Efficacy of sertraline for bulimia nervosa.

OBJECTIVE: The current study examined the efficacy of sertraline in the treatment of individuals diagnosed with bulimia nervosa. METHOD: Eighteen women enrolled in an 8-week open trial of sertraline. Eating disorder psychopathology and depressive symptoms were assessed at baseline and at the end of the trial using both semistructured interviews and self-report questionnaires. RESULTS: Findings indicated significant reductions in eating disorder psychopathology, including the number of binges and purges per week, as well as significant reductions in depressive symptoms. In addition, participants did not experience significant weight gain or any other sertraline side effect assessed at the end of the trial compared with baseline. DISCUSSION: Findings from the current study indicate that sertraline is efficacious in the treatment of bulimia nervosa. A double-blind controlled trial of sertraline is recommended for future research.

The practice of psychology in rural communities: potential ethical dilemmas.

The practice of psychology in rural areas offers unique challenges for psychologists as they try to provide optimal care, often with a minimum of resources. Psychologists are frequently required to be creative and flexible in order to provide effective services to a wide range of clients. However, these unique challenges often confront psychologists with ethical dilemmas and problems for which their urban-based training has not prepared them. The author examines how certain characteristics of rural communities may lead to specific ethical dilemmas. By being a part of a small community, psychologists will inevitably face multiple relationship dilemmas. Confidentiality is harder to maintain in a small town, particularly with its informal information-sharing network. To provide services to meet community needs, with a limited number of referral options, psychologists typically need to be generalists. This may lead to concerns about scope of practice, training, and experience with diverse populations. Psychologists also face other competency issues, such as a lack of supervision and consultation resources. Other concerns addressed include the psychologist's personal life, and the blurring of professional and personal roles. Suggestions are made for coping with each of these ethical issues, although more quantitative research and discussion are needed on the practice of psychology in rural areas.