The influence of Val158Met COMT on physiological stress responsivity.

We tested the extent to which the catechol-O-methyltransferase (COMT) Val158Met polymorphism is associated with stress response and pain in both men and women. The participants were assessed on measures of perceived pain and state/trait anxiety in association with their COMT allele status. We also measured cortisol and salivary alpha-amylase (sAA) levels since previous research suggests an association between the COMT Val159Met polymorphism, cortisol secretion, and sAA activity. We found significant differences between methionine (Met) allele carriers and valine (Val) homozygotes following a stress manipulation in sAA levels. Met allele carriers had a stronger sAA response when compared to Val homozygotes. Furthermore, Val homozygotes showed a positive correlation between their sAA levels and trait anxiety at baseline and 20 min post-stress manipulation but displayed a negative correlation with the change in sAA levels from baseline to 20 min post-stress manipulation. Finally, state/trait anxiety was significantly correlated in Met allele carriers. These findings add support to the COMT warror/worrier model which states under stressful situations, increased dopamine levels in Val (warrior) homozygotes affords an emotional advantage relative to Met (worrier) allele carriers, who show an increased reactivity to aversive stimuli. Summary These findings offer new support for the warrior/worrier model of COMT genotype (rs4680) on human behavior. Twenty minutes following exposure to a cold stress, Val homozygotes (warrior) showed a lower biochemical stress response (salivary alpha-amylase, sAA) relative to methionine (Met) allele carriers (worrier). We further show that the COMT genotype differentially influences state and trait anxiety measures as they relate to stress responses and to each other.

Predoctoral prescriptive authority curricula: a training option.

The purpose of the current article is to encourage discussion among stakeholders about the viability and benefits of predoctoral prescriptive authority (RxP) training. The existing APA model curriculum for RxP training requires that such training is postdoctoral. However, predoctoral models are potentially viable and offer several distinct advantages: reducing the time and financial costs of training, attracting more applicants with a biopsychosocial orientation, and, as more individuals complete this training, enlarging the constituency for state prescriptive authority initiatives. Several possible predoctoral model curricula including the incorporation of a postdoctoral master's degree in clinical psychopharmacology are described within existing APA PhD program requirements, with suggested accommodations for PsyD programs. These are offered as alternatives to, rather than as replacements for, postdoctoral training for RxP.

Societal Reentry of Prison Inmates With Mental Illness: Obstacles, Programs, and Best Practices.

Societal reentry from prison presents a wide array of extreme challenges to inmates attempting to reintegrate with society. This process is significantly more daunting for inmates suffering from mental illness for several reasons. This paper examines the reentry process for inmates with mental illness. Three sample reentry programs (Forensic Assertive Community Treatment, Critical Time Intervention, and Thresholds' Prison Aftercare Program) that were developed for inmates with mental illness are discussed along with research testifying to the effectiveness of these programs. Finally, components that would comprise an ideal prison reentry program for mentally ill inmates are outlined, which include a three-phase structure and a focus on preparing both inmates and communities for the reentry process.

The Effects of Restrictive Housing on the Psychological Functioning of Inmates.

The use of restrictive housing as a correctional management tool has received much attention in recent years, especially as it impacts psychological functioning. While there is considerable literature advocating for the reduced use of restrictive housing, much of it is based on opinions, interview data, and testimonials. This article reviews only the empirical evidence regarding the effects of restrictive housing on psychological functioning in actual correctional settings. Results of this review indicate that only a limited number of empirical studies examine the effects of restrictive housing on mental functioning in correctional settings. Findings from these studies are mixed and are fraught with definitional, geographic, and methodological problems. These problems are identified and discussed. Also, suggestions are made for future research directions to more clearly understand the effects of restrictive housing on psychological functioning.

Self-injurious behavior in correctional settings.

This article reviews the literature concerning self-injury among criminal offenders. It describes many of the problems, barriers, and obstacles to effective assessment and treatment of self-injury and discusses the absence of a clear paradigm within which to develop a classification system and standardized nomenclature to describe the spectrum of self-injurious behaviors. This article distinguishes between self-injury resulting from suicidal versus nonsuicidal intent, presents treatment strategies for managing each, and concludes with a proposed set of eight recommended goals for creating a national strategy to develop self-injury programming in correctional settings.