The Clinical Correlates of Reported Childhood Sexual Abuse: An Association Between Age at Trauma Onset and Severity of Depression and PTSD in Adults

This study investigated the relationship between the age of -self‐reported sexual abuse occurrence and the development of post-traumatic stress disorder and/or depressive symptoms in adulthood. Subjects were evaluated for the presence of post-traumatic stress disorder and/or depressive symptoms as well as for a self-reported history of sexual abuse before the age of 18. Results found that relative risk of having severe post-traumatic stress disorder symptoms was 10 times higher in patients reporting sexual abuse after age 12 than in those reporting sexual abuse before age 12. Relative risk of having severe depressive symptoms was higher for those abused before the age of 12 than for those abused after the age of 12. Findings suggest that the impact of reported sexual abuse at different stages of development may lead to distinct psychiatric symptoms in adulthood.     

Origins and Destinations,but How Much and When? Educational Disparities in Smoking and Drinking Across Adolescence and Young Adulthood

Educational inequalities in health behaviors change dynamically across the life course. Yet, how parental and personal education interactively shape age-specific behavioral inequalities across the transition to adulthood has yet to be understood. Drawing on national Add Health data (N?=?12,605; 6,675 women and 5,930 men), we analyze age- and gender-specific trajectories of current smoking and binge drinking from adolescence to young adulthood. In line with previous work, we find that parental education associates with smoking and drinking disparities even after respondents’ own education is completed. Reciprocally, we also find that disparities by eventual educational attainment appear early. During the college years, higher parental education predicts higher—not lower—rates of binge drinking. We find that attaining higher education “against the odds” of an educationally disadvantaged family background circumscribes the lowest rates of smoking and drinking for men and women alike, and especially during the college years, while “falling from grace” by not attaining higher education at levels matching one’s parents predicts the highest levels of smoking and drinking for both genders during or after college. These results shed new light on the interactive socioeconomic processes that help to explain behavioral health gradients across adolescence and adulthood.

     

Sexual Minority and Heterosexual Former Foster Youth: A Comparison of Abuse Experiences and Trauma-Related Beliefs

The current study compared the abuse experiences of 108 sexual minority and heterosexual former foster youth who received scholarships through the Orphan Foundation of America. Participants used an anonymous online survey to answer questions regarding their history of physical and sexual abuse. All participants who reported a history of sexual abuse also completed the Trauma Related Beliefs questionnaire (TRB; Hazzard, 1993). Differences across sexual orientation were observed in sexual, but not physical, abuse rates and in the Self-Blame/Stigmatization subscale of the TRB. Specifically, sexual minority participants reported more incidents of sexual abuse, as well as higher scores on the TRB subscale, than did heterosexual participants. These results suggest that sexual orientation is relevant to the experience of abuse among children in the child welfare system.     

Prevention in integrated children's services: the impact of sure start on referrals to social services and child protection registrations

Every Child Matters, the English government's plans for integrated children's services, proposed that preventative approaches such as those developed through Sure Start should be able to reduce the numbers of children requiring more intensive support from children's social services and, by implication, the numbers of children on the child protection register. This study examined the impact of Sure Start local programmes (SSLPs) on four local authorities with social services responsibilities in the northeast of England. The researchers analysed routinely collected statistical data concerning over 10,000 referrals of children under four years and over 1,600 child protection registrations (CPRs) in an eight‐year period before and after the introduction of 19 SSLPs. They also analysed interviews with 36 key informants in eight case study SSLP areas. Contrary to expectations, the quantitative data revealed no discernable short‐term effect on the numbers of referrals, or on CPRs. Interview data showed broad agreement on the potential impact of preventative work undertaken by SSLPs and many respondents believed that it was too early to draw conclusions. Alternatively, the universal approach to prevention within the Sure Start areas and the attempts to provide non‐stigmatising and non‐intrusive community‐based services may be ineffective in reducing the need for intensive support for ‘at risk’ families. The findings are discussed in relation to ‘targeted’ prevention programmes and government policy intentions. Copyright © 2007 John Wiley & Sons, Ltd.     

Mothers' Reports of Events Causing Anger Differ Across Family Relationships

Mother's reports of anger causes within the family were analyzed in terms of the family relationships of the persons experiencing and eliciting anger and three independent components of the anger-eliciting event—Type of Cause, Focus of Anger, and Temporal Specificity. Mothers' reports suggest substantial differences (a) in anger causes across relationships, (b) depending on whether parents or children were experiencing or eliciting anger events, and (c) for the three independent components of the anger events. For example, for type of cause, mothers' reports indicated more expectancy violations for parents' than children's anger, but more goal blockages for children's than parents' anger. Also, elicitormattered; mothers' reports indicated more goal blockages elicited by parents than by children, but more expectancy violations elicited by children than by parents. These patterns are interpreted in terms of differential power and status within the family.     

A comparison of multiple imputation and doubly robust estimation for analyses with missing data

Summary.  Multiple imputation is now a well-established technique for analysing data sets where some units have incomplete observations. Provided that the imputation model is correct, the resulting estimates are consistent. An alternative, weighting by the inverse probability of observing complete data on a unit, is conceptually simple and involves fewer modelling assumptions, but it is known to be both inefficient (relative to a fully parametric approach) and sensitive to the choice of weighting model. Over the last decade, there has been a considerable body of theoretical work to improve the performance of inverse probability weighting, leading to the development of 'doubly robust' or 'doubly protected' estimators. We present an intuitive review of these developments and contrast these estimators with multiple imputation from both a theoretical and a practical viewpoint.     

Assessing parameter uncertainty via bootstrap likelihood ratio confidence regions

In this paper, we show that, under certain regularity conditions, constructing likelihood ratio confidence regions using a boostrap estimate of the distribution of the likelihood ratio statistic-instead of the usual chi 2 approximation-leads to regions which have a coverage error of O(n- 2), which is the same as that achieved using a Bartlett-corrected likelihood ratio statistic. We use the boostrap method to assess the uncertainty associated with dose-response parameters that arise in models for the Japanese atomic bomb survivors data.     

Professional Identity for Clinical Social Workers: Impact of Changes in Health Care Delivery Systems

The recent rapid changes in funding and delivery of mental health services have impacted professional identity for social workers. A study of 127 clinical social workers in 3 different practice settings explored the sense of fit between personal and professional values: How much are they in concert and how much are they in conflict? Social workers described values in their own words. The sense of strain between values varied according to workplace setting. Implications for theory, research, practice, and training are discussed.     

A Monte Carlo EM algorithm for random-coefficient-based dropout models

Longitudinal studies of neurological disorders suffer almost inevitably from non-compliance, which is likely to be non-ignorable. It is important in these cases to model the response variable and the dropout mechanism jointly. In this article we propose a Monte Carlo version of the EM algorithm that can be used to fit random-coefficient-based dropout models. A linear mixed model is assumed for the response variable and a discrete-time proportional hazards model for the dropout mechanism; these share a common set of random coefficients. The ideas are illustrated using data from a five-year trial assessing the efficacy of two drugs in the treatment of patients in the early stages of Parkinson's disease.     

Priority Topics in the Study of Environmental Risk in Developing Countries: Report on a Workshop Held at the East–West Center, August, 1988

The rapid industrialization occurring in developing regions of the world brings not only economic benefits, but changes in the types and severity of health and environmental problems that each region experiences. As the industrialized world moves toward the use of risk assessment methodologies to aid in problem evaluation and regulatory and policy decision analysis, it seems inevitable that these methodologies will be applied globally. The changes brought about by rapid industrialization, however, must be viewed within the context of societies that are still struggling with the more traditional and basic environmental problems associated with urban and rural poverty. The urgency of development and the lack of adequate resources for characterizing health and environmental changes, often present under these circumstances, offer special challenges to the application of risk assessment methodologies.