Misgivings of medicine?: African Americans' skepticism of psychiatric medication

Research has consistently documented black-white differences in rates of voluntary psychiatric treatment that cannot be reduced entirely to differences in either need or access. A variety of explanations have been offered for the gap that remains, but the empirical testing of alternative propositions has thus far been minimal. Using the 1998 General Social Survey's Pressing Issues in Health and Medical Care module (n = 1,387), I find consistent and substantial black-white differences in a variety of beliefs about psychiatric medications, one of the most common treatments for mental illness, and the predisposition to use them. Specifically, blacks express less willingness to use psychiatric medications themselves or to administer them to a child for whom they are responsible. Neither socioeconomic status, knowledge, religious involvement, nor trust in medicine appears to explain this reluctance. Rather, it stems almost entirely from blacks' beliefs about psychiatric medications' efficacy and side-effects. The results indicate, first, that researchers should not assume that African Americans will use psychiatric medications at rates similar to whites if offered equal access. Second, the results indicate that blacks' skepticism of psychiatric medications may be rooted in specific beliefs about psychiatric medications, rather than general ideologies about medical practice. Health beliefs about psychiatric treatment, therefore, will continue to play an important role in understanding race differences in the use of psychiatric medications.     

Using a Community Participatory Research Approach to Understand Satisfaction with Psychopharmacology Among Families of Children with Psychiatric Co-Morbidities

How do parents of children with psychiatric co-morbidities perceive their children’s use of psychiatric medications? To learn more, the Parent/Professional Advocacy League of Massachusetts (PAL), representing families of children with mental health needs, collaborated with researchers on a community-based participatory research (CBPR) study. A questionnaire assessed satisfaction with psychiatric medication as it pertained to children with psychiatric co-morbidities (n = 212). Satisfied parents were likely to employ alternative therapies and feel that prescribers had informed them about medication use and side effects. Results reinforce the need for prescribers to discuss psychopharmacology with families. CBPR improved study relevance and supported PAL’s advocacy efforts.     

Sexual Behaviors and Attitudes and Ethnic Identity During College

This study examined ethnic differences in sexual behaviors and attitudes, and associations between ethnic identity commitment and sexual behaviors and attitudes. African American (32%), Latino American (29%), and European American (39%) first-year college students (N = 434; 52% female) completed surveys about their sexual behaviors (number of partners, condom use, and alcohol use before intercourse) and attitudes (conservative attitudes, condom-related beliefs, and fear of AIDS) and ethnic identity commitment. Analyses of covariance and hierarchical linear regressions were performed. Among the three groups, Latino Americans reported riskier condom-related behaviors and attitudes, whereas European Americans were less fearful of AIDS. Ethnic identity commitment was a protective factor against risky attitudes regardless of ethnicity. For sexual behaviors, however, ethnic identity served as a protective factor only for European Americans. This study contributes to the understanding of adolescents' sexuality during college and the role of ethnic identity in their sexual experiences.     

Decision-making around psychotropic medications for children in foster care: Perspectives from foster parents

Background and objectiveChildren in foster care have complex mental health needs and receive high rates of psychotropic medications. Rarely can foster parents make legal decisions about treatment, yet they are intricately involved in the child's life and responsible for the child's safety and well-being. We aimed to conduct the first study of foster parent perspectives on decision-making relevant to the use of psychotropics with children in foster care.MethodsWe conducted semi-structured phone interviews with 13 parents in a small northeastern state who had fostered a child receiving psychotropics in the past 5 years. The state child welfare agency sent information about the study via email to all foster and adoptive parents for whom they had email contact. Interviews queried parents' knowledge and attitudes toward psychotropics, engagement in decisions, and recommendations for the decision-making process. Interview responses were coded and synthesized using mixed inductive and deductive methods in Dedoose software.ResultsChildren came into care on an average of four psychotropics. Parents reported receiving little information about the medications and finding information on their own. Parents acknowledged the potential benefits of medications, yet attitudes were largely against their use. Internal and external pressures for and against the use of medications were described. Many parents felt left out of the decisions and recommended team decisions.ConclusionsEfforts to improve foster parents' knowledge of medications, side effects, and monitoring, as well as team decision protocols, are sorely needed to improve decisions for this population.     

CROSSRACIAL DIFFERENCES IN THE RACIAL PREFERENCES OF POTENTIAL DATING PARTNERS: A Test of the Alienation of African Americans and Social Dominance Orientation

Studying interracial romance has been useful for understanding general race relations. Theories of African American alienation and social dominance orientation help explain why previous research has found African Americans to be the least desired racial dating partners. Alienation predicts that African Americans are less willing to interracially date than other racial groups since they are not allowed to participate in the majority culture. Social dominance orientation predicts that African Americans are more willing to interracially date than other racial groups because they occupy the lowest position in our racial hierarchy. This study utilizes an Internet dating website to explore the racial dating preferences of European Americans, African Americans, Hispanic Americans, and Asian Americans. The theory of African American alienation is upheld, as African Americans are generally less willing to interracially date than other races and are especially less willing to date European Americans.     

Acceptance of Foreigners: Ethnic and Gender Differences Among Americans

This study examined American students' (N = 207) attitudes and behavior towards students of various nationalities. The findings suggest that, while these students rated Africans lower than Westerners, and Asians no differently than the other two groups, there were ethnic and gender differences among the Americans. Female students rated Westerners as being better liked than Africans, and minority students rated Westerners both as better liked and better adjusted than Africans. Males and Whites rated the three groups equally. Overall ratings by women were more favorable than those by men. In terms of volunteering hospitality, these students were as generous to the Asian and the African foreigners as to the Westerners, but in general, a greater proportion of ethnic minority students was willing to be hospitable.     

‘How Do You Feel About Studying Social Work?’—Social Work Students in Greece: Demands,Support, Feelings About Their Studies and Attitudes Towards Themselves

This paper presents the results of a study exploring the nature and extent of the demands placed upon social work students during their studies, the support available to them inside and outside the course, their feelings about their work and their attitudes towards themselves. Demands from the course were rated higher than demands from financial, family and part-time work responsibilities. Important support was obtained from friends, relatives and fellow students while, except for practice teachers, the lack of support from the course was emphasized. A large number of students often felt exhausted, not due to the actual work with users but mostly due to obligations to the course such as essays. On the whole, however, students felt good about what they had accomplished so far and held positive attitudes towards themselves. The need for structured support resources offered within the educational institution was evident and recognized by more than half of the students, who stated they would be willing to use them had they been available. Students expressed no intention to quit their studies despite the demands placed upon them; the prospect of unemployment was an additional source of worry for more than half of them.     

A Heart to Learn and Care? Teachers' responses toward special needs children in mainstream schools in Hong Kong

This article examines the problems associated with introducing integrated education into Hong Kong's mainstream schooling system. The research objectives were to examine the experience of teachers in teaching children with special needs in mainstream schools; to examine the attitude of mainstream teachers towards integrated education, and explore whether the differences in perception of difficulties and attitudes are attributable to types of disability and availability of resources. This was achieved through a research strategy utilising a questionnaire survey combined with individual and group interviews. The results demonstrate that there is a clear hierarchy of preference amongst teachers in relation to special needs children. Students with a learning disability and/or behavioural problems pose more challenges to teachers than those with a physical difficulty. Teachers that had both types of special needs children in a class experience more problems in maintaining classroom discipline, have a greater workload and struggle to manage the disparate academic standards amongst students. Teachers in schools with extra funding provisions, teachers trained to teach special needs children, additional counselling resources and specialist support expressed more accepting attitudes towards children with special needs and their admission into mainstream schools. Resource classes did not exert a positive effect on acceptance. More than 70% of questionnaire respondents were supportive of two positive value statements 'realisation of equal opportunities' and 'a good chance for students to interact'. At the same time teachers tended to agree with the statements 'integration was a burden to the schools and teachers' (over 60%) and 'a painful struggle for special students' (48%). Although there is a general normative acceptance of inclusion, the statistical pattern suggests that teachers' attitudes are not static or based solely on ideology.     

Public attitudes towards human life extension by intervening in ageing

A number of biogerontologists have expressed an interest in intervening in the ageing process in order to extend the human life span. This study explored the attitudes of members of the Australian public towards the potential development and use of life-extension technologies and their attitudes towards the ethical, social and personal implications of life extension. Participants were presented with a vignette outlining the prospect of a “life-extension pharmaceutical” that could increase maximum life span by slowing the ageing process. While 65% supported such research, only 35% said that they would use a life-extension technology if one became available. Men were more supportive of research and more disposed to use life-extension technologies than women. Concerns about the potential ethical, social and personal implications predicted levels of overall support for, and intention to use, life-extension technologies. Our survey suggests that public attitudes towards life extension are neither overwhelmingly “pro” or “con” and in fact more nuanced than either proponents or opponents of life extension have often assumed.     

Willingness to have unprotected sex

Little is known about people's willingness to engage in sex without protection from unwanted pregnancy. This study surveyed 1,497 women and men at 75 clinics and physician offices across California after their reproductive health care visits in late 2007 and early 2008. When asked if they would have sex without contraception, 30% said definitively that yes, they would have unprotected sex, and 20% indicated they would "sometimes" or "maybe" engage in unprotected sex. In multivariate models, compared to non-Latino White respondents, Latinos who responded to the survey in English were 52% more likely and African Americans were 75% more likely to report willingness to have unprotected intercourse. Wanting a child within the next three years was associated with increased willingness to have unprotected sex. Age, gender, parity, and relationship status were not significant in multivariate models. A considerable proportion of women and men may be willing to have unprotected sex, even with access to subsidized contraceptive services and even when recently counseled about birth control. The dominant behavioral models of contraceptive use need to acknowledge the widespread likelihood of occasional unprotected sex, even among people motivated to usually use contraceptives. Findings underscore the need to make contraceptive methods accessible, easy to use, and even pleasurable.     

Physical Punishment in Christian Arab Families in Israel: Attitudes and Behaviour

The present study examines the attitudes towards physical punishment (PP) and its actual use as reported by Christian Arab parents and their children in Israel. Participants were parents and one child (of at least two) in 50 Christian Arab families. Three questionnaires based on semi‐structured interviews were developed for the study. Results show no difference in family members’ attitudes towards the use of PP. Whereas, the mean scores indicate ambivalent acceptance of this practice, the great majority of participants reported its frequent use. Mothers’ and fathers’ attitudes were found to be highly correlated and significant predictors of such behaviour. All three groups reported that mothers use PP much more than fathers do, although it was the fathers whom the children feared most. The results also show that the parents’ most frequent reaction to seven categories of children’s misbehaviour was verbal violence and the second most frequent reaction was PP. These and other results are discussed in the context of Arab culture in Israel, the social situation model and relevant research.     

The Use of Psychiatric Medication,Human Capital,and the Amplification of Mistrust

This research investigates the relationships among willingness to utilize psychiatric medication, education, and three forms of mistrust—generalized mistrust, mistrust in physicians, and mistrust in psychiatric medication. Utilizing human capital theory and two waves of the U.S. General Social Survey (N = 2,671), our findings show a curvilinear relationship between willingness to use psychiatric drugs and education, such that individuals with less than a high school diploma and those with a college or advanced degree are more willing to use psychiatric drugs compared to those with a high school degree. Also, the effects of all three forms of mistrust are amplified and have significant, negative effects on the use of psychiatric medication among college graduates. Mistrust in physicians and mistrust in psychiatric drugs matters for high school graduates, while only mistrust in psychiatric medication impacts the use of psychotropics for those with less than a high school degree.     

How to work with elderly patients on a general psychiatric unit

Currently, there are specialized geropsychiatric units being used for elderly psychiatric inpatients. However, these units are not always available to the growing elderly population. The general inpatient psychiatric unit seems to be well suited for treating the medical and mental illness of elderly psychiatric patients (Billig, 1989; Conwell, 1989; Liptzin, 1987). As identified earlier, nurses may not be enthusiastic about adding this population to their unit. Our society is youth-oriented and the elderly tend to be viewed as slow, needy, and sick. It is essential for nurses to explore their own feelings regarding aging and what it means to be old. If the nurse has not dealt with issues such as her own mortality and that of her parents and close friends, it may be difficult for her to understand and work with the elderly. The ability to understand the feelings of another and to communicate this understanding has been identified as a crucial variable related to positive therapeutic outcome (Kirk, 1982). Inservice programs and groups that give the staff opportunities to explore their attitudes and feelings toward the elderly may result in more effective therapeutic interventions (Farley, 1983). To many elderly patients, nurses are seen as supportive figures, interpreters of the unknown, and potential allies who have an empathic regard for them (Davis, 1968). The nurse can use these impressions to initiate interventions. This, along with coming to terms with one's own feelings about aging, can result in a greater understanding of these patients. This article has given a very brief overview of the many issues related to the care of the elderly psychiatric inpatient.(ABSTRACT TRUNCATED AT 250 WORDS)     

Arts policy and practice for disabled children and young people: towards a ‘practice spectrum’ approach

This article argues for an approach to the evaluation of arts policy and practice for disabled children and young people that goes beyond the dialogic antagonism between Disability Arts and community arts, and towards a ‘practice spectrum’. Little is known about the extent to which a Disability Arts perspective has extended into arts policy and practice for disabled children and young people. The article aims to redress this knowledge gap. It is based upon two sets of data collected in relation to the East Midlands region of England during 2014. First, a critical evaluation was conducted of official and institutional attitudes to arts practice with disabled children and young people. Second, interviews exploring contemporary practice were conducted with 24 arts organisations. Their practice represents a diverse range of art forms and programmes undertaken in the region, and a range of attitudes and positions taken towards disabled children and young people. We argue that the best way to conceive of current practice is as a spectrum, as opposed to an antagonism between community arts and Disability Arts perspectives. There is, however, little evidence of the penetration of a Disability Arts perspective into policy and practice for children and young people.     

Factors that influence elementary school teachers’ attitudes towards inclusion of visually impaired children in Turkey

There is a scarcity of research on inclusion of visually impaired children in Turkey. Specifically, a gap exists concerning the attitudes of elementary school teachers towards the inclusion of visually impaired children in mainstream schools. This article uses data from two questionnaires, leveraging the responses of 253 teachers from rural and urban areas. The results demonstrate that elementary school teachers commonly hold positive attitudes towards the inclusion of visually impaired children and that teachers’ initial and in-service training about inclusion positively influenced their attitudes. Our findings are in contrast with earlier research which argues that teachers do not hold positive attitudes to inclusion, and highlights that a key barrier to inclusion stems from elementary school teachers feeling unprepared to teach visually impaired children. We conclude that greater post-qualification training is required to enable teachers to operationalise different approaches that facilitate the inclusion of visually impaired children.     

Attitudes Towards Gambling and Gambling Reform in Australia

The Attitudes Towards Gambling Scale (ATGS) is a 14-item survey instrument examining general attitudes towards gambling (Orford et al. in Int Gambl Stud 9(1):39–54, 2009). The current study examined the validity of this scale in an Australian community sample of 1794 adults (52.8 % female). As well as considering measures of internal consistency and factor loadings, we examined the functional utility of the scale as a mediator of gambling activity, problem gambling status, and consequent opinions on national gambling-reform legislation. We found internal consistency and factor loadings of the ATGS within the Australian sample to be comparable with those observed in the original UK study. Additionally, ATGS scores were found to be a relatively robust predictor of attitudes towards gambling reform and harm minimisation. Further, the ATGS mediated the relationships between experiences with gambling and attitudes towards harm reduction. The findings suggest that the ATGS is a useful tool for examining general attitudes towards gambling within an Australian context.     

Internet Use Among People with HIV/AIDS

ABSTRACT

The Internet offers people with HIV/AIDS timely information about treatment advances and supportive social contacts for this stigmatized disease, yet little is known about Internet use patterns among people with HIV/AIDS. This study of 120 persons with HIV/AIDS in the U.S. found approximately 19% used the Internet for HIV/AIDS-related purposes, much lower than the rate for general Internet use among the U.S. population. Lower incomes were associated with lower rates of use, echoing the “digital divide” found in the general population. Access from home was most common and information sought was primarily on medical treatments and medications. Possible reasons for low access rates, strategies for increasing access, and implications for other client groups are discussed.     

Teachers' Views of Students with Gay or Lesbian Parents

Eighty-three female and 24 male teachers responded to an anonymous questionnaire exploring four aspects of teachers' views of students who have gay or lesbian parents: (1) exposure to and general knowledge about homosexuality, (2) attitudes towards gays and lesbians, (3) interactions with gay or lesbian parents, including school practices and policies, and (4) beliefs about problems experienced by students with gay and lesbian parents. Most teachers knew some gay males and lesbians, had limited education and knowledge about homosexuality, and possessed moderately tolerant attitudes towards gays and lesbians. They believed that students with gay or lesbian parents had more problems in social interaction but were more mature, tolerant, and self-reliant than other students. Open-ended questions about gay and lesbian parents and their children revealed a wide range of answers, ranging from very supportive to noticeably hostile.