ABSTRACTS - World Psychiatric Association

attainment and abstinence contingent housing and work/training; contingency
managed work place for abstinent contingent access to paid
work; and behavioral day treatment. Recent ineffective efforts to develop
effective cocaine blocking medication, and research on the treatment
success of disulfiram, with alcoholic and non-alcoholic cocaine
dependent patients, are also to be considered. Current work pointing
the way to likely future clinical developments is reviewed. Bachelors
and masters degree trained counselors, supervised by doctoral clinicians,
are being used to implement manualized effective interventions
with quality control to reduce costs. Dismantling research is discovering
effective component(s) of current effective treatments which can be
used as briefer, less expensive, but still effective intervention. Work is
underway to develop stepped care approaches, which utilize derived
components from effective treatment as initial less complicated and
expensive intervention, where patients who fail to respond can be
transferred to the full intervention from which components were
derived. Lastly, recent work on medication is reviewed, including
efforts to develop blocking medications, a cocaine vaccine, use of old
drugs with new applications, like disulfiram, and use of effective psychological
interventions as a floor treatment for pharmacotherapy.
NRS8.
ETHICAL AND LEGAL ISSUES
NRS8.1.
THE ROLE OF PERCEIVED NORMS
IN THE STIGMATIZATION OF MENTAL ILLNESS
R. Norman, R. Sorrentino, D. Windell, Y. Ye, A. Szeto,
R. Manchanda
University of Western Ontario and Prevention and Early
Intervention Program for Psychoses, London, Ontario, Canada
Although the concept of stigma emphasizes the role of perceived
social consensus or norms in determining reaction to those with a
stigmatizing identity, the importance of such perceived norms has not
been extensively investigated in the context of the stigmatization of
mental illness. Instead, research on the stigma of mental illness has
almost exclusively focused on the importance of an individual’s
beliefs about mental illness and the mentally ill as determinants of
social distance. We present evidence from three studies testing the
hypothesis that individual differences in perceptions of both descriptive
and injunctive norms add significantly to the prediction of behavioral
intention, beyond the level possible using measures of beliefs
about mental illness. Two of the studies involved university students
and one used data from community services clubs. In each case, perceptions
of relevant norms added significantly to the prediction of
preferred level of social distance to a hypothetical individual with
either depression or schizophrenia.
NRS8.2.
THE SIGNIFICANCE OF THE NEW UN CONVENTION
ON THE RIGHTS OF PERSONS WITH DISABILITIES
FOR THE PRACTICE OF INSTITUTIONAL
PSYCHIATRY
M. Perlin
New York Law School, New York, NY, USA
As of May 2008, the UN Convention on the Rights of Persons with
Disabilities becomes international law. The Convention, for the first
time, applies international human rights protections to persons with
disabilities, including people with psychosocial disabilities who are
institutionalized. Among the specified rights are: respect for inherent
dignity; non-discrimination; freedom from torture or cruel, inhuman
or degrading treatment or punishment; freedom from exploitation,
violence and abuse; and a right to protection of the integrity of the
person. It is still highly unclear how these rights will be interpreted by
regional human rights courts and commissions, but it is clear that the
articulation of these rights will bring new focus on institutional psychiatry
worldwide. This paper will discuss the implications of this
new Convention and its meaning for psychiatrists who work in institutional
settings. Among the questions to be raised are the following.
Will the articles of this Convention be interpreted broadly or narrowly
Will the interpreting courts rely on the already-existing bodies of
caselaw based variously on the UN Mental Illness Principles of 1991,
the European Convention on Human Rights and/or American constitutional
caselaw in deciding such cases How will legal representation
be provided in such cases What will (or what should) the role of
organized psychiatry be (if any) in such cases
NRS8.3.
THE WILL TO LIVE AS AN INDICATOR OF WELL-
BEING AND PREDICTOR OF SURVIVAL IN OLD AGE
S. Carmel
Center for Multidisciplinary Research in Aging, Faculty of Health
Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Conceptually, the will to live (WTL) is defined as the psychological
expression of a natural instinct of human beings, the striving for life,
which is comprised of rational and irrational components, and can be
self-assessed. Considering that the WTL not only expresses a state of
general well-being, but also one’s commitment to life and desire to
continue living, we hypothesized that it is a unique indicator of elderly
persons’ well-being and survival. These hypotheses were put to
test in four large scale national studies of Israelis, one of which used
a longitudinal design. The findings from these studies systematically
show that the will to live significantly correlates with well established
indicators of well-being. It weakens with age, being weakest among
the oldest-old. Furthermore, relatively weak social groups in the population,
such as women and new immigrants, report a weaker WTL in
comparison to their counterparts. The WTL was also found as a good
predictor of long-term survival (7.5 years), especially among elderly
women after controlling for age, health and psychosocial variables.
Based on the systematically repeated findings, we conclude that the
will to live is an important indicator of general well-being, due to its
diagnostic and prognostic values, and recommend using it in daily
practice.
NRS8.4.
MENTAL HEALTH AND DOMESTIC VIOLENCE
FATALITIES: RECOMMENDATIONS FROM REVIEW
BOARDS
J. Wilson
University of Oklahoma, Oklahoma City, OK, USA
Multidisciplinary domestic violence fatality review boards are part of
a growing global movement to prevent family fatalities by analyzing
deaths that occur among family and intimate partners. Multidisciplinary
teams at local, state, and national levels gather aggregate data on
all domestic violence fatality cases and select a number of cases to
review in-depth. Case data is gathered by staff from a broad array of
confidential and public records. Records and chronologies of events
leading up to the fatality are reviewed by board members to answer
the following questions: How could this death have been prevented
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