The Media Abuse of Children. Jake's Progress from Demonic Icon to Restored Childhood Innocent

While scholarly analysis of child protection and the media has grown substantially during the 1990s (Aldridge, 1994; Franklin and Parton, 1991; Kitzinger and Skidmore, 1995), studies have ignored a crucial dimension which forms the focus for discussion here. We wish to suggest that media reporting of children and child abuse may itself constitute an abusive activity. Media presentations of children and childhood, since press coverage of the Bulger case in 1993, have assumed a distinctive and sinister guise which, we argue, fundamentally revises the previously held perception of children and childhood. We suggest that this new understanding of childhood is damaging to children and, because of the impact of such media presentations on the public mood and policy climate, harms their interests. The discussion is in three parts. First, newspaper reporting of the Bulger case is analysed to reveal how coverage challenged the idea of childhood as a period of innocence and replaced it with a perception of childhood as essentially ‘evil’. Second, the characterization of Jake, the central figure in Alan Bleasdale's recent television dramaJake's Progress, is analysed to serve as an illustrative exemplar of this new construction of childhood. Finally, we consider the possible messages conveyed by such presentations to perpetrators and victims of abuse.     

A qualitative case study of a Korean former addict’s existential self‐interpretation and identity transformation

This study explored the case of a former addict, focusing on his existential self‐interpretation and identity transformation process. This study began from the question of whether philosophical processes related to existential self‐interpretation could lead to the formation of the concept of bottoming out and of identity transformation. To answer this question, the study analyzed the case of a male in his mid‐forties who was addicted to drugs for approximately 30 years and has only recently maintained abstinence. The study used the phenomenological approach to determine the meaning drugs held for him in each stage, and what drug‐related identity he had in each stage. Further, this study identified the integrative implications of these meanings in terms of existential self‐interpretation and identity transformation. The four different identities the man identified for the four stages of his life were juvenile delinquent, gang member, half‐gangster, and breadwinner, and the associated meanings drugs had for him during each period were “glue,” “filthy,” “leeches,” and “abstinence,” respectively. Finally, this study elucidated the integration of these meanings through the hermeneutic circle, identified the social welfare implications of the findings, and developed educational recommendations.     

Legal Marriage,Unequal Recognition,and Mental Health Among Same‐Sex Couples

The authors examined whether the perception of unequal relationship recognition ‐ a novel couple‐level minority stressor ‐ has negative consequences for mental health among same‐sex couples. Data were analyzed from a dyadic study of 100 same‐sex couples (200 individuals) in the United States. Being in a legal marriage was associated with lower perceived unequal recognition and better mental health; being in a registered domestic partnership or civil union—but not also legally married—was associated with greater perceived unequal recognition and worse mental health. Actor partner interdependence models tested associations between legal relationship status, unequal relationship recognition, and mental health (nonspecific psychological distress, depressive symptomatology, and problematic drinking), net controls (age, gender, race and ethnicity, education, and income). Unequal recognition was consistently associated with worse mental health, independent of legal relationship status. Legal changes affecting relationship recognition should not be seen as simple remedies for addressing the mental health effects of institutionalized discrimination.     

The victim–offender overlap in late adulthood

This study contributes to the general knowledge of the victim–offender overlap by determining whether the phenomenon exists among older adults and whether known correlates of crime and victimization explain the relationship. Cross-sectional survey data from telephone interviews conducted with individuals 60 years and older (N = 2,000) residing in Arizona and Florida are used to estimate confirmatory factor models for both victimization and criminal offending. The results from a series of multivariate regression models show that victimization is associated with criminal offending. While factors such as low self-control, depression, and spending time in commercial drinking establishments partially attenuate the victimization–crime link, the statistically significant relationship persists in a multivariate context. Further testing indicates that the observed findings are robust across measurement and modeling strategies. Coupled with prior research, the results support the argument that the victim–offender overlap exists (and is difficult to explain) over the life course.     

Development of the Emergency Department Senior Abuse Identification (ED Senior AID) tool

Emergency departments (EDs) are an important health care setting for the identification of elder abuse (EA). Our objective was to develop an ED-based tool to identify EA. The initial tool included a brief cognitive assessment, questions to detect multiple domains of EA, and a physical examination. Refinement of the tool was based on input from clinical experts and nurse and patient feedback. The revised tool, which included 15 questions about EA, was then tested in an academic ED. We calculated the inter-rater reliability, sensitivity, and specificity of individual EA questions. Among ED patients age≥65 (N = 259), 17 (7%) screened positive for suspicion of EA. We identified a combination of six questions that cover the included domains of EA, demonstrated good or excellent inter-rater reliability, and had a sensitivity and specificity of 94% (95% confidence interval (CI) 71–100%) and 90% (95% CI 85–93%), respectively. These results inform a proposed screening tool for multisite validation testing.     

Listening to Young People with Learning Disabilities Who Have Experienced,or Are at Risk of,Child Sexual Exploitation in the UK

This paper reports on a UK study which examined the identification of, and support for young people with learning disabilities who experience, or are at risk of, child sexual exploitation (CSE). CSE has received considerable attention in the UK, with evidence suggesting an increased risk for young people with learning disabilities. However, no study has specifically focused on this group, and their voices remain largely unheard. In‐depth interviews with 27 young people with learning disabilities were undertaken to explore how to meet their needs. This paper presents the young people's voices and identifies areas for improvements in policy and practice.     

Benefits and costs associated with mutual-help community-based recovery homes: The Oxford House model

We used data from a randomized controlled study of Oxford House (OH), a self-run, self-supporting recovery home, to conduct a cost-benefit analysis of the program. Following substance abuse treatment, individuals that were assigned to an OH condition (n = 68) were compared to individuals assigned to a usual care condition (n = 61). Economic cost measures were derived from length of stay at an Oxford House residence, and derived from self-reported measures of inpatient and outpatient treatment utilization. Economic benefit measures were derived from self-reported information on monthly income, days participating in illegal activities, binary responses of alcohol and drug use, and incarceration. Results suggest that OH compared quite favorably to usual care: the net benefit of an OH stay was estimated to be roughly $29,000 per person on average. Bootstrapped standard errors suggested that the net benefit was statistically significant. Costs were incrementally higher under OH, but the benefits in terms of reduced illegal activity, incarceration and substance use substantially outweighed the costs. The positive net benefit for Oxford House is primarily driven by a large difference in illegal activity between OH and usual care participants. Using sensitivity analyses, under more conservative assumptions we still arrived at a net benefit favorable to OH of $17,830 per person.     

Assessing state substance abuse prevention infrastructure through the lens of CSAP's Strategic Prevention Framework

Although the organizational structures and operating procedures of state substance abuse prevention systems vary substantially across states, there is scant empirical research regarding approaches for rigorous assessment of system attributes and which attributes are most conducive to overall effectiveness. As one component of the national cross-site evaluation of the SPF State Incentive Grant Program (SPF SIG), an instrument was developed to assess state substance abuse prevention system infrastructure in order to measure infrastructure change and examine the role of state infrastructure in achieving prevention-related outcomes. In this paper we describe the development of this instrument and summarize findings from its baseline administration. As expected, states and territories were found to vary substantially with respect seven key characteristics, or domains, of state prevention infrastructure. Across the six domains that were assessed using numeric ratings, states scored highest on data systems and lowest on strategic planning. Positive intercorrelations were observed among these domains, indicating that states with high capacity on one domain generally have relatively high capacity on other domains as well. The findings also suggest that state prevention infrastructure development is linked to both funding from state government and the presence of a state interagency coordinating body with decision-making authority. The methodology and baseline findings presented will be used to inform the ongoing national cross-site evaluation of the SPF SIG and may provide useful information to guide further research on state substance abuse prevention infrastructure.     

Organizational characteristics that foster early adoption of cultural and linguistic competence in outpatient substance abuse treatment in the United States

Recent years have seen an increased interest in developing culturally and linguistically responsive systems of care in substance abuse treatment in the United States. This study examines the extent to which external and internal organizational pressures contributed to the degree of adoption of culturally and linguistically responsive practices in the nation's outpatient substance abuse treatment system early in the period of development of this system of care. Findings show that a higher degree of adoption of culturally competent practices was most likely in treatment programs with high dependence on external funding and regulation. Internally, programs with a larger number of professionals were associated with the lowest degree of adoption, while managers’ cultural sensitivity contributed significantly to a high degree of adoption of these responsive practices. Considering the passage of recent legislation enforcing the use of cultural and linguistic competence in health care, implications of these baseline findings on early adoption patterns are discussed for future research and health care policy evaluation.