Ethical issues in the treatment of weight-dissatisfied clients.

A number of ethical issues must be considered in the treatment of clients who are dissatisfied with their weight. Current societal attitudes of opprobrium toward fat affect psychologists as well as the general public, and may have deleterious effects on the ability to provide competent, responsible, and respectful help to large clients, particularly women. Psychologists should be aware that weight status has a large biogenetic component and that dieting is remarkedly ineffective in producing long-term weight loss. Professionals tend to overestimate the harmful effects of obesity and underestimate the negative impact of dieting on physical and psychological functioning. It is proposed that psychologists accept diversity of body size as a manifestation of human differences, promote overall health over thinness, and help clients become self-accepting instead of self-depriving. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Race and sex differences in long-term survival rates for elderly patients with pulmonary embolism

OBJECTIVES: The goal of this study was to provide estimates of race- and sex-specific survival rates over a 10-year period for a cohort of 49,752 Medicare patients admitted to the hospital in 1984 with a diagnosis of pulmonary embolism. METHODS: Data were derived from Medicare Provider Analysis and Review Record inpatient claims files and the National Death Index file. RESULTS: For a primary diagnosis of pulmonary embolism, median survival times among Black men and women were 2.5 years and 5.2 years, respectively; for White men and women, the median survival times were 4.3 years and 5.9 years, respectively. Median survival times for Black men and women and White men and women with a secondary diagnosis of pulmonary embolism were 0.4 years, 0.7 years, 0.8 years, and 1.4 years, respectively. Survival rates declined with advancing age. CONCLUSIONS: Overall, survival rates among Blacks were lower than those among Whites, and men had lower survival rates than women. These survival estimates provide new insights into outcomes following pulmonary embolism in hospitalized elderly people.     

Noctilucent clouds: modern ground-based photographic observations by a digital camera network

Noctilucent, or "night-shining," clouds (NLCs) are a spectacular optical nighttime phenomenon that is very often neglected in the context of atmospheric optics. This paper gives a brief overview of current understanding of NLCs by providing a simple physical picture of their formation, relevant observational characteristics, and scientific challenges of NLC research. Modern ground-based photographic NLC observations, carried out in the framework of automated digital camera networks around the globe, are outlined. In particular, the obtained results refer to studies of single quasi-stationary waves in the NLC field. These waves exhibit specific propagation properties--high localization, robustness, and long lifetime--that are the essential requisites of solitary waves.     

Factors affecting agreement between severely mentally ill alcohol abusers' and collaterals' reports of alcohol and other substance abuse.

This study examined subject-collateral reports of alcohol use among a sample of 167 dually diagnosed individuals seeking outpatient treatment at a community mental health clinic. All subjects met Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for a schizophrenia-spectrum or bipolar disorder and for alcohol abuse or dependence. Subjects were recruited within 2 weeks of treatment entry and completed measures of cognitive functioning, alcohol dependence severity, psychiatric symptoms, and quantity and frequency of substance use over the previous 60 days using the Timeline Follow-Back interview (L. C. Sobell & M. B. Sobell, 1996). They also provided a urine sample, which was screened for recent drug use. Collateral interviews were conducted by phone and included an assessment of the subject's alcohol and drug use over the same 60-day period. Collaterals also reported their confidence in the accuracy of their reports. Overall, the results indicated generally poor subject-collateral agreement. However, subject-collateral agreement appeared better for those individuals (n = 97) with negative urine drug screens. The most consistent predictor of subject-collateral discrepancy scores was subjects' recent drug use. Recommendations for enhancing the validity of self-reports of substance use in a severely mentally ill population are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of A history of alcoholism.

Reviews the book, A history of alcoholism by Jean-Charles Sournia (1990). This book was first published in French in 1986, and this English translation was published in 1990. The book consists of 12 chapters divided into 3 parts. The first 3 chapters cover a period of 19 centuries, ending at approximately 1850. Included in these 3 chapters are materials pertaining to alcohol use and drunkenness in antiquity and drinking throughout Europe and in the United States during the 1700s and into the mid-1800s. The second part of the book, composed of 5 chapters, covers the following 100 years. It includes chapters on the Swedish physician Magnus Huss, the evolution of drinking patterns in several European countries (with a particular focus on France), alcohol and medicine, and the development and activities of temperance societies. The third and final part includes 4 chapters and covers the years since 1950, a period that has witnessed many advances in research on alcohol effects, risk markers, treatment, and prevention. The strongest section of the book is the first part, which provides an overview on the history of alcoholism. This section also provides a variety of interesting notions about alcohol use from the Ancient Greek world, in which wine played an important role. The book starts out strong and provides an interesting and readable perspective on the history of drunkenness and alcoholism. The last third of the book loses steam, direction, and focus, though. However, for the reader interested in a historical overview, the first two thirds of this volume are enjoyable and recommended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Strategies for preparing clients for treatment. A review

Substantial numbers of mental health clients do not return following their initial therapy visits or drop out of treatment prematurely. Two general classes of strategies designed to reduce premature attrition and enhance treatment participation are reviewed. Research on psychotherapy preparatory techniques (role induction, vicarious therapy pretraining, and experiential pretraining) indicates that these educational techniques are effective in reducing early treatment attrition and may be especially effective with populations at high risk for dropout (e.g., lower socioeconomic groups, chronically mentally ill clients, and institutionalized juvenile delinquents). Motivational interviewing, a technique originally developed for clients with alcohol problems, is designed to reduce client ambivalence toward therapy and change and enhance commitment to and motivation for treatment. Research in the alcohol field suggests that a session of pretreatment motivational interviewing enhances treatment outcome. Both motivational interviewing and psychotherapy preparatory techniques are relatively brief and easy to incorporate into existing mental health care.     

Characterization of transthyretin mutants from serum using immunoprecipitation, HPLC/electrospray ionization and matrix-assisted laser desorption/ionization mass spectrometry

A mass spectrometry approach for the detection and identification of variants of the plasma protein transthyretin (TTR) is presented. The single amino acid substitutions found in TTR are closely associated with familial transthyretin amyloidosis (ATTR), a hereditary degenerative disease. A definitive diagnosis of ATTR relies on the detection and identification of TTR variants. The approach presented here is based on isolation of serum TTR using immunoprecipitation. The detection of the variant is achieved by mass measurement of the intact protein with electrospray ionization mass spectrometry (ESIMS). The liquid chromatography/ESIMS analysis of the tryptic digest of the protein followed by subsequent matrix-assisted laser desorption/ionization (MALDI) time-of-flight mass spectrometry and MALDI postsource decay of the relevant recovered chromatographic fraction containing the variant peptide allows the identification of unknown variants. The method was successfully tested using serum from ATTR patients with known variants (Val30-->Met and Val122-->Ile). A new TTR variant, Ser23-->Asn, was detected and identified using the above method where isoelectric focusing and restriction enzyme analysis failed to identify the nature of the variant.     

Illinois School of Professional Psychology predoctoral minor in sexual abuse.

This article describes a predoctoral minor in sexual abuse designed to prepare psychologists to work with maltreated populations including child and adult victims, offenders, and abusive family systems. This program aims to help students develop clinical competence in the areas of diagnostics, therapeutic intervention, forensic issues, research, and program development. The considerations involved in designing the curriculum course content, clinical practicum and internship, and clinical research project are described. Additionally, issues confronted in developing this program are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The renunciation of love: Dismissive attachment and its treatment.

The developmental insights of attachment theory as applied to children and adults suggest that insecure attachment correlates with relational difficulties over the course of time. Specifically, individuals with an avoidant attachment style who have been rebuffed by caregivers in childhood will be defensively constricted and unable to love in adulthood. These patients present particular challenges in treatment because they have become organized around avoidance of affect and relationship. Theories of treatment and technique that seem related to the successful resolution of such difficulties are discussed. Curative factors include a focus on defenses against relational longings, interpretation of and provision for certain selfobject needs, and a relatively high level of therapist self-disclosure. It is suggested that an integration of the findings of attachment research with relational theories that focus on treatment has potential to advance psychoanalytic thinking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Symptom formation: An integrative self psychological perspective.

Proposes self psychology as a relational model of psychopathology that can be incorporated into a biopsychosocial paradigm of symptom formation for Axis I disorders. Four specific pathways to symptom formation are outlined: (1) a self-state of impending fragmentation that is warded off through involvement with a substance or activity, as in addictive disorders; (2) a state of fragmentation without a behavioral means of self-restitution other than avoidance, as in anxiety disorders; (3) the use of a symptom as a compromise formation among conflicting impulses as a result of psychological trauma, as in dissociative and somatoform disorders; and (4) an internalized conflict between maintaining needed relationships and pursuing self-differentiation, resulting in symptoms such as depressive states and work inhibitions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)