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PubMed2003

Correlates of adolescent reports of sexual assault: findings from the National Survey of Adolescents.

This study examines how key demographic variables and specific child sexual assault (CSA) incident characteristics were related to whether adolescents reported that they had told anyone about an alleged sexual assault. The study also investigates whether there were differences in the correlates of CSA disclosure as a function of gender and race/ethnicity. A national household probability sample of 4,023 adolescents was interviewed by telephone about childhood experiences, including CSA history. Significant gender and racial/ethnic differences were obtained in rates of CSA disclosure: Sexually abused boys and African American youth were less likely to report telling anyone they had been sexually abused. Separate regression models examining correlates of CSA disclosure yielded differences as a function of gender and race/ethnicity.

Adolescent↗
PubMed2003

Words of wisdom: language use over the life span.

Two projects explored the links between language use and aging. In the first project, written or spoken text samples from disclosure studies from over 3,000 research participants from 45 different studies representing 21 laboratories in 3 countries were analyzed to determine how people change in their use of 14 text dimensions as a function of age. A separate project analyzed the collected works of 10 well-known novelists, playwrights, and poets who lived over the last 500 years. Both projects found that with increasing age, individuals use more positive and fewer negative affect words, use fewer self-references, use more future-tense and fewer past-tense verbs, and demonstrate a general pattern of increasing cognitive complexity. Implications for using language as a marker of personality among current and historical texts are discussed.

Adolescent↗
PubMed1996

Measurement and correlates of internalized homophobia: a factor analytic study.

We developed a scale to measure internalized homophobia in men who have sex with men, which is comprised of items derived from theoretical and clinical reports of internalized homophobia. Two hundred two men who have sex with men and who attend "Man to Man" sexual health seminars in a midwestern U.S. city completed the scale at baseline. Orthogonal factor analysis revealed four dimensions of internalized homophobia: public identification as gay, perception of stigma associated with being homosexual, social comfort with gay men, and the moral and religious acceptability of being gay. Factor scoring of these dimensions indicated that they were associated significantly with relationship satisfaction, duration of longest relationship, extent of attraction to men and women, proportion of social time with gay people, membership of gay/bisexual groups, HIV serostatus, and disclosure of sexual orientation. Internalized homophobia is measurable and consists of four dimensions that are associated significantly with low disclosure, shorter length of and satisfaction with relationships, lower degree of sexual attraction to men and higher degree of attraction to women, and lower social time with gay people.

Adult↗
PubMed2006

Disclosures of illness by doctors to their patients: a qualitative study of doctors with HIV and other serious disorders.

OBJECTIVE: To examine issues concerning doctor's disclosures of their illness to their patients. METHODS: We interviewed 50 health care providers who had serious illnesses concerning their experiences with disclosures of their illness to patients. RESULTS: With regard to their diagnoses, these doctors struggled with whether, when, how and what to tell patients. These issues were prominent, and had broader implications for doctor-patient communication and interactions among doctors with HIV, but arose among doctors with other diagnoses as well. Particularly with HIV, questions emerged concerning whether to: tell patients without being asked, respond only if asked, tell the truth, lie or misrepresent the information. Patients appeared to face dilemmas of whether to ask about a doctor's diagnosis, and whether they had a right to know. Some patients hesitated to ask or felt ambivalent about knowing, as the illness could threaten the doctor-patient relationship. At times, patients learned of a doctor's illness only after the latter had died. Disclosures could strengthen or skew the doctor-patient relationship. We present a model and framework--concerning the complexities of these communications--that can be useful in exploring other key aspects of doctor-patient interactions. CONCLUSION: These data raise larger questions of what information patients should be told about physicians. Medical education needs to address these issues better. PRACTICE IMPLICATIONS: Physicians should realize that patients may be anxious about these concerns, and may view the pros and cons of physicians' disclosures of illness differently than do these physicians themselves.

Adaptation, Psychological↗
PubMed1997

Health effects of emotional disclosure in rheumatoid arthritis patients.

This study examined the effects of emotional disclosure of stressful events on the pain, physical and affective dysfunction, and joint condition of patients with rheumatoid arthritis (RA). Patients were randomly assigned to talk privately about stressful events (disclosure group, n = 36) or about trivial topics (control group, n = 36) for 4 consecutive days. Disclosure resulted in immediate increases in negative mood. At 2 weeks the 2 groups did not differ on any health measure, but at 3 months disclosure patients had less affective disturbance and better physical functioning in daily activities. There was no main effect of disclosure on pain or joint condition, but among the disclosure patients, those who experienced larger increases in negative mood after talking demonstrated improvements in the condition of their joints. This study concludes that, among RA patients, verbal disclosure and emotional processing of stressful life events induces an immediate negative mood followed by improved psychological functioning.

Activities of Daily Living↗
PubMed1988

Coming out to mom and dad: a study of gay males and their relationships with their parents.

This study explores the relationship between gay men coming out to parents and specific perceived parental variables in an attempt to discriminate between parents who are more or less accepting. In addition, other factors such as how the disclosure occurs and reasons for coming out were investigated. Results indicate that most parents initially react negatively to the disclosure, but become more accepting over time. Parental values and characteristics associated with homophobia were found to be good predictors of the change in parent-son relationship following disclosure. However, the predictions were often in unexpected directions. The majority of respondents reported having a more positive relationship with their mothers than with their fathers, both before and after coming out.

Adaptation, Psychological↗
PubMed2005

In from the outer generational differences in coming out and gay identity formation.

This paper explores generational differences among gay men in their experience of, and narratives relating the process of, coming out. The interview data for 32 gay men living in Melbourne, Australia, is drawn from the Community, Attachment, Structures and the epidemic (CASE) Study. Narratives of coming out for three generational groups: pre-AIDS, peri-AIDS, and post-AIDS, are examined in terms of the experiences of disclosure to family and friends. A shift from narratives organised around crisis and disjunction to those organised around consolidation is matched by differences in the degree to which peer networks are maintained post-coming out.

Adult↗
PubMed1980

Privacy and solidarity: effects of nursing home accommodation on environmental perception and sociability preferences.

This field study of nursing home accommodations examines the influence of type of living accommodation and personal characteristics upon environmental perception and interaction preferences with regard to privacy and sociability. Ward residents view their dwelling as less secure and feel less able to control social encounters occurring therein than do single room residents. In terms of preferences, however, it is the single room residents who express greater desires for isolation and disclosure restriction. These data and the absence of differences in resident satisfaction, are consistent with an adaptation model of privacy-sociability preference.

Adaptation, Psychological↗
PubMed1999

Inhibition of emotional expression in breast cancer patients.

To obtain a better understanding of the inhibited emotional expression often reported in breast cancer patients, the authors compared 48 breast cancer patients and 49 healthy women with respect to disturbed emotional processes (alexithymia), emotional disclosure, emotional expression, assertiveness, repression, and distress. The patient group showed significantly more ambivalence over emotional expression, more restraint, and more anxiety than the healthy controls. No differences were found between the 2 groups in alexithymia, expressing emotions in general, or willingness to talk with others about emotions. The image of the breast cancer patient that emerged in the study was that of a person who has conflicting feelings with regard to expressing emotions, is reserved and anxious, is self-effacing, and represses aggression and impulsiveness. These findings suggest that cancer patients' inhibited behavior is a reaction to the disease rather than a reflection of a personality characteristic predisposing an individual to (breast) cancer.

Affective Symptoms↗
PubMed2000

Family secrets: disclosure of HIV status among gay men with HIV/AIDS to the family of origin.

A mail survey obtained a sample of 117 gay men with HIV/AIDS to examine levels of disclosure of HIV status to the family of origin and the association between disclosure and levels of support and barriers to support from the family. Among men with HIV there was a significant difference in knowledge of HIV status between family members such that mothers and siblings were more likely to be knowledgeable than fathers. For the total sample disclosure of HIV status was associated with higher levels of support from all family members and with a lower level of barrier to support from mothers and fathers. Implications for practice are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Does emotional disclosure have any effects? A systematic review of the literature with meta-analyses.

OBJECTIVES: Emotional disclosure has been widely publicized as having beneficial effects on physical and psychological health. A full systematic review was undertaken, with standard health technology appraisal methods, with the aim to assess the effects of emotional disclosure on healthy participants and those with pre-existing morbidity, particularly on longer-term physical health, performance, and psychological outcomes. METHODS: Randomized controlled trials of emotional disclosure were obtained from database searches (Medline (1966-2003), Embase (1980-2003), Cochrane Library (2002, issue 4), Web of Science (1981-2003), Cinahl (1982-2003), and Theses (March 2003), Internet sites (including Professor J.W. Pennebaker's home pages), and personal contacts. Quality was assessed qualitatively and by Jadad score. Meta-analysis was conducted, using Revman 4.1 software, where more than two trials reported the same outcome. RESULTS: Sixty-one trials were found meeting the inclusion criteria. Most had less than 100 participants and the median Jadad score was 0. A wide variety of physical, physiological, immunological, performance, and psychological outcomes were measured, but fewer were reported. There was no clear improvement for emotional disclosure compared with controls in objectively measured physical health and most other outcomes assessed. CONCLUSIONS: The opinion that this intervention is beneficial needs to be reassessed in light of the totality of evidence available.

Expressed Emotion↗
PubMed1996

Investigation of the validity of facilitated communication through the disclosure of unknown information.

Three individuals (8, 10, and 24 years old with diagnoses of autism and mental retardation) participated in a message-passing format to determine whether they could disclose information previously unknown to their facilitators. Results showed valid facilitated communication from each participant. The facilitated speakers participated in 14 sessions, each lasting approximately 1 to 1.5 hours. A wide range of information was collected, coded, and analyzed for validity, consistency, language difficulties, behavioral compliance, and style of facilitation. Out of 720 communicative interactions, participants disclosed 77 incidents of unknown information. Each participant revealed unique behaviors and styles of responding, and all were able to demonstrate genuinely independent communication through disclosure of specific information previously unknown to a facilitator, although much inconsistency was noted. Results suggest that a phenomena as complex as facilitated communication eludes a cursory exploration.

Adolescent↗
PubMed1981

Androgyny, Stereotypy and the perception of female therapists.

Assessed the effects of female therapists' experience (expert or nonexpert) and disclosure level (high or low) and Ss' sex role orientation (stereotyped or androgynous) on perceived expertness, attractiveness, and trustworthiness. Forty-six sex role stereotyped and 46 androgynous Ss rated therapists after they had read three brief transcripts of therapist-client interactions. Results indicated that experts were seen as more expert and more trustworthy, and high disclosing therapists were seen as more attractive. Moreover, a three-way interaction indicated that trustworthiness ratings of expert females were similar for stereotyped and androgynous Ss. However, nonexperts were rated differently by stereotyped Ss as a function f therapist disclosure level, whereas, androgynous Ss' ratings of nonexperts did not differ from their ratings of experts. The differential ratings as a function of sex role orientation were discussed, and future research directions were suggested.

Adolescent↗
PubMed2006

The role of stigma in reasons for HIV disclosure and non-disclosure to children.

This study examined how stigma may impact HIV-positive women's disclosure to their children. Participants included HIV-infected women recruited from AIDS service organizations located in large midwestern cities. Using a questionnaire and guided interview, quantitative data were obtained regarding perceived HIV-related stigma and rates of maternal disclosure to children aged 5-18. According to the Kruskal-Wallis test, comparison between the disclosure groups showed non-significant differences in the total score of HIV stigma (chi(2)=0.518 with df = 2, p=0.77).

Adolescent↗
PubMedDate not supplied

HIV risk assessment: a video doctor seeks patient disclosure.

We assessed the influence of a "video doctor's" affective communication style (warm vs. neutral) and of a preamble to questions about sexual activity on patients' disclosure of risky sexual behavior and injectable drug use. To isolate the effects of the independent variables, we created an interactive multimedia program for HIV risk assessment using a video doctor portrayed by an actor. Participants were assigned to one of four conditions: no preamble and a neutral physician, no preamble and a warm physician, a preamble and a neutral physician, or a preamble and a warm physician. Almost 60% of a convenience sample of 393 subjects reported engaging in two or more risky behaviors. Disclosure of risky behaviors was not significantly affected by the preamble. A warm communication style elicited more disclosure than a neutral style, suggesting that physicians' communication style is important in determining how much sensitive information patients are willing to reveal.

Adult↗
PubMed2006

Social support, disclosure, and use of antiretroviral therapy.

This paper investigates the association between social support, disclosure of HIV/AIDS, and odds of initiating combination antiretroviral drug therapy in its first years on the market. Data are drawn from the first three rounds of the Community Health Advisory and Information Network (CHAIN) survey, collected between 1994 and 1997. CHAIN documents service needs and rates of service utilization among a representative sample of persons with HIV/AIDS in New York City. A two-step logistic regression estimated associations between (1) perceived social support and use of combination antiretroviral therapy, and (2) the interaction between concealing HIV/AIDS and perceived social support. Results offered evidence that the positive association between social support and use of highly active antiretroviral treatment (HAART) and other combination antiretroviral therapies is contingent upon disclosure of HIV status within the household or among friend and acquaintance networks. A positive association between social support and odds of using combination therapy was only observed among those who disclosed their HIV status.

Adult↗
PubMed2006

Sex trade, sexual risk, and nondisclosure of HIV serostatus: findings from HIV-infected persons with a history of alcohol problems.

The purpose of this study was to assess the relationships between disclosure of HIV serostatus to sex partners and recent sexual risk behavior, substance abuse, and violence among sexually active HIV-infected patients with a history of alcohol problems. Participants (n = 124) were 79% males; age 25-61 years; 49% Black; and 35% with less than a high school education. Separate logistic regression models were used to assess relationships between each independent variable of interest and nondisclosure. Results demonstrate that buying sex and having more than one sex partner in the past 6 months were significantly associated with nondisclosure of HIV serostatus to a sex partner. Findings from this study underscore the ongoing need for behavioral interventions with HIV-infected individuals concerning disclosure. Programs that emphasize serostatus disclosure and/or consistent condom use in the context of sex trade and with multiple sexual partners will be particularly important.

Adult↗
PubMed1995

Forming a consortium: a design for interagency collaboration in the delivery of service following the disclosure of incest.

A central issue in the treatment of intrafamilial sexual abuse is the "secondary trauma" experienced by both the victimized child and her family when the wider system of regulatory and treatment agencies present redundant, incongruent, or conflicting perspectives and demands. This article describes an attempt to effect second-order change through formation of a consortium of regulatory and treatment agencies to develop a consistent and coordinated response to the disclosure of sexual abuse. Feminist, social constructionist, and organizational development ideas are used to develop principles of intersubjectivity, collaboration and a "both-and" stance, which have guided both the clinical and wider systems work.

Child↗