Animal Hoarding: Slipping Into the Darkness of Comorbid Animal and Self-Neglect

Substantial research and literature indicate how people and companion animals form relationships that are, for the most part, mutually beneficial. Yet there are highly dysfunctional human–animal relationships that do occur, meriting attention and remediation. One of the most perplexing and problematic human–animal relationships is encountered in cases of animal hoarding—a deviant behavior associated with extremely deleterious conditions of comorbid animal and self-neglect. Adult Protective Services workers often encounter theoretical and methodological dilemmas with these complex cases. To intervene most effectively, it becomes critical to elucidate some of the developmental factors of animal hoarding behavior and its correlation with self-neglecting behaviors in general. This article presents an in-depth diagnostic perspective as derived from the author's research and clinical experience. An analysis of the complex dynamics of the relationship between animal hoarders and their pets is presented in conjunction with accepted theories of self-neglect. With enhanced knowledge and understanding of animal hoarding, human service professionals will be better prepared to respond to these clients, evoke greater rapport and cooperation, and engage in the interdisciplinary efforts that are essential for optimal resolution.     

Correlates of depression in self-neglecting older adults: A cross-sectional study examining the role of alcohol abuse and pain in increasing vulnerability

ABSTRACT

Self-neglect among older adults results in increased morbidity and mortality rates. Depression is strongly linked to self-neglect and when untreated, severely complicates management of health and functional outcomes. The study aims to identify factors correlated with depression to inform approaches to service recruitment and retention that improve long-term outcomes. The sample included urban community-dwelling older adults (n = 96) 65 years of age and older with Adult Protective Services-substantiated self-neglect. All participants completed a range of validated cognitive, functional, and self-report demographic and clinical measures around health and mental health functioning. A secondary data analysis using multivariable logistic regression revealed that a positive screen for alcohol abuse, low self-rated health, and higher self-reported pain were associated with significantly higher odds of self-reported depression. Further research is needed to understand the temporality between these correlates and depression and to inform prevention and intervention practices for self-neglecting older adults.     

Frailty in self-neglecting older adults: A secondary analysis

ABSTRACT

Self-neglect (SN) and frailty in older adults is associated with increased disability and mortality. Despite these commonalities, there have been no studies objectively assessing frailty in older adults who SN. This secondary analysis classified frailty in N = 37 older adults with Adult Protective Services validated SN using the Fried Frailty Phenotype (FFP) of weight loss, weakness, exhaustion, activity level, and walking speed. Overall, 3% were classified as robust, 62% as prefrail, and 35% as frail. Most (72%) were overweight/obese, with clinically significant decreases in activity level (60%) and walking speed (97%). Compared to the original FFP population, older adults who SN exhibit important differences in frailty phenotypes, and finding that the largest percentage of older adults who SN were prefrail may indicate a critical opportunity for intervening in this population to reduce future functional decline and mortality.     

Feasibility of intervention in elder self-neglecters: Setting the stage for future research

Objectives: Interventions are critical to improving clinical outcomes in elder self-neglecters. This study assessed feasibility of a randomized controlled trial of oral vitamin D in Adult Protective Services-substantiated self-neglect clients ≥65 years.

Methods: Participants were directly observed to consume ergocalciferol 50,000 IU (treatment) or ergocalciferol 400 IU (control), once a month, for 10 months. For months 6–10, half the control group randomly crossed into the treatment group (crossover). Intervention feasibility was measured by number of potential participants who agreed to participate and by retention rates during the study.

Results: Ninety-four referrals were received and 59 (63%) agreed to participate. Forty-nine participants were enrolled after prescreening and 35 completed the two-phase trial for a 72% retention rate. The participants’ average age was 75.2 ± 6.8 years, mainly female (59%), African-American (47%), and living alone (41%).

Discussion: Despite assumptions that self-neglecters are resistant to care, we have successfully conducted the first clinical intervention in this vulnerable population.     

Sacred time: Ensuring the provision of excellent supervision

In this study, the authors explore the beliefs and attitudes regarding what constitutes “excellent supervision” from the perspectives of frontline workers and supervisors employed by one voluntary services organization in Northern Ireland. Several themes emerged from focus group narratives, regardless of participants’ agency position, and a concept map provides an understanding of the relationships of the identified themes. This study reflects the important role of organizational context and culture in relation to staff’s ability to provide excellent supervision, as well as in sustaining organizational change efforts regardless of organizational setting. The potential of peer and/or group supervision to address improving staff support with limited resources is also suggested.     

Teaching Social Work in an Online Environment

This article discusses the current debate surrounding online instruction (also known as distance) versus in-class social work instruction and reviews the relevant literature associated with those instructional models. The discussion specifically focuses on key issues, including the definition and growth of online education and the Blackboard revolution, and it addresses concerns about the effectiveness of teaching online compared to in-class social work instruction in areas related to students’ learning outcomes and satisfaction. Literature references also suggest that factors such as demographics may be related to outcome differences between distance and traditional students, while others found no significant differences between both student populations and their learning outcomes in particular courses such as research methods courses. Even today, however, the comparisons between online and traditional courses are unsettled, and many questions remain about the appropriateness or usefulness of these models. Therefore, the debate will continue to lead to even larger disagreements between researchers and educators on both sides. The concern about the effectiveness of teaching in an online environment is still the main concern of educational models in general and of social work education in particular. Even deeper concerns are found among educators and scholars about the ethical issues surrounding the entire online education debate.     

Teenage Black Girls and Violence: Coming of Age in an Urban Environment

Abstract

Exposure to violence and fear of violence in relation to hopefulness and anger were investigated for 30 teenage Black girls 14 to 19 years of age. Information from focus groups was included to provide a context for the empirical data. Results indicated that overall the girls were hopeful, with a mean score of 135 (SD = 18.2) out of a possible score of 168. Correlation and regression procedures revealed a statistically significant negative relationship between hopefulness and exposure to violence. No significant relationship was found between anger and hopefulness. Fear of violence was positively related to exposure to violence but did not appear related to anger or hopefulness. The findings were mixed and did not capture the kind of hopelessness and anger which often appear in the literature describing children growing up in urban environments. Through the use of focus groups the teenage girls provided contextual information which seemed to indicate that many of them shared the values of mainstream society in terms of their future aspirations and assessment of their communities.     

Walking the Tightrope: Directing a Student Health Center at a Research Institution With an Academic Medical Center

Reporting lines for directors of student health centers (SHCs) at colleges and universities are a matter of continuing interest for those of us who must follow them. SHC directors at institutions with academic medical centers face a greater number of reporting choices that also have the potential of being more politically charged. The author describes his experience at 2 such institutions and offers some cautious advice.     

Risk and protective factors for depression and substance use in an adolescent child welfare sample

Research on the mental health needs of maltreated youth in out-of-home care remains limited. The goal of the current study was to examine two common mental health concerns (i.e., depression, substance use) among 122 12-15 year olds in out-of-home placements. Specifically, we investigated potential risk and protective factors among socio-demographic, maltreatment, youth, family, and community variables. We relied on data collected through the AAR-C2, a Canadian needs assessment and outcome monitoring tool. Approximately 4 in 10 (39.2%) youth endorsed at least one mental health problem, which we defined as the youth scoring at least one standard deviation above the sample mean for the depression items and the youth indicating the presence of alcohol and/or substance use over the past year. Almost 1 in 10 (8.3%) reported struggling with both mental health issues. Results from logistic regressions indicated that adolescent females were at higher risk of experiencing depression than males, and increasing age was associated with increased risk for substance use. Turning to protective factors, results indicated that the greater the perceived quality of the youth-caregiver relationship, the lower the risk for mental health difficulties (i.e., depression, substance use). Moreover, participation in extracurricular activities appeared to protect youth against depression or substance use. Results imply that the youth-caregiver relationship and involvement in extracurricular activities are important areas to consider to promote the well-being of maltreated youth in out-of-home care.     

Anxiety and Depression: Implications for Older Adults

By the year 2030, it is projected that one in every three Americans will be 55-years-old or older. This age group is by far thefastest growing segment of the population. With the growing number of older adults, the importance of understanding aging and common disorders of laterlife is essential. In particular, anxiety anddepression are among the most common problems in older adults. However, differentiating anxiety and depression at the mood, symptom, and syndromal levels has been a long-standing problem in psychopathology research. In addition to a growing need for research, clinicians will also need to take an active role in the development and implementation of treatment as the population of older adults increases. In particular, mental health service providers must become informed about the economic implications for older adults as the structure of health insurance continues to change.     

Assessing Depression in Childhood and Adolescence: A Guide for Social Work Practice

Depression is relatively common in children and adolescents, and if left undetected and untreated, can have long-term negative consequences. Social workers providing services to families, children and adolescents need to understand the characteristics, and conduct developmentally appropriate assessments, of depressive symptoms. This paper provides a review of current literature related to the definition, prevalence, co-occurrence, and measurement of depression in childhood and adolescence. It also highlights relevant gender, race, and ethnic influences.     

Laughing Through This Pain: Medical Clowning During Examination of Sexually Abused Children: An Innovative Approach

This study examined the role of medical clowns during medical examinations of children who were sexually abused. Three case studies are described, illustrating diverse interactions among the victimized child, the medical clown, and the medical forensical examiner during medical forensic examinations held at the Tene Center for Sexually Abused Children, Poria-Pade Medical Center, Israel. The results indicated that medical clowns play a unique role both in lowering anxiety and fear among children before and during the unpleasant forensic examination as well as in mitigating potential retraumatization of the sexual abuse event resulting from the medical examination. The medical clown was found to assist in creating a pleasant and calm atmosphere, thus improving the child's cooperation during the examination.     

Claymation for Collective Intelligence and Intergenerational Learning in an Educational Environment

Elementary students, volunteering older adults, and university students use their collective intelligence as they engage in intergenerational learning during an after-school enrichment activity producing Claymation videos. Participant reflections, completed questionnaires, and candid photos document learning and relationship building, suggesting intergenerational visual art engagement as a replicable method of lifelong learning for multiages in a school environment.     

优化儿童成长环境是社会的重要责任——“儿童成长环境与社会责任”理论研讨会综述

儿童健康成长是中国社会的重要责任,当前,儿童成长环境中还存在一些不利于儿童成长的客观因素,比如家庭过度教育问题、教育机制导向问题、儿童安全问题、青少年犯罪及立法问题等。因此,必须加强儿童工作的力度,切实落实相关政策,为儿童的健康成长提供有利的保护。习近平总书记在2013年“六·一”前夕以一个大朋友身份来到北京市少年宫,向全国儿童祝贺节日的同时,勉励儿童既要学习书本知识,又要多学课外知识;既要勤于思考,又要培养创造精神。以此为契机,上海社会科学院青少年研究所举办了“儿童成长环境与社会责任”研讨会．就以上问题展开热烈讨论,并提出具体策略以供相关部门参考。     

Cortisol Rise Following Awakening Among Problem Gamblers: Dissociation from Comorbid Symptoms of Depression and Impulsivity

Gambling pathology has been associated with elevated levels of distress, depression and impulsivity. The present investigation assessed whether these behavioral features would be evident among problem gamblers as they are among pathological gamblers. As well, given that gambling has been associated with increased life stress, as an objective index of ongoing distress, elevations of morning cortisol levels were assessed in problem and pathological gamblers relative to recreational gamblers, and their relations to depressive symptoms and impulsivity were assessed. Recreational, problem, and pathological gamblers (N = 140) completed the Beck Depression Inventory and the Barratt Impulsiveness Scale-11, and provided saliva samples at awakening, 30 min, 3.5 h, and 5.5 h afterward. Consistent with the view that problem and pathological gambling are associated with elevated life stressors, the rise of morning cortisol from awakening to 30 min following awakening was greater than in recreational gamblers. Heightened impulsivity was evident among both problem and pathological gamblers, whereas depressive symptoms were only evident among pathological gamblers. In neither instance were these psychological indices related to the morning cortisol rise. Indeed, increased depressive symptoms were not evident among problem gamblers, despite the fact that elevated morning cortisol levels were evident. The elevated morning cortisol rise may be secondary to gambling problems or distress related to gambling problems. Furthermore, the sustained morning cortisol elevations may be indicative of allostatic overload, and could potentially be a harbinger for potential health risks among problematic gamblers.     

Underemployment: Individual and marital adjustment to income loss

Psychological and interpersonal adjustments to income loss were investigated by comparing 25 couples in which husbands were underemployed to 88 couples in which husbands had been continuously employed. Husbands were considered underemployed if they had lost 20% of their annual earnings. Via questionnaires, husbands and wives reported on attitudes and on attributions for their present financial circumstances. Underemployed husbands and their wives were less satisfied with their finances and their marriages than the comparison group. The components of depression and marital dissatisfaction, for under-employed and continuously employed couples, and the importance of gathering data from both spouses, are discussed.Research reported in this paper was supported by funds from the Agricultural Experiment Station, Regional Project W-167—Coping with Stress: Adaptation of Nonmetropolitan Families to Socioeconomic Change (Technical Paper #8358). An earlier version was presented at the Annual Meeting of the National Council on Family Relations, Dearborn, Michigan, November 5, 1986.The assistance of Tom Guss and Linda Ladd in gathering these data is gratefully acknowledged. The author also wishes to thank Petra Zengerle for statistical analysis; Alan Sugawara, Alexis Walker, Dorothy Price, Mari Wilhelm, and two anonymous reviewers for their helpful comments on an earlier draft.Anisa M. Zvonkovic received her Ph.D. from Pennsylvania State University. Research interests include close relationships and the effect of socio-economic changes on interpersonal bonds. Address correspondence to Dr. Zvonkovic, Assistant Professor, Department of Human Development and Family Studies, Oregon State University, Corvallis, OR 97331.