精神障害と治療

Background: Contemporary social policy fosters social inclusion of persons with developmental disabilities. Methods: This paper advocates for the “intentional community” approach based on an evaluation of Botton Village, a UK intentional community, in addressing challenges being encountered in Ontario in implementing social inclusion. Results: Challenges such as long wait lists, lack of meaningful engagement and access to adult services and unmet health care needs continue to persist in current integrated communities. Conclusions: This paper suggests intentional communities have the potential for creation of lives with meaning for adult individuals with developmental disabilities and for their caregivers.

The Stroop Color-Word Test or SCWT (on Card A, S reads 100 color names, on Card B names 100 color patches, on Card C names 100 incongruous ink colors in which color names are printed) has been in existence for over 80 years. It is best known in modern psychology as a tool in the armamentarium of the clinical neuropsychologist. However, its usefulness has been limited in that researchers’ singular use of achievement measures (e.g., total time per card, total number of errors per card, derived scores from total time measures, namely: speed factor, total time on Card A; color-difficulty factor, total time on B/total time on A; interference factor, total time on C - total time on B) does not finely discriminate among groups exhibiting different psycho- and neuro-pathologies. We argue here that a process-oriented approach to the SCWT - focusing on an analysis of the types of errors involved in the identification of stimuli and the maintenance of serial organization, types of nonverbal behaviors/cognitive strategies to complete the task, and metacognitive estimates of performance) - will complement its traditional achievement approach and increase its discriminative ability (cf. Werner on process vs. achievement). Toward this end, we describe studies from an ongoing research program in our laboratory. In doing so, we also attempt to rectify two longstanding concerns leveled against the SCWT - the needs to standardize its materials/administration/scoring and to develop a comprehensive set of norms, in our case one unified by a classic theory of development.

With the advent of one-way mirrors, videotapes, smartphones with filming capabilities, and other audio-visual devices, much research has been conducted on the effects of observation on the psychotherapeutic process. However, as outlined by Zinberg , this research has traditionally focused on the ways in which observation affects isolated processes in both therapists (e.g., concentration) and patients (e.g., defense mechanisms) or simply on participants’ (patients, trainees)experience of observation with both sets of participants reporting favorable attitudes. In contrast, the present work describes a case study in which the in vivo non-participant observation of an ongoing therapy case led to extremely positive therapeutic benefits for the patient. Underlying processes (e.g., life review, mindfulness, self-other differentiation) and mechanisms (e.g., activation of self- and relational observation, elaboration of affect-laden material) as well as implications for therapy, education, and research are discussed.

Introduction: Village health workers (VHW)/Lay workers have been used effectively in HIV programmes in Zimbabwe and may potentially be useful in supporting caregivers of people with mental illness, if they are adequately trained and supervised by health professionals. Objective: To explore the training needs of VHW in supporting caregivers of persons with mental illness. Methods: Fifty two VHWs were conveniently selected from 5 out of 9 provinces in Zimbabwe and participated in focus group discussions (FGD) using a standardized study guide. Forty six health professionals completed a self-administered open ended questionnaire. Interviews were audio recorded and transcribed verbatim in Shona and translated into English. Data were analyzed thematically using Atlas Ti. Statistical Package for Social Sciences version 16 was used for sociodemographic data analysis. Results: The overall perceived training needs for VHW included training on counseling skills, psycho- education for caregivers, stress management, education on mental health conditions in order for them to effectively support caregivers of patients with mental illness in their communities in Zimbabwe. Conclusion: The needs analysis demonstrates perceived gaps in the knowledge of VHW in training caregivers of patients with mental illness. Designing a curriculum and assessing its impact on patient care and caregiver perceptions may go a long way in reducing caregiver burden in Zimbabwe.

The purpose of this study was to validate the Multi group Ethnic Identity Measure (MEIM) on a sample of Afro- Caribbean American college students. This investigation is unique in that it disaggregated the data to go beyond the usual labels of Black and African American used in past validation studies. Due to being subsumed in the past under such monikers, information on the ethnic identity of Afro-Caribbean American college students has largely been missing from the literature. This investigation served as a comparison to past investigations on ethnic identity in populations of African descent. The results of this study indicated that the structure of the MEIM is consistent in this population. However, the results also indicated that ethnic identity does not have the same relationship with selfesteem and depression as it has in previously studied Black/African American and minority populations in the United States. The uniqueness of this population as well as the distinctive study results are discussed.

Female Muslim immigrant youths are at a developmental stage of transition to adulthood and face many challenges in their identity transformation due to racism, migration status and gender role. They are members of a cultural group whose experiences of mental health are established through multiple contexts. Informed by different theoretical perspectives, the methodology of ethnography is introduced as an appropriate approach to explore female Muslim immigrant youths’ mental health. This article also introduces critical ethnography as an appropriate design to examine critically the contextual and intersecting factors that influence female Muslim immigrant youths’ experiences. The steps to conduct an ethnographic study on female Muslim immigrant youths are also listed. This paper finally mirrors strengths, limitations and challenges of ethnographic approach in research related to female Muslim immigrant youths.

Studies and surveys undertaken by the European Agency for Safety and Health at Work indicate an “increasing number of workers exposed to psychosocial risks at work and affected by work-related stress” affecting mental health. Any innovative methods for psychosocial risk assessment at work are thus welcome. On the basis of the Square of Perceived Action model elaborated regarding competencies in action for work activities integrated in a psychodynamic approach, a protocol was developed and applied in a French company for psychosocial risk assessment regarding 35 professions and focusing on difficulties related to skill discretion. Four illustrating cases, the insight of the in-depth analysis for one profession and a macro-approach taking all the professions into account were considered. Beyond the characterization of the psychosocial risks and the orientation regarding remedial measures implemented, the method enabled analysts to objectify and quantify the risks and helped them to center the remedial measures on the right target or to better assess the degree of emergency of remedial measures. These results also showed that the method is exhaustive for psychosocial risk assessment provided that it is combined with other tools. Benefits and limits of this innovative method are discussed.