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Phosphatidylethanol (PEth) forms in erythrocyte membranes after alcohol consumption, offering a persisting biomarker, that is measurable in whole blood, washed erythrocytes and dried blood spots. For a predominantly erythrocyte-restricted analyte, erythrocyte concentrations seem to have most validity in patients who are anemic through alcoholism or other pathologies, despite preparation increasing assay complexity. Differences in specimen preparation alter PEth concentrations for the same patient, meaning that criteria for interpreting PEth results should relate to specimen type, presenting a barrier to achieving harmonization. We therefore tested whether erythrocyte PEth might be validly calculated by hematocrit correction of a whole blood PEth measurement. PEth testing primarily serves to distinguish drinkers from non-drinkers. In choosing between specimen types, it is important to compare their utility in separating those two groups. We therefore processed 281 blood samples from 17 non-drinkers and 61 drinkers, to prepare matched whole blood and washed erythrocyte specimens. These were assayed by liquid chromatography–tandem mass spectrometry and compared in identifying alcohol consumption. The erythrocyte PEth concentration in the whole blood specimens was also calculated by correcting whole blood concentration by the specimen’s hematocrit, as an alternative to prepare washed erythrocytes. The hematocrit-corrected erythrocyte concentrations were included in these comparisons. Predictably, this work found that sensitivity was consistently better at the lower cut-off of 8 µg/L than at 20 µg/L. Sensitivities were also higher for washed erythrocytes than whole blood, explained by the lower erythrocyte mass in the same volume of whole blood. Hematocrit-corrected whole blood PEth concentrations correlated with erythrocyte concentrations, except for the four highest values, which did not influence comparative sensitivity. Specificity was 100% for washed erythrocytes, whole blood and hematocrit-corrected whole blood at either cut-off because non-drinkers had undetectable PEth. We conclude that hematocrit correction of whole blood PEth concentrations theoretically provides an alternative to the preparation of washed erythrocytes.

Erythrocyte membrane-incorporated phosphatidylethanol (PEth) forms only in the presence of ethanol and, once formed, provides a persisting marker for historical alcohol consumption. Relationships between PEth concentration, extent of consumption and time from consumption are under investigation. Threshold values of PEth have been proposed as indicators for any, or for harmful alcohol consumption. Here, we describe an assay for erythrocyte PEth 16:0/18:1 that offers the efficiency needed for routine clinical deployment, in the context of a fully validated methodology. However, we observe that conventional procedures for validating assay methodology are insufficient where the analyte of interest, membrane-incorporated PEth 16:0/18:1, has different physicochemical properties to the soluble PEth 16:0/18:1 and PEth 16:0/18:1-d5 that are used for making calibrator, controls and internal standards. Whereas the internal standard did fully correct for differences in matrix effects and recovery when different extraction solvents were applied to calibrators and controls (in soluble form), it failed to correct for a 1.5-fold difference in the relative efficiency of two solvents, in this case, acetonitrile and isopropanol in extracting PEth from erythrocyte membrane in clinical samples. Differences in the efficiency of the extraction of membrane-bound PEth translate to different results from the same specimen. That can mean that threshold values derived by one methodology cannot be safely generalised to another. That hampers the generalisability of individual laboratory's experience with PEth assay results. Harmonising extraction methodology between laboratories becomes very important where membrane-incorporated PEth itself remains unavailable as an assay standard.

The therapeutic working alliance is a vital ingredient of psychotherapy, specifically for clients diagnosed with anorexia nervosa, as progress is often slow and treatment difficult. This qualitative phenomenological study investigated the experiences of eight clients with anorexia nervosa and seven therapists who work with this population, regarding which therapist factors aided in and challenged the working alliance formation in individual psychotherapy. Data was gathered through semi-structured interviews. Some helpful therapist factors included collaboration, appropriate self-disclosure, providing a warm and safe environment, and willingness to be contacted outside of a session. Unhelpful factors included lack of attunement and objectivity and failure to individualize treatment.

While tonic immobility (TI) is a phenomenon well known and documented in the animal world, far less is known about its manifestation in humans. Available literature demonstrates that TI is significantly associated with less hopeful prognoses when compared with survivors who did not experience TI (Fiszman et al., 2008; Heidt et al., 2005). If survivors who experience TI are at increased risk for "depression, anxiety, posttraumatic stress disorder (PTSD), and peritraumatic dissociation" (Heidt et al., 2005, p. 1166) and respond more poorly "to standard pharmacological treatment for PTSD" (Fiszman et al., 2008, p. 196), the implications for treatment are significant, suggesting that TI "should be routinely assessed in traumatized patients" (Fiszman et al., 2008, p. 193). Literature indicates that "TI is thought to be particularly relevant to survivors of rape and other sexual assault" and that "sexual assault is a trauma that appears to entail virtually all of the salient elements associated with the induction of TI in nonhuman animals, namely, fear, contact, and restraint" (Marx et al., 2008, p. 79). Describing the phenomenon as it is experienced by survivors is especially important because the ability to accurately understand and describe the nature of the phenomenon is the first step toward accurately identifying, diagnosing, and treating the sequelae of such a response. This study examines the experience of TI from the perspective of 7 women who survived a sexual assault accompanied by tonic immobility using qualitative phenomenological methodology, and yields a description of the core defining themes of the experience of TI.

The purpose of this study was to understand the experiences of both participants and educators in the Building Healthy Marriages (BHM) program. This program aimed to educate couples and increase relationship satisfaction. The researchers utilized a phenomenological methodology designed to elicit thick descriptions of the personal experiences of participants and educators in this program (Creswell 2007). The sample consisted of 23 participants and 7 educators. Results showed that participants cultivated relationship skills that had positive, long-lasting impacts on their relationship satisfaction not only with their partners but also with others, including family (especially their children), friends, and coworkers.

This study measured marital satisfaction of low-income couples in a Western state following participation in the Building Healthy Marriages program, which aimed to educate couples and increase relationship satisfaction. The researchers’ goals were the following: To determine the areas in which participants experienced the greatest number of problems before entering the program, to assess the program’s impact on marital satisfaction, and to examine the differences in program impact between various demographic groups. To assess the program’s impact, participants were administered the Marital Satisfaction Inventory–Revised before beginning the program and 1 year after completing the pretest. Before starting the program, couples experienced the greatest number of challenges in relationships within their families of origin and problem-solving communication and the fewest problems in areas related to their children. Couples reported significant improvements in marital satisfaction. These changes did not differ significantly between different gender and ethnicity groups.

The focus of this study is on the spoken and written discourse of Alcoholics Anonymous (AA) and its constitutive effect on its social organisation. Relevant aspects of AA literature are examined, while other data has been obtained from observation and tape recordings of AA meetings. It is argued that AA written and spoken texts are marked by the avoidance of power differentials in that ideologies and prescriptions that mark such differentials are avoided. It is further argued that the structure and social practices of AA are themselves determined by these discursive features, and their function is to maintain these. This creates a discursive setting that allows AA members to participate in self-revelatory and self-exploratory sharing in a framework of trust that facilitates a re-evaluation of their personal power over alcoholism and the larger world

This article presents a case study illustrating the blending of individual cognitive therapy with family therapy in the treatment of anorexia nervosa. Family members explored attributions they made about each other’s behavior. The communication strategies helped this family to communicate more effectively with each other about eating disorders, positive and negative observations in behavior, and ways that the family could be supportive. This approach allowed new behaviors to emerge and began to create new patterns of relating. A significant gain from this approach is that it helped each person face personal weaknesses and to see how the roles they had taken on were very confining to themselves and to other family members.

Although there is increasing literature on secondary traumatic stress, little is known about the therapist’s perspective and experience in working with traumatized children. This qualitative study utilized an interpretivist paradigm to understand therapists’ experiences in working with such children. Interviews suggest that therapists perceive common issues related to treatment, impact of the therapeutic work, and the importance of making personal meaning of their work. Most importantly, becoming a trauma specialist is a developmental process requiring careful examination, willingness to be changed, and a program of self-care, as therapists work to help children who have been witness to and often victims of horrors many find unspeakable. Implications for training, supervision, community support, and self-care are discussed. [Brief Treatment and Crisis Intervention 4:353–366 (2004)]

This paper is an attempt to explore the possible research stances available to the researcher involved in participant observation of Alcoholics Anonymous (AA). It examines some ethnographic studies of AA, within both naturalistic and symbolic interactionism research paradigms. However, mindful of the constitutive nature of language in social interaction and also wishing to focus on AA as a discoursal process, ethnomethodological approaches are examined, particularly the insights available through Conversational Analysis (CA) and Institutional Interaction. The methods of scrutiny available through these approaches--the emphasis on data and fine-grained detail as well as the context sensitivity available to the acculturated observer--it is argued, make the ethnomethodological approach eminently appropriate in terms of exploring the reflexive relationship between AA discourse and its social organisation. Key Words: Participant Observation, Alcoholics Anonymous, Ethnography, Ethnomethodology, Conversation Analysis, Institutional Interaction, Insider / Outsider Introduction The purpose or this paper is to explore the positions of the insider and outsider in social research and relate these to ethnographic and ethnomethodological research methods involving participant observation of Alcoholics Anonymous (AA). The paper will focus on method, which though determining what is known is itself determined by a particular way of seeing. It is useful to try to conceptualise and locate possible approaches according to the four paradigms Gubrium and Holstein (1997) refer to as four idioms of qualitative inquiry, namely naturalism, ethnomethodology, postmodernism and emotionalism. This paper will explore the first two of these approaches from the point of view of insider observation of AA. It will look at some existing research and argue that AA, being constituted mainly through discourse, may be effectively approached through ethnomethodology, focusing particularly on the form of Conversation Analysis (CA) known as institutional interaction. The paper is also an exploration of what Collins' (1991, p. 53) calls a 'personal biography'. She sees 'personal and cultural biographies as significant sources of knowledge' for 'outsiders within the academy'. Naturalism In exploring the role of inside observer, it is useful to start by examining Naturalism, being the most fully established of the four idioms of qualitative inquiry referred to above. According to Gubrium and Holstein (1997, p. 6), 'naturalism seeks rich descriptions of people and interaction as they exist and unfold in their natural habitats'. Implicit in traditional forms of naturalistic ethnography is the notion of a coming together of two essentially discrete entities; one being the researcher and his/her methodology and the other the participants and their social world. Room (1993) in her studies of AA as a social movement takes a macroscopic perspective on AA as a structured social entity and tries to locate it in the context of history and other social movements in the United States. She looks at its formative influences, membership, impact on society and its organisational structure, remarking 'AA has succeeded in creating an organisation that breaks Michels' "iron law of oligarchy" (1958, p. 171) by building in structures and principles that minimize the professionalization of leadership and keep effective organisational power at the level of egalitarian face-to-face interaction". Using such a wide-angled lens, we are presented with an overview in the context of history and society in general. However, the voices involved in this 'face-to-face interaction'; are not heard nor their emotional world felt. For this, a more ethnographic approach is required. Neither does Room attempt to give insights into the possible constitutive reflexivity of the relationship between the organisational structures and that face-to-face interaction that an ethnomethodological approach may explore. …

In this article we discuss the importance of anticipating and addressing the emotional difficulties students experience in graduate-level courses on trauma and violence. Herman's (1997) model for treating survivors of trauma serves as a framework for recommendations for ameliorating secondary traumatic stress in the classroom; we draw on a variety of sources to suggest self-care strategies that students can use outside of the classroom. We also address the importance of self-care for instructors of classes on trauma and violence.

The Questionnaire for Eating Disorder Diagnoses (Q-EDD) operationalizes eating disorder criteria of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders and differentiates (a) between those with and without an eating disorder diagnosis, (b) among eating-disordered, symptomatic, and asymptomatic individuals, and (c) between those with anorexia and bulimia diagnoses. Three studies examined the Q-EDD's psychometric properties. Convergent validity was supported by correspondence between Q-EDD diagnoses and established inventory scores. Criterion validity was supported by high correspondence between Q-EDD and interview or clinician diagnoses. Incremental validity was supported by greater accuracy of Q-EDD diagnoses than those yielded by an established inventory. Test-retest reliability and interscorer agreement were very good. Future use is discussed.

Test d'une hypothese de la «self-efficacy theory», selon laquelle la performance a des tâches verbales et mathematiques serait en rapport avec la confiance en sa reussite professionnelle et ses interets professionnels

The purpose of this study was to examine the relationships of the perceived influence of female and male role models, gender role, and performance self-esteem to college women's career salience and career-related aspirations and choices. One hundred and seven senior women responded to a survey assessing the variables of interest. Results of stepwise regression analyses revealed that perceived role model influences, in isolation, were significantly related to career salience, level of educational aspirations, and nontraditionality of occupational choices. Role model influences were also significantly, but not very strongly, predictive of college major choices. Finally, performance self-esteem in addition to role model influences significantly predicted career salience, educational aspirations, and the nontraditionality of career choices, while the gender-role variables were largely nonpredictive. Implications of the findings for research and counseling are discussed.