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PubMed1991

Designing mental health facilities: an interactive process.

Program and funding changes in mental health service delivery in the past 15 years have resulted in ever-changing demands on the use of physical space in mental health facilities. An interactive planning process facilitated by a multidisciplinary design team can anticipate and address many difficulties with space utilization in construction or renovation. An architectural feasibility, study, including a careful definition of user requirements, is a useful document for facilitating intraagency communication, securing external funding, and moving capital projects to completion.

Adult↗
PubMed1995

A production task evaluation of individual differences in mental addition skill development: internal and external validation of chronometric models.

A production task paradigm for obtaining reaction times to mental addition stimuli was used for internal and external validation of chronometric models of mental addition processing. The first analysis explored the internal validity of extant chronometric models and found that three models, (a) a tabular memory network retrieval strategy (PRODUCT), (b) a nontabular memory network retrieval strategy (ERROR RATE), and (c) a computational strategy (MIN), were able to encompass individual differences in strategy choice for 155 individuals from Grades 2 to 8 and 111 college students. Patterns of convergent and discriminant validity for these models were also demonstrated. The second analysis explored the external validity of relations among (a) two traditionally measured factor analytic dimensions of ability, Numerical Facility and Perceptual Speed; (b) two information processing dimensions presumed to underlie mental addition. Addition Efficiency and Speediness; and (c) a digit-span measure of Short-Term Memory. We specified a series of two-group (grade school and college) structural equation models to represent the relations among all measures and showed that individual differences in the apparently calculative processes that underlie the traditionally defined ability dimension of Numerical Facility are highly related to individual differences in Addition Efficiency and Speediness of information processing.

Adolescent↗
PubMed2003

When mentalizing fails.

The author presents a long-term psychotherapy process that illustrates the challenges of helping a patient with a severe personality disorder to engage in the process of mentalizing. Illustrative therapist-patient dialogue from several sessions over the course of the psychotherapy supports the author's conclusion that, despite the therapist's perseverance, the patient remained stuck in her determination to use the therapist as a means toward self-sabotaging practical ends rather than establishing a relationship that would support reflection and growth.

Humans↗
PubMed1994

Mental contamination and mental correction: unwanted influences on judgments and evaluations.

We define mental contamination as the process whereby a person has an unwanted response because of mental processing that is unconscious or uncontrollable. This type of bias is distinguishable from the failure to know or apply normative rules of inference and can be further divided into the unwanted consequences of automatic processing and source confusion, which is the confusion of 2 or more causes of a response. Mental contamination is difficult to avoid because it results from both fundamental properties of human cognition (e.g., a lack of awareness of mental processes) and faulty lay beliefs about the mind (e.g., incorrect theories about mental biases). People's lay beliefs determine the steps they take (or fail to take) to correct their judgments and thus are an important but neglected source of biased responses. Strategies for avoiding contamination, such as controlling one's exposure to biasing information, are discussed.

Cognition↗
PubMedDate not supplied

The ability of the stress process model to explain mental health outcomes.

No theory adequately explicates the relationships between stress, social support, and health. The recently developed Stress Process Model incorporates multiple levels of support and stress at the individual, family, and community level, with a focus on predicting mental health outcomes. The purpose of this study was to use an existing database to assess the predictive value of the Stress Process Model in explaining mental health outcomes in community-dwelling subjects with and without panic attacks. This study is a secondary analysis using data obtained in 1990 through 1991 for the Panic Attack Care-Seeking Threshold (PACT) study. Subjects who agreed to participate completed an in-depth interview concerning demographic features, panic characteristics, chronic medical problems, family characteristics, illness attitudes and behaviors, coping strategies, symptom perceptions, psychiatric morbidity, health care utilization, and functional status. The utility of the Stress Process Model is supported by three lines of reasoning. First, most of the relationships predicted by the model were documented in this study. Second, the model accounted for significant amounts of variance in moderating factors, primary and secondary stressors, and mental health outcomes. Finally, two of the three hypotheses were supported by this study. The integration of family and neighborhood variables into the stress process should be attractive to mental health workers in primary care and community settings.

Adaptation, Psychological↗
PubMed2003

Patients' conceptions of how health processes are promoted in mental health nursing. A qualitative study.

The most important goal of nursing care is to promote the subjective experience of health. The health promoting efforts of mental health care nurses must be aimed at creating encounters where the patient will be confirmed both existentially and as an individual worthy of dignity. The patient in mental health care is often viewed by the nurse as nothing more than a passive recipient of care and the belief in the patient's potential is minimal. This can lead to a situation where the patient loses control in the caring situation and feels unable to improve his/her health, which conflicts with the goal of the nursing care. The aim of the study was to describe patients' conceptions of how health processes are promoted in mental health nursing. Twelve patients with experience of mental health nursing were interviewed, and the data material was analysed using a phenomenographic approach. The results show 13 different conceptions of the phenomenon, and these were summarized into four descriptive categories: interaction, attention, development and dignity. The conceptions described show that the patients need to be treated as equals and that the nurse must trust the patient's ability to make decisions and to promote his/her health process. It is suggested that mental health nursing should be built on humanistic science and its view that every individual has the ability to grow and develop. This view is one of the most important preconditions for the promotion of health processes in mental health nursing.

Adult↗
PubMed1984

Phonological process analysis of the speech of mentally retarded adults.

A phonological process analysis was performed on the speech of 20 mentally retarded adults. Results indicated that these subjects exhibited deletion of final consonant, cluster reduction, weak syllable deletion, and stopping. These processes are similar to those previously reported for mentally retarded children and unintelligible nonretarded children. Differences between subjects classified as moderately and severely retarded appear to be quantitative rather than in type of process exhibited.

Adult↗
PubMed2000

Long-term memory for spatial and temporal mental models includes construction processes and model structure.

There is a strong case that people construct and manipulate mental models in working memory but relatively little evidence that mental models are preserved in long-term memory. Instead people may remember an episodic construction trace: a record of the operations used to construct a mental model (Payne, 1993). Experiment 1 investigated memory for determinate spatial descriptions (which describe a single configuration of objects) and indeterminate spatial descriptions (which describe two equally plausible configurations). Recognition performance was impaired when the overlap between the episodic construction trace of a description at learning and at test was disrupted by reordering the sentences within a description. Participants were better at remembering the gist of determinate descriptions than that of indeterminate descriptions. For indeterminate descriptions, provided differences in gist recognition were controlled, participants showed better memory for the original description. Experiment 2 showed a similar pattern of results with temporal descriptions. A third experiment manipulated the similarity between foils in the recognition test and the original descriptions to provide further evidence for both episodic construction trace and remembered mental models. In combination, these results favour a hybrid account of memory for mental models, which includes information about both construction processes and model structure.

Adult↗
PubMed2005

Effects of dynamic rotation on event-related brain potentials.

Event-related potentials were recorded during a mental rotation task. Subjects were shown pairs of letter-like shapes and were asked to make a parity judgment. The shape on the left was always in its canonical position and the shape on the right could either be in its canonical position or be a mirror image. Two variables were manipulated for the shape on the right. First, it could appear at different orientations (50 degrees , 100 degrees or 150 degrees ); second, it could be presented in a stationary position, in a dynamic congruent direction (the shape slowly rotating toward its normal upright position) or in a dynamic incongruent direction (the shape slowly rotating in the opposite direction to its normal upright position). Orientation- and direction-dependent modulations of a negative slow wave were found. For orientation, the typical amplitude effect over parietal sites was found, the amplitude becoming more negative as the rotational angle increased. For direction, the amplitude of the negative slow wave was larger for stationary and dynamic incongruent trials than for dynamic congruent trials at 100 degrees and 150 degrees . This result suggests that presentation of a stimulus in a dynamic congruent direction facilitates the mental rotation process. At 50 degrees , differences between dynamic incongruent trials and both stationary and dynamic congruent trials were found, suggesting that the incongruent movement elicits an obstructing effect over the mental rotation process. In summary, the present experiment provides new evidence in support of the idea that the amplitude modulation over the parietal cortex is a psychophysiological marker of the mental rotation process.

Adolescent↗
PubMed2002

Parietal magnetic stimulation delays visuomotor mental rotation at increased processing demands.

Visuomotor rotation (VMR) is a variant of the classic mental rotation paradigm. Subjects perform a center-out arm reaching movement, with the instruction to point clockwise or anticlockwise away from the direction of a reaction signal by a prespecified amount. Like classic mental rotation (MR) tasks, there is a linear relationship between reaction time (RT) and required angle of rotation (angular disparity). Although functional imaging studies have consistently demonstrated parietal activations centered around the intraparietal sulcus during MR tasks, the involvement of parietal cortex in VMR has not been investigated. The aim of the present experiments was to test in human subjects whether VMR also involves activity in parietal areas. We used short trains of transcranial magnetic stimulation (TMS) to produce a temporary "virtual lesion" of the posterior parietal cortex (PPC) around the intraparietal sulcus during the reaction period of a VMR task. Four pulses of 20-Hz rTMS were applied to the left PPC, right PPC, or vertex (control condition) 100 ms after the presentation of an instruction cue. Reaction times (RTs) were evenly prolonged by right or left parietal TMS compared with vertex stimulation, but only for large angles of rotation, and without affecting the spatial accuracy of the final response. A control experiment showed that parietal rTMS did not impair visual perception or the ability to judge the size of visual angles. The data thus provide evidence for bilateral involvement of the PPC in VMR that increases with processing demands.

Adult↗
PubMed2003

Do integrated mental healthcare organisations facilitate process quality in the treatment of people with schizophrenia and related psychoses?

OBJECTIVE: The objective of this study is to investigate the influence of mergers of ambulatory and mental healthcare organisations on the process quality of care for persons suffering from schizophrenia or related psychoses. THEORY: On the basis of the theory of Donabedian we assume the relationships between three types of quality in healthcare: structure quality, process quality and outcome quality. This study focuses on the influences of structure quality, i.e. years since merger and catchment area size upon process quality. METHODS: Criteria according to Tugwell for evaluating healthcare were used to describe the process quality of schizophrenia care, resulting in a process quality questionnaire with 6 subscales and 21 items. Leading psychiatrists of 31 Dutch mental healthcare organisations, covering 89% of the country, answered the questionnaire. Both programmes and documents from the responding institutions and schizophrenia projects were analysed. Correlations of two determinants, age of the merged organisation and catchment area size, were made with total scale scores and the sub scores of the questionnaire. RESULTS: The response rate was 97% (31/32). Twenty-two organisations (71%) had a score of more than 50% on the used scale, 8 (29%) scored less. Two evidence-based interventions were implemented in more than 50% of the organisations, three in less than 50%. A low degree of implementation occurs in establishing care for people with schizophrenia from ethnic minorities, standardising diagnostic procedures and continuity of care. No significant relationship between the age of the merged organisation ('age') and the total process quality of schizophrenia care was found, however, the relationships between age and the subscales availability of interventions and integrated treatment were significant. No association was found between the size of the MHO's catchment area and any of the used subscales. CONCLUSIONS: The age of integration of residential and ambulatory mental health institutions correlates significantly with two subscales of process quality of schizophrenia care, i.e. availability of interventions and treatment. Catchment area size is not significantly associated with process quality or any of the subscales. Despite the mentioned positive effects, the overall picture of schizophrenia care is not very positive. Additional forces other than merely integration of ambulatory and residential services are needed for the further implementation of evidence-based interventions, diagnostic standards and continuity of care. The development of a national 'schizophrenia standard' (like in other countries) in relation with implementation plans and strategies to evaluate care on a regional level is recommended as well as further research on patient outcomes in relation to mergers of mental healthcare organisations.

Journal Article↗
PubMed1993

Neuropsychological manifestations of hyponatremia in chronic schizophrenic patients with the syndrome of psychosis, intermittent hyponatremia and polydipsia (PIP).

We examined the neuropsychological sequelae of water intoxication in nine schizophrenic patients with the syndrome of psychosis, intermittent hyponatremia and polydipsia (PIP). Patients were assessed using a standardized test battery on two occasions following laboratory blood work: once during hyponatremia (serum sodium < 130 mmol/l) and once during normonatremia (serum sodium > 136 mmol/l). Results revealed significant deficits during hyponatremia involving complex information processing skills such as mental flexibility and verbal fluency. In contrast, short-term memory was intact and no deficits in sustained attention or visual-motor scanning were observed. Our results underscore the dramatic fluctuations in neuropsychological functioning due to metabolic and osmotic changes during water loading in PIP syndrome patients. In addition, we found that the neuropsychological effects of hyponatremia are remarkably consistent across patients. These complications, if not recognized, are likely to contribute to worsening of psychosis despite appropriate pharmacological treatment while severely limiting patient ability to actively participate in behavioral interventions.

Adult↗