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PubMed2003

Effects of legal mechanisms on perceived coercion and treatment adherence among persons with severe mental illness.

This study takes preliminary steps to examine the effects of 2 legal mechanisms-outpatient commitment (OPC) and representative payeeship (rep payee)-on perceived coercion and treatment adherence in persons with severe mental illness (SMI). Data were collected in structured interviews from 258 involuntarily-admitted inpatients with SMI who were followed for 1 year after discharge. Subjects' clinicians and family members were also interviewed. The analyses show that subjects with both OPC and a rep payee perceived their mental health treatment to be significantly more coercive than subjects who did not receive these legal interventions. Duration of OPC and having a newly-appointed rep payee were both significantly associated with increased treatment adherence over the course of 1 year. For treatment-adherent subjects, neither form of legal mechanism was associated with perceived coercion in treatment, whereas subjects who were nonadherent perceived legal mechanisms as significantly more coercive. The data suggest that these legal tools both affect adherence to treatment, but when used together significantly increase the perceived coerciveness of treatment. Questions remain concerning the underlying mechanism of these effects.

Adolescent↗
PubMed2006

HIV risk behaviors and the context of sexual coercion in young adults' sexual interactions: results from a diary study in rural South Africa.

BACKGROUND: Gender inequalities in relationship power may promote unprotected sexual intercourse. GOALS: The goal of this study was to gain insight into the specific gender dynamics in the intimate relationships of rural South African young adults that contribute to risk for HIV infection. STUDY: Using diary methods, 25 female and 25 male secondary school students in rural South Africa provided daily reports (N = 1000) over a 3-week timeframe, including details regarding 466 sexual interactions. RESULTS: Inconsistent condom use was more likely in relationships in which the male partner had ever used threat or force to engage in sex during this period (unadjusted odds ratio, 13.4; 95% confidence interval, 1.57-114.26). Male sexual coercion was more likely in relationships in which alcohol was ever used in conjunction with sex and when a man's desire to engage in sex was perceived as greater than the woman's. CONCLUSION: This study adds to the growing evidence that sexual relationships characterized by gender inequality and sexual coercion are contexts of sexual risk.

Adolescent↗
PubMedDate not supplied

Coercion theory: application to the inpatient treatment of conduct-disordered children.

TOPIC: Conduct disorders in children are a phenomenon of concern in child and adolescent psychiatric nursing. PURPOSE: To review the major principles of coercion theory, provide an analysis of the relevant research, and discuss implications for inpatient nursing care. SOURCES: Published literature from the fields of medicine, nursing, psychology, sociology, and clinical experience. CONCLUSIONS: The principles of coercion theory are conceptually relevant in developing intervention strategies to treat conduct disorders and to interrupt escalation of aggressive behavior patterns in inpatient settings.

Adolescent↗
PubMed2001

Moral problems in the use of coercion in dealing with nonadherence in the diagnosis and treatment of tuberculosis.

Coercion and detainment can be a morally acceptable strategy to fight the spread of tuberculosis, but these measures need to be placed into a much broader context than that of their short-term potential effectiveness. TB should be de-stigmatized by full acknowledgment that we all share the blame for its perpetuation. When coercion and detention are necessary, they should incorporate a strategy of optimum protection for minimum violation of autonomy. National and international health care programs should provide effective and nonthreatening treatments for TB and other related illnesses such as HIV and should develop policies to tackle the environmental causes of TB and provide support for vulnerable victims. Corporate pressures to continue world poverty must be undermined.

Civil Rights↗
PubMed2006

A comparison of sexual coercion experiences reported by men and women in prison.

Comparisons were made between self-reports from 382 men and 51 women who had experienced sexual coercion while incarcerated. Victim data were obtained from a sample of 1,788 male inmates and 263 female inmates who responded to an anonymous written survey distributed in 10 midwestern prisons. Men reported that their perpetrators in worst-case incidents were inmates (72%), staff (8%), or inmates and staff collaborating (12%). Women reported that their perpetrators were inmates (47%) and staff (41%). Greater percentages of men (70%) than women (29%) reported that their incident resulted in oral, vaginal, or anal sex. More men (54%) than women (28%) reported an incident that was classified as rape. Men and women were similar in feeling depression; however, more men (37%) than women (11%) reported suicidal thoughts and suicide attempts (19% for men, 4% for women). Implications of results for prevention of sexual coercion in prison are discussed.

Adolescent↗
PubMed2006

Dating aggression, sexual coercion, and aggression-supporting attitudes among college men as a function of participation in aggressive high school sports.

Aggressive male sports have been criticized as bastions of sexism and training grounds for aggression against women, but there have been few empirical demonstrations of these alleged relationships. The authors studied self-reported dating aggression and sexual coercion in 147 college men. Men who had participated in aggressive high school sports, as compared with other men, engaged in more psychological aggression, physical aggression, and sexual coercion toward their dating partners, caused their partners more physical injury, were more accepting of violence, had more sexist attitudes and hostility toward women, were more accepting of rape myths, and were less tolerant of homosexuality. Results indicate that participation in aggressive high school sports is one of the multiple developmental pathways leading to relationship violence.

Adult↗
PubMed2000

Developmental antecedents of sexual coercion in juvenile sexual offenders.

Previous research has linked adult sex offending behavior to a multiplicity of variables, including juvenile delinquency and the experience of childhood abuse. The purpose of this study was to explore developmental pathways among childhood abuse, juvenile delinquency, and personality dimensions possibly conducive to adolescent sexual coercion. Using a retrospective self-report inventory, we measured the extent to which juvenile sexual offenders experienced childhood trauma, engaged in adolescent delinquency, and exhibited particular dispositions and cognitive biases. The effects of childhood and adolescent antecedents on sexual coerciveness were then analyzed through simultaneous multiple regression path analyses. Results suggest that sexual compulsivity and hypermasculinity, through misogynistic fantasy behavior, significantly discriminate verbally and physically coercive juvenile offenders from those offenders who do not report using force in their offenses. Results also suggest that alcohol abuse may play a more salient role in the expression of coercive juvenile sexual coercion than previously hypothesized.

Adolescent↗
PubMed2006

Sexual behavior and experience of sexual coercion among secondary school students in three states in North Eastern Nigeria.

BACKGROUND: Interest in the reproductive health of adolescents continues to grow throughout the world. Few studies had explored the reproductive health knowledge, sexual behavior and experience of sexual coercion among secondary school students in North Eastern states of Nigeria. The objectives of this descriptive survey were to collect data to plan appropriate interventions that meet the reproductive health knowledge, service and skills needs of students in Bauchi, Borno and Gombe states. METHODS: Face-to-face interviews were conducted for 624 consenting students who were randomly selected from eighteen secondary schools using an 83-item structured questionnaire. Data were collected on demographic profile, reproductive health knowledge, sexual behavior and experience of sexual coercion. RESULTS: The mean age of the respondents was 16.5 years. There were slightly more males (52%) than females (48%). Students' knowledge about reproductive health was generally low even though girls had better knowledge than boys. Thirteen percent of the entire students had had sexual experience; significantly more males (19%) than females (6%) had done so (p < 0.001). Among boys the age at sexual debut ranged from 10-26 with a mean of 15.7 and median of 16. By contrast, the age at first sex among girls ranged from 10 to 18 years with a mean and median of 16.1 and 17 years respectively. Only 24% of those who were sexually active used a condom during their last sexual encounter. Overall 11% of the students reported that they had been tricked into having sex, 9% had experienced unwanted touch of breast and backside, and 5% reported rape. CONCLUSION: Students low reproductive health knowledge and involvement in risky sexual activities predispose them to undesirable reproductive health outcomes.

Adolescent↗
PubMed2004

Understanding perpetrators of nonphysical sexual coercion: characteristics of those who cross the line.

Sexual coercion is defined here as a form of male sexual misconduct in which nonphysical tactics (e.g., verbal pressure) are utilized to gain sexual contact with an unwilling female partner. This study compares the risk characteristics of sexually coercive (n=81) and nonoffending college males (n=223) across several domains. Results revealed that sexual coercers differed from nonoffenders in that they more often subscribed to rape myths, viewed interpersonal violence as more acceptable, reported greater hostility toward females, and perceived male-female relationships as more inherently adversarial. In addition, compared to nonoffenders, sexually coercive males showed stronger indicators of promiscuity and delinquency, reported more psychopathic personality traits, had more empathic deficits, and were more likely to have experienced certain forms of childhood abuse. In most respects, coercers did not differ from those who reported engaging in more severe forms of sexual assault involving the use of physical force. These results suggest important differences between nonoffending males and those who "cross the line" by engaging in sexually coercive acts. In addition, consistent parallels can be drawn between the predictors of sexual coercion identified in this study and those documented in the sexual aggression (e.g., forcible rape) literature.

Antisocial Personality Disorder↗
PubMed2003

Sexual coercion among adolescents in northern Thailand: prevalence and associated factors.

Sexual coercion was assessed in a cross-sectional survey of drug use and sexual behavior in vocational school students from Chiang Rai, Thailand (n = 1725; ages 15-21), using audio-computer assisted self-interview. Sexual coercion was reported by 6.5% of males and 21% of females. Mean age at first occurrence was 16 years (range 8-20) among males and 17 years (range 5-21) among females. Most perpetrators were male (52% among males; 98% among females) and known by the participants. Among females, associated factors were history of pregnancy, selling sex, marijuana use, perceived risk of STD, two or more lifetime sexual partners, and living away from family. Among males, associated factors were homo- or bisexual self-identification, parents living together, and ulcerative STD history.

Adolescent↗
PubMed2005

Coercion in the treatment of anorexia nervosa: clinical, ethical and legal implications.

Because of its high mortality and treatment resistence, clinicians sometimes invoke the law in aid of retaining their most acutely ill-patients in treatment or re-feeding programs. Depending on the jurisdiction, various laws, including mental health and adult guardianship laws, have been invoked to achieve this objective (Carney, Tait, Saunders, Touyz & Beumont, 2003). Until recently, little was known about the therapeutic impact of coercion on patients (Saunders, 2001, Carney & Saunders 2003), or the relative advantages of different avenues of coercion (Carney, Saunders, Tait, Touyz & Ingvarson 2004). Most obscure of all, however, has been our understanding of the factors influencing clinical decisions within specialist anorexia treatment units regarding which in-patients will be selected for coerced treatment. This paper reports legal and ethical implications of findings from analysis of data gathered from a major Australian specialist anorexia treatment facility over nearly 5 years.

Anorexia Nervosa↗
PubMed1988

In-group-out-group differences in the perceived efficacy of coercion and conciliation in resolving social conflict.

In-group and out-group members were predicted to differ in the judged efficacy of coercion and conciliation as social influence strategies, with coercion perceived as relatively more effective than conciliation by outgroup rather than ingroup members. In Experiment 1, all subjects read a description of a conflict between two hypothetical nations, with half of the subjects taking the perspective of the defense minister of one nation and half the perspective of the other. Each nation was developing weapons that increased rather than decreased the likelihood of war. Each subject was asked to consider the effectiveness of an array of social influence strategies, varying in degree of coercive or conciliatory tone, that could modify the actions of either their own or the other country. The prediction was confirmed, both by indexes of rated effectiveness and by a ranking of effectiveness. In Experiment 2, the perspective-taking manipulation was weakened by merely asking subjects to imagine that they were citizens of one country or the other. Experiment 2 replicated the basic findings of Experiment 1. The implications of these results for international conflict, with particular reference to the arms race, are discussed.

Coercion↗
PubMed1997

Male and female adolescents' perceived interpersonal communication skills according to history of sexual coercion.

This report summarizes the experience of 61 female adolescents recruited through a private adolescent family planning clinic, and 183 9th through 12th-grade adolescents recruited from a private suburban high school regarding their experiences with dating relationships, sexual communication skills, and psychological status. The samples were predominantly white and middle to upper income. Perceptions of interpersonal communication skills were analyzed according to gender, clinic versus school, and history of sexual coercion. The adolescents were generally confident that they could assert their own preferences and stand up to other regarding sexual issues with the exception of the small group of high school males reporting having had experienced sexual coercion. This group (N = 20) expressed difficulty in talking to their partners about safer sex, getting their partner(s) to listen to them, or turning down alcohol or drugs prior to having sex. These boys were also more likely to report missing classes or having other kinds of trouble with school, to be concerned about use of alcohol and drugs, and about feeling unpopular. None of the female groups had this profile of communication and emotional problems. Implications for preventive education programming on interpersonal skills and sexuality are considered.

Adaptation, Psychological↗
PubMed2005

Coercion, involuntary treatment and quality of mental health care: is there any link?

PURPOSE OF REVIEW: This paper summarizes major results and debates in the field of coercive or involuntary treatment of the mentally ill and how these relate to the quality of care, as published in literature during 2002 and 2003. RECENT FINDINGS: Studies focus on four major issues: involuntary hospital placement and treatment of mentally ill patients, compulsory outpatient treatment, attitudes towards or perceived coercion, and ethics of coercive measures in mental health care. Studies suggest a complex correlation between the involuntary placement of mentally ill patients, coercive measures, and outcomes. Outcome indicators for the quality of mental health care are not standardized, but vary with the point of view of the individual or collective assessor. None of the results question the necessity or the legality of involuntary treatments or conclude to refrain from employing coercive measures in mental health care if these cannot be avoided. Many results of research on attitudes towards involuntary treatments or perceived coercion suggest an acceptance of the application of coercive measures, even by the persons concerned, if the legal conditions are clearly defined. Research standards or study designs may benefit from some improvement. Study samples usually are small and only in rare cases has their selection been representative. SUMMARY: Research activities are remarkably few in number, especially considering the frequency of involuntary measures and the controversial perception or discussion of these measures among the persons concerned, professionals, or a wider public. Many basic research questions still remain to be adequately addressed, such as the long-term effects of involuntary treatment.

Journal Article↗
PubMed1997

Patterns of sexual coercion in adult heterosexual relationships: an exploration of male victimization.

The sexual coercion of adult males by females in heterosexual relationships has received little empirical attention. The purpose of this study was to identify and describe such relationships--in comparison with relationships involving the sexual coercion of females, of both males and females, and of neither--through analysis of data for 3,032 couples that completed the Preparation for Marriage instrument (Holman, Busby, & Larson, 1989). Current individual and couple characteristics were investigated for male subjects and their partners. The results revealed greater deficiencies in relational resources and commitment in coercive versus noncoercive couples. In addition, gender differences were noted among results for different victim/offender configurations.

Female↗
PubMed1994

Patient satisfaction with inpatient psychiatric care. The influence of personality traits, diagnosis and perceived coercion.

The aim of the study was to investigate the influence of personality traits, diagnosis and perceived coercion on patient satisfaction with inpatient psychiatric care. The study was performed as a cross-sectional study on 7 inpatient wards in southern Sweden. A cohort of 50 psychiatric inpatients evaluated satisfaction with care and also made ratings on a personality questionnaire. Patients with a higher level of the trait aggressive nonconformity were significantly less satisfied with the ward's physical and psychosocial environment, the treatment design and the treatment program. The phenomenon of acquiescence was not related to the reported level of satisfaction. Analyses of patient satisfaction according to diagnostic groups showed that patients with affective disorders had significantly better satisfaction than patients with a diagnosis of schizophrenia. Patients who perceived that they were involuntarily admitted were measured as being significantly less satisfied with the care in all areas. It is concluded that, to attain a higher specificity in analyses of variation in patient satisfaction, focus may be put on situational and setting factors of the care delivered along with specific patient characteristics. Risk groups, which require great attention in the development of quality assessment and quality assurance policies, are patients with schizophrenia and patients who perceive coercion in connection with inpatient psychiatric treatment.

Adolescent↗
PubMed2005

More on parental living liver donation for children with fulminant hepatic failure: addressing concerns about competing interests, coercion, consent and balancing acts.

Parental living liver donation for children with fulminant hepatic failure raises complex ethical issues. According to a recent editorial in this journal, these include contradictory interests, the possibility of coercion and compromised consent and the need to balance the risks to the donor against the potential benefits for the recipient. Here I argue that in this setting, interests are often aligned rather than conflicted, that coercion of parental donors is rare, that consent may sometimes be valid even when it is not fully informed and that the correct balance to consider is the relative weights of risks and benefits for the donor. I conclude that living liver donation by parents of children with fulminant hepatic failure is consistent with societal norms of parental behavior, ethically acceptable and should be permitted regardless of the efficiency of the deceased donor organ recovery program.

Adult↗
PubMed1983

The role of coercion in rehabilitation of drug abusers.

The impact of coercion in rehabilitation of drug abusers was examined in a 1979 study of a population of drug abusers in treatment programs in South Jersey. The experimental group consisted of patients in treatment through the TASC program, while the control group was made up of patients who had voluntarily committed themselves to treatment. A validated interview schedule was utilized for both coerced and noncoerced groups. Data analysis utilized analysis of contingency tables involving chi 2 tests of significance and Pearsons Correlation Coefficients, as well as one-way and two-way analyses of variance. This study found that coercion facilitates success for certain population groups (e.g., older, longer-term heroin addicts), only by certain criteria (e.g., arrest and abstinence) for certain treatment settings (e.g., drug-free vs methadone maintenance programs). Confirmation of the maturing-out process with regard to treatment of heroin addicts was also noted. Based on study findings and literature review, a number of policy-related recommendations are made.

Adult↗