Introduction: the need to address older women's mental health issues

Women are the primary consumers of mental health services. Ironically, research addressing their unique needs lags behind that of men's issues. The aging process introduces an important variable that accentuates the relative lack of information and specific treatment guidelines for older women who are confronted by mental health problems. This volume offers a comprehensive overview for the health professional who is seeking a greater depth of understanding with respect to the study of mental health problems in general, and how these issues pertain specifically to women and the aging process. A second goal of this project is to provide the practicing therapist and counselor with a research update and a broad clinical perspective offered by seasoned clinicians. Using current psychiatric diagnosis as a framework, the contributions address the range of mental health problems, including dementia and cognitive impairment, schizophrenia, alcohol abuse, mood and anxiety disorders, traumatic and dissociative conditions, sexual and eating disorders, and personality disorders. It is hoped that this book will inform, inspire and encourage students and health professionals in their work with middle aged and older women who are facing mental health challenges.     

The Role of Social Support in Coping during the Anticipatory Stage of Organizational Change: A Test of an Integrative Model

Few researchers have explored how employees use social support to cope during organizational change. The current research proposed and tested a model that integrates moderation and mediation effects in order to understand how perceived available support influences employees' use of support mobilization to deal with change‐related stress. Survey data were collected from 476 health professionals working in a large public hospital undergoing large‐scale change and downsizing. Moderated path analyses revealed evidence to suggest that perceived available support plays a moderated mediation role during coping with change. Support mobilization mediated the indirect relationship between change‐related stress and job satisfaction, at both low and high levels of perceived available colleague support. Perceived available non‐work support moderated the relationship between support mobilization and job satisfaction, and perceived available supervisor support moderated the relationship between change‐related stress and support mobilization. The direction of simple effects was not always as expected and alternative explanations for these unexpected findings are offered, along with practical implications for supervisors managing organizational change.     

Culture, Modernization, and Politics: Ethnic Differences in Union Formation in Kyrgyzstan

The unique cultural and political history of Central Asia has produced intriguing ethnic variations in union formation. We use data from a survey of 1,535 young adults conducted in 2005 in northern Kyrgyzstan to examine ethnic patterns of entry into marriage versus cohabitation. To reflect the historic-cultural and political realities of Kyrgyzstan, we subdivide ethnic Kyrgyz into two categories based on the degree of linguistic Russification??more-Russified Kyrgyz and less-Russified Kyrgyz??and compare them to each other and to respondents of European origin. The results of the multinomial discrete-time logit models show significant differences among the three groups. Thus, Europeans were most likely to enter cohabitation whereas less-Russified Kyrgyz were least likely to do so, net of other factors. The three groups were lined up in the converse order with respect to probability of entering marriage, but upon breakdown by gender this ordering was present only among women. In contrast, among men, more-Russified Kyrgyz were less likely to marry than both less-Russified Kyrgyz and Europeans. We interpret these findings in light of long-term historic-cultural and demographic distinctions as well as more recent politically induced cleavages in Kyrgyzstan.     

Inference on Counterfactual Distributions

Counterfactual distributions are important ingredients for policy analysis and decomposition analysis in empirical economics. In this article, we develop modeling and inference tools for counterfactual distributions based on regression methods. The counterfactual scenarios that we consider consist of ceteris paribus changes in either the distribution of covariates related to the outcome of interest or the conditional distribution of the outcome given covariates. For either of these scenarios, we derive joint functional central limit theorems and bootstrap validity results for regression‐based estimators of the status quo and counterfactual outcome distributions. These results allow us to construct simultaneous confidence sets for function‐valued effects of the counterfactual changes, including the effects on the entire distribution and quantile functions of the outcome as well as on related functionals. These confidence sets can be used to test functional hypotheses such as no‐effect, positive effect, or stochastic dominance. Our theory applies to general counterfactual changes and covers the main regression methods including classical, quantile, duration, and distribution regressions. We illustrate the results with an empirical application to wage decompositions using data for the United States. As a part of developing the main results, we introduce distribution regression as a comprehensive and flexible tool for modeling and estimating the entire conditional distribution. We show that distribution regression encompasses the Cox duration regression and represents a useful alternative to quantile regression. We establish functional central limit theorems and bootstrap validity results for the empirical distribution regression process and various related functionals.     

Development of a Measure of College Students' Adherence to Religious Doctrine Concerning Sexual Behavior

Abstract

Objective: The authors developed a 14-item measure of adherence to religious doctrine concerning sexual behavior (ARDSB). The ARDSB psychometric properties were investigated to better understand religious motivations associated with changes in sexual behavior that may provide support for sexual health promotion and prevention programs. Participants: Four hundred eighty-three undergraduates aged 18 to 26. Methods: Data were collected from an online survey during the 2012–2013 academic school year. Results: Principle components factor analysis identified 2 factors: reasons to break religious doctrine and reasons to adhere to religious doctrine concerning sexual behavior. The subscales had good internal consistency. Correlations, t tests, and analyses of variance of the subscales with measures of intrinsic and extrinsic religiosity and self-reported sexual behavior and risk provide support for concurrent validity. Conclusions: The ARDSB could be employed as a measure to better understand sexual behavior; it is inexpensive and relatively easy to employ in both research and campus ministry settings.     

From Detention Camps of Thailand to Freedom in the Foothills of North Carolina: One Family’s Remarkable Story

In the 1980s, a number of Hmong families relocated from Thailand detention camps to the United States. This research explores one such family. The family became the key informant in snowball sampling for a larger, ongoing study. Following a series of interviews, qualitative narrative life stories were created and themes of family preservation, survival, and perpetuation of Hmong culture began to emerge. Importantly, parental concerns about how to keep the family intact despite different levels of acculturation surfaced during the process. The purpose of this research was to examine one family’s attempts to preserve the oral history of the Hmong culture and to promote understanding across generations and community members from different cultural backgrounds. The interviews gave the family a forum to expose and discuss their secret journey along with their sacrifices and triumphs. Significantly, the sense of urgency to blend the Hmong and American cultures was profound.     

Diagnostic significance of free salivary testosterone measurement using a direct luminescence immunoassay in healthy men and in patients with disorders of androgenic status

The accurate measurement of testosterone remains a challenge. The determination of the blood testosterone concentrations in serum by conventional immunoassays is inaccurate in men and even more so in females and children. A new luminescence enzyme immunoassay (LIA) has been developed and validated. The high analytical (8.7 pmol/L) and functional (17.3 pmol/L) sensitivity allows the quantification of the very low concentration in saliva, as well as in serum, after 1/40 dilution. This study measured salivary testosterone levels and compared the results with the free levels calculated from total testosterone and sex hormone-binding globulin in eugonadal and hypogonadal men. Salivary testosterone concentrations in healthy men in morning hours were 369 pmol/L (mean), range 263–544 pmol/L, which was statistically significantly higher than that in men with androgen deficiency, 215 pmol/L (mean), range 51–249 pmol/L.

Repetitive determination of free testosterone concentrations in saliva (once a week for 5 weeks) showed high stability of results over time, with coefficient of variation 9% (range 5–23%).

In this study we showed that free salivary testosterone levels in morning samples correlated well with calculated free testosterone in blood, both in healthy men (R = 0.754, P = 0.001), and in patients with androgen deficiency (R = 0.889, P = 0.0001), though in cases with very low testosterone, salivary concentrations were systematically higher than calculated free testosterone levels in blood.