A Comparison of Child-sex-abuse-related and Mental-disorder-related Suicide in a Six-year Cohort of Regional Suicides: The Importance of the Child Protection-Psychiatric Interface

Correspondence to: Professor Colin Pritchard, Department of Mental Health, School of Medicine, Southampton University, Royal South Hants Hospital, Southampton SO14 0YG, UK. E-mail: cp1{at}soton.ac.uk Summary The study compares Mental-Disorder-Related (MDR) suicide rateswith Child-Sex-Abuse-Related (CSAR) suicide of ‘Victims’and ‘Perpetrators’ of child sex abuse, based uponan examination of all Coroners’ inquest files over a six-yearperiod (n = 1,017). Census data, psychiatric case register andpolice records were used to calculate the potential MDR andCSAR populations. There were five main findings: (i) male andfemale CSAR victim suicide rates were 2.2. and 2.5 times theGeneral Population Suicide Rate (GPSR), respectively; (ii) everyfemale, and 80 per cent of male CSAR victim suicides, also hada mental disorder but none of the CSAR perpetrator suicides;(iii) male and female MDR suicide rates were 5 and 6 times theCSAR Victim rates; (iv) the sex abuser perpetrators’ suiciderate was more than 3 times the male MDR rate; (v) the intra-and extra-familial perpetrator suicide rates, were 25 and 78times the GPSR, respectively. Possible explanations for thesesurprising results are briefly discussed. They confirm the overrepresentationof people with mental disorder amongst suicides, and identifyan overrepresentation of CSAR suicides, particularly perpetrators.The results have implications for suicide prevention programmes,whilst highlighting the importance of the child protection-psychiatricinterface, and indicates the futility of simple explanationsin an area of practical and moral complexity.     

Conflicts of interest in academic research: policies, processes, and attitudes

Few studies have examined academic researchers' understandings or attitudes toward conflict of interest policies even though these understandings and attitudes represent a crucial component of both compliance and educational efforts. This study reports the results of a large-scale, cross-sectional survey of research faculty at the nine campuses of the University of California regarding their understandings of and attitudes toward campus conflict of interest policies. We gathered information on their general assessments of investigators with financial ties to industry sponsors and reactions to the process of implementing conflict of interest policies at their respective campuses. We surveyed 1,971 faculty members from the nine-campus University of California system and had 779 responses (39% response rate). The sampled faculty were in the ten departments with the most number of financial disclosures at each campus. We utilized the WebSurveyor software to create a secure, online, 21-item survey. Our study reveals faculty with complex, sometimes contradictory, feelings about academic-industry relationships and highlights perceived gaps in policy and process. Most respondents were concerned about unlimited financial relationships, but a sizable number also viewed campus policies as irrelevant. Some expressed considerable anger over the process of policy implementation, rejecting the policies on the basis of professional and individual self-determination and moral integrity. Our study suggests the need for renewed efforts to encourage awareness of the relevance of conflict of interest policies for all faculty, new efforts to increase understanding of the situational nature of conflicts of interest, and reexamination of the processes of policy implementation at the campus level.     

Ovulatory shifts in female sexual desire

Women's reproductive biology imposes heavy obligatory costs of parental investment, creating strong selective forces hypothesized to shape female mating psychology around critical decisions such as the choice of partner, the timing of sexual intercourse, and the timing of reproduction. We propose that female sexual desire has evolved as one adaptation among several designed to regulate these decisions. We hypothesize (a) an increase in desire as conception probability increases, but only among women who are in committed long-term relationships; and (b) a shift in the desire for a primary partner as compared with extra-pair partners as ovulation approaches, dependent upon a woman's evaluation of her primary partner's relative quality. We tested several predictions derived from these hypotheses in a study of 173 women who were not taking oral contraceptives. Results confirmed Hypothesis 1: An ovulatory peak in sexual desire was found only for mated women; for unmated women, conception probability and sexual desire were uncorrelated. Hypothesis 2 was partially supported. Among mated women, those with higher conception probability exhibited higher levels of in-pair sexual desire relative to those at lower conception probability. Conception probability and relationship length interacted significantly to predict extra-pair desires, such that women in longer relationships were more likely to experience desire for extra-pair partners during periods of high conception probability. The pursuit of an in-pair conceptive strategy (as opposed to an extra-pair conceptive strategy) was also associated with the occurrence of sexual activity in the relationship.     

Factors Contributing to Parents’ Preparation For Special-Needs Adoption

Three hundred and sixty-eight parents shared their perceptions of special-needs adoption preparation. Utilizing both quantitative and qualitative data to determine and understand what factors contribute to preparation, this study found that 12 child, family, and agency variables were correlated with perceived preparation, and that parents perceived level of preparation was predicted by the childs ability to attach, by the parents relationship with the agency, by the duration of the adoption, and by the parents ages at the time of adoption. Implications of these findings are discussed, as they relate to supporting parents, children, and families in special-needs adoptive placements.     

LEGISLATING LOVE: The Effect of Child Support and Welfare Policies on Father–child Contact

Reducing non-marital childbearing and making nonresidential fathers take greater responsibility for their children were identified as goals of numerous policy changes since the 1980s. Child-support award rates for children born to unmarried parents have been quite low historically, leading lawmakers to focus on increasing both award and payment rates for this group. Nonmarital fathers are also much less likely to have contact with their children. Although evidence suggests that policy efforts increase child support awards and receipt, the link between child support policies, child support outcomes, and father-child contact has received less attention. This paper uses data from the Survey of Income and Program Participation on children born between 1985–1997 to investigate the relationship between child-support award and receipt and the amount of contact that fathers have with their non-residential children. Since it is likely that both of these behaviors are, in part, determined by unobservable characteristics of the father, we estimate an instrumental variables Tobit model. The model is identified by our assumption that child support policy variables can impact child support awards and payments, but father-child contact cannot be directly legislated. Our results suggest that there are unintended, but desirable effects of child support establishment and collection. Policies to collect child support not only increase financial resources to families, but through their impact on payments increase visitation and contact between these children and their fathers. The estimated impact of receiving child support on contact is more than 27 days per year.An earlier version of this paper was presented at the Annual Meetings of the American Economic Association, Washington DC, January 2003 and the Annual Meetings of the Association of Public Policy and Management, November 2003. Support from NICHD Grant # HD30944 is gratefully acknowledged. We would like to thank Suzann Eshleman for excellent computer programming and James Scully for providing us with data on genetic testing laws.     

Aesthetics and the Artistic Career: A Study of Anomie in Fine-Art Painting*

This is an empirical study of the relationship between aesthetic evaluation, collective action, and artistic success. Documentary evidence is examined to show that the initial artistic success of Jackson Pollock, the leading painter in the early years of Abstract Expressionism, was not due to coherent aesthetic evaluation by the New York art world. Secondary sources are then reviewed and it is suggested that Pollock's rise to artistic preeminence was brought about directly by collective action in the form of a promotional campaign on the part of a small, but influential, group of actors closely associated with the artist.     

Comparative Potency Method for Cancer Risk Assessment: Application to Diesel Particulate Emissions1

An estimation of the human lung cancer “unit risk” from diesel engine particulate emissions has been made using a comparative potency approach. This approach involves evaluating the tumorigenic and mutagenic potencies of the particulates from four diesel and one gasoline engine in relation to other combustion and pyrolysis products (coke oven, roofing tar, and cigarette smoke) that cause lung cancer in humans. The unit cancer risk is predicated on the linear nonthreshold extrapolation model and is the individual lifetime excess lung cancer risk from continuous exposure to 1 μg carcinogen per m³ inhaled air. The human lung cancer unit risks obtained from the epidemiologic data for coke oven workers, roofing tar applicators, and cigarette smokers were, respectively, 9.3 × 10^?4, 3.6 × 10^?4, and 2.2 × 10^?6 per μg particulate organics per m³ air. The comparative potencies of these three materials and the diesel and gasoline engine exhaust particulates (as organic extracts) were evaluated by in vivo tumorigenicity bioassays involving skin initiation and skin carcinogenicity in SENCAR mice and by the in vitro bioassays that proved suitable for this analysis: Ames Salmonella microsome bioassay, L5178Y mouse lymphoma cell mutagenesis bioassay, and sister chromatid exchange bioassay in Chinese hamster ovary cells. The relative potencies of the coke oven, roofing tar, and cigarette smoke emissions, as determined by the mouse skin initiation assay, were within a factor of 2 of those determined using the epidemiologic data. The relative potencies, from the in vitro bioassays as compared to the human data, were similar for coke oven and roofing tar, but for the cigarette smoke condensate the in vitro tests predicted a higher relative potency. The mouse skin initiation bioassay was used to determine the unit lung cancer risk for the most potent of the diesel emissions. Based on comparisons with coke oven, roofing tar, and cigarette smoke, the unit cancer risk averaged 4.4 × 10^?4. The unit lung cancer risks for the other, less potent motor-vehicle emissions were determined from their comparative potencies relative to the most potent diesel using three in vitro bioassays. There was a high correlation between the in vitro and in vivo bioassays in their responses to the engine exhaust particulate extracts. The unit lung cancer risk per μg particulates per m³ for the automotive diesel and gasoline exhaust particulates ranged from 0.20 × 10^?4 to 0.60 × 10^?4; that for the heavy-duty diesel engine was 0.02 × 10^?4. These unit risks provide the basis for a future assessment of human lung cancer risks when combined with human population exposure to automotive emissions.     

Health in household context: living arrangements and health in late middle age

People living in some arrangements show better health than persons in other living arrangements. Recent prospective studies document higher mortality among persons living in particular types of households. We extend this research by examining the influence of household structure on health using longitudinal data. We theorize that individuals experience role-based household relations as sets of resources and demands. In certain household structures, individuals are more likely to perceive that the demands made on them outweigh the resources available to them. This perceived imbalance poses a risk to individual health. We test our expectations by analyzing the relationship between living arrangements and health using data from waves 1 and 2 of the Health and Retirement Study. We focus on persons ages 51-61 and explore gender differences. We find prospective links between household structure and self-rated health, mobility limitation, and depressive symptoms. Married couples living alone or with children only are the most advantaged; single women living with children appear disadvantaged on all health outcomes. Men and women in other household types are disadvantaged on some health outcomes. Our results suggest that the social context formed by the household may be important to the social etiology of health. In addition, they qualify the well-known link between marital status and health: The effect of marital status on health depends on household context.