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PubMed1992

The association of maternal and socioeconomic characteristics in metropolitan Adelaide with medical, obstetric and labour complications and pregnancy outcomes.

Multiple regression analysis was used to measure associations of maternal age, race, gravidity, marital status and socioeconomic status with medical problems and pregnancy outcomes. The study population comprised all singleton births to residents of metropolitan Adelaide (in South Australia) during 1988 that were included in the State's perinatal statistics collection. The results indicate that in metropolitan Adelaide, low socioeconomic status is related to a higher risk profile of mothers and babies. It also highlights that there is a strong association of divorce and separation with medical problems and an adverse pregnancy outcome. Poorer outcomes are also seen in never married women, teenage women, older women, non-Caucasian women and primigravid women. These poorer outcomes in older women and primigravidas include higher risks of low birth-weight and prematurity of their babies. The study also demonstrates that groups that are less likely to have choice of obstetric care, eg. teenage women, non-Caucasian women, and women of low socioeconomic status, have a lower odds of obstetric intervention as characterized by nonspontaneous labour and elective Caesarean section.

Adult↗
PubMed2004

What do physicians tell patients about themselves? A qualitative analysis of physician self-disclosure.

OBJECTIVE: Physician self-disclosure (PSD) has been alternatively described as a boundary violation or a means to foster trust and rapport with patients. We analyzed a series of physician self-disclosure statements to inform the current controversy. DESIGN: Qualitative analysis of all PSD statements identified using the Roter Interaction Analysis System (RIAS) during 1,265 audiotaped office visits. SETTING AND PARTICIPANTS: One hundred twenty-four physicians and 1,265 of their patients. MAIN RESULTS: Some form of PSD occurred in 195/1,265 (15.4%) of routine office visits. In some visits, disclosure occurred more than once; thus, there were 242 PSD statements available for analysis. PSD statements fell into the following categories: reassurance (n = 71), counseling (n = 60), rapport building (n = 55), casual (n = 31), intimate (n = 14), and extended narratives (n = 11). Reassurance disclosures indicated the physician had the same experience as the patient ("I've used quite a bit of that medicine myself"). Counseling disclosures seemed intended to guide action ("I just got my flu shot"). Rapport-building disclosures were either humorous anecdotes or statements of empathy ("I know I'd be nervous, too"). Casual disclosures were short statements that had little obvious connection to the patient's condition ("I wish I could sleep sitting up"). Intimate disclosures refer to private revelations ("I cried a lot with my divorce, too") and extended narratives were extremely long and had no relation to the patient's condition. CONCLUSIONS: Physician self-disclosure encompasses complex and varied communication behaviors. Self-disclosing statements that are self-preoccupied or intimate are rare. When debating whether physicians ought to reveal their personal experiences to patients, it is important for researchers to be more specific about the types of statements physicians should or should not make.

Counseling↗
PubMed1986

Alcohol use by adolescents in disrupted families.

Alcohol use increases among adults in response to marital disruption and divorce, but data that are available regarding adolescent alcohol use are inconsistent in the light of whether or not families are intact. To explore this question we obtained measures of frequency and quantity of alcohol use from 2595 junior and senior high school students, together with information about family intactness and parental alcohol use. Adolescents in single and stepparent families reported more alcohol use than adolescents from intact families, for both frequency and quantity of use. This was the case for boys and for girls, as well as for junior high school and for senior high school students. Parents in nonintact families also were reported to be using more alcohol than parents in intact families. Adolescent alcohol use was significantly correlated with parental alcohol use. After adjusting adolescent alcohol use for parental alcohol use as a covariate, the finding of greater alcohol use by adolescents in non-intact families remained.

Adolescent↗
PubMed1995

Predictors of mortality in alcoholic men: a 20-year follow-up study.

This study investigates the predictors of mortality in 156 male alcoholics who were psychiatrically hospitalized between 1967 and 1968 and followed for > 20 years. The findings showed that an older age, liver cirrhosis, and separation or divorce at intake were all associated with a shorter time to death. These results corroborate those of other follow-up studies that have identified age, health, and social support as independent correlates of mortality in alcoholics. From a therapeutic standpoint, the most alterable predictor is social support. Thus, the establishment of a salutary social network and social support system should be an integral part of the alcoholic's treatment plan.

Alcoholism↗
PubMed1982

China's Marriage Law: a model for family responsibilities and relationships.

China's Marriage Law of 1981 is presented with a brief commentary. The law encompasses the responsibilities of spouses, parents, children, grandparents, and siblings to one another. The new law is contrasted with the 1950 Marriage Law, which prohibited such feudal practices of former times as arranged marriages and child betrothals. The 1981 law is concerned with equality and the lawful needs of women, children, and the aged. Family planning is encouraged. Divorce is made easier to obtain. Adoptees and stepchildren are provided for. The law provides a legislative model for personal relationships.

Adoption↗
PubMed1983

Joint custody: parental problems and satisfactions.

Joint custody, the total care of children by each parent part of the time, enables both parents to be "custodial" parents after divorce. Increasingly it has become a solution to custody problems, allowing both parents major involvement in their childrens' lives as well as freedom for themselves. This research addresses joint custody from the parents' perspective, exploring the salient issues. The problems and satisfactions are discussed, and the sex differences are highlighted.

Adaptation, Psychological↗
PubMed1987

When is a parent out of the picture? Different custody, different perceptions.

This study investigated how 200 children from mother-, father-, or joint-custody arrangements perceived their divorced families. The authors argue that it is not the type of custody that shapes the child's view of whether one parent is peripheral but, rather, the nature of relationships within the various custody arrangements.

Adolescent↗
PubMed1988

Joint custody: research, theory, and policy.

A majority of states have now enacted legislation addressing the issue of joint custody of children after divorce. This article examines current research on the subject, explores its implications for family theory, and attempts to draw some empirically based conclusions regarding policy. The literature would seem to support a structuralist view of the family and to undermine normative theories of the family life cycle. The author concludes that policy should not be aimed at developing a presumption of joint legal custody alone, but, rather, of joint physical custody with specified limitations.

Adolescent↗
PubMed2002

Effects of family interaction on the child's behavior in single-parent or reconstructed families.

The effects of the family interaction on children's behavior were studied in single-parent or reconstructed families (N = 63) in a white population in Finland. The focus was on the spousal and the parent-child interaction. Teachers assessed children's behavior and parents were interviewed. The interviews were analyzed qualitatively using the grounded-theory method. The boundary ambiguity theory developed by Pauline Boss was used to examine the interaction in the families. About two fifths of the parents reported that their spousal interaction was good, family boundaries were clear, and the children were taken care of together. Another two fifths interacted only because of the child and family boundaries were ambiguous. In 14 families the involvement of the noncustodial parent was both physically and psychologically low. The physically close but psychologically distant parent-child interaction seemed to affect the child's behavior detrimentally, whereas children with physically and psychologically close interaction with their parents showed less behavioral problems. The children with behavioral problems were more likely to have problems with both parents. They were also more likely to have a stepparent with whom they had conflicts. In conclusion, a good interaction between the parents and clarified family boundaries protect children's mental health after their parents' divorce or separation.

Adaptation, Psychological↗
PubMed2005

An Asian perspective on relationship and marriage education.

The goal of this article is to provide couple therapists and relationship educators with information to enhance the cultural relevance of their work with Asian populations. Because of the rapid social, economic, cultural, and gender role changes, the various Asian interpretations of the institution of marriage are undergoing major transformation. This article describes the general trends in marriage in several Asian nations, with a focus on the swiftly rising divorce rates and changing cultural attitudes to marriage, and discusses current relationship education initiatives in these nations. Finally, based on my experiences working with Asian populations, I present a few humble insights regarding adaptation of marriage education to render it more culturally appropriate for Asians.

Asian People↗
PubMed2003

Challenging the myths about parents' adjustment after the sudden, violent death of a child.

PURPOSE: To examine three commonly held myths: (a) a child's death by suicide results in the worst parental outcomes compared with other causes of violent death, (b) divorce is not only more common among bereaved than nonbereaved married couples, it might be inevitable, and (c) "letting go and moving on" is an essential bereavement task needed for a satisfactory adjustment following the violent death of a child. DESIGN AND METHODS: Review of empirical evidence and critical reviews, review of Internet resources available to the general public, and the inclusion of original data obtained from a longitudinal, prospective study conducted by the authors. FINDINGS: Conclusive evidence was found to dispel two of the three myths, but sufficient evidence was not found to draw conclusions about the third myth regarding parents' adjustment to a child's suicidal death. CONCLUSIONS: Myths in regard to parental bereavement are resistant to disconfirming evidence and they appear to persist among professional practitioners and the general public despite contrary empirical evidence.

Accidents↗
PubMed1983

The bi-seasonal incidence of some suicides. Experience from Finland by marital status, 1961-1976.

The seasonal variation in suicides in Finland is examined by marital status using the individual records for all suicides committed in 1961-1976 and periodic regression analysis. Suicides were usually most frequent in spring or summer, but there was an exceptional secondary concentration of suicides in the autumn period among married and widowed females, which makes the monthly pattern bimodal. Suicides among divorced and widowed males aged 15-44 years showed a unimodal variation with the peak in autumn. While an influence from certain social factors might be entertained, the reasons for the seasonal variation in suicides in general and for this anomalous bimodality in particular remain unknown.

Divorce↗
PubMed1987

The relationships of childhood socio-demographic factors and early parental loss to major depression in adult life.

Sixty middle-aged urban women with a major depressive episode (DSM-III) diagnosed in a community survey were compared with those 400 participants of the study who had no history of major depression. There were no significant differences between groups regarding most childhood demographic variables such as grade of urbanization, social class, school education, size of sibship and ordinal position. The subjects with major depression and especially those with melancholia had experienced parental loss before age 17 significantly more often than had the controls. This difference dealt only with parental divorce and other separations but not with parental death. There were no significant differences regarding parental death between melancholics, non-melancholic major depressives and controls.

Adult↗
PubMed1987

Comparison of depressed patients with and without suicide attempts in their past history.

Forty-eight inpatients with the diagnosis of a Brief or Prolonged Depressive Reaction according to ICD-9 who had attempted suicide just before the admission were compared to 24 inpatients with the same diagnosis but no history of previous suicide attempts. The variables investigated included sociodemographic characteristics, family history, life events within the year prior to admission, social functioning, social support, and personality factors. The comparison of these two groups revealed that alcoholism and suicide attempts in first degree relatives, and divorce or separation of the patients' parents predispose for a depressive reaction associated with the suicidal behavior. No differences between the two patient groups were found for personality factors, number and quality of life events in the year before index admission, social functioning, and social support during the last 4 weeks. Due to the small number of patients in both groups the conclusions drawn are preliminary.

Adult↗
PubMed1989

Early separation and suicidal behaviour in the parental homes of 40 consecutive suicide attempters.

Forty suicide-attempt patients who were consecutively admitted to an intensive-care unit, their significant others and treatment personnel were investigated by semistructured interviews. The patients were divided into neurosis (n = 14), abuse (n = 19) and psychosis (n = 7) groups. Twenty-one of the patients (52%) had lost contact with one or both parents before the age of 18, in 25% of cases owing to death and in 27% because of the parents' divorce or separation. Parents and/or siblings of 19 patients (47%) had shown suicidal behaviour in the form of attempted suicide and/or suicide. Differences between the groups were not significant. Alcohol abuse in the parental home was overrepresented in the abuse group compared with the other groups. The role of identification with the dead and suicidal parent in prompting suicidal actions in adulthood is discussed, as well as that of the impeded evolution of stable external object relations owing to parental losses.

Adult↗
PubMed1977

Trigenerational enmeshment: unresolved ties of single-parents to family of origin.

Some divorced single-parent mothers return home to live with their families of origin. The absence of clear delineation of the roles of grandmother, mother, and child can produce a dysfunctional family unit, identified here as trigenerational enmeshment. Clinical features of this subgroup are discussed, and examples of treatment approaches are presented.

Child↗
PubMed1980

Divorcees and widows: similarities and differences.

Based on findings from age-standardized survey data, divorced women feel more restricted in their relationships with others and have less favorable attitudes toward their ex-spouses than do widows. The greater clarity of the widowed role may provide more social support and ease adjustment to the end of a marriage for the widow in ways unavailable to the still somewhat stigmatized status of the divorcee.

Adaptation, Psychological↗
PubMed1984

Joint custody: a critical analysis and appraisal.

Joint custody, now in the statutes of over half the states, is becoming the legally preferred custody arrangement. It eases the burden on the courts, and is thought to benefit all family members. Research has indicated that children generally gain from maintaining a relationship with each parent; however, the assumption that joint custody promotes cooperation between divorced parents is a research question that has yet to be answered. There is a disparity between the strength of the joint custody movement and the sufficiency of evidence that this is the optimum approach for all children.

Child↗

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