Course of Treatment During a Cohort-Based Inpatient Program for Posttraumatic Stress Disorder

This study examined one group of veterans with post-traumatic stress disorder (PTSD) over the course of a four month inpatient treatment program. The aim of the study was to examine treatment process factors that may contribute to the generally poor outcome reported in previous studies. Group members made weekly ratings in the domains of PTSD symptoms, morale, interpersonal relationships, and physical problems. Results contrasted with clinical assumptions usually made regarding the treatment process in these programs. Despite an appearance of cohesion among group members, variation of scores on functional domains was explained largely by individual differences. Progress through the program showed a strongly linear pattern, with no phase effects. Somatic complaints did not increase during the phase when traumatic material was explored. Degree of improvement or worsening was best predicted by level of PTSD symptoms at admission, indicating that more symptomatic veterans did worse in the program. Additional factors of race, combat exposure, childhood abuse, and application for disability had no effect on the process variables measured.     

Conduct Disorder in Girls: A Review of the Literature

The study of Conduct Disorder (CD) has primarily been limited to boys. The lack of research resulted from a premise that CD in girls was rare. However, CD in girls is a relatively common psychiatric diagnosis, and appears to be associated with several serious outcomes, such as Antisocial Personality Disorder and early pregnancy. Understanding gender differences in the course and severity of CD may lead to important information about etiology. Empirical studies on precursors, developmental course, risk factors and treatment for CD in girls are reviewed, while highlighting similarities and differences between girls and boys. Generally, CD symptoms in girls are stable. Precursors to CD in girls probably include Oppositional Defiant Disorder and temperamental factors, but also may include certain negative cognitions. What distinguishes CD in girls is the high risk they have to develop comorbid conditions, especially internalizing disorders. Risk factors for CD in girls partly overlap with those known for boys, but some factors appear to be highly salient for girls. Finally, there may be some significant effects of gender on treatment efficacy. Implications of these findings for future etiologic research are discussed.     

Evaluation of antecedent stimulus parameters for the treatment of escape-maintained aberrant behavior

We evaluated a methodology for identifying the range of stimulus features of antecedent stimuli associated with aberrant behavior in demand contexts in natural settings. For each participant, an experimental analysis of antecedents (Phase 1) was conducted to confirm the hypothesis that task instructions occasioned increases in aberrant behavior. During Phase 2, specific stimulus features associated with the presentation of task instructions were assessed by evaluating the child's behavior across two distinct settings, therapists, and types of tasks in a sequential fashion. Aberrant behavior occurred immediately across settings and therapists, presumably because the presence of a discriminative stimulus for escape-maintained behavior (the delivery of a task instruction) occasioned aberrant behavior. However, aberrant behavior decreased initially across tasks, suggesting that familiarity with the task might be a variable. During Phase 3, an experimental (functional) analysis of consequences was conducted with 2 participants to verify that aberrant behavior was maintained by negative reinforcement. During Phase 4, a treatment package that interspersed play with task instructions was conducted to disrupt the ongoing occurrence of aberrant behavior. Immediate and durable treatment effects occurred for 2 of the 3 participants.     

Instrumental and expressive violence in Belgian homicide perpetrators

The present study aimed to examine offender types in a sample of Belgian single‐perpetrator/single‐victim homicide cases. First, it was investigated if the distinction between instrumental and expressive aggression could be documented in crime scene and offender background characteristics. Second, the instrumental and expressive themes from the first analysis were examined in relation to the motives the perpetrators themselves provided for their offence. A sample of 97 solved homicide cases was analysed using the non‐metric multidimensional scaling procedure Proxscal. The results revealed that 62% of the homicide crime scenes and 67% of the offender backgrounds could be classified as either expressive or instrumental. The self‐reported motives did not correspond with the themes according to the Proxscal analysis. Copyright © 2010 John Wiley & Sons, Ltd.     

The specifi city of torture as trauma: The human wilderness when words fail1

The author attempts to situate the specifi city of torture‐understood as the product of political violence and of totalitarian states‐within the historical framework of the concept of trauma in psychoanalysis. When the mind and social ties are simultaneously affected, the intrapsychic and transpersonal aspects of the suffered damage intertwine in a complex and unique web. The author aims to dismantle the notion of victim, considering it both stigmatizing and inaccurate. The goal is not just to identify the after‐effects and the disabilities suffered by those affected by torture, but also to integrate their experiences and their narratives into a life project. Rather than individual psychopathology, this essay refl ects upon those phenomena of suggestion and hypnosis that are at work in human groups under ordinary conditions and that are exacerbated under social crises, following the Freudian axis developed in Group psychology and the analysis of the ego.     

老年甲状腺结节的诊治经验

介绍笔者及科室老年甲状腺结节的诊治经验,对2003年1月至2009年12月期间共收治的144例年龄大于60岁的老年甲状腺结节患者进行分析和总结。老年甲状腺结节以多发为主;压迫症状、异物和不适感、继发性甲状腺功能亢进是老年甲状腺结节患者主要的手术指证;术中发现喉返神经和甲状旁腺有脂肪沉着;病理方面良性结节的钙化率较高;患者术后切口水肿比较明显;暂时性低钙血症的发生率较高;虽然术前麻醉ASA评分较低,但术后心肺并发症的发生率并未上升。老年甲状腺结节患者以全麻为宜,最好采用双甲近全切除术,这不仅可避免术后复发和再次手术率,更可减少甲状腺素制剂的用量,减少药物副作用。     

The social nature of benevolent sexism and the antisocial nature of hostile sexism: Is benevolent sexism more likely to manifest in public contexts and hostile sexism in private contexts?

Previous research converges on demonstrating that benevolent sexism (BS) is socially approved, whereas hostile sexism (HS) is socially disapproved. We postulated that a sample of married women would be likely to report that their husbands express hostile sexist attitudes and engage in related actions towards them more in private than public contexts, where they lie concealed from public censure. By contrast, the women would report that their husbands would be likely to express benevolent sexist attitudes and engage in related actions more in public than private contexts, where they are reinforced not only by their target (i.e. wife), but also by significant others and the society at large. We tested these hypotheses with a sample of Black, heterosexually married Zimbabwean women (n = 109, mean age = 31.83). Results supported our hypotheses: the women reported hostile sexist attitudes and actions to be more likely to occur in private than public contexts; on the other hand, they reported benevolent sexist attitudes and actions to be more likely in public than private contexts. We conclude that differences in social approval of BS and HS account for these results.     

Meta-Analysis of the Effects of Peer-Administered Psychosocial Interventions on Symptoms of Depression

Many community mental health centers have implemented peer treatment models that employ recovered former clients as cost‐efficient adjunct providers. The effectiveness of these and other peer‐administered interventions (PAIs) for treating depression symptoms has not been well‐established. The current study is a meta‐analysis of PAIs’ effects on depression symptoms. Twenty‐three eligible studies were identified. Study characteristics were coded by multiple raters, random‐effects models were used to compare mean effect sizes, and mixed‐effects models were used to test for moderation. PAIs produced significant pre‐post reductions in depression symptoms (d = .5043 [95 % CI .3675–.6412]). In direct comparisons, PAIs performed as well as non‐peer‐administered interventions (.0848 [?.1455–.3151]), and significantly better than no‐treatment conditions (.2011 [.0104–.3918]). PAIs that involved a professional in a secondary treatment role were significantly less effective than those that were purely peer‐administered, and educational/skills‐based PAIs produced better outcomes than those that were mainly supportive. Follow‐up data, when available, indicated that PAIs’ benefits were maintained. PAIs reduce depression symptoms and warrant further study. The clinical significance of PAIs’ benefits, and whether they are better suited as stand‐alone or adjunct treatments, remain to be established. Implications for the roles of mental health professionals are discussed.     

Sequenced neurocognitive and behavioral parent training for the treatment of ADHD in school-age children

The present study examines the potential of sequencing a neurocognitive intervention with behavioral parent training (BPT) to improve executive functions (EFs), psychiatric symptoms, and multiple indices of functional impairment in school-age children aged 7 to 11 years who have been diagnosed with attention-deficit/hyperactivity disorder (ADHD). Specifically, in a randomized controlled trial design, 85 children were assigned to either Cogmed Working Memory Training (CWMT) followed by an empirically supported, manualized BPT intervention, or to a placebo version of CWMT followed by the same BPT intervention. Working memory maintenance (i.e., attention control/short-term memory), working memory processing and manipulation, ADHD and oppositional defiant disorder (ODD) symptoms, impairment in parent–child dynamics, familial impairment, and overall functional compromise were evaluated as outcomes. The results suggest specific effects of the combined CWMT and BPT program on verbal and nonverbal working memory storage and nonverbal working memory processing and manipulation but no incremental benefits in regard to ADHD symptoms, ODD symptoms, and functional outcomes. The present findings do not support the hypothesis regarding the complementary and augmentative benefits of sequenced neurocognitive and BPT interventions for the treatment of ADHD. These results, the study’s limitations, and future directions for research are further discussed.