ABSTRACT
This study aimed to test the assumption drawn from weak central coherence theory that a central cognitive mechanism is responsible for integrating information at both conceptual and perceptual levels. A visual semantic memory task and a face recognition task measuring use of holistic information were administered to 15 children with autism and 16 typically developing children. If there is a central integration mechanism, performance on the two tasks should be positively associated. No relationship was found, however, between the two abilities in the comparison group and, unexpectedly, a strong significant inverse correlation was found in the autism group. Classification data further confirmed this finding and indicated the possibility of the presence of subgroups in autism. The results add to emerging evidence suggesting that central coherence is not a unitary construct.
Subject(s)
Autistic Disorder/psychology , Perceptual Disorders/psychology , Visual Perception , Autistic Disorder/classification , Autistic Disorder/diagnosis , Case-Control Studies , Child , Cognition Disorders/psychology , Concept Formation , Humans , Memory Disorders/psychology , Neuropsychological Tests , Reaction TimeABSTRACT
BACKGROUND: Introduction of crisis resolution/home treatment teams has been associated with a reduction in hospital admissions in trials. Between 2001 and 2004 there was a rapid expansion in the numbers of these teams in England. AIMS: To examine whether national implementation of these teams was associated with comparable reductions in admissions. METHOD: Observational study using routine data covering working age adult patients in 229 of the 303 local health areas in England from 1998/9 to 2003/4. RESULTS: Admissions fell generally throughout the period, particularly for younger working age adults. Introduction of crisis resolution teams was associated with greater reductions for older working age women (35-64 years); teams always on call were associated with additional reductions for older men and younger women. By the end of the study admissions had fallen by 10% more in the 34 areas with crisis resolution teams in place since 2001, and by 23% more in the 12 of these on call around the clock than in the 130 areas without such teams by 2003/4. Reductions in bed use were smaller. Introduction of assertive outreach teams was not associated with overall reductions in admissions. CONCLUSIONS: Introduction of crisis resolution teams has been associated with reductions in admissions.
Subject(s)
Community Mental Health Services/statistics & numerical data , Crisis Intervention/statistics & numerical data , Hospitalization/statistics & numerical data , Mental Disorders/therapy , Adolescent , Adult , Community Mental Health Services/trends , Crisis Intervention/trends , England , Female , Hospitalization/trends , Humans , Male , Middle AgedABSTRACT
BACKGROUND: Mathematical models relating rates of mental health care use to population characteristics such as social deprivation are widely used in both planning and researching mental health services. The models currently in wide use in England are based on data mostly derived from the 10-yearly population censuses. These are perceived to be out of date many years before new census data are available for their replacement. A new set of government deprivation monitoring statistics based mainly on annually updatable data has recently been developed. This study set out to produce a mental illness needs index based on these new data. METHODS: A series of regression models were tested using individual domain scores from the DETR Index of Multiple Deprivation and the Office of National Statistics area-type classification as independent variables to predict 1998/9 psychiatric admission rates for broad diagnostic groups for 8251 of the 8414 electoral wards in England as dependent variables. RESULTS: The distribution of admission numbers in wards showed a pattern of over-dispersion with an excessive number of zero values for conventional regression approaches. A two-stage 'hurdle' model was, thus, adopted, predicting first the likelihood that wards would produce any admissions and second the probable number. This produced satisfactory predictive power, with residual variance showing strong geographical patterns associated with administrative areas, probably arising from differential resourcing or idiosyncratic clinical practice. CONCLUSIONS: A website providing data on the various indicators has been provided and its uses are indicated.
