Self-rated Health in Relation to Rape and Mental Health Disorders in a National Sample of College Women

Abstract

Objective: The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. Participants: A national sample of 2,000 female college students participated in a structured phone interview between January and June 2006. Methods: Interview modules assessed demographics, posttraumatic stress disorder, major depressive episode, substance use, rape experiences, and physical health. Results: Logistic regression analyses showed that poor self-rated health was associated with low income (odds ratio [OR] = 2.70), lifetime posttraumatic stress disorder (OR = 2.47), lifetime major depressive episode (OR = 2.56), past year illicit drug use (OR = 2.48), and multiple rape history (OR = 2.25). Conclusions: These findings highlight the need for university mental health and medical service providers to assess for rape history, and to diagnose and treat related psychiatric problems in order to reduce physical morbidity.     

Psychiatric Disorders and Treatment in Adoptees: A Meta-Analytic Comparison with Non-Adoptees

ABSTRACT

This meta-analysis integrates the results of 85 studies on psychiatric disorders and treatment in adoptees and non-adoptees. The risk of adoptees experiencing psychiatric disorders, contact with mental health services, or treatment in a psychiatric hospital was approximately twice as high as that of non-adoptees. Elevated risks were observed for attention-deficit/hyperactivity disorders, anxiety disorders, conduct disorders/oppositional defiant disorders, depression, substance use disorders, and psychoses. Larger effect sizes were, in part, found in clinical studies than in community-based studies, in studies with a higher percentage of individuals adopted after the age of three years and international adoptees, and in older studies.     

Assessing Social Work's Contribution to Controlled Outcome Studies in the Alcohol Dependence Treatment Literature

ABSTRACT

Alcohol use disorders are among the most prevalent and disabling conditions encountered by social work practitioners. Although a substantial body of research findings has accrued evaluating the effectiveness of available alcohol dependence treatments, few efforts have been made to assess the contribution that social work has made to this database. Thus, this study examined the contribution of social work to the alcohol dependence treatment outcome research literature over the past half-century. Controlled investigations of alcohol dependence treatments published between 1950 and 2000 were analyzed by publication outlet type and primary author's professional affiliation. Computerized bibliographic searches of medical and social science databases were conducted and a manual search of 13 core social work journals to identify controlled studies of alcohol dependence interventions. Results indicate that researchers affiliated with schools or departments of social work as well as studies contained within core social work journals have contributed little to knowledge development, with respect to controlled studies, in the alcohol dependence treatment literature. Greater social work involvement in chemical dependency research would contribute much to current efforts to promote evidence-based practice and clinical guideline development in this important practice area.     

The Role of Work on Family Relationships

Abstract

Work and family are two major institutions in society. Family has been considered as an important socializing agent for an individual's growth and development, while work provides the individual opportunities to develop a sense of identity and a self-image. For people with mental illness, work has been recognized as an important tool for facilitating psychiatric rehabilitation. In fact, the work experiences of those with mental illness have an effect on their family relationships, which may in turn affect their mental health. Using an intensive interview method, this article shows that work experiences from sheltered workshops have a significant impact on the family relationships of workers in Hong Kong.     

Facilitating interviews with children who may have been sexually abused

The introduction of the Memorandum of Good Practice on interviewing children who have been sexually abused has had an important unifying effect on professional practice. However, because of the traumatic nature of sexual abuse there will be a group of children about whom there are high levels of suspicion and where arrangements need to be made for their future care, protection and treatment. These include children who have learning disabilities or communication problems, have psychiatric disorders associated with abuse, or where there have been considerable delays since allegations were first made. Such children require a second-stage facilitative assessment interview. These include different forms of questioning, and the use of a wide range of prompting materials including art work, free and structured play context and the use of anatomically correct dolls. These approaches are reviewed and illustrated through case studies.     

Detained girls' treatment engagement over time: The role of psychopathology and quality of life

Although treatment engagement is considered important to achieve positive outcomes, it is still not well known why some girls in detention are more engaged in treatment than others. This is the first study to examine to what extent psychopathology and self-perceived quality of life (QoL) are related to treatment engagement. Participants were 108 detained girls (M_age = 16.21) who completed standardized questionnaires about mental health problems and QoL, and were interviewed with a structured diagnostic interview to assess DSM-IV psychiatric disorders. One and two months after this baseline assessment, the girls reported how much they engaged in treatment. The results showed low levels of treatment engagement and no significant changes in treatment engagement over time. Overall, detained girls with internalizing disorders reported higher treatment engagement scores, while the reverse was true for girls with externalizing disorders. Regarding QoL, the girls with greater satisfaction about their physical and psychological health and about their environment reported higher treatment engagement, while the opposite was true for the domain of social relationships. Our findings emphasize the need for strength-based and motivational approaches and techniques in residential treatment programs for girls, in order to enable change.     

Defining Computer Literacy in Human Services

Abstract

Computer literacy in human services is defined as an intersection of both computer and human services abilities. With different levels of ability possible, a matrix is created which can be used to operationally define computer literacy within any area of human service practice. Child protective work is used to demonstrate the utility of this definitional approach. Various issues within computer literacy are also discussed.     

A screening tool for detecting eating disorder risk and diagnostic symptoms among college-age women

Objective: As eating disorders (EDs) often emerge during college, managing EDs would ideally integrate prevention and treatment. To achieve this goal, an efficient tool is needed that detects clinical symptoms and level of risk. This study evaluated the performance of a screen designed to identify individuals at risk for or with an ED. Participants: Five hundred forty-nine college-age women. Methods: Participants completed a screen and diagnostic interview. Results: Using parsimonious thresholds for ED diagnoses, screen sensitivity ranged from 0.90 (anorexia nervosa) to 0.55 (purging disorder). Specificity ranged from 0.99 (anorexia nervosa) to 0.78 (subthreshold binge eating disorder) compared to diagnostic interview. Moderate to high area under the curve values were observed. The screen had high sensitivity for detecting high risk. Conclusions: The screen identifies students at risk and has acceptable sensitivity and specificity for identifying most ED diagnoses. This tool is critical for establishing stepped care models for ED intervention.     

Impact of Childhood Out-of-Home Placement on a Southwestern American Indian Tribe

SUMMARY

One of the defining characteristics of American Indian and Alaska Native communities is the removal of hundreds of thousands of children from their natural parents, extended families, and often, reservation environments. Though widely discussed, little is known about the sequelae of out-of-home placement among American Indians. In this paper we investigate the occurrence of out-of-home placement among 580 Southwestern American Indian tribal members. Out-of-home placement is examined here within a broad context of trauma, alcohol abuse and dependence, and other psychiatric disorders.     

The Psychiatric Medication History

Abstract

This article presents The Psychiatric Medication History: An Interview Schedule, a 30-step semi-structured protocol designed to help practitioners understand how clients manage their psychotropic medications and interpret their effects. The critical perspective leading to the design of this interview schedule, its purposes for clients and practitioners, its divergence from traditional treatment histories, and its uses and limitations are discussed. The author contends that, in a safe space, taking a psychiatric medication history according to these suggested guidelines offers clients an opportunity to construct an independent, evidence-tested personal narrative about their medication use. To practitioners, taking such a medication history offers a person-in-en-vironment point of entry into the psychopharmacology scene.     

Interpersonal Dependency Among Adult Survivors of Childhood Sexual Abuse in Therapy

ABSTRACT

This study investigated dependency in survivors of childhood sexual abuse (CSA). The Interpersonal Dependency Inventory (IDI) was administered at intake to 24 men and 85 women seen in therapy at a university-based community mental health clinic. In contrast to findings from earlier studies, no significant gender differences were obtained for IDI whole-scale or subscale scores. Analyses comparing CSA IDI scores with the IDI scores of previously studied groups indicated that among women, CSA survivors obtained higher dependency scores than non-CSA psychiatric patients, community adults, and college students. Findings for men were less consistent. Follow-up analyses revealed that commonly investigated CSA characteristics were unrelated to survivors' dependency scores. Implications of these findings for future research and clinical practice are explored.     

Best Practices in the Treatment of Substance-Abusing Women in the Child Welfare System

ABSTRACT

This paper reviews the literature on women's chemical dependency and its effects on their children. Many risk factors (e.g., a history of traumatic exposure) and consequences (interference with parenting) of substance abuse are unique for women, giving rise to special treatment needs of substance-abusing women with children. Substance-abusing mothers also experience unique barriers to receiving the services they need to recover, such as absence of child care and lack of gender-specific treatment in their communities. Model programs are described and recommendations are offered for best treatment practices for women with chemical dependency who present in the child welfare system.     

The Clustering of Psychiatric Disorders in High-Risk Gambling Populations

The aims of this study were to examine the associations between psychiatric disorders and pathological gambling (PG) and the clustering of psychiatric disorders in high risk gambler populations. The sample comprised 140 regular gamblers who were recruited from the general public. A variety of self- report and semi structured questionnaires was administered, including the Mini International Neuropsychiatric Interview, The Personality Diagnostic Questionnaire-4th Edition, NORC DSM-IV Screen for Gambling Problems Self- administered and Problem Gambling Severity Index. Axis I and Axis II psychiatric disorders and personality disturbances were found to be more prevalent amongst pathological gamblers than other gamblers with the strongest differences observed for mood and anxiety-related disorders. Almost two-thirds of pathological gamblers reported both an anxiety or mood disorder in conjunction with another type of disorder. These differences between the gambling groups existed even after controlling for gender. The results highlight the high rates of co-morbidity in pathological gamblers in the community and the extent to which anxiety and mood disorders co-existing with other forms of pathology. These results highlight the significant challenges facing treatment services in the treatment of PG and the extent to which this should be treated as the primary disorder.     

Information Technology Foundations for Professional Social Work Practice

Summary

Graduate social work curricula and human service organizations (HSOs) are behind in the use of current information technology (IT) for professional social work practice. Knowledge and use of computer run client advocacy based management information systems (CAMIS) are key prerequisites to the management of professional practice in HSOs. Discussion is augmented by focus on an automated CAMIS (IBM-PC, Rbase) used in the classroom as well as agency settings. Software demos are available.     

Evaluation of Lehman's Brief Quality of Life Interview in Assessing Outcome in Psychiatric Rehabilitation in People with Severe and Persistent Mental Disorder

Abstract

Lehman's Brief Quality of Life Interview (QOLI) was administered to psychiatric rehabilitation program clients 6 times at 6-month intervals. Participants were individuals with predominantly psychotic-type diagnoses. Results showed no change over time and few gender differences. No change over time indicates no improvement but also no deterioration in this chronic population. Correlations between test times indicated that the subjective scales were relatively stable in comparison to the objective scales. Results indicate that the QOLI has poor sensitivity, and therefore limited utility, for assessing change in psychiatric rehabilitation of individuals with severe and persistent mental disorders. However, the QOLI does have an important use: It provides a good indication of the clients' perspectives on the quality of their lives and services received.     

(Mini-SCID) Structured Clinical Interview for DSM-III-R

Abstract

Product Summary: The Mini-SCID is a microcomputer version of the Structured Clinical Interview for DSM-III-R (SCID) and is structured to collect data directly from patients with at least a 7th grade reading level.

It is suggested by its authors that the derived data can be used for two purposes. First, it can be utilized for the first stage of a complete diagnostic evaluation to be combined with another software package, DTREE, the computer based system for making DSM-III-R diagnoses. Second, it can be utilized for screening for the presence of adult Axis I disorders. Since it has been designed to be overinclusive (i.e., to give a high rate of false positive responses) the authors recommend that it only be employed in conjunction with a complete clinical exam.

Reviewed by Paul R. Raffoul and Ed Lyles     

An Investigation of Successfully Treated Adolescent Sex Offenders

SUMMARY

Little is known about the characteristics of adolescent sex offenders who do not reoffend. Most studies emphasize reoffense rates, recidivism and those who reoffend. Moreover, these studies provide quantitative summaries without describing the individual, his behavior, and challenges after treatment. The present study seeks to provide novel information about the life experiences of adolescent sex offenders who have not reoffended after reentering society. Through a structured questionnaire and an in-depth qualitative interview, the adolescents (N = 7) provided information regarding their life experiences after treatment with an emphasis on the challenges they face in society.     

Mental Health and Clinical Correlates in Lesbian,Gay, Bisexual,and Queer Young Adults

Abstract

Objective: This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students. Participants: College students at a large public university. Methods: An anonymous, voluntary survey was distributed via random e-mail generation to university students during April and May of 2011. LGBQ students were compared with their heterosexual counterparts on psychological and physical status as well as academic performance. Results: LGBQ students reported worse depressive symptoms, higher levels of perceived stress, considered themselves less attractive, and were more likely to be overweight. LGBQ students were significantly more likely to report histories of affective, substance use, and certain anxiety disorders as well as compulsive sexual behavior and compulsive buying. Conclusions: The higher rates of many psychiatric conditions among LGBQ students underscore the need for universities to provide LGBQ students a nonjudgmental environment to discuss sexual orientation and health issues.     

Whole in Body,Mind & Spirit: Wholistic Health and the Limits of Medicine

Abstract

Use of the Substance Abuse Subtle Screening Inventory (SASSI), a new instrument for assessing the presence of chemical dependency, was tested on a college population. In tests with 376 subjects, the SASSI showed significant promise in discriminating between nonabusers, moderate abusers, and severe abusers. Further, results of the SASSI obvious attributes scale were correlated in the expected directions with indicators of level of chemical use. The particular need for an alcohol and drug abuse assessment instrument that is relatively impervious to social desirability effects is discussed in light of the history of assessment problems in this area.     

Working with Narratives

ABSTRACT

This article will discuss healing across cultures and describe narrative practice as a means of access to coping strategies in African American folk beliefs and traditional healing practices. Four elements were found in empirical research on folk healing among African Americans: spirituality, ritual, the power of words, and dreams. These culture-specific healing elements often emerge as themes in personal narratives about coping in response to stress, crisis, and trauma. Viewing healing elements as themes is a useful framework for construing meanings from clients' experiences of stress, trauma, and crisis and coping strategies embedded in folk beliefs and traditional healing practices.

Additionally, the author presents a structured interview questionnaire for identifying folk healing themes, illustrates narrative practice as an approach for integrating folk beliefs and healing practices, and discusses implications for clinical training.