bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Semantic Uses of First Person Pronouns as Possible Linguistic Markers of Recovery in Psychotherapy
Authors: Van Staden C. W. , Fulford K. W. M. 
Published: December 2009

Objective: To examine changes in linguistic markers in the course of psychotherapy, drawing on Frege's logic of relations to define semantic variables distinct from syntactic variables. Method: From a sample of 73 patients, 10 patients with the best and 10 patients with the worst outcomes were selected. Forty transcribed sessions of each outcome group were compared statistically for change between commencement and termination of psychotherapy in: (i) the syntactic usage of first person pronouns (‘I’, ‘me’, ‘we’, ‘us’, ‘implied I’, ‘implied me’); (ii) semantic usage of first person pronouns (expressing alpha, omega, or unclear positions); and (iii) non-pronoun linguistic variables (passive voice, negative, copula, auxiliary verbs expressing a sense of obligation). Results: There were no significant differences between the best and worst outcome groups in the change of either syntactic usage, or of the non-pronoun linguistic variables. However, the outcome groups differed significantly in the change of their semantic usage (alpha: p = 0.002; omega: p = 0.028): The best outcome group showed an increase of alpha positions and a decrease of omega positions, whereas the worst outcome group showed the inverse (i.e. decrease of alpha and increase of omega positions). Conclusions: Results suggest only semantic, that is meaning-driven, usage of first person pronouns marks recovery in the course of psychotherapy. If replicated, this finding could be used to monitor treatment responses. Replication in other kinds of treatment could mean these semantic changes are markers of recovery more generally than in psychotherapy.
Enhancing Medication Adherence: Clinician Outcomes from the Medication Alliance Training Program
Authors: Byrne Mitchell K. , Deane Frank P. , Lambert Gordon , Coombs Tim 
Published: December 2009

Objective: Patient nonadherence to psychiatric medication is a key cause of relapse but clinicians do not appear to possess specific adherence skills. We sought to demonstrate that a brief training program on medication adherence strategies could improve the adherence skills, attitudes and knowledge of mental health clinicians. Methods: Twenty-three Tasmanian mental health workers were provided a 3 day training workshop on strategies to enhance patient adherence to medications (Medication Alliance). Pre- and post-training measures were taken of clinician knowledge about adherence strategies, ability to identify predictors of nonadherence, attitudes toward working with nonadherent patients, and optimism about treatment outcomes for patients. Videotapes of clinicians demonstrating key adherence therapy skills were also collected before and after training and blind-rated by two experienced therapists. Results: A series of paired samples t-tests indicated significant improvements in skills, knowledge and attitudes. Conclusions: Compared with similar studies in the UK, Medication Alliance was found to be an effective and efficient training program. However, there is a need for further research to assess maintenance of training effects over time and patient outcomes.
Pre-Existing Antidepressants and the Outcome of Group Cognitive Behaviour Therapy for Social Phobia
Authors: Rosser Stephanie , Erskine Alicia , Crino Rocco 
Published: December 2009

Objective: This is a naturalistic treatment outcome study investigating the impact of preexisting antidepressant use on the effectiveness of group cognitive behaviour therapy (CBT) for social phobia. Method: Of the 133 participants who completed the CBT program, 49 reported taking antidepressants (CBT ++ AD group), while 84 reported not taking antidepressants (CBT group). The treatment program involves 40 h of structured, group-based CBT over 7 weeks. The dependent measures included the Social Phobia Scale and Social Interaction Anxiety Scale, the Fear of Negative Evaluation Scale, the Depression, Anxiety and Stress Scale and the Short Form-12. Results: Both the CBT ++ AD group and the CBT group improved significantly across treatment on all dependent measures. There were no significant differences between the groups on any outcome measure and the rate of improvement from pre- to post-treatment for both groups did not differ. Conclusions: Pre-existing antidepressants did not significantly enhance or detract from the positive treatment outcome of a structured, group-based CBT program for social phobia.
The Relationship Between Public Causal Beliefs and Social Distance Toward Mentally Ill People
Authors: Dietrich Sandra , Beck Michael , Bujantugs Bujana , Kenzine Denis , Matschinger Herbert , Angermeyer Matthias C. 
Published: December 2009

Objective: The aim of this study is to investigate the nature of the relationship between public causal beliefs and social distance toward people with mental disorders, particularly schizophrenia and depression. Method: In total, three representative surveys were carried out in Germany, Russia and Mongolia using personal, fully structured interviews. Results: Despite the subjects' different cultural backgrounds, their responses show similar trends with regard to attributing depression and schizophrenia to psychosocial causes: ‘acute stress’ (life event) was most frequently endorsed as the cause for these two disorders. The biological causes (‘brain disease’ and ‘heredity’) were less frequently selected for depression than for schizophrenia. Irrespective of place and type of mental disorder, endorsing biological factors as the cause of schizophrenia was associated with a greater desire for social distance, the same relationship applies to depression in half the instances. Conclusions: It would be premature to draw conclusions with regard to interventions aimed at reducing discrimination based on stigma. However, our study provides stimulus for re-considering the assumptions underlying antistigma interventions: that promulgating biological concepts among the public might not contribute to a desired reduction in social distance toward people with mental disorders.
Quality of Life and Related Risk Factors in a Taiwanese Village Population 21 Months after an Earthquake
Authors: Chou Frank Huang-Chih , Chou Pesus , Su Tom Tung-Ping , Ou-Yang Wen-Chen , Chien I-Chia , Lu Ming-Kun , Huang Ming-Wei 
Published: December 2009

Objective: To investigate quality of life and related risk factors of Taiwanese earthquake survivors with different psychiatric disorders 21 months after the earthquake. Method: This was a population survey. Trained assistants used the Medical Outcomes Study Short Form-36 (MOS SF-36) and questionnaires to interview 461 respondents (209 males and 252 females) 16 years or older who were equally exposed to the earthquake. Psychiatrists interviewed the same respondents using the Mini-International Neuropsychiatric Interview (MINI), with an adjusted response rate of 79.9%. Results: The prevalence of varied psychiatric disorders in earthquake survivors ranged from 3.3% to 18%. However, there was almost a positive trend in quality of life in survivors among the following groups: posttraumatic stress disorder combined with major depressive episode; major depressive episode; posttraumatic stress disorder; other psychiatric diseases; and healthy mentality groups on the physical aspect or mental aspect of the MOS SF-36. When survivors were elderly or female and had experienced prominent financial loss immediately after the earthquake, social network change, and mental impairment, their quality of life tended to be worse. Conclusion: The earthquake survivors had a higher percentage of psychiatric disorders. The risk factors that affected quality of life in survivors were age, female sex, financial loss, social network change, and mental impairment.
Prevention and Treatment of Childhood and Adolescent Aggression and Antisocial Behaviour: A Selective Review
Authors: Bor William 
Published: December 2009

Objective: In this paper I examine the possible role of public sector child and youth mental health services in prevention and treatment of childhood and adolescent aggression. The problem of juvenile antisocial behaviour in Australian society is discussed. Method: The review details the extent, concern and costs of juvenile antisocial behaviour. The most efficacious prevention and treatment programs for aggressive and antisocial behaviour are reviewed within the context of reforms to public sector mental health services. The place of evidence-based mental health programs within child and youth mental health services is discussed. Results: Recommendations are made on the adoption of selective programs demonstrated to be efficacious in the prevention and treatment of aggression and antisocial behaviour. Conclusion: Child and youth mental health services can make a specific contribution to crime prevention.
Correlates of Dysmorphic Concern in People Seeking Cosmetic Enhancement
Authors: Castle David J. , Molton Michael , Hoffman Keturah , Preston Neil J. , Phillips Katharine A. 
Published: December 2009

Objective: To determine the clinical correlates of dysmorphic concern in persons seeking cosmetic enhancement from cosmetic physicians. Method: A questionnaire survey of 137 patients attending the practices of two cosmetic physicians. Results: Four subjects (2.9%; 95% CI = 0.8%–7.3%) had a diagnosis of body dysmorphic disorder (BDD), but many more expressed overconcern with physical appearance (‘dysmorphic concern’). Dysmorphic concern accounted for a substantial amount of the variance for mood, social anxiety, and impairment in work and social functioning, while concerns related to how self or others perceive the putative flaw in appearance, impacted significantly on work and leisure activities, but did not apparently influence mood and social anxiety to any significant degree. Conclusions: Dysmorphic concern is a broad dimensional construct that is related to both inter- and intrapsychic distress and disablement associated with people seeking cosmetic enhancement
Beliefs of Women Concerning Causes and Risk Factors for Bulimia Nervosa
Authors: Mond Jonathan M. , Hay Phillipa J. , Rodgers Bryan , Owen Cathy , Beumont Pierre J. V. 
Published: December 2009

Objective: To examine the beliefs of women concerning causes and risk factors for eatingdisordered behaviour. Method: Face-to-face interviews were conducted with a community sample of 208 women aged 18–45 years. Respondents were presented with a vignette describing a fictional person meeting diagnostic criteria for bulimia nervosa (BN) and were asked to indicate whether each of several factors was ‘very likely’, ‘likely’ or ‘not likely’ to be a cause of the problem described, which factor was most likely to be a cause, and whether particular subgroups of people would be ‘more likely’, ‘less likely’ or ‘equally likely’ to have or develop the problem described. Results: ‘Having low self-esteem’ was considered very likely to be a cause of BN by 75.0% of respondents, and the most likely cause by 40.5% of respondents. Other factors perceived as significant were ‘problems from childhood’, ‘portrayal of women in the media’, ‘being overweight as a child or adolescent’ and ‘day-to-day problems’, while genetic factors and preexisting psychological problems were perceived to be of minor significance. Most respondents believed that women aged under 25 years were at greatest risk of having or developing BN. Conclusions: Women's beliefs concerning causes and risk factors for BN are generally consistent with empirical evidence. However, information concerning the increased risk associated with pre-existing anxiety and affective disorders might usefully be included in prevention programs. Systematic investigation of the benefits of addressing individuals' beliefs concerning risk factors for eating disorders – as opposed to risk factors per se – would be of interest.
Evaluating Treatments for the Mood Disorders: Time for the Evidence to Get Real
Authors: Parker Gordon 
Published: December 2009

Objective: To detail limitations to level I evidence derived from randomised controlled trials of antidepressant treatments and which is held to be fundamental to the development and validity of treatment guidelines. Method: Recent efficacy studies and meta-analyses of treatments of major depression are considered. Results: The largest database in psychiatry – demonstrating that all principal treatments are of similar efficacy, and that antidepressant drugs are not distinctly superior to placebo treatment – is unlikely to be valid. Conclusion: Excessive belief in and weighting of the evidence emerging from randomised controlled trials deserves to be criticized. An argument is put for adopting alternative approaches to evaluating the likely effectiveness of any antidepressant treatment.
Australian and New Zealand Clinical Practice Guidelines for the Management of Adult Deliberate Self-Harm
Authors:   Royal Australian And New Zealand College Of Psychiatrists Clinical Practice Guidelines Team For Deliberate Self-Harm
Published: December 2009

Background: The Royal Australian and New Zealand College of Psychiatrists is coordinating the development of clinical practice guidelines (CPGs) in psychiatry, funded under the National Mental Health Strategy (Australia) and the New Zealand Health Funding Authority. Method: For these guidelines, the CPG Team for Deliberate Self-harm reviewed the treatment outcome literature (including meta-analyses) and consulted with practitioners and patients. Treatment recommendations: (i) Organization of general hospital services to provide: emergency department admission; a safe environment; integrated medical and psychiatric management; risk assessment; identification of psychiatric morbidity, and adequate followup. (ii) Detection and treatment of any psychiatric disorder. (iii) Dialectical behaviour therapy, psychoanalytically orientated partial hospitalization or home-based interpersonal therapy (for certain patients) to reduce repetition of deliberate self-harm (DSH). Conclusion: Deliberate self-harm is common and is costly in terms of both individual distress and service provision. General hospitals are often the first point of clinical contact, but may not be appropriately organized to care for these patients. Evidence for the effectiveness of psychological treatments is based on single RCTs without replication. The three recommended psychological treatments are not widely available in Australia and New Zealand, and the interventions that are, such as cognitive behaviour therapy, problem solving and ‘green cards’ (an agreement guaranteeing access to services), do not reduce repetition of DSH. The effect of follow-up in psychiatric hospitals or in the community is poorly understood. We need to develop and evaluate interventions that will reduce repetition of both fatal and non-fatal deliberate self-harm and improve the person's functioning and quality of life.
The Emerging Role of Pharmacogenetics: Implications for Clinical Psychiatry
Authors: Hong Ng Chee , Hong Ng Chee , Schweitzer Isaac , Norman Trevor , Easteal Simon 
Published: December 2009

Objective: This article aims to review the implications of pharmacogenetics for clinical psychiatry; these are discussed in the context of environmental and sociocultural factors. Method: A selective literature review was conducted using Medline search and other relevant references available to the authors. Results: The individual differences in therapeutic and adverse effects of psychotropic drugs are largely determined by genetic factors. Recent advances in pharmacogenetics have highlighted the potential utility in predicting metabolic phenotypes, risks for side-effects and likelihood of drug response for the individual patient. Conclusions: Genotyping, especially for drug metabolizing enzymes, could enable more rational, cost-effective and optimal prescribing in future psychopharmacotherapy. Although the advances of pharmacogenetics may have many benefits in clinical practice, the importance of non-genetic factors must also be considered as cultural and environmental factors significantly impinge on response to medications. To clarify the extent pharmacogenetics can be adopted in clinical practice to predict drug response in patients from diverse backgrounds, further studies in different ethnic groups and clinical settings are required.
Assessing Cost-Effectiveness in Mental Health: Family Interventions for Schizophrenia and Related Conditions
Authors: Mihalopoulos Cathrine , Mihalopoulos Cathrine , Magnus Anne , Carter Rob , Vos Theo 
Published: December 2009

Objective: Existing evidence suggests that family interventions can be effective in reducing relapse rates in schizophrenia and related conditions. Despite this, such interventions are not routinely delivered in Australian mental health services. The objective of the current study is to investigate the incremental cost-effectiveness ratios (ICERs) of introducing three types of family interventions, namely: behavioural family management (BFM); behavioural intervention for families (BIF); and multiple family groups (MFG) into current mental health services in Australia. Method: The ICER of each of the family interventions is assessed from a health sector perspective, including the government, persons with schizophrenia and their families/carers using a standardized methodology. A two-stage approach is taken to the assessment of benefit. The first stage involves a quantitative analysis based on disability-adjusted life years (DALYs) averted. The second stage involves application of ‘second filter’ criteria (including equity, strength of evidence, feasibility and acceptability to stakeholders) to results. The robustness of results is tested using multivariate probabilistic sensitivity analysis. Results: The most cost-effective intervention, in order of magnitude, is BIF (A$8000 per DALY averted), followed by MFG (A$21 000 per DALY averted) and lastly BFM (A$28 000 per DALY averted). The inclusion of time costs makes BFM more cost-effective than MFG. Variation of discount rate has no effect on conclusions. Conclusions: All three interventions are considered ‘value-for-money’ within an Australian context. This conclusion needs to be tempered against the methodological challenge of converting clinical outcomes into a generic economic outcome measure (DALY). Issues surrounding the feasibility of routinely implementing such interventions need to be addressed.
Risk Factors for Suicide and other Deaths Following Hospital Treated Self-Poisoning in Australia
Authors: Reith David M. , Whyte Ian , Carter Greg , McPherson Michelle , Carter Natalia 
Published: December 2009

Objective: To analyze the risk factors for suicide, premature death and all-cause death in a representative population of hospital-treated deliberate self-poisoning patients. Method: A prospective cohort study using data-linkage between the Hunter Area Toxicology Service Database and the National Death Index of the Australian Institute of Health and Welfare, from January 1991 to December 2000. Results: There were 4105 subjects, of whom 228 (5.6%) died, 122 (2.9%) by premature death and 58 (1.4%) by suicide. The probability of suicide after 10 years follow-up was 2%. The adjusted hazard ratios (95% CI) for suicide were: ‘disorders usually diagnosed in infancy, childhood and adolescence’, 5.28 (95% CI = 2.04–13.65): male gender, 4.25 (95% CI = 2.21–8.14); discharge to involuntary psychiatric hospital admission, 3.20 (95% CI = 1.78–5.76); and increasing age, 1.02 (95% CI = 1.01–1.04). Men and women showed different patterns of multivariate risks, although increased risk with increasing age and discharge to an involuntary psychiatric admission was true for both. The standardized all-cause mortality ratio (95% CI) was: for men, 6.42 (95% CI = 5.44–7.57), and for women 4.39 (95% CI = 3.56–5.41). The standardized suicide mortality ratio (95% CI) was: for men, 20.55 (95% CI = 15.24–27.73), and for women 22.95 (95% CI = 13.82–38.11). Conclusions: Men and women have different risk factors for subsequent suicide after selfpoisoning. Hospital-treated self-poisoning patients have increased risk of subsequent suicide, premature and all-cause death. Psychiatric assessment, leading to discharge decisions, is worthwhile in identifying patients at long-term risk of suicide, premature and all-cause death.
Borderline Personality Disorder: Attitudinal Change Following Training
Authors: Krawitz Roy 
Published: December 2009

Objective: To assess the effect of a two-day training workshop on clinician attitudes to working with people with borderline personality disorder (BPD). The main goal of the workshop was to achieve positive change in the attitude of clinicians treating people with BPD in a public setting. The hypothesis underlying the intervention was that informing clinicians about current concepts of the diagnosis, aetiology, prognosis and treatment of BPD, combined with detailed discussion of the principles of treatment in the public setting, would result in positive attitude change. Method: Changes in attitudes (optimism, enthusiasm, confidence and willingness to work with people with BPD) and self-perceptions of knowledge and skills among staff working with BPD patients were assessed for 418 participants from public mental health and substance abuse services who attended the workshops over an 18-month period. A survey questionnaire was administered pre- and post-workshop and at 6 month follow-up (time 1, time 2, time 3, respectively). One-way repeated measures analysis of variance (ANOVA) were carried out to compare scores on attitudes and perceptions of knowledge and skills at time 1, time 2 and time 3. Results: The results from repeated measures ANOVA show that there was a statistically significant effect for time for all six items. Analyses of within-subject contrasts indicated that, for all six variables, the time 2 and the time 3 scores were statistically significantly different from time 1 scores (p < 0.01). These findings confirm that there were statistically significant changes at the post-workshop assessment, which were either maintained or showed a nonsignificant decrease at 6-month follow-up. Conclusions: The brief training workshop described was effective in achieving positive attitude change in clinicians working with patients with BPD. This research shows that it is possible through brief training to assist clinician positivity and to effect clinician attitude change. Implications of this research could include the influencing of future training of clinicians in public mental health and substance abuse fields.