The role of impulsivity in the development of substance use and eating disorders

Impulsivity is now widely viewed as a multidimensional construct consisting of a number of related dimensions. Although many measures of impulsivity are correlated, most recent factor analyses support at least a two-factor model. In the current paper, these two factors have been labelled reward sensitivity, reflecting one of the primary dimensions of Gray's personality theory, and rash-spontaneous impulsiveness. The evidence supporting the existence of two dimensions of impulsivity is reviewed in relation to substance misuse and binge eating. (C) 2004 Elsevier Ltd. All rights reserved.

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of schizophrenia and related disorders

Background: The Royal Australian and New Zealand College of Psychiatrists is co-ordinating the development of clinical practice guidelines (CPGs) in psychiatry, funded under the National Mental Health Strategy (Australia) and the New Zealand Health Funding Authority. This paper presents CPGs for schizophrenia and related disorders. Over the past decade schizophrenia has become more treatable than ever before. A new generation of drug therapies, a renaissance of psychological and psychosocial interventions and a first generation of reform within the specialist mental health system have combined to create an evidence-based climate of realistic optimism. Progressive neuroscientific advances hold out the strong possibility of more definitive biological treatments in the near future. However, this improved potential for better outcomes and quality of life for people with schizophrenia has not been translated into reality in Australia. The efficacy-effectiveness gap is wider for schizophrenia than any other serious medical disorder. Therapeutic nihilism, under-resourcing of services and a stalling of the service reform process, poor morale within specialist mental health services, a lack of broad-based recovery and life support programs, and a climate of tenacious stigma and consequent lack of concern for people with schizophrenia are the contributory causes for this failure to effectively treat. These guidelines therefore tackle only one element in the endeavour to reduce the impact of schizophrenia. They distil the current evidence-base and make recommendations based on the best available knowledge. Method: A comprehensive literature review (1990-2003) was conducted, including all Cochrane schizophrenia reviews and all relevant meta-analyses, and a number of recent international clinical practice guidelines were consulted. A series of drafts were refined by the expert committee and enhanced through a bi-national consultation process. Treatment recommendations: This guideline provides evidence-based recommendations for the management of schizophrenia by treatment type and by phase of illness. The essential features of the guidelines are: (i) Early detection and comprehensive treatment of first episode cases is a priority since the psychosocial and possibly the biological impact of illness can be minimized and outcome improved. An optimistic attitude on the part of health professionals is an essential ingredient from the outset and across all phases of illness. (ii) Comprehensive and sustained intervention should be assured during the initial 3-5 years following diagnosis since course of illness is strongly influenced by what occurs in this 'critical period'. Patients should not have to 'prove chronicity' before they gain consistent access and tenure to specialist mental health services. (iii) Antipsychotic medication is the cornerstone of treatment. These medicines have improved in quality and tolerability, yet should be used cautiously and in a more targeted manner than in the past. The treatment of choice for most patients is now the novel antipsychotic medications because of their superior tolerability and, in particular, the reduced risk of tardive dyskinesia. This is particularly so for the first episode patient where, due to superior tolerability, novel agents are the first, second and third line choice. These novel agents are nevertheless associated with potentially serious medium to long-term side-effects of their own for which patients must be carefully monitored. Conventional antipsychotic medications in low dosage may still have a role in a small proportion of patients, where there has been full remission and good tolerability; however, the indications are shrinking progressively. These principles are now accepted in most developed countries. (vi) Clozapine should be used early in the course, as soon as treatment resistance to at least two antipsychotics has been demonstrated. This usually means incomplete remission of positive symptomatology, but clozapine may also be considered where there are pervasive negative symptoms or significant or persistent suicidal risk is present. (v) Comprehensive psychosocial interventions should be routinely available to all patients and their families, and provided by appropriately trained mental health professionals with time to devote to the task. This includes family interventions, cognitive-behaviour therapy, vocational rehabilitation and other forms of therapy, especially for comorbid conditions, such as substance abuse, depression and anxiety. (vi) The social and cultural environment of people with schizophrenia is an essential arena for intervention. Adequate shelter, financial security, access to meaningful social roles and availability of social support are essential components of recovery and quality of life. (vii) Interventions should be carefully tailored to phase and stage of illness, and to gender and cultural background. (viii) Genuine involvement of consumers and relatives in service development and provision should be standard. (ix) Maintenance of good physical health and prevention and early treatment of serious medical illness has been seriously neglected in the management of schizophrenia, and results in premature death and widespread morbidity. Quality of medical care for people with schizophrenia should be equivalent to the general community standard. (x) General practitioners (GPs)s should always be closely involved in the care of people with schizophrenia. However, this should be truly shared care, and sole care by a GP with minimal or no special Optimal treatment of schizophrenia requires a multidisciplinary team approach with a consultant psychiatrist centrally involved.

The link between prejudiced attitudes and discriminatory behaviour: The role of ingroup norms

In the present research, a reconceptualisation of the role of norms in the link between prejudiced attitudes and discriminatory behaviour — along the lines suggested by the social identity perspective — was tested. In the first study, group salience and group norm were manipulated. As expected, participants ascribed negative traits to significantly fewer Asian university students when they had received consensus information along these lines from a salient ingroup rather than from a salient outgroup. These results were replicated on a measure of strength of motivation to appear nonprejudiced. In a second study, group salience and norm were once again manipulated and strength of attitude and perceived group threat were measured. As predicted, people's negative attitudes towards globalisation were more likely to predict congruent behavioural responses to the extent that the group norm supported the attitude and group salience was high, particularly when high levels of group threat were perceived.

Suppressing the negative effect of devaluation on group identification: The role of intergroup differentiation and intragroup respect

We examined (N = 76) how social creativity strategies such as intergroup differentiation and intragroup respect suppress the negative impact of threat to an ingroup's value on group identification. Threat was manipulated through false feedback concerning how other groups perceived an ingroup. Both intergroup differentiation and intragroup respect were higher when participants learned that the ingroup was devalued compared to when it was valued. Mediational analyses demonstrated that these factors suppressed the direct negative relationship between value threat and group identification. Discussion focused on the consequences of these social creativity strategies for group identification and collective action. (C) 2004 Elsevier Inc. All rights reserved.

'Lots of little kindnesses': valuing the role of older Australians as informal volunteers in the community

This paper describes the ways in which older people contribute to their communities and families as informal volunteers. It challenges current ways of thinking that assign an economic value to the productive activities undertaken by older people. Using qualitative data from a study of older people resident in Queensland, Australia, the paper explores the ways that older people contribute to their families and to the community and the outcomes associated with these activities. Two specific themes emerged from the data: first, the ways' in which older people contribute to strong inter-generational relations, and second, how they provide essential mutual support that permits many older people to remain living in the community. These contributions, while often small in themselves, are in aggregate critical both to family functioning and to the maintenance of sustainable and healthy communities. Many are reciprocal interactions that add value to the lives of individuals and offer positive social roles in later life, and they may be particularly important for those from minority cultural backgrounds or at risk of social isolation. The findings suggest that older people are integral to community and civil society and, therefore, that social policy should respond to the ageing of Australia's population and recognise the positive contributions of older people, rather than emphasising the costs of demographic change.

The impact of expert testimony on jurors' decisions: Gender of the expert and testimony complexity

The present study investigated whether people used the gender of an expert witness as a heuristic cue to evaluate the evidence presented by the expert. Specifically, the gender of the expert and the complexity of the expert's testimony (low, high) were varied systematically within a simulated civil trial involving an antitrust price-fixing agreement. It was expected that the male expert would be more persuasive than the female expert, but only when the testimony presented was complex. As predicted, this interaction was revealed across a range of dependent measures. Somewhat unexpected was the finding of a female expert advantage in the low-complexity condition. The implications of these findings are discussed.

The role of CD4 T help in multiple vaccinations when using minimal CD8 T cell epitope peptides

Background: The fact that some cancers and viral infections can be controlled by effector CD8 T cells led to the possibility of utilising minimal CD8 T cell epitope peptides as vaccines. However using minimal CD8 T cell epitope peptide immunisations and a tumour protection model in mice, we have previously shown that functional memory CD8 T cells are not generated unless CD4 T help is provided at the time of CD8 T cell priming. Short-lived effector cells nevertheless are generated in the absence of T help. Aim: To determine the role of CD4 T help in multiple immunisations. Method: Minimal CD8 T cell peptides of HPV16 E7 protein and Ovalbumin were used (with adjuvants Quil-A or IFA) as immunogens in C57BL mice. The presence of effector CD8 T cells were determined by tumour protection assays and was quantified by IFN-gamma ELISPOT assays. Results: In the present study we show that unless T help is provided at the time CD8 T cells are primed, no CD8 effector cells are generated when boosted with the vaccine again in the absence of T help. Our results further show that this failure could be prevented by the inclusion of a T helper peptide during the primary or booster immunisations.

The role of R&D technology in asymmetric research joint ventures

We characterize asymmetric equilibria in two-stage process innovation games and show that they are prevalent in the different models of R&D technology considered in the literature. Indeed, cooperation in R&D may be accompanied by high concentration in the product market. We show that while such an increase may be profitable, it may be socially inefficient.