Papers by Geoffrey M Reed
As part of the development of the Eleventh Revision of International Classificationof Diseases an... more As part of the development of the Eleventh Revision of International Classificationof Diseases and Related Health Problems (ICD-11), the World Health Organization Departmentof Mental Health and Substance Abuse is conducting a series of case-controlled field stud-ies using a new and powerful method to test the application by clinicians of the proposedICD-11 diagnostic guidelines for mental and behavioural disorders. This article describes thecase-controlled field study for Disorders Specifically Associated with Stress. Using a vignette-based experimental methodology, 1,738 international mental health professionals diagnosedstandardized cases designed to test key differences between the proposed diagnostic guide-lines for ICD-11 and corresponding guidelines for ICD-10. Across eight comparisons, severalproposed changes for ICD-11, including the addition of Complex PTSD and Prolonged Grief Dis-order, produced significantly improved diagnostic decisions and clearer application of diagnosticguidelines compared to ICD-10. However, several key areas were also identified, such as thedescription of the diagnostic requirement of re-experiencing in PTSD, in which the guidelineswere not consistently applied as intended. These results informed specific revisions to improvethe clarity of the proposed ICD-11 diagnostic guidelines. The next step will be to further testthese guidelines in clinic-based studies using real patients in relevant settings.
The core constitutional responsibilities
of the WHO include the promotion of
global cooperation, ... more The core constitutional responsibilities
of the WHO include the promotion of
global cooperation, acting as a directing
authority for international initiatives
that contribute to the advancement
of health. The Global Clinical Practice
Network (GCPN), created by WHO’s
Department of Mental Health and
Substance Abuse, holds promise for
promoting collaborative initiatives that
enhance training, research, and clinical
capacity for mental health worldwide.
Eventually, these initiatives can change
the way that mental health care is
practised globally.
Background: World Health Organization (WHO) is in the process of revising the International Class... more Background: World Health Organization (WHO) is in the process of revising the International Classification of Diseases
10 (ICD‑10). For increasing the acceptability of the ICD‑11, WHO along with World Psychiatric Association (WPA),
conducted a survey of psychiatrists around the world, in which 386 psychiatrists from India participated.
Aim: To present the findings of “WPA‑WHO Global Survey of Psychiatrists’ Attitudes toward Mental Disorders
Classification” for Indian psychiatrists who participated in the survey as members of Indian Psychiatric Society.
Methodology: The online survey was sent to qualified psychiatrists who are members of Indian Psychiatric Society and
are residing in India.
Results: Of the 1702 members who were urged to participate in the survey, 386 (22.7%) participated. Most(79%) of
the psychiatrists opined that they use formal classificatory systems in their day‑to‑day clinical practice. ICD‑10 was the
most commonly (71%) followed classificatory system. Nearly half (48%) felt the need for only 10–30 categories for use
in clinical settings and another 44% opined that 31-100 categories are required for use. Most of the participants (85%)
suggested that a modified/simpler classificatory system should be designed for primary care practitioners. Similarly, the
same number of participants (89%) argued that for maximum utility of a nosological system diagnostic criteria should
provide flexible guidance that allows cultural variation and clinical judgement. About 75% opined that the diagnostic
system they were using was difficult to apply across cultures.
Conclusion: Findings of the survey suggest that classificatory systems are routinely used in day‑to‑day practice by
most of the participating psychiatrists in India and most expect that future classificatory system should provide flexible
guidance that allows cultural variation and clinical judgement.
Patients with chronic or advancing disease often generate perceptions that they
or others can con... more Patients with chronic or advancing disease often generate perceptions that they
or others can control aspects of their illness such as its symptoms, course, and
treatment. This article considers self-generated feelings of control, and provides
evidence from patients with cardiac disease, cancer, and AIDS concerning the
adaptiveness of these feelings. The research suggests that beliefs in personal
control generally appear to be adaptive. Perceptions of control do not appear to
be explained by the absence of negative affectivity, and instead, appear to reduce
anxiety and depression. Cognitions concerning control by others yield more
mixed results. Whereas women and patients with good prognoses appear to
profit psychologically from feelings of vicarious control, men and patients with poor prognoses do not. Implications for the literatures on psychological control,
the illusion of control, and adjustment to chronic illness are discussed.
The transition of a medical or surgical procedure from impossible to standard therapy requieres a... more The transition of a medical or surgical procedure from impossible to standard therapy requieres a stage of experimentation, during which research priorities must be balanced with the interests of the patient. This paper examines such a "first case", and the interpersonal and group dynamics that play a part in the choice of a specific patient to be the first to receive that procedure.
The relationship of control beliefs to psychological adjustment was investigated in
a sample of 2... more The relationship of control beliefs to psychological adjustment was investigated in
a sample of 24 gay men diagnosed with AIDS, participants in the University of
California, Los Angeles site of the Multicenter AIDS Cohort Study (MACS). Distinctions
between generalized contingency beliefs and specific competence beliefs and
between personal and vicarious control beliefs were included in the questionnaire and
interview measures administered. The results support these distinctions and indicate
that beliefs in personal control over day-to-day symptoms and over course of illness
were positively related to adjustment, whereas beliefs in control by others over course
of illness and over medical care and treatment were negatively related to adjustment.
These relationships appeared to be strongest for men who reported poorer health.
These associations were not accounted for by locus of control beliefs, negative affectivity,
or time since diagnosis with AIDS.
Ten principles are advanced which serve as criteria for the evaluation and quality
assurance of m... more Ten principles are advanced which serve as criteria for the evaluation and quality
assurance of mental health services for Persons Living with HIV/AIDS (PWAs). The principles
build on the assertion that evaluation activities must result from a collaboration among PWAs,
community based organizations, and researcher-scientists. Both formative and outcome
evaluation are necessary. The three communities must negotiate both concrete measures
and conceptualizations of the outcomes (goals and objectives) of a service delivery program.
Reed and Collins (1994) have proposed a "Three Communities Model" of mental health
intervention research and mental health services. The model's central theorem argues that
mental health intervention research policy should maximize the joint set composed of the
shared goals and activities among researchers, community-based organizations (CBOs), and
persons living with HIV and AIDS (PWAs). In that paper we argue that measuring program
impact and quality assurance is a superordinate goal that (a) brings into focus the
interdependence of the three communities and (b) intrinsically requires constructive
collaboration among the three communities.
In the present paper, we develop a third point: (c) Program evaluation and quality assurance
is an important research policy issue. Program evaluation and quality assurance also demand
the attention of the mental health intervention and service community. The case for evaluation
and quality assurance is clear even when the goals of the research community are
considered separately from the goals of community-based organizations (CBOs) and PWAs. Program evaluation and quality assurance should be an integral and necessary component of
all mental health intervention research and mental health service delivery systems.
The Three Communities Model of collaboration among researchers,
community-based organizations, an... more The Three Communities Model of collaboration among researchers,
community-based organizations, and persons living with HIV and AIDS (PWAs) is based on
the idea that HIV mental health intervention research and service delivery should include
constructive collaboration among these three communities throughout all phases of research
and practice. Obstacles to collaboration arise from different perspectives, but a social
psychological model of interdependence suggests that Federal policy and funding can be
structured to support and facilitate future collaboration.
If behavioral and mental health researchers are to make a direct contribution to the fightagainst
AIDS, research must focus on the effectiveness of behavioral and mental health
interventions, the populations for which different intervention approaches are most effective,
and the specific mechanisms that make these interventions effective. Research on the
effectiveness of interventions, however, cannot be conducted without the participation of
those who design the research, those who deliver the interventions, and those who receive
the interventions. This article argues that the significance, validity, and effectiveness of
intervention research, and the translation of empirically-tested interventions into practical
community-based programs, will be maximized by the mutual collaboration of the three
groups deirectly involved--researchers, service providers, and clients--along with the Federal
government.
Considerable differences in perspective, needs, and agendas initially separate these groups.
However, our model assumes that there are already overlapping spaces occupied by each community (see Figure 1). If increased collaboration is to be achieved, an important goal is to
expand the size of the joint space occupied by the three communities, represented by the
shaded area in Figure 1. Social psychology suggests that this can be accomplished if mental
health intervention research in HIV/AIDS is conceptualized as a superordinate goal (Sherif,
1936) in which everyone has a stake and cooperative interaction is required for a satisfactory
outcome. The resulting interdependent model has implications for Federal policy and funding
that can facilitate collaboration at the community level.
Although theoretical accounts of adaptation in the terminally ill suggest that realistic acceptan... more Although theoretical accounts of adaptation in the terminally ill suggest that realistic acceptance of one's
disease is adaptive, some investigations suggest that such responses are associated with increased mortality.
This prospective psychobiological investigation involved 74 gay men with AIDS. Six scores reflecting
responses to disease were derived from a detailed psychosocial questionnaire. One pattern of response.
Realistic Acceptance, was a significant predictor of decreased survival time. Median estimated survival time
for participants with low Realistic Acceptance scores was 9 months greater than for participants with high
Realistic Acceptance scores. This effect was not accounted for by time since diagnosis with AIDS, selfreported
health status, number of CD4 T lymphocyte cells, psychological distress, age, education, initial
diagnosing condition, use of AZT, smoking, or alcohol and drug use.
Research has suggested that attributions—the perceived causes of events—may affect
psychological ... more Research has suggested that attributions—the perceived causes of events—may affect
psychological and physical health and the immune system. The authors hypothesized that
attributions reflecting negative beliefs about the self, the future, and control would affect
helper T cell (CD4) decline and onset of AIDS in individuals with HIV, either directly or
through associations with psychological states such as depression. HIV+ gay men (N = 86)
participated in a structured interview from which causal attributions were extracted and coded.
Attributing negative events to aspects of the self significantly predicted faster CD4 decline
over 18 months following the interview, controlling for potential psychological, behavioral,
social, and health mediators such as depression and health behavior. However, attributions did
not predict AIDS diagnosis during the study period. The results support the idea that causal
attributions related to beliefs about the self may have an influence on the immune system
Many psychologists are finding new opportunities for practice in primary care settings. These set... more Many psychologists are finding new opportunities for practice in primary care settings. These settings
challenge many aspects of traditional practice and require adaptation and innovation. Psychologists
must consider changes in their site of practice, treatment duration, type of intervention, and role as
part of a health care team. This article describes the culture of primary care medicine and offers 10
practical tips for the adaptation of psychological practice to primary care.
The study of psychosocial influences on the course of disease has been filled with controversy. ... more The study of psychosocial influences on the course of disease has been filled with controversy. For some, it conjures up associations to medieval witchcaft or primitive religious practices, whereas for others, it has borne an unfortunate association with low methodological standards (e.g. Angell, 1985). Standards, however, have now improved, with the result that research relating psychosocial variables to disease course has proliferated, and the methodologies employed have become varied and sophisticaed (e.g. Friedman & Booth-Kewley, 1987; Friedman et al., 1993; Peterson, Seligman & Vaillant, 1988).
Treatment guidelines for psychotherapy
describe a set of best practices based in
part on scientif... more Treatment guidelines for psychotherapy
describe a set of best practices based in
part on scientific evidence. There have
been several sets of such guidelines
published recently by governmental,
professional, and health services
organizations. The adequacy of such
guidelines, which perforce reduce the
variability of professional services,
depends on the adequacy of the scientific
evidence with respect to both efficacy and
clinical utility. The American
Psychological Association formed a Task
Force to develop a Template for
Developing Guidelines in order to
evaluate the scientific evidence for these guidelines. This article describes the
Template and then applies it to a set of
recently promulgated guidelines. The
Template was able to demonstrate the
strengths and weaknesses of the various
documents.
This study examined negative HIV-related expectancies, AIDS-related bereavement, and the
interact... more This study examined negative HIV-related expectancies, AIDS-related bereavement, and the
interaction of expectancies and bereavement as predictors of the onset of significant
HIV-related symptoms among previously asymptomatic HIV-positive gay men. From a
longitudinal psychobiological investigation, 72 men were selected who had been HIV-positive
and asymptomatic from study entry (approximately 3 years). Participants were followed for an
additional 2'/^ to 3'/2 years after psychosocial assessment, with symptom status assessed every
6 months. The interaction of negative HlV-specinc expectancies and bereavement was a
significant predictor of symptom onset. Negative HTV-specific expectancies predicted the
subsequent development of symptoms among bereaved men, controlling for immunological
status, use of zidovudine, high-risk sexual behavior, substance use, and depression.
Psychological beliefs such as optimism, personal control,
and a sense of meaning are known to be ... more Psychological beliefs such as optimism, personal control,
and a sense of meaning are known to be protective of
mental health. Are they protective of physical health as
well? The authors" present a program of research that has
tested the implications of cognitive adaptation theory, and
research on positive illusions for the relation of positive
beliefs to disease progression among men infected with
HIV. The investigations have revealed that even unrealistically'
optimistic beliefs about the future may be health
protective. The abili~' to find meaning in the experience is
also associated with a less rapid course of illness. Taken
together, the research suggests" that psychological beliefs
such as meaning, control, and optimism act as resources,
which may not only preserve mental health in the context of
traumatic or life-threatening events but be protective of
physical health as well.
Emerging telecommunications technology is changing psychological practice by enabling the provisi... more Emerging telecommunications technology is changing psychological practice by enabling the provision
of services across time and distance, yet there are significant concerns about these applications. In
response to developments in telehealth—the term used for health services provided through these
technologies—an interdisciplinary group developed a series of principles to inform health care practice.
In this article, the authors review these principles and their implications for psychological telehealth,
emphasizing that psychologists' ethical and professional requirements do not change with the introduction
of a new tool. The principles provide a framework of critical ethical and professional issues that
psychologists must consider in undertaking telehealth practice.
Most psychologists in private practice will at some point consider contracting with a managed car... more Most psychologists in private practice will at some point consider contracting with a managed care
organization (MCO) as a part of joining that MCO's provider panel. Such contracts are structured to
advantage the HMO, and there are a number of specific contractual features that psychologists have often
found problematic. This article offers a review of issues and contractual features that psychologists may
wish to consider when contracting with MCOs and offers recommendations for alternative contractual
arrangements that may be helpful for psychologists to negotiate when possible.
To support psychology's continued evolution as a profession, it is important to conceptualize rol... more To support psychology's continued evolution as a profession, it is important to conceptualize roles that
psychologists can play in the future and create pathways for developing and accessing them. This article
considers a variety of roles that may become central to professional psychology in the future. Important
opportunities appear to exist in the areas of psychological management of health and disease, serious
mental illness, and public policy. Psychology faces both internal and external barriers to accessing these
roles in larger numbers. Strategies related to public education, policy and advocacy, marketing, and
training are recommended for overcoming them.
Society expects autonomous professions to ensure the competency of its practitioners, and profess... more Society expects autonomous professions to ensure the competency of its practitioners, and professions
should facilitate the continuing education and training of its members. Given the shift from psychology
as a mental health profession to that of a health profession, the authors propose a self-assessment model
for the individual practitioner to gauge his or her readiness to provide professional services in expanded
areas of practice. This model could also be useful to the American Psychological Association, state
psychological associations, and other purveyors of continuing education programs in systematically
developing postgraduate experiences. A template for self-assessment that reflects well-accepted core
domains of knowledge and skills is presented.
At the direction of the Council of Representatives
of the American Psychological Association
(APA... more At the direction of the Council of Representatives
of the American Psychological Association
(APA), the Task Force on Test User Qualifications
(TFTUQ) was established in October 1996 to
develop guidelines that inform test users and the general
public of the qualifications that the APA considers important
for the competent and responsible use of psychological
tests. The TFTUQ reviewed the relevant
literature related to test user qualifications (see, e.g.,
Eyde, Moreland, Robertson, Primoff, & Most, 1988, and
Tyler, 1986), as well as policy statements developed by
the APA (1950, 1992) and other groups both national
(e.g., American Educational Research Association
[AERA], APA, & National Council on Measurement in
Education [NCME], 1999; American Association for
Counseling and Development, 1988) and international
(British Psychological Society, 1995, 1996; International
Test Commission, 2000). The task force then
developed a set of comprehensive guidelines and solicited
comments from numerous individuals and groups
involved with test use both within and outside the APA.
The final report of the TFTUQ was approved by the
APA Council of Representatives in August 2000. This
article provides a brief summary of the Guidelines on
Test User Qualification (APA, 2000) that are now APA
policy.
Uploads
Papers by Geoffrey M Reed
of the WHO include the promotion of
global cooperation, acting as a directing
authority for international initiatives
that contribute to the advancement
of health. The Global Clinical Practice
Network (GCPN), created by WHO’s
Department of Mental Health and
Substance Abuse, holds promise for
promoting collaborative initiatives that
enhance training, research, and clinical
capacity for mental health worldwide.
Eventually, these initiatives can change
the way that mental health care is
practised globally.
10 (ICD‑10). For increasing the acceptability of the ICD‑11, WHO along with World Psychiatric Association (WPA),
conducted a survey of psychiatrists around the world, in which 386 psychiatrists from India participated.
Aim: To present the findings of “WPA‑WHO Global Survey of Psychiatrists’ Attitudes toward Mental Disorders
Classification” for Indian psychiatrists who participated in the survey as members of Indian Psychiatric Society.
Methodology: The online survey was sent to qualified psychiatrists who are members of Indian Psychiatric Society and
are residing in India.
Results: Of the 1702 members who were urged to participate in the survey, 386 (22.7%) participated. Most(79%) of
the psychiatrists opined that they use formal classificatory systems in their day‑to‑day clinical practice. ICD‑10 was the
most commonly (71%) followed classificatory system. Nearly half (48%) felt the need for only 10–30 categories for use
in clinical settings and another 44% opined that 31-100 categories are required for use. Most of the participants (85%)
suggested that a modified/simpler classificatory system should be designed for primary care practitioners. Similarly, the
same number of participants (89%) argued that for maximum utility of a nosological system diagnostic criteria should
provide flexible guidance that allows cultural variation and clinical judgement. About 75% opined that the diagnostic
system they were using was difficult to apply across cultures.
Conclusion: Findings of the survey suggest that classificatory systems are routinely used in day‑to‑day practice by
most of the participating psychiatrists in India and most expect that future classificatory system should provide flexible
guidance that allows cultural variation and clinical judgement.
or others can control aspects of their illness such as its symptoms, course, and
treatment. This article considers self-generated feelings of control, and provides
evidence from patients with cardiac disease, cancer, and AIDS concerning the
adaptiveness of these feelings. The research suggests that beliefs in personal
control generally appear to be adaptive. Perceptions of control do not appear to
be explained by the absence of negative affectivity, and instead, appear to reduce
anxiety and depression. Cognitions concerning control by others yield more
mixed results. Whereas women and patients with good prognoses appear to
profit psychologically from feelings of vicarious control, men and patients with poor prognoses do not. Implications for the literatures on psychological control,
the illusion of control, and adjustment to chronic illness are discussed.
a sample of 24 gay men diagnosed with AIDS, participants in the University of
California, Los Angeles site of the Multicenter AIDS Cohort Study (MACS). Distinctions
between generalized contingency beliefs and specific competence beliefs and
between personal and vicarious control beliefs were included in the questionnaire and
interview measures administered. The results support these distinctions and indicate
that beliefs in personal control over day-to-day symptoms and over course of illness
were positively related to adjustment, whereas beliefs in control by others over course
of illness and over medical care and treatment were negatively related to adjustment.
These relationships appeared to be strongest for men who reported poorer health.
These associations were not accounted for by locus of control beliefs, negative affectivity,
or time since diagnosis with AIDS.
assurance of mental health services for Persons Living with HIV/AIDS (PWAs). The principles
build on the assertion that evaluation activities must result from a collaboration among PWAs,
community based organizations, and researcher-scientists. Both formative and outcome
evaluation are necessary. The three communities must negotiate both concrete measures
and conceptualizations of the outcomes (goals and objectives) of a service delivery program.
Reed and Collins (1994) have proposed a "Three Communities Model" of mental health
intervention research and mental health services. The model's central theorem argues that
mental health intervention research policy should maximize the joint set composed of the
shared goals and activities among researchers, community-based organizations (CBOs), and
persons living with HIV and AIDS (PWAs). In that paper we argue that measuring program
impact and quality assurance is a superordinate goal that (a) brings into focus the
interdependence of the three communities and (b) intrinsically requires constructive
collaboration among the three communities.
In the present paper, we develop a third point: (c) Program evaluation and quality assurance
is an important research policy issue. Program evaluation and quality assurance also demand
the attention of the mental health intervention and service community. The case for evaluation
and quality assurance is clear even when the goals of the research community are
considered separately from the goals of community-based organizations (CBOs) and PWAs. Program evaluation and quality assurance should be an integral and necessary component of
all mental health intervention research and mental health service delivery systems.
community-based organizations, and persons living with HIV and AIDS (PWAs) is based on
the idea that HIV mental health intervention research and service delivery should include
constructive collaboration among these three communities throughout all phases of research
and practice. Obstacles to collaboration arise from different perspectives, but a social
psychological model of interdependence suggests that Federal policy and funding can be
structured to support and facilitate future collaboration.
If behavioral and mental health researchers are to make a direct contribution to the fightagainst
AIDS, research must focus on the effectiveness of behavioral and mental health
interventions, the populations for which different intervention approaches are most effective,
and the specific mechanisms that make these interventions effective. Research on the
effectiveness of interventions, however, cannot be conducted without the participation of
those who design the research, those who deliver the interventions, and those who receive
the interventions. This article argues that the significance, validity, and effectiveness of
intervention research, and the translation of empirically-tested interventions into practical
community-based programs, will be maximized by the mutual collaboration of the three
groups deirectly involved--researchers, service providers, and clients--along with the Federal
government.
Considerable differences in perspective, needs, and agendas initially separate these groups.
However, our model assumes that there are already overlapping spaces occupied by each community (see Figure 1). If increased collaboration is to be achieved, an important goal is to
expand the size of the joint space occupied by the three communities, represented by the
shaded area in Figure 1. Social psychology suggests that this can be accomplished if mental
health intervention research in HIV/AIDS is conceptualized as a superordinate goal (Sherif,
1936) in which everyone has a stake and cooperative interaction is required for a satisfactory
outcome. The resulting interdependent model has implications for Federal policy and funding
that can facilitate collaboration at the community level.
disease is adaptive, some investigations suggest that such responses are associated with increased mortality.
This prospective psychobiological investigation involved 74 gay men with AIDS. Six scores reflecting
responses to disease were derived from a detailed psychosocial questionnaire. One pattern of response.
Realistic Acceptance, was a significant predictor of decreased survival time. Median estimated survival time
for participants with low Realistic Acceptance scores was 9 months greater than for participants with high
Realistic Acceptance scores. This effect was not accounted for by time since diagnosis with AIDS, selfreported
health status, number of CD4 T lymphocyte cells, psychological distress, age, education, initial
diagnosing condition, use of AZT, smoking, or alcohol and drug use.
psychological and physical health and the immune system. The authors hypothesized that
attributions reflecting negative beliefs about the self, the future, and control would affect
helper T cell (CD4) decline and onset of AIDS in individuals with HIV, either directly or
through associations with psychological states such as depression. HIV+ gay men (N = 86)
participated in a structured interview from which causal attributions were extracted and coded.
Attributing negative events to aspects of the self significantly predicted faster CD4 decline
over 18 months following the interview, controlling for potential psychological, behavioral,
social, and health mediators such as depression and health behavior. However, attributions did
not predict AIDS diagnosis during the study period. The results support the idea that causal
attributions related to beliefs about the self may have an influence on the immune system
challenge many aspects of traditional practice and require adaptation and innovation. Psychologists
must consider changes in their site of practice, treatment duration, type of intervention, and role as
part of a health care team. This article describes the culture of primary care medicine and offers 10
practical tips for the adaptation of psychological practice to primary care.
describe a set of best practices based in
part on scientific evidence. There have
been several sets of such guidelines
published recently by governmental,
professional, and health services
organizations. The adequacy of such
guidelines, which perforce reduce the
variability of professional services,
depends on the adequacy of the scientific
evidence with respect to both efficacy and
clinical utility. The American
Psychological Association formed a Task
Force to develop a Template for
Developing Guidelines in order to
evaluate the scientific evidence for these guidelines. This article describes the
Template and then applies it to a set of
recently promulgated guidelines. The
Template was able to demonstrate the
strengths and weaknesses of the various
documents.
interaction of expectancies and bereavement as predictors of the onset of significant
HIV-related symptoms among previously asymptomatic HIV-positive gay men. From a
longitudinal psychobiological investigation, 72 men were selected who had been HIV-positive
and asymptomatic from study entry (approximately 3 years). Participants were followed for an
additional 2'/^ to 3'/2 years after psychosocial assessment, with symptom status assessed every
6 months. The interaction of negative HlV-specinc expectancies and bereavement was a
significant predictor of symptom onset. Negative HTV-specific expectancies predicted the
subsequent development of symptoms among bereaved men, controlling for immunological
status, use of zidovudine, high-risk sexual behavior, substance use, and depression.
and a sense of meaning are known to be protective of
mental health. Are they protective of physical health as
well? The authors" present a program of research that has
tested the implications of cognitive adaptation theory, and
research on positive illusions for the relation of positive
beliefs to disease progression among men infected with
HIV. The investigations have revealed that even unrealistically'
optimistic beliefs about the future may be health
protective. The abili~' to find meaning in the experience is
also associated with a less rapid course of illness. Taken
together, the research suggests" that psychological beliefs
such as meaning, control, and optimism act as resources,
which may not only preserve mental health in the context of
traumatic or life-threatening events but be protective of
physical health as well.
of services across time and distance, yet there are significant concerns about these applications. In
response to developments in telehealth—the term used for health services provided through these
technologies—an interdisciplinary group developed a series of principles to inform health care practice.
In this article, the authors review these principles and their implications for psychological telehealth,
emphasizing that psychologists' ethical and professional requirements do not change with the introduction
of a new tool. The principles provide a framework of critical ethical and professional issues that
psychologists must consider in undertaking telehealth practice.
organization (MCO) as a part of joining that MCO's provider panel. Such contracts are structured to
advantage the HMO, and there are a number of specific contractual features that psychologists have often
found problematic. This article offers a review of issues and contractual features that psychologists may
wish to consider when contracting with MCOs and offers recommendations for alternative contractual
arrangements that may be helpful for psychologists to negotiate when possible.
psychologists can play in the future and create pathways for developing and accessing them. This article
considers a variety of roles that may become central to professional psychology in the future. Important
opportunities appear to exist in the areas of psychological management of health and disease, serious
mental illness, and public policy. Psychology faces both internal and external barriers to accessing these
roles in larger numbers. Strategies related to public education, policy and advocacy, marketing, and
training are recommended for overcoming them.
should facilitate the continuing education and training of its members. Given the shift from psychology
as a mental health profession to that of a health profession, the authors propose a self-assessment model
for the individual practitioner to gauge his or her readiness to provide professional services in expanded
areas of practice. This model could also be useful to the American Psychological Association, state
psychological associations, and other purveyors of continuing education programs in systematically
developing postgraduate experiences. A template for self-assessment that reflects well-accepted core
domains of knowledge and skills is presented.
of the American Psychological Association
(APA), the Task Force on Test User Qualifications
(TFTUQ) was established in October 1996 to
develop guidelines that inform test users and the general
public of the qualifications that the APA considers important
for the competent and responsible use of psychological
tests. The TFTUQ reviewed the relevant
literature related to test user qualifications (see, e.g.,
Eyde, Moreland, Robertson, Primoff, & Most, 1988, and
Tyler, 1986), as well as policy statements developed by
the APA (1950, 1992) and other groups both national
(e.g., American Educational Research Association
[AERA], APA, & National Council on Measurement in
Education [NCME], 1999; American Association for
Counseling and Development, 1988) and international
(British Psychological Society, 1995, 1996; International
Test Commission, 2000). The task force then
developed a set of comprehensive guidelines and solicited
comments from numerous individuals and groups
involved with test use both within and outside the APA.
The final report of the TFTUQ was approved by the
APA Council of Representatives in August 2000. This
article provides a brief summary of the Guidelines on
Test User Qualification (APA, 2000) that are now APA
policy.
of the WHO include the promotion of
global cooperation, acting as a directing
authority for international initiatives
that contribute to the advancement
of health. The Global Clinical Practice
Network (GCPN), created by WHO’s
Department of Mental Health and
Substance Abuse, holds promise for
promoting collaborative initiatives that
enhance training, research, and clinical
capacity for mental health worldwide.
Eventually, these initiatives can change
the way that mental health care is
practised globally.
10 (ICD‑10). For increasing the acceptability of the ICD‑11, WHO along with World Psychiatric Association (WPA),
conducted a survey of psychiatrists around the world, in which 386 psychiatrists from India participated.
Aim: To present the findings of “WPA‑WHO Global Survey of Psychiatrists’ Attitudes toward Mental Disorders
Classification” for Indian psychiatrists who participated in the survey as members of Indian Psychiatric Society.
Methodology: The online survey was sent to qualified psychiatrists who are members of Indian Psychiatric Society and
are residing in India.
Results: Of the 1702 members who were urged to participate in the survey, 386 (22.7%) participated. Most(79%) of
the psychiatrists opined that they use formal classificatory systems in their day‑to‑day clinical practice. ICD‑10 was the
most commonly (71%) followed classificatory system. Nearly half (48%) felt the need for only 10–30 categories for use
in clinical settings and another 44% opined that 31-100 categories are required for use. Most of the participants (85%)
suggested that a modified/simpler classificatory system should be designed for primary care practitioners. Similarly, the
same number of participants (89%) argued that for maximum utility of a nosological system diagnostic criteria should
provide flexible guidance that allows cultural variation and clinical judgement. About 75% opined that the diagnostic
system they were using was difficult to apply across cultures.
Conclusion: Findings of the survey suggest that classificatory systems are routinely used in day‑to‑day practice by
most of the participating psychiatrists in India and most expect that future classificatory system should provide flexible
guidance that allows cultural variation and clinical judgement.
or others can control aspects of their illness such as its symptoms, course, and
treatment. This article considers self-generated feelings of control, and provides
evidence from patients with cardiac disease, cancer, and AIDS concerning the
adaptiveness of these feelings. The research suggests that beliefs in personal
control generally appear to be adaptive. Perceptions of control do not appear to
be explained by the absence of negative affectivity, and instead, appear to reduce
anxiety and depression. Cognitions concerning control by others yield more
mixed results. Whereas women and patients with good prognoses appear to
profit psychologically from feelings of vicarious control, men and patients with poor prognoses do not. Implications for the literatures on psychological control,
the illusion of control, and adjustment to chronic illness are discussed.
a sample of 24 gay men diagnosed with AIDS, participants in the University of
California, Los Angeles site of the Multicenter AIDS Cohort Study (MACS). Distinctions
between generalized contingency beliefs and specific competence beliefs and
between personal and vicarious control beliefs were included in the questionnaire and
interview measures administered. The results support these distinctions and indicate
that beliefs in personal control over day-to-day symptoms and over course of illness
were positively related to adjustment, whereas beliefs in control by others over course
of illness and over medical care and treatment were negatively related to adjustment.
These relationships appeared to be strongest for men who reported poorer health.
These associations were not accounted for by locus of control beliefs, negative affectivity,
or time since diagnosis with AIDS.
assurance of mental health services for Persons Living with HIV/AIDS (PWAs). The principles
build on the assertion that evaluation activities must result from a collaboration among PWAs,
community based organizations, and researcher-scientists. Both formative and outcome
evaluation are necessary. The three communities must negotiate both concrete measures
and conceptualizations of the outcomes (goals and objectives) of a service delivery program.
Reed and Collins (1994) have proposed a "Three Communities Model" of mental health
intervention research and mental health services. The model's central theorem argues that
mental health intervention research policy should maximize the joint set composed of the
shared goals and activities among researchers, community-based organizations (CBOs), and
persons living with HIV and AIDS (PWAs). In that paper we argue that measuring program
impact and quality assurance is a superordinate goal that (a) brings into focus the
interdependence of the three communities and (b) intrinsically requires constructive
collaboration among the three communities.
In the present paper, we develop a third point: (c) Program evaluation and quality assurance
is an important research policy issue. Program evaluation and quality assurance also demand
the attention of the mental health intervention and service community. The case for evaluation
and quality assurance is clear even when the goals of the research community are
considered separately from the goals of community-based organizations (CBOs) and PWAs. Program evaluation and quality assurance should be an integral and necessary component of
all mental health intervention research and mental health service delivery systems.
community-based organizations, and persons living with HIV and AIDS (PWAs) is based on
the idea that HIV mental health intervention research and service delivery should include
constructive collaboration among these three communities throughout all phases of research
and practice. Obstacles to collaboration arise from different perspectives, but a social
psychological model of interdependence suggests that Federal policy and funding can be
structured to support and facilitate future collaboration.
If behavioral and mental health researchers are to make a direct contribution to the fightagainst
AIDS, research must focus on the effectiveness of behavioral and mental health
interventions, the populations for which different intervention approaches are most effective,
and the specific mechanisms that make these interventions effective. Research on the
effectiveness of interventions, however, cannot be conducted without the participation of
those who design the research, those who deliver the interventions, and those who receive
the interventions. This article argues that the significance, validity, and effectiveness of
intervention research, and the translation of empirically-tested interventions into practical
community-based programs, will be maximized by the mutual collaboration of the three
groups deirectly involved--researchers, service providers, and clients--along with the Federal
government.
Considerable differences in perspective, needs, and agendas initially separate these groups.
However, our model assumes that there are already overlapping spaces occupied by each community (see Figure 1). If increased collaboration is to be achieved, an important goal is to
expand the size of the joint space occupied by the three communities, represented by the
shaded area in Figure 1. Social psychology suggests that this can be accomplished if mental
health intervention research in HIV/AIDS is conceptualized as a superordinate goal (Sherif,
1936) in which everyone has a stake and cooperative interaction is required for a satisfactory
outcome. The resulting interdependent model has implications for Federal policy and funding
that can facilitate collaboration at the community level.
disease is adaptive, some investigations suggest that such responses are associated with increased mortality.
This prospective psychobiological investigation involved 74 gay men with AIDS. Six scores reflecting
responses to disease were derived from a detailed psychosocial questionnaire. One pattern of response.
Realistic Acceptance, was a significant predictor of decreased survival time. Median estimated survival time
for participants with low Realistic Acceptance scores was 9 months greater than for participants with high
Realistic Acceptance scores. This effect was not accounted for by time since diagnosis with AIDS, selfreported
health status, number of CD4 T lymphocyte cells, psychological distress, age, education, initial
diagnosing condition, use of AZT, smoking, or alcohol and drug use.
psychological and physical health and the immune system. The authors hypothesized that
attributions reflecting negative beliefs about the self, the future, and control would affect
helper T cell (CD4) decline and onset of AIDS in individuals with HIV, either directly or
through associations with psychological states such as depression. HIV+ gay men (N = 86)
participated in a structured interview from which causal attributions were extracted and coded.
Attributing negative events to aspects of the self significantly predicted faster CD4 decline
over 18 months following the interview, controlling for potential psychological, behavioral,
social, and health mediators such as depression and health behavior. However, attributions did
not predict AIDS diagnosis during the study period. The results support the idea that causal
attributions related to beliefs about the self may have an influence on the immune system
challenge many aspects of traditional practice and require adaptation and innovation. Psychologists
must consider changes in their site of practice, treatment duration, type of intervention, and role as
part of a health care team. This article describes the culture of primary care medicine and offers 10
practical tips for the adaptation of psychological practice to primary care.
describe a set of best practices based in
part on scientific evidence. There have
been several sets of such guidelines
published recently by governmental,
professional, and health services
organizations. The adequacy of such
guidelines, which perforce reduce the
variability of professional services,
depends on the adequacy of the scientific
evidence with respect to both efficacy and
clinical utility. The American
Psychological Association formed a Task
Force to develop a Template for
Developing Guidelines in order to
evaluate the scientific evidence for these guidelines. This article describes the
Template and then applies it to a set of
recently promulgated guidelines. The
Template was able to demonstrate the
strengths and weaknesses of the various
documents.
interaction of expectancies and bereavement as predictors of the onset of significant
HIV-related symptoms among previously asymptomatic HIV-positive gay men. From a
longitudinal psychobiological investigation, 72 men were selected who had been HIV-positive
and asymptomatic from study entry (approximately 3 years). Participants were followed for an
additional 2'/^ to 3'/2 years after psychosocial assessment, with symptom status assessed every
6 months. The interaction of negative HlV-specinc expectancies and bereavement was a
significant predictor of symptom onset. Negative HTV-specific expectancies predicted the
subsequent development of symptoms among bereaved men, controlling for immunological
status, use of zidovudine, high-risk sexual behavior, substance use, and depression.
and a sense of meaning are known to be protective of
mental health. Are they protective of physical health as
well? The authors" present a program of research that has
tested the implications of cognitive adaptation theory, and
research on positive illusions for the relation of positive
beliefs to disease progression among men infected with
HIV. The investigations have revealed that even unrealistically'
optimistic beliefs about the future may be health
protective. The abili~' to find meaning in the experience is
also associated with a less rapid course of illness. Taken
together, the research suggests" that psychological beliefs
such as meaning, control, and optimism act as resources,
which may not only preserve mental health in the context of
traumatic or life-threatening events but be protective of
physical health as well.
of services across time and distance, yet there are significant concerns about these applications. In
response to developments in telehealth—the term used for health services provided through these
technologies—an interdisciplinary group developed a series of principles to inform health care practice.
In this article, the authors review these principles and their implications for psychological telehealth,
emphasizing that psychologists' ethical and professional requirements do not change with the introduction
of a new tool. The principles provide a framework of critical ethical and professional issues that
psychologists must consider in undertaking telehealth practice.
organization (MCO) as a part of joining that MCO's provider panel. Such contracts are structured to
advantage the HMO, and there are a number of specific contractual features that psychologists have often
found problematic. This article offers a review of issues and contractual features that psychologists may
wish to consider when contracting with MCOs and offers recommendations for alternative contractual
arrangements that may be helpful for psychologists to negotiate when possible.
psychologists can play in the future and create pathways for developing and accessing them. This article
considers a variety of roles that may become central to professional psychology in the future. Important
opportunities appear to exist in the areas of psychological management of health and disease, serious
mental illness, and public policy. Psychology faces both internal and external barriers to accessing these
roles in larger numbers. Strategies related to public education, policy and advocacy, marketing, and
training are recommended for overcoming them.
should facilitate the continuing education and training of its members. Given the shift from psychology
as a mental health profession to that of a health profession, the authors propose a self-assessment model
for the individual practitioner to gauge his or her readiness to provide professional services in expanded
areas of practice. This model could also be useful to the American Psychological Association, state
psychological associations, and other purveyors of continuing education programs in systematically
developing postgraduate experiences. A template for self-assessment that reflects well-accepted core
domains of knowledge and skills is presented.
of the American Psychological Association
(APA), the Task Force on Test User Qualifications
(TFTUQ) was established in October 1996 to
develop guidelines that inform test users and the general
public of the qualifications that the APA considers important
for the competent and responsible use of psychological
tests. The TFTUQ reviewed the relevant
literature related to test user qualifications (see, e.g.,
Eyde, Moreland, Robertson, Primoff, & Most, 1988, and
Tyler, 1986), as well as policy statements developed by
the APA (1950, 1992) and other groups both national
(e.g., American Educational Research Association
[AERA], APA, & National Council on Measurement in
Education [NCME], 1999; American Association for
Counseling and Development, 1988) and international
(British Psychological Society, 1995, 1996; International
Test Commission, 2000). The task force then
developed a set of comprehensive guidelines and solicited
comments from numerous individuals and groups
involved with test use both within and outside the APA.
The final report of the TFTUQ was approved by the
APA Council of Representatives in August 2000. This
article provides a brief summary of the Guidelines on
Test User Qualification (APA, 2000) that are now APA
policy.