Psychiatric consultation. I. A general systems approach.
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Biomedical subjects
Publications and source records attributed to W B Miller.
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Students in a middle-class and in an economically lower-class high school were surveyed regarding their attitudes and behavior with respect to sexuality, contraception, and pregnancy. A large majority of students approved of premarital intercourse for both sexes within the context of a loving relationship. The most important deterrent to sexual intercourse was fear of pregnancy. A majority of both sexes had had sexual intercourse. Forty percent of the sexually active had used no contraception on some occasions, and many of the remainder had used poor methods such as withdrawal or rhythm. The pregnancy rate was high-at least 20 percent in several of the sexually active subgroups. Parents were an infrequent source of information about sex. On the other hand, there was some evidence that students exposed to a sex education program retained useful information if it was relevant to their situation, and if they were appropriately motivated.A model for integrating the various aspects of this subject area is offered.
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In this study we assume that fertility decisions are made one birth at a time and use longitudinal data collected from 401 married couples over a two-year period to explore how having a child affects two types of fertility motivation and three types of fertility desires. Using a series of five constrained multiple regression analyses, we tested the effects of two childbearing variables on these five types of motivation and desires in the context of a large set of control variables also hypothesized to affect fertility motivation and desires. The results demonstrate that the childbearing variables have a substantial effect in all five regression models. Specific findings indicate that childbearing stimulates greater positive motivation for childbearing and an increase in the number of children desired. Although this situation would appear to create a positive feedback loop in which each child born further increases the motivation and desire for children, the findings also suggest three different mechanisms whereby childbearing causes a counterbalancing regulation of that loop. These mechanisms include a negative motivation mechanism, a satiation mechanism, and a delay mechanism. The effect of these mechanisms on the termination of childbearing is considered in conjunction with a fourth mechanism, the achievement of desired family size.
In this study we develop and then test a couple model of contraceptive method choice decision-making following a pregnancy scare. The central constructs in our model are satisfaction with one's current method and confidence in the use of it. Downstream in the decision sequence, satisfaction and confidence predict desires and intentions to change methods. Upstream they are predicted by childbearing motivations, contraceptive attitudes, and the residual effects of the couples' previous method decisions. We collected data from 175 mostly unmarried and racially/ethnically diverse couples who were seeking pregnancy tests. We used LISREL and its latent variable capacity to estimate a structural equation model of the couple decision-making sequence leading to a change (or not) in contraceptive method. Results confirm most elements in our model and demonstrate a number of important cross-partner effects. Almost one-half of the sample had positive pregnancy tests and the base model fitted to this subsample indicates less accuracy in partner perception and greater influence of the female partner on method change decision-making. The introduction of some hypothesis-generating exogenous variables to our base couple model, together with some unexpected findings for the contraceptive attitude variables, suggest interesting questions that require further exploration.
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Relationships between positive and negative childbearing motivations and an abortion attitude index are examined among men and women from 401 married couples--half of whom had one child and half of whom were childless. A multivariate model tests for differences in these relationships, as well as in the association of the attitude index with personality traits, personal value systems and age, across both gender and parity groups. The results indicate that three of the four measures of negative childbearing motivation and one of the five measures of positive childbearing motivation are associated with a more accepting attitude toward abortion. These relationships are independent of the effects of personality, personal values and age, and are the same for both males and females and for respondents with no children and one child.