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Different Communication Strategies For Disclosing A Diagnosis Of Schizophrenia And Related Disorders

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Abstract

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:

To evaluate evidence from randomised controlled trials (RCTs) for the efficacy of different communication strategies used by clinicians to inform patients about the diagnosis and outcome of schizophrenia, compared with treatment as usual

To compare efficacy between different communication strategies.

Background

Description of the condition

Schizophrenia, a serious mental illness, is a group of heterogeneous disorders typically characterised by the presence of delusions, hallucinations, disorganised speech, disorganised behaviour, and negative symptoms (avolition, apathy, anhedonia, alogia, affective blunting). The two major classification systems, the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD-10), have different requirements of symptoms duration for the diagnosis of schizophrenia. While the DSM requires a total duration of a minimum of six months, the ICD-10 warrants a minimum duration of one month. The DSM-IV has a requirement for...

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Lies in the Doctor-Patient Relationship

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Have you ever lied to your patients or been surprised to learn that one of your patients lied to you? Have you considered it important to learn why lies emerge in the treatment relationship? Have you wondered whether (or how) you should confront such untruths? If you have, then the following discussion should provide the forum for answers to these and other questions related to the exploration, detection, and management of lies in the medical arena.

Clinicians realize that making an accurate diagnosis relies on the provision of reliable information by patients and their family members and that timely, astute, and compassionate care depends on effective bidirectional communications (between the patient and the physician). Unfortunately, both patients and physicians are often challenged by complicated communications; each group withholds, distorts, obfuscates, fabricates, or lies about information that is crucial to the doctor-patient relationship and to effective treatment....

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Niacin Skin Flush Test: A Research Tool for Studying Schizophrenia.

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Abstract

BACKGROUND:

A body of biochemical evidence suggests that abnormal phospholipid metabolism may play a role in the etiology of schizophrenia, and possibly, other psychiatric and neurological diseases. Niacin, a B-complex vitamin, induces prostaglandin synthesis, vasodilatation, and skin flushing when applied as a solution on the skin or taken orally. In schizophrenia, diminished or absent skin response to niacin represents a robust finding.

RESULTS:

Attenuated niacin skin-flush response has been analysed as a potential biochemical marker of impaired prostaglandin signaling in schizophrenia. Diminished skin redness after topical application of niacin might be caused by a reduced level of the precursor arachidonic acid in the peripheral membranes, increased activity of the enzyme phospholipase A2, abnormal expression of niacin or prostaglandin receptors, or poor vasomotor activity of cutaneous capillary walls. Heritability estimates established in several studies support niacin skin flush response as a vulnerability...

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About Schizophrenia and Psychosis

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About one in a hundred people have schizophrenia and can have a variety of ‘positive’ symptoms, such as hallucinations, delusions or disordered speech/behaviour, and ‘negative’ symptoms such as problems with fluency of language and thoughts or with expression of emotions.

As is the case with most mental illness, the cause of schizophrenia is not known. The conventional treatment for schizophrenia is usually long-term treatment with antipsychotic medication. A nutritional approach works alongside conventional treatment and may improve both positive and negative symptoms, and also reduce the side-effects of medication.

Below is an outline of nutrition approaches that may be relevant:

• Correcting blood sugar problems made worse by excess stimulant and drug use • Addressing essential fat imbalances • Increasing antioxidants; niacin (Vitamin B3) therapy • Addressing methylation problems helped by B12 and folic acid • Investigating pyroluria and the need for zinc and identifying any food allergies

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What-If Analysis

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Definition

In order to be able to evaluate beforehand the impact of a strategic or tactical move so as to plan optimal strategies to reach their goals, decision makers need reliable predictive systems. What-if analysis is a data-intensive simulation whose goal is to inspect the behavior of a complex system, such as the corporate business or a part of it, under some given hypotheses called scenarios. In particular, what-if analysis measures how changes in a set of independent variables impact a set of dependent variables with reference to a given simulation model such a model is a simplified representation of the business, tuned according to the historical corporate data. In practice, formulating a scenario enables the building of a hypothetical world that the analyst can then query and navigate.

Historical Background

Though what-if analysis can be considered as a relatively recent discipline, its background is rooted at the confluence... ..

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Czech Factors Related to Reproductive Coercion and Pregnancy Avoidance Among Women Experiencing Intimate Partner Violence

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Approximately 5% of US women have experienced reproductive coercion – an intimate partner trying to get them pregnant when they did not want to be (Black et al., 2011). Reported prevalence is higher (14-74%) in smaller community samples of women receiving services (Miller et al., 2010; Moore, Frohwirth, & Miller, 2010; Raphael, 2005). Associations with physical/sexual violence have been mixed (Messing & Thaller, 2012; Miller et al., 2010), though reproductive coercion was related to unintended pregnancy when physical violence was present (Miller et al., 2010). Reproductive coercion has also been associated with compromised sexual health decision-making (fear of refusing sex or asking a partner to use a condom; Messing & Thaller, 2012). There is need to investigate other factors associated with reproductive coercion and pregnancy avoidance among women experiencing intimate partner violence (IPV) to inform development of screening tools and targeted interventions....

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Technology Arms Peeping Toms with a New and Dangerous Arsenal: A Compelling Need for States to Adopt New Legislation, 17 J. Marshall J. Computer & Info. L. 1167 (1999)

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I. INTRODUCTION

The act of voyeurism is becoming an increasingly prevalent and unsettling threat to human dignity and the right to privacy. The "peeping Tom" of yesterday is now armed with a new arsenal that threatens more than just the unsuspecting victim standing by an open window. With the development and advancement of surveillance technology, voyeurism has evolved into something an increasing number of people suspect and fear. The accessibility of small video cameras and other viewing or recording methods eases the barriers for perverts to observe others engaged in otherwise personal activities. The story of Susan and Gary Wilson, recent victims of video voyeurism, illustrates what these peeping perverts can do with the aid of a video camera. In 1996, the couple went looking for a home and at the suggestion of a friend and fellow church member, Steve Glover,...

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Voyeurism And Exhibitionism: How Common Are They?

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Do you enjoy R-rated movies with steamy sex scenes? Most people do. There’s a little bit of voyeur in all of us.

Do you ever wear tight, form-fitting, or revealing clothing to show off some aspect of your body? Many people do from time to time at the beach, the gym, or socially. There’s a little bit of exhibitionist in most of us, too.

But how many people are really deeply into watching sex or exposing themselves in public? That’s been a mystery but a Swedish study has investigated the issue, providing what, as far as I know, are the only real data on the subject.

Researchers at the Karolinska Institute (the university that awards Nobel Prizes) surveyed a random sample of 2,450 Swedes age 18 to 60. Seventy-six (3.1 percent) reported at least one incident of feeling sexually aroused by exposing their genitals...

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The Misuse Of Input Information In Judgments Of Outcomes

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Abstract

In this paper we identify an input bias, the systematic misuse of input information in judgments of outcome quality. In many settings irrelevant input measures, such as the amount of time an employee spends in the office, influence outcome assessments, such as performance reviews. Across four studies we find that input values subtly, but significantly distort judgments of outcome quality.Irrelevant input information predictably influences outcome assessments even when people recognize that input measures should not matter and believe that input information did not matter. We examine the mechanics of the input bias, and suggest that because input measures are often easy to manipulate or misrepresent, the input bias is likely to have broad implications for managerial judgment and decision making.

2003 Published by Elsevier Science (USA)

1. Introduction

Judgments of quality are essential prerequisites for many decision making tasks. For example, prior to making a hiring decision a manager needs to assess thequality of...

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Why Thought Stopping Doesn’t Work

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Some therapists still recommend a technique called "thought stopping". This is quite unfortunate since thought-stopping leads to thought rebounding. The research by Wegner at Harvard on "white bears and other unwanted thoughts" shows that trying not to think of a thought leads to the thought persisting later. In a recent review of strategies that people use, Yale psychologists Ameli Aldao and Susan Nolen-Hoeksema found that suppression strategies for thoughts and emotions are associated with greater anxiety and depression, whereas other strategies (such as problem-solving, acceptance and cognitive restructuring) are associated with less anxiety.

"Thought-stopping,"is a now discarded behavioral technique that involves getting rid of negative or unwanted thoughts by suppressing them. Thus, whenever you have the worry that you will lose all your money in the stock market, you are encouraged to force yourself to stop having these thoughts by snapping a rubber band on your...

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Non-Robbery-related Occupational Homicides In The Retail Industry, 2003-2008.

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Abstract

BACKGROUND:

The purpose of this study was to examine non-robbery-related occupational homicides in the retail industry from 2003 to 2008.

METHODS:

Data were abstracted from the Census of Fatal Occupational Injuries. Motive (robbery- or non-robbery-related) and workplace violence (WPV) typology (Type I-IV) were assigned using narrative text fields. Non-robbery-related homicide rates were calculated and compared among WPV types, demographic characteristics, and occupation.

RESULTS:

Twenty-eight percent of homicides that occurred in the retail industry were non-robbery-related. The leading event associated with non-robbery-related homicides was Type II (perpetrated by customers) (34%), followed by Type IV (perpetrated by personal relationship) (31%). The majority of homicides were due to arguments (50%). Security guards and workers in drinking establishments had the highest homicide rates per 100,000 workers (14.3 and 6.0, respectively).

CONCLUSIONS:

Non-robbery-related homicides comprised a meaningful proportion of workplace homicides in the retail ...

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The Psychology and the Politics of Nightclub Surveillance Video

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Last week, pro football player Aaron Hernandez was found guilty of first-degree murder for the killing of his friend Odin Lloyd after a disagreement at a nightclub in June 2013. Surveillance video footage played an important role in the trial, for both the prosecution and the defense.

In order to demonstrate Hernandez’s volatile personality, the prosecution called a witness who testified about meeting Hernandez at the club the same night of his altercation with Lloyd. When she didn’t want to dance with Hernandez, she said, he became “agitated” and “aggressive.” Hernandez’s defense attorney then tried to undermine that testimony with video footage from inside the club that showed the witness dancing with Hernandez, seemingly willingly.

Surveillance video can indict or defend, however, depending on how it’s spun; prosecutors also used several hours of video footage of Hernandez’s house to try to demonstrate that he was acting calmly, normally, and without remorse,...

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Hormonal Birth Control Use And Relationship Jealousy: Evidence For Estrogen Dosage Effects

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Abstract:

Women who use hormonal contraceptives have been shown to report higher levels of jealousy than women who are regularly cycling. Here, we extend these findings by examining if self reported levels of jealousy vary with the dose of synthetic estrogen and progestin found in combined oral contraceptives in a sample of 275 women. A univariate ANOVA analysis revealed that higher levels of ethinyl estradiol were associated with significantly higher levels of self-reported jealousy. There was, however, no relationship between combined oral contraceptive progestin dose and reported jealousy levels. When controlling for age, relationship status, mood, and combined oral contraceptive progestin dose the results for ethinyl estradiol were maintained. A test for the interaction between the jealousy sub-scale items (reactive, possessive, and anxious jealousy) was however non-significant: ethinyl estradiol dose thus does not affect one type of jealousy more than another but rather affects overall jealousy....

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Bargaining Citizenship: Women’s Organizations, The State, And Marriage Migrants In South Korea

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DISSERTATION ABSTRACT

Since 1948, South Korea has maintained restrictive immigration and citizenship policies that promote ethnic homogeneity and discourage the settlement of immigrants who do not have marital or family ties to ethnic Koreans. From 2005, the Korean government has instituted unprecedented reforms that have included local voting rights to permanent residents, dual citizenship for certain categories of citizens, and policies that promote multiculturalism; such reforms have made Korea the country with the most progressive stance on immigration in East Asia. Why has the Korean government proactively embraced immigrant incorporation under the banner of multiculturalism, after decades of promoting ethnic homogeneity and racial purity?

In contrast to previous studies that focus on the adoption of liberal international norms, the remnants of the developmental state, and grassroots pressures from civil society, this dissertation explains immigrant incorporation in Korea as the unintended consequences of the negotiations between state efforts to...

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The Peremarital Communication Roots of Marital Distress and Divorce: The First Five Years of Marriage

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Abstract

Using data from 210 couples who provided data across the first five years of marriage, we examined how premarital communication quality was related to divorce and later distress. The results showed that premarital observed negative and positive communication nearly reached significance as predictors of divorce, while self-reported negative communication was significantly associated with divorce. In terms of marital adjustment, we found that both premarital observed and self-reported negative premarital communication (but not observed positive communication) were associated with lower adjustment during the first five years of marriage. The most important questions addressed in this study pertain to how positive and negative dimensions of communication change over time and how these changes are related to being distressed or nondistressed after five years of marriage. This is the first study, to our knowledge, to examine the changes in communication over time that are so central to theories...

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