Projective measures in the clinical evaluation of sexually abused children

This paper addresses the use of human figure drawings as a strategy for assessing clinically relevant experiences of sexually abused children. Clinical issues relevant to the use of human figure drawings are discussed.     

Assessment of Research Quality of Telehealth Trials in Pain Management: A Meta‐Analysis

Although telehealth‐based pain management research has grown over the last decade, it is difficult to determine the state of the research because of methodological differences and variability in quality among existing studies. In a previous systematic review, we outlined these differences and preliminarily explored the promise of telehealth for pain intervention. We completed a PRISMA compliant meta‐analysis of telehealth pain management research to more precisely describe the state of the research and to uncover gaps in the existing literature that highlight directions for future research. We identified 10 relevant studies completed between 2000 and 2011 including 3 noninferiority and 7 superiority studies. Meta‐analysis revealed an overall benefit of telehealth interventions over control conditions and equivalence with in‐person intervention. However, some of the reviewed studies found no benefit for telehealth over control conditions. Some methodological concerns among the examined research included poor research quality, small sample sizes, and the examination of telehealth pain interventions without proven efficacy for in‐person treatment. Recommendations for future studies are reviewed.     

Risk factors,pathophysiology, and treatment of hot flashes in cancer

Answer questions and earn CME/CNE Hot flashes are prevalent and severe symptoms that can interfere with mood, sleep, and quality of life for women and men with cancer. The purpose of this article is to review existing literature on the risk factors, pathophysiology, and treatment of hot flashes in individuals with cancer. Electronic searches were conducted to identify relevant English‐language literature published through June 15, 2012. Results indicated that risk factors for hot flashes in cancer include patient‐related factors (eg, age, race/ethnicity, educational level, smoking history, cardiovascular risk including body mass index, and genetics) and disease‐related factors (eg, cancer diagnosis and dose/type of treatment). In addition, although the pathophysiology of hot flashes has remained elusive, these symptoms are likely attributable to disruptions in thermoregulation and neurochemicals. Therapies that have been offered or tested fall into 4 broad categories: pharmacological, nutraceutical, surgical, and complementary/behavioral strategies. The evidence base for this broad range of therapies varies, with some treatments not yet having been fully tested or showing equivocal results. The evidence base surrounding all therapies is evaluated to enhance hot flash treatment decision‐making by clinicians and patients. CA Cancer J Clin 2013. © 2013 American Cancer Society.     

Prenatal stress and childhood psychopathology

The documentation of levels of prenatal maternal stress and anxiety of four populations of severely emotionally disturbed children and adolescents was retrospectively reviewed to examine their relationship to the later development of childhood psychopathology. Significantly more of those children were born to unmarried mothers who had not planned to become pregnant, felt unhappy about being pregnant, lived in family discord, emotionally rejected being pregnant, and experienced significantly more physical problems than would be expected by chance. This study supports the hypothesis that chronic prenatal stress adds both physiological and psychological risk factors to the later development of childhood psychopathology.An earlier version of this paper was presented at the 54th Annual Meeting of the American Orthopsychiatric Association in New York, New York on April 13–16, 1977.