Developmental issues in child abuse: Implications for intervention

This paper reviews some of the issues in child abuse such as problems of definition, characteristics of abuser and abused, and etiology. It emphasizes that child abuse can start at any age. A developmental approach is suggested in order to understand the relationship between the child's stage of development and its idiosyncratic potential for stimulating aggression on the part of the parent. This approach offers a broad framework in which phase specific stressors, characteristics of the child, the abuse prone personality of the abuser, as well as the family system and external stress factors, can be considered together and upon which intervention strategies can be planned.Lynn Ohrenstein is Administrative Supervisor at the Jewish Board of Family and Children's Services, a doctoral candidate at Yeshiva University, and in private practice.This is an expanded version of a paper delivered November 4, 1982 by the author at an interdivisional meeting at the Jewish Board of Family and Children's Services devoted to Issues on Domestic Violence.     

Public attitudes toward the use of psychiatric medications for children

Psychiatric medication use for children has increased dramatically over the past three decades. Despite substantial media attention to the issue, little is known about how the lay public feels about the use of psychiatric medications for children. Drawing on theories of medicalization, we describe and analyze Americans' attitudes towards the use of psychiatric medications generally and Prozac specifically for children described as having three types of behavioral problems. Using data from the 1998 General Social Survey's Pressing Issues in Health and Medical Care Module, we find that more Americans (57%) are willing to use psychiatric medications for children who have expressed suicidal statements than for "oppositional" behaviors (34.2%) or for hyperactivity (29.5%). Across the board, respondents are less willing to give Prozac than the general class of psychiatric medications. While socio-demographics do little to identify Americans with differing positions, the strongest and most consistent correlates of willingness to give psychiatric medications to children are trust in personal physicians, general attitudes towards psychiatric medications, and the respondent's expressed willingness to take psychiatric medications herself or himself.     

A study of the relationship between protective behaviors and drinking consequences among undergraduate college students

The authors identified the number, type, and frequency of protective behaviors that undergraduate college students who consume alcohol use to prevent alcohol-related consequences. Their hypothesis was that students who engage in more types of protective behaviors with greater frequency would be less likely to experience alcohol-related consequences. Participants consisted of a randomly selected sample of 1,355 undergraduates aged 18 years and older at a large public university. Students completed a mailed questionnaire on alcohol and health behaviors in spring 2002. The findings (after adjustment for covariates) indicated that self-protective behaviors are inversely associated with alcohol-related problems for women but not for men. The influences of gender and racial and ethnic differences are considered in relation to prevention and intervention programs aimed at reducing alcohol-related consequences on college campuses.     

Trajectories of gender role orientations in adolescence and early adulthood: a prospective study of the mental health effects of masculinity and femininity

Adolescence is the segment of the life course when gender differences in mental health emerge and gender becomes a more salient factor shaping orientations toward oneself and views of one's place in the social world. This study uses mixture modeling, to identify trajectories of masculinity and femininity between ages 12 and 25, and OLS regression, to examine the effects of those trajectories on mental health in young adulthood (measured as depressive symptoms and alcohol problems at age 25). Four waves of prospective data from the Rutgers Health and Human Development Project are used; respondents (n = 447) are age 12 at Wave 1 (1979-81), 15 at Wave 2 (1982-84), 18 at Wave 3 (1985-87), and 25 at Wave 4 (1992-94). Results indicate that having relatively high and increasing levels of masculinity over adolescence decreases depressive symptoms in early adulthood for both males and females. Reflecting the privileging of males over females, the findings suggest that masculinity, but not femininity, is a central axis on which advantages and disadvantages across some dimensions of mental health accumulate over adolescence.     

The Impact of the Therapist's Curiosity on the Treatment Process of Children and Adolescents

Therapists bring their own initiative, interest, and wonder—their professional curiosity—into treatment sessions. Some children and adolescents pull away in reaction to this curiosity, bristling or withdrawing, if only for a moment. This can happen abruptly, even in response to the first hello, but most often it occurs subtly, over the course of treatment. These children and adolescents may be replaying the ruptures in relationships they experienced when they have expressed their own initiative and curiosity to important others in their lives. Therapists need to utilize opportunities to understand the dynamics, explore where the original ruptures may have occurred, and bring the experience into therapeutic focus. Case vignettes illustrate these dynamics.     

Evaluating consumer satisfaction in residential continuing care settings

The outcome of the project reported on here is a client-centered consumer satisfaction questionnaire designed to evaluate new models of residential continuing care in Alberta, Canada. Satisfaction is defined as a multi-dimensional construct that is grounded in the consumer's experience. Consultation with the clients of the services during development of the instrument ensured that characteristics important to the clients were assessed. The result is an instrument with which to measure satisfaction that is fully client-centered and that, with appropriate modifications, can be used to monitor any client-centered program for cognitively-able continuing care clients.     

Prevalence and correlates of alcohol-induced blackouts among college students: results of an e-mail survey

The authors conducted an e-mail survey of 772 college students to learn more about their experiences with blackouts. Approximately half (51%) of those who had ever consumed alcohol reported they had experienced a blackout at some point in their lives, and 40% had experienced 1 in the year before the survey. Among those who drank in the 2 weeks before the survey, nearly 1 in 10 (9.4%) had experienced a blackout during that period. Many later learned that, during the blackout, they had vandalized property, driven an automobile, had sexual intercourse, or engaged in other risky behaviors. Experiencing 3 or more blackouts was associated with a variety of other experiences, including heavier drinking, lower grades, an earlier age of drinking onset, and having others express concerns about their drinking. The female students who reported blackouts during the 2 weeks before the survey drank far less than male students did during this time period, supporting the use of gender-specific definitions of risky drinking.     

The Media and Genetically Modified Foods: Evidence in Support of Social Amplification of Risk

Empirical examinations of the "social amplification of risk" framework are rare, partly because of the difficulties in predicting when conditions likely to result in amplification effects will occur. This means that it is difficult to examine changes in risk perception that are contemporaneous with increases and/or decreases in social or media discussion of the risks associated with a particular risk event. However, the collection of attitude data before, during, and after the increased reporting of the risks of genetically modified food in the United Kingdom (spring 1999) has demonstrated that people's risk perceptions do increase and decrease in line with what might be expected upon examination of the amplification and attenuation mechanisms integral to the framework. Perceptions of benefit, however, appeared to be permanently depressed by negative reporting about genetically modified food. Trust in regulatory institutions with responsibility for protecting the public was not affected. It was concluded that the social amplification of risk framework is a useful framework for beginning to explain the potential impact on risk perceptions of a risk event, particularly if that risk event is presented to the public as a new hazard occurring in a crisis context.     

True patient safety begins at the top. Leaders at one large health system rally around safety,avoid blame game

Making patient safety the No. 1 priority at a hospital or clinic sounds like a easy task. It isn't. At one Oklahoma health system, an improved patient safety program is a massive effort requiring input and participation from every member of the staff. Figuring out how to convince employees that patient safety is their first priority means developing an extensive communication and education program.     

Optimizing out-of-school time: the role of free-choice learning

Free-choice learning, a new paradigm for the learning that youth and their families engage in outside school, can play an important role in the healthy development of youth, their families, and communities.