高危服刑人员冲动性特点与其儿童期虐待的相关研究

目的 了解高危服刑人员冲动性的特点及其影响因素,为识别服刑人员冲动性的高危因素并进行有效干预提供参考.方法 以南京市某监狱588名男性服刑人员为研究对象,按暴力犯罪案由、高冲动性、边缘型人格及反社会人格为特点将其分为四组,收集服刑人员一般人口学资料和犯罪信息,采用自编物质使用情况调查表、Barratt冲动性量表第11版...     

男性服刑人员的心理状况与人格特征的相关性

目的 探讨济南市监狱男性服刑人员的心理状况及相关影响因素.方法 采用症状自评量表（SCL-90）和艾森克人格问卷（EPQ）对550名监狱男性服刑犯进行调查.结果 研究组SCL-90总分及各因子分均高于全国常模（P＜0.01）;EPQ的精神质、内外向、神经质分量表评分均高于全国常模（P＜0.01）;掩饰性分量表评分低于全国常模（P＜0.01）.研究组SCL-90总分及所有因子分与EPQ分量表精神质（P）维度、神经质（N）维度呈正相关（P＜0.01）;SCL-90总分及除敌对及偏执因子外所有因子分与内外向（E）维度呈负相关（P＜0.05）;SCL-90总分及除躯体化因子外所有因子分与掩饰性（L）维度呈负相关（P＜0.05）.多元线性回归显示婚姻状况、犯罪类型和EPQ的神经质（N）、内外向（E）、精神质（P）进入SCL-90阳性症状的回归方程.结论 服刑人员存在较多的心理健康问题,在人格特征上存在高精神质、高神经质、高外倾性和低掩饰性的特点,其影响因素较多.     

新入监服刑人员心理健康和自尊状况关系研究

目的探讨新入监服刑人员的心理健康状况及其与自尊水平之间的关系。方法使用症状自评量表(SCL-90)和Rosenberg自尊量表(RSES)对100名新入监服刑人员的心理健康状况及自尊水平进行调查,并分析其相关性。结果新入监服刑人员的SCL-90总分、总均分、阳性项目数及躯体化、强迫、抑郁、焦虑、恐怖、偏执、精神病性因子分的得分上均显著高于全国常模(P<0.05或P<0.01),主要心理问题表现为抑郁、强迫、焦虑等方面,而且性别、年龄、犯罪类型、刑期对心理健康状况有影响。RSES总分与SCL-90总分及强迫、人际关系敏感、抑郁、焦虑、敌对、恐怖因子分均呈显著负相关,自尊是SCL-90总分和多个因子分的显著预测变量(P<0.05或P<0.01)。结论新入监服刑人员的心理健康状况存在明显的异常,自尊水平越低的人员心理健康状况越差,自尊对心理健康状况具有显著负向预测作用。在对新入监服刑人员进行心理干预时,需要重视自尊因素。     

宝山监狱服刑人员的心理健康状况及其相关因素分析

目的 了解监狱内服刑人员的心理状况及其相关因素.方法 采用自编一般情况调查表、焦虑自评量表(SAS)、抑郁自评量表(SDS)、症状自评量表(SCL-90)、对宝山监狱2000例服刑人员进行评定.结果 服刑人员的焦虑、抑郁总分显著高于正常人群(P＜0.001);而SAS总分高于正常人群上限者占39.9%,SDS总分高于正常人群上限者占52.6%;既有焦虑又有抑郁情绪的人占35.4%;负性情绪中未婚和离婚者显著高于已婚者(P＜0.05);焦虑、抑郁情绪与学历、刑期、是否愿意与心理工作者交流、症状自评量表总分均有不同程度的相关性.其中焦虑情绪在不同刑期之间经F检验有显著差异(P＜0.05),SCL-90总分、均分、8项因子分显著高于常模(P＜0.001),其总分的高低与年龄、学历、SAS总分、SDS总分显著相关,而不同刑期的服刑人员之间的量表总分经F检验则无显著差异(P＞0.05).结论 服刑人员中较多的人存在着心理障碍.     

冲动性与非冲动性自杀未遂的比较

目的 自杀未遂是我国重要的公共卫生问题,但缺乏针对性的、有效的干预措施。本研究通过比较冲动性与非冲动性自杀未遂的特征,为制定相应的预防措施奠定基础。方法 对4所市县级综合医院的306例病情较重的自杀未遂病人用自制调查表进行调查。按其自杀前考虑自杀时间的长短人为地分为冲动性(≤2小时,164例)和非冲动性(>2小时,142例)两组,并对两组进行比较。结果 两组在许多方面有显著差异。用非条件Logistic回归分析控制不同因素之间的相互影响后,发现在自杀未遂者中,自杀前2周抑郁程度越轻、自杀意图强度越低,有急性(≤1月)负性生活事件、自杀前1个月生命质量越高、居住在乡村、越年轻越易发生冲动性自杀行为;而性别和其他因素与冲动性自杀行为的发生无关。结论 冲动性与非冲动性自杀未遂的特征明显不同,对这两种不同的自杀未遂人群是否应采取不同的预防及干预措施是目前迫切需要解决的问题。     

服刑人员睡眠状况研究

目的 研究服刑人员睡眠状况。方法采用睡眠质量自评问卷(SRSS)对66名服刑人员进行测试,测试结果运用SPSS11．5进行统计分析。结果 服刑人员的睡眠状况低于全国常模,且服刑人员睡眠障妨的检出率较高,服刑人员睡眠质量与其刑期和年龄呈一定相关。     

冲动性与自杀行为关系的研究进展

个体冲动性与自杀行为密切相关。本文将从自杀意念、自杀未遂和自杀完成三个方面回顾有关冲动性和自杀行为的研究进展,并比较不同自杀理论对于冲动性与自杀关系的理解,旨在为冲动性与自杀行为关系的未来的研究提供新的思考。     

不同服刑期的男性服刑人员心理防御机制与家庭环境的关系

目的 调查不同服刑期的男性服刑人员心理防御机制及其家庭环境状况,分析其心理防御机制与家庭环境的关系。方法 于2015年4月-6月采用随机数字表法抽取广东省某监狱的男性服刑人员200名作为研究对象,并根据其服刑期,将服刑人员分为已服刑5年以下组（n=108）和5年及以上组（n=92）,采用防御方式问卷（DSQ）和家庭环境量表中文版（FES-CV）评定其防御方式和家庭环境情况。采用Pearson相关分析检验各量表评分间的相关性。结果 已服刑5年以下组DSQ不成熟防御机制与中间型防御机制因子评分均低于已服刑5年及以上组,差异均有统计学意义（t=4.198、1.137,P均<0.01）。已服刑5年以下组FES-CV亲密度、情感表达和组织性因子评分均高于已服刑5年及以上组（t=3.122、2.993、2.203,P均<0.01）,矛盾性因子评分低于已服刑5年及以上组（t=-3.682,P<0.01）。男性服刑人员DSQ不成熟防御机制、中间型防御机制及掩饰因子评分与FES-CV的亲密度和情感表达因子评分均呈负相关（r=-0.428~-0.172,P<0.05或0.01）,DSQ的4个因子评分与FES-CV的矛盾性因子评分均呈正相关（r=0.175~0.384,P<0.05或0.01）。结论 相较于已服刑5年以下的男性服刑人员,已服刑5年及以上者表现出更多的不成熟和中间型心理防御机制,其家庭环境呈现更高程度的矛盾性,更低程度的亲密度、情感表达与组织性;服刑人员的心理防御机制缺陷与其家庭环境相关。     

男性精神分裂症服刑人员教养方式与人格相关性研究

目的探讨男性精神分裂症服刑人员(schizophrenia inmates,SI)教养方式与人格相关性。方法对83例SI患者及与其人口学资料相匹配的630名精神分裂症患者作为对照组,分别进行父母教养方式量表及艾森克人格问卷进行测评。结果 (1)SI组在父母教养方式调查问卷(Egna Minnen Barndoms Uppfostran,EMBU)量表中的父亲因子Ⅰ得分高于对照组,母因子Ⅱ的得分低于对照组[(47.84±10.27)分vs(44.77±10.20)分,(35.95±6.28)分vs(34.04±7.22)分],差异有统计学意义(t=-2.581,P=0.010;t=-2.299,P=0.022);(2)SI组中父亲因子Ⅰ与EPQ量表中E量表显著相关,与N量表得分呈负相关;(3)对照组中父亲因子Ⅰ与EPQ量表中E呈正相关,与P、N得分呈负相关;母亲因子Ⅱ与E、N得分呈正相关,与L得分呈负相关,结论父亲温暖理解不能阻止男性精神分裂症患者出现违法行为,母亲过分干涉对犯罪有影响,男性精神分裂症服刑人员父母教养方式对患者人格形成的影响降低。     

成年男性服刑人员神经质人格、人际关系敏感与社会支持的关系

目的了解成年男性服刑人员的神经质人格、人际关系敏感和社会支持的现状以及三者之间的关系,为对其进行有针对性的心理健康教育提供参考。方法于2017年5月-10月随机抽取山东省某市周边两所监狱中的244名成年男性服刑人员,采用症状自评量表(SCL-90)、艾森克人格问卷(EPQ)和社会支持评定量表(SSRS)调查其人际关系敏感状况、神经质人格特征和社会支持情况。结果①男性服刑人员EPQ神经质维度评分、SCL-90人际关系敏感评分、SSRS评分与全国常模比较,差异均有统计学意义(t=-7.86～16.54,P均0.01)。②依次检验回归系数显示,成年男性服刑人员的人际关系敏感对社会支持的影响通过神经质人格实现[加入中介变量前(β=-0.164,P=0.034);加入后,(β=-0.237,P=0.133)]。结论成年男性服刑人员的神经质人格较为典型,人际关系较为敏感;神经质人格在社会支持和人际关系敏感中起中介作用。     

Racism and mental health and the role of mental health professionals

The concept of “race” and consequently of racism is not a recent phenomenon, although it had profound effects on the lives of populations over the last several hundred years. Using slaves and indentured labor from racial groups designated to be “the others,” who was seen as inferior and thus did not deserve privileges, and who were often deprived of the right to life and basic needs as well as freedoms. Thus, creation of “the other” on the basis of physical characteristics and dehumanizing them became more prominent. Racism is significantly related to poor health, including mental health. The impact of racism in psychiatric research and clinical practice is not sufficiently investigated. Findings clearly show that the concept of “race” is genetically incorrect. Therefore, the implicit racism that underlies many established “scientific” paradigms need be changed. Furthermore, to overcome the internalized, interpersonal, and institutional racism, the impact of racism on health and on mental health must be an integral part of educational curricula, from undergraduate levels through continuing professional development, clinical work, and research. In awareness of the consequences of racism at all levels (micro, meso, and macro), recommendations for clinicians, policymakers, and researchers are worked out.     

Reflections on the use of mental health resilience concepts in migration and global mental health

Abstract

With the concept of resilience increasingly deployed across a range of issues in development studies—from conflict resilience to climate resilience—this paper considers the relevance of resilience concepts to current issues and concerns in global mental health. Resilience discourses can be seen as one response to the need for more holistic accounts of mental health that focus, not only on stressors and risk factors for mental ill health, but also recognize the sometimes overlooked capacities of people and communities to manage and coproduce their own mental wellbeing. For example, migration forms the backdrop to global mental health for a significant proportion of the world’s populace. And yet, thus far, most literature on migrant mental health has tended to focus on risk factors and stressors with comparatively little consideration given to potential sources or resources for positive mental health and coping with adversity. Nevertheless, while concepts of “resilience” are increasingly advocated in development studies and global mental health contexts, such concepts also have their critics. For example, resilience rhetorics can “depoliticize” by appearing to normalize otherwise unacceptable circumstances which might—from post-development and other alternative critical perspectives—be viewed as politically constituted through-and-through.     

Correlation between addictive behaviors and mental health in university students

Aims:  The present study aims to clarify the relationships of addictive behaviors and addiction overlap to stress, acceptance from others and purpose in life.
Methods:  A survey was conducted on 691 students at eight universities. The Eating Attitude Test-20 was used to identify students with food addiction or food addictive tendencies. The Kurihama Alcoholism Screening Test was used to identify students with alcohol addiction or alcohol addictive tendencies. The Fagerström Test for Nicotine Dependence was used to identify students with nicotine addictive tendencies or nicotine addiction. The Visual Analog Scale was used to assess stress and acceptance from others. The Purpose in Life Test was used to measure meaning and purpose in life. Results were compared between students with addictive behaviors, with addictive tendencies and without addictive behaviors.
Results:  Significant differences among the three groups were observed for stress, acceptance from others, and Purpose in Life scores for students with food and nicotine addiction, but no significant differences existed in relation to alcohol addiction. In addition, 28.8% of students displayed addictive behaviors in one of the three areas (food, alcohol or nicotine), 8.5% displayed addictive behaviors in two of the three areas, and 0.4% had addictive behaviors in all three areas. Significant differences existed in stress and acceptance from others among students with one addictive behavior, ≥two addictive behaviors and no addictive behaviors. However, no significant differences existed in Purpose in Life scores with respect to overlapping addictions.
Conclusion:  The results suggest a relationship between mental health, addictive behaviors and overlapping addiction among university students.     

Association between childhood attention-deficit-hyperactivity symptoms and adulthood dissociation in male inmates: preliminary report

The present study examined associations between childhood attention-deficit-hyperactivity disorder (ADHD) symptoms and adulthood dissociation in 799 male inmates using self-reporting questionnaires. Consequently, 33% of the subjects reported childhood physical abuse, and 11.8% reported childhood sexual abuse. A significant association was found between childhood ADHD symptoms and current dissociative tendency (r = 0.51, P < 0.001). Clinical implications of intervention focusing on dissociation in correctional/forensic practices for adult offenders are discussed.     

Recommendations of mental health professionals and the general population on how to treat mental disorders

Objective The objectives of the study are (1) to assess the mental health literacy of mental health professionals, (2) to determine whether there is agreement between different professional groups with respect to different psychopathological conditions and (3) to compare the professionals' knowledge with that of the general population. Methods Two representative samples of mental health professionals and laypersons were presented with a vignette depicting either a person with schizophrenia, major depression or without any psychiatric symptoms (‘non-case’). Out of 18 treatment proposals, the respondents were asked to indicate the proposals regarded as helpful and those considered as being harmful, respectively, for the person depicted. Results Mental health professionals view their profession and less often their treatment methods as helpful. Dealing with the situation alone, electroconvulsive therapy, hypnotics and sedatives are consistently regarded as harmful. For the individual with schizophrenia, mental health professionals agree about helpful treatments. Regarding depression, a lack of consensus is found about treatment proposals such as psychiatric hospitalisation, antidepressants and complementary and alternative medicine. An important part of mental health professionals suggests medical help (psychologists and general practitioners) for the non-case vignette. Fewer nurses, social workers, vocational workers and occupational therapists (‘other therapists’) as compared to psychiatrists and psychologists recommend standard treatment methods. Professionals and the general population significantly differ in their attitudes towards the treatment suggestions, especially regarding medication and alternative medicine. Conclusions To improve the treatment of mental disorders, various strategies must be considered. These include permanent education of all mental health professionals, especially nurses and other therapists. A special focus must be given to affective disorders and a potential (over-) treatment of normal behaviour.     

Norms for mental health services in South Africa

Background In the aftermath of apartheid, South Africa has inherited a fragmented, under-resourced and inequitable public sector mental health service. Attempts are being made to reform mental health services, in keeping with new health policy, which proposes the downscaling of psychiatric institutions and the development of community-based services. This study set out to develop a set of service norms for the care of people with severe psychiatric conditions (SPC) in South Africa, to assist the implementation of the new policy. Methods A national situation analysis of current public sector mental health services was conducted. A model was developed for estimating the mental health service resource needs of people with SPC. Following consultation with provincial stakeholders, a set of service norms were developed taking into account national indicators from the situation analysis (as a baseline level) and proposals of the model (as a target level). Results The study recommends an increase in the number of acute psychiatric beds in general hospitals; development of community-based residential care; redistribution of staff from hospital to community services, particularly in rural areas; and the development of information systems to monitor the transitions to community-based care. Conclusions The norms proposals presented in this study express mental health service needs in terms of quantifiable service resource and utilisation levels. In doing so, the study attempts to make explicit the assumptions and values on which planning is based.     

Patterns of mental health service utilization in a general hospital and outpatient mental health facilities

Purpose Mental health is one of the priorities of the European Commission. Studies of the use and cost of mental health facilities are needed in order to improve the planning and efficiey of mental health resources. We analyze the patterns of mental health service use in multiple clinical settings to identify factors associated with high cost. Subjects and methods 22,859 patients received psychiatric care in the catchment area of a Spanish hospital (2000–2004). They had 365,262 psychiatric consultations in multiple settings. Two groups were selected that generated 80% of total costs: the medium cost group (N = 4,212; 50% of costs), and the high cost group (N = 236; 30% of costs). Statistical analyses were performed using univariate and multivariate techniques. Significant variables in univariate analyses were introduced as independent variables in a logistic regression analysis using “high cost” (>7,263$) as dependent variable. Results Costs were not evenly distributed throughout the sample. 19.4% of patients generated 80% of costs. The variables associated with high cost were: age group 1 (0–14 years) at the first evaluation, permanent disability, and ICD-10 diagnoses: Organic, including symptomatic, mental disorders; Mental and behavioural disorders due to psychoactive substance use; Schizophrenia, schizotypal and delusional disorders; Behavioural syndromes associated with physiological disturbances and physical factors; External causes of morbidity and mortality; and Factors influencing health status and contact with health services. Discussion Mental healthcare costs were not evenly distributed throughout the patient population. The highest costs are associated with early onset of the mental disorder, permanent disability, organic mental disorders, substance-related disorders, psychotic disorders, and external factors that influence the health status and contact with health services or cause morbidity and mortality. Conclusion Variables related to psychiatric diagnoses and sociodemographic factors have influence on the cost of mental healthcare.     

The current state of adult mental health care in France

Since the 1960s, French public mental health services are organised in “sectors”, each sector catering for a mean population of 54,000 inhabitants. Although this organisation was aimed at insuring equal access to care whatever the place of residence, there are still huge disparities in number of staff and bed resources from one sector to another. The reduction in the number of hospital beds started later in France than in most other European countries, and was really effective in the 1990s. In 2000, there were 9.4 beds for 10,000 inhabitants aged over 20 years. Hospital-based care has still an overwhelming importance, and is associated with a marked under-development of community services and lack of sheltered housing for the most disabled patients. With more than 13,000 registered psychiatrists in France, the density of psychiatrists is one of the highest in the world. However, French psychiatry has currently to face a structural crisis due to the reduction in public health budgets, as well as to the reduction of 30% in the number of French psychiatrists over the next two decades. The numerous national programmes aimed at renovating French mental health services, published over the last decade, have not yet kept their promises.     

Determinants of self-reported mental health and utilization of mental health services in Canada

Research evidence suggests that the prevalence of mental health conditions in Canada has increased while a considerable percentage of people with a mental health issue do not seek professional mental health services. Weighted logistic regression models were used to determine whether age, sex, income, and education predict the self-reported mental health status of Canadians and their odds of utilizing mental health services. This study found clear disparities in reporting mental health and utilization of mental health services. Young adults (aged 25 to 44) have 1.4 times (95% CI: 1.3 to 1.6 times) higher odds of reporting poorer mental health status than seniors (aged 65 or older). Females are 2.7 times (95% CI: 2.3 to 3.1 times) more likely to utilize mental services than males. The lowest income group (<$15,000) has 2.2 times (95% CI: 1.9 to 2.4 times) higher odds of rating poorer mental health status than the highest income group (>$80,000). The least educated group (<high school education) has 1.5 times (95% CI: 1.3 to 1.6 times) higher odds of reporting poorer mental health status than the highest educated group (post-secondary education). However, the highest educated group is 1.6 times (95% CI: 1.3 to 2.0 times) more likely to utilize mental health services than the least educated group. Even in a country that has a universal health insurance system such as Canada, disparities and inequities associated with mental health burden and health care utilization persist, specifically among groups with lower education, lower income, and males.