Understanding intimate partner violence against women in the rural South

Most U.S. intimate partner violence (IPV) research to date has been limited to women residing in urban areas, with the small body of research focusing on rural populations being primarily qualitative. In this case-control study of Southern rural women, while many factors are consistent with those found in urban settings, unlike findings elsewhere, IPV risk appears to increase with age, and race showed no increased risk. Furthermore, in rural areas where guns are more acceptable than in other parts of the United States, partners of IPV victims are considerably more likely to carry weapons than partners of nonabused women. Given the geographic limitations to police and medical response to severe IPV in a rural setting, an improved understanding of IPV risk among this population can aid health care providers in ascertaining risk before it escalates further.     

A prospective examination of depression,anxiety and stress throughout pregnancy

BackgroundPerinatal distress has largely been conceptualised as the experience of depression and/or anxiety. Recent research has shown that the affective state of stress is also present during the perinatal period and thus may add to a broader understanding of perinatal distress.AimThe aims of the present study were to investigate the changes in depression, anxiety and stress symptoms across pregnancy, and to explore the prospective relationships between these symptoms.MethodsTwo-hundred and fourteen pregnant women were recruited when they were less than 16 weeks gestation. Women completed depression, anxiety and stress measures on a monthly basis, from 16 weeks gestation through to 36 weeks gestation. The covariate measures of sleep quality and social support were assessed bi-monthly at 16, 24 and 32 weeks gestation.FindingsLevels of depression, anxiety and stress symptoms were all shown to change over time, with women experiencing fewer symptoms during the middle of their pregnancy. Higher symptoms early in pregnancy predicted higher symptom levels throughout the rest of pregnancy. Higher depression scores early in pregnancy were also shown to predict higher anxiety and higher stress scores in late pregnancy. Increased stress scores during mid pregnancy also predicted higher anxiety scores in late pregnancy.ConclusionCurrent findings indicate that symptom levels of depression, anxiety and stress vary over the course of pregnancy. Increased depression in early pregnancy seemed to be particularly pertinent as it not only predicted later depression symptoms, but also increased anxiety and stress in late pregnancy. Collectively, these results further highlight the importance of emotional health screening early in pregnancy.     

The transition to motherhood: Towards a broader understanding of perinatal distress

BackgroundA substantial body of research has focused on maternal perinatal mood and wellbeing, with the focus predominantly being on depression, and to a lesser extent, anxiety. Perinatal maternal stress has also been investigated recently, but to a far lesser extent. The present paper questions whether the term ‘perinatal distress’ accurately captures the range of challenges experienced by women during the perinatal period, when the scope of ‘distress’ is limited to the experience of depression and anxiety alone.MethodA review of the perinatal literature was conducted using several databases, to identify studies that have focused on the experience of stress as a distinct affective state in the perinatal period.FindingsThe findings of two recent studies which have employed a broader conceptualisation of perinatal distress to encompass the experience of stress as well as depression and anxiety are outlined. These recent studies have identified the experience of stress both in conjunction with and independent of depression and anxiety.ConclusionIt is argued that future studies should investigate the concept of stress as a separate affective state throughout the perinatal period, in order to further assess how it differs from depression and/or anxiety. A more comprehensive understanding of women's experiences during their transition to motherhood, and whether ‘stress’ plays a critical role in the development and maintenance of perinatal anxiety and/or depression is needed.     

Research with children: sharing the dilemmas

This paper identifies a number of significant gaps between the principles of good practice in research with children and the practical realities of conducting a research project with children. The context of the discussion is an ongoing research study of children and young people in Scotland with a parent or carer with HIV. The paper argues that conducting research with what is a hidden (and in many ways secret) population throws into sharp relief some difficulties and contradictions that are at the heart of the research process. The paper does not intend to present easy answers to the complex questions that it raises: the research project it describes is ongoing and not yet at the stage of disseminating findings in any definitive way. Moreover, it seems likely that there are no answers to the questions raised, but that the act of posing the questions may contribute to the development of better, more reflexive research with children.     

Re-examining Children's Consent to Medical Treatment

The question of consent to the medical treatment of children is looked at across the four disciplines of law, medicine, psychology and philosophy. The conclusion is reached that while there is a remarkable consensus on the issues considered to be important, none of the disciplines provides a complete answer to the problems involved. As an experiment, reference is made throughout the article to various literary conceptions of childhood. It is hoped that some of these may give cause for thought about how children are treated by the professions. The article was prepared for publication before release of the judgements of the High Court in Re Marion in May 1992 (renamed Secretary, Department of Health and Community Services v JWB and SMB on appeal). In the appeal a majority of the High Court followed the Full Court of the Family Court in Re Marion and confirmed that judicial consent is required for the medical treatment of children in some cases. The notion of treatment being therapeutic or non-therapeutic was not accepted, the majority preferring to rest judgement on assessments of the risks and gravity of consequences of a wrong decision (JWB and SMB 79,180 and 79,206–7). There are many other points of interest discussed by the High Court, for example, Brennan J's comments on the absurdities of the concept of substituted consent (79,196–7), Deane J's acceptance that the issues involved were moral and social and therefore beyond legal competence (79,208) and McHugh J's understanding of the sources of the parental power to consent (79,214). Although adding authority to some of the views expressed in the Full Court of the Family Court, the judgements of the High Court do not dispose of debate on the issues raised in the article.