Carol C. Nadelson

Incest and sexual abuse of children

Abstract Incest is defined, and the literature on it is reviewed. Clinical illustrations focus on the complexity of the issues involved and emphasize the need for careful, long-term, controlled studies using a broad population base for sampling. In addition, we stress the importance of determining clearer and more substantial criteria for psychological assessment because the specific impact of incestuous experiences is unclear, multidetermined, and may later in life manifest itself in a variety of ways including sexual dysfunction and depression.

Gender Differences in Research Grant Applications and Funding Outcomes for Medical School Faculty

PURPOSE To evaluate whether there were differences in acquisition of research grant support between male and female faculty at eight Harvard Medical School-affiliated institutions. METHODS Data were obtained from the participating institutions on all research grant applications submitted by full-time faculty from 2001 through 2003. Data were analyzed by gender and faculty rank of applicant, source of support (federal or nonfederal), funding outcome, amount of funding requested, and amount of funding awarded. RESULTS Data on 6319 grant applications submitted by 2480 faculty applicants were analyzed. Women represented 29% of investigators and submitted 26% of all grant requests. There were significant gender differences in the mean number of submissions per applicant (women 2.3, men 2.7), success rate (women 41%, men 45%), number of years requested (women 3.1, men 3.4), median annual amount requested (women

Boundaries in the doctor-patient relationship.

115,325, men

Sexual knowledge and attitudes of adolescents: relationship to contraceptive use.

150,000), mean number of years awarded (women 2.9, men 3.2), and median annual amount awarded (women

Stress and adaptation in medical students: who is most vulnerable?

98,094, men

Recruiting Researchers in Psychiatry: The Influence of Residency vs. Early Motivation.

125,000). After controlling for academic rank, grant success rates were not significantly different between women and men, although submission rates by women were significantly lower at the lowest faculty rank. Although there was no difference in the proportion of money awarded to money requested, women were awarded significantly less money than men at the ranks of instructor and associate professor. More men than women applied to the National Institutes of Health, which awarded higher dollar amounts than other funding sources. CONCLUSIONS Gender disparity in grant funding is largely explained by gender disparities in academic rank. Controlling for rank, women and men were equally successful in acquiring grants. However, gender differences in grant application behavior at lower academic ranks also contribute to gender disparity in grant funding for medical science.

Consequences of rape: clinical and treatment aspects

Boundaries in the doctor–patient relationshipis an important concept to help healthprofessionals navigate the complex andsometimes difficult experience between patientand doctor where intimacy and power must bebalanced in the direction of benefitingpatients. This paper reviews the concept ofboundary violations and boundary crossings inthe doctor–patient relationship, cautions aboutcertain kinds of boundary dilemmas involvingdual relationships, gift giving practices,physical contact with patients, andself-disclosure. The paper closes with somerecommendations for preventing boundaryviolations.

Psychosomatic aspects of obstetrics and gynecology.

Despite the decline in the total birth rate in the United States, there has been an increase in adolescent pregnancies, most of which are unplanned. This report discusses the medical and psychologic complications of teenage pregnancy and presents data from a study of 296 adolescents. The study includes pregnant adolescents who planned to continue their pregnancy and those who requested abortion, and compared these groups with non- pregnant high school students. The areas of inquiry included sexual information, contraceptive practice, relation of sex education course to use of contraceptives, methods of coping, and family relations. No significant difference was found between the groups in source of information—in all groups peers were the usual source. Those in the abortion and nonpregnant sample were more likely to use contraceptives. Of those who failed to use contraceptives in all groups, the most frequent response reflected a failure to acknowledge consciously the consequences of sexual activity. Adolescents in maternity homes showed less emphasis on independent decision making. They also revealed less conflict at home. The authors suggest that expectations for consistent, responsible contraceptive planning may be at variance with the developmental stage of many sexually active adolescents. Furthermore, they suggest that conscious and unconscious motivation to become pregnant may be important factors. This, added to the problem of obtaining adequate contraception or of finding creative alternatives to establishing adulthood, may play a role in the high incidence of adolescent pregnancy.

Coping resources and health responses among men and women medical students

Abstract There is concensus that medical school years are stressful but there has been little systematic investigation of the relationship between these stresses and manifestations of distress in the students. This paper reports results from the first wave of data in a longitudinal study of the physical and psychological health concomitants of the stresses of medical school. Two entering classes were surveyed by questionnaire in the fall of 1980. The number of recent life changes, degree of perceived stress, habits of nervous tension, depression, anxiety, and number of physical symptoms were among the variables measured. There were no significant sex or minority status differences in number or amount of perceived stresses. Moderate positive correlations were observed between level of stress and both psychological and physical distress. Few sex or minority status differences appeared. This diverse population of medical students showed a marked similarity in levels of stresses brought to the training period although there was some variation in the source of the stresses.

The hormone replacement therapy controversy

BackgroundThe declining numbers of clinician-researchers in psychiatry and other medical specialties has been a subject of growing concern. Residency training has been cited as an important factor in recruiting new researchers, but there are essentially no data to support this assertion. This study aimed to explore which factors have influenced motivation to conduct research among senior psychiatry residents.MethodsThe authors surveyed senior residents, inquiring about their level of interest in research, demographics, background, research experiences, and factors influencing motivation for research. The authors had confirmed participation from 16 of 33 residency programs with a class size of 10 or more. They received 127 responses, a 67% response rate, from participating programs.ResultsResidents with high stated interest in research differed from those with low and moderate interest in their research-intense post-residency plans. They were more likely to have graduate degrees. Those planning research careers had a consistent pattern of interest and involvement in research, starting well before residency. The majority of residents had had research exposure in college, but research involvement of those with very high versus lower interest diverged sharply thereafter. Those with high research interest were overwhelmingly male and tended to have lower debt than those with less interest.ConclusionThe great majority of residents appear to have decided whether or not to pursue a research career by the time they reached residency, and few of those with less than the highest research interest were enrolled in research tracks. Efforts to increase recruitment into research should center on identifying early developmental influences, eliminating barriers specific to women, and ensuring adequate funding to provide secure careers for talented potential researchers.