The making of a scientist-psychotherapist: the research training environment and the psychotherapist.

A theory of the research training environment (RTE) proposed by Gelso (Counseling Psychologist, 8:7-35, 1979; Professional Psychology: Research and Practice, 24:468-476, 1993; The Counseling Psychologist, 25:307-320, 1997) is updated, and the research evidence that bears upon this theory is reviewed. Evidence accumulated over more than three decades supports the influence of the RTE on the research attitudes, research self-efficacy, and research productivity of graduate students in psychotherapy-related fields in psychology. Both the global RTE and 10 ingredients posited by RTE theory are reviewed. The ingredients that seem to have the greatest association with theorized training outcomes in students are (1) faculty modeling of scientific behavior, (2) positive reinforcement of students' scientific behavior, (3) teaching students, through the advising relationship and research teams, that science can be a partly social-interpersonal experience, and (4) teaching students that all research is flawed and limited. The training program faculty is responsible for arranging the training environment so that it will maximally impact psychotherapy graduate students' research attitudes, research self-efficacy, and productivity.

Cognitive function and brain structure in females with a history of adolescent-onset anorexia nervosa.

OBJECTIVE: Abnormalities in cognitive function and brain structure have been reported in acutely ill adolescents with anorexia nervosa, but whether these abnormalities persist or are reversible in the context of weight restoration remains unclear. Brain structure and cognitive function in female subjects with adolescent-onset anorexia nervosa assessed at long-term follow-up were studied in comparison with healthy female subjects, and associations with clinical outcome were investigated. PATIENTS AND METHODS: Sixty-six female subjects (aged 21.3 +/- 2.3 years) who had a diagnosis of adolescent-onset anorexia nervosa and treated 6.5 +/- 1.7 years earlier in a tertiary care hospital and 42 healthy female control subjects (aged 20.7 +/- 2.5 years) were assessed. All participants underwent a clinical examination, magnetic resonance brain scan, and cognitive evaluation. Clinical data were analyzed first as a function of weight recovery (n = 14, <85% ideal body weight; n = 52, >or=85% ideal body weight) and as a function of menstrual status (n = 18, absent/irregular menses; n = 29, oral contraceptive pill; n = 19, regular menses). Group comparisons were made across structural brain volumes and cognitive scores. RESULTS: Compared with control subjects, participants with anorexia nervosa who remained at low weight had larger lateral ventricles. Twenty-four-hour urinary free-cortisol levels were positively correlated with volumes of the temporal horns of the lateral ventricles and negatively correlated with volumes of the hippocampi in clinical participants. Participants who were amenorrheic or had irregular menses showed significant cognitive deficits across a broad range of many domains. CONCLUSIONS: Female subjects with adolescent-onset anorexia nervosa showed abnormal cognitive function and brain structure compared with healthy individuals despite an extended period since diagnosis. To our knowledge, this is the first study to report a specific relationship between menstrual function and cognitive function in this patient population. Possible mechanisms underlying neural and cognitive deficits with anorexia nervosa are discussed. Additional examination of the effects of estrogen on cognitive function in female subjects with anorexia nervosa is necessary.