Episodes of anger are capable of triggering the onset of acute myocardial infarction, but aspirin may reduce this risk. A better understanding of the manner in which external events trigger the onset of acute cardiovascular events may lead to innovative preventive strategies aimed at severing the link between these external stressors and their pathological consequences.

This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.practicing professionals. In the proposals, the authors address the following topics: definitions and categories; preparing the system; self-assessment; remediation; diversity; communication across various levels of the system; confidentiality; and ethical, regulatory, and legal underpinnings. They also propose future directions for the assessment of problems in professional competence in both students and practicing psychologists.

Trainees with problems of professional competence (TPPC) are a significant phenomenon in psychology education and training. Although most faculty and students are able to identify at least one TPPC over a 5-year period (Forrest, Elman, Gizara, & Vacha-Haase, 1999), investigations have typically focused on trainers; trainees' perspectives are relatively unexplored. We used survey research to assess perspectives on TPPC from 321 trainees in counseling, clinical, school, and combined psychology programs from masters' through predoctoral internship training levels. Questions targeted (a) training on TPPC and awareness of program policies, (b) general beliefs about faculty/supervisor/peer awareness and action related to TPPC, (c) specific experience with TPPC, (d) characteristics of the experience with a TPPC, (e) impact of program dynamics, (f) faculty/supervisor/peer actions with specific TPPC instances, (g) making a decision to take action, (h) personal and systemic impact of taking action, and (i) not taking action. Results revealed that 44% of students were aware of a TPPC. Participants were confident that trainers were aware of TPPC, yet less certain that trainers would address TPPC. Similarly, participants held more confidence that their peers were aware of TPPC than they were that peers would take action. Although more than half of participants reported taking action, a majority did not draw on their training when doing so. Common action strategies included consulting with faculty/supervisors and peers, venting with peers, or approaching the TPPC. Implications for training are discussed, including attention to training related to TPPC and understanding faculty and student roles.

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Trainees with professional competency problems, also called problems of professional competence SUE C. JACOBS, Associate Professor, Training Director, and Ledbetter Lemon Endowed Diversity Professor in Counseling Psychology at Oklahoma State University earned her PhD from the University of Southern Mississippi in 1989. Her interests include issues in ethics, education and training, difficult dialogues, the teaching of psychology, older adults, health, diversity, social justice, disaster response, mindfulness and anger. STEVEN K. HUPRICH earned his PhD in clinical psychology from the University of North Carolina-Greensboro in 1999. He is an Associate