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PubMed1994

Interpersonal conflict and physical violence during the childbearing year.

Reducing physical abuse directed at women by male partners is one of the nation's Year 2000 health objectives. An important target group for achieving this health objective is pregnant women. The present study examines the frequency, severity, perpetrators and psychosocial correlates of violence during the childbearing year. A panel of 275 women were interviewed 3 times during pregnancy and at 6 months postpartum. Moderate or severe violence was somewhat more common during the postpartum period than during the prenatal period--19% of women reported experiencing moderate or severe violence prenatally, compared to 25% in the postpartum period. For partner-perpetrated violence, being better educated was associated with increased risk of violence as was having had a sex partner who ever shot drugs; being older, having a confidant and having social support from friends were significant protective factors. For violence perpetrated by someone other than a male partner, having a confidant was a significant protective factor. Obstetric care providers who routinely come in contact with pregnant women, as well as emergency department staff, need to be systematically screening for violence against women. Efforts to enhance women's social support networks should be included in primary and secondary prevention programs.

Adolescent↗
PubMed1984

Stigma in patients with rectal cancer: a community study.

A self-rating measure of stigma and several supplementary questions were devised in order to assess perceived stigma in a community survey of the quality of life in 420 rectal cancer patients, of whom 265 had a permanent colostomy. Half the patients felt stigmatised, higher proportions being observed among younger patients and among those with a colostomy. Feelings of stigma were associated with poor health, particularly emotional disorders, with the presence of other medical problems, and with disablement. Patients who perceived stigma made more use of medical services but were less satisfied with them, particularly with regard to communication with health professionals. Socio-economic factors, such as employment status, higher income, and higher social and housing class, did not protect patients against feeling stigmatised by cancer or by colostomy. Most patients, with or without stigma, enjoyed close relationships with intimates, but the stigmatised were more likely to have withdrawn from participation in social activities. Assessing stigma by self-rating gives information which adds to that obtained by the usual methods of assessing quality of life.

Aged↗
PubMedDate not supplied

Development of an introductory course in child protection.

The maltreatment of children is a significant public health and social problem. Healthcare professionals have a crucial role to play working with other agencies to protect children from abuse and neglect. The need for training, support and clinical supervision in this work has been identified. This article discusses the collaborative work that led to the establishment of an introductory course in child protection (English National Board 970) at one school of nursing and midwifery and outlines the benefits of undertaking such a course. The course has attracted participants from a range of healthcare settings and has proved to be well evaluated and oversubscribed. Practitioners have returned to their work setting with increased awareness of child maltreatment and an understanding of the need for a proactive approach to child protection.

Child↗
PubMed2002

Parental expressed emotion in depressed adolescents: prediction of clinical course and relationship to comorbid disorders and social functioning.

BACKGROUND: High expressed emotion (EE) predicts worse clinical course for a number of disorders. High EE is more frequent in parents of disordered children than normal controls. It is uncertain whether EE and its components are disorder-specific, whether EE is more closely related to parent characteristics or child characteristics, and whether EE predicts clinical course independently of clinical variables that reflect severity of disorder. EE has not been investigated in adolescent depression. METHOD: The 57 participants in this study were a sub-sample of a longitudinal study of the clinical course of depression. Adolescents and parents were recruited from consecutive referrals to all psychiatric outpatient clinics and inpatient units in a geographic catchment area. The association between EE and one-year clinical outcome of major depressive disorder was tested and associations between EE and characteristics of the adolescent, the parent, and the family were examined. RESULTS: EE was independent of socio-demographic characteristics, comorbid diagnoses, and parental depression. High EE was associated with worse adolescent social functioning according to either adolescent or parent report. High EE was associated with the presence of more depression symptoms. Low EE predicted major depression remission in participants without comorbid attention-deficit/hyperactivity disorder (ADHD), but this association was not independent of the association between social functioning and depression remission. CONCLUSIONS: The findings indicate a need to examine possible protective effects of low EE. Relationships between EE, social functioning, and depression persistence and remission require further examination.

Adolescent↗
PubMed1984

[Psychological defense mechanisms in the clinical picture of alcoholism].

Forms of psychological protection in cases of the so-called social alcohol abuse and in chronic alcoholism are described. The role of the psychological protective mechanisms in the development of the disease was ascertained. The following phenomena of the perceptive protection were identified and depicted: ignoring of drunkenness, deformation of perceptive evaluation, emphasizing, partial perception. A special attention was paid to the role of the rationalization mechanisms, particularly motivational rationalization which underlies the formation of the explanatory systems. An attempt was made to explain the development of a number of clinical phenomena in chronic alcoholism in relation to the system of the personality psychological protection.

Alcoholism↗
PubMed2005

Low socioeconomic status of the opposite sex is a risk factor for middle aged mortality.

OBJECTIVES: To examine the relations between subjective social status, and objective socioeconomic status (as measured by income and education) in relation to male/female middle aged mortality rates across 150 sub-regions in Hungary. DESIGN: Cross sectional, ecological analyses. SETTING: 150 sub-regions of Hungary. PARTICIPANTS AND METHODS: 12,643 people were interviewed in the Hungaro-study 2002 survey, representing the Hungarian population according to sex, age, and sub-regions. Independent variables were subjective social status, personal income, and education. MAIN OUTCOME MEASURE: For ecological analyses, sex specific mortality rates were calculated for the middle aged population (45-64 years) in the 150 sub-regions of Hungary. RESULTS: In ecological analyses, education and subjective social status of women were more significantly associated with middle aged male mortality, than were male education, male subjective social status, and income. Among the socioeconomic factors female education was the most important protective factor of male mid-aged mortality. Subjective social status of the opposite sex was significantly associated with mid-aged mortality, more among men than among women. CONCLUSION: Pronounced sex interactions were found in the relations of education, subjective social status, and middle aged mortality rates. Men seem to be more vulnerable to the socioeconomic status of women than women to the effects of socioeconomic status of men. Subjective social status of women was an important predictor of mortality among middle aged men as was female education. The results suggest that improved socioeconomic status of women is protective for male health as well as for female health.

Cross-Sectional Studies↗
PubMed1996

Delayed traumatic recall in adults: a synthesis with legal, clinical, and forensic recommendations.

Despite considerable consensus on what is known and unknown about delayed traumatic recall in adults, this topic remains one of the most polarized issues within both forensic psychiatry and society as a whole. Competing priorities of values contribute to this polarization. So do often subtle confusions of categories: experiential with substantive realities; clinical with legal priorities and criteria; distinctions between explicit and implicit with declarative and procedural memory; conditioned avoidance with declarative knowledge; and prediction of traumatic sequelae from known traumatic events with postdiction of possible traumatic events from symptoms that may imply prior traumatization. Memories are rendered more vulnerable to falsification through social influence and intrinsic suggestibility-- and probably more so when suggestive input bypasses conscious scrutiny. Legal, clinical, and forensic guidelines are proposed to sort out these complexities, balance conflicting professional duties and priorities, balance protection of children with defending legitimate social structures such as the family, and better use our growing knowledge about the vicissitudes of human memory.

Adult↗
PubMed2004

Emotional resilience: risk and protective factors for depression among alternative education students in New Zealand.

A total of 268 alternative education students from New Zealand were surveyed to examine risk and protective factors for depression within the social environment. Twenty-eight (35.4%) of the girls and 31 (21.1%) of the boys had cut-off scores that indicated a high likelihood of significant psychopathology from depression. Multivariate analysis demonstrated that family and peer connections were protective against depression. High levels of poverty, witnessing violence at home, and experiencing bullying at school were significant risk factors for depression.

Adolescent↗
PubMed2000

Hostility, social support, and carotid artery atherosclerosis in the National Heart, Lung, and Blood Institute Family Heart Study.

This cross-sectional study investigates the association of hostility and social support (measured by standardized instruments) to carotid artery atherosclerosis in men and women with a high familial risk for coronary heart disease (CHD) and those with low to medium risk. The hypothesis was that high hostility and low social support would have a stronger association in subjects with a familial predisposition to CHD. There were 535 low- to medium-risk women, 491 low- to medium-risk men, 1,950 high-risk women, and 1,667 high-risk men in the study. The extent of carotid artery atherosclerosis was assessed by B-mode ultrasound imaging. A lesion was defined as an intimal-medial far wall thickness of 1 mm in the common, internal, or carotid bifurcation, or identification of plaque at any site. Odds ratios and their 95% confidence intervals were calculated using generalized estimating equations (GEE) for logistic regression. Family was specified as the clustering variable, and robust SEEs were obtained that account for dependence of the data within families. After controlling for age, education, body mass index, ever having smoked, ever drinking > 5 drinks a day, and metabolic index, hostility was significantly associated with increased odds of carotid lesions in only high-risk women. High-risk women showed a significantly reduced odds of carotid lesions with high social support, but the extent of this protection was reduced when age and education were included in the equation. A combination of high hostility and low social support was associated with higher odds than hostility alone in both high-risk men and women. These results suggest that women with a high familial predisposition for CHD may be more vulnerable to cardiovascular influences from hostility and social support than high-risk men or men and women with low to medium risk.

Adult↗
PubMed2006

Child care and social support modify the association between maternal depressive symptoms and early childhood behaviour problems: a US national study.

OBJECTIVE: To investigate the presence and patterns of modification effects of the sex of the child, social support, and childcare on the relation between maternal depressive symptoms and child behaviour problems at two developmental stages. DESIGN: Analyses are based on prospective longitudinal data from the study of early child care. PARTICIPANTS: A total of 1216 families were drawn from 10 locations across the USA. Mothers were age 18 or older at the time of the study child's birth and had completed outcome measures for at least one follow up time point (24 months, 36 months). MAIN OUTCOME MEASURES: Child internalising and externalising behaviour problems assessed at the child's age of 24 months and 36 months, as reported by the mother. RESULTS: Results from generalised estimating equation analyses showed that the association between child externalising behaviour problems and maternal depressive symptoms varied according to the social support received by the mother (p<0.05). Overall, social support mitigated the relation, but protective effects diminished at increasing levels of depressive symptoms. Associations between child internalising behaviour problems and maternal depressive symptoms varied according to whether or not the child received care from caregivers other than the mother (p<0.05). CONCLUSIONS: Health providers who are working with mothers with depressive symptoms may want to examine social support that is available to mothers, especially if mothers are not severely depressed. Furthermore, recommendations to begin, continue, or perhaps increase provision of childcare from other caregivers can provide respite for mothers and opportunities for children to engage in protective interactions with others.

Adolescent↗
PubMed2003

Does active leisure protect cognition? Evidence from a national birth cohort.

Social, physical and intellectual activities are thought to facilitate cognitive performance and slow the rate of age associated cognitive decline, but little is known about this association in younger adulthood. We used multiple regression to test the association between two kinds of activity at 36 years-physical exercise and spare-time activity-and verbal memory at 43 and 53 years in 1919 males and females enrolled in the MRC National Survey of Health and Development (the British 1946 birth cohort). Both kinds of activities were significantly and positively associated with memory performance at 43 years, after controlling for sex, education, occupational social class, IQ at 15 years, and recurrent ill health and significant mental distress. Furthermore, physical exercise at 36 years (but not spare-time activity) was associated with a significantly slower rate of decline in memory from 43 to 53 years, after controlling for the same factors, with evidence that continuing physical exercise after 36 years was important for protection. We conclude that physical exercise and spare-time activity are significantly associated with benefit to memory in midlife, although these two kinds of voluntary activity may exert their effects on cognition via different paths.

Adult↗
PubMed1998

Radiation protection recommendations as applied to the disposal of long-lived solid radioactive waste. ICRP Publication 81.

The present publication deals with the radiological protection of members of the public following the disposal of long-lived solid radioactive waste using the 'concentrate and retain' strategy. It covers options including shallow land burial and deep geological disposal. The recommendations made in this report apply to new disposal facilities.The main protection issue concerns exposure that may or may not occur in the far future, i.e. a situation of potential exposure. Constrained optimisation is the central approach to evaluating the radiological acceptability of a waste disposal system. In this context optimisation of protection is a judgmental process with social and economic factors being taken into account and should be conducted in a structured essentially qualitative way.Two broad categories of exposure situations have to be considered: natural processes and human intrusion. Application of the radiological protection criteria to these two categories of exposure situations is different.In the first case, assessed doses or risks arising from natural processes should be compared with a constraint of no more than about 0.3 mSv per year or its risk equivalent of around 10(-5) per year. With regard to human intrusion, understood here as inadvertent human intrusion, the consequences from one or more plausible stylised scenarios should be considered in order to evaluate the resilience of the repository to such events. The Commission considers that in circumstances where human intrusion could lead to doses to those living around the site sufficiently high that intervention on current criteria would almost always be justified, reasonable efforts should be made at the repository development stage to reduce the probability of human intrusion or to limit its consequences. In this respect, the Commission has previously advised that an existing(1) annual dose of around 10 mSv per year may be used as a generic reference level below which intervention is not likely to be justifiable. Conversely, an existing(1) annual dose of around 100 mSv per year may be used as a generic reference level above which intervention should be considered almost always justifiable. Similar considerations apply in situations where the thresholds for deterministic effects in relevant organs are exceeded.The conclusion of the report is that in the Commission's view, provided reasonable measures have been taken both to satisfy the constraint for natural processes and to reduce the probability or the consequences of inadvertent human intrusion, and technical and managerial principles have been followed, then radiological protection requirements can be considered to have been complied with.

Journal Article↗
PubMed2005

[Instruments for the measurement of the social network].

The social network can be an important pathogenic, pathoplastic, or protective factor in the development and course of mental and somatic illnesses. "Social network" describes a complex construct which has been understood, defined, and operationalized in many different ways. In research and clinical practice it is advisable to refer to scientifically elaborated instruments when measuring or evaluating the social network of patients. In this paper a review is given on available instruments for the measurement of the social network. They are discussed in respect to their clinical usefulness. Only few measures can be recommended for clinical practice because of the time needed to get the information or because of their content.

Animals↗
PubMed1999

Moderating influence of social support on suicidal ideation in a sample of Mexican immigrants.

The present study explored social support as a moderator in the relationship between depression and suicidal ideation in a sample of 104 immigrant Mexican-American adults. Participants completed the Personal Resource Questionnaire--Part 2, the Center for Epidemiologic Studies-Depression Scale, and the Adult Suicidal Ideation Questionnaire. Ineffective social support and high depression were significantly associated with elevated suicidal ideation. Further analyses indicated a significant interaction between social support and depression in predicting suicidal ideation, thereby suggesting that social support may serve as a protective factor against suicidal ideation during the acculturative process.

Adult↗
PubMed2026

Associations of Trajectories of Loneliness and Neighborhood Stability with Depression, Alcohol and Substance Use, and Quality of Life among Women Living with HIV.

Social relationships are an important social determinant of health. Loneliness, the perceived gap between one's actual and desired relationships, has emerged as an important mechanism through which social relationships impact health. Like other intrapersonal-level factors associated with health, loneliness is influenced by broader social and structural factors, including characteristics of one's neighborhood social environment. Although neighborhood-level protective and risk factors for loneliness and for mental health have been identified, prior studies have often focused solely on self-reported perceptions of the neighborhood environment. Further, few have considered aspects of the neighborhood social environments, such as neighborhood stability (i.e., stability of the community with long or short-term residents), independent of neighborhood socioeconomic conditions. In the current analysis, we explored longitudinal patterns of loneliness in conjunction with neighborhood stability among women with HIV (WWH) enrolled into the MACS/WIHS Combined Cohort Study (MWCCS) from 2014-2019 (N 2019=1,394) to examine whether trajectories of loneliness and neighborhood stability were associated with depressive symptoms, non-prescription substance use, past-year cannabis use, number of alcoholic drinks per week, and several domains of quality of life. Loneliness at baseline (Betas = 0.24 - 0.54) and changes in loneliness over time (Betas = 0.11 - 0.26) were associated with each outcome, except for the association between changes in loneliness over time and drinks per week (Beta=0.13, p = 4.14x10-2), which did not persist after correcting for multiple comparisons. Neighborhood stability at baseline was associated with past year cannabis use (Beta=0.26, p = 1.00x10-2), depressive symptoms (Beta=-0.12, p = 1.54x10-3), and overall self-reported health (Beta=-0.08, p = 2.05x10-2). Changes in neighborhood stability across time were not associated with any outcome. Neighborhood stability moderated the association between changes in loneliness and general health perceptions. Our results demonstrate both overall loneliness and changes in loneliness over time have implications for current mental health in WWH, while changes in neighborhood stability did not.

Journal Article↗
PubMed2002

Developmental well-being among low and normal birth weight U.S. Puerto Rican children.

Low birth weight is a more common occurrence among Puerto Rican children than among children from most other racial and ethnic groups in the United States, and they are more likely to experience the added risk of living in poverty. This study addresses what is protective for the development 602 normal birth weight and 554 low birth weight children from the Puerto Rican Maternal and Infant Health Study. The results presented in the current analysis identify several protective influences for development (particularly maternal social support, medical insurance, and paternal employment) among low birth weight children (who are at a high risk for developmental problems), and almost none for normal birth weight children. The results largely support the contention that protective factors emerge, or increase in strength, only in the presence of risk, indicating the use of targeted child health programs based on birth weight are an effective and efficient way to improve the developmental well-being of young Puerto Rican children in the United States.

Adaptation, Psychological↗
PubMedDate not supplied

The role of social networks and media receptivity in predicting age of smoking initiation: a proportional hazards model of risk and protective factors.

The increasing prevalence of adolescent smoking demonstrates the need to identify factors associated with early smoking initiation. Previous studies have shown that smoking by social network members and receptivity to pro-tobacco marketing are associated with smoking among adolescents. It is not clear, however, whether these variables also are associated with the age of smoking initiation. Using data from 10,030 California adolescents, this study identified significant correlates of age of smoking initiation using bivariate methods and a multivariate proportional hazards model. Age of smoking initiation was earlier among those adolescents whose friends, siblings, or parents were smokers, and among those adolescents who had a favorite tobacco advertisement, had received tobacco promotional items, or would be willing to use tobacco promotional items. Results suggest that the smoking behavior of social network members and pro-tobacco media influences are important determinants of age of smoking initiation. Because early smoking initiation is associated with higher levels of addiction in adulthood, tobacco control programs should attempt to counter these influences.

Acculturation↗
PubMed1996

Confidentiality and managed care: ethical and legal concerns.

As managed care companies take over the allocation of funds, the monitoring of treatment, and the measurement of outcomes, social workers encounter an ethical and legal dilemma with the demise of confidentiality in the professional-client relationship. Given that the profession has long heralded the protection of client confidentiality, it is timely that social workers re-examine traditional ethical and legal responsibilities to clients and challenge managed care personnel to protect clients' right to confidentiality. This article highlights problems concerning confidentiality that often arise for social workers working with managed care systems. It focuses also on ethical and legal standards related to confidentiality and social work responsibilities regarding informed consent.

Confidentiality↗