Interpreting and defensively responding to threat: examining appraisals and coping with acquaintance sexual aggression

Resistance and prevention programming aimed at strengthening women's ability to protect themselves against acquaintance sexual aggression has lacked attention to the cognitive and emotional processes women engage in when encountering such threats. Building upon current theory related to cognitive appraisal and coping processes, this study applies a theoretical model of how women evaluate and respond to sexual aggression by male acquaintances. Two hundred and two college women who had been sexually victimized by male acquaintances responded to a questionnaire that assessed their cognitive appraisals of and emotional and behavioral responses to the incident, in addition to aggression characteristics. Path analytic regression analyses examined theorized relationships among primary and secondary appraisal and emotional response variables in addition to their collective prediction of behavioral responding. The hypothesized model accounted for significant variance in behavioral responding and indicated different patterns of appraisals, emotions, and aggression characteristics predicting women's assertive and diplomatic behavioral responses to their assaults. These findings are consistent with research and theory related to individuals' appraisal of and coping with threatening events. Theoretical and intervention implications for resistance and prevention efforts are discussed.     

Medical complications of female genital mutilation.

More than 130 million women are subjected to genital mutilation. Despite increasing efforts to reduce the practice, there are many obstacles to eliminating this 2,000-year-old practice, which is based on strong cultural traditions. As college health clinicians provide care to more international students from countries where female genital mutilation is performed, increased awareness and knowledge of the procedure will enable clinicians to understand and manage its complications. We report a case of obstructive uropathy resulting in hydronephrosis secondary to female genital mutilation and review the medical literature regarding this and other complications of genital mutilation "surgery."     

Spirit Possession and Exorcism in the Treatment of a Bedouin Psychiatric Patient

A male Bedouin psychiatric patient was initially misdiagnosed and treated as a paranoid schizophrenic. The modern mental health care system correctly understood the form of the patient's symptoms, auditory and visual hallucinations. It did not however at first appreciate their content, or cultural significance. The patient had unresolved anger toward his family which was manifested in an angry exchange with his mother. This exchange created guilt and the belief that the patient had sinned against God and was possessed by demons. A psychiatric social worker was able to reconcile the patient with his mother and to incorporate a traditional Bedouin healer, the Dervish, to exorcise the patient. The patient was cured by the Dervish, re-diagnosed as a neurotic by the modern system, and continued successfully with both systems for several months in follow-up treatment before being discharged.     

Imprecise preferences and the WTP-WTA disparity

This article reports the results of a study designed to elicit willingness to pay (WTP) and willingness to accept (WTA) values for changes in the risk of nonfatal road injuries. We examine the possibility that individuals' preferences over combinations of wealth, risk, and safety are imprecise, and that this imprecision might result in the observed disparity between WTP and WTA measures of value. The results confirm that individuals' preferences for safety are significantly imprecise, but that this alone is insufficient to explain more than part of the disparity. Indeed, respondents' estimates of the minimum that they would be prepared to accept for a risk increase frequently exceed the maximum that they would be prepared to pay for an equivalent risk reduction.     

Food Banks and Food Security: Welfare Reform,Human Rights and Social Policy. Lessons from Canada?

In the past twenty years food banks have established themselves as one of the fastest–growing charitable industries in first world societies. As institutionalized centres or clearing houses for the redistribution of donated and surplus food they have emerged as a key frontline response to the growing problem of food poverty and inequality. As welfare states have been restructured and cut back and basic entitlements have been denied, food banks have become secondary extensions of weakened social safety nets. This paper explores the growth of food banking in Canada and analyses its role in terms of advancing the human right to food, its effectiveness in achieving food security and the extent to which it contributes to, and/or counters the increasing emphasis by governments on welfare reform policies informed by neo–conservative ideology. Food banks are examined from the perspective of their origins and purposes, institutionalization, usage, food distributed and effectiveness. The rise of food banks in Canada is concrete evidence both of the breakdown of the social safety net and the commodification of social assistance. As such, they undermine the state's obligation, as ratified in international conventions, to respect, protect and fulfil the human right to food. They enable governments to look the other way and neglect food poverty and nutritional health and well–being. A possible future role for food banks in countries where they are already established lies in public education and advocacy, but their institutionalization makes this seem an unlikely course. In countries where they are in their infancy, the question of whether to support their development should be a matter of urgent public debate.     

The impact of routine assessment of past or current mental health on help-seeking in the perinatal period

BackgroundClinical practice guidelines now recommend that women be asked about their past or current mental health as a routine component of maternity care. However, the value of this line of enquiry in increasing engagement with support services, as required, remains controversial.AimThe current study aimed to examine whether assessment of past or current mental health, received with or without referral for additional support, is associated with help-seeking during pregnancy and the postpartum.MethodsA subsample of women drawn from the Australian Longitudinal Study on Women's Health (young cohort) who reported experiencing significant emotional distress during pregnancy (N = 398) or in the 12 months following birth (N = 380) participated in the study.ResultsMultivariate analysis showed that women who were not asked about their emotional health were less likely to seek any formal help during both pregnancy (adjOR = 0.09, 95%CI: 0.04–0.24) and the postpartum (adjOR = 0.07, 95%CI: 0.02–0.13), as were women who were asked about these issues but who were not referred for additional support (antenatal: adjOR = 0.26, 95%CI: 0.15–0.45; postnatal: adjOR = 0.14, 95%CI: 0.07–0.27). However, considerable levels of consultation with general practitioners, midwives and child health nurses, even in the absence of referral, were evident.ConclusionThis study demonstrates that enquiry by a health professional about women's past or current mental health is associated with help-seeking throughout the perinatal period. The clinical and resource implications of these findings for the primary health care sector should be considered prior to the implementation of future routine perinatal depression screening or psychosocial assessment programmes.     

Public Perceptions of Risk and Preference-Based Values of Safety

This article reports the results of two studies aimed at estimating preference-based values of safety in three contexts—namely rail, domestic fires and fires in public places—relative to the corresponding value for roads using matching (or equivalence) questions. In addition, both studies included a variety of questions intended to shed light on respondents' perceptions of risk and attitudes to safety in the various contexts. While the two studies were, to all intents and purposes, identical in the procedure that they employed, the essential difference between them was that the first study took place in late 1998, whereas the second study was carried out in early 2000 in the aftermath of a major rail accident at Ladbroke Grove near London's Paddington station which occurred in October 1999 and in which 29 passengers and 2 train drivers died. In addition, the second study sample was deliberately weighted to contain an above-average proportion of regular rail users. These studies demonstrated how certain factors which have been shown to affect people's perception of risk (see Slovic, P. (1992). In S. Krimsky and D. Golding (eds.), Social Theories of Risk, Westport, CT: Praeger, pp. 117–152) also affected our respondents' priorities over safety programs. The results also showed however, that the impact of these perceptions upon the trade-offs between preventing deaths in different hazard contexts was a good deal less pronounced than has been suggested by the value differentials that are currently implicit—and in some cases, explicit—in public policy making.     

A Microeconometric Test of Alternative Stochastic Theories of Risky Choice

The random preference, Fechner (or white noise), and constant error (or tremble) models of stochastic choice under risk are compared. Various combinations of these approaches are used with expected utility and rank-dependent theory. The resulting models are estimated in a random effects framework using experimental data from two samples of 46 subjects who each faced 90 pairwise choice problems. The best fitting model uses the random preference approach with a tremble mechanism, in conjunction with rank-dependent theory. As subjects gain experience, trembles become less frequent and there is less deviation from behaviour consistent with expected utility theory.