American Journal of Orthopsychiatry via MedWorm.com

Children with co-occurring anxiety and externalizing disorders: Family risks and implications for competence.

American Journal of Orthopsychiatry — Tue, 26 Jan 2010 16:56:08 +0100

This study used data from 340 mother–child dyads to examine characteristics of children with co-occurring diagnoses of anxiety and externalizing disorders and compared them with children with a sole diagnosis or no diagnosis. Comparisons were made using 4 child-diagnostic groups: anxiety-only, externalizing-only, co-occurrence, and no-problem groups. Most mothers were characterized by low income and histories of psychiatric diagnoses during the child’s lifetime. Analyses using multinomial logistic regressions found the incidence of co-occurring childhood disorders to be significantly linked with maternal affective/anxiety disorders during the child’s lifetime. In exploring implications for developmental competence, we found the co-occurrence group to have the lowest level of adaptive...

Parents’ evaluation of adoption success: A follow-up study of intercountry and domestic adoptions.

American Journal of Orthopsychiatry — Tue, 26 Jan 2010 16:56:08 +0100

Parents of 165 children adopted from Romania and 52 children adopted from within the United Kingdom rated the success of the adoptions when the children were 11 years old. As was the case at two earlier study waves, satisfaction was found to be extremely high. Both positive and negative assessments were generally stable between ages 6 and 11, although for the children who had more problems there was an increase in negative evaluation, albeit within an overall positive picture. Parents’ evaluations were somewhat more negative for this group of children; however, parents reported that having the child as part of their family was very rewarding. Negative evaluation was not directly related to age at placement, but appeared to be a reflection of the later-placed children’s higher rates of ...

Age of minority sexual orientation development and risk of childhood maltreatment and suicide attempts in women.

American Journal of Orthopsychiatry — Tue, 26 Jan 2010 16:56:08 +0100

This study investigated relationships between self-reported ages of achieving minority sexual orientation development milestones (first awareness of same-gender attractions, disclosure of a minority sexual orientation to another person, and same-gender sexual contact), and childhood maltreatment and suicide attempt experiences in a sample of 2,001 women recruited from multiple-community sources. Younger age of minority sexual orientation development milestones was positively linked to self-reported recall of childhood maltreatment experiences, and to a childhood suicide attempt. After adjusting for differences in maltreatment, the odds of suicide attempt attributable to younger age of sexual orientation development milestones was reduced by 50 to 65%, suggesting that maltreatment may accou...

Social and psychological well-being in lesbians, gay men, and bisexuals: The effects of race, gender, age, and sexual identity.

American Journal of Orthopsychiatry — Tue, 26 Jan 2010 16:56:08 +0100

Using a social stress perspective, the authors studied the mental health effects of added burden related to socially disadvantaged status (being African American or Latino, female, young, and identifying as bisexual vs. gay or lesbian) in a community sample of 396 self-identified lesbian, gay, and bisexual (LGB) adults. Mental health outcomes were social and psychological well-being contrasted with depressive symptoms. When mental health deficiencies by disadvantaged social status were detected, the authors examined whether LGB community connectedness and positive sexual identity valence played a mediating role, reducing the social status disparity in outcome. The authors found different patterns when looking at social versus psychological well-being and positive versus negative mental hea...

Social support and mental health among college students.

American Journal of Orthopsychiatry — Tue, 26 Jan 2010 16:56:08 +0100

This study is the first, to our knowledge, to evaluate the relationship between mental health and social support in a large, random sample of college students. A Web-based survey was administered at a large, public university, with 1,378 students completing the measures in this analysis (response rate = 57%). The results support our hypothesis that students with characteristics differing from most other students, such as minority race or ethnicity, international status, and low socioeconomic status, are at greater risk of social isolation. In addition, the authors found that students with lower quality social support, as measured by the Multidimensional Scale of Perceived Social Support, were more likely to experience mental health problems, including a sixfold risk of depressive symptoms ...

Emotion regulation as a mediator of the relation between emotion socialization and deliberate self-harm.

American Journal of Orthopsychiatry — Tue, 26 Jan 2010 16:56:08 +0100

This study examined (a) whether retrospective reports of specific parent responses to sadness (i.e., reward, punishment, neglect, override, magnification) were related to deliberate self-harm (DSH) and (b) whether difficulties regulating emotions (i.e., difficulties monitoring, evaluating, and modifying emotions) mediated those relations. One hundred eighteen college students completed measures of parental emotion socialization, emotion regulation difficulties, and DSH. Parental reward and override of sadness were directly related to lower DSH scores. Parental punishment and neglect of sadness were related to higher DSH scores, and these associations were mediated by difficulties evaluating emotions. In other words, parental punishment and neglect of sadness may place individuals at risk f...

Strengthening prevention performance using technology: A formative evaluation of interactive Getting To Outcomes®.

American Journal of Orthopsychiatry — Tue, 26 Jan 2010 16:56:08 +0100

This article reports on a formative evaluation within 2 states’ prevention systems of an Internet system designed to build capacity on a large scale, interactive Getting To Outcomes® (iGTO). In Tennessee, 30 coalitions were randomly assigned to receive either the iGTO system or nothing. In Missouri, 18 coalitions receiving iGTO were compared with 8 like coalitions who did not receive iGTO. The primary outcome was iGTO’s impact on the performance of the coalitions’ programs, assessed through interviews at baseline and after a year of iGTO implementation. Analyses suggest that iGTO-programs improved their performance of prevention practices over non-iGTO programs. Semi-structured interviews of iGTO users and state-level stakeholders showed that iGTO was adopted by most iGTO-assigned c...

Intimate partner and general aggression perpetration among combat veterans presenting to a posttraumatic stress disorder clinic.

American Journal of Orthopsychiatry — Tue, 26 Jan 2010 16:56:08 +0100

This study examined rates and correlates of intimate partner and general aggression perpetration among 236 male combat veterans seeking services in a Veteran’s Affairs posttraumatic stress disorder (PTSD) clinic. Approximately 33% of those in an intimate relationship reported perpetrating partner physical aggression in the previous year, and 91% reported partner psychological aggression. Comparable rates were found for general aggression perpetration among partnered and nonpartnered veterans. PTSD symptoms as well as symptoms of depression were associated with aggression across subgroups and forms of aggression, and PTSD symptoms reflecting arousal and lack of control were generally the strongest predictor of aggression. Findings indicate a need for additional aggression screening and in...

Revising the personality disorder diagnostic criteria for the Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (DSM-V): Consider the later life context.

American Journal of Orthopsychiatry — Tue, 26 Jan 2010 16:56:08 +0100

Discrepant feeling rules and unscripted emotion work: Women coping with termination for fetal anomaly.

American Journal of Orthopsychiatry — Tue, 26 Jan 2010 16:56:07 +0100

The sociology of emotion is rapidly evolving and has implications for medical settings. Advancing medical technologies create new contexts for decision-making and emotional reaction that are framed by “feeling rules.” Feeling rules guide not only behavior, but also how one believes one should feel, thereby causing one to attempt to bring one’s authentic feelings into line with perceived feeling rules. Using qualitative data, the theoretical existence of feeling rules in pregnancy and prenatal testing is confirmed. Further examination extends this analysis: at times of technological development feeling rules are often discrepant, leaving patients with unscripted emotion work. Data from a study of women who interrupted anomalous pregnancies indicate that feeling rules are unclear when ...

Obituary: Jane Knitzer (1941–2009).

American Journal of Orthopsychiatry — Tue, 26 Jan 2010 16:56:07 +0100

Presents an obituary for Jane Knitzer. Knitzer obtained her degrees from Wellesley College and Harvard University, and received a postdoctoral fellowship from the National Institute of Mental Health. This was followed by an assistant professorship in the Department of Human Development and Family Studies at the College of Human Ecology at Cornell University, and then a position as a senior policy specialist with the Children’s Defense Fund. During this time, she wrote several landmark documents in child policy that had a tremendous impact on the field of children’s mental health. She was the founding director of the Institute for Child and Youth Policy Studies as part of Statewide Youth Advocacy and also an adjunct professor at the Graduate School of Education and Human Development at ...

The American Journal of Orthopsychiatry: Proud tradition, promising future.

American Journal of Orthopsychiatry — Tue, 26 Jan 2010 16:56:05 +0100

Since 1930, the American Journal of Orthopsychiatry (AJO) has been the flagship journal of the American Orthopsychiatric Association and today continues to foster development of interdisciplinary theory and research designed to inform practice and policy advocacy. This transitional editorial expresses appreciation to contributors, highlights issues and activities of the journal, and passes the torch to the new editors. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Another breed of “service” animals: STARS study findings about pet ownership and recovery from serious mental illness.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:43 +0100

This study elucidates the role of pets in recovery processes among adults with serious mental illness. Data derive from interviews with 177 HMO members with serious mental illness (52.2% women, average age 48.8 years) in the Study of Transitions and Recovery Strategies (STARS). Interviews and questionnaires addressed factors affecting recovery processes and included questions about pet ownership. Data were analyzed using a modified grounded theory method to identify the roles pets play in the recovery process. Primary themes indicate pets assist individuals in recovery from serious mental illness by (a) providing empathy and “therapy”; (b) providing connections that can assist in redeveloping social avenues; (c) serving as “family” in the absence of or in addition to human family m...

Factors associated with the adjustment of foster children in the Netherlands.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:43 +0100

Information obtained from 419 case files was used to investigate the associations between the foster child’s adjustment to the foster family and factors in the histories of the child and the parents, as well as factors in the relationship between foster children and their biological parents while they are placed in foster care. Problems in the foster child’s prior history, particularly attachment disorders and the experience of replacements, affect the extent of adjustment to the foster family. In-home visits by the child and the absence of parental permission to stay with the foster family are two factors related to the parent–child relationship that impeded adjustment. In general, parental problem factors did not affect adjustment. The fact that many foster children come from probl...

Peer sexual harassment victimization at school: The roles of student characteristics, cultural affiliation, and school factors.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:43 +0100

This study examines the links between students’ reports of sexual harassment victimization by peers and a number of individual and school contextual factors. It is based on a nationally representative sample of 16,604 students in Grades 7 through 11 in 327 schools across Israel who completed questionnaires during class. Hierarchical Linear Modeling was used to examine the links. Overall, approximately one in four students (25.6%) were victims of at least one unwanted and unwelcome act of harassment by peers (such as being touched or pinched in sexual manner) in the prior month. The most vulnerable groups were Israeli-Arab boys and students with negative perceptions of their school climate. The school correlates associated with higher levels of victimization were a higher share of student...

Traumatic events involving friends and family members in a sample of African American early adolescents.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:43 +0100

This study found that violent and nonviolent traumatic events were pervasive in the lives of these urban youth, and that they were as likely to report loss and injury of a close other through an accident as an act of violence. There were strong gender differences in the data. Unexpectedly, injury or loss of a close friend or family member from nonviolent events, but not from violent events, predicted PTSD, internalizing, and depression for boys. The results are discussed in terms of their implications for school-based universal interventions in communities where large numbers of children live with loss and trauma. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Sociocultural disadvantage, traumatic life events, and psychiatric symptoms in preadolescent children.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:43 +0100

Previous research has demonstrated impact of psychosocial adversity on the mental health of children. This cross-sectional study examined specific influences of psychosocial adversity on internalizing versus externalizing symptoms, as explained by relative neighborhood disadvantage, sociocultural disadvantage, and exposure to interpersonal and non-interpersonal traumatic life events. Participants included 258 children aged 6 to 12 years from two Swedish elementary schools located in two socioeconomically distinct neighborhood settings. Information was obtained from their parents by means of questionnaires (a demographic form including information about parental occupation and country of origin, the Strengths and Difficulties Questionnaire and the Life Incidence of Traumatic Events checklis...

Thriving as becoming resolute in narratives of women surviving childhood maltreatment.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:43 +0100

This study offers a new understanding of the experience of women gaining solid footing in their lives, the peace of knowing the abuse is over, and power to move in an upward trajectory. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Conducting filial therapy with homeless parents.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:43 +0100

This article’s purpose is to (a) educate clinicians about the psychological complexities of homelessness with parents and their children and (b) highlight the benefits of using filial therapy as an evidence-based intervention with this population. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Parenting adults who become homeless: Variations in stress and social support.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:43 +0100

This article focuses on the stressors of parenting an adult child who experiences homelessness. Parents whose adult children become homeless may provide support to this child, but they may also subsequently experience stress and require social support themselves. Findings from this study support the hypothesis that parents who spend more time or money helping their homeless adult offspring experience higher levels of stress. Results also show higher levels of stress among parents who helped with activities of daily living and among parents who worked to prevent harm involving their adult homeless offspring. Among 37 respondents, a majority of whom were African American mothers parenting homeless sons, parents who engaged in activities to prevent harm and parents who experienced stress from...

Effects of social support and conflict on parenting among homeless mothers.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:43 +0100

This study examined the impact of conflict and social support on parenting behaviors in a sample of mothers who are homeless and were involved in a study of case management interventions of varying intensity. We found that women who reported high emotional and instrumental social support self-reported greater improvements in parenting consistency over time than those who reported lower levels of support. However, three-way interactions showed that conflict in support networks was a risk factor for harsh parenting practices among participants who reported lower levels of instrumental social support. Results suggest that social support may enhance homeless mothers’ ability to provide consistent parenting, but that these benefits may be undermined if conflict occurs in combination with limi...

Parenting, parental mental health, and child functioning in families residing in supportive housing.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:43 +0100

Long-term homelessness is associated with other psychosocial risk factors (e.g., adult mental illness, substance abuse, and exposure to violence). All of these factors are associated with impairments in parenting effectiveness and child adjustment, but there are very limited data investigating parenting among families who are homeless and highly mobile. In particular, there is no literature examining the relationships among observed parenting, parental mental health, and child adjustment in a supportive housing sample. Data are reported from a multimethod study of 200 children in 127 families residing in supportive housing agencies in a large metro area. Observed parenting and parents’ mental health symptoms directly affected children’s adjustment. The influence of parenting self-effic...

Examining the impact of parental risk on family functioning among homeless and housed families.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:42 +0100

The present study used data from 132 families that were homeless and a comparison group of 434 housed families in order to compare family functioning across the two groups. Family functioning was assessed by family support workers when the families sought help from one of seven family service agencies in Washington, DC. Multiple regression models showed that there were few differences between homeless and housed families; a difference that did emerge showed that homeless families fared better than housed families in terms of children’s developmental stimulation. However, when considering the compounding effects of additional family risk factors, adverse effects of homelessness were observed. As compared with housed families, homeless families with a history of parental mental illness had...

What research tells us about the intersecting streams of homelessness and foster care.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:42 +0100

This paper reviews mounting evidence linking foster care and homelessness and considers new approaches for intervention. Although there is no causal evidence that family homelessness leads to foster care or vice versa, the association no longer originates solely from samples of homeless people, but also from samples of people with childhood histories of foster care. Many programs work with families, children or youth based on their current living situations and limits imposed by funders. This results in discontinued services when the living situations change. Given the strong and consistent associations between homelessness and foster care, a better approach is to design programs that work with transient families regardless of their living situation. Parenting is key. Whether the parents a...

Parent-adolescent violence and later behavioral health problems among homeless and housed youth.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:42 +0100

Parent-adolescent violence (i.e., violence between parents and adolescents) is an important pathway to homelessness and predicts poor behavioral health outcomes among youth. However, few studies have examined links between parent violence and outcomes among youth who are homeless. Existing research has also tended to ignore adolescent violence toward parents, despite evidence that mutual violence is common. The current study examines prospective links of parent-adolescent violence to outcomes among youth who were homeless and demographically matched youth, through two complementary substudies: (a) an exploratory factor analysis (EFA) of items measuring parent and adolescent violence combined in the same analysis; and (b) an examination of predictive relationships between the factors identi...

Commentary: A provider perspective on supporting parents who are homeless.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:42 +0100

The author, a Pediatric Nurse Practitioner and member of the Mercy Children’s Health Outreach Project, an expansion program of Baltimore Health Care for the Homeless, works with families who are homeless. Her team consists of three pediatric nurse practitioners, a social worker, an arts program coordinator, and volunteers. They make weekly visits to eight sites, including emergency family shelters, transitional housing, a therapeutic daycare center, and a day drop-in center. The team provides medical and behavioral health care to children who are homeless and assists with educational issues. In this article, the author shares her experience with two families their team met at emergency shelters, one several years ago, and one recently. She suggests that interventions for families should ...

Commentary: A consumer perspective on parenting while homeless.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:42 +0100

The author describes her experiences of domestic violence, homelessness, and the services and programs she was forced to rely upon. She and her young daughter went in and out of temporary housing programs. At one point she was hospitalized, and her daughter was put into foster care, until her family was located. When she got better, she had to prove that she was a worthy parent to the Department of Social Services. She and her daughter are currently on the road to recovery. They were fortunate to have met some compassionate social workers, service providers who went above and beyond, her caring family doctor, and others in the field who respected her drive to achieve and move past the trauma she experienced. They helped her turn her tragedies into empowerment and healing. She gained respec...

Parenting and homelessness: Overview and introduction to the special section.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:42 +0100

This overview of parenting and homelessness includes the characteristics and needs of families who are homeless, with a focus on the unique challenges faced by mothers, fathers, and children. In addition, the authors discuss how homeless families are narrowly defined based on the family members who present at shelters and other service programs. In order to fully support parents and their children as they exit homelessness, homeless service programs should consider the broader context of the nontraditional family system and support networks. The overview also includes common challenges to parenting while homeless, a summary of the articles in the Special Section, and recommendations for research, practice, and policy. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: Am...

Special section on parenting and homelessness.

American Journal of Orthopsychiatry — Thu, 22 Oct 2009 15:43:42 +0100

The authors recognize those who supported the development of the special section on parenting and homelessness appearing in the current issue of American Journal of Orthopsychiatry., including the Substance Abuse and Mental Health Services Administration; the Journal's staff; and the Homeless Programs Branch, Division of Service and Systems Improvement, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, which provided funding. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Contrasting concepts of depression in Uganda: Implications for service delivery in a multicultural context.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:06:37 +0100

Depression is a rising public health concern worldwide. Understanding how people conceptualize depression within and across cultures is crucial to effective treatment in a global environment. In this article, we highlight the importance of considering both lay and professional perspectives when developing a culturally competent and contextually relevant model for service delivery. We conducted interviews with 246 Ugandan adults to elicit their explanatory belief models (EMs) about the nature of depression, its causes, social meanings, effects, help seeking, and treatment. Interviews were transcribed, content analyzed, and coded. We compared EMs of community members (n = 135) to those of professional practitioners (n = 111), whom we further categorized into traditional healers, primary care...

Stigma and self-concept among adolescents receiving mental health treatment.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:06:30 +0100

Although studies indicate that adolescents diagnosed with mental disorders are stigmatized by the American public, we know very little about the extent to which stigma is experienced by these youth and its effects on their well-being. This cross-sectional study utilizes interviews with 60 adolescents treated in a wraparound program to examine: (a) the extent to which adolescents diagnosed and treated for psychiatric disorders experience mental illness stigma and cope by using secrecy, (b) the extent to which stigmatization is associated with self-concept (self-esteem, mastery, future outlook) and morale (depression), and (c) which clinical and demographic characteristics are associated with perceived stigma. A secondary purpose was to explore the usefulness with adolescents of stigma measu...

Using the People of Color Racial Identity Attitude Scale among Asian American college students: An exploratory factor analysis.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:06:24 +0100

In this study, an exploratory factor analysis of the People of Color Racial Identity Attitude Scale (PRIAS; Helms, 1995b) among a sample of Asian American college students (N = 225) was conducted. The factorial structure that emerged revealed mixed results in terms of consistency with the People of Color (POC) theory (Helms, 1995a). The measure’s construct validity for Asian Americans may be improved through further scale development and revision. Directions for future research on the PRIAS are discussed. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

School-age adopted Chinese girls’ behavioral adjustment, academic performance, and social skills: Longitudinal results.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:06:20 +0100

Longitudinal data on 177 school-age adopted Chinese girls (Time 1: mean age = 8.92 years, SD = 1.76; Time 2: mean age = 11.18 years, SD = 1.79) were analyzed to determine their long-term outcomes in behavioral adjustment, academic performance (measured with the Child Behavior Checklist/6–18), and social skills (measured with the Social Skills Rating System) and how these outcomes were related to preadoption adversity. More than 90% of the girls were adopted at 24 months or younger (M = 19.25, SD = 21.67). Results revealed that over a 2-year period, there was a moderate to strong stability in the children’s behavioral adjustment and academic performance. However, there was a significant increase in the number of children with deviant internalizing problems. At both times, higher degrees...

Coming in: An examination of people with co-occurring substance use and serious mental illness exiting chronic homelessness.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:06:09 +0100

Despite national efforts, the number of people who are chronically homeless in our cities remains high. People with serious mental illness and substance abuse problems continue to represent the majority of those experiencing long-term homelessness. Traditional shelters have difficulty engaging and addressing the needs of this group; however, there are an increasing number of alternative models, including the Safe Haven shelter program, developed to better meet their needs. In this article, the authors examine responses from 28 qualitative interviews conducted with 16 residents of a Safe Haven shelter serving chronically homeless people, at 3 and 9 months after entry. All had a severe mental illness and were actively substance abusing. The importance of a model that respects personhood, a p...

Predictors of residential placement following a psychiatric crisis episode among children and youth in state custody.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:05:59 +0100

This study examined the extent and correlates of entry into residential care among 603 children and youth in state custody who were referred to psychiatric crisis services. Overall, 27% of the sample was placed in residential care within 12 months after their 1st psychiatric crisis screening. Among the children and youth placed in residential care, 51% were so placed within 3 months of their 1st crisis screening, with an additional 22% placed between 3 and 6 months after screening. Risk behavior and functioning, psychiatric hospitalization following screening, older age, placement type, and caregiver’s capacity for supervision were associated with increased residential placement. The findings highlight the importance of early identification and treatment of behavior and functioning probl...

Measuring mental health following traumatization: Psychometric analysis of the Kuwait Raha Scale using a random national household data set.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:05:40 +0100

The authors report on the psychometric properties of the Kuwait Raha Scale (KRS), a measure developed to assess well-being among Kuwaitis. Specific aims of the study were to (a) evaluate competing models of the latent structure of the KRS using exploratory factor analysis and identify the best model, (b) compare the model developed from a nationally representative sample with the initial model reported with Kuwaiti undergraduate students, and (c) assess the discriminant validity of the KRS with the General Health Questionnaire (GHQ). Factor analysis suggested that a 5-factor model best suited the data, whereas the development of the KRS indicated a 4-factor model. Differences in the latent structure found between the current study and the original examination of the KRS factor structure ma...

Posttraumatic stress symptoms in children after Hurricane Katrina: Predicting the need for mental health services.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:05:28 +0100

This study included 7,258 children and adolescents from heavily affected Louisiana parishes. Measures included the Hurricane Assessment and Referral Tool for Children and Adolescents developed by the National Child Traumatic Stress Network (NCTSN, 2005). Results were generally supportive of our hypotheses, and specific exposure and demographic variables were found to be strongly related to posttraumatic stress symptoms in children and adolescents. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

The Lost Boys of Sudan: Coping with ambiguous loss and separation from parents.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:05:12 +0100

The Lost Boys of Sudan were separated from their families by civil war and subsequently lived in three other countries—Ethiopia, Kenya, and the United States. In-depth interviews were conducted with 10 refugees about their experiences of separation from parents and ambiguous loss, and the coping strategies the youth used when they did not know if other members of their family were dead or alive. All of the youth reported using both emotion-focused and problem-focused coping strategies. The youth also discussed the importance of support from peers and elders while they lived in the refugee camps. In addition, they reflected on the psychological presence of parents who were physically absent, and the important role that hope of being reunited with parents played as they struggled with surv...

Too close for comfort: Inadequate boundaries with parents and individuation in late adolescent girls.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:04:52 +0100

This longitudinal study examined the ramifications of psychological control–guilt induction, parentification, triangulation, and blurring in parent–adolescent relationships for girls’ individuation and adjustment. The study followed 120 girls in their transition from high school to military service. Results from the variable-centered and person-centered analyses merged in underscoring the somewhat different developmental path of two groups of inadequate boundary constellations. The group with high guilt induction and psychological control, which involves rejection and invalidation of the child’s autonomous self, evinced the worst coping and adjustment to the transition and the lowest level of individuation with a combination of angry entanglement and strivings for overindependence....

Mediating pathways explaining psychosocial functioning and revictimization as sequelae of parental violence among adolescent mothers.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:04:38 +0100

This study used structural equation modeling to investigate mediators of the effects of parental child abuse on later psychosocial functioning and revictimization (in the form of intimate partner violence and sexual violence) among adolescent mothers, with longitudinal data spanning 2.4 years. On psychological distress in the final time period, parental physical child abuse had an early and then maintained effect but also effects mediated by earlier psychological distress and revictimization. Psychological distress rather than substance use appeared as the primary psychosocial factor mediating the effects of parental violence on both future distress and revictimization. For prevention of further psychosocial impairment and revictimization, these findings indicate the need for early interve...

Women’s perspective on men’s control and aggression in intimate relationships.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:04:25 +0100

The relationship of men’s self-control capability; their need to control their wives; and their use of verbal aggression, threats, and physical forms of aggression against their partners, as reported by women, were examined. Data were obtained from a stratified probability sample of 2,544 women drawn from the general population in Israel. Initially, structural equation modeling analysis showed that (a) men’s need to control their partners and their ability to control themselves were negatively related, and were 2 aspects of personal control; (b) men’s verbal aggression, threats of physical aggression and actual physical aggression toward their partners were closely related, and were 3 aspects of aggressive behavior; (c) personal control and aggressive behavior were closely related. N...

When oppression is the pathogen: The participatory development of socially just mental health practice.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:04:17 +0100

Social justice perspectives have revealed the ways that racist, sexist, heterosexist and classist assumptions are embedded within conventional mental health theory and practice. Moreover, recent research has explored the pathogenic influence of structural oppression on the emotional well-being of people impacted by it. How can practitioners develop socially just interventions in keeping with these findings, especially with regard to their practice with clients from oppressed groups? In addressing this question, the authors propose the participatory development of socially just mental health practice and provide three examples of their community-based work. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Socioeconomic status in the treatment of depression.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:04:11 +0100

This study examined outcomes and attrition across three treatments for depression in relation to socioeconomic status (SES). The study was based on data available from the Treatment of Depression Collaborative Research Program (TDCRP) of the National Institute of Mental Health (NIMH; Elkin, 1994), a multisite collaborative study that examined the effectiveness of two forms of psychotherapy, cognitive behavior therapy and interpersonal psychotherapy, and pharmacotherapy. Results indicated that lower SES, measured by the Hollingshead Index of Social Position, was associated with less improvement across all three treatments for depression. The effect of SES on outcome did not differ by treatment modality. Contrary to expectations, SES was not associated with attrition. These findings suggest ...

Profane research versus researching the profane: Commentary on Basoglu (2009).

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:04:11 +0100

Torture survivors, therapists, and society look to behavioral science for help understanding the traumatization, needs, and treatment of torture survivors. Any research of torture can and possibly will be used by torturers to refine their abuse of prisoners. It is difficult but necessary to discern profane research from therapeutic research of a profane activity. M. Basoglu’s (2009) study of the traumatization of torture survivors is enormously helpful to clinicians who must heal and to policymakers who must understand the psychological toll of torture. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

A multivariate contextual analysis of torture and cruel, inhuman, and degrading treatments: Implications for an evidence-based definition of torture.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:04:09 +0100

Current thinking on what constitutes torture in a detention/interrogation setting focuses solely on particular procedures, without regard for contextual factors that mediate traumatic stress. The present study examined stressor interactions that determined severity and psychological impact of captivity stressors in 432 torture survivors in former Yugoslavia countries and Turkey. A principal components analysis of 46 captivity stressors measured by an Exposure to Torture Scale identified meaningful stressor clusters, which suggested that multiple detention procedures were used in combination to maximize their impact. Perceived torture severity related to ’cruel, inhuman, and degrading’ treatments (CIDT) but not to physical torture. Posttraumatic stress disorder related to war-related ca...

Speaking up about the unspeakable.

American Journal of Orthopsychiatry — Sat, 06 Jun 2009 05:04:08 +0100

Torture, an ugly word for an ugly act, evokes in most of us unpleasant visceral reactions. It would be comforting to relegate torture to a less enlightened past and believe that it is a phenomenon that civilized humans have moved past. However, although we may escape to comfortable corners of our mind to avoid the topic, torture does not go away. It has never gone away and until it does, it is a topic that demands our attention. This editorial introduces the article in this issue by Metin Basoglu on torture, as well as a commentary by Steven Miles. Basoglu has devoted his professional career to shedding light on, and scrutinizing, the acts and consequences of torture. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Cultural influences on help-seeking attitudes in Asian American students.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

There is considerable evidence indicating that Asian American college students have less favorable attitudes toward and are less likely to use mental health services than other ethnic groups in the United States. Because a person's attitudes are often strongly associated with their voluntary behaviors, understanding what influences help-seeking attitudes may help shed light on why Asian American college students refrain from seeking mental health treatment. Andersen's Sociobehavioral Model is commonly used as a guide to understand help-seeking in the mainstream population. A modified version of this model that includes culture-related variables (i.e., level of acculturation and stigma tolerance) was used to guide this study. Results indicated that stigma tolerance predicted help-seeking at...

Attributions to discrimination and depression among Latino/as: The mediating role of competence.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

The present study examined the role of attributions to discrimination and competence in predicting depression among a sample of 93 Latino/a adults. The major findings showed that attributions to discrimination were related to decreases in both general competence and intercultural competence, which were in turn associated with increases in depressive symptoms. This pattern of results suggests that general and intercultural competence partially mediated the relationship between attributions to discrimination and depression. The findings are discussed within the context of the cultural adaptation process and factors that ameliorate Latino/a mental health. In addition, theoretical and practical implications are outlined along with areas of future research. (PsycINFO Database Record (c) 2009 AP...

Lesbian and heterosexual preadoptive couples' openness to transracial adoption.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

This study uses data from 147 White preadoptive couples (54 lesbian, 93 heterosexual) to examine adopters' subjective explanations for why they are open or not open to adopting transracially. Participant perceptions of racial-ethnic diversity in their communities and families, perceptions of family support or nonsupport, and attitudes about race were among the factors they cited as influencing their openness. These findings hold important implications for training and service delivery in transracial adoption. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Female adoptees' perceptions of contact with their birth fathers: Satisfactions and dissatisfactions with the process.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

Qualitative data were analyzed to identify factors associated with adoptees' satisfactions or dissatisfactions in their contact experiences with their birth fathers. Participants were 17 women who had been adopted prior to 2 years of age and had subsequently met their birth fathers. All women completed a questionnaire and 7 also took part in a semistructured interview. Four main themes were identified that affected satisfaction with contact: birth fathers' attributes and behavior, adoptees' attributes (e.g., expectations), behavior of others (e.g., birth mother, birth father's family, and adoptive parents), and circumstances of the conception and relinquishment. The implications of these findings for members of the adoption triangle and those providing postadoption services are discussed. ...

Non-suicidal self-injury and eating pathology in high school students.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

Although past research has explored self-injurious behaviors and disordered eating among adults in clinical settings, little research has been conducted examining nonsuicidal self-injury (NSSI) and eating pathology in community samples of adolescents. Four hundred and 40 students were screened for the presence of NSSI; a prevalence rate of 13.9% was found. Those who indicated that they engaged in NSSI (n = 59) and a comparison group of non-self-injurers (n = 57) completed the Eating Disorders Inventory. Results indicate that students who engage in NSSI display significantly more eating pathology than their non-NSSI peers, including poor interoceptive awareness; difficulties with impulse regulation; an increased sense of ineffectiveness, distrust, and social insecurity; and increased bulimi...

Victimization, anger, and gender: Low anger and passive responses work.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

This study examined the contributions of gender, anger, expectations of positive outcomes, and frequency of victimization by and bullying of peers among school-aged children to predict individual differences in intentions to respond to provocative events with nonassertive behavior. Children between the ages of 9 and 13 (N = 505, 246 female, 259 male) completed the Anger Response Inventory, Child Version (Tangney et al., 1996) and measures of victimization and bullying. Results of regression procedures demonstrated that female gender and low anger predicted ignoring and using distraction. Nonassertive responses, low anger, and low victimization predicted expecting more positive outcomes following provocation. Victimization was unrelated to intentions to use nonassertive responses but bullyi...

Cocaine-exposed infant behavior during Still-Face: Risk factor analyses.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

Prenatal cocaine exposure and the role of gender were evaluated using risk factor analyses to determine whether 6-month-old cocaine-exposed male infants demonstrated greater disruptions in infant–caregiver socioemotional interactions during a Still-Face test. Overall, non–cocaine-exposed infants spent more time looking at toys, compared with cocaine-exposed infants; nonexposed female infants spent more time scanning the environment, compared with nonexposed male infants. When caregiver behavior during the Still-Face was evaluated, differences emerged in amount of time the caregiver spent vocalizing to the infant. She vocalized more to a cocaine-exposed infant compared with a nonexposed one; she reduced vocalizing more during the test if the cocaine-exposed infant was female. An exposur...

The longitudinal impact of HIV+ parents' drug use on their adolescent children.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

The impact of parental substance use on the emotional and behavioral adjustment of their adolescent children was examined over 5 years. A representative sample of 220 parents with HIV (PWH) and 330 adolescent children in New York City were repeatedly assessed. Some parents never used marijuana or hard drugs over the 5 years (nonusers). Among those who were users, substance use varied over time. PWH who used substances during a specific 3-month period were classified as active users and those who abstained from substance use were classified as inactive users. Longitudinal regression analyses were used to analyze the impact of variations in patterns of substance use over time on their adolescent children's emotional adjustment and behavioral problems. PWH relapse exacerbated adolescent subst...

Paternal and maternal influences on problem behaviors among homeless and runaway youth.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

Using an Attachment Theory conceptual framework, associations were investigated among positive paternal and maternal relationships, and recent problem behaviors among 501 currently homeless and runaway adolescents (253 males, 248 females). Homeless and runaway youth commonly exhibit problem behaviors such as substance use, various forms of delinquency and risky sex behaviors, and report more emotional distress than typical adolescents. Furthermore, attachments to their families are often strained. In structural equation models, positive paternal relationships significantly predicted less substance use and less criminal behavior, whereas maternal relationships did not have a significant effect on or association with either behavior. Positive maternal relationships predicted less survival se...

Psychiatric disorders in property, violent, and versatile offending detained male adolescents.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

This study examines the past year prevalence rate of psychiatric disorders in detained male adolescents and the relation between psychiatric disorders and type of offending. The Diagnostic Interview Schedule for Children (DISC-IV) was administered in a sample (N = 245) of male detained adolescents aged 12 to 17 years. Based on lifetime official criminal history, participants were classified into property, violent, and versatile subgroups. High rates of psychiatric disorders were found in all groups. In addition, property offenders reported significantly higher rates of depression, disruptive behavior disorders, substance use disorders and comorbidity than violent and versatile offenders. Overall, versatile offenders did not differ from violent offenders, with the exception of more marijuan...

Self-regulation and its relations to adaptive functioning in low income youths.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

This study indicates that self-regulation is robustly associated with a range of important indices of adaptive functioning across many domains. Findings are discussed in light of their implications for theory and intervention for children of diverse economic backgrounds. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Beyond point and level systems: Moving toward child-centered programming.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

Many residential treatment facilities and child inpatient units in the United States have been structured by way of motivational programming such as the point and/or level systems. On the surface, they appear to be a straightforward contingency management tool that is based on social learning theory and operant principles. In this article, the authors argue that the assumptions upon which point and level systems are based do not hold up to close empirical scrutiny or theoretical validity, and that point and level system programming is actually counterproductive with some children, and at times can precipitate dangerous clinical situations, such as seclusion and restraint. In this article, the authors critique point and level system programming and assert that continuing such programming is...

The influence of religious participation on the adjustment of female inmates.

American Journal of Orthopsychiatry — Mon, 16 Mar 2009 05:00:00 +0100

Incarcerated women at a state correctional facility (N = 213) participated in a study of the relationship between stress, adjustment, institutional misconduct, and degree of personal support derived from religious participation. A series of multivariate analyses of variance investigated differences on adjustment indicators between four groups of inmates who differed on their self-reported support from religious activities, while controlling for self-reported support for other institutional activities. Inmates who received high-level support from participation in religious activities reported significantly less depression, recounted perpetrating fewer aggressive acts, and committed fewer serious institutional infractions than those who did not attend religious activities as well as those wh...

Relationship of stigma to HIV risk among women with mental illness.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

This study tests the relationship between perceived stigma and HIV risk behaviors among women with SMI. The authors interviewed 92 women attending community mental health programs using the Stigma of Psychiatric Illness and Sexuality Among Women Questionnaire. There were significant relationships between personal experiences of mental illness and substance use accompanying sexual intercourse; perceived ethnic stigma and having a riskier partner type; and experiences of discrimination and having a casual or sex-exchange partner. Higher scores on relationship stigma were associated with a greater number of sexual risk behaviors. The findings underscore the importance of exploring how stigma attached to mental illness intersects with other stigmatized labels to produce unique configurations o...

The association between timely outpatient visits and the likelihood of rehospitalization for schizophrenia patients.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

This study aims to examine the association between the frequency of timely outpatient visits and the likelihood of early rehospitalization in schizophrenia patients. After adjusting for gender, age, substance use, and length of stay, patients failing to attend any outpatient appointments within 2 months after discharge had significantly higher rehospitalization rates than those attending at least 1 appointment. Thus, timely outpatient visits, shortly after discharge, may be associated with a decreased risk of rehospitalizations. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

How expressions of forgiveness, purpose, and religiosity relate to emotional intelligence and self-concept in urban fifth-grade students.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

This study investigated how the tendency to express forgiveness, purpose, and religiosity in a free-response essay relates to emotional intelligence and self-concept in 89 5th-graders (mean age = 10.84 years) from an urban public school district in New Jersey. Readers coded essays for expressions of forgiveness, purpose, and religiosity using originally developed rubrics. These data were compared with self-reports on scales of emotional intelligence and self-concept. It was hypothesized that expressions of the predictor variables would correlate positively with emotional intelligence and self-concept. In contrast to expressions of purpose, which were common among students, expressions of forgiveness and religiosity were infrequent. Furthermore, forgiveness was not significantly related to ...

Identity development and psychological well-being in Korean-born adoptees in the U.S.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

Because adult Korean-born adoptees have unique experiences, the factors that contribute to their psychological well-being need to be studied separately from both Caucasian and Korean Americans. In this Internet-based study with 83 adult Korean-born adoptees in the United States, both ethnic identity and adjustment to adoption (considered a component of adoptive identity) were expected to predict psychological well-being. Results supported predictions: Each measure of psychological well-being (personal growth, self-acceptance, and positive relationships with others) was affected by the predictive variables in unique ways. Cultural socialization experiences also were related to personal growth, but this association was fully mediated by strength of ethnic identity. Implications for adoptive ...

"I used to dream of lupus as some sort of creature": Chronic illness as an internal object.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

This study examines the place occupied by chronic illness in the inner lives of 15 women suffering from Systemic Lupus Erythematosus (SLE). A phenomenological analysis of illness narratives demonstrates that sufferers construe their illness as a protagonist or, using an object-relations informed perspective, as an internal object. That is, with time sufferers constituted a mental representation of SLE that in itself has the power to influence the sufferers' affective states and behaviors. An insight into these "illness relations" is conducive to a better understanding of the "lived experience" of SLE for disabled, economically disadvantaged women. Through their experience, the study of risk and resilience in chronic illness may be advanced. (PsycINFO Database Record (c) 2009 APA, all right...

Working with families in Assertive Community Treatment (ACT): The case manager's perspective.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

In response to research findings of insufficient family involvement in mental health services for people with severe mental illness, this grounded theory study examines case managers' interactions with families of clients in Assertive Community Treatment (ACT). Findings suggest that case managers conceptualize families as sources of social connections, rather than sources of care, for clients. This conceptualization is influenced by case managers' goals, which also guide their assessments of families for involvement in treatment in terms of the extent to which families help attain treatment goals. In developing strategies to work with families, case managers engage in ongoing assessments and consider client permission for family involvement in treatment, family availability to clients, and...

Tics, twitches, tales: The experiences of Gilles de la Tourette's syndrome.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

Gilles de la Tourette's syndrome (GTS) is well described and although many clinicians are aware of the condition, misunderstandings about the disorder still persist. There have been few accounts of the experiences of people with GTS, and none from affected medical practitioners. The first personal account in the medical literature was over 25 years ago. This is the first personal account of having GTS written by a practicing physician. The sensation of having a tic is a peculiar one and is difficult to describe to those who have not experienced them for themselves. Tics are distinctly voluntary, though not wanted. The desire to tic stems from the relief of a physical sensation (that is distinct from a conventional somatic sensation) that builds up prior to the tic and is relieved by it. Ho...

Deliberate self-harm and alcohol involvement in college-aged females: A controlled comparison in a nonclinical sample.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

This study compared individuals who have engaged in deliberate self-harm to controls on a range of alcohol measures. Five hundred females completed questionnaires assessing deliberate self-harm and alcohol involvement. Controlling for differences in psychopathology and impulsivity, the DSH group did not differ from the controls relative to quantity and frequency of alcohol use but did differ relative to negative consequences, risky behaviors, and alcohol expectancies. The authors discuss mechanisms that account for increased negative consequences and expectancies of alcohol consumption in the absence of differences in quantity and frequency, as well as the clinical importance of assessing a broad spectrum of alcohol involvement in the DSH population. (PsycINFO Database Record (c) 2009 APA,...

Psychiatric symptom patterns, proximal risk factors, and sexual risk behaviors among youth in outpatient substance abuse treatment.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

The purpose of the current study was to classify adolescents receiving outpatient treatment for alcohol or other drug (AOD) problems via self-reports of the Diagnostic and Statistical Manual of Mental Disorders (4th ed. American Psychiatric Association, 1994) psychiatric symptoms, and to identify group differences in measures of proximal risk factors for sexual risk behaviors (SRBs) and self-reported SRBs. Structured interviews were administered to 300 adolescent clients (202 males, 98 females; M = 16.22 years; SD = 1.13) receiving treatment services as part of a larger National Institute on Alcohol Abuse and Alcoholism (NIAAA)-funded randomized clinical trial. Ward's method cluster analysis (Ward, 1963) was used to classify adolescents into distinct groups based on psychiatric symptom pro...

Acute stress responses: A review and synthesis of ASD, ASR, and CSR.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

This article critically compares the diagnostic criteria of acute stress disorder (ASD), acute stress reaction (ASR), and CSR. Prospective studies concerning the predictive value of ASD, ASR, and CSR are reviewed. Questions, recommendations, and implications for clinical practice are raised concerning the completeness of the current acute stress response diagnoses, the heterogeneity of different stressors, the scope of expected outcomes, and the importance of decline in function as an indicator of future psychological, psychiatric, and somatic distress. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

The role of socioeconomic status in helpseeking from hotlines, shelters, and police among a national sample of women experiencing intimate partner violence.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

This study used a national sample of 1,077 women who had experienced IPV to explore the role of income and education in helpseeking from hotlines, shelters, and police. The authors found that SES did not play a large role in the use of hotlines, the least often used service in this study. Women with more income were less likely to use shelters and were less likely to feel they should have used them. There was an interaction between income and severity of violence in predicting police use, such that severity of violence only predicted calling police among higher income women. This finding suggests the possibility of a lower threshold for reporting violence among the lowest income women. The authors discuss the need for research using a more diverse sample of women, and the need to fine tune...

Examining the sexual offenses of female juveniles: The relevance of childhood maltreatment.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

This study examines data from the case histories of 118 female juvenile sex offenders. In contrast to portrayals in previous research, this study shows that female sex offenders are not a homogeneous group. Findings also included differentiation between female juvenile sexual offenders with a history of child maltreatment and those without a history of child maltreatment. Female juvenile sex offenders who had a history of child maltreatment were more likely to have a current mental health diagnosis and experience clinical levels of anger--irritability and depression--anxiety than those without a history of child maltreatment. The impact of a history of sexual abuse for female juvenile sex offenders was found to be important with regard to higher levels of coercion of their sexual abuse vic...

The complexity of trauma types in the lives of women in families referred for family violence: Multiple mediators of mental health.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

Responding to calls for further research about the impact of multiple types of trauma across the life span, this study examines the interconnections among types of trauma in childhood and adulthood in a convenience clinical sample of 283 women obtaining social services for family violence. In particular, variables including family of-origin dysfunction and other childhood risk factors, relationship victimization in adulthood, and the presence of adult resources were examined as mediators of links between child maltreatment and adult mental health symptoms. Variables were assessed at different time points, 3 years apart. Path analysis revealed that the conceptual model of multiple pathways between childhood family violence exposure and adult outcomes fit the data well. In particular, the li...

National and global agendas on violence against women: Historical perspective and consensus.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

A policy analysis of 11 national and global institutions' violence against women agendas spanning 1990 to 2006 is presented. Analysis revealed 85 distinct recommendations. The highest percentages of them referenced prevention (29%); data, design, and measurement (21%); and psychotherapy and support (19%). Consensus (percentage of recommendations for future activities included in four or more agendas) was highest for advocacy (75%), funding (50%), prevention (48%), and data, design, and measurement (44%). Changes in emphasis over time, aims that have been abandoned, and observations contrasting U.S. and global agendas are also examined. The results create a context to inform the agendas currently in development within psychology, criminal justice, medicine, nursing, public health, and other...

Call to action: Reducing interpersonal violence across the lifespan.

American Journal of Orthopsychiatry — Mon, 05 Jan 2009 05:00:00 +0100

On September 12-13, 2008, more than 40 representatives from national professional organizations, grass roots organizations, governmental agencies, policy organizations, and advocacy movements gathered together in San Diego, California, as part of the Think Tank on Reducing Interpersonal Violence Across the Lifespan: Connecting Agendas. Working as a whole and in small groups, the think tank identified major gaps and issues facing the field of interpersonal violence prevention and began to develop a blueprint for integrating action across types of violence and types of populations, as well as integrating research, practice, and policy across the lifespan. Recognizing the need for a mechanism to facilitate communication and integrative collaboration in research, practice, and policy activitie...

Women and suicidal behavior: A cultural analysis.

American Journal of Orthopsychiatry — Tue, 28 Oct 2008 08:04:51 +0100

Around the world girls and women have higher rates of suicidal ideation and behavior but lower rates of suicide than boys and men. There is, however, significant variability in gender patterns and meanings suicidal behavior within and across cultures. For example, in the United States, suicide is most common among older "White" men, and is typically considered masculine behavior. Women who kill themselves are viewed as acting like men, and therefore deviant. By contrast, in other societies, including China, suicide is viewed as an act of the powerless, and is most frequent in young women. In these societies, men who kill themselves are considered weak and effeminate. The cultural diversity in gender patterns and interpretations of suicidal behavior challenges essentialist perspectives on g...

African American inner-city youth exposed to violence: Coping skills as a moderator for anxiety.

American Journal of Orthopsychiatry — Tue, 28 Oct 2008 08:04:50 +0100

The current study examined types of coping as either protective or vulnerability factors for youth exposed to community violence in a sample of 240 inner-city, African American pre- and early adolescents across sixth and seventh grade. Coping was conceptualized within a contextually relevant framework. It was predicted that avoidant coping would interact with exposure to violence to predict reductions in anxiety, cross-sectionally and longitudinally, whereas approach coping was expected to interact with violence exposure to predict increases in anxiety. Youth and parents both reported on youth exposure to community violence and anxiety symptoms; youth provided self-reports of their coping strategies. Data were analyzed by using hierarchical multiple regression analyses. As predicted, avoid...

Person-job match among frontline staff working in residential treatment centers: The impact of personality and child psychopathology on burnout experiences.

American Journal of Orthopsychiatry — Tue, 28 Oct 2008 08:04:50 +0100

This study tested the hypothesis that the effect of personality on burnout would be moderated by the psychiatric characteristics of the youth served on the milieu. Two hundred and three frontline staff working in 21 residential treatment centers in Illinois serving troubled youth completed surveys regarding opinions about their jobs, the Big Five Inventory (BFI), a youth presenting problems scale for the entire milieu, and the Maslach Burnout Inventory (MBI). Results indicated that the effect of neuroticism on burnout is moderated by psychosis and posttraumatic stress disorder (PTSD); high and moderate milieu ratings of psychosis and PTSD showed a positive relationship between neurosis and burnout, while low ratings of these conditions showed no relationship. These findings suggest that th...

Assessing mental health and psychosocial status in communities exposed to traumatic events: Sri Lanka as an example.

American Journal of Orthopsychiatry — Tue, 28 Oct 2008 08:04:49 +0100

The purpose of this study was to develop a measure of psychosocial status that could reliably and accurately assess psychosocial functioning in Sinhalese Sri Lankans impacted by traumatic events. A culturally grounded methodology using qualitative data was used to develop and validate the Sri Lankan Index of Psychosocial Status--Adult Version (SLIPSS-A). The SLIPPS-A is a 26-item measure assessing local indicators of distress, with items placed on a frequency scale from 0 (never) to 4 (6-7 days per week). The instrument was administered to 170 Sinhalese Sri Lankans (72% women) between the ages of 21 and 71 years with differing types of trauma exposure. The measure demonstrated excellent reliability (a = .92) and was significantly correlated with the Postraumatic Stress Disorder (PTSD) Chec...

Toward assessing traumatic events and stress symptoms in preschool children from low-income families.

American Journal of Orthopsychiatry — Tue, 28 Oct 2008 08:04:45 +0100

Traumatic events can seriously disrupt the development of preschool children. Yet few studies capture developmentally specific examples of traumas and the expression of distress for this age group. Mothers and teachers of 138 preschoolers from low-income families were interviewed about traumatic events and completed a new measure assessing their child's traumatic stress symptoms. They reported traumatic events as the death of a person, death of a pet, family violence, high conflict divorce, sudden family loss, accident or injury, and viewing the World Trade Center attack. Factor analysis of 17 trauma symptoms revealed three internally consistent and valid scales: Intrusions, Emotional Reactivity, and Fears, plus a Total omnibus score. Traumatic stress symptoms varied by the type of event. ...

Children in planned lesbian families: A cross-cultural comparison between the United States and the Netherlands.

American Journal of Orthopsychiatry — Tue, 28 Oct 2008 08:04:45 +0100

A total of 78 planned lesbian families in the United States were compared with 74 planned lesbian families in the Netherlands. Children were interviewed about disclosure to peers about living in a lesbian family and about their experiences of homophobia; mothers filled out the Child Behavior Checklist (CBCL). Results showed that Dutch children were more open about growing up in a lesbian family, experienced less homophobia, and demonstrated fewer emotional and behavioral problems than American children. Homophobia was found to account for part of the difference in psychosocial adjustment between the Dutch and the American children. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Prevalence of codependence in young women seeking primary health care and associated risk factors.

American Journal of Orthopsychiatry — Tue, 28 Oct 2008 08:04:44 +0100

Codependence as a relational problem that often, but not necessarily always, occurs in conjunction with familial alcoholism. Previous research has shown that various etiological factors resulting from recurring stressful circumstances experienced in childhood or adulthood may contribute to this relation. Another factor arises out of the "submission script" that may be assumed by women living within a culture that typically promotes unequal power between women and men. To examine the prevalence of codependence and its predictors, a cross-sectional study was conducted among a population of 845 young women seeking primary health care in Mexico City. Odds ratio prevalence (ORP) was used to estimate the strength of possible association between codependence and exposure to several factors. A pre...

The influence of clinical, treatment, and healthcare system characteristics on psychiatric readmission of adolescents.

American Journal of Orthopsychiatry — Tue, 28 Oct 2008 08:04:43 +0100

This study examined predictors of readmission for a sample of 522 adolescents enrolled in Medicaid and admitted to three inpatient psychiatric hospitals in Maryland. Comprehensive data on clinical, treatment, and health care system characteristics were collected from archival sources (medical records, Medicaid claims, and the Area Resource File). Predictors of readmission were examined with bivariate (Kaplan Meier) and multivariate (Cox Regression) survival techniques. One-year readmission rates were 38% with the majority occurring within 3 months after discharge. Adolescent demographic (age and gender), clinical (severity of symptoms, comorbidity, suicidality) and family characteristics (level of family risk) were associated with readmission. However, treatment factors including type of a...

Childhood maltreatment and antisocial behavior: Comparison of self-reported and substantiated maltreatment.

American Journal of Orthopsychiatry — Tue, 28 Oct 2008 08:04:41 +0100

Although accurate assessment of maltreatment is critical to understanding and interrupting its impact on the life course, comparison of different measurement approaches is rare. The goal of this study is to compare maltreatment reports from official Child Protective Services (CPS) records with retrospectively self-reported measures. Research questions address the prevalence and concordance of each type of measure, their relationship to social disadvantage, and their prediction to four antisocial outcomes in adolescence and early adulthood including arrest, self-reported violence, general offending, and illegal drug use. Data to address this comparison come from the Rochester Youth Development Study (RYDS), a longitudinal panel study of 1,000 adolescents. Findings indicate that self-reporte...

Resilience in homeless youth: The key role of self-esteem.

American Journal of Orthopsychiatry — Tue, 28 Oct 2008 08:04:40 +0100

This study examined the protective role of self-esteem, social involvement, and secure attachment among homeless youths. These protective factors were examined as they ameliorate risks among 208 homeless youths surveyed in New York City and Toronto. Both mental and physical health indicators were employed in this study, including loneliness, feeling trapped, suicidal ideation, subjective health status, and substance use. Self-esteem emerged as a key protective factor, predicting levels of loneliness, feeling trapped, and suicide ideation, and buffering against the deleterious effect of fearful attachment on loneliness. Findings highlight the role of the self-concept in risk and resilience among homeless youth. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (Source: American J...

Personal resources, appraisal, and coping in the adaptation process of immigrants from the Former Soviet Union.

American Journal of Orthopsychiatry — Tue, 28 Oct 2008 08:04:40 +0100

Between 1989 and 2005, Israel absorbed over a million new immigrants, about 90% of whom were from the Former Soviet Union (FSU). The present study investigated the adaptation of these FSU new immigrants in a sample of 301 participants (67% women, ages 25-45 years), who completed inventories measuring personal resources (tolerance of ambiguity and cognitive flexibility), cognitive appraisals (of employment, language, and housing problems), coping strategies, well-being, distress, and willingness to remain in Israel. A structural equation modeling (SEM) analysis showed that tolerance for ambiguity and cognitive flexibility contributed positively to control appraisals, task-oriented coping, and level of participant well-being, and negatively to threat/loss appraisals, emotion/avoidance-orient...

"For the dream of being here, one sacrifices...": Voices of immigrant mothers in a home visiting program.

American Journal of Orthopsychiatry — Tue, 28 Oct 2008 08:04:39 +0100

Fourteen Latina immigrants participating in an innovative home visiting program for mothers of infants and young children at risk of child maltreatment were interviewed about their experiences coming to the United States, conditions they were living in after arriving, and perceptions of the intervention. Findings from the qualitative analyses detail rich, descriptive information regarding the struggles and adaptations of the immigrant mothers and families. Poverty in home countries propelled these women to move to the United States, leaving close family and sometimes children behind. Harrowing journeys to a new country are chronicled as well as the women's isolation and depression, and the strengths they utilized in adapting to new lives. Findings provide insight into the role of the bilin...

Lifetime and 12-month intermittent explosive disorder in Latinos.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:47 +0100

This study examined the occurrence, correlates, and psychiatric co-morbidities of lifetime and 12-month intermittent explosive disorder (IED) and whether impairment due to IED differed across Latino groups. We used data on 2,554 Latino adults (75.5% response rate) from the National Latino and Asian American Study (NLAAS). Lifetime and 12-month prevalence of IED among Latinos were 5.8% and 4.1%, respectively. Unemployment was a common risk factor for both lifetime and 12-month IED. Protective factors for both lifetime and 12-month IED were having poor/fair English proficiency and being born outside the U.S. mainland. Cubans, Mexicans and other Latinos had lower odds of both lifetime and 12-month IED relative to Puerto Ricans, while Puerto Ricans with IED did not demonstrate worse impairment...

International Family, Adult, and Child Enhancement Services (FACES): A community-based comprehensive services model for refugee children in resettlement.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:44 +0100

The development of evidence-based mental health interventions for refugees is complicated by the cultural and linguistic diversity of the participants, and the need to balance treatment of past traumatic experiences with ongoing support during the process of acculturation. In an effort to gather "practice-based evidence" from existing mental health services for refugees, a collaborative study of International Family, Adult, and Child Enhancement Services (FACES), a comprehensive, community-based mental health program working with refugee children, was conducted to describe the program participants and service delivery model and to assess whether participants improved over time as a function of services. Results showed that participants improved, but that the improvement was not related to ...

Psychological distress and adjustment of Vietnamese refugees in the United States: Association with pre- and postmigration factors.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:42 +0100

The purpose of this study was to examine how pre- and postmigration factors affect the psychological distress and adjustment for a community sample of Vietnamese refugees resettled in the United States. The sample included a substantial proportion of ex-political detainees who experienced a particularly large number of traumatic events prior to migration. Additionally, the study assessed postmigration experiences using multidimensional and bidirectional measures of acculturation to the Vietnamese and American cultures and measures of satisfaction with social support from like-ethnic and host culture network members. Psychological adjustment and distress were assessed with depression, anxiety, alienation, and life satisfaction. Findings show that premigration traumatic experiences predicted...

Cumulative trauma and posttraumatic stress disorder among children exposed to the 9/11 World Trade Center attack.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:40 +0100

Two and one-half years after the September 11, 2001 World Trade Center attack, 204 middle school students in an immigrant community located near Ground Zero were assessed for posttraumatic stress disorder (PTSD) symptoms as influenced by "dose" of exposure to the attack and accumulated lifetime traumas. Ninety percent of students reported at least one traumatic event other than 9/11 (e.g., community violence) with an average of 4 lifetime events reported. An interaction was obtained such that the dose-response effect depended on presence of other traumas. Among students with the lowest number of additional traumas, the usual dose-response pattern of increasing PTSD symptoms with increasing 9/11 exposure was observed; among those with medium to high cumulative life trauma, PTSD symptoms wer...

Parents' experience and meaning construction of the loss of a child in a national terror attack.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:37 +0100

This paper describes a qualitative study aimed at exploring the meanings that are given by parents to the loss of their children in terror attacks in Israel and examining how specific aspects of these meanings help or hinder them in coping with the loss. This paper focuses the collective context of loss, a theme that emerged from in-depth interviews with 16 bereaved parents who lost their children in different terror attacks. The collective context of loss includes three subthemes: (a) the loss in the context of Jewish and Israeli history; (b) assigning responsibility for the loss; and (c) using the collective meaning in the process of coping. Overall, the findings highlight the role of the sociocultural context in the bereavement process. The discussion raises possible explanations for th...

Mental health in Japanese members of the United Nations peacekeeping contingent in the Golan Heights: Effects of deployment and the Middle East situation.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:31 +0100

This study evaluates the mental health of Japan Self-Defense Force (JSDF) members of the peacekeeping contingent in the Golan Heights before and since the Second Gulf War between 1998 and 2003. Before the war, the General Health Questionnaire 30 (GHQ30) scores during and after duty tended to be lower than those before duty; all scores were lower than those of adult Japanese men in general. After the war, GHQ30 scores did not significantly change between before, during, and after duty. Manifest Anxiety Scale (MAS) scores were not significantly different between groups. Stressors identified included problems with foreign language and familial matters at home. Post war stressors included work content and relationships with collaborating foreign army units. These findings suggest that the ment...

Violence exposure across multiple contexts: Individual and joint effects on adjustment.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:30 +0100

This study examined the relationship between violence exposure in three different contexts (home, school, and community) and internalizing and externalizing outcomes in early adolescents. We modeled both context-specific and cumulative effects of exposure to violence. After controlling for a number of risk factors associated with violence exposure, violent incidents encountered at school and at home were consistently related to multiple outcomes. Violence exposure in the community was related only to aggressive fantasies but not to other externalizing or internalizing problems. High levels of violence exposure in the community attenuated the relationship between home violence and internalizing symptoms and school violence and externalizing problems. Cumulative exposure to violence was rela...

Child internalizing and externalizing behavior as predictors of age at first admission and risk for repeat admission to a child inpatient facility.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:28 +0100

Gaining a better understanding of the types of child symptomatology that predict age at first admission and risk for readmission to a child psychiatric inpatient facility could help to inform the focus of intervention. Accordingly, the current study examined whether internalizing and externalizing behavior problems, alone or in combination, were associated with age at first admission and risk for repeat admission. Analyses were based on a sample of 372 children (M = 9.13 years, SD = 1.91) admitted to an acute psychiatric inpatient facility. Internalizing behavior was associated with a later age at admission, but unrelated to repeat admission. Externalizing behavior was associated with an earlier age at admission and increased risk for repeat admission. Co-occurring internalizing and extern...

The permanence of family ties: Implications for youth transitioning from foster care.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:26 +0100

Research on the experiences of youth leaving foster care as they enter adulthood has noted that they often reconnect, and sometimes live with, members of their family of origin. This is often thought to be a curious finding because at some earlier point, the families were deemed unsafe, requiring removal of the child to foster care. Although this finding has been consistent, it has not been the central focus of a research study and, therefore, its implications have been largely unexamined. In this article, the authors review what is known about the extent to which young adults reunite with their families after they leave foster care. To provide guidance in thinking further about former foster youth reuniting with their families, the authors also examine research and theoretical literature ...

Relationship network quality: Adolescent adjustment and perceptions of relationships with parents and friends.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:25 +0100

Early, mid-, and late adolescents (N = 406) from an ethnically diverse community completed questionnaires describing positive and negative features of relationships with their mothers, fathers, and same-sex best friends. School grades, self-reported adjustment problems, and self-worth differed as a function of both the number of relationships that adolescents described as high on positive features and the number of relationships that adolescents described as high on negative features. Adolescents with relationships that were uniformly good quality (i.e., high on positive features and low on negative features) were better adjusted than adolescents with relationships that were uniformly poor quality (i.e., low on positive features and high on negative features). The results failed to support...

Addressing economic stress in the treatment of depression.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:24 +0100

This study investigates the importance of addressing issues of economic stress in standardized treatments for major depression. Using a sample from the National Institute of Mental Health Treatment of Depression Collaborative Research Program, the study found high levels of patient introduction of economic stress topics, with relatively high levels of therapist approach of this material. There was significant evidence for a positive association between therapist approach of these economic stress topics and outcome. There was very little evidence for socioeconomic status differences in any of these findings. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Beyond treatment effects: Comorbid psychopathologies and long-term outcomes among substance-abusing delinquents.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:23 +0100

Secondary analyses of a randomized clinical trial controlled for treatment condition effects and examined the impact of comorbid psychopathologies on the mental health, physical health, and criminal behavior of 80 substance abusing delinquents approximately 5 years later in emerging adulthood. Overall, emerging adults with a comorbid disorder during adolescence scored higher on psychopathology, criminal behavior, and health problems. Participants with both internalizing and externalizing disorders exhibited more negative outcomes than those with a comorbid externalizing disorder. For the entire sample, more internalizing diagnoses forecasted higher internalizing and aggression scores, more criminality, and poorer physical health. More externalizing disorders predicted higher internalizing,...

Ego development, psychopathology, and parenting problems in substance-abusing mothers.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:21 +0100

The authors examined maternal ego development in relation to psychopathology and parenting problems in a sample of substance abusing mothers. Given predilections at higher levels of ego development for introspection and guilt, the authors expected mothers at higher levels to report more psychopathology. Given predilections at lower levels of ego development for dichotomous perceptions and limited conceptions of causation, the authors expected mothers at low levels to report more problematic parenting behaviors. Intelligence was expected to correlate but not overlap with ego development. Subjects were 182 mothers who expressed interest in a randomized clinical trial for a new parenting intervention. Measures included the Washington University Sentence Completion Task--Short Form, the Parent...

Behavioral outcomes for substance-exposed adopted children: Fourteen years postadoption.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:18 +0100

This study examined the influence of prenatal substance exposure on children's externalizing behaviors at 14 years postadoption. Using Wave 4 data from the California Long-Range Adoption Study, the authors employed growth curve modeling to examine behavioral trajectories of 275 children as influenced by foster care status, age at adoption, and gender. Outcomes are measured using a shortened Behavioral Problem Index. Prenatal exposure predicted elevated behavior problems that increased normatively compared with nonexposed children, and were not found to trigger the negative behavior sequelae once feared. Foster children tended to fare better over the life course than those adopted through other means, except for children adopted at older ages. Adopted children's problem behaviors may be dir...

Siblings of children with severe emotional disturbances: Risks, resources, and adaptation.

American Journal of Orthopsychiatry — Thu, 01 May 2008 07:56:14 +0100

This study examines risks, resources, and adjustment among siblings of children with severe emotional disturbances (SED) involved in an initiative to develop family centered Systems of Care in North Carolina. These siblings experience many of the same risks as the children who have been diagnosed with SED (i.e., "targets"), but have received relatively little attention from the system or researchers. This first systematic study of these siblings describes an early sample (n = 56), compares them to their system-identified brothers and sisters, and explores contextual factors related to sibling resources and adjustment. Findings suggest the siblings, much like the targets: (a) have been exposed to extremely high levels of adversity, and (b) evidence substantial variability in behavioral and ...

Aggression in very high-risk youth: Examining developmental risk in an inpatient psychiatric population.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:12:04 +0100

The goal of this study was to examine the utility of clinical records of psychiatrically hospitalized youth for predicting critical incidents during treatment. Intake data from inpatients (N = 484, mean age = 14 years) in a secure psychiatric facility were coded for the presence of theoretically based individual and contextual risk factor information and analyzed prospectively to predict youths' involvement in incidents of seclusion and restraint. Findings indicated that whereas several individual and contextual risk factors accounted for the likelihood of a youth becoming involved in seclusion or restraint, only histories of various types of aggression, number of prior residential placements and body mass index could predict the extent of this involvement. The implications of these findin...

Victimization of children with disabilities.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:12:04 +0100

In this study, the authors examined the characteristics of abuse reported by CWDs based on forensic statements made by 40430 alleged abuse victims, 11% categorized as children with minor disabilities, and 1.2% categorized as children with severe disabilities. Proportionally more of the CWDs than of the TD children were allegedly victims of sexual rather than physical abuse. CWDs failed to disclose abuse and delayed disclosure more often than TD suspected victims. CWDs were more likely than TD children to be abused by parent figures and to experience physical abuse resulting in body injury or serious sexual offenses, including those involving penetration, repeated abuse, use of force, and threats. Higher levels of disability were associated with increased risk of sexual abuse. Both the heig...

Emotional availability in a sample of mothers with a history of abuse.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:12:03 +0100

Maternal history of abuse has been proposed as a risk factor for child maltreatment, but the background of this "cycle of abuse" is as yet poorly understood. As a contribution toward a deeper understanding of this phenomenon, this study analyzed whether emotional availability is altered by maternal experiences of physical or sexual abuse during their upbringing. Mothers were contacted by mail and presented with the Childhood Trauma Questionnaire. To form the index group, women who reached a cutoff for severe sexual and/or physical abuse and whose children were term babies with APGAR scores 7 were included in the study. The women were invited to the laboratory when their infants were 5 months old. Emotional availability was compared with a group of mother-infant pairs matched for infant gen...

Understanding the influence of gambling opportunities: Expanding exposure models to include adaptation.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:12:03 +0100

Many regions are considering expanding the various forms of gambling that are available to residents. The expansion of legalized gambling frequently is the topic of heated debate because of possible harmful ramifications on individuals' mental and physical health as well as the public's health in general. Conventional wisdom holds that the expansion of gambling relates to increases in gambling-related problems among the population (i.e., the exposure effect). A review of empirical evidence provides an opportunity to verify the accuracy of this wisdom. An evaluation of available research studies provides some support for the exposure effect, but also raises questions about the durability of that phenomenon across settings and time points. Some exposure studies indicate specific patterns of ...

Substance abuse and psychosocial impairments among clients with schizophrenia.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:12:03 +0100

This study assessed correlates of current substance abuse severity not evaluated in past research (e.g., manic symptoms, traumatic stress, self-care deficits, interpersonal relationship problems), as well as factors previously shown to be associated with substance abuse among clients with schizophrenia (e.g., age, gender, depressive symptoms, psychotic symptoms, work/school problems, legal problems). Multiple regression analyses revealed that more severe self-care deficits and less extreme psychotic symptomatology were related to exacerbated symptoms of substance abuse. Implications of these findings for future research are discussed. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Essentialism and the cultural psychology of gender in extreme son preference communities in India.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:12:02 +0100

Using a cultural ecological framework, the authors examined key psychological antecedents of a pressing public health problem in Tamilnadu, India: the persistence of extreme forms of female neglect including female infanticide and feticide. Community-based respondents (N = 798) were recruited from Tamilnadu, a south Indian state, from villages with highly male biased sex ratios. Study 1 examined beliefs about behavioral gender transgressions in the villages that are identified as having extremely male-biased sex ratios. Study 2 examined the same participants several weeks later, investigating beliefs about biological gender essentialism and attitudes toward violence. Although behavioral and biological aspects of gender were essentialized differently, a regression analysis controlling for S...

Mother-infant synchrony and the development of moral orientation in childhood and adolescence: Direct and indirect mechanisms of developmental continuity.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:12:01 +0100

Links between the temporal parameters of mother-infant synchrony and moral orientation in adolescence were examined in 31 children monitored from 3 months to 13 years. At 3 and 9 months, mother's and infant's affective states during face-to-face play were microcoded and synchrony was assessed with time-series analysis. Verbal IQ, behavior problems, child self-regulated compliance, and maternal warm control discipline were examined at 2, 4, and 6 years. Moral cognition and dialogical empathy were evaluated at 6 and 13 years. Three mechanisms of continuity were proposed: continuity in small steps, continuity through a mediating variable, and direct continuity. Mother-infant synchrony across the 1st year, indexed by the lagged associations between maternal and infant affective involvement, pr...

Predicting readiness to adopt evidence-based programs for divorcing families: Champions, attitudes, and access to funding.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:12:01 +0100

This paper attempts to identify the factors that explain service provider readiness to fund and implement evidence-based programs for children from divorcing families. Representatives from 128 family courts in United States counties were surveyed about the programs currently being offered for families of divorce and plans for changes in the services provided. Path analyses provided evidence that readiness to adopt effective programming was predicted by (a) the presence of champions who could potentially advocate for adoption, (b) county size, and (c) community attitudes favorable to services for families of divorce. The counties' ability to access funding to support programming did not predict ultimate readiness to adopt extended programming. Implications for research on the dissemination ...

Partners of perinatal substance users: Forgotten, failing, or fit to father?

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:12:01 +0100

Discussion of case studies can yield increased knowledge about the role of fathers in the lives of families affected by perinatal substance abuse. This will lead to better-informed treatment interventions, research, and public policy. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

(How) does it make a difference? Perspectives of adults with lesbian, gay, and bisexual parents.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:12:00 +0100

In this study, 46 adult children of LGB parents were interviewed, and their perceptions of how growing up with LGB parents influenced them as adults were examined. Qualitative analysis revealed that adults felt that they were more tolerant and open minded and had more flexible ideas about gender and sexuality as a function of growing up with LGB parents. Participants often felt protective of their parents and the gay community, and some went to great efforts to defend them to peers, family members, and society. Some participants struggled with issues of trust in adulthood, which they related to the experience of their parents' unexpected coming out, as well as to experiences of teasing and bullying. The importance of understanding these findings in the context of societal heterosexism is d...

Influence of group cohesion on maternal well-being among participants in a support/education group program for single mothers.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:12:00 +0100

Single mothers are at increased risk of psychosocial disadvantage, social isolation and physical and mental health difficulties. The authors present (1) the results of group cohesion assessments completed by mothers participating in a trial of community-based support/education groups, and (2) assessments of the association between group cohesion ratings and intervention outcomes of maternal self-evaluations of well-being (mood, self-esteem, and social support) and parenting. Mothers participating in groups completed the Group Atmosphere Scale, a measure of group cohesion, postgroup. Overall, most participants provided strong ratings of group cohesion. Significant associations were found between group cohesion and specific positive outcomes. This suggests a positive association between grou...

Prevalence and correlates of depression, anxiety, and suicidality among university students.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:11:59 +0100

Mental health among university students represents an important and growing public health concern for which epidemiological data are needed. A Web-based survey was administered to a random sample at a large public university with a demographic profile similar to the national student population. Depressive and anxiety disorders were assessed with the Patient Health Questionnaire (R. L. Spitzer, K. Kroenke, J. B. W. Williams, & the Patient Health Questionnaire Primary Care Study Group, 1999). Nonresponse weights were constructed with administrative data and a brief nonrespondent survey. The response rate was 56.6% (N = 2,843). The estimated prevalence of any depressive or anxiety disorder was 15.6% for undergraduates and 13.0% for graduate students. Suicidal ideation in the past 4 weeks was ...

Risk and promotive factors related to depressive symptoms among Japanese youth.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:11:59 +0100

This study examined the symptoms of depression among 802 Japanese youth attending postsecondary schools in the Sapporo area. Separate analyses were conducted for males and females to determine whether the importance of risk and promotive factors varied by gender. The results showed that many factors that had been linked to depressive symptoms in Western samples were predictive of depressive symptoms in Japanese youth. The risk and promotive factors accounted for 50% and 59% of the variance in depressive symptoms for the female and male subsamples, respectively. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Quality of care after early childhood trauma and well-being in later life: Child Holocaust survivors reaching old age.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:11:58 +0100

The link between deprivation and trauma during earliest childhood and psychosocial functioning and health in later life was investigated in a group of child Holocaust survivors. In a nonconvenience sample 203 survivors, born between 1935 and 1944, completed questionnaires on Holocaust survival experience and several inventories on current health, depression, posttraumatic stress, loneliness, and attachment style. Quality of postwar care arrangements and current physical health independently predicted lack of well-being in old age. Loss of parents during the persecution, year of birth of the survivors (being born before or during the war), and memories of the Holocaust did not significantly affect present well-being. Lack of adequate care after the end of World War II is associated with low...

Witnessing community violence and health-risk behaviors among detained adolescents.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:11:58 +0100

This study examines whether witnessing community violence, in the 12 months prior to juvenile detention, is related and health-related outcomes in the 2 months prior to being detained among 550 youth. Participants answered survey questions using audio-computer assisted self-interviewing procedures, which assessed demographic, problem, and drug and sexual risk behaviors. Multiple logistic regression analyses, controlling for significant covariates, indicated that adolescents, in the last 12 months, who reported witnessing community violence, relative to their peer witnessing no violence, were in the last 2 months prior to being detained, twice more likely to have suicidal threats, 2 times more likely to use marijuana and alcohol, 2 times more likely to get high on alcohol or other drugs dur...

Outcomes for youth receiving intensive in-home therapy or residential care: A comparison using propensity scores.

American Journal of Orthopsychiatry — Thu, 07 Feb 2008 20:11:57 +0100

This study compares outcomes for behaviorally troubled children receiving intensive in-home therapy (IIHT) and those receiving residential care (RC). Propensity score matching is used to identify matched pairs of youth (n = 786) with equivalent propensity for IIHT. The majority of pretreatment differences between the IIHT and RC groups are eliminated following matching. Logistic regression is then conducted on outcome differences at 1 year postdischarge. Results show that IIHT recipients had a greater tendency (.615) toward living with family, making progress in school, not experiencing trouble with the law, and placement stability compared with RC youth (.558; p < .10). This suggests that IIHT is at least as effective for achieving positive outcomes. Given IIHT's reduced restrictiveness a...

Adolescent female murderers: Characteristics and treatment implications.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:20 +0100

This study examines individual and family characteristics of a population of 29 adolescent females charged with homicide or attempted homicide in the juvenile justice system. The purpose of this study is to contribute to the limited knowledge about adolescent females charged with homicide. Data were collected including the MAYSI-2, a risk classification instrument, and social, educational and family histories. Findings include high rates of reported substance use, delinquent peers, early indicators of mental health problems, and limited control and supervision by parents. The most common weapon used was a car and the most common victim was a known person. A comparison was conducted on girls charged with homicide during the commission of another crime or committed during a conflict. The con...

Gender differences in the mediated relationship between alcohol use and academic motivation among late adolescents.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:19 +0100

This study utilized structural equation modeling to examine the relationship between alcohol use and academic motivation controlling for potentially mediating variables of deviant behavior, depressive cognitions, family communication, and peer relations. The study also examined the manner in which these relationships were moderated by gender. Results indicated that alcohol use was directly related to deviance for both males and females, but was not associated with depressive cognitions for either males or females. Deviant behavior was directly associated with depressive cognitions for both males and females, but this effect was significantly stronger for females. Deviance was significantly, inversely related to family communication among males, but not females. Depressive cognitions were s...

Longitudinal helpseeking patterns among victims of intimate partner violence: The relationship between legal and extralegal services.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:19 +0100

This study describes the pattern of formal helpseeking efforts in a sample of 406 IPV victims over the course of a year. Further, we explore the relationship between legal and extralegal helpseeking, reflecting current controversy over how these two types of interventions should be coordinated. We constructed and tested latent growth curve models using structural equation modeling to explore helpseeking patterns, and found that repeated helpseeking was common, with 80% seeking additional help during follow-up. Results also showed that legal and extralegal helpseeking decreased together over time, and that this similarity in pattern can best be described as a connection between behaviors that are similarly influenced by time-specific events like re-abuse, rather than a connection between ov...

Children's self-report about violence exposure: An examination of the Things I Have Seen and Heard Scale.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:18 +0100

This study examined a version of the Things I Have Seen and Heard Scale in a sample of 784 children who completed the scale at both age 6 and 8. There was only modest support for the use of the scale as a set of single-item measures or as a simple sum of items. Exploratory factor analyses suggested that the scale consisted of two factors: a global/community violence scale and a home violence scale. The evidence for validity of the scales was stronger at age 8 than at age 6. These findings suggest that there may be some limits to the utility of self-reports of violence exposure in very young children. However, there is initial evidence that the global/community scale is a reliable and valid indicator of young children's exposure to violence. Further use and exploration of the subscales is w...

Treating depression in vulnerable urban women: A feasibility study of clinical outcomes in community service settings.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:18 +0100

There is a paucity of literature on direct treatment outcomes for impoverished minority populations. The current study supports the feasibility of successfully treating women for depressive symptoms in community settings where they typically seek care, adding to the small but growing direct knowledge base in this area. The sample of the 2-site study consisted of 91 women seeking treatment for depressive complaints at a homeless shelter program and a municipal hospital psychiatric clinic for Latino patients. Participants were randomly assigned to either a 16-week cognitive-behavioral group or a 16-week supportive/exploratory group for depression. Best-practice features with this population were integrated throughout. Findings showed that both treatment conditions were equally effective in d...

Do urban adolescents become desensitized to community violence? Data from a national survey.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:17 +0100

This study explored whether the response of urban adolescents to community violence exposure differs from their response to family violence and sexual assault. More specifically, the authors explored whether desensitization to community violence exposure was more common compared with desensitization to other violence-related stressors. Participants included 1,245 urban adolescents drawn from a national probability sample of 4,023 youth (aged 12-17 years) who were interviewed about their history of interpersonal violence exposure, symptoms of posttraumatic stress disorder (PTSD), and delinquency. A negative curvilinear effect of community violence exposure on PTSD combined with a positive linear effect of exposure on delinquency was considered evidence for desensitization. Results provided ...

Tomorrow's players under occupation: An analysis of the association of political violent with psychological functioning and domestic violence, among Palestinian youth.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:17 +0100

A 2005 survey of 2,328 youth (ages 12 to 18) in the West Bank, Palestine, revealed an association between exposure to politically violent events, domestic violence, and school violence and with psychological symptomatology. Results also found associations between family violence, family economic status, and psychological symptomatology. Respondents reported low levels of family functioning. Data revealed some geographic variability in experiences of politically violent events, domestic violence, school violence, and psychological symptomatology. Implications for practice are discussed. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Posttraumatic distress and growth among wives of prisoners of war: The contribution of husbands' posttraumatic stress disorder and wives' own attachments.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:17 +0100

This study examined distress and growth among wives of former combat veterans and prisoners of war (POWs), and the contribution of their husband's posttraumatic stress disorder (PTSD) and the wives' own attachment style to these outcomes. Two groups of wives participated in the study: 87 wives of former POWS, and 74 wives of control veterans. The wives of POWs reported significantly higher levels of distress and growth than did the wives of the controls. Husbands' PTSD symptomatology, as well as higher levels of avoidance and anxiety dimensions of attachment, contributed positively to distress and to growth. Further studies on the unique predictors of growth are needed. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Mental health screening of preschool children: Validity and reliability of ABLE.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:16 +0100

Children with behavioral, emotional or language problems struggle to do well at school often with limited success. ABLE (Attention, Behavior, Language, and Emotions), a new screening tool, was used to estimate the prevalence and the severity of concerns parents and teachers have about children's school adjustment and evaluate their need for services. Data obtained from the parents and teachers of children randomly selected from public Pre-K classrooms in 6 states (N = 415) and from a mental health screening of rural and urban children (N = 5,577) support the validity and reliability of ABLE. Parents identified severe problems in 18.4% of children and Pre-K teachers identified 10.5%. By kindergarten, the proportion of children identified by their teachers with serious problems more than dou...

Psychiatric housing: Locational patterns and choices.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:16 +0100

This study investigated locational patterns and choices in recently sited psychiatric housing. It examined the socioeconomic attributes of the neighborhoods of a sample of supervised houses and apartments for persons with severe mental illness in seven states, and the factors associated with the choice of those locations. Using data drawn from the U.S. Census and interviews with mental health administrators and residential staff, the study identified siting patterns that linked housing affordability to development in mixed use, walkable neighborhoods that provided residents with access to community resources in a variety of small towns and metropolitan areas. Although residences were located in neighborhoods with a range of socioeconomic attributes including low and high poverty rates, mea...

Acculturation and acculturative stress as indictors for suicide risk among African Americans.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:15 +0100

The literature on African American suicide and the acculturation literature were examined to derive a possible explanation for increases in suicide deaths for African American men and apparent resilience for African American women. Historically, African Americans were believed to be unaffected by suicide because of protective factors (e.g., strong religious values and cohesive familial support systems) embedded in the culture. However, minority mental health investigators have found that acculturation sometimes leads to negative consequences for individuals from ethnic minority backgrounds. Accordingly, acculturation and acculturative phenomena are proposed as a model to shed light on African American male suicide as African Americans increasingly engage mainstream values, beliefs, and pra...

Family systems psychiatry: Principles, good practice guidelines, clinical examples, and challenges.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:15 +0100

This article describes a collaborative action research project, carried out in Germany and designed to promote the integration of family systems thinking and methods into the core practices of everyday psychiatric care. During 1997-2002, "good practice" guidelines were compiled in an initial research project, involving 17 in- and outpatient psychiatric services. In the second phase of the project (2002-2008), the approach is now well established, being taught and evaluated in three state hospitals in Germany. This article outlines the development of the project and the application of family systems psychiatry principles, demonstrating their feasibility and value in a number of different psychiatric hospitals. Two clinical vignettes illustrate the usefulness of the family systems approach a...

Impact of perceived racial discrimination and collective self-esteem on psychological distress among Vietnamese-American college students: Sense of coherence as mediator.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:15 +0100

This study examined whether sense of coherence mediated relationships of perceived racial discrimination and of collective self-esteem to psychological distress (depression and anxiety) among 122 Vietnamese American college students. Higher levels of perceived racial discrimination (PRD) were associated with a reduced sense of coherence (SOC) and with higher levels of depression and anxiety. Path analysis found that SOC partially mediated the relationship of PRD to depression as well as to anxiety. Higher collective self-esteem (CSE) was associated with a stronger SOC, which in turn was associated with lower depression and anxiety. SOC mediated the relationship between CSE and depression, and part of the relationship between CSE and anxiety. (PsycINFO Database Record (c) 2007 APA, all righ...

Families affected by parental mental illness: A multiperspective account of issues and interventions.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:15 +0100

A multiperspective account of the issues and subsequent interventions for families affected by parental mental illness is reviewed in this article, including those involving the children, the parent with mental illness, other family members, agencies, and society in general. An overview of various issues and interventions for families affected by parental mental illness is seen as potentially useful for practitioners and program developers as well as providing a resource bank for systematic evaluation, research, and policy. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

A review of the literature on the effectiveness of housing and support, assertive community treatment, and intensive case management interventions for persons with mental illness who have been homeless.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:15 +0100

A review of 16 controlled outcome evaluations of housing and support interventions for people with mental illness who have been homeless revealed significant reductions in homelessness and hospitalization and improvements in other outcomes (e.g., well-being) resulting from programs that provided permanent housing and support, assertive community treatment (ACT), and intensive case management (ICM). The best outcomes for housing stability were found for programs that combined housing and support (effect size = .67), followed by ACT alone (effect size = .47), while the weakest outcomes were found for ICM programs alone (effect size = .28). The results of this review were discussed in terms of their implications for policy, practice, and future research. (PsycINFO Database Record (c) 2007 APA...

Definition and accountability: A youth perspective.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:15 +0100

This paper reviews the systemic flaws of residential treatment facilities from a youth perspective concerning the lack of transparency, definition and accountability, and the subsequent mistreatment and human rights violations of youth experiencing emotional, behavioral, and cognitive challenges. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Ensuring the preconditions for transformation through licensing, regulation, accreditation, and standards.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:15 +0100

Residential treatment is a potentially powerful intervention for children and families, currently facing the imperative to fundamentally change practice models to achieve greater quality efficacy, efficiency, and effectiveness. Such transformation is best accomplished from a solid foundation which is created by licensing, regulation, accreditation, and internal standards. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (Source: American Journal of Orthopsychiatry)

Residential treatment for children and youth: Time for reconsideration and reform.

American Journal of Orthopsychiatry — Thu, 01 Nov 2007 12:16:15 +0100

The recent special section of the American Journal of Orthopsychiatry (Volume 76(3), 2006) on Residential Treatment for Youth attracted significant attention from various sources and constituencies. Accompanying this commentary are two other commentaries, one from Lieberman and Bellonci (2007, see record 2007-11621-002) representing the American Association of Children's Residential Centers (AACRC) and another one by Whitehead, Keshet, Lombrowski, Domenico, and Green (2007, see record 2007-11621-003) representing the Community Alliance for the Ethical Treatment of Youth (CAFETY). These commentaries represent, respectively, both the traditional and alternative views on this level of care. Lieberman and Bellonci offer a more positive view of residential treatment for children and youth as be...

Subclinical self-harm: Range of behaviors, extent, and associated characteristics.