Anxiety and Related Symptoms in Older Persons With Dementia: Directions for Practice

Anxiety disorders and related symptoms commonly occur in older people with cognitive impairment or dementia, significantly worsening functioning and reducing quality of life. This review of the literature outlines the extent of the problem, and focuses on current best practices in psychosocial interventions anxiety in persons with dementia. Discussion follows on promising nonpharmacological interventions that are recommended for further consideration and future research.     

Sexual deception as a social-exchange process: development of a behavior-based sexual deception scale

The use of deception in association with sexual encounters may take many forms, ranging from outright lies to more subtle, evasive manipulations. To address such deceptions, a behavior-based sexual deception scale was developed utilizing social exchange theory. Participants were 267 individuals associated with two large universities who were surveyed regarding different aspects of their sexual deceptive behaviors. In addition, items addressing sexually related behaviors and attitudes were assessed for validation purposes. Principal components analysis identified three components of sexual deception, labeled Blatant Lying, Self-Serving, and Avoiding Confrontation. Confirmatory factor analysis verified the resulting structure, and promising validity was noted. In general, those using any of these deceptions reported more sexual partners and one-night stands. Those telling blatant lies to have sex were more likely to report greater needs for sex, while those using self-serving lies or having sex to avoid confrontation experienced greater worry about partner loss. Men were more likely to use blatant lies to have sex, while women were more likely to have sex to avoid confrontation. Results support sexual deception as an exchange process, with sex for pleasure and positive relationship outcomes acting as rewards, and unwanted sex and deception consequences as costs. Implications for health interventions and primary prevention applications are discussed.     

A comparison of risk factors for sexual victimization among gay, lesbian, bisexual, and heterosexual homeless young adults

Although high rates of sexual victimization have been reported among homeless youth, less is known about whether the risk factors vary for gay, lesbian, and bisexual youth compared to heterosexual youth. Based on a sample of 172 homeless young adults ages 19 to 26, results revealed that depressive symptoms, prostitution, and having friends who traded sex were significantly associated with higher levels of sexual victimization. Gay, lesbian, and bisexual young adults experienced more sexual victimization compared to heterosexual young adults. A test for interactions revealed that the effect of sexual orientation on sexual victimization was moderated by trading sex and having friends who traded sex. Finally, there is support for partial mediation of the effects of sexual abuse, neglect, and depressive symptoms on sexual victimization through other risk factors.     

Pregnant women's attitudes toward the abortion of defective fetuses

A survey asked 190 pregnant women their opinions on whether a hypothetical other woman would be justified in having an abortion under ten different circumstances, four of which related to abnormalities of the fetus. They were then asked whether they would be justified in having an abortion under these same circumstances. Also assessed were these women's views concerning the justifiability of abortion for a specific group of fetal abnormalities, neural tube defects. Respondents were more likely to view abortion as justifiable for a hypothetical other than for themselves. However, there was no evidence that pregnant women's views about abortion are more conservative than those of the general public. The majority of respondents considered abortion of a defective fetus to be justified, both for themselves and for others. The best predictor of abortion attitudes was respondent's views about the ideal number of children in a completed family.This research was supported by a grant from Maternal and Child Health Research, Bureau of Community Health Services, DHHS. Reprint requests should be sent to Dr. Ruth Faden at the Johns Hopkins University School of Hygiene and Public Health, Division of Health Education, 615 N. Wolfe Street, Baltimore, MD 21205.     

Anxiety and related symptoms in older persons with dementia: directions for practice

Anxiety disorders and related symptoms commonly occur in older people with cognitive impairment or dementia, significantly worsening functioning and reducing quality of life. This review of the literature outlines the extent of the problem, and focuses on current best practices in psychosocial interventions anxiety in persons with dementia. Discussion follows on promising nonpharmacological interventions that are recommended for further consideration and future research.     

A Qualitative Study of the Formation and Composition of Social Networks Among Homeless Youth

Although social networks are essential for explaining protective and risk factors among homeless youth, little is known about the formation and composition of these groups. In this study, we utilized 19 in-depth interviews with homeless youth to investigate their social network formation, role relationships, housing status, and network member functions. Our findings reveal that the formation of these networks occurred in different ways including meeting network members through others or in specific social situations. The majority of social network members were currently housed and provided various functions including instrumental and social support and protection. Responses from participants provide valuable insight into the formation of social networks and potentially explain their subsequent involvement in risky behaviors.     

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.     

The effect of poor parenting on male and female dating violence perpetration and victimization

This study examines the effects of poor parenting on dating violence perpetration and victimization among approximately 900 males and females from the National Longitudinal Survey of Adolescent Health (Add Health). Results revealed that more physical abuse and low parental warmth were linked to greater substance use and higher rates of delinquency. In addition, low parental warmth, more neglect, and greater delinquency had positive direct effects on dating violence perpetration, whereas more physical abuse, low parental warmth, and increased delinquency were all positively associated with dating violence victimization. Finally, delinquency mediated the link between low parental warmth and dating violence perpetration and victimization. The results provide some support for both social learning theory and an antisocial orientation perspective.     

Conceptual model and map of psychological abuse of older adults

Psychological abuse of older adults is a hidden and pervasive problem that is not well conceptualized nor well measured. Goals. The goals were to (a) conceptualize psychological abuse using three-dimensional concept maps, and (b) develop theoretical models. Methods. Statements describing the construct were generated by local and national panels. These were sorted and rated using Concept Systems software whereby the concepts were depicted as a map. Results. The concept maps guided development of theoretical hierarchies. Significance. Theoretical models may help to develop measures to estimate prevalence better and may enable more precise screening for triage into appropriate interventions.     

The Impact of Childhood Sexual Abuse on Later Sexual Victimization among Runaway Youth

Path analysis was used to investigate the impact of childhood sexual abuse on later sexual victimization among 372 homeless and runaway youth in Seattle. Young people were interviewed directly on the streets and in shelters by outreach workers in youth service agencies. High rates of both childhood sexual abuse and street sexual victimization were reported, with females experiencing much greater rates compared with their male counterparts. Early sexual abuse in the home increased the likelihood of later sexual victimization on the streets indirectly by increasing the amount of time at risk, deviant peer affiliations, participating in deviant subsistence strategies, and engaging in survival sex. These findings suggest that exposure to dysfunctional and disorganized homes place youth on trajectories for early independence. Subsequently, street life and participation in high‐risk behaviors increases their probability of sexual victimization.