Informed consent decision-making in deep brain stimulation

Deep brain stimulation (DBS) has proved useful for several movement disorders (Parkinson’s disease, essential tremor, dystonia), in which first and/or second line pharmacological treatments were inefficacious. Initial evidence of DBS efficacy exists for refractory obsessive-compulsive disorder, treatment-resistant major depressive disorder, and impulse control disorders. Ethical concerns have been raised about the use of an invasive surgical approach involving the central nervous system in patients with possible impairment in cognitive functioning and decision-making capacity. Most of the disorders in which DBS has been used might present with alterations in memory, attention, and executive functioning, which may have an impact on the mental capacity to give informed consent to neurosurgery. Depression, anxiety, and compulsivity are also common in DBS candidate disorders, and could also be associated with an impaired capacity to consent to treatment or clinical research. Despite these issues, there is limited empirical knowledge on the decision-making levels of these patients. The possible informed consent issues of DBS will be discussed by focusing on the specific treatable diseases

Protections for Juveniles in Self- Incriminating Legal Contexts, Developmentally Considered

My comments use a developmental perspective on adolescents’ capacities as a way to supplement the conclusions of three previous articles in this volume (Tepfer, Nirider and Drizin;1 Frumkin;2 and Heilbrun et al.3) that discuss policies to protect juveniles in legal contexts in which they are asked to make self-incriminating statements. The Tepfer and Frumkin articles provide ample reason for concern about adolescents’ responses to police interrogation. They argue adolescents are at greater risk of making false confessions (as they are more susceptible to police interrogation strategies) and are more likely to waive their rights due to poor understanding or acquiescence. Tepfer and his coauthors point out that we have entered an era of juvenile justice reform that recognizes that “adolescents are different,” a perspective that has received special emphasis by the U.S. Supreme Court in several recent cases.4 Age, the Court says, must be taken into consideration when weighing the validity of a confession.5 Frumkin describes some of the things that mental health examiners can do to assist courts in weighing youths’ capacities and vulnerability—especially their suggestibility—in individual cases that challenge confessions. Both articles refer broadly to differences between adolescents and adults. My comments add some complexities that arise when we go beyond these differences to address diversity among young people across the adolescent age span. This leads me to suggest some refinements in our thinking about the types of protections needed for juveniles in police interrogations

Individual Case Study: An In Depth Look into LA Fitness

LA Fitness is a health and fitness club chain that has locations throughout the United States and Canada. LA Fitness is a health and fitness club that has locations throughout the United States and Canada. This company has been seen as a strong competitor in the industry since its introduction, especially because of its differentiation strategy. While LA Fitness has done well for themselves during their last thirty years in business, there are some changes that could be made in order to develop a sustainable competitive advantage. The recommendations I have for LA Fitness are: 1) have longer hours of operation, 2) communicate company decisions and how they benefit the consumer, 3) train associates on customer service, 4) create a new marketing campaign, 5) expand further in the US and Canada, and 6) adjust proportions of company debt. These changes will allow LA Fitness to create and sustain a competitive advantage in the health and wellness industry

Guidance for Improving Forensic Reports: A Review of Common Errors

This study employed a national sample of forensic reports that had been critiqued by a panel of advanced forensic mental-health practitioners serving as reviewers for the American Board of Forensic Psychology. The study describes all of the discrete types of faults that reviewers encountered in the reports, and then converts them to prescriptive statements to guide forensic report writing. The study also identifies the most frequent report-writing problems in this sample. The results were not intended to describe the quality of forensic reports in the U.S., but rather to offer guidance for improving the quality of forensic reports

The Relationship between English Language Proficiency and Academic Achievement for English Language Learners

The purpose of this quantitative correlational research study was to test the threshold hypothesis as it applied to the performance of English language learner students on the Oklahoma Core Curriculum Test (OCCT) in third grade reading and the Assessing Comprehension and Communication in English State to State for English language learners assessment, also known as the ACCESS for ELLs. The OCCT assesses student performance on third grade reading content and the ACCESS for ELLs assesses the English language proficiency levels in speaking, listening, reading, and writing. This study specifically proposed to analyze the relationship between the ACCESS for ELLs reading proficiency level and the student performance on the OCCT third grade reading assessment. Additional analysis was proposed to determine if the relationship in student performance on the assessments was influenced by the number of years in which the student had been receiving English language development services. The participants in the study were third grade English language learner students enrolled in a large school district in Oklahoma for the 2014-2015 school year

Cyberchondria and Health Anxiety During the COVID19 Pandemic

The COVID-19 pandemic has resulted in an increase in mental health issues/problems. This research sought to assess whether cyberchondria during the pandemic resulted in an increase in health anxiety levels. A total of 45 participants from Longwood University completed either survey A, which contained a 6 item cyberchondria measure and the 18 item Short Health Anxiety Inventory (SHAI), or survey B which contained a modified version of the cyberchondria measure and the SHAI. Survey B was modified to explicitly mention COVID-19 in the items. Our results found no difference in health anxiety levels between the two participants and an additional analysis revealed no difference in cyberchondria behaviors between the two groups. Any increase in health anxiety levels may have been mediated by a new increased focus on maintaining a healthy mental state during the COVID-19 health crisis. Health-related information seeking on the internet seems to be only temporary and not long term which could explain why cyberchondria levels were similar between the two groups. The research suggested of our study suggest that the pandemic may not have as much of an effect on cyberchondria and health anxiety levels for our population as once thought. Other psychological areas should be evaluated in an effort to find problematic areas the pandemic has affected and work to aid such areas

ALCOHOL USE AND THE OLDER ADULT: ADDRESSING OLDER ADULTS’ PERCEPTIONS

In order to create more efficient, useful alcohol treatment and intervention methods tailored specifically for the older population, it is important to understand the reasons that older adults perceive that they consume alcohol. For this reason, this study explored older adults’ perceptions regarding why they use alcohol. Older adults, age 60 and older, were surveyed through questionnaires completed at senior community centers within San Bernardino County. This was a mixed method design that used qualitative and quantitative analysis for the purpose of exploring the most frequently reported reasons for why older adults use alcohol. The main finding of the study is that older adults in the sample most frequently reported using alcohol for “having fun and celebration” and for “social reasons.” However, it is important to note that older adults reported a variety of motivations for using alcohol. Further research is suggested to determine correlations between demographics, alcohol use patterns, and older adults’ perceptions of why they use alcohol

Developmental Research and the Child Advocacy Process

This text is excerpted from Grisso, T., & Steinberg, L. (2005). Between a rock and a soft place: Developmental research and the child advocacy process. Journal of Clinical Child and Adolescent Psychology, 34, 619-627

Social Determinants of Health and What Mothers Say They Need and Want After Release From Jail.

Identifying the biopsychosocial needs of mothers who have been released from jail is critical to understanding the best ways to support their health and stability after release. In May through August 2014, we interviewed 15 mothers who had been released from an urban jail about their reentry experiences, and we analyzed transcripts for themes. Eight domains of community reentry emerged through analysis: behavioral health services, education, employment, housing, material resources, medical care, relationships with children, and social support. Participants defined barriers to successful reentry, which paralleled the social determinants of health, and shared suggestions that could be used to mitigate these barriers