Friday Factoids: Dangerous New Synthetic Drug

 

 

‘Flakka’ is a new synthetic drug that has recently been moving across the country and may soon find itself in Kentucky (and the effects in our hospital and area). News articles have reported that about a year ago, police officers had never heard of the drug. However, it has recently been called an “epidemic” in Florida and has crossed into Tennessee.

 

Flakka has been described as similar to bath salts. A report stated, “they get an initial high and when the high wears off, that is when hallucinations start. They are experiencing super human strengths.” Individuals who have taken Flakka tend to believe they are being chased, can be aggressive, and have been described as having no fear. A police officer noted, “A taser is not effective, verbal commands not effective, pepper spray not effective, and you don’t know what extreme you are going to be in.”

 

Flakka has become popular because it seems to be easily attainable and cheap (some sources saying $5-$10).One story reported a man felt he was being chased and, in an attempt to get into a police station, began to climb over a fence and impaled his leg on the fence. A couple of news stories are listed below for more information. It may be beneficial for us to be familiar with the symptoms of this drug as we may soon see people who have used it. Flakka does not appear on a typical drug screen panel, so it may not be easily identifiable.

 

http://www.wptv.com/news/region-c-palm-beach-county/west-palm-beach/cops-battle-flakka-crazy-street-drug

 

http://news.yahoo.com/naked-paranoids-begging-police-save-them-thats-flakka-092502635.html

 

Brittany Best, MA
WKPIC Doctoral Intern

 

 

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WKPIC Trains Valuable Skills

 Liiike, first class photo bombing!!
(We might or might not know this former practicum student. Her name might or might not be Cassie Sturycz. She might or might not be working on her doctorate. . .)



    

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Friday Factoids: Myths and Truths about Anxiety Disorders

 

How much do you know about anxiety? Have you bought into any of these myths? Here’s some information that might help!

 

Myth

Truth

If I have a bad panic attack, I will pass out/faint. It is very unlikely you will faint during a panic attack.   Fainting is typically caused by a sudden drop in blood pressure and, during a   panic attack, blood pressure actually rises slightly.
I should just avoid situations that stress me out. Avoiding anxiety tends to reinforce the anxiety. When   individuals avoid anxiety-provoking situations, they continue to believe they   cannot manage or cope with those situations.
I’ll carry a paper bag in case I hyperventilate. Paper bags (similar to as-needed medications) can become a   safety crutch for anxiety.
Medication is the only treatment for my anxiety. Therapy can also help to reduce worry and anxiety. In   fact, research shows that a combination of cognitive-behavioral therapy (CBT)   and medication can be the most effective treatment.
I’m just a worrywart and nothing can really help me. Therapy can help anyone to learn a different relationship   with their own thoughts, emotions, and behaviors.
If I eat well, exercise, avoid caffeine, and live a   healthy lifestyle, my anxiety will just go away. Healthy living can help with worry and anxiety; however,   it cannot cure an anxiety disorder.

“You need more help than just reducing your stress. You   may need to face your fears, learn new facts about your symptoms, stop   avoiding, learn tolerance for some experiences, or change how you think,   feel, and behave with respect to other people.”

My family is always reassuring and help me avoid stress,   which helps me. Similar to the paper bags, well-meaning friends and family   can contribute to and prolong anxiety. Encouraging and supportive friends and   family can better help by assisting an individual through anxiety and   discomfort rather than helping avoid.

 

Would you like some resources for anxiety? Some organizations with helpful resources include National Alliance on Mental Illness (NAMI), Anxiety and Depression Association of America (ADAA), International Obsessive Compulsive Disorder Foundation, Association for Behavioral and Cognitive Therapy, and National Institute of Mental Health (NIMH).

 

Anxiety and Depression Association of America. (2015). “Myth-conceptions,” or common fabrications, fibs, and folklore about anxiety.

 

Brittany Best, MA
WKPIC Doctoral Intern

 

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Friday Factoids: Balance Between “Alone Time” and “Isolation”

 

In our society today, we are constantly connected to people near and far through technology and social media. Here at the hospital, we discuss improving social supports and interactions. Additionally, isolation can be a red flag. However, some interesting research indicates that some alone time may be beneficial for health and wellbeing.

 

Spending time on your own may:

 

  1. Make you more creative.
    “Decades of research have consistently shown that brainstorming groups think of far fewer ideas than the same number of people who work alone and later pool their ideas,” Keith Sawyer, a psychologists at Washington University in St. Louis.
  2. Make you work harder.
    The concept of “social loafing” suggests that people put in less effort when others are involved in the task.
  3. Be the key to your happiness (IF you are an introvert).
    “For introverts, most social interactions take a little out of that cup instead of filling it the way it does for extroverts. Most of us like it. We’re happy to give, and love to see you. When the cup is empty though, we need some time to refuel.” Kate Bartolotta, Huff Post blogger.
  4. Help you meet new people.
    Participating in activities on your own may help you meet people with similar interests.
  5. Help with depression (especially for teenagers).
    A study found that “Adolescents.. who spent an intermediate amount of their time alone were better adjusted than those who spent little or a great deal of time along,” Reed W. Larson, emotional development expert.
  6. Clear your mind.
    “Constantly being ‘on’ doesn’t give your brain a chance to rest and replenish itself,” Sherrie Bourg Carter.
  7. Help you do what you want to do.
    Nobody else to please!

 

Weingus, Leigh. (2015). ‘Alone time’ is really good for you.

 

Brittany Best, MA
WKPIC Doctoral Intern

 

 

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Peer Support: Relationships in Recovery

Peer Support training states that there are ten guiding principles of recovery.  One of these is the “relational” principle.  It tells us that an individual’s chances of recovery are greatly increased if he or she has a strong foundation of support at home and in the community.  This can be a difficult principle to achieve for many, as people often find themselves isolated when they leave institutions.  Some patients have burned bridges they feel can’t be repaired.  Family members may have abandoned them.  In some cases, family wants to be involved, but with privacy laws, they are unable to help the patient regulate mediation or keep in touch with the patient’s doctors to find out about any progress or regression.  Some patients entered the hospital not only because of mental illness, but also because of stress put on them from toxic people, sometimes family.

 

According to the Kentucky Peer Support training, through healthy relationships, a person with a mental illness or substance abuse disorder can find roles which can give him or her purpose through social interaction.  Being a volunteer, a student, an employee, or a peer support can make one feel a greater sense of self and give one a better outlook on life.  Becoming a part of an advocacy group can help others while empowering the individual as well.

 

When a mentally ill person or a person diagnosed with a substance abuse disorder cannot find support in a faith-based institution or with family, there are other organizations on which to lean.  The National Alliance on Mental Illness has chapters across the country and may have support groups or day-time programs. There are also volunteer possibilities through them.  The Depression and Bipolar Support Alliance (dbsalliance.org) also gives opportunities for people living with these illnesses to become facilitators of support groups and to volunteer and advocate on behalf of others with mental illnesses.  The Schizophrenia and Related Disorders Alliance of America (sardaa.org) is yet another group.

 

There are many possibilities for a mentally ill person to integrate into the community, even if it is through social media at first.  Any connection to groups of people with similar experiences helps.  Any connections that allow for socialization and the promotion of friendships will help an individual in his or her recovery journey.  The “relational” aspect of the recovery process is an important one.

 

 

Rebecca Coursey, KPS
Peer Support Specialist

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Diagnosing Autistic Spectrum Disorder: Differences Between Boys and Girls?

Diagnosing Autistic Spectrum Disorder: Differences Between Boys and Girls?

 

A recent study conducted by researchers at the Kennedy Krieger Institute in Baltimore, MD, has found that girls are diagnosed with Autistic Spectrum Disorder (ASD) later than boys. Data was obtained by reviewing the institute’s Interactive Autism Network, which is an online registry that includes nearly 50,000 individuals and family members affected by ASD.  The researchers examined gender differences regarding the age of an ASD diagnosis and symptom severity. Of the participants in the registry, the age of diagnosis was available for 9, 932 children. Of the participants in the registry, 5,103 were available to be assessed for symptom severity as they had completed the Social Responsiveness Scale, an instrument that assesses the presence and severity of social impairments.

 

The data review yielded results stating that girls were diagnosed with Pervasive Developmental Disorder, a type of ASD, at a mean age of 4.0 years; boys were diagnosed with it at 3.8 years. Girls were diagnosed with Asperger’s Syndrome, which affects language and behavioral development, at a mean age of 7.6 years, as compared to 7.1 years for boys.

One possible explanation is that females often exhibit less severe symptoms than males; therefore ASD is often less recognizable with girls than boys. The researchers suggest that girls tend to struggle more with issues related to social cognition and impairments in interpreting social cues, while boys tend to exhibit more severe mannerisms, such as repetitive behaviors (e.g., hand flapping) and/or highly restricted interests.  The researchers suggest improving screening methods as a way to diagnosis ASD more effectively, in addition to increasing public awareness.

 

Faisal Roberts, M.A.

WKPIC Doctoral Intern

 
Nauert PhD, R. (2015). Autism Diagnosis Made Later in Girls. Psych Central. Retrieved on April 30, 2015, from http://psychcentral.com/news/2015/04/29/autism-diagnosis-made-later-in-girls/84057.html

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Article Review: Quick Personality Assessment Schedule (PAS-Q): Validation of a brief screening test for personality disorders in a population of psychiatric outpatients.

Review by:

Faisal Roberts M.A.

WKIPC Psychology Intern

 

The presence of a personality disorder (PD) can profoundly impact an individual’s quality of life in addition to the management of comorbid mental health issues, therefore screening for PDs should be an integral part of the mental health evaluation process. Although somewhat subjective and imperfect, standardized clinical interviews (SCI) are currently considered to be the most reliable and valid methods available to screen for PDs. However, SCIs can be time consuming. While self-report instruments can be effective regarding efficiency and time conservation, the drawbacks are that a self-report inventory may have relatively poor specificity (bereft of elaboration from a clinician), the patients must possess, at minimum, a fundamental reading level, and the possibility of patient fatigue due to having to read and concentrate during the self-report assessment. The authors of this article suggest a compromise between an SCI and a self-report assessment in the form of a brief structured interview.

 

For this study, the authors employed the Quick Personality Assessment Schedule (PAS-Q), which is a brief structured interview that takes approximately 15 minutes to complete. The PAS-Q begins with open questions regarding character traits, personality traits, interpersonal relationships, occupational performance, substance use issues, and legal history. The next area, comprised of eight general sections, assesses constructs relevant to PDs: 1) Suspiciousness & Sensitivity (Paranoid PD); 2) Aggression & Callousness (Antisocial PD); 3) Aloofness & Eccentricity (Schizoid PD); 4) Impulsive & Borderline (Borderline PD); 5) Childishness & Lability (Histrionic PD); 6) Conscientiousness & Rigidity (Obsessive Compulsive PD); 7) Anxiousness & Shyness (Avoidant PD); and, 8) Resourcefulness & Vulnerability (Dependent PD). In order to identify a PD each section begins with two screening questions; positive responses to these screening questions leads to additional exploratory questions probing for PD symptoms, leading to scoring the characteristics in question. The intervieweer not only uses the information obtained from the PAS-Q, but also relevant historical/background information from the patient. The PAS-Q is scored according to four levels of severity ranging from 0 to 3: 0 = no severity; 1 = personality difficulty; 2 = simple PD; and, 3 = diffuse or complex PD.

 

The present study focuses on the validity of the PAS-Q. The purpose of examining the PAS-Q was derived from the following considerations: 1) the PAS-Q is based on the universally accepted ICD-10 categories (as opposed to the majority of the available PD screeners, which are predominantly based on the DSM classification system); 2) the PAS-Q does not focus on the prediction of any PD (as the majority of PD screening instruments do), but provides the opportunity to obtain more specific prognoses of distinct PDs; and, 3) the PAS-Q response scales are not limited to a simple dichotomy (i.e., absence or presence of PD symptoms) but instead allow for increased nuances corresponding with level of severity. The researchers chose the Structured Clinical Interview for DSM-IV – II (SCID-II) to serve as the basis of comparison as it is internationally the most widely use and best known measure to assess for PDs (the SCID-I examines Axis I Disorders, while the SCID-II examines Axis II disorders–which includes PDs).

 

Materials and Methods

 

For this study, the researchers randomly recruited 207 participants from a large community mental health center in the city of Tilburg, the Netherlands. However, 12 participants dropped out during the study. Of the 195 participants that completed the study, 112 were female (57.4 %) and 83 were male (42.6 %). The mean age of the participants was 32.7 years. The researchers utilized both the PAS-Q and the SCID-II in order to evaluate the participants. The PAS-Q was completed first; subsequently the SCID-II was completed 1-2 weeks later. The PAS-Q was then completed a second time 2-3 weeks later. The same clinician evaluated all the participants in order to eliminate extraneous variables regarding evaluator differences. The test-retest reliability of each item on the PAS-Q, in addition to the overall score, was estimated using Pearson correlation coefficients. The dimensionality of the PAS-Q was assessed using factor analysis. The effect of changes in the cut-off score of the PAS-Q for the purpose of predicting SCID-II diagnoses were assessed using receiver operating characteristic (ROC) analysis.

 

Results

Although the study began with 207 participants, 12 dropped out, resulting in 195 participants that completed the study.  Based on the SCID-II, a total of 97 of the 195 (50 %) participants received a PD diagnosis. In the group of participants with PD, the mean number of PDs was 1.8. The test-retest coefficient for the total score yielded a high score of 0.92. The section of Aloofness & Eccentricity had the lowest stability; the sections of Aggression & Callousness, Borderline, and Childishness & Lability had the highest stability over time.  Overall internal consistency, as reflected by Cronbach alpha coefficient, for the total PAS-Q scale was 0.35. Internal consistency coefficients were low, ranging from 0.16 (Borderline) to 0.47 (Conscientiousness & Rigidity). These scores are suggestive that a high degree of heterogeneity exists between the different sections. The scores of the factor analysis were as follows: 0.43 (regarding the positive connections between Aggression and Impulsiveness & Borderline), 0.50 (regarding Resourcefulness & Vulnerability and Anxiousness & Shyness), and 0.40 (regarding Aloofness & Eccentricity and Suspiciousness and Sensitivity). The ROC analysis was used to determine the effect of the changing cut-off score on the PAS-Q in predicting a SCID-II PD diagnosis. The ROC scores, as demonstrated graphically by a curve (the ROC curve), had an area-under-the-curve of 83 % (with a 95 % confidence interval). This is stating that the cut-off score correctly identified 81 % of the participant pool as correctly having a PD.

 

Discussion:

In 81 % of the cases the PAS-Q was able to correctly identify the presence of a PD. The researchers state that its low overall consistency should not be interpreted that the PAS-Q is a test that performs poorly. The researchers suggest that latent variables between the sets of items may be implicated in the low homogeneity of the sections. Overall, the researchers were pleased with the outcome of the PAS-Q, believing that it can be a useful tool to identify PDs in adult psychiatry. They suggest that patients that receive a score of 2 (or higher) should be interviewed detailed structured, or semi-structured, interview for PDs.

 

A perceived limitation of the applicability of the study (regarding use in the United States) is that the PAS-Q only assessed for 8 of the recognized 10 personality disorders from the DSM classification system. Although this is not considered a limitation of the study itself, since an objective of the study was to assess the validity of an instrument grounded in the ICD-10 classification system (and it accounts for the eight primary PDs recognized by the ICD-10). The authors also did not disclose the success rate of the comparative method, the SCID-II. The data regarding which of the participants had a PD was already obtained as all of the participants were preexisting members of the community mental health agency. Therefore the success rate of 81 % from the PAS-Q was held against the prerecorded diagnoses of the patients from the mental health clinic. The article did not mention the success rate of the SCID-II (unless it was to be assumed that the SCID-II had a success rate of 100 % since that was, presumably, the method in which the mental health clinic obtained their diagnoses in the first place). Finally, while the fact that a single interviewer conducted all the interviews is considered a strength of the study, it can also simultaneously be considered a weakness due to time constraints. The clinician conducted all the interviews was forced to conduct a high number of interviews in a relatively low amount of time, therefore some interviews may have been rushed, in addition to the fact that the participants’ background information was not reviewed for any of the cases.

 

Germans, S., Van Heck, G., Hodiamont, P. (2011). Quick Personality Assessment Schedule (PAS-Q): Validation of a brief screening test for personality disorders in a population of psychiatric outpatients.

Australian and New Zealand Journal of Psychiatry, 45, 9, p 756-762

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Friday Factoids: Mandatory Psychological Testing for Disability Claims?

A new report from the Institute of Medicine (IOM) recommends broader standardized psychological testing for applicants that are submitting claims for mental health disabilities to the U.S. Social Security Administration (SSA) with the belief that incorporating additional psychological testing could improve both the accuracy and the consistency of disability determinations. In 2012 the SSA provided disability benefits to approximately 15 million adults and children. Proponents contend that mandatory psychological testing, validity based measures in particular, would result in significantly lower application approval rate, resulting in a substantial cost savings.

 

At the present, state agencies determine eligibility for disability based on medical records in addition to other evidence deemed relevant in an applicant’s case record. Standardized psychological tests that have been conducted are considered to be eligible material permitted for review within an applicant’s case file. Tests assessing validity can be used in conjunction with standardized psychological tests in order to assess whether the individual being evaluated is exerting a genuine effort and/or providing an accurate portrayal of their symptoms. While the SSA recognizes that utility and validity of psychological testing, it currently only requires testing to be conducted in cases pertaining to intellectual disability (ID), as an intelligence quotient (IQ) score is required in order to determine ID eligibility criteria.

 

Currently, SSA policy prevents requiring an applicant to submit psychological testing, but applicants (and their representatives) are permitted to submit psychological testing in support of their claims. It was recommended by the IOM that the SSA adopt a policy that incorporates mandatory standardized, non-cognitive psychological testing for all applicants that purport non-cognitive related impairments. It is their contention that testing should be required when the purported symptoms is based primarily on an applicant’s self-reported symptoms in the absence of objective medical evidence or longitudinal medical records that are considered sufficient to make a determination for disability. At the present, the IOM is gathering more information in order to more accurately offer an approximation of the cost savings that may be gained through mandatory incorporation of psychological testing in disability claims.

 

Faisal Roberts, M.A.

WKPIC Doctoral Intern

 

Nauert PhD, R. (2015). Report Urges More Psychological Testing to Determine Disability Claims. Psych Central. Retrieved on April 13, 2015, from http://psychcentral.com/news/2015/04/13/recommendation-expand-psychological-testing-to-better-determine-disability-status/83466.html

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Accreditation News!

WKPIC is elated to announce that we discovered this on APA’s website today, thanks to former intern David Wright:

 

Western Kentucky Psychology Internship Consortium – Hopkinsville, KY – Effective December 9, 2014
Next site visit 2021

At its meeting on March 19-22, 2015, the APA Commission on Accreditation reviewed the psychology internship program at theWestern Kentucky Psychology Internship Consortium and voted to approve initial accreditation, with the next site visit scheduled 7 years from the date of the program’s last site visit. The 7 year decision is based on CoA’s professional judgment of compliance or substantial compliance with all domains of the Guidelines and Principles for Accreditation (G&P). No serious deficiencies.

 

Reaching for Success

 

 

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Friday Factoids: Are Mental Practice Exercises Beneficial for Individuals that Have Experienced a Stroke?

 

 

Results yielded from a new study conducted by Georgia State University indicates that a person recovering from a recent stroke should undergo both physical therapy and mental practice (also known as motor imagery) in order to gain the most optimal results. Motor imagery is a mental rehearsal of a motor action without actually performing the action (while physical therapy involves using repetitive, task-oriented training on the body part that is impaired). The combination of physical therapy and motor imagery should be used to improve motor movement, balance, and coordination in individuals that have suffered a recent stroke.

 

For participants, the researchers employed the use of 13 older stroke survivors in addition to 17 healthy control participants. The participants from the stroke group were placed in two groups: 1) motor imagery only; or, 2) motor imagery and physical therapy. The treatment was given within 14 to 51 days of the participants’ stroke; each participant experienced 60 total hours of rehabilitation. To assess the effectiveness of each treatment, the participants in the stroke group and the control group underwent functional magnetic resonance imaging (fMRI) scans before and after each treatment.

 

During normal brain functioning, there are multiple cortical areas of the brain that communicate with each other; however, following a stroke, these interactions are disrupted. After a stroke, there is damage to brain cells; it can take a long time for the neurons to grow back, if they grow back at all. Dr. Butler, a faculty member at Georgia State University, stated that when attempting physical therapy many stroke patients are unable to move at all. Therefore the treatment teams often incorporate motor imagery, as if the stroke patients simply think about moving that area of the body, it helps keep the neurons active near the area that died in the brain.  Results obtained from this study indicated that the individuals in the stroke group that participated in both physical therapy and motor imagery had a significant increase in the flow of information between several brain regions.

 

It’s interesting that simply thinking about something can produce such beneficial and even tangible outcomes. What other areas of health can this notion be applied towards?

 

Faisal Roberts, M.A.

WKPIC Doctoral Intern

 

Pedersen, T. (2015). Both Physical Therapy, Mental Practice Important in Stroke Recovery. Psych Central. Retrieved on April 13, 2015, from http://psychcentral.com/news/2015/04/13/both-physical-therapy-mental-practice-important-in-stroke-recovery/83468.html

 

 

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