A Forensic Interview Protocol for Adult Sexual Assault: Content Validity and Consumer Acceptability

This study examined the content validity and consumer satisfaction of a newly developed forensic interviewing protocol and accompanying barriers screen. Results suggest content experts rated the protocol as acceptable and that subjects rated the protocol slightly more favorably than the Forensic Experiential Trauma Interview. Further, although only a minority of subjects did not like the alternative hypotheses component, this component did not significantly decrease subjects’ favorable attitudes towards the protocol, suggesting that incorporating this element may not be as controversial as previously assumed. Last, providing resources to the victim via the barriers screen was rated favorably by participants, suggesting that this might be a useful tool to improve victim’s sense of support, overall satisfaction and possible willingness to pursue prosecution post-assault (AU)

Identifying grooming of children for sexual abuse: gender effects and increased false positives from internet information

Some child sexual abusers engage in grooming prior to committing abuse. These tactics are methods that perpetrators use to gain access to their future victims and prepare them to be more compliant with the abuse. At times, grooming can be difficult to distinguish from typical adult-child interactions, and definitions of grooming have varied. The current study examined the extent to which participants could be trained to more accurately differentiate grooming behavior based upon participation in three types of training. One-hundred forty-seven undergraduate psychology students were invited to complete an online study. Participants were presented with hypothetical scenarios describing potential grooming behaviors and were asked to make judgments about the appropriateness of each behavior and whether or not it was indicative of grooming. Then participants were randomized to one of three training groups: 1) an experimental presentation which trained participants to focus on the behavior's function and context; 2) a treatment-as-usual (TAU) presentation designed to mimic what a person would find out about grooming on the internet; and 3) a no treatment control. Afterward, participants were again asked to respond to hypothetical scenarios. The experimental and control groups performed equally well at post-test; however, the TAU group performed significantly worse (p= .003) suggesting a possible iatrogenic effect of information from the internet. In addition, there was a gender effect in which females outperformed males when labeling grooming behaviors (p= .027). There appears to be a need for more training about grooming behaviors and how to detect these.Keywords: grooming, child sexual abuse, judgment, online training

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Science and pseudoscience in the development of eye movement desensitization and reprocessing: implications for clinical psychology.

The enormous popularity recently achieved by Eye Movement Desensitization and Reprocessing (EMDR) as a treatment for anxiety disorders appears to have greatly outstripped the evidence for its efficacy from controlled research studies. The disparity raises disturbing questions concerning EMDR's aggressive commercial promotion and its rapid acceptance among practitioners. In this article, we: (1) summarize the evidence concerning EMDR's efficacy; (2) describe the dissemination and promotion of EMDR; (3) delineate the features of pseudoscience and explicate their relevance to EMDR; (4) describe the pseudoscientific marketing practices used to promote EMDR; (5) analyze factors contributing to the acceptance of EMDR by professional psychologists; and (6) discuss practical considerations for professional psychologists regarding the adoption of EMDR into professional practice. We argue that EMDR provides an excellent vehicle for illustrating the differences between scientific and pseudoscientific therapeutic techniques. Such distinctions are of critical importance for clinical psychologists who intend to base their practice on the best available research.

Problems with the DSM-IV diagnosis of pedophilia.

This paper examines the taxonomic adequacy of the Diagnostic and Statistical Manual, 4th ed., DSM-IV (American Psychiatric Association, 1994) diagnostic category of pedophilia. This diagnosis, as well as the other sexual disorders, have been ignored in DSM field trials. There is no empirical information about the reliability or validity of this diagnosis. Moreover, because the vagueness of the diagnostic criteria, clinicians would need to make inferences that would likely lead to reliability problems in diagnosis. Further, the DSM diagnostic criteria include constructs that are not intersubjectively verifiable and for which there are no valid measures. This can also lead to lack of diagnostic reliability and accuracy. Most problematical however, there are aspects of the diagnostic criteria, most notably the presence of an "ego dystonic sexual attraction to children," that are incorrect exclusion criteria. Suggestions for improvement are provided.

Characteristics of empirically supported treatments.

This study presents a survey of general characteristics of empirically supported treatments (ESTs) identified by the American Psychological Association Division 12 Task Force on the Promotion and Dissemination of Psychological Procedures. Results indicate that the ESTs share the following characteristics: they involve skill building, have a specific problem focus, incorporate continuous assessment of client progress, and involve brief treatment contact, requiring 20 or fewer sessions. Traditional assessment methods, such as intelligence testing, projectives, and objective personality tests such as the MMPI-2, are rarely used in these treatments. Although it is recognized that these findings are in part an artifact of sociological factors present in contemporary psychotherapy development and research, the findings may also serve as a heuristic aid in the development of therapies.

Hypoxemia during sleep in patients with chronic obstructive pulmonary disease: significance, detection, and effects of therapy.

NOD is a common event in patients with symptomatic COPD who are not hypoxemic while awake. Up to 45% of these patients may have significant oxyhemoglobin desaturation during sleep, and most have evidence of pulmonary arterial hypertension. Although intuitively it would seem that supplemental oxygen during sleep should be of medical benefit in COPD patients with NOD, studies to data have not substantiated this idea. Medicare requirements for prescribing nocturnal oxygen are relatively liberal and there is the possibility of misuse, which would cause a substantial increase in the cost of home health care. A well designed multicenter study is needed to provide appropriate indications and guidelines for therapy in these patients.

Sexual harassment.

We review the current state of sexual harassment theory, research, treatment, and prevention. Definitional problems and implications are discussed. An examination of the epidemiology of sexual harassment is presented, highlighting correlates that include characteristics of the organizational environment, the perpetrator, and the recipient of unwanted sexual behavior. Normative responses to sexual harassment and consequences are discussed. Descriptions of the most prevalent models of sexual harassment are offered and the empirical evidence for them is briefly reviewed. From there, the effect of model development and evaluation on the prevention and treatment of sexual harassment is considered. We comment on the steps that would need to be taken to develop viable prevention and treatment programs. Suggestions for fruitful avenues of research and theory development are offered.

What is a delusion? Epistemological dimensions.

Although the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) clearly indicates delusions have an epistemic dimension, it fails to accurately identify the epistemic properties of delusions. The authors explicate the regulative causes of belief revision for rational agents and argue that delusions are unresponsive to these. They argue that delusions are (a) protected beliefs made unfalsifiable either in principle or because the agent refuses to admit anything as a potential falsifier; (b) the protected belief is not typically considered a "properly basic" belief; (c) the belief is not of the variety of protected scientific beliefs; (d) in response to an apparent falsification, the subject posits not a simple, testable explanation for the inconsistency but one that is more complicated, less testable, and provides no new corroborations; (e) the subject has a strong emotional attachment to the belief; and (f) the belief is typically supported by (or originates from) trivial occurrences that are interpreted by the subject as highly unusual, significant, having personal reference, or some combination of these.

Sexual assault prevention programs: current issues, future directions, and the potential efficacy of interventions with women.

Current problems facing the primary prevention of sexual assault are reviewed. Effective sexual assault prevention programs for both males and females have been slow to develop due to the fact that the etiologies of sexual assault have not been identified. Although dissemination of prevention programs has become increasingly popular in recent years, few programs have evaluated the extent to which the constructs identified in the interventions are effective at decreasing rates of sexual assault. This article discusses previous studies in sexual assault prevention programs, methodological and conceptual problems that currently exist in the field, pragmatic difficulties regarding program implementation and evaluation, and recommendations for future research with an emphasis on interventions with female participants.

Psychotherapy for male sexual dysfunction: a review.

There are nine major diagnostic categories of male sexual dysfunction in the DSM-IV. Psychotherapy outcome studies focusing on these problems are reviewed. Currently, there appears to be little evidence that effective psychological interventions exist for these problems. Reasons for this include numerous methodological problems of existing research, effect sizes that are not clearly clinically significant, lack of compelling follow-up data indicating durability of treatment gains, and lack of treatment manuals that allow replication. Also, some disorders have been ignored by researchers. Guidelines for sample selection and description, assessment and diagnosis, and research design are provided.

Clinical and economic considerations in the treatment of acute exacerbations of chronic bronchitis.

Limited data exist to guide physicians in the cost-effective treatment of acute exacerbation of chronic bronchitis (AECB). Therefore, the main objective of this study was to determine the antimicrobial efficacy and related costs for patients with AECB. A retrospective review of 60 outpatient medical records with a diagnosis of chronic obstructive pulmonary disease (COPD) and chronic bronchitis episodes from a pulmonary clinic of a teaching institution was undertaken. The participating patients had a total of 224 episodes of AECB requiring antibiotic treatment. Before review, empirical antibiotic choices were divided into first-line (amoxycillin, co-trimoxazole, tetracyclines, erythromycin), second-line (cephradine, cefuroxime, cefaclor, cefprozil) and third-line (co-amoxiclav, azithromycin, ciprofloxacin) agents. Patients receiving first-line agents failed significantly more frequently than third-line agents (19% vs 7%, P < 0.05). Additionally, patients prescribed first-line agents were hospitalized significantly more often for AECB within 2 weeks of outpatient treatment as compared with patients prescribed third-line agents (18.0% vs 5.3% third-line agents; P < 0.02). Time between subsequent AECB episodes requiring treatment was significantly longer for patients receiving third-line agents compared with first-line and second-line agents (P < 0.005). Pharmacy costs were lowest with first-line agents (first-line US$10.30 +/- 8.76; second-line US$24.45 +/- 25.65; third-line US$45.40 +/- 11.11; P < 0.0001), but third-line agents showed a trend towards lower mean total costs of AECB treatment (first-line US$942 +/- 2173; second-line, US$563 +/- 2296; third-line, US$542 +/- 1946). The use of third-line antimicrobials, co-amoxiclav, ciprofloxacin or azithromycin, significantly reduced the failure rate and need for hospitalization, prolonged the time between AECB episodes, and showed a lower total cost for the management of AECB. Prospective studies are needed to confirm these findings.

Sexual harassment: identifying risk factors.

A new model of the etiology of sexual harassment, the four-factor model, is presented and compared with several models of sexual harassment including the biological model, the organizational model, the sociocultural model, and the sex role spillover model. A number of risk factors associated with sexually harassing behavior are examined within the framework of the four-factor model of sexual harassment. These include characteristics of the work environment (e.g., sexist attitudes among co-workers, unprofessional work environment, skewed sex ratios in the workplace, knowledge of grievance procedures for sexual harassment incidents) as well as personal characteristics of the subject (e.g., physical attractiveness, job status, sex-role). Subjects were 266 university female faculty, staff, and students who completed the Sexual Experience Questionnaire to assess the experience of sexual harassment and a questionnaire designed to assess the risk factors stated above. Results indicated that the four-factor model is a better predictor of sexual harassment than the alternative models. The risk factors most strongly associated with sexual harassment were an unprofessional environment in the workplace, sexist atmosphere, and lack of knowledge about the organization's formal grievance procedures.

Epistemological barriers to radical behaviorism.

The historian and philosopher of science Gaston Bachelard proposed the concept of epistemological barriers to describe the intellectual challenges encountered by scientists in their work. In order to embrace novel ways of approaching a problem in science, scientists must overcome barriers or obstacles posed by their prior views. For example, Einsteinian physics presents scientists with claims that space is curved and that time and space are on the same continuum. We utilize Bachelard's concept of epistemological barriers to describe the differences between the intellectual journeys students pursuing advanced studies face when attempting to accept cognitive psychology or radical behaviorism. We contend that the folk psychological beliefs that students typically hold when entering these studies pose less challenge to cognitive psychology than to radical behaviorism. We also suggest that these barriers may also partly be involved in the problematic exegesis that has plagued radical behaviorism. In close, we offer some suggestions for dealing with these epistemological barriers.

Home oxygen therapy.

Home oxygen therapy has well-established benefits for patients with chronic obstructive pulmonary disease and resting hypoxemia. The indications for therapy have been clearly defined in the United States by the Health Care Financing Administration (HCFA), and these guidelines have been accepted by most third-party payers. Controversies regarding the use of oxygen during sleep and exercise when daytime hypoxemia is not present have important therapeutic and financial implications. HCFA has recently proposed a substantial reduction in reimbursement for home oxygen which could have a major adverse effect if done on a global, across-the-board, basis. Some of the new technological developments in oxygen delivery systems are presented in this article.

Classical conditioning of female sexual arousal.

The classical conditioning of subjective and physiological aspects of female sexual arousal was examined. Experimental subjects were run in a delayed conditioning design, where an amber light was paired with excerpts from erotic videos. Control subjects received presentations of the same amber light and videos, but these presentations did not overlap with one another. Dependent variables included subjective ratings of arousal to the light and the videos as well as change in vaginal pulse amplitude assessed during exposure to the different stimuli. Experimental subjects evidenced increased arousal to the light over conditioning trials, as assessed by subjective ratings of sexual arousal. This finding is suggestive of a learned effect. However, results failed to indicate significant differences between experimental control groups. Therefore, the increased arousal to the light evidenced by experimental subjects may not be due to classical conditioning. Suggestions regarding these findings, clinical implications, and future research are discussed.

Psychotherapy for female sexual dysfunction: a review.

The increasing recognition of the significant incidence of female sexual dysfunction as well as the increasing acceptance of sex therapy as the preferred option for addressing problems in sexual functioning give rise to questions as to effectiveness of psychotherapy for female sexual dysfunction. This article presents a review of empirical studies of the treatment of female sexual dysfunction that meet minimal methodological criteria. Because of the variety and seriousness of methodological problems in the studies reviewed, guidelines for sample selection and description, research design, assessment and classification, and data analysis are provided. In addition, the 21 studies reviewed are examined for information they give about the treatment of female sexual dysfunction.

The effects of anxiety and distraction on sexual arousal in a nonclinical sample of heterosexual women.

The effects of anxiety and distraction on sexual arousal in a nonclinical sample of heterosexual women between the ages of 19 and 35 were studied. Using a dichotic listening paradigm, the study extended Geer and Fuhr's (1976) research by examining the effects of distraction on sexual arousal in women. Results indicated that both vaginal pulse amplitude and subjective measures of sexual arousal vary as a function of distraction level, with increased distraction leading to decreased arousal. However, the data failed to support Masters and Johnson's (1970) assertion that anxiety decreases sexual arousal. Although no significant effect for anxiety emerged using a physiological measure of sexual arousal, a significant Anxiety x Distraction interaction was observed using a subjective measure of sexual arousal. Several competing interpretations of this interaction are discussed.