The exploration of factors relevant to enhancing mental health service provision and psychological therapies for persons of South Asian origin

Background: Community participation is one element of the recovery process for people with schizophrenia, however little is known about how this occurs for persons of South Asian origin. Aims/objectives: This study explores the concept and experience of community participation and recovery amongst South Asians with schizophrenia living in Toronto, Canada. Methods: This longitudinal study took place over the course of eight months. Seven people of South Asian origin with schizophrenia were recruited through purposeful sampling strategy and interviewed at three time points. A theoretical sampling approach was employed to recruit 19 key supports and community members who were interviewed at least once during the course of the study in an effort to capture multi-level perspectives of persons of South Asian origin. Qualitative data was analysed using social constructionist Grounded Theory informed by Charmaz. Results: A rigorous grounded theory approach revealed five themes; i) cultivating an autonomous self within the collectivist family-based culture, ii) cultural conceptualizations of self and mental illness, iii) developing individual ethnic identity and sense of belonging in a community context, iv) points of exclusion in the community, v) points of inclusion in the community. These five themes interlinked, creating a complex dynamic between individuals, families, various communities’ people belonged to and, in turn, experience of mental health. The multi-level approach to data collection provided insight into the many systems and structures that impact on this community. These experiences shaped identity, self-concept, perceptions of self as well as other racial/ethnic groups, and in turn the spaces, places and people interacted with. Spaces that provided acceptance and inclusion also facilitated the cultivation of an empowered sense of self. Conclusions: Provider efforts to encourage community participation and recovery for persons of South Asian origin with schizophrenia should take into account the multiple and intersecting aspects of individual identity as well as those at a community level. A multi-level approach informed by social capital theory could lead to the promotion of social inclusion and integration of persons with schizophrenia. It is recommended that this strategy focus on three areas; i) advancing mental health service provision and psychological therapies, ii) education and training of health professionals and community members for example faith leaders, iii) local and national policy that addresses poverty and mandates services to address the specific needs of mental health in South Asian communities

The Effectiveness of the Personality Assessment Inventory in Detecting Exaggerated Psychological Symptoms of Traumatic Brain Injury.

Background: In this study the identification of exaggerated psychological symptoms of traumatic brain injury (TBI) is suggested as an additional method in strengthening the detection of Malingered Neurocognitive Dysfunction. Objective: The aim of this study was to evaluate the effectiveness of the Personality Assessment Inventory (PAI) in detecting exaggerated psychological symptoms of TBI. Method: A three-group simulation quasi-experimental design was used to compare outcomes on the eleven Clinical scales of the PAI, and three Validity indices: Negative Impression Scale (NIM), Malingering Index (MAL), and Rogers Discriminant Function (RDF). The three participant groups included a TBI group (n=30), a control group (n=30), and a simulator group (n=30). The ability of the Validity indices to detect exaggerators (simulator group), and accurately detect non-exaggerators (TBI and healthy group) was examined. Results: Overall, no evidence of difference was found between the simulator and TBI group on the eleven Clinical scales, or on the NIM index. Differences were found between the TBI and control group, and the simulator and control group, on six of the Clinical scales and the NIM index. No difference was found between all three participant groups on the MAL index. The RDF index yielded a significant difference between the TBI and simulator group. On the whole, all three of the Validity indices, at suggested cut-offs indicating exaggerated psychological symptoms, showed limited ability to accurately detect exaggerators (simulator group), and undesirable to perfect ability to accurately detect non-exaggerators (TBI and control group). Conclusions: The results showed that the TBI group expressed specific psychological difficulties in comparison to the control group, and these difficulties were closely replicated by the simulator group. Results also showed limited utility of the PAI as a measure of detecting exaggerated psychological symptoms of TBI

The Effectiveness of the Personality Assessment Inventory in Detecting Exaggerated Psychological Symptoms of Traumatic Brain Injury.

Background: In this study the identification of exaggerated psychological symptoms of traumatic brain injury (TBI) is suggested as an additional method in strengthening the detection of Malingered Neurocognitive Dysfunction. Objective: The aim of this study was to evaluate the effectiveness of the Personality Assessment Inventory (PAI) in detecting exaggerated psychological symptoms of TBI. Method: A three-group simulation quasi-experimental design was used to compare outcomes on the eleven Clinical scales of the PAI, and three Validity indices: Negative Impression Scale (NIM), Malingering Index (MAL), and Rogers Discriminant Function (RDF). The three participant groups included a TBI group (n=30), a control group (n=30), and a simulator group (n=30). The ability of the Validity indices to detect exaggerators (simulator group), and accurately detect non-exaggerators (TBI and healthy group) was examined. Results: Overall, no evidence of difference was found between the simulator and TBI group on the eleven Clinical scales, or on the NIM index. Differences were found between the TBI and control group, and the simulator and control group, on six of the Clinical scales and the NIM index. No difference was found between all three participant groups on the MAL index. The RDF index yielded a significant difference between the TBI and simulator group. On the whole, all three of the Validity indices, at suggested cut-offs indicating exaggerated psychological symptoms, showed limited ability to accurately detect exaggerators (simulator group), and undesirable to perfect ability to accurately detect non-exaggerators (TBI and control group). Conclusions: The results showed that the TBI group expressed specific psychological difficulties in comparison to the control group, and these difficulties were closely replicated by the simulator group. Results also showed limited utility of the PAI as a measure of detecting exaggerated psychological symptoms of TBI

Validation of the MUSIC Model of Motivation Inventory for use with cognitive training for schizophrenia spectrum disorders:A multinational study

AimLow motivation is a core symptom of schizophrenia which significantly impacts successful engagement in and benefit from psychosocial treatments. Therefore, it is important for clinicians to design psychosocial treatments to effectively motivate and engage patients during the treatment. The MUSIC® Model of Academic Motivation Inventory (MMI) is an 18-item instrument with five scales that assess students' motivation during academic tasks. The objective of the current study was to validate the MMI for use with schizophrenia-spectrum patients undergoing cognitive training.MethodsParticipants included 181 people with schizophrenia spectrum disorders enrolled in cognitive training in four countries. A confirmatory factor analysis (CFA) assessed construct validity. Quality of fit was determined using the Comparative Fit Index (CFI), the Standardized Root Mean Square Residual (SRMR), and the Root Mean Square Error of Approximation (RMSEA). Pearson's correlation coefficients assessed construct validity and Cronbach's alphas assessed reliability. Furthermore, we examined factor loadings for each inventory item and assessed predictive validity by analyzing MMI scales with attendance outcomes.ResultsConsistent with the original MMI validation studies used in academic settings, we found CFI values indicated a good fit, as did the SRMR and RMSEA values. The scales were correlated yet distinct. Cronbach's alpha values ranged from good to excellent and factor loadings showed that all items loaded very well onto their intended factors. The MMI had a positive relationship to treatment intensity.ConclusionThe MMI is a valid and reliable tool to use with individuals with schizophrenia spectrum disorders undergoing a cognitive training intervention