Why is formulation daunting? A response to Bagster et al.’s ‘instructions’ for developing skills in formulation

Objective: To explore the theme identified by Bagster et al.1 in their selective psychiatric literature review that formulation can appear daunting. Conclusion: Formulation is understandably daunting, even though it occurs in all human encounters. The plural nature of mental symptoms is such that anxiety-provoking intuitive judgement is required at all points in both the process and explication of formulation, a type of instinctive guessing. There are no rules for this, because the laws of vertical integration of systems are not established. Guidelines are more appropriate than ‘instructions’. Much of the wider mental health and clinical reasoning literature addresses intuitive judgement, but the current psychiatric literature tends to focus on pattern recognition as a deliberative cognitive act of Type 2 processes. Arguably this reductionism adds to the dauntingness. Anxiety detected about the intuitive judgement involved can be addressed in supervision, taking into account the psychological mindedness of the trainee.

Relationships between Psychopathology, Psychological Process Variables, and Sociodemographic Variables and Comparison of Quarantined and Non-Quarantined Groups of Malaysian University Students in the COVID-19 Pandemic

The COVID-19 pandemic has had considerable psychological health impacts across the globe. This study aimed to establish the psychological process variables underlying psychopathology in Malaysian public university students during the national Movement Control Order (MCO). The aim was to craft structured and sustainable psychological support programs with these students. We conducted a cross-sectional study involving Malaysian university students subjected to the Malaysian MCO. Structured questionnaires measuring sociodemographic factors, measures of depression, anxiety, stress, psychological mindedness, psychological flexibility and state mindfulness were employed. A total of 515 students participated in this study with 12 students (2.3%) being quarantined at the time. Many of them scored ‘moderate’ or above on the Depression, Anxiety and Stress Scale (DASS) with 20.2%, 25.0% and 14.2%, respectively. Quarantined students had higher depressive symptoms, with female students scoring significantly higher for depression, anxiety, and stress. Multiple regressions suggested gender and quarantine status predicted depression scores. However, only gender significantly predicted anxiety and stress. Psychological flexibility and psychological mindedness (Insight subscale) are significantly correlated with depression, anxiety, and stress, with psychological mindedness predicting all three psychopathologies. This study demonstrates that gender, psychological flexibility, and psychological mindedness are key demographic and psychological factors impacting students. Targeting psychological flexibility and psychological mindedness may enable timely prevention and intervention programs for our students to support their mental and physical health as we move through, and out of, the pandemic.

Comparative Changes in Psychological Mindedness, Mindfulness, and Concordance Attitudes between Online and Face-to-Face Undergraduate Psychiatry Education in a University in Borneo, Malaysia

Introduction: Psychiatry posting is one of essential posting for medical students in Universiti Malaysia Sabah. Apart from learning about mental health disorder, students are also exposed to various psychotherapies techniques are crucial in psychiatric practise. However, in view of COVID-19, online learning had to be adopted, instead of the traditional face-to-face learning. Methods: The study aimed to assess the difference in diverse psychological constructs, such as psychological mindedness, flexibility, and mindfulness; pre- & post-psychiatry posting, and to determine whether online learning was comparable to face-to-face learning. The study was done on 58 undergraduate medical student populations, utilizing a set of scales to determine the psychological constructs, viz., balanced Index of psychological mindedness, Leeds attitudes to Concordance Scale II (LATCon II), the mindful attention awareness scale, and the acceptance and action questionnaire-II, which were administered before & after completion of the posting. Results: Results were subsequently analysed using IBM SPSS. Interestingly, both control group (mean difference= 15.155, p= 0.004) and online psychiatry posting (mean difference 12.691, p= 0.014) had higher mindfulness level when compared to face-to-face psychiatry posting. Despite the common perception that psychiatry posting raises awareness regarding mental health, it was found that there were no significant differences in psychological constructs pre- and post-psychiatry posting. Interestingly, the online psychiatry posting also found to be as effective as the face-to-face psychiatry posting. Conclusion: This study highlighted the applicability of online learning in psychiatry, which could be crucial in maintaining continuity of learning during these uncertain times.

Validation of Bahasa Malaysia Version of Psychological Mindedness in a University Population

INTRODUCTION: Psychological mindedness concept is widely accepted to be significantly correlated to psychological strength and mental health. There are multiple scales that attempted to measure psychological mindedness objectively, with the most recent one being Balanced Index of Psychological Mindedness (BIPM). Psychological mindedness is an area of interest in psychiatry and psychology in Malaysia. Hence, this study aims to validate the Bahasa Malaysia Version of Balanced Index of Psychological Mindedness (BIPM-M). MATERIALS AND METHODS: The 14-items scale was translated according to World Health Organization guidelines. 141 participants were recruited from the university population. Participants were required to fill the basic demographic information, as well as Bahasa Malaysia version of Balanced Index of Psychological Mindedness, and two other scales, namely Mindful Awareness Attention Scale (MAAS), and Acceptance and Action Questionnaire-II Scale (AAQ-II). RESULTS: BIPM-M showed excellent internal consistency with Cronbach α of 0.87. As per the original BIPM, the Bahasa Malaysia version also suggested two factor structures in this scale. BIPM-M was significantly correlated with AAQ-II. Conclusion: BIPM-M is a psychometrically sound instrument that can be utilized to assess the psychological mindedness among Malaysians, and certainly enhance the array of psychological assessments available as Malaysia faces the mental health after-effect of COVID-19.

SERBIAN ADAPTATION OF THE PSYCHOLOGICAL MINDEDNESS SCALE - PSYCHOLOGY STUDENTS SAMPLE

The purpose of this research was to evaluate the quality criteria and the factor structure of the Serbian translation of the Psychological Mindedness Scale (PMS) (Shill and Lumley, 2002). In this paper we offer the detailed description of the translation and validation procedures we fallowed. Psychological Mindedness outlines the interest as well as the ability of an individual to introspectively reflect on emotions and conflicts. The sample consisted of 166 university students. Results indicate good psychometric propperties. Internal consitancy is good. Explorative factor analysis suggested that a four factor solution is better that the original five factor, because of fewer cross-loadings and better content validity of the factors. Good convergent validity was demonstrated by a strong negative correlation between the whole PMS, and all four factors separately, and Toronto Alexithymia Scale (TAS-20). Perspectives for further improvement of the instrument and its application in therapeutic process are discussed in the conclusion.