Tag Archive for 'mental illness'

Cog mod for PTSD

Published on 6 July 2011 in Acting in, Acting out, Mental health, News, Research, The press and Treatment. 1 Comment Tags: , , , , , , , , , , .

In the Journal of Behavior Therapy and Experimental Psychiatry, Joanna Kowalik and colleagues reported that their review of studies on the use of cognitivie behavioral therapy for treating posttraumatic stress disorder (PTSD) revealed that cog-mod appears effective in changing raters’ responses on some of the widely used scales of the Child Behavior Checklist. However, the results of their literature review are not as powerful as one might hope, given the small number of studies and substantial variability in the studies themselves.

Abstract

Background and objectives There is no clear gold standard treatment for childhood posttraumatic stress disorder (PTSD). An annotated bibliography and meta-analysis were used to examine the efficacy of cognitive behavioral therapy (CBT) in the treatment of pediatric PTSD as measured by outcome data from the Child Behavior Checklist (CBCL).

Method A literature search produced 21 studies; of these, 10 utilized the CBCL but only eight were both 1) randomized; and 2) reported pre- and post-intervention scores.

Results The annotated bibliography revealed efficacy in general of CBT for pediatric PTSD. Using four indices of the CBCL, the meta-analysis identified statistically significant effect sizes for three of the four scales: Total Problems (TP; ?.327; p = .003), Internalizing (INT; ?.314; p = .001), and Externalizing (EXT; ?.192; p = .040). The results for TP and INT were reliable as indicated by the fail-safe N and rank correlation tests. The effect size for the Total Competence (TCOMP; ?.054; p = .620) index did not reach statistical significance.

Limitations Limitations included methodological inconsistencies across studies and lack of a randomized control group design, yielding few studies for meta-analysis.

Conclusions The efficacy of CBT in the treatment of pediatric PTSD was supported by the annotated bibliography and meta-analysis, contributing to best practices data. CBT addressed internalizing signs and symptoms (as measured by the CBCL) such as anxiety and depression more robustly than it did externalizing symptoms such as aggression and rule-breaking behavior, consistent with its purpose as a therapeutic intervention.

Because they are integrating so few studies it is very difficult to have a sensitive meta-analysis in this case. However, that Professor Kowalik and her collaborators found differences at all is encouraging. I hope they’ll continue to follow this literature. Also, I hope researchers will be using other measures of outcomes and that those other measures will be examined in future integrative literature reviews, too.

Kowalik, J., Weller, J., Venter, J., & Drachman, D. (2011). Cognitive behavioral therapy for the treatment of pediatric posttraumatic stress disorder: A review and meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 42, 405-413. doi:10.1016/j.jbtep.2011.02.002

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Virginia campaign promotes action agenda

Published on 22 June 2011 in Families, Mental health, News and The press. 0 Comments Tags: , , , , , , , , , , , .

The Campaign for Children’s Mental Health outlined an agenda for improving mental health policy for children and youths in the US commonwealth of Virginia on 14 June 2011. The “Action Agenda” expresses the need for Govenor Bob McDonnell to exert leadership in three policy areas so that the problems of 100,000 minors with mental health issues are addressed:

  • Children with mental health disorders and their families need to have a full array of high quality treatment and support services in their own communities, no matter where in Virginia they reside.
  • Children with serious mental health disorders who require public sector services need to have access to the same array of services regardless of payment source or custody status in order to maximize the impact of and curb inappropriate use of public dollars in the treatment system.
  • Children with mental health disorders and their families should be recognized and included as experts on their own and their children’s treatment needs.

Visit the 1 in 5 Website (see it over in the sidebar, too) and download the full statement of the Action Agenda.

I am very glad to have and I hope others will join me in signing a petition to support this effort. Isn’t it great to have this effort right here in Virginia? Do you have similar efforts in the area where you live?

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The Congressional Mental Health Caucus

Published on 17 January 2011 in Mental health, News, Policy and The press. 0 Comments Tags: , , , , , , , , .

Sadly, mental health has been in the US news of late. I’m reminded that in the US legislature there is the Congressional Mental Health Caucus, which takes as its goals reducing negativism and stigma, aiding efforts to access mental health services, improving work-related productivity, and protecting veterans who have mental health problems. Although the caucus does not explicitly state child mental health as a focus of concern, it has supported awareness efforts such as National Children’s Mental Health Day.
Continue reading ‘The Congressional Mental Health Caucus’

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Teaching about mental health

Published on 23 November 2010 in Administration, Bi-polar, Mental health, News, Schizophrenia and The press. 0 Comments Tags: , , , , , .

Teachers who are concerned about helping students understand mental health issues have at least one sensible places where they can go for teaching resources: Breaking the Silence, a Web resource offered by a local National Alliance on Mental Illness group. BTS, as it calls itself, provides a combination of neighborhood (NY, US) and widely available services (including a downloadable teacher’s “toolkit” with lesson plans, posters, and more).
The BTS folks make the case for teaching about mental health in this way:
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Brain features associated with neonatal risk for schizophrenia

Published on 28 June 2010 in Causes, Families, News, Research and Schizophrenia. 0 Comments Tags: , , , , , , , .
Differences in neonate brains

Writing in the American Journal of Psychiatry, John Gilmore and colleages reported that the size and structure of the brains of newborn boys—but not girls—who are at risk for developing schizophrenia differ from those of their peers. Using multiple scanning methods at different times during gestation and infancy, the researchers compared the brains of offspring of mothers who have schizophrenia to the offspring of mothers who do not have schizophrenia; they found that high-risk boys had larger brains and larger lateral ventricles than baby boys whose mothers did not have psychiatric illness.

Because the risk of developing schizophrenia is much greater for close relatives of schizophrenics, the differences between the groups provides a strong indicator of later potential development of disease. Professor Gilmore wondered “Could it be that enlargement is an early marker of a brain that’s going to be different?”
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Jani’s story updated

Published on 29 December 2009 in Families, News, Schizophrenia and The press. 0 Comments Tags: , , , , , .

In “Hushing the intruders in her brain,” Shari Roan continued her account of childhood-onset schizophrenia as experieinced by January (‘Jani’) Schofield. In the current story, Ms. Roan provided an update about Jani’s and her family’s life and progress. The coverage includes content about changes in Jani’s therapy and medications, the family’s living situation, and other aspects of life with childhood schizophrenia. As previously, there are accompanying multimedia features to the story, including this video by Don Kelsen.


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Virginia Campaign for Children’s Mental Health

Published on 15 December 2009 in Acting in, Acting out, Assessment, Autism, Bi-polar, Causes, Conduct disorder, Delinquency, Depression, Families, Musings, News, Policy, Prevention, Research, Schizophrenia, The press and Treatment. 0 Comments Tags: , , , , , , , , , , , , , , , , , , , , , , , .

Twelve key children’s services for community services boards
  1. specialized children’s emergency services;
  2. crisis stabilization;
  3. evaluations for Comprehensive Services Act services;
  4. psychiatric/medication;
  5. office-based mental health therapy;
  6. office-based substance abuse therapy;
  7. mental health case management;
  8. intellectual disabilities case management;
  9. substance abuse case management;
  10. home-based behavioral treatment and support for families;
  11. school-based day treatment; and
  12. local residential services.

Right here in my home commonwealth of Virginia last week, Mira Signe, Vicki Hardy-Murrell, John Morgan, and Margaret Nimmo Crowe explained why it is important that government and private organizations attend to and address issues in children’s mental health. By explaining that Virginia has inadequate services and that one in every five children or youths experience mental health problems at some time during their lives, they made the point that that there is a tremendous need for public focus on these issues. This was the kick-off event for the Campaign for Children’s Mental Health.

The Campaign for Children’s Mental Health is a 3-year sustained effort to make mental health services more available and accessible to Virginia children in need. It will strongly endorse Governor-elect McDonnell’s call for system improvements; urge the General Assembly and state and local government to work collaboratively with the administration to address system deficiencies; and conduct a high-profile three-year advocacy and education drive to build public and political support for improved mental health services for children.

Only about one in 20 of Virginia’s children have access to the key services listed in the accompanying box. So, four out of five children who need these services do not have access to them.

No, Virginia, this is not an acceptable way to treat our children. Let’s do better.

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Screening teens

Published on 6 August 2009 in Acting in, Assessment, Depression, Families, News, Prevention and The press. 0 Comments Tags: , , , , , , , , , , , .

Writing under the headline “Pros and cons of screening teens for depression,” Brendan Borrell examined some of the issues that sometimes roar around surveying youths to identify those who are depressed or at risk for depression. Mr. Borrell’s article, which is one in a series of articles about depression appearing in the Los Angeles Times, addressed concerns such as parental reservations about testing of their children without permission, false positive identification of a high percentage of students, and the absence of adequate treatment for many who need help.

Mr. Borrell established the importance of the issue in his lead:

By the time a teenager graduates high school, about one out of nine of his or her peers has attempted suicide. Suicide is the third leading cause of death among young people, behind car accidents and homicide, and 10% to 12% of teens ponder suicide every day.

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Following Danny Watt’s story

Published on 31 July 2009 in Acting in, Bi-polar, Depression, Families, News, Schizophrenia, The press and Treatment. 0 Comments Tags: , , , , , , , , .

Tom Jackman’s article about Danny Watt to which I referred a few days ago (see this post) is generating a lot of discussion on the Post’s Web site. The comments on Mr. Jackman’s story are informative. For example, at least a half dozen mention having a family member with mental illness. Link to the comments.

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Media matters

Published on 30 July 2009 in Bi-polar, Depression, Families, Musings, Schizophrenia and The press. 0 Comments Tags: , , , , .

The recent posts about news coverage of mental illness (e.g., “Danny Watt’s Story” and “Jani Illustrates Troubles“) has had me thinking about how popular media portray these problems. Over on Psych Central, Margarita Tartakovsky has an article entitled “Media’s Damaging Depictions of Mental Illness” that I recommend to readers of EBD Blog. In addition to discussing myths that are too commonly perpetuated by media such as television and film, she recommends ways to help distinguish between accurate and inaccurate portrayals of mental illness.

Link to Ms. Tartakovsky’s article.

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Danny Watt’s story

Published on 28 July 2009 in Bi-polar, Families, News, Policy, Schizophrenia, The press and Treatment. 1 Comment Tags: , , , , , , , , , , , , , .

The parents of Daniel Watt, a youth who had multiple problems, told the story of their son’s life and suicide. Tom Jackman of the Washington Post reported the story of Danny and his parents, helping explain some of the problems of addressing the needs of children with multiple diagnoses—co-morbid schizoaffective disorder and substance abuse, in Danny’s case.

Danny Watt once leapt from a moving train. He hurtled through the windshield of a rolling car. Got pummeled by drug dealers. Overdosed. Swallowed rat poison. Tried to hang himself.

In his tumultuous 21 years, Danny Watt danced with death in the most amazing, horrible ways. In the end, two college students spotted him facedown in the cold, murky water of the C&O Canal one afternoon in April 2008. The medical examiner said Danny had drowned.

Continue reading ‘Danny Watt’s story’

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Familiar concerns?

Published on 29 June 2009 in Acting in, Acting out, ADHD, Assessment, Bi-polar, Conduct disorder, Delinquency, Depression, Families, Prevention, The press and Treatment. 0 Comments Tags: , , , , , , , , , , .

Summer in the US finds children and youths out of school and, perhaps, less vulnerable to some of the problems that are associated with the social and academic demands that are part of schooling. As a result, perhaps fewer of the familiar problems illustrated in this poster are apparent during summer.

If summer seems like a relief from such problems, though, that could be an important indicator that those very problems need to be addressed. A few weeks away from school probably will not cure them. Those same difficulties may still be occurring, just less obviously, and they are likely to recur soon.

Individuals or the families of children who experience the kinds of problems noted in the poster should consult the resources available from the US government’s Substance Abuse and Mental Health Services Administration. One will not find easy cures there, but by carefully perusing the resources available one can learn what signs to monitor and where to go to get help.

The image is hot. Click it to get to a good starting place.

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