Substance abusers' personality disorders and staff members' emotional reactions

<p>Abstract</p> <p>Background</p> <p>Previous research has indicated that aggressive behaviour and DSM-IV cluster B personality disorders (PD) may be associated with professionals' emotional reactions to clients, and that cluster C PD may be associated with positive emotional reactions.</p> <p>Methods</p> <p>Staff members recruited from workshops completed a self-report inventory of emotional reactions to patients, the Feeling Word Checklist-58, and substance abusers completed a self-report of DSM-IV personality disorder, the DSM-IV and ICD-10 Personality Disorder Questionnaire. Correlational analysis and multiple regression analysis was used to assess the associations between personality disorders and emotional reations.</p> <p>Results</p> <p>Cluster B disorder features were associated with feeling distance to patients, and cluster C disorder features were associated with feeling helpful towards patients. Cluster A disorders had no significant impact on emotional reactions.</p> <p>Conclusion</p> <p>The findings confirm clinical experiences that personality disorder features in patients with substance abuse have an impact on staff members reactions to them. These reactions should be considered in supervision of staff, and in treatment models for patients with co-morbid personality disorders and substance abuse.</p

What do clinicians want? Interest in integrative health services at a North Carolina academic medical center

BACKGROUND: Use of complementary medicine is common, consumer driven and usually outpatient focused. We wished to determine interest among the medical staff at a North Carolina academic medical center in integrating diverse therapies and services into comprehensive care. METHODS: We conducted a cross sectional on-line survey of physicians, nurse practitioners and physician assistants at a tertiary care medical center in 2006. The survey contained questions on referrals and recommendations in the past year and interest in therapies or services if they were to be provided at the medical center in the future. RESULTS: Responses were received from 173 clinicians in 26 different departments, programs and centers. There was strong interest in offering several specific therapies: therapeutic exercise (77%), expert consultation about herbs and dietary supplements (69%), and massage (66%); there was even stronger interest in offering comprehensive treatment programs such as multidisciplinary pain management (84%), comprehensive nutritional assessment and advice (84%), obesity/healthy lifestyle promotion (80%), fit for life (exercise and lifestyle program, 76%), diabetes healthy lifestyle promotion (73%); and comprehensive psychological services for stress management, including hypnosis and biofeedback (73%). CONCLUSION: There is strong interest among medical staff at an academic health center in comprehensive, integrated services for pain, obesity, and diabetes and in specific services in fitness, nutrition and stress management. Future studies will need to assess the cost-effectiveness of such services, as well as their financial sustainability and impact on patient satisfaction, health and quality of life

Collective movement in the Tibetan macaques (Macaca thibetana): Early joiners write the rule of the game

Collective behavior has recently attracted a great deal of interest in both natural and social sciences. While the role of leadership has been closely scrutinized, the rules used by joiners in collective decision making have received far less attention. Two main hypotheses have been proposed concerning these rules: mimetism and quorum. Mimetism predicts that individuals are increasingly likely to join collective behavior as the number of participants increases. It can be further divided into selective mimetism, where relationships among the participants affect the process, and anonymous mimetism, where no such effect exists. Quorum predicts that a collective behavior occurs when the number of participants reaches a threshold. To probe into which rule is used in collective decision making, we conducted a study on the joining process in a group of free-ranging Tibetan macaques (Macaca thibetana) in Huangshan, China using a combination of all-occurrence and focal animal sampling methods. Our results show that the earlier individuals joined movements, the more central a role they occupied among the joining network. We also found that when less than three adults participated in the first five minutes of the joining process, no entire group movement occurred subsequently. When the number of these early joiners ranged from three to six, selective mimetism was used. This means higher rank or closer social affiliation of early joiners could be among the factors of deciding whether to participate in movements by group members. When the number of early joiners reached or exceeded seven, which was the simple majority of the group studied, entire group movement always occurred, meaning that the quorum rule was used. Putting together, Macaca thibetana used a combination of selective mimetism and quorum, and early joiners played a key role in deciding which rule should be used