Anger Disorder (Part Two): Can Bitterness Become a Mental Disorder?

To fellow PT blogger, literary professor Christopher Lane--and the American PsychiatricAssociation's DSM-V Task Force-- I say, yes, you bet, as to whether bitterness can become problematical enough in some cases to warrant being deemed a mental disorder. Emphatically yes.

Bitterness, which I define as a chronic and pervasive state of smoldering resentment, is one of the most destructive and toxic of human emotions. Bitterness is a kind of morbid characterological hostility toward someone, something or toward life itself, resulting from the consistent repression of anger, rage or resentment regarding how one really has or perceives to have been treated. Bitterness is a prolonged, resentful feeling of disempowered and devalued victimization. Embitterment, like resentment and hostility, results from the long-term mismanagement of annoyance, irritation, frustration, anger or rage. Philosopher Friedrich Nietzsche noted that "nothing consumes a man more quickly than the emotion of resentment."

Most mental disorders stem either directly from--or secondarily generate--anger, rage, ...

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Human Rights Group: Mexican Mental Hospitals Performing Lobotomies Without Consent

Ten years ago a human rights group released a scathing, ground-breaking report on abusive, decrepit conditions in Mexican institutions for the mentally and physically disabled, moving the country to promise change and to take the lead in writing international agreements to protect the disabled.

But in a new report released Tuesday, the group, Disability Rights International, working with a Mexican human rights organization, said a yearlong investigation revealed “atrocious and abusive conditions” that included lobotomies performed without consent, children missing from orphanages, widespread filth and squalor and a lack of medical care.

At one institution here in the capital, which a reporter visited with investigators from the groups, men walked around half-naked, feces littered a yard, bed sheets were missing, the smell of urine permeated a day room, bathroom faucets malfunctioned and patients lay sprawled on several patches of grass....

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Discharged From A Mental Health Admission Ward: Is It Safe To Go Home? A Review On The Negative Outcomes Of Psychiatric Hospitalization

Abstract

Before psychiatry emerged as a medical discipline, hospitalizing individuals with mental disorders was more of a social stigmatizing act than a therapeutic act. After the birth of the mental health disciplines, psychiatric hospitalization was legitimized and has proven to be indispensable, preventing suicides and helping individuals in need. However, despite more than a century passing since this legitimization occurred, psychiatric hospitalization remains a controversial issue. There is the question of possible negative outcomes after a psychiatric admission ceases to take its protective effect, and even of whether the psychiatric admission itself is related to a negative setback after discharge. This review aims to summarize some of the most important negative outcomes after discharge from a psychiatric institution. These experiences were organized into two groups: those after a brief psychiatric hospitalization, and those after a long-stay admission. The author further suggests possible ways to minimize these..

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Injunction Sought to Bar DSHS from Using Jail Settings for Mental Health Competency Services

Plaintiffs in the class action lawsuit A.B/Trueblood v. DSHS filed a motion last night in U.S. District Court seeking a Temporary Restraining Order (TRO). The TRO would prevent the Department of Social and Health Services (DSHS) from violating the Court’s order requiring DSHS to ensure that competency restoration treatment is provided in a therapeutic environment similar to what is found at state psychiatric hospitals. Instead of creating a plan to increase capacity at the state psychiatric hospitals, DSHS developed a competency restoration program in a Yakima jail wholly unsuitable for treating people with mental illness.

“The use of jails to treat people with mental illness is inhumane, and a plain violation of the Court’s order. It is an unsafe practice that is further evidence of this State’s continued disregard of its legal obligations,” said La Rond Baker, ACLU-WA Staff Attorney.

The underlying lawsuit was filed in 2014 on behalf of people with mental...

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Deprivation, Discrimination, Human Rights Violation, And Mental Health Of The Deprived

INTRODUCTION

Human behavior is conceived of as an outcome of genetic and biochemical characteristics, past learning experiences, motivational states, psycho-social antecedents, and the cultural context in which it unfolds[1] Culture plays a complex role in the natural history and psycho-social development of human behavior[2] comprising of customs, beliefs, values, knowledge, and skills.[3] Social norms, the shared rules that specify appropriate and inappropriate behaviors;[4] mores, that people consider vital to their well-being and to their most cherished values,[5] and sanctions, the socially imposed rewards and punishments that compel people to comply with norms,[6] constitute important ingredients of a culture. Orlandi et al. (1992),[2] define culture as shared values, beliefs, norms, traditions, customs, art, history, folklore, and institutions of a group of people. A society which is a cohesive group of people shares all the ingredients of the culture among its members...

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Admitting Mental Health Evidence To Impeach The Credibility Of A Sexual Assault Complainant

INTRODUCTION

The 1970 edition of Wigmore on Evidence offers the proposition that every female complainant in a rape prosecution should be subject to a psychiatric examination and echoes turn-of-the century psychoanalysts in its explanation: “The unchaste (let us call it) mentality finds incidental but direct expression in the narration of imaginary sex incidents of which the narrator is the heroine or victim.” In other words, some women falsely accuse men of rape because, either intentionally or inadvertently, they have confused a sexual fantasy with a violent crime. The focus of this Comment, and the focus of considerable controversy and difficulty in rape trials, is evidentiary procedure when the defendant claims that the complainant consented to the intercourse. Putting aside the philosophical problem of defining consent, in the absence of physical injuries the only relevant evidence of the crime will be testimony from the defendant,,

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How To Convince Politicians That Mental Health Is A Priority

Politicians, especially ministers of health, are crucial to drive national policy and strategy, because they can bring political will to bear on decision making, speed up decision making, and steer decisions in a specific direction. Therefore it is important to persuade politicians that mental health should be a priority.

One of the most helpful things a minister of health can do to make mental health a real priority is to ensure that mental health is well integrated into the national health sector strategic plan at each level (community, primary care, district, provincial and national). This will make it much more likely that community based and primary care health staff will see mental health as an integral part of their work, that district staff will see mental health as an essential part of their support responsibilities to primary care alongside other health priorities, and that provincial level staff...

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Deinstitutionalization and Its Discontents: American Mental Health Policy Reform

INTRODUCTION

Mental illness is real. 10 percent of children and 25 percent of adults in America struggle with serious emotional and mental disorders which cause significant daily functional impairment.

Mental illness is pervasive. 4 of the 10 leading causes of disability in the United States are mental disorders. Children, adolescents and adults from all classes, backgrounds, faiths, and walks of life suffer.

Mental illness is ruinous. 31 percent of homeless adults have a combination of mental illness and addiction disorder. Adults living with serious mental illness die 25 years earlier than other Americans. Over 90 percent of those who die by suicide have a mental disorder. 24 percent of state prisoners and 21 percent of jail prisoners have mental illnesses. 70 percent of youth in the juvenile justice system have at least one mental disorder. Over 50 percent of students with a mental disorder drop out of high school...

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Mental Health Medications

Overview

Medications can play a role in treating several mental disorders and conditions. Treatment may also include psychotherapy (also called “talk therapy”) and brain stimulation therapies (less common). In some cases, psychotherapy alone may be the best treatment option. Choosing the right treatment plan should be based on a person's individual needs and medical situation, and under a mental health professional’s care.

The National Institute of Mental Health (NIMH), a Federal research agency, does not provide medical advice or referrals. Resources that may help you find treatment services in your area are listed on ourHelp for Mental Illnesses web page.

NIMH also does not endorse or recommend any particular drug, herb, or supplement. Results from NIMH-supported clinical research trials (What are Clinical Research Trials?) that examine the effectiveness of treatments, including medications, are reported in the medical literature. This health topic webpage is...

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Community Mental Health Team Management In Severe Mental Illness: A Systematic Review

Abstract

Background Community mental health teams are now generally recommended for the management of severe mental illness but a comparative evaluation of their effectiveness is lacking.

Aims To assess the benefits of community mental health team management in severe mental illness.

Method A systematic review was conducted of community mental health team management compared with other standard approaches.

Results Community mental health team management is associated with fewer deaths by suicide and in suspicious circumstances (odds ratio=0.32, 95% Cl 0.09-1.12), less dissatisfaction with care (odds ratio=0.34, 95% Cl 0.2-0.59) and fewer drop-outs (odds ratio=0.61, 95% Cl 0.45-0.83). Duration of in-patient psychiatric treatment is shorter with community team management and costs of care are less, but there are no gains in clinical symptomatology or social functioning.

Conclusions Community mental health team management is superior to standard care in promoting greater acceptance of treatment, and may also reduce...

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Deprivation of Liberty: the Mental Health Act or the Mental Capacity Act?

Abstract

Both the Mental Health Act (1983) and the Mental Capacity Act 2005 now have provisions that authorise the care and treatment of a person in circumstances that amount to a deprivation of liberty. In accordance with the requirements of article 5 of the European Convention on Human Rights both regimes require a person to be suffering from a mental disorder before they can be subject to a deprivation of liberty. This article rebuts the assumption that practitioners can pick and choose which method to use when authorising a deprivation of liberty. It goes on to highlight the primacy of the Mental Health Act (1983) when a deprivation of liberty is necessary to treat a mental disorder in hospital or care home...

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Mental Fatigue Impairs Physical Performance In Humans

Abstract

Mental fatigue is a psychobiological state caused by prolonged periods of demanding cognitive activity. Although the impact of mental fatigue on cognitive and skilled performance is well known, its effect on physical performance has not been thoroughly investigated. In this randomized crossover study, 16 subjects cycled to exhaustion at 80% of their peak power output after 90 min of a demanding cognitive task (mental fatigue) or 90 min of watching emotionally neutral documentaries (control). After experimental treatment, a mood questionnaire revealed a state of mental fatigue (P = 0.005) that significantly reduced time to exhaustion (640 ± 316 s) compared with the control condition (754 ± 339 s) (P = 0.003). This negative effect was not mediated by cardiorespiratory and musculoenergetic factors as physiological responses to intense exercise remained largely...

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Surreptitious Practices In The Management Of Persons With Serious Mental Illnesses – Perspectives From The Schizophrenia Research Foundation

Abstract

The aim of this communication is to briefly describe the surreptitious practices and management of non-adherence, observed at the services offered by the Schizophrenia Research Foundation. Screening of records at our services for documentations of this practice and the efforts made to deal with non-adherence and concealed treatment was done. Surreptitious practices in SCARF's out-patient services and in community outreach programs have been documented. Efforts to manage non-adherence include educating families on pharmacotherapy and strategies of dealing with non-adherence. At the level the patient, individualised and group strategies deal with the issues addressing lack of insight, acceptance of the disorder, or dealing with perceived side effects are held. Ethical principles of autonomy, justice, beneficence, and respect are adopted in implementing these strategies. There are potential advantages and disadvantages of adopting surreptitious treatment strategies in persons with serious mental illnesses. There is a need to formulate rigorous guidelines for the management of non-adherence...

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Road to Recovery: Employment and Mental Illness

INTRODUCTION

Individuals with mental illness are a diverse group of people, with a wide range of talents and abilities. They work in all sectors of the U.S. economy, from the boardroom to the factory floor, from academia to art. Employment not only provides a paycheck, but also a sense of purpose, opportunities to learn and a chance to work with others. Most importantly, work offers hope, which is vital to recovery from mental illness. Our nation must invest in vocational strategies that work. The good news is that there are a number of effective supported employment programs. However, despite approximately $4 billion annually in federal funding for supported employment, employment rates for people with mental illness—which were abysmal to begin with—have declined even more over the last decade. This distressing trend is attributable to a number of factors. For example, many state vocational rehabilitation programs...

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Exploring The Link Between Unemployment And Mental Health Outcomes

The U.S. economy shed over 10 million jobs from 2007 to 2009 and gross domestic product (GDP) dropped by more than 5 percent — the largest decline since World War II. The unemployment rate soared from 5 percent to well over 9 percent, leading this period to be dubbed the Great Recession. At the height of the Great Recession the average bout of unemployment lasted half a year and some estimates suggest that half of the unemployed were out of work for more than two years. This was an economically devastating epoch in our nation’s history.

Psychologists (Eisenberg and Lazarsfield 1938) and sociologists (Jahoda et al. 1933) have argued as far back as the Great Depression that unemployment damages emotional health and undermines the social fabric of society. Psychologists draw a conceptual connection between involuntary joblessness and mental health in numerous ways such as: incomplete...

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Social Workers and Involuntary Treatment in Mental Health

Abstract

Involuntary treatment is often a reality in mental health social work. The current research examined 330 mental health social workers' involvement in and opinions about involuntary treatment as part of their primary job functions. Varieties of involuntary intervention and typical frequency were investigated. The most often cited areas of involuntary treatment experience proved to be mandated outpatient counseling and emergency hospitalization. In general, participants reported a high level of support for the existence of involuntary intervention, both in "idea" and "implementation." The study also explored the attitudes social workers have about these sometimes "ethically-complex" social work interventions and how these attitudes may have changed over the life of their practice careers due to practice experience and personal growth, job changes, and exposure to the reality of mental illness...

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