Ryan McBain

Females excel at basic face perception

Females are generally better than males at recognizing facial emotions. However, it is not entirely clear whether and in what way females may also excel at non-affective face recognition. Here, we tested males and females on two perceptual face recognition tasks that involved only neutral expressions: detection and identity discrimination. On face detection (Experiment 1), females were significantly more accurate than males in detecting upright faces. This gender difference was reduced during inverted face detection, and not present during tree detection, suggesting that the magnitude of the gender difference for performance co-varies with the extent to which face processing mechanisms are involved. On facial identity discrimination (Experiment 2), females again outperformed males, particularly when face images were masked by visual noise, or the delay between comparison face images was extended from 0.5 to 3s. These results reveal a female advantage in processing face-specific information and underscore the role of perceptual factors in socially relevant gender differences.

Service availability and utilization and treatment gap for schizophrenic disorders: a survey in 50 low- and middle-income countries

OBJECTIVE To outline mental health service accessibility, estimate the treatment gap and describe service utilization for people with schizophrenic disorders in 50 low- and middle-income countries. METHODS The World Health Organization Assessment Instrument for Mental Health Systems was used to assess the accessibility of mental health services for schizophrenic disorders and their utilization. The treatment gap measurement was based on the number of cases treated per 100,000 persons with schizophrenic disorders, and it was compared with subregional estimates based on the Global burden of disease 2004 update report. Multivariate analysis using backward step-wise regression was performed to assess predictors of accessibility, treatment gap and service utilization. FINDINGS The median annual rate of treatment for schizophrenic disorders in mental health services was 128 cases per 100,000 population. The median treatment gap was 69% and was higher in participating low-income countries (89%) than in lower-middle-income and upper-middle-income countries (69% and 63%, respectively). Of the people with schizophrenic disorders, 80% were treated in outpatient facilities. The availability of psychiatrists and nurses in mental health facilities was found to be a significant predictor of service accessibility and treatment gap. CONCLUSION The treatment gap for schizophrenic disorders in the 50 low- and middle-income countries in this study is disconcertingly large and outpatient facilities bear the major burden of care. The significant predictors found suggest an avenue for improving care in these countries.

Post-traumatic stress symptoms among former child soldiers in Sierra Leone: follow-up study

BACKGROUND Former child soldiers are at risk of developing post-traumatic stress disorder (PTSD); however, the trajectory of symptoms has yet to be examined. AIMS The risk and protective factors associated with PTSD symptom change among former child soldiers in Sierra Leone were investigated. METHOD Data from 243 former child soldiers (mean age 16.6 years, 30% female) were analysed. RESULTS Self-reported rates of possible PTSD using standard cut-off points declined from 32% to 16% 4 years later (P<0.05). Symptoms of PTSD at baseline were significantly associated with war experiences (P<0.01) and post-conflict family abuse (P<0.001). Reliable improvement in symptoms was reported by 30%. In growth models examining symptom change, worsening of symptoms was associated with death of a parent (P<0.05) and post-conflict stigma (P<0.001). Protective effects were observed for increases in family acceptance (P<0.001). CONCLUSIONS The findings indicated improvement in PTSD symptoms among former child soldiers despite limited access to care. Family and community support played a vital part in promoting psychological adjustment.

Deficient biological motion perception in schizophrenia: results from a motion noise paradigm

Background: Schizophrenia patients exhibit deficient processing of perceptual and cognitive information. However, it is not well-understood how basic perceptual deficits contribute to higher level cognitive problems in this mental disorder. Perception of biological motion, a motion-based cognitive recognition task, relies on both basic visual motion processing and social cognitive processing, thus providing a useful paradigm to evaluate the potentially hierarchical relationship between these two levels of information processing. Methods: In this study, we designed a biological motion paradigm in which basic visual motion signals were manipulated systematically by incorporating different levels of motion noise. We measured the performances of schizophrenia patients (n = 21) and healthy controls (n = 22) in this biological motion perception task, as well as in coherent motion detection, theory of mind, and a widely used biological motion recognition task. Results: Schizophrenia patients performed the biological motion perception task with significantly lower accuracy than healthy controls when perceptual signals were moderately degraded by noise. A more substantial degradation of perceptual signals, through using additional noise, impaired biological motion perception in both groups. Performance levels on biological motion recognition, coherent motion detection and theory of mind tasks were also reduced in patients. Conclusion: The results from the motion-noise biological motion paradigm indicate that in the presence of visual motion noise, the processing of biological motion information in schizophrenia is deficient. Combined with the results of poor basic visual motion perception (coherent motion task) and biological motion recognition, the association between basic motion signals and biological motion perception suggests a need to incorporate the improvement of visual motion perception in social cognitive remediation.

The Role of Health Systems Factors in Facilitating Access to Psychotropic Medicines: A Cross-Sectional Analysis of the WHO-AIMS in 63 Low- and Middle-Income Countries

In a cross-sectional analysis of WHO-AIMS data, Ryan McBain and colleagues investigate the associations between health system components and access to psychotropic drugs in 63 low and middle income countries.

Differential roles of low and high spatial frequency content in abnormal facial emotion perception in schizophrenia.

While schizophrenia patients are impaired at facial emotion perception, the role of basic visual processing in this deficit remains relatively unclear. We examined emotion perception when spatial frequency content of facial images was manipulated via high-pass and low-pass filtering. Unlike controls (n=29), patients (n=30) perceived images with low spatial frequencies as more fearful than those without this information, across emotional salience levels. Patients also perceived images with high spatial frequencies as happier. In controls, this effect was found only at low emotional salience. These results indicate that basic visual processing has an amplified modulatory effect on emotion perception in schizophrenia.

The intergenerational impact of war: longitudinal relationships between caregiver and child mental health in postconflict Sierra Leone

BACKGROUND Trauma from witnessing events such as bombings and killings as well as direct victimization or participation in violence has been associated with psychosocial distress and poor mental health among war-exposed children and adolescents. This study examines the relationship between caregiver mental health and child internalizing (anxiety and depression) symptoms over a 4-year period in postconflict Sierra Leone. METHODS The sample included 118 adolescent Sierra Leonean youth (73% male; mean age = 16.5 years at Time 1) and their caregivers (40% male; mean age = 39.0 at Time 1). To measure depression and anxiety symptoms, the Hopkins Symptom Checklist-25 was used with adults and the Oxford Measure of Psychosocial Adjustment - previously validated for use with children and adolescents in the region - was used to assess youth. A multivariate hierarchical linear model (HLM) for studying change within dyads was implemented to study covariation in internalizing symptoms among caregivers and youth over time; these models also included covariates at the individual, family and community levels. The relationship of caregiver mental health to childs internalizing was tested in a latent variable extension of the HLM. RESULTS The latent variable extension estimated that a one standard deviation (SD) change in caregiver anxiety/depression was associated with a .43 SD change in youth internalizing (p < .01) over the 4-year period. Family acceptance was negatively related to youth internalizing (p < .001), while community stigma was positively associated (p < .001). CONCLUSIONS The findings highlight an important interplay between caregiver and child mental health within the postconflict setting and the need for psychosocial interventions to extend beyond the individual to account for family dynamics.

Reduced Ability to Detect Facial Configuration in Middle-Aged and Elderly Individuals: Associations With Spatiotemporal Visual Processing

Visual sensitivity decreases with age, and this presumably has an impact on face recognition. However, the relationship between aging in basic visual processing and in the sensory and cognitive mechanisms mediating face recognition is not well understood. Face detection, a foundational step in recognizing faces, relies primarily on sensory information. This study measured the ability to detect facial configuration and contrast detection in young (<40 years), middle-aged (40-59 years), and elderly adults (>59 years). Performance on both face detection and contrast detection was moderately degraded in the middle-aged group compared with the young group and was further degraded in elderly adults. Face detection was correlated strongly with contrast sensitivities, but only weakly with verbal IQ. The results suggest that face detection ability begins to reduce in early aging, and is associated with spatiotemporal visual processing.

Global Mental Health Resources and Services: A WHO Survey of 184 Countries

Data derived from the World Health Organization’s (WHO) Mental Health Atlas Project 2011 are presented. These data provide the latest estimates on available resources for the treatment and prevention of neuropsychiatric disorders covering 98 percent of the world’s population. Resources are defined in terms of governance, financing, mental health care delivery, human resources, essential medicines, and information systems. The Atlas project was initiated to guide policy and planning efforts in order to meet the large and growing burden of neuropsychiatric disorders worldwide. Results indicate that 60 percent of countries have a dedicated mental health policy; 71 percent possess a mental health plan; and 59 percent report having dedicated mental health legislation. Median mental health expenditures per capita are US

Strengthening Health Systems While Responding to a Health Crisis: Lessons Learned by a Nongovernmental Organization During the Ebola Virus Disease Epidemic in Sierra Leone

1.63, with large variation among income groups, ranging from US