RECENT STUDIES^1-5 have found that patients with affective and anxiety disorders experience significantly more medically unexplained symptoms and use more health care compared with patients without these disorders. For example, patients with major depression have twice the number of overall health care costs compared with nondepressed patients after controlling for medical comorbidities.^2,3 Elderly patients with significant depressive symptoms have had 30% to 50% higher overall ambulatory medical care costs compared with nondepressed older individuals after controlling for medical comorbidities.⁴ Similarly, high users of medical care have had increased rates of major depression (23.5%), generalized anxiety disorder (21.8%), panic disorder (11.8%), and dysthymic disorder (16.8%).⁵ Despite the relationship between affective/anxiety disorders and health care costs, little is known about the magnitude of health care costs and use that specifically relate to posttraumatic stress disorder (PTSD).

Although the term attachment disorder is ambiguous, attachment therapies are increasingly used with children who are maltreated, particularly those in foster care or adoptive homes. Some children described as having attachment disorders show extreme disturbances. The needs of these children and their caretakers are real. How to meet their needs is less clear. A number of attachment-based treatment and parenting approaches purport to help children described as attachment disordered. Attachment therapy is a young and diverse field, and the benefits and risks of many treatments remain scientifically undetermined. Controversies have arisen about potentially harmful attachment therapy techniques used by a subset of attachment therapists. In this report, the Task Force reviews the controversy and makes recommendations for assessment, treatment, and practices. The report reflects American Professional Society on the Abuse of Children's (APSAC) position and also was endorsed by the American Psychological Association's Division 37 and the Division 37 Section on Child Maltreatment.

Researchers and institutional review boards are routinely called upon to evaluate the cost-benefit status of proposed research protocols that involve human participants. Often these assessments are based on subjective judgments in the absence of empirical data. This reliance on subjective judgments is of particular concern for studies involving clinical samples where unfounded assumptions may adversely affect research progress or clinical outcomes. The Reactions to Research Participation Questionnaire (RRPQ) was designed to address this shortcoming and to help promote ethical decision making about research practice. The present study describes development of the RRPQ and presents a series of exploratory and confirmatory analyses investigating its structure. Based on these findings, a revised version of the instrument and suggestions for future research are presented. This approach provides a foundation for scientifically informed protection of human subjects.