Psychotherapy for sexually abused girls: psychopathological outcome findings and patterns of change

BACKGROUND

Controversy exists about the efficacy of psychotherapy for the mental health problems of sexually abused children.

AIMS

To compare the relative efficacy of focused individual or group therapy in symptomatic sexually abused girls, and to monitor psychiatric symptoms for persistence or change.

METHOD

A multi-centre psychotherapy outcome study recruited 71 sexually abused girls aged 6-14 years who were randomly assigned to focused individual psychotherapy (up to 30 sessions) or psychoeducational group therapy (up to 18 sessions). Changes over the course of the study were monitored.

RESULTS

Both treatment groups showed a substantial reduction in psychopathological symptoms and an improvement in functioning, but with no evident difference between individual and group therapy. However, individual therapy led to a greater improvement in manifestations of post-traumatic stress disorder (PTSD).

CONCLUSIONS

The beneficial effects on PTSD support the use of individual therapy. However, the small sample size and lack of a control group limit conclusions about changes attributable to treatment.

Cycle of child sexual abuse: links between being a victim and becoming a perpetrator

BACKGROUND

There is widespread belief in a 'cycle' of child sexual abuse, but little empirical evidence for this belief.

AIMS

To identify perpetrators of such abuse who had been victims of paedophilia and/or incest, in order to: ascertain whether subjects who had been victims become perpetrators of such abuse; compare characteristics of those who had and had not been victims; and review psychodynamic ideas thought to underlie the behaviour of perpetrators.

METHOD

Retrospective clinical case note review of 843 subjects attending a specialist forensic psychotherapy centre.

RESULTS

Among 747 males the risk of being a perpetrator was positively correlated with reported sexual abuse victim experiences. The overall rate of having been a victim was 35% for perpetrators and 11% for non-perpetrators. Of the 96 females, 43% had been victims but only one was a perpetrator. A high percentage of male subjects abused in childhood by a female relative became perpetrators. Having been a victim was a strong predictor of becoming a perpetrator, as was an index of parental loss in childhood.

CONCLUSIONS

The data support the notion of a victim-to-victimiser cycle in a minority of male perpetrators but not among the female victims studied. Sexual abuse by a female in childhood may be a risk factor for a cycle of abuse in males.

The role of environmental health officers in the protection of allergic consumers

Those suffering from serious food allergy are advised to avoid contact with the trigger allergens. However, it can prove difficult to avoid such food allergens, especially those hidden as unnamed components of composite foods. Many cases of serious illness and death following the accidental consumption of trigger foods, such as peanuts and other nuts, have been noted in the literature. This study reports the findings of a survey of the role of environmental health officers (EHOs) in Northern Ireland, in relation to the protection of the allergic consumer. This study shows that although EHOs use hazard analysis as a general method of improving food safety, this approach is not currently being applied in the control of the allergenic risks posed to sensitive consumers, consuming nut-and peanut-containing foodstuffs. This study has established that the main reasons for not applying HACCP systems in the reduction of this risk are related to concerns in relation to lack of knowledge and appropriate training in this subject.

Genome size and karyotype evolution in the slipper orchids (Cypripedioideae: Orchidaceae)

Nuclear DNA contents (4C) were estimated by Feulgen microdensitometry in 27 species of slipper orchids. These data and recent information concerning the molecular systematics of Cypripedioideae allow an interesting re-evaluation of karyotype and genome size variation among slipper orchids in a phylogenetic context. DNA amounts differed 5.7-fold, from 24.4 pg in Phragmipedium longifolium to 138.1 pg in Paphiopedilum wardii. The most derived clades of the conduplicate-leaved slipper orchids have undergone a radical process of genome fragmentation that is most parsimoniously explained by Robertsonian changes involving centric fission. This process seems to have occurred independently of genome size variation. However, it may reflect environmental or selective pressures favoring higher numbers of linkage groups in the karyotype.

Ovine fetal umbilical artery Doppler systolic diastolic ratios and nitric oxide synthase

OBJECTIVE

To evaluate the effect of nitric oxide synthase activity inhibition on the fetal lamb umbilical artery flow velocity waveform.

METHODS

Five pregnant Corriedale cross ewes were operated on at 125-130 days' gestation. Fetal and maternal vascular catheters were inserted along with a Doppler flow meter cuff on the fetal common umbilical artery. Each fetus received a 40-minute intravenous (i.v.) infusion of N omega-nitro-D-arginine as a control, and then after a recovery period of 1 hour, a 40-minute i.v. infusion of N omega-nitro-L-arginine, an inhibitor of nitric oxide synthase activity. Maternal and fetal heart rate, blood pressure, blood gases, and fetal umbilical artery flow velocity waveforms were recorded at basal time and after the 40-minute i.v. infusions.

RESULTS

There were no differences in fetal or maternal heart rate, blood pressure, or blood gases with the infusion of the nitric oxide synthase inhibitor N omega-nitro-L-arginine. However, N omega-nitro-L-arginine caused a significant increase (41%) in the fetal umbilical artery flow velocity waveform systolic to diastolic ratio (S/D) above the baseline levels.

CONCLUSIONS

Inhibition of nitric oxide synthase activity in the lamb fetoplacental circulation with N omega-nitro-L-arginine is associated with an increase in the umbilical artery S/D.

Initial burn management in the primary care situation

Each year more than 150,000 people in Australia and New Zealand experience burning of sufficient severity for them to seek medical help, with 400 people dying annually. Primary care involves careful identification of burn healing potential and severity of injury. Major burns are best managed by regional Burn Units. The assessment, early management and burns unit transfer indications are addressed in this article.

Key features of cereal genome organization as revealed by the use of cytosine methylation-sensitive restriction endonucleases

Unlike mammalian genomes, cereal (Gramineae) genomes exhibit little suppression of CpG dinucleotides. In cereal genomes, however, most of the numerous potential recognition sites for CpG methylation-sensitive restriction enzymes are methylated. Analysis of cereal genomic libraries and of regions flanking genes indicates that unmethylated NotI sites are useful landmarks for regions containing genes/single-copy sequences. Studies of a rye chromosome arm indicate that its pericentromeric region has a reduced density of unmethylated NotI (and MluI) sites and therefore of genes. Unmethylated MluI and NruI sites are distributed nonrandomly in the genomes of wheat, barley, and rice. Analysis of the genomic blocks defined by these sites in wheat and barley indicates that they are most likely to have arisen by amplification. These observations form the basis of a proposed model for the organization and evolution of the wheat, barley, and rice genomes.

Screening schoolchildren for high risk of emotional and educational disorder

Junior schoolchildren were screened for high risk of emotional and educational disorder. The information was gathered from the school, using standard and objective tests. The multiple criterion screen employed, comprised: (a) classroom behaviour scale (Rutter B Scale), rated by teachers; (b) sociometric tests; choice of companions by classmates. From these, lack of positive choices was taken as a measure of isolation and a high rate of negative choices, as a measure of rejection; (c) Reading quotient of 75 or below on the Young Reading Test; (d) Absence from school for reasons considered by teachers to be trivial. The number of cases identified by the screening was found to be 322 children per thousand. They may be seen as representing a high risk rate. Using extreme scores as indicative of high risk, approximately 17 per cent of children were identified on the basis of the behaviour test; 12 per cent by the reading test; 9 per cent by the isolation test; 8 per cent by the rejection test and 3 per cent by the absenteeism test. Seventy per cent of the identified children were rated clinically as disturbed. Absenteeism identified the smallest percentage of cases and made the smallest independent contribution of identification. Isolation was not impressively related to neurotic or antisocial behaviour. The three important criteria, therefore, were behaviour, rejection and reading. Corrected disturbance rates for our population of 7-8-year-old children, including those not identified by the screen, were 6-8 per cent markedly maladjusted and 33-7 per cent somewhat maladjusted.