The impact of childhood sexual abuse in anorexia nervosa

OBJECTIVE: The aim of this study was to examine the impact of childhood sexual abuse (CSA) on clinical characteristics and premature termination of treatment in anorexia nervosa (AN). METHOD: The participants were 77 consecutive patients with AN admitted to an inpatient eating disorders unit. The patients were assessed in terms of eating disorder symptoms, general psychopathology, and CSA history at admission to hospital. RESULTS: Thirty-seven patients (48%) reported a history of CSA before the onset of the eating disorder. Individuals with a history of CSA reported significantly greater psychiatric comorbidity, including higher levels of depression and anxiety, lower self-esteem, more interpersonal problems, and more severe obsessive-compulsive symptoms. Patients with the binge-purge subtype of AN (AN-BP) were significantly more likely to report a history of CSA prior to the onset of the eating disorder as compared with patients with the restricting subtype (AN-R) of the illness (65% of the AN-BP patients vs. 37% of the AN-R patients; p<.02). Contrary to our predictions, abused patients were not significantly more likely to dropout of treatment overall. However, patients of the binge-purge subtype (AN-BP) with a history of CSA were significantly more likely to terminate treatment prematurely as compared with the other patients. CONCLUSIONS: Consistent with previous findings, the present results indicate that the prevalence of CSA is high among individuals seeking inpatient treatment for AN. A history of CSA was associated with greater psychiatric disturbance overall and a higher rate of dropout for patients of the binge-purge subtype.     

The abuse-related beliefs questionnaire for survivors of childhood sexual abuse

OBJECTIVE: To evaluate the psychometric properties of a new measure, the Abuse-Related Beliefs Questionnaire (ARBQ), designed to assess abuse-related beliefs among adult survivors of childhood sexual abuse (CSA). Study 1 examined the structure of the scale, and Study 2 evaluated its reliability and validity. METHOD: One hundred and seventy female CSA survivors recruited into a group psychotherapy intervention study were administered the ARBQ in Study 1. A subsample of 45 women completed the ARBQ again 12 months later. In Study 2, 70 women from a health maintenance organization who identified themselves as survivors of CSA completed the ARBQ along with the Trauma Symptom Checklist-40 (TSC-40) and the Symptom Checklist 90R (SCL-90-R). RESULTS: Three reliable ARBQ subscales emerged in Study 1: Guilt, Shame, and Resilience. Twelve-month test-retest reliability was high (r=.60-.64). The internal consistency of the subscales was further supported in Study 2, and validity was demonstrated by moderate to high correlations with the distress measures. CONCLUSIONS: The results indicate that the ARBQ has good psychometric characteristics, supporting the feasibility of its use in measuring abuse-related beliefs in research on survivors of CSA. A next step for validation of the ARBQ would be to evaluate its sensitivity in measuring changes in studies of interventions for treating CSA survivors.     

Relationships among childhood maltreatment, PTSD, and health in female veterans in primary care

OBJECTIVE: Women with histories of childhood maltreatment (CM) have higher rates of physical health problems and greater medical utilization compared to women without abuse histories. This study examined whether current post-traumatic stress disorder (PTSD) symptoms mediate the relationship between CM and indicators of physical health and medical utilization in female veterans. METHOD: Respondents were 221 female veterans (56% of the potential sample), who received medical care from the San Diego VA Healthcare System during a 12-month period. Respondents provided self-report information about CM, PTSD symptoms, use of pain medication, and physical symptoms and functioning. Additional information about medical utilization was extracted from respondents' medical charts. Regression-based models were conducted to test whether PTSD symptoms mediate the relationships between CM and physical symptoms and between CM and medical utilization. RESULTS: Emotional abuse was associated with poorer role-physical functioning, increased bodily pain and greater odds of using pain medication in the past 6 months. Physical abuse was associated with poorer general health. Contrary to prediction, emotional neglect was associated with better role-physical functioning, and CM was not associated with increased healthcare utilization. PTSD was shown to mediate the relationship between emotional and physical abuse and health outcomes. CONCLUSIONS: PTSD, or psychopathology more generally, appears to be an important factor in the negative health impact of CM. Given that several empirically supported interventions are available for PTSD, there may be physical health benefits in early identification and treatment of psychopathology related to CM.     

Rapid visual processing by college students in reading irregular words and phonologically regular pseudowords presented singly and in contiguity

Using normal adult readers, this study examined the relative involvement of magnocellular and parvocellular processes in reading English phonologically regular pseudowords and irregular words presented in isolation and in contiguity from left to right. The data showed that a low temporal frequency visual measure that implied more parvocellular involvement was active in processing irregular words presented singly and pseudowords presented in contiguity. However, the results failed to show the involvement of the magnocellular pathway (as implicated by low spatial and/or high temporal frequency visual measures) in reading words presented in contiguity from left to right. The discrepancy was discussed in terms of the sensitivity of the tasks used in testing the two pathways.     

e-Learning Object Portals: a new resource that offers new opportunities for librarians

e-Learning Object Portals are emerging as a new form of electronic information. Four portals most effective in providing health care information are identified: The Medical Library Association's Center of Research and Education (CORE), the Health Education Assets Library (HEAL), the American Academy of Medical College's MedEDPortal, and the Multimedia Education Resource for Learning and Online Teaching (MERLOT). Various user groups such as librarians, educators, and students are discussed, as well as their reasons for using e-learning object portals. New roles for librarians in promoting and developing these portals are also reviewed.     

Getting the picture: medical images on the Web

Visual representations are used to convey ideas and concepts. They add value to educational venues. Files digitized from hard-copy media or born-digital files are standard formats, and the Internet is a resource for locating billions of these files. Searchers should be cognizant of the legal and ethical implications of using images downloaded from the Internet. This article intends to inform users about medical images on the Internet, as well as providing a select list of Web-based medical image sources.     

Learning to use the Internet as a study tool: a review of available resources and exploration of students' priorities

BACKGROUND: The Internet is a valuable information tool, but users often struggle to locate good quality information from within the vast amount of information available. OBJECTIVE: The aim of the study was to identify the online information resources available to assist students develop Internet searching skills, and to explore the students' priorities in online guides. METHODS: A qualitative approach was adopted with two phases. The first was a structured search of available online study skills resources. The second comprised 10 group interviews with a total of 60 students at all stages of five undergraduate health and social care related courses at a UK university. RESULTS: The study found that there were good online guides available, but that, perversely, the better guides tended to require the best searching skills to locate them. A few students were enthusiastic about using online support, however the majority felt that if they had the skills to locate such resources they wouldn't use a study guide to improve these skills, and if they did not have the skills they would not think of using an online guide to develop them. CONCLUSIONS: Students wanted assistance when they had problems or questions, rather than sites that offered structured learning experiences. Personal support rather than virtual support was also considered to be most important to the students in this study.