Group marital therapy: A review

The demand for marital therapy has steadily increased as have divorce rates. Accompanying this phenomenon is the continual enquiry as to how clinicians can offer a cost-effective service for couples in distress. This paper reviews the area of group marital therapy indicating that this form of treatment is widely practised. Attention is given to the role of the therapist, the therapeutic factors operating in group marital therapy, indications and contra-indications and a brief evaluation of the research.     

Recruitment of medial prefrontal cortex neurons during alcohol withdrawal predicts cognitive impairment and excessive alcohol drinking

Chronic intermittent access to alcohol leads to the escalation of alcohol intake, similar to binge drinking in humans. Converging lines of evidence suggest that impairment of medial prefrontal cortex (mPFC) cognitive function and overactivation of the central nucleus of the amygdala (CeA) are key factors that lead to excessive drinking in dependence. However, the role of the mPFC and CeA in the escalation of alcohol intake in rats with a history of binge drinking without dependence is currently unknown. To address this issue, we examined FBJ murine osteosarcoma viral oncogene homolog (Fos) expression in the mPFC, CeA, hippocampus, and nucleus accumbens and evaluated working memory and anxiety-like behavior in rats given continuous (24 h/d for 7 d/wk) or intermittent (3 d/wk) access to alcohol (20% vol/vol) using a two-bottle choice paradigm. The results showed that abstinence from alcohol in rats with a history of escalation of alcohol intake specifically recruited GABA and corticotropin-releasing factor (CRF) neurons in the mPFC and produced working memory impairments associated with excessive alcohol drinking during acute (24–72 h) but not protracted (16 –68 d) abstinence. Moreover, abstinence from alcohol was associated with a functional disconnection of the mPFC and CeA but not mPFC and nucleus accumbens. These results show that recruitment of a subset of GABA and CRF neurons in the mPFC during withdrawal and disconnection of the PFC–CeA pathway may be critical for impaired executive control over motivated behavior, suggesting that dysregulation of mPFC interneurons may be an early index of neuroadaptation in alcohol dependence.     

The relationship between impulsivity and impulse control disorders in Parkinson's disease

A range of behaviors presumed to be related to dopaminergic medications have been recently recognized in Parkinson's disease (PD). We evaluated 50 consecutive cognitively intact PD patients on stable dopamine agonist and levodopa therapy and 100 healthy controls for compulsive sexual behavior, compulsive buying, or intermittent explosive disorders assessed by the Minnesota Impulsive Disorders Interview (MIDI), pathological gambling (South Oaks Gambling Screen, SOGS), impulsivity (Barratt Impulsiveness Scale), compulsivity (Maudsley obsessional‐compulsive inventory), and depression scores (Geriatric Depression Scale). Overall 28% PD (14/50) and 20% healthy controls (20/100) reported at least one abnormal behavior at MIDI or pathological SOGS score. PD patients had higher scores than controls for impulsivity (P = 0.006), compulsivity (P < 0.001), and depression (P < 0.001). There was no correlation between impulsivity, compulsivity, and depression scores in PD. Male gender and higher impulsivity score, but not dose and kind of dopaminergic medications, were associated in PD with increased probability of impulsive disorders at MIDI. Impulse control disorders are also common in the control population. Individual susceptibility factors, such as high impulsivity and depression, underline abnormal behaviors in PD patients treated with stable dopaminergic therapy. © 2007 Movement Disorder Society     

Intentional Unprotected Anal Intercourse among Sex Who have Sex with Men: Barebacking—from Behavior to Identity

Unprotected sex among gay/bisexual men throughout the AIDS epidemic has usually been described as unintentional due to a relapse from safer sex behavior. The term “barebacking” emerged among HIV-positive men explicitly seeking unprotected sex with seroconcordant partners, but has come into use in the larger gay community to simply mean condomless sex. Some men have also taken on the identity as a “barebacker.” The present study assessed prevalence and predictors of bareback identity in a sample 687 gay/bisexual men attending community events. Barebackers reported significantly more use of crystal methamphetamine and higher peer norms for unprotected sex; HIV-negative barebackers were higher in sexual compulsivity while HIV-positive barebackers were higher in romantic obsession as well as drug/alcohol influenced sexual expectancies. HIV prevention efforts targeting barebackers and barebacking must be carefully developed if programs and campaigns are to be effective given the open debates about this phenomenon in the gay community.     

Development and Validation of a Brief Measure of Eating Compulsivity (MEC)

Food addiction is increasingly being recognised as a contributory factor in overweight and obesity. Management of eating compulsivity, a key component of food addiction, may assist greatly in the successful treatment of obesity.

Measurement of food addiction and its core characteristic of eating compulsivity is fundamental to increasing understandings of the concept of food addiction, its prevalence among people with and without obesity and its utility within a treatment context.

The current study describes the development and initial validation of a brief measure of eating compulsivity that can be used within clinical and research settings to establish a person's level of eating compulsivity.

Sixty five participants with a BMI ≥30 (mean BMI 38.1) were recruited from a general population sample within Christchurch, New Zealand. Participants completed the test version of the Measure of Eating Compulsivity (MEC) and the Yale Food Addiction Scale (YFAS) as well as providing self-reported measures of height and weight.

The 10-item MEC was developed. This measure was shown to have excellent internal consistency (Cronbach's alpha =.946), based on a single factor accounting for 67.4% of the variance and excellent test-retest reliability (r =.923). MEC10 score was strongly predictive of being categorised as having food addiction based on the YFAS, although not associated with BMI.

This brief tool is likely to have high utility in clinical and research settings and requires further validation with a range of populations including those with and without obesity, binge eating disorder and other eating disorders.