Author Archives: Susan

Stress Solutions

by Susan Andrews, PhD

New Years’ Resolution: This Year I’ve Got to Manage Stress Better

It’s that special time of the year when we make those statements about our goals for better living for the coming year. I don’t know about you, but every time I make a resolution that resolution that involves diet or exercise or work habits, I tend to forget that I even made such a resolution by mid-March. Life happens, and we adapt and move on. The first thing to go for many people is exercise unless you are one of those people who have been focused on exercise and have made it a full-blown habit. Stress takes a big toll on most professionals who are building a career. Consider making a 2019 Resolution to manage your stress better this year. It will improve your health and your happiness.

Habits are very stubborn things. It is tough to break a habit. But, it is even tougher to build a new habit. A few new books have even been written about how to build good habits and keep them going strong. I recommend The Power of Habit: Why We Do What We Do in Life and Business, by Charles Duhigg (2014). This book was a New York Times Bestseller and available many places.

Developing a habit is like making a decision and then working to make it “automatic” behavior, things you do without planning them first or even thinking about them or making a list. Duhigg asked some great beginning questions in the prologue: What is the first thing you do in the morning? Hop in the shower? Brush your teeth? Grab your cell phone and check your messages? Duhigg’s basic message is that habits can be changed if you understand how they work.

William James wrote in 1892: “All of our life, so far as it has definite form, is but a mass of habits.” Whereas many of our habits get in our way and keep us in a loop, developing strong positive habits can make you more productive and effective at what you want to do.

Pick out one or two ways that you want to try to manage your stress better on a daily basis. We have gone over a large number of them. Don’t try to do too many at once. You are more likely to be successful if you start with one or two relaxation techniques that do not take a huge amount of time and that you think will really work for you. If successful, you can always add more down the line.

The key to building any new habit, even taking frequent relaxation breaks, is to repeat the new behavior frequently so that it can become an established pattern or link in your nervous system. Developing a habit basically means that a behavior becomes more or less automatic for you. Various experts offering advice on how long it takes to build a habit agree that it takes frequent repetition for 14 to 21 days. That means you have to be very aware of and conscious of repeating the same behavior each day multiple times. Any person who has made a New Year’s resolution to lose weight or start an exercise regimen knows that if you miss even a few days in the beginning of trying to start a new habit, you are probably not going to succeed. The old expression “just wait till next year” may come from that. There is no time like the present to start building a new habit of working with stress solutions. So, I leave you with the following message: This is a good time to take a relaxation break.

 

Mary Poppins Returns: Supercalifragilisticexpialidocius?

by Alvin G. Burstein

I viewed the 2018 sequel in the context of two of its predecessors: the 1964 Mary Poppins block-buster film featuring Julie Andrews and Dick Van Dyke and the 1934 book by that name written by P. L. Travers.

Set in 1935, the sequel picks up the story of the Banks family twenty-five years after Mary Poppins departure in the first film. Michael, the oldest son, is now widowed and trying, with the help of his sister, Jane and Ellen, the maid, to raise his two children. Having to raise money that his paltry salary is inadequate to meet, he has taken a loan from his employer, the Fidelity Fiduciary Bank, and has fallen behind in re-paying it. As the movie opens, he and the family learn that the Bank is about to repossess their home and evict them. His son, George, finds his father’s childhood, about to be discarded kite, and takes it to the park. Once airborne, the kite returns—bearing Mary Poppins. She returns to her nanny duties, involving the children in sundry adventures, and ultimately is central in foiling the threatened dispossession of the family.

Both films are froth, fanciful confections. If you liked the first film, you will like the second. But there are some differences. Though real in a cartoonish sense—think chim chim cher-ee and superacalifragilisticexpialidocius. Those of the sequel more mood lifting, like Orphan Annie’s Tomorrow.

Dick Van Dyke, the chalk artist and chimney sweep in the first film, dances with Astaire-like precision; Lin-Manuel Miranda, the lamp-lighter in the sequel, dances with an athleticism that evokes memories of Gene Kelley. Emily Blunt’s Mary Poppins displays a taste for exhibitionism and an attachment to her charges that is less prominent than is Julie Andrew’s. Both films center on an evolution in the character of the fathers in succeeding generations. In the first film, Mr. Banks becomes less business oriented, more playful and familycentered. In the second film, his son, that Mr. Banks, becomes less depressed and more assertive. Changes in both cases, but quite different ones.

Lastly, doubtless as a function of a heightened contemporary concern about such matters, the second film is much more scrupulous in avoiding invidious racial stereotyping. The second film has Black characters in substantial roles; the first has Admiral Boom, upset at the sight of a group of sooty chimney sweeps cavorting, having his cannon fired at them, referring to them as Hottentots.

Both films differ from the Travers book in important ways. Most important is that the movies’ great strength is spectacle, fascinating the audience with an elaborate, intricate, kaleidoscopic firework display. The book, when read, stimulates the imagination. The films distract. The book provokes. The experiences of children reading the book or having it read to them by a parent is vastly different and much richer than that of a child entranced by the film. That is probably true in general of movie watching versus reading. That difference is especially clear in the case of Mary Poppins, who, in Travers book, has a hamadryad in her ancestry and wears a snake skin belt. For readers of any age, that Mary Poppins is darker, more complex, and more compelling than her screen version.

 

Gov. Appoints Mr. Heller To Psychology Board as New Consumer Member

On December 27 the Governor appointed Amitai Heller, of New Orleans, to the Louisiana State Board of Examiners of Psychologists. Heller is an attorney with the Advocacy Center of Louisiana. He will serve as a private citizen and consumer member on the board, a new reform put forward in the 2018 legislative session by Senator Mills.

Mr. Heller works in the legal division of the Advocacy Center, an organization that serves people with disabilities and senior citizens. According to their website, “The Advocacy Center of Louisiana protects, empowers, and advocates for the human and legal rights of people with disabilities and seniors living in Louisiana, in order that they may live an integrated life in the community, free from abuse, neglect and exploitation.”

“The agency was founded pursuant to a federal law establishing protection and advocacy systems in each state and territory in the U.S. The mandate of the protection and advocacy systems is “to pursue legal, administrative, and other appropriate means to ensure the rights of persons with development disabilities in the state.” Since 1977, we have added other populations to our client base including persons with other mental and physical disabilities and senior citizens

Rural Health Focus On Opioid Deaths

The Louisiana Department of Health announced in September 2018 that it had received a Federal grant of more than $24 million toward addressing the opioid epidemic in our state, said Dr. Tiffany Jennings, licensed psychologist in Shreveport, and Louisiana Psychological Association (LPA) Rural Health Coordinator for the American Psychological Association, and chair of the LPA the Rural and TeleHealth Services Committee.

According to the United States Department of Agriculture (USDA) almost 200 people per day died from drug overdose in 2017, more than 72,000 Americans during the year. The overwhelming majority of these overdose deaths involved an opioid. The Centers for Disease Control and Prevention said that the rates of drug overdose deaths are rising in rural areas, surpassing the numbers in urban areas.

“This grant was funded from the Center for Disease Control and Prevention and the US Dept. of Health and Human Services,” said Dr. Jennings. “The money will be used for improving access to treatment, prevention strategies, improving surveillance data and to enable health centers and other agencies to expand integrated services treatment.”

“But we’ve still got a long way to go,” said Jennings. “Mental Health America ranked Louisiana 45th for access to mental health care. In 2016, the Medicaid expansion did provide insurance coverage for more than 430,000 people, it’s difficult to obtain mental health services. Many doctors and agencies will not accept Medicaid due to reimbursement issues and low reimbursement rates. Agencies that do take Medicaid have a waiting list,” she said.

Dr. Jennings has previously served as a neuropsychologist at Overton Brooks Veterans Administration Medical Center in Shreveport and also neuropsychologist for the U.S. Army’s Traumatic Brain Injury Clinic in Fort Polk in Leesville, Louisiana.

As Rural Health Coordinator for APA and LPA, Dr. Jennings has said that one of the goals of her committee is to “develop an ongoing community where those in rural areas, or who serve rural populations, can collaborate with each other.” She said that sharing experiences as to how to set up various telehealth services and also to review current guidelines will be important goals ….”

“Another objective in mind is initiating and continuing the conversation regarding the opioid crisis,” said Dr. Jennings previously. “… it’s a major focus of concern.”

“Telemedicine has been gaining more ground in treatment, particularly for those in rural areas where treatment services may be limited, or non-existent,” she said. “University Health in Shreveport was highlighted in the local media (KTBS.com) highlighting the advantages of telemedicine –such as cost, reduced transportation burden–and that telemedicine can be as effective as traditional in-person treatments,” said Jennings.

This past fall the USDA launched an interactive data tool aimed to help communities build grassroots strategies to stem the opioid epidemic, to help rural leaders make data-driven decisions for their communities.

The USDA invites leaders to see the many ways your community can partner with USDA to meet immediate needs in this fight. According to the USDA, their program resources can help rural communities address many of the deeper, systemic, and long-term issues making these places vulnerable to the opioid crisis in the first place, the agency notes. Their infographic illustrates how USDA can help rural communities respond to the opioid epidemic by addressing some of the root causes.

Interview with Dr. Heather Pedersen Brain–Health a Growing Concern as Boomers Age

The Center for Disease Control (CDC) announced their State and Local Public Health Partnerships to Address Dementia, The 2018- 2023 Road Map, as part of the CDC Healthy Brain Initiative. The Road Map helps chart a course for state and local public health agencies to prepare their communities to deal with the ever expanding need for brain-health concerns.

According to CDC and their Healthy Brain Initiative, there are at least five to six million people currently living with age-related dementias in the U.S. This translates into one out of every six women and one out of every 10 men, who live past the age of 55. As the population increases, and more Baby Boomers reach older ages, these numbers are expected to rise.

The CDC wants to stimulate changes in policies, systems, and environments. They convened experts who developed 25 actions for public health leaders to promote brain health, better care for people with cognitive impairment, increased attention to caregivers, and efforts to build public health capacity.

“Dementia is a devastating condition that impacts millions of people annually,” said Dr. Heather Pedersen, a board certified clinical neuropsychologist at the Algiers Neurobehavioral Resource, LLC, located in New Orleans.

“Dementia,” she said “is a generic term that refers to when an individual is experiencing cognitive problems––such as memory loss, difficulty with logic, or trouble with language––to such an extent that they cannot manage aspects of daily life.”

According to the CDC, while there are various forms of dementia, around 70 percent of cases are due to Alzheimer’s and the next most common type is vascular dementia. African Americans, Hispanics, and women are particularly at risk of developing Alzheimer’s and other dementias. More than 95% of people with dementia have one or more other chronic conditions. And, one in three Alzheimer’s caregivers report their health has become worse due to care responsibilities.

“There are many diseases and conditions that can lead to dementia,” Pedersen said, “with Alzheimer’s disease being the leading cause of dementia. Per the CDC, the number of adults with Alzheimer’s disease is expected to triple over the next 40 years. Alzheimer’s disease and other dementiacausing diseases impact individuals, families, friends, caregivers, health-care agencies, and communities in wide-ranging ways,” Dr. Pedersen said.

According to the CDC, they seek to promote the use of effective interventions and best practices to protect brain health, address cognitive impairment, and help meet the needs of caregivers for people with dementia. They aim to improve inclusion of healthcare quality measures that address cognitive assessments, improve the delivery of care planning to people with diagnosed dementia, and improve outcomes.

Another of the CDC’s goals is to educate public health professionals about the best available evidence on dementia, including detection. CDC Director Robert R. Redfield, MD, said. “Early diagnosis is key to helping people and their families cope with loss of memory, navigate the health care system, and plan for their care in the future.

“The importance of early detection and intervention for many dementia processes cannot be overstated,” Dr. Pedersen explained. “Some medications are more effective when started earlier and compensatory strategies can often be put into place so as to be more useful in the long run. However, in order to be able to put these interventions into place, an individual has to first be diagnosed with dementia.”

What are some of the benefits of early diagnosis of dementia?

“Early diagnosis of course allows for individuals to begin appropriate medication earlier on in the process, as there are medications for certain diseases, like Alzheimer’s, that can slow down the disease process. But, early diagnosis also allows for individuals and their families to begin to adjust and adapt their lives in ways to make good years last as long as possible,” Dr. Pedersen said. “By making slight changes to schedules, home management, or other systems, individuals can maintain independence for as long as possible.”

Can neuropsychologists’ findings help with treatments and/or treatment planning?

“Absolutely,” Pedersen said. “By helping with an accurate diagnosis, neuropsychologists can also help other providers make informed decisions about treatment options. Neuropsychologist evaluations also help by determining individual’s cognitive strengths and weaknesses,” she said.

“By maximizing strengths to compensate for weaknesses, neuropsychologists can help make suggestions to make tasks more efficient or easier to complete.”

Neuropsychologists can often help caregivers better understand issues for their loved ones and better cope with and adjust to the caring role.

“It is often very helpful for caregivers and other family members to understand the basics about what is causing the cognitive problems or dementia,” Dr. Pedersen explained. “As part of the evaluation process, clients and loved one’s are provided with feedback about what is likely causing their cognitive problems. We spend time discussing the causes, prognosis, treatments, and other strategies that might be helpful in maximizing the client to live their best life.”

In today’s medical culture, the approach is often the quick screening rather than the comprehensive assessment. Is this a concern? A quick screening may not be able to determine the cause of an individual’s cognitive problems, Pedersen explained.

“A comprehensive assessment is critical in the accurate diagnosis of dementia. There are many conditions that can masquerade as dementia and given the permanent, progressive nature of some dementias, it is vital that one isn’t falsely diagnosed,” she said. “There are many different diseases and conditions that cause dementia, some of which are treatable and some of which are not. Depression and some metabolic conditions can ‘look like’ dementia, but in fact are treatable conditions.”

The American Academy of Neurology (AAN) has recommended neuropsychological testing since 1996 for patients who may have experienced a traumatic brain injury, a stroke, Parkinson disease, multiple sclerosis, a neurotoxic exposure, or dementia. Neuropsychological testing “is particularly valuable in distinguishing between normal aging and mild dementias,” they AAN noted.

Dr. Pedersen, who earned her PhD from the University of North Dakota, and completed her postdoctoral fellowship in clinical neuropsychology at the Memphis Veterans Affairs Medical Center and UT Health Sciences Center Consortium, is licensed in Louisiana, Minnesota, and Arizona.

Among her training and research achievements, Dr. Pedersen has co-authored “The next major neuropsychological and neuropsychiatric breakthrough: Alzheimer’s disease,” for the Handbook of Neuropsychiatry Research. She also co-authored research on concussions for American Journal of Alzheimer’s Disease and Other Dementias, and co-authored “Later life health optimism, pessimism, and realism: Psychosocial contributors and health correlates,” published in Psychology and Health.

“Each person who walks through my door is a unique constellation of traits, strengths, and weaknesses, who is looking for some sort of assistance,” Dr. Pedersen said. “I find it very satisfying to come along side each client to work with them in their treatment goals.”

“That process of collaborating with my clients is a very enjoyable process for me,” she said.

ASPPB Uses Carrot & Stick for New EPPP2

Members of the Louisiana State Board of Examiners, at their November 30 meeting in Baton Rouge, discussed how the Association of State and Provincial Psychology Boards (ASPPB) has adopted a reward and punishment program for those state boards still resisting adopting the controversial second examination a psychology license, the EPPP2.

Complaints about the new exam had been growing and escalated when officials at ASPPB decided in August 2017 that the new test was to be mandatory. Following that move and resulting controversy, ASPPB backpedaled somewhat and on October 24 notified its members that they would have an option to use the EPPP but without the EPPP2.

However, there are penalties associated. Some members said they view this as an attempt to coerce states into compliance.

According to the October 24 announcement from Dr. Sharon Lightfoot, President of the ASPPB Board of Directors, if Louisiana chooses to decline the use of EPPP2, individuals here will not be allowed to take EPPP2 even if they wish to do so. Also, those test-takers from compliant states will pay $300 as a reward for early adoption of the additional exam, while those from late adopters will pay $450.

“Only applicants who are registered through a jurisdiction that has adopted the Enhanced Exam, and who have passed the knowledge portion of the exam, will be allowed to take the skills portion of the exam,” said Lightfoot.

“January 1, 2020 through December 31, 2021 is designated as an early adoption period. All jurisdictions who decide to adopt the Enhanced EPPP at any point during this time frame will be offered reduced fees for their applicants,” wrote Lightfoot.

In October, LSBEP members Drs. Amy Henke and Greg Gormanous, and Executive Director, Jaime Monic, attended the annual meeting of ASPPB in Salt Lake City, Utah. The EPPP-2 was discussed in depth.

Henke has been critical of the move since she lead opposition and the passage of a Resolution in the Louisiana Psychological Association. Sources say that some consider the ASPPB to be more in the mode of a “sales” organization and that there was little opportunity given for the ASPPB member jurisdictions to voice concerns.

One source said that ASPPB appears to be going around its board members and marketing the new test to internship programs and state legislatures. It was reported that they have also said that student groups support the new test when that is not the case.

Through 2016 and 2017 objections to the EPPP2 mounted, mostly from student and early career psychologist organizations.

In 2016, Dr. Henke, then a Director on the Executive Council of the Louisiana Psychological Association (LPA) and Co-Chair of the LPA Early Career Psychologists Committee in LPA, put forth a Resolution to oppose the EPPP2 for Louisiana, which passed unanimously. Dr. Henke is now serving on the state psychology board.

Objections, from Henke and others, involve technical and scientific issues, but also the criticism that there is no problem that the new test needs to solve. “There is no evidence that the public is facing some sort of previously unheard of crisis in terms of safety from currently practicing psychologists,” said Dr. Henke in 2016.

The Examination for Practice of Professional Psychology (EPPP) is privately owned by the ASPPB, which claims to serve its 64 members, regulatory boards of psychology. In a plan that appears to have been in place for a number of years, the ASPPB has decided to double the content and the price of its main product, the EPPP, from $600 to $1200, plus administration fees.

LSU’s Dr. Frick and Dr. Matson Named World Class Scholars

In two separate reports, Louisiana State University Psychology Professors, Dr. Paul Frick and Dr. Johnny Matson, have been designated as top scholars in comparison to all others worldwide.

In an October report from LSU News, Dr. Paul Frick was noted to be one of only four researchers from LSU who achieved an h-index over 100, based on the Google Scholar Citations database. Only 3,160 scholars worldwide reach this level of significance.

Dr. Johnny Matson, professor of psychology and Distinguished Research Master, was noted for his interdisciplinary achievements, as one of only three LSU researchers who were among the top cited scholars by Clarivate Analytics this year, based on a review of journals indexed in the Web of Science Core Collection 2006-2016. According to LSU News, this measure takes into account the top 1% within each of 21 broad fields, over a specific period of time.

Dr. Paul Frick holds the Roy Crumpler Memorial Chair and is professor of psychology at LSU. His research investigates the many interacting factors that can lead children and adolescents to have serious emotional and behavioral problems, such as aggressive and antisocial behavior.

The h-index measures both productivity and impact of published papers. The score measures the researcher’s total number of papers as well as how many times each paper is cited by other scholars. An h-index over 100 amounts to 100 research papers each cited over 100 times.

“It’s quite an honor to be on this list,” Frick told LSU. “In my research, we have looked at kids with behavioral problems and developed ways of identifying them and treating them. Once your scale or system of how a disease or problem is classified and diagnosed is picked up by entities such as the World Health Organization and the American Psychiatric Association, you tend to get a lot of citations because everyone who uses your measure and has to cite you to justify theirs.”

Dr. Matson was included in the Clarivate Analytics 2018 list of only 6,078 scholars worldwide and one of only 2,020 in the new, interdisciplinary category.

This is the first year that Clarivate Analytics has looked specifically at cross-field citations, “…as frontier areas of research are frequently interdisciplinary, it is even more important to identify scientists and social scientists working and contributing substantially at the CrossField leading edge.”

Dr. Paul Frick is the inaugural recipient of the Roy Crumpler Memorial Chair in Psychology at Louisiana State University, Baton Rouge campus. Frick most recently served as the Department Chair in Psychology at the University of New Orleans.

In 2017, he was named the Editor-in-Chief for the prestigious Journal of Abnormal Child Psychology, the official journal of the International Society for Research in Child and Adolescent Psychopathology (ISRCAP), a multidisciplinary scientific society.

Frick is a leading international authority in child and adolescent diagnosis and behavior and his work focuses on the pathways by which youth develop severe antisocial behavior and aggressiveness. He has published over 180 manuscripts in either edited books or peer-reviewed publications and he is the author of 6 additional books and test manuals. He has been Distinguished Professor and Chair of the Department of Psychology at the University of New Orleans, and was named the recipient of the Robert D. Hare Lifetime Achievement Award by the Society for the Scientific Study of Psychopathy.

Dr. Frick’s research has been funded by the National Institute of Mental Health, Office of Juvenile Justice and Delinquency Prevention, and the John T. and Catherine D. MacArthur Foundation. In 2008, he received the MacArthur Foundation’s Champion for Change in Juvenile Justice Award for the state of Louisiana. He has been the editor of the Journal of Clinical Child and Adolescent Psychology, is past president of the Society for the Scientific Study of Psychopathy. He has an Honorary Doctorate from Orebro University in Orebro, Sweden in recognition of his research contributions in psychology. He is also Professor in the Learning Sciences Institute of Australia at Australian Catholic University.

Dr. Matson is expert in autism, mental disabilities, and severe emotional disorders in children and adolescents, and has produced more than 700 publications and 38 books. Just a few of his titles are the International Handbook of Autism and Pervasive Developmental Disorders, Practitioner’s Guide to Applied Behavior Analysis for Children with Autism Spectrum Disorders, Practitioner’s Guide to Social Behavior and Social Skills in Children, and Assessing Childhood Psychopathology and Developmental Disabilities, and Treating Childhood Psychopathology and Developmental Disabilities.

Matson has served as Editor-in-Chief for Research in Autism Spectrum Disorders (Oxford England), Editor-in- Chief for Research in Developmental Disabilities (Oxford, England), and Associate Editor for Journal of Mental Health Research in Intellectual Disabilities (London).

Through the years he has served on 80 editorial boards, both US and International, including as Editor-in-Chief for Applied Research in Mental Retardation and the Official Journal of the American Association for University Affiliated Programs. He has also served as guest reviewer for over 50 journals, both US and International. And, he has visited as a professor around the world, including Canada, Sweden, and India.

Among his many professional activities, Matson has been a guest expert on ABC’s 20/20, consulted with the Alabama, California, Georgia, Illinois, Iowa, Louisiana, Missouri, Virginia, and the US Departments of Mental Health. He has been a guess expert on CBS Eye-to-Eye and consulted for the DSM III-R Educational Testing Service. He has served on the President’s Committee on Mental Retardation, and consulted to the US States Department of Justice, and the US Department of Education.

“This is really about having a few decent ideas but mostly about having a goal and working and working to reach it,” Dr. Matson said to the Times.

“Maintaining that level of focus over that period of time is not easy,” he said, “at least it wasn’t for me. In my case, largely it has been about getting researchers and clinicians to be made aware of and to have the tools to identify co-morbid challenging behaviors and psychopathology in persons with autism and/or intellectual disabilities,” he said.

“If I have been able to do that, in some small way, then it will mean better care for many persons with developmental disabilities.”

CDC Data Points to Higher Psychological Distress in America

The CDC reported new numbers last month in both deaths by suicide and drug overdoses that point to the worsening psychological well-being of America’s citizens. The CDC Director said the sobering statistics should be a wake up call.

Robert Redfield, M.D., CDC Director, said, “The latest CDC data show that the U.S. life expectancy has declined over the past few years. Tragically, this troubling trend is largely driven by deaths from drug overdose and suicide. Life expectancy gives us a snapshot of the Nation’s overall health and these sobering statistics are a wakeup call that we are losing too many Americans, too early and too often, to conditions that are preventable.”

In its newest report, the CDC notes that the age-adjusted suicide rate increased 33% from 10.5 per 100,000 in 1999 to 14.0 in 2017.

The rate of suicide among females increased from 4.0 per 100,000 in 1999 to 6.1 in 2017, while the rate for males increased from 17.8 to 22.4. Compared with rates in 1999, suicide rates in 2017 were higher for males and females in all age groups from 10 to 74 years, said the CDC.

For 2017, the age-adjusted suicide rate for the most rural counties (20.0) was 1.8 times the rate for the most urban counties (11.1).

The rate for the most rural counties in 2017 (20.0) was 53% higher than the rate in 1999 (13.1).

The age-adjusted suicide rate for the most urban counties in 2017 (11.1 per 100,000) was 16% higher than the rate in 1999 (9.6).

Since 2008, suicide has ranked as the 10th leading cause of death for all ages in the United States. In 2016, suicide became the second leading cause of death for ages 10–34 and the fourth leading cause for ages 35–54.

Another report for 2017 figures from the CDC indicated that there were 70,237 drug overdose deaths in the United States, 9.6% higher than the rate in 2016.

The age-adjusted rate of drug overdose deaths increased from 6.1 per 100,000 standard population in 1999 to 21.7 in 2017. For each year, rates were significantly higher for males than females.

Rates of drug overdose continued to increase. In 2017, the age-adjusted rate of drug overdose deaths was 9.6% higher than the rate in 2016 (21.7 vs 19.8 per 100,000), although the percentage increase was lower than that seen from 2015 to 2016, when the rate rose by 21% (from 16.3 to 19.8 per 100,000).

The rate of drug overdose deaths in 2017 was 3.6 times higher than the rate in 1999. Rates increased for both men (from 8.2 in 1999 to 29.1 in 2017) and women (from 3.9 in 1999 to 14.4 in 2017). In 2017, the highest rates of drug overdose deaths occurred among adults aged 25 to 54 years.

From 1999 to 2017, the greatest increase in drug overdose death rates occurred among adults aged 55 to 64, from 4.2 to 28.0 per 100,000, a more than six-fold increase.

LSBEP to Begin Complaints Processing Procedure Updates

The Louisiana State Board of Examiners of Psychologists (LSBEP) will make changes to their disciplinary policies and procedures, including promulgating new rules and regulations if needed, the Board members announced at their recent Long-Range Planning meeting. The meeting was held November 30 at the Board’s new offices located at 4334 S. Sherwood Forest Blvd., in Baton Rouge.

The new disciplinary procedures are the result of study by a task team, which has been meeting over the past months in confidential discussions to craft these new procedures. Members of the task team are LSBEP Chair, Dr. Jesse Lambert, current LSBEP Executive Director, Ms. Jaime Monic, board attorney for complaints issues, Ms. Courtney Newton, and Louisiana Psychological Association Chair of Professional Affairs, Dr. Kim Van Geffen.

At the November 30 public meeting, Ms. Newton explained to members and attendees about the changes. She said that it was essential for a bifurcated and completely separate process to exist between the investigative element and the hearing element of a disciplinary action, and that the task team worked to create a two-pronged process with a firewall between the two elements.

One of the changes that is being proposed is that whenever a complaint is received and needs to be investigated, a Complaints Committee will be formed. This committee will include the LSBEP attorney, the Board Investigator, who is a private investigator, and a Complaints Coordinator.

In July this year the Board added contracts so that there would be three psychologists available as Complaints Coordinators. The contracts were for Sasha Lambert, PhD (Complaints Coordinator I), Erin Skaff Vandenweghe, PsyD (Complaints Coordinator II), and Mark Vigen, PhD (Complaints Coordinator III). The Board also confirmed Statewide Surveillance as the source for services for Licensed Investigators, in July.

The new complaints process will also include a board member, who is to be part of the investigation process. If the complaint goes to a hearing, the Board member who sits on the Complaints Committee will recuse themselves from the hearing panel.

Previously, the Board had held that no board member could be involved because of the fact that a vote of four of five board members was required for disciplinary actions.

Another of the elements included in the renewed approach is the “Letter of Education.” This has been used before and addresses actions that do not rise to the level of a violation and so are not subject to open records or reporting. This allows the board to recommend further education and avoid a licensee being reported.

The new procedures also allow for confidential process when those with substance abuse problems may be referred for colleague assistance programs, also without always being reported.

The psychology Board is currently involved in litigation involving its complaints procedures and this required closed meetings of the task team during the past year, according to sources.

In February 2017 a psychologist appealed a decision made by the LSBEP. The Judge in the 19th Judicial District Court, Judge Michael Caldwell, vacated the board’s decision, saying that the process “reeked” with due process violations, according to sources.

Next, the LSBEP appealed Caldwell’s decision on two of the issues: 1) That the board’s attorneys were law partners; and 2) the Board’s prosecuting attorney had previously been involved in the psychologist’s child custody case.

The LSBEP won the appeal and now the remaining issues are back in Judge Caldwell’s court.

In another issue, this one regarding time-limits, the Board appears to have confused different requirements during hearings in 2015. One case appears to still be on appeal due to this issue.

State boards have come under the notice of the Louisiana Legislature for process issues and several laws have been passed to address citizens’ complaints. In particular, the state medical board has been in front of the Legislature with citizen’s associations’ complaining about heavy-handed treatments at the board. Louisiana’s board actions increased over the last ten years without a similar increase in lawsuits. (See graph).

Senator Fred Mills advanced several measures and this year passed Act 515, moving boards under the Department of Health, because of what he termed, “…virtually no oversight” at the boards. Act 655 allows citizens to make complaints to the the Legislature committees.

[Editor’s Note: For additional information, see: “The Secret Life of Board Complaints,” in Psychology Times, Vol 6, Nos 10 and 12; “Board May Have Botched Time Limits,” Vol 6 No 10; “Judge Says Psych Board Procedures Unconstitutional,” in Vol.8, No 6; and Appeals Court Reverses Judge Caldwell’s “Reeks” Decision in Cerwonka– LSBEP Dispute,” in Vol 9, No 5.]

New Study Shows EPPP Can Discriminate Against African-Americans, Hispanics

A new study demonstrates that the Examination for Professional Practice in Psychology, known as the EPPP, has differing fail and pass rates for different races, and that the difference is large enough for AfricanAmericans and Hispanics to fall into “disparate impact” discrimination, as described in Title VII of the Civil Rights Act of 1964.

The study, “Are demographic Variables Associated with Performance on the Examination for Professional Practice in Psychology (EPPP)?” is published in The Journal of Psychology: Interdisciplinary and Applied, October 22, 2018. The author, Brian Sharpless, PhD, is associate professor at the American School of Professional Psychology. To collect data, he used a Freedom of Information Act (FOIA) to request test results and demographics from the New York state board of psychology for its candidates.

Dr. Sharpless gathered data on 4892 applicants and first-time EPPP takers. He obtained “Records of all doctoral-level psychology licensure applicants from the previous 25 years with EPPP scores, gender, ethnicity, and degree type were requested.”

He found that Blacks had a failure rate of 38.50% and Hispanics had a failure rate of 35.60%. Whereas, Whites had a failure rate of 14.07% and Asians had a failure rate of 24%.

New York uses converted scores for the EPPP, from 0 to 100, with 75 as the passing score.

The differences in minority candidates’ selection rate violates what is known as the “four-fifths rule.” This means that the pass rate for minority groups fails to reach at least 80% of the pass rate for the majority group.

Typically, when a test has this impact, industrialorganizational psychologists exercise very careful methods to set cut scores, seek additional validity or research, and investigate possible replacements with less disparate impact.

Dr. Sharpless wrote, “… given the ethnic performance discrepancies and limited validity evidence, additional psychometric investigation of the EPPP appears warranted (e.g., in terms of criterion and predictive validity testing),” Sharpless also wrote. “Further, it is recommended that the EPPP Step-2 should undergo similar assessments prior to implementation.”

“Additional empirical attention should be devoted to the cut score (i.e., a scaled score of 500, roughly corresponding to 70% correct).” He noted that “…the determination of the ‘passing’ score is one of the most important, yet difficult, psychometric tasks in testing …”

And he noted that “… passage of the EPPP carries serious professional ramifications for applicants. There appears to have been limited discussion of the theoretical and/or empirical justifications for the current cut off score in the publicly available EPPP literatures…”

While regulatory boards aren’t employers, the principles of employee selection may apply. Employers using tests often fall under Title VII of the Civil Rights Act of 1964 which prohibits employers from using neutral tests or selection procedures that have the effect of disproportionately excluding persons based on race, or other protected characteristics. Test
New Study Shows That EPPP Can Discriminate,developers and users must demonstrate that the use is necessary and related to relevant characteristics.

Industrial-organizational psychologists, who help companies show business necessity when a company is paying for employee performance, with a legitimate business goals of seeking top performing employees, may point out that regulatory boards do not have this same business necessity.

Regulatory boards concern themselves with the lower end of the distribution of performers, those likely to exhibit gross negligence or in some way endanger the public. Denying a license to a candidate because they perform at the average range, or even below average, might conceivably violate that candidate’s property rights and have no impact on safety.

Dr. Sharpless noted similar issues. “… if the EPPP is found to lack acceptable validity evidence (or if a decision is made to not submit the measure to further empirical testing), then it will remain open to charges of being a potentially arbitrary barrier in an already protracted path to professional independence…” Sharpless wrote.

He notes the lack of Blacks and Hispanic psychologists and suggests that these issues could be related.

And, he said, “… psychologists have always been at the forefront of developing tests of individual differences with valid and reliable scores…” And he wrote, “A case could be made that psychology gained recognition, as well as a more coherent professional identity, through such testing efforts. Therefore, it only makes sense that we submit our own licensing exam to these same high levels of scientific scrutiny.”

Brian A. Sharpless is an associate professor at the American School of Professional Psychology at Argosy University, Northern Virginia. He received his PhD in clinical psychology and MA in philosophy from Penn State University and completed post-doctoral fellowships at the University of Pennsylvania.

To link to the article go to: https://doi.org/10.1080/00223 980.2018.1504739

Stress Solutions

by Susan Andrews, PhD

Improved Sleep Reduces Stress, Improves Health

A recent article in the Healthcare Journal of New Orleans on The Art & Science of Sleep caught my eye this month. So many of us are burning the midnight oil trying to finish up reports and work for 2018. This article contained good “evidence-based tips for improving sleep quality.” Since everyone’s time is short these days, it is sometimes helpful to read a summary of key points instead of having to read a longer piece.

Have you noticed how many adults and kids go to bed with their phones. Kids are playing games up until parents force light out. Adults are reading email and new stories until their eyes force them to put it down. It is actually harder for most people to fall asleep if they are still pumping excess cortisol through their systems. It is harder to empty your mind and stop thinking under those circumstances. An important tip is to try to stop all games and reading at least 30 minutes before you hope to fall asleep.

Sleep is so important for losing weight, keeping your immune system healthy, and keeping your energy level up to the challenges of the new day. I was surprised at some of the “evidence-based” tips to improve sleep quality. The author of the article is Erin Baldwin and a good reference list from peer-reviewed journals is offered at the end of the article. These tips are derived from the 11 referenced journal articles.

Tip 1: Reduce exposure to blue light before bed and increase exposure to natural light during the day. This tip has to do with the effects of light exposure on the secretion of melatonin. Melatonin levels need to rise at night and drop in the morning. Exposure to light before bed suppresses melatonin secretion. Red light does not interfere with melatonin as much as blue light (sunlight and smart phone light) does. So, refrain from using electronics at least 30 minutes prior to bed. (Figuero & Rea, J. of Endocrinology, 2010)

Tip 2: Allow your core temperature to drop before bed. Warming your feet with socks can help. The National Sleep Foundation recommends a bedroom temperature of 65 degrees. Keep your head cool to help alleviate insomnia. (Nature 1999; Nofzinger et al, J. Clin Sleep Med 2006)

Tip 3: Make your bedroom a sacred place. Think of the classical conditioning work of Pavlov and his dogs.

Tip 4: Stick to a Sleep Schedule.

Tip 5: Wind down before bed. Allow your mind to slow down. Stop worrying over problems that make it hard to shut down thinking about. Listen to soft music or do a meditation. The article suggests using a drop of Lavender essential oil on your pillow or rub some into your hands and inhale from cupped hands.

Tip 6: Rethink your sleeping position. Alight and elongate your body, no joint stress.

Tip 7: Cut back on nighttime use of alcohol and anti-anxiety medications. While both cause you to fall asleep faster, they also decrease your sleep quality later in the night. Benzos can disrupt the normal sleep cycle and suppress REM sleep. (Pagel & Parnes, J. Clin Psychiatry 2001)

Tip 8: Reduce Stress. This is almost redundant, but the article highlights the value of regular physical exercise a few hours before bedtime.

Have a restful and happy holiday.

Girl in the Spider’s Web

by Alvin G. Burstein

Almost 150 years ago, the philosopher John Stewart Mill published what was then a provocative essay, On the Subjection of Women. Mill, a former child prodigy and later, a noted public intellectual. He argued that women were not just disadvantaged, but as, half of humankind, the largest group of enslaved humans. He documented the peculiarly onerous abuse to which women could suffer because “…their masters require something more from them than actual service. Men do not want solely the obedience of women, they want their sentiments…not just a forced slave but a willing one….” For that reason, he predicted that our patriarchal society would stubbornly resist acknowledging women’s rights to liberty and equality. He would not be surprised by the circumstance that Americans would elect a black man as President before according that office to a woman. He would have taken pleasure in the reality of a recent Congressional election that saw record numbers of women candidates, and victors.

Despite his Victorian context, Mill is clearly a bellwether of the twentieth century #Me Too movement that gives voice to women’s experience of abuse, especially sexual abuse. Steig Larsson, author of the popular Millenium novel series that spawned the Swedish and American versions of The Girl With The Dragon Tattoo films is another such bellwether. The motivational focus of both the novels and the films is its protagonist’s, Lisbeth Salander’s hatred of men who hurt women.

The success of the three American films—The Girl With The Dragon Tattoo, The Girl Who Played With Fire, and The Girl Who Kicked The Hornets’ Nest
assured its sequel, The Girl In The Spider’s Web. The new film will satisfy fans of the first three, bringing back the main characters: Salander, journalist Blomquist, his editor and sometime lover, Erika Berger and the unorthodox computer genius, Plague. Continuity with its predecessors is underscored by the opening scene. Salander interrupts a sadistic abuser in flagrante delicto, exposing the perpetrator and hanging him by his heels.

As it unfolds, some backstory emerges. Salandar is provided with a sister, and the two are victims of their father’s sexual abuse. Another innovation is Salander’s involvement in an international struggle for control of a world-wide network of atomic weapons. She must now deal, not only with criminal gangs, like those trafficking in prostitution in the earlier films—though there is one of those here as well, Spider, but also with American and Swedish security forces.

There are some shortcomings. Salander’s use of tasers, satisfying in the original films, gets tediously familiar in this one. More central is the handling of the relationship between Salander and Blomquist. In the earlier films, her vulnerability to his casual sexual involvements, her hurt when she takes the risk of loving a man, only to discover his tomcat character is powerful and painful. In this sequel, she turns to him with caution and only out of situational need. And Bomquist’s decision as the film’s end to forego a scoop feels artificial. Finally, and most critical plot-wise, is a motivational switch. A key motivational element in this film is sibling rivalry between daughters, not hatred for men who hurt women.