Self-regulation and the etiology of sexual deviance: evaluating causal theory

Recently introduced theories of sex offending, including the self-regulation model and the multimodal self-regulation theory, have implicated self-regulatory deficits as a key variable in the development of sexually inappropriate interests and behaviors. While dysregulation has been considered an important component of a variety of behavioral, emotional, and interpersonal disorders, sexual behaviors have rarely been conceptualized within this context. In this study, we have examined a number of variables linked to self-regulation and dysfunctional outcomes in a sample of 95 sex-offending men. Results of a path analysis demonstrated that self-regulatory deficits were significantly predictive of paraphilic and antisocial behaviors in this group. Implications for our understanding of the etiology of sexual deviance and future research in this area are discussed.     

Mental Health of Non-gamblers Versus “Normal” Gamblers Among American Indian Veterans: A Community Survey

Goal This analysis was undertaken to assess the demographic and mental health characteristics of “normal” or non-problem gamblers versus non-gamblers in a representative community sample. Sample Study participants consisted of 557 North Central American Indian veterans. Data collection included a demographic and trauma questionnaire, a computer-based Diagnostic Interview Schedule for DSM-III-R, and a treatment history algorithm. Findings Univariate analyses revealed that gamblers had greater social competence (i.e., higher education, living with a spouse) and higher lifetime psychiatric morbidity. Binary regression analysis revealed that, compared to non-gamblers, gamblers were older, more highly educated, and more apt to be married. More gamblers showed evidence for lifetime risk-taking as evidenced by Antisocial Personality Disorder and Tobacco Dependence. Conclusions Social achievement and disposable income function as prerequisites for “normal” gambling in this population, although “externalizing” or “risk-taking” disorders also serve as independent contributors to at least some gambling. The increased rate of “internalizing” or emotional disorders are only indirectly related to gambling, perhaps through increasing age or through the “externalizing” disorders.     

The Role of Affect Regulation in a Case of Attempted Maternal-Filicide Suicide: Commentary on an Act of Despair

A case of attempted maternal-filial suicide is discussed from the perspective of trauma, emotional regulation and defense mechanisms. Case details which include childhood sexual abuse, observed parental violence and emotional neglect allow for an illustration of the impact of childhood family experiences on adult intimacy and coping patterns. Domestic violence and the perception of protection are also explored. Emotional regulation in the experience of despair is approached from an object relations perspective. Based on this, implications for prevention and treatment are presented.

Internet use, abuse, and dependence among students at a southeastern regional university

OBJECTIVE: To assess Internet use, abuse, and dependence. PARTICIPANTS: 411 undergraduate students. RESULTS: Ninety percent of participants reported daily Internet use. Approximately half of the sample met criteria for Internet abuse, and one-quarter met criteria for Internet dependence. Men and women did not differ on the mean amount of time accessing the Internet each day; however, the reasons for accessing the Internet differed between the 2 groups. Depression was correlated with more frequent use of the Internet to meet people, socially experiment, and participate in chat rooms, and with less frequent face-to-face socialization. In addition, individuals meeting criteria for Internet abuse and dependence endorsed more depressive symptoms, more time online, and less face-to-face socialization than did those not meeting the criteria. CONCLUSIONS: Mental health and student affairs professionals should be alert to the problems associated with Internet overuse, especially as computers become an integral part of college life.     

The development of a CAHPS instrument for Nursing Home Residents (NHCAHPS)

We report on a federal initiative to develop a CAHPS (The Consumer Assessment of Healthcare Providers and Systems) survey to measure residents' experiences with quality-of-care and quality-of-life in nursing homes (known as NHCAHPS). We focus on how we created and tested questions for inclusion in the instrument and tested a possible cognitive screener to determine which residents could participate in a NHCAHPS interview. The major lessons learned were: (1) In contrast to other CAHPS surveys, ratings were more useful than reports because of the difficulty that residents had with summarizing over time and people; (2) consistent with other CAHPS surveys, the 0 to 10 response scale appeared to work well with nursing home residents for many of the quality-of-care questions; however, a different response scale was needed for many of the quality-of-life items; and (3) in contrast with typical survey methodology and other CAHPS surveys where explicit time reference periods are used, a non-specific present reference period in questions seemed to work best.     

The experience of trauma recovery: a qualitative study of participants in the Women Recovering from Abuse Program (WRAP)

The efficacy of intensive group treatment programs for child maltreatment has been established. The aim of this qualitative study was to understand how women with a history of child maltreatment experienced the Women Recovering from Abuse Program (WRAP), an existing intensive group treatment program. Seven women were interviewed following their participation in WRAP. Three themes emerged: Breaking Trauma-Based Patterns, Doing Therapy, and The Healing Journey as a Continuous Process. These findings deepen our understanding about how participants view the recovery process. Theoretical and clinical implications are discussed.     

WORKING CARERS OF OLDER ADULTS

Juggling work and care presents particular challenges to carers and employers. Employers are increasingly under pressure, both from within organizations and from recent government legislation and policy, to develop family-friendly policies to support informal carers in the workplace. Yet existing ‘family-friendly’ schemes and services are still primarily designed for working parents of young children and rarely address the needs of employees who care for older or disabled adults. This paper reports on a study which investigated how working carers and managers in two public sector organizations — a Social Services Department (SSD) and a National Health Service (NHS) Trust — combined their work and caring responsibilities. A multi-method approach was adopted consisting of five phases. First, a profile of the two organizations was established, followed by a short screening questionnaire to all employees to identify who was caring for an older adult over the age of 60. Third, a lengthier postal survey was sent to the 365 carers who had indicated a willingness to participate further. In the fourth and fifth phases, carers and managers were interviewed in depth about their experiences. This paper reports briefly on the survey, but then concentrates in particular on what was said in the interviews about what helps and hinders working carers of older adults. Despite the existence of policies to support carers, our findings suggest that these were far less important than informal support from colleagues and a sympathetic manager in the workplace. Commuting distance between work, home and the older person also posed difficulties for carers, along with inflexible schedules and work overload. Employers are urged to explore these issues further if they are serious about recruiting and retaining employees, and developing the work – life balance agenda to meet the needs of those caring for older and disabled adults.     

AIDS Risk Behaviors among American and Australian Homeless Youth

We examined HIV/AIDS risk behaviors among homeless youth in cross-national data collected in Melbourne, Australia ( n = 398), and Los Angeles, California ( n = 498). Using structural equation modeling, we found that the Australian youth reported greater involvement in AIDS risk behaviors than the American youth and the Australian youth were more involved in intervening risk factors that promote risk behaviors and less involved with protective factors that reduce risk behaviors. Youth reporting the highest rates of delinquent behaviors also had peers engaging in delinquent acts, used alcohol and marijuana, and were more likely to utilize social services. These findings underscore the importance of having a service sector that is able to adequately address the needs of homeless youth .     

The development of palliative care programs in the Veterans Administration: Zelda Foster's legacy

The U.S. Department of Veterans Affairs (VA) has been a leader in program development and service delivery in the areas of geriatrics, hospice and palliative care for decades. Zelda Foster, MSW, serving as the Chief of Social Work Services at the Brooklyn VA Hospital for almost 20 years, was a force in the early days of the palliative care and hospice movement in the United States, publishing a seminal article in 1965, and contributing through educational initiatives, program development, information dissemination and mentorship of countless social workers. With an early recognition of the demographic imperative of aging veterans, the VA established a number of innovative programs which have been widely replicated outside of the VA. Zelda Foster was a central figure in the evolution of these programs and a strong and effective advocate for the inclusion of social workers. She deserves much credit for the fact that social workers are now centrally involved in an array of leadership activities in palliative and end-of-life care both within and outside of VA.