Objective: Transgender individuals are vulnerable to negative health risks and outcomes, but research remains limited because data sources, such as electronic medical records (EMRs), lack standardized collection of gender identity information. Most EMR do not include the gold standard of self-identified gender identity, but International Classification of Diseases (ICDs) includes diagnostic codes indicating transgender-related clinical services. However, it is unclear if these codes can indicate transgender status. The objective of this study was to determine the extent to which patients' clinician notes in EMR contained transgender-related terms that could corroborate ICD-coded transgender identity. Methods: Data are from the US Department of Veterans Affairs Corporate Data Warehouse. Transgender patients were defined by the presence of ICD9 and ICD10 codes associated with transgender-related clinical services, and a 3:1 comparison group of nontransgender patients was drawn. Patients' clinician text notes were extracted and searched for transgender-related words and phrases. Results: Among 7560 patients defined as transgender based on ICD codes, the search algorithm identified 6753 (89.3%) with transgender-related terms. Among 22 072 patients defined as nontransgender without ICD codes, 246 (1.1%) had transgender-related terms; after review, 11 patients were identified as transgender, suggesting a 0.05% false negative rate. Conclusions: Using ICD-defined transgender status can facilitate health services research when self-identified gender identity data are not available in EMR.

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Forty percent of all long-term care hospitalization days are accounted for by patients with schizophrenia. New approaches to managing this disorder are needed, including improved efficacy and better tolerability to enhance compliance with treatment. Sertindole hydrochloride is a novel antipsychotic medication soon to be available in the United States and Canada. As part of multisite phase II and III studies, we studied effects of this medication in five patients with chronic schizophrenia and examined the side effect profile. With more than 30 patient-months of exposure, sertindole treatment was not associated with neurologic side effects and was well tolerated in all patients studied. No evidence of hematologic abnormalities was found. Serial electrocardiograms revealed slight increases in QTc that were not considered clinically significant and did not lead to discontinuance of treatment. While data from larger samples are needed, in this small population sertindole hydrochloride was tolerated well with no evidence of acute neurologic side effects associated with traditional treatments for schizophrenia. Individuals with schizophrenia may benefit from enhanced compliance with treatment and a possible reduction in hospitalizations in the future.

The literature on cross-dressing men has been primarily limited to self-identified patients at psychiatric clinics who are in distress. To understand the personality trait characteristics and sexual functioning of nonpatient cross-dressers, 188 non-treatment-seeking male cross-dressers completed the NEO Personality Inventory (NEO-PI) and the Derogatis Sexual Functioning Inventory (DSFI). Respondents were classified as transvestites (TV; N = 83), transgenderists (TG; N = 61), or transsexuals (TS; N = 44) based on self-report and the nature of their cross-gender activities (e.g., use of female hormones, desire for sex reassignment, and amount of time spent in female role). These diagnostic groups did not differ on the five broad personality domains of the NEO-PI, but TS men scored higher than TV and TG men on the Aesthetics facet scale of Openness to Experience (O). In terms of the DSFI scales, TS men reported lower sexual drive than TV and TG men, and TS and TG men exhibited greater psychiatric symptoms and feminine gender role, and poorer body image than TV men. Upon exclusion of a group of 49 respondents who previously sought treatment for psychological problems, no significant differences emerged among the three diagnostic groups on the NEO-PI domain and facet scales. Consideration of the DSFI scales showed that TS men experienced less sexual drive, more psychiatric symptoms, and a greater feminine gender role than TV or TG men. This study suggests that cross-dressers not seen for clinical reasons are virtually indistinguishable from non-cross-dressing men using a measure of personality traits, a sexual functioning inventory, and measures of psychological distress. These results emphasize the importance of using clinical significance criteria as required by DSM-IV guidelines before diagnosing men who cross-dress with an axis I disorder.

Reviews the book, Self-Relations in the Psychotherapy Process by J. Christopher Muran (see record 2000-16556-000). The self is alive and well and living in psychology, at least if the contributors to J. Christopher Muran's stimulating volume, Self-Relations in the Psychotherapy Process, are to be taken seriously. The self is a central construct in psychoanalytic, humanistic, and cognitive-behavioral theories, but nowadays even some radical behaviorists find the self to be an important concept. Thus, the present is a propitious time for a book that presents the major theoretical approaches to the self in psychotherapy and, fortunately for us, Muran, by gathering the views of leading psychodynamic, humanistic, cognitive-behavioral, and radical behavioral thinkers, has assembled a volume of almost uniformly high quality. Inspired by postmodernism, especially by the growing popularity of dialogic and perspectival epistemologies, Muran has a constructed this book as a set of six dialogues among contributors of varying theoretical persuasions, and although I doubt that dialogic and perspectival epistemologies are necessarily postmodern, I nevertheless find that this volume's dialogic structure makes for interesting reading and adds to its intellectual contributions. Because Muran's contention, with which I agree, is that the self is not an isolated entity but rather part of a relational matrix, it is perhaps necessary for this book to be structured dialogically. Whether postmodern or not, this book is an important one, one that conveys a great deal about what it means to be human as we enter the 21st century. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Responsibility for teaching communication skills often falls to a multidisciplinary group of faculty who lack both a common model for teaching and prior experience teaching communication in small groups. This article describes East Tennessee State University's multifaceted faculty development program in teaching communication skills. The program was developed and implemented in three phases. First, a two-step Delphi approach helped identify core communication skills. Phase two gave faculty the opportunity to practice identifying communication teaching issues and effective strategies for working with small groups. The third phase involved the videotaping of faculty teaching small groups of students. These tapes were reviewed both individually and in faculty groups. The tapes were also reviewed by students, who provided realtime, moment-to-moment feedback to the faculty. Implementation and review of the program has helped to identify new strategies for effectively facilitating small-group teaching of communication skills.

Objectives Motorcycle helmet laws vary by state, with Kentucky requiring helmets only for younger riders. We hypothesized that motorcyclists injured in Kentucky and seen at a Tennessee trauma center would be more likely to be unhelmeted, have more severe head injuries, and sustain more fatal injuries than those injured in Tennessee or Virginia. Methods A Trauma Registry review of 729 injured motorcyclists from January 2005 through June 2015 examined state location of crash, demographics, helmet use, and clinical outcomes. Multivariate logistic regression analysis evaluated predictors for head injury severity and death. Results Unhelmeted motorcycle rider status predicted more severe head injuries (relative risk 15.3, P < 0.001) and death (relative risk 4.2, P < 0.001). Motorcyclists injured in the state of Kentucky were more likely to be unhelmeted, require an operative procedure, have more severe head injuries, have longer lengths of stay, and sustain more fatal injuries (all with < 0.001) than motorcyclists injured in Tennessee or Virginia. Conclusions This study lends support for maintaining and enforcing current universal motorcycle helmet laws for all ages in states where they are in effect and for upgrading helmet laws that apply only to some riders.

Over a 6-year period, 106 women involved with men who cross-dress (mostly heterosexual transvestites) completed a questionnaire regarding themselves, their male partners, and their relationships. Interview data supplemented these questionnaires for 75% of the respondents. All respondents were recruited from nonclinical settings. The "modal" female partner was a 40-year-old Protestant, Caucasian woman, who was a firstborn child, in her first marriage. She was more likely than other women her age to be childless, and to have earned at least a 2-year college degree. She was no more likely to have had lesbian experiences or substance use problems than comparably aged American women. She had been married to her cross-dressing mate for 13 years and had known of his activities for 9 years. A quarter of women reported at least occasional sexual arousal to their mate's cross-dressing. The two variables associated with low acceptance of cross-dressing were discovery of their partner's cross-dressing after marriage and lack of sexual arousal to cross-dressing stimuli. Low acceptance was unrelated to firstborn status, amount of exposure to cross-dressing activities, or having had children. This group may be more representative of women in relationships with cross-dressing men than previous reports limited to cross-dressers and spouses who are in treatment.

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No description available.