Substance abuse and sexual trauma in a female veteran population.

An increasing number of researchers have explored connections between substance abuse, posttraumatic stress disorder (PTSD), and sexual assault histories in civilian women. Despite literature suggesting the prevalence of substance abuse and sexual assault for female veterans, few studies have investigated these variables in a female veteran population. Thus, this paper was designed to provide preliminary information about this group of women. The results of this preliminary study suggest a high incidence of PTSD related to sexual trauma in a substance-abusing population of female veterans and a high incidence of substance abuse among female veterans who presented requesting help for sexual trauma. Suggestions for future study include examination of comparison samples of female veterans with and without PTSD and substance abuse across a variety of dimensions, including psychiatric symptoms, substance use, treatment utilization, and impact of treatment. Implications for assessment are highlighted.

Neuropsychiatric sequelae of cerebral malaria in Vietnam veterans.

Approximately 250,000 Vietnam veterans suffered cerebral malaria, an illness that often results in damage to subcortical white matter and fronto-temporal areas of neocortex. Case reports dating back 2500 years indicate that survivors of cerebral malaria show depression, poor memory, personality change, and irritability/violence. The purpose of the present study was to compare the neuropsychiatric status of Vietnam veterans who had suffered cerebral malaria in the remote past (i.e., 1966 to 1969) with that of Vietnam veterans wounded in combat who had not suffered malaria or other neurological conditions. Findings indicate that cerebral malaria results in multiple, major, substantially underappreciated neuropsychiatric symptoms in Vietnam veterans, including poor dichotic listening, "personality change," depression, and, in some cases, partial seizure-like symptoms. Findings strongly suggest that history of malaria should be considered in any medical, psychological, or psychiatric workup of a Vietnam War veteran because a positive response could result in substantial changes in diagnosis and treatment.

Long-term cognitive sequelae of cerebral malaria in Vietnam veterans.

The brains of fatal cases of cerebral malaria exhibit capillary occlusion, punctiform hemorrhages, and focal necrosis in subcortical white matter. Some studies have suggested that the brain pathology of survivors is similar to that of fatal cases. The purpose of this study was to investigate the hypothesis that cerebral malaria survivors would exhibit neuropsychological impairment due to the residual cerebral damage sustained from the infection. Vietnam veterans reporting a history of cerebral malaria were compared with a group of veterans with a history of combat-related injuries on standard neuropsychological tasks and on dichotic listening (DL). The cerebral malaria group performed worse on memory tasks and exhibited greater clinical impairments on DL, consistent with presumed disruption of subcortical white matter tracts.

Critical performance behaviors of radiology residents: evaluation of two category systems.

OBJECTIVE: Previous research has suggested that certain behavioral aspects of job performance are critical for successful performance in a diagnostic radiology residency. We report two studies conducted to determine the long-term stability of critical performance behaviors for radiology residents and refine their definitions. SUBJECTS AND METHODS: A trained psychology graduate student conducted critical incident interviews with 20 senior faculty in diagnostic radiology. From these interviews, the faculty generated 120 descriptions of exemplary or poor resident performance. These descriptors were then independently sorted by two radiologists into the previously defined categories of behaviors to evaluate consistency of the behaviors. As a second study, the 120 descriptors were sorted into an expanded behavioral definition system and the reproducibility, using the expanded system, was compared with the original results. RESULTS: The interrater reliability for placing the current incidents in the originally described behavioral categories was good (Cohen's kappa 0.70). The overall distribution of incidents showed strong similarity to the original data. Sorting into the expanded categories improved the Cohen's kappa from 0.70 to 0.92, indicating that the expanded behavioral definitions improved reliability for categorizing a behavioral incident. CONCLUSION: The critical behaviors necessary for successful performance in diagnostic radiology residency are stable over time. The expanded and refined system of definitions of these behaviors is more efficacious than the original system was.

A prospective study of cognitive and noncognitive selection criteria as predictors of resident performance.

The primary purpose of this study was to compare objective measures of diagnostic radiology resident applicant performance, such as National Board (NBME) scores, with nonobjective measures, such as conscientiousness and interpersonal skills, in their prediction of resident performance. A second purpose of the study was to examine the predictive usefulness of the Accomplishment Interview (AI), a behavioral selection interview. Thirty resident applicants were interviewed using standard interviews, the AI, and objective data on the applicants were gathered. Four years later, during their diagnostic radiology residency, evaluations were gathered on these applicants, allowing for comparison of current resident performance with past predictive data. Results indicated that noncognitive factors were as important as cognitive factors in the prediction of resident behavior. Further, objective measures, such as NBME scores, failed to adequately predict residents' performance. The implications of these findings for resident selection are discussed.

Factors influencing choice of academic or practice careers in radiology.

Factors, both personal and job-related in nature, that influence career choice among radiology residents are identified. Twenty-six third and fourth year radiology residents at two separate locations, and 17 age-matched and sex-matched internal medicine residents completed a 30-minutes interview and rated themselves on a series of job-related competencies. Data were collected on five groups of variables: demographic data, residency-related variables, factors that influence career choice, self-descriptions, and personal competencies. The results indicate that residents who choose academic careers and those who plan to have private practice careers differ substantially in their reasons for career choice. An academic career is chosen because of its atmosphere, emphasis on research and specialized techniques, and opportunity for teaching. In contrast, private practice careers are selected because of the autonomy they allow, the accompanying lifestyle, and financial reimbursement.