This report described 19 female patients (M = 23.5) diagnosed as obsessive compulsive disorder (OCD; DSM-I//-R) who exhibited additional symptoms of self-mutilation, dysmenorrhea, and dysorexia. A biphasic pattern related to menstruation during the course of O C D emerged: Phase 1, amenorrheic-characterized by anorexia nervosa, amenorrhea, and aggressive behavior, and Phase 2, postamenorrheic-characterized by self-mutilation following the return of the menstrual cycle, dysorexia, and aggressive behavior. All mutilative acts were reported by the patients to be painless and consisted of slashes. Seventy percent of the patients were sexually abused during childhood. All patients underwent an open trial of clomipramine (M = 200 mgiday) for 6 months, and intensive behavior therapy for 8 weeks. Based on clinical observations and self-reports, there was a decrease in self-harm and OCD symptoms. The emergence of OCD, selfmutilation, dysorexia, and dysmenorrhea in a sequential manner may suggest a specific clinical syndrome or the presence of an O C D subset. A biological working hypothesis of a hypothalamic dysfunction with serotonergic participation was suggested. 0 1995

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In this article the authors report on the development and validation of a computer‐based rehabilitation caseload management simulation as a teaching and evaluation tool in counselor education. The computer simulation was administered to 18 rehabilitation students and 18 rehabilitation counselors. Their performance on the simulation was evaluated using six caseload management performance indicators. These performance indicators, derived from the computer simulation, were found to be effective in differentiating the student group from the experienced counselor group using discriminant analysis. Implications for the use of computer simulations in rehabilitation counselor education and future research directions are discussed.

In this article, we examined the extent of alcohol abuse among several groups of individuals with other disabilities. We then compared our results with rehabilitation counselors estimates of alcohol abuse in the same client groups. One hundred and thirty-four rehabilitation clients were administered the Michigan Alcoholism Screening Test (MAST) at the time of initial interview to determine their level of alcohol consumption and/or abuse. The results indicated that clients with chronic mental illness and those with limitations resulting from physical trauma have a appreciably higher rate of alcohol abuse than the other identified client groups (those with congenital & developmental disabilities) or the general population. When we asked 40 rehabilitation counselors to estimate probable alcohol abuse rates for these client groups, we found that the counselors slightlyoverestimated alcohol abuse problems among people with congenital and development disabilities, and appreciably underestimated the prevalence of alcohol abuse among clients with physically induced trauma or chronic mentallllness. The results suggest that rehabilitation counselors may lack awareness about this “hidden disability,” within selected client groups, and, the results also imply a need for improved counselor training related to alcohol abuse issues in rehabilitation populations.

The articles published in the South African Medical Journal between 1927 and 1975 were examined for the presence of psychological and psychiatric themes. Two hundred and seventy-seven articles and editorials were identified and analysed. The relative space allocated to issues psychological remained quite stable at low levels in the period under investigation. The following themes are discussed: psychopathology and treatment, psychoneuroses, psychology and physical disease, psychological testing, and psychology as an auxiliary to the medical profession.