Flashback phenomena in survivors of childhood sexual abuse: A four-stage treatment model

There has been a growing awareness of Post-Traumatic Stress Disorder (PTSD) as a consequence of childhood sexual trauma. Central to this diagnosis is the flashback experience. Flashbacks are essentially memories which have not been integrated into everyday consciousness and return as intrusive symptoms, usually accompanied by dread and panic. This article presents a treatment strategy based on a four-stage model. The model includes (1) education; (2) assisting clients in identifying their flashback patterns; (3) designing coping strategies; and (4) processing the flashback. The goal is to assist the client with the management and integration of traumatic memory.This article is based on a paper practical guidelines to treating incest survivors' flashbacks presented at the World Congress of Cognitive Therapy, Toronto, June 1992.     

Effects of consent form information on self-disclosure

When researchers encounter preexisting psychological distress in participants, ethical codes provide little guidance on how to balance issues of beneficence and autonomy. Although researchers may inform participants what will occur given responses indicating distress, this information may lead to biased self-reports. This important issue was addressed in this study by manipulating consent form information regarding the type of psychopathology to be assessed and various levels of possible follow-up. In comparing responses on self-report measures of anxiety, depression, and general psychological distress, men who believed depression was the focus of the study reported fewer symptoms of depression and less trait anxiety as intrusiveness of experimenter follow-up increased. These results are discussed within the framework of socialization theory. Given that half of the sample did not correctly answer questions regarding information contained in the consent form, guidelines to improve consent form comprehension are offered.     

Social Contact,Loneliness, and Mass Media Use: A Test of Two Hypotheses1

The possible connections between social variables such as frequency of social activity and subjective loneliness on the one hand, and extent of mass media use on the other, have received relatively little empirical attention. In this investigation, two related hypotheses concerning such links are proposed. The compensation hypothesis holds that persons with little social contact or greater loneliness will be more likely to utilize mass media to compensate for social impoverishment. The buffering hypothesis more specifically predicts that such compensation is effective; that is, persons “at risk” for loneliness because of diminished social contact may be at least partially protected from subjective loneliness due to heavy use of mass media. The hypotheses were tested in two samples: college students and a group of adolescent males attending a summer camp. Little support was found for the compensation hypothesis. While limited support was found for the buffering hypothesis, analyses also revealed an unexpected opposite effect; for the music variable, heavy media use actually intensified the association between social deficits and subjective loneliness. Some limitations of this study are discussed, and issues related to the unexpected “intensification” effects are presented.     

The Impact of A Discredited Key Witness

An experiment was conducted in order to assess the impact of discredited testimony presented by a key witness in a court setting. One of two videotaped cases was presented to subjects who were asked to assume the role of jurors and to make judgments as to the defendant's liability on the basis of the evidence presented. The three possible effects of discredited testimony on judgments were examined: logic, overcorrection, and perseverance. Subjects dealt with discredited testimony logically, ignoring it, except in one version of one of the cases where the witness' discredited testimony constituted a false accusation. In this version, subjects overcorrected in their judgments.     

Taste,odor, and tactile discrimination before and after smoking

Differential sensitivity was measured before and after smoking a cigarette by seven smokers, using six non-smokers as controls. Stimuli consisted of the tastes of sucrose, sodium chloride, citric acid, caffeine, and quinine hydrochloride; the odors of vanillin and 2-butanone; and the viscosity produced by a carrageenan gum. No significant jnds were observed between smokers and non-smokers, nor before vs after smoking. Therefore, the data supported neither longterm nor short-term influences of cigarette smoking. Practice effects were noted among the control group, as more correct responses were obtained on the second than on the first set of solutions in most of the test stimuli.     

Comparison of Telephone and Televideo Modes for Delivery of Genetic Counseling: a Randomized Trial

Telephone and televideo have yielded equivalent patient satisfaction and psychosocial outcomes when compared to in-person genetic counseling, yet little is known about how they compare to one another. In this randomized controlled trial, veterans received genetic counseling via telephone or traveled to a clinic to participate via encrypted televideo. Knowledge and visit satisfaction were assessed 2 weeks later. Travel time, mileage, and out-of-pocket costs were calculated for videoconferencing. Qualitative interviews were conducted with patients and counselors to assess acceptability. Of the 20 male patients randomized to telephone, 90% received counseling and provided outcomes; of the 18 randomized to televideo, 67% received counseling and 50% provided outcomes. Telephone patients answered a mean of 4.4 of eight questions correctly at baseline and 4.7 at follow-up; televideo means were 5.6 and 6.5, respectively. Satisfaction was 25.2 out of 30 for telephone and 26.9 for televideo. Televideo patients incurred a median of 2.8 h of travel time, 40 roundtrip miles, and $67.29 in costs. Patients and counselors found both modes acceptable for providing education and answering questions. Although patients liked the flexibility of telephone, counselors felt patients missed more appointments and were distracted when using telephone. A noted advantage of videoconferencing was reading body language. Further evaluation of alternative delivery modes is needed.     

Beyond Consent: Building Trusting Relationships With Diverse Populations in Precision Medicine Research

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: (1) Address the role of history and experience on trust, (2) engage concerns about potential group harm, (3) address cultural values and communication barriers, and (4) integrate patient values and expectations into oversight and governance structures.