Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training

Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma’s effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents (n = 17; 2 sites) or community physicians (n = 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs.     

An overview of the literature on sexual harassment: Perpetrator,theory, and treatment issues

Sexual harassment has been recognized as a serious problem in the literature over the past 30 years. In this paper, we review the existing research surrounding the phenomenon of sexual harassment, paying particular attention to factors of relevance for understanding perpetrators of sexual harassment. We also provide an overview of the perplexing nature of sexual harassment and the various concerns that have surrounded the topic leading to its recognition. The different theoretical perspectives and models of sexual harassment (sociocultural, organizational, sex-role spillover, natural/biological, socio-cognitive, and four-factor) are also considered and reviewed. Finally, lack of empirical evidence and focus on assessment and treatment for harassers is recognized in this paper, and several suggestions are made for future research and treatment avenues relating to the sexual harasser.     

How Gender and Race Stereotypes Impact the Advancement of Scholars in STEM: Professors’ Biased Evaluations of Physics and Biology Post-Doctoral Candidates

Sex Roles - The current study examines how intersecting stereotypes about gender and race influence faculty perceptions of post-doctoral candidates in STEM fields in the United States. Using a...     

An analysis of stereotypy during prevocational instruction of an adolescent with severe mental retardation

An adolescent with severe retardation was observed during participation in several vocational tasks. The vocational tasks were comprised of repeating sequences of work-related responses. Across two experiments, conditions that are typical in the training of vocational tasks in special education and adult vocational programs were manipulated and the effects of these conditions on rates of vocational sequences completed and rates of stereotypic behavior were assessed. In Experiments 1 and 2, the adolescent was reinforced with a food item following the completion of vocational sequences under two alternating reinforcement contingencies. Under one contingency, the adolescent performed with frequent errors and under the other, often performed without errors. In Experiment 3, the adolescent participated with another student in a different vocational task on alternating days and in an alternating sequence of work conditions in each task. In one condition, both adolescents had vocational materials nearly continuously present and the teacher prompted and reinforced both adolescents as needed. In the other condition, the vocational materials were presented to the adolescents on an alternating basis, and the teacher prompted and reinforced first one and then the other. Across both experiments, increased competence reflected as high rate, error free, and consistent vocational performances were associated with low rates of stereotypic behavior when compared to conditions with less competent performances, and with leisure periods in Experiment 3. © 1997 John Wiley & Sons, Ltd.     

THE REDUCTION OF SELF INJURY IN TWO ADOLESCENTS WITH PROFOUND RETARDATION BY THE ESTABLISHMENT OF A SUPPORTED ROUTINE

Two experiments applied a conceptualization of competence to the treatment of self injury in two adolescents with profound retardation. In Experiment 1, a multiple baseline design across two activity periods was used to assess the effects of reinforcing completion of a five-step packaging routine on repetitious facial hitting in one participant. The rate of facial hits decreased when teachers reduced the latency between a pause by the participant and a prompt from the teacher to continue, pauses having been observed to be followed often by sequence errors, and sequence errors by facial hitting. In Experiment 2, a reversal design was used to compare the effects on head hitting and hand biting by substituting a premeal and dining routine in a second participant. The new routine replaced a largely instructional routine that required discriminations, receptive language, and motor performances not likely to emerge in the participant's repertoire. Discontinuation of the instructional routine reduced self injury; institution of the new routine permitted the development of a highly independent series of performances without reoccurrence of self injury. The combined results of the two experiments point to the potentially evocative nature of common teaching approaches and techniques, and the habilitative effects of designing performance expectations with greater prognosis for acquisition.     

Maternal Empathy and Changes in Mothers’ Permissiveness as Predictors of Toddlers’ Early Social Competence with Peers: A Parenting Intervention Study

The goal of the current study was to examine how changes in parenting due to a parenting intervention designed to decrease permissive parenting affected the quality of children’s peer interactions. Forty-nine mothers of toddlers aged 2–3 years participated in a 12-week intervention in which half got hands-on training and practice using positive guidance in a toddler classroom setting, while the other half learned positive guidance solely via a seminar format. To observe children’s peer interactions, toddlers were divided into 8 groups of 5–7 children mixed across condition. Observers coded mothers’ empathy, permissiveness, and positive guidance parenting strategies. Children’s peer interactions were coded for antisocial behaviors, verbal aggression, physical aggression, prosocial behaviors, positive social bids, and empathy. Prior analysis of this intervention indicated that mothers in both conditions showed reductions in permissiveness over the course of the intervention. Results from the present study indicated that reductions in permissiveness predicted decreases in toddlers’ verbal aggression. Maternal empathy was a moderator such that mothers low in empathy who got hands-on training in positive guidance had children who demonstrated the greatest reductions in antisocial behaviors.     

Cognitive Complexity and Dissociative Identity Disorder

Thirteen patients with dissociative identity disorder (DID), 13 with other mental disorders, and 10 nondiagnosed comparison participants were given individual grids. Results showed that displaying alternate personalities did not portend a more multidimensional level of thinking. Instead, the nonclinical comparison group had the greater degree of complexity in comparison to both clinical groups. A notable clinical observation was that DID patients, as compared to non-DID participants, had a greater understanding and speed in completing the grid. Findings are discussed in terms of the advantages of personal construct theory for conceptualizing the construct of dissociation.     

Semantics without Truth in Later Mohist Philosophy of Language

In this paper, I examine the concept of truth in classical Chinese philosophy, beginning with a critical examination of Chad Hansen’s claim that it has no such concept. By using certain passages that emphasize analogous concepts in the philosophy of language of the Later Mohist Canons, I argue that while there is no word in classical Chinese that functions as truth generally does in Western philosophy for grammatical reasons, the Later Mohists were certainly working with a notion of semantic adequacy in which a language-to-world relationship is made an object of investigation, challenging Hansen’s position that classical Chinese functions within a primarily pragmatic linguistic framework in which a language-to-user relationship determines the meaning of words.