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Objective Muscle dysmorphia is a relatively recently identified psychological condition that, since its inception, has been variously conceptualized as an eating disorder and subsequently as a type of body dysmorphic disorder within the somatoform disorders. This review aims to inform and encourage ongoing debate surrounding the diagnostic placement of this disorder. Method We present a review and synthesis of the extant literature with a view to informing future decisions regarding the conceptualization of muscle dysmorphia. Results The validity of muscle dysmorphia as a clinical entity has been empirically demonstrated. While the condition bears little semblance to somatization as currently conceptualized, the research suggests a strong conceptual similarity with anorexia nervosa. However, future research needs to utilize more appropriate measures of male eating disorder pathology. Muscle dysmorphia is also inclusive of obsessive compulsive features that are typical to those seen in eating disorder presentations. Discussion We suggest that muscle dysmorphia be reanalyzed through the lens of an eating disorder spectrum. Recognition of muscle dysmorphia as an eating disorder may offer more clinical utility in recognizing the male experience of eating disorder pathology and also help reduce the number of current male cases falling into the EDNOS category. © 2010 by Wiley Periodicals, Inc. Int J Eat Disord 2010; 43:483-491 [ABSTRACT FROM AUTHOR]

The authors present their thoughts on commentary from M.D. Griffiths et al. on their paper outlining the criteria for internet gaming disorder (IGD), arguing against claims the paper does not constitute a consensus and misinterprets IGD criteria. They note that rather than reach a consensus, the study was designed as a guideline for future research on the evaluation of IGD.

This commentary paper critically discusses the recent debate paper by Petry et al. (2014) that argued there was now an international consensus for assessing Internet Gaming Disorder (IGD). Our collective opinions vary considerably regarding many different aspects of online gaming. However, we contend that the paper by Petry and colleagues does not provide a true and representative international community of researchers in this area. This paper critically discusses and provides commentary on (i) the representativeness of the international group that wrote the ‘ consensus ’ paper, and (ii) each of the IGD criteria. The paper also includes a brief discussion on initiatives that could be taken to move the field towards consensus. It is hoped that this paper will foster debate in the IGD field and lead to improved theory, better methodologically designed studies, and more robust empirical evidence as regards problematic gaming and its psychosocial consequences and impact. [ABSTRACT FROM AUTHOR]

Western societies over the last few decades have seen an increased interest in questions of group belonging and group identities, including ethno‐national groups. According to essentialising or constructivist paradigms, belonging to a national group is commonly conceptualised in the range of objective versus subjective criteria, where objective entails ascription and subjective, self‐identification. This paper suggests disentangling the paired dimensions—objective and other‐classification versus subjective and self‐classification—by analysing the late Habsburg Empire. I argue that the introduction of national registers in the new provincial constitutions and electoral laws of Moravia, Bukovina and Galicia accelerated an objective understanding of nationality and increasingly favoured other‐classification over self‐classification in cases where national belonging had become an administrative category. Yet, to do justice to the individual's subjective feelings, authorities were supposed to investigate objectively a citizen's subjective identification—a procedure that can be termed "objectivisation." Such objectivising procedures thus reconciled an individual's subjective identification with an increasingly objective understanding of nationality by developing guidelines on how classification by others should proceed. [ABSTRACT FROM AUTHOR]

The validity and reliability of diagnoses in psychiatry is a challenging topic in mental health. The current mental health categorization is based primarily on symptoms and clinical course and is not biologically validated. Among multiple ongoing efforts, neurological observations alongside clinical evaluations are considered to be potential solutions to address diagnostic problems. The Bipolar‐Schizophrenia Network on Intermediate Phenotypes (B‐SNIP) has published multiple papers attempting to reclassify psychotic illnesses based on biological rather than symptomatic measures. However, the effort to investigate the relationship between this new categorization approach and other neuroimaging techniques, including resting‐state fMRI data, is still limited. This study focused on investigating the relationship between different psychotic disorders categorization methods and resting‐state fMRI‐based measures called dynamic functional network connectivity (dFNC) using state‐of‐the‐art artificial intelligence (AI) approaches. We applied our method to 613 subjects, including individuals with psychosis and healthy controls, which were classified using both the Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV) and the B‐SNIP biomarker‐based (Biotype) approach. Statistical group differences and cross‐validated classifiers were performed within each framework to assess how different categories. Results highlight interesting differences in occupancy in both DSM‐IV and Biotype categorizations compared to healthy individuals, which are distributed across specific transient connectivity states. Biotypes tended to show less distinctiveness in occupancy level and included fewer cellwise differences. Classification accuracy obtained by DSM‐IV and Biotype categories were both well above chance. Results provided new insights and highlighted the benefits of both DSM‐IV and biology‐based categories while also emphasizing the importance of future work in this direction, including employing further data types. [ABSTRACT FROM AUTHOR]

This paper explores a collaborative generative approach to psychological assessment employed in Puerto Rico, with children, adolescents, and adults. It begins with a critical reflection on how the dominant discourse of mental health, founded in the suppositions and practices of Euro‐American‐centred psychological knowledge, has been disseminated to the globalise south under the claim that its assertions are unaffected by social, ideological, or historical forces. It discusses how its claims of expert scientific knowledge have contributed, through classificatory instruments such as the DSM and the ICD, to the production and re‐production of deficit narratives in our day‐to‐day life. It also examines how these practices have been applied in the use of assessment instruments in Puerto Rico. It then describes, how, through a collaborative approach and narrative theory, the established colonising practices and narratives of traditional forms of psychological assessment can be questioned, deconstructed, and transformed. This approach promotes the co‐creation of dialogic and generative spaces that allow for the emergence of multiple stories and performances that give meaning to a person's identity and relational being. A brief clinical case exposition is used to illustrate how this collaborative, dialogic, and culturally sensitive approach to psychological assessment can help to undermine and disrupt deficit‐based narratives and provide families with new generative possibilities for re‐storying and re‐performing their lives and particularly, the lives of their children. [ABSTRACT FROM AUTHOR]

There is considerable controversy around psychiatric diagnosis generally and personality disorders specifically. Since its conception, borderline personality disorder has been controversial because of the stigma associated with the diagnosis and the therapeutic nihilism held by practitioners who encounter people with this high prevalence problem in acute settings. This paper reviews the history of the diagnosis of BPD and summarizes some of the controversy surrounding the categorical nature of diagnosis. Both the DSM 5 and ICD‐11 will be discussed; however, for the purposes of this paper, the DSM 5 will take the primary focus due to greater cultural significance. Recent developments in the treatment of borderline personality disorder suggest that it is a highly treatable condition and that full clinical recovery is possible. This paper formulates an argument that despite problems with psychiatric diagnosis that are unlikely to be resolved soon, a diagnosis should be made with an accompanying formulation to enable people to receive timely and effective treatment to enable personal and clinical recovery. [ABSTRACT FROM AUTHOR]

This commentary discusses the systematic review by Walsh et al. that has found that people with atypical anorexia nervosa have similar symptoms and severity as have people with anorexia nervosa. In this paper, the discussion is broadened to other eating disorders diagnoses and the problem of overlap and crossover between syndromes that impacts adversely on the need for diagnoses to be distinct both at assessment but also over time. It is argued that the derivation of eating disorder diagnostic criteria has also been vulnerable to erroneous assumptions and biased observations. Whether atypical anorexia nervosa becomes a standalone diagnosis or is joined with an expanded anorexia nervosa, future delineations should be based on empirical research including neuroscience. [ABSTRACT FROM AUTHOR]

Since the publication of DSM‐III in 1980, the scientist‐practitioner gap in clinical psychology has expanded, as almost all outcome research in clinical psychology has been on diagnosed mental disorders within a medical model using drug trial methodologies, whereas most practising clinicians undertake functional analyses and case formulations of clinical psychological problems (CPPs) and then apply tailored interventions within an ongoing hypothesis‐testing methodology. But comparatively reliable assessment and generalizable conclusions in psychotherapy outcome research require a comprehensive theory‐derived conception or operational definition of 'CPPs', standardized functional analyses, and a taxonomy of CPPs comparable to DSM's listings of mental disorders. An alternative conception and taxonomy of CPPs have recently been proposed, offering improvements in the reliability and generalizability of case formulation‐based psychotherapy outcome research. It conceives of CPPs as instances of the formation and operation of self‐sustaining problem‐maintaining circles (PMCs) of psychological‐level causal elements—that is, at the level of cognitions, behaviours, emotions, and events or situations (stimuli). The paper describes this new conception of CPPs, a subsequent nascent taxonomy of evidence‐based PMCs which standardizes the underlying mechanisms that maintain CPPs, and ensuing benefits to research (as well as to practice) in clinical psychology. These benefits include being able to encompass all treatment‐worthy CPPs, not just diagnosable mental disorders; to assess theory‐derived intervention strategies, not just arbitrary therapy bundles; and to directly feed back into psychological theories, not just expand an atheoretical list of patented "evidence supported therapies." [ABSTRACT FROM AUTHOR]

Background: There is extremely limited population‐based research on social (pragmatic) communication disorder (SCD). Population‐based samples have the potential to better characterize the SCD phenotype by mitigating confounds and biases that are typical of convenience and clinical samples. Aims: The aims of this preliminary epidemiologic study were to advance our understanding of the SCD phenotype relative to developmental language disorder (DLD), obtain an estimate of prevalence, identify risk factors and lay the groundwork for future population level research of SCD. Methods & Procedures: We analysed existing data from the EpiSLI Database to examine social communication skills in 393 8th grade (13–14 years) children with and without a history of DLD. The primary measure used to evaluate SCD was the Children's Communication Checklist (CCC‐2). Two case definitions of SCD reflecting DSM‐5 criteria were examined. Both definitions involved significant pragmatic impairment, employing a commonly adopted clinical cut‐point of 1.5 SD. In one case, pragmatic deficits could occur along with structural language deficits and, in the other case (established using principal component analysis), pragmatic and social skills were disproportionately lower than structural language abilities. Outcomes & Results: When using the first case definition, SCD was much more common in children with a history of DLD than without DLD and history of language disorder at kindergarten was a significant risk factor for SCD in adolescence. However, it is important to note that SCD could be found in children with no prior deficits in other aspects of language. When the second definition was employed, SCD was equally distributed across children with and without a history of DLD. Male sex was a significant risk factor using this case definition of SCD. The estimated prevalence of SCD ranged from 7% (SE = 1.5%) to 11% (SE = 1.7%), acknowledging that prevalence depends on the cut‐point selected to determine communication disorder. Conclusions & Implications: These findings contribute to our understanding of the association between SCD and DLD by recognizing varying profiles of pragmatic and social communication difficulties, which in turn may help refine our diagnostic categories. Preliminary prevalence estimates of SCD can serve as an initial guidepost for identification and planning for intervention services for this condition. What this paper adds: What is already known on this subject: There is considerable debate about the diagnostic category of SCD and its relation to other neurodevelopmental disorders. What this study adds to existing knowledge: Using data from a US‐based epidemiologic sample of DLD, this study offers new information about the association between SCD and DLD, provides preliminary estimates of SCD prevalence, and identifies risk factors for SCD. Clinical implications of this study: Improved understanding of possible profiles of pragmatic and social communication deficits will help to clarify diagnostic categories and preliminary prevalence estimates may assist with ensuring availability of adequate intervention services. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the author discusses conceptual development of the proposed Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria and classification of autism spectrum disorders (ASDs).

This paper offers some reflections on Griffith Edwards' continuing legacy with particular reference to his and Milton Gross's formulation of alcohol dependence as a 'provisional' clinical syndrome. The ideas and language from this seminal paper have heavily influenced international diagnostic classification systems. However, it is observed that there has also been significant (and increasing) divergence-in particular around the original proposal that dependence and negative alcohol-related consequences are independent, if inevitably inter-related dimensions. This is most apparent in the conflation of alcohol-related problems and dependence phenomena implicit in DSM-V. It is also argued that the alcohol dependence syndrome (ADS) has substantial continuing influence and relevance to current clinical practice. The hypothesis that degree of alcohol dependence is a useful indicator of the possibility of a return to controlled drinking continues to receive support, and underpins the widespread implementation of brief interventions for 'early stage' problem drinkers. It is suggested that the kind of careful clinical observations that underpinned the original concept of alcohol dependence have continuing relevance to the formulation of improved understanding, measurement instruments, diagnostic systems and clinical responses. [ABSTRACT FROM AUTHOR]

Abstract: For almost half a century social scientists have explored the phenomenon of chronic illness. In this paper, I examine how the concept of chronicity participates in present‐day mental health care settings. Using ethnomethodology and material‐semiotic theory within science and technology studies, I investigate how the classification ‘chronically mentally ill’ interacts with the everyday socio‐material shaping of public mental health care in the context of professional institutions. Drawing on ethnographic fieldwork in a psychiatric day hospital and in a community day care centre in Berlin, Germany, I demonstrate how the classification of chronicity acts as a tool of description (of people or their conditions), regulation (of therapy, health care or administration), and connection to infrastructures of care (practised technologies or standards of various kinds). In these ways, I argue, the classification engages in actions of producing treatability, arranging resources, demarcating responsibilities, practicing accountability, and doing presence. Notably, community mental health care has developed into a designated territory of the concept: explicitly arranged for ‘the chronically mentally ill’ as a human kind, we can take everyday life in these institutions as instructive of how chronicity is defined in daily practice. [ABSTRACT FROM AUTHOR]

Objective: There are no generally accepted definitions or markers of treatment nonresponse in eating disorders (EDs). The aim of this paper was to examine how the duration of illness and other potential prognostic markers impacted on nonresponse and drop‐out from treatment across different EDs subtypes. Methods: A total sample of 1199 consecutively treated patients with EDs, according to Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria, participated in this study. Kaplan–Meier curves were calculated for each ED diagnosis in which the probability of recovery was plotted against the duration of illness. Results: Full remission was more likely for people with binge eating disorder (BED; 47.4%) and anorexia nervosa (AN; 43.9%) compared to bulimia nervosa (BN; 25.2%) and other specified feeding and EDs (OSFED; 23.2%). The cut‐off points for the duration of the illness related with high likelihoods of poor response was 6–8 years among OSFED, 12–14 years among AN and BN and 20–21 years among BED. Other variables predicting nonresponse included dysfunctional personality traits. Conclusions: Nonresponse to treatment is associated with duration of illness which is in turn associated with poor response to previous treatment. However, there was no evidence for staging the illness using specific duration of illness criteria. Nevertheless, the shorter temporal trajectory for OSFED suggests that early interventions may be of importance for this group. Highlights: Almost a half of people with anorexia nervosa (AN) and binge eating disorder (BED) had a good response to treatment, whereas for bulimia nervosa (BN) and other specified feeding and eating disorder (OSFED) only a quarter attained this outcome. Approximately a third of cases dropped out of treatment prematurely (highest for OSFED).The outcome of all EDs, except BED, is associated with duration of illness and number of previous treatment attempts. Optimising the treatment response early in the course of illness (particularly in the group with milder ED symptoms [OSFED]), may prevent the illness from taking a chronic course. However, there are no clear criteria for staging the illness using duration of illness as a marker.Treatments that target traits, such as persistence and harm avoidance, may improve the outcome of AN, and self‐directedness and reward dependence may improve the outcome of BN and BED, respectively. [ABSTRACT FROM AUTHOR]

Aims For the first time, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduces nonsubstance addictions as psychiatric diagnoses. The aims of this paper are to (i) present the main controversies surrounding the decision to include internet gaming disorder, but not internet addiction more globally, as a non-substance addiction in the research appendix of the DSM-5, and (ii) discuss the meaning behind the DSM-5 criteria for internet gaming disorder. The paper also proposes a common method for assessing internet gaming disorder. Although the need for common diagnostic criteria is not debated, the existence of multiple instruments reflect the divergence of opinions in the field regarding how best to diagnose this condition. Methods We convened international experts from European, North and South American, Asian and Australasian countries to discuss and achieve consensus about assessing internet gaming disorder as defined within DSM-5. Results We describe the intended meaning behind each of the nine DSM-5 criteria for internet gaming disorder and present a single item that best reflects each criterion, translated into the 10 main languages of countries in which research on this condition has been conducted. Conclusions Using results from this cross-cultural collaboration, we outline important research directions for understanding and assessing internet gaming disorder. As this field moves forward, it is critical that researchers and clinicians around the world begin to apply a common methodology; this report is the first to achieve an international consensus related to the assessment of internet gaming disorder. [ABSTRACT FROM AUTHOR]

This commentary on Livesley's paper in this special issue on International Classification of Diseases (ICD)‐11's personality disorder (PD) section addresses each of four issues that Livesley claims are impeding progress towards an evidence‐based system for the classification of personality pathology. I focus my commentary on the third issue, but also comment briefly on the others. Regarding, first, the complexity of personality pathology and, second, problematic assumptions about the nature of personality pathology, I contend that Livesley's comments are accurate, but omit that the fundamental impediment is the refusal of the Diagnostic and Statistical Manual of Mental Disorders (DSM) establishment to allow the official classification to reflect the reality of personality pathology that he describes, in contrast to its acceptance in the ICD‐11. In response to Livesley's third claim that a viable alternative to categorical diagnosis is not available, I take issue with various aspects of his assertions and develop arguments that the ICD‐11 PD model provides a useful, although admittedly imperfect, system. Finally, I agree with Livesley that the revision processes for official classifications are conservative and open to non‐scientific influences, but maintain that whereas the Diagnostic and Statistical Manual of Mental Disorders establishment held fast to the status quo, the ICD‐11 PD Working Group made considerable progress towards a valid PD diagnostic system. © 2020 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Despite the emphasis on evidence‐based treatment for psychological disorders, to date, there has been limited research examining treatment for nine of the 10 categorical personality disorders in DSM‐5 Section 2. This is perhaps not surprising given the complex heterogeneity and co‐morbidity within personality pathology. The hierarchical taxonomy of psychopathology (HiTOP) was proposed to address limitations within the traditional categorical model of the diagnostic system. Within this system are five spectra: detachment, antagonistic externalizing, disinhibited externalizing, thought disorder and internalizing. These foundational personality traits potentially have direct and specific treatment implications. The purpose of this paper is to highlight potential psychotherapeutic and pharmacological treatment recommendations within the personality spectra. Additionally, we outline the advantages of considering the personality science found within dimensional models of psychopathology in clinical assessment and intervention to aid in treatment planning. © 2019 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The authors present a comment on an article focusing on the diagnosis of personality disorders. Topics discussed include the need to revise the diagnosis and classification of personality disorders, the World Health Organization, and the International, European and North American Societies for the Studies of Personality Disorders' (ISSPD, ESSPD and NASSPD) missions on these diseases.

Background and Aims: Previous twin research suggests relationship status can moderate underlying genetic liability towards alcohol misuse. This paper examined: (1) whether genome‐wide polygenic scores (GPS) for alcohol consumption are associated with alcohol misuse; (2) whether these GPS are moderated by romantic relationships (gene–environment interaction; G × E) and (3) whether G × E results are consistent across sex. Design: Linear mixed‐effects models were used to test associations between genome‐wide polygenic scores, relationship status and alcohol use/misuse. Setting: Finnish twins born between 1983 and 1987 identified through Finland's central population registry. Participants: An intensively studied subset of Finnish Twin Study (FinnTwin12) during the young adult phase (aged 20–26 years). The analytical sample includes those with complete interview and genetic data (n = 1201). Measurements Key measurements included involvement in a romantic partnership, drinking frequency, intoxication frequency and DSM‐IV alcohol dependence (AD) symptoms. Genome‐wide polygenic scores (GPS) were created from available summary statistics from a large genome‐wide association study (GWAS) of drinks per week. Results: GPS predicted drinking frequency [b = 0.109; 95% confidence interval (CI) = 0.050, 0.168], intoxication frequency (b = 0.111; 95% CI = 0.054, 0.168) and AD symptoms (b = 0.123; 95% CI = 0.064, 0.182). Having a romantic relationship negatively influenced the association between GPS and drinking frequency (b = −0.105; 95% CI = −0.211, −0.001), intoxication frequency (b = −0.118; 95% CI = −0.220, −0.016) and AD symptoms (b = −0.119; 95% CI = −0.229, −0.009). There was a three‐way interaction between sex, relationship status and GPS for intoxication frequency (b = 0.223; 95% CI = 0.013, 0.433), such that the reduced association between GPS and intoxication frequency for those in a relationship was only apparent in males. We found no evidence of three‐way interactions for drinking frequency or AD symptoms. Conclusions: Being in a romantic relationship reduced the association between genetic predisposition and drinking, high‐risk drinking and alcohol problems. However, for high‐risk drinking the protective effect was limited to males, mapping onto earlier findings suggesting that males benefit more from romantic partnerships. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption and problems are increasing among older adults, who are at elevated risk for alcohol‐related accidents and medical problems. This paper describes a pilot follow‐up of older adults with a history of alcohol dependence that was designed to determine the feasibility of conducting a more extensive investigation. Methods: The sample consisted of previously assessed subjects in the Collaborative Studies on the Genetics of Alcoholism who: (i) were age 50+; (ii) had lifetime DSM‐IV AD; and (iii) had DNA available. Individuals were located through family contacts, Internet searches, and death registries. A brief telephone interview assessed demographics, health, and alcohol involvement. Results: Of the total sample (N = 2,174), 36% were contacted, 24% were deceased, and 40% were not yet located. Most (89%) contacted subjects were interviewed, and 99% of them agreed to future evaluation. Thirty percent of interviewed subjects reported abstinence for 10+ years, 56% reported drinking within the past year, and 14% last drank between >1 and 10 years ago. There were no age‐related past‐year differences in weekly consumption (overall sample mean: 16 drinks), number of drinking weeks (30.8), maximum number of drinks in 24 hours (8.1), or prevalence of weekly risky drinking (19%). Among those who drank within the past 5 years, the 3 most common alcohol‐related problems were spending excessive time drinking or recovering (49%), drinking more/longer than intended (35%), and driving while intoxicated (35%); and about a third (32%) received some form of treatment. Conclusions: Over a 1‐year period, we located 60% of individuals last seen an average of 23 years ago. The majority of contacted individuals were interviewed and willing to be evaluated again. Although the proportion of individuals currently drinking diminished with age, subjects exhibited troublesome levels of alcohol consumption and problems. Our findings suggest the importance and feasibility of a more comprehensive follow‐up. [ABSTRACT FROM AUTHOR]

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A substantial body of evidence supports the role of exercise interventions for people with a mental illness. However, much of this literature is conducted using outpatient and community-based populations. We undertook a systematic review examining the effect of exercise interventions on the health of people hospitalized with depression, schizophrenia, bipolar disorder, or anxiety disorders. Eight studies met our inclusion criteria. Several studies show positive health outcomes from short-term and long-term interventions for people hospitalized due to depression. Although positive, the evidence for inpatients with schizophrenia, bipolar disorder, or anxiety disorders is substantially less. There is an urgent need to address the paucity of literature in this area, in particular the optimal dose and delivery of exercise for people hospitalized as a result of mental illness. Standardization of reporting exercise programme variables, the assessment of mental illness, and the reporting of adverse events must accompany future studies. [ABSTRACT FROM AUTHOR]

The inclusion of “Internet gaming disorder (IGD)” in the fifth edition of Diagnostic and statistical manual of mental disorders (DSM‐5) creates a possible line of research. Despite the fact that adolescents are vulnerable to IGD, studies had reported wide array of prevalence estimates in this population. The aim of this paper is to review the published studies on prevalence of IGD among adolescents. Relevant studies prior to March 2017 were identified through databases. A total of 16 studies met the inclusion criteria. The pooled prevalence of IGD among adolescents was 4.6% (95% CI = 3.4%–6.0%). Male adolescents generally reported higher prevalence rate (6.8%, 95% CI = 4.3%–9.7%) than female adolescents (1.3%, 95% CI = 0.6%–2.2%). Subgroup analyses revealed that prevalence estimates were highest when studies were conducted in: (i) 1990s; (ii) use DSM criteria for pathological gambling; (iii) examine gaming disorder; (iv) Asia; and (v) small samples (<1,000). This study confirms the alarming prevalence of IGD among adolescents, especially among males. Given the methodological deficits in past decades (such as reliance on DSM criteria for “pathological gambling,” inclusion of the word “Internet,” and small sample sizes), it is critical for researchers to apply a common methodology for assess this disorder. [ABSTRACT FROM AUTHOR]

Abstract: Despite its demonstrated empirical superiority over the DSM‐5 Section 2 categorical model of personality disorders for organizing the features of personality pathology, limitations remain with regard to the translation of the DSM‐5 Section 3 alternative model of personality disorders (AMPD) to clinical practice. The goal of this paper is to outline a general and preliminary framework for approaching treatment from the perspective of the AMPD. Specific techniques are discussed for the assessment and treatment of both Criterion A personality dysfunction and Criterion B maladaptive traits. A concise and step‐by‐step model is presented for clinical decision making with the AMPD, in the hopes of offering clinicians a framework for treating personality pathology and promoting further research on the clinical utility of the AMPD. Copyright © 2018 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: This article examines the status of the literature on night-eating syndrome (NES) according to five criteria that have been proposed by Blashfield, Sprock, and Fuller1 (Compr Psychiatry 1990;31:15–19) to determine whether NES warrants inclusion in the psychiatric nosology as a distinct eating disorder. Method: Relevant research papers were identified in Medline and PsychInfo using the search term “night-eating syndrome.” Results: None of the five criteria was met. Specifically, at the time of review, there were not yet 25 empirical papers on NES; no commonly accepted definition of or assessment approach to NES has been adopted; the utility and validity of NES need to be established, and NES needs to be differentiated more clearly from other eating disorder syndromes. Conclusion: This review suggests that the most pressing step toward clarifying the status of NES is to develop a uniform definition of NES. Once accomplished, research can progress to accumulating the necessary evidence to determine whether NES should be included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006 [ABSTRACT FROM AUTHOR]

Aims Over the past two decades, many nosological issues have been addressed by the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) substance use disorders workgroups. Even with those efforts, there are key issues that have not been resolved and must be revisited, or addressed de novo, by the workgroups. These lingering points are broad, due to the array of substances classified under the diagnostic umbrella of substance use disorders. They include substantive issues ranging from dimensional approaches, similar criteria for each substance, cut-points and thresholds, distinct abuse and dependence classifications, new criteria and drugs, to less substantive ones, such as the adjectives used to describe the severity of the behaviors. Results This paper describes the characteristics of the data sets that will be needed to resolve the key nosological issues. Ten points are described: (1) data must be true to nomenclature under study; (2) flexible regarding rearrangements of scoring algorithms; (3–4) able to assess substances individually and retain former versions of the criteria; (5) not rely on shortened versions; (6) utilize samples that are generalizable; (7) make diagnoses with transparent algorithms; (8) combine mixed methods for corroborating data; (9) utilize assessments that collect reliable and valid diagnoses and criteria; and (10) stretch the limits by allowing for new discoveries. Conclusions This paper describes each of these and gives examples of the limitations and strengths of data for the purpose of defining a useful, unified concept of addictive behaviors. [ABSTRACT FROM AUTHOR]

Aims Since the publication of the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV), many studies have addressed substance use disorders (SUD) in adolescents. Based on that adolescent literature, this paper suggests further research to help guide decisions about revising for DSM-V the SUD criteria in DSM-IV. Method The author has reviewed the ‘Substance Related Disorders’ section of DSM-IV-TR, recalled his experience in helping to draft that section, accessed relevant articles in PubMed and reviewed his own extensive file of literature citations. Results This paper suggests six questions for adolescent research to help guide the framers of DSM-V’s ‘Substance Related Disorders’ section: (a) DSM-IV did not provide a diagnosis of cannabis withdrawal; should DSM-V continue that position? (b) Should SUD be included or referenced among ‘Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence’? (c) Can inter-rater reliability of the substance abuse (SA) criteria be improved with altered example situations, text descriptions or phrasing of the current criteria? (d) Between ages 14 and 18 years is earlier onset of SUD a severity marker that could be incorporated into DSM-V as a predictor of worse course? (e) In DSM-V could a phenotypic descriptor of pathological multi-substance involvement document severity and predict course of SUD? (f) Could clinicians and patients benefit from DSM-V-related postpublication procedures for classifying emerging new drugs into DSM-V’s categories? Conclusion Without substantive changes in SA or substance dependence diagnostic criteria, research may improve the usefulness of those criteria for adolescents. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this article is to fill the need for an updated concept analysis of compassion fatigue. Methods This review used Rodgers' Evolutionary Model to direct the analysis of 25 papers published between 2005 and 2015. This review focused strictly on healthcare providers in the formal healthcare setting. Conclusions The authors provided an analysis of the evolution of compassion fatigue and identified surrogate terms, attributes and defining characteristics, and antecedents and consequences of the term, true to Rodgers' Evolutionary Model. Related terms are also discussed and a brief case model is provided. Clinical Relevance A better understanding of compassion fatigue will allow researchers and clinicians to identify its causes, prevention, and treatment. This could impact the rate at which healthcare providers leave clinical practice and their ability to compassionately engage with patients. [ABSTRACT FROM AUTHOR]

School-aged children with autism spectrum disorders (ASDs) have delayed gestural development, in comparison with age-matched typically developing children. In this study, an intervention program taught children with low-functioning ASD gestural comprehension and production using video modelling (VM) by a computer-generated robot animation. Six to 12-year-old children with ASD ( N = 20; IQ < 70) were taught to recognize 20 gestures produced by the robot animation (phase I), to imitate these gestures (phase II) and to produce them in appropriate social contexts (phase III). Across the three phases, significant differences were found between the results of the pretest and the immediate and follow-up posttests; the results of both posttests were comparable, after controlling for the children's motor and visual memory skills. The children generalized their acquired gestural skills to a novel setting with a human researcher. These results suggest that VM by a robot animation is effective in teaching children with low-functioning ASD to recognize and produce gestures. Lay Description What is already known about this topic: Children with autism spectrum disorders (ASDs) have difficulties with nonverbal communication., Children with ASD have difficulties in recognizing and producing gestures., What this paper adds: A multiphase therapeutic intervention program using video modelling (VM) of robot animation is effective to promoting the gestural communication skills, both recognition and production, in children with low-functioning ASD., Children with ASD have improved their skills to recognize the taught gestures (phase I), imitate them (phase II) and produce them in appropriate social contexts (phase III)., Children with ASD are able to generalize the acquired skills to human-to-human interactions after the intervention program., Implications for practice and/or policy: VM of a robot animation is effective in teaching children with low-functioning ASD both gesture recognition and gesture production., The multiphase therapeutic intervention protocol can be recommended for clinicians or teachers in special schools to teach children with low-functioning ASD gestural communication skills. [ABSTRACT FROM AUTHOR]

The field has embarked on an effort to better integrate neurobiological and psychological dimensions of functioning with putative psychopathological syndromes. If successful, this effort aims to be a turning point as impactful as the change, a century ago, away from the study of symptom dimensions and toward the study of psychopathological syndromes. New statistical and neurobiological methods and findings hold considerable promise in this regard, and several papers in the present issue underscore these ongoing and important new directions. For this proposed direction to succeed, however, three guiding principles are necessary. First, the syndromal approach must continue to be viewed as provisional, and not reified. Second, in contrast, individual dimensions of neurobiology, psychology, personality, or symptoms should not be decontextualized but considered in relation to other traits and dimensions, syndromal configurations. Major clinical syndromes cannot be ignored. Third, following the Kraepelian insights of a century ago in addition to the more recent insights of developmental psychopathlogy, trait and dimension aspects of psychopathology need to be understood in their developmental context. Whether an integrated dimensional-categorical-developmental understanding of psychopathology can be extended to the entire nosology or only parts of it remains to be seen. [ABSTRACT FROM AUTHOR]

Hoarding disorder is a relatively new diagnosis in the DSM‐5, only just included in the most recent edition. The disorder has piqued the interest of many in the community, in part because of the hit TV show called "Hoarders." Although there is interest, there continues to be relatively few research studies into the causes, treatment, and management of this disorder specifically in adolescences. Yet, in the research that has been published, it often sites the disorder first appearing in adolescents. This paper will discuss the following elements of adolescent hoarding disorder: The potential etiology and risk factors noted in the literature, the DSM‐5 criteria for the diagnosis of hoarding disorder, and the characteristic signs and symptoms found in the adolescent presentation, as well as treatment. Finally, it will also include recommendations for healthcare professionals for early screening and treatment. [ABSTRACT FROM AUTHOR]

The article presents the discussion on addressing health equity starting at home. Topics include diagnostic terms and associated words having potential unintended consequences of harming people and contributing to social injustice; and offering little resistance while simultaneously shielding police from accountability.

Objective The objective of this paper was to examine the relationships between perceived parental bonding, Early Maladaptive Schemas (Young et al., 2003), and outcome of schema therapy of Cluster C personality problems and whether the perceptions of parental bonding could be influenced by schema therapy. Method The sample consisted of 45 patients with panic disorder and/or agoraphobia and Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Cluster C personality traits who participated in an 11-week inpatient programme consisting of two phases; the first was a 5-week panic/agoraphobia-focused cognitive therapy, whereas the second phase was a personality-focused schema therapy. The patients were assessed at pre-treatment, mid-treatment and post-treatment and at 1-year follow-up. Results Opposite to our hypothesis, lower paternal care at pre-treatment was related to more reduction in Cluster C personality traits from pre-treatment to 1-year follow-up. Maternal protection was related to the schema domains of impaired autonomy and exaggerated standards. Overall schema severity and the schema emotional inhibition at pre-treatment were associated with less change in Cluster C traits. Perceived maternal care was reduced from pre-treatment to 1-year follow-up, and more reduction in maternal care was related to less reduction in Cluster C traits. Discussion Parental bonding failed to predict treatment outcome in the expected direction, but maternal protection was related to two of the schema domains. Overall schema severity and the particular schema emotional inhibition predicted outcome. Furthermore, perceived maternal care was reduced from before to after treatment. Future studies should examine these questions in larger samples of Cluster C patients receiving schema therapy of a longer duration. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message Most schemas within the impaired autonomy domain and the schema self-sacrifice seem to be related to low perceived maternal protection., Overall schema severity and the schema emotional inhibition predict a poorer outcome of schema therapy of Cluster C personality problems, and therapy should give priority to emotional inhibition when this schema is endorsed., Therapists should be aware that schema therapy carries the risk to lead to a more negative view of mother's care during upbringing and this risk is accentuated with less benefit of therapy. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented that focuses on issues related to personality disorder (PD) classification system, including the multifactorial contextual factors and aetiology of PD, the continued reliance on a strict medical model for psychiatric classification, and viable dimensional alternatives to categorical diagnosis.

'Depression is a common, debilitating, and potentially lethal disorder.' This is a standard opening to many a scientific paper on depression. And it is often followed by some very grim statistics. Over 300 million people in the world are estimated to live with depression, and the disorder is ranked by WHO as the single largest contributor to global disability. Most worryingly, adolescents with major depressive disorder are up to 30 times more likely to commit suicide. Yet, what exactly is depression? Do all 300 million depressed people in the world suffer from the same thing, with the same aetiology? Is depression one disorder that comes in different shades of severity or is it best thought of as heterogeneous mix of problems that we have given one common name to? And, more practically, should we be treating all depression in similar ways? [ABSTRACT FROM AUTHOR]

Copyright of Family Process is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Delusions are one of the most elusive concepts in psychiatry. There have been several theories on the nature and definition of delusions. Jaspers described them as entailing a total transformation of reality and considered primary delusions as un-understandable. When it comes to clinical practice, psychiatrists resort to criteria of falsity, incorrigibility, conviction and being out of keeping with the person's culture. All these criteria have been subject to various criticisms, some of which will be discussed in the paper. We will use the concept of epistemic injustice to explore the role of stereotypes and prejudice in the identification of delusions. We will discuss cases where patients are suffering from testimonial injustice by virtue of having a mental disorder that is so often associated with attributions of irrationality, bizarreness and incomprehensibility. Two vignettes will be presented to show that this is often the case in clinical practice. We will discuss relevant issues around the epistemology of the delusions. We think that in order to challenge the testimonial injustice, there needs to be an awareness of its possibility and thus recognition of the role of certain stereotypes in assessing these mental states. Challenging the stigma against mentally ill and adopting a holistic view of delusions can help tackle the prejudice that pre-empt the testimonial injustice. [ABSTRACT FROM AUTHOR]

Copyright of Family Process is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT The DSM-5 Personality and Personality Disorders Work Group has suggested that the DSM-IV depressive personality disorder (DPD) construct be assessed within a proposed set of trait domains, which include anxiousness, depressivity, and anhedonia, and that the diagnostic category itself be removed from the DSM-5. A review of studies on DPD has demonstrated many challenges and limitations to DPD research, despite strong evidence of its validity and clinical utility. Nevertheless, there remains much interest in how a depressive personality construct fits into a dimensionalized framework of assessing psychopathology. In this paper, I offer three major research directions that can help advance our understanding of the depressive personality construct. These directions can inform researchers and clinicians how depressive personality fits within broad trait dimensions of classification, as well as the internal psychological processes, dynamics and content that characterize this type of psychopathology. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: Given renewed interest in dimensional approaches in psychiatric nosology, we review evidence for the utility of including dimensions of eating disorder (ED) psychopathology, comorbid psychopathology, and neurobiology in the classification of EDs. Method: We searched on-line databases and reference lists of published papers for articles on dimensional methods in psychiatric classification, with an emphasis on EDs. Results: ED classification may be enhanced by including dimensional assessments. Specifically, some ED features appear to exist on a continuum with normality, and dimensional measures of ED severity are likely to have utility in clinical contexts. Furthermore, accumulating data support the validity of ED classification schemes that incorporate dimensions of comorbid psychopathology. Finally, neurobiological dimensions have gained increasing notice across the psychiatric literature and may be particularly salient to the classification of EDs. Discussion: An approach to ED classification that incorporates multiple dimensional measures may have the greatest utility for advancing ED treatment. © 2013 by Wiley Periodicals, Inc. (Int J Eat Disord 2013; 46:396-403) [ABSTRACT FROM AUTHOR]

As advances in neuroscience and genetics reveal complex associations between brain structures, functions and symptoms of mental disorders, there have been calls for psychiatric classifications to be reconfigured, to conceptualize mental disorders as disorders of the brain. In this paper, I argue that this view is mistaken, and that the level at which we identify mental disorders is, and should be, the person, not the brain. This is not to deny physicalism or argue that the mental realm is somehow distinct from the physical, but rather to suggest the things that are going 'wrong' in mental disorder are picked out at the person-level: they are characterized by breaches in epistemic, rational, evaluative, emotional, social and moral norms. However, as our scientific understanding of the brain becomes advanced, what makes an identified neurobiological difference in brain structure or functioning indicative of pathology is its association with these behaviours at the person-level. Instead of collapsing psychiatry into biomedicine, biomedicine may benefit from drawing closer to the expertise of psychiatry, as it is able to accommodate social, psychological and biological explanations while focusing on the person, within their environment. [ABSTRACT FROM AUTHOR]

Science can only offer a limited account of, and prescription for, mental health care. Yet the language of science and faith in the universal applicability of particular scientific methods to the craft of mental health care has come to permeate mental health practice communities. In this paper, the argument that many beliefs held by mental health professionals might be considered to be based on faith rather than science is presented, and the view that culture provides a useful lens for understanding mental health services and these paradoxes is proposed. Clearly there is a grand mental health narrative or colonizing influence of biological psychiatry that in various ways affects all mainstream mental health services. Local health services and professional communities might be considered subcultures. Understanding how mental health professions and practice are embedded in culture might be useful in considering how practice changes and why. Culture and caring practices are mutually embedded in localized subcultures. Therefore, a rich description of context and history is necessary in publication, presentation, or other communications to enable genuine understanding by a global audience. Viewing mental health practice in a cultural context highlights the importance of values and differences, and encourages humility in the face of ambiguity. [ABSTRACT FROM AUTHOR]

Background Children with speech sound disorders (SSD) form a heterogeneous group who differ in terms of the severity of their condition, underlying cause, speech errors, involvement of other aspects of the linguistic system and treatment response. To date there is no universal and agreed-upon classification system. Instead, a number of theoretically differing classification systems have been proposed based on either an aetiological (medical) approach, a descriptive-linguistic approach or a processing approach. Aims To describe and review the supporting evidence, and to provide a critical evaluation of the current childhood SSD classification systems. Methods & Procedures Descriptions of the major specific approaches to classification are reviewed and research papers supporting the reliability and validity of the systems are evaluated. Main Contribution Three specific paediatric SSD classification systems; the aetiologic-based Speech Disorders Classification System, the descriptive-linguistic Differential Diagnosis system, and the processing-based Psycholinguistic Framework are identified as potentially useful in classifying children with SSD into homogeneous subgroups. The Differential Diagnosis system has a growing body of empirical support from clinical population studies, across language error pattern studies and treatment efficacy studies. The Speech Disorders Classification System is currently a research tool with eight proposed subgroups. The Psycholinguistic Framework is a potential bridge to linking cause and surface level speech errors. Conclusions & Implications There is a need for a universally agreed-upon classification system that is useful to clinicians and researchers. The resulting classification system needs to be robust, reliable and valid. A universal classification system would allow for improved tailoring of treatments to subgroups of SSD which may, in turn, lead to improved treatment efficacy. [ABSTRACT FROM AUTHOR]

Background Diagnostics and care for people with intellectual disabilities (ID) and psychiatric disorders need to be improved. This can be done by using assessment instruments to routinely measure the nature and severity of psychiatric symptoms. Up until now, in the Netherlands, assessment measures are seldom used in the psychiatric care for this population. The objective of the present paper is to evaluate the use of the Brief Symptom Inventory (BSI), a widely used standardised questionnaire in general psychiatry, in a well-defined sample of people with borderline intellectual functioning or mild ID diagnosed with one or more psychiatric disorders. Methods A total of 224 psychiatric outpatients with either borderline intellectual functioning or mild ID participated in this study. All participants were new patients of Kristal, Centre for Psychiatry and Intellectual Disability in the Netherlands, in the period between 1 April 2008 and 1 October 2009. All participants were assessed by a multidisciplinary team, including a certified psychiatrist. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria were applied. The mean total intelligence quotient was measured with the Wechsler Adult Intelligence Scale (WAIS-III). The BSI was administered in an assisted fashion. Utility and psychometric properties of the BSI were investigated. Internal consistency coefficients (Cronbach's alphas) were computed. Bivariate correlations between the sub-scales were computed to assess differentiation between the scales. Mean sub-scale scores were compared between different DSM-IV-TR subgroups to investigate the discriminant abilities of the scales. A confirmatory factor analysis was conducted. Results The results suggest that the BSI is practically useful. Internal consistencies ranged from 0.70 to 0.96 and thus are considered good to adequate. Sub-scale inter-correlations showed there is a degree of differentiation between the sub-scales. Discriminant validity was shown for the sub-scales depression, anxiety and phobic anxiety. Confirmatory factor analysis showed that the underlying structure of the BSI could be described by the same nine-factor model as reported in previous studies. Conclusions As a result of the psychometric properties illustrated, this study supports the use of the BSI as a screener for psychopathology and a general outcome measure in people with ID. [ABSTRACT FROM AUTHOR]

ABSTRACT In this paper, we discuss avoidant personality disorder and its complexities by presenting a case in which the differential diagnosis was extremely difficult. The presented case concerns a patient, who initially received the diagnosis of 'Taijin kyofusho', a diagnosis commonly made in the traditional psychiatry in Japan, and later, his diagnosis was changed to avoidant personality disorder as the DSM-III gained popularity. His chief complaint was his concern over his odour from his genitourinary organs, which led him to avoid interpersonal relationships. During the course of illness, his concern over his body odour and appearance grew to the extent that he sought surgical treatment, but he managed to succeed in his business. Currently, he is being treated with the medium dose of selective serotonin reuptake inhibitors in addition to psychotherapy, but his symptoms concerning interpersonal relationships still remain. Many symptoms other than typical ones of avoidant personality disorder were observed, and other psychiatric diagnoses, including delusional disorder, somatization disorder, and body dysmorphic disorder, were considered for differential diagnosis. Although they were ruled out in light of the criteria in the current diagnostic classification, this case illustrates the complex nature of the diagnosis of avoidant personality disorder, and furthermore, of psychiatric diagnoses. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Purpose. This paper studies how diagnosis is currently conceptualized in the field of psychiatry, and examines whether this mode of diagnosis is relevant for psychotherapeutic intervention. Method. Narrative literature review was used in this study. Results. In the context of the DSM, diagnosis is equated with classification. Symptoms and complaints are approached in terms of a medical semiological model, and are seen as signs of underlying illness processes. In discussing this approach the author makes use of Gottlob Frege's theory, in which three aspects of a sign are discerned: the reference/referent or Bedeutung, the sense or Sinn, and the representation/idea or Vorstellung. Based on this distinction, it is argued that in the transition from the DSM-III to the DSM-5 much effort has been taken to disambiguate the sense attributed to symptoms and complaints, while person-specific ideas and representations have been excluded. This exclusion of the Vorstellung is criticized, both from a psychiatric and a psychotherapeutic perspective. Subsequently it is argued that whereas the DSM-III and DSM-IV avoided strong statements on etiology, the DSM-5 makes clear choices. The DSM-5, and more recently the RDoC group within the NIMH, aims at developing systems of classification that start from the assumption that psychiatric disorders are brain disorders. It is argued that by doing so a referent is classified that is different from the object of intervention that psychotherapeutic theories are concerned with. Conclusion. Such a view of diagnosis is not workable for psychotherapy. The exclusion of personal experiences associated with symptoms and complaints is problematic and the referent that recent psychiatric classification uses, that is, brain processes, is not compatible with the referent that psychotherapeutic theories use. Case formulation can be seen as an alternative to standard classification. Practitioner Points A clear distinction between classification and diagnosis should be made., Psychotherapeutic diagnosis cannot exclude information on the embedding of problems in broader life contexts., Case formulation is a viable alternative to classification. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims This paper aims to identify appropriate criteria for tobacco dependence assessment, evaluate relevant research and suggest revisions that may be incorporated into DSM-5. Methods Desirable conceptual and psychometric features of tobacco dependence assessments were identified, including the types of outcomes against which such assessment should be validated. DSM-IV criteria were matched against these criteria and compared with other dependence measures. Results DSM-IV criteria were found to be ambiguous, little used in tobacco research, and have relatively low predictive validity. Other dependence measures were found to have greater validity in the prediction of important dependence features such as relapse likelihood. Strength of urges to smoke on typical smoking days and during abstinence, markers of nicotine intake or frequency of smoking and latency to smoke soon after waking were found to be useful dependence measures. Conclusion The use and utility of DSM-5 will be enhanced by eliminating most DSM-IV criteria and adding new ones based on smoking pattern, smoking heaviness, and the severity of craving during periods of smoking and withdrawal. [ABSTRACT FROM AUTHOR]

Over the past two decades, research on pediatric bipolar disorder has grown geometrically. The diagnosis of pediatric bipolar disorder was met with enthusiasm, which in healthy doses catalyzed change, and skepticism, which in good measure pushes for rigor. Skepticism led to productive questions about the phenomenology of pediatric bipolar disorder and how best to diagnose and treat it. With regard to prevalence, key questions included whether it was increasing over time, and whether it was limited to the United States. In 2011, we published a meta‐analysis addressing the prevalence questions; results indicated that bipolar disorder manifested at statistically indistinguishable rates in youth community samples across the world. In their recent paper, Parry et al. examine the studies included in the 2011 meta‐analysis using a qualitative approach. Their opinion piece represents a step backwards; every study has shortcomings, but in focusing on a dozen individual studies, Parry et al. fail to take into account the preponderance of evidence – literally thousands of articles across countries, cohorts and methodologies – that support the existence of bipolar disorder in both prepubescent youth and adolescents. This commentary addresses misperceptions regarding the diagnosis of bipolar disorder in youth, particularly with regard to cross‐informant agreement, to present converging data from international sources regarding the onset of bipolar disorder in childhood, and to correct the false claim that pediatric bipolar disorder is controversial. As clinicians and researchers, we have an obligation to do what we can to improve the lives of youth affected by mental illness. Denying the existence of a serious mood disorder will not serve the best interests of young people and will perpetuate the long delays many experience before getting an accurate diagnosis, appropriate treatment, and a fair chance at a good quality of life. Read the Editors' introduction at: doi: 10.1111/camh.12315 Read the core debate at: doi: 10.1111/camh.12231; doi: 10.1111/camh.12243; doi: 10.1111/camh.12306 Read more perspectives in this debate at: doi: 10.1111/camh.12318 doi: 10.1111/camh.12317; doi: 10.1111/camh.12316; doi: 10.1111/camh.12313; doi: 10.1111/camh.12310; doi: 10.1111/camh.12314 [ABSTRACT FROM AUTHOR]

The association between poverty and intellectual disability (ID) has been well documented. However, little is known about persons with ID who face circumstances of extreme poverty, such as homelessness. This paper describes the situation of persons with ID who were or are homeless in Montreal and are currently receiving services from a team dedicated to homeless persons. (1) To describe the characteristics, history and current situation of these persons; and (2) to report within-group differences as a function of gender and current residential status. The data were collected from files using an anonymous chart summary. Descriptive statistics on the whole sample ( n = 68) and inferential statistics on cross-tabulations by gender and residential status were performed. Persons with ID exhibited several related problems. Some of these persons, primarily women, experienced relatively short periods of homelessness and their situations stabilised once they were identified and followed up. Other persons with ID experienced chronic homelessness that appeared to parallel the number and severity of their other problems. When compared with a previous epidemiological study of the homeless in Montreal, the population of homeless persons with ID differed from the overall homeless population in a number of respects. The results suggest prevention and intervention targets. The need for epidemiological research appears particularly clear in light of the fact that below-average intellectual functioning has been identified as a risk factor for homelessness and a predisposing factor for vulnerability among street people. [ABSTRACT FROM AUTHOR]

TOPIC: Anticipatory stress chronically activates the stress response in children with post-traumatic stress disorder (PTSD). Effects of the allostatic load may begin even before birth in a stressful environment. PURPOSE: The purpose of this paper is to discuss the anticipatory stress response in children with PTSD. The paper discusses the etiology, the impact of the disorder on long-term health, cognitive and behavioral manifestations, and clinical management and treatment options. SOURCES USED: A review on current literature is presented and includes several key studies. CONCLUSIONS: Anticipatory stress in PTSD has acute and long-term health implications for the child. The psychiatric nurse plays a key role in preventing the long-term effects of PTSD. [ABSTRACT FROM AUTHOR]