Insomniacs' reported use of CBT components and relationship to long-term clinical outcome.

Although there is considerable evidence for the efficacy of non-pharmacological treatment of insomnia, many of the larger trials have delivered CBT in multicomponent format. This makes it impossible to identify critical ingredients responsible for improvement. Furthermore, compliance with home implementation is difficult to ascertain in psychological therapies, and even more so when trying to differentiate across a range of elements. In the present report, 90 patients who had completed 12 month follow-up after participation in a clinical effectiveness study of CBT in general medical practice, responded to a questionnaire asking them about their use of the ten components of the programme. Reports of home use were then entered as predictors of clinical response to treatment. Results indicated that reported home use of stimulus control/sleep restriction was the best predictor of clinical improvement in sleep latency and nighttime wakefulness. Cognitive restructuring also contributed significantly to reduction in wakefulness. In spite of being the most highly endorsed component (by 79% of respondents) use of relaxation did not predict improvement on any variable. Similarly, sleep hygiene was unrelated to sleep pattern change and use of imagery training was modestly predictive of poor response in terms of sleep latency. There are methodological limitations to this type of post hoc analysis, nevertheless, these results being derived from a large patient outcome series raise important issues both for research and clinical practice.     

Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth.

This study assessed the effects of 3 theoretically grounded, school-based HIV prevention interventions on inner-city minority high school students' levels of HIV prevention information, motivation, behavioral skills, and behavior. It involved a quasi-experimental controlled trial comparing classroom-based, peer-based, and combined classroom- and peer-based HIV prevention interventions with a standard-of-care control condition in 4 urban high schools (N = 1,532, primarily 9th-grade students). At 12 months postintervention, the classroom-based intervention resulted in sustained changes in HIV prevention behavior. This article discusses why both of the interventions involving peers were less effective than the classroom-based intervention at the 12-month follow-up and, more generally, suggests a set of possible limiting conditions for the efficacy of peer-based interventions.     

Sexual Peak: Socially Shared Cognitions About Desire,Frequency, and Satisfaction in Men and Women

Is a man’s sexual peak earlier than a woman’s? Three studies were conducted to examine (a) whether the perception that men achieve their sexual peak at a younger age than do women is shared across individuals of different ages and sexes, (b) whether sexual peak is defined differently for men and women, and (c) whether differences between definitions contribute to differences in the age at which men and women are perceived to reach sexual peak. Study 1 suggested that participants believed that females reach their sexual peak at an older age than do males. Study 2 indicated that the defining feature of sexual peak for males was sexual desire and for females was sexual satisfaction. Study 3 suggested that predictions of male sexual peak coincided with participants’ predictions of male age of highest desire and frequency, but not satisfaction, and that female sexual peak coincided with participants' predictions of female age of highest satisfaction but not frequency or desire. Discussion focuses on potential reasons for differences between the perception of male and female sexuality, as well as the social and evolutionary importance of each of the dimensions of sexuality for both males and females.     

Who is buying bioethics research?

Growing ties to private industry have prompted many to question the impartiality of academic bioethicists who receive financial support from for-profit corporations in exchange for ethics-related services and research. To the extent that corporate sponsors may view bioethics as little more than a way to strengthen public relations or avoid potential controversy, close ties to industry may pose serious threats to professional independence. New sources of support from private industry may also divert bioethicists from pursuing topics of greater social importance, such as the needs of medically underserved communities. To inform ongoing debates about the financing of bioethics and its transparency to those concerned about potential sources of bias, we examined funding disclosures appearing in original research reports in major bioethics journals. Reviewing research published over a 15-year period, we found little evidence that for-profit corporations are influencing bioethics research directly. Instead, we found evidence that a great number of organizations, both public and private, support bioethics research. These findings suggest that worries about the cooption of bioethics research by a few interested stakeholders are greatly overstated and undersupported by available data.     

Validation and predictive utility of the Sociocultural Attitudes Toward Appearance Questionnaire for Eating Disorders (SATAQ-ED): internalization of sociocultural ideals predicts weight gain

A widely used measure of societal influences on body image and eating disturbances—the Sociocultural Attitudes Toward Appearance Questionnaire (SATAQ) was validated in women with eating disorders. The original SATAQ and measures of convergence and divergence were administered to 165 eating disordered inpatients. Factor analyses were conducted to determine the underlying structure of the SATAQ. Convergent validity, diagnostic category norms and the predictive utility of the revised SATAQ were examined. Factor analyses indicated three factors: Internalization, Awareness, and Success. Internalization significantly predicted treatment success after controlling for admission BMI and drive for thinness. The revised SATAQ-ED measures multiple aspects of societal influence, predicts short-term outcome, and can be a useful tool for evaluating potential outcome and treatment efficacy.     

Every time you go away: changes in affect, behavior, and physiology associated with travel-related separations from romantic partners

This study investigated changes in day-to-day affect, behavior, and physiology (hypothalamic-pituitary-adrenocortical axis activity) associated with temporary physical separations from romantic partners (such as those brought about by work-related travel). Daily diaries and measures of salivary cortisol were collected from 42 couples over a 21-day period that was timed to coincide with a naturally occurring 4- to 7-day separation. There were significant changes from preseparation to separation and from separation to reunion in the quality of partners' interactions, their positive and negative affect, sleeping problems, subjective stress, physical symptoms, and cortisol levels. Separation and reunion effects were generally more pronounced in homebound partners, partners with high attachment anxiety, and partners who had less contact with each other during the separation. Separation and reunion effects were not moderated by relationship length, relationship satisfaction, how often couples underwent separations, or the presence of children in the home. The results are discussed with respect to the role of daily proximity and contact between partners for day-to-day affective and physiological regulation.     

MMPI-2 characteristics of transsexuals requesting sex reassignment: comparison of patients in prehormonal and presurgical phases

To assess psychopathology in transsexuals at different phases of sex reassignment, we administered the Spanish adaptation of the MMPI-2 (Avila-Espada & Jiménez-Gómez, 1999) to 107 male-to-female and 56 female-to-male transsexuals. Except for the Mf scale, mean T scores from the Clinical scales were within the normal range and did not differ between sexes. Male-to-female transsexuals seeking sex-reassignment hormonal therapy, but not female-to-male patients, scored significantly higher on the Depression, Hysteria, Psychopathic Deviate, Schizophrenia, and Social Introversion scales than patients seeking sex-reassignment surgery. The results show that the majority of patients were free of psychopathology. Transsexuals in the initial phases of sex reassignment may experience more distress than in later phases; however, these results are unlikely to reflect clinically relevant differences.     

Predictors of intimacy in couples' discussions of relationship injuries: an observational study.

The interpersonal process model of intimacy (H. T. Reis & P. Shaver, 1988) proposes that self-disclosure and empathic responding form the basis of intimate interactions. This study examined this model in 102 community couples who completed intimacy measures following videotaped discussions about relationship injuries occurring both within and outside the relationship. Observational assessments of self-disclosure and empathic responding, as well as their respective components, were related to self-reported ratings of post-interaction intimacy. Men's own disclosure and empathic responding predicted their feelings of intimacy, whereas women's intimacy was predicted by their partner's disclosure and empathic responding. Self-disclosure and empathic responding appear to be important behavioral determinants of intimate feelings, but the manner in which they influence intimacy differs according to gender.