Reducing drug and alcohol use and improving well-being for Indigenous and non-Indigenous Australians using the Community Reinforcement Approach: A feasibility and acceptability study

There is a lack of evidence of effective and appropriate drug and alcohol treatment for Aboriginal and Torres Strait Islander peoples. This paper contributes to addressing the evidence gap by examining the feasibility and acceptability and conducting a pre/post-evaluation of the Aboriginal-adapted Community Reinforcement Approach (CRA) delivered in New South Wales, Australia. Aboriginal and non-Aboriginal clients (n = 55) received tailored CRA delivery between March and November 2013. Compared to the original US version, tailored CRA had reduced technical language, reduced number of treatment sessions, and the addition of group delivery option. An Australian training manual with local case studies was developed. Alcohol, Smoking and Substance Involvement Test (ASSIST), Kessler-5 (K-5) and the Growth Empowerment Measure were used. 58% of participants were followed-up at 3 months. Tailored CRA was feasible to deliver in a rural, community-based health setting, and rated by clients as highly effective and acceptable. CRA was associated with statistically significant reductions in the use of alcohol, tobacco, cannabis, amphetamine and over the counter medication, and levels of psychological distress, and an increase in levels of empowerment for Aboriginal and non-Aboriginal clients. This study provides evidence for the feasibility and acceptability of an Aboriginal-adapted psychological intervention addressing drug, alcohol and mental health outcomes.     

Pavlov's legacy to behavioral psychology,physiology, and psychiatry: A program about Pavlov

A program about Pavlov was held at the Countway Library as part of the “Leaders in American Medicine” series on 12 March 1980. A film (Pavlov Himself) was shown; it was produced by USSR Central Television and the Soviet Academy of Science and obtained from Films for the Humanities, P.O. Box 2053, Princeton, N.J. 08540. Three distinguished scholars discussed Pavlov's influence on psychology (Professor B. F. Skinner), physiology (Professor John Pappenheimer), and psychiatry (Dr. Peter Dews).     

The Santa Fe style in American anthropology: Regional interest,academic initiative,and philanthropic policy in the first two decades of the Laboratory of Anthropology,Inc.

During the 1920s the American Southwest, an area rich in ethnographic and archelogical resources, became an important focus of interest on the part of both eastern academic anthropologists and the Rockefeller philanthropies. Successfully coopting or overriding previously established regional anthropological interests, nationally oriented anthropologists were instrumental in establishing a Laboratory of Anthropology modelled in part on the Marine Biological Laboratory at Woods Hole, Massachusetts. When Rockefeller funding was terminated in the middle 1930s, the Laboratory was left to forage in the economic desert of the depression Southwest and was unable to find either adequate financial support or a clearly defined mission. In 1947, it was incorporated into the State Museum system, where it functions today as a coordinating center for archeological research in the Rio Grande Basin.     

Antenatal caregiving representations and perinatal behavior in mothers with severe lifetime psychopathology

Psychopathology poses a risk for optimal parenting. The current study explored antenatal caregiving representations as markers for later risk of nonoptimal maternal behavior among mothers with severe mental illness. Sixty-five mothers diagnosed with psychosis, bipolar disorder, depression (psychopathology group), and nonclinical controls participated in a longitudinal study from pregnancy to 16 weeks after birth. Mental health diagnoses and caregiving representations were assessed during pregnancy. Maternal behavior was assessed during the 5-min recovery phase of the still-face paradigm at 16 weeks. Mothers with psychopathology reported significantly higher levels of “heightened” caregiving representations (i.e., separation anxiety from the child) than did controls. The only significant diagnostic group difference in perinatal maternal behavior was that mothers diagnosed with depression exhibited more overriding-intrusive behavior than did nonclinical control mothers. Regression modeling results showed that antenatal caregiving representations of “role reversal” predicted significantly lower levels of sensitivity and higher levels of overriding-intrusive behavior independent of the effect of psychopathology. The findings can be interpreted in the context of representational transformation to motherhood during pregnancy. The results provide preliminary evidence for the potential of a new questionnaire measure of caregiving representations as a screening instrument for antenatal representational risk.     

The effects of gormone manipulations on aggressive target-biting in mice

Aggressive biting of an inanimate target by mice was studied. Males attacked the bite-target more frequently than females, but this difference disappeared after castration when the response rate of the males approached that of the females. Ovariectomizing the females had little effect on their bite-attack frequencies. Subsequent androgen injections restored the biting-attack frequency of the castrated males to preoperative levels but had little effect on the intact males. Estrogen had little effect on the response frequency of the females, whereas androgen produced a slight increase in their bite-attack frequency. Results indicate that androgen is critical for the maintenance of this aggressive response and that the single subject paradigm utilized in this study was a sensitive measure of aggressive tendencies in mice.     

Holocaust survivors in a primary care setting: fifty years later

Past studies have not assessed the prevalence of emotional disturbances in Holocaust survivors seeking medical treatment in a family practice environment. The present study examined the prevalence of lifetime (the presence of symptomatology at any time) and current posttraumatic stress disorder (PTSD) symptoms, general anxiety, and depression in Holocaust survivors seeking medical treatment in a primary care setting. 20 of the 27 Holocaust survivors in our sample received a current diagnosis of PTSD and reported significant symptoms of depression and general anxiety. Although 74% of the survivors were currently diagnosed with PTSD, participants in this study had reported an overall decline in reexperiencing, hyperarousal, and overall PTSD symptoms but exhibited increased avoidance and numbing symptoms throughout the lifespan. These preliminary results suggest that removing avoidance as a defense mechanism during the course of psychotherapy may leave these survivors without an adequate way for coping with their trauma, subsequently increasing their vulnerability to psychopathology. Implications for psychological interventions are provided.     

HMOs and physician conflicts of interest

In a recent issue of this journal, Francis Beckwith's "The Ethics of Referral Kickbacks and Self-Referral and the HMO Physician as Gatekeeper: An Ethical Analysis" provided an admirably provocative defense of the claim that Health Maintenance Organization (HMO) physician gatekeepers are morally indistinguishable from physician referral kickbacks and self-referrals. Here I will argue that Beckwith's defense is weak. I will also make some tentative suggestions about approaching the issue of physician conflicts of interest.