The role of aberrant salience and alexithymia in psychotic experiences of non-treatment-seeking adolescent immigrants compared with natives

Aberrant salience (AS) is an anomalous world experience which plays a major role in psychotic proneness. In the general population, a deployment of this construct – encompassing personality traits, psychotic-like symptoms, and cannabis use – could prove useful to outline the relative importance of these factors. For this purpose, 106 postgraduate university students filled the AS Inventory (ASI), the Community Assessment of Psychic Experiences (CAPE), the Temperament and Character Inventory (TCI), and the Symptom Checklist 90-Revised (SCL-90-R). Lifetime cannabis users (n = 56) and individuals who did not use cannabis (n = 50) were compared. The role of cannabis use and psychometric indexes on ASI total scores was tested in different subgroups (overall sample, cannabis users, and nonusers). The present study confirmed that cannabis users presented higher ASI scores. The deployment of AS proved to involve positive symptom frequency (assessed through CAPE), character dimensions of self-directedness and self-transcendence (TCI subscales), and cannabis use. Among nonusers, the role of personality traits (assessed through the TCI) was preeminent, whereas positive psychotic-like experiences (measured by means of CAPE) had a major weight among cannabis users. The present study suggests that pre-reflexive anomalous world experiences such as AS are intertwined with reflexive self-consciousness, personality traits, current subclinical psychotic symptoms, and cannabis use. In the present study, subthreshold psychotic experiences proved to play a major role among cannabis users, whereas personality appeared to be more relevant among nonusers.

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Computational Models of Learning Mechanisms in Psychosis

A New Understanding of Mental Disorders ◽

10.7551/mitpress/9780262036894.003.0007 ◽

2017 ◽

Author(s):

Andreas Heinz

Keyword(s):

Mental Disorders ◽

Psychiatric Disorders ◽

Computational Models ◽

The Self ◽

Psychotic Experiences ◽

Learning Mechanisms ◽

Top Down ◽

Bottom Up ◽

Surrounding World

Psychotic experiences may best be described as an alteration in the self-ascription of thoughts and actions, which is associated with a profoundly altered experience of oneself and the surrounding world. Computational models of key symptoms of psychiatric disorders are discussed with respect to the attribution of salience and self-relatedness to otherwise irrelevant stimuli and the role of top-down modelling in the generation of delusions. Top-down and bottom-up approaches in understanding mental disorders and their computational models are compared and critically reflected.

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Assessing the role of the private sector in surveillance for malaria elimination in Haiti and the Dominican Republic: a qualitative study

Malaria Journal ◽

10.1186/s12936-019-3024-3 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Abigail Sidibe ◽

Alysse Maglior ◽

Carmen Cueto ◽

Ingrid Chen ◽

Arnaud Le Menach ◽

...

Keyword(s):

Malaria Elimination ◽

Health Sector ◽

Traditional Healers ◽

Treatment Seeking ◽

Care Seeking ◽

Private Providers ◽

Private Health Sector ◽

Ongoing Support ◽

Care Seeking Behaviour

Abstract Background Haiti and the Dominican Republic (DR) are targeting malaria elimination by 2022. The private health sector has been relatively unengaged in these efforts, even though most primary health care in Haiti is provided by non-state actors, and many people use traditional medicine. Data on private health sector participation in malaria elimination efforts are lacking, as are data on care-seeking behaviour of patients in the private health sector. This study sought to describe the role of private health sector providers, care-seeking behaviour of individuals at high risk of malaria, and possible means of engaging the private health sector in Hispaniola’s malaria elimination efforts. Methods In-depth interviews with 26 key informants (e.g. government officials), 62 private providers, and 63 patients of private providers, as well as 12 focus group discussions (FGDs) with community members, were conducted within seven study sites in Haiti and the DR. FGDs focused on local definitions of the private health sector and identified private providers for interview recruitment, while interviews focused on private health sector participation in malaria elimination activities and treatment-seeking behaviour of febrile individuals. Results Interviews revealed that self-medication is the most common first step in the trajectory of care for fevers in both Haiti and the DR. Traditional medicine is more commonly used in Haiti than in the DR, with many patients seeking care from traditional healers before, during, and/or after care in the formal health sector. Private providers were interested in participating in malaria elimination efforts but emphasized the need for ongoing support and training. Key informants agreed that the private health sector needs to be engaged, especially traditional healers in Haiti. The Haitian migrant population was reported to be one of the most at-risk groups by participants from both countries. Conclusion Malaria elimination efforts across Hispaniola could be enhanced by engaging traditional healers in Haiti and other private providers with ongoing support and trainings; directing educational messaging to encourage proper treatment-seeking behaviour; and refining cross-border strategies for surveillance of the high-risk migrant population. Increasing distribution of rapid diagnostic tests (RDTs) and bi-therapy to select private health sector facilities, accompanied by adopting regulatory policies, could help increase numbers of reported and correctly treated malaria cases.

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