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.     

Behavior of rats under fixed consecutive number schedules: effects of drugs of abuse.

Four rats responded under a simple fixed consecutive number schedule in which eight or more consecutive responses on the run lever, followed by a single response on the reinforcement lever, produced the food reinforcer. Under this simple schedule, dose-response curves were determined for diazepam, morphine, pentobarbital, and phencyclidine. The rats were then trained to respond under a multiple fixed consecutive number schedule in which a discriminative stimulus signaled when the response requirement on the run lever had been completed in one of the two fixed consecutive number component schedules. Under control conditions, the percentage of reinforced runs under the multiple-schedule component with the discriminative stimulus added was much higher than the percentage of reinforced runs under the multiple-schedule component without the discriminative stimulus. All of the drugs decreased the percentage of reinforced runs under each of the fixed consecutive number schedules by increasing the conditional probability of short run lengths. This effect was most consistently produced by morphine. The drugs produced few differences in responding between the multiple fixed consecutive number components. Responding under the simple fixed consecutive number schedule, however, was affected at lower doses of the drugs than was responding under the same fixed consecutive number schedule when it was a component of the multiple schedule. This result may be due to the difference in schedule context or, perhaps, to the order of the experiments.     

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.     

Effectively counseling the military population: Training needs for counselors

Counselors (N = 49) interested in working with the military population described what is needed to feel competent and confident counseling this population in a mixed-methods research study. Findings suggest counselors do not believe their programs are preparing them to work with this population. Participants indicate strategies which would increase their ability to work with the military. Results provide implications for counseling programs on how they can better prepare students to work effectively with this population and increase the employment rates in serving the military.     

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.