scholarly journals A Theoretical Framework for Evaluating Psychiatric Research Strategies

2017 ◽  
Vol 1 ◽  
pp. 184-207 ◽  
Author(s):  
Kentaro Katahira ◽  
Yuichi Yamashita
Keyword(s):  
Mental Disorders ◽  
Statistical Power ◽  
Computational Models ◽  
Diagnostic Category ◽  
Theoretical Framework ◽  
Research Strategy ◽  
Psychiatric Research ◽  
Research Strategies ◽  
Advantages And Disadvantages ◽  
Diagnostic Categories

One of the major goals of basic studies in psychiatry is to find etiological mechanisms or biomarkers of mental disorders. A standard research strategy to pursue this goal is to compare observations of potential factors from patients with those from healthy controls. Classifications of individuals into patient and control groups are generally based on a diagnostic system, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases ( ICD). Several flaws in these conventional diagnostic-based approaches have been recognized. The flaws are primarily due to the complexity in the relation between the pathogenetic factors (causes) and disorders: The current diagnostic categories may not reflect the underlying etiological mechanisms. To overcome this difficulty, the National Institute of Mental Health initiated a novel research strategy called Research Domain Criteria (RDoC), which encourages studies to focus on the neurobiological mechanisms and core aspects of behavior rather than to rely on traditional diagnostic categories. However, how RDoC can improve research in psychiatry remains a matter of debate. In this article, we propose a theoretical framework for evaluating psychiatric research strategies, including the conventional diagnostic category-based approaches and the RDoC approach. The proposed framework is based on the statistical modeling of the processes of how the disorder arises from pathogenetic factors. This framework provides the statistical power to quantify how likely relevant pathogenetic factors are to be detected under various research strategies. On the basis of the proposed framework, we can discuss which approach performs better in different types of situations. We present several theoretical and numerical results that highlight the advantages and disadvantages of the strategies. We also demonstrate how a computational model is incorporated into the proposed framework as a generative model of behavioral observations. This demonstration highlights how the computational models contribute to designing psychiatric studies.

Assessing the opinions and experiences of German-speaking psychiatrists regarding necessary changes for the 11th revision of the mental disorders chapter of the international classification of disorders (ICD-11)

2010 ◽  
Vol 25 (8) ◽  
pp. 437-442 ◽  
Author(s):  
J. Zielasek ◽  
H.J. Freyberger ◽  
M. Jänner ◽  
H.P. Kapfhammer ◽  
N. Sartorius ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Attention Deficit Disorder ◽  
Goodness Of Fit ◽  
Diagnostic Category ◽  
International Classification ◽  
Free Text ◽  
Diagnostic Categories ◽  
German Speaking ◽  
Icd 10

AbstractWe performed an Internet-based questionnaire survey of the opinions of German-speaking psychiatrists regarding the experiences with the 10th revision of the international classification of mental disorders (chapter F of ICD-10). We received 304 completed questionnaires including more than 500 free-text comments. The responding group was characterized by professionally experienced middle-aged psychiatrists. German-speaking psychiatrists were comparatively content with ICD-10. Most diagnostic categories received a “satisfied” or “very satisfied” rating by the majority of respondents. Negative “goodness of fit” ratings – a possible indicator of the need for revision – were not higher than 50% for any category. Based on free-text entries, neurasthenia was the single diagnostic category most often suggested for deletion in ICD-11. Changes were considered necessary mainly for dementias and personality disorders. Adult attention deficit disorder and narcissistic personality disorder were the two diagnostic categories most frequently suggested to be added as new categories. This study provides valuable information related to perceived clinical utility of the classification, though with a narrow sample. Information about clinicians’ experiences should be combined with scientific evidence for the revision process of ICD-11.

scholarly journals Portrayals of mental disorders in music: How are the studied?

2021 ◽  
Author(s):  
Fabián Pavez ◽  
Erika Saura ◽  
Gemma Pérez ◽  
Pedro Marset
Keyword(s):  
Mental Health ◽  
Content Analysis ◽  
Mental Disorders ◽  
Quantitative Methods ◽  
Qualitative Content Analysis ◽  
Social Representations ◽  
Research Strategy ◽  
Research Strategies ◽  
The Social ◽  
Song Lyrics

Introduction and Objectives. The importance of the study of social representations of mental disorders and psychiatry in music, and particularly in songs lyrics, have been discussed in previous communications. It is a small-explored topic, and most published articles do not exhibit a rigorous research methodology. In this communication, we review the methods used in published studies addressing depictions of mental disorders or mental health concerns in music (advantages and limitations); in order to propose a framework for the study of the social representations of psychiatry and mental disorders in song lyrics. Methods. Descriptive study. Methods used in thirty-seven articles addressing the depictions of mental disorders or mental health issues in music were reviewed. Frequencies of the research methods used are provided. Finally, a theoretical review of the advantages and limitations of different research strategies was performed. Results/Conclusion. Research designs are heterogenous between studies. Despite Content Analysis was the most frequent research strategy identified, there is a high representation of opinion articles or essays. Quantitative methods are rarely used (if we consider Content Analysis as a Qualitative Strategy). Content analysis is frequently used in studies addressing exposition to risk factors (mostly, depictions of substance use). We propose a mixed method by using descriptive statistics (frequency measures of references to mental disorders in song lyrics, that is a quantitative content analysis), followed by qualitative content analysis and thematic analysis. This strategy allows a deeper approximation to the contents, favoring the access to the social meanings of psychiatry or mental disorders expressed throught music.

Problems of psychopathologic systematics: alternative approaches and clinical practice requests

2020 ◽  
Vol LII (2) ◽  
pp. 20-28
Author(s):  
Мikhail L. Zobin ◽  
Natalia V. Ustinova
Keyword(s):  
Clinical Practice ◽  
Mental Disorders ◽  
Conceptual Framework ◽  
Reliability And Validity ◽  
Research Domain Criteria ◽  
Advantages And Disadvantages ◽  
Diagnostic Categories ◽  
Clinical Instability ◽  
Alternative Approaches ◽  
Research Domain

The reliability and validity of traditional classifications give rise to justifiable criticism because of the conventionality of the boundaries between norm and pathology, fuzzy delimitation of disorders and their frequent co-occurrence, heterogeneity and clinical instability of symptoms within the diagnostic categories. There is little evidence that the majority of mental disorders are discrete entities. Discontent with the expert consensus classifications have led to attempts at a new quantitative and empirical systematization of psychopathology. Two alternative projects have been proposed: Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP). The aim of the paper is to clarify the conceptual framework of RDoC and HiTOP, discuss their advantages and disadvantages in terms of the prospects for use in clinical practice.

Consortium-Based Consultation/Liaison Research: Commentary and Perspective

1988 ◽  
Vol 17 (3) ◽  
pp. 237-248 ◽  
Author(s):  
Jeffrey S. Hammer ◽  
James J. Strain ◽  
John Petraitis
Keyword(s):  
Psychiatric Morbidity ◽  
Cost Benefit ◽  
Basic Research ◽  
Research Strategy ◽  
Research Strategies ◽  
Liaison Psychiatry ◽  
Prevalence Studies ◽  
Advantages And Disadvantages ◽  
Benefit Evaluation ◽  
Research Consortium

Although a consortium approach for clinical trials is a common research strategy which has made important contributions in other disciplines in medicine, to date it has not been employed for research efforts in the consultation/liaison setting. There are several reasons for this: the relative newness of the field, lack of administrative control over patient care, and the unavailability of a standard methodology that could be adapted to multiple sites. Four basic research strategies can be employed within the framework of a research consortium to advance scientific knowledge in consultation/liaison psychiatry: 1) prevalence studies of psychiatric morbidity in medical settings; 2) interrelationship among psychiatric and medical conditions; 3) the outcome of psychiatric interventions within medical milieu; and, 4) cost-benefit evaluation. A field-tested computerized database protocol and a software system useable on an office-based microcomputer were employed to obtain standardized data across multiple training sites. The advantages and disadvantages of consortium studies are described.

Pre-morbid IQ in mental disorders: a Danish draft-board study of 7486 psychiatric patients

2009 ◽  
Vol 40 (4) ◽  
pp. 547-556 ◽  
Author(s):  
A. Urfer-Parnas ◽  
E. Lykke Mortensen ◽  
D. Sæbye ◽  
J. Parnas
Keyword(s):  
Mental Disorders ◽  
Psychiatric Patients ◽  
Diagnostic Category ◽  
Mental Illnesses ◽  
Stress Disorders ◽  
Psychiatric Disease ◽  
Diagnostic Categories ◽  
Functional Patterns ◽  
The Relationship ◽  
Normal Controls

BackgroundLongitudinal studies indicate that future schizophrenia patients exhibit lower IQ than healthy controls. Recent studies suggest that future patients with other mental illnesses obtain lower pre-morbid IQ. The aims of this study were to compare pre-morbid IQ among five diagnostic categories and normal controls, to examine the distribution of pre-morbid IQ, and to investigate the relationship between pre-morbid IQ and risk of mental illness.MethodA total of 7486 individuals hospitalized with psychiatric disease and 20 531 controls. IQ was measured at the draft board and hospital diagnoses [schizophrenia (Sz), non-schizophrenic, non-affective psychoses (NSAP), affective (AD), personality (PD) and neurotic/stress disorders (ND)] were followed up to ages 43–54 years. Individuals hospitalized ⩽1 year after appearing before the draft board were excluded.ResultsAll future patients obtained significantly lower pre-morbid IQ than controls (3–7 IQ points), AD had the highest IQ and PD the lowest. In each diagnostic category, decreasing IQ was associated with an increasing risk of becoming a patient [odds ratios (ORs) 0.5–2.5 over the full IQ spectrum]. IQ distributions was nearly normal and uni-modal.ConclusionsIQ deficits in each diagnostic category may reflect different functional patterns and temporal vicissitudes of the specific pathogenetic processes involved in different mental disorders.

Suicidality and Treatment Experience Among Young People Who Inject Drugs

2020 ◽  
Author(s):  
Mary Ellen Mackesy-Amiti ◽  
Lawrence J. Ouellet
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Young People ◽  
Mental Disorders ◽  
Mental Health Treatment ◽  
People Who Inject Drugs ◽  
Multivariable Analysis ◽  
Psychiatric Research ◽  
Health Treatment ◽  
The Past

Background. We examined correlates of past year suicidal thoughts and behavior (STB) and described past year treatment experiences among young people who inject drugs (PWID). Methods. Participants were 570 adults (18-25 years) who injected primarily heroin. Interviews were conducted at field stations operated by Community Outreach Intervention Projects in Chicago, Illinois (USA). Interviewers administered the Psychiatric Research Instrument for Substance and Mental Disorders. Substance use and mental disorders were based on DSM-IV diagnostic criteria. Past year STB was based on multiple questions. Results. Sixteen percent of men and 25% of women reported STB in the past year. In multivariable analysis, STB was associated with non-heterosexual orientation, foster care, and being raised by two parents. Primary major depression, post-traumatic stress disorder, other anxiety disorders, and borderline personality disorder had independent effects on suicidality. Among those reporting past year STB (n=111), 83% ever received mental health treatment, while 44% did so in the past year. While 24% of respondents indicated that at least one treatment matched their needs very well, 30% reported treatment that did not match their needs at all. The most common reason for ending treatment was program completion (about 50%) while getting better was endorsed by about 25%. Nearly half reported ending treatment due to a bad experience, logistical issues, or expense. Conclusions. Young PWID are at high risk for suicidal behavior and their mental health treatment experiences often do not meet their needs. There is a pressing need for more integrated substance use and mental health treatment.

scholarly journals Integrating qualitative research methodologies and phenomenology—using dancers’ and athletes’ experiences for phenomenological analysis

2021 ◽  
Author(s):  
Susanne Ravn
Keyword(s):  
Qualitative Research ◽  
Research Strategy ◽  
Subjective Experiences ◽  
Research Strategies ◽  
Research Methodologies ◽  
Second Person ◽  
Person Perspective ◽  
Moving Body ◽  
Emic Perspective ◽  
Second Person Perspective

AbstractThis paper sets out from the hypothesis that the embodied competences and expertise which characterise dance and sports activities have the potential to constructively challenge and inform phenomenological thinking. While pathological cases present experiences connected to tangible bodily deviations, the specialised movement practices of dancers and athletes present experiences which put our everyday experiences of being a moving body into perspective in a slightly different sense. These specialised experiences present factual variations of how moving, sensing and interacting can be like for us as body-subjects. To use of these sources inevitably demands that qualitative research methodologies – especially short-term ethnographical fieldwork – form part of the research strategy and qualify the way the researcher involves a second-person perspective when interviewing dancers and athletes about their experiences. In the subsequent phases analysing the data generated, I argue that researchers first strive to achieve internal consistency of empirical themes identified in the case of movement practices in question thus keeping to a contextualised and lived perspective, also denoted as an emic perspective. In subsequent phases phenomenological insights are then actively engaged in the exploration and discussion of the possible transcendental structures making the described subjective experiences possible. The specialised and context-defined experiences of ‘what a moving body can be like’ are accordingly involved as factual variations to constructively add to and potentially challenge phenomenological descriptions. Lastly, I exemplify how actual research strategies have been enacted in a variety of projects involving professional dancers’, golfers’ and sports dancers’ practices and experiences, respectively.

scholarly journals Impact of ethnic density on adult mental disorders: narrative review

2012 ◽  
Vol 201 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Richard J. Shaw ◽  
Karl Atkin ◽  
Laia Bécares ◽  
Christo B. Albor ◽  
Mai Stafford ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Ethnic Minority ◽  
Asian American ◽  
Statistical Power ◽  
Narrative Review ◽  
American People ◽  
Ethnic Density ◽  
Minority Adolescents ◽  
Multilevel Studies

BackgroundThe ‘ethnic density hypothesis' is a proposition that members of ethnic minority groups may have better mental health when they live in areas with higher proportions of people of the same ethnicity. Investigations into this hypothesis have resulted in a complex and sometimes disparate literature.AimsTo systematically identify relevant studies, summarise their findings and discuss potential explanations of the associations found between ethnic density and mental disorders.MethodA narrative review of studies published up to January 2011, identified through a systematic search strategy. Studies included have a defined ethnic minority sample; some measure of ethnic density defined at a geographical scale smaller than a nation or a US state; and a measure ascertaining mental health or disorder.ResultsA total of 34 papers from 29 data-sets were identified. Protective associations between ethnic density and diagnosis of mental disorders were most consistent in older US ecological studies of admission rates. Among more recent multilevel studies, there was some evidence of ethnic density being protective against depression and anxiety for African American people and Hispanic adults in the USA. However, Hispanic, Asian–American and Canadian ‘visible minority’ adolescents have higher levels of depression at higher ethnic densities. Studies in the UK showed mixed results, with evidence for protective associations most consistent for psychoses.ConclusionsThe most consistent associations with ethnic density are found for psychoses. Ethnic density may also protect against other mental disorders, but presently, as most studies of ethnic density have limited statistical power, and given the heterogeneity of their study designs, our conclusions can only be tentative.

scholarly journals Natural kinds of mental disorder

Synthese ◽  
2021 ◽  
Author(s):  
Sander Werkhoven
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mental Health Problems ◽  
Natural Kinds ◽  
Health Problems ◽  
Abnormal Behaviour ◽  
Diagnostic Categories ◽  
Socially Constructed

AbstractAre mental disorders (autism, ADHD, schizophrenia) natural kinds or socially constructed categories? What is at stake if either of these views prove to be true? This paper offers a qualified defence for the view that there may be natural kinds of mental disorder, but also that the implications of this claim are generally overestimated. Especially concerns about over-inclusiveness of diagnostic categories and medicalisation of abnormal behaviour are not addressed by the debate. To arrive at these conclusions the paper opens with a discussion of kind formation in science, followed by an analysis of natural kinds. Seven principled and empirically informed objections to the possibility of natural kinds of mental disorder are considered and rejected. The paper ends with a reflection on diagnostics of mental health problems that don’t fall into natural kinds. Despite the defence of the possibility of natural kinds of mental disorder, this is likely to be the majority of cases.

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