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Yasui M, Pottick KJ, Chen Y. Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families. Clin Child Fam Psychol Rev 2017; 20:250-332. [PMID: 28275923 PMCID: PMC5614708 DOI: 10.1007/s10567-017-0229-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Despite the central role culture plays in racial and ethnic disparities in mental health among ethnic minority and immigrant children and families, existing measures of engagement in mental health services have failed to integrate culturally specific factors that shape these families' engagement with mental health services. To illustrate this gap, the authors systematically review 119 existing instruments that measure the multi-dimensional and developmental process of engagement for ethnic minority and immigrant children and families. The review is anchored in a new integrated conceptualization of engagement, the culturally infused engagement model. The review assesses culturally relevant cognitive, attitudinal, and behavioral mechanisms of engagement from the stages of problem recognition and help seeking to treatment participation that can help illuminate the gaps. Existing measures examined four central domains pertinent to the process of engagement for ethnic minority and immigrant children and families: (a) expressions of mental distress and illness, (b) causal explanations of mental distress and illness, (c) beliefs about mental distress and illness, and (d) beliefs and experiences of seeking help. The findings highlight the variety of tools that are used to measure behavioral and attitudinal dimensions of engagement, showing the limitations of their application for ethnic minority and immigrant children and families. The review proposes directions for promising research methodologies to help intervention scientists and clinicians improve engagement and service delivery and reduce disparities among ethnic minority and immigrant children and families at large, and recommends practical applications for training, program planning, and policymaking.
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Affiliation(s)
- Miwa Yasui
- School of Social Service Administration, University of Chicago, 969 E 60th St, Chicago, IL, 60637, USA.
| | - Kathleen J Pottick
- School of Social Work and Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, 112 Paterson St, New Brunswick, NJ, 08903, USA
| | - Yun Chen
- School of Social Service Administration, University of Chicago, 969 E 60th St, Chicago, IL, 60637, USA
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Treating the Child or Syndrome: Does Context Matter for Treatment Decisions for Antisocially Behaving Youth? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017. [DOI: 10.1007/s10862-017-9599-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Racial/Ethnic Disproportionality in Psychiatric Diagnoses and Treatment in a Sample of Serious Juvenile Offenders. J Youth Adolesc 2016; 46:1424-1451. [DOI: 10.1007/s10964-016-0573-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 09/13/2016] [Indexed: 10/21/2022]
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McFarland P, Sanders J, Hagen B. Perspectives on the aetiology of ODD and CD: a grounded theory approach. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2015. [DOI: 10.1080/13632752.2015.1120073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kim NS, Paulus DJ, Nguyen TP, Gonzalez JS. Do clinical psychologists extend the bereavement exclusion for major depression to other stressful life events? Med Decis Making 2012; 32:820-30. [PMID: 22523141 DOI: 10.1177/0272989x12443417] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In assessing potential cases of major depressive disorder (MDD), to what extent do clinicians interpret symptoms within the explanatory context of major life stressors? Past research suggests that when clinicians know a plausible life event cause for a person's disordered symptoms, they generally judge that person to be less abnormal than if the cause was unknown. However, the current, fourth edition of the Diagnostic and Statistical Manual of Mental Disorders specifies that only bereavement-related life events exclude a client from a diagnosis of MDD, and the upcoming fifth edition of the manual (DSM-V) is currently slated to eliminate this bereavement clause altogether. OBJECTIVE To systematically examine whether clinicians' judgments reflect agreement with either of these formal DSM specifications. METHOD In a controlled experiment, 72 practicing, licensed clinical psychologists made judgments about realistic MDD vignettes that included a bereavement event, stressful non-bereavement event, neutral event, or no event. RESULTS Bonferroni-corrected paired comparisons revealed that both bereavement and non-bereavement life events led MDD symptoms to be rated as significantly less indicative of a depression diagnosis, less abnormal, less rare, and less culturally unacceptable (all P ≤ 0.001) relative to control conditions. LIMITATIONS Clinicians made judgments of realistic, controlled vignettes rather than patients. CONCLUSIONS The results suggest that practicing clinical psychologists assess symptoms within the explanatory context of bereavement and non-bereavement life stressors, indicating a departure from the DSM's recommendations, both current and proposed. IMPLICATIONS for diagnostic decision making and the clinical utility of the DSM's recommendations are discussed.
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Affiliation(s)
- Nancy S Kim
- Department of Psychology, Northeasternn University, Boston, Massachusetts (NSK, DJP, TPN)
| | - Daniel J Paulus
- Department of Psychology, Northeasternn University, Boston, Massachusetts (NSK, DJP, TPN)
| | - Thao P Nguyen
- Department of Psychology, Northeasternn University, Boston, Massachusetts (NSK, DJP, TPN)
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Diabetes Research Center, Albert Einstein College of Medicine, Bronx, New York (JSG)
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Pajer K, Stein S, Tritt K, Chang CN, Wang W, Gardner W. Conduct disorder in girls: neighborhoods, family characteristics, and parenting behaviors. Child Adolesc Psychiatry Ment Health 2008; 2:28. [PMID: 18837974 PMCID: PMC2572160 DOI: 10.1186/1753-2000-2-28] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Accepted: 10/06/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about the social context of girls with conduct disorder (CD), a question of increasing importance to clinicians and researchers. The purpose of this study was to examine the associations between three social context domains (neighborhood, family characteristics, and parenting behaviors) and CD in adolescent girls, additionally testing for race moderation effects. We predicted that disadvantaged neighborhoods, family characteristics such as parental marital status, and parenting behaviors such as negative discipline would characterize girls with CD. We also hypothesized that parenting behaviors would mediate the associations between neighborhood and family characteristics and CD. METHODS We recruited 93 15-17 year-old girls from the community and used a structured psychiatric interview to assign participants to a CD group (n = 52) or a demographically matched group with no psychiatric disorder (n = 41). Each girl and parent also filled out questionnaires about neighborhood, family characteristics, and parenting behaviors. RESULTS Neighborhood quality was not associated with CD in girls. Some family characteristics (parental antisociality) and parenting behaviors (levels of family activities and negative discipline) were characteristic of girls with CD, but notll. There was no moderation by race. Our hypothesis that the association between family characteristics and CD would be mediated by parenting behaviors was not supported. CONCLUSION This study expanded upon previous research by investigating multiple social context domains in girls with CD and by selecting a comparison group who were not different in age, social class, or race. When these factors are thus controlled, CD in adolescent girls is not significantly associated with neighborhood, but is associated with some family characteristics and some types of parental behaviors. However, the mechanisms underlying these relationships need to be further investigated. We discuss possible explanations for our findings and suggest directions for future research.
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Affiliation(s)
- Kathleen Pajer
- The Ohio State University College of Medicine, Department of Pediatrics, Columbus, OH, USA.
| | - Stefanie Stein
- The Ohio State University College of Medicine, Department of Pediatrics, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA,Department of Psychosomatic Medicine, University Clinic, Regensburg, Germany
| | - Karin Tritt
- The Ohio State University College of Medicine, Department of Pediatrics, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA,Department of Psychosomatic Medicine, University Clinic, Regensburg, Germany
| | - Chien-Ni Chang
- The Ohio State University College of Medicine, Department of Pediatrics, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA,Department of Psychosomatic Medicine, University Clinic, Regensburg, Germany
| | - Wei Wang
- The Ohio State University College of Medicine, Department of Pediatrics, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA,Department of Psychosomatic Medicine, University Clinic, Regensburg, Germany
| | - William Gardner
- The Ohio State University College of Medicine, Department of Pediatrics, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA,Department of Psychosomatic Medicine, University Clinic, Regensburg, Germany
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Pottick KJ, Kirk SA, Hsieh DK, Tian X. Judging mental disorder in youths: Effects of client, clinician, and contextual differences. J Consult Clin Psychol 2007; 75:1-8. [PMID: 17295558 DOI: 10.1037/0022-006x.75.1.1] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Using a vignette-based, mailed survey of 1,401 experienced psychologists, psychiatrists, and social workers, the authors examined how clients' race/ethnicity and clinicians' professional and social characteristics affect their judgment of mental disorder among antisocially behaving youths. Vignettes described problematic behaviors meeting the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) criteria for conduct disorder but contained contextual information suggesting either disorder or nondisorder, following DSM-IV guidelines. Clinicians depended on contextual information to decide whether a mental disorder existed, and they judged White youths to have a disorder more frequently than Black or Hispanic youths. Clinicians' occupation, theoretical orientation, and age also were associated with disorder judgments, whereas their gender, race, and experience were not. Research and training implications of these variations in clinical judgments are discussed.
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Affiliation(s)
- Kathleen J Pottick
- School of Social Work, Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.
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Jensen PS, Youngstrom EA, Steiner H, Findling RL, Meyer RE, Malone RP, Carlson GA, Coccaro EF, Aman MG, Blair J, Dougherty D, Ferris C, Flynn L, Green E, Hoagwood K, Hutchinson J, Laughren T, Leve LD, Novins DK, Vitiello B. Consensus report on impulsive aggression as a symptom across diagnostic categories in child psychiatry: implications for medication studies. J Am Acad Child Adolesc Psychiatry 2007; 46:309-322. [PMID: 17314717 DOI: 10.1097/chi.0b013e31802f1454] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine whether impulsive aggression (IA) is a meaningful clinical construct and to ascertain whether it is sufficiently similar across diagnostic categories, such that parallel studies across disorders might constitute appropriate evidence for pursuing indications. If so, how should IA be assessed, pharmacological studies designed, and ethical issues addressed? METHOD Experts from key stakeholder communities, including academic clinicians, researchers, practicing clinicians, U.S. Food and Drug Administration, National Institute of Mental Health, industry sponsors, and patient and family advocates, met for a 2-day consensus conference on November 4 and 5, 2004. After evaluating summary presentations on current research evidence, participants were assigned to three workgroups, examined core issues, and generated consensus guidelines in their areas. Workgroup recommendations were discussed by the whole group to reach consensus, and then further iterated and condensed into this report postconference by the authors. RESULTS Conference participants agreed that IA is a substantial public health and clinical concern, constitutes a key therapeutic target across multiple disorders, and can be measured with sufficient precision that pharmacological studies are warranted. Additional areas of consensus concerned types of measures, optimal study designs, and ethical imperatives. CONCLUSION Derived from scientific evidence and clinical experience, these consensus-driven recommendations can guide the design of future studies.
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Affiliation(s)
- Peter S Jensen
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred.
| | - Eric A Youngstrom
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Hans Steiner
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Robert L Findling
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Roger E Meyer
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Richard P Malone
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Gabrielle A Carlson
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Emil F Coccaro
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Michael G Aman
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - James Blair
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Donald Dougherty
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Craig Ferris
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Laurie Flynn
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Evelyn Green
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Kimberly Hoagwood
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Janice Hutchinson
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Tom Laughren
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Leslie D Leve
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Douglas K Novins
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
| | - Benedetto Vitiello
- Dr. Vitiello's and Dr. Laughren's contributions to this article were made in their private capacity. No official support or endorsement by the National Institute of Mental Health or the U.S. Food and Drug Administration is intended nor should be inferred
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Diagnosing Conduct Problems of Children and Adolescents in Residential Treatment. CHILD & YOUTH CARE FORUM 2007. [DOI: 10.1007/s10566-006-9027-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wakefield JC, Kirk SA, Pottick KJ, Hsieh DK, Tian X. The lay concept of conduct disorder: do nonprofessionals use syndromal symptoms or internal dysfunction to distinguish disorder from delinquency? CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2006; 51:210-7. [PMID: 16629345 DOI: 10.1177/070674370605100402] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Conduct disorder (CD) must be distinguished from nondisordered delinquent behaviour to avoid false positives, especially when diagnosing youth from difficult environments. However, the nature of this distinction remains controversial. The DSM-IV observes that its own syndromal CD diagnostic criteria conflict with its definition of mental disorder, which requires that symptoms be considered a manifestation of internal dysfunction to warrant disorder diagnosis. Previous research indicates that professional judgments tend to be guided by the dysfunction requirement, not syndromal symptoms alone. However, there are almost no data on lay conceptualizations. Thus it remains unknown whether judgments about CD are anchored in a broadly shared understanding of mental disorder that provides a basis for professional-lay consensus. OBJECTIVE The present study tests which conception of CD, syndromal-symptoms or dysfunction-requirement, corresponds most closely to lay judgments of disorder or nondisorder and compares lay and professional judgments. We hypothesized that lay disorder judgments, like professional judgments, tend to presuppose the dysfunction requirement. METHOD Three lay samples (nonclinical social workers, nonpsychiatric nurses, and undergraduates) rated their agreement that youths described in clinical vignettes have a mental disorder. All vignettes satisfied DSM-IV CD diagnostic criteria. Vignettes were varied to present syndromal symptoms only, symptoms suggesting internal dysfunction, and symptoms resulting from reactions to negative circumstances, without dysfunction. RESULTS All lay samples attributed disorder more often to youths whose symptoms suggested internal dysfunction than to youths with similar symptoms but without a likely dysfunction. CONCLUSIONS The dysfunction requirement appears to reflect a widely shared lay and professional concept of disorder.
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Abstract
PURPOSE OF REVIEW The purpose of this paper is to review the most recent literature on personality disorders. RECENT FINDINGS Recent data suggest that individual personality disorder criteria and full diagnosis may remit within 1-2 years. The same line of evidence disputes the separation of axis I and axis II disorders and suggests the presence of a continuum. Neuropsychological, neurobiological and genetic studies favor the presence of cognitive disorders and a non-specific mode of hereditability concerning all externalizing disorders. How to best treat personality disorders remains elusive. The most impressive news in the forensic field concerns the introduction of a new concept, dangerous and severe personality disorder by the UK government, for prevention and treatment purposes. SUMMARY The most recent data do not adequately support a separate axis II. Future classification may need to move personality disorders to axis I, each under a suitable group of diseases and eliminate the very term 'personality' from the nomenclature, since it constitutes an empirically unsupported theoretical invasion in a system supposed to be 'atheoretical'.
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Kirk SA, Hsieh DK. Diagnostic consistency in assessing conduct disorder: an experiment on the effect of social context. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2004; 74:43-55. [PMID: 14769108 DOI: 10.1037/0002-9432.74.1.43] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The major objective of the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (see, e.g., the 4th ed., American Psychiatric Association, 1994) has been to achieve better diagnostic consistency. This has proved to be an elusive goal, because the diagnostic criteria and their rules for application can be ambiguous. This study mailed systematically varied case vignettes of conduct disorder to a nationally representative sample of 1,500 mental health clinicians in order to examine the effect of social context on diagnostic consistency. It found that consistency of diagnosis was modest and that it was affected by context and varied by profession.
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Affiliation(s)
- Stuart A Kirk
- School of Public Policy and Social Research, University of California, Los Angeles, CA 90095-1656, USA.
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