The study investigated the associations between several forms of intimate partner violence (IPV) and posttraumatic stress disorder (PTSD) symptoms. We hypothesized that women who had experienced sexual relationship abuse would report more PTSD symptoms and have higher rates of probable PTSD than those who had not, that sexual violence would be a unique predictor of PTSD symptoms relative to sexual coercion, and that sexual abuse would predict PTSD symptoms above and beyond the effects of physical assault and psychological abuse. Of 216 female partners, 134 (64.1%) reported no sexual relationship abuse in the previous six months, 36 (17.2%) reported sexual coercion but no sexual violence, and 39 (18.7%) reported sexual violence. Women who experienced sexual coercion or violence reported more PTSD symptoms and had higher rates of probable PTSD than others. Counter to hypotheses, sexual coercion was a unique predictor of PTSD symptoms relative to sexual violence, but the reverse was not found. In multivariate analyses examining multiple forms of abuse, sexual abuse was not uniquely associated with PTSD symptoms, whereas psychological abuse was. The findings suggest that sexual relationship abuse is an important area for assessment and treatment and provide additional evidence for the importance of psychological abuse in understanding posttraumatic reactions among victims of intimate partner violence.

No abstract

Recovery from substance abuse and mental health disorders represents a journey through which individuals move beyond treatment of provider-identified problems toward a path of achieving wellness and productive lives. Overcoming obstacles and barriers encountered along the recovery process, individuals reveal their own strengths and resilience necessary to cope, survive, and thrive in the face of adversity. Recovery-oriented system of care (ROSC) is a framework designed to address the multidimensional nature of recovery by creating a system for coordinating multiple systems, services, and supports that are person centered and build on the strengths and resiliencies of individuals, families, and communities. As is common knowledge among substance abuse and mental health providers, consumers often present with high rates of comorbidity, which complicates care. In addition, behavioral health consumers engage in risky health behaviors (e.g., smoking) at a disproportionate rate, which places them at increased risk for developing noncommunicable diseases. ROSCs are ideal for addressing the complicated and varied needs of consumers as they progress toward wellness. The challenges of creating an ROSC framework that is effective, efficient, and acceptable to consumers is formidable. It requires change on the part of agencies, organizations, providers, and consumers. The importance of comprehensive, integrated screening is highlighted as a critical component of ROSC. Key suggestions for initiating ROSC are offered.

Screening, brief intervention, and referral to treatment (SBIRT) has become an empirically supported and widely implemented approach in primary and specialty care for addressing substance misuse. Accordingly, training of providers in SBIRT has increased exponentially in recent years. However, the quality and fidelity of training programs and subsequent interventions are largely unknown because of the lack of SBIRT-specific evaluation tools. The purpose of this study was to create a coding scale to assess quality and fidelity of SBIRT interactions addressing alcohol, tobacco, illicit drugs, and prescription medication misuse. The scale was developed to evaluate performance in an SBIRT residency training program. Scale development was based on training protocol and competencies with consultation from Motivational Interviewing coding experts. Trained medical residents practiced SBIRT with standardized patients during 10- to 15-min videotaped interactions. This study included 25 tapes from the Family Medicine program coded by 3 unique coder pairs with varying levels of coding experience. Interrater reliability was assessed for overall scale components and individual items via intraclass correlation coefficients. Coder pair-specific reliability was also assessed. Interrater reliability was excellent overall for the scale components (>.85) and nearly all items. Reliability was higher for more experienced coders, though still adequate for the trained coder pair. Descriptive data demonstrated a broad range of adherence and skills. Subscale correlations supported concurrent and discriminant validity. Data provide evidence that the MD3 SBIRT Coding Scale is a psychometrically reliable coding system for evaluating SBIRT interactions and can be used to evaluate implementation skills for fidelity, training, assessment, and research. Recommendations for refinement and further testing of the measure are discussed. (PsycINFO Database Record

placebo gels were rubbed onto the skin in the same way as active treatments, we found that active treatments were significantly better than placebo. Creating double blind conditions in trials of counter irritants can be problematic as rubefacients irritate the skin whereas inactive placebos do not. Some studies allowed for this by removing the principle ingredient from the treatment, leaving a placebo vehicle containing some other potentially irritant ingredients. Although the number needed to treat for combined outcomes of trials of this type was greater (worse) than for trials with inactive placebo, the difference was not statistically significant and there was insufficient evidence to draw conclusions.