Performance-enhancing drugs in sport: a different form of drug abuse

The use and abuse of drugs in American society is recognized as a major issue among those who study youth. This paper addresses an often overlooked area of drug abuse: performance-enhancing drugs in sport. The reasons these vocational drugs are used by athletes are different from those of the recreational drug user. This paper examines the seriousness and prevalence of performance-enhancing drugs and presents the results of a series of interviews with steroid users to determine their attitudes. These attitudes and rationalizations suggest that an expanded view of drugs is required if performance-enhancing drug use is to be understood.     

Conditioned taste aversions: From poisons to pain to drugs of abuse

Learning what to eat and what not to eat is fundamental to our well-being, quality of life, and survival. In particular, the acquisition of conditioned taste aversions (CTAs) protects all animals (including humans) against ingesting foods that contain poisons or toxins. Counterintuitively, CTAs can also develop in situations in which we know with absolute certainty that the food did not cause the subsequent aversive systemic effect. Recent nonhuman animal research, analyzing palatability shifts, has indicated that a wider range of stimuli than has been traditionally acknowledged can induce CTAs. This article integrates these new findings with a reappraisal of some known characteristics of CTA and presents a novel conceptual analysis that is broader and more comprehensive than previous accounts of CTA learning.     

Confidentiality in the military

This article presents and analyzes options military physicians face regarding whether or not to respect gay servicepersons' confidentiality. This situation is considered to be generic to others that involve similar conflicts. Dilemmas arising before and after the emergence of HIV-related diseases are discussed. Recommendations regarding psychiatrists' ethical obligations when conducting forensic exams are compared with military physicians' obligations to respect servicepersons' confidentiality. It is suggested that military psychiatrists should violate servicepersons' confidentiality under some circumstances, but generally should warn them in advance that they will do so. Possible exceptions exist when warning servicepersons would increase the likelihood that justice would be violated or substantial harm would occur.     

Psychiatric malpractice in the military

Available data indicates that the incidence of malpractice in military psychiatry, involving both civilian and active duty beneficiaries, is the lowest of all specialties and may be lower than in the civilian sector. Recovery for malpractice damages by means of claim versus suit is restricted to civilian patients; active duty service members recover through a special disability system. The federal government provides military psychiatrists with considerable protection from personal financial loss when involved in malpractice, but there may be limits to that protection. There have been recent efforts to criminally prosecute military physicians in some instances. A registry review of military psychiatry malpractice cases from 1978 to 1987provides a profile of the malpractice situation and suggests areas of practice that need vigilance. The Department of Defense has established a broad-based, comprehensive program of quality assurance and risk management in the interest of maximizing the benefit of medical care and minimizing substandard practice.     

A preliminary scale for assessing attitudes toward homosexuals in the military

This paper reports a factor analytical study of responses to statements of attitudes concerning lesbians and gay men in the military by 72 23.4-yr.-old members of the U.S. Marine Corps Reserve. Using exploratory factor analysis with an oblique rotation four factors were found which accounted for 64.9% of the total common variance. A factor labeled Trust accounted for 40.6% of the common variance, Comfort accounted for 8.7%, Acceptance accounted for 8.2%, and the fourth factor, Threat, accounted for 7.5%. Cronbach a ranged from .63 to .78. Validity was .75 when scores were correlated with those on the Attitudes Toward Lesbians and Gay Men scale, supporting the 4-factor interpretation. It is recommended that additional factor analyses be performed to further investigate the validity of the four factors and that of the entire scale.     

Rethinking the military paradigm

The article begins with an overview of the historic moment of ‘the end of the Cold War’, and of the paradoxically deepening moral, social, and environmental problems posed by the military system. It demonstrates that historical and contemporary analyses of defence and war have dogmatically presupposed the military paradigm, and have therefore failed to recognize the self‐reproducing structure of covert premisses and inferences upon which it rests. In laying bare this underlying system of unreason, the analysis demonstrates that the military paradigm's ultimately self‐contradictory concepts of ‘security’ and ‘defence’ repose on unstated interests of social and political rule. Proposing new distinctions between pathological and life‐enabling forms of war, and between guilty and innocent combatants, the argument develops alternative, non‐military principles of war to guide rational and moral agency     

Learning techniques for alcohol abuse

Eighteen month follow-up data are presented for two projects evaluating the effectiveness of learning techniques for treating alcohol abuse and achieving moderation using three groups of subjects-inpatient alcoholics, outpatient alcoholics and problem drinkers. Subjects received various combinations of the following procedures: videotape self-confrontation of drunken comportment, blood alcohol concentration discriminating training, aversion training for overconsumption, avoidance practice, behavior counseling and alternatives training, and alcohol education. While the loss of subjects was considerable between 12 and 18 months follow-up, the data were very similar. Subjects in all groups improved in terms of reductions in alcohol intake and on drinking-related variables. Significant between-groups differences in favor of subjects whose training included actual experience in drinking moderately were found only for the inpatient alcoholics. In this research, the best candidate for moderation was the less chronic. younger drinker with a relatively lower alcohol intake, a more stable vocational record and no history of hospitalization for alcohol abuse or physical deterioration from drinking. We believe that the techniques with the greatest potential for the prevention and treatment of alcohol abuse are videotape self-confrontation, blood alcohol discrimination training, and alcohol education/alternatives training.     

Sudden gains in treatment-as-usual couple therapy for military veterans

Previous studies of couple therapy have conceptualized change as a gradual process. However, there is growing evidence that, for many clients, the majority of gains in other treatment modalities are often achieved between just 2 sessions. Isolating the frequency, nature, and predictors of these sudden gains (SGs) in couple therapy can add to a growing understanding of how and why couple therapy works. In a sample of 67 couples receiving treatment-as-usual couple therapy in two Veterans Affairs hospitals, 25% of individuals experienced a SG in relationship satisfaction. The magnitude of these SGs were large (d = 1.62) and fully explained the total pre-post change for individuals who experienced them. Individuals with SGs showed significantly greater satisfaction gains during therapy; however SGs were not related to relationship satisfaction or relationship status at 18-month follow-up. SGs were predicted by the content of the previous session, putative change mechanisms of communication, intimacy, and behavior, as well as the partner's SGs during the same period. Results suggest that SGs are an important component of change during couple therapy for some individuals, challenging the assumption of continuous change in previous studies. In addition, predictors of SGs were generally consistent with theoretical and empirical examinations of mechanisms of change in couple therapy.     

Harnessing the power of the group for latency-aged sexual abuse victims

For children who have been sexually abused, group therapy is often a preferred treatment modality. Although much consideration has been given to what structured activities, goals, and objectives should be included in groups for sexually abused children, limited attention has been paid to the dynamics and processes inherent in the group. This article follows the dynamic unfolding of a short-term structured group for latency-aged, female sexual abuse victims. Special emphasis is placed on listening to the messages underlying children's actions and responding to the message rather than suppressing or limiting the behavior. It is argued that by attending to group dynamics and processes in a theme-focused group, structured activities become more effective and the power of the group can be harnessed to foster opportunities for healing that otherwise might go unrecognized.     

Probative aspects of the medical evaluation for child sexual abuse

The medical evaluation of a child for sex abuse has been viewed by some as an acid-test for the presence of abuse. This article examines the medical evaluation for child sexual abuse, evidence potentially revealed by the examination, and the probative value of such evidence.     

Infants at risk for child abuse

Child abuse is most likely to occur when socially isolated parents react impulsively to aversive stimuli emitted by their children. Certain child signals and characteristics are aversive to adults. Infant cries are aversive to all parents, but children who are unusually irritable or whose cries are especially grating may become aversive to their parents even when they are not crying. Studies show that the cries of premature infants and the cries of babies incorrectly labelled premature are more aversive to parents, and that abusive mothers and the mothers of premature infants find cries more aversive than other mothers do. The incidence of abuse would be reduced by the availability of supportive social networks and the elimination of distorted parental expectations.     

A parenting group for women dealing with child sexual abuse and substance abuse

This article describes a group developed to address the parenting needs of women dealing with child sexual abuse and substance abuse. A solution-focused 12-week group intervention is described, and the results of an evaluation are presented. Participants included 29 women who attended seven parenting groups. The results suggest that the group was perceived as beneficial by the women, who reported an increase in self-esteem, parenting satisfaction, and parenting self-esteem and an improvement in their attitudes toward their children.     

Comparison of closed testing procedures for pairwise testing of means

A Monte Carlo simulation was conducted to compare 9 pairwise multiple comparison procedures. Procedures were evaluated on the basis of any-pair power and all-pairs power. No procedure was found to be uniformly most powerful. A modification due to A. J. Hayter (1986) of Fisher's least significant difference was found to provide the best combination of ease of use and moderately high any-pair power in most cases. Pilot or exploratory studies can expect good power results with this relatively simple procedure. The greatest all-pairs power was usually provided by 1 of 2 partition-based versions of E. Peritz's (1970) procedure. Confirmatory studies will require such complex methods but may also need larger sample sizes than have been customary in psychological research.     

Ethical considerations in the testing of biopharmaceuticals for adventitious agents

Safety testing of biological pharmaceuticals is often carried out by contract testing laboratories which perform these tests on behalf of the drug’s developer. These laboratories are confronted with a number of ethical issues related to selling their services, maintaining confidentiality, and the handling of results. This paper outlines these issues, and, by way of illustration, discusses how one such laboratory addresses them.     

Performance-enhancing technologies and moral responsibility in the military

New scientific advances have created previously unheard of possibilities for enhancing combatants' performance. Future war fighters may be smarter, stronger, and braver than ever before. If these technologies are safe, is there any reason to reject their use? In this article, I argue that the use of enhancements is constrained by the importance of maintaining the moral responsibility of military personnel. This is crucial for two reasons: the military's ethical commitments require military personnel to be morally responsible agents, and moral responsibility is necessary for integrity and the moral emotions of guilt and remorse, both of which are important for moral growth and psychological well-being. Enhancements that undermined combatants' moral responsibility would therefore undermine the military's moral standing and would harm combatants' well-being. A genuine commitment to maintaining the military's ethical standards and the well-being of combatants therefore requires a careful analysis of performance-enhancing technologies before they are implemented.