Linguistic Predictors of Psychological Adjustment in Healthcare Workers during the COVID-19 Pandemic

COVID-19 broke out in China in December 2019 and rapidly became a worldwide pandemic that demanded an extraordinary response from healthcare workers (HCWs). Studies conducted during the pandemic observed severe depression and PTSD in HCWs. Identifying early predictors of mental health disorders in this population is key to informing effective treatment and prevention. The aim of this study was to investigate the power of language-based variables to predict PTSD and depression symptoms in HCWs. One hundred thirty-five HCWs (mean age = 46.34; SD = 10.96) were randomly assigned to one of two writing conditions: expressive writing (EW n = 73) or neutral writing (NW n = 62) and completed three writing sessions. PTSD and depression symptoms were assessed both pre- and post-writing. LIWC was used to analyze linguistic markers of four trauma-related variables (cognitive elaboration, emotional elaboration, perceived threat to life, and self-immersed processing). Changes in PTSD and depression were regressed onto the linguistic markers in hierarchical multiple regression models. The EW group displayed greater changes on the psychological measures and in terms of narrative categories deployed than the NW group. Changes in PTSD symptoms were predicted by cognitive elaboration, emotional elaboration, and perceived threat to life; changes in depression symptoms were predicted by self-immersed processing and cognitive elaboration. Linguistic markers can facilitate the early identification of vulnerability to mental disorders in HCWs involved in public health emergencies. We discuss the clinical implications of these findings.

Fostering the Reconstruction of Meaning Among the General Population During the COVID-19 Pandemic

The COVID-19 outbreak has seen people in many countries asked to radically modify their way of life in compliance with sweeping safety measures. During the current crisis, technology is turning out to be key, in that it allows practitioners to deliver psychological services to people who would otherwise be unreachable. However, professionals cannot solely rely on their traditional modes of practice, in that different methods are required to bring to light the needs of those affected by the emergency. People are being overwhelmed by a cascade of unusual and unexpected events that are putting a strain on their everyday routines and usual meaning-making systems; ongoing challenges to their employment and financial status will likely divert personal resources away from psychological well-being. We therefore argue that psychologists should also consider the needs of the general population. Among those who may require help-aside from the main targets of psychological intervention, such as healthcare personnel and COVID-19 patients and their relatives-specific attention should be paid to those who are not at the center of the crisis. We suggest that this large segment of potential users may benefit from a non-medical approach focused on the promotion of meaning-making processes. Indeed, the disruptive nature of the current situation hinders sense-making and threatens to undermine psychological balance and well-being, at an individual as well as at a societal level. The present article proposes a methodological perspective based on the reconstruction of meaning-making processes (sense of coherence, predictability, metaphors, narratives). Specifically, psychological interventions should promote personal and collective resources with a view to: "normalizing" current distressful experiences (i.e., acknowledging that such reactions are normal in light of the present situation); widening the observational field, taking relational contexts into account, and promoting an understanding of distressful experiences as coping strategies; fostering meaning-making/reconstruction processes through the use of appropriate metaphors and narratives; promoting a sense of coherence. We present two clinical vignettes to illustrate how these principles might be applied in practice. In conclusion, the exceptional psychological challenges posed by the COVID-19 pandemic require practitioners to adopt a broad and flexible perspective on clinical intervention.

Demedicalizing the Aftermath of Sexual Assault: Toward a Radical Humanistic Approach

An entrenched assumption in the mental health field is that if left “untreated” the aftermath of sexual assault will inevitably lead to some diagnosable form of emotional distress. This assumption has focused the search for pathology on individual survivors rather than systems and led to societal pressure for medical or psychotherapeutic treatment following unwanted sexual experiences in the United States and globally. Humanistic psychology is grounded in an existential phenomenological approach that privileges agency and a sociopolitical context of lived experience. As such, it has great overlap with the social justice mission of liberation psychology and is well equipped to respond to sexual assault survivors and the oppressive and patriarchal systems that perpetuate gender-based violence. This article explores the rising use of neoliberal medicalized frameworks to respond to sexual assault in therapy, analyzing both positive and negative aspects of medicalization. Implications for responses to the global prevalence of sexual violence are discussed. Suggestions for alternative epistemic and therapeutic approaches that can be used by humanistic psychologists and that aim to enhance an appreciation for the context of survivor’s experiences are provided.

'You must know what you mean when you say that': the morality of knowledge claims about ADHD in radio phone-ins

Drawing on a corpus of radio phone-ins, we present a discursive psychological analysis of how mothers carefully tailor their knowledge claims regarding their children with Attention Deficit Hyperactivity Disorder (ADHD). Mothers typically claim knowledge about their children's good intentions, but not about the 'ADHD-ness' of their conduct. Whereas the former is seen as appropriate knowledge for a concerned parent, the latter is treated as a matter of expert knowledge. We show that as soon as problematic behaviour is treated as observable from the outside and describable by mothers and other lay persons, it becomes vulnerable to being formulated as 'normal disobedience', rather than symptomatic of a professionally administered, doctorable condition. We argue that it is important to be aware of the moralities hidden in knowledge claims, as they help sustain an unproductive perspective in which either the child's brain or his mother is blamed for behaviour perceived as problematic.

B. F. Skinner's Science and Human Behavior: Some Further Consequences

Skinner's (1953) Science and Human Behavior suggested that a science of human behavior could potentially have both negative and positive impacts on human welfare. The present paper first outlines how the contemporary gambling, and advertising, industry illustrate several of Skinner's (1953) concerns and then discusses how medicalization and the critical psychiatry movement share important epistemological similarities with Skinner's work. Skinner (1953) worried that a science of human behavior might negatively impact human welfare, and Skinner's concerns, and potential solutions, are explored in the context of current research.

The Solving Problems in Everyday Living Model: Toward a Demedicalized, Education-Based Approach to “Mental Health”

We argue that human existential pain and threat may usefully be helped by a noncoercive educational approach that also resonates with many interpersonally focused psychological approaches, rather than by the widely touted current medical model of “mental health” treatment (using psychoactive drugs and supportive psychotherapy). First, the “progress” leading to the latest Diagnostic and Statistical Manual of Mental Disorders is briefly reviewed, highlighting the scientific limitations of the medical model. Next, an educational model of self-understanding and change, based on Popper’s fallibilism, Freire’s critical pedagogy, and Miller’s feedback-informed treatment is explicated. Finally, some options for funding and testing the model are discussed. We hope this offers mental health clinicians another important alternative to conceptualize the helping encounter to ameliorate personal problems in living.

Critical Psychiatry, Critical Psychology, and the Behaviorism of B. F. Skinner

Critical psychiatry suggests that the currently dominant medical model in psychiatry overstates internal disturbance and understates environmental stressors as important causal factors in psychological distress. Critical psychology suggests that when individuals experience problems in a culture, psychology emphasizes individual, rather than cultural, change. This article provides a brief overview of critical psychiatry and critical psychology and outlines how both movements share important epistemological similarities with the writings of B. F. Skinner, the founder of radical behaviorism.

Neoliberalism and the Commodification of Mental Health

This article contributes to the existing literature on neoliberalism as an ideological hegemonic project by addressing how the image of social reality it advances normalizes the medicalization of human life. Because success, virtue, and happiness in a neoliberal market society are often associated with material wealth, prestige, and “coming out on top,” it follows that normalcy itself is typically conceived along these reified objectives. Acquiring services and/or products that might aid people to meet these results is thus viewed as benevolent and perhaps even indispensable in the pursuit of a fulfilling and productive life. What this also suggests is that integration, mental health, and human well-being become largely functions of consumerism. We address how an emphasis on medicalization, particularly the use of psychotropic drugs, can be traced to the psychopharmacological revolution of the mid-twentieth century and its obsession with situating illness within the individual. We then address how this obsession with medicalization and the tendency to treat “mental illness” as a problem within the individual continues to be supported within the prevailing neoliberal logic that downplays the social realm, treats individuals as self-contained agents, and pathologizes thoughts and behaviors that deviate from what the market defines as functional, productive, or desirable.

Fundamental Flaws of the DSM: Re-Envisioning Diagnosis

The Diagnostic and Statistical Manual (DSM) of mental disorders is evaluated according to the empirical scientific criteria of validity and reliability, and it is found to be fundamentally flawed on both counts. Additionally, any diagnostic approach based on the objectivizing principles of empirical science is found to be both ontologically and epistemologically unable to account for the complexity of human subjectivity/intersubjectivity. A revisioning of psychological diagnosis according to specifically human scientific criteria is called for; and an outline of criteria to serve as fundamental guidelines for the development of phenomenological and holistic approaches to diagnosis is presented.