Direct and modifying influences of selected risk factors on children's pre-adoption functioning and post-adoption adjustment

Child adoption outcomes are influenced by child's behavior and parents' expectations (Haugaard & Hazan, 2003). Pre-adoption risk factors, such as prenatal alcohol, tobacco and/or other drug (ATOD) exposure, male sex, sexual abuse, and multiple out-of-home placements have been linked to increased externalizing (acting out) behaviors that are difficult to manage and are most closely associated with adoption disruption (Barth, 1991, 2001 Rosenthal & Groze, 1991; Smith & Howard, 1999). However, adoption researchers have found that positive outcomes (fewer externalizing behaviors) are possible for children who have been exposed to pre-adoption risk factors, suggesting that adoptive families provide protective environments that allow healing (Barth, 1991, 1993; Barth & Brooks, 2000). The current study sought to increase understanding of the influence of these pre-adoption risk factors on adoption outcome with attention to the influence of prenatal alcohol, tobacco, and/or other drug (ATOD) exposure. Results indicated that pre-adoption functioning was significantly influenced by prenatal ATOD exposure, but post-adoption adjustment was not. Structural equation modeling then was used to analyze both the direct and moderating influences of the identified risk factors on the relationship between the child's pre-adoption functioning and post-adoption adjustment. Negative influences of the risk factors on the child's externalizing behavior, individually and additively, in both direct effects and moderation analyses, were not found, with one exception. The only model to have a statistically significant effect was the moderation analysis containing the interaction of all four risk factors. Child development, child welfare, addiction professionals, and adoptive families will find this information to be of value in their quest to facilitate successful adoptions and growth of healthy children and families.     

Commentary: Barriers to a Sustained Restraint-Free Environment

A restraint-free culture is becoming a standard practice in the provision of long-term care services for older people, a standard by which licensure and accreditation agencies evaluate providers. Although most health care providers initiate restraint-elimination processes, many fail to achieve the intended result or sustain the practice because of a variety of barriers. Faltering organizations find themselves faced with monumental changes in administrative and supervisory staff, substantial recruitment and retention crises, and inadequate attention to a culture of continuous learning, teamwork, and leadership skill building. This article informs policy makers about the barriers to achieving and sustaining a restraint-free environment and suggests public policy agendas and processes to improve conditions for the aging population.     

The effect of variability in the fertility schedule on numbers of kin

The kinship formulas developed by Goodman, Keyfitz, and Pullum (1974) are extended to encompass populations in which fertility varies among women. An expression is derived to determine the amount by which the number of sisters in a heterogeneous population exceeds that in a population with homogeneous fertility. This expression, which is a function of the variance in the gross reproduction rate of the population, can readily be applied to numbers of other kin, such as aunts and cousins. Several trial calculations indicate that calculations of average numbers of sisters based on an assumption of uniform fertility could result in an underestimate of about 13 percent.     

Sex differences in life cycle measures of widowhood

Using formulas which measure life cycle characteristics of widowhood as a function of life table survivorship and age at marriage, we illustrate changes in patterns of widowhood and widowerhood since 1950, as well as differences by race, by age of bride and of groom, and by age differences between spouses. Although the current inequality in the risks of widowhood and widowerhood for the average couple is mostly due to sex differences in mortality, a one year age difference between spouses has about the same impact as does a one year difference in life expectancy. Calculations based on current distributions of age of groom by age of bride indicate that the older the age of groom, the greater the age difference between spouses and the higher the likelihood of a woman outliving her husband: the typical groom who marries in his fifties faces a 4 to 1 chance that he will be outlived by his spouse.     

The Post-Hospital Mental Patient and Family Therapy: Prospects and Populations*

Changes in the pattern of delivery of mental health services have led to dramatic increases in the number of patients discharged from mental hospitals. These post-hospital mental patients represent a new challenge to the field of family therapy. Of the approximately 1 million patient admissions to state and county mental hospitals, general hospitals, and private psychiatric hospitals, over 380,000 are married, and more than half of the remaining patients are estimated to be living with family. Almost 135,000 admissions receive family therapy during their hospitalization, and an estimated 650,000 mental patients will return to their families upon discharge.     

Some methodological problems in estimating incidence and prevalence in child sexual abuse research

Research into child sexual abuse is fraught with methodological problems. This paper provides an overview of some common aspects of them. Definitional inconsistencies are frequent, including that of child sexual abuse itself and what age limits define a child. Other methodological difficulties include determining the number of children sexually abused in any period of time, choice of sample, the type and number of questions asked, factors such as publicity associated with the historical period, and estimates of the rate of increase of child sexual abuse over time. It is suggested that greater consistency, particularly of definition, would assist comparative conclusions to be made with less ambiguity and greater validity.