Teaching professionalism through formal curricula is paramount in helping develop new generations of compassionate and responsible physicians. Additional strategies such as consistent role modeling of professional behaviors are also needed to encourage the development of professional physicians.

Computerized cognitive training (CCT) interventions are increasing in their use in outpatient mental health settings. These interventions have demonstrated efficacy for improving functional outcomes when combined with rehabilitation interventions. It has recently been suggested that patients with more cognitive impairment have a greater therapeutic response and that reduced engagement in training can identify cases who manifest low levels of benefit from treatment. Participants were psychiatric rehabilitation clients, with diagnoses of major depression, bipolar disorder and schizophrenia. Newly admitted cases received CCT, delivered via Brain HQ, with cognitive functioning divided into groups on the basis of a BACS t-score of 40 or less vs. more. Training engagement was indexed by the number of training levels achieved per day trained. Forty-nine cases trained on average for 17 days and completed a mean of 150 levels. Overall, patients improved by an average of 4.4 points (0.44 SD) in BACS t-scores (p < .001). Improvements were positively correlated with training engagement (r = 0.30, p < .05), but not with days trained (r = 0.09) or levels earned (r = 0.03) alone. Patients with higher levels of baseline cognitive performance had reduced cognitive gains (p < .003), but did not have less training engagement (p = .97). Diagnoses did not predict cognitive gains (p = .93) or target engagement (p = .74). Poorer performance at baseline and higher levels of training engagement accounted for >10% in independent variance in cognitive gains. The mean level of cognitive improvement far exceeded practice effects. The index of engagement, levels achieved per training day, is easily extracted from the training records of patients, which would allow for early and continuous monitoring of treatment engagement in CCT activities and therapist intervention as needed to improve engagement.

Strain in parental relationships may be associated with BAS dysregulation for individuals with bipolar disorder.

Following a brief introduction to response planning for terrorism and other disasters, the authors present their experiences in developing a grassroots, interdisciplinary group charged with incorporating a mental health response component into the bioterrorism response plan for the metropolitan Atlanta area. This group was organized and supported by the Center for Public Health Preparedness at the DeKalb County Board of Health. Various viewpoints of key participating agencies are presented. Recommendations are provided for other localities and stakeholders who plan to incorporate a community mental health component into local disaster response plans.

Despite some recent improvements in public health preparedness in many communities, efforts to incorporate mental health plans and services into bioterrorism response planning remain in their infancy. A recent report from the Institute of Medicine recommended that "to address the prevention, health care, and promotion needs related to psychological consequences of terrorism, this area must be integrated into national, state, and local planning." 1 Bioterrorism events may produce unique consequences compared to other manmade or natural disasters. 2 Fear-inducing threats of contamination, the likelihood of covert release of poisonous agents, and the possibility of contagion may result in large numbers of adverse emotional/psychological reactions. These "psychological casualties" of a bioterrorism event will likely far outnumber the medical casualties; nevertheless, response planners have been relatively slow to incorporate mental health considerations into terrorism response plans. Psychological consequences 1,3-7 can be classified as distress responses (e.g., insomnia, fear, sense of vulnerability), behavioral changes (e.g., acting out, social withdrawal, increased consumption of nicotine, alcohol, or other drugs), 4,5 psychosomatic symptoms and outbreaks of medically unexplained symptoms, 8 psychiatric/psychological symptoms (e.g., sadness, irritability, dissociation), and psychiatric illnesses such as depression and posttraumatic stress disorder. 6,7 The protection and promotion of mental health in the community is a critical component of pre-event planning for bioterrorism events. Mental health elements should be included in all disaster response plans, and should be regarded with equal weight and immediacy as other elements of the plans. These mental health functions should include: 9-14 • Assessing and providing appropriate services; • Preparing content for and advising on the process of risk communication; • Creatively using assets belonging to the public trust (such as mental health facilities); • Consulting with community mental health leaders on the psychology of epidemics, managing fear and uncertainty, and managing responder and leadership distress; • Training local community thought leaders in group coping methods; and