Aradhana Bela Sood

Assessment and Diagnosis of Mental Illness in Persons with Mental Retardation: Methods and Measures

The assessment and diagnosis of psychiatric disorders in individuals with mental retardation has been a neglected area of research. However, current research indicates that these individuals suffer from the same range of psychiatric disorders that is evident in those who are not mentally retarded. A model of assessment and diagnosis of mental illness in this population is presented that incorporates psychiatric as well as behavioral methods. The emphasis is on the comprehensive assessment of an individuals behavior, based on family history, self and informant clinical interviews, rating scales, direct observations, and an experimental analysis of the target behaviors. The model provides the basis for making differential diagnoses in terms of related psychiatric disorders and between psychiatric disorders and behavior problems. Depression and schizophrenia are used as illustrative disorders to describe the application of this model. Given the paucity of literature on the assessment and diagnosis of mental illness in individuals with mental retardation, a number of suggestions are made regarding future research and refinement of the model.

Prevention of Youth Violence: A Public Health Approach

The causes of youth violence are multifactorial and include biological, individual, familial, social, and economic factors. The influence of parents, family members, and important adults can shape the beliefs of the child toward violence in a significant manner. However, the influence of school and the neighborhood also have an important role in attitudes and behaviors of children toward violence. The complexity of factors related to violence requires a comprehensive public health approach. This article focuses on evidence-based models of intervention to reduce violence while emphasizing collective impact as a guiding principle.

Prevention of Mental Health Disorders: Principles and Implementation

Health care in the United States was once considered to be the best in the world; however, this is no longer true. When measured in terms of life expectancy and health care costs, the United States ranks at the bottom of developed countries. While it is true that the United States continues to lead the world in innovations, we have made little progress in advancing treatments in the common medical problems that lead to premature death and account for the vast majority of health care costs in our country. As concluded by the Robert Wood Johnson Foundation report, “Time to act: investing in the health of our children and communities,” it is time for our country to take a more “health focused approach to medical care in our country.” To put it simply, it is time to develop new strategies to help the healthy stay well, prevent those at risk for developing illness from becoming ill, and to innovate new ways to help those who are already ill. Overwhelming evidence points to prevention of illness in high-risk individuals as a logical step to reduce later health care problems and stem the rising cost of treatment. Moreover, there is emerging evidence that promoting health may be even more powerful than focused prevention approaches. Despite this compelling argument, there is little funding allocated to health-promotion and illness-prevention programs. However, the gradual recognition that prevention is essential to the future of health and wellness by policymakers in national health care innovation think tanks is slowly creating a momentum to establish the evidence base for these programs. What holds promise is if policy at a legislative level could create a shared agenda of advocacy for intervention and prevention efforts rather than dichotomizing the two. This could lead to a fiscally supported prevention strategy. A public health approach where health and wellness

Proximal Influences on the Trajectory of Suicidal Behaviors and Suicide during the Transition from Adolescence to Young Adulthood

Youth transitioning to adulthood have unique developmental tasks that make them vulnerable to suicide. Brain development, life stressors, and psychological adjustments during the transition contribute to a high rate of suicidal gestures. To reduce the incidence of self-harm in this age group, a public health approach that identifies and reduces risk factors and enhances protective factors should be used. Institutions and employment arenas should consider structural supports to facilitate this transition of youth into adulthood, with a particular focus on youth with self-harm thoughts, and should provide education about suicide, evidence-based resources, and intervention programs to encourage help seeking.

Attention Deficit Hyperactivity Disorder and DSM 5: What’s New?

The diagnostic and statistical manual (DSM) serves as a guide for the clinical practice of psychiatry internationally. The newest version, the DSM 5 was published in 2013. In this version, the diagnostic criteria for attention deficit hyperactivity disorder (ADHD) have undergone significant changes. This chapter focuses on the current criteria for diagnosing attention deficit disorder (ADD) and provides a synopsis of the changes in the criteria set for ADHD/ADD in the DSM 5 in comparison to DSM IV R. This chapter frames the new/revised criteria for ADHD/ADD by comparing them with the DSM IV TR and provides the reader with the theoretical rationale for the changes. The impact that these new criteria may have on the prevalence and incidence rates of ADHD/ADD and the manner in which the diagnosis in adults and children is arrived at are discussed. The role of culture on similarities and differences, and the manner in which these syndromes present in the USA and India are covered. A brief overview of broad assessment techniques and treatment strategies focusing primarily on the child and adolescent population are also discussed. Clinical vignettes are used to illustrate how these changes potentially affect clinical practice.