In an attempt to study predisposition to bipolar manic-depressive disorder, we developed a behavioral paradigm to identify persons at risk for various forms of the disorder. We provide a theoretical discussion for denning bipolar disorder within the broader framework of common human diseases and then employ this framework to derive dimensions of bipolar disorder that define its distinctness from the normal phenotype. These dimensions (behavioral and nonbehavioral features of disorder) are operationalized in the form of a self-report inventory which estimates the probability that an individual is at risk. Five external validation studies using nontest criteria are presented, including interview, roommate, family history, clinical characteristics, and longitudinal mood rating investigations. Results indicate that the inventory serves as a promising first-stage case identification procedure for bipolar disorder when employed in a research context. To date, most research on human disorders has focused on the pathophysiology underlying signs and symptoms (Depue & Evans, 1981). If comprehensive models of etiology are to be derived, however, other

No abstract

The mental health and addiction workforce has long been plagued by shortages, high turnover, a lack of diversity, and concerns about its effectiveness. This article presents a framework to guide workforce policy and practice, emphasizing the need to train other health care providers as well as individuals in recovery to address behavioral health needs; strengthen recruitment, retention, and training of specialist behavioral health providers; and improve the financial and technical assistance infrastructure to better support and sustain the workforce. The pressing challenge is to scale up existing plans and strategies and to implement them in ways that have a meaningful impact on the size and effectiveness of the workforce. The aging and increasing diversity of the US population, combined with the expanded access to services that will be created by health reform, make it imperative to take immediate action.