Assessing the specific psychopathology of binge eating disorder patients: Interview or self-report?

Research addressing the assessment of binge eating and associated eating disorder psychopathology has steadily increased in recent years. Few studies have examined the relationship between the various assessment methods. This study compared an investigator-based interview, the Eating Disorder Examination (EDE), with a self-report version of that interview, the EDE-Q. Fifty-two individuals (six men and 46 women) with binge eating disorder (BED) completed both instruments. Modest-to-good agreement and significant correlations (P < 0.0001) were found between the two methods on all four subscales assessing specific eating disorder psychopathology (i.e., Restraint, Eating Concern, Weight Concern, and Shape Concern subscales). However, higher levels of disturbance were consistently reported on the EDE-Q than the EDE interview. The two methods were not significantly or reliably related to one another when assessing binge eating. This may be due in part to the difficulty inherent in identifying binges in subjects with BED. Examination of individual item scores suggest that it might be possible to improve the performance of the EDE-Q by clarifying the definitions of certain complex features, although this should not be at the expense of compromising the practical utility of its self-report format.     

Family history and gender roles: Critical factors in practitioners' views of family interactions

This study examined practitioners' perceptions of family and individual family member functioning in relationship to family roles, gender of family leadership, beliefs about the consequences of maternal employment, and paternal division of responsibility in practitioner family of origin. Practicing counselors and mental health therapists rated two videotaped family interviews, one demonstrating a matriarchal style of family interaction and the second a patriarchal style. Findings indicated that practitioners were vulnerable to view a patriarchal style of family interaction as more healthy in comparison to a matriarchal style and that their perceptions of family members were related to personal beliefs about the consequences of maternal employment and to personal family history. These and other findings suggest that practitioners may be prone to errant perceptions and misguided intervention related to personal history and attitudes.     

Treatment of overweight children: The relationship between dependent measures and a clinically significant outcome

Behavioral treatments for overweight children have not fared well in achieving or maintaining clinically significant weight losses. The use of more appropriate dependent measures which also take height, sex, and age into consideration is suggested. A multiple-baseline analysis of the behavioral treatment of seven overweight children was conducted. Results support the contention that a more clinically significant outcome emerges when appropriate measures are used.     

A Sequential Analysis of Depressive Behaviors Within Adolescent Peer Interactions

This study examined depressive and positive patterns of interactions among clinical and nonclinical adolescent peers within an interpersonal context. Ten clinical dyads with a depressed partner and 10 nonclinical dyads engaged in 16-min audiotaped conversations under positive and negative task instructions discussing positive and negative experiences. Conversations were unitized and coded according to depressive, aggressive, positive, and neutral behaviors. The clinical dyad-group demonstrated over two times more depressive behaviors than did the nonclinical dyad-group. Both dyad-groups exhibited increased depressive interactions during negative task instructions and increased positive interaction during positive task instructions. The loglinear approach to sequential analysis demonstrated significant overall bidirectional influence in the adolescents' dyadic interaction. Specifically, we found that the depressed adolescents' depressive behaviors decreased the likelihood of partners' aggressive behaviors, and increased the likelihood of partners' positive behaviors. Clinical and nonclinical dyad-groups showed reliable patterns of positive interaction sequences. Results demonstrate that depressive and positive behaviors are functional in adolescent dyadic interaction.     

循证医学与临床实践

循证医学是９０ 年代诞生的新兴医学科学。其要点是将临床医学领域的研究结果进行系统、全面的综合评价,为临床医疗实践、科研、卫生决策和医学教育提供可靠的科学证据。在发达国家的运用表明它已经对临床实践产生了重大而深远的影响,并将继续在临床医学领域发挥重要的作用。     

Cultural Issues in Psychopharmacology: Integrating Medication Treatment with Lakota Sioux Traditions

Psychologists may soon be entering into the practice of pharmacologic treatment of mental illness. Although there has been some investigation of biologic differences in drug response among various ethnic and racial groups, very little attention has been paid to the nonbiologic differences. Cultural definitions of health, healing, and illness and specific cultural practices are likely to have a significant impact on various aspects of treatment, compliance, and interaction effects. This article addresses the issue of culture and the impact of cultural practices on the use of psychotropic medications with the Lakota (Sioux) people of the Northern Plains. Specific examples of traditional Lakota ceremonies and their potential interactions with psychotropic medications are presented with recommendations to prescribers for handling these situations in a culturally responsive manner. Emphasis is placed on creating collaborative relationships between prescribers and traditional spiritual healers in the care of Native American clients. Recommendations for future research are discussed.     

The Biomedical Disciplines and the Structure of Biomedical and Clinical Knowledge

The relation between biomedical knowledge and clinicalknowledge is discussed by comparing their respectivestructures. The knowledge of a disease as a biologicalphenomenon is constructed by the interaction of factsand theories from the main biomedical disciplines:epidemiology, diagnostics, clinical trial, therapydevelopment and pathogenesis. Although these facts andtheories are based on probabilities andextrapolations, the interaction provides a reliableand coherent structure, comparable to a Kuhnianparadigma. In the structure of clinical knowledge,i.e. knowledge of the patient with the disease, notonly biomedical knowledge contributes to the structurebut also economic and social relations, ethics andpersonal experience. However, the interaction betweeneach of the participating ``knowledges' in clinicalknowledge is not based on mutual dependency andaccumulation of different arguments from each, as inbiomedical knowledge, but on competition and partialexclusion. Therefore, the structure of biomedicalknowledge is different from that of clinicalknowledge. This difference is used as the basis for adiscussion in which the place of technology,evidence-based medicine and the gap between scientificand clinical knowledge are evaluated.     

Clinical cutoffs for the beck Depression inventory and the Geriatric Depression scale with older adult psychiatric outpatients

The present study developed new clinical cutoffs for the Beck Depression Inventory (BDI) and the Geriatric Depression Scale (GDS) with 59 older adult psychiatric outpatients. Maximum discrimination of a current major depressive episode resulted, with cutoff scores of 22 for the BDI and 16 for the GDS. Specifically, the following validity scores emerged for the BDI: sensitivity, 64%; specificity, 73%; positive predictive power, 75%; negative predictive power, 61%; and hit rate 68%. For the GDS the validity scores were as follows: sensitivity, 79%; specificity, 69%; positive predictive power, 77%; negative predictive power, 72%; and hit rate, 75%. Combined BDI and GDS scores did not result in improved prediction of a current major depressive episode as compared to the GDS alone. These results support the notion that the BDI and GDS are valid quick screening instruments in discriminating a current major depressive episode for older adult psychiatric outpatients.