Fibrous Dysplasia in the Calcaneus

Fibrous dysplasia in the calcaneus is extremely rare; the most common locations of monostotic fibrous dysplasia of extremity bones being the proximal femoral shaft, tibia, humerus, and radius. An extensive literature search has revealed only 3 case reports that have been published concerning this topic, the most recent published in 2003. This is a case report of fibrous dysplasia in the calcaneus of a young male, including a discussion of the classical presentation of fibrous dysplasia and how this case differed.

LEVELS OF EVIDENCE

Therapeutic, Level IV: Case study.

Development of a behavior analytically derived alcohol-specific role-play assessment instrument

Social learning theory postulates that chronic alcohol abusers may have deficits in ability to cope with stressful situations, and these deficits may be associated with relapse after treatment. Attempts to study the hypothesized deficits have been hampered by methodological problems. Therefore, a behavior analytic procedure was used to develop 10 categories of situations based on over 600 drinking situations elicited from alcoholics. Role plays were developed for each of these categories, and samples of alcoholics in treatment were asked to respond as if they were trying not to drink. Videotaped responses were behaviorally rated by trained judges for skill and anxiety, and subjects completed self-report ratings of urge to drink, anxiety, difficulty and skill after each role play. Good interrater reliabilities and internal consistency were found across three samples of alcoholics, with virtually no gender differences. Previous and current investigations show the validity and utility of this instrument. The Alcohol Specific Role Play Test therefore shows promise as a means of assessing alcoholics' reactions to high-risk situations.

Alcohol abusers' and social drinkers' responses to alcohol-relevant and general situations

Responses of alcohol abusers and social drinkers were compared on general and alcohol-specific problem situations using role-play methodology. Multiple responses were assessed including behavioral observational ratings, self-reports and psychophysiologic measures. There were few differences between groups in responses to the general situations. Alcohol abusers had higher urges to drink than did the social drinkers in both the general and the alcohol-specific situations. However, in response to the alcohol-specific situations, the alcohol abusers, compared to the social drinkers, were rated by judges as significantly less skillful, and they displayed more self-reported anxiety, had a higher frequency of occurrence of problem situations in the natural environment and reported greater perceived realism of the alcohol-specific situations. Psychophysiologic measures did not differentiate between the groups. Results are discussed with respect to the importance of situation specificity in understanding the precipitants of drinking and their treatment implications.