Sample records for abuse disclosure considerations

  1. Child Abuse: Betrayal and Disclosure

    ERIC Educational Resources Information Center

    Foynes, Melissa Ming; Freyd, Jennifer J.; DePrince, Anne P.

    2009-01-01

    Objective: The current study tested several hypotheses about disclosure of childhood sexual, physical, and emotional abuse derived from Betrayal Trauma Theory [Freyd, J. J. (1996). Betrayal trauma: The logic of forgetting childhood abuse. Cambridge, MA: Harvard University Press]. We predicted that the duration of time from abuse to its disclosure…

  2. Childhood disclosure of sexual abuse: Necessary but not necessarily sufficient.

    PubMed

    Swingle, Janine M; Tursich, Mischa; Cleveland, Jonathan M; Gold, Steven N; Tolliver, Sue Fields; Michaels, Landon; Kupperman-Caron, Laura N; Garcia-Larrieu, Maria; Sciarrino, Nicole A

    2016-12-01

    Prevention programs often encourage sexually abused children to disclose without fully considering the potential for adverse consequences. This study examined the impact of disclosure on abuse cessation and later adult symptomatology. A clinical sample of 301 adult survivors completed the Impact of Event Scale (IES/IES-R), and the Beck Depression Inventory (BDI-II). Participants were divided into 3 groups: Nondisclosure (n=221), Disclosure/Abuse Ended (n=25), and Disclosure/Abuse Continued (n=55). Multivariate analyses of covariance, adjusting for abuse characteristics (age of onset, penetration, and number of perpetrators) and other trauma exposure, revealed significant differences in psychiatric symptom severity among the three groups, Wilks' λ=0. 95, F (6, 584)=2.69, p=0.014, η p 2 =0.03. Specifically, those in the Disclosure/Abuse Continued group scored significantly higher on the IES/IES-R Intrusion subscale (p=0.04) and the BDI-II (p=0.01), as compared to the Nondisclosure group. The Disclosure/Abuse Ended group did not differ significantly from the other groups. Results suggest that disclosure may be detrimental unless adequate steps are taken to ensure abuse cessation and appropriate treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Interviewing Children Versus Tossing Coins: Accurately Assessing the Diagnosticity of Children’s Disclosures of Abuse

    PubMed Central

    LYON, THOMAS D.; AHERN, ELIZABETH C.; SCURICH, NICHOLAS

    2014-01-01

    We describe a Bayesian approach to evaluating children’s abuse disclosures and review research demonstrating that children’s disclosure of genital touch can be highly probative of sexual abuse, with the probative value depending on disclosure spontaneity and children’s age. We discuss how some commentators understate the probative value of children’s disclosures by: confusing the probability of abuse given disclosure with the probability of disclosure given abuse, assuming that children formally questioned about sexual abuse have a low prior probability of sexual abuse, misstating the probative value of abuse disclosure, and confusing the distinction between disclosure and nondisclosure with the distinction between true and false disclosures. We review interviewing methods that increase the probative value of disclosures, including interview instructions, narrative practice, noncontingent reinforcement, and questions about perpetrator/caregiver statements and children’s reactions to the alleged abuse. PMID:22339423

  4. Disclosure of Child Sexual Abuse: The Case of Pacific Islanders.

    PubMed

    Xiao, Hong; Smith-Prince, Jaynina

    2015-01-01

    A number of factors influence the disclosure of child sexual abuse by survivors. While the influence of race and ethnicity on disclosure patterns is getting more attention, little has been written on abused children of Pacific Islanders, due in part to both lack of relevant data and a relatively small Pacific Islander population in the United States. Drawing on interviews with Pacific Islander women who were sexually abused in childhood and who delayed revealing their victimization, we explore the reasons for delayed disclosure. Findings suggest that cultural norms and family dynamics affect disclosure decisions. Concerns for the family and self-blame were the most common reasons for delay and lack of disclosure. We discuss implications of the findings and make policy recommendations.

  5. Children's disclosures of sexual abuse: learning from direct inquiry.

    PubMed

    Schaeffer, Paula; Leventhal, John M; Asnes, Andrea Gottsegen

    2011-05-01

    Published protocols for forensic interviewing for child sexual abuse do not include specific questions about what prompted children to tell about sexual abuse or what made them wait to tell. We, therefore, aimed to: (1) add direct inquiry about the process of a child's disclosure to a forensic interview protocol; (2) determine if children will, in fact, discuss the process that led them to tell about sexual abuse; and (3) describe the factors that children identify as either having led them to tell about sexual abuse or caused them to delay a disclosure. Forensic interviewers were asked to incorporate questions about telling into an existing forensic interview protocol. Over a 1-year period, 191 consecutive forensic interviews of child sexual abuse victims aged 3-18 years old in which children spoke about the reasons they told about abuse or waited to tell about abuse were reviewed. Interview content related to the children's reasons for telling or for waiting to tell about abuse was extracted and analyzed using a qualitative methodology in order to capture themes directly from the children's words. Forensic interviewers asked children about how they came to tell about sexual abuse and if children waited to tell about abuse, and the children gave specific answers to these questions. The reasons children identified for why they chose to tell were classified into three domains: (1) disclosure as a result of internal stimuli (e.g., the child had nightmares), (2) disclosure facilitated by outside influences (e.g., the child was questioned), and (3) disclosure due to direct evidence of abuse (e.g., the child's abuse was witnessed). The barriers to disclosure identified by the children were categorized into five groups: (1) threats made by the perpetrator (e.g., the child was told (s)he would get in trouble if (s)he told), (2) fears (e.g., the child was afraid something bad would happen if (s)he told), (3) lack of opportunity (e.g., the child felt the opportunity to

  6. Cultural Issues in Disclosures of Child Sexual Abuse

    ERIC Educational Resources Information Center

    Fontes, Lisa Aronson; Plummer, Carol

    2010-01-01

    Cultural norms affect the likelihood that child sexual abuse will be discovered by an adult or disclosed by a child. Cultural norms also affect whether abused children's families will report child sexual abuse to authorities. This article explores the ways ethnic and religious culture affect child sexual abuse disclosure and reporting, both in the…

  7. Intelligence Is Associated With Voluntary Disclosure in Child Sexual Abuse Victims.

    PubMed

    Bae, Seung Min; Kang, Jae Myeong; Hwang, In Cheol; Cho, Hyeongrae; Cho, Seong-Jin

    2017-09-01

    The purpose of this study was (1) to determine whether intelligence level is associated with the pattern of the disclosure and (2) to elucidate which, between the verbal and performance intelligence, better reflect the pattern of disclosure in child and adolescent sexual abuse victims. Data were collected on 162 participants who visited a public center for sexually abused children and adolescents between January 2013 and December 2014. Demographic information, case characteristics, and disclosure pattern as well as intelligence quotients (IQs) of subjects were gathered. Intelligence was analyzed as level, full scale IQ, and the verbal and performance IQ. Eighty-one subjects (50.0%) voluntarily disclosed that they have been sexually abused. In regression analysis, intellectual level, age, and the number of perpetrators were associated with disclosure pattern. Full scale IQ was associated with the disclosure pattern (odds ratio = .983, 95% confidence interval = .968-.997, p = .017). When intelligence was divided into verbal and performance IQ, verbal IQ affected the pattern of disclosure (odds ratio = .973, 95% confidence interval = .956-.991, p = .003) with linear correlation (p = .001). We found that IQ was associated with the disclosure pattern. The intelligence, especially in verbal domain, is linearly correlated with the probability of voluntary disclosure. We suggest that special legal assistance and social concern are required for children and adolescent victims below normal intelligence to make them disclose the sexual abuse. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  8. Adult Disclosure of Sexual Abuse: A Primary Cause of Psychological Distress?

    ERIC Educational Resources Information Center

    McNulty, Craig; Wardle, Jane

    1994-01-01

    This paper surveys research evidence relating to the disclosure of childhood sexual abuse by adults and argues that, for some adults, the disclosure of sexual abuse may be a primary cause of psychological distress, resulting in the dissolution of social support systems and increasing the individual's vulnerability to psychiatric disorder.…

  9. Disclosure of child sexual abuse. For better or for worse.

    PubMed

    Sauzier, M

    1989-06-01

    The data presented here offer a longitudinal perspective on sexually abused children. Disclosure data are postulated to be important variables in the short-term and long-term victim-to-patient process. Fifty-five per cent of the 156 children seen purposefully disclosed their sexual abuse, most frequently to their mothers. Children who never told, but were seen after accidental disclosures, showed less distress, whether hiding minor or major forms of sexual abuse. This finding support the clinical impression that disclosure adds extra stress on children and cannot be expected of every victim. A history of past mental health intervention did not seem to enhance the child's ability to tell. Education of all professionals is critical. Approximately 18 months after the end of the crisis intervention offered at intake, 115 of the 156 cases were re-evaluated. Overall, most children showed improvements on standardized tests, but 24 per cent got worse. Specific symptoms were found to cluster in four groups: acute anxiety, characterologic, family dynamics, and specific symptoms related to sexual abuse (sexual maladjustment, prostitution, revictimization, sexually assaultive behavior). Although the data seem to support the notion that crisis intervention by trained clinicians is helpful, it is too early to tell if the ominous findings described in adult survivors can really be decreased. The impact of disclosing child sexual abuse on entire families should not be underestimated, even in cases of extrafamilial abuse. The poor ratings parents gave law enforcement, judicial, and Child Protective Service professionals may be linked to the reluctance of victims to disclose their abuse and underscores the need to review current procedures and practices. Overall, a great majority of parents did see the sexual abuse as harmful to the child and to the family, but they were evenly divided about whether the disclosure was harmful or helpful to the child and family. A final word of

  10. Interviewing Children versus Tossing Coins: Accurately Assessing the Diagnosticity of Children's Disclosures of Abuse

    ERIC Educational Resources Information Center

    Lyon, Thomas D.; Ahern, Elizabeth C.; Scurich, Nicholas

    2012-01-01

    We describe a Bayesian approach to evaluating children's abuse disclosures and review research demonstrating that children's disclosure of genital touch can be highly probative of sexual abuse, with the probative value depending on disclosure spontaneity and children's age. We discuss how some commentators understate the probative value of…

  11. "I Keep That Hush-Hush": Male Survivors of Sexual Abuse and the Challenges of Disclosure

    ERIC Educational Resources Information Center

    Sorsoli, Lynn; Kia-Keating, Maryam; Grossman, Frances K.

    2008-01-01

    Disclosure is a prominent variable in child sexual abuse research, but little research has examined male disclosure experiences. Sixteen male survivors of childhood sexual abuse were interviewed regarding experiences of disclosure. Analytic techniques included a grounded theory approach to coding and the use of conceptually clustered matrices.…

  12. Gender Differences in Social Reactions to Abuse Disclosures, Post-Abuse Coping, and PTSD of Child Sexual Abuse Survivors

    ERIC Educational Resources Information Center

    Ullman, S.E.; Filipas, H.H.

    2005-01-01

    Objective: This research examines the understudied issue of gender differences in disclosure, social reactions, post-abuse coping, and PTSD of adult survivors of child sexual abuse (CSA). Method: Data were collected on a cross-sectional convenience sample of 733 college students completing a confidential survey about their demographic…

  13. Child Peer Sexual Abuse: Preliminary Data on Outcomes and Disclosure Experiences

    ERIC Educational Resources Information Center

    Sperry, Debbie M.; Gilbert, Brenda O.

    2005-01-01

    Objective: This study compared experiences of children sexually abused by peers to those of children abused by adolescents/adults. Variables examined included perceived negativity of the abuse, self-reported outcomes, overall psychological functioning, and disclosure. Method: An archival data set containing retrospective reports of childhood…

  14. Children's Disclosures of Sexual Abuse: Learning from Direct Inquiry

    ERIC Educational Resources Information Center

    Schaeffer, Paula; Leventhal, John M.; Asnes, Andrea Gottsegen

    2011-01-01

    Objectives: Published protocols for forensic interviewing for child sexual abuse do not include specific questions about what prompted children to tell about sexual abuse or what made them wait to tell. We, therefore, aimed to: (1) add direct inquiry about the process of a child's disclosure to a forensic interview protocol; (2) determine if…

  15. Adult Female Victims of Child Sexual Abuse: Multitype Maltreatment and Disclosure Characteristics Related to Subjective Health

    ERIC Educational Resources Information Center

    Jonzon, Eva; Lindblad, Frank

    2005-01-01

    This study examined the impact of child sexual abuse and disclosure characteristics on adult psychological and psychosomatic symptoms. Data on abuse characteristics, disclosure-related events, and subjective health were collected through semistructured interviews and questionnaires from 123 adult women reporting having been sexually abused in…

  16. Prevalence of childhood sexual abuse and timing of disclosure in a representative sample of adults from Quebec.

    PubMed

    Hébert, Martine; Tourigny, Marc; Cyr, Mireille; McDuff, Pierre; Joly, Jacques

    2009-09-01

    Our study sought to explore patterns of disclosure of child sexual abuse (CSA) in a sample of adult men and women. A telephone survey conducted with a representative sample of adults (n = 804) from Quebec assessed the prevalence of CSA and disclosure patterns. Analyses were carried out to determine whether disclosure groups differed in terms of psychological distress and symptoms of posttraumatic stress, and a logistic regression was used to examine factors associated with prompt disclosure. Prevalence of CSA was 22.1% for women and 9.7% for men. About 1 survivor out of 5 had never disclosed the abuse, with men more likely not to have told anyone, than women. Only 21.2% of adults reported prompt disclosure (within a month of the first abusive event), while 57.5% delayed disclosure (more than 5 years after the first episode). CSA victims who never disclosed the abuse and those who delayed disclosure were more likely to obtain scores of psychological distress and posttraumatic stress achieving clinical levels, compared with adults without a history of CSA. In the multivariate analysis, experiencing CSA involving a perpetrator outside the immediate family and being female were factors independently associated with prompt disclosure. A significant number of adult women and men reported experiencing CSA, and most victims attested to either not disclosing or significantly delaying abuse disclosure.

  17. Disclosure of Sexual Abuse in Sport Organizations: A Case Study

    ERIC Educational Resources Information Center

    Parent, Sylvie

    2011-01-01

    The disclosure of sexual abuse in the world of sports is a process that has not been widely documented. This article presents the results of a document analysis of sport organization policies and interviews conducted with 27 sport stakeholders. The interviews focus on these stakeholders' perceptions of how the disclosure process would unfold if a…

  18. Child sexual abuse is largely hidden from the adult society. An epidemiological study of adolescents' disclosures.

    PubMed

    Priebe, Gisela; Svedin, Carl Göran

    2008-12-01

    The aim of this study was to investigate disclosure rates and disclosure patterns and to examine predictors of non-disclosure in a sample of male and female adolescents with self-reported experiences of sexual abuse. A sample of 4,339 high school seniors (2,324 girls, 2,015 boys) was examined with a questionnaire concerning sexual experiences in this study with a focus on disclosure of sexual abuse (non-contact, contact or penetrating abuse, and including peer abuse). Of the sample, 1,505 girls (65%) and 457 boys (23%) reported experience of sexual abuse. The disclosure rate was 81% (girls) and 69% (boys). Girls and boys disclosed most often to a friend of their own age. Few had disclosed to professionals. Even fewer said that the incident had been reported to the authorities. Logistic regression showed that it was less likely for girls to disclose if they had experienced contact sexual abuse with or without penetration, abuse by a family member, only a single abuse occasion or if they had perceived their parents as non-caring. Boys were less likely to disclose if they studied a vocational program, lived with both parents or had perceived their parents as either caring and overprotective or non-caring and not overprotective. Disclosing sexual abuse is a complex process. Much is hidden from the adult society, especially from professionals and the legal system. Since peers are the most common receivers of abuse information, programs for supporting peers ought to be developed. Differences in disclosure patterns for girls and boys indicate that a gender perspective is helpful when developing guidelines for professionals. Professionals, especially in the school system, need to be more aware of the finding that few sexually abused children seek help from professionals or other adults and that support offers should be directly addressed not only to the vulnerable young persons themselves but also to peers who wish to help a friend.

  19. Health Professionals' Responses to Disclosure of Child Sexual Abuse History: Female Child Sexual Abuse Survivors' Experiences

    ERIC Educational Resources Information Center

    McGregor, Kim; Julich, Shirley; Glover, Marewa; Gautam, Jeny

    2010-01-01

    This study reports on a postal questionnaire, conducted in 2004, with female survivors of historic child sexual abuse. The questionnaire explored their experiences of health professionals' responsiveness to disclosure of child sexual abuse history. Of 61 participants, aged between 22 and 65, 69% had disclosed to health professionals. Those who had…

  20. Disclosure of Sexual Orientation and Subsequent Substance Use and Abuse Among Lesbian, Gay, and Bisexual Youths: Critical Role of Disclosure Reactions

    PubMed Central

    Rosario, Margaret; Schrimshaw, Eric W.; Hunter, Joyce

    2010-01-01

    Research on whether disclosure of sexual orientation promotes lower substance use among lesbian, gay, and bisexual (LGB) individuals has been inconsistent. One reason for this may be that disclosure results in accepting and rejecting reactions. The current report longitudinally examines whether the types of reactions to disclosure are associated with substance use and abuse among an ethnically diverse, urban sample of 156 LGB youths (ages 14 – 21 years). Neither the number of disclosures nor the numbers of accepting or neutral disclosure reactions experienced were associated with substance use or abuse. However, the number of rejecting reactions to disclosure was associated with current and subsequent alcohol, cigarette, and marijuana use even after controlling for demographic factors, social desirability, and emotional distress. Further, high numbers of accepting reactions were found to moderate or protect youths from the negative role of rejecting reactions on alcohol use, but not other substances. This research indicates that, rather than disclosure per se, it is the number of accepting and rejecting reactions in response to disclosure that are critical to understanding substance use among LGB youths. Further, the results suggest that to be maximally effective in helping LGB youths, substance use prevention and treatment efforts should address the rejecting reactions to disclosure of sexual orientation. PMID:19290704

  1. Many Ways of Telling: Expanding Conceptualizations of Child Sexual Abuse Disclosure

    ERIC Educational Resources Information Center

    Alaggia, R.

    2004-01-01

    Objective:: The aim of this study was to explore influences that inhibit or promote child sexual abuse (CSA) disclosure. Method:: Face-to-face in-depth interviews of 24 female and male survivors of CSA were conducted, using the Long-Interview method to trace disclosure processes. Verbatim transcriptions of the interviews were analyzed by hand and…

  2. Predictors of victim disclosure in child sexual abuse: Additional evidence from a sample of incarcerated adult sex offenders.

    PubMed

    Leclerc, Benoit; Wortley, Richard

    2015-05-01

    The under-reporting of child sexual abuse by victims is a serious problem that may prolong the suffering of victims and leave perpetrators free to continue offending. Yet empirical evidence indicates that victim disclosure rates are low. In this study, we perform regression analysis with a sample of 369 adult child sexual offenders to examine potential predictors of victim disclosure. Specifically, we extend the range of previously examined potential predictors of victim disclosure and investigate interaction effects in order to better capture under which circumstances victim disclosure is more likely. The current study differs from previous studies in that it examines the impact of victim and offense variables on victim disclosure from the perspective of the offender. In line with previous studies, we found that disclosure increased with the age of the victim and if penetration had occurred. In addition, we found that disclosure increased when the victim came from a non-dysfunctional family and resisted the abuse. The presence of an interaction effect highlighted the impact of the situation on victim disclosure. This effect indicated that as victims get older, they are more likely to disclose the abuse when they are not living with the offender at the time of abuse, but less likely to do so when they are living with the offender at the time of abuse. These findings are discussed in relation to previous studies and the need to facilitate victim disclosure. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Disclosure of Child Sexual Abuse by Adolescents: A Qualitative In-Depth Study

    ERIC Educational Resources Information Center

    Schonbucher, Verena; Maier, Thomas; Mohler-Kuo, Meichun; Schnyder, Ulrich; Landolt, Markus A.

    2012-01-01

    This qualitative study aimed to study the process of disclosure by examining adolescents from the general population who had experienced child sexual abuse (CSA). Twenty-six sexually victimized adolescents (23 girls, 3 boys; age: 15-18 years) participated in a qualitative face-to-face in-depth interview on different aspects of disclosure. A…

  4. Experiences of mothers of sexually abused children in North-West province, post disclosure.

    PubMed

    Masilo, Gaboipolelwe M; Davhana-Maselesele, Mashudu

    2016-08-16

    Sexual violence against children is increasing at an alarming rate in South Africa. In 2010 the South African Police Service (SAPS) reported 21 538 rape cases of children under 18 years. In the North-West province (NWP) 5039 incidents of rape cases were reported in 2009. Mothers often experience emotional pain following child sexual abuse disclosure. It is seldom acknowledged that these mothers experience trauma and need support, post disclosure. The researcher has no known evidence of research conducted on the experiences of these mothers in NWP. The objective of the study was to explore and describe the experiences of mothers of sexually abused children post disclosure of the abuse. The research design was qualitative, exploratory, descriptive and contextual. Purposive sampling was used to select mothers of sexually abused children aged 23 to 59 years whose children ranged from 0 to 16 years. Permission to conduct the study was sought from the Provincial Department of Health and informed consent was obtained from the mothers. Interviews were conducted with a sample of n = 17 until data saturation. Data were collected through in-depth interviews using a voice recorder and field notes to enhance triangulation. Tesch's method of open coding was used to analyse data. Findings indicated that mothers experienced emotional pain post sexual abuse. They expressed shock, anger and guilt for not noticing the abuse. They showed significant depression as a result of lack of support by stakeholders. Mothers experienced secondary trauma that poses social and psychological challenges with far-reaching implications.

  5. Disclosure of physical, emotional and sexual child abuse, help-seeking and access to abuse response services in two South African Provinces.

    PubMed

    Meinck, Franziska; Cluver, Lucie; Loening-Voysey, Heidi; Bray, Rachel; Doubt, Jenny; Casale, Marisa; Sherr, Lorraine

    2017-03-01

    Physical, emotional and sexual child abuse are major problems in South Africa. This study investigates whether children know about post-abuse services, if they disclose and seek services, and what the outcomes of help-seeking behaviour are. It examines factors associated with request and receipt of services. Confidential self-report questionnaires were completed by adolescents aged 10-17 (n = 3515) in South Africa. Prevalence of frequent (>weekly) physical abuse was 7.4%, frequent emotional abuse 12.4%, and lifetime contact sexual abuse 9.0%. 98.6% could name one suitable confidante or formal service for abuse disclosure, but only 20.0% of abuse victims disclosed. Of those, 72% received help. Most common confidantes were caregivers and teachers. Of all abuse victims, 85.6% did not receive help due to non-disclosure or inactivity of services, and 14.4% received help: 4.9% from formal health or social services and 7.1% through community vigilante action. Emotional abuse, sexual abuse and female gender were associated with higher odds of help-seeking. While children in South Africa showed high knowledge of available services, access to and receipt of formal services among abused children was low. Notably fewer children received help from formal services than through community vigilante action. Urgent action is needed to improve service access for child abuse victims.

  6. Cognitions and distress in caregivers after their child's sexual abuse disclosure.

    PubMed

    Runyon, Melissa K; Spandorfer, Ellen D; Schroeder, Christine M

    2014-01-01

    The impact of child sexual abuse on children is well documented, but few studies have examined the impact of a child's sexual abuse disclosure on maternal caregivers. The studies that have been conducted suggest that parental response postdisclosure is variable. The present study examined the association between maternal attributions and abuse-specific cognitions with depression and trauma symptoms postdisclosure. Participants included 68 nonoffending maternal caregivers of children between the ages of 3 and 17 years who experienced child sexual abuse. Findings indicated that caregivers' abuse-specific cognitions were the best predictor of self-reported symptoms of depression after controlling for general negative attributions. These findings suggest that in order to reduce caregivers' distress and to enhance their support of their children, it is important to assess and treat caregivers' abuse-specific cognitions.

  7. Delay in disclosure of non-parental child sexual abuse in the context of emotional and physical maltreatment: A pilot study.

    PubMed

    Tashjian, Sarah M; Goldfarb, Deborah; Goodman, Gail S; Quas, Jodi A; Edelstein, Robin

    2016-08-01

    The present pilot study sought to identify predictors of delays in child sexual abuse (CSA) disclosure, specifically whether emotional and physical abuse by a parental figure contributes to predicting delays over and above other important victim factors. Alleged CSA victims (N=79), whose parental figures were not the purported sexual abuse perpetrators, were interviewed and their case files reviewed, across two waves of a longitudinal study. Regression analyses indicated that experiencing both emotional and physical abuse by a parental figure was uniquely predictive of longer delays in disclosure of CSA perpetrated by someone other than a parental figure. Victim-CSA perpetrator relationship type and sexual abuse duration also significantly predicted CSA disclosure delay, whereas victim age at the time of the police report, victim gender, and victims' feelings of complicity were not significant unique predictors. Child abuse victims' expectations of lack of parental support may underlie these findings. Parent-child relationships are likely crucial to timely disclosure of CSA, even when a parent is not the CSA perpetrator. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Health professionals' beliefs about domestic abuse and the issue of disclosure: a critical incident technique study.

    PubMed

    Taylor, Julie; Bradbury-Jones, Caroline; Kroll, Thilo; Duncan, Fiona

    2013-09-01

    Domestic abuse is increasingly recognised as a serious, worldwide public health concern. There is a significant body of literature regarding domestic abuse, but little is known about health professionals' beliefs about domestic abuse disclosure. In addition, the intersection between health professionals' beliefs and abused women's views remains uninvestigated. We report on a two-phase, qualitative study using Critical Incident Technique (CIT) that aimed to explore community health professionals' beliefs about domestic abuse and the issue of disclosure. We investigated this from the perspectives of both health professionals and abused women. The study took place in Scotland during 2011. The study was informed theoretically by the Common Sense Model of Self-Regulation of Health and Illness (CSM). This model is typically used in disease-orientated research. In our innovative use, however, CSM was used to study the social phenomenon, domestic abuse. The study involved semi-structured, individual CIT interviews with health professionals and focus groups with women who had experienced domestic abuse. Twenty-nine health professionals (Midwives, Health Visitors and General Practitioners) participated in the first phase of the study. In the second phase, three focus groups were conducted with a total of 14 women. Data were analysed using a combination of an inductive classification and framework analysis. Findings highlight the points of convergence and divergence between abused women's and health professionals' beliefs about abuse. Although there was some agreement, they do not always share the same views. For example, women want to be asked about abuse, but many health professionals do not feel confident or comfortable discussing the issue. Overall, the study shows the dynamic interaction between women's and health professionals' beliefs about domestic abuse and readiness to discuss and respond to it. Understanding these complex dynamics assists in the employment of

  9. Child Sexual Abuse Is Largely Hidden from the Adult Society: An Epidemiological Study of Adolescents' Disclosures

    ERIC Educational Resources Information Center

    Priebe, Gisela; Svedin, Carl Goran

    2008-01-01

    Objectives: The aim of this study was to investigate disclosure rates and disclosure patterns and to examine predictors of non-disclosure in a sample of male and female adolescents with self-reported experiences of sexual abuse. Method: A sample of 4,339 high school seniors (2,324 girls, 2,015 boys) was examined with a questionnaire concerning…

  10. Secondary Traumatization in Parents Following the Disclosure of Extrafamilial Child Sexual Abuse: Initial Effects.

    ERIC Educational Resources Information Center

    Manion, Ian G.; And Others

    1996-01-01

    This study examined the adjustment of 93 parents within 3 months of the disclosure of extrafamilial sexual abuse of their children in comparison with a nonclinical group of 136 parents. Parents, especially mothers, of sexually abused children experienced greater overall emotional distress, poorer family functioning, and lower satisfaction in their…

  11. Psychological and Physical Health of Nonoffending Parents After Disclosure of Sexual Abuse of Their Child.

    PubMed

    Cyr, Mireille; Frappier, Jean-Yves; Hébert, Martine; Tourigny, Marc; McDuff, Pierre; Turcotte, Marie-Ève

    2016-10-01

    Disclosure of child sexual abuse can be traumatic for nonoffending parents. Research has shown its impact on mothers' mental health, which includes heightened psychological distress, depression, and post-traumatic stress disorder. Very little is known, however, about its impact on their physical health or on fathers' health. The self-perceived mental and physical health of nonoffending parents after child sexual abuse disclosure was compared to determine gender-related differences in this regard. Interviews were conducted with 109 mothers and 43 fathers of 6- to 13-year-old sexually abused children. Bivariate analyses revealed that a fair proportion of parents reported psychological and physical problems after disclosure. However, proportionally more mothers than fathers reported psychological distress, depression, and use of professional services. Fathers were more likely to resort to health services instead of social services and to use medication for depression. Study findings provide leads for health and social service providers for the development of intervention protocols and referral procedures sensitive to gender issues, and they shed new light on specific needs of nonoffending parents.

  12. Psychometrics of a Child Report Measure of Maternal Support Following Disclosure of Sexual Abuse

    PubMed Central

    Smith, Daniel W.; Sawyer, Genelle K.; Heck, Nicholas C.; Zajac, Kristyn; Solomon, David; Self-Brown, Shannon; Danielson, Carla K.; Ralston, M. Elizabeth

    2018-01-01

    Objective The purpose of this study was to develop a psychometrically sound child-report measure of maternal support following disclosure of child sexual abuse. Maternal support following disclosure of child sexual abuse is an important predictor of child adjustment; however, this construct is not well defined, and a psychometrically sound method to assess maternal support from a child’s perspective does not exist. Methods Demographic and abuse-specific information was collected via structured interview from 146 mother-child dyads presenting for an initial forensic evaluation at a child advocacy center. Mothers completed the Maternal Self-report Support Questionnaire, and children completed the Trauma Symptom Checklist for Children and 32 items considered for inclusion in a new measure known as the Maternal Support Questionnaire – Child Report (MSQ-CR). Results Exploratory factor analysis of the MSQ-CR resulted in a three factor solution: Emotional Support (9 items), Skeptical Preoccupation (5 items), and Protection/Retaliation (6 items). Each factor demonstrated adequate internal consistency reliability. Analyses with the Maternal Self-report Support Questionnaire and the Trauma Symptom Checklist supported the construct and concurrent validity of the new measure. Conclusions The MSQ-CR demonstrated sound psychometric properties. Future research is needed to determine whether the MSQ-CR provides a more sensitive approximation of maternal support following disclosure of sexual abuse, relative to measures of global parent-child relations. Additional research is needed to contextualize discrepancies between mother and child ratings of maternal support. Important limitations of the investigation are reviewed. PMID:28471341

  13. Disclosure and Psychological Well-Being of Sexually Abused Adolescents in Hong Kong.

    PubMed

    Lam, Kindy Yuk-Ip

    2015-01-01

    The role of disclosure on psychological well-being of adolescents with child sexual abuse experience was investigated in a subsample of 74 disclosers among 800 adolescents recruited in the community in Hong Kong. The results supported that CSA experiences have differential impact on adolescents' psychological well-being. Family characteristics of the disclosers accounted for only a small amount of the variance in an array of psychological well-being measures. CSA characteristics were robust predictors of disclosers' sexual eroticism and externalizing behavioral symptoms. Disclosers' cognitive appraisal of CSA experience and quality of parental attachment were strong predictors of their self-esteem and internalizing behavioral problems. After controlling for the aforementioned factors, negative disclosure experience still significantly predicted lower self-esteem, higher sexual anxiety, more internalizing behavior, and more severe post-traumatic stress disorder responses. Research to understand the factors that generate negative disclosure experiences is needed for developing effective intervention strategies to mitigate the negative consequences of disclosure.

  14. Mapping the Maze: An Art Therapy Intervention following Disclosure of Sexual Abuse

    ERIC Educational Resources Information Center

    Pifalo, Terry

    2009-01-01

    Disclosures of child sexual abuse create an immediate crisis within the child's family unit. Reactions of nonoffending caregivers in particular may prevent them from being emotionally available to respond immediately to the needs of the child victim. This article describes an art therapy intervention of visual mapping used in a support group of…

  15. ''A Burden in Your Heart'': Lessons of Disclosure from Female Preadolescent and Adolescent Survivors of Sexual Abuse

    ERIC Educational Resources Information Center

    Staller, Karen M.; Nelson-Gardell, Debra

    2005-01-01

    Objectives: To enhance understanding of the sexual abuse disclosure process from the perspective of preteen and teenage survivors. To reconsider prominent models of the disclosure process in light of our findings. Methods: We conducted a secondary analysis of data from four focus groups in which 34 preadolescent and adolescent female survivors of…

  16. Childhood sexual abuse severity and disclosure as predictors of depression among adult African American and Latina women

    PubMed Central

    Sciolla, Andres; Glover, Dorie A.; Loeb, Tamra B.; Zhang, Muyu; Myers, Hector F.; Wyatt, Gail E.

    2011-01-01

    A history of childhood sexual abuse (CSA) has been associated with adult depression, but data on abuse severity and disclosure are scant, particularly among low income ethnic minorities. CSA often co-occurs with other adversities, which also increase the risk of depression. This study examined the peri-trauma variable of abuse severity and the post-trauma variables of disclosure and self-blame as predictors of current depression symptoms in 94 low-income African American and Latina women with histories of CSA. After controlling for non-sexual childhood adversity and adult burden (i.e., chronic stress), severe CSA overall was associated with higher depression scores, especially among Latinas who disclosed their abuse. Depression symptoms among African American women were highest in those who disclosed and reported high levels of self-blame at the time of the incident. The link between depression and specific peri- and post-CSA factors in minority women may help guide future interventions. PMID:21716061

  17. 14 CFR 1263.105 - Considerations in determining whether production or disclosure should be made.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Considerations in determining whether... § 1263.105 Considerations in determining whether production or disclosure should be made. The General...) Whether disclosure might improperly reveal trade secrets, or commercial or financial information that is...

  18. The effects of gender, personal trauma history and memory continuity on the believability of child sexual abuse disclosure among psychologists.

    PubMed

    Page, Alexandra; Morrison, Natalie M V

    2018-06-01

    Gender, a personal history of trauma and attitudes towards continuous vs recovered memories of abuse significantly impact the believability of Child Sexual Abuse (CSA) disclosures in community samples. Yet, whether these variables influence the believability of CSA disclosure and subsequent clinical decisions made by practicing psychologists is underexplored. A vignette of trauma disclosure from a hypothetical adult client was presented via an online survey to 292 registered psychologists. Participants rated the believability of the disclosure, answered an open-ended item regarding treatment planning, and completed the Brief Betrayal Trauma Survey to measure personal trauma history. Results indicated that female psychologists believed disclosures significantly more than male psychologists and that disclosures comprised of continuous memories were believed more than recently recovered memories. A significant interaction between gender and personal trauma history was also revealed. Female psychologists believed disclosures regardless of their personal trauma history, while male psychologists with a personal history of trauma believed disclosures significantly more than male psychologists without personal trauma history. Reported believability of the disclosure, while unrelated to treatment planning, was associated with a reported intention to validate the client's experience. The results support that, similar to community samples, gender and a personal trauma history impact psychologist believability of CSA disclosure. The research further supports that psychologist level of belief then translates into clinical implications. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. A preliminary mapping of individual, relational, and social factors that impede disclosure of childhood sexual abuse.

    PubMed

    Collin-Vézina, Delphine; De La Sablonnière-Griffin, Mireille; Palmer, Andrea M; Milne, Lise

    2015-05-01

    Uncovering the pathways to disclosures of child sexual abuse (CSA) and the factors influencing the willingness of victims to talk about the abuse is paramount to the development of powerful practice and policy initiatives. Framed as a long interview method utilizing a grounded theory approach to analyze data, the objective of the current study was to provide a preliminary mapping of the barriers to CSA disclosures through an ecological systemic lens, from a sample of 67 male and female CSA adult survivors, all of whom had recently received counselling services. The current project led to the identification of three broad categories of barriers that were each comprised of several subthemes, namely: Barriers from Within (internalized victim-blaming, mechanisms to protect oneself, and immature development at time of abuse); Barriers in Relation to Others (violence and dysfunction in the family, power dynamics, awareness of the impact of telling, and fragile social network); and Barriers in Relation to the Social World (labelling, taboo of sexuality, lack of services available, and culture or time period). This study points to the importance of using a broad ecological framework to understand the factors that inhibit disclosure of CSA, as barriers to disclosure do not constrain solely the victims. Results are discussed in light of their implications for research, prevention and intervention programs, and social policies and media campaigns, as the burden is on the larger community to create a climate of safety and transparency that makes the telling of CSA possible. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Abuse Characteristics and Individual Differences Related to Disclosing Childhood Sexual, Physical, and Emotional Abuse and Witnessed Domestic Violence.

    PubMed

    Bottoms, Bette L; Peter-Hagene, Liana C; Epstein, Michelle A; Wiley, Tisha R A; Reynolds, Carrie E; Rudnicki, Aaron G

    2016-04-01

    Many adult survivors of childhood abuse hide their victimization, avoiding disclosure that could identify perpetrators, end the abuse, and bring help to the victim. We surveyed 1,679 women undergraduates to understand disclosure of childhood sexual, physical, and emotional abuse, and, for the first time, witnessed domestic violence, which many consider to be emotionally abusive. A substantial minority of victims failed to ever disclose their sexual abuse (23%), physical abuse (34%), emotional abuse (20%), and witnessed domestic violence (29%). Overall, abuse-specific factors were better predictors of disclosure than individual-level characteristics. Disclosure of sexual abuse was related to experiencing more frequent abuse (by the same and by multiple perpetrators), being more worried about injury and more upset at the time of the abuse, and self-labeling as a victim of abuse. Disclosure of physical abuse was related to experiencing more frequent abuse (by the same and multiple perpetrators), being less emotionally close to the perpetrator, being older when the abuse ended, being more worried and upset, and self-labeling as a victim. Disclosure of emotional abuse was associated with being older when the abuse ended, and being more worried and upset. Disclosure was unrelated to victim demographic characteristics or defensive reactions (dissociative proneness, fantasy proneness, repressive coping style, and temporary forgetting), except that among physical and emotional abuse victims, repressors were less likely to disclose than non-repressors. Disclosure of witnessing domestic violence was not significantly related to any factors measured. © The Author(s) 2014.

  1. Secondary traumatization in parents following the disclosure of extrafamilial child sexual abuse: initial effects.

    PubMed

    Manion, I G; McIntyre, J; Firestone, P; Ligezinska, M; Ensom, R; Wells, G

    1996-11-01

    Disclosure or discovery of extrafamilial sexual abuse (ESA) has the potential to traumatize the entire family system. Little controlled research has examined the initial reactions of parents to this type of trauma. The present study evaluated the adjustment of 93 parents (63 mothers and 30 fathers) within 3 months of the disclosure of ESA. Parents' functioning was compared to that of a nonclinical comparison group of 136 parents (74 mothers, 62 fathers). Parent adjustment was assessed using self-report measures of psychological distress, parent competence, family functioning, marital functioning, life stressors, and environmental support. Results revealed that mothers of sexually abused children, in comparison to mothers of nonabused children, experienced greater overall emotional distress, poorer family functioning, and lower satisfaction in their parenting role. Fathers of sexually abused children also experienced greater overall emotional distress relative to comparison fathers but their level of distress remained below that of mothers. Standard and hierarchical multiple regressions on maternal self-reports revealed that mothers' satisfaction with their parenting role and their perceived level of environmental support predicted their emotional functioning. Abuse-related variables did not contribute to the prediction of emotional functioning. These results emphasize the need to expand our focus beyond the child victims to the traumatized families and to normalize the potential for all close family members to be vulnerable to experience adjustment difficulties following ESA.

  2. Funding considerations for the disclosure of genetic incidental findings in biobank research

    PubMed Central

    Black, L; Avard, D; Zawati, MH; Knoppers, BM; Hébert, J; Sauvageau, G

    2013-01-01

    The use of biobanks in biomedical research has grown considerably in recent years. As a result of the increasing analysis of tissue samples stored in biobanks, there has also been an increase in the probability of discovering—in addition to the research target—incidental findings (IF). We identified 23 laws, policies and guidelines from international, regional and national organizations that provide guidance or identify the need for the disclosure of IF to research participants. We analyzed these instruments to determine their contemplation of the funding considerations for the disclosure of IF, examining their guidance for who discloses and the extent of researcher responsibilities. We found that the available normative documents provide little guidance to researchers and biobanks for how they should address cost and funding concerns associated with IF disclosure. It is therefore essential that the research and policy communities think through the financial implications of imposing an ethical responsibility to disclose IF. Concerted efforts should be made by policymakers, ethicists, researchers, clinicians and research institutions to develop detailed funding recommendations, potentially universal in application, to aid in the disclosure of IF, and we provide recommendations on steps that can be taken to ensure full consideration of these issues. PMID:23662709

  3. DEPRESSIVE AND POSTTRAUMATIC SYMPTOMS AMONG WOMEN SEEKING PROTECTION ORDERS AGAINST INTIMATE PARTNERS: RELATIONS TO COPING STRATEGIES AND PERCEIVED RESPONSES TO ABUSE DISCLOSURE

    PubMed Central

    Flicker, Sharon M.; Cerulli, Catherine; Swogger, Marc T.; Talbot, Nancy L.

    2014-01-01

    This investigation examined the relationship of abuse-specific coping strategies and perceived responses to abuse disclosure to symptoms of depression and posttraumatic stress among 131 women seeking a protection order against an intimate partner. Disengagement, denial, and self-blame coping strategies, as well as blaming of the participant by others, were associated with greater depressive and posttraumatic symptoms. None of the strategies of coping or responses to abuse disclosure were negatively related to depressive or posttraumatic stress symptoms. Findings suggest that mental health providers may find it useful to address these negative styles of coping while public education campaigns should target victim-blaming. PMID:22735315

  4. Effect of Social Support and Disclosure of Child Abuse on Adult Suicidal Ideation: Findings From a Population-Based Study.

    PubMed

    Baiden, Philip; Fallon, Barbara; Antwi-Boasiako, Kofi

    2017-11-16

    To examine the proportion of Canadian adults with a history of child abuse who disclosed the abuse to child protection services before age 16 years and identify the effect of social support and disclosure of child abuse on lifetime suicidal ideation. Data for this study came from the Statistics Canada 2012 Canadian Community Health Survey-Mental Health (N = 9,076). Binary logistic regression was conducted to identify the effect of social support and disclosure of child abuse on suicidal ideation while simultaneously adjusting for the effect of type of child abuse and demographic, socioeconomic, health, and mental health factors. Of the 9,076 respondents who experienced at least one child abuse event, 21.5% reported ever experiencing suicidal ideation. Fewer than 6% of the respondents disclosed the abuse to someone from a child protection service before age 16 years. In the multivariate logistic regression model, respondents who disclosed the abuse to someone from child protection services were 1.37 times more likely to report lifetime suicidal ideation (95% CI, 1.10-1.71) than those who did not. Each additional unit increase in social support decreased the odds of lifetime suicidal ideation by a factor of 3% (95% CI, 0.95-0.98). Social support interventions that are effective in improving individuals' perception that support is available to them may help reduce suicidal ideation among those with a history of child abuse. © Copyright 2017 Physicians Postgraduate Press, Inc.

  5. Explaining mental health disparities for non-monosexual women: abuse history and risky sex, or the burdens of non-disclosure?

    PubMed

    Persson, Tonje J; Pfaus, James G; Ryder, Andrew G

    2015-03-01

    Research has found that non-monosexual women report worse mental health than their heterosexual and lesbian counterparts. The reasons for these mental health discrepancies are unclear. This study investigated whether higher levels of child abuse and risky sexual behavior, and lower levels of sexual orientation disclosure, may help explain elevated symptoms of depression and anxiety among non-monosexual women. Participants included 388 women living in Canada (Mean age = 24.40, SD = 6.40, 188 heterosexual, 53 mostly heterosexual, 64 bisexual, 32 mostly lesbian, 51 lesbian) who filled out the Beck Depression and Anxiety Inventories as part of an online study running from April 2011 to February 2014. Participants were collapsed into non-monosexual versus monosexual categories. Non-monosexual women reported more child abuse, risky sexual behavior, less sexual orientation disclosure, and more symptoms of depression and anxiety than monosexual women. Statistical mediation analyses, using conditional process modeling, revealed that sexual orientation disclosure and risky sexual behavior uniquely, but not sequentially, mediated the relation between sexual orientation, depression and anxiety. Sexual orientation disclosure and risky sexual behavior were both associated with depression and anxiety. Childhood abuse did not moderate depression, anxiety, or risky sexual behavior. Findings indicate that elevated levels of risky sexual behavior and deflated levels of sexual orientation disclosure may in part explain mental health disparities among non-monosexual women. Results highlight potential targets for preventive interventions aimed at decreasing negative mental health outcomes for non-monosexual women, such as public health campaigns targeting bisexual stigma and the development of sex education programs for vulnerable sexual minority women, such as those defining themselves as bisexual, mostly heterosexual, or mostly lesbian. Copyright © 2014 Elsevier Ltd. All rights

  6. Expected Consequences of Disclosure Revealed in Investigative Interviews with Suspected Victims of Child Sexual Abuse

    ERIC Educational Resources Information Center

    Malloy, Lindsay C.; Brubacher, Sonja P.; Lamb, Michael E.

    2011-01-01

    The current study explored the expected consequences of disclosure discussed by 204 5- to 13-year-old suspected victims of child sexual abuse during the course of investigative interviews conducted using the NICHD Investigative Interview Protocol. Expected consequences were mentioned in nearly half of all interviews, with older children and those…

  7. Outcome-Based Practice: Disclosure Rates of Child Sexual Abuse Comparing Allegation Blind and Allegation Informed Structured Interviews.

    ERIC Educational Resources Information Center

    Cantlon, Julie; And Others

    1996-01-01

    This study evaluated the use of "allegation blind" interviews (in which interviewers did not know the specific allegation involved) with children (n=1535) suspected of being victims of child sexual abuse. The "allegation blind" interview technique yielded a statistically higher disclosure rate than the "allegation informed" interviews. (Author/DB)

  8. 22 CFR 206.6 - Considerations in determining whether production or disclosure should be made pursuant to a demand.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Considerations in determining whether production or disclosure should be made pursuant to a demand. 206.6 Section 206.6 Foreign Relations AGENCY... WHERE A.I.D. IS NOT A PARTY § 206.6 Considerations in determining whether production or disclosure...

  9. 28 CFR 16.26 - Considerations in determining whether production or disclosure should be made pursuant to a demand.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Considerations in determining whether production or disclosure should be made pursuant to a demand. 16.26 Section 16.26 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION Production or Disclosure in Federal...

  10. Women and substance abuse: gender, age, and cultural considerations.

    PubMed

    Stevens, Sally J; Andrade, Rosi A C; Ruiz, Bridget S

    2009-01-01

    Historically, data has shown that a smaller percentage of women use alcohol and illicit substances compared to men, and that frequency of use has been lower among women compared to use among men. Although this data on usage may be true, researchers also acknowledge that substance use among women has been a hidden issue, one not realistically acknowledged by society, especially prior to the mid-1960s. Along with this, more recent data indicates that rates of substance use among women are increasing. Factors contributing to this increase in substance abuse have begun to receive considerable attention, and recent research suggests that many issues exist that are unique to substance use among women. The purpose of this article is to discuss gender specific considerations in women's substance abuse by examining the history of substance use among women; analyzing gender-specific factors, including physiological factors, trauma-related factors, mental health issues, and cultural considerations that impact on women's substance use; articulating treatment approaches for working with substance abusing women and girls; and providing recommendations for further research in this area.

  11. Characteristics of sexual assault and disclosure among women in substance abuse recovery homes.

    PubMed

    Hunter, Bronwyn A; Robison, Emily; Jason, Leonard A

    2012-09-01

    Research suggests that many women experience some form of sexual assault in their lifetime and that women who engage in substance abuse often have a higher incidence of past sexual assault than women in the general population. Given the documented rates of sexual assault among women in recovery from substance use, it is important to explore community interventions that promote positive recovery from substance use and sexual assault. One model that promotes successful substance use recovery is the Oxford House--a democratic, self-supported substance use recovery home. Research demonstrated that living in an Oxford House provides sober social support and that this increased social support may promote the use of positive coping strategies to strengthen recovery from substance use, however; the relationship between social support and sexual assault for women is unclear. Thus, the current study examines the Oxford House model for women in recovery from substance use who have experienced sexual assault. A cross-sectional sample of women living in Oxford Houses in the United States was obtained to examine the relationship among disclosure of sexual assault, social support, and self-esteem. Results suggested that many women used Oxford House as a setting in which to disclosure prior sexual assault. Results also indicated that women who disclosed their assault experience reported higher self-esteem and social support than women who had not disclosed. Possible implications include the value of substance abuse recovery homes as a safe, supportive environment for women to address issues related to sexual assault.

  12. Masculine norms, disclosure, and childhood adversities predict long-term mental distress among men with histories of child sexual abuse.

    PubMed

    Easton, Scott D

    2014-02-01

    Child sexual abuse (CSA) can have a profound effect on the long-term mental health of boys/men. However, not all men with histories of CSA experience psychopathology. To improve prevention and intervention services, more research is needed to understand why some male survivors experience mental health problems and others do not. The purpose of this study was to examine factors related to mental distress among a large, non-clinical sample of men with histories of CSA (N=487). Using a cross-sectional design with purposive sampling from three national survivor organizations, data were collected through an anonymous Internet-based survey. Multivariate analyses found that only one of the four CSA severity variables-use of physical force by the abuser-was related to mental distress. Additional factors that were related to mental distress included the number of other childhood adversities, years until disclosure, overall response to disclosure, and conformity to masculine norms. Overall, the final model predicted 36% of the variance in the number of mental health symptoms. Mental health practitioners should include masculine norms, disclosure history, and childhood adversities in assessments and intervention planning with male survivors. To more fully explicate risk factors for psychopathology in this population, future studies with probability samples of men that focus on mediational processes and use longitudinal designs are needed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Pathways to PTSD, Part II: Sexually Abused Children

    PubMed Central

    Kaplow, Julie B.; Dodge, Kenneth A.; Amaya-Jackson, Lisa; Saxe, Glenn N.

    2009-01-01

    Objective The goal of this research was to develop and test a prospective model of posttraumatic stress symptoms in sexually abused children that includes pretrauma, trauma, and disclosure-related pathways. Method At time 1, several measures were used to assess pretrauma variables, trauma variables, and stress reactions upon disclosure for 156 sexually abused children ages 8 to 13 years. At the time 2 follow-up (7 to 36 months following the initial interview), the children were assessed for posttraumatic stress disorder (PTSD) symptoms. Results A path analysis involving a series of hierarchically nested ordinary least squares multiple regression analyses indicated three direct paths to PTSD symptoms: avoidant coping, anxiety/arousal, and dissociation, all measured during or immediately after disclosure of sexual abuse. Additionally, age and gender predicted avoidant coping, while life stress and age at abuse onset predicted symptoms of anxiety/arousal. Taken together, these pathways accounted for approximately 57% of the variance in PTSD symptoms. Conclusions Symptoms measured at the time of disclosure constitute direct, independent pathways by which sexually abused children are likely to develop later PTSD symptoms. These findings speak to the importance of assessing children during the disclosure of abuse in order to identify those at greatest risk for later PTSD symptoms. PMID:15994713

  14. Abusive supervision and subordinate performance: Instrumentality considerations in the emergence and consequences of abusive supervision.

    PubMed

    Walter, Frank; Lam, Catherine K; van der Vegt, Gerben S; Huang, Xu; Miao, Qing

    2015-07-01

    Drawing from moral exclusion theory, this article examines outcome dependence and interpersonal liking as key boundary conditions for the linkage between perceived subordinate performance and abusive supervision. Moreover, it investigates the role of abusive supervision for subordinates' subsequent, objective work performance. Across 2 independent studies, an experimental scenario study (N = 157; Study 1) and a time-lagged field study (N = 169; Study 2), the negative relationship between perceived subordinate performance and abusive supervision was found to hinge on a supervisor's outcome dependence on subordinates but not on a supervisor's liking of subordinates. Furthermore, Study 2 demonstrated (a) a negative association between abusive supervision and subordinates' subsequent objective performance and (b) a conditional indirect effect of perceived performance on subsequent objective performance, through abusive supervision, contingent on the degree of outcome dependence, although these relationships did not reach conventional significance levels when controlling for prior objective performance. All in all, the findings highlight the role of instrumentality considerations in relation to abusive supervision and promote new knowledge on both origins and consequences of such supervisory behavior. (c) 2015 APA, all rights reserved).

  15. Application Use, Online Relationship Types, Self-Disclosure, and Internet Abuse among Children and Youth: Implications for Education and Internet Safety Programs

    ERIC Educational Resources Information Center

    Blau, Ina

    2011-01-01

    This study explores the relationships between Internet abuse (IA)--self-disclosure, online application usage, and relationship types--traditional long-distance, purely virtual, and migratory mixed-mode. An online questionnaire was administered to 2884 children and youth. According to the hypotheses, applications differed in their relationships…

  16. Maternal support following childhood sexual abuse: Associations with children's adjustment post-disclosure and at 9-month follow-up.

    PubMed

    Zajac, Kristyn; Ralston, M Elizabeth; Smith, Daniel W

    2015-06-01

    Maternal support has been widely cited as an important predictor of children's adjustment following disclosure of sexual abuse. However, few studies have examined these effects longitudinally. The current study examines the relationships between a multidimensional assessment of maternal support rated by both mothers and children and children's adjustment in various domains (internalizing, externalizing, anger, depression, and posttraumatic stress disorder symptoms) concurrently and longitudinally. Participants were 118 mother-child dyads recruited from a Child Advocacy Center where children were determined through a forensic evaluation to be victims of sexual abuse. Child and mother ratings of maternal support and child adjustment were collected shortly after the forensic evaluation and at 9-month follow-up. Results were consistent with findings from past studies that maternal support is significantly related to children's post-disclosure adjustment and extends these findings longitudinally. Additionally, the study sheds light on differential relations between dimensions of maternal support (Emotional Support, Blame/Doubt, Vengeful Arousal, and Skeptical Preoccupation) and child adjustment and suggests the importance of using both child and mother ratings of maternal support in future research. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Assessment for self-blame and trauma symptoms during the medical evaluation of suspected sexual abuse.

    PubMed

    Melville, John D; Kellogg, Nancy D; Perez, Nadia; Lukefahr, James L

    2014-05-01

    The purpose of this study was to describe behavioural and emotional symptoms and to examine the effect of abuse-related factors, family responses to disclosure, and child self-blame on these symptoms in children presenting for medical evaluations after disclosure of sexual abuse. A retrospective review was conducted of 501 children ages 8-17. Trauma symptoms were determined by two sets of qualitative measures. Abstracted data included gender, ethnicity, and age; severity of abuse and abuser relationship to child; child responses regarding difficulty with sleep, school, appetite/weight, sadness, or self-harm, parent belief in abuse disclosure, and abuse-specific self-blame; responses to the Trauma Symptom Checklist in Children-Alternate; and the parent's degree of belief in the child's sexual abuse disclosure. Overall, 83% of the children had at least one trauma symptom; 60% had difficulty sleeping and one-third had thoughts of self-harm. Child age and abuse severity were associated with 3 of 12 trauma symptoms, and abuse-specific self-blame was associated with 10 trauma symptoms, after controlling for other variables. The children of parents who did not completely believe the initial disclosure of abuse were twice as likely to endorse self-blame as children of parents who completely believed the initial disclosure. Screening for behavioural and emotional problems during the medical assessment of suspected sexual abuse should include assessment of self-blame and family responses to the child's disclosures. In addition, parents should be informed of the importance of believing their child during the initial disclosure of abuse and of the impact this has on the child's emotional response to the abuse. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Psychometrics of a Child Report Measure of Maternal Support following Disclosure of Sexual Abuse.

    PubMed

    Smith, Daniel W; Sawyer, Genelle K; Heck, Nicholas C; Zajac, Kristyn; Solomon, David; Self-Brown, Shannon; Danielson, Carla K; Ralston, M Elizabeth

    2017-04-01

    The study examined a new child report measure of maternal support following child sexual abuse. One hundred and forty-six mother-child dyads presenting for a forensic evaluation completed assessments including standardized measures of adjustment. Child participants also responded to 32 items considered for inclusion in a new measure, the Maternal Support Questionnaire-Child Report (MSQ-CR). Exploratory factor analysis of the Maternal Support Questionnaire-Child Report resulted in a three factor, 20-item solution: Emotional Support (9 items), Skeptical Preoccupation (5 items), and Protection/Retaliation (6 items). Each factor demonstrated adequate internal consistency. Construct and concurrent validity of the new measure were supported in comparison to other trauma-specific measures. The Maternal Support Questionnaire-Child Report demonstrated sound psychometric properties. Future research is needed to determine whether the Maternal Support Questionnaire-Child Report provides a more sensitive approximation of maternal support following disclosure of sexual abuse, relative to measures of global parent-child relations and to contextualize discrepancies between mother and child ratings of maternal support.

  19. Outcry Consistency and Prosecutorial Decisions in Child Sexual Abuse Cases.

    PubMed

    Bracewell, Tammy E

    2018-05-18

    This study examines the correlation between the consistency in a child's sexual abuse outcry and the prosecutorial decision to accept or reject cases of child sexual abuse. Case-specific information was obtained from one Texas Children's Advocacy Center on all cases from 2010 to 2013. After the needed deletion, the total number of cases included in the analysis was 309. An outcry was defined as a sexual abuse disclosure. Consistency was measured at both the forensic interview and the sexual assault exam. Logistic regression was used to evaluate whether a correlation existed between disclosure and prosecutorial decisions. Disclosure was statistically significant. Partial disclosure (disclosure at one point in time and denial at another) versus full disclosure (disclosure at two points in time) had a statistically significant odds ratio of 4.801. Implications are discussed, specifically, how the different disciplines involved in child protection should take advantage of the expertise of both forensic interviewers and forensic nurses to inform their decisions.

  20. Perceptions of the Role of Mothers in the Disclosure and Nondisclosure of Child Sexual Abuse: A Qualitative Study.

    PubMed

    Hunter, Sally V

    2015-01-01

    One of the aims of this research was to develop an understanding of the role mothers were perceived to play during the process of disclosure of child sexual abuse. Using narrative inquiry methodology, face-to-face in-depth interviews were conducted with 22 men and women who had an early sexual experience. Even though a mother's support and protection is known to be important, this study showed that many mothers were seen as unable to offer such support, which had an important influence on nondisclosure. The heterogeneity of perceptions of mothers among adults who experienced child sexual abuse and gender differences are described. Health professionals need to manage complex relational dynamics between adult survivors and their mothers.

  1. One dozen considerations when working with women in substance abuse groups.

    PubMed

    Bright, Charlotte Lyn; Osborne, Victoria A; Greif, Geoffrey L

    2011-01-01

    Women and men have different histories, presentations, and behaviors in substance abuse groups. Twelve considerations are offered for the beginning group leader when encountering women with substance abuse issues. These include understanding sexism, what brings women to treatment, and how women behave in group treatment. Implications for clinical practice with women in single-gender and mixed-gender groups are included.

  2. A qualitative systematic review of published work on disclosure and help-seeking for domestic violence and abuse among women from ethnic minority populations in the UK.

    PubMed

    Femi-Ajao, Omolade; Kendal, Sarah; Lovell, Karina

    2018-03-07

    Domestic violence and abuse has been recognised as an international public health problem. However, the pervasiveness of the problem is unknown due in part to underreporting, especially among women from ethnic minority populations. In relation to this group, this review seeks to explore: (1) the barriers to disclosure; (2) the facilitators of help-seeking; and (3) self-perceived impacts of domestic violence. We systematically identified published qualitative studies conducted among women from ethnic minority populations in the UK. Data analysis was completed using thematic analysis approach. 562 papers were identified and eight papers from four studies conducted among women from ethnic minority populations in the UK met the inclusion criteria and were reviewed. Barriers to disclosure include: Immigration status, community influences, problems with language and interpretation, and unsupportive attitudes of staff within mainstream services. Facilitators of help-seeking were: escalation of abuse and safety of children. Self-perceived impact of abuse includes: shame, denial, loss of identity and lack of choice. There is an on-going need for staff from domestic violence services to be aware of the complexities within which women from ethnic minority populations experience domestic violence and abuse.

  3. "A Very Steep Climb": Therapists' Perspectives on Barriers to Disclosure of Child Sexual Abuse Experiences for Men.

    PubMed

    Gruenfeld, Elizabeth; Willis, Danny G; Easton, Scott D

    2017-01-01

    Recent studies indicate that men experience unique barriers to disclosure of child sexual abuse. Blind spots held by mental health providers and social service agencies may inadvertently help produce and sustain these barriers. However, therapists who specialize in treating this population may also hold important insights into the barriers clients face. Because delayed and nondisclosure of child sexual abuse have been associated with negative mental health outcomes for adult survivors, understanding these barriers is critical to improve clinical practice and facilitate help-seeking. Using conventional content analysis, this study examined the perceptions of nine therapists who specialize in the treatment of men who were sexually abused in childhood, many of whom are considered pioneers in the field. Analyses identified nine types of barriers, which were organized into three categories: intrapersonal experience (difficult feelings, lack of language, and self-engagement), social milieu (internalized social stigma, negative responses, social loss or judgment, and masculine identity dissonance), and health care environment (structural barriers, relational challenges with therapists, and unhelpful therapeutic strategies). Implications for future research, clinical training, and clinical practice are discussed.

  4. First incest disclosure.

    PubMed

    Donalek, J G

    2001-09-01

    Despite the pivotal importance of disclosure to incest treatment and healing, disclosure has never been studied from the victim's perspective. How do incest victims move from keeping the secret to speaking about their abuse? Nine adult women were asked to talk about the first time they each told about the incest. They often spoke, not of "telling" in the commonly understood sense (i.e. giving information to someone who understands one's meaning), but instead of a time when some form of knowledge of the incest first entered an interaction with another person. Colaizzi's (1978) phenomenological method was used to analyze the interviews. Seven themes emerged: (1) living in the silencing home; (2) I am totally and particularly alone; (3) my mother, the focus of need; (4) incest as burden; (5) the secret must be kept; (6) disclosure: trying to balance above a chasm; and (7) disclosure as loss: no matter what, I still lose. The themes were then integrated into an essential description of first incest disclosure. Implications for nursing practice are explored.

  5. Psychosocial characteristics of nonoffending mothers of sexually abused girls: findings from a prospective, multigenerational study.

    PubMed

    Kim, Kihyun; Noll, Jennie G; Putnam, Frank W; Trickett, Penelope K

    2007-11-01

    This study examined psychosocial characteristics of nonoffending mothers of sexually abused girls. The sample consisted of 72 ethnically diverse mothers of sexually abused girls aged 6 to 16 years, and 55 mothers of girls who were demographically similar with the abused girls on age, socioeconomic status, and family constellation. The variables examined included measures of the mothers' childhood developmental histories and current functioning (e.g., depression, parenting), as well as their current family environment. The specific questions addressed were (a) whether mothers of sexually abused girls could be distinguished from mothers of comparison girls on various psychosocial characteristics and (b) whether three subgroups of mothers (i.e., mother and daughter sexually abused, daughter-only abused, neither mother nor daughter abused) would exhibit different patterns of psychosocial characteristics. Results show that nonoffending mothers of sexually abused girls may confront considerable psychosocial challenges following the disclosure of their daughters' sexual abuse and that mother's own childhood abuse experiences may be an important factor to understand these challenges.

  6. Factors affecting disclosure among Israeli children in residential care due to domestic violence.

    PubMed

    Lev-Wiesel, Rachel; Gottfried, Ruth; Eisikovits, Zvi; First, Maya

    2014-04-01

    Disclosure of child abuse may enable initiating interventions to end maltreatment and mediate its negative physical and psychological consequences. The present study reviews the field of disclosure and examines factors affecting disclosure among a service population of abused children who were placed in residential care due to various forms of abuse (e.g., physical, sexual, emotional, neglect and witnessing domestic violence). The sample consisted of 286 Israeli (Hebrew and Arabic speaking) children aged 12-17 (mean=14±1). Following approval of the Ethics committee of the University and parents' written consent, participants were administered a self-report questionnaire that included the following measures: a Socio-Demographic Questionnaire, the Childhood Trauma Questionnaire (CTQ), the Juvenile Victimization Questionnaire (JVQ), and the Disclosure of Trauma Questionnaire (DTQ). Results indicated that the three key factors enhancing the likelihood of disclosure were: moral factors, external initiatives and intolerable physical pain. The three key factors inhibiting disclosure were feelings of shame, fear of losing social support and uncertainty as to how and to whom to disclose. Results also showed that children preferred to disclose to their nuclear family members (parents and siblings) in comparison with professionals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. When Daughter's Sexual Abuse Is an Injury to Mother's Narcissism.

    ERIC Educational Resources Information Center

    DePinho, Connie Maria

    The mother's reaction to the disclosure of sexual abuse is often dramatic and her particular type of response in turn affects the daughter's coping mechanisms to deal with the abuse and the disclosure. The type of symptoms developed are thus considered in part dependent on the mother's reaction. Mothers of children who have been sexually abused…

  8. 42 CFR 2.33 - Disclosures permitted with written consent.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Disclosures permitted with written consent. 2.33 Section 2.33 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures With Patient's Consent § 2...

  9. 42 CFR 2.33 - Disclosures permitted with written consent.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Disclosures permitted with written consent. 2.33 Section 2.33 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures With Patient's Consent § 2...

  10. 42 CFR 2.33 - Disclosures permitted with written consent.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Disclosures permitted with written consent. 2.33 Section 2.33 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures With Patient's Consent § 2...

  11. 42 CFR 2.33 - Disclosures permitted with written consent.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Disclosures permitted with written consent. 2.33 Section 2.33 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures With Patient's Consent § 2...

  12. 42 CFR 2.33 - Disclosures permitted with written consent.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Disclosures permitted with written consent. 2.33 Section 2.33 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures With Patient's Consent § 2...

  13. School Nurses Avoid Addressing Child Sexual Abuse.

    PubMed

    Engh Kraft, Lisbet; Rahm, GullBritt; Eriksson, Ulla-Britt

    2017-04-01

    Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an available person prepared to listen. The aim of the study was to explore the ability of the school nurses to detect and support sexually abused children. It is a secondary analysis of focus group interviews with school nurses. Thematic analysis was performed. Results showed that the school nurses avoided addressing CSA due to arousal of strong emotions, ambivalence, and a complicated disclosure process. In order to detect CSA and support abused children, attentiveness of sexual abuse as a possible cause of physical and mental ill-health is crucial.

  14. Sexually Abused Boys.

    ERIC Educational Resources Information Center

    Reinhart, Michael A.

    1987-01-01

    Reports of male victims (N=189) of child sexual abuse were retrospectively reviewed. Comparison to an age- and race-matched group of female victims revealed similarities in patterns of disclosure and perpetrator characteristics. (Author/DB)

  15. Domestic abuse awareness and recognition among primary healthcare professionals and abused women: a qualitative investigation.

    PubMed

    Bradbury-Jones, Caroline; Taylor, Julie; Kroll, Thilo; Duncan, Fiona

    2014-11-01

    To investigate the dynamics of domestic abuse awareness and recognition among primary healthcare professionals and abused women. Domestic abuse is a serious, public health issue that crosses geographical and demographic boundaries. Health professionals are well placed to recognise and respond to domestic abuse, but empirical evidence suggests that they are reluctant to broach the issue. Moreover, research has shown that women are reluctant to disclose abuse. A two-phase, qualitative study was conducted in Scotland. Twenty-nine primary health professionals (midwives, health visitors and general practitioners) participated in the first phase of the study, and 14 abused women took part in phase two. Data were collected in 2011. Semi-structured, individual interviews were conducted with the health professionals, and three focus groups were facilitated with the abused women. Data were analysed using a framework analysis approach. Differing levels of awareness of the nature and existence of abuse are held by abused women and primary healthcare professionals. Specifically, many women do not identify their experiences as abusive. A conceptual representation of domestic abuse - the "abused women, awareness, recognition and empowerment' framework - arising from the study - presents a new way of capturing the complexity of the disclosure process. Further research is necessary to test and empirically validate the framework, but it has potential pedagogical use for the training and education of health professionals and clinical use with abused women. The framework may be used in clinical practice by nurses and other health professionals to facilitate open discussion between professionals and women. In turn, this may empower women to make choices regarding disclosure and safety planning. © 2014 John Wiley & Sons Ltd.

  16. Child Sexual Abuse Myths: Attitudes, Beliefs, and Individual Differences

    ERIC Educational Resources Information Center

    Cromer, Lisa DeMarni; Goldsmith, Rachel E.

    2010-01-01

    Child sexual abuse myths comprise incorrect beliefs regarding sexual abuse, victims, and perpetrators. Relations among myth acceptance, responses to disclosure, legal decisions, and victims' subsequent psychological and health outcomes underscore the importance of understanding child sexual abuse myths. Despite accurate knowledge regarding child…

  17. Interventions to address parenting and parental substance abuse: conceptual and methodological considerations.

    PubMed

    Neger, Emily N; Prinz, Ronald J

    2015-07-01

    Parental substance abuse is a serious problem affecting the well-being of children and families. The co-occurrence of parental substance abuse and problematic parenting is recognized as a major public health concern. This review focuses on 21 outcome studies that tested dual treatment of substance abuse and parenting. A summary of theoretical conceptualizations of the connections between substance abuse and parenting provides a backdrop for the review. Outcomes of the dual treatment studies were generally positive with respect to reduction of parental substance use and improvement of parenting. Research in this area varied in methodological rigor and needs to overcome challenges regarding design issues, sampling frame, and complexities inherent in such a high-risk population. This area of work can be strengthened by randomized controlled trials, use of mixed-methods outcome measures, consideration of parent involvement with child protective services, involvement of significant others in treatment, provision of concrete supports for treatment attendance and facilitative public policies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Interventions to Address Parenting and Parental Substance Abuse: Conceptual and Methodological Considerations

    PubMed Central

    Neger, Emily N.; Prinz, Ronald J.

    2015-01-01

    Parental substance abuse is a serious problem affecting the well-being of children and families. The co-occurrence of parental substance abuse and problematic parenting is recognized as a major public health concern. This review focuses on 21 outcome studies that tested dual treatment of substance abuse and parenting. A summary of theoretical conceptualizations of the connections between substance abuse and parenting provides a backdrop for the review. Outcomes of the dual treatment studies were generally positive with respect to reduction of parental substance use and improvement of parenting. Research in this area varied in methodological rigor and needs to overcome challenges regarding design issues, sampling frame, and complexities inherent in such a high-risk population. This area of work can be strengthened by randomized controlled trials, use of mixed-methods outcome measures, consideration of parent involvement with child protective services, involvement of significant others in treatment, provision of concrete supports for treatment attendance and facilitative public policies. PMID:25939033

  19. 49 CFR 240.119 - Criteria for consideration of data on substance abuse disorders and alcohol/drug rules compliance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Process § 240.119 Criteria for consideration of data on substance abuse disorders and alcohol/drug rules.... (b) Fitness requirement. (1) A person who has an active substance abuse disorder shall not be... certified engineer who is determined to have an active substance abuse disorder shall be suspended from...

  20. 49 CFR 240.119 - Criteria for consideration of data on substance abuse disorders and alcohol/drug rules compliance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Process § 240.119 Criteria for consideration of data on substance abuse disorders and alcohol/drug rules.... (b) Fitness requirement. (1) A person who has an active substance abuse disorder shall not be... certified engineer who is determined to have an active substance abuse disorder shall be suspended from...

  1. 49 CFR 240.119 - Criteria for consideration of data on substance abuse disorders and alcohol/drug rules compliance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Process § 240.119 Criteria for consideration of data on substance abuse disorders and alcohol/drug rules.... (b) Fitness requirement. (1) A person who has an active substance abuse disorder shall not be... certified engineer who is determined to have an active substance abuse disorder shall be suspended from...

  2. 49 CFR 240.119 - Criteria for consideration of data on substance abuse disorders and alcohol/drug rules compliance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Process § 240.119 Criteria for consideration of data on substance abuse disorders and alcohol/drug rules.... (b) Fitness requirement. (1) A person who has an active substance abuse disorder shall not be... certified engineer who is determined to have an active substance abuse disorder shall be suspended from...

  3. 49 CFR 240.119 - Criteria for consideration of data on substance abuse disorders and alcohol/drug rules compliance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Process § 240.119 Criteria for consideration of data on substance abuse disorders and alcohol/drug rules.... (b) Fitness requirement. (1) A person who has an active substance abuse disorder shall not be... certified engineer who is determined to have an active substance abuse disorder shall be suspended from...

  4. Dissociation predicts later attention problems in sexually abused children

    PubMed Central

    Kaplow, Julie B.; Hall, Erin; Koenen, Karestan C.; Dodge, Kenneth A.; Amaya-Jackson, Lisa

    2008-01-01

    Objective The goals of this research are to develop and test a prospective model of attention problems in sexually abused children that includes fixed variables (e.g., gender), trauma, and disclosure-related pathways. Methods At Time 1, fixed variables, trauma variables, and stress reactions upon disclosure were assessed in 156 children aged 8 to 13 years. At the Time 2 follow-up (8 to 36 months following the initial interview), 56 of the children were assessed for attention problems. Results A path analysis involving a series of hierarchically-nested, ordinary least squares multiple regression analyses indicated two direct paths to attention problems including the child’s relationship to the perpetrator (β = .23) and dissociation measured immediately after disclosure (β = .53), while controlling for concurrent externalizing behavior (β = .43). Posttraumatic stress symptoms were only indirectly associated with attention problems via dissociation. Taken together, these pathways accounted for approximately 52% of the variance in attention problems and provided an excellent fit to the data. Conclusions Children who report dissociative symptoms upon disclosure of CSA and/or were sexually abused by someone within their family are at an increased risk of developing attention problems. Practice Implications: Findings from this study indicate that children who experienced sexual abuse at an earlier age, by someone within their family, and/or report symptoms of dissociation during disclosure are especially likely to benefit from intervention. Effective interventions should involve (1) providing emotion regulation and coping skills; and (2) helping children to process traumatic aspects of the abuse to reduce the cyclic nature of traumatic reminders leading to unmanageable stress and dissociation. PMID:18308391

  5. Evaluations of children who have disclosed sexual abuse via facilitated communication.

    PubMed

    Botash, A S; Babuts, D; Mitchell, N; O'Hara, M; Lynch, L; Manuel, J

    1994-12-01

    To review the findings of interdisciplinary team evaluations of children who disclosed sexual abuse via facilitated communication. Case series. Tertiary care hospital outpatient child sexual abuse program in central New York. Between January 1990 and March 1993, 13 children who disclosed sexual abuse via facilitated communication and were referred to a university hospital child abuse referral and evaluation center. The range of previously determined developmental diagnosis included mental retardation, speech delay, and autism. None. Medical records were reviewed for (1) disclosure, (2) physical evidence, (3) child's behavioral and medical history, (4) disclosures by siblings, (5) perpetrator's confession, (6) child protective services determinations, and (7) court findings. Four children had evidence of sexual abuse: two had physical findings consistent with sexual abuse, one also disclosed the allegation verbally, and one perpetrator confessed. These results neither support nor refute validation of facilitated communication. However, many children had other evidence of sexual abuse, suggesting that each child's case should be evaluated without bias.

  6. 45 CFR 303.21 - Safeguarding and disclosure of confidential information.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... instances of physical or mental injury, sexual abuse or exploitation, or negligent treatment or maltreatment... reasonable evidence of domestic violence or child abuse against a party or a child and that the disclosure of..., and shall include use of the family violence indicator required under § 307.11(f)(1)(x) of this...

  7. 45 CFR 303.21 - Safeguarding and disclosure of confidential information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... instances of physical or mental injury, sexual abuse or exploitation, or negligent treatment or maltreatment... reasonable evidence of domestic violence or child abuse against a party or a child and that the disclosure of..., and shall include use of the family violence indicator required under § 307.11(f)(1)(x) of this...

  8. 45 CFR 303.21 - Safeguarding and disclosure of confidential information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... instances of physical or mental injury, sexual abuse or exploitation, or negligent treatment or maltreatment... reasonable evidence of domestic violence or child abuse against a party or a child and that the disclosure of..., and shall include use of the family violence indicator required under § 307.11(f)(1)(x) of this...

  9. 45 CFR 303.21 - Safeguarding and disclosure of confidential information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... instances of physical or mental injury, sexual abuse or exploitation, or negligent treatment or maltreatment... reasonable evidence of domestic violence or child abuse against a party or a child and that the disclosure of..., and shall include use of the family violence indicator required under § 307.11(f)(1)(x) of this...

  10. Counselors' Role in Preventing Abuse of Older Adults: Clinical, Ethical, and Legal Considerations

    ERIC Educational Resources Information Center

    Forman, Julia M.; McBride, Rebecca G.

    2010-01-01

    Mistreatment of older adults is commonplace. These individuals are subjected to abuse, financial exploitation, and neglect. The authors present an overview of the literature concerning mistreatment, with an emphasis on clinical, ethical, and legal considerations. Methods are proposed for prevention, including counselor education, advocacy, and…

  11. Circadian Rhythms and Substance Abuse: Chronobiological Considerations for the Treatment of Addiction.

    PubMed

    Webb, Ian C

    2017-02-01

    Reward-related learning, including that associated with drugs of abuse, is largely mediated by the dopaminergic mesolimbic pathway. Mesolimbic neurophysiology and motivated behavior, in turn, are modulated by the circadian timing system which generates ∼24-h rhythms in cellular activity. Both drug taking and seeking and mesolimbic dopaminergic neurotransmission can vary widely over the day. Moreover, circadian clock genes are expressed in ventral tegmental area dopaminergic cells and in mesolimbic target regions where they can directly modulate reward-related neurophysiology and behavior. There also exists a reciprocal influence between drug taking and circadian timing as the administration of drugs of abuse can alter behavioral rhythms and circadian clock gene expression in mesocorticolimbic structures. These interactions suggest that manipulations of the circadian timing system may have some utility in the treatment of substance abuse disorders. Here, the literature on bidirectional interactions between the circadian timing system and drug taking is briefly reviewed, and potential chronotherapeutic considerations for the treatment of addiction are discussed.

  12. Disclosure of sexual abuse, and personal and familial factors as predictors of post-traumatic stress disorder symptoms in school-aged girls.

    PubMed

    Bernard-Bonnin, Anne-Claude; Hébert, Martine; Daignault, Isabelle V; Allard-Dansereau, Claire

    2008-07-01

    The aim of the present study was to analyze predictive factors of post-traumatic stress disorder (PTSD) symptoms in school-aged girls. A group (n=67) of seven- to 12 year-old girls consulting a paediatric hospital following disclosure of sexual abuse were compared with a group (n=67) of nonabused girls. The girls answered questionnaires related to PTSD, coping, sense of hope, self-esteem, sibling relationships and perceived social support. Mothers answered questionnaires related to family relationships, family violence, perceived support given and psychological distress. The mean +/- SD age of the girls was 9+/-1.5 years. In the sexual abuse group, single-parent families were more frequent (53.7% versus 32.3%; P<0.01), mothers were less educated (10.8% versus 13.1%; P<0.0001) and socioeconomic level was lower (36.8% versus 47.9%; P<0.0001). A history of sexual abuse in childhood was reported by 50% of mothers of sexually abused children and 37% of mothers of the comparison group children. A higher prevalence of PTSD clinical scores was found for the girls reporting sexual abuse (46.3% versus 18.5%; P<0.001). Regression analyses controlling for parental education level and family structure revealed that group membership (sexual abuse group versus comparison group) was predictive of the level of PTSD symptoms. In addition, the mother's level of support, the child's perception of parental support and the child's reliance on avoidance coping predicted PTSD symptoms. Sense of hope and the child witnessing interparental physical violence were marginally associated with the level of PTSD symptoms. PTSD was common in the present study's sample of sexually abused girls. Because predictive factors relate to both child-related variables and familial context, interventions for this population should target not only the child, but also the family.

  13. School Nurses Avoid Addressing Child Sexual Abuse

    ERIC Educational Resources Information Center

    Engh Kraft, Lisbet; Rahm, GullBritt; Eriksson, Ulla-Britt

    2017-01-01

    Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an…

  14. Dissociation Predicts Later Attention Problems in Sexually Abused Children

    ERIC Educational Resources Information Center

    Kaplow, Julie B.; Hall, Erin; Koenen, Karestan C.; Dodge, Kenneth A.; Amaya-Jackson, Lisa

    2008-01-01

    Objective: The goals of this research are to develop and test a prospective model of attention problems in sexually abused children that includes fixed variables (e.g., gender), trauma, and disclosure-related pathways. Methods: At Time 1, fixed variables, trauma variables, and stress reactions upon disclosure were assessed in 156 children aged…

  15. Against the Odds: The Impact of Woman Abuse on Maternal Response to Disclosure of Child Sexual Abuse

    ERIC Educational Resources Information Center

    Alaggia, Ramona; Turton, Jennifer V.

    2005-01-01

    Although the co-occurrence of woman abuse and child sexual abuse is high little research exists exploring the impact of woman abuse on maternal response to child sexual abuse (CSA). Findings from two qualitative studies indicate the form of woman abuse to have differential impact on maternal response. Mothers who were abused in non-physical ways,…

  16. A Quantitative Study on Gender Differences in Disclosing Child Sexual Abuse and Reasons for Nondisclosure.

    PubMed

    Okur, Pinar; van der Knaap, Leontien M; Bogaerts, Stefan

    2017-07-01

    Despite the available literature on disclosure of child sexual abuse (CSA), little is known about how gender affects disclosure. This article aims to quantitatively examine whether gender differences exist in formal (to legal or child protection authorities) and informal (to a family member or friend) disclosure of CSA and, if so, to assess whether this relation is associated with abuse characteristics and attitudes toward gender roles. The study also aimed to examine whether gender differences exist in reasons not to disclose CSA. Data of a sample of 586 participants, who reported to have experienced CSA committed by a single person, have been used for the analyses. There were no gender differences for formal disclosure, but the informal disclosure rate of CSA was 2.4 times higher for women than men, and this effect remained significant after controlling for abuse characteristics and attitudes, even though the gender difference decreased slightly. Furthermore, women and men reported different reasons for not disclosing CSA in their personal network. Women were more worried than men that family and friends would discover the abuse and reported more insecurity of what to do in this situation. Professionals in the field of CSA should consider a gender perspective when developing guidelines. Men have rarely been the subject of studies of disclosure after CSA. Professionals should focus more on general mental health outcomes of men that are not related with CSA directly, but where the effects of CSA may exert more indirectly through associations with other problems in life.

  17. Disclosure of HIV positive result to a sexual partner among adult clinical service users in Kemissie district, northeast Ethiopia.

    PubMed

    Seid, Mohammed; Wasie, Belaynew; Admassu, Mengesha

    2012-03-01

    HIV Status disclosure is vital for HIV prevention efforts and the couple's health in the context of accelerated highly active antiretroviral therapy. This study aimed to identify factors associated with disclosure of HIV Status to a sexual partner and its outcomes. A facility based cross-sectional study was conducted at Kemissie Health center on 360 HIV positive individuals selected by systematic random sampling. Data were collected using a structured, interviewer administered questionnaire. The level of disclosure to a sexual partner was 93.1%. Among those who disclosed, 74.5% were accepted, 10.8% minor challenges or suspicion of result and the last 7.8% faced physical abuse and blame. The main reasons for not disclosing were fear of divorce [32%], fear of stigma and discrimination [32%] and fear of physical abuse [16%]. Prior discussion, disclosure to family, smooth relationship and knowing partner status were significantly associated with disclosure. HIV prevention programs and counseling efforts should focus on mutual disclosure of HIV test results, by encouraging discussion, reduction of stigma, for better disclosure and continuing care.

  18. 42 CFR 2.65 - Procedures and criteria for orders authorizing disclosure and use of records to criminally...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use § 2.65..., rape, kidnapping, armed robbery, assault with a deadly weapon, and child abuse and neglect. (2) There...

  19. 42 CFR 2.65 - Procedures and criteria for orders authorizing disclosure and use of records to criminally...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use § 2.65..., rape, kidnapping, armed robbery, assault with a deadly weapon, and child abuse and neglect. (2) There...

  20. 42 CFR 2.65 - Procedures and criteria for orders authorizing disclosure and use of records to criminally...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use § 2.65..., rape, kidnapping, armed robbery, assault with a deadly weapon, and child abuse and neglect. (2) There...

  1. 42 CFR 2.65 - Procedures and criteria for orders authorizing disclosure and use of records to criminally...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use § 2.65..., rape, kidnapping, armed robbery, assault with a deadly weapon, and child abuse and neglect. (2) There...

  2. 42 CFR 2.65 - Procedures and criteria for orders authorizing disclosure and use of records to criminally...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Court Orders Authorizing Disclosure and Use § 2.65..., rape, kidnapping, armed robbery, assault with a deadly weapon, and child abuse and neglect. (2) There...

  3. 42 CFR 2.1 - Statutory authority for confidentiality of drug abuse patient records.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.1 Statutory authority for confidentiality of drug abuse patient records. The restrictions of these regulations upon the disclosure and use of drug abuse patient records were initially authorized by section 408...

  4. 42 CFR 2.1 - Statutory authority for confidentiality of drug abuse patient records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.1 Statutory authority for confidentiality of drug abuse patient records. The restrictions of these regulations upon the disclosure and use of drug abuse patient records were initially authorized by section 408...

  5. 42 CFR 2.1 - Statutory authority for confidentiality of drug abuse patient records.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.1 Statutory authority for confidentiality of drug abuse patient records. The restrictions of these regulations upon the disclosure and use of drug abuse patient records were initially authorized by section 408...

  6. 42 CFR 2.1 - Statutory authority for confidentiality of drug abuse patient records.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.1 Statutory authority for confidentiality of drug abuse patient records. The restrictions of these regulations upon the disclosure and use of drug abuse patient records were initially authorized by section 408...

  7. 42 CFR 2.1 - Statutory authority for confidentiality of drug abuse patient records.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Introduction § 2.1 Statutory authority for confidentiality of drug abuse patient records. The restrictions of these regulations upon the disclosure and use of drug abuse patient records were initially authorized by section 408...

  8. Emotional security in the family system and psychological distress in female survivors of child sexual abuse.

    PubMed

    Cantón-Cortés, David; Cantón, José; Cortés, María Rosario

    2016-01-01

    The Emotional Security Theory (EST) was originally developed to investigate the association between high levels of interparental conflict and child maladaptative outcome. The objective of the present study was to analyze the effects of emotional security in the family system on psychological distress among a sample of young female adult survivors of child sexual abuse (CSA). The role of emotional security was investigated through the interactive effects of a number of factors including the type of abuse, the continuity of abuse, the relationship with the perpetrator and the existence of disclosure for the abuse. Participants were 167 female survivors of CSA. Information about the abuse was obtained from a self-reported questionnaire. Emotional security was assessed with the Security in the Family System (SIFS) Scale, and the Symptom Checklist-90-Revised (SCL-90-R) was used to assess psychological distress. In the total sample, insecurity (preoccupation and disengagement) was correlated with high psychological distress scores, whereas no relationship was found between security and psychological distress. The relationship between emotional insecurity and psychological distress was stronger in cases of continued abuse and non-disclosure, while the relationship between emotional security and distress was stronger in cases of extrafamilial abuse and especially isolated or several incidents and when a disclosure had been made. No interactive effect was found between any of the three emotional variables and the type of abuse committed. The results of the current study suggest that characteristics of CSA such as relationship with the perpetrator and, especially, continuity of abuse and whether or not disclosure had been made, can affect the impact of emotional security on psychological distress of CSA survivors. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Informal social reactions to college women's disclosure of intimate partner violence: associations with psychological and relational variables.

    PubMed

    Edwards, Katie M; Dardis, Christina M; Sylaska, Kateryna M; Gidycz, Christine A

    2015-01-01

    This researchers assessed informal (e.g., friends, family) social reactions to college women's (N = 139) disclosure of intimate partner violence (IPV) within their current romantic relationships and associated psychological (i.e., posttraumatic stress symptoms [PTSS] and global psychological distress symptoms) and relational (i.e., intentions to leave the abusive relationship) variables. Women completed confidential surveys, which assessed current partner abuse, psychological and relational variables, and three types of social reactions from informal supports to disclosure of IPV: positive (e.g., believing, validating the victim), negative (e.g., disbelieving, blaming the victim), and leaving (i.e., being told to end the relationship) reactions. At the bivariate level, negative social reactions to women's disclosure were related to increases in global psychological distress, PTSS, and leaving intentions; positive social reactions to disclosure related only to increases in PTSS; and being told to leave the relationship related to increases in PTSS and leaving intentions. In the regression analyses, after controlling for abuse severity, negative social reactions were significantly related to global psychological distress and PTSS, and being told to leave significantly related to leaving intentions and PTSS. Mechanisms for these relationships and implications are discussed. © The Author(s) 2014.

  10. Greek Teachers' Experience and Perceptions of Child Abuse/Neglect

    ERIC Educational Resources Information Center

    Bibou-Nakou, I.; Markos, A.

    2017-01-01

    The present paper focuses on teachers' experiences of child abuse/neglect cases, teachers' awareness of reporting or discounting, and their ways of responding to a hypothetical disclosure of abuse/neglect. A total of 1877 teachers in Greek public schools participated from a national teacher in-service training across the country; of them, 306…

  11. Investigating Sexual Abuse: Findings of a 15-Year Longitudinal Study

    ERIC Educational Resources Information Center

    McCormack, Bob; Kavanagh, Denise; Caffrey, Shay; Power, Anne

    2005-01-01

    Background: There is a lack of longitudinal large-scale studies of sexual abuse in intellectual disability services. Such studies offer opportunities to examine patterns in disclosure, investigation and outcomes, and to report on incidence and trends. Methods: All allegations of sexual abuse (n = 250) involving service users as victims or…

  12. Speaking With and Without Words-An Analysis of Foster Children's Expressions and Behaviors That Are Suggestive of Prior Sexual Abuse.

    PubMed

    Wubs, Dorijn; Batstra, Laura; Grietens, Hans W E

    2018-01-01

    This exploratory study reports on foster children's informal self-disclosures of previously unknown histories of sexual abuse. Data were collected from 40 children's files, and an inductive thematic analysis of verbal and behavioral expressions was conducted. Findings suggest that foster children's self-disclosures can be fragmented, spontaneous, narrative, or triggered and often occur during everyday activities in the foster family. The children disclose their past by referring to the perpetrator or the severity of the abuse or by acting out, mostly by reenacting sexual abuse experiences. In addition, some children use childish vocabulary focusing on genitals or sexual acts they were involved in or want to be involved in. Last, some foster children seem to be linguistically challenged to disclose that a female person abused them or that they were forced to reciprocate sexually. This study adds to the understanding of the complex process of child sexual abuse disclosure in the context of foster care.

  13. Willingness to disclose child maltreatment: CSA vs other forms of child abuse in relation to gender.

    PubMed

    Lev-Wiesel, Rachel; First, Maya

    2018-05-01

    The aim of the study was to examine the role of gender in willingness to disclose childhood sexual abuse (CSA) compared to other forms of abuse (physical, emotional and neglect) in young adolescents. Willingness was examined through two terms: reluctance- the level of unwillingness or disinclination to disclose, and urge-the need to share in order to get rid of unbearable feelings. The sample consisted of 3,156 boys (n = 1,544) and girls (n = 1,612) between the ages of 11-16 who reported having been abused at least once during their life. Participants were divided into three groups: experiencing other than CSA, sexual abuse with no physical contact, and sexual abuse with physical contact. Regarding measures, a self-report questionnaire incorporating the following instruments was administered: Demographics, the Juvenile Victimization Questionnaire (JVQ), and the Disclosure of Trauma Questionnaire (DTQ). Study results indicated that CSA victims were more reluctant to disclose than victims of other than CSA forms of abuse. The more severe the CSA (physical contact) the lower was the willingness to disclose. Boys were more reluctant than girls to disclose sexual abuse whether or not it involved physical contact. Reluctance to disclose was positively associated with emotional reactions to disclosure while urge to talk was negatively correlated with emotional reactions to disclosure. Copyright © 2018. Published by Elsevier Ltd.

  14. It Happened to Me: A Qualitative Analysis of Boys' Narratives About Child Sexual Abuse.

    PubMed

    Foster, Jennifer M

    2017-10-01

    Previous research on children's narratives about sexual abuse written predominately by girls uncovered several themes, including: (a) memories of the abuse, (b) the disclosure and subsequent events, and (c) the healing journey and a meta-theme titled "fear and safety." This follow-up study explored how boys describe their life prior to, during, and after sexual abuse in the form of trauma narratives and if there are distinctive features of boys' experiences that differ from those of girls. Analysis of narratives written by males ages 3 to 17 (N = 19) found that boys ascribe to the same themes as the initial research but also have experiences and perspectives that are unique to being male survivors. This article focuses on the first two themes: memories of the abuse and the disclosure and subsequent events. Gender differences are discussed along with recommendations for prevention of male sexual abuse.

  15. Facilitators and barriers to disclosing abuse among women with disabilities.

    PubMed

    Curry, Mary Ann; Renker, Paula; Robinson-Whelen, Susan; Hughes, Rosemary B; Swank, Paul; Oschwald, Mary; Powers, Laurie E

    2011-01-01

    An anonymous audio computer-assisted self-interview (A-CASI) designed to increase awareness of abuse was completed by 305 women with diverse disabilities. Data were also collected about lifetime and past year abuse; perpetrator risk characteristics; facilitators and barriers to disclosing abuse; abuse disclosure to a health provider, case manager, or police officer; and whether a health provider had ever discussed abuse or personal safety. A total of 276 (90%) women reported abuse, 208 (68%) reported abuse within the past year. Women who reported the most abuse experiences in the past year and the most dangerous perpetrators endorsed fewer facilitators and more barriers, but were also more likely to have ever disclosed abuse. Only 15% reported that a health provider had ever discussed abuse and personal safety.

  16. Diagnostic imaging of child abuse

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kleinman, P.K.

    1987-01-01

    This book provides a description for all the known radiological alterations occurring in child abuse. This allows for precise interpretation of findings by radiologists. It also helps eliminate the confusion among both clinicians and non-medical personnel involved in the diagnosis, management, and legal issues related to child abuse. CONTENTS: Introduction; Skeletal trauma: general considerations; Extremity trauma; Bony thoracic trauma; Spinal trauma; Dating fractures; Visceral trauma; Head trauma; Miscellaneous forms of abuse and neglect; The postmortem examination; Differential diagnosis of child abuse; Legal considerations; Psychosocial considerations; Technical considerations and dosimetry.

  17. Recantation in Child Sexual Abuse Cases.

    ERIC Educational Resources Information Center

    Rieser, Margaret

    1991-01-01

    Reviews the literature on children's retraction of their disclosure of having been sexually abused. The evidence indicates that very few lied originally. The circumstances that underlie recantation, including false allegations, secrecy, denial, lack of support, pressure to recant, societal attitudes, and intervening events, are discussed, and…

  18. Attachment Representations and Anxiety: Differential Relationships among Mothers of Sexually Abused and Comparison Girls

    ERIC Educational Resources Information Center

    Kim, Kihyun; Trickett, Penelope K.; Putnam, Frank W.

    2011-01-01

    The present study sought to document an example of how childhood sexual abuse and attachment representation interact while contributing to the trait anxiety of nonoffending mothers following the disclosure of their daughters' sexual abuse. The study sample consisted of 57 ethnically diverse mothers of sexually abused girls aged 6 to 16 and 47…

  19. Maternal Perceptions Of And Responses To Child Sexual Abuse

    PubMed Central

    Vidovič, Lea

    2016-01-01

    Abstract Background Several researches indicate that most child victims delay disclosing of sexual abuse for significant periods of time. There are numerous reasons as to why children are avoiding the disclosure of the abuse. The aim of this study was to determine how a mother’s response to a child’s allegations impacts the child’s willingness to disclose sexual abuse. Methods We conducted a retrospective quantitative and qualitative analysis of 73 court-referred cases of child sexual abuse which have been disclosed in Slovenia in the last ten years. All the child victims included in the study were female and the perpetrators adult male persons. The expert opinions were made by the same expert. Results We realized that, at the occurrence of abuse, the child victims were from 4 to 15 years old and their mean age was at 11. 5 years. About two-thirds of children were victims of the intra-familial type (61.6%) and a little more than one third of extra-familial type of sexual abuse (38.4%). The group of victims with the support of their mothers needed about 9 months to disclose the secret, while the delay of the disclosure in the cases without the support of mothers was much longer (M=6.9 years). Conclusion For female child victims of sexual abuse the perceived protective attitude of their mothers is very important. Especially when the sexual abuse happened in the family, the mother’s support can attribute to stop the ongoing abuse, eliminate its immediate effects and decrease its likely negative long-term outcome. PMID:27284381

  20. [Abuse of minors. Clinical considerations on physical abuse, sexual aggression and emotional deprivation].

    PubMed

    Loredo-Abdalá, A; Trejo-Hernández, J; Bustos-Valenzuela, V

    1999-01-01

    Physicians and other health personnel dealing with the consequences of child abuse ought to have abroad understanding of the magnitude of this serious medical and social phenomenon. The three main patterns of child mistreatment as observed at a pediatric hospital are reviewed, with emphasis on its medical and juridical aspects. Various pathologic entities are to be taken into account for differential diagnoses when child abuse is suspected. Risk factors regarding the victims, the abusers and the psychosocial environment are noted.

  1. Adolescent homosexuality and concerns regarding disclosure.

    PubMed

    Harrison, Therese W

    2003-03-01

    Development of sexual identity in middle childhood and early adolescence is a natural process. However, it is more stressful for homosexual adolescents. Society continues to stigmatize and marginalize homosexuality. To avoid rejection and hostility, homosexual adolescents are pressured to hide their sexual identities. This fact compounds the anticipated normal developmental concerns of adolescence, and can create unique problems for the homosexual adolescents. Homosexuality can place them at risk for social stigmatization, isolation, depression, suicide, abuse, and rejection by their families and friends. During this exceptionally stressful time, both adolescent students and their families need anticipatory guidance and support. In providing anticipatory guidance, this article discusses critical roles played by professionals who work with adolescents in community or school settings. Included are insights into development of this normal variant of sexual attraction and orientation, risks that homosexual adolescent students may face as well as their disclosure concerns, and possible reactions families may have following disclosure. Supporting homosexual adolescents and their families is emphasized with regard to sensitively providing information, disclosure decisions, coping with stigmatization, and resiliency factors.

  2. A child sexual abuse research project: a brief endnote.

    PubMed

    Roberts, Susan; Vanstone, Maurice

    2014-01-01

    There is a dearth of research on sexual abuse perpetrated by educators. Although the problem is receiving increasing attention, little emphasis has been placed on abuse directed at younger schoolchildren and on offenders' accounts of this form of abuse. Here, we attempt to address this gap in knowledge by exploring the narratives of five convicted, imprisoned male child sexual abusers, each of whom worked with children in educational settings in the United Kingdom. We draw on four themes that emerged from detailed interviews with offenders, namely: the power of reputation, authority and control, the "front of invulnerability," and disclosure of abuse. We conclude by considering the implications of our work for policy and practice.

  3. Containing the secret of child sexual abuse.

    PubMed

    McElvaney, Rosaleen; Greene, Sheila; Hogan, Diane

    2012-04-01

    This study reports a grounded theory study of the process of how children tell of their experiences of child sexual abuse from the perspectives of young people and their parents. Individual interviews were conducted with 22 young people aged 8 to 18, and 14 parents. A theoretical model was developed that conceptualises the process of disclosure as one of containing the secret of child sexual abuse. Three key dynamics were identified: the active withholding of the secret on the part of the child, the experience of a 'pressure cooker effect' reflecting a conflict between the wish to tell and the wish to keep the secret, and the confiding itself which often occurs in the context of an intimacy being shared. Children's experiences of disclosure were multidetermined and suggest the need for multifaceted and multisystemic approaches to prevention and intervention. The need for the secret to be contained, individually and interpersonally in appropriate safeguarding and therapeutic contexts needs to be respected in helping children tell.

  4. Disclosure of intimate partner violence to informal social support network members: a review of the literature.

    PubMed

    Sylaska, Kateryna M; Edwards, Katie M

    2014-01-01

    This article presents a review of the published literature to date on rates, experiences, and correlates of victims' disclosure of or help seeking for intimate partner violence to informal social support network members (e.g., friends, family, classmates, and coworkers). Research indicates that the majority of individuals disclose to at least one informal support and that victims' disclosure is associated with a number of demographic (e.g., victims' sex, age, race), intrapersonal (e.g., victims' feelings of shame/embarrassment, perception of control over abuse), and situational (e.g., violence frequency and severity, if abuse is witnessed) factors. Following disclosure, victims experience a wide range of positive (e.g., believing the victim's reports, validating the victim's experiences) and negative (e.g. disbelieving, blaming the victim) social reactions, with positive reactions rated as the most common and most helpful forms of support by victims. Finally, a review of psychological correlates associated with reactions to disclosure indicates that positive social reactions are associated with more psychological health benefits and fewer negative health symptoms, whereas negative social reactions were associated with increased negative psychological health symptoms. Future research methodologies and implications for violence prevention, intervention, and policy are discussed.

  5. Predictors of Clinical Outcomes in Sexually Abused Adolescents.

    PubMed

    Tocker, Lotem; Ben-Amitay, Galit; Horesh-Reinman, Netta; Lask, Michal; Toren, Paz

    2017-01-01

    This cross-sectional, case control study examines the association between child sexual abuse and interpersonal and intrapersonal outcomes among 54 adolescents, examining specific clinical measures (depression, anxiety, dissociation, and posttraumatic stress disorder, attachment patterns, self-esteem, self-disclosure, and family environment characteristics). The research results point to a correlation between sexual abuse and higher levels of the clinical measures. In addition, a correlation was found between sexual abuse and level of avoidant attachment, self-esteem, and family environment characteristics. Stepwise hierarchical regressions were conducted to examine how adolescent attributes predicted depression, anxiety, and dissociation beyond the prediction based on sexual abuse. A combination of self-esteem, anxiety attachment, and family cohesiveness made sexual abuse insignificant when predicting levels of depression, anxiety, and dissociation. This study contributes to characterizing the emotional, personal, and family attributes of adolescents who experienced sexual abuse. It also raises questions about the clinical outcomes usually associated with sexual abuse.

  6. Identifying the turning point: using the transtheoretical model of change to map intimate partner violence disclosure in emergency department settings.

    PubMed

    Catallo, Cristina; Jack, Susan M; Ciliska, Donna; Macmillan, Harriet L

    2012-01-01

    Background. The transtheoretical model of change (TTM) was used as a framework to examine the steps that women took to disclose intimate partner violence (IPV) in urban emergency departments. Methods. Mapping methods portrayed the evolving nature of decisions that facilitated or inhibited disclosure. This paper is a secondary analysis of qualitative data from a mixed methods study that explored abused women's decision making process about IPV disclosure. Findings. Change maps were created for 19 participants with movement from the precontemplation to the maintenance stages of the model. Disclosure often occurred after a significant "turning point event" combined with a series of smaller events over a period of time. The significant life event often involved a weighing of options where participants considered the perceived risks against the potential benefits of disclosure. Conclusions. Abused women experienced intrusion from the chaotic nature of the emergency department. IPV disclosure was perceived as a positive experience when participants trusted the health care provider and felt control over their decisions to disclose IPV. Practice Implications. Nurses can use these findings to gauge the readiness of women to disclose IPV in the emergency department setting.

  7. Identifying the Turning Point: Using the Transtheoretical Model of Change to Map Intimate Partner Violence Disclosure in Emergency Department Settings

    PubMed Central

    Catallo, Cristina; Jack, Susan M.; Ciliska, Donna; MacMillan, Harriet L.

    2012-01-01

    Background. The transtheoretical model of change (TTM) was used as a framework to examine the steps that women took to disclose intimate partner violence (IPV) in urban emergency departments. Methods. Mapping methods portrayed the evolving nature of decisions that facilitated or inhibited disclosure. This paper is a secondary analysis of qualitative data from a mixed methods study that explored abused women's decision making process about IPV disclosure. Findings. Change maps were created for 19 participants with movement from the precontemplation to the maintenance stages of the model. Disclosure often occurred after a significant “turning point event” combined with a series of smaller events over a period of time. The significant life event often involved a weighing of options where participants considered the perceived risks against the potential benefits of disclosure. Conclusions. Abused women experienced intrusion from the chaotic nature of the emergency department. IPV disclosure was perceived as a positive experience when participants trusted the health care provider and felt control over their decisions to disclose IPV. Practice Implications. Nurses can use these findings to gauge the readiness of women to disclose IPV in the emergency department setting. PMID:22792480

  8. Disclosure of information and informed consent: ethical and practical considerations.

    PubMed

    Steinberg, Avraham

    2009-12-01

    Disclosure of information and informed consent are relatively new concepts in the patient-physician relationship. They are based primarily on the principle of autonomy and they have many favorable practical advantages. However, the practical implementation of these requirements is fraught with difficulties, some of which can cause harm to the patient or be obstacles in fulfilling the moral obligation of beneficence. This is particularly true when disclosure of information and informed consent are done by physicians in a defensive way for fear of malpractice suits. The most ethically defensible approach is to tailor and navigate the information according to the needs and desires of each individual patient in a sensitive and empathic manner. The informed consent should be a process of mutually shared responsibility by the patient and the physician, ensuring adequate and relevant information that is well comprehended by the individual patient, and is used correctly for his or her decision making.

  9. Leader identity as an antecedent of the frequency and consistency of transformational, consideration, and abusive leadership behaviors.

    PubMed

    Johnson, Russell E; Venus, Merlijn; Lanaj, Klodiana; Mao, Changguo; Chang, Chu-Hsiang

    2012-11-01

    Drawing from identity-based theories of leadership, we examined relations of leader identity with leader behavior and perceived effectiveness. To do so, we employed multiwave methodology to examine the differential impact of leaders' chronic collective, relational, and individual identities on the frequency and consistency of their subsequent transformational, consideration, and abusive behaviors over a 3-week period. We also examined the relative importance of these leadership behaviors for predicting perceived leader effectiveness as rated by subordinates and peers. Results indicated that leaders' collective and individual identities were uniquely related to transformational and abusive behaviors, respectively. We also observed a significant collective by individual identity interaction, such that abusive behaviors were most frequent when a strong individual identity was paired with a weak collective identity. Frequency of transformational behaviors accounted for the largest proportion of variance in perceived leader effectiveness, followed by frequency of abusive behaviors and consistency of transformational behaviors. We discuss the implications of these findings for leadership theory and development. (c) 2012 APA, all rights reserved.

  10. Practical and ethical considerations for using social media in community consultation and public disclosure activities.

    PubMed

    Galbraith, Kyle L

    2014-10-01

    Social media are becoming increasingly integrated into both the clinical and the research dimensions of emergency medicine. They can provide methods for sharing crucial information to targeted individuals or groups in a rapid fashion. As a result, investigators conducting emergency research under the exception from prospective informed consent requirements are beginning to turn to social media platforms as they engage in required community consultation and public disclosure activities before their research begins. At present, there are limited data regarding how effectively social media have been used for performing those consultation and disclosure activities. This article offers investigators four specific areas to consider before using social media in consultation and outreach efforts. First, understand the forms of outreach social media platforms can provide. Second, recognize how those outreach methods relate to the specific goals of community consultation and public disclosure. Third, consider whether or not the intended audiences of community consultation and public disclosure will be available via social media. Finally, think about how social media outreach efforts will be measured and assessed before consultation and disclosure activities are under way. © 2014 by the Society for Academic Emergency Medicine.

  11. Factors influencing disclosure among women experiencing intimate partner violence during pregnancy in Moshi Municipality, Tanzania.

    PubMed

    Katiti, Victor; Sigalla, Geofrey Nimrod; Rogathi, Jane; Manongi, Rachel; Mushi, Declare

    2016-08-04

    Intimate Partner Violence (IPV) has serious negative health effects to millions of women around the globe. While disclosing IPV could open doors for support and eventually prevent partner abuse, the factors associated with IPV disclosure during pregnancy are not well known. The aim of this study was to examine factors influencing IPV disclosure to any person of interest or organization supporting women during pregnancy in Moshi Municipality, Tanzania. Data were from a prospective cohort study of 1123 pregnant women followed-up by the project aiming to assess the impact of violence in the reproductive health conducted in Moshi Municipality, Tanzania from March 2014 to May 2015. Inclusion criteria to the current analysis were all 339 pregnant women who reported to have experienced physical, sexual and/or emotional violence during the index pregnancy. Data analysis used SPSS Version 20. Odds ratio with 95 % Confidence Interval (CI) for factors associated with IPV disclosure was estimated using multivariate logistic regression models while controlling for age, education and parity. A p-value of less than 0.05 was considered for a statistically significant difference. IPV disclosure was found to be 23.3 % (n = 79). Disclosure of IPV was less likely among unemployed (OR = 0.5, 95 % CI 0.30-0.90) and women whose index pregnancy was unplanned (OR = 0.53, 95 % CI 0.29-0.98). Women who regularly participated in women's or community groups, religious groups or political associations at least once a month had 2 times higher odds of IPV disclosure compared to those who did not attend regularly (OR = 2.12, 95 % CI 1.13-3.95). Most of the abused women during pregnancy who disclosed their experience of IPV (69 %) disclosed to a member of the family of birth followed by friends (14 %) and a member of family of the partner (11 %). Most of the women who experienced IPV during pregnancy kept suffering in silence while less than a quarter of all the abused (23.3

  12. Navigating treatment impasses at the disclosure of incest: combining ideas from feminism and social constructionism.

    PubMed

    Sheinberg, M

    1992-09-01

    This article describes an approach to the social and emotional schisms that characterize the disclosure of intrafamilial sexual abuse (incest). It argues that ideas from social constructionism and feminism can be combined in such a way that what appear as either/or choices become both--and possibilities. These include: social control versus therapy, shame versus pride, attachment to one's abusive partner versus attachment to one's injured child, and "justice" versus "care."

  13. What Canadian Youth Tell Us about Disclosing Abuse

    ERIC Educational Resources Information Center

    Ungar, Michael; Tutty, Leslie M.; McConnell, Sheri; Barter, Ken; Fairholm, Judi

    2009-01-01

    Objective: To report findings from a study of anonymous disclosures of abuse experiences among a national sample of youth in Canada who participated in violence prevention programming. Methods: A qualitative analysis was done of a purposeful sample of 1,099 evaluation forms completed following Red Cross RespectED violence prevention programming…

  14. Child sexual abuse and mandatory reporting intervention preservice content preferred by student teachers.

    PubMed

    Goldman, Juliette D G; Grimbeek, Peter

    2014-01-01

    The importance of preservice university teacher training about child sexual abuse and its mandatory reporting intervention is addressed in educational literature, although very little is known about student teachers' learning interests and preferences in this area. In this article, student teachers refer to students in university who are training to become teachers whose training includes teaching experiences in schools. This study examines the content about child sexual abuse and its intervention that student teachers believe they should learn. Results based on quantitative analyses show the relative importance of gender in determining responses to questions about university training and, to a lesser extent, the importance of a previous acquaintance with victims of sexual abuse, previous employment, and the length of the university course. Results based on qualitative data show that content knowledge preferred by elementary/primary and secondary school student teachers includes the teacher's role in mandatory reporting of child sexual abuse and signs, experiences, and responses to student disclosure. Student teachers prefer content examples of school professionals' responses and procedures after disclosure and prefer direct learning content from intervening school professionals. These outcomes could usefully guide teachers and educators who design intervention curricula on child sexual abuse for preservice teachers.

  15. 45 CFR 164.512 - Uses and disclosures for which an authorization or opportunity to agree or object is not required.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... that have been recalled, withdrawn, or are the subject of lookback); or (D) To conduct post marketing... violence—(1) Permitted disclosures. Except for reports of child abuse or neglect permitted by paragraph (b... individual whom the covered entity reasonably believes to be a victim of abuse, neglect, or domestic violence...

  16. 45 CFR 164.512 - Uses and disclosures for which an authorization or opportunity to agree or object is not required.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... (D) To conduct post marketing surveillance; (iv) A person who may have been exposed to a communicable...)(1) of this section. (c) Standard: Disclosures about victims of abuse, neglect or domestic violence... whom the covered entity reasonably believes to be a victim of abuse, neglect, or domestic violence to a...

  17. 45 CFR 164.512 - Uses and disclosures for which an authorization or opportunity to agree or object is not required.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... (D) To conduct post marketing surveillance; (iv) A person who may have been exposed to a communicable...)(1) of this section. (c) Standard: Disclosures about victims of abuse, neglect or domestic violence... whom the covered entity reasonably believes to be a victim of abuse, neglect, or domestic violence to a...

  18. 45 CFR 164.512 - Uses and disclosures for which an authorization or opportunity to agree or object is not required.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... that have been recalled, withdrawn, or are the subject of lookback); or (D) To conduct post marketing... violence—(1) Permitted disclosures. Except for reports of child abuse or neglect permitted by paragraph (b... individual whom the covered entity reasonably believes to be a victim of abuse, neglect, or domestic violence...

  19. 45 CFR 164.512 - Uses and disclosures for which an authorization or opportunity to agree or object is not required.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... that have been recalled, withdrawn, or are the subject of lookback); or (D) To conduct post marketing... violence—(1) Permitted disclosures. Except for reports of child abuse or neglect permitted by paragraph (b... individual whom the covered entity reasonably believes to be a victim of abuse, neglect, or domestic violence...

  20. Containing the Secret of Child Sexual Abuse

    ERIC Educational Resources Information Center

    McElvaney, Rosaleen; Greene, Sheila; Hogan, Diane

    2012-01-01

    This study reports a grounded theory study of the process of how children tell of their experiences of child sexual abuse from the perspectives of young people and their parents. Individual interviews were conducted with 22 young people aged 8 to 18, and 14 parents. A theoretical model was developed that conceptualises the process of disclosure as…

  1. The health visitor's role in the identification of domestic abuse.

    PubMed

    Litherland, Rachel

    2012-08-01

    Internationally, domestic abuse is a significant public health issue in terms of imposing physical and psychological distress upon victims, having a detrimental impact upon parenting and causing psychological problems for victim's children. Figures identify that one in four UK women experience domestic abuse. However, it is acknowledged that reported rates are gross underestimates of true figures and that multiple barriers exist that inhibit domestic abuse identification. This paper reviews the literature to explore these barriers and ascertain evidence-based strategies that will help practitioners to identify domestic abuse more effectively. Particular attention is paid to domestic abuse screening tools, as research suggests their use increases disclosure rates. The paper concludes that routine and recurrent enquiry using a screening tool, information giving to all women, knowledgeable staff and supportive environments, are all potential facilitators to identification.

  2. From public to private: the history of domestic abuse in Britain.

    PubMed

    McIntosh, Tania; Ashwin, Cathy

    2012-02-01

    Today all midwives are expected to be able to ask women about domestic abuse, and to respond appropriately to any disclosure. However, it is only in the last twenty years that health professionals, including midwives, have begun to appreciate both the scale and effect of domestic abuse. This article delves into the hidden history of this most secret aspect of family relationships and explores why midwives finally began to 'ask the question'.

  3. The Impact of Therapist Disclosure on Patient Disclosure

    ERIC Educational Resources Information Center

    Simonson, Norman R.

    1976-01-01

    A psychotherapy analogue study examined the effects of therapist disclosure on subject disclosure to the therapist during a first interview. Three levels of therapist disclosure, no disclosure, demographic disclosure, and personal disclosure, and two levels of therapist warmth were manipulated. Results are discussed. (Author)

  4. Exploring the Impact of Childhood Abuse on HIV Social and Attitudinal Factors Among Adults With and Without this History in Sub-Saharan Africa: Findings from NIMH Project Accept (HPTN 043).

    PubMed

    Richter, Linda; Makusha, Tawanda; Komárek, Arnošt; Daniels, Joseph; Coates, Tom

    2016-04-01

    Using data from four sites in three African countries, this community randomized study examined the association between childhood sexual and/or physical abuse (CSA and/or CPA) and HIV disclosure, HIV-related stigma, stress, and social support among adults with and without a history of abuse. A history of abuse among men was associated with higher levels of adult-reported stress and HIV-related stigma, and with significantly lower rates of HIV test result disclosure to current partners. Women with a history of CSA and/or CPA had significantly higher perceived stigma, discrimination and stress. Although childhood abuse was significantly associated with adult stress and stigmatization, participants with histories of CSA and/or CPA also reported significantly higher perceived social support compared to people without such experiences. These findings may reflect support received in response to disclosure of CSA or CPA or emotional ambivalence in relationships that have been found to be associated with child abuse. We conclude that it is critical for HIV prevention interventions to advocate for the primary prevention of child abuse, for early identification of adolescents and adults who report experiencing childhood abuse, and to address stigma and stress-related attitudinal, behavioral and relationship difficulties experiences as an aftermath of early abuse that increase their risk of HIV.

  5. Chemically dependent physicians and informed consent disclosure.

    PubMed

    Ackerman, T F

    1996-01-01

    Developments in law, professional guidelines, and public attitudes support informed consent disclosure by physicians who have been treated for chemical dependency. This view is built on the apparent materiality of the risk of relapse to informed treatment decisions by patients. Several considerations undercut this position. The probability is remote that a patient will be injured by a recovering physician who suffers an undetected relapse while being properly monitored. Monitoring by impaired physicians programs provides a more sensitive and specific mechanism for detecting relapsed physicians. Moreover, compromise of the privacy and employment rights of recovering physicians by consent disclosure is not justified if programs provide rigorous monitoring that protects the welfare of patients. Finally, required consent disclosure will reduce referrals of chemically dependent physicians to impaired physicians programs, thereby increasing the danger to patients. Limiting demands for required consent disclosure necessitates effective operation of impaired physicians programs.

  6. Prognostic Disclosures to Children: A Historical Perspective.

    PubMed

    Sisk, Bryan A; Bluebond-Langner, Myra; Wiener, Lori; Mack, Jennifer; Wolfe, Joanne

    2016-09-01

    Prognostic disclosure to children has perpetually challenged clinicians and parents. In this article, we review the historical literature on prognostic disclosure to children in the United States using cancer as an illness model. Before 1948, there was virtually no literature focused on prognostic disclosure to children. As articles began to be published in the 1950s and 1960s, many clinicians and researchers initially recommended a "protective" approach to disclosure, where children were shielded from the harms of bad news. We identified 4 main arguments in the literature at this time supporting this "protective" approach. By the late 1960s, however, a growing number of clinicians and researchers were recommending a more "open" approach, where children were included in discussions of diagnosis, which at the time was often synonymous with a terminal prognosis. Four different arguments in the literature were used at this time supporting this "open" approach. Then, by the late 1980s, the recommended approach to prognostic disclosure in pediatrics shifted largely from "never tell" to "always tell." In recent years, however, there has been a growing appreciation for the complexity of prognostic disclosure in pediatrics. Current understanding of pediatric disclosure does not lead to simple "black-and-white" recommendations for disclosure practices. As with most difficult questions, we are left to balance competing factors on a case-by-case basis. We highlight 4 categories of current considerations related to prognostic disclosure in pediatrics, and we offer several approaches to prognostic disclosure for clinicians who care for these young patients and their families. Copyright © 2016 by the American Academy of Pediatrics.

  7. Elder Abuse and Neglect: Considerations for Mental Health Practitioners

    ERIC Educational Resources Information Center

    Thompson, Heather; Priest, Ronnie

    2005-01-01

    Elder abuse and neglect are prevalent throughout the U.S. and are often unrecognized and untreated. It is projected that by the year 2030, the number of older adults (age 60 and older) will double, thereby increasing the likelihood that mental health practitioners will encounter instances of elder abuse and neglect. The authors address the…

  8. When the face reveals what words do not: facial expressions of emotion, smiling, and the willingness to disclose childhood sexual abuse.

    PubMed

    Bonanno, George A; Keltner, Dacher; Noll, Jennie G; Putnam, Frank W; Trickett, Penelope K; LeJeune, Jenna; Anderson, Cameron

    2002-07-01

    For survivors of childhood sexual abuse (CSA), verbal disclosure is often complex and painful. The authors examined the voluntary disclosure-nondisclosure of CSA in relation to nonverbal expressions of emotion in the face. Consistent with hypotheses derived from recent theorizing about the moral nature of emotion, CSA survivors who did not voluntarily disclose CSA showed greater facial expressions of shame, whereas CSA survivors who voluntarily disclosed CSA expressed greater disgust. Expressions of disgust also signaled sexual abuse accompanied by violence. Consistent with recent theorizing about smiling behavior, CSA nondisclosers made more polite smiles, whereas nonabused participants expressed greater genuine positive emotion. Discussion addressed the implications of these findings for the study of disclosure of traumatic events, facial expression, and the links between morality and emotion.

  9. Special Considerations for Substance Abuse Intervention with Latino Youth

    ERIC Educational Resources Information Center

    Goldbach, Jeremy T.; Thompson, Sanna J.; Holleran Steiker, Lori K.

    2011-01-01

    Nearly 10% of Latino youth who are twelve and older are in need of substance abuse treatment for alcohol or illicit drug use. Ethnic differences exist with regard to susceptibility to drug use, attitudes regarding drugs, and drug resistance strategies. The failure of some substance abuse prevention programs can be traced in part to their lack of…

  10. 42 CFR 2.64 - Procedures and criteria for orders authorizing disclosures for noncriminal purposes.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Procedures and criteria for orders authorizing disclosures for noncriminal purposes. 2.64 Section 2.64 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS...

  11. 42 CFR 2.64 - Procedures and criteria for orders authorizing disclosures for noncriminal purposes.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Procedures and criteria for orders authorizing disclosures for noncriminal purposes. 2.64 Section 2.64 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS...

  12. 42 CFR 2.64 - Procedures and criteria for orders authorizing disclosures for noncriminal purposes.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Procedures and criteria for orders authorizing disclosures for noncriminal purposes. 2.64 Section 2.64 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS...

  13. 42 CFR 2.64 - Procedures and criteria for orders authorizing disclosures for noncriminal purposes.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Procedures and criteria for orders authorizing disclosures for noncriminal purposes. 2.64 Section 2.64 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS...

  14. 42 CFR 2.64 - Procedures and criteria for orders authorizing disclosures for noncriminal purposes.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Procedures and criteria for orders authorizing disclosures for noncriminal purposes. 2.64 Section 2.64 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS...

  15. Disclosure and help seeking behavior of women exposed to physical spousal violence in Dhaka slums.

    PubMed

    Parvin, Kausar; Sultana, Naznin; Naved, Ruchira Tabassum

    2016-05-10

    Despite high prevalence of intimate partner violence (IPV) and its adverse social and health consequences, the rate of help seeking for IPV is generally low. Although the level of IPV is much higher in urban slums of Bangladesh, the level and nature of help seeking of the victims are unknown. This paper aims to address this gap in the literature. Using a cross-sectional survey conducted between August 2011-February 2012, we explored disclosure of violence, help seeking behavior, and their correlates among randomly selected currently married women aged 15-29 in Dhaka slums (n = 2604). About 60 % of the currently married women reported past year spousal physical violence, but only 21 % disclosed and 19 % sought any help. High acceptance of violence was the main reason for not seeking help. Help was most commonly sought from informal sources (89 %). Any education, frequent and severe physical abuse, and presence of children increased the likelihood of disclosure and help seeking. Most survivors from slum who disclosed also sought help. Despite widespread physical abuse, many survivors never sought help. Wide acceptance of violence hampering help seeking needs to be challenged. Increasing disclosure would also enhance help seeking. Awareness rising regarding rights of women to live a violence free life is essential. Although many services are available in the urban area, information about these services needs to be available to women. Promoting education is important in increasing both disclosure and service uptake.

  16. When the analyst is ill: dimensions of self-disclosure.

    PubMed

    Pizer, B

    1997-07-01

    This article examines questions related to the "inescapable," the "inadvertent," and the "deliberate" personal disclosures by an analyst. Technical and personal considerations that influence the analyst's decision to disclose, as well as the inherent responsibilities and potential clinical consequences involved in self-disclosure, are explored, with particular attention to transference-countertransference dynamics, therapeutic goals, and the negotiation of resistance. The author describes her clinical work during a period of prolonged illness, with case vignettes that illustrate how-self-disclosure may be regarded as both an occasional authentic requirement and a regular intrinsic component of clinical technique.

  17. Special Medicare reimbursement and fraud and abuse considerations for management services organizations, medical foundations, and integrated delivery systems.

    PubMed

    DeMuro, P R; Owens, J F

    1994-01-01

    This chapter discusses certain Medicare reimbursement and fraud and abuse considerations for management services organizations (MSOs), medical foundations, and integrated delivery systems. It stresses the necessity of a business plan, the sources of capitalization that might be used in creating an integrated delivery system, and their effect on Medicare reimbursement. It also discusses related party principles and considerations and the Medicare "incident to" regulations. Furthermore, it discusses the application of certain Medicare safe harbor regulations on MSOs' structures and services, and those of medical foundations and integrated delivery systems.

  18. Three controversies over item disclosure in medical licensure examinations

    PubMed Central

    Park, Yoon Soo; Yang, Eunbae B.

    2015-01-01

    In response to views on public's right to know, there is growing attention to item disclosure – release of items, answer keys, and performance data to the public – in medical licensure examinations and their potential impact on the test's ability to measure competence and select qualified candidates. Recent debates on this issue have sparked legislative action internationally, including South Korea, with prior discussions among North American countries dating over three decades. The purpose of this study is to identify and analyze three issues associated with item disclosure in medical licensure examinations – 1) fairness and validity, 2) impact on passing levels, and 3) utility of item disclosure – by synthesizing existing literature in relation to standards in testing. Historically, the controversy over item disclosure has centered on fairness and validity. Proponents of item disclosure stress test takers’ right to know, while opponents argue from a validity perspective. Item disclosure may bias item characteristics, such as difficulty and discrimination, and has consequences on setting passing levels. To date, there has been limited research on the utility of item disclosure for large scale testing. These issues requires ongoing and careful consideration. PMID:26374693

  19. Three controversies over item disclosure in medical licensure examinations.

    PubMed

    Park, Yoon Soo; Yang, Eunbae B

    2015-01-01

    In response to views on public's right to know, there is growing attention to item disclosure - release of items, answer keys, and performance data to the public - in medical licensure examinations and their potential impact on the test's ability to measure competence and select qualified candidates. Recent debates on this issue have sparked legislative action internationally, including South Korea, with prior discussions among North American countries dating over three decades. The purpose of this study is to identify and analyze three issues associated with item disclosure in medical licensure examinations - 1) fairness and validity, 2) impact on passing levels, and 3) utility of item disclosure - by synthesizing existing literature in relation to standards in testing. Historically, the controversy over item disclosure has centered on fairness and validity. Proponents of item disclosure stress test takers' right to know, while opponents argue from a validity perspective. Item disclosure may bias item characteristics, such as difficulty and discrimination, and has consequences on setting passing levels. To date, there has been limited research on the utility of item disclosure for large scale testing. These issues requires ongoing and careful consideration.

  20. Mental illness disclosure in Chinese immigrant communities

    PubMed Central

    Chen, Fang-pei; Ying-Chi Lai, Grace; Yang, Lawrence

    2014-01-01

    Support from social networks is imperative to mental health recovery of persons with mental illness. However, disclosing mental illness may damage a person’s participation in networks due to mental illness stigma, especially in Chinese-immigrant communities where social networks (the guanxi network) has specific social-cultural significance. This study focused on mental illness disclosure in Chinese-immigrant communities in New York City. Fifty-three Chinese psychiatric patients were recruited consecutively from two Chinese bilingual psychiatric inpatient units from 2006 to 2010. Two bilingual psychologists interviewed each participant once in a semi-structured interview, including 6 questions on mental illness disclosure. Conventional content analysis was applied to conceptualize the phenomenon. Results showed that participants voluntarily disclosed to a circle of people composed primarily of family and relatives. The decisions and strategies to disclose depended on participants’ consideration of three critical elements of social relationships. Ganqing, affection associated with relationship-building, ultimately determined who had the privilege to know. Renqing, the moral code of reciprocal kindness, further influenced disclosure decisions and what participants anticipated as responses to disclosure. Lastly, concerns over preserving face (lian), a construct representing personal and familial dignity, oftentimes prohibited disclosure. Additionally, in this tight-knit network involuntary disclosure could happen without participants’ permission or knowledge. Participants commonly suffered from stigma after disclosure. However, half of our participants reported situations where they experienced little discriminatory treatment and some experienced support and care as a result of cultural dynamics. Recommendations for culturally sensitive practice to facilitate mental illness disclosure among Chinese immigrants were discussed. PMID:23647389

  1. Measures That Identify Prescription Medication Misuse, Abuse, and Related Events in Clinical Trials: ACTTION Critique and Recommended Considerations.

    PubMed

    Smith, Shannon M; Jones, Judith K; Katz, Nathaniel P; Roland, Carl L; Setnik, Beatrice; Trudeau, Jeremiah J; Wright, Stephen; Burke, Laurie B; Comer, Sandra D; Dart, Richard C; Dionne, Raymond; Haddox, J David; Jaffe, Jerome H; Kopecky, Ernest A; Martell, Bridget A; Montoya, Ivan D; Stanton, Marsha; Wasan, Ajay D; Turk, Dennis C; Dworkin, Robert H

    2017-11-01

    Accurate assessment of inappropriate medication use events (ie, misuse, abuse, and related events) occurring in clinical trials is an important component in evaluating a medication's abuse potential. A meeting was convened to review all instruments measuring such events in clinical trials according to previously published standardized terminology and definitions. Only 2 approaches have been reported that are specifically designed to identify and classify misuse, abuse, and related events occurring in clinical trials, rather than to measure an individual's risk of using a medication inappropriately: the Self-Reported Misuse, Abuse, and Diversion (SR-MAD) instrument and the Misuse, Abuse, and Diversion Drug Event Reporting System (MADDERS). The conceptual basis, strengths, and limitations of these methods are discussed. To our knowledge, MADDERS is the only system available to comprehensively evaluate inappropriate medication use events prospectively to determine the underlying intent. MADDERS can also be applied retrospectively to completed trial data. SR-MAD can be used prospectively; additional development may be required to standardize its implementation and fully appraise the intent of inappropriate use events. Additional research is needed to further demonstrate the validity and utility of MADDERS as well as SR-MAD. Identifying a medication's abuse potential requires assessing inappropriate medication use events in clinical trials on the basis of a standardized event classification system. The strengths and limitations of the 2 published methods designed to evaluate inappropriate medication use events are reviewed, with recommended considerations for further development and current implementation. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

  2. From disclosure to transparency: the use of company payment data.

    PubMed

    Chimonas, Susan; Frosch, Zachary; Rothman, David J

    2011-01-10

    It has become standard practice in medical journals to require authors to disclose their relationships with industry. However, these requirements vary among journals and often lack specificity. As a result, disclosures may not consistently reveal author-industry ties. We examined the 2007 physician payment information from 5 orthopedic device companies to evaluate the current journal disclosure system. We compared company payment information for recipients of $1 million or more with disclosures in the recipients' journal articles. Payment data were obtained from Biomet, DePuy, Smith & Nephew, Stryker, and Zimmer. Disclosures were obtained in the acknowledgments section, conflict of interest statements, and financial disclosures of recipients' published articles. We also assessed variations in disclosure by authorship position, payment-article relatedness, and journal disclosure policies. Of the 41 individuals who received $1 million or more in 2007, 32 had published articles relating to orthopedics between January 1, 2008, and January 15, 2009. Disclosures of company payments varied considerably. Prominent authorship position and article-payment relatedness were associated with greater disclosure, although nondisclosure rates remained high (46% among first-, sole-, and senior-authored articles and 50% among articles directly or indirectly related to payments). The accuracy of disclosures did not vary with the strength of journals' disclosure policies. Current journal disclosure practices do not yield complete or consistent information regarding authors' industry ties. Medical journals, along with other medical institutions, should consider new strategies to facilitate accurate and complete transparency.

  3. Relationships between Maternal Adult Attachment Security, Child Perceptions of Maternal Support, and Maternal Perceptions of Child Responses to Sexual Abuse.

    ERIC Educational Resources Information Center

    Leifer, Myra; Kilbane, Teresa; Skolnick, Linda I.

    2002-01-01

    Study assessed the relationships between maternal adult attachment style, children's perceptions of maternal support following disclosure of sexual abuse, and maternal perceptions of children's behavioral and emotional responses to sexual abuse. Findings indicate that fostering parent-child attachment is important in order to decrease the risk for…

  4. Exploratory Evaluation of a School-Based Child Sexual Abuse Prevention Program

    ERIC Educational Resources Information Center

    Barron, Ian G.; Topping, Keith J.

    2013-01-01

    Internationally, efficacy studies of school-based child sexual abuse prevention programs display a series of methodological shortcomings. Few studies include adolescent participants, recording of disclosures has been inconsistent, and no studies to date have assessed presenter adherence to program protocols or summated the costs of program…

  5. Young men's perspectives on family support and disclosure of same-sex attraction.

    PubMed

    Carpineto, Julie; Kubicek, Katrina; Weiss, George; Iverson, Ellen; Kipke, Michele D

    2008-06-01

    Young men who have sex with men (YMSM) face myriad challenges when deciding to disclose their sexual orientation to family members. Key to this decision is consideration of how disclosure may influence the support they receive from family. This paper explores a diverse sample of YMSM's (N = 43) perspectives on disclosure of their same-sex attractions to key family members and its impact on family support. Several stages/categories of disclosure are described and some YMSM seemed to continue to move between categories. Additionally, relationships after disclosure included negotiations between the expression of their sexual orientation and the maintenance of family support.

  6. Mental illness disclosure in Chinese immigrant communities.

    PubMed

    Chen, Fang-Pei; Lai, Grace Ying-Chi; Yang, Lawrence

    2013-07-01

    Support from social networks is imperative to mental health recovery of persons with mental illness. However, disclosing mental illness may damage a person's participation in networks due to mental illness stigma, especially in Chinese immigrant communities where social networks (the guanxi network) have specific social-cultural significance. This study focused on mental illness disclosure in Chinese immigrant communities in New York City. Fifty-three Chinese psychiatric patients were recruited consecutively from 2 Chinese bilingual psychiatric inpatient units from 2006 to 2010. Two bilingual psychologists interviewed each participant once in a semistructured interview, including 6 questions on mental illness disclosure. Conventional content analysis was applied to conceptualize the phenomenon. Results showed that participants voluntarily disclosed to a circle of people composed primarily of family and relatives. The decisions and strategies to disclose depended on participants' consideration of 3 critical elements of social relationships. Ganqing, affection associated with relationship building, ultimately determined who had the privilege to know. Renqing, the moral code of reciprocal kindness, further influenced disclosure decisions and what participants anticipated as responses to disclosure. Lastly, concerns over preserving face (lian), a construct representing personal and familial dignity, oftentimes prohibited disclosure. Additionally, in this tight-knit network, involuntary disclosure could happen without participants' permission or knowledge. Participants commonly suffered from stigma after disclosure. However, half of our participants reported situations in which they experienced little discriminatory treatment, and some experienced support and care as a result of cultural dynamics. Recommendations for culturally sensitive practice to facilitate mental illness disclosure among Chinese immigrants were discussed. PsycINFO Database Record (c) 2013 APA, all

  7. Attributions of Blame in a Hypothetical Child Sexual Abuse Case: Roles of Behavior Problems and Frequency of Abuse.

    PubMed

    Theimer, Kate; Hansen, David J

    2017-06-01

    Youth who are blamed for their sexual abuse may experience increased negative outcomes, such as amplified self-blame. Similarly, blaming nonoffending parents can impede their ability to support their child following disclosure. Understanding the factors that influence how people perceive victim, caregiver, and perpetrator responsibility is imperative for the protection and treatment of families who have experienced sexual abuse. Little research has explored victim and abuse characteristics that influence the perception of sexual abuse. As such, the purpose of this study was to examine the roles of behavior problems and frequency of abuse in the attribution of blame in a hypothetical sexual abuse case. In addition, the relationship between several respondent characteristics and assignment of responsibility were explored as secondary aims. The study used a two (behavior problems: three suspensions in one school semester vs. no mention of behavior problems) by two (one abuse occurrence vs. five abuse occurrences) between-subjects design. Seven hundred forty-two participants read one of the four child sexual abuse (CSA) vignettes and completed measures related to responsibility. ANOVAs revealed those who read a vignette where the youth experienced multiple abuse incidents rated the victim as more responsible regardless of whether or not the youth was described as having behavior problems. Results indicate that respondents may have attributed more blame to the victim due to the belief that she could have done something to stop the abuse after the first incident. The abuse frequency manipulation when combined with the behavior manipulation appeared to relate to how respondents perceived the victim's parents. Males and younger respondents attributed more blame to the victim; however, sexual abuse or assault history did not associate with victim responsibility ratings. Clinical and research implications were discussed.

  8. Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations

    PubMed Central

    Turk, Dennis C.; O’Connor, Alec B.; Dworkin, Robert H.; Chaudhry, Amina; Katz, Nathaniel P.; Adams, Edgar H.; Brownstein, John S.; Comer, Sandra D.; Dart, Richard; Dasgupta, Nabarun; Denisco, Richard A.; Klein, Michael; Leiderman, Deborah B.; Lubran, Robert; Rappaport, Bob A.; Zacny, James P.; Ahdieh, Harry; Burke, Laurie B.; Cowan, Penney; Jacobs, Petra; Malamut, Richard; Markman, John; Michna, Edward; Palmer, Pamela; Peirce-Sandner, Sarah; Potter, Jennifer S.; Raja, Srinivasa N.; Rauschkolb, Christine; Roland, Carl L.; Webster, Lynn R.; Weiss, Roger D.; Wolf, Kerry

    2013-01-01

    Opioids are essential to the management of pain in many patients, but they also are associated with potential risks for abuse, overdose, and diversion. A number of efforts have been devoted to the development of abuse-deterrent formulations of opioids to reduce these risks. This article summarizes a consensus meeting that was organized to propose recommendations for the types of clinical studies that can be used to assess the abuse deterrence of different opioid formulations. Due to the many types of individuals who may be exposed to opioids, an opioid formulation will need to be studied in several populations using various study designs in order to determine its abuse-deterrent capabilities. It is recommended that the research conducted to evaluate abuse deterrence should include studies assessing: (1) abuse liability; (2) the likelihood that opioid abusers will find methods to circumvent the deterrent properties of the formulation; (3) measures of misuse and abuse in randomized clinical trials involving pain patients with both low risk and high risk of abuse; and (4) post-marketing epidemiological studies. PMID:22770841

  9. Young men's perspectives on family support and disclosure of same-sex attraction

    PubMed Central

    Carpineto, Julie; Kubicek, Katrina; Weiss, George; Iverson, Ellen; Kipke, Michele D

    2011-01-01

    Young men who have sex with men (YMSM) face myriad challenges when deciding to disclose their sexual orientation to family members. Key to this decision is consideration of how disclosure may influence the support they receive from family. This paper explores a diverse sample of YMSM’s (N = 43) perspectives on disclosure of their same-sex attractions to key family members and its impact on family support. Several stages/categories of disclosure are described and some YMSM seemed to continue to move between categories. Additionally, relationships after disclosure included negotiations between the expression of their sexual orientation and the maintenance of family support. PMID:21423842

  10. The impact of disclosure on donor gamete participants: donors, intended parents and offspring.

    PubMed

    Greenfeld, Dorothy A

    2008-06-01

    The present review examines recent publications that provide insight into how the trend toward nonanonymity and disclosure in gamete donation impacts donors, intended parents, and their donor-conceived children. Recent findings show an increase in donor programs that offer open-identity between donors and offspring. The psychological needs of gamete donors and their attitudes toward disclosure are increasingly given consideration. Qualitative research on how parents of donor gamete offspring make decisions about disclosure reveals that even when couples initially disagree about disclosing to offspring, most ultimately come to a united disclosure decision. The literature on the impact of disclosure on donor gamete offspring has extended to include children conceived through embryo donation and children born as a result of surrogacy. The absence of genetic or gestational link between parents and their child does not have a negative impact on parent-child relationships. Parents through surrogacy tend to disclose the method of family creation to their child, whereas parents through embryo donation tend to be secretive about their child's origins. The trend toward greater openness in gamete donation has been accompanied by an increase in programs offering open-identity donation. In addition, the psychological needs of gamete donors and their attitudes toward disclosure are increasingly being given consideration. Parents of donor gamete offspring give careful thought to their disclosure decisions, and the psychological well being of donor-conceived children does not seem to be impacted by those decisions.

  11. [Accomplices under influence, teachers-lovers, "Incestigators" or pimps… Who are females child abusers?

    PubMed

    Cailleau, Virginie; Thirioux, Bérangère; Harika-Germaneau, Ghina; Jaafari, Nematollah

    2017-12-01

    According to victimization surveys, the percentage of females among child abusers is much higher than 2 or 5% as usually reported in the devoted literature. The under-estimated percentage of child sexual abuses committed by females would result from the dissimulation of sexual acts within nursing care, a gender bias in favor of women among child protection system professionals and low disclosures. Sexual abuses committed by females are often more harmful for children than sexual abuses committed by males. Although a few female child abusers suffers from psychiatric disorders, most of them are psychologically and emotionally dependent from a man or have psychopathic, manipulative and sometimes sadistic personality traits. Female child abusers are a heterogeneous population either acting under the influence of a man or initiating actively the offending for pedophile or financial motivations. Deconstructing the persistent myths about female child abusers is necessary to better identify these women, treat them and prevent relapse. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations.

    PubMed

    Turk, Dennis C; O'Connor, Alec B; Dworkin, Robert H; Chaudhry, Amina; Katz, Nathaniel P; Adams, Edgar H; Brownstein, John S; Comer, Sandra D; Dart, Richard; Dasgupta, Nabarun; Denisco, Richard A; Klein, Michael; Leiderman, Deborah B; Lubran, Robert; Rappaport, Bob A; Zacny, James P; Ahdieh, Harry; Burke, Laurie B; Cowan, Penney; Jacobs, Petra; Malamut, Richard; Markman, John; Michna, Edward; Palmer, Pamela; Peirce-Sandner, Sarah; Potter, Jennifer S; Raja, Srinivasa N; Rauschkolb, Christine; Roland, Carl L; Webster, Lynn R; Weiss, Roger D; Wolf, Kerry

    2012-10-01

    Opioids are essential to the management of pain in many patients, but they also are associated with potential risks for abuse, overdose, and diversion. A number of efforts have been devoted to the development of abuse-deterrent formulations of opioids to reduce these risks. This article summarizes a consensus meeting that was organized to propose recommendations for the types of clinical studies that can be used to assess the abuse deterrence of different opioid formulations. Because of the many types of individuals who may be exposed to opioids, an opioid formulation will need to be studied in several populations using various study designs to determine its abuse-deterrent capabilities. It is recommended that the research conducted to evaluate abuse deterrence should include studies assessing: (1) abuse liability, (2) the likelihood that opioid abusers will find methods to circumvent the deterrent properties of the formulation, (3) measures of misuse and abuse in randomized clinical trials involving pain patients with both low risk and high risk of abuse, and (4) postmarketing epidemiological studies. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  13. 42 CFR 2.35 - Disclosures to elements of the criminal justice system which have referred patients.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Disclosures to elements of the criminal justice system which have referred patients. 2.35 Section 2.35 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS...

  14. 42 CFR 2.35 - Disclosures to elements of the criminal justice system which have referred patients.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Disclosures to elements of the criminal justice system which have referred patients. 2.35 Section 2.35 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS...

  15. 42 CFR 2.35 - Disclosures to elements of the criminal justice system which have referred patients.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Disclosures to elements of the criminal justice system which have referred patients. 2.35 Section 2.35 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS...

  16. 42 CFR 2.35 - Disclosures to elements of the criminal justice system which have referred patients.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Disclosures to elements of the criminal justice system which have referred patients. 2.35 Section 2.35 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS...

  17. 42 CFR 2.35 - Disclosures to elements of the criminal justice system which have referred patients.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Disclosures to elements of the criminal justice system which have referred patients. 2.35 Section 2.35 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS...

  18. Inhalant abuse among adolescents: neurobiological considerations

    PubMed Central

    Lubman, D I; Yücel, M; Lawrence, A J

    2008-01-01

    Experimentation with volatile substances (inhalants) is common during early adolescence, yet limited work has been conducted examining the neurobiological impact of regular binge use during this key stage of development. Human studies consistently demonstrate that chronic use is associated with significant toxic effects, including neurological and neuropsychological impairment, as well as diffuse and subtle changes in white matter. However, most preclinical research has tended to focus on acute exposure, with limited work examining the neuropharmacological or toxicological mechanisms underpinning these changes or their potential reversibility with abstinence. Nevertheless, there is growing evidence that commonly abused inhalants share common cellular mechanisms, and have similar actions to other drugs of abuse. Indeed, the majority of acute behavioural effects appear to be underpinned by changes in receptor and/or ion channel activity (for example, GABAA, glycine and 5HT3 receptor activation, NMDA receptor inhibition), although nonspecific interactions can also arise at high concentrations. Recent studies examining the effects of toluene exposure during the early postnatal period are suggestive of long-term alterations in the function of NMDA and GABAA receptors, although limited work has been conducted investigating exposure during adolescence. Given the critical role of neurotransmitter systems in cognitive, emotional and brain development, future studies will need to take account of the substantial neuromaturational changes that are known to occur in the brain during childhood and adolescence, and to specifically investigate the neuropharmacological and toxicological profile of inhalant exposure during this period of development. PMID:18332858

  19. The risks of partner violence following HIV status disclosure, and health service responses: narratives of women attending reproductive health services in Kenya.

    PubMed

    Colombini, Manuela; James, Courtney; Ndwiga, Charity; Mayhew, Susannah H

    2016-01-01

    For many women living with HIV (WLWH), the disclosure of positive status can lead to either an extension of former violence or new conflict specifically associated with HIV status disclosure. This study aims to explore the following about WLWH: 1. the women's experiences of intimate partner violence (IPV) risks following disclosure to their partners; 2. an analysis of the women's views on the role of health providers in preventing and addressing IPV, especially following HIV disclosure. Thirty qualitative interviews were conducted with purposively selected WLWH attending clinics in Kenya. Data were coded using NVivo 9 and analyzed thematically. Nearly one third of the respondents reported experiencing physical and/or emotional violence inflicted by their partners following the sero-disclosure, suggesting that HIV status disclosure can be a period of heightened risk for partner stigma and abuse, and financial withdrawal, and thus should be handled with caution. Sero-concordance was protective for emotional and verbal abuse once the partner knew his positive status, or knew the woman knew his status. Our results show acceptance of the role of the health services in helping prevent and reduce anticipated fear of partner stigma and violence as barriers to HIV disclosure. Some of the approaches suggested by our respondents included couple counselling, separate counselling sessions for men, and facilitated disclosure. The women's narratives illustrate the importance of integrating discussions on risks for partner violence and fear of disclosure into HIV counselling and testing, helping women develop communication skills in how to disclose their status, and reducing fear about marital separation and break-up. Women in our study also confirmed the key role of preventive health services in reducing blame for HIV transmission and raising awareness on HIV as a chronic disease. However, several women reported receiving no counselling on safe disclosure of HIV status

  20. Cultural considerations in the treatment of mental illness among sexually abused children and adolescents: the case of Bali, Indonesia.

    PubMed

    Lesmana, Cokorda Bagus J; Suryani, Luh Ketut; Tiliopoulos, Niko

    2015-01-01

    Childhood and adolescence sexual abuse can have long-lasting and devastating effects on personal and interpersonal growth and development. Sexually abused children tend to exhibit higher rates of poor school performance, aggressive behavior, PTSD (posttraumatic stress disorder), or depressive symptomatology, as well as social and relational deficits (e.g., age-inappropriate sexual behaviors). The trauma following such abuse can further affect neurodevelopment and physiology, aggravating mental or physical problems in adulthood. Early symptom recognition and appropriate interventional applications are important factors in successfully treating or even preventing the development of mental disorders in such cohorts. A central element of effective treatment is the selection of treatment targets. Cultural considerations are rarely or peripherally considered in sexual abuse treatment strategies. Western-trained psychiatrists and clinical psychologists tend to overlook or underestimate such factors in cross-cultural settings, resulting in interventional efforts that may interfere with traditional approaches to healing, and potentially contributing to a transgenerational cycle of trauma. By using Bali (Indonesia) as a focal culture, in this article we discuss the effects of cultural elements and showcase their potential contribution and systematic implementation into a holistic and sensitive interventional model for the treatment of mental illness in childhood and adolescence sexual traumatization. © 2015 Wiley Periodicals, Inc.

  1. Abuse-Deterrent Opioid Formulations: Pharmacokinetic and Pharmacodynamic Considerations.

    PubMed

    Walter, Carmen; Knothe, Claudia; Lötsch, Jörn

    2016-07-01

    Abuse-deterrent formulations (ADFs) are technologically sophisticated pharmaceutical formulations that impede manipulation and extraction of opioids and/or provoke unpleasant effects when they are taken in excessive quantity. This is implemented by creating physical barriers, inseparably combining the opioid with an opioid antagonist or adding aversive agents to the formulation. These pharmaceutical changes may potentially alter the pharmacokinetics and consequently the pharmacodynamics of the opioid. In this review, comparative evidence on pharmacokinetic differences between abuse-deterrent and classical formulations of the same opioids is summarized; furthermore, pharmacodynamic differences, with a focus on analgesia and abuse-related symptoms, are addressed. Most of the 12 studies comparing opioid pharmacokinetics have judged the physically intact ADF as being bioequivalent to the corresponding classical formulation. Pharmacokinetic differences have, however, been reported with physically manipulated ADFs and have ranged from moderate deviations from bioequivalence to complete changes in the pharmacokinetic profile (e.g. from a sustained-release formulation to a fast-release formulation). Pharmacodynamic effects were assessed in 14 comparative studies, which reported that intact ADFs usually provided clinically equivalent analgesia and clear advantages with respect to their addiction potential. However, withdrawal symptoms could be induced by the ADFs, although rarely and, in particular, when the ADFs had been physically altered. This evidence suggests that opioid ADFs are a working concept resulting in mostly minor pharmacokinetic and pharmacodynamic differences in comparison with classical formulations; however, they may deviate from this equivalence when physically altered.

  2. 42 CFR 480.137 - Disclosure to Federal and State enforcement agencies responsible for the investigation or...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... agencies responsible for the investigation or identification of fraud or abuse of the Medicare or Medicaid programs. 480.137 Section 480.137 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... Medicare or Medicaid programs. (a) Required disclosure. Except as specified in §§ 480.139(a) and 480.140...

  3. Attachment representations and anxiety: differential relationships among mothers of sexually abused and comparison girls.

    PubMed

    Kim, Kihyun; Trickett, Penelope K; Putnam, Frank W

    2011-02-01

    The present study sought to document an example of how childhood sexual abuse and attachment representation interact while contributing to the trait anxiety of nonoffending mothers following the disclosure of their daughters' sexual abuse. The study sample consisted of 57 ethnically diverse mothers of sexually abused girls aged 6 to 16 and 47 mothers of comparison girls who were matched with the abused girls on age, socioeconomic status, and family constellation. Results indicate that the mothers' representations of past attachment relationships with their own fathers were differentially related to their current attachment styles, depending on their daughters' childhood sexual abuse status. The representation of past attachment relationships with peers had both main and protective effects on the mothers' trait anxiety symptoms. The relevance of attachment perspectives to adjustment among these mothers and intergenerational process in childhood sexual abuse are discussed, and implications for future research and clinical practices are identified.

  4. Differential Patterns of Disclosure of Child Abuse among Boys and Girls: Implications for Practitioners.

    ERIC Educational Resources Information Center

    Monaco, Nanci M.; Gaier, Eugene L.

    1988-01-01

    Discusses the differential incidence of male versus female reports of sexual abuse through hotlines and solicited reports. Reports occurred after the institution of a child abuse prevention program for 1,920 children K-12. (RJC)

  5. [Disclosure of conflicts of interest in the Tijdschrift voor Psychiatrie].

    PubMed

    Bergoets, M; Pieters, G

    2009-01-01

    Between March 2000 and December 2008 authors disclosed conflicts of interest in 9% of articles in the Tijdschrift voor Psychiatrie. For the same period, in the articles dealing with pharmaceuticals, the percentage of articles containing disclosures of conflict of interest was considerably higher, namely 24%. The policy of the journal with regard to the disclosure of conflicts of interest has helped to promote transparency. Further efforts are needed to encourage authors to disclose conflicts of interest.

  6. Managing identity impacts associated with disclosure of HIV status: a qualitative investigation

    PubMed Central

    Frye, Victoria; Fortin, Princess; MacKenzie, Sonja; Purcell, David; Edwards, Lorece V.; Mitchell, Shannon Gwin; Valverde, Eduardo; Garfein, R.; Metsch, Lisa; Latka, Mary H

    2011-01-01

    Disclosure of HIV status to potential and current sex partners by HIV-positive people (HIVPP) is a complex issue that has received a significant amount of attention. Research has found that disclosure depends upon the evaluation by HIVPP of potential benefits and risks, especially of the risks stemming from the profound social stigma of HIV and AIDS. Drawing on concepts from Goffman’s classic stigma theory and Anderson’s more recently developed cultural-identity theory of drug abuse, we analyzed data from in-depth, post-intervention qualitative interviews with 116 heterosexually active, HIV-positive injection drug users enrolled in a randomized trial of a behavioral intervention to prevent HIV transmission. We explored how disclosure experiences lead to “identity impacts” defined as: (1) identity challenges (i.e. interactions that challenge an individual’s self-concept as a “normal” or non-deviant individual); and (2) identity transformations (i.e. processes whereby an individual comes to embrace a new identity and reject behaviors and values of an old one, resulting in the conscious adoption of a social and/or public identity as an HIV-positive individual). Participants engaged in several strategies to manage the identity impacts associated with disclosure. Implications of these findings for research and prevention programming are discussed. PMID:20024764

  7. Disclosure of their HIV status to perinatally infected youth using the adapted Blasini disclosure model in Haiti and the Dominican Republic: preliminary results.

    PubMed

    Beck-Sagué, Consuelo M; Dévieux, Jessy; Pinzón-Iregui, Maria Claudia; Lerebours-Nadal, Leonel; Abreu-Pérez, Rosa; Bertrand, Rachel; Rouzier, Vanessa; Gaston, Stephanie; Ibanez, Gladys; Halpern, Mina; Pape, Jean W; Dorceus, Patricia; Preston, Sharice M; Dean, Andrew G; Nicholas, Stephen W; Blasini, Ileana

    2015-06-01

    To assess the safety, acceptability, and preliminary efficacy of a culturally-adapted disclosure intervention for perinatally HIV-infected combined antiretroviral therapy patients in Haiti and the Dominican Republic. A quasi-experimental trial was conducted comparing caregiver-youth pairs who completed the intervention [adapted Blasini disclosure model (aBDM)] to pairs who discontinued aBDM participation before disclosure. aBDM consists of five components: structured healthcare worker training; one-on one pre-disclosure intervention/education sessions for youth (describing pediatric chronic diseases including cancer, diabetes and HIV) and for caregivers (strengthening capacity for disclosure); a scheduled supportive disclosure session; and one-on-one postdisclosure support for caregivers and youth. Caregivers of nondisclosed combined antiretroviral therapy patients aged 10.0-17.8 years were invited to participate. Data were collected by separate one-on-one face-to-face interviews of caregivers and youth by study staff and medical record review by pediatricians at enrollment and 3 months after disclosure or after intervention discontinuation. To date, 65 Dominican Republic and 27 Haiti caregiver-youth pairs have enrolled. At enrollment, only 46.4% of youth had viral suppression and 43.4% of caregivers had clinically significant depressive symptomatology. To date, two serious study-related adverse events have occurred. Seven of the 92 (7.6%, 6 in the Dominican Republic) enrolled pairs discontinued participation before disclosure and 39 had completed postdisclosure participation. Median plasma HIV-RNA concentration was lower in youth who completed aBDM than in youth who discontinued participation before aBDM disclosure (<40 versus 8673 copies/ml; P = 0.027). Completers expressed considerable satisfaction with aBDM. Preliminary results suggest safety, acceptability, and possible effectiveness of the aBDM.

  8. Design and implementation of website information disclosure assessment system.

    PubMed

    Cho, Ying-Chiang; Pan, Jen-Yi

    2015-01-01

    Internet application technologies, such as cloud computing and cloud storage, have increasingly changed people's lives. Websites contain vast amounts of personal privacy information. In order to protect this information, network security technologies, such as database protection and data encryption, attract many researchers. The most serious problems concerning web vulnerability are e-mail address and network database leakages. These leakages have many causes. For example, malicious users can steal database contents, taking advantage of mistakes made by programmers and administrators. In order to mitigate this type of abuse, a website information disclosure assessment system is proposed in this study. This system utilizes a series of technologies, such as web crawler algorithms, SQL injection attack detection, and web vulnerability mining, to assess a website's information disclosure. Thirty websites, randomly sampled from the top 50 world colleges, were used to collect leakage information. This testing showed the importance of increasing the security and privacy of website information for academic websites.

  9. Design and Implementation of Website Information Disclosure Assessment System

    PubMed Central

    Cho, Ying-Chiang; Pan, Jen-Yi

    2015-01-01

    Internet application technologies, such as cloud computing and cloud storage, have increasingly changed people’s lives. Websites contain vast amounts of personal privacy information. In order to protect this information, network security technologies, such as database protection and data encryption, attract many researchers. The most serious problems concerning web vulnerability are e-mail address and network database leakages. These leakages have many causes. For example, malicious users can steal database contents, taking advantage of mistakes made by programmers and administrators. In order to mitigate this type of abuse, a website information disclosure assessment system is proposed in this study. This system utilizes a series of technologies, such as web crawler algorithms, SQL injection attack detection, and web vulnerability mining, to assess a website’s information disclosure. Thirty websites, randomly sampled from the top 50 world colleges, were used to collect leakage information. This testing showed the importance of increasing the security and privacy of website information for academic websites. PMID:25768434

  10. [Intra and extra-familiar sexual abuse].

    PubMed

    Taveira, Francisco; Frazão, Sofia; Dias, Ricardo; Matos, Eduarda; Magalhães, Teresa

    2009-01-01

    The sexual abuse of a child or young person constitutes a major social and public health problem and there is recent evidence that intra-familial (IF) sexual abuses are more serious in their consequences than extra-familial (EF). However, there are no studies on this phenomenon in Portugal. Thus, the aim of the present study is to contribute to a better characterization of these types of abuses and to identify possible differences between IF and EF cases. A retrospective study was preformed based on medico-legal reports related to victims below the age of 18, suspected of being sexually abused (n = 764), corresponding to 67% of the total of observed sexual crimes. Results revealed that 34.9% of the abuses are IF and they show statistically significant differences when compared to EF cases. These are due to the following factors found in IF situations: a) lower victim age; b) closeness between victim and abuser; c) abusers with a higher rate of previous sexual abuse; d) sexual practices of reduced physical intrusion; e) decreased physical violence but increased emotional violence; f) greater delay between last abuse and the forensic exam; g) reduced number of injuries or biological evidence (none in the great majority of the cases). Results point out the existence of several characteristics in IF abuse that have been identified as factors that influence the severity of the abuse consequences. Among them are: a) lower victim age; b) greater proximity to the abuser; c) increased amount of emotional violence. These factors account for the reduced visibility of this kind of cases and therefore explain their delayed disclosure and diagnosis. The association of this fact with the reduced intrusiveness of this sort of practice and the consequent decrease in number of injuries and other evidence leads to a marked reduction of the number of cases where evidence of the abuse can be found by physical examination alone. The above aspects underlie the need of using different

  11. Predictors of delayed disclosure of rape in female adolescents and young adults

    PubMed Central

    Bicanic, Iva A. E.; Hehenkamp, Lieve M.; van de Putte, Elise M.; van Wijk, Arjen J.; de Jongh, Ad

    2015-01-01

    Background Delayed disclosure of rape has been associated with impaired mental health; it is, therefore, important to understand which factors are associated with disclosure latency. The purpose of this study was to compare various demographics, post-rape characteristics, and psychological functioning of early and delayed disclosers (i.e., more than 1-week post-rape) among rape victims, and to determine predictors for delayed disclosure. Methods Data were collected using a structured interview and validated questionnaires in a sample of 323 help-seeking female adolescents and young adults (12–25 years), who were victimized by rape, but had no reported prior chronic child sexual abuse. Results In 59% of the cases, disclosure occurred within 1 week. Delayed disclosers were less likely to use medical services and to report to the police than early disclosers. No significant differences were found between delayed and early disclosers in psychological functioning and time to seek professional help. The combination of age category 12–17 years [odds ratio (OR) 2.05, confidence intervals (CI) 1.13–3.73], penetration (OR 2.36, CI 1.25–4.46), and closeness to assailant (OR 2.64, CI 1.52–4.60) contributed significantly to the prediction of delayed disclosure. Conclusion The results point to the need of targeted interventions that specifically encourage rape victims to disclose early, thereby increasing options for access to health and police services. PMID:25967381

  12. BDSM Disclosure and Stigma Management: Identifying Opportunities for Sex Education

    PubMed Central

    Bezreh, Tanya; Weinberg, Thomas S.; Edgar, Timothy

    2012-01-01

    While participation in the activities like bondage, domination, submission/sadism, masochism that fall under the umbrella term BDSM is widespread, stigma surrounding BDSM poses risks to practitioners who wish to disclose their interest. We examined risk factors involved with disclosure to posit how sex education might diffuse stigma and warn of risks. Semi-structured interviews asked 20 adults reporting an interest in BDSM about their disclosure experiences. Most respondents reported their BDSM interests starting before age 15, sometimes creating a phase of anxiety and shame in the absence of reassuring information. As adults, respondents often considered BDSM central to their sexuality, thus disclosure was integral to dating. Disclosure decisions in nondating situations were often complex considerations balancing desire for appropriateness with a desire for connection and honesty. Some respondents wondered whether their interests being found out would jeopardize their jobs. Experiences with stigma varied widely. PMID:22754406

  13. The Cycle of Abuse: When Victims Become Offenders.

    PubMed

    Plummer, Malory; Cossins, Annie

    2016-07-19

    Various psychological theories exist in the literature to explain the behavior of men who commit child sex offences, including the belief that child sexual abuse (CSA) is a predisposing factor for the transition from victim to offender. These theories are, however, unable to explain the fact that while most victims of CSA are female, most perpetrators of CSA are male. The sex specificity of CSA in terms of victims and offenders suggests that the experience of CSA and its psychosocial effects may be different for boys, compared to girls. We hypothesize that CSA experiences may involve risk factors that affect the development of sexually abusive behavior for boys, rather than girls. Our aim was to determine whether the literature provides evidence of a cycle of abuse from victim to offender, and, if so, to document its characteristics. We undertook a comprehensive literature review of studies on both victims and offenders, including studies which revealed the following: age of onset of CSA, duration of abuse, gender of the abuser, the relationship between victim and abuser, grooming behaviors, the types and severity of abuse, and disclosure of abuse. While we found no evidence for the existence of a cycle of abuse for female CSA victims, we discovered evidence to support the existence of a cycle of abuse for male CSA victims who had experienced particular abuse characteristics. As an original contribution to the literature, we identified four factors that may be associated with a boy's transition from victim to offender as well as the methodological issues to be addressed in future research. Based on criminological theories, we argue that these four factors share a common theme, that is, that they represent experiences of power (for the abuser) and powerlessness (for the victim). © The Author(s) 2016.

  14. Social Exchange and Self-Disclosure between Roommates.

    ERIC Educational Resources Information Center

    Berg, John H.

    Psychologists have recently given considerable attention to the study of relationship and friendship development, but the contributing social processes have not been examined in relation to each other over time. To examine the effects of disclosure, similarity, equity, and social exchange on satisfaction with a relationship and liking for one's…

  15. Multiple Forensic Interviews during Investigations of Child Sexual Abuse: A Cost-Effectiveness Analysis

    ERIC Educational Resources Information Center

    Block, Stephanie D.; Foster, E. Michael; Pierce, Matthew W.; Berkoff, Molly C.; Runyan, Desmond K.

    2013-01-01

    In suspected child sexual abuse some professionals recommend multiple child interviews to increase the likelihood of disclosure or more details to improve decision-making and increase convictions. We modeled the yield of a policy of routinely conducting multiple child interviews and increased convictions. Our decision tree reflected the path of a…

  16. Iranian EFL Teachers' Perceptions of Teacher Self-Disclosure

    ERIC Educational Resources Information Center

    Rahimi, Ali; Askari Bigdeli, Rouhollah

    2016-01-01

    Teacher self-disclosure (TSD) as a communication behavior can influence students' learning by increasing their engagement and class participation as well as helping them establish effective interpersonal relationships. Owning to its context-sensitive and culture-dependent nature, however, TSD topics, purposes, and considerations may vary…

  17. Child Sexual Abuse Suspicions: Treatment Considerations during Investigation

    ERIC Educational Resources Information Center

    Kuehnle, Kathryn; Connell, Mary

    2010-01-01

    This article addresses what, if any, psychotherapeutic interventions should be provided to meet the emotional and clinical needs of alleged child victims of sexual abuse while they await judicial determinations from the family, dependency, or criminal courts. The discussion emphasizes that to minimize iatrogenic outcomes, professionals involved in…

  18. Disclosure of their HIV status to perinatally infected youth using the adapted Blasini disclosure model in Haiti and the Dominican Republic: preliminary results

    PubMed Central

    Beck-Sagué, Consuelo M.; Dévieux, Jessy; Pinzón-Iregui, Maria Claudia; Lerebours-Nadal, Leonel; Abreu-Pérez, Rosa; Bertrand, Rachel; Rouzier, Vanessa; Gaston, Stephanie; Ibanez, Gladys; Halpern, Mina; Pape, Jean W.; Dorceus, Patricia; Preston, Sharice M.; Dean, Andrew G.; Nicholas, Stephen W.; Blasini, Ileana

    2015-01-01

    Objectives To assess the safety, acceptability, and preliminary efficacy of a culturally-adapted disclosure intervention for perinatally HIV-infected combined antiretroviral therapy patients in Haiti and the Dominican Republic. Design A quasi-experimental trial was conducted comparing caregiver–youth pairs who completed the intervention [adapted Blasini disclosure model (aBDM)] to pairs who discontinued aBDM participation before disclosure. aBDM consists of five components: structured healthcare worker training; one-on one pre-disclosure intervention/education sessions for youth (describing pediatric chronic diseases including cancer, diabetes and HIV) and for caregivers (strengthening capacity for disclosure); a scheduled supportive disclosure session; and one-on-one postdisclosure support for caregivers and youth. Methods Caregivers of nondisclosed combined antiretroviral therapy patients aged 10.0–17.8 years were invited to participate. Data were collected by separate one-on-one face-to-face interviews of caregivers and youth by study staff and medical record review by pediatricians at enrollment and 3 months after disclosure or after intervention discontinuation. Results To date, 65 Dominican Republic and 27 Haiti caregiver–youth pairs have enrolled. At enrollment, only 46.4% of youth had viral suppression and 43.4% of caregivers had clinically significant depressive symptomatology. To date, two serious study-related adverse events have occurred. Seven of the 92 (7.6%, 6 in the Dominican Republic) enrolled pairs discontinued participation before disclosure and 39 had completed postdisclosure participation. Median plasma HIV-RNA concentration was lower in youth who completed aBDM than in youth who discontinued participation before aBDM disclosure (<40 versus 8673 copies/ml; P = 0.027). Completers expressed considerable satisfaction with aBDM. Conclusion Preliminary results suggest safety, acceptability, and possible effectiveness of the aBDM. PMID:26049543

  19. Developing an Occupational Drug Abuse Program: Considerations and Approaches. Services Research Monograph Series.

    ERIC Educational Resources Information Center

    Stephen, Mae; Prentice, Robert

    This monograph, developed as a guide for companies interested in establishing drug abuse programs, begins with a brief summary of studies assessing the extent and costs of employee drug use. The next section addresses some practical and conceptual issues about establishing a drug abuse program. Suggestions for implementing a drug abuse program are…

  20. [Clinical considerations about traumatic effects of sexual abuse in adolescents].

    PubMed

    Pinelli, Mauro

    2017-01-01

    Sexual abuse, even when it occurs during childhood, may manifest symptoms only in adolescence by the effect of the resignifcation of infantile sexuality, characteristic of that vital moment. In cases of child sexual abuse, in the face of the disruption of impulses and identifcations that occurs in adolescence, there can be trauma that limits the possibilities of processing the psychic apparatus, even in the course of a psychotherapeutic treatment. The acting out reveals itself in transference, it calls for the analyst to relocate the suffering of his patient.

  1. Conflict of interest in oncology publications: a survey of disclosure policies and statements.

    PubMed

    Kesselheim, Aaron S; Lee, Joy L; Avorn, Jerry; Servi, Amber; Shrank, William H; Choudhry, Niteesh K

    2012-01-01

    Disclosure of conflicts of interest in biomedical research is receiving increased attention. The authors sought to define current disclosure policies and how they relate to disclosure statements provided by authors in major oncology journals. The authors identified all oncology journals listed in the Thomson Institute for Scientific Information and sought their policies on conflict-of-interest disclosure. For a subset of journals with an Impact Factor >2.0, they catalogued the number and type of articles and the details of the published disclosures in all papers from the 2 most recent issues. Disclosure policies were provided by 112 of 131 journals (85%); 99 (88%) of these requested that authors disclose conflicts of interest (mean Impact Factor for these journals: 4.6), whereas the remaining 13 (12%) did not (mean Impact Factor: 2.9). Ninety-three journals (94%) required financial disclosure, and 42 (42%) also sought nonfinancial disclosures. For a subset of 52 higher-impact journals (Impact Factor >2.0), we reviewed 1734 articles and identified published disclosures in 51 journals (98%). Many of these journals (31 of 51, 61%) included some disclosure statement in >90% of their articles. Among 27 journals that published editorials/commentaries, only 14 (52%) included disclosures with such articles. There was no publication of any nonfinancial conflicts of interest in any article reviewed. Disclosure policies and the very definition of conflict of interest varied considerably among journals. Although most journals had some policy in this area, a substantial proportion did not publish disclosure statements consistently, with deficiencies particularly among editorials and commentaries. Copyright © 2011 American Cancer Society.

  2. Survivor experience of a child sexual abuse prevention program: a pilot study.

    PubMed

    Barron, Ian G; Topping, Keith J

    2013-09-01

    Addressing gaps in the research, the current study assesses the impact of a community-based child sexual abuse prevention program on known survivor knowledge/skills, disclosures, and subjective experience. Methodologically, novel measures of program fidelity and implementation cost are applied. A pre- posttest wait-list control design was utilized with intervention (n = 10) and comparison groups (n = 10). Measures included a standardized knowledge/skill questionnaire, coding of disclosures, subjective experience questionnaires, in-depth interviews, video analysis of program adherence, and a measure of cost. Analysis involved nonparametric tests and thematic analysis of interview and video data. Cost was calculated for the group and per survivor. Survivors achieved significant gains in knowledge/skills, made further disclosures, and were positive about their program experience. No gains were identified in the control group. Costs were small. Future studies need to explore survivor experience of programs delivered in classrooms.

  3. Psychological abuse: a variable deserving critical attention in domestic violence.

    PubMed

    O'Leary, K D

    1999-01-01

    Policy makers and researchers give psychological abuse considerably less attention than physical abuse in the partner abuse area. One reason for the relative neglect of psychological abuse is that there are difficulties in arriving at a common definition of psychological abuse that might be useful to both the mental health and legal professions. Another reason for the relative neglect of psychological abuse has been an implicit assumption that physical abuse exacts a greater psychological toll on victims than does psychological abuse. At the extreme level of physical abuse, this assumption seems defensible, but at levels of physical aggression that are most common in marriage and long-term relationships, psychological abuse appears to have as great an impact as physical abuse. Even direct ratings of psychological and physical abuse by women in physically abusive relationships indicate that psychological abuse has a greater adverse effect on them than physical abuse. Retrospective reports, longitudinal research, and treatment dropout research all provide evidence that psychological abuse can exact a negative effect on relationships that is as great as that of physical abuse. Finally, psychological abuse almost always precedes physical abuse, so that prevention and treatment efforts clearly need to address psychological abuse. Eight measures of various forms of psychological abuse that have reasonable psychometric properties and considerable construct validity are reviewed and a definition of psychological abuse in intimate relations is provided.

  4. Domestic violence and abuse: an exploration and evaluation of a domestic abuse nurse specialist role in acute health care services.

    PubMed

    McGarry, Julie

    2017-08-01

    The aim of this study was to explore the experiences of clinical staff in responding to disclosure of domestic violence and abuse, and to evaluate the effectiveness of training and support provided by a dedicated Domestic Abuse Nurse Specialist across one acute National Health Service Trust in the UK. The impact of domestic violence and abuse is well documented and is far reaching. Health care professionals have a key role to play in the effective identification and management of abuse across a range of settings. However, there is a paucity of evidence regarding the constituents of effective support for practitioners within wider nonemergency hospital-based services. A qualitative approach semi-structured interviews (n = 11) with clinical staff based in one acute care Trust in the UK. Interviews were informed by an interview guide and analysed using the Framework approach. The organisation of the nurse specialist role facilitated a more cohesive approach to management at an organisational level with training and ongoing support identified as key facets of the role by practitioners. Time constraints were apparent in terms of staff training and this raises questions with regard to the status continuing professional development around domestic violence and abuse. Domestic violence and abuse continues to exert a significant and detrimental impact on the lives and health of those who encounter abuse. Health care services in the UK and globally are increasingly on the frontline in terms of identification and management of domestic violence and abuse. This is coupled with the growing recognition of the need for adequate support structures to be in place to facilitate practitioners in providing effective care for survivors of domestic violence and abuse. This study provides an approach to the expansion of existing models and one which has the potential for further exploration and application in similar settings. © 2016 John Wiley & Sons Ltd.

  5. Commentary: Ethical Considerations in Testing Victims of Sexual Abuse for HIV Infection.

    ERIC Educational Resources Information Center

    Fost, Norman

    1990-01-01

    Ethical issues in screening of victims of sexual abuse for infection with the human immunodeficiency virus (HIV) are raised in response to Gellert (EC 222 881). It is concluded that widescale HIV testing of child victims of sexual abuse is not justified by the available information. (DB)

  6. Teaching Self-Disclosure through an Activity Exploring Disclosure Research and Online Dating Sites

    ERIC Educational Resources Information Center

    Baker, Nicole Marie; Hastings, Sally O.

    2013-01-01

    Most interpersonal communication course textbooks include a section or chapter on the topic of self-disclosure. Students are normally introduced to elements of self-disclosure, such as a definition, functions, or reasons for self-disclosure, risks of self-disclosure, and the role of self-disclosure in relationships. Historically, research on…

  7. Evaluating the abuse potential of opioids and abuse-deterrent -opioid formulations: A review of clinical study methodology.

    PubMed

    Setnik, Beatrice; Schoedel, Kerri A; Levy-Cooperman, Naama; Shram, Megan; Pixton, Glenn C; Roland, Carl L

    With the development of opioid abuse-deterrent formulations (ADFs), there is a need to conduct well-designed human abuse potential studies to evaluate the effectiveness of their deterrent properties. Although these types of studies have been conducted for many years, largely to evaluate inherent abuse potential of a molecule and inform drug scheduling, methodological approaches have varied across studies. The focus of this review is to describe current "best practices" and methodological adaptations required to assess abuse-deterrent opioid formulations for regulatory submissions. A literature search was conducted in PubMed® to review methodological approaches (study conduct and analysis) used in opioid human abuse potential studies. Search terms included a combination of "opioid," "opiate," "abuse potential," "abuse liability," "liking," AND "pharmacodynamic," and only studies that evaluated single doses of opioids in healthy, nondependent individuals with or without prior opioid experience were included. Seventy-one human abuse potential studies meeting the prespecified criteria were identified, of which 21 studies evaluated a purported opioid ADF. Based on these studies, key methodological considerations were reviewed and summarized according to participant demographics, study prequalification, comparator and dose selection, route of administration and drug manipulation, study blinding, outcome measures and training, safety, and statistical analyses. The authors recommend careful consideration of key elements (eg, a standardized definition of a "nondependent recreational user"), as applicable, and offer key principles and "best practices" when conducting human abuse potential studies for opioid ADFs. Careful selection of appropriate study conditions is dependent on the type of ADF technology being evaluated.

  8. [Dynamics of child suggestibility in accusations of sexual abuse in divorce proceedings].

    PubMed

    du Bois, R; Röcker, D

    1996-11-01

    A case of a mother confabulating an extended sexual abuse of her 13 and 15 year old children involving bizarre sadistic features is presented and discussed. The kinship to Munchhausen Syndrome by proxy, identity diffusion, Posttraumatic Stress Syndrome, folie à deux and other concepts is highlighted. It is suggested that sexual confabulations are generated within incestuous family structures as a means to stimulate and satisfy needs of personal closeness when losses and disruptive events have occurred. The disclosure or suspicion of sexual abuse may prove neither true nor false but may hint to an impending emotional breakdown of a parent and to ongoing subtle incestuous traumatisation of a child.

  9. Parental Substance Abuse and Child Well-Being: A Consideration of Parents' Gender and Coresidence

    ERIC Educational Resources Information Center

    Osborne, Cynthia; Berger, Lawrence M.

    2009-01-01

    Parental substance abuse is associated with adverse health and developmental outcomes for children. Existing research, however, has not fully explored the relative magnitude of the associations between maternal, paternal, and both parents' substance abuse and child outcomes, nor has it examined these associations in regard to substance abuse among…

  10. Planning a Stigmatized Nonvisible Illness Disclosure: Applying the Disclosure Decision-Making Model.

    PubMed

    Choi, Soe Yoon; Venetis, Maria K; Greene, Kathryn; Magsamen-Conrad, Kate; Checton, Maria G; Banerjee, Smita C

    2016-11-16

    This study applied the disclosure decision-making model (DD-MM) to explore how individuals plan to disclose nonvisible illness (Study 1), compared to planning to disclose personal information (Study 2). Study 1 showed that perceived stigma from the illness negatively predicted disclosure efficacy; closeness predicted anticipated response (i.e., provision of support) although it did not influence disclosure efficacy; disclosure efficacy led to reduced planning, with planning leading to scheduling. Study 2 demonstrated that when information was considered to be intimate, it negatively influenced disclosure efficacy. Unlike the model with stigma (Study 1), closeness positively predicted both anticipated response and disclosure efficacy. The rest of the hypothesized relationships showed a similar pattern to Study 1: disclosure efficacy reduced planning, which then positively influenced scheduling. Implications of understanding stages of planning for stigmatized information are discussed.

  11. Priorities and strategies for improving disabled women's access to maternity services when they are affected by domestic abuse: a multi-method study using concept maps.

    PubMed

    Bradbury-Jones, Caroline; Breckenridge, Jenna P; Devaney, John; Duncan, Fiona; Kroll, Thilo; Lazenbatt, Anne; Taylor, Julie

    2015-12-28

    Domestic abuse is a significant public health issue. It occurs more frequently among disabled women than those without a disability and evidence suggests that a great deal of domestic abuse begins or worsens during pregnancy. All women and their infants are entitled to equal access to high quality maternity care. However, research has shown that disabled women who experience domestic abuse face numerous barriers to accessing care. The aim of the study was to identify the priority areas for improving access to maternity services for this group of women; develop strategies for improved access and utilisation; and explore the feasibility of implementing the identified strategies. This multi-method study was the third and final part of a larger study conducted in the UK between 2012 and 2014. The study used a modified concept mapping approach and was theoretically underpinned by Andersen's model of healthcare use. Seven focus group interviews were conducted with a range of maternity care professionals (n = 45), incorporating quantitative and qualitative components. Participants ranked perceived barriers to women's access and utilisation of maternity services in order of priority using a 5-point Likert scale. Quantitative data exploration used descriptive and non-parametric analyses. In the qualitative component of each focus group, participants discussed the barriers and identified potential improvement strategies (and feasibility of implementing these). Qualitative data were analysed inductively using a framework analysis approach. The three most highly ranked barriers to women's access and utilisation of maternity services identified in the quantitative component were: 1) staff being unaware and not asking about domestic abuse and disability; 2) the impact of domestic abuse on women; 3) women's fear of disclosure. The top two priority strategies were: providing information about domestic abuse to all women and promoting non-judgemental staff attitude. These were

  12. The impacts of institutional child sexual abuse: A rapid review of the evidence.

    PubMed

    Blakemore, Tamara; Herbert, James Leslie; Arney, Fiona; Parkinson, Samantha

    2017-12-01

    While awareness of institutional child sexual abuse has grown in recent years, there remains limited understanding of its occurrence and outcomes as a distinct form of abuse. Drawing on research commissioned by the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, this article presents a rapid review of available evidence on the impacts of institutional abuse on victim/survivors. Literature searches identified 75 sources spanning international peer reviewed work and reports to Government that document or quantify the impacts of mostly historical child sexual abuse occurring in religious, educational, sporting and residential or out-of-home care settings. Consistent with child sexual abuse in other contexts, institutional child sexual abuse is found to be associated with numerous, pervasive and connected impacts upon the psychological, physical, social, educative and economic wellbeing of victims/survivors. Further, institutional child sexual abuse is associated with vicarious trauma at the individual, family and community level, and with impacts to the spiritual wellbeing of victims/survivors of abuse that occurs in religious settings. The identified literature suggests the trauma of institutional child sexual abuse may be exacerbated by the interplay of abuse dynamics in institutional settings, which may reduce or impede circumstances supporting disclosure, belief, support and protection from future harm. Acknowledging the limitations of the present study and the available evidence, this narrative synthesis provides insights into the complex impacts of institutional child sexual abuse. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. The disclosure processes model: Understanding disclosure decision-making and post-disclosure outcomes among people living with a concealable stigmatized identity

    PubMed Central

    Chaudoir, Stephenie R.; Fisher, Jeffrey D.

    2010-01-01

    Disclosure is a critical aspect of the experience of people who live with concealable stigmatized identities. This article presents the Disclosure Processes Model (DPM)— a framework that examines when and why interpersonal disclosure may be beneficial. The DPM suggests that antecedent goals representing approach and avoidance motivational systems moderate the effect of disclosure on numerous individual, dyadic, and social contextual outcomes and that these effects are mediated by three distinct processes: (1) alleviation of inhibition, (2) social support, and (3) changes in social information. Ultimately, the DPM provides a framework that advances disclosure theory and identifies strategies that can assist disclosers in maximizing the likelihood that disclosure will benefit well-being. PMID:20192562

  14. Planning a Stigmatized Nonvisible Illness Disclosure: Applying the Disclosure Decision-Making Model

    PubMed Central

    Choi, Soe Yoon; Venetis, Maria K.; Greene, Kathryn; Magsamen-Conrad, Kate; Checton, Maria G.; Banerjee, Smita C.

    2016-01-01

    This study applied the disclosure decision-making model (DD-MM) to explore how individuals plan to disclose nonvisible illness (Study 1), compared to planning to disclose personal information (Study 2). Study 1 showed that perceived stigma from the illness negatively predicted disclosure efficacy; closeness predicted anticipated response (i.e., provision of support) although it did not influence disclosure efficacy; disclosure efficacy led to reduced planning, with planning leading to scheduling. Study 2 demonstrated that when information was considered to be intimate, it negatively influenced disclosure efficacy. Unlike the model with stigma (Study 1), closeness positively predicted both anticipated response and disclosure efficacy. The rest of the hypothesized relationships showed a similar pattern to Study 1: disclosure efficacy reduced planning, which then positively influenced scheduling. Implications of understanding stages of planning for stigmatized information are discussed. PMID:27662447

  15. Counselor Self-Disclosure.

    ERIC Educational Resources Information Center

    Anderson, Wayne; Andersen, Blake

    The act of counselor self-disclosure has been regarded favorably by humanistic practitioners, while psychoanalytic figures have generally regarded the sharing of this type of information negatively. Counselor self-disclosure may be a useful means of eliciting reciprocal disclosure by the client or communicating that the counselor is willing to…

  16. Methodologic Considerations for the Study of Childhood Sexual Abuse in Sexual Health Outcome Research: A Comprehensive Review.

    PubMed

    Kilimnik, Chelsea D; Pulverman, Carey S; Meston, Cindy M

    2018-04-01

    Childhood sexual abuse (CSA) has been a topic of interest in sexual health research for decades, yet literature on the sexual health correlates of CSA has been hindered by methodologic inconsistencies that have resulted in discrepant samples and mixed results. To review the major methodologic inconsistencies in the field, explore the scientific and clinical impact of these inconsistencies, and propose methodologic approaches to increase consistency and generalizability to the general population of women with CSA histories. A comprehensive literature review was conducted to assess the methodologic practices used in examining CSA and sexual health outcomes. Methodologic decisions of researchers examining sexual health outcomes of CSA. There are a number of inconsistencies in the methods used to examine CSA in sexual health research across the domains of CSA operationalization, recruitment language, and measurement approaches to CSA experiences. The examination of CSA and sexual health correlates is an important research endeavor that needs rigorous methodologic approaches. We propose recommendations to increase the utility of CSA research in sexual health. We recommend the use of a developmentally informed operationalization of childhood and adolescence, rather than age cutoffs. Researchers are encouraged to use a broad operationalization of sexual abuse such that different abuse characteristics can be measured, reported, and examined in the role of sexual health outcomes. We recommend inclusive recruitment approaches to capture the full range of CSA experiences and transparency in reporting these methods. The field also could benefit from the validation of existing self-report instruments for assessing CSA and detailed reporting of the instruments used in research studies. The use of more consistent research practices could improve the state of knowledge on the relation between CSA and sexual health. Kilimnik CD, Pulverman CS, Meston CM. Methodologic Considerations

  17. Mental illness disclosure decision making.

    PubMed

    Pahwa, Rohini; Fulginiti, Anthony; Brekke, John S; Rice, Eric

    2017-01-01

    Disclosure related to mental illness has been linked to various positive outcomes, including better mental health. However, many individuals with serious mental illness (SMI) continue to practice non-disclosure. Even though disclosure inherently occurs within the context of one's social relationships, research has generally conceptualized mental illness disclosure as an individual level phenomenon and neglected to consider preferences concerning to whom an individual discloses and the factors that influence this decision. The current study uses the disclosure decision-making model (DD-MM) by Greene (2009) to better understand the processes of mental illness disclosure preference and selective disclosure for individuals with SMI (n = 60) using multivariate random intercept logistic regression with an emphasis on the constituent factors of disclosure preference at both individual and relational levels. The majority of participants were found to practice selective disclosure, with 68% of the participants identifying at least 1 network member to whom they could disclose. Family members and friends were central to the selective disclosure process, comprising the greatest proportion of network members who, both were and were not identified as preferred confidants. Women were found to show higher odds of preference for mental illness disclosure than men. Having lower perceived social support was associated with lower odds of disclosure preference. Among relational factors, greater relationship availability and lower dyadic tangible social support were associated with lower odds of disclosure preference. Practice and research implications of using social network analysis to get a deeper understanding of disclosure and disclosure preference are discussed, including implications for future interventions targeting stigma reduction. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  18. Women survivors of child sexual abuse. How can health professionals promote healing?

    PubMed Central

    Schachter, Candice L.; Radomsky, Nellie A.; Stalker, Carol A.; Teram, Eli

    2004-01-01

    OBJECTIVE: To explore how health professionals can practise in ways sensitive to adult women survivors of child sexual abuse. DESIGN: Qualitative semistructured in-depth interviews. SETTING: Small and midsize cities in Ontario and Saskatchewan. PARTICIPANTS: Twenty-seven women survivors of childhood sexual abuse. METHODS: Respondents were asked about their experiences with physical therapists and other health professionals and asked how practice could be sensitive to their needs as survivors. A grounded-theory approach was used. After independent analyses, researchers achieved consensus on the main themes. Findings were checked with participants, other survivors, and mental health professionals. MAIN FINDINGS: A crucial theme was the need to feel safe when consulting any health professional. Participants described specific ways for clinicians to facilitate the feeling of safety. Disclosure of abuse history was another key theme; analysis revealed no one "right way" to inquire about it. CONCLUSION: Women survivors of child sexual abuse want safe, accepting environments and sensitive, informed health professionals with whom to work in partnership on all their health concerns. PMID:15318678

  19. Influence of Intimate Partner Violence Severity on the Help-Seeking Strategies of Female Victims and the Influence of Social Reactions to Violence Disclosure on the Process of Leaving a Violent Relationship.

    PubMed

    Domenech Del Rio, Ines; Sirvent Garcia Del Valle, Elena

    2016-10-01

    This article uses data from the 2015 Spanish Survey on Violence Against Women, a nationally representative survey of 10,171 women aged 16 or above, to analyze the relationship between the severity of intimate partner violence and formal and informal help-seeking strategies, the link between the severity of abuse and the reasons for not seeking formal help, and the influence of social reactions to violence disclosure on the process of leaving a violent relationship. The results show that in Spain, many abused women disclose violence and seek help. However, the severity of the violence strongly determines their help-seeking strategies, especially the search for formal help. Women who experienced less severe incidents tended to minimize their importance and did not seek formal help. For informal help, the differences were smaller, and a high proportion of women talked about the abuse with someone within their social environment, regardless of the severity of the suffered violence. A supportive reaction to violence disclosure had a strong and positive influence on the process of leaving the abusive relationship. The implications of these findings for the design of public policies, education, and awareness-raising campaigns are discussed.

  20. Emotion Regulation in Sexually Abused Preschoolers: The Contribution of Parental Factors.

    PubMed

    Langevin, Rachel; Hébert, Martine; Allard-Dansereau, Claire; Bernard-Bonnin, Anne-Claude

    2016-04-01

    Child sexual abuse (CSA) is associated with emotion regulation deficits in childhood. Parents play a crucial role in the development of emotion regulation in their children, especially at younger ages. Close to 50% of mothers of sexually abused children report having been sexually victimized themselves as children. They are consequently at risk of experiencing significant distress following the disclosure of sexual abuse of their child. Parents' distress could interfere with their ability to provide support and to foster development of emotion regulation in their children. The aim of the present study was to explore the relationship of parental factors (history of sexual victimization in childhood and the current level of distress) to sexually abused preschoolers' emotion regulation competencies. Emotion regulation was assessed in 153 preschoolers by their parents with the Emotion Regulation Checklist; 75 of these children were abused (14 boys); 78 were not abused (21 boys) and were part of a comparison group. Parents reported their level of distress using the Psychiatric Symptom Index. Results indicated that parental factors contributed to some dimensions of preschoolers' emotion regulation (namely displays of underregulation of emotion) above and beyond children's victimization status and gender (Cohen's ƒ(2) = .15). Identifying parental distress and history of sexual victimization as positively associated with emotional dysregulation in preschool children victims of CSA has important research and clinical implications. Copyright © 2016 International Society for Traumatic Stress Studies.

  1. Alcoholism and Familial Abuse: Enhancement of Quality Force Programs Using a Companion-Problem Approach

    DTIC Science & Technology

    1986-04-01

    physical auc] sexual abuse and spouse abuse) hurt Air Force readiness and mission accomiplishmnent. The Air Force needs better means of problem identi- A...Abuse and Domestic Violence ................... 7 Alcohol Abuse and Child Physical Abuse ............... 9 i Alcohol Abuse and Child Sexual Abuse...abuse (spouse abuse, child phyzical abuse, and child sexual abuse) are serious problems in today’s Air Force. Beyond the moral considerations, they

  2. [Child abuse: a world problem].

    PubMed

    Santana-Tavira, R; Sánchez-Ahedo, R; Herrera-Basto, E

    1998-01-01

    Several problems are encountered in the study of child abuse: ignorance of its real proportions, deep cultural and historical roots, diversity of opinion as to its definition and classification and, finally, very diverse considerations on its repercussions and therapeutic management. The present study approaches child abuse from its historical precedents, its classifications, definitions and epidemiology. In addition, repercussions are reviewed, and treatment alternatives considered which are held as fundamental to confront this alarmingly increasing phenomenon. It is important to unify criteria as to the definition and classification of scientific information surrounding demographic data which, in the end, will situate the problem, the progress related to its causes, diagnosis, preventive measures and treatment. It is extremely important to prevent child abuse by all possible means, since this harm is reflected in the adult life of the child. Various classifications are considered, as well as characteristics of the abuser and of the abused.

  3. Understanding HIV disclosure: A review and application of the Disclosure Processes Model

    PubMed Central

    Chaudoir, Stephenie R.; Fisher, Jeffrey D.; Simoni, Jane M.

    2014-01-01

    HIV disclosure is a critical component of HIV/AIDS prevention and treatment efforts, yet the field lacks a comprehensive theoretical framework with which to study how HIV-positive individuals make decisions about disclosing their serostatus and how these decisions affect them. Recent theorizing in the context of the Disclosure Processes Model has suggested that the disclosure process consists of antecedent goals, the disclosure event itself, mediating processes and outcomes, and a feedback loop. In this paper, we apply this new theoretical framework to HIV disclosure in order to review the current state of the literature, identify gaps in existing research, and highlight the implications of the framework for future work in this area. PMID:21514708

  4. 5 CFR 2100.10 - Conditions of disclosure and accounting of certain disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Conditions of disclosure and accounting of certain disclosures. 2100.10 Section 2100.10 Administrative Personnel ARMED FORCES RETIREMENT HOME ARMED FORCES RETIREMENT HOME PRIVACY ACT PROCEDURES § 2100.10 Conditions of disclosure and accounting of...

  5. Women's views and experiences of antenatal enquiry for domestic abuse during pregnancy.

    PubMed

    Salmon, Debra; Baird, Kathleen M; White, Paul

    2015-10-01

    The aim of this study was to explore the acceptability of antenatal enquiry for domestic abuse from the perspective of women using maternity services. It also sought to understand the experiences of referral and support offered to women who had positively disclosed abuse. A multimethod approach was adopted including quantitative and qualitative elements. The survey assessed women's views of the acceptability and impact of routine enquiry for domestic abuse. Interviews aimed, to understand the views and experiences of women who had positively disclosed abuse during their contact with maternity services. 94.4% of those surveyed felt comfortable with a midwife asking about abuse. 96.6% of the participants also believed it was appropriate for a midwife to ask and that midwives should be able to respond to positive disclosure. Interviewees subject to abuse during pregnancy were happy to be questioned, even though they did not always feel able to disclose immediately. Women had a positive view of antenatal enquiry for domestic abuse in healthcare settings and support its continuation. Women expect to be asked and that midwives can respond appropriately. Raising the issue creates a culture in which women are made aware of the impact of abuse and understand there are avenues of support even if she decides not to leave the relationship. Women may choose not to disclose about the abuse at the initial time of asking, for fear of their own safety but asking signifies that she can disclose about at a later contact. © 2013 Blackwell Publishing Ltd.

  6. The influence of child sexual abuse on the self from adult narrative perspectives.

    PubMed

    Krayer, Anne; Seddon, Diane; Robinson, Catherine A; Gwilym, Hefin

    2015-01-01

    The impact of child sexual abuse on the adult self is not yet clearly understood. We explored adult perspectives through the use of narrative interviews (N = 30). Three key themes or views of self were identified in all narratives to varying degrees: the worthless self, the self as unknown, and the potential/developing self. Ambivalence and tension were present in all narratives. Individuals were challenged to integrate the sexual abuse experience in a constructive way and develop a more coherent perception of the self. The narrative method highlighted the dynamic nature of peoples' experiences at the same time recognizing that the narratives themselves are in progress. Reactions to disclosure, social support, and interpersonal connections are crucial at every turn.

  7. Relationship between negative social reactions to sexual assault disclosure and mental health outcomes of Black and White female survivors.

    PubMed

    Hakimi, Dehnad; Bryant-Davis, Thema; Ullman, Sarah E; Gobin, Robyn L

    2018-05-01

    This study investigates the effect of race on the relationship between negative reactions to sexual assault disclosure and the psychological sequelae such as posttraumatic stress disorder (PTSD), depression, and problem drinking in female sexual assault survivors. Using hierarchical regression in an ethnically diverse community sample of 622 female adult sexual assault victims, we assessed for sexual assault; negative reactions to sexual assault disclosure; and symptom severity for PTSD, depression, and problem drinking. Negative social reactions to sexual assault disclosures were significantly associated with negative mental health outcomes across race. Race moderated the influence of negative disclosure reactions on psychological symptoms; however, the moderation was not similar across racial groups and psychological outcome measures. Although Black and White survivors evidenced distress through depression, PTSD, and substance use, Black women who received low to moderate negative reactions to their disclosures of assault were more likely to show increases in PTSD and depression whereas high negative reactions to disclosure were related to higher PTSD and depression similarly for both Black and White women. In addition, Black and White women who experienced more negative social reactions had greater substance abuse, with no difference by race. The results provide further support for detrimental effects of negative reactions on Black and White survivors and highlight the importance of educating people in the community about sexual assault and how to respond in more supportive ways. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  8. Advancing methodology in the study of HIV status disclosure: the importance of considering disclosure target and intent.

    PubMed

    Dima, Alexandra L; Stutterheim, Sarah E; Lyimo, Ramsey; de Bruin, Marijn

    2014-05-01

    Disclosure of HIV status has been the focus of three decades of research, which have revealed its complex relations to many behaviors involved in HIV prevention and treatment, and exposed its central role in managing the HIV epidemic. The causes and consequences of disclosure acts have recently been the subject of several theoretical models. Although it is acknowledged that individual disclosure events are part of a broader process of disclosing one's HIV status to an increasing number of people, this process has received less theoretical attention. In quantitative studies of disclosure, researchers have often implicitly assumed that disclosure is a single unidimensional process appropriately measured via the total number of one's disclosure acts. However, there is also evidence that disclosure may have different causes and consequences depending on the types of actors involved (e.g. family members, friends) and on the presence or absence of the discloser's intention, suggesting that the unidimensionality assumption may not hold. We quantitatively examined the dimensionality of voluntary and involuntary disclosure to different categories of actors, using data collected via structured interviews in the spring of 2010 from 158 people living with HIV in Kilimanjaro, Tanzania. For voluntary disclosure, nonparametric item response analyses identified two multi-category clusters, family and community, and two single-category dimensions, partner and children. Involuntary disclosure consisted of several single- or two-category dimensions. Correlation analyses between the resulting disclosure dimensions and stigma and social support revealed distinct relationships for each disclosure dimension. Our results suggest that treating disclosure as a unidimensional construct is a simplification of disclosure processes that may lead to incorrect conclusions about disclosure correlates. We therefore recommend examining disclosure acts jointly to identify sample-specific dimensions

  9. American Indian youth substance abuse: community-driven interventions.

    PubMed

    Lane, Dakotah C; Simmons, John

    2011-01-01

    Substance abuse among American Indians has a long history that dates back to the colonial era. American Indian youth today continue to have one of the highest substance abuse rates when compared with other groups. Researchers have implemented American Indian youth substance abuse interventions that previously have worked in the general population, but studies have found that they are generally unprepared and poorly designed for American Indian populations. The lack of inclusion of American Indian populations in the interventional studies, poor understanding of American Indian diversity and cultures, and lack of consideration for the unique historical and sociopolitical context of each tribe were cited as reasons the interventions failed. It has been suggested that historical trauma plays a considerable role in American Indian youth substance abuse; however, much of this theoretical framework has yet to be rigorously tested. Contemporary trauma appears to contribute significantly more to American Indian youth substance abuse. The data on American Indian substance abuse are limited, but what is currently available appears to show a vast heterogeneity in the level of substance abuse among American Indian youth that varies across different American Indian tribes and geographical distribution. In summary, this article seeks to describe the special relationship American Indian tribes have with the federal government, review historical and contemporary trauma, review American Indian youth substance abuse and interventions today, and finally describe a unique intervention strategy that tribes in the Pacific Northwest are implementing in order to combat American Indian youth substance abuse. © 2011 Mount Sinai School of Medicine.

  10. 19 CFR 201.29 - Commission disclosure of individual records, accounting of record disclosures, and requests for...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., accounting of record disclosures, and requests for accounting of record disclosures. 201.29 Section 201.29..., accounting of record disclosures, and requests for accounting of record disclosures. (a) It is the policy of... disclosure required by 5 U.S.C. 552, the Privacy Act Officer shall keep an accurate accounting of: (1) The...

  11. Effects of therapist general self-disclosure and countertransference disclosure on ratings of the therapist and session.

    PubMed

    Myers, David; Hayes, Jeffrey A

    2006-01-01

    Therapist decisions about self-disclosure depend theoretically upon both content and context, such as the quality of the therapeutic relationship. In this analogue study, 224 undergraduates viewed 1 of 3 videos for which the working alliance was described as positive or negative and in which a therapist made general self-disclosures, countertransference disclosures, or no disclosures. Interaction effects indicated that participants rated sessions as deeper and the therapist as more expert when the therapist made general disclosures compared to no disclosures, but only when the alliance was positive. When the alliance was negative, participants perceived sessions as shallower and the therapist as less expert when the therapist made either general or countertransference disclosures compared to no disclosures. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  12. Self-Disclosure and Internet Addiction

    ERIC Educational Resources Information Center

    Arslan, Nihan; Kiper, Aydin

    2018-01-01

    The aim of study is to investigate the relationship between self-disclosure and internet addiction. Self-Disclosure Scale and Internet Addiction Scale were applied to students. Results indicated a negative correlation between self-disclosure and internet addiction. Self-disclosure was negative predicted by internet addiction in the structural…

  13. 14 CFR 1212.203 - Disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Records § 1212.203 Disclosures. (a) The system manager shall keep a disclosure accounting for each... computer matching programs (See NASA Management Instruction (NMI) 1382.18). (b) Disclosure accountings are... (2) In accordance with § 1212.203(g) (1) and (2), below. (c) The disclosure accounting required by...

  14. Evaluating Parental Autism Disclosure Strategies

    ERIC Educational Resources Information Center

    Austin, Jillian E.; Galijot, Ratka; Davies, W. Hobart

    2018-01-01

    The relative effects of different autism disclosure methods on the perceptions of a mother-child dyad were investigated. Using three conditions, disclosure card, disclosure bracelet, and no disclosure, U.S. community parents (N = 383) were asked 18 questions about their perceptions of the dyad. An ANOVA revealed significant protection from stigma…

  15. A Practical Approach to Rural Drug Abuse Programming.

    ERIC Educational Resources Information Center

    Rozelle, George R.; And Others

    1980-01-01

    Reviews characteristics of rural drug abuse and general considerations for rural service delivery. Describes the Prevention Project, a rural drug abuse program in Florida, and explains its development, philosophy, and teaching techniques, including a basic educational module for use with rural youth. Includes recommendations for similar programs.…

  16. Important statistical considerations in the evaluation of post-market studies to assess whether opioids with abuse-deterrent properties result in reduced abuse in the community.

    PubMed

    By, Kunthel; McAninch, Jana K; Keeton, Stephine L; Secora, Alex; Kornegay, Cynthia J; Hwang, Catherine S; Ly, Thomas; Levenson, Mark S

    2018-05-01

    Abuse, misuse, addiction, overdose, and death associated with non-medical use of prescription opioids have become a serious public health concern. Reformulation of these products with abuse-deterrent properties is one approach for addressing this problem. FDA has approved several extended-release opioid analgesics with abuse-deterrent labeling, the bases of which come from pre-market studies. As all opioid analgesics must be capable of delivering the opioid in order to reduce pain, abuse-deterrent properties do not prevent abuse, nor do pre-market evaluations ensure that there will be reduced abuse in the community. Utilizing data from various surveillance systems, some recent post-market studies suggest a decline in abuse of extended-release oxycodone after reformulation with abuse-deterrent properties. We discuss challenges stemming from the use of such data. We quantify the relationship between the sample, the population, and the underlying sampling mechanism and identify the necessary conditions if valid statements about the population are to be made. The presence of other interventions in the community necessitates the use of comparators. We discuss the principles under which the use of comparators can be meaningful. Results based on surveillance data need to be interpreted with caution as the underlying sampling mechanisms can bias the results in unpredictable ways. The use of comparators has the potential to disentangle the effect due to the abuse-deterrence properties from those due to other interventions. However, identifying a comparator that is meaningful can be very difficult. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  17. Impromptu everyday disclosure dances: how women with fibromyalgia respond to disclosure risks at work.

    PubMed

    Oldfield, M; MacEachen, E; Kirsh, B; MacNeill, M

    2016-07-01

    Findings from a study examining how women with fibromyalgia remain employed are used to explicate a conceptualization that adds to literature on workplace disclosure of stigmatized illnesses and impairments: disclosure dances that employees improvise in response to workplace-relationships needs and disclosure risks. Critical-discourse-analysis (CDA) methodology framed the study. Data were collected through 26 semi-structured, individual interviews with participant triads or dyads comprising women with fibromyalgia, family members and supervisors or co-workers. Interviews with managers who supervised disabled employees other than the women supplemented these data. Following coding, data were compared within and across triads/dyads through code-dimension summaries, narrative summaries and relational diagrams. Women with fibromyalgia and other stigmatized illnesses improvised everyday disclosures when they needed to explain fluctuating work ability, when others needed reminding about invisible impairments, and when workplace relationships changed. These impromptu disclosures comprised three dimensions: exposing oneself to scrutiny by disclosing both illness and impairments, divulging stigmatized illness, and revealing invisible impairments selectively. Through impromptu disclosure dances, women tailored disclosure to changing immediate circumstances. While assumptions from psychological theories of risk underlie current conceptualizations of disclosure as planned in advance, this article examines disclosure through a different lens: social theories of everyday risk. Implications for rehabilitation For women with fibromyalgia, disclosing illness and impairments at work may entail risks to their jobs and workplace relationships. Rehabilitation professionals need to consider these risks when advising women with fibromyalgia about disclosing their illness and impairments at work. Professionals may first want to learn from clients about their workplace cultures and

  18. Research on Child Abuse in the US Armed Forces

    DTIC Science & Technology

    2001-01-01

    Child maltreatment in the United States has provoked considerable interest in recent years. Child abuse and neglect are prevalent in all parts of...American society. Although children of military personnel experience maltreatment, little research has been completed which compares child abuse rates in...the military with those for civilian populations. Studies that have assessed child abuse in the armed forces have been based on official reports

  19. 32 CFR 310.25 - Disclosure accounting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 2 2013-07-01 2013-07-01 false Disclosure accounting. 310.25 Section 310.25... PROGRAM DOD PRIVACY PROGRAM Disclosure of Personal Information to Other Agencies and Third Parties § 310.25 Disclosure accounting. (a) Disclosure accountings. (1) Keep an accurate record of all disclosures...

  20. 32 CFR 310.25 - Disclosure accounting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 false Disclosure accounting. 310.25 Section 310.25... PROGRAM DOD PRIVACY PROGRAM Disclosure of Personal Information to Other Agencies and Third Parties § 310.25 Disclosure accounting. (a) Disclosure accountings. (1) Keep an accurate record of all disclosures...

  1. 32 CFR 310.25 - Disclosure accounting.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 2 2012-07-01 2012-07-01 false Disclosure accounting. 310.25 Section 310.25... PROGRAM DOD PRIVACY PROGRAM Disclosure of Personal Information to Other Agencies and Third Parties § 310.25 Disclosure accounting. (a) Disclosure accountings. (1) Keep an accurate record of all disclosures...

  2. 32 CFR 310.25 - Disclosure accounting.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 2 2011-07-01 2011-07-01 false Disclosure accounting. 310.25 Section 310.25... PROGRAM DOD PRIVACY PROGRAM Disclosure of Personal Information to Other Agencies and Third Parties § 310.25 Disclosure accounting. (a) Disclosure accountings. (1) Keep an accurate record of all disclosures...

  3. 32 CFR 310.25 - Disclosure accounting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Disclosure accounting. 310.25 Section 310.25....25 Disclosure accounting. (a) Disclosure accountings. (1) Keep an accurate record of all disclosures... accounting is required even if the individual has consented to the disclosure of the information. (3...

  4. Attachment avoidance, alexithymia, and gender: Examining their associations with distress disclosure tendencies and event-specific disclosure.

    PubMed

    O'Loughlin, Julia I; Cox, Daniel W; Kahn, Jeffrey H; Wu, Amery D

    2018-01-01

    Distress disclosure has been linked with reduced psychological distress, increased wellbeing, and successful psychotherapeutic outcome. Because of the importance of distress disclosure, researchers have worked to develop and improve theoretical models of disclosure to facilitate counseling practices that reduce impediments to disclosure. Presently, we conducted a 2-part study to investigate distress disclosure's associations with attachment avoidance, gender, and alexithymia-3 constructs frequently linked with disclosure. In Part 1, we examined the extent to which attachment avoidance, alexithymia, and gender predicted general disclosure tendencies. In Part 2, we examined the extent to which attachment avoidance, alexithymia, and gender predicted event-specific disclosure. Participants were recruited from a crowdsourcing website (N = 178 in Part 1; N = 108 in Part 2). In Part 1, alexithymia partially mediated the association between attachment avoidance and disclosure tendencies, and the link between attachment avoidance and alexithymia was stronger for men than women. In Part 2, the association between distress intensity and event-specific disclosure was weaker for people with high levels of alexithymia. Implications for counseling theory and practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  5. Mother reports of maternal support following child sexual abuse: Preliminary psychometric data on the Maternal Self-report Support Questionnaire (MSSQ).

    PubMed

    Smith, Daniel W; Sawyer, Genelle K; Jones, Lisa M; Cross, Theodore; McCart, Michael R; Ralston, M Elizabeth

    2010-10-01

    Maternal support is an important factor in predicting outcomes following disclosure of child sexual abuse; however, definition of the construct has been unclear and existing measures of maternal support are utilized inconsistently and have limited psychometric data. The purpose of this study was to develop a reliable and valid mother-report measure for assessing maternal support following the disclosure of child sexual abuse. Data from 2 very similar samples of mother-child pairs seeking forensic evaluation following the discovery of child sexual abuse were combined, resulting in a final sample of 246. Exploratory factor analysis resulted in two reliable 7-item factors labeled "Emotional Support" and "Blame/Doubt," each of which had acceptable internal consistency. Analyses with a child-report measure of general maternal support the construct validity of the MSSQ. Concurrent validity analyses revealed unique relations with maternal ratings of child behavior problems and case characteristic data. The study resulted in the development of a brief, easily scored self-report measure of maternal support with reasonable preliminary psychometric properties that could easily be utilized in other studies of sexually abused children. Adoption of this promising measure in future research will reduce the lack of cross-study measurement comparability that has characterized the maternal support literature to date, increase the feasibility of expanding upon current literature on maternal support, and may produce important information leading to clinical and theoretical innovation. Copyright © 2010. Published by Elsevier Ltd.

  6. All Elder Abuse Perpetrators Are Not Alike: The Heterogeneity of Elder Abuse Perpetrators and Implications for Intervention.

    PubMed

    Jackson, Shelly L

    2016-02-01

    The tendency to label all elder abuse perpetrators as the "bad guys" has diminished our ability to respond effectively. A review of the literature demonstrates that elder abuse perpetrators are in fact heterogeneous with important differences across types of abuse. A reformulation of perpetrator interventions away from a singular emphasis on prosecution to meaningful alternatives that utilize criminal justice and/or therapeutic approaches tailored to the needs of the case is needed. These interventions must incorporate the needs of both victims and perpetrators, take into consideration the type of abuse involved, acknowledge the variations in perpetrator culpability, and recognize the continuum of complexity among these cases. Without addressing these nuances, intervention and prevention efforts will be futile if not harmful. © The Author(s) 2014.

  7. Mother Reports of Maternal Support Following Child Sexual Abuse: Preliminary Psychometric Data on the Maternal Self-Report Support Questionnaire (MSSQ)

    ERIC Educational Resources Information Center

    Smith, Daniel W.; Sawyer, Genelle K.; Jones, Lisa M.; Cross, Theodore; McCart, Michael R.; Ralston, M. Elizabeth

    2010-01-01

    Objective: Maternal support is an important factor in predicting outcomes following disclosure of child sexual abuse; however, definition of the construct has been unclear and existing measures of maternal support are utilized inconsistently and have limited psychometric data. The purpose of this study was to develop a reliable and valid…

  8. Relationships between maternal adult attachment security, child perceptions of maternal support, and maternal perceptions of child responses to sexual abuse.

    PubMed

    Leifer, Myra; Kilbane, Teresa; Skolnick, Linda

    2002-01-01

    This study assessed the relationships between maternal adult attachment style, children's perceptions of maternal support following disclosure of sexual abuse, and maternal perceptions of children's behavioral and emotional responses to sexual abuse among African-American child sexual abuse victims aged 4 to 12 (n=96) and a comparison group of non-abused subjects (n=100). Mothers with insecure attachment styles reported significantly higher rates of internalizing behaviors in their sexually abused children than did securely attached mothers. Among mothers of non-abused children, those with insecure adult attachment styles reported significantly higher rates of externalizing behaviors shown by their children in comparison with mothers with a secure adult attachment style. Mothers with insecure adult attachment styles also reported higher rates of overall behavior problems in their non-abused children that approached statistical significance. Sexually abused children's perceptions of maternal support were not related to maternal attachment style nor to child functioning. Contrary to our prediction, mothers of sexually abused children did not show lower rates of secure attachments when compared to mothers of non-sexually abused children. Our findings indicate that fostering parent- child attachment is important in order to decrease the risk for behavior problems and symptomatology in sexually abused children.

  9. Amelioration of sexual fantasies to sexual abuse cues in an adult survivor of childhood sexual abuse: a case study.

    PubMed

    Wilson, Jane E; Wilson, Keith M

    2008-12-01

    Although sexual dysfunction of childhood sexual abuse survivors has received considerable attention, other sexual difficulties experienced by survivors of CSA, such as sexual fantasies to cues of sexual abuse, have received less attention. In this A-B design case study, a young adult female survivor of childhood sexual abuse presented for treatment at a Midwest rape crisis center. After successful treatment of post-traumatic stress disorder, she complained of unwanted sexual fantasies to sexual abuse cues and concomitant guilt and shame. Following baseline data collection, treatment consisted of self-applied aversion therapy to unwanted sexual arousal to sexual abuse cues. Decrease in sexual arousal to these cues was concurrent with the introduction of treatment. A concomitant decrease in guilt and shame occurred while self-ratings of control increased.

  10. 75 FR 25278 - National Institute on Drug Abuse; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ..., MD 21224, (410) 550-1547. (Catalogue of Federal Domestic Assistance Program Nos.: 93.279, Drug Abuse... Abuse; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as... conducted by the National Institute on Drug Abuse, including consideration of personnel qualifications and...

  11. [Disciplinary verdicts in cases of child abuse; lessons for paediatricians].

    PubMed

    Berkers, Gitte; Biesaart, Monique C I H; Leeuwenburgh-Pronk, Wendela G

    2015-01-01

    To give an overview of disciplinary cases regarding action taken by paediatricians and paediatric residents in cases of (suspected) child abuse and to discuss the considerations of the disciplinary board in these cases. Retrospective, descriptive study. We considered all disciplinary cases instigated from 2001 to 2013 against paediatricians or paediatric residents and selected complaints regarding action taken in cases of (suspected) child abuse. We divided these complaints into six categories and studied the considerations of the disciplinary board in these cases. From 33 disciplinary cases instigated from 2001 to 2013, we selected 76 complaints regarding action taken by paediatricians or paediatric residents in cases of (suspected) child abuse. The majority of these complaints concerned the reporting or requesting of information in the context of (suspected) child abuse. All of the complaints in the category 'unwarranted reporting of child abuse' were declared unfounded by the disciplinary judge. The disciplinary board declared all complaints unfounded in cases where the paediatrician or paediatric resident had followed the Dutch national protocol regarding reporting of child abuse and domestic violence. The disciplinary board examines whether action was taken in accordance with reasonable standards of professional competence and considers that paediatricians have an important role in identifying child abuse.

  12. Self-disclosure of HIV status, disclosure counseling, and retention in HIV care in Cameroon.

    PubMed

    Breger, Tiffany L; Newman, Jamie E; Mfangam Molu, Brigitte; Akam, Wilfred; Balimba, Ashu; Atibu, Joseph; Kiumbu, Modeste; Azinyue, Innocent; Hemingway-Foday, Jennifer; Pence, Brian W

    2017-07-01

    Poor retention in care is common among HIV-positive adults in sub-Saharan Africa settings and remains a key barrier to HIV management. We quantify the associations of disclosure of HIV status and referral to disclosure counseling with successful retention in care using data from three Cameroon clinics participating in the Phase 1 International epidemiologic Databases to Evaluate AIDS Central Africa cohort. Of 1646 patients newly initiating antiretroviral therapy between January 2008 and January 2011, 43% were retained in care following treatment initiation. Self-disclosure of HIV status to at least one person prior to treatment initiation was associated with a minimal increase in the likelihood of being retained in care (risk ratio [RR] = 1.14; 95% confidence interval (CI): 0.94, 1.38). However, referral to disclosure counseling was associated with a moderate increase in retention (RR = 1.37; 95% CI: 1.21, 1.55) and was not significantly modified by prior disclosure status (p = .3). Our results suggest that while self-disclosure may not significantly improve retention among patients receiving care at these Cameroon sites, counseling services may play an important role regardless of prior disclosure status.

  13. Addressing Wife Abuse in Mexican Immigrant Couples: Challenges for Family Social Workers

    ERIC Educational Resources Information Center

    Hancock, Tina

    2006-01-01

    This article addresses wife abuse in undocumented Mexican immigrant couples and suggests an ecosystems treatment approach that takes into consideration the structural forces of oppression and discrimination on abusive behaviors in the home and combines individual, family and community level interventions to help immigrant men stop the abuse.…

  14. Prevalence and Pedagogy: Understanding Substance Abuse in Schools

    ERIC Educational Resources Information Center

    Salm, Twyla; Sevigny, Phil; Mulholland, Val; Greenberg, Hirsch

    2011-01-01

    This case study examines not only the prevalence of substance abuse in one rural, Canadian high school, but also how teachers understand teaching and learning in relation to substance abuse. Over one third of students reported that they had used marijuana (37%) and alcohol (38%) in the last seven days, a rate considerably higher than typical…

  15. HIV disclosure among adults living with HIV.

    PubMed

    Mayfield Arnold, E; Rice, E; Flannery, D; Rotheram-Borus, M J

    2008-01-01

    Research on disclosure among heterosexual adult person(s) living with HIV (PLH) was reviewed, omitting disclosure of parental HIV to children. Disclosure has been studied within five additional relational contexts: with partners, family members, friends, healthcare professionals and in work settings. Disclosure is higher among women than men, among Latino and white compared to African-American families, and among younger compared to older HIV-positive adults. Most PLH disclose to their sexual partners and family members, yet there is a significant minority who do not disclose. Similarly, rates of disclosure to employers range from 27-68%, suggesting broad variability in perceived consequences of employment disclosures. Of concern, 40% of PLH do not consistently disclose to their healthcare professionals. Rather than examine HIV disclosures in the context of relationships, it is possible to understand disclosures around personal identity. Disclosure decisions are often made to tell everyone (making HIV status a central attribute of one's identity), no one (requiring strategies for securing social support while remaining anonymous) or some people (requiring strategic decisions based on context). Given that disclosure decisions are central to personal identity, future data on disclosure and interventions designed to increase disclosure or comfort with disclosure must focus on communication strategies adopted by PLH to present a coherent identity.

  16. Examining the Effects of a Service-Trained Facility Dog on Stress in Children Undergoing Forensic Interview for Allegations of Child Sexual Abuse.

    PubMed

    Krause-Parello, Cheryl A; Thames, Michele; Ray, Colleen M; Kolassa, John

    2018-04-01

    Disclosure of child sexual abuse can be a stressful experience for the child. Gaining a better understanding of how best to serve the child, while preserving the quality of their disclosure, is an ever-evolving process. The data to answer this question come from 51 children aged 4-16 (M = 9.1, SD = 3.5), who were referred to a child advocacy center in Virginia for a forensic interview (FI) following allegations of sexual abuse. A repeated measures design was conducted to examine how the presence of a service-trained facility dog (e.g. animal-assisted intervention (AAI) may serve as a mode of lowering stress levels in children during their FIs. Children were randomized to one of the two FI conditions: experimental condition (service-trained facility dog present-AAI) or control condition (service-trained facility dog not present- standard forensic interview). Stress biomarkers salivary cortisol, alpha-amylase, immunoglobulin A (IgA), heart rate, and blood pressure, and Immunoglobulin A were collected before and after the FI. Self-report data were also collected. Results supported a significant decrease in heart rate for those in the experimental condition (p = .0086) vs the control condition (p = .4986). Regression models revealed a significant decrease in systolic and diastolic blood pressure in the experimental condition (p = .03285) and (p = .04381), respectively. Statistically significant changes in alpha-amylase and IgA were also found in relation to disclosure and type of offense. The results of this study support the stress reducing effects of a service-trained facility dog for children undergoing FI for allegations of child sexual abuse.

  17. Physical violence by husbands: magnitude, disclosure and help-seeking behavior of women in Bangladesh.

    PubMed

    Naved, Ruchira Tabassum; Azim, Safia; Bhuiya, Abbas; Persson, Lars Ake

    2006-06-01

    This paper explores the magnitude of physical violence by husbands, the disclosure of it and the help-seeking behavior of abused women in urban and rural Bangladesh. The data come from a larger study on domestic violence against women conducted in Bangladesh during 2000-2004. All ever-married women covered by the population-based survey component (n=2702) conducted in 2001 were included in the current analysis. We also draw on in-depth interviews with 28 women who were physically abused by their husbands. Results show a high prevalence of lifetime physical spousal violence against women: 40% in urban and 42% in rural areas. Most of the abused women (66%) were silent about their experience. The main reasons behind this silence were high acceptance of violence, stigma and fear of greater harm. Sixty percent of urban and 51% of rural abused women never received any help from others. Only 2% ever sought help from institutional sources, from where support was not forthcoming. Women approached these sources only when they could not endure anymore or the violence became life threatening or children were at risk. The findings show that although providing appropriate services is absolutely necessary, it is also important to foster the use of such services and to help women overcome the barriers for accessing these services.

  18. Personal disclosure revisited.

    PubMed

    Olarte, Silvia W

    2003-01-01

    In this paper personal disclosure is defined as a conscious verbal presentation to the patient by the therapist of a personal vignette accompanied by the appropriate dynamic formulation and resolution of a given personal area of conflict. It is conceptualized within theoretical formulations which consider the therapeutic relationship a dyad, where the reality of the patient and the reality of the therapist influence each other, providing the matrix through which the resolution of the patient's past life experiences takes place in the context of this new interpersonal experience. It is specifically differentiated from a boundary violation, because the personal disclosure is brought to the patient's interactional awareness not for gratification of the therapist's sexual or narcissistic needs, but to provoke a response in the patient's conceptualization of a phenomenon being presented in the session and to actively influence the intersubjective field. Within the conceptual framework developed in this paper, personal disclosure reaffirms the patient's current self-discovery and provides for a different formative experience. Personal disclosure is not to be used by the therapist as a vehicle to resolve personal conflicts or as source of personal gratification. When used within the context developed in this paper, personal disclosure enhances both the patient's therapeutic process and the therapist's ever-evolving growth.

  19. FASB Statement No. 132 simplifies benefits disclosures.

    PubMed

    Luecke, R W; Andrzejewski, C

    1999-06-01

    In February 1998, the FASB issued Statement of Financial Accounting Standards No. 132, Employers' Disclosures about Pensions and Other Postretirement Benefits. The new standard is designed to streamline pension and other postretirement benefits disclosures in public and nonpublic entities' financial statements. For nonpublic entities, the statement eliminates separate disclosures of the components of net periodic benefit cost, eliminates the disclosure of the components of benefit obligations and of alternative obligation measures, eliminates the disclosure of plan provisions, adds the disclosure of comprehensive income, eliminates the disclosure of sensitivity to changes in healthcare trend rates, and standardizes the disclosures for pension and other postretirement benefits. Financial managers and their organizations' actuaries and auditors should work together to determine which disclosures their organizations should make to be in compliance with FASB Statement No. 132.

  20. Self-disclosure in eating disorders.

    PubMed

    Basile, B

    2004-09-01

    Secrecy and concealment are typical behaviours in individuals with eating problems. This study explored the relationship between eating-related problems and self-disclosure. It examined whether women with greater eating related problems were less willing to disclose. Different types of self-disclosure were calculated, considering disclosure related to body appearance and to restrained eating. The role of risk factors which concur to the development and maintenance of eating symptomatology was also explored. The Eating Symptoms Inventory was used to investigate the existence of an eventual eating symptomatology, self-disclosure was calculated through the Self-Disclosure Index, while a new scale was validated to assess a self-disclosure related to body image and eating attitudes. Other scales measured the influence of different risk factors, as body dissatisfaction, social pressure to be thin, and restrained eating. A significant inverse relationship was found between general self-disclosure and psychological aspects related to the practice of wrong weight control behaviours and risk factors as dieting, body dissatisfaction, and social pressure to be thin. The significant role of risk factors was confirmed in the development and maintenance of eating disturbances. Interesting results were found using the different self-disclosure indexes as mediators and moderators. Relevant differences were found between Dutch and Italians concerning to their eating attitudes and to the role of different risk factors. Some limits are the impossibility to generalize these findings and the use of a non clinical sample. Some new longitudinal studies should be done in this direction to deepen the relationship between self-disclosure and eating disorders.

  1. Substance abuse and crime: considerations for a comprehensive forensic assessment.

    PubMed

    Esbec, Enrique; Echeburúa, Enrique

    2016-03-02

    There is a strong link between drug use and crime, but this relationship is complex. Drug use does not necessarily lead to an increase in crimes, such as theft, rape or assault, even among regular users or addicts. However, in cases of individuals who consume drugs excessively and commit crimes, both factors are linked. Poverty, personality disorders, social and cultural variables, relationships with other users and previous incarceration or drug use are all factors. These issues play an important role in understanding the risk of crime and drug use. Most addicts should be held liable for most criminal behaviour motivated by addiction, but that addiction can, in some cases, affect one's capacity for self-control over one's actions. This paper examines the current response of the Spanish Criminal Justice System to various aspects of drug abuse, focusing on court decisions related with the nature and enforcement of drug laws. It also addresses aspects of criminal responsibility for drug abuse and drug-related crimes and suggests legislation on drugs, sentencing alternatives for drug offenses, and drug treatment options. Expert evidence plays a crucial role in this area in the court.

  2. Recommendations on recognition and response to child abuse and neglect in the Indian setting.

    PubMed

    Aggarwal, Kiran; Dalwai, Samir; Galagali, Preeti; Mishra, Devendra; Prasad, Chhaya; Thadhani, Anjana

    2010-06-01

    Pediatricians are usually the first point of contact of children with the health system. Studies worldwide have shown that there is insufficient knowledge about child abuse recognition and management among health workers. Presently no uniform guidelines exist in India for pediatricians regarding the appropriate response to child abuse. As part of the Child Rights and Protection Programme (CRPP) under IAP VISION 2007 of Indian Academy of Pediatrics, a Training of Trainers Workshop on Child Rights and Protection was held in Mumbai in January 2007. It was attended by participants from all over the country. The workshop recommended developing country-specific teaching and training material. A Task force of IAP CRPP was formed and it developed a module for Training of Trainers Workshops for Pediatricians. A National Consultative Meet was held in October, 2007 at New Delhi, where the program was discussed and ratified. To train pediatricians to: recognize and respond to child abuse; engage in a multidisciplinary networking mode to deal with child abuse; and, document, record and report instances of child abuse. Guidelines for recognition and management of child abuse are presented. All pediatricians should assess suspected harm with the same thoroughness and attention as they would do with a life threatening condition. Poor management after disclosure can increase psychological damage. Pediatrician should believe, support, reassure, treat and ensure rehabilitation of victims of child abuse, keeping the best interest of the child as the primary goal.

  3. Caregiver Perceptions of Sexual Abuse and Its Effect on Management after a Disclosure

    ERIC Educational Resources Information Center

    Walker-Descartes, Ingrid; Sealy, Yvette M.; Laraque, Danielle; Rojas, Mary

    2011-01-01

    Objective: The aim of the study was to examine caregiver management strategies for child sexual abuse (CSA) when presented with hypothetical scenarios that vary in physical invasiveness. Methods: One hundred fifty three caregivers were given 3 scenarios of CSA with 7 management strategies presented in the 21-item Taking Action Strategies (TAS)…

  4. The Impact of High-Profile Sexual Abuse Cases in the Media on a Pediatric Emergency Department.

    PubMed

    Flannery, Dustin D; Stephens, Clare L; Thompson, Amy D

    2016-01-01

    High-profile media cases of sexual abuse may encourage disclosures of abuse from victims of unrelated assaults and also influence parental concerns, leading to increased emergency department visits. In the region of the study authors' institution, there are two recent high-profile sexual abuse cases with media coverage: Earl Bradley, a Delaware pediatrician, and Jerry Sandusky, a Pennsylvania college football coach. This is a retrospective cohort study of children evaluated for sexual abuse at a pediatric emergency department. Patients were classified as either presenting during a media period or non-media period. The media periods were one-month periods immediately following breaking news reports, when the cases were highly publicized in the media. The non-media periods were the 12-month periods directly preceding the first reports. The median number of emergency department visits per month during a non-media period was 9 visits (interquartile range 6-10). There were 11 visits in the month following the Sandusky case and 13 visits following the Bradley case. There was no statistical difference in number of emergency department visits for sexual abuse between the periods (p = .09). These finding have implications regarding use of resources in pediatric EDs after high-profile sexual abuse cases.

  5. Some Thoughts on Self-Disclosure.

    PubMed

    Richards, Arnold

    2018-04-01

    This paper explores the pros and cons of self-disclosure and self revelation in the analyst. It takes as its starting point a paper by Jeffrey Stern that shows a mixed but generally positive outcome of an incident of self-disclosure. The trend in more recent times has been toward somewhat more self-disclosure, with modern analysts' views on a continuum. The author discusses an example from his own practice, in which he delayed self-disclosure for some time, but did reveal facts about himself, and how this had a mostly positive outcome. He concludes by distinguishing self-disclosure that entails stating facts about self from self-revelation, when the analyst tells his feelings about some specifics from his own life or in the patient's disclosure. Such revelation is not likely to be beneficial to the therapeutic alliance in its early stages, but may be of value as the analytic relationship and trust develop over longer time.

  6. 32 CFR 806b.49 - Disclosure accountings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Disclosure accountings. 806b.49 Section 806b.49... PROGRAM Disclosing Records to Third Parties § 806b.49 Disclosure accountings. System managers must keep an... 771 10 , Accounting of Disclosures. Retain disclosure accountings for 5 years after the disclosure, or...

  7. Prescription Drug Abuse: From Epidemiology to Public Policy

    PubMed Central

    McHugh, R. Kathryn; Nielsen, Suzanne; Weiss, Roger D.

    2014-01-01

    Prescription drug abuse has reached an epidemic level in the United States. The prevalence of prescription drug abuse escalated rapidly beginning in the late 1990s, requiring a significant increase in research to better understand the nature and treatment of this problem. Since this time, a research literature has begun to develop and has provided important information about how prescription drug abuse is similar to, and different from the abuse of other substances. This introduction to a special issue of the Journal of Substance Abuse Treatment on prescription drug abuse provides an overview of the current status of the research literature in this area. The papers in this special issue include a sampling of the latest research on the epidemiology, clinical correlates, treatment, and public policy considerations of prescription drug abuse. Although much has been learned about prescription drug abuse in recent years, this research remains in early stages, particularly with respect to understanding effective treatments for this population. Future research priorities include studies on the interaction of prescription drugs with other licit and illicit substances, the impact of prescription drug abuse across the lifespan, the optimal treatment for prescription drug abuse and co-occurring conditions, and effective public policy initiatives for reducing prescription drug abuse. PMID:25239857

  8. Sexual Identity Group Differences in Child Abuse and Neglect

    PubMed Central

    Alvy, Lisa M.; Hughes, Tonda L.; Kristjanson, Arlinda F.; Wilsnack, Sharon C.

    2013-01-01

    Research suggests that sexual minority women are more likely than heterosexual women to report childhood abuse, but little is known about potential within-group variations in experiences of abuse among sexual minority women. We investigated rates and characteristics of childhood sexual and physical abuse among women from five sexual identity groups. Our analyses used a pooled sample of women from a national probability study and a large community-based study of sexual minority women designed to replicate the national study’s methodology (pooled n = 953). As predicted, heterosexual women reported significantly less childhood abuse than did women who identified as mostly heterosexual, bisexual, mostly lesbian, or lesbian. There was also considerable variability in abuse rates and characteristics, including severity of abuse, among sexual minority subgroups. To the extent that differences in reports reflect the actual prevalence and severity of abuse experiences, sexual identity subgroup differences in childhood abuse have important clinical and public health implications. PMID:23345571

  9. 22 CFR 1003.1 - General policies, conditions of disclosure, accounting of certain disclosures, and definitions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., accounting of certain disclosures, and definitions. 1003.1 Section 1003.1 Foreign Relations INTER-AMERICAN... disclosure, accounting of certain disclosures, and definitions. (a) The Inter-American Foundation will... Accounting Office; or (11) Pursuant to the order of a court of competent jurisdiction. (c) With respect to...

  10. 44 CFR 6.22 - Accounting of disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Accounting of disclosures. 6... Accounting of disclosures. (a) Except for disclosures made pursuant to § 6.20 (a) and (b), an accurate accounting of each disclosure shall be made and retained for 5 years after the disclosure or for the life of...

  11. 38 CFR 17.503 - Improper disclosure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Confidentiality of Healthcare Quality Assurance Review Records § 17.503 Improper disclosure. (a) Improper disclosure is the disclosure of confidential and privileged healthcare quality assurance review records or...

  12. 38 CFR 17.503 - Improper disclosure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Confidentiality of Healthcare Quality Assurance Review Records § 17.503 Improper disclosure. (a) Improper disclosure is the disclosure of confidential and privileged healthcare quality assurance review records or...

  13. 38 CFR 17.503 - Improper disclosure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Confidentiality of Healthcare Quality Assurance Review Records § 17.503 Improper disclosure. (a) Improper disclosure is the disclosure of confidential and privileged healthcare quality assurance review records or...

  14. 38 CFR 17.503 - Improper disclosure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Confidentiality of Healthcare Quality Assurance Review Records § 17.503 Improper disclosure. (a) Improper disclosure is the disclosure of confidential and privileged healthcare quality assurance review records or...

  15. 38 CFR 17.503 - Improper disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Confidentiality of Healthcare Quality Assurance Review Records § 17.503 Improper disclosure. (a) Improper disclosure is the disclosure of confidential and privileged healthcare quality assurance review records or...

  16. Characteristics of Sexual Assault and Disclosure among Women in Substance Abuse Recovery Homes

    ERIC Educational Resources Information Center

    Hunter, Bronwyn A.; Robison, Emily; Jason, Leonard A.

    2012-01-01

    Research suggests that many women experience some form of sexual assault in their lifetime and that women who engage in substance abuse often have a higher incidence of past sexual assault than women in the general population. Given the documented rates of sexual assault among women in recovery from substance use, it is important to explore…

  17. Puppet Play as Interactive Approach in Drug Abuse Prevention

    ERIC Educational Resources Information Center

    Nenadic-Bilan, Diana; Vigato, Teodora

    2010-01-01

    The national strategies of drug abuse prevention across Europe have come to recognise that the drug abuse problem presents a complex set of issues of which there is no simple solution. There is a considerable increase in investment in prevention, treatment and harm-reduction activities and increased focus on supply reduction. School settings are…

  18. [Perceptions on item disclosure for the Korean medical licensing examination].

    PubMed

    Yang, Eunbae B

    2015-09-01

    This study analyzed the perceptions of medical students and faculty regarding disclosure of test items on the Korean medical licensing examination. I conducted a survey of medical students from medical colleges and professional medical schools nationwide. Responses were analyzed from 718 participants as well as 69 faculty members who participated in creating the medical licensing examination item sets. Data were analyzed using descriptive statistics and the chi-square test. It is important to maintain test quality and to keep the test items unavailable to the public. There are also concerns among students that disclosure of test items would prompt increasing difficulty of test items (48.3%). Further, few students found it desirable to disclose test items regardless of any considerations (28.5%). The professors, who had experience in designing the test items, also expressed their opposition to test item disclosure (60.9%). It is desirable not to disclose the test items of the Korean medical licensing examination to the public on the condition that students are provided with a sufficient amount of information regarding the examination. This is so that the exam can appropriately identify candidates with the required qualifications.

  19. Overlooked and Unheard: Abuse of Children Who Are Deaf or Hard of Hearing and Their Experience with CPS and Foster Care

    ERIC Educational Resources Information Center

    Lomas, Gabriel I.; Johnson, Harold A.

    2012-01-01

    Children with hearing loss are considered a low-incidence disability population, yet abuse among this population is up to 4 times that of children who are typically developing. The needs among this population are significant, but resources in communities across the nation are few. The authors discuss barriers to disclosure, school-based concerns,…

  20. 38 CFR 1.576 - General policies, conditions of disclosure, accounting of certain disclosures, and definitions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., conditions of disclosure, accounting of certain disclosures, and definitions. 1.576 Section 1.576 Pensions..., accounting of certain disclosures, and definitions. (a) The Department of Veterans Affairs will safeguard an... Accounting Office; or (11) Pursuant to the order of a court of competent jurisdiction. (c) With respect to...

  1. Emotional disclosure and victim blaming.

    PubMed

    Harber, Kent D; Podolski, Peter; Williams, Christian H

    2015-10-01

    Victim blaming occurs when people are unfairly held responsible for their misfortunes. According to just world theory, witnessing another's victimization threatens just world beliefs, which arouses distress. Victim blaming redeems just world beliefs, thereby reducing distress. However, negative emotions can also be resolved through emotional disclosure, suggesting that disclosure can prevent victim blaming. Two experiments confirmed this prediction. In Study 1 participants viewed a woman being victimized or a woman in a nonvictimizing conflict. Participants then disclosed or suppressed the emotions aroused by these scenes and 1 week later evaluated the woman they had viewed. Disclosure reduced blaming of the victim but did not affect blaming of the nonvictim. Further, the more distress participants disclosed, the less they blamed the victim. Study 2 replicated the primary results of Study 1 and also showed that (a) disclosure exclusively reduces blaming of victims; it does not moderate judgments of victimizers, and (b) the effects of disclosure on blaming applies across genders. These 2 studies confirm that victim blaming is a form of emotion management (per just world theory), and that emotional disclosure prevents blaming by supplying an alternative mode of emotion management. This research also suggests that emotional disclosure moderates social perception, in general. (c) 2015 APA, all rights reserved).

  2. 31 CFR 50.15 - Cap disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Cap disclosure. 50.15 Section 50.15... Disclosures as Conditions for Federal Payment § 50.15 Cap disclosure. (a) General. Under section 103(e)(2) of... existence of the $100,000,000,000 cap under section 103(e)(2). The cap disclosure must be made at the time...

  3. Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations.

    PubMed

    Gasior, Maciej; Bond, Mary; Malamut, Richard

    2016-01-01

    Prescription opioid analgesics are an important treatment option for patients with chronic pain; however, misuse, abuse and diversion of these medications are a major global public health concern. Prescription opioid analgesics can be abused via intended and non-intended routes of administration, both intact or after manipulation of the original formulation to alter the drug-delivery characteristics. Available data indicate that ingestion (with or without manipulation of the prescribed formulation) is the most prevalent route of abuse, followed by inhalation (snorting, smoking and vaping) and injection. However, reported routes of abuse vary considerably between different formulations. A number of factors have been identified that appear to be associated with non-oral routes of abuse, including a longer duration of abuse, younger age, male sex and a rural or socially deprived location. The development of abuse-deterrent formulations of prescription opioid analgesics is an important step toward reducing abuse of these medications. Available abuse-deterrent formulations aim to hinder extraction of the active ingredient, prevent administration through alternative routes and/or make abuse of the manipulated product less attractive, less rewarding or even aversive. There are currently five opioid analgesics with a Food and Drug Administration abuse-deterrent label, and a number of other products are under review. A growing body of evidence suggests that introduction of abuse-deterrent opioid analgesics in the USA has been associated with decreased rates of abuse of these formulations. The availability of abuse-deterrent formulations therefore appears to represent an important step toward curbing the epidemic of abuse of prescription opioid analgesics, while ensuring the availability of effective pain medications for patients with legitimate medical need.

  4. Jury Selection in Child Sex Abuse Trials: A Case Analysis

    ERIC Educational Resources Information Center

    Cramer, Robert J.; Adams, Desiree D.; Brodsky, Stanley L.

    2009-01-01

    Child sex abuse cases have been the target of considerable psycho-legal research. The present paper offers an analysis of psychological constructs for jury selection in child sex abuse cases from the defense perspective. The authors specifically delineate general and case-specific jury selection variables. General variables include…

  5. Laboratory approach for diagnosis of toluene-based inhalant abuse in a clinical setting

    PubMed Central

    Jain, Raka; Verma, Arpita

    2016-01-01

    The steady increase of inhalant abuse is a great challenge for analytical toxicologists. This review describes an overview of inhalant abuse including the extent of the problem, types of products abused, modes of administration, pharmacology and effects of inhalants, the role of laboratory, interpretation of laboratory results and clinical considerations. Regular laboratory screening for inhalant abuse as well as other substance abuse and health risk behaviors must be a part of standard clinical care. PMID:26957863

  6. Impact of different privacy conditions and incentives on survey response rate, participant representativeness, and disclosure of sensitive information: a randomized controlled trial.

    PubMed

    Murdoch, Maureen; Simon, Alisha Baines; Polusny, Melissa Anderson; Bangerter, Ann Kay; Grill, Joseph Patrick; Noorbaloochi, Siamak; Partin, Melissa Ruth

    2014-07-16

    Anonymous survey methods appear to promote greater disclosure of sensitive or stigmatizing information compared to non-anonymous methods. Higher disclosure rates have traditionally been interpreted as being more accurate than lower rates. We examined the impact of 3 increasingly private mailed survey conditions-ranging from potentially identifiable to completely anonymous-on survey response and on respondents' representativeness of the underlying sampling frame, completeness in answering sensitive survey items, and disclosure of sensitive information. We also examined the impact of 2 incentives ($10 versus $20) on these outcomes. A 3X2 factorial, randomized controlled trial of 324 representatively selected, male Gulf War I era veterans who had applied for United States Department of Veterans Affairs (VA) disability benefits. Men were asked about past sexual assault experiences, childhood abuse, combat, other traumas, mental health symptoms, and sexual orientation. We used a novel technique, the pre-merged questionnaire, to link anonymous responses to administrative data. Response rates ranged from 56.0% to 63.3% across privacy conditions (p = 0.49) and from 52.8% to 68.1% across incentives (p = 0.007). Respondents' characteristics differed by privacy and by incentive assignments, with completely anonymous respondents and $20 respondents appearing least different from their non-respondent counterparts. Survey completeness did not differ by privacy or by incentive. No clear pattern of disclosing sensitive information by privacy condition or by incentive emerged. For example, although all respondents came from the same sampling frame, estimates of sexual abuse ranged from 13.6% to 33.3% across privacy conditions, with the highest estimate coming from the intermediate privacy condition (p = 0.007). Greater privacy and larger incentives do not necessarily result in higher disclosure rates of sensitive information than lesser privacy and lower incentives. Furthermore

  7. Impact of different privacy conditions and incentives on survey response rate, participant representativeness, and disclosure of sensitive information: a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Anonymous survey methods appear to promote greater disclosure of sensitive or stigmatizing information compared to non-anonymous methods. Higher disclosure rates have traditionally been interpreted as being more accurate than lower rates. We examined the impact of 3 increasingly private mailed survey conditions—ranging from potentially identifiable to completely anonymous—on survey response and on respondents’ representativeness of the underlying sampling frame, completeness in answering sensitive survey items, and disclosure of sensitive information. We also examined the impact of 2 incentives ($10 versus $20) on these outcomes. Methods A 3X2 factorial, randomized controlled trial of 324 representatively selected, male Gulf War I era veterans who had applied for United States Department of Veterans Affairs (VA) disability benefits. Men were asked about past sexual assault experiences, childhood abuse, combat, other traumas, mental health symptoms, and sexual orientation. We used a novel technique, the pre-merged questionnaire, to link anonymous responses to administrative data. Results Response rates ranged from 56.0% to 63.3% across privacy conditions (p = 0.49) and from 52.8% to 68.1% across incentives (p = 0.007). Respondents’ characteristics differed by privacy and by incentive assignments, with completely anonymous respondents and $20 respondents appearing least different from their non-respondent counterparts. Survey completeness did not differ by privacy or by incentive. No clear pattern of disclosing sensitive information by privacy condition or by incentive emerged. For example, although all respondents came from the same sampling frame, estimates of sexual abuse ranged from 13.6% to 33.3% across privacy conditions, with the highest estimate coming from the intermediate privacy condition (p = 0.007). Conclusion Greater privacy and larger incentives do not necessarily result in higher disclosure rates of sensitive information

  8. Brief Family Based Intervention for Substance Abusing Adolescents

    PubMed Central

    Hernandez, Lynn; Rodriguez, Ana Maria; Spirito, Anthony

    2015-01-01

    Synopsis Research has consistently shown that a lack of parental involvement in the activities of their children predicts initiation and escalation of substance use. Parental monitoring, as well as youth disclosure about their whereabouts, parent child communication, positive parenting and family management strategies, e.g., consistent limit setting, and parental communication about and disapproval of substance use, have all been shown to protect against adolescent substance abuse and substance problems. Given the empirical evidence, family and parenting approaches to preventing and intervening on adolescent substance misuse have received support in the literature. This article discusses the theoretical foundations as well as the application of the Family Check-up, a brief family-based intervention for adolescent substance use. PMID:26092741

  9. Facilitating HIV Disclosure Across Diverse Settings: A Review

    PubMed Central

    Baijal, Parijat; Pegurri, Elisabetta

    2011-01-01

    HIV status disclosure is central to debates about HIV because of its potential for HIV prevention and its links to privacy and confidentiality as human-rights issues. Our review of the HIV-disclosure literature found that few people keep their status completely secret; disclosure tends to be iterative and to be higher in high-income countries; gender shapes disclosure motivations and reactions; involuntary disclosure and low levels of partner disclosure highlight the difficulties faced by health workers; the meaning and process of disclosure differ across settings; stigmatization increases fears of disclosure; and the ethical dilemmas resulting from competing values concerning confidentiality influence the extent to which disclosure can be facilitated. Our results suggest that structural changes, including making more services available, could facilitate HIV disclosure as much as individual approaches and counseling do. PMID:21493947

  10. 17 CFR 30.6 - Disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... in accordance with § 1.55 of this chapter: Provided, however, that the risk disclosure statement may... each prospective qualified eligible person with the Risk Disclosure Statement set forth in § 4.24(b)(2... person with the Risk Disclosure Statement set forth in § 4.34(b)(2) of this chapter and the statement in...

  11. Vaccines for cocaine abuse.

    PubMed

    Orson, Frank M; Kinsey, Berma M; Singh, Rana A K; Wu, Yan; Kosten, Thomas R

    2009-04-01

    Treatments for cocaine abuse have been disappointingly ineffective, especially in comparison with those for some other abused substances. A new approach, using vaccination to elicit specific antibodies to block the access of cocaine to the brain, has shown considerable promise in animal models, and more recently in human trials. The mechanism of action for the antibody effect on cocaine is very likely to be the straightforward and intuitive result of the binding of the drug in circulation by antibodies, thereby reducing its entry into the central nervous system and thus its pharmacological effects. The effectiveness of such antibodies on drug pharmacodynamics is a function of both the quantitative and the qualitative properties of the antibodies, and this combination will determine the success of the clinical applications of anti-cocaine vaccines in helping addicts discontinue cocaine abuse. This review will discuss these issues and present the current developmental status of cocaine conjugate vaccines.

  12. Negotiating cultures: disclosure of HIV-positive status among people from minority ethnic communities in Sydney.

    PubMed

    Körner, Henrike

    2007-01-01

    Because of the multiple stigma attached to HIV/AIDS, disclosure of HIV-positive serostatus is a considerable social risk for those who disclose. While HIV/AIDS-related stigma affects all HIV-positive people, for people from minority cultures additional cultural factors may play a significant role in self-disclosure. This paper draws on data from semi-structured, in-depth interviews with HIV-positive people from minority cultures in Sydney. Disclosure decisions were influenced by gender, sexual orientation, as well as cultural background. Gay men drew on both collectivist and individualist notions of interdependence and self-reliance in different socio-cultural contexts. This enabled them to accommodate the imperative to maintain harmony with the family and meet their individual needs for support. Heterosexual men who had disclosed voluntarily or involuntarily experienced discrimination and avoidance, and interdependence with family and ethnic community was disrupted. Heterosexual women disclosed to no one outside the health care system and were anxious to avoid any disclosure in the future. For all participants, voluntary and involuntary disclosure caused potential and actual disruption of relationships with their families and ethnic communities. The paper concludes by arguing for an ecological perspective of health in which decisions are not located in rational decision making alone but in the broader context of family and community.

  13. Are Norms of Disclosure of Online and Offline Personal Information Associated with the Disclosure of Personal Information Online?

    ERIC Educational Resources Information Center

    Mesch, Gustavo S.; Beker, Guy

    2010-01-01

    This study investigated whether norms of self-disclosure of one's online and offline identity are linked to online disclosure of personal and intimate information. We expected online disclosure of personal and intimate information to be associated with norms of online disclosure. Secondary analysis of the 2006 Pew and American Life Survey of…

  14. 75 FR 17205 - Securities Offering Disclosures

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-05

    ... DEPARTMENT OF THE TREASURY Office of Thrift Supervision Securities Offering Disclosures AGENCY... collection. Title of Proposal: Securities Offering Disclosures. OMB Number: 1550-0035. Form Numbers: SEC...: The Securities Offering regulation provides necessary information, including financial disclosure, to...

  15. 17 CFR 4.34 - General disclosures required.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... such person must be indicated. (g) Principal risk factors. A discussion of the principal risk factors... OF THIS DISCLOSURE DOCUMENT. (b) Risk Disclosure Statement. (1) The following Risk Disclosure... securities laws and regulations or by any applicable laws of non-United States jurisdictions: RISK DISCLOSURE...

  16. Can Lighting Influence Self-Disclosure?

    PubMed

    Mehta, Veli; Mukherjee, Sumitava; Manjaly, Jaison A

    2017-01-01

    With the advent of social networks where people disclose a lot of their information and opinions publicly, this research attempted to re-look at the effect of environmental lighting on willingness and actual disclosure of personal information. Previous literatures mostly addressed counseling setups and the findings were mixed. In order to clarify the effect of lighting on self-disclosure, two experiments were conducted with reported willingness to disclose (Experiment 1) as well as actual disclosure (Experiment 2) on a range of topics like social issues, body, money, work, and personality. While quite a handful of studies have reported differences in disclosure from very subtle environmental lighting manipulations, in both experiments we could not find any effect of ambient room lighting conditions on self-disclosure. These results call for caution both in over-interpreting subtle environmental effects and in increased generalization of perceptual metaphors to actual behavior.

  17. eSelf Disclosure

    EPA Pesticide Factsheets

    The initial module incorporated into the application was the eDisclosure module to track regulatory audit disclosure reports that come through EPA's Central Data Exchange to Region 6 for review, and if approved, route Notice of Determinations back to the disclosing entity via email. This module was developed in 2007 and approved for use on the local area network in September 2008.

  18. Behind the cycle of violence, beyond abuse history: a brief report on the association of parental attachment to physical child abuse potential.

    PubMed

    Rodriguez, Christina M; Tucker, Meagan C

    2011-01-01

    Although the concept of a cycle of violence presumes that the transmission of violence is expressed directly across generations, the role of the overall quality of the parent-child relationship may ultimately be more influential in later parenting behavior. This study investigated whether mothers' poorer attachment to their parents was associated with their current increased child abuse potential and dysfunctional disciplinary style independent of a personal history of child abuse. A sample of 73 at-risk mothers raising children with behavior problems reported on their parental attachment, abuse potential, dysfunctional parenting style, and personal abuse history. An at-risk sample, rather than a sample of identified abuse victims or perpetrators, was studied to better examine the potential continuity or discontinuity from history of abuse to current abuse risk, allowing consideration of those who may break the cycle versus those who potentially initiate abuse in the absence of a personal history. Findings indicate that poor attachment significantly predicted both dysfunctional parenting practices and elevated child abuse potential, controlling for personal child abuse history. Such results highlight the importance of the overall quality of the relationship between the parent and child in potentially shaping future abuse risk. Findings are discussed in terms of continuity or discontinuity in the cycle of violence and future directions for research on attachment in relation to the development of later child abuse risk.

  19. [Disclosure of sources of funding in biomedical journals. Descriptive study of four Spanish publications].

    PubMed

    Roig, F; Borrego, A

    2015-01-01

    The source of research funding can result in bias, and its disclosure is essential in the publication of results. The aim of the study is to identify the frequency and type of sources of funding in the articles published by four Spanish biomedical journals published in Spanish. The frequency and type of financial disclosures in the articles published during 2012 in the ordinary numbers of Atención Primaria, Medicina Clínica, Revista Clínica Española and Revista Española de Cardiología were analyzed. Articles described as "Editorial", "Original article", "Consensus Document", "Review" and "Special Article" were considered. It was decided in each case whether or not the article included any funding disclosure and the type of the declared funding (public or private). Four hundred and twelve publications were analyzed. In 32.5% there was disclosure of funding: 38% in Atención Primaria, 27% in Medicina Clínica, 15% in Revista Clínica Española and 45% in Revista Española de Cardiología. By type of articles, 47% of original articles, 44% of consensus documents, 21% of reviews, 14% of special articles and 8% of editorials had a funding source. In 51.5% of the cases, funding was exclusively public, in 36.5% exclusively private and in 10% mixed. There is considerable variability in the disclosure of funding sources in articles appearing in these four Spanish biomedical journals. It would be necessary to improve the disclosure requirements of sources of funding, making them uniform, clear and transparent.

  20. 12 CFR 1730.3 - Periodic disclosures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Banks and Banking OFFICE OF FEDERAL HOUSING ENTERPRISE OVERSIGHT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SAFETY AND SOUNDNESS DISCLOSURE OF FINANCIAL AND OTHER INFORMATION § 1730.3 Periodic disclosures. (a) Each Enterprise shall prepare disclosures relating to its financial condition, results of...

  1. 12 CFR 1730.3 - Periodic disclosures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Banks and Banking OFFICE OF FEDERAL HOUSING ENTERPRISE OVERSIGHT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SAFETY AND SOUNDNESS DISCLOSURE OF FINANCIAL AND OTHER INFORMATION § 1730.3 Periodic disclosures. (a) Each Enterprise shall prepare disclosures relating to its financial condition, results of...

  2. 12 CFR 1730.3 - Periodic disclosures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Banks and Banking OFFICE OF FEDERAL HOUSING ENTERPRISE OVERSIGHT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SAFETY AND SOUNDNESS DISCLOSURE OF FINANCIAL AND OTHER INFORMATION § 1730.3 Periodic disclosures. (a) Each Enterprise shall prepare disclosures relating to its financial condition, results of...

  3. Perceptions of Therapist Self-Disclosure: An Analogue Study.

    ERIC Educational Resources Information Center

    Nilsson, David E.; And Others

    Self-disclosure to a therapist was investigated with 120 female subjects who viewed a video-taped vignette of a simulated psychotherapy session. Therapist self-disclosure was manipulated so that subjects saw a therapist exhibiting no disclosure, interpersonal disclosure, or intrapersonal disclosure. Subjects rated these therapists on a variety of…

  4. 5 CFR 297.403 - Accounting of disclosure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Office's exempt systems of records, the accounting of disclosures will be made available to the data... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Accounting of disclosure. 297.403 Section... PROCEDURES FOR PERSONNEL RECORDS Disclosure of Records § 297.403 Accounting of disclosure. (a) The Office or...

  5. 5 CFR 297.403 - Accounting of disclosure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Office's exempt systems of records, the accounting of disclosures will be made available to the data... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Accounting of disclosure. 297.403 Section... PROCEDURES FOR PERSONNEL RECORDS Disclosure of Records § 297.403 Accounting of disclosure. (a) The Office or...

  6. 5 CFR 297.403 - Accounting of disclosure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Office's exempt systems of records, the accounting of disclosures will be made available to the data... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Accounting of disclosure. 297.403 Section... PROCEDURES FOR PERSONNEL RECORDS Disclosure of Records § 297.403 Accounting of disclosure. (a) The Office or...

  7. 5 CFR 297.403 - Accounting of disclosure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Office's exempt systems of records, the accounting of disclosures will be made available to the data... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Accounting of disclosure. 297.403 Section... PROCEDURES FOR PERSONNEL RECORDS Disclosure of Records § 297.403 Accounting of disclosure. (a) The Office or...

  8. 5 CFR 2606.207 - Accounting of disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Accounting of disclosures. 2606.207... ACT RULES Access to Records and Accounting of Disclosures § 2606.207 Accounting of disclosures. (a... accounting of disclosures will be retained for at least five years or for the life of the record, whichever...

  9. 17 CFR 4.35 - Performance disclosures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Performance disclosures. 4.35... OPERATORS AND COMMODITY TRADING ADVISORS Commodity Trading Advisors § 4.35 Performance disclosures. (a) General principles—(1) Capsule performance information. Unless otherwise specified, disclosure of the past...

  10. 17 CFR 4.35 - Performance disclosures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 false Performance disclosures. 4.35... OPERATORS AND COMMODITY TRADING ADVISORS Commodity Trading Advisors § 4.35 Performance disclosures. (a) General principles—(1) Capsule performance information. Unless otherwise specified, disclosure of the past...

  11. 17 CFR 4.35 - Performance disclosures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Performance disclosures. 4.35... OPERATORS AND COMMODITY TRADING ADVISORS Commodity Trading Advisors § 4.35 Performance disclosures. (a) General principles—(1) Capsule performance information. Unless otherwise specified, disclosure of the past...

  12. 17 CFR 4.35 - Performance disclosures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Performance disclosures. 4.35... OPERATORS AND COMMODITY TRADING ADVISORS Commodity Trading Advisors § 4.35 Performance disclosures. (a) General principles—(1) Capsule performance information. Unless otherwise specified, disclosure of the past...

  13. 17 CFR 4.35 - Performance disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Performance disclosures. 4.35... OPERATORS AND COMMODITY TRADING ADVISORS Commodity Trading Advisors § 4.35 Performance disclosures. (a) General principles—(1) Capsule performance information. Unless otherwise specified, disclosure of the past...

  14. 5 CFR 2100.12 - Accounting of disclosure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... disclosures will be made available to the data subject upon request in accordance with the access procedures... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Accounting of disclosure. 2100.12 Section... PROCEDURES § 2100.12 Accounting of disclosure. (a) The AFRH or agency will maintain a record of disclosures...

  15. 5 CFR 2100.12 - Accounting of disclosure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... disclosures will be made available to the data subject upon request in accordance with the access procedures... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Accounting of disclosure. 2100.12 Section... PROCEDURES § 2100.12 Accounting of disclosure. (a) The AFRH or agency will maintain a record of disclosures...

  16. 5 CFR 2100.12 - Accounting of disclosure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... disclosures will be made available to the data subject upon request in accordance with the access procedures... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Accounting of disclosure. 2100.12 Section... PROCEDURES § 2100.12 Accounting of disclosure. (a) The AFRH or agency will maintain a record of disclosures...

  17. 5 CFR 2100.12 - Accounting of disclosure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... disclosures will be made available to the data subject upon request in accordance with the access procedures... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Accounting of disclosure. 2100.12 Section... PROCEDURES § 2100.12 Accounting of disclosure. (a) The AFRH or agency will maintain a record of disclosures...

  18. 5 CFR 2100.12 - Accounting of disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Accounting of disclosure. 2100.12 Section... PROCEDURES § 2100.12 Accounting of disclosure. (a) The AFRH or agency will maintain a record of disclosures... in the performance of their duties. (b) This accounting of the disclosures will be retained for a...

  19. 12 CFR 226.27 - Language of disclosures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 3 2011-01-01 2011-01-01 false Language of disclosures. 226.27 Section 226.27... TRUTH IN LENDING (REGULATION Z) Miscellaneous § 226.27 Language of disclosures. Disclosures required by this regulation may be made in a language other than English, provided that the disclosures are made...

  20. 28 CFR 802.20 - Accounting of disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Accounting of disclosures. 802.20 Section... COLUMBIA DISCLOSURE OF RECORDS Privacy Act § 802.20 Accounting of disclosures. (a) We will provide an accounting of all disclosures of a record for five years or until the record is destroyed, whichever is...

  1. The relevance of psychodynamic psychotherapy to understanding therapist-patient sexual abuse and treatment of survivors.

    PubMed

    Yahav, Rivka; Oz, Sheri

    2006-01-01

    Regardless of the therapy modality, research continues to point to the therapeutic relationship as a major salient factor in clinical success or failure. When a patient is sexually abused by his or her therapist, this therapeutic relationship is cynically exploited in a way that does not properly serve the essential needs of the patient. When this patient then seeks reparative therapy, the subsequent therapist needs to pay close attention to issues of the relationship which were breached by the previous clinician. In this article, two case studies showing very different dynamics will be presented in order to demonstrate: (1) relevant factors related to transference, countertransference, projective identification, and the analytic third pertaining to the former, abusive therapy; and (2) needs versus wishes, and issues related to boundaries and self-disclosure in the corrective therapy.

  2. Applying lessons from social psychology to transform the culture of error disclosure.

    PubMed

    Han, Jason; LaMarra, Denise; Vapiwala, Neha

    2017-10-01

    The ability to carry out prompt and effective error disclosure has been described in the literature as an essential skill among physicians that can lead to improved patient satisfaction, staff well-being and hospital outcomes. However, few studies have addressed the social psychology principles that may influence physician behaviour. The authors provide an overview of recent administrative measures designed to encourage physicians to disclose error, but note that deliberate practice, buttressed with lessons from social psychology, is needed to implement further productive behavioural changes. Two main cognitive biases that may hinder error disclosure are identified, namely: fundamental attribution error, and forecasting error. Strategies to overcome these maladaptive cognitive patterns are discussed. The authors note that interactions with standardised patients (SPs) can be used to simulate hospital encounters and help teach important behavioural considerations. Virtual reality is introduced as an immersive, realistic and easily scalable technology that can supplement traditional curricula. Lastly, the authors highlight the importance of establishing a professional standard of competence, potentially by incorporating difficult patient encounters, including disclosure of error, into medical licensing examinations that assess clinical skills. Existing curricula that cover physician error disclosure may benefit from reviewing the social psychology literature. These lessons, incorporated into SP programmes and emerging technological platforms, may improve training and evaluative methods for all medical trainees. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  3. 5 CFR 297.403 - Accounting of disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Accounting of disclosure. 297.403 Section... PROCEDURES FOR PERSONNEL RECORDS Disclosure of Records § 297.403 Accounting of disclosure. (a) The Office or... accounting of the disclosures will be retained for at least 5 years or for the life of the record, whichever...

  4. 38 CFR 17.504 - Disclosure methods.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Disclosure methods. 17.504 Section 17.504 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review Records § 17.504 Disclosure methods. (a) Disclosure of...

  5. 38 CFR 17.504 - Disclosure methods.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Disclosure methods. 17.504 Section 17.504 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review Records § 17.504 Disclosure methods. (a) Disclosure of...

  6. 38 CFR 17.504 - Disclosure methods.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Disclosure methods. 17.504 Section 17.504 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review Records § 17.504 Disclosure methods. (a) Disclosure of...

  7. 38 CFR 17.504 - Disclosure methods.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Disclosure methods. 17.504 Section 17.504 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review Records § 17.504 Disclosure methods. (a) Disclosure of...

  8. 38 CFR 17.504 - Disclosure methods.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Disclosure methods. 17.504 Section 17.504 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review Records § 17.504 Disclosure methods. (a) Disclosure of...

  9. Sibling Self-Disclosure in Early Adolescence.

    ERIC Educational Resources Information Center

    Howe, Nina; Aquan-Assee, Jasmin; Bukowski, William M.; Rinaldi, Christina M.; Lehoux, Pascale M.

    2000-01-01

    Studied sibling-directed self-disclosure of 40 preadolescents through interviews, a questionnaire, and subjects' daily diaries. Found that warmth in sibling relationship was most strongly associated with sibling disclosure, but not with rivalry, conflict, or power. Daily sibling disclosures were more strongly associated with reports of unhappy…

  10. 12 CFR 205.7 - Initial disclosures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... TRANSFERS (REGULATION E) § 205.7 Initial disclosures. (a) Timing of disclosures. A financial institution shall make the disclosures required by this section at the time a consumer contracts for an electronic fund transfer service or before the first electronic fund transfer is made involving the consumer's...

  11. 12 CFR 205.7 - Initial disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... TRANSFERS (REGULATION E) § 205.7 Initial disclosures. (a) Timing of disclosures. A financial institution shall make the disclosures required by this section at the time a consumer contracts for an electronic fund transfer service or before the first electronic fund transfer is made involving the consumer's...

  12. 32 CFR 701.111 - Disclosure accounting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Disclosure accounting. 701.111 Section 701.111... THE NAVY DOCUMENTS AFFECTING THE PUBLIC DON Privacy Program § 701.111 Disclosure accounting. Disclosure accounting allows the individual to determine what agencies or persons have been provided...

  13. 41 CFR 51-9.202 - Accounting of disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Accounting of disclosures... RULES 9.2-Disclosure of Records § 51-9.202 Accounting of disclosures. (a) Except for disclosures made pursuant to paragraphs (a) and (b) of § 51-9.201 of this part, an accurate accounting of each disclosure...

  14. Psychosocial Characteristics of Drug-Abusing Women. Services Research Monograph Series.

    ERIC Educational Resources Information Center

    Burt, Marvin R.; And Others

    In recent years considerable attention has been paid to the status of women as drug abusers and as clients in drug treatment programs. A study of drug abusers' characteristics found a significantly higher history of non-medical psychotherapeutic drug use for females than for males; however, males had a higher prevalence of illicit drug use.…

  15. 10 CFR 1008.18 - Accounting for disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Accounting for disclosures. 1008.18 Section 1008.18 Energy... Parties § 1008.18 Accounting for disclosures. (a) For each disclosure of information contained in a system... accounting of: (1) The date, nature, and purposes of each disclosure of a record made to any person or to...

  16. Talking to children about their HIV status: a review of available resources, tools, and models for improving and promoting pediatric disclosure.

    PubMed

    Wright, S; Amzel, A; Ikoro, N; Srivastava, M; Leclerc-Madlala, S; Bowsky, S; Miller, H; Phelps, B R

    2017-08-01

    As children living with HIV (CLHIV) grow into adolescence and adulthood, caregivers and healthcare providers are faced with the sensitive challenge of when to disclose to a CLHIV his or her HIV status. Despite WHO recommendations for CLHIV to know their status, in countries most affected by HIV, effective resources are often limited, and national guidance on disclosure is often lacking. To address the need for effective resources, gray and scientific literature was searched to identify existing tools and resources that can aid in the disclosure process. From peer-reviewed literature, seven disclosure models from six different countries were identified. From the gray literature, 23 resources were identified including children's books (15), job aides to assist healthcare providers (5), and videos (3). While these existing resources can be tailored to reflect local norms and used to aid in the disclosure process, careful consideration must be taken in order to avoid damaging disclosure practices.

  17. Spiritual disclosure between older adolescents and their mothers.

    PubMed

    Brelsford, Gina M; Mahoney, Annette

    2008-02-01

    This study examines the role of spiritual disclosure within older adolescent-mother relationships. Spiritual disclosure is defined as mutual disclosure of personal religious and spiritual beliefs and practices. Three hundred 18- to 20-year-old college students and 130 of their mothers reported on spiritual disclosure in their relationships. According to both parties, greater spiritual disclosure was related to higher relationship satisfaction, greater use of collaborative conflict resolution strategies, less dysfunctional communication patterns, less verbal aggression, and increased general disclosure in mother-adolescent relationships beyond global religiousness and demographics. Spiritual disclosure also predicted unique variance in collaborative conflict resolution strategies beyond these factors and general disclosure. The findings underscore the value of attending to the interpersonal dimension of religion/spirituality. More specifically, the results suggest that spiritual disclosure is an indicator of relationship quality, one that is tied to better relationship functioning, and one that merits further attention in studies of family dynamics.

  18. Considerations in the Development of a Research to Practice Curriculum for Alcoholism and Substance Abuse Counselors

    ERIC Educational Resources Information Center

    Yalisove, Daniel L.

    2004-01-01

    Most current substance abuse counselor certification education curricula do not include a systematic introduction to alcohol and substance abuse research. I believe that such an introduction would enhance counselor cooperation in research to practice efforts that are currently underway. In this paper I give a brief history of alcoholism and…

  19. Child Abuse in Northern Sri Lanka.

    PubMed

    Sathiadas, M G; Mayoorathy, S; Varuni, K; Ranganathan, Shalini Sri

    2017-02-01

    To identify areas of deficiencies and gaps in child protection services in Northern Sri Lanka. Also, to help in recommending strategies, programmes of interventions for addressing issues of child abuse and advice the legal system. A retrospective study was done to determine the socio-demographic details, type of abuse, clinical profile, relationship of the perpetrator and nature of abuse among children admitted to a tertiary care centre from 2009 through 2014, a period after cessation of a 60-y conflict. Data were obtained from hospital based records and records maintained at the district probation office. Seven hundred twenty cases were referred to the tertiary care centre with abuse. Majority of the children were from the Jaffna district, the northern city of the war affected area and mean age of the children affected was 14.5 ± 2.6 y. Females were affected more than the males and 352 children were seen following sexual abuse. The clinical examination showed penetrative injury in 15 %. The perpetrator was known in 70 % of the situations and the victim was coerced into a relationship for abuse. Attempted suicide was seen in significant numbers during the immediate post war period and school dropout and delinquent behaviour was seen in later years. The problem of child abuse is considerable in this region and there is an urgent need to strengthen the services offered to the victims. Urgent steps are needed to safeguard these children, especially in the war affected areas.

  20. Temperament of juvenile delinquents with history of substance abuse.

    PubMed

    Chang, Hsueh-Ling; Chen, Sue-Huei; Huang, Chien

    2007-01-01

    The etiological factors and interrelations of juvenile delinquents, with psychiatric morbidity and substance abuse have been continuously debated. Cloninger's Tridimensional Theory of Temperament has been reported to predict patterns of substance abuse and comorbidity. In the current study, we aimed to examine the usability of the theory in predicting juvenile delinquency and substance abuse. Sixty consecutive and newly incarcerated male delinquents with history of substance abuse were recruited from a juvenile correctional facility in northwestern Taiwan from January 2002 through December 2003. All subjects were assessed of their temperament, behavioral problems, and psychiatric disorders on an individual base. The juvenile delinquent subjects with childhood history of attention deficit and hyperactivity disorder (ADHD) were significantly younger, consumed less betel nuts, and had more siblings with history of drug abuse. Consistent with the results of Cloninger's studies, novelty seeking positively correlated to the amount of substance abuse, while harm avoidance inversely correlated in juvenile delinquents. Endemic trend of choice of substance abuse needs to be taken into consideration in future research projects.

  1. Therapeutic Self-Disclosure With Borderline Patients

    PubMed Central

    WILKINSON, SALLYE M.; GABBARD, GLEN O.

    1993-01-01

    The therapeutic use of countertransference disclosure as a means of highlighting the borderline patient’s intrapsychic and interpersonal use of the therapist is discussed. Countertransference disclosure is narrowly defined as a form of clinical honesty that focuses on the therapist’s experience of the patient in the here-and-now moment of the session. The effects of disclosure on transference exploration, neutrality, and patient revelations are explored through examination of detailed process notes of therapy sessions. Technical issues such as indirect versus direct disclosure and responses to direct questions are also addressed. PMID:22700154

  2. Therapeutic self-disclosure with borderline patients.

    PubMed

    Wilkinson, S M; Gabbard, G O

    1993-01-01

    The therapeutic use of countertransference disclosure as a means of highlighting the borderline patient's intrapsychic and interpersonal use of the therapist is discussed.Countertransference disclosure is narrowly defined as a form of clinical honesty that focuses on the therapist's experience of the patient in the here-and-now moment of the session. The effects of disclosure on transference exploration, neutrality, and patient revelations are explored through examination of detailed process notes of therapy sessions.Technical issues such as indirect versus direct disclosure and responses to direct questions are also addressed.

  3. The Experience of Mothers Exposed to the Abuse of Their Daughters by an Intimate Partner: "There Is No Definition for It".

    PubMed

    Peled, Einat; Gueta, Keren; Sander-Almoznino, Nili

    2016-11-01

    This qualitative study illuminates the experience of mothers exposed to the intimate partner violence (IPV) of their daughters. In-depth interviews with 11 exposed mothers were conducted. The findings reveal four semi-chronological phases in the participants' experiences: pre-disclosure of the daughter's abuse, the first definitive encounter with the daughter's abuse, living with continued exposure to the daughter's IPV, and the aftermath of the daughter's IPV. A recurrent theme in the mothers' experiences was their dual positioning as a forgotten victim of IPV and as a caregiver of their daughter shaped by prevalent motherhood ideologies. Possible implications for intervention are discussed. © The Author(s) 2016.

  4. Evaluation of family drawings of physically and sexually abused children.

    PubMed

    Piperno, Francesca; Di Biasi, Stefania; Levi, Gabriel

    2007-09-01

    The aim of this study is to analyse the family drawings of two groups of physically and/or sexually abused children as compared to the drawings of non-abused children of a matched control group. The drawings by 12 physically abused, 12 sexually abused and 12 non-abused children, all aged between 5 years-old and 10 years-old, were assessed and compared. Family drawings were analysed using a specific Screening Inventory (FDI-Family Drawing Inventory). This Inventory takes into consideration such qualitative and quantitative variables as the quality of drawing, the children's perception of their family members and their own perception of themselves within the family system. The results have shown significant differences between the abused minors and the control group. Abused children are more likely to draw distorted bodies, the human figure is usually represented devoid of details, their drawings generally show clear signals of trauma and the majority of the abused children are likely to exclude their primary caregiver from the drawings. The "drawings of the family" of physically and/or sexually abused children significantly evidence a greater emotional distress then the drawings of the non-abused children of the matched control group.

  5. 31 CFR 50.15 - Cap disclosure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Cap disclosure. 50.15 Section 50.15 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Disclosures as Conditions for Federal Payment § 50.15 Cap disclosure. (a) General. Under section 103(e)(2) of...

  6. 31 CFR 50.15 - Cap disclosure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Cap disclosure. 50.15 Section 50.15 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Disclosures as Conditions for Federal Payment § 50.15 Cap disclosure. (a) General. Under section 103(e)(2) of...

  7. 31 CFR 50.15 - Cap disclosure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Cap disclosure. 50.15 Section 50.15 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Disclosures as Conditions for Federal Payment § 50.15 Cap disclosure. (a) General. Under section 103(e)(2) of...

  8. 31 CFR 50.15 - Cap disclosure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Cap disclosure. 50.15 Section 50.15 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Disclosures as Conditions for Federal Payment § 50.15 Cap disclosure. (a) General. Under section 103(e)(2) of...

  9. Suicide Disclosure in Suicide Attempt Survivors: Does Family Reaction Moderate or Mediate Disclosure's Effect on Depression?

    PubMed

    Frey, Laura M; Hans, Jason D; Cerel, Julie

    2016-02-01

    Existing literature has found a link between disclosure of a stigmatized identity and improved mental health; however, research on the impact of suicide disclosure to family members is scarce. Suicide attempt survivors (n = 74) in the United States were examined to assess whether family reaction moderates or mediates the relationship between suicide disclosure and subsequent depression symptoms. Family reaction did not moderate but did mediate the relationship between disclosure and depression symptoms while controlling for time since most recent attempt. Higher rates of disclosure predicted more positive family reactions, which in turn predicted less severe depression symptoms. Findings indicate that family members can play an essential role in the recovery process after an attempt occurs, which has important implications for both researchers and clinicians who seek to decrease stigma for attempt survivors while simultaneously decreasing the likelihood of future attempts. © 2015 The American Association of Suicidology.

  10. Mental illness stigma and disclosure in college students.

    PubMed

    Corrigan, Patrick W; Kosyluk, Kristin A; Markowitz, Fred; Brown, Robyn Lewis; Conlon, Bridget; Rees, Jo; Rosenberg, Jessica; Ellefson, Sarah; Al-Khouja, Maya

    2016-06-01

    The aim of this study was to investigate the relationship between mental illness identity, shame, secrecy, public stigma, and disclosure amongst college students. Participants included 1393 college students from five postsecondary institutions. Structural equation modeling was used to examine two path models predicting disclosure and desire to join a program aiding with disclosure. Variables found to be significant in predicting disclosure included mental illness identity and public stigma. In turn, desire for disclosure predicted desire to join a program aiding in disclosure. Gender and race/ethnic differences were observed, with men and Whites more likely to want to disclose a mental illness or join a program aiding with disclosure compared with women and non-Whites, respectively. These findings suggest that some college students may find programs aiding in disclosure useful in assisting them to achieve their desire to be "out" with their mental illness.

  11. Disclosure of Individual Surgeon's Performance Rates During Informed Consent

    PubMed Central

    Burger, Ingrid; Schill, Kathryn; Goodman, Steven

    2007-01-01

    Objective: The purpose of the paper is to examine the ethical arguments for and against disclosing surgeon-specific performance rates to patients during informed consent, and to examine the challenges that generating and using performance rates entail. Methods: Ethical, legal, and statistical theory is explored to approach the question of whether, when, and how surgeons should disclosure their personal performance rates to patients. The main ethical question addressed is what type of information surgeons owe their patients during informed consent. This question comprises 3 related, ethically relevant considerations that are explored in detail: 1) Does surgeon-specific performance information enhance patient decision-making? 2) Do patients want this type of information? 3) How do the potential benefits of disclosure balance against the risks? Results: Calculating individual performance measures requires tradeoffs and involves inherent uncertainty. There is a lack of evidence regarding whether patients want this information, whether it facilitates their decision-making for surgery, and how it is best communicated to them. Disclosure of personal performance rates during informed consent has the potential benefits of enhancing patient autonomy, improving patient decision-making, and improving quality of care. The major risks of disclosure include inaccurate and misleading performance rates, avoidance of high-risk cases, unjust damage to surgeon's reputations, and jeopardized patient trust. Conclusion: At this time, we think that, for most conditions, surgical procedures, and outcomes, the accuracy of surgeon- and patient-specific performance rates is illusory, obviating the ethical obligation to communicate them as part of the informed consent process. Nonetheless, the surgical profession has the duty to develop information systems that allow for performance to be evaluated to a high degree of accuracy. In the meantime, patients should be informed of the quantity of

  12. Does Emotional Disclosure About Stress Improve Health in Rheumatoid Arthritis? Randomized, Controlled Trials of Written and Spoken Disclosure

    PubMed Central

    Lumley, Mark A.; Leisen, James C.C.; Partridge, R. Ty; Meyer, Tina M.; Radcliffe, Alison M.; Macklem, Debra J.; Naoum, Linda A.; Cohen, Jay L.; Lasichak, Lydia M.; Lubetsky, Michael R.; Mosley-Williams, Angelia D.; Granda, Jose L.

    2011-01-01

    Studies of the effects of disclosing stressful experiences among patients with rheumatoid arthritis (RA) have yielded inconsistent findings, perhaps due to different disclosure methods—writing or speaking—and various methodological limitations. We randomized adults with RA to a writing (n = 88) or speaking (to a recorder) sample (n = 93), and within each sample, to either disclosure or one of two control groups (positive or neutral events), which conducted 4, 20-minute, at-home sessions. Follow-up evaluations at 1, 3, and 6 months included self-reported, behavioral, physiological, and blinded physician-assessed outcomes. In both writing and speaking samples, the disclosure and control groups were comparably credible, and the linguistic content differed as expected. Covariance analyses at each follow-up point indicated that written disclosure had minimal effects compared to combined controls—only pain was reduced at 1 and 6 months, but no other outcomes improved. Spoken disclosure led to faster walking speed at 3 months, and reduced pain, swollen joints, and physician-rated disease activity at 6 months, but there were no effects on other outcomes. Latent growth curve modeling examined differences in the trajectory of change over follow-ups. Written disclosure improved affective pain and walking speed; spoken disclosure showed only a marginal benefit on sensory pain. In both analyses, disclosure's few benefits occurred relative to both positive and neutral control groups. We conclude that both written and spoken disclosure have modest benefits for patients with RA, particularly at 6 months, but these effects are limited in scope and consistency. PMID:21315515

  13. Theoretical Perspectives of Male Sexual Abuse: Conceptualization of a Case Study

    ERIC Educational Resources Information Center

    Diamanduros, Terry; Cosentino, Clare E.; Tysinger, P. Dawn; Tysinger, Jeffrey A.

    2012-01-01

    The purpose of this article is to demonstrate the traumatic impact that sexual abuse can have on a young male's development by addressing mediating dispositions that can render a child vulnerable to the effects of sexual abuse. Consideration is given to three different theoretical perspectives that are not exclusive to male victims but shed light…

  14. 40 CFR 350.40 - Disclosure to health professionals.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 28 2014-07-01 2014-07-01 false Disclosure to health professionals... COMMUNITY RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Disclosure of Trade Secret Information to Health Professionals § 350.40 Disclosure to health professionals. (a...

  15. 40 CFR 350.40 - Disclosure to health professionals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 27 2010-07-01 2010-07-01 false Disclosure to health professionals... COMMUNITY RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Disclosure of Trade Secret Information to Health Professionals § 350.40 Disclosure to health professionals. (a...

  16. 40 CFR 350.40 - Disclosure to health professionals.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 29 2012-07-01 2012-07-01 false Disclosure to health professionals... COMMUNITY RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Disclosure of Trade Secret Information to Health Professionals § 350.40 Disclosure to health professionals. (a...

  17. 40 CFR 350.40 - Disclosure to health professionals.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 28 2011-07-01 2011-07-01 false Disclosure to health professionals... COMMUNITY RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Disclosure of Trade Secret Information to Health Professionals § 350.40 Disclosure to health professionals. (a...

  18. 40 CFR 350.40 - Disclosure to health professionals.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 29 2013-07-01 2013-07-01 false Disclosure to health professionals... COMMUNITY RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Disclosure of Trade Secret Information to Health Professionals § 350.40 Disclosure to health professionals. (a...

  19. Reducing Environmental Risks by Information Disclosure: Evidence in Residential Lead Paint Disclosure Rule

    ERIC Educational Resources Information Center

    Bae, Hyunhoe

    2012-01-01

    Recently, there has been a surge in environmental regulations that require information disclosure. However, existing empirical evidence is limited to certain applications and has yet to generalize the effectiveness of this approach as a policy strategy to reduce environmental risks. This study evaluates the disclosure rule of the residential lead…

  20. Developing guidelines for disclosure or non-disclosure of bad news around life-limiting illness and death to people with intellectual disabilities.

    PubMed

    Tuffrey-Wijne, Irene; Giatras, Nikoletta; Butler, Gary; Cresswell, Amanda; Manners, Paula; Bernal, Jane

    2013-05-01

    There is insufficient evidence to guide decisions around (non-)disclosure of bad news of life-limiting illness and death to people with intellectual disabilities. The aim of this study was to develop guidelines for decisions about (non-)disclosure of bad news around life-limiting illness and death to people with intellectual disabilities, by examining stakeholders' preferences (and reasons) around disclosure and non-disclosure. Focus groups and interviews were held with 109 participants: people with intellectual disabilities, family carers, intellectual disabilities professionals and medical healthcare professionals. People with intellectual disabilities had wide-ranging views about disclosure. Reasons for non-disclosure included: preventing distress; too difficult for the bearer of bad news; the bearer of bad news lacks knowledge; inability to understand; no sense of time; conflicting views among stakeholders. Reasons for disclosure included: a right to know; knowledge helps the person cope; need for involvement. Disclosure of bad news could cause harm in some situations, but this needs careful assessment. The authors present guidelines for disclosure that now need to be tested in practice. © 2013 Blackwell Publishing Ltd.

  1. Prevention of Child Sexual Abuse Victimization: A Meta Analysis of School Programs.

    ERIC Educational Resources Information Center

    Rispens, Jan; Aleman, Andre; Goudena, Paul P.

    1997-01-01

    Meta-analysis of 16 evaluation studies of school programs aimed at the prevention of child sexual abuse victimization found significant and considerable mean postintervention and follow-up effect sizes, indicating that the programs were effective in teaching children sexual abuse concepts and self-protection skills. Program duration and content…

  2. Modeling veterans healthcare administration disclosure processes :

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Beyeler, Walter E; DeMenno, Mercy B.; Finley, Patrick D.

    As with other large healthcare organizations, medical adverse events at the Department of Veterans Affairs (VA) facilities can expose patients to unforeseen negative risks. VHA leadership recognizes that properly handled disclosure of adverse events can minimize potential harm to patients and negative consequences for the effective functioning of the organization. The work documented here seeks to help improve the disclosure process by situating it within the broader theoretical framework of issues management, and to identify opportunities for process improvement through modeling disclosure and reactions to disclosure. The computational model will allow a variety of disclosure actions to be tested acrossmore » a range of incident scenarios. Our conceptual model will be refined in collaboration with domain experts, especially by continuing to draw on insights from VA Study of the Communication of Adverse Large-Scale Events (SCALE) project researchers.« less

  3. Mental health problems among clinical psychologists: Stigma and its impact on disclosure and help-seeking.

    PubMed

    Tay, Stacie; Alcock, Kat; Scior, Katrina

    2018-03-24

    To assess the prevalence of personal experiences of mental health problems among clinical psychologists, external, perceived, and self-stigma among them, and stigma-related concerns relating to disclosure and help-seeking. Responses were collected from 678 UK-based clinical psychologists through an anonymous web survey consisting of the Social Distance Scale, Stig-9, Military Stigma Scale, Secrecy Scale, Attitudes towards Seeking Professional Psychological Help Scale-Short Form, alongside personal experience and socio-demographic questions. Two-thirds of participants had experienced mental health problems themselves. Perceived mental health stigma was higher than external and self-stigma. Participants were more likely to have disclosed in their social than work circles. Concerns about negative consequences for self and career, and shame prevented some from disclosing and help-seeking. Personal experiences of mental health problems among clinical psychologists may be fairly common. Stigma, concerns about negative consequences of disclosure and shame as barriers to disclosure and help-seeking merit further consideration. © 2018 Wiley Periodicals, Inc.

  4. Written emotional disclosure for asthma.

    PubMed

    Paudyal, Priyamvada; Hine, Paul; Theadom, Alice; Apfelbacher, Christian J; Jones, Christina J; Yorke, Janelle; Hankins, Matthew; Smith, Helen E

    2014-05-19

    Psychological stress has been widely implicated in asthma exacerbation. Evidence suggests that written emotional disclosure, an intervention that involves writing about traumatic or stressful experiences, helps to reduce stress and promote physical and psychological well-being. Written emotional disclosure may have a role in the management of asthma. This review aims to determine the effectiveness of written emotional disclosure for people with asthma, specifically, to assess:1. overall efficacy of emotional disclosure compared with emotionally neutral writing on self reported quality of life in people with asthma;2. overall efficacy of emotional disclosure compared with emotionally neutral writing on objective measures of health outcome in people with asthma; and3. comparative efficacy of different types of emotional disclosure for people with asthma. Trials were identified from the Cochrane Airways Group Specialised Register of trials, CENTRAL, MEDLINE, EMBASE, CINAHL, AMED and PsycINFO. The latest search was conducted in January 2014. Randomised controlled trials published in any language comparing written emotional disclosure intervention versus a control writing (emotionally neutral) intervention in participants with asthma were included in the review. Two review authors independently assessed studies against predetermined inclusion criteria and extracted the data. Corresponding authors were contacted when necessary to provide additional information. Four studies, involving a total of 414 participants, met the inclusion criteria. Three studies were conducted in adult participants and one in adolescents. The average age of participants ranged from 14 to 43 years. The trials lasted between two months and 12 months. The interventions were based on Pennebaker's method. The risk of bias across most domains of the studies was generally considered to be low, however three of four studies were considered at high risk of bias due to lack of assessor blinding and one

  5. HIV status disclosure rate and reasons for non-disclosure among infected children and adolescents in Enugu, southeast Nigeria.

    PubMed

    Ubesie, A C; Iloh, K K; Emodi, I J; Ibeziako, N S; Obumneme-Anyim, I N; Iloh, O N; Ayuk, A C; Anikene, C J; Enemuo, J E

    2016-12-01

    To determine the rate of HIV status disclosure, caregivers' reasons for non-disclosure, and factors influencing disclosure among a sample of HIV-infected children in Enugu, southeast Nigeria. Data were collected prospectively via a questionnaire on HIV-infected children and their caregivers who visited the pediatric HIV clinic of the University of Nigeria Teaching Hospital between July 1, 2012, and June 30, 2013. The data analysis was performed using Statistical Package for the Social Sciences version 19 software. Caregivers of 107 children (age 5-16 years; mean 10.1 ± 3.2 years) were enrolled in the study. There were 53 (49.5%) boys and 54 (50.5%) girls. HIV status had been disclosed to 31 (29%) of them. The major reason for non-disclosure was the child being considered too young. Age (p < .001), age at HIV diagnosis (p < .001) and baseline CD4 count (p = .008) were seen as significant predictors of HIV disclosure. There is a low rate of HIV disclosure to infected children, and it was found to be lower for younger children. We recommend improving efforts for disclosure counseling to caregivers in pediatric HIV clinics.

  6. Geriatric forensics - Part 2 "Prevalence of elder abuse and their potential forensic markers among medical and dental patients".

    PubMed

    Mattoo, Khurshid A; Garg, Rishabh; Kumar, Shalabh

    2015-01-01

    This study is a continuation of the earlier studies and has been extended to investigate the potential forensic markers of elder abuse. To determine the prevalence of elder abuse in various outpatient departments (OPDs). To study the associated parameters related to the abuser and the abused. To determine the existence of potential forensic markers of elder abuse. The subjects were randomly selected from the medical and the dental OPDs of the university. Eight hundred and thirty two elderly subjects in the age range 40-60 years were interviewed using a questionnaire to determine the existence of elder abuse. The subjects were investigated and examined for weight, nutrition and hydration, vital signs, habits, existing visual and auditory capabilities, medications, disclosure of wills/deeds, signs of depression, and documented cleanliness. The mini-mental state examination, the Geriatric Depression Scale, the Clock drawing test, and the Brief Psychiatric Rating Scale were used to determine the potential forensic markers. Mean values in percentage were determined by dividing the number of determined subjects by the total number of subjects for that parameter. About 37% in medical and 41% in dental OPDs were found to have suffered from abuse, mostly in the age group 60-70 years. Females received more abuse and a combination of son and daughter-in-law constituted most abusers. Various potential markers of elder abuse and neglect investigated among the elder abuse victims included depression (89%), signs of improper feeding (83%), changes in personal hygiene (69%), need for medical/dental treatment (78%), medication misuse (67%), changes in wills/deeds (26%), decubiti (10%), bruises (17%), skin tears (27%), and confusion (23%). Elder abuse exists in one or more forms in both medical and dental OPDs among both males and females in all age groups.

  7. Methods to increase reporting of childhood sexual abuse in surveys: the sensitivity and specificity of face-to-face interviews versus a sealed envelope method in Ugandan primary school children.

    PubMed

    Barr, Anna Louise; Knight, Louise; Franҫa-Junior, Ivan; Allen, Elizabeth; Naker, Dipak; Devries, Karen M

    2017-02-23

    Underreporting of childhood sexual abuse is a major barrier to obtaining reliable prevalence estimates. We tested the sensitivity and specificity of the face-to-face-interview (FTFI) method by comparing the number of disclosures of forced sex against a more confidential mode of data collection, the sealed-envelope method (SEM). We also report on characteristics of individuals associated with non-disclosure in FTFIs. Secondary analysis of data from a cross-sectional survey conducted in 2014, with n = 3843 children attending primary school in Luwero District, Uganda. Sensitivity and specificity were calculated, and mixed effects logistic regression models tested factors associated with disclosure in one or both modes. In the FTFI, 1.1% (n = 42) of children reported ever experiencing forced sex, compared to 7.0% (n = 268) in the SEM. The FTFI method demonstrated low sensitivity (13.1%, 95%CI 9.3-17.7%) and high specificity (99.8%, 95%CI 99.6-99.9%) in detecting cases of forced sex, when compared to the SEM. Boys were less likely than girls to disclose in the FTFI, however there was no difference in prevalence by sex using the SEM (aOR = 0.91, 95%CI 0.7-1.2; P = 0.532). Disclosing experience of other forms of sexual violence was associated with experience of forced sex for both modes of disclosure. The SEM method was superior to FTFIs in identifying cases of forced sex amongst primary school children, particularly for boys. Reporting of other forms of sexual violence in FTFIs may indicate experience of forced sex. Future survey research, and efforts to estimate prevalence of sexual violence, should make use of more confidential disclosure methods to detect childhood sexual abuse.

  8. Criminal investigation of child sexual abuse: a comparison of cases referred to the prosecutor to those not referred.

    PubMed

    Stroud, D D; Martens, S L; Barker, J

    2000-05-01

    The present study sought to identify characteristics of child sexual abuse cases which differentiate cases referred for criminal prosecution ("criminal-action") from those not referred ("dropped") by investigators. The study sample consisted of 1043 children who completed a forensic interview for sexual abuse that allegedly occurred at the hands of an adult between January 1, 1993 and December 31, 1996 in Bernalillo County of New Mexico. Data was systematically obtained from forensic interview files and offender records at the local prosecutor's office. Differences between criminal-action and dropped cases were found in relation to the children (age, sex and ethnicity), the alleged offenders (age, sex and relationship to child), and the case characteristics (disclosure and injury to the child). The present study provided insight into the characteristics of a previously ignored population (reported child sexual abuse cases that are not referred for prosecution). Recommendations are made to address the needs of these children and their families.

  9. The impaired anesthesiologist: what you should know about substance abuse.

    PubMed

    Samuelson, Stefan T; Bryson, Ethan O

    2017-02-01

    Despite our considerable experience with the problem of addiction in our specialty, most anesthesia care providers don't know how to identify or help an impaired colleague. The purpose of this article to provide sufficient information on substance use disorder (SUD) to aid in its identification amongst colleagues and to assist in its management. Depending on the region, 10-15% of the general population is prone to developing a SUD and will abuse drugs or alcohol at some point in their life. Physicians and other healthcare professionals are not immune to the disease of addiction and are just as prone to developing SUD as laypersons. Even so, the risk of mortality is significantly increased because of access to potent and highly addictive anesthetic agents with a narrow therapeutic index when self-administered. Also, the number of anesthesia residents who are identified as having SUD is currently increasing. Due to the considerable morbidity and mortality associated with the abuse of anesthetic agents as well as the continuous increase in the rate of substance abuse by anesthesia providers, it is essential for anesthesia care providers to become familiar with the presenting signs and symptoms of substance abuse and impairment.

  10. Factors influencing HIV disclosure among people living with HIV/AIDS in Nigeria: a systematic review using narrative synthesis and meta-analysis.

    PubMed

    Adeoye-Agboola, D I; Evans, H; Hewson, D; Pappas, Y

    2016-07-01

    To critically review, appraise and evaluate quality of evidence on HIV disclosure among people living with HIV/AIDS (PLWHA) in Nigeria, and to identify a possible gap in knowledge on HIV/AIDS and disclosure. A systematic review using narrative synthesis and meta-analysis. MedLine, PsycINFO, PubMed Central, Scopus and CINAHL were searched. Data were extracted with the use of spread sheet. An analysis of heterogeneity was performed for the disclosure rate and the presence of a supportive reaction from partners. A meta-analysis was performed for the disclosure rates to sexual partners, with data available for all ten studies. Ten studies met the inclusion criteria. The outcomes show that HIV disclosure of sero-positive status is most common between spouses or sexual partners than disclosure to relatives/family members, friends, pastor/Imam or work colleagues/employers. The participants in most of these studies are women, and amongst the most influential factors on disclosure are gender, anticipated outcome, marital status and knowledge of partners' status. Some studies reported non-disclosure as a way of limiting stigma. Almost all of the studies highlighted that there is fear of stigma and social exclusion associated with disclosure. This review discusses the overall experience of HIV disclosure on the management of the disease and barriers to disclosure. We found that PLWHA in Nigeria disclosed to at least one person within their social networks. Stigma is still a major consideration for PLWHA who experience a range of misconceptions around HIV transmission. The findings of this study may inform local policies and plans for improving the PLWHA quality of life. Targeted policies to increase disclosure of sero-positive status and reduce stigma may facilitate disease prevention. The methodological rigour of the included studies was appraised low. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  11. 32 CFR 321.10 - Disclosure to other than subject.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....11. (7) Legal guardians recognized by the Act. (b) Accounting of disclosures. Except for disclosures... Freedom of Information Act, an accounting will be kept of all disclosures of records maintained in DSS... the disclosure is made. (3) An accounting of disclosures made to agencies outside the DoD of records...

  12. 36 CFR 703.5 - Records exempt from disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... disclosure. 703.5 Section 703.5 Parks, Forests, and Public Property LIBRARY OF CONGRESS DISCLOSURE OR PRODUCTION OF RECORDS OR INFORMATION Availability of Library of Congress Records § 703.5 Records exempt from disclosure. (a) The public disclosure of Library records provided for by this part does not apply to records...

  13. 36 CFR 703.5 - Records exempt from disclosure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... disclosure. 703.5 Section 703.5 Parks, Forests, and Public Property LIBRARY OF CONGRESS DISCLOSURE OR PRODUCTION OF RECORDS OR INFORMATION Availability of Library of Congress Records § 703.5 Records exempt from disclosure. (a) The public disclosure of Library records provided for by this part does not apply to records...

  14. 36 CFR 703.5 - Records exempt from disclosure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... disclosure. 703.5 Section 703.5 Parks, Forests, and Public Property LIBRARY OF CONGRESS DISCLOSURE OR PRODUCTION OF RECORDS OR INFORMATION Availability of Library of Congress Records § 703.5 Records exempt from disclosure. (a) The public disclosure of Library records provided for by this part does not apply to records...

  15. 36 CFR 703.5 - Records exempt from disclosure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... disclosure. 703.5 Section 703.5 Parks, Forests, and Public Property LIBRARY OF CONGRESS DISCLOSURE OR PRODUCTION OF RECORDS OR INFORMATION Availability of Library of Congress Records § 703.5 Records exempt from disclosure. (a) The public disclosure of Library records provided for by this part does not apply to records...

  16. Ethical Considerations on Disclosure When Medical Error Is Discovered During Medicolegal Death Investigation.

    PubMed

    Wolf, Dwayne A; Drake, Stacy A; Snow, Francine K

    2017-12-01

    In the course of fulfilling their statutory role, physicians performing medicolegal investigations may recognize clinical colleagues' medical errors. If the error is found to have led directly to the patient's death (missed diagnosis or incorrect diagnosis, for example), then the forensic pathologist has a professional responsibility to include the information in the autopsy report and make sure that the family is appropriately informed. When the error is significant but did not lead directly to the patient's demise, ethical questions may arise regarding the obligations of the medical examiner to disclose the error to the clinicians or to the family. This case depicts the discovery of medical error likely unrelated to the cause of death and describes one possible ethical approach to disclosure derived from an ethical reasoning model addressing ethical principles of respect for persons/autonomy, beneficence, nonmaleficence, and justice.

  17. Non-disclosure of violence among female sex workers: evidence from a large scale cross-sectional survey in India.

    PubMed

    Mahapatra, Bidhubhusan; Battala, Madhusudana; Porwal, Akash; Saggurti, Niranjan

    2014-01-01

    One of the indicators critical to the success of violence reduction programmes among female sex workers (FSWs) is the pattern of disclosure of violence. This study examines the rate of non-disclosure of violence among FSWs in India by perpetrators of violence and programme exposure. Data were drawn from a cross-sectional study conducted among FSWs in 2009 across four states of India: Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu. The analytical sample included 1341 FSWs who experienced physical violence in past six months. Multilevel logistic regression stratified by state was conducted to examine predictors of non-disclosure. About 54% of FSWs did not disclose their experience of violence to anyone with considerable variations in the pattern of disclosure across states. Another 36% of FSWs shared the experience with NGO worker/peer. Compared to violence perpetrated by paying partners/stranger, that by non-paying partner were twice more likely to report non-disclosure (53% vs. 68%, Adjusted Odds Ratio [AOR]: 1.8, 95% Confidence Interval [CI]: 1.3-2.4). Similarly, FSWs who were not registered with an NGO/sex worker collective were 40% more likely to report non-disclosure of violence against those registered (58% vs. 53%, AOR: 1.4, 95% CI: 1.1-1.9). Non-disclosure of physical violence is quite high among FSWs which can be a barrier to the success of violence reduction efforts. Immediate efforts are required to understand the reasons behind non-disclosure based on which interventions can be developed. Community collectivisation and designing gender-based interventions with the involvement of non-paying partners should be the way forward.

  18. Non-Disclosure of Violence among Female Sex Workers: Evidence from a Large Scale Cross-Sectional Survey in India

    PubMed Central

    Mahapatra, Bidhubhusan; Battala, Madhusudana; Porwal, Akash; Saggurti, Niranjan

    2014-01-01

    Objective One of the indicators critical to the success of violence reduction programmes among female sex workers (FSWs) is the pattern of disclosure of violence. This study examines the rate of non-disclosure of violence among FSWs in India by perpetrators of violence and programme exposure. Methods Data were drawn from a cross-sectional study conducted among FSWs in 2009 across four states of India: Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu. The analytical sample included 1341 FSWs who experienced physical violence in past six months. Multilevel logistic regression stratified by state was conducted to examine predictors of non-disclosure. Results About 54% of FSWs did not disclose their experience of violence to anyone with considerable variations in the pattern of disclosure across states. Another 36% of FSWs shared the experience with NGO worker/peer. Compared to violence perpetrated by paying partners/stranger, that by non-paying partner were twice more likely to report non-disclosure (53% vs. 68%, Adjusted Odds Ratio [AOR]: 1.8, 95% Confidence Interval [CI]: 1.3–2.4). Similarly, FSWs who were not registered with an NGO/sex worker collective were 40% more likely to report non-disclosure of violence against those registered (58% vs. 53%, AOR: 1.4, 95% CI: 1.1–1.9). Conclusions Non-disclosure of physical violence is quite high among FSWs which can be a barrier to the success of violence reduction efforts. Immediate efforts are required to understand the reasons behind non-disclosure based on which interventions can be developed. Community collectivisation and designing gender-based interventions with the involvement of non-paying partners should be the way forward. PMID:24846145

  19. Metabolism of designer drugs of abuse.

    PubMed

    Staack, Roland F; Maurer, Hans H

    2005-06-01

    Abuse of designer drugs is widespread among young people, especially in the so-called "dance club scene" or "rave scene", worldwide. Severe and even fatal poisonings have been attributed to the consumption of such drugs of abuse. However, in contrast to new medicaments, which are extensively studied in controlled clinical studies concerning metabolism, including cytochrome P450 isoenzyme differentiation, and further pharmacokinetics, designer drugs are consumed without any safety testing. This paper reviews the metabolism of new designer drugs of abuse that have emerged on the black market during the last years. Para-methoxyamphetamine (PMA), para-methoxymethamphetamine (PMMA) and 4-methylthioamphetamine (4-MTA), were taken into consideration as new "classical" amphetamine-derived designer drugs. Furthermore, N-benzylpiperazine (BZP), 1-(3, 4-methylenedioxybenzyl)piperazine (MDBP), 1-(3-trifluoromethylphenyl)piperazine (TFMPP), 1-(3-chlorophenyl)piperazine (mCPP) and 1-(4-methoxyphenyl)piperazine (MeOPP) were taken into consideration as derivatives of the class of piperazine-derived designer drugs, as well as alpha-pyr-rolidinopropiophenone (PPP), 4'-methoxy-alpha-pyrrolidinopropiophenone (MOPPP), 3', 4'-methylenedioxy-alpha-pyrrolidino-propiophenone (MDPPP), 4'-methyl-alpha-pyrrolidinopropiophenone (MPPP), and 4'-methyl-alpha-pyrrolidinoexanophenone (MPHP) as derivatives of the class of alpha-pyrrolidinophenone-derived designer drugs. Papers describing identification of in vivo or in vitro human or animal metabolites and cytochrome P450 isoenzyme dependent metabolism have been considered and summarized.

  20. Unpacking disclosure: interrupting unquestioned practices.

    PubMed

    McDonald, Carol

    2008-06-01

    Disclosure, the social practice of sharing the details, the "truths" of one's life, is embedded in our social world, and in the assumptions that drive the provision of mental health and psychotherapeutic intervention. In this paper the author interrogates the ways in which categories of sexuality and disclosure itself is historically derived and asks: How would care be different if we consider the constructed categories of sexual orientation as an exemplar of an unstable truth? In addition, the author suggests approaches to practice that unseat the valorization of disclosure.

  1. Parenting in females exposed to intimate partner violence and childhood sexual abuse.

    PubMed

    Jaffe, Anna E; Cranston, Christopher C; Shadlow, Joanna O

    2012-01-01

    Child sexual abuse and intimate partner violence may have a significant impact on parenting. The current study expands on existing research by examining the effects of child sexual abuse and intimate partner violence on parenting styles and parenting self-efficacy. In women from a parenting intervention program (n = 20), child sexual abuse was related to lower parenting self-efficacy and more permissive parenting. In women at a domestic violence shelter (n = 45), child sexual abuse was related to current sexual coercion of the partner, and authoritative parenting was related to higher parenting self-efficacy. These results indicate that having a history of child sexual abuse should be taken into consideration when dealing with mothers in violent relationships.

  2. Control of fraud and abuse in Medicare and Medicaid.

    PubMed

    Pies, H E

    1977-01-01

    This Comment explores issues concerning the control of fraud and abuse in health programs financed with public funds, specifically the Medicare and Medicaid programs. It summarizes the nature, scope, and possible causes of what some regard as a fraud and abuse "crisis," and points out the difficulties and obstacles facing those who attempt to develop legislative and executive action aimed at controlling fraud and abuse. Recent federal initiatives in fraud and abuse control are examined, and a brief summary of key provisions of H.R. 3 (the Medicare-Medicaid Anti-fraud and Abuse Amendments, which may prove to be a landmark piece of legislation in this area) is provided. The author emphasizes that more effective control of fraud and abuse is necessary if further expansion of government financing of health programs, including national health insurance, is to occur in the near future. At the same time, caution must be taken not to neglect the appropriate use of other mechanisms necessary for reducing the costs of medical care and improving its quality. In addition, it is likely that efforts to stem fraud and abuse will raise important medicolegal and public policy issues that will require careful interdisciplinary consideration.

  3. Posttraumatic Stress and Depression in the Nonoffending Caregivers of Sexually Abused Children: Associations with Parenting Practices

    PubMed Central

    Jobe-Shields, Lisa; Swiecicki, Carole C.; Fritz, Darci R.; Stinnette, Jessica S.; Hanson, Rochelle F.

    2016-01-01

    Caregiver mental health is a known correlate of parenting practices, and recent research indicated that parental depression following childhood sexual abuse disclosure is associated with concurrent parenting difficulties. The present study extended this line of research by investigating posttraumatic stress symptoms and depression in a sample of caregivers (N=96) of children who experienced sexual abuse recruited from a Children’s Advocacy Center, as well as parenting practices reported by both caregivers and their children (Mean age = 10.79 years, SD = 3.29; 79% female). Twenty four percent of caregivers met criteria for presumptive clinical depression, clinically significant posttraumatic stress, or both. Results indicated elevated caregiver-reported inconsistent parenting in the context of clinically significant distress across symptom groups; children reported particularly elevated inconsistent parenting for caregivers with posttraumatic stress only. Caregiver depression was associated with low self-reported positive parenting and caregiver involvement, in addition to self-reported inconsistencies. Directions for future research are offered to further elucidate the relationships between caregiver mental health and parenting practices following childhood sexual abuse. PMID:26808966

  4. 32 CFR 310.21 - Conditions of disclosure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DOD PRIVACY PROGRAM Disclosure of Personal Information to Other Agencies and Third Parties § 310.21 Conditions of disclosure. (a) Disclosures to third parties. (1) The Privacy Act only compels...

  5. 32 CFR 310.21 - Conditions of disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DOD PRIVACY PROGRAM Disclosure of Personal Information to Other Agencies and Third Parties § 310.21 Conditions of disclosure. (a) Disclosures to third parties. (1) The Privacy Act only compels...

  6. Self-disclosure on SNS: Do disclosure intimacy and narrativity influence interpersonal closeness and social attraction?

    PubMed

    Lin, Ruoyun; Utz, Sonja

    2017-05-01

    On social media, users can easily share their feelings, thoughts, and experiences with the public, including people who they have no previous interaction with. Such information, though often embedded in a stream of others' news, may influence recipients' perception toward the discloser. We used a special design that enables a quasi-experience of SNS browsing, and examined if browsing other's posts in a news stream can create a feeling of familiarity and (even) closeness toward the discloser. In addition, disclosure messages can vary in the degree of intimacy (from superficial to intimate) and narrativity (from a random blather to a story-like narrative). The roles of disclosure intimacy and narrativity on perceived closeness and social attraction were examined by a 2 × 2 experimental design. By conducting one lab study and another online replication, we consistently found that disclosure frequency, when perceived as appropriate, predicted familiarity and closeness. The effects of disclosure intimacy and narrativity were not stable. Further exploratory analyses showed that the roles of disclosure intimacy on closeness and social attraction were constrained by the perceived appropriateness, and the effects of narrativity on closeness and social attraction were mediated by perceived entertainment value.

  7. Social Cognitive Theory Recommendations for Improving Modeling in Adolescent Substance Abuse Prevention Programs.

    ERIC Educational Resources Information Center

    Cleaveland, Bonnie L.

    1994-01-01

    Current state-of-the-art substance abuse prevention programs are mostly social cognitive theory based. However, there are few publications which review specifically how modeling is applied to adolescent substance abuse prevention programs. This article reviews theoretical considerations for implementing modeling for this purpose. (Author/LKS)

  8. Cancer disclosure: experiences of Iranian cancer patients.

    PubMed

    Valizadeh, Leila; Zamanzadeh, Vahid; Rahmani, Azad; Howard, Fuchsia; Nikanfar, Ali-Reza; Ferguson, Caleb

    2012-06-01

    This study explored Iranian patients' experiences of cancer disclosure, paying particular attention to the ways of disclosure. Twenty cancer patients were invited to participate in this qualitative inquiry by research staff in the clinical setting. In-depth, semistructured interview data were analyzed through content analysis. The rigor of the study was established by principles of credibility, transferability, dependability, and confirmability. Four themes emerged: the atmosphere of non-disclosure, eventual disclosure, distress in knowing, and the desire for information. Non-disclosure was the norm for participants, and all individuals involved made efforts to maintain an atmosphere of non-disclosure. While a select few were informed of their diagnosis by a physician or another patient, the majority eventually became aware of their diagnosis indirectly by different ways. All participants experienced distress after disclosure. The participants wanted basic information about their prognosis and treatments from their treating physicians, but did not receive this information, and encountered difficulty accessing information elsewhere. These challenges highlight the need for changes in current medical practice in Iran, as well as patient and healthcare provider education. © 2012 Blackwell Publishing Asia Pty Ltd.

  9. 32 CFR 701.110 - Conditions of disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of Federal and state bodies having authority to issue such process. Note: Disclosure accounting is... considered a single agency. Note: No disclosure accounting required. (b) FOIA. Records must be disclosed if... disclosure accounting required. (c) Routine use. Each DON PA system of records notice identifies what records...

  10. 28 CFR 802.3 - Guidelines for disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Guidelines for disclosure. 802.3 Section 802.3 Judicial Administration COURT SERVICES AND OFFENDER SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA DISCLOSURE OF RECORDS Freedom of Information Act § 802.3 Guidelines for disclosure. (a) The...

  11. Disclosure appraisal mediating the association between perceived stigma and HIV disclosure to casual sex partners among HIV+ MSM: a path model analysis.

    PubMed

    Li, Haochu; Chen, Xinguang; Yu, Bin

    2016-01-01

    HIV stigma is widely believed to be related to HIV disclosure. However, there is a dearth of studies examining the mechanisms that link stigma to disclosure. This is a specific study to assess the relationship between perceived stigma and HIV disclosure to casual sex partners based on a social cognitive theory. HIV+ men who have sex with men (MSM) from two US cities (N = 297) completed questionnaires administered using audio computer-assisted self-interviewing. Path modeling analysis was used to assess the theory-based structural relationships. Perceived stigma was negatively associated with attitudes, intention and behavior of HIV disclosure to casual sex partners. The association was fully mediated by disclosure appraisal, including disclosure outcome expectations, costs and self-efficacy. Findings of this study add new knowledge regarding HIV stigma and disclosure, and provide timely data supporting more effective behavioral interventions to encourage HIV disclosure among MSM.

  12. Error disclosure: a new domain for safety culture assessment.

    PubMed

    Etchegaray, Jason M; Gallagher, Thomas H; Bell, Sigall K; Dunlap, Ben; Thomas, Eric J

    2012-07-01

    To (1) develop and test survey items that measure error disclosure culture, (2) examine relationships among error disclosure culture, teamwork culture and safety culture and (3) establish predictive validity for survey items measuring error disclosure culture. All clinical faculty from six health institutions (four medical schools, one cancer centre and one health science centre) in The University of Texas System were invited to anonymously complete an electronic survey containing questions about safety culture and error disclosure. The authors found two factors to measure error disclosure culture: one factor is focused on the general culture of error disclosure and the second factor is focused on trust. Both error disclosure culture factors were unique from safety culture and teamwork culture (correlations were less than r=0.85). Also, error disclosure general culture and error disclosure trust culture predicted intent to disclose a hypothetical error to a patient (r=0.25, p<0.001 and r=0.16, p<0.001, respectively) while teamwork and safety culture did not predict such an intent (r=0.09, p=NS and r=0.12, p=NS). Those who received prior error disclosure training reported significantly higher levels of error disclosure general culture (t=3.7, p<0.05) and error disclosure trust culture (t=2.9, p<0.05). The authors created and validated a new measure of error disclosure culture that predicts intent to disclose an error better than other measures of healthcare culture. This measure fills an existing gap in organisational assessments by assessing transparent communication after medical error, an important aspect of culture.

  13. Improving mental health service responses to domestic violence and abuse.

    PubMed

    Trevillion, Kylee; Corker, Elizabeth; Capron, Lauren E; Oram, Siân

    2016-10-01

    Domestic violence and abuse is a considerable international public health problem, which is associated with mental disorders in both women and men. Nevertheless, victimization and perpetration remain undetected by mental health services. This paper reviews the evidence on mental health service responses to domestic violence, including identifying, referring, and providing care for people experiencing or perpetrating violence. The review highlights the need for mental health services to improve rates of identification and responses to domestic violence and abuse, through the provision of specific training on domestic violence and abuse, the implementation of clear information sharing protocols and evidence-based interventions, and the establishment of care referral pathways. This review also highlights the need for further research into mental health service users who perpetrate domestic violence and abuse.

  14. 45 CFR 1644.4 - Case disclosure requirement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Case disclosure requirement. 1644.4 Section 1644.4 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION DISCLOSURE OF CASE INFORMATION § 1644.4 Case disclosure requirement. (a) For each case filed in court by its...

  15. 31 CFR 50.10 - General disclosure requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false General disclosure requirements. 50.10 Section 50.10 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Disclosures as Conditions for Federal Payment § 50.10 General disclosure requirements. (a...

  16. 31 CFR 50.10 - General disclosure requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false General disclosure requirements. 50.10 Section 50.10 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Disclosures as Conditions for Federal Payment § 50.10 General disclosure requirements. (a...

  17. 31 CFR 50.10 - General disclosure requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false General disclosure requirements. 50.10 Section 50.10 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Disclosures as Conditions for Federal Payment § 50.10 General disclosure requirements. (a...

  18. 31 CFR 50.10 - General disclosure requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false General disclosure requirements. 50.10 Section 50.10 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Disclosures as Conditions for Federal Payment § 50.10 General disclosure requirements. (a...

  19. 31 CFR 50.10 - General disclosure requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false General disclosure requirements. 50.10 Section 50.10 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Disclosures as Conditions for Federal Payment § 50.10 General disclosure requirements. (a...

  20. 6 CFR 9.3 - Certification and disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Certification and disclosure. 9.3 Section 9.3 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY RESTRICTIONS UPON LOBBYING General § 9.3 Certification and disclosure. (a) Each person shall file a certification, and a disclosure...

  1. 5 CFR 2606.207 - Accounting of disclosures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... disclosures in cases where records about the data subject are disclosed from OGE's system of records except..., the accounting of disclosures will be made available to the data subject upon request in accordance... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Accounting of disclosures. 2606.207...

  2. 5 CFR 2606.207 - Accounting of disclosures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... disclosures in cases where records about the data subject are disclosed from OGE's system of records except..., the accounting of disclosures will be made available to the data subject upon request in accordance... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Accounting of disclosures. 2606.207...

  3. 5 CFR 2606.207 - Accounting of disclosures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... disclosures in cases where records about the data subject are disclosed from OGE's system of records except..., the accounting of disclosures will be made available to the data subject upon request in accordance... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Accounting of disclosures. 2606.207...

  4. 5 CFR 293.406 - Disclosure of records.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... RECORDS Employee Performance File System Records § 293.406 Disclosure of records. Disclosure as used here... of official duties. Disclosure of information from this file system shall be made only as permitted..., only under a routine use published by the Office for the system of records covering these records...

  5. 5 CFR 293.406 - Disclosure of records.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... RECORDS Employee Performance File System Records § 293.406 Disclosure of records. Disclosure as used here... of official duties. Disclosure of information from this file system shall be made only as permitted..., only under a routine use published by the Office for the system of records covering these records...

  6. 5 CFR 293.406 - Disclosure of records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... RECORDS Employee Performance File System Records § 293.406 Disclosure of records. Disclosure as used here... of official duties. Disclosure of information from this file system shall be made only as permitted..., only under a routine use published by the Office for the system of records covering these records...

  7. 5 CFR 293.406 - Disclosure of records.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... RECORDS Employee Performance File System Records § 293.406 Disclosure of records. Disclosure as used here... of official duties. Disclosure of information from this file system shall be made only as permitted..., only under a routine use published by the Office for the system of records covering these records...

  8. 5 CFR 293.406 - Disclosure of records.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... RECORDS Employee Performance File System Records § 293.406 Disclosure of records. Disclosure as used here... of official duties. Disclosure of information from this file system shall be made only as permitted..., only under a routine use published by the Office for the system of records covering these records...

  9. 12 CFR 226.39 - Mortgage transfer disclosures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... involves multiple covered persons who jointly acquire the loan, a single disclosure must be provided on... single disclosure is provided on behalf of more than one covered person, the information required by this... single disclosure is provided on behalf of more than one covered person and one of them has been...

  10. 46 CFR 503.62 - Accounting of disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 9 2010-10-01 2010-10-01 false Accounting of disclosures. 503.62 Section 503.62... Record of Identifiable Personal Information § 503.62 Accounting of disclosures. (a) The Secretary shall make an accounting of each disclosure of any record contained in a system of records in accordance with...

  11. 21 CFR 20.90 - Disclosure to contractors.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... INFORMATION Limitations on Exemptions § 20.90 Disclosure to contractors. (a) Data and information otherwise... employees; (4) Limitations on reproduction, transmission, and disclosure of the data and information; (5) A... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Disclosure to contractors. 20.90 Section 20.90...

  12. 10 CFR 2.704 - Discovery-required disclosures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Discovery-required disclosures. 2.704 Section 2.704 Energy....704 Discovery-required disclosures. (a) Initial disclosures. Except to the extent otherwise stipulated...; and (2) A copy of, or a description by category and location of, all documents, data compilations, and...

  13. 21 CFR 20.90 - Disclosure to contractors.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... INFORMATION Limitations on Exemptions § 20.90 Disclosure to contractors. (a) Data and information otherwise... employees; (4) Limitations on reproduction, transmission, and disclosure of the data and information; (5) A... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Disclosure to contractors. 20.90 Section 20.90...

  14. 34 CFR 82.110 - Certification and disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Certification and disclosure. 82.110 Section 82.110 Education Office of the Secretary, Department of Education NEW RESTRICTIONS ON LOBBYING General § 82.110 Certification and disclosure. (a) Each person shall file a certification, and a disclosure form, if required...

  15. 12 CFR 411.110 - Certification and disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Certification and disclosure. 411.110 Section 411.110 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES NEW RESTRICTIONS ON LOBBYING General § 411.110 Certification and disclosure. (a) Each person shall file a certification, and a disclosure...

  16. 36 CFR 1121.11 - Accounting of disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Accounting of disclosures... COMPLIANCE BOARD PRIVACY ACT IMPLEMENTATION § 1121.11 Accounting of disclosures. (a) The Board shall, except... an accurate accounting of— (1) The date, nature and purpose of each disclosure of a record to any...

  17. 36 CFR 1008.10 - Accounting for disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Accounting for disclosures... ACT § 1008.10 Accounting for disclosures. (a) Maintenance of an accounting. (1) Where a record is... person or agency to whom the disclosure was made. (3) Accountings prepared under this section shall be...

  18. 44 CFR 6.21 - Procedures for disclosure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Procedures for disclosure. (a) Upon receipt of a request for disclosure, the system manager shall verify the... other requirements of this part, the system manager shall make the requested records available. (b) If the system manager determines that the disclosure is not permitted under the provisions of § 6.20 or...

  19. 21 CFR 20.90 - Disclosure to contractors.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Disclosure to contractors. 20.90 Section 20.90... INFORMATION Limitations on Exemptions § 20.90 Disclosure to contractors. (a) Data and information otherwise exempt from public disclosure may be disclosed to contractors with the Food and Drug Administration and...

  20. 49 CFR 10.23 - Accounting of disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Accounting of disclosures. 10.23 Section 10.23... INDIVIDUALS Maintenance of Records § 10.23 Accounting of disclosures. Each operating administration, the... accurate accounting of: (1) The date, nature, and purpose of each disclosure of a record to any person or...

  1. Daily self-disclosure and sleep in couples.

    PubMed

    Kane, Heidi S; Slatcher, Richard B; Reynolds, Bridget M; Repetti, Rena L; Robles, Theodore F

    2014-08-01

    An emerging literature provides evidence for the association between romantic relationship quality and sleep, an important factor in health and well-being. However, we still know very little about the specific relationship processes that affect sleep behavior. Therefore, the goal of this study was to examine how self-disclosure, an important relational process linked to intimacy, relationship satisfaction, and health, is associated with sleep behavior. As part of a larger study of family processes, wives (n = 46) and husbands (n = 38) from 46 cohabiting families completed 56 days of daily diaries. Spouses completed evening diaries assessing daily self-disclosure, relationship satisfaction, and mood and morning diaries assessing the prior night's sleep. Multilevel modeling was used to explore the effects of both daily variation in and average levels across the 56 days of self-disclosure on sleep. Daily variation in self-disclosure predicted sleep outcomes for wives, but not for husbands. On days when wives self-disclosed more to their spouses than their average level, their subjective sleep quality and sleep efficiency that night improved. Furthermore, daily self-disclosure buffered the effect of high negative mood on sleep latency for wives, but not husbands. In contrast, higher average levels of self-disclosure predicted less waking during the night for husbands, but not for wives. The association between self-disclosure and sleep is one mechanism by which daily relationship functioning may influence health and well-being. Gender may play a role in how self-disclosure is associated with sleep.

  2. Supervisee self-disclosure: a clinical psychology perspective.

    PubMed

    Spence, Nicola; Fox, John R E; Golding, Laura; Daiches, Anna

    2014-01-01

    Clinical supervision is a multi-functional intervention within numerous psychotherapeutic professions, including clinical psychology. It often relies on supervisees' verbal disclosures of pertinent information. There is limited research on supervisee self-disclosure in the UK, and none using clinical psychology populations. This study aimed to address the limitations in the evidence base. It used a constructivist grounded theory methodology to investigate qualified UK clinical psychologists' use of self-disclosure in supervision in order to develop a theoretical understanding of their self-disclosure processes. Ten clinical psychologists from various time points across the career span were recruited to the study. Four core conceptual categories were identified in the analysis as being integral to participants' decision-making processes: 'Setting the Scene', 'Supervisory Relationship', 'Using Self-disclosure' and 'Reviewing Outcome of Self-disclosure'. These four categories are comprised of a number of subcategories. The study's findings are compared with the current literature base, and it is argued that there are tensions with the scientist-practitioner model as it could be interpreted to encourage an expert stance, which may limit the self-disclosure of qualified supervisees. The implications of this perspective are discussed. Supervision is a key process in supporting qualified clinical psychologists and the use of disclosure appears to be important in facilitating useful supervision. It appears that clinical psychologists go through a number of complex processes in deciding whether to self disclose. Copyright © 2012 John Wiley & Sons, Ltd.

  3. The Disclosure Processes Model: Understanding Disclosure Decision Making and Postdisclosure Outcomes among People Living with a Concealable Stigmatized Identity

    ERIC Educational Resources Information Center

    Chaudoir, Stephenie R.; Fisher, Jeffrey D.

    2010-01-01

    Disclosure is a critical aspect of the experience of people who live with concealable stigmatized identities. This article presents the disclosure processes model (DPM)--a framework with which to examine when and why interpersonal disclosure may be beneficial. The DPM suggests that antecedent goals representing approach and avoidance motivational…

  4. Review of Self-disclosure in psychotherapy.

    PubMed

    Hamilton, Rachel A; Del Castillo, Darren M; Stiles, William B

    2007-09-01

    Reviews the book, Self-disclosure in psychotherapy by Barry A. Farber (see record 2006-11792-000). At one point or another, most therapists have wondered how much their patients are telling them and wrestled with how much they should reveal themselves to their patients. This book aims to provide an integrative and up-to-date review of the literature that has addressed these kinds of questions. By looking at patient, therapist, supervisee, and supervisor self-disclosure, Farber attempts to show both common and unique aspects of self-disclosure across the different parties involved in psychotherapy. Work from historical, clinical, research, and cultural perspectives comes together to provide readers with a multifaceted view of self-disclosure in psychotherapy. This book will be of interest to therapists, researchers, psychotherapy supervisors, and therapists-in-training. Farber's discussion of self-disclosure offers a nuanced perspective on the dilemmas involved in the psychotherapy process. By highlighting the features of self-disclosure across patients, therapists, supervisees, and supervisors, Farber enriches understanding of the phenomenon and encourages empathy for the perspectives of those in other psychotherapy roles. We believe that Farber has successfully synthesized work from various perspectives to create an illuminating review of self-disclosure in psychotherapy. The book condenses a broad range of literature into clearly organized and digestible chapters. The integration of research and theory with clinical vignettes, quotations from books and movies, and popular song lyrics make this work an unusually engaging and accessible read. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  5. Truth Disclosure Practices of Physicians in Jordan.

    PubMed

    Borgan, Saif M; Amarin, Justin Z; Othman, Areej K; Suradi, Haya H; Qwaider, Yasmeen Z

    2018-03-01

    Disclosure of health information is a sensitive matter, particularly in the context of serious illness. In conservative societies-those which predominate in the developing world-direct truth disclosure undoubtedly presents an ethical conundrum to the modern physician. The aim of this study is to explore the truth disclosure practices of physicians in Jordan, a developing country. In this descriptive, cross-sectional study, 240 physicians were initially selected by stratified random sampling. The sample was drawn from four major hospitals in Amman, Jordan. A closed-ended questionnaire was distributed and completed by self-report. A total of 164 physicians completed the questionnaire. Thirty-seven physicians (23 per cent) usually withheld the diagnosis of "serious illness" from patients, while 127 physicians (77 per cent) usually divulged the information directly. Among the latter, 108 physicians (86 per cent) made exceptions to their disclosure policy. Specialists were more likely to withhold health information (p = 0.04998). Non-disclosure was primarily motivated by request from the patient's family (seventy-one participants, 54 per cent). In twenty cases (15 per cent), non-disclosure was undertaken independently. In conclusion, most respondents opt to disclose the truth; however, the vast majority of these respondents make exceptions. Instances of non-disclosure are primarily motivated by sociocultural constructs.

  6. 20 CFR 401.80 - Accounting for disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Accounting for disclosures. 401.80 Section... AND INFORMATION The Privacy Act § 401.80 Accounting for disclosures. (a) We will maintain an accounting of all disclosures of a record for five years or for the life of the record, whichever is longer...

  7. 22 CFR 1101.10 - Accounting for disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Accounting for disclosures. 1101.10 Section 1101... STATES SECTION PRIVACY ACT OF 1974 § 1101.10 Accounting for disclosures. (a) Each system manager shall establish a system of accounting for all disclosures of records, either orally or in writing made outside...

  8. 43 CFR 2.57 - Accounting for disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Accounting for disclosures. 2.57 Section 2... INFORMATION ACT Privacy Act § 2.57 Accounting for disclosures. (a) Maintenance of an accounting. (1) Where a... the person or agency to whom the disclosure was made. (3) Accountings prepared under this section...

  9. 12 CFR 792.61 - Accounting for disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Accounting for disclosures. 792.61 Section 792... Accounting for disclosures. (a) Each system manager identified in the “Notice of Systems of Records” must establish a system of accounting for all disclosures of information or records under the Privacy Act made...

  10. 8 CFR 103.30 - Accounting for disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Accounting for disclosures. 103.30 Section... DUTIES; AVAILABILITY OF RECORDS § 103.30 Accounting for disclosures. (a) An accounting of each disclosure of information for which accounting is required (see § 103.24 of this part) shall be attached to the...

  11. 31 CFR 1.25 - Accounting of disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Accounting of disclosures. 1.25... Privacy Act § 1.25 Accounting of disclosures. (a) Accounting of certain disclosures. Each component, with respect to each system of records under its control, shall: (1) Keep an accurate accounting of: (i) The...

  12. 10 CFR 2.704 - Discovery-required disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... at the NRC Web site, http://www.nrc.gov, and/or the NRC Public Document Room, a sufficient disclosure... based on the information then reasonably available to it. A party is not excused from making its... disclosures when required under paragraph (e) of this section. (c) Pretrial disclosures. (1) In addition to...

  13. 14 CFR 1212.203 - Disclosures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Disclosures. 1212.203 Section 1212.203 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION PRIVACY ACT-NASA REGULATIONS Access to... computer matching programs (See NASA Management Instruction (NMI) 1382.18). (b) Disclosure accountings are...

  14. Disclosure experience in a convenience sample of Quebec-born women living with HIV: a phenomenological study.

    PubMed

    Rouleau, Geneviève; Côté, José; Cara, Chantal

    2012-10-18

    In Canada, there has been a considerable increase in the number of women infected with the human immunodeficiency virus (HIV). Within a stigmatized social context, disclosure of HIV positivity is still a prevailing concern among women. Little is known about the global understanding of how French-speaking, Quebec-born women living with HIV, live their serostatus disclosure experience. The aim of this qualitative study is to describe and understand the disclosure experience of these women. We conducted semi-structured interviews with seven women. A convenience sample of French-speaking, Quebec-born women was chosen because they all responded to the criteria of wishing to share their disclosure experience. The mean age of the participants was 46 years old (SD±12). They lived with HIV for an average of 10 years; time since diagnosis varied from 8 months to 23 years. Two out of four mothers had given birth to HIV positive children. Data analysis proposed by van Manen was performed to discover the essential themes of the experience. Seven themes were identified to understand the experience of disclosure in women: 1) Respecting for self and confidants; 2) Feeling apprehension; 3) Exercising control to ensure protection; 4) Deliberately engaging in a process of disclosure/non-disclosure; 5) Exposing oneself to stigma and social exclusion; 6) Suffering internally; and 7) Benefitting from the positive effects of one's decision. For these women, disclosing their HIV status meant: Living the ambivalence of a paradoxical process of revealing/concealing, in a state of profound suffering, exacerbated by stigma, while also being enriched by the benefits attained. Understanding the experience of disclosure in WLHIV is important to guide actions in the practice to support and accompany these women in their unique reality. Health professionals have to broaden their role and work on individual, interpersonal, inter-organizational and intersectoral levels. Mobilization of actors from

  15. Disclosure experience in a convenience sample of quebec-born women living with HIV: a phenomenological study

    PubMed Central

    2012-01-01

    Background In Canada, there has been a considerable increase in the number of women infected with the human immunodeficiency virus (HIV). Within a stigmatized social context, disclosure of HIV positivity is still a prevailing concern among women. Little is known about the global understanding of how French-speaking, Quebec-born women living with HIV, live their serostatus disclosure experience. The aim of this qualitative study is to describe and understand the disclosure experience of these women. Methods We conducted semi-structured interviews with seven women. A convenience sample of French-speaking, Quebec-born women was chosen because they all responded to the criteria of wishing to share their disclosure experience. The mean age of the participants was 46 years old (SD±12). They lived with HIV for an average of 10 years; time since diagnosis varied from 8 months to 23 years. Two out of four mothers had given birth to HIV positive children. Data analysis proposed by van Manen was performed to discover the essential themes of the experience. Results Seven themes were identified to understand the experience of disclosure in women: 1) Respecting for self and confidants; 2) Feeling apprehension; 3) Exercising control to ensure protection; 4) Deliberately engaging in a process of disclosure/non-disclosure; 5) Exposing oneself to stigma and social exclusion; 6) Suffering internally; and 7) Benefitting from the positive effects of one’s decision. For these women, disclosing their HIV status meant: Living the ambivalence of a paradoxical process of revealing/concealing, in a state of profound suffering, exacerbated by stigma, while also being enriched by the benefits attained. Conclusions Understanding the experience of disclosure in WLHIV is important to guide actions in the practice to support and accompany these women in their unique reality. Health professionals have to broaden their role and work on individual, interpersonal, inter-organizational and

  16. Patient Perspectives on Gender Identity Data Collection in Electronic Health Records: An Analysis of Disclosure, Privacy, and Access to Care

    PubMed Central

    Thompson, Hale M.

    2016-01-01

    Abstract Purpose: In 2015, the Centers for Medicare and Medicaid Services ruled that health organizations comply with additional requirements for electronic health records (EHRs), known as “Meaningful Use,” and develop the capacity to collect gender identity data. Research has established effectiveness of a two-step gender identity question to collect these data. This study examines transgender patient perspectives on the use of a two-step question and experiences with privacy and sensitive disclosures in EHRs and healthcare settings. Methods: Four focus groups (N=30) were conducted in Chicago, Illinois in 2014–2015. Participants were asked to compare two intake forms—one with a two-step question and one with a single question—and discuss experiences with gender identity disclosure, privacy, and access to care. Narratives were transcribed verbatim to identify patterns and themes; the extended case method was used and grounded the data analysis process in the concept of intersectionality. Results: Participants expressed appreciation for improved reliability and competencies that the two-part question may afford. Narratives reveal concerns related to patient privacy, safety, and access because of the contexts in which these data are collected and transmitted. Virtually all participants described situations whereby sensitive gender identity information had been involuntarily disclosed, misinterpreted, or abused, and safety and care were compromised. Conclusion: Participants recognized the potential of the two-part question as a measurement and competency tool, but anticipated new privacy violations and involuntary disclosures. Narratives indicate that effects of sensitive disclosures may vary intersectionally, whereby white participants experienced lesser harms than their immigrant, HIV-positive, and black trans feminine counterparts. Discrimination and privacy violations may occur regardless of a two-part or one-part gender identity question, but increasing

  17. Patient Perspectives on Gender Identity Data Collection in Electronic Health Records: An Analysis of Disclosure, Privacy, and Access to Care.

    PubMed

    Thompson, Hale M

    2016-01-01

    Purpose: In 2015, the Centers for Medicare and Medicaid Services ruled that health organizations comply with additional requirements for electronic health records (EHRs), known as "Meaningful Use," and develop the capacity to collect gender identity data. Research has established effectiveness of a two-step gender identity question to collect these data. This study examines transgender patient perspectives on the use of a two-step question and experiences with privacy and sensitive disclosures in EHRs and healthcare settings. Methods: Four focus groups ( N =30) were conducted in Chicago, Illinois in 2014-2015. Participants were asked to compare two intake forms-one with a two-step question and one with a single question-and discuss experiences with gender identity disclosure, privacy, and access to care. Narratives were transcribed verbatim to identify patterns and themes; the extended case method was used and grounded the data analysis process in the concept of intersectionality. Results: Participants expressed appreciation for improved reliability and competencies that the two-part question may afford. Narratives reveal concerns related to patient privacy, safety, and access because of the contexts in which these data are collected and transmitted. Virtually all participants described situations whereby sensitive gender identity information had been involuntarily disclosed, misinterpreted, or abused, and safety and care were compromised. Conclusion: Participants recognized the potential of the two-part question as a measurement and competency tool, but anticipated new privacy violations and involuntary disclosures. Narratives indicate that effects of sensitive disclosures may vary intersectionally, whereby white participants experienced lesser harms than their immigrant, HIV-positive, and black trans feminine counterparts. Discrimination and privacy violations may occur regardless of a two-part or one-part gender identity question, but increasing these sensitive

  18. 22 CFR 1003.1 - General policies, conditions of disclosure, accounting of certain disclosures, and definitions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true General policies, conditions of disclosure, accounting of certain disclosures, and definitions. 1003.1 Section 1003.1 Foreign Relations INTER-AMERICAN FOUNDATION RULES SAFEGUARDING PERSONAL INFORMATION IN IAF RECORDS § 1003.1 General policies, conditions of...

  19. Intracranial Self-Stimulation to Evaluate Abuse Potential of Drugs

    PubMed Central

    Miller, Laurence L.

    2014-01-01

    Intracranial self-stimulation (ICSS) is a behavioral procedure in which operant responding is maintained by pulses of electrical brain stimulation. In research to study abuse-related drug effects, ICSS relies on electrode placements that target the medial forebrain bundle at the level of the lateral hypothalamus, and experimental sessions manipulate frequency or amplitude of stimulation to engender a wide range of baseline response rates or response probabilities. Under these conditions, drug-induced increases in low rates/probabilities of responding maintained by low frequencies/amplitudes of stimulation are interpreted as an abuse-related effect. Conversely, drug-induced decreases in high rates/probabilities of responding maintained by high frequencies/amplitudes of stimulation can be interpreted as an abuse-limiting effect. Overall abuse potential can be inferred from the relative expression of abuse-related and abuse-limiting effects. The sensitivity and selectivity of ICSS to detect abuse potential of many classes of abused drugs is similar to the sensitivity and selectivity of drug self-administration procedures. Moreover, similar to progressive-ratio drug self-administration procedures, ICSS data can be used to rank the relative abuse potential of different drugs. Strengths of ICSS in comparison with drug self-administration include 1) potential for simultaneous evaluation of both abuse-related and abuse-limiting effects, 2) flexibility for use with various routes of drug administration or drug vehicles, 3) utility for studies in drug-naive subjects as well as in subjects with controlled levels of prior drug exposure, and 4) utility for studies of drug time course. Taken together, these considerations suggest that ICSS can make significant contributions to the practice of abuse potential testing. PMID:24973197

  20. Disclosure of Medical Errors in Oman

    PubMed Central

    Norrish, Mark I. K.

    2015-01-01

    Objectives: This study aimed to provide insight into the preferences for and perceptions of medical error disclosure (MED) by members of the public in Oman. Methods: Between January and June 2012, an online survey was used to collect responses from 205 members of the public across five governorates of Oman. Results: A disclosure gap was revealed between the respondents’ preferences for MED and perceived current MED practices in Oman. This disclosure gap extended to both the type of error and the person most likely to disclose the error. Errors resulting in patient harm were found to have a strong influence on individuals’ perceived quality of care. In addition, full disclosure was found to be highly valued by respondents and able to mitigate for a perceived lack of care in cases where medical errors led to damages. Conclusion: The perceived disclosure gap between respondents’ MED preferences and perceptions of current MED practices in Oman needs to be addressed in order to increase public confidence in the national health care system. PMID:26052463

  1. Perceptions of child sexual abuse in a hypothetical cybersexploitation case: the importance of perpetrator honesty, outcome type, and respondent gender.

    PubMed

    Davies, Michelle; Rogers, Paul; Hood, Paul A

    2009-01-01

    This study investigated perceptions of child sexual abuse in a hypothetical cybersexploitation case. Men were predicted to be more negative toward the victim than were women. Victims were predicted to be more negatively judged when they consented to sex than when they did not and when they were lied to than when they were not. Two hundred and seventy-six respondents read a sexual abuse depiction in which the perpetrator's disclosure about his age (being honest from the outset, lying, or refusing to disclose when questioned) and the final outcome of the meeting (consensual verses nonconsensual sexual intercourse) were varied between subjects. Respondents then completed a 17-item attribution scale. ANOVAs revealed broad support for the predictions. Results have implications for education about cybercrime.

  2. Daily Self-Disclosure and Sleep in Couples

    PubMed Central

    Kane, Heidi S.; Slatcher, Richard B.; Reynolds, Bridget M.; Repetti, Rena L.; Robles, Theodore F.

    2014-01-01

    Objective An emerging literature provides evidence for the association between romantic relationship quality and sleep, an important factor in health and well-being. However, we still know very little about the specific relationship processes that affect sleep behavior. Therefore, the goal of this study was to examine how self-disclosure, an important relational process linked to intimacy, relationship satisfaction and health, is associated with sleep behavior. Method As part of a larger study of family processes, wives (n=46) and husbands (n=38) from 46 cohabiting families completed 56 days of daily diaries. Spouses completed evening diaries assessing daily self-disclosure, relationship satisfaction, and mood and morning diaries assessing the prior night's sleep. Multilevel modeling was used to explore the effects of both daily variation in and average levels across the 56 days of self-disclosure on sleep. Results Daily variation in self-disclosure predicted sleep outcomes for wives, but not for husbands. On days when wives self-disclosed more to their spouses than their average level, their subjective sleep quality and sleep efficiency that night improved. Furthermore, daily self-disclosure buffered the negative effect of daily negative mood on sleep latency for wives, but not husbands. In contrast, higher average levels of self-disclosure predicted less waking during the night for husbands, but not for wives. Conclusion The association between self-disclosure and sleep is one mechanism by which daily relationship functioning may influence health and well-being. Gender may play a role in how self-disclosure is associated with sleep. PMID:25068453

  3. 42 CFR 2.14 - Minor patients.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.14 Minor patients. (a) Definition of minor... or drug abuse treatment, any written consent for disclosure authorized under subpart C of these... drug abuse treatment, any written consent for disclosure authorized under subpart C of these...

  4. 42 CFR 2.14 - Minor patients.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.14 Minor patients. (a) Definition of minor... or drug abuse treatment, any written consent for disclosure authorized under subpart C of these... drug abuse treatment, any written consent for disclosure authorized under subpart C of these...

  5. 42 CFR 2.14 - Minor patients.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.14 Minor patients. (a) Definition of minor... or drug abuse treatment, any written consent for disclosure authorized under subpart C of these... drug abuse treatment, any written consent for disclosure authorized under subpart C of these...

  6. 42 CFR 2.14 - Minor patients.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.14 Minor patients. (a) Definition of minor... or drug abuse treatment, any written consent for disclosure authorized under subpart C of these... drug abuse treatment, any written consent for disclosure authorized under subpart C of these...

  7. 42 CFR 2.14 - Minor patients.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ALCOHOL AND DRUG ABUSE PATIENT RECORDS General Provisions § 2.14 Minor patients. (a) Definition of minor... or drug abuse treatment, any written consent for disclosure authorized under subpart C of these... drug abuse treatment, any written consent for disclosure authorized under subpart C of these...

  8. 42 CFR 480.142 - Disclosure of sanction reports.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.142 Disclosure of sanction reports. (a) The QIO must disclose...

  9. 42 CFR 480.142 - Disclosure of sanction reports.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.142 Disclosure of sanction reports. (a) The QIO must disclose...

  10. Hospitalizations Among Homeless Women: Are There Ethnic and Drug Abuse Disparities?

    PubMed Central

    Gelberg, Lillian; Andersen, Ronald; Longshore, Douglas; Leake, Barbara; Nyamathi, Adeline; Teruya, Cheryl; Arangua, Lisa

    2013-01-01

    This paper explores associations among the vulnerabilities of being female, being a member of a minority group, and being a drug abuser in homeless women’s hospitalizations. It uses a 1997 probability survey of 974 homeless females age 15–44 in Los Angeles. In unadjusted analyses, whites were more likely than other ethnic minority groups to be hospitalized, and drug abusers were more likely to be hospitalized than non-drug abusers. Multiple logistic regression analyses indicated that factors associated with hospitalization differed considerably among the ethnic and drug-abuse subgroups. For example, ethnic disparities in inpatient health care were found for drug-abusing women, but not for those who did not abuse drugs. Pregnancy was the only important determinant of hospitalization in all subgroups (OR, 2.9–17.4). Preventing unintended pregnancy appears to be the most inclusive means of reducing hospitalization and attendant costs among homeless women. PMID:18923904

  11. Relevant Information and Informed Consent in Research: In Defense of the Subjective Standard of Disclosure.

    PubMed

    Dranseika, Vilius; Piasecki, Jan; Waligora, Marcin

    2017-02-01

    In this article, we seek to contribute to the debate on the requirement of disclosure in the context of informed consent for research. We defend the subjective standard of disclosure and describe ways to implement this standard in research practice. We claim that the researcher should make an effort to find out what kinds of information are likely to be relevant for those consenting to research. This invites researchers to take empirical survey information seriously, attempt to understand the cultural context, talk to patients to be better able to understand what can be potentially different concerns and interests prevalent in the target population. The subjective standard of disclosure should be seen as a moral ideal that perhaps can never be perfectly implemented but still can and should be used as a normative ideal guiding research practice. In the light of these discussions, we call for more empirical research on what considerations are likely to be perceived as relevant by potential research participants recruited from different socio-economic and cultural groups.

  12. The prevalence of lifetime abuse among older adults in seven European countries.

    PubMed

    Eslami, Bahareh; Viitasara, Eija; Macassa, Gloria; Melchiorre, Maria Gabriella; Lindert, Jutta; Stankunas, Mindaugas; Torres-Gonzalez, Francisco; Barros, Henrique; Ioannidi-Kapolou, Elisabeth; Soares, Joaquim J F

    2016-11-01

    To investigate the lifetime prevalence rate of abuse among older persons and to scrutinize the associated factors (e.g. demographics). This cross-sectional population-based study had 4467 participants, aged 60-84, from seven European cities. Abuse (psychological, physical, sexual, financial and injuries) was measured based on The Revised Conflict Tactics Scale, and the UK survey of abuse/neglect of older people. Over 34 % of participants reported experiencing lifetime psychological, 11.5 % physical, 18.5 % financial and 5 % sexual abuse and 4.3 % reported injuries. Lifetime psychological abuse was associated with country, younger age, education and alcohol consumption; physical abuse with country, age, not living in partnership; injuries with country, female sex, age, education, not living in partnership; financial abuse with country, age, not living in partnership, education, benefiting social/partner income, drinking alcohol; and sexual abuse with country, female sex and financial strain. High lifetime prevalence rates confirm that elder abuse is a considerable public health problem warranting further longitudinal studies. Country of residence is an independent factor associated with all types of elder abuse which highlights the importance of national interventions alongside international collaborations.

  13. 42 CFR 480.142 - Disclosure of sanction reports.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.142 Disclosure of sanction reports. (a) The QIO must disclose sanction reports...

  14. 42 CFR 480.142 - Disclosure of sanction reports.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.142 Disclosure of sanction reports. (a) The QIO must disclose sanction reports...

  15. 42 CFR 480.142 - Disclosure of sanction reports.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.142 Disclosure of sanction reports. (a) The QIO must disclose sanction reports...

  16. 42 CFR 480.130 - Disclosure to the Department.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.130 Disclosure to the Department. Except as limited by §§ 480...

  17. 42 CFR 480.130 - Disclosure to the Department.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.130 Disclosure to the Department. Except as limited by § 480.139...

  18. Men's and Women's Emotional Disclosures: The Impact of Disclosure Recipient, Culture, and the Masculine Role.

    ERIC Educational Resources Information Center

    Snell, William E., Jr.; And Others

    1989-01-01

    Presents three studies that investigate the following aspects of emotional self-disclosure: (1) males' and females' willingness to discuss emotions; (2) impact of gender and culture on emotional disclosures to males and females; and (3) impact of gender and masculine role on willingness to disclose emotionally to parents and therapists. (JS)

  19. Parent Preferences for Medical Error Disclosure: A Qualitative Study.

    PubMed

    Coffey, Maitreya; Espin, Sherry; Hahmann, Tara; Clairman, Hayyah; Lo, Lisha; Friedman, Jeremy N; Matlow, Anne

    2017-01-01

    According to disclosure guidelines, patients experiencing adverse events due to medical errors should be offered full disclosure, whereas disclosure of near misses is not traditionally expected. This may conflict with parental expectations; surveys reveal most parents expect full disclosure whether errors resulted in harm or not. Protocols regarding whether to include children in these discussions have not been established. This study explores parent preferences around disclosure and views on including children. Fifteen parents of hospitalized children participated in semistructured interviews. Three hypothetical scenarios of different severity were used to initiate discussion. Interviews were audiotaped, transcribed, and coded for emergent themes. Parents uniformly wanted disclosure if harm occurred, although fewer wanted their child informed. For nonharmful errors, most parents wanted disclosure for themselves but few for their children.With respect to including children in disclosure, parents preferred to assess their children's cognitive and emotional readiness to cope with disclosure, wishing to act as a "buffer" between the health care team and their children. Generally, as event severity decreased, they felt that risks of informing children outweighed benefits. Parents strongly emphasized needing reassurance of a good final outcome and anticipated difficulty managing their emotions. Parents have mixed expectations regarding disclosure. Although survey studies indicate a stronger desire for disclosure of nonharmful events than for adult patients, this qualitative study revealed a greater degree of hesitation and complexity. Parents have a great need for reassurance and consistently wish to act as a buffer between the health care team and their children. Copyright © 2017 by the American Academy of Pediatrics.

  20. 42 CFR 480.130 - Disclosure to the Department.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.130 Disclosure to the Department. Except as limited by § 480.139(a) and § 480...

  1. 42 CFR 480.130 - Disclosure to the Department.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.130 Disclosure to the Department. Except as limited by § 480.139(a) and § 480...

  2. 42 CFR 480.130 - Disclosure to the Department.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Confidential Information § 480.130 Disclosure to the Department. Except as limited by § 480.139(a) and § 480...

  3. [Child abuse: a disturbing problem].

    PubMed

    Martínez-Martínez, E; Reyes-Rodrguez, R

    1993-08-01

    This current information on "battered child syndrome" (BCS) was obtained during 1990 from nine institutions in Tijuana, Baja California; 549 cases of BCS were studied, of which 338 were female, 203 male, eight of indeterminate sex due to loss documentation. Child abuse was manifested in all its forms: beatings, sexual abuse, neglect, and affective indifference. The victim's and perpetrator's characters were analyzed together with other factors which had to be taken into consideration in order to detect results which were similarly described in the literature. It is of utmost importance to alert all medical staff to this terrible social problem for the complete treatment of the affected child and the family environment. Community support, and legislation to adequately cover rights of minors and their protection are imperative to elimination of the battered child syndrome.

  4. Exploring the “Bisexual Bridge”: A Qualitative Study of Risk Behavior and Disclosure of Same-Sex Behavior Among Black Bisexual Men

    PubMed Central

    Arriola, Kimberly Jacob; Jenkins, Tyrrell R.; Dauria, Emily; Patel, Shilpa N.

    2010-01-01

    Objectives. We explored factors influencing sexual behavior, disclosure of same-sex behavior, and condom-use practices among Black bisexual men. Methods. We conducted semistructured interviews with 38 Black men in Atlanta, Georgia, who reported having had oral, vaginal, or anal sex with both men and women in the prior 6 months. Results. Participants described approaches to disclosure of same-sex behavior as part of a complex decisional balance influenced by both situational and individual factors and ranging from full disclosure to total secrecy. Influences on sexual behavior and condom-use practices included: (1) type of relationship, (2) gender-specific considerations, (3) perceptions of comfort or trust, and (4) fear of disease or pregnancy. Conclusions. Disclosure of same-sex behavior was not a major influence on the sexual behavior and condom-use practices of the Black bisexual men in our study, who demonstrated heterogeneity in approaches to sexual behavior, disclosure of same-sex behavior, and condom-use practices. Additional research is needed to assess the social determinants of sexual risk for this population. Future HIV-prevention efforts should include initiatives to encourage accuracy in risk assessment and in taking sexual histories in clinical settings. PMID:19910348

  5. "Should I tell my employer and coworkers I have arthritis?" A longitudinal examination of self-disclosure in the work place.

    PubMed

    Gignac, Monique A M; Cao, Xingshan

    2009-12-15

    To examine arthritis self-disclosure at work, factors associated with disclosure, and prospective relationships of self-disclosure and work place support with changes to work place interactions, work transitions, and work place stress. Using a structured questionnaire, participants with osteoarthritis or inflammatory arthritis were interviewed at 4 time points, 18 months apart. At time 1, all participants (n = 490; 381 women, 109 men) were employed. Of the entire sample, 71% were retained throughout the study. Respondents were recruited using community advertising and from rheumatology and rehabilitation clinics. Self-disclosure and perceived support from managers and coworkers was assessed, as well as demographic, illness, work-context, and psychological variables. Generalized estimating equations modeled associations of disclosure and support on changes at work (e.g., job disruptions, work place stress). At each time point, 70.6-76.6% of participants had self-disclosed arthritis to their manager and 85.2-88.1% had told a coworker. Intraindividual variability in disclosure was considerable. Factors associated with self-disclosure were often inconsistent over time, with the exception of variables assessing the need to self-disclose (e.g., activity limitations) and perceived coworker support. Self-disclosure was not associated with changes to work. However, coworker support was related to fewer job disruptions, help with work tasks, and being less likely to reduce hours. Perceived managerial support was associated with less work place stress. Greater awareness is needed about issues related to self-disclosing arthritis at work. This study emphasizes the importance of a supportive work place, especially supportive coworkers, in decisions to discuss arthritis at work and in changes to work that might enable people to remain employed.

  6. [Therapist self-disclosure in cognitive-behavioral therapy].

    PubMed

    Panagiotidou, K; Zervas, I

    2014-01-01

    Social changes and developments in medical science prompted mental health professionals to adopt new roles in relation to their self-disclosure practices. The physician-patient relationship has balanced on a different level, promoting the equity and the autonomy of the second. The contemporary patient is better informed, asks more questions and requires more answers. The boundaries between "professional" and "personal" are less strict and patients believe that they have a right to know whether the personal experiences (educational, clinical, research) of their therapists enable them to understand and help them. Although the latest version of the American Psychological Association's Ethics Code (APA, 2002) offers no explicit guidance on therapist self-disclosure, it incorporates an implicit message that therapists can no longer choose non-disclosure without having considered the issue carefully. Non-disclosure is no longer the easy answer, as it may affect adversely the therapeutic relationship and the therapeutic effect. These new circumstances prompted representatives of all psychotherapeutic orientations to reconsider traditional positions on therapist self-disclosure, to adapt to the diverse needs of the patients and the modern requirements of the therapeutic process and to define the framework within which its conduct is not only safe but also effective. This review attempts to describe the concept of therapist self-disclosure and its use and its functions in Cognitive-Behavioral Therapy, following a history of the term in other major therapeutic schools (psychoanalytic, client-centered and systemic). As the focus of any psychotherapy is the patient himself, we added reports of patients' experiences by their therapists' disclosures. Those descriptions reveal clearly not only the benefits of therapist self-disclosure but also the dangers posed by improper use. Finally, we attempt to set a framework in the form of proposals, as these result from existing

  7. Self-disclosure and occupational stress in Chinese professionals.

    PubMed

    Hamid, P N

    2000-12-01

    The relationship of self-disclosure with occupational stress and symptoms of stress was examined among 243 Hong Kong Chinese adult professionals. Self-disclosure was negatively correlated with both occupational stress and psychological symptoms of stress for disclosures of personal feelings and social relationships when disclosing to a Best Friend, indicating a stress-buffering effect. There was a positive correlation between occupational stress and psychological symptoms of stress for disclosure of personal feelings and information about social relationships when disclosing to Mother. While both sexes reported similar occupational stress, the total self-disclosure of women was higher than for men, and this was especially true for intimate topics. The implications of the results were discussed.

  8. 10 CFR 1044.04 - What is a protected disclosure?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false What is a protected disclosure? 1044.04 Section 1044.04 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) SECURITY REQUIREMENTS FOR PROTECTED DISCLOSURES UNDER SECTION 3164 OF THE NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2000 § 1044.04 What is a protected disclosure? A protected disclosure is: (a)...

  9. 10 CFR 1044.04 - What is a protected disclosure?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false What is a protected disclosure? 1044.04 Section 1044.04 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) SECURITY REQUIREMENTS FOR PROTECTED DISCLOSURES UNDER SECTION 3164 OF THE NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2000 § 1044.04 What is a protected disclosure? A protected disclosure is: (a)...

  10. 10 CFR 1044.04 - What is a protected disclosure?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false What is a protected disclosure? 1044.04 Section 1044.04 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) SECURITY REQUIREMENTS FOR PROTECTED DISCLOSURES UNDER SECTION 3164 OF THE NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2000 § 1044.04 What is a protected disclosure? A protected disclosure is: (a)...

  11. 10 CFR 1044.04 - What is a protected disclosure?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false What is a protected disclosure? 1044.04 Section 1044.04 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) SECURITY REQUIREMENTS FOR PROTECTED DISCLOSURES UNDER SECTION 3164 OF THE NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2000 § 1044.04 What is a protected disclosure? A protected disclosure is: (a)...

  12. 10 CFR 1044.04 - What is a protected disclosure?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false What is a protected disclosure? 1044.04 Section 1044.04 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) SECURITY REQUIREMENTS FOR PROTECTED DISCLOSURES UNDER SECTION 3164 OF THE NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2000 § 1044.04 What is a protected disclosure? A protected disclosure is: (a)...

  13. Diminishing self-disclosure to maintain security in partners' care.

    PubMed

    Lemay, Edward P; Melville, Michael C

    2014-01-01

    Six studies demonstrate that perceivers' desire to bond with targets motivates perceivers to misconstrue their own self-disclosure in ways that maintain perceivers' security in targets' care and commitment. Perceivers who strongly valued relationships with targets reported high levels of global self-disclosure, consistent with many findings suggesting salutary effects of disclosure. However, these same perceivers reported low self-disclosure of needs and desires in hypothetical (Study 1) and actual (Study 2) situations characterized by targets' unresponsive behavior. Similarly, in daily report (Study 3) and behavioral observation (Study 4) studies, perceivers who valued relationships with targets perceived high levels of self-disclosure when targets were responsive, but they perceived low self-disclosure when targets were unresponsive, and these perceptions seemed partly illusory. In turn, these perceptions of low self-disclosure in situations characterized by partners' unresponsive behavior predicted decreased perceptions of diagnosticity of targets' behavior (Studies 1-3) and buffered the negative affective and interpersonal effects of unresponsive behavior (Study 4). Experimental manipulations (Studies 5 and 6) demonstrated the motivational nature of perceived self-disclosure. Collectively, the results suggest that a desire to bond with targets motivates perceivers to downplay the diagnosticity of targets' unresponsive behavior through diminishing their self-disclosure, in turn preserving perceivers' trust in targets' care and commitment.

  14. “The doctor said I didn’t look gay”: Young adults’ experiences of disclosure and non-disclosure of LGBTQ identity to healthcare providers

    PubMed Central

    Rossman, Kinton; Salamanca, Paul; Macapagal, Kathryn

    2018-01-01

    Shifting cultural attitudes and legislation have increased focus on the healthcare needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients. However, patient non-disclosure of LGBTQ identity creates a barrier to accessing care. This study examined a diverse sample of LGBTQ young adults and their experiences of disclosure and non-disclosure to medical providers. Participants (N = 206, age range 18–27) completed questionnaires assessing healthcare access and use as part of a larger study. Participants’ responses to open-ended items asking about experiences of LGBTQ identity disclosure to medical providers and reasons for non-disclosure were analyzed thematically. Results revealed intra- and interpersonal factors related to patient disclosure. Reasons for participant non-disclosure included providers not asking about identity, internalized stigma, and belief that health and LGBTQ identity are not related. When participants did disclose, they experienced reactions ranging from discrimination and disbelief to affirmation and respect. Findings confirm and extend previous research on young adults’ identity disclosure and provide avenues continuing education for health professionals working with LGBTQ patients. PMID:28459379

  15. Disclosure of Adverse Events in Pediatrics.

    PubMed

    2016-12-01

    Despite increasing attention to issues of patient safety, preventable adverse events (AEs) continue to occur, causing direct and consequential injuries to patients, families, and health care providers. Pediatricians generally agree that there is an ethical obligation to inform patients and families about preventable AEs and medical errors. Nonetheless, barriers, such as fear of liability, interfere with disclosure regarding preventable AEs. Changes to the legal system, improved communications skills, and carefully developed disclosure policies and programs can improve the quality and frequency of appropriate AE disclosure communications. Copyright © 2016 by the American Academy of Pediatrics.

  16. 48 CFR 9903.202 - Disclosure requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ACCOUNTING STANDARDS CONTRACT COVERAGE CAS Program Requirements 9903.202 Disclosure requirements. ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Disclosure requirements. 9903.202 Section 9903.202 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD...

  17. 48 CFR 952.204-72 - Disclosure of information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... classified information or restricted data: Disclosure of Information (APR 1994) (a) It is mutually expected... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Disclosure of information... FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 952.204-72 Disclosure...

  18. 48 CFR 952.204-72 - Disclosure of information.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... classified information or restricted data: Disclosure of Information (APR 1994) (a) It is mutually expected... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Disclosure of information... FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 952.204-72 Disclosure...

  19. 48 CFR 952.204-72 - Disclosure of information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... classified information or restricted data: Disclosure of Information (APR 1994) (a) It is mutually expected... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Disclosure of information... FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 952.204-72 Disclosure...

  20. 12 CFR 1102.307 - Disclosure of exempt records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Disclosure of exempt records. 1102.307 Section 1102.307 Banks and Banking FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL APPRAISER REGULATION Description of Office, Procedures, Public Information § 1102.307 Disclosure of exempt records. (a) Disclosure...

  1. 15 CFR 766.11 - Matter protected against disclosure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 2 2014-01-01 2014-01-01 false Matter protected against disclosure... ADMINISTRATIVE ENFORCEMENT PROCEEDINGS § 766.11 Matter protected against disclosure. (a) Protective measures. It... concern, and that are to be protected against disclosure. Accordingly, and without limiting the discretion...

  2. Adult survivors of childhood cancers' identity disclosures in the workplace.

    PubMed

    Martinez, Larry R; Hebl, Michelle R

    2016-04-01

    Recent medical advances have resulted in unprecedented increases in the number and vitality of employed adult survivors. These survivors must make decisions about whether or not to disclose their identities to others. The purpose of this study was to examine the characteristics that are related to cancer survivorship disclosure in workplace settings (perceived organizational support, centrality of survivorship to one's self-concept, and the degree to which family and friends know about one's survivor status) and an important organizational consequence: intentions to leave one's job. A total of 151 adult survivors of childhood cancer completed an online survey. Extent of disclosure of one's identity as a cancer survivor was negatively associated with turnover intentions. Furthermore, organizational support, identity centrality, and disclosure outside of work were all related to disclosure in the workplace. Relative weight analysis revealed that disclosure outside of work was the most strongly related to disclosure at work. Finally, there were indirect relations such that disclosure mediated the relations among organizational support, identity centrality, and disclosure outside of work and turnover intentions. Survivors who were more open about their cancer survivor status at work had fewer intentions to leave their organizations. Importantly, although some antecedents to disclosure were personal characteristics, organizations can also encourage identity disclosure demonstrating that they are related to of work retention. While disclosure in the workplace is a complex decision to make, the relationship with work retention may reflect that disclosure is more likely to occur in an existing positive work environment or that disclosure itself may contribute to a positive work environment where employees tend to remain. The specific factors that trigger both disclosure and retention require further study although they are clearly related.

  3. Abuse-deterrent formulations of prescription opioid analgesics in the management of chronic noncancer pain.

    PubMed

    Hale, Martin E; Moe, Derek; Bond, Mary; Gasior, Maciej; Malamut, Richard

    2016-10-01

    Misuse, abuse and diversion of prescription opioid analgesics represent a global public health concern. The development of abuse-deterrent formulations (ADFs) of prescription opioid analgesics is an important step toward reducing abuse and diversion of these medications, as well as potentially limiting medical consequences when misused or administered in error. ADFs aim to hinder extraction of the active ingredient, prevent administration through alternative routes and/or make abuse of the manipulated product less attractive, less rewarding or aversive. However, opioid ADFs may still be abused via the intended route of administration by increasing the dose and/or dosing frequency. The science of abuse deterrence and the regulatory landscape are still relatively new and evolving. This paper reviews the current status of opioid ADFs, with particular focus on different approaches that can be used to deter abuse, regulatory considerations and implications for clinical management.

  4. 48 CFR 1330.202 - Disclosure requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Disclosure requirements. 1330.202 Section 1330.202 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 1330.202 Disclosure...

  5. 48 CFR 1430.202 - Disclosure requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Disclosure requirements. 1430.202 Section 1430.202 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 1430.202 Disclosure...

  6. 48 CFR 30.202 - Disclosure requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Disclosure requirements. 30.202 Section 30.202 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 30.202 Disclosure...

  7. 48 CFR 430.202 - Disclosure requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Disclosure requirements. 430.202 Section 430.202 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 430.202 Disclosure...

  8. 48 CFR 30.202 - Disclosure requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Disclosure requirements. 30.202 Section 30.202 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 30.202 Disclosure...

  9. 48 CFR 1330.202 - Disclosure requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Disclosure requirements. 1330.202 Section 1330.202 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 1330.202 Disclosure...

  10. 48 CFR 1430.202 - Disclosure requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Disclosure requirements. 1430.202 Section 1430.202 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 1430.202 Disclosure...

  11. 48 CFR 430.202 - Disclosure requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Disclosure requirements. 430.202 Section 430.202 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Program Requirements 430.202 Disclosure...

  12. Substance Abuse Prevention, Assessment, and Treatment for Lesbian, Gay, Bisexual, and Transgender Youth.

    PubMed

    Aromin, Romulo Alcalde

    2016-12-01

    Knowing how to manage substance abuse in all youth is an important aspect of pediatric care, including providing clinically appropriate anticipatory guidance, monitoring, assessment, and treatment. Although most lesbian, gay, bisexual, and transgender (LGBT) youth do not abuse substances, as a group they experience unique challenges in self-identity development that put them at an increased risk for substance abuse. This article addresses prevention and management of substance use in LGBT youth relevant to pediatrics and allied professions as an aspect of their overall health care. It reviews basic information about substance abuse in youth and special considerations for LGBT youth. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. 49 CFR 604.40 - Public disclosure of evidence.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... disclosure of information in the record by filing a written motion to withhold specific information with the PO. The person shall state specific grounds for nondisclosure in the motion. (c) The PO shall grant the motion to withhold information from public disclosure if the PO determines that disclosure would...

  14. 49 CFR 604.40 - Public disclosure of evidence.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... disclosure of information in the record by filing a written motion to withhold specific information with the PO. The person shall state specific grounds for nondisclosure in the motion. (c) The PO shall grant the motion to withhold information from public disclosure if the PO determines that disclosure would...

  15. 17 CFR 4.25 - Performance disclosures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 false Performance disclosures. 4.25... OPERATORS AND COMMODITY TRADING ADVISORS Commodity Pool Operators § 4.25 Performance disclosures. (a) General principles—(1) Capsule performance information—(i) For pools. Unless otherwise specified...

  16. 17 CFR 4.25 - Performance disclosures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Performance disclosures. 4.25... OPERATORS AND COMMODITY TRADING ADVISORS Commodity Pool Operators § 4.25 Performance disclosures. (a) General principles—(1) Capsule performance information—(i) For pools. Unless otherwise specified...

  17. 17 CFR 4.25 - Performance disclosures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Performance disclosures. 4.25... OPERATORS AND COMMODITY TRADING ADVISORS Commodity Pool Operators § 4.25 Performance disclosures. (a) General principles—(1) Capsule performance information—(i) For pools. Unless otherwise specified...

  18. 17 CFR 4.25 - Performance disclosures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Performance disclosures. 4.25... OPERATORS AND COMMODITY TRADING ADVISORS Commodity Pool Operators § 4.25 Performance disclosures. (a) General principles—(1) Capsule performance information—(i) For pools. Unless otherwise specified...

  19. 17 CFR 4.25 - Performance disclosures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Performance disclosures. 4.25... OPERATORS AND COMMODITY TRADING ADVISORS Commodity Pool Operators § 4.25 Performance disclosures. (a) General principles—(1) Capsule performance information—(i) For pools. Unless otherwise specified...

  20. 25 CFR 141.48 - Translation of disclosure statements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Translation of disclosure statements. 141.48 Section 141.48 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES BUSINESS... Translation of disclosure statements. Disclosure required by §§ 141.46 and 141.47 shall be made in writing...