Constructivist self-development theory: a theoretical framework for assessing and treating traumatized college students.

The authors present a new conceptual framework for assessing and treating traumatized college students. The framework, constructivist self-development theory (CSDT), blends object relations, self-psychology, and social cognition theories. It is founded upon a constructivist view of trauma in which the individual's unique history shapes his or her experience of traumatic events and defines the adaptation to trauma. Within this theory, the authors suggest approaches to setting the frame for trauma therapy, including stabilizing acute symptoms and setting appropriate expectations for treatment. CSDT provides a framework for the systematic assessment and practical treatment of three aspects of the self that are affected by trauma. These include self-capacities, or the ability to tolerate strong affect and regulate self-esteem; cognitive schemas, or beliefs and expectations about self and others in the areas of frame of reference (or identity and world view), safety, trust, esteem, intimacy, power, and independence; and intrusive trauma memories and related distressing affect. Finally, the authors provide guidelines for assessing the need for longer term treatment.     

Permutation tests of scale using deviances

Robust tests for comparing scale parameters, based on deviances—absolute deviations from the median—are examined. Higgins (2004) proposed a permutation test for comparing two treatments based on the ratio of deviances, but the performance of this procedure has not been investigated. A simulation study examines the performance of Higgins’ test relative to other tests of scale utilizing deviances that have been shown in the literature to have good properties. An extension of Higgins’ procedure to three or more treatments is proposed, and a second simulation study compares its performance to other omnibus tests for comparing scale. While no procedure emerged as a preferred choice in every scenario, Higgins’ tests are found to perform well overall with respect to Type I error rate and power.     

Court decisions hold implications for managed care plans--Part one

The managed care industry--and HMOs in particular--is now facing the realities of a maturing business. Maturity has brought a competitive tension to the HMO/managed care field, one consequence of which is increased litigation, not only among HMOs but also between HMOs and their suppliers, customers, and indemnity insurers. Entanglement in the legal system is an outgrowth of efforts to gain or preserve a competitive edge, reduce costs, and attract customers. This article highlights selected legal developments from the past two years that reflect the causes and effects of this environment. Additional cases will be discussed in the March-April 1990 issue of the journal.     

Sex differences in the vocabulary of college students

The present study replicated Jastrow's 1891 experiment concerning differences between male and female vocabulary. Participants were 20 male and 20 female Caucasian middle‐class college students. They recorded up to 100 nouns in a 15‐minute period. Results indicate that women have increased their use of unusual words compared to women in 1891. Males used more scientific words and more body part words than females. In contrast to the previous study, there are no significant differences between the sexes in use of animal, nature, and food words. Females used more clothing words than males in this study, as in the previous study, and produced more different words than males. Vocabulary changes appear to reflect changes in the social structure of the society.     

EAP Service Use in a Managed Behavioral Health Care Organization: From the Employee Perspective

Contemporary employee assistance program (EAP) services are typically provided in broad-brush programs delivered by large external vendors in a network model. Yet research has not kept pace with EAP evolution, including in terms of how EAP clients themselves view services. We surveyed a random sample of EAP service users from a national provider (361 respondents). About one-third of respondents reported getting help for workplace issues. Most learned about the EAP through employer communications such as the company website. The large majority reported that the EAP helped them "a lot" or "some," suggesting they valued this benefit.     

Analyzing industrial trends—A collaborative approach

Dynamic, complex environments demand sensitive, timely scanning. This paper describes a scanning process of use to interdependent organizations for collaboratively assessing issues active in their shared environment. Collaborative scanning expands the field of vision of an individual organization and produces several other benefits to participating organizations. The need for matching an organization's allocations of resources and attention to the patterns of issues revealed by the scanning process is stressed.     

Why the rise in adolescent fertility rates in the Dominican Republic in the 1990s?

Despite concern over high pregnancy rates and levels of risk for sexually transmittedinfections, adolescent fertility rates in the Dominican Republic have not changed substantially since the early 1980's, and actually increased during the early to mid 1990s. The present study was undertaken to assess the factors contributing to the recent rise in fertility among Dominican adolescents. The findings suggest that although contraceptive use among adolescents and young adults has increased, this has been more than offset by ominous trends on other determinants of fertility. Among these are declines in mean age at first sex and first marriage/union without a commensurate decline in mean age at first contraceptive use, and stubbornly high discontinuation rates for oral contraceptives andcondoms. There is also some evidence that rates of induced abortion among adolescents may have increased, without which adolescent fertility rates would have been even higher. Demand for children among Dominican adolescents remains strong, suggesting that efforts to reduce the current high prevalence of risky sexual behaviors need to influence social norms in order to be successful.