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PubMed1976

Penile prosthesis: psychologic factors.

A thirty-one-year-old paraplegic male requested a penile prosthesis. Psychiatric evaluations were done of both the patient and his wife. Within seventy-two hours of his arriving home with the prosthesis installed, his wife left their house to seek a divorce. The implications of this event for selecting patients for such devices are explored. Reservations are expressed about a prosthesis being inserted for patients married after the onset of impotence.

Adult↗
PubMed1985

Sexual and marital relationships after treatment for nonseminomatous testicular cancer.

Data from 121 patient questionnaires suggest that treatment for nonseminomatous testicular cancer not only causes sterility but also disrupts marital and sexual happiness in 10 to 20 per cent of patients. Treatment included unilateral orchiectomy and retroperitoneal lymphadenectomy alone in 47 men; 30 had additional chemotherapy, 8 had additional radiotherapy, and 26 were treated with all three modalities. Erectile and orgasmic problems were more prevalent when radiotherapy was included. Compared with healthy men, patients reported less sexual activity, lower sexual desire, more erectile dysfunction, more difficulty achieving orgasm, reduced orgasmic intensity, and, for 82 per cent, a greatly reduced semen volume. The longer the time since treatment, the more likely the patient was to have antegrade ejaculation. Although the patients' 12.8 per cent divorce and/or separation rate is not unusually high, those whose marriages ended cited sexual dysfunction and cancer treatment as significant sources of stress. Sterility was a frequent source of anxiety for one quarter of the patients.

Adolescent↗
PubMed1991

Stressful life events and Graves' disease.

The role of stressful life events in the onset of Graves' disease (toxic diffuse goitre) is controversial. However, the numerous early clinical reports that supported such an association were not adequately controlled and specificity of the diagnosis could be questioned. Later studies have not shown a causal relation, but these studies were small, did not have proper controls, or epidemiological methods were inappropriate. To assess possible associations between life events, heredity, social support, and Graves' disease, we have done a population-based case-control study in a defined area with about 1 million inhabitants. Over 2 years, 208 (95%) of 219 eligible patients with newly-diagnosed Graves' disease and 372 (80%) of all selected matched controls answered an identical mailed questionnaire about marital status, occupation, drinking and smoking habits, physical activity, familial occurrence of thyroid disease, life events, social support, and personality. Compared with controls, patients claimed to have had more negative life events in the 12 months preceding the diagnosis, and negative life-event scores were also significantly higher (odds ratio 6.3, 95% confidence interval 2.7-14.7, for the category with the highest negative score). Individuals who had relatives with thyroid disease (especially first-degree and second-degree relatives) were more likely to have Graves' disease (3.6, 2.2-5.9). Slightly more patients than controls were divorced (1.8, 1.0-3.3) and reported a less frequent intake of alcohol (0.4, 0.2-0.8). When results were adjusted for possible confounding factors in multivariate analyses, risk estimates were almost unchanged. These findings indicate that negative life events and hereditary factors may be risk factors for Graves' disease.

Adult↗
PubMed1982

Sexual abuse: a sociological perspective.

How have contemporary social changes affected the problem of child sexual abuse? The rapid rise of this problem to public attention in the United States is in part due to the mobilization around the problem by the women's movement and the child welfare movement there. But factors shown by research to be associated with the problem--social isolation and patriarchal authority--are so widespread as to suggest that this is a problem of international proportions, as well. The rising divorce rate in the U.S. and worldwide, would appear to put more children at risk at the same time that it has also made it easier for children and their mothers to escape from the most oppressive and intolerable family situations. The sexual revolution and the erosion of external controls on sexual behavior have also in all likelihood aggravated the problem, too. Sexual abuse needs to be seen as a problem distinct from physical child abuse--characterized by the preponderance of offenders who are males. This suggests searching for the sources of the problem in male sexual socialization rather than in problems of inadequate and disaffected parenting.

Adult↗
PubMed1996

Risk of physical abuse to children of spouse abusing parents.

The purpose of this study is to estimate the gender-specific probability of a violent spouse also physically abusing his or her child within a representative sample. The study is based on a sample of 3,363 American parents interviewed for the 1985 National Family Violence Survey. The study shows that marital violence is a statistically significant predictor of physical child abuse. The greater the amount of violence against a spouse, the greater the probability of physical child abuse by the physically aggressive spouse. This relationship is stronger for husbands than for wives. The probability of child abuse by a violent husband increases from 5% with one act of marital violence to near certainty with 50 or more acts of marital violence. The predicted probability of child abuse by a violent wife increases from 5% with one act of marital violence to 30% with 50 or more acts of marital violence. Implications for divorce custody proceedings are discussed.

Adolescent↗
PubMedDate not supplied

School-aged children of depressed parents: a blind and controlled study.

This study examines the prevalence of psychiatric dysfunction in the children of parents diagnosed with affective disorders. Sixty children from 37 proband families were compared to 43 children from 26 families obtained from matched controls as well as 20 children from 13 medically ill families. Group differences in diagnosable childhood disorders and familial characteristics are investigated. Significantly more disorders and symptoms were noted in the children with psychiatrically ill parents as compared to children from matched controls and medically ill parents. Using logistic and Cox survival analyses, correlates for the risk of affective disorder, attention deficit and conduct disorder in the children were examined. Maternal depression and paternal alcoholism were related to the risk for depression in the child. The child's sex and the presence of affective disorders in the father were significantly related to the risk for attention deficit disorder. Maternal alcoholism, parental divorce and the type of subject (proband or control family) were significantly related to the risk for conduct disorder. The findings are discussed relative to results from earlier studies on rates of disorder in the offspring of depressed parents.

Adult↗
PubMed1985

A hostility measure for use in family contexts.

A modification of the Gottschalk-Gleser standardized instructions for eliciting speech samples was developed and tested in ongoing family studies. This modification, the Wynne-Gift technique, allows the interviewer to focus on the speaker's relationships with various family members. The usefulness and validity of the approach was assessed in a study of differences in attitudes toward the husband of 10 separated or divorced women as compared to the attitudes of 11 married women. Significant differences were found in the expected direction between mean hostility outward scores as well as hostility toward the spouse or ex-spouse of these two groups of women. The range of applications of this modification of eliciting speech samples is discussed.

Adult↗
PubMed1988

Are demographic developments influenced by social security?

"On the basis of the existing literature we examined the points at which social security and family demography meet. The main conclusions are: (1) child allowances will only affect fertility if the level of benefit is rather substantial; (2) unemployment provisions may affect fertility; (3) remarriage frequency is probably affected by public assistance benefits; (4) the same possibly holds for the divorce frequency. These conclusions are tentative: the results are contradictory from many viewpoints, some fields have hardly been investigated and it is unclear whether the effects are temporary or lasting." The geographical focus is on developed countries.

Aid to Families with Dependent Children↗
PubMed1988

The single parent family and the child's mental health.

The prevalence of psychiatric and psychosomatic disorders in a 1 year birth cohort from northern Finland followed up until 19 years was examined on the basis of hospital records and national registers for subsidies for chronically sick children. Psychiatric disorders were found to occur with higher frequency in children of single parent families, especially those lacking a father during the child's whole life. Childhood enuresis was most frequent in the children who had experienced the divorce of their parents. Discriminant function analysis was used to establish the explanatory value of the family constellation for both psychiatric disorders and enuresis. The other significant explanatory variables for psychiatric disorders were school performance, place of residence and the child's height at 1 year of age, with poor school performance, high population density and short stature increasing the risk. The other significant variables increasing the risk of enuresis were psychiatric disorders, poor school performance, juvenile smoking and small size of dwelling. Disabled children had psychiatric disorders 9 times as frequently as non-disabled ones.

Cerebral Palsy↗
PubMed1991

Parental responses to consanguinity and genetic disease in Saudi Arabia.

In-depth interviews of 36 Saudi families whose children suffered from neuro-metabolic disorders were conducted at a specialist hospital in Riyadh in order to examine parental understanding of disease and attitudes towards future births and consanguineous marriages. Parents had difficulty accepting a genetic explanation for diseases that did not affect all children at the time of birth; they also expressed religious or folk beliefs to account for illness. Coping behaviours included denial and resignation to the situation, divorce and remarriage. Some families adopted a cautious approach to cousin marriages and future births; this was significantly related to their education level, but not to previous infant deaths. Awareness of medical facts brought little emotional comfort to parents but allowed for preventive measures through screening adult carriers and identifying affected infants. This study presents new material from Saudi Arabia to strengthen current awareness that the range of religious beliefs, social attitudes and reproductive behaviours adopted by families in a society undergoing rapid change is of direct relevance to health care.

Adaptation, Psychological↗
PubMed1991

Who stopped smoking? Results from a panel survey of living conditions in Sweden.

1905 smokers were investigated from a random sample of 4424 persons among the Swedish population interviewed in 1974 and 1981. On average, 28% of those smoked in 1974 had stopped smoking by 1981. A multivariate method was used to study whether socioeconomic and demographic factors, tobacco consumption level or health contributed to changes in smoking behaviour. Most successful in smoking cessation were senior salaried employees (35% quit), well educated persons (33% quit) and those who smoked less than ten cigarettes per day (36% quit). On the other hand, only 20% of divorced parents with children succeeded in smoking cessation. Tobacco consumption turned out to be the most important variable for explaining the variance. The probability of smoking cessation increased by 40% if one smoked less than 10 cigarettes per day. The low explained variance, 6%, of this multivariate approach indicates, however, that socioeconomic factors have only marginal effects on the decision to stop smoking. It seems more likely that many factors, e.g. demographic, socioeconomic, motivational, self-efficacy, social and therapeutic support, nicotine dependence etc. act together in a complex way.

Adolescent↗
PubMed1992

Sociological and economic theories of suicide: a comparison of the U.S.A. and Taiwan.

Time-series analyses were carried out to explore the importance of sociological and economic variables in accounting for the suicide rate in the U.S.A. and in Taiwan for 1952-1984. Sociological variables (divorce and female labor force participation) played similar roles in the multiple regressions for both nations while economic variables (GNP per capita/growth and unemployment) played a role only in the U.S.A.

Cross-Cultural Comparison↗
PubMed1994

Teenage alcohol drinking and non-standard family background.

The teenage alcohol drinking in 1980 is described in a cohort of 12,058 subjects born in Northern Finland in 1966, with special reference to non-standard families (with one or both parents absent). The percentage of boys (girls) who had been drinking alcohol at the age of 14 years, was 59.1 (58.3)%, being 57.5 (55.6%) in standard, full families and 66.0 (69.0)% in non-standard families. The percentage of having been drunk was 25.2 (25.1)%, or 22.8 (22.1)% in full families and 36.1 (37.1)% in the non-standard families. When adjusted for the maternal age at birth, place of residence, social class and child's status in the family (firstborn or not, only child or not) by means of regression modelling, the risk of alcohol drinking/having been drunk was still increased in non-standard families, especially in cases of divorce or same-sex parental death, the risk differences as compared to the standard family usually being between 10-20%. The results suggest that a non-standard family structure is associated with early juvenile alcohol drinking. Parental loss or absence may constitute one important factor leading to excessive haste in adopting the adolescent culture, including its potentially destructive habits.

Adolescent↗
PubMed1991

Oral and maxillofacial surgery: outcomes and attitudes.

A survey of 56 former oral and maxillofacial surgery residents at one institution indicated that they believe their specialty was satisfying and rewarding and their training prepared them well for practice, but that they were lacking in business skills and knowledge. Those who elected not to take the American Board examination did so because they saw no advantages. The stress and demands of residency and practice were not major factors for those who had experienced divorce.

Attitude of Health Personnel↗
PubMed1986

Unmarried at delivery. I. The mothers and their care.

Information on 934 never married mothers (Single) were compared with 301 who were widowed, divorced or separated (Once-married) and 15 225 who were married at the time of delivery and were part of the 1970 British Births Survey. Once the maternal age and parity differences had been taken into account the major findings concerned the mothers' health behaviour and the obstetric care they received. Single and Once-married mothers were markedly less likely than the Married group to have used contraceptives in the 18 months before conception, to know accurately the date of the last menstrual period, to commence antenatal care before the third trimester, and to attend antenatal or parentcraft classes. Both groups were more likely to smoke, the Once-married group having an especially high rate of heavy smokers. Single mothers were more likely to be anaemic during pregnancy and the Once-married to have a history of bleeding. Both groups were more likely to be delivered in a consultant unit. Relatively high proportions of Single and Once-married mothers had delivered without any pain relief.

Analgesia↗
PubMed1986

Unmarried at delivery. II. Perinatal morbidity and mortality.

The British Birth Survey included 98% of all deliveries in Great Britain in one week of April 1970. For this report, singleton births to 934 Single (never-married), 301 Once-married (widowed, separated or divorced) and 15 225 Married mothers were compared. After allowing for maternal age, parity and smoking history, there was still a reduction in birth weight in the two unmarried groups, which was mainly associated with pre-term gestation rather than growth retardation. Perinatal mortality was considerably elevated, especially for the Once-married. The excess mortality was mainly among the 'Macerated normally formed stillbirths' and 'Asphyxia' categories of the Wigglesworth classification.

Asphyxia Neonatorum↗
PubMed2004

Childhood abuse and neglect and adult intimate relationships: a prospective study.

OBJECTIVE: The present study extends prior research on childhood maltreatment and social functioning by examining the impact of early childhood physical abuse, sexual abuse, and neglect on rates of involvement in adult intimate relationships and relationship functioning. METHOD: Substantiated cases of child abuse and neglect from 1967 to 1971 were matched on gender, age, race, and approximate family class with non-abused and non-neglected children and followed prospectively into adulthood. Between 1989 and 1995, 1,196 participants (676 abused and neglected and 520 controls) were administered a 2-hour in-person interview, including a psychiatric assessment and a variety of standardized rating scales. RESULTS: Male and female abuse and neglect victims reported higher rates of cohabitation, walking out, and divorce than controls. Abused and neglected females were also less likely than female controls to have positive perceptions of current romantic partners and to be sexually faithful. CONCLUSIONS: Although previous research on childhood maltreatment and adult intimate relationships has emphasized outcomes for female victims of childhood sexual abuse, present findings suggest that other forms of early maltreatment (physical abuse and neglect) also have a negative effect on both males' and females' ability to establish and maintain healthy intimate relationships in adulthood.

Adult↗
PubMed2004

Early caregiving and physiological stress responses.

Inadequate early caregiving has been associated with risks of stress-related psychological and physical illness over the life span. Dysregulated physiological stress responses may represent a mechanism linking early caregiving to health outcomes. This paper reviews evidence linking early caregiving to physiological responses that can increase vulnerability to stress-related illness. A number of high-risk family characteristics, including high conflict, divorce, abuse, and parental psychopathology, are considered in the development of stress vulnerability. Three theoretical pathways linking caregiving to physiological stress responses are outlined: genetic, psychosocial, and cognitive-affective. Exciting preliminary evidence suggests that early caregiving can impact long-term physiological stress responses. Directions for future research in this area are suggested.

Adolescent↗