research-in-mental-health

David Earl Johnson, LICSW

1 minute read

Image by angela7dreams via FlickrI tripped over an article at Psych Central News describing some recent research on sexist humor. “…those who had listened to sexist jokes were much more tolerant with male battering than those who had not.” The results ring true. I have found domestic violence, even street violence is justified in the mind of the offender by disrespect. People in general tend to diminish in importance even dehumanize a party they wish to assault.

David Earl Johnson, LICSW

3 minute read

Image via Wikipedia I very much enjoyed recent exchange on [Psychotherapy Brown Bag][1]. I find myself frequently thinking of the implications of our approach to research and how it contributes to our understanding of psychology. “Intuition is, by no means, useless. A half-century ago, Karl Popper (1959) gave an answer to this that today remains powerfully compelling. Intuition, inductive reasoning, and philosophical theories are extremely valuable as the first step of a multi-step process.

David Earl Johnson, LICSW

27 minute read

ResearchBlogging.org Aaron Beck, considered the Father of Cognitive Therapy, is an American psychiatrist and a professor emeritus at the Department of Psychiatry at the University of Pennsylvania. He is President of the Beck Institute for Cognitive Therapy and Research that is directed by his daughter, Judith S. Beck, Ph.D.. He is noted for his research in psychotherapy, psychopathology, suicide, and psychometrics, and the Beck Depression Inventory (BDI), one of the most widely used instruments for measuring depression severity. At age 87, the man is still publishing, building on his pioneering work on the cognitive model of depression. In his latest article published in the American Journal of Psychiatry, he recalls his early work:

Caught up with the contagion of the times, I was prompted to start something on my own. I was particularly intrigued by the paradox of depression. This disorder appeared to violate the time-honored canons of human nature: the self-preservation instinct, the maternal instinct, the sexual instinct, and the pleasure principle. All of these normal human yearnings were dulled or reversed. Even vital biological functions like eating or sleeping were attenuated. The leading causal theory of depression at the time was the notion of inverted hostility. This seemed a reasonable, logical explanation if translated into a need to suffer. The need to punish one’s self could account for the loss of pleasure, loss of libido, self-criticism, and suicidal wishes and would be triggered by guilt. I was drawn to conducting clinical research in depression because the field was wide open–and besides, I had a testable hypothesis. I decided at first to make a foray into the “deepest” level: the dreams of depressed patients. I expected to find signs of more hostility in the dream content of depressed patients than nondepressed patients, but they actually showed less hostility. I did observe, however, that the dreams of depressed patients contained the themes of loss, defeat, rejection, and abandonment, and the dreamer was represented as defective or diseased. At first I assumed the idea that the negative themes in the dream content expressed the need to punish one’s self (or “masochism”), but I was soon disabused of this notion. When encouraged to express hostility, my patients became more, not less, depressed. Further, in experiments, they reacted positively to success experiences and positive reinforcement when the “masochism” hypothesis predicted the opposite (summarized in Beck). Some revealing observations helped to provide the basis for the subsequent cognitive model of depression. I noted that the dream content contained the same themes as the patients’ conscious cognitions–their negative self-evaluations, expectancies, and memories–but in an exaggerated, more dramatic form. The depressive cognitions contained errors or distortions in the interpretations (or misinterpretations) of experience. What finally clinched the new model (for me) was our research finding that when the patients reappraised and corrected their misinterpretations, their depression started to lift and–in 10 or 12 sessions–would remit.” We owe a lot to Dr. Beck. His cognitive model of depression still dominates how I and most of my colleagues write treatment plans for persons suffering with depression. Our goal is to inspire and teach our clients to change their negative self-evaluations, correct distorted memories, and create an expectation of success. The only problem is depression is not that simple. Try as they might, many clients are able to recognize what they need to do, understand how their thoughts about themselves and their world need to change, are able to state those changes, and diligently practice them. But when they really need to be able to master their fate, when ruminative thoughts spiral downward into the depths of depression, their efforts quickly collapse and they succumb. So is the Cognitive Model of Depression wrong? No, I think it’s incomplete. There is the biomedical model of depression involving errant neurotransmitter levels treated by various anti-depressants. That discussion is beyond this article’s purpose. I’m more interested in what we as therapists can do differently in the counseling office. Of course we need to be sure a severely depressed client is referred for a medication review. But I want to know how we might better facilitate our clients attempts to master their mood. To this end, I will review my recent reading on the subject of emotion and argue to include emotion in a new Cognitive Theory.

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David Earl Johnson, LICSW

3 minute read

Image via Wikipedia Hat tip to Psych Central for an report on a higher than expected prevalence of suicidal thoughts among college students. Researchers surveyed 26,000 students across 70 colleges and universities. Half reported having at least one episode of suicidal thinking at some point in their lives. Fifteen percent of students surveyed reported having seriously considered attempting suicide and more than 5 percent attempted at least once. “Presenting at the 116th Annual Convention of the American Psychological Association, psychologist David J.

David Earl Johnson, LICSW

2 minute read

Finally, researchers have gotten beyond finding the “one cause” or “sure-fire cure” for the various forms of mental illness. It has always been futile to find a particular biological cause. Clinicians practicing in the field have been aware of the complexity of development. It makes much more sense to look in several directions at once, for resilience, risk factors and biologically based vulnerabilities to particular symptom clusters. Mental illness is caused by a complicated combination of developmental and environmental stressors and biological strengths and weaknesses.

David Earl Johnson, LICSW

2 minute read

SAMHSA released incidence statistics for depression over the the years of 2004 and 2005. Statistics were sorted by age and state and included all individuals who experienced at least one major depressive episode (MDE) in the past year. Youths aged 12 to 17 had a higher rate of incidence at 8.88 percent. Adults aged 18 or older were measured at 7.65 percent. But thats not all. The data demonstrates a confusing variation in the rate by state.

David Earl Johnson, LICSW

2 minute read

Hallucinations and odd ideas are much more common than the psychosis the text books would have us believe. For too long, Some of us may have suspected this all along. I’ve seen well meaning psychiatrists diagnose as schizophrenic, and medicate with powerful anti-psychotics, people who were experiencing one or both. Sometimes these experiences are signs of a history of abuse, neglect or trauma. Sometimes it’s a product of odd beliefs within a family where such experiences are common and expected.

David Earl Johnson, LICSW

5 minute read

I’m very excited about a new venture I’m hosting at ePsyQ.com. I’ve had an interest in research for a long time, but my work in direct practice and management always came first. Now I’ve found a passion for online building, and frankly find it far more entertaining than television. My interest was piqued by an article from NIMH I tripped over a couple weeks ago. A long-term, large-scale study has found that an Internet-based intervention program may prevent some high risk, college-age women from developing an eating disorder.

David Earl Johnson, LICSW

7 minute read

UPDATE: Click Here. Today, perusing the various RSS news I get daily, I tripped over this article, in ScienceDaily. A search of the University of Manchester web site produced no mention of this work. A Google search found the apparent original source, a press release by the U of M. The article is a particularly disturbing example of the press distributing prepublication reports of results before the academic community has an opportunity to review the study.