Mothers living with suicidal adolescents: a phenomenological study of their experience

Adolescents who exhibit suicidal behaviors have a devastating effect on their mothers, but unfortunately, the mothers' experience is often the hidden dimension in the family. Currently, there is a considerable lack of research into the maternal experience of living with a suicidal adolescent. This phenomenological study describes and enhances the understanding of what life is like for 6 mothers living with suicidal adolescents. The data were collected through unstructured interviews. Thematic analysis using van Manen's methodology identified six themes: failure as a good mother, the ultimate rejection, feeling alone in the struggle, helplessness and powerlessness in the struggle, cautious parenting, and keeping an emotional distance. From these themes, the essence, "multiple loss and unresolved grief," was captured. The findings have implications for nursing education, practice, and research. In the provision of quality family-centered care, nurses can be educated and guided in their interventions by phenomenological research that recognizes the importance of the maternal perspective in the experience of living with suicidal adolescents.     

Differential labeling of mental illness by social status: a new look at an old problem

Whether the higher rates of mental hospitalization and involuntary treatment for marginal social groups are due to differential labeling or simply to the occurrence of higher rates of disorder in these groups remains unresolved. I reexamine this issue with data from the National Comorbidity Survey (N = 5,877) that allow comparisons between disturbed individuals living in the community untreated and disturbed persons who have been hospitalized or seen a professional for their mental health problems under pressure or voluntarily. Contrary to labeling theory, members of lower status groups are not consistently overrepresented among those who have been hospitalized or seen a professional against their will. Consistent with self-labeling theory, persons with greater education and those not in poverty are disproportionately present among individuals who sought treatment by choice. Additional analyses show that factors that predict service utilization are important determinants of mental health service use but do not account systematically for status disparities in hospital or outpatient treatment, especially disparities by poverty status. Although I do not confirm a central tenet of labeling theory here, the negative consequences of labeling and stigma continue to be well-supported in the literature.     

Risk Factors,Parental Communication,Self and Peers’ Beliefs as Predictors of Condom Use Among Female Adolescents Attending Family Planning Clinics

This study examined the impact of risk factors, self and peers’ beliefs, and parental communication on condom use among 290 female adolescents who attended family planning clinics. The major findings showed that in addition to risk factors, self and peer beliefs about condom use and parental communication about birth control predicted actual condom use. Implications for social workers about the importance of encouraging communication between adolescents and their parents are discussed.     

Differential Labeling of Mental Illness Revisited: Patterns Before and After the Rise of Managed Care

With the National Comorbidity Survey of the early 1990s, Thoits (2005) recently showed that lower-status mentally ill individuals were not more often hospitalized or pressured into psychiatric treatment than comparably ill persons of higher status, disconfirming a central hypothesis of labeling theory. However, that finding may have been due to changes in the mental health treatment system introduced by the spread of managed care. The differential labeling hypothesis is reexamined here with data from the Epidemiological Catchment Area Studies (ECA) collected in the early 1980s before managed-care plans began to dominate the insurance marketplace and from the National Comorbidity Survey Replication conducted in the early 2000s when managed care had saturated the market. Little systematic support for the differential labeling hypothesis was found in the three studies, although, over time, the higher rates of mental hospitalization among less educated and low-income individuals found in the ECA survey disappeared. Trends across the studies suggest that educated and affluent persons with psychiatric problems more frequently sought hospital care. These findings further undermine the validity of the differential labeling hypothesis and suggest that service utilization or treatment-seeking factors may help explain mental hospitalization rates.     

Managing the Emotions of Others

Although research has focused on how individuals manage their own emotions, little attention has been paid to how individuals manage the emotions of other people. Here, I describe several techniques of interpersonal emotion-management, drawing from observations of a psychodrama-based encounter group which deliberately manipulated its members' feelings. Analysis reveals a number of strategies (e.g., group enactments, provocations, comforting) which, when used sequentially, produced first emotional loss of control in the individual and then positive emotion. Group solidarity was sometimes affected by these interpersonal emotion-management techniques as well. Some techniques may be similar to those used in military training and cult group recruitment, although further research attention is needed in these arenas. Other settings in which members play upon the emotions of others should be examined to identify other interpersonal techniques and the sequencing of strategies which produce desired individual and group outcomes.     

GENDER DILEMMAS, GENDER QUESTIONS, AND THE GENDER MANTRA

This paper discusses the social constructions of gender and the problematic effects of these constructions-masculine/feminie-on intimate attachments. It summarizes the aspect of feminist scholarship which revised the traditional developmental paradigm to include a psychology of women and cites recent infant research which re-describes development as a process of increasingly complex forms of relatedness rather than as a progression from attachment to separation. The authors are influenced by the school of feminist revisionism which argues on behalf of the integration of male and female attributes in each person. Two clinical techniques are suggested-"gender questions" and the "gender mantra"-which identify the contradictions inherent in the social construction of gender and encourage alternative constructions that more adequately represent men's and women's actual psychological experience.