Personality-based clusters in bulimia nervosa: differences in clinical variables and ecological momentary assessment

The present study examined whether personality-based subgroups of bulimic individuals differed in eating disorder behavior, comorbid psychopathology, treatment history, and momentary assessments of mood and behavior. Participants completed an Ecological Momentary Assessment (EMA) protocol for a period of 2 weeks. Latent profile analysis on the Dimensional Assessment of Personality Pathology revealed 3 groupings of bulimic participants: Interpersonal-emotional, Stimulus seeking-hostile, and Low personality pathology. The personality-based groups differed in histories of mood, anxiety, substance use disorders, features of borderline personality disorder, treatment history, and several momentary measures. These findings suggest that personality variation within the bulimia nervosa diagnostic construct may be associated with meaningful conceptual and clinical differences, including daily experiences in the natural environment.     

Domestic violence and sexual assault services: Inside the black box

Research examining the efficacy of community-based domestic violence and sexual assault services is yielding promising findings; however, little is known about the structure, components, and content of these services. Although service guidelines exist, a critical gap persists because review, comparison, and synthesis of these recommendations have not been undertaken. This research addresses this knowledge gap through a review of the domestic violence and sexual assault services literature. We gathered relevant literature by conducting systematic searches of databases, and by soliciting the service guidelines and training manuals from all the Domestic Violence and Sexual Assault Coalitions in the United States. These efforts yielded 43 articles, books, or manuals for review. The findings show strong consensus on core services for survivors, including crisis services, legal and medical advocacy, support groups, individual counseling, and shelter. This article presents the review results in tables comparing the service goals, intervention strategies, and recommendations for service delivery. We also found areas of contention (e.g., whether to continuously staff domestic violence shelters, and whether combined agencies can effectively offer both domestic violence and sexual assault services). Building upon the review findings, we discuss the implications for domestic violence and sexual assault services and intervention research.     

Neighborhood Environment, Sexual Risk Behaviors and Acquisition of Sexually Transmitted Infections Among Adolescents Diagnosed with Psychological Disorders

The association between neighborhood environment and prevalence of STIs, sexual partner variables and condom use among adolescents with psychological disorders was examined. Cross-sectional data in three urban areas of the US (Southeast, Northeast and Midwest) were obtained from 384 sexually active male and female participants who provided urine samples for laboratory-confirmed testing of Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis. A total of 15.4% of participants tested positive for one of the three STIs. Results indicated that relative to adolescents living in low risk neighborhood environments, those living in high risk environments were significantly more likely to have a STI and to report having casual partners. Findings suggest that in high risk neighborhoods, STI acquisition may be less dependent on condom use and more dependent on other contextual factors. The importance of expanding public health research to include assessment of neighborhood context as a determinant of sexual risk-taking is emphasized.     

Acceptance and Commitment Therapy and Habit Reversal Training for the Treatment of Trichotillomania

Trichotillomania is a behavioral problem, and is often referred to as a habit disorder, but it is important to consider the cognitive and emotional components of the behavior. Current treatment recommendations include a traditional behavioral approach (Habit Reversal Training; HRT) combined with an approach that addresses the cognitive and emotional components of the behavior (Acceptance and Commitment Therapy [ACT] or Dialectical Behavior Therapy [DBT]). Current evidence indicates a combination of ACT and HRT is an effective treatment for trichotillomania. The goal of this article is to replicate the effectiveness of the ACT/HRT treatment package for trichotillomania and to provide practical clinical guidance on how to deliver the treatment. This guidance is presented in the context of an empirical study in which 5 participants demonstrating high levels of pulling at pretreatment were treated with 8 sessions of a combination of ACT and HRT. Treatment resulted in an 88.87% reduction in pulling across participants from pretreatment to posttreatment, and all 5 responded to the treatment. At 3-month follow-up, 2 participants maintained the treatment gains, 2 lost half of the treatment gains, and 1 was at pretreatment levels. A discussion of the results is presented along with implications for clinical practice and future directions for research.     

Understanding Affirmative Action

The purpose of this article is to lay a conceptual groundwork that is needed if social scientists and policy makers are to design and implement fair and effective affirmative action programs. Because affirmative action is not well understood, in or out of the academy, the article starts with definitions, both general and technical, contrasts affirmative action with equal opportunity, and touches on the distinction between policy and practice. I then argue that affirmative action is a necessary policy, that it can be effective, and that it is fair. But the policy is for three other reasons: (a) it focuses on deficiencies, (b) it disturbs expectations, and (c) it poses a threat to individualism, interfering with self-congratulations.     

Preferences for religious help-seeking: racial and gender differences,interfaith intolerance,and defensive theology

We examined the relation between preference for religious help-seeking and defensive theology, interfaith intolerance, spiritual conceptualisations of mental health problems, race/ethnicity, and gender in a predominantly Christian sample of 389 college students. MANOVA revealed significant main effects for race/ethnicity, with African American participants showing higher scores than Caucasians and Latinos/as across all main study variables. Follow-up ANOVA yielded main effects for race across all four variables and main effects for gender on spiritual conceptualisation of mental health problems and defensive theology. All race/ethnicity by gender interactions were nonsignificant. Preference for religious help-seeking was regressed in a hierarchical manner on race/ethnicity and gender, followed by interfaith intolerance, defensive theology, and spiritual conceptualisation of mental health problems. A statistically significant model explaining 46% of the variance emerged incorporating all variables except race. A framework for understanding help-seeking preference is presented, followed by directions for future research.     

Cognitive behavioral therapy for compulsive buying disorder

To our knowledge, no psychotherapy treatment studies for compulsive buying have been published. The authors conducted a pilot trial comparing the efficacy of a group cognitive behavioral intervention designed for the treatment of compulsive buying to a waiting list control. Twenty-eight subjects were assigned to receive active treatment and 11 to the waiting list control group. The results at the end of treatment showed significant advantages for cognitive behavioral therapy (CBT) over the waiting list in reductions in the number of compulsive buying episodes and time spent buying, as well as scores on the Yale–Brown Obsessive Compulsive Scale—Shopping Version and the Compulsive Buying Scale. Improvement was well-maintained at 6-month follow-up. The pilot data suggests that a cognitive behavioral intervention can be quite effective in the treatment of compulsive buying disorder. This model requires further testing.