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We generate and test a context theory of the impact of involvement in work-related critical incidents, positing that variation in units' postevent support and control climates explains cross-unit variation in individual stressor-strain relationships, that posttraumatic distress mediates the link between critical incident involvement and negative emotional states, and that current support and control climates assume relevance by operating as contextual moderators of these individual-level mediated paths. Using multilevel data from New York City firefighters, many of whom were involved in 9/11, we find significant but unique cross-level moderating effects for both climate factors. Research and practice implications are discussed. [ABSTRACT FROM AUTHOR]

Objective: The New York City's Thrive (ThriveNYC) and the Los Angeles County Health Neighborhood Initiative (HNI) are two local policies focused on addressing the social determinants of behavioral health as a preventive strategy for improving health service delivery. On January 29, 2016, leaders from both initiatives came together with a range of federal agencies in health care, public health, and policy research at the RAND Corporation in Arlington, Virginia. The goal of this advisory meeting was to share lessons learned, consider research and evaluation strategies, and create a dialogue between stakeholders and federal funders - all with the purpose to build momentum for policy innovation in behavioral health equity.Methods: This article analyzes ethnographic notes taken during the meeting and in-depth interviews of 14 meeting participants through Kingdon's multiple streams theory of policy change.Results: Results demonstrated that stakeholders shared a vision for behavioral health policy innovation focused on community engagement and social determinants of health. In addition, Kingdon's model highlighted that the problem, policy and politics streams needed to form a window of opportunity for policy change were coupled, enabling the possibility for behavioral health policy innovation.Conclusions: The advisory meeting suggested that local policy makers, academics, and community members, together with federal agents, are working to implement behavioral health policy innovation. [ABSTRACT FROM AUTHOR]

The aim of the current research was to advance understanding of child protection in Australia by examining the factors associated with recurrence of child protection notifications to the formal child protection system. Extant research has been primarily undertaken in the USA and it is important to understand whether similar factors associated with recurrence actually hold in the Australian context. Administrative data were obtained for a sample of 9608 children first subject to a screened-in report in 2011–12. Children were followed for 12 months. Cox Proportional Hazard models were used to measure associations between 26 independent variables and four types of recurrence: subsequent reports, subsequent investigations, subsequent substantiations, and subsequent intervention. Factors associated with recurrence in Australia were broadly similar to those identified in other jurisdictions, including reports and substantiation for neglect, younger age, prior child protection involvement in the household, and parental characteristics including drug use, mental health problems, and history of maltreatment as a child. As in previous studies, post-investigative service provision was positively associated with recurrence. In prior US research, race did not predict recurrence. However, in the present study, Indigenous Australian children were significantly more likely to be subject to all types of recurrence measured. Future research on recurrence should aim to disentangle the complex relationships between child protection recurrence, child maltreatment, and service delivery. Recurrence is not a good proxy indicator of child safety. The findings have implications for the equity of recurrence-based risk assessment tools as they are applied to indigenous populations. [ABSTRACT FROM AUTHOR]

Children in the child welfare system comprise a group characterized by exposure to trauma via experiences of maltreatment, under circumstances presenting multiple risk factors for traumatic stress. High rates of posttraumatic stress have been observed in this population. However, there is currently no standard for the universal screening of children in child welfare for trauma exposure and traumatic stress. This study examined the trauma experiences of a sample of maltreated children and whether their child welfare workers were effective screeners of traumatic stress symptoms. Descriptive and correlational analyses were conducted regarding a sample of children (N = 131) with trauma screenings completed by their child welfare workers and clinical measures of traumatic stress symptoms. Four hierarchical regression models were also examined to determine whether workers' screening information regarding child age, trauma exposure history and symptoms of traumatic stress were predictive of outcomes on clinical measures. The analyses revealed complex trauma exposure histories and high rates of traumatic stress symptoms among this generally younger sample of maltreated children. Additionally, the models supported workers' efficacy in screening for symptoms of total posttraumatic stress and specific trauma symptoms of intrusion and avoidance. Workers were less effective in screening for the symptoms of arousal. These findings support the importance of identifying the trauma recovery needs of maltreated children and the utility of child protection workers in assisting with the trauma screening process. Implications are provided for related practice, policy and training efforts in child welfare. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify the pathways from childhood physical and sexual abuse to adolescent physical and sexual victimization by assessing behavior symptoms (both internalizing and externalizing) and peer popularity as potential mediating variables. The data derive from Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), which tracks the consequences of child abuse and neglect using five study sites across the US. Child physical and sexual abuse was measured at age 12 using self-reports of life-time maltreatment experiences. Internalizing and externalizing symptoms were assessed at age 12 using the Child Behavior Checklist (CBCL). Peer popularity was assessed at age 14 by teachers. Peer victimization was assessed at age 16 using the modified version of the Juvenile Victimization Questionnaire. The results indicated that physical abuse had no direct effect on either physical or sexual peer victimization, whereas sexual abuse had significant direct effect on both physical and sexual victimization. Assessed at age 12, children who had been physically or sexually maltreated were found to have higher levels of internalizing and externalizing symptoms. These increased symptoms are associated with lower peer popularity at age 14, which in turn is associated with greater physical and sexual peer victimization at age 16. The findings suggest that multiple points for interventions may exist to disrupt the cycle of victimization. Early assessment and treatment for externalizing symptoms and for low peer popularity may be helpful in preventing physical peer victimization among adolescents who have been physically and/or sexually abused. [ABSTRACT FROM AUTHOR]

The complementary nature of positive psychology and coaching psychology has long been recognised by both researchers and practitioners. The last decade saw a tenfold increase of articles relating to positive psychology coaching and even more literature attempting to apply some of the findings from positive psychology in a coaching practice. However, despite the interest and the complexity of both fields, there is a lack of systematic approach to this new practice. The current paper introduces the Conceptual Framework for Positive Psychology Coaching Practice, the aim of which is to offer advice to both practitioners and researchers of the elements necessary to exist, in order to practise positive psychology coaching, as well as inform the policy and curriculum of programmes teaching positive psychology coaching in third level education. [ABSTRACT FROM AUTHOR]

Coaching psychology has been used successfully in various health and wellbeing contexts, but there are conflicting views as to whether coaching is an appropriate form of mental health support. Since mental health is a relatively new area for the application of coaching, a scoping review has been conducted to delineate the current state of research in the field. This article reports on two aspects of that scoping review: first, it describes how the fledgling scoping review method was adapted for this research study, offering recommendations for future scoping reviewers. Second, implications of the findings are discussed, with an exploration of how the potential of mental health coaching could be leveraged in future practice and research. [ABSTRACT FROM AUTHOR]

This research sought to identify distinctions in the practice of coaches within Wales. A survey design was adopted, with a snowball sampling strategy generating 150 respondents. Seven surveyed aspects of coaching practice produced distinctive responses from coaches within Wales compared with respondents from other European nations: they are less likely to have membership of any professional coaching bodies, they spend a very small proportion of their working time coaching, they are more likely to operate as internal coaches or for low fees, they are more likely to engage in self-reflection and participate in peer networks, they have a marked preference for behavioural/goal-focused methods, they are thorough in the range of topics they cover when contracting and they are likely to be selected as coaches based predominantly upon their experience levels. Recommendations are made for future analytical research to identify causal factors for these distinctions. [ABSTRACT FROM AUTHOR]

The current study investigated whether children’s relative social status within a context influences their ability to identify others’ mental states. Across two experiments, 3- to 7-year-olds ( N  = 103) were randomly assigned to hold either an advantaged or disadvantaged social status and were assessed on their ability to accurately identify others’ mental states (via false-belief and belief-emotion “theory of mind” assessments). When participants’ status was manipulated by a structural factor (gender; Experiment 1), participants with disadvantaged status were more likely than participants with advantaged status to pass the false-belief and belief-emotion assessments. When status was manipulated by an individual factor (performance; Experiment 2), participants with disadvantaged status were more likely to pass the false-belief assessment but not the belief-emotion assessment. Results provide the first empirical evidence that an individual’s contextualized perspective (i.e., his or her social status situated within a given context) influences the individual’s ability to identify others’ mental states. [ABSTRACT FROM AUTHOR]

ME/CFS is a medically contested illness and its understanding, framing and treatment has been the subject of heated debate. This paper examines why framing the condition as a psychiatric issue—what we refer to as ‘psychiatrisation’—has been so heavily contested by patients and activists. We argue that this contestation is not simply about stigmatising mental health conditions, as some have suggested, but relates to how people diagnosed with mental illness are treated in society, psychiatry and the law. We highlight the potentially harmful consequences of psychiatrisation which can lead to people’s experiential knowledge being discredited. This stems, in part, from a psychiatric-specific form of ‘epistemic injustice’ which can result in unhelpful, unwanted and forced treatments. This understanding helps explain why the psychiatrisation of ME/CFS has become the focus of such bitter debate and why psychiatry itself has become such a significant field of contention, for both ME/CFS patients and mental health service users/survivors. Notwithstanding important differences, both reject the way psychiatry denies patient explanations and understandings, and therefore share a collective struggle for justice and legitimation. Reasons why this shared struggle has not resulted in alliances between ME and mental health activists are noted. [ABSTRACT FROM AUTHOR]

There is substantial research about international postgraduate students but little research about their experiences as parents or their children’s experiences. We focus on four postgraduate international students with young children navigating early childhood education and care in New Zealand. A narrative analysis, informed by socio-cultural understandings of learning and post-structuralist understandings of identity, revealed emotional complexities, stress and transformation as parents and children made many transitions. Parents wanted their own culture respected and their host culture decoded. Families experienced tensions around the use of home and host languages as they juggled children’s present and future linguistic needs. Supporting international students in their family identity has positive effects for them, their children and their doctoral studies, and hence for universities. Further research about the experiences of international students who are parents and of their children could assist in the formulation of policies to effect such support. [ABSTRACT FROM AUTHOR]

Previous studies have revealed that preschoolers selectively allocate their resources based on their social relationship with recipients such as friendship. In this investigation, we investigated how expectations about recipients’ prosociality and the ability of future thinking relate to the selective allocation of resources. In Study 1, participants aged 3.5–6 years chose how to allocate resources from two ways (selfish allocation, where only the participants could receive stickers, and equal allocation, where the participants and recipients receive get the same number of stickers) in costly and non-costly situations with three recipients (friend, peer, and stranger). Participants were asked to state which alternatives the recipients would choose if they were given a choice. The results showed that children aged 5 and 6 years tended to choose equal allocation of resources when they expected the recipients to do the same both in costly and non-costly situations. This tendency was not observed in children aged 3.5 and 4 years. In Study 2, the relationships between selectivity in non-costly allocation and two facets of future thinking (delay of gratification and mental time travel) were investigated in children aged 5 and 6 years. The results suggested that children with a higher mental time travel ability tended to be more selective in allocating resources based on social relationships; they tended to allocate more resources to the friend and fewer to the peer. Our findings suggest that expectations about a recipient’s prosociality and the ability of mental time travel affect selectivity of resource allocation in children aged 5 and 6 years. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The current study examined the efficacy of a virtual reality (VR) education system that simulates the experience of the positive symptomology associated with schizophrenic spectrum and other psychotic disorders. Method: The sample comprised of 50 participants from the general public and various psychology undergraduate programs. Participants completed pre‐test measures exploring knowledge of diagnosis, attitudes, and empathetic understanding, before being exposed to an immersive VR simulation of a psychotic episode. Participants then completed the original measures with the addition of a user‐experience scale, which explored sub‐factors understood to share a relationship with VR effectiveness (i.e., fidelity, immersion, presence, and user buy‐in). Results: Participants’ scores were significantly enhanced at post‐test across each outcome measure, with significant correlations found between a number of the gain and user‐experience scores. Conclusions: The findings suggest that VR‐based simulations of psychopathology may offer a promising platform for delivering a constructionist approach to psychology education. [ABSTRACT FROM AUTHOR]

Objectives: Individuals use social media with varying quantity, emotional and behavioral attachment that may have differential associations with mental health outcomes. In this study, we sought to identify distinct patterns of social media use (SMU) and to assess associations between those patterns and depression and anxiety symptoms. Methods: In October 2014, a nationally-representative sample of 1730 US adults ages 19 to 32 completed an online survey. Cluster analysis was used to identify patterns of SMU. Depression and anxiety were measured using respective 4-item Patient-Reported Outcome Measurement Information System (PROMIS) scales. Multivariable logistic regression models were used to assess associations between cluster membership and depression and anxiety. Results: Cluster analysis yielded a 5-cluster solution. Participants were characterized as "Wired", "Connected", "Diffuse Dabblers", "Concentrated Dabblers" and "Unplugged". Membership in 2 clusters - "Wired" and "Connected" - increased the odds of elevated depression and anxiety symptoms (AOR = 2.7, 95% CI = 1.5-4.7; AOR = 3.7, 95% CI = 2.1-6.5, respectively and AOR = 2.0, 95% CI = 1.3-3.2; AOR = 2.0, 95% CI = 1.3-3.1, respectively). Conclusions: SMU pattern characterization of a large population suggests 2 patterns are associated with risk for depression and anxiety. Developing educational interventions that address use patterns rather than single aspects of SMU (eg, quantity) would likely be useful. [ABSTRACT FROM AUTHOR]

Previous studies have suggested the consequence of mental health-related public stigma: the problem of knowledge may develop into problem of attitude and behaviour. However, this has not been directly explored in a longitudinal study. As the secondary analysis from our previous randomized controlled trial (RCT) for 219 participants who completed the survey at the 12-month follow-up, we aimed to investigate whether the knowledge and attitude components of stigma toward people with schizophrenia affect each other. At baseline and at 12 months, three types of stigma scales were measured: favorable understanding, negative stereotype, and social distance toward people with schizophrenia. A structured equation model was fitted to the trajectory of stigma scales taking into account the effect of the other stigma components and the interventions. The results showed that greater social distance toward people with schizophrenia at baseline was associated with less favorable understanding and more negative stereotype at the 12-month follow-up. This was not in line with the existing consequences from the previous studies; however, in line with the recent RCTs showing that social contact is the most effective intervention to reduce stigma. Future observational studies with a larger sample size are needed to clarify this relationship further. [ABSTRACT FROM AUTHOR]

This section of the journal encourages discussion between several authors on a policy-related topic. The same question may, therefore, be addressed from different theoretical, cultural or spatial perspectives. Dialogues may be applied or highly abstract. The Dialogue in this issue starts with Burrai and Hannam contribution herehttps://doi.org/10.1080/19407963.2017.1362809. [ABSTRACT FROM PUBLISHER]

Abstract: Aim: Despite the large scientific debate concerning potential stigmatizing effects of identifying an individual as being in an at‐risk mental state (ARMS) for psychosis, studies investigating this topic from the subjective perspective of patients are rare. This study assesses whether ARMS individuals experience stigmatization and to what extent being informed about the ARMS is experienced as helpful or harmful. Methods: Eleven ARMS individuals, currently participating in the follow‐up assessments of the prospective Basel Früherkennung von Psychosen (FePsy; English: Early Detection of Psychosis) study, were interviewed in detail using a semistructured qualitative interview developed for this purpose. Data were analysed using Interpretative Phenomenological Analysis. Results: Most individuals experiencing first symptoms reported sensing that there was ‘something wrong with them’ and felt in need of help. They were relieved that a specific term was assigned to their symptoms. The support received from the early detection centre was generally experienced as helpful. Many patients reported stigmatization and discrimination that appeared to be the result of altered behaviour and social withdrawal due to the prepsychotic symptoms they experienced prior to contact with the early detection clinic. Conclusions: The results suggest that early detection services help individuals cope with symptoms and potential stigmatization rather than enhancing or causing the latter. More emphasis should be put on the subjective experiences of those concerned when debating the advantages and disadvantages of early detection with regard to stigma. There was no evidence for increased perceived stigma and discrimination as a result of receiving information about the ARMS. [ABSTRACT FROM AUTHOR]

Research on relationships and health often interprets culture as the passively transmitted "content" of social ties, an approach that overlooks the influence of cultural resources on relationships themselves. I propose that mental health patients seek social support partly based on cultural resources held by their network members, including members' medical knowledge and beliefs. I test hypotheses using data from the Indianapolis Network Mental Health Study, an egocentric network survey of new mental health patients ( N = 152) and their personal relationships ( N = 1,868). Results from random-intercept regressions show that patients obtain support from network members who trust doctors and who have experience with mental problems. In contrast, network members who distrust doctors disproportionately cause problems for patients. I discuss how cultural resources can categorize network members as supportive cultural guides or disruptive cultural critics. Reconsidering how culture shapes relationships clarifies the role of networks during illness management and illustrates their potentially harmful effects. [ABSTRACT FROM AUTHOR]

Humanitarian aid workers experience adverse mental health effects from their work at higher rates than the military, police and other emergency service personnel. Whilst there is considerable literature investigating risk and resilience factors for workers within this field, little is known about the status of such factors among individuals prior to their joining the profession. Semi-structured interviews were conducted with ten commencing undergraduates of a Bachelor of Humanitarian and Development Studies course to explore their aspirations and resilience factors regarding future work. Thematic analysis identified that whilst there was a high level of reported altruism among trainees, these perceptions appeared to constrain individual use of social support networks and help-seeking behaviours. Education and training appeared to shift future work preferences from humanitarian relief work towards development-related roles. The findings suggest that humanitarian aid trainees exhibit known risk and resilience factors before they enter the profession, whilst highlighting practice expectations and personal support perceptions that are amenable to positive change through training. [ABSTRACT FROM AUTHOR]

Background: ClinicalTrials.gov is valuable for aggregate-level analysis of trials. The recently published final rule aims to improve reporting of trial results. We aimed to assess variability in ClinicalTirals.gov records reporting participants’ baseline measures. Methods and findings: The September 2015 edition of the database for Aggregate Analysis of ClinicalTrials.gov (AACT), was used in this study. To date, AACT contains 186,941 trials of which 16,660 trials reporting baseline (participant) measures were analyzed. We also analyzed a subset of 13,818 Highly Likely Applicable Clinical Trials (HLACT), for which reporting of results is likely mandatory and compared a random sample of 30 trial records to their journal articles. We report counts for each mandatory baseline measure and variability reporting in their formats. The AACT dataset contains 8,161 baseline measures with 1206 unique measurement units. However, of these 6,940 (85%) variables appear only once in the dataset. Age and Gender are reported using many different formats (178 and 49 respectively). “Age” as the variable name is reported in 60 different formats. HLACT subset reports measures using 3,931 variables. The most frequent Age format (i.e. mean (years) ± sd) is found in only 45% of trials. Overall only 4 baseline measures (Region of Enrollment, Age, Number of Participants, and Gender) are reported by > 10% of trials. Discrepancies are found in both the types and formats of ClinicalTrials.gov records and their corresponding journal articles. On average, journal articles include twice the number of baseline measures (13.6±7.1 (sd) vs. 6.6±7.6) when compared to the ClinicalTrials.gov records that report any results. Conclusions: We found marked variability in baseline measures reporting. This is not addressed by the final rule. To support secondary use of ClinicalTrials.gov, a uniform format for baseline measures reporting is warranted. [ABSTRACT FROM AUTHOR]

Living according to one's personal values is expected to promote mental health and satisfaction with life. However, there is scarce empirical research on the effects of the relative importance of values and their realization in daily life. We implemented a new measure to examine the realization of Schwartz's values and its correlation with mental health and satisfaction with life in two German online samples. Analysis of sample 1 ( n = 6,989; 70.2% female) reveals that both the importance and realization of Schwartz's values have a hierarchical organization corresponding to basic requirements of successful social functioning. Correlational analyses between the importance and realization of values indicate that with respect to their importance, values representing conservation are more consistently realized than values representing self-transcendence, self-enhancement, and openness to change. In sample 2 ( n = 163; 71.3% female), hierarchical regression analysis show that realization of values significantly predicts mental health and satisfaction with life. The realization of values indicating openness to change (e.g., stimulation, hedonism) is especially associated with better mental health and higher satisfaction with life. The health-promoting and health-harming effects of value realization as well as discrepancies between value importance and realization might be considered in clinical interventions and future research. [ABSTRACT FROM AUTHOR]

Using social media for the purpose of disseminating mental health information is a critical area of scientific inquiry for health communication professionals. The purpose of this study was to investigate whether the presence of a first-person testimonial in educational mental health information placed in Facebook and Twitter messages influenced college students’ (N = 257) source perceptions, information processing, cognitive elaboration, health information recall, beliefs, and behavioral intentions. Results show that exposure to social media messages that featured mental health information embedded with a testimonial predicted less source homophily and more critical thoughts about the social media source, less systematic message processing, and less cognitive elaboration. Health information recall was significantly impacted by both the social media platform and message content such that participants in the testimonial condition on Facebook were more likely to recall the health facts in those messages whereas participants who viewed the testimonial in Twitter were less likely to recall the facts in those tweets. Compared to those who read Facebook messages, participants who read Twitter messages reported higher levels of systematic message processing. These findings suggest that the integration of health testimonials into social media messages might inadvertently provoke psychological resistance to mental health information, thereby reducing the persuasive impact of those messages. [ABSTRACT FROM PUBLISHER]

The recovery approach is now among the most influential paradigms shaping mental health policy and practice across the English-speaking world. While recovery is normally presented as a deeply personal process, critics have challenged the individualism underpinning this view. A growing literature on "family recovery" explores the ways in which people, especially parents with mental ill health, can find it impossible to separate their own recovery experiences from the processes of family life. While sympathetic to this literature, we argue that it remains limited by its anthropocentricity, and therefore struggles to account for the varied human and nonhuman entities and forces involved in the creation and maintenance of family life. The current analysis is based on an ethnographic study conducted in Australia, which focused on families in which the father experiences mental ill health. We employ the emerging concept of the "family assemblage" to explore how the material, social, discursive and affective components of family life enabled and impeded these fathers' recovery trajectories. Viewing families as heterogeneous assemblages allows for novel insights into some of the most basic aspects of recovery, challenging existing conceptions of the roles and significance of emotion, identity and agency in the family recovery process. [ABSTRACT FROM AUTHOR]

Task-shifting in mental health such as engaging Traditional Health Practitioners (THPs) in appropriate management of mental disorders is crucial in reducing global mental health challenges. This study aims to determine the outcomes of using evidence-based mental health Global Action Programme Intervention guide (mhGAP-IG) to provide psychosocial interventions among depressed patients seeking care from THPs. THPs were trained to deliver psychosocial interventions to their patients screening positive for mild to severe depression on Beck's Depression Inventory (BDI). Assessments were conducted at 0, 6 and 12 weeks and Analysis of Variance (ANOVA) performed to determine the change in depression scores over the three time period. BDI mean score was 26.52 before intervention and reduced significantly at 6 (13%) and 12 (35%) weeks after intervention. 58 and 78% of patients showed reduction in symptoms of depression at 6 and 12 weeks. It is therefore crucial to engage THPs in the care of patients with depression and the need for inclusion of training packages; and other mental disorders in order to establish and maintain collaboration between THPs and conventional health workers and promote evidence-based care among marginalized populations. Moreover, further research on randomized control trials of mhGAP-IG intervention versus usual care is required. [ABSTRACT FROM AUTHOR]

Previous research suggests that exposure to early life stress (ELS) affects the structural integrity of the uncinate fasciculus (UF), a frontolimbic white matter tract that undergoes protracted development throughout adolescence. Adolescence is an important transitional period characterized by the emergence of internalizing psychopathology such as anxiety, particularly in individuals with high levels of stress sensitivity. We examined the relations among sensitivity to ELS, structural integrity of the UF, and anxiety symptoms in 104 early adolescents. We conducted structured interviews to assess exposure to ELS and obtained subjective and objective ratings of stress severity, from which we derived an index of ELS sensitivity. We also acquired diffusion MRI and conducted deterministic tractography to visualize UF trajectories and to compute measures of structural integrity from three distinct segments of the UF: frontal, insular, temporal. We found that higher sensitivity to ELS predicted both reduced fractional anisotropy in right frontal UF and higher levels of anxiety symptoms. These findings suggest that fibers in frontal UF, which are still developing throughout adolescence, are most vulnerable to the effects of heightened sensitivity to ELS, and that reduced structural integrity of frontal UF may underlie the relation between early stress and subsequent internalizing psychopathology. [ABSTRACT FROM AUTHOR]

The article critically reviews our knowledge about torture definition, structure, and its physical, mental, and societal effects on the tortured and torturer. Current perspective that focuses on torture as a single interpersonal trauma lacks a convincing conceptual framework and is untenable. Torture is complex intergroup and institutional traumas that negatively affect torture survivor and individual perpetrator. Further, current research should consider more focused and advanced analysis of the consequences of torture beyond posttraumatic stress disorder and the dominant linear perspective. To fill some gaps in the literature, the article provided reanalysis of a data set to demonstrate the usefulness of the new approaches in delineating the structure of torture as a cumulative trauma that consists of several trauma types. It also reanalyzed the same data to explore the nonlinear effects of torture. Additionally, the proposed reconceptualization of torture and the new findings should help develop more effective intervention strategies with torture survivors. [ABSTRACT FROM AUTHOR]

Based on qualitative methods, the study describes experiences of parents of young people attending concurrent dialectical behaviour therapy (DBT) group interventions. Parents reported a positive group experience, noticing benefits for themselves and their children, and a greater sense of hope for the future. [ABSTRACT FROM AUTHOR]

This short reflective piece includes the viewpoints of three first year trainees on a clinical psychology doctorate course on the non-academic challenges of the first six months of training. Points of shared experience are offered, which highlight some of the potential challenges to be overcome during clinical training and suggestions made for current and future trainees. [ABSTRACT FROM AUTHOR]

This paper uses a qualitative methodology to explore how those with a diagnosis of bipolar disorder view their mental health as related to their finances. Themes identified were guilt around impulse spending, comfort spending and avoidant coping with finances. [ABSTRACT FROM AUTHOR]

This article describes the development of a multidisciplinary stepped-care model for adults with attention deficit hyperactivity disorder (ADHD), as well as its challenges and achievements to date on how best to integrate this model of care in current services and economic climate. [ABSTRACT FROM AUTHOR]

Stress is the emotional and physical strain caused by our response to pressure from outside the world. It is a dynamic condition I which an individual is confronted with an opportunity, constraint, or demand related to what he or she desires and for which the outcome is perceived to be both uncertain and unimportant. Stress is also often typified by a lack of control over conditions at work. Stress is the physical and mental response of the body to demands made upon it. It is the result of our reaction to outside events, not necessarily the events themselves. Stress is the anticipated and unavoidable element of life due to unavoidable element of life due to ever increasing complexities and competitiveness in living standards. The speed of change in humankind today is certainly overwhelming and breathtaking. In the fast changing world of today, no individuals are free from stress nor is any profession stress free. It is just not enough to treat the causes but the consequences of stress one physical, emotion and behaviors areas also require due attention. [ABSTRACT FROM AUTHOR]

The study explored the different factors that affect mental health of adolescents. A total of 1209 adolescents participated of which 591 adolescents responded in English and 618 adolescents responded in Hindi. The participants were given a language choice. About 1089 adolescents were attending school and 120 adolescents were school dropouts. In the current study, original tripartite structure of Hindi-translated Mental Health Continuum Short Form was confirmed. The measurement invariance results indicated that Mental Health Continuum Short Form is a valid scale in English and Hindi languages. Multivariate results indicated age group (early vs. middle vs. late), type of school (government vs. private), place of residence (urban vs. rural), ability to express thoughts and opinion in front of parents, presence of relaxed environment at home and satisfaction with dressing style affected adolescent's mental health. Adolescents attending school displayed better mental health functioning than drop outs. [ABSTRACT FROM AUTHOR]

In her searching paper “Going Too Far: Relational Heroines and Relational Excess,” (this issue) Slochower finds the potential for excess as inherent in any psychoanalytic theory. I argue that context is key in understanding this phenomenon within relational psychoanalysis; what she describes may not be the case for other theories. The beginnings of relational theory as a movement, generational and radical, could lead to therapeutic overconfidence or certainty around countertransference insights and disclosures. Slochower sees an abundance of certainty in this stance, as well as pressure for premature mutuality. As a complement or balance to this intense mode of interpersonal engagement, Slochower elaborates her own work on holding, wherein the analyst “brackets” her experience and respects the patient’s need for privacy and nonimpingement. Uncertainty is an affirmative stance in letting the patient’s inner life come into being. There are a number of polarities in Slochower’s paper—between mutuality and privacy, certainty and uncertainty, and in the origin story of relational psychoanalysis between relational and classical theories. I argue that pluralism offers a path forward from polarities to a rich complex world of multiple possibilities and recognition of different minds and theories. [ABSTRACT FROM AUTHOR]

In discussing Joyce Slochower’s paper “Going Too Far: Relational Heroines and Relational Excess,” (this issue) the author welcomes its self-critical emphasis, suggesting that analysts from all schools of thought benefit more from noticing the risks and pitfalls in their own approach—thus becoming able to improve their own clinical work—than from polemically highlighting what is faulty in other, competing approaches. Such polemics run a risk of their own: turning our theoretical homes into theoretical fortresses, and blocking richer communication among analysts. He shares the concern about some specific attributes of relational and intersubjective clinical work but relates many of the issues raised by Slochower to tensions and dilemmas present in older models of the analytic relationship as well, offering examples from the work of Freud, Ferenczi, Balint, Winnicott, and Racker. [ABSTRACT FROM AUTHOR]

This response to the commentaries by Drs. Willock and Cornell explores themes raised in their commentaries related to regression, containment, and unconscious processes in analyses that feature intergenerational trauma. In addition, this response seeks to elaborate on how a psychoanalyst and patient might respond clinically to the “errand” presented to them by previous generations that “haunt” the treatment as ghosts. [ABSTRACT FROM AUTHOR]

In this paper I respond to Dr. Slochower’s “Going Too Far: Relational Heroines and Relational Excess” from my vantage point as a second generation relational analyst. While mindful of the risks of overemphasizing expressiveness and interaction (Stern, 2014), I do not see the pervasive clinical excess Dr. Slochower critiques as representative of relational work today. I appreciate many of Dr. Slochower’s suggestions for advancing the “individual element” and focusing on the inner world. My principle differences involve some of the assumptions that underlie Dr. Slochower’s discussion in her paper. Specifically, I believe that relational psychoanalysis represents a paradigm shift and not an over-reach in a dialogic pendulum. I question the shaping role Dr. Slochower assigns to analytic ideals in contemporary theory and practice. I differ with her interpretation of mutuality and uncertainty, which I understand to be descriptions of aspects of the analytic relationship and the analyst’s relationship to knowledge, rather than ideals that direct clinical conduct. I suggest that analytic intent, which I define by building on Mitchell’s (2000) notion of the analyst’s intention with the addition of analytic love, offers a more useful compass for navigating the therapeutic journey than the concept of relational ideals. [ABSTRACT FROM AUTHOR]

I consider the evolution of our relational ideal—its implications for our therapeutic goals, our patients, and for ourselves. Who do we aim to be in the consulting room? How do we view our patient—her potential and her limitations? What are the clinical goals of a relational analysis? What might those goals occlude? In this context I address the historical excesses of our ideal and the ways we may have gone too far. [ABSTRACT FROM AUTHOR]