Vol 7-3 Review Article

Mental health clinical exams’ evident adherence to industry standards for testing

The developers of clinical exams for US mental health licensure have faced significant recent criticism and calls for their exams to be paused or discontinued.1,2 Critics cite concerns over exams lacking evidence of validity, while they demonstrate strong evidence of racial and ethnic bias. Developers, in turn, argue that their exams are developed using accepted methods that conform with industry standards, specifically, the Standards for Educational and Psychological Testing.3

This manuscript challenges that assertion. Based on external research as well as developers’ own statements and publications, clinical exams for US mental health care licensure appear to deviate in important ways from both the letter and the spirit of the Standards. Clinical exams should be paused unless and until they are shown to be fair, equitable, valid, and more fully consistent with industry norms.

DOI: 10.29245/2578-2959/2023/3.1283 View / Download Pdf
Vol 7-3 Research Article

Adolescent Woes? Approval Motivation, Test Anxiety, and the Role of Perceived Self-Control

The Association of Adolescents and Child Care in India (AACCI) conducts multicentric studies on youth behavior in India. Using openly accessible psychometric tools, the present study discusses the demographic-wise interrelationships between the Children’s Perceived Self-Control (PSC), Martin-Larsen Approval Motivation (AM), and Friedben’s Test Anxiety Scales (FTAS) administered to 712 students (Group-1: 10-14 yrs.; Group-II: 15-18 yrs.) from two Delhi-based schools. The survey-questionnaire included four demographic variables: age, gender, sibling status, and body mass index. Although mainstream literature has uniformly contented in favour of the benefits of PSC, one-way ANOVAs in the present study revealed that high PSC was associated with significantly high AM (F[2,709] =3.033, p =0.049), suggesting that people with high PSC may diligently weigh short- and long-term consequences, choosing behaviors that best align with their interests and enduringly valued goals. Further, this relationship was statistically significant for participants in the no siblings (p =0.005) and underweight groups (p =0.031). Participants with high PSC had the lowest FTAS scores; however, this relationship was not statistically significant. Lastly, AM and FTAS were negatively correlated (r =-0.216, p<0.01), especially for females, Group-II, and participants with siblings (r =-0.278, -0.292, and -0.244, respectively), clarifying distinct differences between AM and FTAS’ subscales. The implications of findings were shared with the school management to conduct customized interventions using the WHO’s Life Skills Education framework. The findings highlight the need for time-series interventional analysis to ascertain the direct and cumulative effects of intervention on the interrelationships between PSC, AM, and FTAS.

DOI: 10.29245/2578-2959/2023/3.1278 View / Download Pdf
Vol 7-3 Review Article

Remote Warfare with Intimate Consequences: Psychological Stress in Service Member and Veteran Remotely-Piloted Aircraft (RPA) Personnel

The use of remote piloted aircraft (RPAs) has been a part of military operations for decades and this type of service can present its own unique constellation of combat experiences and psychological consequences. The RPA crewmember experience has typically involved surveillance, targeting, striking, and after-battle assessments of individuals of interest to a host country or agency from a distance that can span several thousand miles. These operators are engaged in physically remote activities that carry a significant degree of intimacy due to the live, high-resolution, high-fidelity images and sounds that are available to the combatants in real-time. The potential psychological consequences of this type of military occupational specialty can include the symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD) as well as moral injury, mental exhaustion or burnout, and disturbed sleep. The following narrative review examines the current state of RPA warfare from a psychological trauma perspective with an emphasis on the evolution of the inherent technology, the operator force, the psychological experiences and consequences of this type of service, and potential preventative interventions for servicemembers. A key objective of this narrative review is to integrate the available peer-reviewed empirical data, experiential military perspectives and analyses, clinician observations from this unique population, and exemplar reports from those with lived experience on an RPA crew regarding psychological consequences of this military occupational specialty.

DOI: 10.29245/2578-2959/2023/3.1289 View / Download Pdf
Vol 7-3 Case Report

Generalized Anxiety Disorder and Depression Associated with Developmental Prosopagnosia: A Case Report

Developmental prosopagnosia is a disorder of facial recognition that begins during early childhood in the absence of acquired central nervous system disease. We report the case of a 15-year-old female with developmental prosopagnosia as measured by the 20-item Prosopagnosia Index and Cambridge Face Memory Test who ultimately developed generalized anxiety disorder and depression despite relatively normal social and psychological function during early childhood. In elementary school, the case patient adapted by learning alternative ways to identify others, such as by clothing and hairstyle, but this became more difficult in junior high school due to the requirement for school uniforms and regulations on hairstyle. This difficulty in turn led to interpersonal problems that ultimately resulted in symptoms of generalized anxiety disorder and depression, such as headache and sleep dysfunction. People with developmental prosopagnosia are generally prone to having depressed and anxious feelings. However, to the best of our knowledge, this is the first case report of anxiety disorder or depression related to developmental prosopagnosia. This comorbidity may be relatively common, especially in ethnically homogeneous countries with strict school regulations on personal appearance such as Japan.

DOI: 10.29245/2578-2959/2023/3.1290 View / Download Pdf
Vol 7-3 Research Article

Social Anxiety in University Students: Towards an Intentional Life-Skills Based Prevention Model

Research suggests that staying connected with people is very beneficial to our physical and mental well-being. Moreover, a lack of social connection is associated with poor mental and physical health, and lower overall well-being. For individuals with social anxiety, it is particularly difficult to cultivate social connections. Due to the prolonged period of social isolation during the COVID-19 pandemic, research suggests that social anxiety in university students has increased. This study employed a convergent parallel mixed method design and administered a self-reported questionnaire which included quantitative and qualitative questions. The questionnaire was administered to 301 undergraduate students to determine if feelings of social anxiety in students changed during and after the pandemic. This study also analyzed social anxiety levels across racial and ethnocultural demographics and assessed the cultural stigmas and barriers that may prevent students from accessing mental health services. Results from the quantitative analyses showed a significant difference in social anxiety scores before and after the pandemic. However, in our sample, feelings of social anxiety post-pandemic did not differ across race, or income which were our main variables of interest. In addition, there was a positive correlation between social anxiety scores and household income and fear of negative evaluation. The qualitative results showed that important barriers to accessing mental health services include fear of parents learning they are in therapy, cost of mental health services, language barriers, and concern that a therapist would not have cultural sensitivity. This study highlights the need for increased interventions to reduce social anxiety among students, and proposes a preventative approach we refer to as “Life-Skills Training” to address social anxiety.

DOI: 10.29245/2578-2959/2023/3.1282 View / Download Pdf