Addressing multiple relationships between clients and therapists in lesbian, gay, bisexual, transgender communities

Therapists working in lesbian, gay, bisexual, and transgender (LGBT) communities are likely to experience the potential to engage in multiple relationships with their clients. Currently, the American Psychological Association's (2002) ethics code and the related literature base offer minimal direct guidance to therapists practicing in LGBT communities. In this article, the authors review current literature regarding multiple relationships in psychotherapy, considering how this literature addresses issues specific to practitioners working within LGBT communities, present a case study highlighting the negotiation of a multiple relationship between a client and therapist who both identify as lesbian, and offer recommendations for practitioners working within LGBT communities.     

Emotional learning and glutamate: translational perspectives

Anxiety disorders are a common focus of clinical concern and certain forms of anxiety may be conceptualized as disorders of emotional learning. Behavior therapies effective in the treatment of anxiety are modeled on extinction training as a means of reducing pathological anxiety. The present understanding of human anxiety has been informed by preclinical research using rodent models to study the acquisition and extinction of fear. Glutamate appears to have a central role in both of these processes. The authors review this literature and discuss novel applications of D-cycloserine, a partial N-methyl-D-aspartate agonist, for the treatment of anxiety.     

Why are hispanics at greater risk for PTSD?

Several studies have found that Hispanic Americans have higher rates of posttraumatic stress disorder (PTSD) than non-Hispanic Caucasian and Black Americans. The authors identified predictors of PTSD symptom severity that distinguished Hispanic police officers (n=189) from their non-Hispanic Caucasian (n=317) and Black (n=162) counterparts and modeled them to explain the elevated Hispanic risk for PTSD. The authors found that greater peritraumatic dissociation, greater wishful thinking and self-blame coping, lower social support, and greater perceived racism were important variables in explaining the elevated PTSD symptoms among Hispanics. Results are discussed in the context of Hispanic culture and may be important for prevention of mental illness in the fastest growing ethnic group in the United States.     

Laboratory behavioral measures of impulsivity

Previous research and theory have conceptualized impulsivity as a multifaceted construct that requires multiple modes of measurement for accurate assessment. This article describes a software package that includes four paradigms for measuring multiple and unique aspects of impulsivity. Specifically, four tasks are described: (1) the two choice impulsivity paradigm, (2) the single key impulsivity paradigm, (3) the GoStop impulsivity paradigm, and (4) the time paradigm. These tasks measure processes related to the capacity to tolerate delay for reward, to inhibit an already initiated response, and to estimate the passage of time. These processes have been found to be important to the understanding of impulsive behaviors. The programs are flexible and allow the experimenter to manipulate a number of parameters related to delay-reward contingencies, timing, performance feedback/payment, and data output variables. Manipulation of these parameters makes the paradigms scalable to a wide range of ability levels and appropriate for samples ranging from children to adults. The four paradigms in this software package are available at no cost and can be obtained by contacting the corresponding author.     

Visual analogue scale correlates of musculoskeletal fatigue

Visual analogue scale has been shown to reflect subjective feelings but rarely has it been used for musculoskeletal fatigue so in the present study VAS ratings were used to quantify musculoskeletal fatigue. A total of 20 students underwent a fatigue protocol (M age=21.3 yr., SD= 1.0). A series of randomized external loads at 0, 5, 10, 15, 25, 35, and 50% of the maximum voluntary contraction was generated by the BTE Primus and applied at the distal end of the dominant arm, which was sustained at the 90 degrees forward flexion position. After 60 sec. of force exertion for each loading, the subject marked the scale to reflect their extent of fatigue at the shoulder muscle. Analysis showed fatigue scores were significantly correlated with the percentages of maximum load applied (r =.73, p < or = .01). The correlation between higher external loads (25-50% maximum load) and fatigue scores was .57 (p < or = .01) and that for lower external loads (0-15% maximum load) was .44 (p < or = .01). The validity of using a visual analogue scale as a measure of musculoskeletal fatigue requires further study, particularly for a low load.     

Family Environments of Women Seeking BRCA1/BRCA2 Genetic Mutation Testing: An Exploratory Analysis

Although there is some understanding of the shared characteristics and predictors of psychological distress of women participating in hereditary breast and ovarian cancer registries, these same characteristics are only beginning to be identified in research on community women seeking genetic testing for BRCA1/BRCA2 gene mutations. This study provides an initial exploration of characteristics associated with family environments for 51 community women waiting to receive such genetic testing results. Thirty-four of the 36 women classified on family environment type of the Family Environment Scale (FES) were from Personal Growth-Oriented families. Comparisons of women with and without personal cancer histories resulted in a trend for women with personal cancer histories to be classified as from Independence-Oriented families. Reported distress appears to vary for different family emphases based on family and personal cancer history. A moral-religious family emphasis consistently appeared to be associated with decreased psychological distress. Preliminary analyses comparing these community women (who were not part of a hereditary registry but were self- or physician-referred) seeking genetic testing with normal and distressed family means found that increased cohesion and expressiveness may be related to decreased conflict, indicative of potentially supportive family environments for these women. When compared with normative data, a subset consisting of the Ashkenazi Jewish women showed a trend of less cohesion than normal families, but similar cohesion levels as distressed families.