Article Review: Frightening Truths About First Episode Psychosis: Results From a 2011 NAMI Survey

 

 

For many psychologists, greater experience comes at a costly price tag of desensitization. When conducting a routine structured interview, the phrase “Do you often hear or see things that others cannot?” would hardly elicit a noticeable response reaction, from even the most novice clinician. We may unintentionally disregard that the field of Human Services often times involves evaluating very real, sometimes very difficult human experiences.  Treating these experiences with the great humility and reverence they deserve can unfortunately sometimes fade with time.  It is therefore imperative that clinicians be hypervigilent and proactive in submerging themselves into research studies and literature, which aim to connect and help clinicians to understand these distressing experiences. Experiences such as psychosis can be extremely frightening, confusing and deeply personal not only for those experiencing it, but also for those closely related and wanting to help, like friends and family members.

 

The National Alliance on Mental Health conducted an online survey of people who experienced psychosis or witnessed a friend or family member have an episode of psychosis. The 2011 survey followed another NAMI survey that found that, on average, there is a nine-year gap between a person’s first psychotic episode and the time they begin to receive treatment for their diagnosis.

 

The 2011 NAMI survey also focused on finding the possible reasons why people with psychosis go close to a decade before receiving treatment, and possible solutions to solving the problem. First, there was the issue of lack of knowledge about psychosis. According to the survey, approximately 40 percent of the people who had psychosis said they were the first to recognize the problem themselves. These people reported that they realized something was wrong but they did not know what it was, due to lack of understanding about psychosis in general. This problem was compounded by the fact that many people who experience psychosis tend to isolate from others. According to the NAMI survey, around 20 percent of the responders reported that they did not receive help from friends or family when they had their first psychosis episode (NAMI, 2011). Lack of knowledge also proved to be a problem among family and friends. Just like the patients who experience a psychotic episode, family and close friends have a difficult time understanding and recognizing the symptoms of psychosis when they see it, making it difficult to get the help needed for their loved one.

 

A second challenge that prevents psychosis sufferers from receiving treatment is the stigma attached to mental illness. Again, this problem stems from lack of knowledge about psychosis. Respondents to the NAMI survey said that the issues they found the most challenging were confronting the stigma of mental illness, telling others about their psychosis, and worrying about no longer being taken seriously by others.

 

All these issues lead to a similar problem, which is, mental health professionals do not become a part of the treatment of patients who have psychosis, until many years down the line after their first episode. This is a significant obstacle to the treatment of psychosis because many of the respondents to the survey suggested that finding the “right” doctor, keeping appointments, and taking medication were very helpful in their treatment.

 

Observing the results of the NAMI survey, this writer believes that a comprehensive approach is necessary to solve the problem of delayed diagnosis of psychosis. According to the survey, many of the respondents said that they first received information about psychosis online. As such, putting relevant information online would be a good first step in educating the public about psychosis. Also, having an educational blitz in schools, workplaces and other institutions about psychosis would go a long way in both destigmatizing mental illness, and providing relevant information for people to get help for themselves and their family members.

 

Finally, understanding that psychosis can be a frightening, confusing, and very personal experience for any individual. The human exchange of simply gaining information and marking a check symbol in some box cannot (hopefully) be a comforting solution for any clinician, when uncovering someone’s experiences with psychosis.  In fact, if the tables were turned, what kind of qualities would you require from the person sitting across from you, before you felt comfortable enough to open up about such a deeply profound experience?

 

“The psychological equivalent to air, is to feel understood” – Stephen R. Covey

 

Reference: https://www.nami.org/psychosis/report

 

 

Dianne Rapsey-Vanburen, M.A.
WKPIC Doctoral Intern

 

 

Friday Factoids Catch-Up: Differentiating Subgroups of ADHD

Penn State University (2016) researchers recently found that young adults with Attention-Deficit/Hyperactivity Disorder (ADHD) demonstrate subtle physiological signs that may help provide a more accurate diagnosis and possible identification of types of ADHD.  Their findings indicated that while engaged in a continuous motor task, individuals with ADHD had greater difficulty inhibiting motor responses and produced more force during the task compared to controls.  This research allowed for a more precise measure of motor responses compared to previous assessments based on key-press response.  Additionally, the amount of force was related to the self-report of ADHD symptoms of inattention, hyperactivity, and impulsivity.

 

The goal of this research was reportedly to help differentiate subgroups of those diagnosed with ADHD, which aims to inform treatment and offer diagnostic specificity.  The use of continuous performance tests (CPT) in ADHD assessments has yielded variable reviews, although the use of CPT in research has provided valuable information specific to ADHD (Bjorn, Uebel-von Sandersleben, Wiedmann, & Rothenberger, 2015).  Regardless, research indicates that CPT provides information specific to sustained attention and impulsivity, and can be utilized as a tool to aid diagnosis and per Penn State researchers, possibly identify more subtle signs that could directly inform treatment and interventions.

 

References

Albrecht, B., Uebel-von Sanderslebem, H., Wiedmann, K., & Rothenberger, A. (2015). ADHD history of the concept: the case of the continuous performance test. Current Developmental Disorders Reports, 2(1), p. 10-22.

 

Penn State. (2016). Inhibitory motor control problems may be unique identifier in adults with ADHD. Retrieved from https://www.sciencedaily.com/releases/2016/11/161116103443.htm

 

Dannie Harris, MA
WKPIC Doctoral Intern

 

 

Friday Factoids Catch-Up: Impact of Trauma on Later Mental Illness

Palmier-Claus, Berry, Bucci, Mansell, and Varese (2016) found childhood adversity, described as neglect, bullying, and emotional, physical, or sexual abuse, was 2.63 times more likely to have occurred with individuals with bipolar disorder.

 

They note the effect of emotional abuse was particularly robust, with emotional abuse being 4 times more likely to have occurred with individuals with bipolar disorder.  Given the severity, course, and deleterious impact of this disorder on the individual and their family, highlights a need to identify risk factors that can inform treatment.  Similar findings have shown a link between childhood adversity and other mental disorders.  Specifically, Matheson, Shepherd, Pinchbeck, Laurens, and Carr (2013) found medium to large effect size of childhood adversity with individuals with schizophrenia.

 

Thus, for both bipolar disorder and schizophrenia, research suggests childhood adversity as a possible risk factor for development of these disorders.

 

References

Matheson, S. L., Shepherd, A. M., Pinchbeck, R. M., Laurens, K. R., & Carr, V. J. (2013). Childhood adversity in schizophrenia: a systematic meta-analysis. Psychological Medicine, 43(2), 225-238.

 

Palmier-Claus, J. E., Berry, K., Bucci, S., Mansell, W., & Varese, F. (2016). Relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis. The British Journal of Psychiatry, 209(6), 454-459.

 

Dannie Harris, MA
WKPIC Doctoral Intern

 

 

Friday Factoids Catch-Up: Teens and Legalization of Marijuana

Gruber and Sagar (2017) highlight concerns of legalization of marijuana and its potential impact on adolescents.  They suggest that with legalization, adolescents may develop beliefs that marijuana use is acceptable or harmless.  Gruber and Sagar (2017) indicate that there is increased vulnerability for individuals under 25 using marijuana.  More specifically, research has shown the brain is still developing during this time period, with critical executive functioning skills developing into the mid-20s.

 

Research has demonstrated marijuana use that began in adolescence has been linked to problems with memory and increased marijuana use in the future.  Furthermore, those with more frequent and chronic use have been shown to have increased problems with cognition and memory.  Other studies have shown marijuana use has been linked to psychosis (Di Forti et al., 2014; Di Forti et al., 2015), as well as damage to the corpus collosum with use of high potency marijuana (Rigucci et al., 2015).  Gruber and Sagar (2017) suggest concerns with potency, in that some products may have higher levels of tetrahydrocannabibol (THC) compared to others, as well as when compared to marijuana used decades ago.  There is concern that policy has “outpaced science” (Gruber & Sagar, 2017, p. 2), indicating that proper research has not yet been accomplished relative to the legalization and established polices.

 

As a result, consideration regarding age restrictions, restriction of advertising to youth, and determining guidelines for use is recommended.

 

References

Di Forti, M.,  Sallis, H., Allegri, F., Trotta, A., Ferraro, L., Stilo, S. A.,…Murray, R. M.(2014). Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users. Schizophrenia Bulletin, 40(6), 1509-1517.

 

Di Forti, M., Macroni, A., Carra, E., Fraietta, S., Trotta, A., Bonomo, M.,…Murray, R. M. (2015). Proportion of patients in south London with first-episode psychosis is attributable to use of high potency cannabis: a case-control study. Retrieved from http://cannabisclinicians.org/wp-content/uploads/2015/02/Psychosis-Skunk-2-15.pdf

 

Gruber, S. A., & Sagar, K. A. (2017). Marijuana on the mind? The impact of marijuana on cognition, brain structure, and brain function, and related public policy implications. Retrieved from www. Sciencedaily.com/releases/2017/02/170208094219.htm
Rigucci, S., Margues, T. R., Di Forti, M. Taylor, H., Dell’Acqua, F., Mondelli, V.,…Dazzan, P. (2015). High potency cannabis affects corpus collosum (CC) microstructural organization. European Psychiatry, 30, 291.

 

Dannie Harris, MA
WKPIC Doctoral Intern

 

 

Friday Factoid Catch-Up: Teen Coping Strategies

A recent article in the New York Times by Lisa Damour (2017) discussed coping strategies of teenagers.  Along with feedback from practicing psychologists, Damour provided some interesting descriptors of coping mechanisms that may be criticized or possibly overlooked by adults.  The author notes that it is common for teenagers to reread childhood books or re-watch television shows or movies that they used to love when younger to cope with stress.  These simple tasks have been shown to lift spirits and improve a depressed mood.  Here the revisiting of youthful activities or completing simple or repetitive tasks may help teenagers distract themselves from expectations or personal demands.

 

The article suggests that teens who use approach coping mechanisms, such as problem solving, are more satisfied with their lives compared to teens that use avoidance coping strategies (e.g., ignoring or worrying). Parents can help monitor if distractions or coping strategies are adaptive or interfering with one’s responsibilities.  Identifying the source of stress as either something that can be changed or something that is out of one’s control is also necessary and may influence the type of coping skills that could be useful.  Also the author highlights that some situations may be beyond a child’s capacity to handle or manage without support (e.g., death, trauma); therefore professional support may be beneficial.  In short, parents may find it helpful to recognize that coping mechanisms are personal, and though these activities may appear rudimentary, their effects have shown to have a positive effect on how teens manage stress.

 

 

References
Damour, L. (2017). When a teenager’s coping mechanisms is SpongeBob. Retrieved from https://nyti.ms/2kNpzqJ

 

Dannie Harris, MA
WKPIC Doctoral Intern