Experiencing breast cancer in the context of mental illness in New Zealand

ABSTRACT

This study aimed to explore the experiences of women with mental illness who had also experienced breast cancer diagnosis and treatment, in particular, to identify barriers and facilitators to cancer treatment. Semi-structured interviews were conducted with ten breast cancer survivors who had had contact with secondary mental health services prior to their cancer diagnosis. Thematic analysis was used to identify key themes. Participants described positive experiences of cancer treatment, expressing surprise at both how well they coped with diagnosis and treatment and how well they were treated by services. Many contrasted this with their less positive experience of mental illness and mental health services. The women interviewed were active participants in their cancer treatment and did not report feeling stigmatised because of their mental health experiences. A lack of connection between cancer and mental health services was described, but this was not regarded as necessarily a bad thing. This study begins to counter the stereotypes of the difficult patient or the person unable to understand and cooperate in their own care which are prevalent in the literature. Further work is needed to understand the reasons for disparities in cancer outcomes.     

A Survey of Specialist Youth Gender Diversity Services in Australia: A Whole‐of‐Family Approach

The number of referrals for children and young people seeking to affirm their gender has risen exponentially in Australia and elsewhere. Whilst the individual mental health needs and treatment outcomes for this group have been the subject of recent research, considerably less emphasis has been placed on exploring and amalgamating individual family member experiences, particularly siblings, using circular questioning. Yet, gender diversity is known to affect everyone in the family, and research clearly demonstrates that youth who feel validated and supported by individual family members in their gender identities benefit from improved mental health and global outcomes. This study aims to explore current clinical practices, professional viewpoints, use of circular questioning, and whole‐of‐family involvement in specialist youth gender diversity services in Australia. Clinical leads and coordinators of publicly funded youth gender diversity services and individual specialists across Australia were invited to complete an online survey, exploring individual protocols and practices in relation to involving the family, and the rationale underpinning this. All six respondents agreed that adopting a systemic understanding, considering general family functioning, and seeking individual family member opinions, was critical. Nevertheless, all family members were infrequently seen, with resourcing issues and time constraints being cited as the main reasons. The value of adopting a systemic and whole‐of‐family line of enquiry was supported by all respondents. Whilst sibling viewpoints were considered valuable by most professionals, siblings were infrequently seen for a variety of reasons. Further attention could therefore be given to involving siblings during specialist assessments. The findings consistently highlighted the value of a systemic line of enquiry and whole‐of‐family approach for gender diversity services and specialists. However, no current assessment guidelines incorporate this as a recommendation. Therefore, future Australian guidelines could formalise a systemic approach.     

To tweet or not to tweet: Exploring the determinants of early adoption of Twitter by House members in the 111th Congress

The adoption of communication forms like Twitter presents students of congressional behavior an interesting case to examine the intersection of technology and politics. Twitter represents a social media venue that provides an immediate and direct link between the Member of Congress (MC) and constituents, which entails a benefit and a potential risk. In this paper, I examine Twitter use in the 111th Congress in order to better understand congressional early adoption of new technology. The primary question addressed is what systematic determinants shape the decision to adopt Twitter as a component of an MC's media strategy. Using data collected from MC Twitter accounts and the 2008 congressional election, I find partisan, cohort, and ideological determinants on early Twitter adoption. Republicans are more likely to use Twitter even in multivariate analysis; ideological extremism influences the use of Twitter. In contrast to past technologies, district demographics have no systematic effect on the early adoption of Twitter.     

Union Transitions Following the Birth of a Child to Cohabiting Parents

Despite a growing interest in the family trajectories of unmarried women, there has been limited research on union transitions among cohabiting parents. Using data from the 2002 National Survey of Family Growth, we examined how family complexity (including relationship and fertility histories), as well as characteristics of the union and birth, were associated with transitions to marriage or to separation among 1,105 women who had a birth in a cohabiting relationship. Cohabiting parents had complex relationship and fertility histories, which were tied to union transitions. Having a previous nonmarital birth was associated with a lower relative risk of marriage and a greater risk of separation. In contrast, a prior marriage or marital birth was linked to union stability (getting married or remaining cohabiting). Characteristics of the union and birth were also important. Important racial/ethnic differences emerged in the analyses. Black parents had the most complex family histories and the lowest relative risk of transitioning to marriage. Stable cohabitations were more common among Hispanic mothers, and measures of family complexity were particularly important to their relative risk of marriage. White mothers who began cohabiting after conception were the most likely to marry, suggesting that “shot-gun cohabitations” serve as a stepping-stone to marriage.     

Working with parents of disturbed adolescents: a multifaceted group approach

Experience with this parents' group model suggests that there are a number of advantages in using a multifaceted approach when working with parents of severely disturbed adolescents. Basic support and reduction of guilt and blaming are derived from the therapeutic aspect of the group process. This is augmented by having the parents in a leadership role, in the manner of a self-help group. Bringing in educational and advocacy elements allows the group to respond directly to the parents' need for detailed, accurate information about the disorders and treatment resources for dealing with them. This approach is not designed to replace family therapy, but to provide resources and support to parents. Future research will be necessary to substantiate the clinical impression that the group is quite helpful to parents and to elucidate all the factors producing success.     

The Limits of Catastrophe Aversion

We discuss the management of catastrophe-risks from a theoretical point of view. The concept of a catastrophe is informally and formally defined, and a number of desiderata for catastrophe-averse decision rules are introduced. However, the proposed desiderata turn out to be mutually inconsistent. As a consequence of this result, it is argued that the "rigid" form of catastrophe aversion articulated by, for example, the maximin rule, the maximum probable loss rule, (some versions of) the precautionary principle, and the rule proposed in Ekenberg et al. (1997, 2000) should be given up. An alternative form of "non-rigid" catastrophe aversion is considered.     

Men's and Women's Interpretation and Endorsement of Items Measuring Self-Reported Heterosexual Aggression

Early research on sexual aggression (e.g., sexual coercion, sexual assault, and rape) mainly focused on men as perpetrators and women as victims; more recently, researchers have begun to investigate women as perpetrators of sexual aggression as well. However, most measures of sexual aggression perpetration were designed for use with men and have not been well validated with women. This study sought to examine two different measures of sexual aggression perpetration in terms of their convergent validity for both men and women and to examine gender differences and similarities in item interpretation using open-ended inquiries. Participants were 590 individuals (395 women, 195 men) with a mean age of 25 years (SD = 8.1) recruited from an undergraduate psychology subject pool and an online convenience sample. The majority of the sample was White (65.4%) and Black (20.3%). All measures were completed online anonymously. Results suggested that convergent validity for the two measures was less than optimal, particularly for women. Further, item interpretation analyses revealed that, compared to men, more than twice the percentage of women provided a false-positive response to one of the measures, suggesting that women may be more likely than men to endorse self-report perpetration items incorrectly.