Diverse faces of domestic violence.

Domestic violence is one of the most common causes of serious injury among women. Domestic violence victims endure physical and psychological sequelae that often go undetected by the health care professionals they encounter. There are many barriers women who are victims of domestic violence face. Women of color encounter additional barriers such as stereotypes that construct domestic violence as a "minority" issue. This article surveys the relevant literature to provide the reader with a review of the current state of knowledge for this special sub-population of domestic violence victims. Health care professionals need to be aware of the issues of this sub-population and be appropriately educated and trained to actively screen them. In addition, health care professionals need to be culturally sensitive to the needs of women of color who may experience domestic violence in order to appropriately screen and refer women for services that meet their needs.     

Phonological reading skills acquisition by children with mental retardation

Twenty children with mental retardation (MR), age 7-12, completed a phonological reading skills program over approximately 10 weeks. As a result of the instruction, they were better able to sound out learned and transfer words compared to a control group matched on age, IQ, nonword reading, language comprehension, and phonemic awareness. Final sounding out was predicted by beginning reading skill in both groups, by phonemic awareness and articulation speed in the control group only, and by general language ability in the instruction group only. Neither IQ nor verbal working memory correlated significantly with final sounding out ability in either group. It is suggested that the instruction succeeded in compensating for weaknesses in phonemic awareness and speech articulation, but favored those who had better language skills.     

Psychotherapy for obsessive-compulsive disorder

Cognitive-behavioral therapy (CBT) with exposure and response prevention is a first-line intervention for adult and childhood obsessive-compulsive disorder. Methodologically rigorous controlled trials have suggested that benefits from CBT exceed those from placebo and attention-control conditions and have similar or greater efficacy than serotonergic monotherapy. This article reviews the nature of CBT and associated outcome data, highlighting recent empiric findings in the treatment literature.     

Interactions Between Genotype and Depressive Symptoms on Obesity

Depression and Genetic variation in serotonin and monoamine transmission have both been associated with body mass index (BMI), but their interaction effects are not well understood. We examined the interaction between depressive symptoms and functional polymorphisms of serotonin transporter (SLC6A4) and monoamine oxidase A (MAOA) on categories of BMI. Participants were from the National Longitudinal Study of Adolescent Health. Multiple logistic regression was used to investigate interactions between candidate genes and depression on risk of obesity (BMI ≥ 30) or overweight + obese combined (BMI ≥ 25). Males with an MAOA active allele with high depressive symptoms were at decreased risk of obesity (OR 0.22; 95% CI 0.06–0.78) and overweight + obesity (OR 0.48; 95% CI 0.26–0.89). No similar effect was observed among females. These findings highlight that the obesity–depression relationship may vary as a function of gender and genetic polymorphism, and suggest the need for further study. Handling editor: Tatiana Foroud.     

Estrogen and Progesterone Receptor and p53 Gene Expression in Adenoid Cystic Cancer

Objectives The current study examined the role of estrogen receptors (ER), progesterone receptors (PR) and p53 expression in adenoid cystic carcinoma (ACC) to determine if simple expression or possible overexpression of these products might influence the development and natural course of this cancer. Study Design ER and PR status and p53 overexpression were retrospectively evaluated utilizing immunohistochemical evaluation of 47 ACC specimens. Methods Formalin-fixed paraffin-embedded tissues from 47 ACC specimens and 47 samples of normal salivary gland tissue were evaluated histochemically for the presence of ER, PR and p53. Immunoreactivity was scored using a 0 to +3 scale in which staining was either (0) negative, (+1) spotty, (+2) weakly positive, or (+3) strongly positive. Results ER was expressed in 8 of 47 tumors while PR was expressed in 4 of 47 tumors. p53 aberrations were demonstrated in 26 of 47 tumors. Tumors showed varying degrees of immunopositivity ranging from 0 to +3. Conclusions These studies suggest that p53 aberrations may be involved in ACC tumor progression and that ER and PR may play a role in ACC development.     

Midwifery Management of the Woman With an Eating Disorder in the Antepartum Period

A 21‐year‐old gravida 1, para 0 at 11 weeks and 4/7 days by last normal menstrual period presented to our clinic for prenatal care. She has never had a serious illness, surgery, or hospitalization. Her family history was positive for chronic depression and substance abuse. Her psychological history was positive for bulimia nervosa, which she reported first developing at 18 years of age. Although she had been working with a therapist for the past couple of years, she reported binge eating 1 to 2 times a week and compensatory behaviors, including excessive exercise, laxative use, fasting, and self‐induced vomiting. She denied suicidal and homicidal ideation. She reported that her boyfriend and family provided a good social support system. Over the past few weeks, she had experienced symptoms of fatigue, nausea, and vomiting, but she denied dizziness and hyperemesis. The physical examination revealed that her vital signs were stable, and all systems were found to be normal, with uterine size equal to dates. She measured 5 feet 6 inches tall, with a prepregnancy weight of 127 pounds and a body mass index (BMI) of 20.5. She estimated gaining about 5 pounds since becoming pregnant. Moderate ketones were noted on urine dipstick. Laboratory values ordered at the first prenatal visit and at 28 weeks' gestation were all within normal limits, with the exception of a hemoglobin value of 11.6 and a hematocrit of 33.8 at 28 weeks' gestation, indicating mild anemia. The woman attended clinic regularly and had an uncomplicated prenatal course, gaining a total of 34 pounds. She was offered anticipatory guidance at each antepartum visit and was counseled by her midwife on nutrition and weight gain. She kept bimonthly appointments with her regular therapist throughout the duration of her pregnancy. While she attempted to refrain from binging and compensatory behaviors, she did not completely abstain, reporting an average of 1 to 3 binge eating episodes (followed by self‐induced vomiting or laxative use) per month. She gave birth vaginally to a healthy 8 lb, 5 oz baby boy at 40 weeks and 3/7 days without complications.     

Clinical Correlates and Treatment Response of the Yale-Brown Obsessive Compulsive Scale Auxiliary Items

The current study examined clinical correlates and treatment response as they relate to auxiliary clinical characteristics (i.e., insight; avoidance; indecisiveness; sense of responsibility; pervasive slowness; pathological doubt; duration of obsession-free and compulsion-free intervals) in 172 adults with OCD. A trained evaluator administered the Yale-Brown Obsessive Compulsive Scale and the Anxiety Disorders Interview Schedule for DSM-IV. As well, patients completed the Obsessive Compulsive Inventory-Revised; Beck Depression Inventory-Second Edition; State-Trait Anxiety Inventory; RAND 36-Item Health Survey; and Sheehan Disability Scale. Results indicated numerous associations between auxiliary OCD features and both depressive and anxious symptoms as well as impaired health and functioning. All auxiliary features, excluding insight, were reduced following cognitive-behavioral therapy. In particular, changes in symptom-free intervals; avoidance; and indecisiveness were most reliably associated with reductions in core OCD features. The lack of a relationship with insight did not come as a surprise, as insight is considered a relatively stable construct in those with OCD. Implications of these findings in the assessment and treatment of patients with OCD are highlighted.