion of motivation for change.
Gauging Your Attention Span and Distractibility Delay
Authors: Safren Steven A. , Sprich Susan E. , Perlman Carol A. , Otto Michael W.
Published: June 2017

This chapter contains instructions that adult clients with ADHD can use to gauge their attention span and use the “distractibility delay” technique. The first step is for clients to gauge the length of time that they can reasonably expect themselves to work on a boring or difficult task. The second step is to break tasks down into smaller “chunks” that will likely take that amount of time. The “distractibility delay” skill involves committing to keep working on a task for a certain period of time. During that time, the client writes down distractions but does not act on them. After the agreed-upon period of time, the client can decide if they are tasks that need to be done immediately, tasks that can go onto the task list, or tasks that are pure distractions and can be discarded.
Introducing a Cognitive Model of ADHD
Authors: Safren Steven A. , Sprich Susan E. , Perlman Carol A. , Otto Michael W.
Published: June 2017

This chapter provides information about the cognitive component of the cognitive-behavioral model of ADHD. We introduce the concept of automatic thoughts. The chapter then outlines the relationship between thoughts, behaviors, and feelings. A list of thinking errors is provided. Clients learn how to begin to self-monitor their thoughts using a thought record.
Informational Session with Spouse, Partner, or Family Member (if applicable)
Authors: Safren Steven A. , Sprich Susan E. , Perlman Carol A. , Otto Michael W.
Published: June 2017

This chapter describes an optional session that can be conducted with a spouse, partner, or family member of the client with ADHD. In this session the therapist would provide psychoeducation about ADHD to the client’s spouse, partner, or family member. The therapist would also provide an overview of the treatment. The chapter offers suggestions on how to conduct a discussion of the role the family member will play in the client’s treatment. The chapter concludes with a case vignette.
Organization of Multiple Tasks
Authors: Safren Steven A. , Sprich Susan E. , Perlman Carol A. , Otto Michael W.
Published: June 2017

This chapter focuses on how the therapist can help the client with ADHD organize and prioritize tasks. It describes how to help the client choose and begin using an effective calendar and task list system. It offers advice on how to help clients manage multiple tasks. Information is provided about how to help clients prioritize tasks. A case vignette is provided to illustrate these concepts.
Gauging the Client’s Attention Span and Teaching Distractibility Delay
Authors: Safren Steven A. , Sprich Susan E. , Perlman Carol A. , Otto Michael W.
Published: June 2017

This chapter contains instructions for helping clients with ADHD to reduce distractibility. Clients are taught to gauge their attention span, the length of time that they can reasonably expect themselves to work on a boring or difficult task, and then to break tasks down into smaller chunks that will likely take that amount of time. The chapter also contains information on teaching the “distractibility delay” skill. The client sets an amount of time during which he or she commits to staying on task. If distracting thoughts pop into the client’s head during that time, he or she writes them down. After the agreed-upon length of time, the client can decide if they are tasks that need to be done immediately, tasks that can go onto the task list, or tasks that are pure distractions and can be discarded. A case vignette illustrates the use of these techniques.
Application of Skills to Procrastination (optional)
Authors: Safren Steven A. , Sprich Susan E. , Perlman Carol A. , Otto Michael W.
Published: June 2017

This chapter outlines an optional session for clients with ADHD that focuses on procrastination. It describes how the therapist can discuss the attractive aspects of procrastination and how the client can learn to identify the negative consequences of procrastination. An exercise is presented where the client goes over the pros and cons of procrastination using a specific example. The chapter includes a discussion of how previously taught skills of problem-solving, adaptive thinking, and cognitive restructuring can be applied to procrastination. A case vignette illustrates the process of identifying the long-term and short-term effects of procrastination.
Teaching Fire Safety Education: Basic Awareness Concepts
Authors: Kolko David J. , Vernberg Eric M.
Published: June 2017

This chapter provides a guide for teaching the basic components of fire, how fires start, and how damaging a fire can be. It discusses ways to convey this information, allowing for the child’s existing level of knowledge about fire. Sections include the impact of smoke and fire, burns and scalds, emphasizing prevention. A discussion on firefighters is included, stressing the training and knowledge required to safely deal with fire. The chapter covers reviewing, with parents and children, some details of local fires and their impact on people and property. It also describes reviewing reasons children start fires in general, and the child’s recent fire incident, fire safety, fire triangle, firesetting motivation, fire science, and prevention skills. Certainly, the child’s age and level of sophistication will determine, in part, which and how many of these concepts you review. And, if other concepts not included herein seem important to review with a given child or teen, you may find additional content on the internet or in other sources.
Teaching Fire Safety Education: Strategies to Support Safety
Authors: Kolko David J. , Vernberg Eric M.
Published: June 2017

This chapter continues the subject of fire safety education with practical information on the dangers of fires and ways to avoid it that includes teaching skills to help the child reduce exposure to fire and prevent injuries or other damages by responding effectively to it. It provides additional materials for families to support children in fire prevention, including a home project. Sections include emphasis on fire as a tool, not a toy; reporting a fire, extinguishers, evacuation, and the stop-drop-roll technique. Also discussed is how to review the child’s fire-safety knowledge and provide suggestions to apply what has been learned. An important addition addresses how to prepare a babysitter or other caregiver with all necessary fire safety information.
Affect Regulation and Cognitive Control
Authors: Kolko David J. , Vernberg Eric M.
Published: June 2017

This chapter introduces emotional and cognitive control skills to children, instructing them to understand their own and others’ emotions, and the role of various types of thoughts. It provides a discussion on approaching others to discuss feelings, automatic thoughts, and muscle relaxation techniques. Activities to help a child learn these skills include: making a list of emotions; identifying clues to how someone feels; and connecting events, thoughts, and feelings. The chapter includes explanations of automatic thoughts, how thoughts are associated with emotions, and how different emotions (negative/positive) lead to different actions. These activities are explained using forms provided in an appendix.
Effective Problem-Solving
Authors: Kolko David J. , Vernberg Eric M.
Published: June 2017

This chapter introduces problem-solving skills to children. The content includes an overview of identifying problems, determining options, and making decisions based on goals. Emphasis is placed on reviewing materials from the previous chapter regarding the role of thoughts and interpretations. These skills are generalized to various areas of the child’s life before being applied to fire-related situations. A multi-step process is introduced to help the child learn to, first identify problems and goals, then problem-solve and consider consequences. These skills are then practiced by applying them to a recent problem situation that the child experienced. Worksheets provided in the appendix are used to facilitate the implementation of these activities.
Update and Review of Home Management Plan/Program
Authors: Kolko David J. , Vernberg Eric M.
Published: June 2017

This chapter describes the final treatment topic of constructing a home management program and contingency plan targeting the child’s behavior. It introduces and elaborates on various management structures. It includes a review and extension of material already discussed on the use of consequences (i.e., contingencies) to manage and support the child’s behavior at home. Emphasis is put on working with the parent(s) to ensure the home management plan is both feasible and effective, through discussion of current plans, revision of the plan, and final review. The family is advised on preparing for the termination of the sessions.
Effective Billing and Collecting
Authors: Kozak Thomas M. , Miller Andrea Kozak
Published: June 2017

This chapter examines billing for psychological services through an ethical and procedural lens. Types of billing are reviewed, including fee-for-service and various types of insurance. The usual and customary rate for billing as compared to the amount paid by various types of insurance companies is explored, as is the insurance coverage related to psychological testing. Patient-centered medical homes are discussed, including their relationship to managed care and health maintenance organizations. Capitated systems are reviewed, including how to plan for services and ethical concerns in this model. Other types of billing, including Medicare and Medicaid, are discussed as is the use of a sliding fee scale and collection agencies. This chapter offers a general overview of billing and collecting for psychological services while exploring ethical and real-world considerations.
The Basics of Managed Care and Its Impact on Private Practice
Authors: Herz Gordon I.
Published: June 2017

This chapter describes “managed care” insurance systems and practices that were created to manage healthcare costs. Effects on private mental health practice are identified, such as decreases in reimbursement, documentation requirements, treatment reviews, and other intrusions into clinician–client privacy and decision making. Potential advantages of participation are also identified. Key factors that private practitioners should take into account when deciding whether to participate with managed care organizations include careful contract reviews, likely credentialing requirements, and the impact of reimbursement on a practice. Potential solutions to common challenges are provided, such as limits on balance billing and waiver of co-payments. Ethical concerns specific to providing mental health treatment in the managed care context are discussed, such as limits on privacy and confidentiality. Potential implications of the ongoing seismic changes in the healthcare system for the future of managed care and private practitioners are explored.
Issues in Developing and Joining a Group Practice
Authors: Wise Edward A.
Published: June 2017

When a mental health practitioner joins or forms a group practice, an infinite number of complex issues must be addressed. These include an array of personal, professional, and business decisions. The aim of this chapter is to review some of the more common questions that arise when joining or creating a group practice. These topics include the fit between the individual and the group along a variety of dimensions, including the composition of the group, its legal and operational structures, the market position and growth opportunities for the practice, the developmental phase of the group, and conflict management within the group. The roles of consultants to assess the legal and financial health of the group are also reviewed.
The Use of Social Media in Marketing a Practice
Authors: Wittenberg Heather
Published: June 2017

This chapter explains how social media use can be a powerful practice-marketing tool for private practitioners. It can help build referral sources, improve one’s visibility as a clinical and media expert, provide important health education to the public, create a bridge to academic research, and build one’s professional network. Use of social media for clinicians is expanding rapidly, and the lack of a thorough understanding of its effective and ethical use can now be a detriment to clinical practice. Types of social media are explained, and trends in clinical training, supervision, and clinician use are reviewed. Areas of caution and concern, including how to handle online reviews of clinicians, communicating with clients via social media, and other ethical issues, are explored. Guidance and recommendations for clinicians with both beginning and experienced skills in social media are provided, as are tips for creating and maintaining an effective social media presence.
Common Ethical Transgressions by Private Practitioners
Authors: Koocher Gerald P. , Suffrin Rachael L.
Published: June 2017

Most ethical transgressions by private practitioners arise from errors rather than bad intentions. Such slips often occur when the clinician attempts to take unwise shortcuts, lacks awareness, or shows lapses in judgment. This chapter explores the most common triggers of ethical breaches among practitioners and suggests preventive strategies. Common problems include failure to maintain competence in evidence-based practice or in serving diverse populations. Other important issues include risky business practices, challenges associated with newer technologies such as telepractice, recordkeeping, billing, professional isolation, and role slippage. Suggestions are offered to promote ethical practice and reduce the risk of adverse incidents.
Ethics Issues Regarding Supervision and Consultation in Private Practice
Authors: Goodyear Rodney K. , Falender Carol A. , Rousmaniere Tony
Published: June 2017

This chapter describes key ethical challenges confronting mental health professionals who provide supervision and consultation in private practice settings. Essential features of supervision and consultation are explained. The value and content of a supervision or consultation contract are discussed. Demands and challenges of the gatekeeping role for supervisors are considered. Types of competence and implications for supervision and consultation are presented. Guidance is provided in managing multiple relationships in supervision and consultation and in avoiding conflicts of interest. Competence, security, and confidentiality in using technology for supervision and training are considered. The chapter concludes with a discussion of nine common ethical dilemmas for supervisors and consultants in private practice settings.
Malpractice Issues for the Private Practitioner
Authors: Shapiro David L. , Younggren Jeffrey N.
Published: June 2017

This chapter provides an overview of major concerns for practicing mental health professionals regarding issues of negligence. It discusses the concept of a professional relationship, the standard of care that derives from that relationship, the deviations from standards of care, and damages directly due to the deviations. Frequent areas of malpractice litigation are reviewed with illustrative cases presented. Common defenses against malpractice are discussed, focusing on challenging whether all four elements of malpractice have been met, and whether or not there have been contributions to the unfortunate outcomes by the patient or client herself or himself (contributory or comparative negligence). The guidance in this chapter also reduces the likelihood of administrative legal actions like board complaints. Do you want to narrow it so much. Risk management strategies are presented to assist practitioners to minimize the risk of malpractice occurring.
The Private Practitioner and Family Issues
Authors: Behrman Lauren
Published: June 2017

Independent practice can provide an opportunity for practitioners who are parents to maximize flexibility and work/life balance. It can allow them to carry on a meaningful and financially sustainable career while at the same time being available for their children and family in developmentally appropriate ways. The author proposes that by understanding their dual role as clinician and small business owner early in their career, mental health practitioners who are parents can plan for practice activities and niches that coordinate with the availability of their partners and the developmental needs of their children at any stage. The experiences of mothers versus fathers in practice are compared. Recommendations for effectively addressing these issues are provided.
Evaluations for Testing Accommodations for Adolescents and Adults with Specific Learning Disorders or Attention-Deficit/Hyperactivity Disorder
Authors: Mapou Robert L.
Published: June 2017

Testing to determine if adolescents or adults have a specific learning disorder or attention-deficit/hyperactivity disorder (ADHD) is a niche practice area for psychologists experienced with assessment. Testing may be done to update earlier documentation or to determine whether an individual having difficulty in school or on the job has a learning disability or ADHD that accounts for his or her difficulties. Often, one goal of these evaluations is to determine if an individual qualifies for accommodations on classroom and standardized tests. This chapter describe the author’s training and the information clinicians need to have to complete these evaluations. Clinicians must be familiar with research on learning disabilities and ADHD in adolescents and adults, so that their evaluations will be evidence based, and with disability law. The positive and negative aspects of this practice area and business considerations are discussed. The chapter concludes with advice for how clinicians interested in these evaluations can obtain training.
Intensive Outpatient Treatment for Eating Disorders
Authors: Buchanan Linda Paulk
Published: June 2017

As the vast majority of people with eating disorders cannot recover with traditional outpatient psychotherapy, a multimodal and multidisciplinary approach is recognized as the best practice for treatment of this population. Treatment begins with assessment of psychological, psychiatric, and nutritional functioning followed by a combination of individual, family, nutrition, and group therapy. The author shares how she became interested in this field and describes some of the joys and challenges she has experienced in developing a freestanding, psychologist-owned intensive outpatient facility. This chapter covers levels of care, treatment components, and some of the common misconceptions associated with these individuals. The author discusses the business aspects of her practice. Resources are provided for developing this niche.
Behavioral Sleep Medicine
Authors: Loomis Catherine C.
Published: June 2017

Our knowledge of sleep disorders has grown dramatically in recent years, and sleep disorders are increasingly being recognized by the medical community and the public. Cognitive-behavioral therapy for insomnia has extensive research to support its effectiveness and is now seen as the first-line treatment for insomnia. Beyond insomnia, there are promising approaches to address psychological and behavioral aspects of many sleep disorders. This chapter describes the field of behavioral sleep medicine and outlines the author’s experience in developing a private practice devoted to sleep disorders. It offers advice for those who may be interested in practicing in this area and addresses business aspects of this niche practice. Resources are provided for readers who want to further their knowledge in this area.
Co-Parenting
Authors: Rotter Annette
Published: June 2017

Co-parenting therapy is a niche practice area that focuses on providing parents with tools to diminish conflict and develop their co-parenting skills before, during, and after divorce. Co-parenting therapists work to fortify parental cooperation with the goal of diminishing the long-term negative effects of parental conflict on children’s mental health. Few clinicians are trained in this area. The author describes this niche area of practice and how she became interested in this challenging and impactful area. She covers the joys and challenges of a practice focused on co-parenting therapy, discusses the business aspects of this niche area, and offers professional advice about pursuing this specialty. Resources are listed to assist interested clinicians.
Cognitive Developmental Considerations in Supporting Bereaved Students
Authors: Comerchero Victoria A.
Published: June 2017

This chapter covers the major cognitive developmental theories and the common cognitive developmental issues associated with grief that are relevant to different age groups (preschool/early childhood, middle childhood, and adolescence/young adulthood). The primary purpose of the chapter is to provide insight into how cognitive developmental frameworks influence variations in children’s responses to death and, in turn, the choice of interventions tailored to each student/family’s unique needs. The discussion of the frequently observed reactions to death based on developmental period will enable practitioners to differentiate what are generally considered to be adaptive versus maladaptive reactions to loss in normative development. Examples are given of developmentally appropriate evidence-based practices drawn from recent empirical research that may be implemented with bereaved individuals and groups within school settings. The chapter concludes by discussing some of the developmental needs to consider when working with grieving students with intellectual disabilities and giftedness.
Using Bibliotherapy to Support Bereaved Students
Authors: Young Ellie L. , Heath Melissa A. , Smith Kathryn , Phillbrick Afton , Miller Karli , Stein Camden , Kama Haliaka
Published: June 2017

This chapter describes bibliotherapy, an intervention based on the tenets of cognitive-behavioral therapy and solution-focused therapy, as a developmentally appropriate strategy to address grieving children’s emotional needs. Bibliotherapy incorporates literature into the counseling process to address four basic tasks of grief. This chapter discusses key guidelines for implementing a bibliotherapy lesson with bereaved youth. The importance of selecting books and develop activities that align with the bereaved child’s developmental needs, the family’s cultural and religious beliefs, and other facets of the child’s experience is highlighted. The chapter includes recommended books and associated activities that address the tasks of grief and facilitate children’s expression of feelings. A sample bibliotherapy lesson plan is included.
Thinking about the future
Authors: MacLeod Andrew
Published: June 2017

The ability to think about the future has been fundamental to human evolutionary success, as well as to our everyday functioning. But, it also plays a key role in our emotional well-being and mental health. The growing recognition of the importance of prospection is shown by the burgeoning literature on the topic, including an expanding literature relating to well-being and mental health. This introductory chapter provides a brief overview of the importance of prospection, its relative neglect in the psychological literature and the recent blossoming of interest in the area. The chapter concludes with an overview of the material covered in the remainder of the book.
Memory
Authors: MacLeod Andrew
Published: June 2017

Prospection is only possible because of memory. The well-established difficulty that people have when they are depressed in recalling specific memories is mirrored by a difficulty in thinking about specific future episodes. These, and other similarities between memory and prospection, suggest that elements of episodic memory are used to construct mental representations of future possible episodes. As well as similarities between memory and prospection, Chapter 6 also discusses differences, including the greater involvement of semantic memory in thinking about future episodes. Future episodes are less specific than memories, due to the fact that they are having to be imagined rather than retrieved, but they are consistently rated as more important and more positive than memories, reinforcing the importance of prospection to well-being.
Prospection, well-being, and mental health
Authors: MacLeod Andrew
Published: June 2017

Chapter 11 provides an overview of Chapters 1 to 10 and introduces the idea of a subjective future life trajectory. A subjective future life trajectory describes the sense that persons have of themselves being located in the present, but always moving forward into the future. The trajectory involves both short-term and long-term representations about the future, which vary in detail and value. Disruptions to the trajectory can take different forms, with anxiety and depression representing the two main kinds of disruption. A settled trajectory enables someone to focus on the present, whereas disrupted trajectories pull attention away from the present to try to ‘repair’ the trajectory. A future trajectory, and a present focus, can also be disrupted by memories relating to the past portion of the trajectory. Methodological issues that have been touched upon throughout the book are revisited and suggestions made for how research could move forward.
The Structure, Validity, and Specificity of PTSD Symptoms
Authors: Watson David , O’Hara Michael W.
Published: June 2017

This chapter explicates the properties of posttraumatic stress disorder (PTSD) symptoms. It focuses on four basic types of PTSD symptoms: intrusions/reexperiencing, avoidance, hyperarousal, and dysphoria/numbing. Indicators of intrusions/reexperiencing showed the strongest overall criterion validity and impressive diagnostic specificity vis-à-vis PTSD diagnoses; they also displayed significant incremental predictive power in logistic regression analyses. Avoidance symptoms behaved similarly and also appear to have a relatively strong and specific association with PTSD diagnoses. The data for hyperarousal symptoms were more mixed: They tended to exhibit moderate to strong criterion validity, with inconsistent evidence of diagnostic specificity and incremental validity. Finally, although dysphoria/numbing symptoms displayed some criterion validity, they actually showed diagnostic specificity to major depression—not PTSD—and demonstrated virtually no incremental predictive power in the logistic regression analyses. Thus, these symptoms were neither specific to PTSD nor necessary in predicting the diagnosis.
Introduction to Military Suicide
Authors: Sheykhani Elvin , Holleran Lori , Hummel Kasie , Bongar Bruce
Published: June 2017

This chapter examines suicide within the United States military as a whole. A cultural and historical perspective is used to understand the context of current policies regarding the assessment and treatment of mental health conditions of those within the military. Suicide base rates as well as service utilization within the armed forces are discussed and recommendations regarding current practices are presentenced. Currently, perceived stigmas, traumatic exposure, multiple deployments as well as other barriers to care are thought to have contributed to the overall increase in suicide behaviors within the US military. Although policies are currently in place which help reduce stigma and bolster mental health service utilization, suicide continues to be an issue within the military as a whole.
Suicide Risk Assessment with Combat Veterans—Part I
Authors: AhnAllen Christopher G. , Adler Abby , Kleespies Phillip M.
Published: June 2017

This chapter provides a background for understanding suicide risk assessment in combat veterans. Given that military veterans constitute a unique cultural group, the chapter provides an overview of specific experiences that are germane to military service, including deployment to combat. It first reviews general military culture, including reasons for joining the military, traditions and values within the military, and specific details associated with the personnel. The next part of the chapter focuses on military stress that can be experienced with deployment, including the activities related to leaving home, engaging in combat service, and then the experiences related to returning home. Finally, military culture is considered as a potential barrier to accessing mental health care for veterans.
The Collaborative Assessment and Management of Suicidality with Suicidal Service Members
Authors: Jobes David A. , Schembari Blaire C. , Jennings Keith W.
Published: June 2017

This chapter provides an overview of an evidence-based, suicide-specific, clinical approach called the Collaborative Assessment and Management of Suicidality (CAMS). CAMS has a robust evidence base from nonrandomized and randomized clinical trial research. CAMS is designed to form a strong therapeutic alliance and to increase patient motivation to be engaged in their own suicide-specific care. The Suicide Status Form is a multipurpose clinical assessment, treatment-planning, tracking, and outcome tool that provides the essential CAMS roadmap for engaging a suicidal patient in successful treatment. This chapter features the case example of “Jon,” a multiply-deployed suicidal US Army sergeant, to illustrate how CAMS can be used as both a philosophy suicide-specific care tool as well as a flexible clinical framework for engaging and effectively treating suicidal service members in military treatment facilities.
Healing the Hidden Wounds of War
Authors: Hendin Herbert
Published: June 2017

Posttraumatic stress disorder (PTSD) is the condition most associated with suicide in both military personnel and veterans. Most veterans with PTSD, however, are not at risk of suicide. The major factor distinguishing those who attempted or were preoccupied with suicide is persistent severe guilt over behavior in combat while emotionally out of control. A short-term psychodynamic psychotherapy (12 sessions), presented in this chapter, showed promise of success in dissipating the guilt from combat-related actions in veterans of the war in Vietnam. Preliminary work with combat veterans of the wars in Iraq and Afghanistan indicates it may be equally successful in treating them. Basic aspects of the psychodynamic approach could be incorporated into current therapies and should improve clinicians’ ability to treat veterans with PTSD at risk for suicide. Case examples are provided.
The Problem of Suicide in the United States Special Operations Forces
Authors: Bongar Bruce , Maslowski Kate , Hausman Catherine , Spangler Danielle , Vargo Tracy
Published: June 2017

Since 1986, the US Special Operations Command (SOCOM) has been employed by the military for carrying out a range of challenging tasks key to counterterrorism efforts. These Special Operations Forces (SOF) represent a unique group within the military and has traditionally been considered highly resistant to deleterious effects of both physical and psychological strain; however, recent figures suggest a rise in suicides within special operators. Increasingly, suicide prevention efforts within the military have focused more explicitly on enhancing resilience rather than decreasing suicide risk. In line with this newer mentality, SOCOM has developed the Preservation of the Force and Family (POTFF). The POTFF program aims to enhance the service member’s resilience by addressing four domains: physical performance, psychological performance, social performance, and spiritual performance. The rationale and design of the POTFF program is reviewed in this chapter. Future directions and challenges associated with this effort are also discussed.
Caring Letters for Military Suicide Prevention
Authors: Luxton David D.
Published: June 2017

The caring letters concept is a suicide intervention that involves the routine sending of the brief expressions of care to high-risk patients following hospitalization or emergency department treatment. Caring letters is one of the only interventions that has been shown to reduce suicide mortality rates in a randomized controlled trial. Additional studies using various modalities including email, SMS texting, postcards, and phone contacts have further supported the caring letters concept in preventing suicide behaviors. Given the high level of suicide risk among posthospitalized psychiatric patients and the rise in suicide rates within the US military over the past decade, it is important to implement empirically supported interventions. This chapter describes the caring letters intervention and a test of the intervention at US military and veterans hospitals. The theoretical basis for the intervention, as well as practical procedures and recommendations for implementing caring contact programs, are discussed.
Evaluation of Layer-by-Layer Segmented Ganglion Cell Complex Thickness for Detecting Early Glaucoma According to Different Macular Grids
Authors: Kim Hae Jin , Park Ki Ho , Kim Young Kook , Jeoung Jin Wook
Published: June 2017

Purpose:

To investigate the diagnostic performance of layer-by-layer segmented macular ganglion cell complex (GCC) thickness for detecting early glaucoma using spectral-domain optical coherence tomography (SD-OCT) with different macular grids.

Materials and Methods:

Sixty-two early-stage open-angle glaucoma patients and 70 healthy subjects were enrolled in this study. The SD-OCT with automated segmentation was used to obtain macular scans with different grids of “1, 2, and 3 mm”; “1, 2.22, and 3.45 mm”; and “1, 3, and 6 mm” diameters. The separate thicknesses of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), ganglion cell-inner plexiform layer (GCIPL: GCL+IPL), and GCC (RNFL+GCL+IPL) were measured in each grid. The areas under the receiver operating characteristics were used to compare their specific diagnostic abilities.

Results:

In all macular grid diameters, the mRNFL, GCL, and IPL thicknesses, except mRNFL in the 1 to 2 mm macular grid, were significantly thinner in patients with early glaucoma than in healthy subjects. The GCC and GCL in the 3 to 6 mm macular grid diameters were best able to discriminate between early glaucoma and normal groups. When including quadrant parameters in the 3 to 6 mm macular grid diameter, the temporal GCL had the largest areas under the curve of receiver operating characteristics (0.906).

Conclusions:

Large macular grids have generally high discriminating power for the diagnosis of early glaucoma by SD-OCT. The GCL or GCC thickness in 3 to 6 mm macular grid could be useful for the identification of early glaucomatous structural loss.
Fourth-Degree Perineal Laceration in Nonconsenual Fisting
Authors: Cappelletti Simone , Fiore Paola Antonella , Bottoni Edoardo , Aromatario Mariarosaria
Published: June 2017

We present the case of an 18-year-old girl who was sexually assaulted with transanal forearm penetration resulting in a fourth-degree perineal laceration. Fisting is an uncommon sexual practice consisting in the penetration of the vagina, anus, or both of them with fingers, hand (fist) or forearm.

Perineal lacerations are a relatively common finding in both consensual and nonconsensual fisting victims. Even though cases of fisting with first-, second-, and third-degree lacerations have been reported in literature, only one previous case of fourth-degree perineal laceration has been described in a woman, who died after anal fisting.

The clinical and morphological findings related to this sexual practice have been presented. No previous reports concerning nonfatal cases of fourth-degree perineal laceration, due to anal fisting, exists in literature. We report a case in which the forensic evaluation and the identification of the sexual assault were delayed because of both the atypical and uncommon pattern of injury and the unconsciousness of the patient. The information gathered thanks to this article would support forensic pathologists and sexual assault forensic examiners in recognizing doubtful cases, and this is particularly important when the suspect of sexual assault arise.
Undiagnosed Pheochromocytoma Simulating Malignant Hyperthermia
Authors: Ramani Nisha S. , Stoppacher Robert , Morani Ajaykumar C. , Catanese Charles
Published: June 2017

Introduction

Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. They are surgically curable but can be lethal if remain undiagnosed. We report a patient earlier diagnosed with malignant hyperthermia but later found to have pheochromocytoma on autopsy.

Case report

After a preprocedural pain block for elective right shoulder arthroscopy, a 53-year-old hypertensive white man developed chest pain. In the operating room, he had increased blood pressure. Postoperatively, his blood pressures dropped from 220/100 to 80/30 mm Hg. He later developed high fever with core temperature reaching a peak of 42.2°C, rapid breathing, and died after unsuccessful attempts to stabilize him.

Autopsy

Autopsy revealed a tumor in his right adrenal gland, measuring 10 cm in greatest dimension and weighing 530 g. It was red brown with a hemorrhagic and cystic cut surface. A thin rim of yellow-orange adrenal cortex was visible at the margin of the tumor, indicating that it originated from the underlying adrenal medulla. The left adrenal gland was unremarkable.

Sections showed hypercellular tumor with zellballen architecture. The tumor cells were round to oval with finely granular basophilic cytoplasm and mild pleomorphism. A 24-hour urine sample collected before his death showed greater than 22727 μg/g Ratio to Creatinine metanephrines and normetanephrine, indicating that the tumor was active and secreted high levels of catecholamine. The cause of death was established as the complications of pheochromocytoma in the settings of general anesthesia for shoulder arthroscopy. The manner of death was natural.

Conclusions

Pheochromocytoma can mimic malignant hyperthermia, and it should always be considered and managed appropriately in such scenarios to avoid untoward consequences. Pathologists must also be aware of this when conducting an autopsy in cases with a previous clinical diagnosis of malignant hyperthermia.
An Unusual Medicolegal Case of 32-Year-Old Mother and Her 29-Week Fetus With Hemolysis, Elevated Liver Enzymes, and Low Platelet Count Syndrome
Authors: Szeremeta Michał , Drobuliakova Petra , Przepieść Jerzy , Załuski Janusz , Sackiewicz Adam , Niemcunowicz-Janica Anna
Published: June 2017

Forensic medicine experts are well aware of blunt abdominal trauma, which often lead to death because of serious internal organ injury with severe blood loss. Sometimes careful examination of such cases may reveal some other underlying conditions, such as an existing disease that had contributed to the death or life-threatening complications. Our article presents a rare case of spontaneous hepatic rupture and intraperitoneal hemorrhage in a 32-year-old primigravida and her 29-week fetus, which was a result of hemolysis, elevated liver enzymes, and low platelet count syndrome. The said syndrome is a life-threatening obstetric complication usually considered to be a variant or complication of pre-eclampsia, which is characterized by hemolysis with microangiopathy, elevated liver enzymes, and low platelet count.