International medical graduates in child and adolescent psychiatry: adaptation, training, and contributions.

This article reviews, consolidates, and enhances current knowledge about the issues and problems child and adolescent psychiatry international medical graduates face. Their training, work force issues, and establishment and advancement of professional identity are presented. Acculturation and immigration dynamics include facing prejudice and discrimination, social mirroring, and difficulties with language. Treatment issues are discussed with a special focus on therapeutic alliance, resistance, transference, countertransference, and child rearing practices. Recommendations for training and future goals are considered.

Assessment of behavioral and cognitive impulsivity: development and validation of the Lifetime History of Impulsive Behaviors Interview.

The construction and initial psychometric evaluation of an interview assessment of clinically significant impulsivity (Lifetime History of Impulsive Behaviors; LHIB) is presented. Personality-disordered and control subjects participated by completing self-report measures of depression, anxiety and social desirability, along with self-report and laboratory analogue measures of impulsivity, and finally the LHIB. The LHIB demonstrated good to excellent internal consistency and test-retest reliability. Supporting concurrent construct validity, scores on the LHIB correlated with other self-report measures of impulsivity. Diagnostic group differences were obtained and the LHIB evidenced concurrent validity in its ability to classify subjects by scores. No relationship was obtained between the LHIB and laboratory analogue measures. While evidence of discriminant validity was mixed, these data suggest that the LHIB may be a useful instrument for the assessment of impulsive behavior.