Outcomes of an emotion regulation intervention group in young adults with autism spectrum disorder.

Individuals on the autism spectrum experience difficulties in social relationships and emotion regulation. The aim of the present exploratory research study was to develop and explore the effectiveness of a manualized emotion regulation group intervention for autistic adults to improve emotion regulation and social communication. The group participants included seven young adults (age > 18 years) on the autism spectrum. Primary outcome measures were the Social Responsiveness Scale (SRS-2) and the Emotion Regulation Questionnaire (ERQ). Group participants reported significant improvements on the Social Communication and Interaction subscale (SCI; t = 2.601, p = .041), the Social Awareness (AWR; t = 3.163, p = .019), and the Social Cognition (COG; t = 4.861, p = .003) subscales of the SRS-2: Self Report. Overall, this study provides preliminary evidence of the effectiveness of a group treatment approach that focuses on emotion regulation to improve social interactions for young adults on the autism spectrum.

Sexuality in the Autism Spectrum Study (SASS): Reports from Young Adults and Parents.

Previous research indicates that although those with ASD desire sexual relationships, they may not effectively engage in romantic and intimate interactions. The purpose of this study was to compare reports from young adults with ASD and parents from the same families on the young adult's sexual behavior, experiences, knowledge, and communication. 100 young adults (18-30 years) and parents completed an online survey. Results indicated that young adults reported more typical privacy and sexual behaviors, and higher sexual victimization than their parents reported on their behalf. Our findings indicated that individuals with ASD desire and pursue sexual relationships typical of most people and suggest the need for sex education and communication about topics generally covered for neurotypically developing young adults.

Toward a common focus in psychotherapy research.

Documenting the schisms in clinical psychology, the author suggests that clinical scientists lay aside theoretical allegiances and work together by adopting a common focus in psychotherapy research on the determinants of effectiveness. Citing evidence showing that personal and interpersonal factors are primary determinants of effectiveness, the author suggests that humanism, broadly defined, provides the best philosophical and theoretical "home" for psychotherapy. Based on the evidence presented in the article, the author describes the revolutionary changes that must occur in research, training, and practice to bring clinical psychology into alignment with the findings of contemporary science.

The humanistic and behavioral traditions: areas of agreement and disagreement.

This comment, a response to Steven Hayes's contribution, addresses areas of agreement and disagreement between the humanistic and behavioral traditions. Areas of agreement include a common interest in humanism, cognition, and contextualism. Areas of disagreement include Hayes's analysis of humanistic psychology's historical focus on human science and qualitative research as well as his view that humanistic psychology is not scientifically based. In the interest of collaboration, the article concludes with a request that behavioral clinicians be more cautious about extolling the specialness of behavioral approaches in psychotherapy.

Psychometric properties of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) Clinical, Content, and Supplementary scales in a forensic sample.

In this study, we evaluated the internal psychometric properties and external correlates of scores on the Clinical, Content, and Supplementary scales in a forensic sample of 496 adolescents (315 boys and 181 girls) who were court-ordered to receive psychological evaluations. We examined Cronbach's alpha coefficients, scale intercorrelation matrices, and frequencies of scale elevations. Further, we found varying degrees of support for the convergent and discriminant validity of scores on the MMPI-A (Butcher et al., 1992 ) Clinical, Content, and Supplementary scales. This study adds to the body of literature establishing the utility of the MMPI-A in forensic evaluations.

Validity of the Massachusetts Youth Screening Instrument-2 (MAYSI-2) scales in juvenile justice settings.

High prevalence rates of psychological problems among juvenile offenders underscore the need for effective mental health screening tools in the juvenile justice system. In this study, we evaluated the validity of the Massachusetts Youth Screening Instrument-2 (MAYSI-2) developed by Grisso and Barnum (2001) to identify mental health needs of adolescents in various juvenile justice settings. The sample was 1,192 adolescents (1,082 boys and 110 girls) admitted into Virginia juvenile correction facilities between the dates of July 2004 and June 2006. Analyses revealed higher MAYSI-2 scale scores for girls than for boys and MAYSI-2 scale intercorrelations were similar to those reported in the MAYSI-2 manuals (Grisso & Barnum, 2003, 2006). We also evaluated the concurrent validity of MAYSI-2 scales by examining scale score correlations with related and unrelated extratest variables. Results showed strong convergent validity for several MAYSI-2 scales.

Impact of race on breast cancer in lower socioeconomic status women.

Lower socioeconomic status and lack of access to care are often implicated as plausible causes for African American women to present with later stage breast cancer than Caucasian women. Our objective is to determine if racial differences are present in newly diagnosed breast cancer in women of equivalent socioeconomic status. A retrospective review of prospectively gathered data from women with newly diagnosed breast cancer was performed. All women presented to the indigent (uninsured and below the poverty line) breast clinic for evaluation and treatment of their breast pathology. Data pertaining to epidemiologic factors, diagnosis, pathology, and treatment were collected. The data were analyzed by chi-squared and tailed t-tests. Between March 2002 and May 2004, 52 women (African American=36, Caucasian=16) were diagnosed with breast cancer at our clinic. The median age for both groups at presentation was 56.6 years. The staging assessment based on the pathologic size of the tumor was also equivalent between African American and Caucasian women at 2.29 cm and 2.21 cm, respectively. Metastatic lymph node involvement occurred in 14 women (African American=7, Caucasian=7), with 19.4% African American and 43.8% Caucasian being node positive (p=0.068). In fact, there were no statistically significant differences between the races for menarche, menopause, body mass index (BMI), duration of symptoms before presentation, type of diagnostic biopsy or surgery chosen, histology, receptor status, utilization of chemotherapy and radiation, and length of follow-up. The only statistical differences found were in the age of the first live birth (African American=19, Caucasian=22; p=0.028), the use of ultrasound in initial evaluation of a breast mass (less use in African American; p=0.012), and utilization of sentinel lymph node biopsy (Caucasian=75%, African American=42%; p=0.026). Breast cancer in African American women traditionally presents at a more advanced stage and with poor prognostic features. However, when matched for lower socioeconomic status, racial disparities essentially disappear.

Cosmesis with bilateral mammoreduction for conservative breast cancer treatment.

Over 7 years, 57 women with breast cancer underwent lumpectomy and bilateral mammoreduction. Physical complaints about large or lax breast shape were the predominate rationale. Two patients were immediately lost to follow-up, 55 patients remained and were followed every 3 months for an average of 1.6 years. This is the largest series traceable by computer and literature search. Chart review and patient examination in this retrospective review were utilized as the basis for data within the article. Collated notes from patients' doctors were assessed, as well as documented patient responses to the procedure. Pictures without head/face for identifiers were taken of the patients. Chart data were collected by clinicians, but were reviewed blindly by a statistician. The overall control and cosmesis rates as well as alleviation of heavy breast problems were noted. Only 6% of women had fair to poor cosmetic results; the majority (82%) had excellent to good results. Women with very large breasts or markedly relaxed breast tissue of concern to the patients proved optimal candidates for lumpectomy of cancer and bilateral mammoreduction in the conservative treatment of these cancers. There was a significant reduction in the physical complaints of the patients as well. For women with very pendulous or extremely large breasts, lumpectomy and bilateral mammoreduction may prove to be the optimal course of action.

Challenges of a pandemic: HIV/AIDS-related problems affecting Kenyan widows.

The paper reports the findings of a qualitative study using focus group discussions and in-depth interviews about the challenges faced by widows as they confront the direct and indirect impacts of HIV/AIDS in Nyanza, Kenya. Two focus groups were conducted with widows from two community-based organizations. This was followed by in-depth interviews with four members and two leaders from each of the community-based organizations. The contents were analysed using grounded theory. The findings reveal several challenges encountered by widows in their struggles with the direct and indirect impacts of HIV/AIDS. Widows who know or do not know their HIV status are conscious about the possibility of contracting or transmitting the virus. Wife inheritance (a Luo custom), emerged as an outstanding issue for the widows in the context of HIV/AIDS transmission. The widows employ various strategies to resist being inherited. Widows in the current epidemic navigate issues of sexuality in various ways, such as insisting their partners use condoms or permanently abstaining from sexual intercourse.

Lymphedema of the arm and breast in irradiated breast cancer patients: risks in an era of dramatically changing axillary surgery.

The purpose of this study was to assess risk for lymphedema of the breast and arm in radiotherapy patients in an era of less extensive axillary surgery. Breast cancer patients treated for cure were reviewed, with a minimum follow-up of 1.5 years from the end of treatment. Clinical, surgical, and radiation-related variables were tested for statistical association with arm and breast lymphedema using regression analyses, t-tests, and chi-squared analyses. Between January 1998 and June 2001, 240 women received radiation for localized breast cancer in our center. The incidence of lymphedema of the ipsilateral breast, arm, and combined (breast and arm) was 9.6%, 7.6%, and 1.8%, respectively, with a median follow-up of 27 months. For breast edema, t-test and multivariate analysis showed body mass index (BMI) to be significant (p = 0.043, p = 0.0038), as was chi-squared and multivariate testing for site of tumor in the breast (p = 0.0043, p = 0.0035). For arm edema, t-test and multivariate analyses showed the number of nodes removed to be significant (p = 0.0040, p = 0.0458); the size of the tumor was also significant by multivariate analyses (p = 0.0027). Tumor size appeared significant because a number of very large cancers failed locally and caused cancer-related obstructive lymphedema. In our center, even modern, limited level 1-2 axillary dissection and tangential irradiation carries the risk of arm lymphedema that would argue in favor of sentinel node biopsy. For breast edema, disruption of draining lymphatics by surgery and radiation with boost to the upper outer quadrant increased risk, especially for the obese. Fortunately both breast and arm edema benefited from manual lymphatic drainage.

Quality of life with well-differentiated thyroid cancer: treatment toxicities and their reduction.

INTRODUCTION: Patients with well-differentiated thyroid cancer have a good prognosis but a significant chance for local recurrence. In the past, limited surgery with postoperative 131I only for extremely high-risk cases or recurrence was not uncommon. As more aggressive surgical and postoperative treatments appear to gain wider acceptance, toxicity and long-term morbidity become more important issues. Our goal is to present the experience of a single institution with emphasis on oral side effects related to 131I as well as acute and chronic symptoms related to this diagnosis and their impact on quality of life. METHODS: Fifty-seven patients were followed for a median time of 19.3 months. All patients received therapeutic 131I (mean dose, 154.7 mCi) between January 1, 1996 and August 30, 2002. RESULTS: Fifty-four patients (94.7%) were alive at the time of analysis. Sixteen (28.1%) required a second treatment: any sign of persistence resulted in retreatment. Complaints with 131I treatment included altered taste, 26.3%; acute xerostomia, 21.1%; and acute sialoadenitis, 15.8%. Chronic xerostomia occurred in 6 (35.3%) of all patients who received multiple treatments. The incidence of chronic xerostomia was reduced to 1 of 11 (9.1%) with amifostine pretreatment. Other chronic side effects associated with this disease included fatigue 54.4%, weight gain of more than 6 months duration 24.6%, with 12 (27.9%) of those under 60 experiencing an average gain of 2.3 kg from initial diagnosis. CONCLUSION: Review of treatment-related symptoms prompted policies to reduce toxicity including amifostine pretreatment for 131I therapy and thyrotropin (synthetic TSH) use in place of iatrogenic hypothyroidism for thyroglobulin testing and scanning.

Luteinizing hormone beta polymorphism and risk of familial and sporadic prostate cancer.

BACKGROUND: Circulating testosterone plays an important role in maintenance and growth of prostate cells. Luteinizing hormone (LH), secreted from the anterior pituitary, signals testicular Leydig cells to secrete testosterone. A genetic variant of the LH-beta protein, LH-betaV, exists in up to 40% of Caucasians and is more bioactive than the wild-type protein. We hypothesized that genetically determined variation in LH function might affect susceptibility to prostate cancer via altered testosterone secretion. METHODS: We determined the frequency of the LH-betaV polymorphism (two linked polymorphisms: Trp(8) --> Arg and Ile(15) --> Thr) in familial prostate cancer patients (n = 446), in sporadic prostate cancer patients (n = 388), and in population-based controls without prostate cancer (n = 510) to assess the role of this polymorphism in susceptibility to prostate cancer. RESULTS: A higher frequency of this variant genotype (LH-betaV: Arg(8)/Thr(15)) was observed in familial prostate cancer patients (18.6%) than in controls (13.7%), and after taking into account the correlation of the familial cases and adjusting for age and body mass index (BMI), there was a weak positive association between the variant LH-beta genotype, and risk of familial prostate cancer (OR = 1.29; 95% CI 0.96-1.75). The sporadic case group was also slightly more likely to have a variant genotype (15.2%) compared to the controls (13.7%), and after adjustment for age and BMI, a similar association with this variant was found (OR = 1.33; 95% CI 0.86-02.07). Surgical cases showed a slightly stronger association for the variant LH-beta genotype compared to non-surgical cases, but among the surgical cases there was little variability in risk across nodal status, stage, and tumor grade. CONCLUSIONS: These data are consistent with the hypothesis that the LH-beta variant is a weak risk factor for prostate cancer.

MMPI-A validity scale uses and limitations in detecting varying levels of random responding.

Although there is a substantial research literature on the effects of random responding on the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989), there are very few studies available on this topic with the MMPI-A (Butcher et al., 1992). Archer and Elkins (1999) found that MMPI-A validity scales F and VRIN were particularly useful in detecting entirely random profiles from those derived standardly in clinical settings but noted that "all random" protocols could not be used to evaluate the usefulness of the T-score difference between the first half (F1) and the second half (F2) of the MMPI-A test booklet. Following up on this issue, this study extended the methodology of previous research by examining the hit rate, positive predictive power, negative predictive power, sensitivity, and specificity of VRIN, F, F1, F2 and the absolute value of the T-score difference between F1 and F2 (denoted as IF1-F21) in 5 samples varying in the degree of protocol randomness. One of the samples consisted of 100 adolescent inpatients administered the MMPI-A under standard instructions, and another sample consisted of 100 protocols randomly generated by computer. The additional 3 samples of 100 protocols each contained varying degrees of computer-generated randomness introduced in the latter half of the MMPI-A item pool. Over- all, the results generally indicate that several MMPI-A validity scales are useful in detecting protocols that are largely random, but all of these validity scales are more limited in detecting partially random responding that involves less than half the total item pool located in the second half of the test booklet. Clinicians should be particularly cautious concerning validity inferences based on the observed T-score difference that occurs for the F1 and F2 subscales and current findings do not support the clinical usefulness of this index.

Analysis of the RNASEL gene in familial and sporadic prostate cancer.

The RNASEL gene on chromosome 1q25 was recently identified as a candidate gene for hereditary prostate cancer (PC). To confirm these findings, we screened 326 patients from 163 families with familial PC for potential germline mutations, by use of conformation-sensitive gel electrophoresis, followed by direct sequence analysis. A total of six variants were identified, including one intronic and five exonic changes (three missense and two silent alterations). There were no unequivocal pathogenic changes. To further test for potential associations between genes and increased risk for disease, the three missense polymorphisms (Ile97Leu, Arg462Gln, and Glu541Asp) were genotyped in 438 patients with familial PC and in 510 population-based control subjects. Association testing revealed no significant differences between patients and control subjects for either the Leu97 variant (chi(2) trend test = 1.42; P=.23) or the Asp541 variant (chi2=1.52; P=.22). However, significant differences were detected for the Arg462Gln genotypes (chi2=5.20; P=.02; odds ratio [OR] = 0.54; 95% confidence interval [CI] 0.32-0.91) when the genotype Gln/Gln was compared with Arg/Arg. In subset analyses, associations were also observed in the younger group (age at diagnosis