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The Family Functioning in Adolescence Questionnaire: a measure of psychosocial family health during adolescence.

An instrument has been developed to assess psychosocial health of the family during the stage of having adolescent children, as perceived by the adolescent. The measure is based on a model integrating family systems research and the developmental tasks of adolescents. It examines six dimensions of family functioning: (1) Structure, (2) Affect, (3) Communication, (4) Behaviour control, (5) Value Transmission and (6) External Systems. A sample of 413 Year 10 students (means = 15.7 years) participated in the development of the instrument. Satisfactory levels of reliability and validity are reported. The Family Functioning in Adolescence Questionnaire (FFAQ) provides a means of assessment for researchers interested in family functioning during adolescence, and also for therapists and counsellors working with teenagers.

Adolescent↗

Child sexual abuse and incest: community-based intervention.

OBJECTIVE: The primary aim of this article is to determine the effectiveness of community intervention in the case of child sexual abuse. The article describes and analyses an actual case in a small urban community in Israel. METHOD: After several incidents of child sexual abuse, much of it incestuous, were brought to light in the community, they were discussed openly, contained, and punished. A community campaign, in which community activists as well as all the service providers were involved, was organized by community social workers. Individual, group, and community interventions were used. RESULTS: The continuation of the abuse has been checked, and, so far, there is no evidence to suggest its resurgence. Community apathy to child sexual abuse seems to have been halted and reversed. The involvement of community residents, particularly the activists, has increased, and this appears to be the major factor in changed community norms toward child sexual abuse. CONCLUSION: Implications of the individual, group, and community interventions are discussed. An integrated program of intervention practices is advocated to contain and prevent the incidence of child sexual abuse and incest.

Attitude to Health↗

Coping resources of maltreated children in the family: a salutogenic approach.

OBJECTIVE: Most research in child maltreatment within family focuses mainly on the pathological damage caused to the battered child. This study, based on a salutogenic approach, focuses on the resources that may help maltreated children to cope with their state and stay well. METHOD: Resilience was measured by two variables: perceived competence and psychological distress. The moderating or buffering variables that may contribute to better coping were: sense of family coherence, psychological sense of school membership, and social support. Two hundred and twenty-six 8th graders answered an anonymous self-report inventory. Based on the students' answers, they were divided into two groups: those who reported that they had been maltreated (MC) (n = 81) and those who did not (NMC) (n = 145). RESULTS: The study revealed a significantly high percentage of adolescents (35.6%) who reported having been maltreated within their families. A significant difference was found between the MC and the NMC in levels of perceived competence (higher for the NMC) and psychological distress (higher for the MC group). The moderating variables were found to have a differential effect on the dependent variables within the two groups. Sense of family coherence was found to be the main contributor to variance explanation of perceived competence among the MC, while sense of school membership had the main effect among NMC. CONCLUSIONS: The findings support a salutogenic approach in studying maltreated children. Implications on the possible detection of maltreated children in the community and on their coping resources that may contribute to resilience are discussed.

Adaptation, Psychological↗

Group conversational-skills training and social validation with mentally retarded adults.

Seven community-dwelling, mildly and moderately mentally retarded adults participated in a group social skills training program designed to improve conversational skills. A group multiple-baseline design was used. Conversational components trained were asking questions about the conversational partner, giving compliments, and appropriately disclosing information about oneself. Training sessions consisted of instructions, modeling, and behavioral rehearsal. Assessment during baseline and treatment consisted of recording conversations between subject dyads after each session. Generalization of training was assessed during baseline and treatment and at 1-month, 3-month, and 6-month follow-ups by recording conversations between subjects and novel, nonretarded persons. Behavioral ratings of the tapes indicated substantial improvements in the targeted behaviors as a function of training. Subjective social validity ratings of pretraining and posttraining generalization tapes by community volunteers reflected improvements in their social perceptions of subjects as a function of training. The results suggest that community-dwelling, mentally retarded adults can be taught to make changes in their conversational behavior that are viewed positively by others living in their communities.

Adult↗

Born out of wedlock and never married--it breaks a man's heart.

This study examines whether men who were born outside marriage in early twentieth century Sweden run a higher risk of dying from ischaemic heart disease (IHD) in middle and old age compared to men who were born inside marriage. Analyses are based on the male half of the Uppsala Birth Cohort Study, Sweden, consisting of all 7411 boys who were born alive at the Uppsala Academic Hospital during the period 1915-1929. The statistical method used is Cox regression. The results demonstrated a statistically significant excess mortality among men born outside marriage, which could not be explained by either social class of origin or birth weight for gestational age. Instead, this elevated mortality was largely explained by the more than doubled mortality risk among those men born outside wedlock who never married in relation to the corresponding group of men born to married parents. Even when three indicators of adult socio-economic status were adjusted for, men who never married and were born outside marriage still ran a 93 per cent higher risk of dying from IHD than men who never married but were born inside marriage. This intervening effect of adult marital status was restricted to the category of never married men. Thus, although divorcees demonstrated an even higher mortality risk in relation to the married than did those who never married, this was equally true for men born inside and men born outside marriage. In the concluding section of the paper I argue that these findings should be understood in terms of the childhood social stigma that the illegitimate children experienced. This stigma may have resulted in an increased susceptibility, which in combination with the "failure" in adulthood to comply with the established norms of society regarding matrimony led to higher levels of IHD mortality in middle and old age.

Aged↗

Negotiating spaces in home environments: older women living with arthritis.

Within medical geography there has been a surge of interest in applying critical concepts in social theory to empirical settings, including those for persons with disabilities. The ways through which persons with disabilities negotiate space vary widely according to material and social experiences of being disabled. For older women, chronic illness as a type of disability shapes the way in which they approach their daily lives with respect to both the physical and social aspects of their home environments. In the first half of the paper, conceptually, I take a relational view of space and argue that household, as a narrow reading of domestic space, needs to be replaced by home environment which incorporates more fully age- and ablement-sensitive readings of the spaces constitutive of domestic space. This lays the basis for a contextualized socio-spatial understanding of the ways older women with chronic illness negotiate the spaces in home environments because it accounts for the disadvantaged positionings of access to power and resources as well as the uneven distributions of income based on gender, age, and (dis)ability. It also takes into account the material and social aspects of being disabled. In the second half of the paper, I present case studies of three older women diagnosed with rheumatoid arthritis to illustrate these arguments.

Activities of Daily Living↗

Pain catastrophizing and general health status in a large Dutch community sample.

The aim of the present study was to examine the association between pain catastrophizing and general health status in a Dutch adult community sample, including various subgroups of people with musculoskeletal pain in the analyses. For exploratory reasons this study partly replicated previous studies of the factor structure, reliability, and validity of the Pain Catastrophizing Scale (PCS). Results demonstrated that across different pain subgroups, catastrophizing uniquely contributed variance to the prediction of the various aspects of general health status beyond the variance explained by pain intensity, age, gender, and chronicity. Across subgroups strongest associations were found between catastrophizing and mental health, general health perception, social functioning, and vitality. Furthermore, the association between catastrophizing and the various aspects of general health status was not moderated by the chronicity of the pain. Results of the confirmatory factor analysis statistically confirmed a three-factor model of the PCS, which was invariant across different subgroups of people with musculoskeletal pain. Inter-factor correlations were high, and the incremental explanatory power of the three-factor model over that of a one-factor model was only marginal. This implies that a one-factor model might be justifiable as well, at least in the general community. Across various pain subgroups the reliability of the PCS total and subscales was adequate. Additional evidence for the concurrent validity of the PCS was found as well.

Adult↗

Social skill as determinant of social networks and perceived social support in schizophrenia.

Factors influencing supportive social networks of people with schizophrenia are little understood. Data from 46 outpatients with schizophrenia were analysed using structural equation modelling to test plausible sets of inter-relationships between social skill, social networks, and social support. The data supported a tentative model about the causal relationships between variables. Paths showed that people with greater social skill had larger social networks, but did not necessarily perceive greater support from these networks. Negative symptoms accounted for some of the effect of social skill on social networks. Whereas groups of single-admission and multiple-admission participants did not differ in terms of social skill, social networks, or support, the age of the participants influenced their social skill and the size of their social networks. Younger participants had greater social skill and larger social networks. The results appear to suggest the importance of early intervention for young people with first-episode psychosis.

Adult↗

Interpersonal factors contributing to the stigma of schizophrenia: social skills, perceived attractiveness, and symptoms.

This study investigated the interpersonal factors (i.e., social skills, symptoms, perceived physical attractiveness) which are related to the stigma of schizophrenia. Social skills performance was assessed for 39 individuals with schizophrenia who participated in two role-plays with a confederate. Social skills ratings comprised 'overall social skill', 'meshing', 'clarity', and 'fluency' of speech, 'gaze', 'pleasantness' of conversation, 'involvement' in conversation, 'number of questions asked' during conversation, and 'perceived strangeness'. Symptomatology was assessed with the Brief Psychiatric Rating Scale. Ratings of perceived physical attractiveness were obtained by pausing the videotaped role-plays after the first 2s of the interaction. Ratings of 'social distance', based on an independent sample who observed the role-plays, were used as a proxy measure of stigma. The results showed that social distance was best statistically predicted by perceived strangeness, which in turn, was best statistically predicted by ratings of overall social skill. Negative symptoms appeared to have a more robust association with desired social distance than positive symptoms. Interpersonal factors, such as overall social skill, negative symptoms, and perceived strangeness, may contribute to stigma.

Adult↗

Has there been a decrease in the prevalence of mood disorders in HIV-seropositive individuals since the introduction of combination therapy?

PURPOSE: The aim of this study was to assess the prevalence of current mood disorders in HIV-seropositive patients treated with combined antiretroviral drug therapy including or not protease inhibitors. SUBJECTS AND METHODS: A random sample of 90 subjects consecutively attending, between February 1 and July 31, 1998, the outpatient unit of the Second Department of Infectious Diseases of the 'L. Sacco' Hospital in Milan was assessed by means of the Structured Clinical Interview for DSMIII-R (SCID) and the Zung Self-Rating Depression Scale (ZSDS). RESULTS: Twenty-three-point-three percent of the subjects were classified in CDC stage A, 32.3% in CDC stage B and 44.4% in CDC stage C. A DSMIII-R psychiatric diagnosis of current mood disorder was found in 4.4% of the recruited sample (dysthymia: 2.2%; adjustment disorder with depressed mood: 2.2%). CONCLUSIONS: Direct and indirect effect of new combination therapies, epidemiological changes in social groups affected by HIV and possible modifications in social perception of people with HIV infection may explain, at least in part, the decreased prevalence of current mood disorders observed in our study as compared to prevalence rates reported in the pre-HAART era.

Adult↗

Attention to emotion modulates fMRI activity in human right superior temporal sulcus.

A parallel neural network has been proposed for processing various types of information conveyed by faces including emotion. Using functional magnetic resonance imaging (fMRI), we tested the effect of the explicit attention to the emotional expression of the faces on the neuronal activity of the face-responsive regions. Delayed match to sample procedure was adopted. Subjects were required to match the visually presented pictures with regard to the contour of the face pictures, facial identity, and emotional expressions by valence (happy and fearful expressions) and arousal (fearful and sad expressions). Contour matching of the non-face scrambled pictures was used as a control condition. The face-responsive regions that responded more to faces than to non-face stimuli were the bilateral lateral fusiform gyrus (LFG), the right superior temporal sulcus (STS), and the bilateral intraparietal sulcus (IPS). In these regions, general attention to the face enhanced the activities of the bilateral LFG, the right STS, and the left IPS compared with attention to the contour of the facial image. Selective attention to facial emotion specifically enhanced the activity of the right STS compared with attention to the face per se. The results suggest that the right STS region plays a special role in facial emotion recognition within distributed face-processing systems. This finding may support the notion that the STS is involved in social perception.

Adult↗

Living with difference: caring for a premature baby at home.

This grounded theory study explores the experience of caring for a premature baby following discharge from hospital. The idea for the study arose from our nursing practice with new parents. Seven participants from one region contributed to the development of a substantive theory, which we named "Living with Difference: Caring for a premature baby at home". The participants were convinced that their experience was different from that of mothers of full-term babies. The women articulated the areas of difference as being: needing and receiving support; developing confidence; feeling guilty, and experiencing smallness. The results from this study will contribute to a body of knowledge which will inform future family and child health practice.

Adaptation, Psychological↗

Do mothers-in-law matter? Family dynamics and fertility decision-making in urban squatter settlements of Karachi, Pakistan.

The perspectives of mothers-in-law about intra-household decision-making, family size and family planning are investigated, and their views compared with those of their sons and daughters-in-law. Women (717 daughters-in-law), their husbands (717 sons) and their 522 mothers-in-law were interviewed in eight squatter settlements in Karachi, Pakistan. Decisions about the schooling and health care of children, and the purchase of jewellery, are perceived to lie within the nuclear family domain (i.e. husband and wife). There was a difference in mothers-in-law's, daughters-in-law's and sons' desire to have more children. Twenty-eight per cent of mothers-in-law versus 58%, of daughters-in-law did not want more grandsons/sons and 36%, of mothers-in-law versus 66% of daughters-in-law did not want more granddaughters/daughters. The difference was markedly greater among the mother-in-law/daughter-in-law pairs than in the mother/son pairs. Overall, the mother-in-law's role seems to be somewhat overshadowed by that of her son (family male member), except for limiting family size. It is suggested that mothers-in-law should be included in Information-Education-Communication (IEC) campaigns about family planning.

Adult↗

Children's emotion processing: relations to emotionality and aggression.

We examined the relations between emotionality, emotion processing, and aggression in 182 first- and second-grade children. Consistent with Tomkins' and Izard's theoretical predictions, emotionality correlated with emotion processing. In particular, the happiness component of emotionality correlated with emotion attribution accuracy and empathy, the anger component correlated with anger attribution bias and empathy, and the fear component correlated with fear attribution bias. Multiple emotion processing deficits--including emotion attribution accuracy, anger attribution bias, and self-report of empathy--placed children at risk for heightened levels of teacher-reported aggression. Mediational analyses revealed that an emotion processing risk index fit a model of significant partial mediation between happiness and aggression but not between anger and aggression. The results suggest the multifaceted manner in which children's emotion experiences may influence the development of aggressive tendencies.

Aggression↗

Structural and experiential neighborhood contexts, developmental stage, and antisocial behavior among urban adolescents in poverty.

This study explored the effects of structural and experiential neighborhood factors and developmental stage on antisocial behavior, among a sample of poor urban adolescents in New York City. Conceptually and empirically distinct profiles of neighborhood experience were derived from the data, based on measures of perceived neighborhood cohesion, poverty-related hassles, and involvement in neighborhood organizations and activities. Both the profiles of neighborhood experience and a measure of census-tract-level neighborhood hazard (poverty and violence) showed relationships to antisocial behavior. Contrary to expectation, higher levels of antisocial behavior were reported among adolescents residing in moderate-structural-risk neighborhoods than those in high-structural-risk neighborhoods. This effect held only for teens in middle (not early) adolescence and was stronger for teens perceiving their neighborhoods as hassling than for those who did not. Implications for future research and preventive intervention are discussed.

Adolescent↗

Review of adaptive behavior studies in mentally retarded persons with autism/pervasive developmental disorder.

A review is presented of the investigations carried out concerning the adaptive behavior of persons with the dual disability of mental retardation and autism/PDD. A close correspondence is found between the results obtained by means of a Dutch set of scales, the SRZ, SGZ, and SMZ, and those obtained by means of the Vineland Adaptive Behavior Scales. Compared with matched nonautistic persons, the performance of dually disabled persons is found to be particularly poor in the domain Social Skills/Socialization and somewhat less poor in the domain Communication. Performance of the two categories does not differ in the domains Self Help/Daily Living Skills and Gross Motor Skills/Motor Skills. As a net result, persons of the dually disabled category are found to obtain comparatively low total scores for social competency, the SRZ-Total/Adaptive Behavior Composite. In addition, autistic mentally retarded persons are found to display more maladaptive behavior. For comparative studies in the mental retardation field the use of level of Self Help/Daily Living Skills and, to a lesser extent, level of Gross Motor Skills/Motor Skills are recommended as suitable matching variables.

Activities of Daily Living↗

The changing moral economy of ancestor worship in a Chinese emigrant district.

This paper describes the reciprocal influences between Anxi County Fujianese, whose families and clans have migrated to Singapore, and their ancestral villages in Fujian, China. The Singaporeans bring wealth and cultural capital to their poor relations in rural China. Their participation is crucial for local socioeconomic development. Besides bringing material support and globalizing values and lifestyles, they also reinvigorate and transform the local religious tradition. They, in turn, reaffirm and even remake their own ethnic and regional identity. The complex outcome illustrates the fact that China's social change under economic reforms and global influence is, in its huge rural core, not merely a matter of infrastructural, market, and social welfare improvements, but involves exchange and transformation in meanings of rituals and experiences. We can see that kinship and religion are not unchanging aspects of the cultural tradition that are separate from programs of modernity. Indeed, modernity and tradition appear to be inseparable, and they may reveal that the recipe for effective community projects requires a vital tie between cultural, social, and interpersonal processes.

Attitude↗