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PubMed1993

Ethical issues in family law.

This article focuses on a few key ethical issues which arise in the context of family law. One of the issues faces mental health practitioners who are often engaged as expert witnesses in family law disputes. In another realm, family law attorneys face several fundamental ethical dilemmas in the course of their work. The client's right to appropriate treatment will be considered in the light of multidisciplinary services. On a broader level, the courts need to examine the ethical implications of the commonly used guideline in judicial process, 'the best interests of the child'. When these ethical issues are considered, it becomes clear what changes need to be made in individual practice, professional standards and social policy. The underlying premise is based on the knowledge we have gained in recent years through research and clinical experience with divorcing families. It is suggested that a radically different approach to society's handling of divorce is needed. Denmark's administrative handling of these problems is presented as a working alternative model.

Adult↗
PubMed1993

The slowing metabolism of marriage: figures from 1988 U.S. marital status life tables.

Marital status life tables for the United States, 1988, show a continuing retreat from marriage. For both sexes, the proportion ever marrying declined and the average age at first marriage rose. The 1988 rates imply that 43% of marriages end in divorce. That represents a slight decline from the 1983 figure, and suggests that divorce has peaked at a level below that estimated in earlier analyses.

Adult↗
PubMed1977

Marital instability and the economic status of women.

This paper uses longitudinal data from the Panel Study of Income Dynamics to examine the relationship between changes in marital status and economic status. Differences between men and women and between whites and blacks are also considered. A major finding is that, after adjusting for changes in family size, the economic status of divorced or separated men improves, while that of women declines. Components of income change are discussed, with special emphasis on changes in the labor force and welfare status of women who were divorced or separated during the analysis period. Finally, data on the magnitude and distribution of alimony/child-support payments are presented.

Child Care↗
PubMed1993

The economic costs of martial disruption for young women over the past two decades.

This paper examines the economic costs of separation and divorce for young women in the United States from the late 1960s through the late 1980s. Broadened opportunities for women outside marriage may have alleviated some of the severe economic costs of marital disruption for women. This paper contrasts the experiences of two cohorts of young women: those who married and separated or divorced in the late 1960s through the mid-1970s and those who experienced these events in the 1980s. Based on panel data from the National Longitudinal Surveys of Youth 1979-1988. Young Women 1968-1978, and Young Men 1966-1978, the results show stability in the costs of disruption. A multivariate analysis shows that young women in the more recent cohort have more labor force experience before disruption than those in the earlier cohort, but prior work history does not protect women from the severe costs of marital disruption.

Adolescent↗
PubMed1996

The influence of parents' martial dissolutions on children's attitudes toward family formation.

We investigate the influence of parents' martial dissolutions on their children's attitudes toward several dimensions of family formation. Hypotheses focus on the role of patients' attitudes as a mechanism linking parents' behavior to their children's attitudes. We test these hypotheses using intergenerational panel data that include measures of children's attitudes taken directly from children. Results demonstrate strong effects of parental divorce, remarriage, and widowhood on children's attitudes toward premarital sex, cohabitation, marriage, childbearing, and divorce. The results also show that parents' own attitudes link their behavior to their children's attitudes, although substantial effects of parental behavior remain after controlling for parents' attitudes.

Adolescent↗
PubMed1996

The use of multiple outcomes in stress research: a case study of gender differences in responses to marital dissolution.

This study tests the hypothesis that the use of a single outcome variable distorts the mental health consequences of a stressor among different social groups. It uses the example of the impact of marital dissolution on the mental health of men and women to see whether rates of depression and alcohol problems rise disproportionately among women and men, respectively, who experience the same type of stressor. The sample compares 465 married subjects with 127 separated or divorced subjects drawn from a longitudinal study of 25-, 28-, and 31-year-olds. With controls for earlier rates of depression and alcohol problems, as well as for secondary stressors connected with separation and divorce, women undergoing marital dissolution show significantly greater increases in rates of depression compared to men who experience this stressor. Although men report far more alcohol problems than women, rates of these problems do not increase disproportionately among men, compared to women, during marital dissolution. The results indicate that the use of gender-typical mental health outcomes reduce, but do not eliminate,gender differences in the response to marital dissolution. They also indicate the need to use outcomes that typify how each group under study responds to stressful social conditions.

Adolescent↗
PubMed1997

[The relationship between marital status and health].

In the Netherlands there are considerable health differences by marital status; differences are found in subjective and objective health measures, in mental and physical health, and in morbidity and mortality. In general divorced people have the most and married people the least health problems. Married people have less health problems than unmarried people living with a partner. Differences in mortality by marital status are smaller among women than among men. There are two explanatory theories: the social causation theory (marital status influences health) and the selection theory (health influences marital status). Both theories play a role in the explanation of the health differences. The effect of marital status on health among men is mainly mediated by psychosocial factors, whereas material circumstances are the principal intermediary factor among women. Health intervention among unmarried men should be aimed at intensifying social support from the environment, among divorced women it should be aimed at improving material conditions.

Divorce↗
PubMed1996

Psychological factors in the longitudinal course of battering: when do the couples split up? When does the abuse decrease?

The longitudinal course of battering was investigated over a 2-year time span. Forty-five batterers and their spouses were assessed with self-report, psychophysiological, and marital interaction measures. Both the stability of the relationship and of the battering were assessed. At the two-year follow-up, 62% of the couples were still married and living together, while 38% had separated or divorced. A combination of six variables, reflecting severity of husband emotional abuse, wife dissatisfaction, husband physiological arousal, and wife defending herself assertively, was 90.2% accurate in predicting separation or divorce 2 years later. Of the couples still living together at follow-up, 46% of the batterers did not reduce their levels of severe violence, while 54% did significantly decrease levels of violence. Husbands who continued to be severely violent at 2-year follow-up were more domineering, globally negative and emotionally abusive toward their wives at Time 1 than husbands who reduced their levels of violence. Even though 54% of the batterers decreased the frequency of violent acts over the 2-year period, only 7% achieved complete desistance. Moreover, husband emotional abuse did not decrease over the 2-year period, even when physical abuse did.

Adult↗
PubMed1997

[Selected psychosocial factors and the sexual development of girls].

In a group of 771 Czech girls aged 16 to 18 years who were examined by means of an interview, the influence of three psychosocial factors on their sexual development was studied. Through statistical analysis of data it was found that probands living in towns had their first sexual intercourse significantly earlier (p < 0.004) than village girls and further they had more experience with cunnilingus and fellatio. Their level of education and that of both parents was significantly higher than in probands living in villages. However, in the second study we ascertained that sexual development of students in comparison with girl-apprentices was highly significantly retarded (p < 0.004). In the third study a comparison of psychosexual development of 535 girls who lived in complete and stable families, and of 166 probands from divorced marriages was carried out. Sexual development in the later group was accelerated (p < 0.02). The emotional atmosphere in disrupting families and the incompleteness after divorce influenced negatively the development of girls during their adolescence in different directions.

Adolescent↗
PubMed1976

Homogamous and heterogamous marriages.

This paper explores two marital constructs set forth by Peter Giovacchini. The first is based on a symbiotic reenactment in which the investment of both partners is tenacious and reciprocal, an attachment which Giovacchini refers to as a "character object" relationship. It represents intrapsychic homogramy. In the second construct, this deep form of attraction is absent and the dyadic bond is superficial, frequently transitory. The latter couples do not require an elementary, intrapsychic bond but do share particular defensive traits or symptoms. Thus these unions are termed "symptom object" relationships and are characterologically heterogamous. By means of a group case study approach, this distinction was statistically supported. Furthermore, it was found that homogamous marriages stay in treatment longer, maintain a lower divorce rate, and respond best to individual psychoanalytic psychotherapy. Heterogamous marriages, by contrast, show a higher divorce rate and tend to leave therapy prior to termination. The research also suggests that the initial treatment of choice for this type of marriage may well be conjoint or group psychotherapy.

Compulsive Personality Disorder↗
PubMed1998

Childhood abuse and parental disorders reported by Navy outpatient mental health patients.

OBJECTIVE: To ascertain the number of Navy outpatient mental health patients reporting a history of childhood abuse. To explore the relationships among abuse history, parental/step-parental substance abuse, mental illness, and divorce. METHOD: Review of 134 clinical data forms completed by patients when first seen. RESULTS: Twenty-six percent reported at least one type of childhood abuse (physical, sexual, verbal, emotional). Proportionally more females reported any one type of abuse. Assailants were predominantly males, typically fathers or stepfathers. Verbal abuse significantly affected childhood happiness. Parental substance abuse, mental illness, or divorce before age 19 reduced childhood happiness, and abuse further reduced it. CONCLUSION: Childhood abuse is commonly reported by Navy mental health patients and may affect their adjustment to military life.

Adult↗
PubMed1998

The Burgess decision and the Wallerstein brief.

Divorcing couples traditionally incorporate into their settlement contracts a stipulation regarding relative degree of freedom to relocate, especially if the relocating parent has primary custody of the children. Typically, the primary custodial parent might be restricted from moving outside of the state in which the divorcing couple has resided, or there may be a specific mile radius or travel time radius beyond which the primary custodial parent cannot relocate. In recent years, courts have become increasingly permissive with regard to allowing relocation by primary custodial parents, and the once stringent requirements that needed to be satisfied to justify relocation are being progressively relaxed. In 1996, the Supreme Court of California in In Re the Marriage of Burgess, 913 P.2d 473 (Cal. 1996), has set a precedent for even further relaxation of these once rigid restrictions. The Burgess decision has been frequently quoted in the State of California and is receiving widespread attention elsewhere. It is the author's opinion that this precedent is ill conceived and will most likely result in significant grief and suffering for the nonrelocating parent as well as the relocating children.

California↗
PubMed1998

[Treatment of patients with psychogenic amnesia with the help of therapeutic anamnesis].

Psychogenic (dissociative) amnesia is a psychiatric disorder characterised by a sudden loss of memory which is too extensive to be explained by ordinary forgetfulness, but which has no organic disease or explanation. Psychogenic amnesia is categorised among the dissociative disorders in DSM-IV and ICD-10 and begins suddenly, usually after severe psychosocial stress. The prognosis is good with complete recovery, and there is seldom relapse. This article describes a man, 45 years of age, who developed severe depression and amnesia following a very troublesome divorce. He did not talk, he communicated by signs and gestures, and he isolated himself in his mother's home. After being admitted to a psychiatric ward he became anorectic and developed erosive eoesophagitis/gastroduodenitis. Initially he was given perfenazin (Trilafon) 24 mg/day. The psychiatric treatment produced no results for the first three weeks, but the patient gradually recovered when the therapist and the patient recapitulated the conflicts associated with the divorce, using documents from the patient's lawyer as a guide. This method is called "therapeutic anamnesis" and is similar in many ways to psychiatric treatment of post-traumatic stress reactions.

Amnesia↗
PubMed1998

The relationship of family structure and conflict to levels of intimacy and parental attachment in college students.

Randomly selected college juniors and seniors completed questionnaires concerning marital conflict, parental attachment, and attitudes about love and sex. Results indicated that intimacy was negatively correlated with parental conflict and divorce. Divorce and higher levels of conflict were associated with lower levels of intimacy in students' romantic relationships.

Adult↗
PubMed1993

Indicators of woman abuse based on a chart review at a family practice center.

OBJECTIVE: To identify demographic and health indicators of domestic violence. DESIGN: Anonymous questionnaire survey of patients regarding violence and a chart review regarding symptoms and diagnoses. SETTING: Community-based family practice residency training center in a midwestern city. PARTICIPANTS: Women 18 years of age or older visiting the center over a 2-month period in 1990. Of 476 eligible participants, 394 (82.7%) consented to complete the survey. MEASURES: A detailed, standardized measure of violence was used. Physical and psychological problems were given codes from the International Classification of Diseases, Ninth Revision (ICD-9). RESULTS: Younger women and those separated or divorced from their partners were more likely to have been victims. Never-married women also had substantially high rates of victimization. Depression was the strongest indicator of victimization, even when controlling for demographic factors. Back pain, ulcers, headaches, and anxiety were not strong indicators of abuse. A classification analysis showed that a combination of all variables could predict lifetime injury only about half the time and violence in the past year only about 20% of the time. CONCLUSIONS: Since neither demographic nor health factors could accurately predict who had been victimized, all women need to be asked about abuse. Physicians should also keep in mind that divorced and unmarried women are often affected by abuse, either immediately or by its long-term aftereffects.

Adolescent↗
PubMed1998

Prevalence and correlates of harassment among US women physicians.

BACKGROUND: Despite concerns about its prevalence and ramifications, harassment has not been well quantified among physicians. Previous published studies have been small, have surveyed only 1 site or a convenience sample, and have suffered from selection bias. METHODS: Our database is the Women Physicians' Health Study, a large (4501 respondents; response rate, 59%), nationally distributed questionnaire study. We analyzed responses concerning gender-based and sexual harassment. RESULTS: Overall, 47.7% of women physicians reported ever experiencing gender-based harassment, and 36.9% reported sexual harassment. Harassment was more common while in medical school (31% of gender-based and 20% for sexual harassment) or during internship, residency, or fellowship (29% for gender-based and 19% for sexual harassment) than in practice (25% for gender-based and 11% for sexual harassment). Respondents more likely to report gender-based harassment were physicians who were now divorced or separated and those specializing in historically male specialties, whereas those of Asian and other (nonwhite, nonblack, non-Asian, non-Hispanic) ethnicity, those living in the East, and those self-characterized as politically very conservative were less likely to report gender-based harassment. Being younger, born in the United States, or divorced or separated were correlated with reporting ever experiencing sexual harassment; those who were Asian or who were currently working in group or government settings were less likely to report it. Those who felt in control of their work environments, were satisfied with their careers, and would choose again to become physicians reported lower prevalences of ever experiencing harassment. Those with histories of depression or suicide attempts were more likely to report ever having been harassed. CONCLUSIONS: Women physicians commonly perceive that they have been harassed. Experiences of and sensitivity to harassment differ among individuals, and there may be substantial professional and personal consequences of harassment. Since reported rates of sexual harassment are higher among younger physicians, the situation may not be improving.

Adult↗
PubMed2005

Marital quality and occurrence of the metabolic syndrome in women.

BACKGROUND: Marital status is associated with the early stages and progression of cardiovascular disease, an association that may stem in part from the influence of marital quality on metabolic factors. The objective of this study was to examine whether women reporting marital satisfaction are at reduced risk of developing the metabolic syndrome compared with other women. METHODS: Four hundred thirteen middle-aged women from the Pittsburgh Healthy Women Study completed measures of marital status and marital satisfaction at baseline and 3 years later. Metabolic syndrome (diagnosed according to the criteria of the National Cholesterol Education Program) was assessed at baseline and at the last follow-up visit (an average of 11.5 years later). RESULTS: Compared with maritally satisfied women, maritally dissatisfied (odds ratio [OR], 3.02; 95% confidence interval [CI], 1.46-6.24), divorced (OR, 2.47; 95% CI, 1.02-5.97), and widowed (OR, 5.82; 95% CI, 1.88-18.03) women were significantly more likely to have the metabolic syndrome at follow-up. The differences between maritally satisfied women and dissatisfied (OR, 3.18; 95% CI, 1.42-7.15) and widowed (OR, 5.69; 95% CI, 1.70-9.04) women remained significant in the full multivariate model. The difference between maritally satisfied women and divorced women (OR, 2.35; 95% CI, 0.89-6.18) was reduced to marginal significance in the full multivariate model. Single (OR, 2.84; 95% CI, 0.84-9.64) and moderately satisfied (OR, 1.06; 95% CI, 0.35-3.21) women did not differ significantly from maritally satisfied women. CONCLUSIONS: Women in high-quality marriages are at lower risk of developing the metabolic syndrome. Social histories of patients should include assessment of marital quality.

Adult↗
PubMed1997

Effects of family structure information on nurses' impression formation and verbal responses.

The purpose of this study was to investigate the effects of family structure information on how nurses (a) interpreted information, (b) gathered data, and (c) responded to a patient. Nurses were randomly assigned to see one of eight videotaped interviews portraying: married mother, married with no children, divorced mother, divorced with no children, unmarried mother, unmarried with no children, remarried with spouse's children (stepmother), and remarried with no children. The results indicate that the technical aspects of nursing may be affected only in a relatively minor way, but the affective dimensions of nursing care may be more detrimentally influenced by knowing about a patient's family structure.

Adult↗