This study evaluated and compared emotion-focused therapy for trauma (EFTT) with imaginal confrontation (IC) of perpetrators (n=20) and EFTT with empathic exploration (EE) of trauma material (n=25). Clients were women and men with histories of different types of childhood maltreatment (emotional, physical, and sexual abuse; emotional neglect). Clients were randomly assigned to treatment condition. Outcome measures assessed symptom distress, self and interpersonal problems, and abuse resolution. Results indicated statistically and clinically significant improvements on eight measures at posttest, maintenance of gains at follow-up, and no statistically significant differences between conditions. There were higher rates of clinically significant change in IC and a lower attrition rate for EE (7% vs. 20%). More severe personality pathology negatively influenced some dimensions of outcome, particularly in EE.

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BACKGROUND:Many physicians are overly cautious about prescribing opioids for chronic pain because of fears of iatrogenic addiction. However, in patients with chronic pain, addiction to opioid analgesics is exceedingly rare when there is no prior history of alcohol or drug abuse.OBJECTIVE:To validate an instrument that separates possible opioid abusers from those who are at low risk.DESIGN/METHODS:The Screening Instrument for Substance Abuse Potential (SISAP) was designed to identify individuals with a possible substance abuse history quickly and accurately. It is based on the National Alcohol and Drug Use Survey (n=9915). Using the first half of the sample (n=4967), two previously validated alcohol use items were combined with three illicit drug use items. These five questions identified those with a history of alcohol and/or illicit drug use.RESULTS:Using the second half of the sample (n=4948), the validation procedure showed that the five combined items correctly classified 91% of substance abusers and had a low rate of false negatives.DISCUSSION:The SISAP is brief and resistant to misrepresentation or falsification. The SISAP is expected to improve pain management by facilitating focus on the appropriate use of opioid analgesics and therapeutic outcomes in the majority of patients who are not at risk of opioid abuse, while carefully monitoring those who may be at greater risk.

These findings support a multidimensional approach to weight-related self-evaluation and further our understanding of the process of weight-related self-evaluation in eating-disordered patients.

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