Physicians and obligatory social activism

This essay examines the claim that physicians have a special obligation to engage in social and political activism. Four ethical paradigms are considered. Two paradigms, the preventive medicine and the social medicine models, embody a limited professional obligation to advocate the priority of health in society; the justification for a more aggressive stance is limited by the failings of paternalism. The radical model and the heroic model speak to issues of personal virtue rather than professional obligation; they are not strictly comparable.     

Flexible Manualized Treatment for Pediatric Obsessive–Compulsive Disorder: A Case Study

The following case study describes the treatment of an 8 year-old girl with early-onset obsessive compulsive disorder using a manualized cognitive-behavioral therapy with exposure and response prevention (CBT/EPR) protocol, implemented using a “flexibility within fidelity” approach. The case study focuses on how the treatment manual was successfully implemented in a flexible manner to address unique aspects of the case. These unique factors included the child’s extreme shyness at the beginning of treatment (with implications for rapport building), the primarily obsessional presentation of this child’s symptoms, the child’s avoidance of discussing the content of her obsessive thoughts, and secondary depressive symptoms (excessive guilt, frequent crying, and sadness) that contributed to the child’s impairment and distress. Assessment of progress indicated improvement in symptoms after four sessions of cognitive skill building and again in the last five sessions after implementing increased exposure to obsessive thoughts using narrative techniques. The implications for clinicians and student therapists, including the importance of rapport building, developmentally tailoring treatment, and flexibly implementing treatment to address the unique characteristics of the individual patient are discussed.     

A Preliminary Analysis of Counseling Students' Attitudes Toward Counseling Women and Women of Color: Implications for Cultural Competency Training

In this study, 56 counseling students responded to peer‐generated presentations on counseling women and counseling women of color. Qualitative methodology was used to identify students' racial, ethnic, and gender attitudes in counseling contexts. Implications for cultural competency training are provided.     

Exploring the Relationships Between Racial/Cultural Identity and Ego Identity Among African Americans and Mexican Americans

Relationships between collective identity and ego identity were examined among 299 African American and Mexican American university students. Participants completed scales measuring racial or cultural identity and ego identity. Regression analyses indicated that ego identity was significantly related to racial identity for African Americans and cultural identity for Mexican Americans.     

Resampling programs for multiway contingency tables with fixed marginal frequency totals

A resampling algorithm is presented for analyzing multiway contingency tables with fixed marginal frequency totals. Applications are illustrated with extensions of Fisher's exact, Pearson's chi-squared, and likelihood-ratio tests to three-way contingency tables.     

Linkages between violence-associated attitudes and psychological,physical, and sexual dating abuse perpetration and victimization among male and female adolescents

Attitudes about violence and sex in dating relationships were related to psychological, physical, and sexual teen dating abuse perpetration and victimization. Data from Wave 4 of the national, randomly selected, Growing up with Media cohort (n = 876 adolescents aged 14-19 years), collected in 2011, were analyzed. Dating youth perceived more peer pressure to have sex and were more accepting of sex in brief or nonmarital relationships than pre-dating youth. Boys had higher levels of rape-supportive attitudes than girls. Among dating youth, the relative odds of involvement in teen dating abuse as a perpetrator or a victim were generally associated with greater acceptance of relationship violence, perceived peer pressure to have sex, and acceptance of sex in brief and/or nonmarital relationships. Rape-supportive attitudes were not significantly associated with any type of teen dating abuse involvement. Programs aimed at preventing dating abuse might benefit from targeting attitudes associated with sexual activity as well as relationship violence.