Electronic support groups, patient-consumers, and medicalization: the case of contested illness

This article illustrates the role electronic support groups play in consumer-driven medicalization. The analysis is based on an observational study of a year in the life of an electronic support group for sufferers of the contested illness fibromyalgia syndrome. The analysis builds on and extends scholarship concerning the growing influence of lay expertise in the context of medical uncertainty by showing how the dominant beliefs and routine practices of this electronic community simultaneously (and paradoxically) challenge the expertise of physicians and encourage the expansion of medicine's jurisdiction. Drawing on their shared embodied expertise, participants confirm the medical character of their problem and its remedy, and they empower each other to search for physicians who will recognize and treat their condition accordingly. Physician compliance is introduced as a useful concept for understanding the relationship between lay expertise, patient-consumer demand, and contemporary (and future) instances of medicalization.     

Prevalence, type, disclosure, and severity of adverse life events in college students

OBJECTIVE: Some information on the prevalence of adverse life experiences is available for the general population and college students, but the extent, nature, and severity of these events is unclear. PARTICIPANTS: The authors recruited undergraduate college students (N = 6,053) from diverse academic settings (public and private schools) and geographic locations. METHODS: They examined the prevalence, nature, severity, and disclosure of adverse events, in addition to reports of posttraumatic stress disorder (PTSD) symptomatology within the sample. RESULTS: Across multiple studies, prevalence rates of adverse events ranged from 55.8% to 84.5%, replicating previous findings in larger samples. In a subset of undergraduate students (n = 97) who the authors interviewed in greater depth, 9% reported symptoms of clinical PTSD and an additional 11% reported subclinical symptoms. CONCLUSIONS: Research using college samples for the study of stressful life events is a useful and reasonable strategy. The authors discuss implications for research, as well as screening and referral services at universities.     

A National Survey on Depression,Internalized Homophobia,College Religiosity,and Climate of Acceptance on College Campuses for Sexual Minority Adults

ABSTRACT

Sexual minority persons have an increased risk for negative mental health outcomes in adulthood. This seems to largely be due to experiences of stigma in social settings. This study sought to understand the relationship between attending a religiously conservative college, internalized homophobia (a measure of sexual stigma), and depressive symptoms for sexual minority adults. Sexual minority adult participants (n = 384) from across the U.S. were recruited and completed a Web-based, anonymous survey. A mediation model predicting depression through college religious conservatism, college acceptance of sexual minority identities, and internalized homophobia was tested using path analysis. Results revealed an indirect effect of increased religious conservatism of a college predicted higher depression through lower college acceptance and higher internalized homophobia. Implications for the mental health of sexual minority adults and future research are examined.     

Money value of consumption and income of rural families: Two measures of economic status

In this study a measure of economic status, money value of consumption, is defined and its relationship to income is examined using data collected from 628 U.S. rural families and 1170 North Carolina rural families. Findings suggest that for rural families money value of consumption is linearly related to income, that the variance of money value of consumption is proportional to income and that money value of consumption is more equally distributed than income. Money value of consumption is more closely related to income for one-and four-or-more-person families than for two-or-three-person families. A comparison of how the two measures (money value of comsumption and income) rank rural families by consumption status indicates that income is most likely to rank families inaccurately at very low and very high levels of income. Findings should assist in the appropriate interpretation of income when it is used as a proxy for consumption.     

Self-care: Why do parents leave their children unsupervised?

We used a preferences-and-constraints model to develop four hypotheses to explain why parents may choose self-care (an unsupervised arrangement) as the primary child care arrangement for their children over supervised alternatives and tested them in a multivariate framework using 1995 data from the Survey of Income and Program Participation. We found that the choice of self-care over supervised care alternatives is linked to the availability of parents' time to care for children, the child's level of responsibility and maturity, and the neighborhood context. However, we found no evidence that parents' ability to pay for child care is related to the choice of self-care. The results also suggest that parents use different decision-making processes, depending on their children's ages.     

Factors affecting early family formation: A path model

The age at which women initiate family formation has important social and economic implications. To explore factors that determine age at initiation of childbearing, a non-recursive path model was estimated using data for young women in the National Longitudinal Survey. Results suggest that the young woman's family of orientation has important effects on the age at which she begins family building, but that the process is not simple or direct. Age at first marriage, educational attainment, and age at family formation are strongly interdependent; however, the process seems to vary by race.Kristin A. Moore and Sandra L. Hofferth are affiliated with the Urban Institute, 2100 M. Street, N.W., Washington, D.C. Requests for reprints should be directed to Kristin Moore.     

Social control correlates of arrest behavior among homeless youth in five U.S. cities

This study identified homelessness, substance use, employment, and mental health correlates of homeless youths' arrest activity in 5 cities. Two hundred thirty-eight street youth from Los Angeles, Austin, Denver, New Orleans, and St. Louis were recruited using comparable sampling strategies. Ordinary least squares (OLS) regression results reveal that being arrested for criminal activity is associated with length of homelessness, history of juvenile detention and incarceration, receiving income from theft, substance abuse, and mental illness. Arrests are also associated with interactions between lack of formal employment income and receiving income from theft and between drug and alcohol abuse/ dependency. Understanding the health and situational factors associated with homeless youths' delinquent activity has implications for providing more comprehensive health, mental health, and substance abuse services.     

Socioeconomic Risk for Adolescent Cognitive Control and Emerging Risk‐Taking Behaviors

This study examined whether cognitive control mediated the association between socioeconomic status (SES; composite of income‐to‐needs ratio and parent education) and changes in risk‐taking behaviors. The sample included 167 dyads of adolescents (53% male; M_age = 14.07 years at Time 1) and their parents, assessed annually across 4 years. Parents reported socioeconomic variables at Time 1. Adolescents reported risk‐taking behaviors at Times 1 and 4, and completed a functional magnetic resonance imaging cognitive control task at Times 2 and 3. Lower SES was associated with lower behavioral (but not neural) cognitive control, which was associated with increases in risk‐taking behaviors. The findings suggest that elevated socioeconomic risk may compromise cognitive control which can cascade into maladaptive behaviors in adolescence.     

Freedom and struggling openly in psychotherapy: A qualitative inquiry with LGBQ young adults from religious families

Lesbian, gay, bisexual, and queer (LGBQ) young people from religious families are at increased risk of family rejection, poor mental health outcomes, and are overrepresented in mental health services. This article describes a two‐part qualitative study aimed at exploring the experiences of LGBQ young adults from religious families in psychotherapy, identifying positive and negative psychotherapy experiences, and understanding the influence of family and religion on the psychotherapy experience. Data were collected through a web‐based survey (n = 77) and interviews (n = 7) with LGBQ young adults (ages 18–25) from religious families. The study followed an interpretative phenomenological approach. Integrated results found often invisible, relational therapy processes, and religious discourses as significant to LGBQ young people who seek psychotherapy. Implications for future research, effective systemic family therapy practices with LGBQ young people from religious families, and a critique on ethical and legal limits of confidentiality with policy implications are outlined.     

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