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What does the term “specialist” really mean?
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Abstracts / Comprehensive Psychiatry 50 (2014) e45–e59
indicate elevated risk for later psychosis. Parental age is an established risk factor for schizophrenia, however few studies have attempted to replicate these findings with psychotic-like symptoms. The goal of this study is to examine the relationship between parental age and risk of psychotic like symptoms in the general population. Methods: Data come from the National Comorbidity Survey Replication (NCS-R), a nationally representative cross-sectional survey. Both maternal age and paternal age at birth were assessed by self-report and were analyzed as three-level categorical variables based on their distributions: young (b20 years for mothers, b25 years for fathers), middle (20–29 years for mothers, 25–34 years for fathers) and older (≥30 years for mothers, ≥35 years for fathers). Lifetime occurrence of six psychotic-like symptoms was assessed: 1) ever see a vision others couldn't see, 2) ever hear voices others couldn't hear, 3) ever have a mind control experience, 4) ever feel your mind taken over by strange forces, 5) ever experience communication attempts from strange voices, and 6) ever experience an unjust plot to harm you or have people follow you. These symptoms were examined as a binary (any vs. none) variable using logistic regression. Models were adjusted for age, sex, race, education, household income, marital status, and birth order. Point estimates and standard errors were analyzed using survey procedures in SAS to account for the complex sampling design. Results: Of 924 respondents with complete data, 11% (n = 103) reported experiencing one or more psychotic-like symptoms. In fully-adjusted logistic regression models paternal age was significantly associated with reporting any psychotic-like symptoms (χ 2 = 6.56, P b 0.05). Compared to the youngest fathers, respondents with fathers aged 25–34 years at time of birth were less likely to experience psychotic-like symptoms (OR: 0.75, CI: 0.31–1.82), but those with older fathers were more likely to experience these symptoms (OR: 1.62, CI: 0.53–5.01). There was no significant relationship between maternal age and psychotic-like symptoms in the offspring (χ2 = 0.22, P = .89). Discussion: Older paternal age at birth, but not older maternal age, is associated with offspring report of experiencing one or more psychotic-like symptoms. Our findings are broadly consistent with epidemiologic work on paternal age and risk of schizophrenia, although more research is needed to identify the mechanisms linking paternal age with non-pathological psychotic-like symptoms. http://dx.doi.org/10.1016/j.comppsych.2014.08.010
What does the term “specialist” really mean? Glazier Kimberly Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA Background: In the mental health field, the term “specialist” is ambiguous and unregulated. However, the term specialist is commonly utilized by mental health professionals. Objective: To determine the average number of areas of specialty and theoretical orientations endorsed by mental health providers. Method: A random sample of 146 clinicians' profiles listed under Psychology Today's “therapist finder” function was reviewed. Profiles were selected from the three most populous and three least populous U.S. cities, listed on the 2009 United States Census Bureau's 1000 most populous cities. Information regarding the professionals' gender, title, degree, location, number/types of areas of specialty and number/types of theoretical orientations was obtained. Results: The average numbers of self-reported areas of specialty and theoretical orientations among the 146 mental health professionals' profiles reviewed were 19.8 (SD = 9.4) and 4.9 (SD = 2.4), respectively. No significant correlations between the mental health providers' demographic information and number of areas or specialties or theoretical orientations were found. Conclusion: The preliminary data suggest that mental health providers identify as specializing in numerous clinical areas and base their practice on multiple theoretical orientations. The term specialist needs to be more concretely defined and certification programs to ensure expertise in self-reported areas of specialty and orientations should be mandated. http://dx.doi.org/10.1016/j.comppsych.2014.08.011
Mental health antecedents of midlife insomnia: Evidence from a four-decade longitudinal study Goldman-Mellor Sidra J a,b,c,d, Gregory Alice e, Caspi Avshalom b,c,d,f, Harrington HonaLee b,c,d, Parsons Michael g, Poulton Richie h, Moffitt Terrie E b,c,d,f a Center for Developmental Science, University of NC at Chapel Hill, USA b Department of Psychology & Neuroscience, Duke University, USA c Institute for Genome Sciences & Policy, Duke University, USA d Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, USA e Department of Psychology, Goldsmiths, University of London, London, United Kingdom f Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, United Kingdom g MRC Harwell, Harwell Science and Innovation Campus, Oxfordshire, United Kingdom h Dunedin Multidisciplinary Health and Development Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand Study objectives: Insomnia is a highly prevalent condition that constitutes a major public health and economic burden. However, little is known about the developmental etiology of adulthood insomnia. Design: We examined whether indicators of psychological vulnerability across multiple developmental periods (psychiatric diagnoses in young adulthood and adolescence, childhood behavioral problems, and familial psychiatric history) predicted subsequent insomnia in adulthood. Setting and participants: We used data from the ongoing Dunedin Multidisciplinary Health and Development Study, a population-representative birth cohort study of 1037 children in New Zealand who were followed prospectively from birth (1972–1973) through their fourth decade of life with a 95% retention rate. Measurements: Insomnia was diagnosed at age 38 according to DSM-IV criteria. Psychiatric diagnoses, behavioral problems, and family psychiatric histories were assessed between ages 5 and 38. Results: In cross-sectional analyses, insomnia was highly comorbid with multiple psychiatric disorders. After controlling for this concurrent comorbidity, our results showed that individuals who have family histories of depression or anxiety, and who manifest lifelong depression and anxiety beginning in childhood, are at uniquely high risk of age-38 insomnia. Other disorders did not predict adulthood insomnia. Conclusions: The link between lifelong depression and anxiety symptoms and adulthood insomnia calls for further studies to clarify the neurophysiological systems or behavioral conditioning processes that may underlie this association. http://dx.doi.org/10.1016/j.comppsych.2014.08.012
A new measure of social hedonic capacity: The ACIPS Gooding DC, Pflum MJ, Siggelkow CL University of Wisconsin-Madison, Madison, WI, USA Background: Social hypohedonia, the reduced capacity to enjoy social interactions and interpersonal relationships, is observed in individuals at heightened risk for the later development of schizophrenia, as well as individuals experiencing depression and schizophrenia. Thus, there is increasing interest in assessing social hedonic capacity in the general population and in various diverse patient populations. The study objective was to highlight the psychometric advantages of the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS; Gooding & Pflum, 2014, Psychiatry Research), by demonstrating its relationship with extant measures. Methods: The association between trait hedonic capacity and schizotypal personality was examined in two independent nonclinical samples. In both investigations, hedonic capacity was measured using the 17-item Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS). In Study One, we explored the association between the ACIPS and the Schizotypal
Abstracts / Comprehensive Psychiatry 50 (2014) e45–e59
indicate elevated risk for later psychosis. Parental age is an established risk factor for schizophrenia, however few studies have attempted to replicate these findings with psychotic-like symptoms. The goal of this study is to examine the relationship between parental age and risk of psychotic like symptoms in the general population. Methods: Data come from the National Comorbidity Survey Replication (NCS-R), a nationally representative cross-sectional survey. Both maternal age and paternal age at birth were assessed by self-report and were analyzed as three-level categorical variables based on their distributions: young (b20 years for mothers, b25 years for fathers), middle (20–29 years for mothers, 25–34 years for fathers) and older (≥30 years for mothers, ≥35 years for fathers). Lifetime occurrence of six psychotic-like symptoms was assessed: 1) ever see a vision others couldn't see, 2) ever hear voices others couldn't hear, 3) ever have a mind control experience, 4) ever feel your mind taken over by strange forces, 5) ever experience communication attempts from strange voices, and 6) ever experience an unjust plot to harm you or have people follow you. These symptoms were examined as a binary (any vs. none) variable using logistic regression. Models were adjusted for age, sex, race, education, household income, marital status, and birth order. Point estimates and standard errors were analyzed using survey procedures in SAS to account for the complex sampling design. Results: Of 924 respondents with complete data, 11% (n = 103) reported experiencing one or more psychotic-like symptoms. In fully-adjusted logistic regression models paternal age was significantly associated with reporting any psychotic-like symptoms (χ 2 = 6.56, P b 0.05). Compared to the youngest fathers, respondents with fathers aged 25–34 years at time of birth were less likely to experience psychotic-like symptoms (OR: 0.75, CI: 0.31–1.82), but those with older fathers were more likely to experience these symptoms (OR: 1.62, CI: 0.53–5.01). There was no significant relationship between maternal age and psychotic-like symptoms in the offspring (χ2 = 0.22, P = .89). Discussion: Older paternal age at birth, but not older maternal age, is associated with offspring report of experiencing one or more psychotic-like symptoms. Our findings are broadly consistent with epidemiologic work on paternal age and risk of schizophrenia, although more research is needed to identify the mechanisms linking paternal age with non-pathological psychotic-like symptoms. http://dx.doi.org/10.1016/j.comppsych.2014.08.010
What does the term “specialist” really mean? Glazier Kimberly Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA Background: In the mental health field, the term “specialist” is ambiguous and unregulated. However, the term specialist is commonly utilized by mental health professionals. Objective: To determine the average number of areas of specialty and theoretical orientations endorsed by mental health providers. Method: A random sample of 146 clinicians' profiles listed under Psychology Today's “therapist finder” function was reviewed. Profiles were selected from the three most populous and three least populous U.S. cities, listed on the 2009 United States Census Bureau's 1000 most populous cities. Information regarding the professionals' gender, title, degree, location, number/types of areas of specialty and number/types of theoretical orientations was obtained. Results: The average numbers of self-reported areas of specialty and theoretical orientations among the 146 mental health professionals' profiles reviewed were 19.8 (SD = 9.4) and 4.9 (SD = 2.4), respectively. No significant correlations between the mental health providers' demographic information and number of areas or specialties or theoretical orientations were found. Conclusion: The preliminary data suggest that mental health providers identify as specializing in numerous clinical areas and base their practice on multiple theoretical orientations. The term specialist needs to be more concretely defined and certification programs to ensure expertise in self-reported areas of specialty and orientations should be mandated. http://dx.doi.org/10.1016/j.comppsych.2014.08.011
Mental health antecedents of midlife insomnia: Evidence from a four-decade longitudinal study Goldman-Mellor Sidra J a,b,c,d, Gregory Alice e, Caspi Avshalom b,c,d,f, Harrington HonaLee b,c,d, Parsons Michael g, Poulton Richie h, Moffitt Terrie E b,c,d,f a Center for Developmental Science, University of NC at Chapel Hill, USA b Department of Psychology & Neuroscience, Duke University, USA c Institute for Genome Sciences & Policy, Duke University, USA d Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, USA e Department of Psychology, Goldsmiths, University of London, London, United Kingdom f Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, United Kingdom g MRC Harwell, Harwell Science and Innovation Campus, Oxfordshire, United Kingdom h Dunedin Multidisciplinary Health and Development Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand Study objectives: Insomnia is a highly prevalent condition that constitutes a major public health and economic burden. However, little is known about the developmental etiology of adulthood insomnia. Design: We examined whether indicators of psychological vulnerability across multiple developmental periods (psychiatric diagnoses in young adulthood and adolescence, childhood behavioral problems, and familial psychiatric history) predicted subsequent insomnia in adulthood. Setting and participants: We used data from the ongoing Dunedin Multidisciplinary Health and Development Study, a population-representative birth cohort study of 1037 children in New Zealand who were followed prospectively from birth (1972–1973) through their fourth decade of life with a 95% retention rate. Measurements: Insomnia was diagnosed at age 38 according to DSM-IV criteria. Psychiatric diagnoses, behavioral problems, and family psychiatric histories were assessed between ages 5 and 38. Results: In cross-sectional analyses, insomnia was highly comorbid with multiple psychiatric disorders. After controlling for this concurrent comorbidity, our results showed that individuals who have family histories of depression or anxiety, and who manifest lifelong depression and anxiety beginning in childhood, are at uniquely high risk of age-38 insomnia. Other disorders did not predict adulthood insomnia. Conclusions: The link between lifelong depression and anxiety symptoms and adulthood insomnia calls for further studies to clarify the neurophysiological systems or behavioral conditioning processes that may underlie this association. http://dx.doi.org/10.1016/j.comppsych.2014.08.012
A new measure of social hedonic capacity: The ACIPS Gooding DC, Pflum MJ, Siggelkow CL University of Wisconsin-Madison, Madison, WI, USA Background: Social hypohedonia, the reduced capacity to enjoy social interactions and interpersonal relationships, is observed in individuals at heightened risk for the later development of schizophrenia, as well as individuals experiencing depression and schizophrenia. Thus, there is increasing interest in assessing social hedonic capacity in the general population and in various diverse patient populations. The study objective was to highlight the psychometric advantages of the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS; Gooding & Pflum, 2014, Psychiatry Research), by demonstrating its relationship with extant measures. Methods: The association between trait hedonic capacity and schizotypal personality was examined in two independent nonclinical samples. In both investigations, hedonic capacity was measured using the 17-item Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS). In Study One, we explored the association between the ACIPS and the Schizotypal