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PubMed1994

An examination of the associations between life problems and psychiatric disorders in a rural patient population.

The objective of this clinical study was to examine the differential effects of adversity on pathology. Data obtained from a previously described consecutive series of 707 patients was re-analysed to this effect. A series of specific life events, as well as behaviours that were likely to be secondary to psychiatric disorder, were examined. High rates of life problems such as incest, sexual assault, domestic violence, suicide attempts, and alcohol, tranquilliser and substance abuse were found in the group of patients in general. There were no major differences in the prevalence of these problems in patients with major functional disorders, anxiety disorders, short-lived minor psychiatric disorders, or in "control" patients with no primary Axis I or Axis II diagnosis. Patients with personality disorders as their major psychiatric diagnosis did, however, experience higher levels of the majority of these problems. The clinical implications of the findings are discussed. It is concluded that patients who develop chronic psychiatric illnesses are probably more psychologically or biologically vulnerable than those patients who develop short-lived disorders and who do not achieve a major psychiatric diagnosis from the practising clinician.

Adult↗
PubMed2001

Honor your father and your mother.

While on the one hand there is much mutual love and care in the relationship between parents and their offspring, there may, on the other hand, be also much mutual 'sound and fury', which sometimes is far from 'signifying nothing' (William Shakespeare, Macbeth). Indeed, from conception on, individuals are confronted with parent-offspring conflicts of all kinds. Initially these conflicts concern physiological matters (implantation, nutrition, weaning, etc.), but later in life the accent is on psychological ('you must this', 'you must that', 'don't do that' etc.) and social affairs, and phenomena such as child abuse, infanticide and incest may occur. It is, therefore, certainly not self-evident that children honor their parents. To reinforce their position, parents (societies) may appeal to a 'divine' commandment which helps them make their children suppress any tendency to conflict toward them (and hence to their culture), so that children conform to their parents' norms and values. When such psychological and sociological parent-offspring conflicts are not resolved satisfactorily, it can be suggested, children may (consciously or unconsciously) have aggressive feelings toward their parents: Freud's 'Oedipus complex'. This complex, it is argued, can also be seen as a parent-offspring conflict. Given their biological basis, parent-offspring conflicts can hardly be considered as abnormal. Conflicts between adults and their offspring have always existed and will always exist, simply because it is inherent in our genetic make-up: parents and offspring of sexually reproducing species--humans included--are only about 50% genetically related and hence have different interests at all levels of being. Indeed, parent-offspring conflicts are such stuff as we are made on, and our little life is rounded with its consequences (adapted from William Shakespeare, The Tempest).

Adult↗
PubMed1997

The rules of drug taking: wine and poppy derivatives in the ancient world. II. Wine-induced loss of control and vigilance.

The loss of control, the misjudgment of events, and the lack of vigilance were among the effects of drunkenness that the Ancients perceived as being particularly harmful. The sexual behavior was mainly affected by the loss of control: rape, incest, and fulfillment of a tragic oracle were examples of the ruinous outcome of drunkenness. Excessive drinking, besides the intervention of a good, was considered responsible for a temporary loss of judgment, which could be fatal for the drinker. Finally, several mythological examples were provided to support the view that drunk people were harmless in front of the enemy.

Alcoholic Intoxication↗
PubMed2004

Knowledge, behaviour and attitudes on induced abortion and family planning among Sri Lankan women seeking termination of pregnancy.

INTRODUCTION: In Sri Lanka over 500 induced abortions are done daily in spite of restrictive legislation. Experiences in other countries show that liberal laws alone have not solved the issues of induced abortions which may harm a woman's physical and mental health. OBJECTIVE: To determine the socio-demographic features of women seeking termination of pregnancy, and their knowledge, attitude and behaviour with respect to induced abortion and family planning. METHODS: A prospective study on a randomly selected group of 210 women attending a clinic in Colombo requesting termination of pregnancy. A pre-tested interviewer-administered questionnaire was used for data collection. RESULTS: Over 80% of women seeking abortion were between 20 and 40 years of age. All religions were represented. 13% were single and 10% wanted to postpone a pregnancy. 38.6% had three or more children. In 90% the period of gestation was less than 10 weeks. Presence of a young child was the commonest reason for termination, followed by poverty. Only 0.9% were due to incest and foetal abnormality. 96% were not aware of adverse effects of abortion. 91% thought that induced abortion was immoral and 94% did not know that it was illegal. 29% had previous terminations and post-abortion contraception counselling was poor. Although 78% were knowledgeable on at least one method of contraception, only 16.3% were using it regularly. DISCUSSION: A majority used induced abortion as a family planning method. Improving accessibility and the quality of family planning services is of paramount importance. Every encounter of a woman with a health care worker should be an opportunity for counselling.

Abortion, Induced↗
PubMed2004

Psychiatric and legal features of 113 men convicted of sexual offenses.

BACKGROUND: To increase understanding of the relationships among sexual violence, paraphilias, and mental illness, the authors assessed the legal and psychiatric features of 113 men convicted of sexual offenses. METHOD: 113 consecutive male sex offenders referred from prison, jail, or probation to a residential treatment facility received structured clinical interviews for DSM-IV Axis I and II disorders, including sexual disorders. Participants' legal, sexual and physical abuse, and family psychiatric histories were also evaluated. We compared offenders with and without paraphilias. RESULTS: Participants displayed high rates of lifetime Axis I and Axis II disorders: 96 (85%) had a substance use disorder; 84 (74%), a paraphilia; 66 (58%), a mood disorder (40 [35%], a bipolar disorder and 27 [24%], a depressive disorder); 43 (38%), an impulse control disorder; 26 (23%), an anxiety disorder; 10 (9%), an eating disorder; and 63 (56%), antisocial personality disorder. Presence of a paraphilia correlated positively with the presence of any mood disorder (p <.001), major depression (p =.007), bipolar I disorder (p =.034), any anxiety disorder (p=.034), any impulse control disorder (p =.006), and avoidant personality disorder (p =.013). Although offenders without paraphilias spent more time in prison than those with paraphilias (p =.019), paraphilic offenders reported more victims (p =.014), started offending at a younger age (p =.015), and were more likely to perpetrate incest (p =.005). Paraphilic offenders were also more likely to be convicted of (p =.001) or admit to (p <.001) gross sexual imposition of a minor. Nonparaphilic offenders were more likely to have adult victims exclusively (p =.002), a prior conviction for theft (p <.001), and a history of juvenile offenses (p =.058). CONCLUSIONS: Sex offenders in the study population displayed high rates of mental illness, substance abuse, paraphilias, personality disorders, and comorbidity among these conditions. Sex offenders with paraphilias had significantly higher rates of certain types of mental illness and avoidant personality disorder. Moreover, paraphilic offenders spent less time in prison but started offending at a younger age and reported more victims and more non-rape sexual offenses against minors than offenders without paraphilias. On the basis of our findings, we assert that sex offenders should be carefully evaluated for the presence of mental illness and that sex offender management programs should have a capacity for psychiatric treatment.

Adolescent↗
PubMedDate not supplied

Training needs for providers of adolescent health care: results of a survey.

A survey of the training needs of professionals who work with the adolescent population was undertaken in the state of Colorado in December 1980. Over 550 questionnaires were sent to nurses, social workers, mental health personnel and others in rural and urban areas, and 46% of these forms were returned. The eight highest ranked topics were: depression and suicide, family disruption, sexuality, psychosocial growth and development, interviewing, incest, emotional problems, and substance abuse. There was remarkable concurrence in rating these subjects by frequency of choice, by priority, by discipline, and by geographic area. This survey clearly delineates specific topics relevant for continuing education programs for adolescent health care providers.

Adolescent↗
PubMed1999

[Contempt and hatred: sociologic indications for an approach to current juvenile violence].

Violence is present in all forms of society that impose limits that must not be surpassed (murder, incest ...) in order for social life to be possible. But these limits are always broken. Youth are, in this respect, in a difficult situation, especially those from marginalized areas. Victims of contempt and exclusion, they react through violent acts; to violence experienced because of excessive constraints in school, they respond with violence. This juvenile violence calls for macro-social responses that return credibility to the institutional system often corrupt and responsible for hidden social violence. It also calls for micro-social actions, especially within the community. These actions may allow for awareness of violence generating phenomena, the discovery of obstacles to exercising rights, and the make-up of conflicts and their resolution in negotiation procedures.

Adolescent↗
PubMed1976

Motivation, crime, and cultural change: a review of fifteen years experience in the law courts.

The author's forensic experience among the different cultural groups of this country stress the doctor's twin obligations as physician as well as witness. Provisional definitions of psychiatric disorder and criminality in this context are given. The medicolegal aspects of cargo cult, customary land rights, and the incest taboo transgression are discussed, and suggestions made that the law can act as an educational force, as well as having a social control function, and that legislation could be prepared with this additional end in view.

Crime↗
PubMed2001

Personal constructs, childhood sexual abuse and revictimization.

Within the theoretical framework of Ryle's Procedural Sequence Object Relations Model and Kelly's Personal Construct Theory, this study investigates sex-role polarization of incest survivors and the centrality of abuse within survivors' constructs of men that may contribute to revictimization. Repertory grid methodology was used with 40 female survivors of childhood sexual abuse and 28 non-abused women. Grid measures and psychometric measures were compared between groups of women who had and had not experienced childhood sexual abuse, revictimized and non-revictimized survivors, and survivors who had and had not experienced incestuous abuse. Results showed significant differences between survivors and non-abused women, with survivors having higher levels of depression and perceived distress, lower self-esteem and higher self/ ideal self discrepancy. Hypothesized differences in sex-role polarization were not found. There were few differences between revictimized and non-revictimized survivors, although revictimized survivors rated 'self now' as more powerful than non-revictimized survivors. No differences were found between survivors who had and had not experienced incestuous abuse. In addition to the value of exploring personal constructs, a range of models need to be considered in understanding revictimization and women's construal of men. The implications of using repertory grid methodology for research and clinical work are discussed.

Adolescent↗
PubMed1979

[Mechanisms in group formation and cohesion in Tupaia glis Diard, 1820. Results of long-term studies of a family group].

In long-term studies of a family group, all the partner-orientated interactions are quantitatively registered and analysed in connection with the usuage of space by the animals. From this, the connections between the interactions and respectively status forms of the group members are recognizable. During the growing-up period of the juveniles in the group, beginning with the first leaving of the nest box at the age of about 33 days, three phases can be differentiated. A phase of "integration" of about 5 to 8 days, in which the behavior patterns between adults and juveniles are polarized on licking mouth with the adults and scent marking the juveniles, is obviously the presupposition for including the rising generation in the relational system (including the space system) of the adults. This phase is followed by a "neutral phase", lasting about 30 days, during which the juveniles stand in connection with the adults by means of a space bonding, in which relatively few interactions occur. Through the joint use of parental resting places and through the resting in close spatial neighbourhood, a true retention of experience for the juveniles must be thought of. At the age of about 60 days an 'ambivalent phase" begins, in which the contacts between parents and the offspring increases again, with an alteration and a superposition of sexual and agonistic interactions. Besides, the sex-specific differences become recognizable: the male interacts with his daughters increasingly sexually, with the sons he is more and more aggressive; the relations of the mother with the female offspring are ambivalent, during which she shows male behaviour patterns and with her sons the female scarcely has contact. Lying in bodily contact has, beyond the importance for a pair bonding, significance for a group bonding. Licking the mouth as an element of the care system (infantile behavior) can be used as an appeasement gesture. The age of 90--100 days, in which the parents frequently have aggressive gesture with their offspring of the same sex, is regarded as the time of reaching sexual maturity. A longer lasting integration of a female offspring (and a male) is described. The social organization of Tupaia glis is based on a permanent pair bonding. Through the addition of the young, a parental family with a maximum of two generations of brothers and sisters can arise. Limiting factors of the group size are incest barriers, a density stress, and the possibilities of communication of the species themselves.

Aggression↗
PubMed2001

Personal constructs, childhood sexual abuse and revictimization.

Within the theoretical framework of Ryle's Procedural Sequence Object Relations Model and Kelly's Personal Construct Theory, this study investigates sex-role polarization of incest survivors and the centrality of abuse within survivors' constructs of men that may contribute to revictimization. Repertory grid methodology was used with 40 female survivors of childhood sexual abuse and 28 non-abused women. Grid measures and psychometric measures were compared between groups of women who had and had not experienced childhood sexual abuse, revictimized and non-revictimized survivors, and survivors who had and had not experienced incestuous abuse. Results showed significant differences between survivors and non-abused women, with survivors having higher levels of depression and perceived distress, lower self-esteem and higher self/ideal self discrepancy. Hypothesized differences in sex-role polarization were not found. There were few differences between revictimized and non-revictimized survivors, although revictimized survivors rated 'self now' as more powerful than non-revictimized survivors. No differences were found between survivors who had and had not experienced incestuous abuse. In addition to the value of exploring personal constructs, a range of models need to be considered in understanding revictimization and women's construal of men. The implications of using repertory grid methodology for research and clinical work are discussed.

Journal Article↗
PubMedDate not supplied

Did abortion legalization reduce the number of unwanted children? Evidence from adoptions.

CONTEXT: The legalization of abortion in the United States led to well-known changes in reproductive behavior, but its effect on adoptions has not been investigated. METHODS: Variation across states in the timing and extent of abortion legalization is used to identify the effects of changes in the legal status of abortion on adoption rates from 1961 to 1975. These effects are estimated in regression analyses that control for states' economic, demographic and political characteristics, as well as for health care availability within states. RESULTS: The rate of adoptions of children born to white women declined by 34-37% in states that repealed restrictive abortion laws before Roe v. Wade. The effect was concentrated among adoptions by petitioners not related to the child. Legal reforms resulting in small increases in access, such as in cases of rape and incest, were associated with a 15-18% decline in adoptions of children born to nonwhite women; however, this decline may have been due to other changes in the policy environment for such adoptions. Rates of adoption of children born to white women appear to have declined after Roe v. Wade, but this association is not statistically significant. CONCLUSIONS: The estimated effect of abortion legalization on adoption rates is sizable and can account for much of the decline in adoptions, particularly of children born to white women, during the early 1970s. These findings support previous studies' conclusions that abortion legalization led to a reduction in the number of "unwanted" children; such a reduction may have improved average infant health and children's living conditions.

Abortion, Legal↗
PubMed1994

Polish parliament votes to reform harsh abortion law.

On June 30, the Polish senate voted to liberalize the country's abortion law, ratifying a provision adopted by the lower House of Parliament (Sejm) on June 10. Based on a model measure prepared by women deputies, the new proposal allows women facing economic or personal hardship to obtain legal abortions. In contrast, the current law only allows abortions when a woman's life is endangered or when the pregnancy resulted from rape or incest. Last year, the Polish anti-choice campaign successfully pressured members of Parliament to restrict abortion by appealing to Catholic doctrine and associating more liberal abortion laws with the Communist regime, which had left access to abortion essentially unfettered. Since enactment of the harsh law last year, Polish women have been forced to travel abroad for abortions, to resort to often unsafe procedures by providers operating illegally within the country, or to attempt self-abortion. Although President Walesa has indicated that he will veto the measure, his executive action could be overridden by a two-thirds vote of the Parliament. Poland is one of the many countries in Eastern and Central Europe that have experienced a surge in anti-choice organizing since the collapse of Communist governments. Groups seeking to impose additional restrictions on abortion in the region are often supported by US-based organizations. Human Life International, for example, recently sponsored a conference for anti-abortion activists in Moscow, Russia. For more information, contact Urszula Nowakowska, visiting attorney in CRLP's International Program.

Abortion, Induced↗
PubMed1994

Idaho judge rebuffs abortion funding rule.

In a 3-page ruling on July 11, Ada County District Court Judge Duff McKee chastised Idaho officials for issuing new Medicaid regulations limiting abortion coverage to the same extent as an earlier rule found unconstitutional by the court. Judge McKee opened his order by calling the new rule "a blatant and ill-concealed attempt to maintain the status quo." Invalidating the prohibition on Medicaid coverage for low-income women's abortions except when two physicians certify that continued pregnancy will result in "grave, long-lasting physical damage," Judge McKee reiterated his holding that such a measure violates the Idaho Constitution. On February 1, Judge McKee held that the state Constitution provides broader protection for the right of privacy than the federal Constitution. The court indicated that the initial Medicaid regulation conflicted with a constitutional guarantee of neutrality, which requires Idaho to be evenhanded when subsidizing the exercise of a constitutionally protected right. Plaintiffs in Roe v. Harris--represented by ACLU Reproductive Freedom Project's Louise Melling, Planned Parenthood Federation's Carole Chervin, and cooperating attorney Newal Squyres--challenged the new regulation in early July. The lawsuit was originally filed in August of 1993. An Idaho statute, which was challenged but upheld, provides Medicaid funding when two physicians certify that it is necessary to save the woman's life or health, or when a court determines the pregnancy resulted from rape or incest.

Abortion, Induced↗
PubMed1997

Ohio House approves two restrictive abortion bills.

A bill prohibiting the use of state funds to pay for state employees' health benefits related to "nontherapeutic abortions" passed the House on September 9 by a vote of 60-34. The measure, HB 395, defines a "nontherapeutic abortion" as a procedure performed when the life of the mother would not be endangered by carrying the pregnancy to term; the bill was amended to exempt victims of rape and incest from the funding restriction. Under HB 395, the state would pay for benefit plans that allow state employees to purchase an optional rider for abortion coverage. Also on September 9, the House passed HB 421 by a vote of 66-28. The measure amends Ohio's informed consent law for abortion by requiring a physician, but not necessarily the same physician who will perform the procedure, to meet with the patient in person and in a private setting 24 hours prior to the procedure. Just before the vote was taken, an amendment was offered and approved 68-26 which changes Ohio's parental notification law to parental consent. Both bills have been referred to the Senate for consideration.

Abortion, Induced↗
PubMedDate not supplied

[Deliquency: an alternative to melancholy].

The authors by illustrating three cases of deviant behaviour (of which two followed up in psychotherapy), and referring to the figure of the "criminal urged by a sense of guilt" described by Freud, declare that criminality may represent an alternative to melancholy. They also state that the antisocial behaviour is the most economical "solution" for the subject possessed by the sense of guilt originated by the Super-Ego for the unconscious ambivalence conflicts towards the parental figures. In fact, perpetrating a crime the delinquent is punished for a crime whose importance is lower than those conceived by their fantasy (incest, parricide) by a tribunal that does not apply the lex talionis, unlike the Super-Ego. The authors finally point out that criminality not always represents the "solution" of a neurotic conflict and this is due to the fact that the "choice" is also dependent upon the socio-economic conditions of the various subjects.

Adult↗
PubMed1994

House subcommittee rejects effort to remove abortion coverage.

On May 12, (1994) a subcommittee of the House Education and Labor Committee voted 16-11 in support of retaining abortion coverage in the President's proposed health care plan. With its vote, the Labor/Management Relations subcommittee rejected an amendment by Representative Ron Klink (D-PA), which would have allowed insurers to cover abortions only in cases of forcible rape or incest, or life endangerment. Two Republican Representatives joined 14 Democrats voting against the amendment, while 3 Democratic Representatives were among the 11 people supporting the Klink amendment. The subcommittee also defeated an amendment introduced by Representative Dick Armey (R-TX), which would have prohibited any language in a health care reform bill from overruling constitutional state laws restricting abortion. 14 subcommittee members voted against the Armey amendment; 11 voted in favor. The subcommittee is not expected to act on a final health care measure before the Memorial Day recess. In related news, a Veterans' Affairs House subcommittee voted 11-8 on May 11 to prohibit the performance of abortions at Department of Veterans' Affairs Hospitals or the coverage of abortion services by VA funds. The amendment was introduced in the Hospitals and Health Care subcommittee by Representative Chris Smith (R-NJ). Neither subcommittee action represents a final decision on abortion coverage in health care reform and none of the 5 Congressional committees considering health reform is expected to finalize their proposals before the Memorial Day recess. The Senate Labor and Human Resources Committee and the House Ways and Means Committee started work on health care reform on May 18. The Senate Finance Committee has only been meeting privately thus far, while neither the full House Education and Labor Committee nor the House Energy and Commerce Committee has met.

Abortion, Induced↗
PubMed1994

Agency announces policy on use of U.S. dollars to fund abortions.

In an April 1994 statement, the USAID articulated its current policy on abortion. Reiterating the Clinton Administration's view that abortions should be "safe, legal, and rare," the policy remains surprisingly close to the positions of the Reagan and Bush Administrations. According to the Helms Amendment to the Foreign Assistance Act (FAA), AID monies cannot be used for the "performance of abortion as a method of family planning." Under the previous Administrations, AID ceased all abortion funding based on this restrictive language. The Clinton Administration policy notes that AID neither "advocate[s] the use of abortion as a method of family planning" nor "use[s] its policies or programs to restrict ... [the] right to choose" abortion. Yet it interprets the Helms Amendment to permit abortion funding only in cases of rape, incest, and life endangerment--the same conditions placed on federal Medicaid funds by the Hyde Amendment. Funds can also be used for the treatment of complications caused by unsafe, incomplete, or septic abortions. Because the US is a major contributor to population and family planning programs, a change in AID policy can have a widespread impact on the reproductive health of women worldwide, especially in developing countries. Up to 167,000 women are estimated to die each year as a result of unsafe abortion and its complications.

Abortion, Induced↗