Ethical practice from the perspective of the forensic psychologist : commentary on the uses and value of the Australian Psychological Society (2007) code of ethics

Forensic practice in Australia and around the world attracts a high level of public and judicial scrutiny. The way in which the forensic psychologist conducts him or herself in ethically challenging situations is important not only to the reputation of the individual practitioner, but to the profession more widely. This paper outlines some of the ethical issues that commonly arise in forensic psychology practice and discusses these in relation to the recently published Australian Psychological Society (2007) Code of Ethics. Four ethically challenging scenarios are described and discussed in terms of how the Code might be used to offer guidance to psychologists about how they might best respond.

Intake of B vitamins in childhood and adult life in relation to psychological distress among women in a British birth cohort

Background : Lower levels of B vitamins (particularly folate, vitamin B12 and vitamin B6) may be associated with psychological distress. Little is known about the impact of childhood nutrition on psychological distress in adult life.

Objective : We investigated whether prospectively measured childhood and adult dietary intakes of thiamin, riboflavin, niacin, folate, vitamin B6 and vitamin B12 were related to the psychological distress of women in mid-age, taking into account socio-economic, behavioural and lifestyle factors.

Design : Prospective data were collected from a cohort of 636 British women followed up since their birth in 1946. Participants completed a 28-item, scaled version of the General Health Questionnaire (GHQ-28) to measure psychological distress at age 53 years. Dietary intakes in childhood (at age four) were determined by 24h recall and in adulthood (at age 36, 43 and 53 years) by a 5d food record.

Results : Low dietary vitamin B12 intake at age 53 was associated with higher psychological distress at that age. Women in the lowest third of vitamin B12 intake in adulthood had a higher GHQ-28 score compared with those in the highest third (percentage change, adjusted regression coefficient, 21 (95% CI 3, 39)). There were no other significant associations between dietary B vitamin intake in childhood or adulthood and psychological distress in the cohort.

Conclusions : Overall, there is evidence that intake of vitamin B12 at age 53 is related to adult psychological distress but there is no evidence for the effects of other adult B vitamin intakes or childhood intakes on psychological distress.

Psychological and cumulative cardiovascular effects of repeated angry ruminaton and visuospatial suppression

Brooding rumination is associated with depressed mood, increased negative affect, prolonged anger and inhibited cardiovascular (CV) recovery. Distraction from rumination on a stressful interpersonal encounter is associated with faster CV recovery and decreased negative affect. Studies have suggested that a concurrent visuospatial (VS) task inhibits the maintenance of imagery associated with the perseveration of intrusive negative memories. 120 healthy participants were recruited for the study. As an analogue of repeated angry rumination, the authors explored the effects of repeated visual recall of a provocative confederate and the subsequent impact of two visuospatial (VS) distraction tasks on negative affect, blood pressure (BP) and heart rate (HR). Repeated recall of the provocation generated repeatedly elevated HR with a cumulative trend that may have CV disease risk implications for chronic ruminators. VS distraction did not aid recovery compared with the Control task.

The impact of the work conditions of allied health professionals on satisfaction, commitment and psychological distress

BACKGROUND: Allied health professionals are integral to the effective delivery of hospital-based health care, yet little is known about the working conditions associated with the attitudinal and health outcomes of these employees.

PURPOSE: The purpose of this study was to investigate the extent to which the demand-control-support model, in combination with organizational justice variables, predicts the employee-level outcomes of allied health professionals.

METHODOLOGY/APPROACH: Allied health professionals from an Australian health care organization were surveyed, with 113 (52.6%) participating. The survey included measures of job demands, job control, social support, organizational justice, satisfaction, commitment and psychological distress.

FINDINGS: Multiple regression analyses reveal that the additive demand-control-support model predicts the outcome variables of job satisfaction, organizational commitment and psychological distress, whereas the organizational justice variables predicted organizational commitment and psychological distress. Further, both work and nonwork sources of support, in addition to specific justice dimensions, were closely associated with employee-level outcomes.

PRACTICAL IMPLICATIONS: When coupled with previous research involving social support and organizational justice, the findings from this study suggest that initiatives aimed at strengthening supervisor and nonwork support, while enhancing perceptions of organizational fairness, may offer useful avenues for increasing the levels of satisfaction, commitment and well-being experienced by allied health professionals.

Habitus shock : a model for architect-client relationships on house projects based on sociological and psychological perspectives

The widening gap between architects and clients and the associated problems in the management of their relationship have long been recognised by practitioners and researchers alike. An emerging trend in recent studies is to develop descriptive models to describe behavioural characteristics of relationships based on observations of ' real world' practice, indicating the significance of understanding the complexities of the social environment in which the architect-client relationship is within. This research built upon the work of past descriptive models by exploring the architect-client relationship on house projects with a focus on the client's voice. It is an interdisciplinary study drawing theory from sociology to further understand this built environment industry problem. Sixty-nine percent of architects in Australia spend some of their work time on house projects and therefore improvements in this area can have significant impact on a considerably large portion of the profession. Habitus theory borrowed from sociology explains that the nature of architecture as a specialised activity places architects within an architectural habitus, distinguishing them from clients who are .not trained in the field. An underlying premise of thi s study is that a mismatch between the architect and client's habituses occurs as they enter into a relationship on the house project. This phenomenon is termed habitus shock, referring to the client 's experience of disorientation as they are confronted with an unfamiliar architectural habitus on the project. Culture shock theory is examined for its contribution to explain the process to which the client adjusts to the unfamiliar environment during habitus shock. The habitus shock model proposed in this paper suggests that the client may achieve learning during habitus shock and it is this client learning that can lead to successful relationships.

Beating the blues after cancer : randomised control trial of a tele-based psychological intervention for high distress patients and carers

Background : The diagnosis and treatment of cancer is a major life stress such that approximately 35% of patients experience persistent clinically significant distress and carers often experience even higher distress than patients. This paper presents the design of a two arm randomised controlled trial with patients and carers who have elevated psychological distress comparing minimal contact self management vs. an individualised tele-based cognitive behavioural intervention.

Methods/design : 140 patients and 140 carers per condition (560 participants in total) will been recruited after being identified as high distress through caller screening at two community-based cancer helplines and randomised to 1) a single 30-minute telephone support and education session with a nurse counsellor with self management materials 2) a tele-based psychologist delivered five session individualised cognitive behavioural intervention. Session components will include stress reduction, problem-solving, cognitive challenging and enhancing relationship support and will be delivered weekly. Participants will be assessed at baseline and 3, 6 and 12 months after recruitment. Outcome measures include: anxiety and depression, cancer specific distress, unmet psychological supportive care needs, positive adjustment, overall Quality of life.

Discussion : The study will provide recommendations about the efficacy and potential economic value of minimal contact self management vs. tele-based psychologist delivered cognitive behavioural intervention to facilitate better psychosocial adjustment and mental health for people with cancer and their carers.

Enablers and barriers to accessing mental health services for adults with high prevalence psychological disorders in South West Victoria

Knowing what services are available and how to access them can be challenging in rural areas. The aim of the South West Mental Health Mapping project was to identify the level, accessibility and effectiveness of mental health services for high prevalence psychological disorders amongst the adult population in the South West region of Victoria. This study includes data from a number of sources: regional records of the number and location of health professionals; a telephone survey of 1297 people in five Local Government Areas in the region; and a social network analysis of contact points. Additional qualitative interviews and surveys were conducted with 25 service recipients and 37 health professionals to identify issues from different perspective. This paper will focus on the social network analysis of the project. It highlights the relative prominence of each type of service provider within the overall network. The social network map shows the centrality of the General Practitioner and the wide range of agencies that become involved in supporting people with mental health issues. The discussion identifies primary contact points for people seeking help and places of referral. The main barrier acknowledged by people requiring assistance was lack of knowledge about where to go for help. Enablers included Medicare Better Access funded schemes. The findings show that there is a reasonable range of mental health professionals across the region, although there are challenges with recruitment and retention of staff. Even with available services, a major problem is communicating this information to potential consumers