Child custody evaluations when one divorcing parent has a physical disability.

Objective: To explore how parents' physical disability status might impact the process of divorce-related child custody evaluations and custody decisions, the level of training received by psychologists regarding assessment of parents with physical disabilities, and whether psychologists recognize that testing persons with physical disabilities requires specialized knowledge. Study Design: Survey mailed in 4 waves. Participants: 206 child custody evaluators (31% response rate). Outcome Measures: A survey regarding custody evaluations, a custody questionnaire, evaluation practices, education and training regarding disability, demographics, and a question about the purpose of the study. Results: Almost 70% had performed ≥1 child custody evaluation involving a parent with a physical disability. Over 85% of participants reported no training with regard to such evaluations, and 49% reported no training regarding any disability issues. 65% stated they would use the same tests without modifications, regardless of disability status of the parent. Conclusions: Recommendations include mandated training on disability for child custody evaluators, graduate training on disability accommodations in assessment, specifying conditions when evaluating parents with disabilities, more information regarding accommodations in custody evaluations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors associated with women's adherence to mammography screening guidelines

OBJECTIVE: To examine individual and environmental factors associated with adherence to mammography screening guidelines. DATA SOURCES: A unique data set that combines a national probability sample (1992 National Health Interview Survey); a national probability sample of mammography facility characteristics (1992 National Survey of Mammography Facilities); county-level data on 1990 HMO market share; and county-level data on the supply of primary care providers (1991 Area Resource File). STUDY DESIGN: The design was cross-sectional. DATA EXTRACTION/ANALYSIS: Data sets were linked to create an individual-level sample of women ages 50-74 (weighted n = 2,026). We used multipart, sequential logistic regression models to examine the predictors of having ever had mammography, having had recent mammography, and adherence to guidelines. We categorized women as adherent if they reported a lifetime number of exams appropriate for their age (based on screening every two years) and they reported having had an exam in the past two years. PRINCIPAL FINDINGS: Only 27 percent of women had the age-appropriate number of screening exams (range 16 percent-37 percent), while 59 percent of women had been screened within two years. Women were significantly more likely to adhere to screening guidelines if they reported participating with their doctor in the decision to be screened; were younger; had smaller families, higher education and income, and a recent Pap smear; reported breast problems; and lived in an area with a higher percentage of mammography facilities with reminder systems, no shortage of primary care providers, higher HMO market share, and higher screening charges. CONCLUSIONS: A small percentage of women adhere to screening guidelines, suggesting that adherence needs to become a focus of clinical, programmatic, and policy efforts.     

Stability of lipid/DNA complexes during agitation and freeze-thawing

Among persons with a family history of premature coronary heart disease (CHD), siblings bear an excess risk of CHD that is as high as 12 times that of the general population. Aggressive, new, national guidelines for CHD risk reduction have focused on high-risk families, yet little is known about actual remediable risk factors in siblings of persons with premature CHD. To determine the magnitude of the problem relative to the general population, we screened 846 unaffected siblings (ages 30 to 59 years) of persons with documented CHD before age 60 years and compared their risk factor values with population reference norms obtained in the Third National Health and Nutrition Examination Survey (NHANES III) and the National Health Interview Survey (NHIS). Mean levels of low-density lipoprotein cholesterol were 0.52 mmol/L (20 mg/dl) higher in siblings; the prevalence of low-density lipoprotein cholesterol > or =4.14 mmol/L (160 mg/dl) was nearly twice that of race, sex, and age-specific values from NHANES III. Levels of high-density lipoprotein cholesterol <0.91 mmol/L (35 mg/dl) were similar between siblings and NHANES III (11% and 12%, respectively). Only 4% of all siblings had triglyceride levels > or =4.52 mmol/L (400 mg/dl). Hypertension prevalence was twice as high among siblings as among the NHANES III. Current smoking was 33.9% in white siblings and 25.5% in the NHIS, whereas smoking in African-Americans was similar to that in the NHIS (31.1% vs 29.2%). A mere 13% to 29% of siblings were without any major remediable risk factors. The overwhelming need for risk factor modification in this easily identifiable high-risk population supports aggressive national guidelines and demonstrates the lack of adequate treatment of apparently healthy siblings of persons with premature CHD.     

Effects of depressive symptoms on health behavior practices among older adults with vision loss.

Objective: The authors examined the interface between visual impairment and depressive symptoms on health behaviors, self-care, and social participation among adults ages 65 and older. Method: The authors analyzed data from the 1997–2004 National Health Interview Survey on visual impairment and depressive symptoms for 49,278 adults ages 65 and older, comparing visually impaired adults (n = 8,787) with and without depressive symptoms with a reference group of adults with neither condition (n = 3,136) for outcome measures: physical health, health behaviors, and difficulties with self-care and social participation. Results: Adults with visual impairment and severe depressive symptoms were more likely than adults with neither condition to smoke (14.9%, adjusted odds ratio [AOR] = 1.6), be obese (28.2%, AOR = 1.9), be physically inactive (80.5%, AOR = 3.0), have fair–poor health (76.0%, AOR = 26.5), and have difficulties with self-care (27.9%, AOR = 11.8) and social participation (52.1%, AOR = 10.9). Discussion and Conclusions: Older visually impaired adults with depressive symptoms are vulnerable to health decline and further disablement without timely interventions that target smoking cessation, healthy eating, and increased physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transitioning to independence: challenges for young people with disabilities and their caregivers

For all teens, the process of moving from childhood to adulthood is challenging. For young people with disabilities, transitioning to independence presents even more challenges. Barriers to successful transition for young people with disabilities include low expectations by parents and other significant people in the community, lack of knowledge of existing career and vocational education services, and lack of self-advocacy skills. This article provides an overview of issues related to transitioning to adult independence and offers suggestions for assessment, planning, and intervention that can help nurses be effective partners with families and other caregivers in transition efforts. Nurses caring for children with disabilities can help families see strengths in their children and develop realistic, developmentally-appropriate expectations for skill development, attitudes, and behaviors that will promote self-sufficiency in adulthood. Nurses can help families think about possibilities for independence and refer families to community resources that can help young people with disabilities pursue postsecondary education, obtain and maintain jobs, and live independently.     

Children with lesbian parents: A community study.

Existing research on children with lesbian parents is limited by reliance on volunteer or convenience samples. The present study examined the quality of parent-child relationships and the socioemotional and gender development of a community sample of 7-year-old children with lesbian parents. Families were recruited through the Avon Longitudinal Study of Parents and Children, a geographic population study of 14,000 mothers and their children. Thirty-nine lesbian-mother families, 74 two-parent heterosexual families, and 60 families headed by single heterosexual mothers were compared on standardized interview and questionnaire measures administered to mothers, co-mothers/fathers, children, and teachers. Findings are in line with those of earlier investigations showing positive mother-child relationships and well-adjusted children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Illicit drug use by persons with disabilities: insights from the National Household Survey on Drug Abuse

OBJECTIVES: This study sought to evaluate the association of drug use with disability in a representative sample of the US household population. METHODS: The use of illicit drugs and alcohol reported by respondents in the 1991 National Household Survey on Drug Abuse who identified themselves as "disabled, unable to work" was compared with respondents without disabilities. RESULTS: Among younger adults (18-24 years), persons with disabilities were more likely than those without disabilities to report that they had used heroin (adjusted odds ratio [OR] = 6.89; 95% confidence interval [CI] = 1.35, 35.1) or crack cocaine (OR = 6.38; 95% CI = 1.05, 38.6). Among older adults (35 years and older), persons with disabilities were more likely to report the use of sedatives (OR = 2.46; 95% CI = 1.21, 4.94) or tranquilizers (OR = 2.18: 95% CI = 1.08; 4.42) not medically prescribed. CONCLUSIONS: These results suggest that use of illicit drugs is a potentially serious problem among persons with disabilities and requires both research and clinical attention.     

Wellness Promotion in Persons With Disabilities: Physicians' Personal Behaviors, Attitudes, and Practices.

Objective: To examine physicians' attitudes, personal wellness behaviors, and wellness promotion practices with their patients who were living with a disability. Design and Participants: A 20-item survey was mailed to 1,200 physicians from a national stratified random sample. Responses were received from 417 physicians (34.8% response rate). Results: Physicians who reported engaging in high levels of wellness promotion with their patients with disabilities rated wellness promotion as more important and reported feeling more competent and responsible. Several barriers and incentives to wellness promotion were reported. Conclusions: Physicians' attitudes and perceived competencies may influence their wellness promotion activities with their patients with disabilities. Medical training modules and other methods may increase physicians' wellness promotion activities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting and the socialization of religiousness and spirituality.

This study examined parenting style dimensions as moderators of relations between family religiousness and individual religiousness and spirituality. Participants were 122 emerging adults ages 17–31 (M = 20.90, SD = 2.75). Cross-sectional data were obtained through an online survey. Participants rated the frequency with which they engaged in various religious activities with their families when they were younger, the frequency with which they personally do those behaviors currently, their current spirituality, and the parenting styles used by their parents when they were younger. Family religiousness positively predicted individual religiousness and spirituality. Rejection and autonomy-support moderated the association between family religiousness and individual religiousness, while warmth, rejection, structure, chaos, and autonomy-support moderated the relationship between family religiousness and individual spirituality. Thus, religious beliefs and practices, at whatever level, may be more readily appropriated by the next generation in families characterized by authoritative parenting. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Perceptions of control of students with and without cognitive disabilities

Research in the educational and psychological literature has linked adaptive perceptions of control to positive adult outcomes like better employment, higher quality of life, and increased independence. In recent years these findings have been extended to people with mental retardation. Research with this population has suggested that they tend to be more externally oriented than peers without disabilities or peers with other types of disabilities. This research, however, has not provided direct comparisons between people with mental retardation and other populations. The present study compared the perceptions of control of 431 students (227 boys, 204 girls) ages 10-20 years (M = 14.3) with mental retardation (n = 94), learning disabilities (n = 159), or no disabilities (n = 178). Analysis confirmed that students with mental retardation scored significantly more externally on measures of locus of control and attributions of academic success and failure than their peers with learning disabilities or without disabilities. The discussion focuses on implications for these students.     

Patterns of authority and affection in two generations.

Using data gleaned from a normative longitudinal study of more than 200 families by workers in the Institute of Child Welfare of the University of California at Berkeley, the research was devised to answer the question as to whether the perception of one's own parents influences parental attitudes towards one's own children. These relationships were studied through the media of 3 variables, viz., authority, affection, and involvement, and their intercorrelation. The "characteristic" or modal family pattern which emerges from the data is described and discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Occupational injuries among older workers with visual, auditory, and other impairments. A validation study

This study aims to validate a previously defined model of the risk of occupational injuries among older workers with visual, auditory, or other impairments. That model was based upon the Health and Retirement Study (HRS). The previous logistic regression model was recalculated using data from the 1994 National Health Interview Survey (NHIS). The parameter estimates for impaired hearing (.181 in NHIS, 1.55 in HRS), impaired vision (2.42 in NHIS, 1.48 in HRS), and self-employment (0.22 in NHIS, 0.49 in HRS) were in same direction and of roughly the same magnitude. The previously defined model was confirmed using NHIS data. The data suggest that as the workforce ages, more attention must be paid to the accommodation of disabilities in the workplace, especially sensory impairments-poor vision and hearing.     

The effectiveness of counseling groups in reducing stress of parents of children with learning disabilities.

This study investigated the impact of counseling groups as compared with educational groups on attitudes, levels of stress, and sense of control among parents of a child with learning disabilities (LD) and a non-LD sibling. Conducted in one learning center in Israel, the study comprised 49 families in the counseling group and 46 families in the educational group. Results of the hierarchical analyses (mixed models) indicated significantly higher gains in the counseling groups for both mothers (who participated in the intervention) and fathers (who did not), mostly with respect to the child with LD. Children's self-reports supported these gains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Piloting the Family Check-Up With Incarcerated Adolescents and Their Parents.

The purpose of the current investigation was to pilot the Family Check-Up (FCU; see T. J. Dishion & K. Kavanagh, 2003) with 10 incarcerated adolescents and their parents or guardians. The FCU is based on principles of motivational interviewing (W. R. Miller & S. Rollnick, 2002). The authors delivered FCU with a high degree of fidelity and adherence on the basis of ratings from parents, therapists, and observers. Results suggest that the FCU positively impacted families (effect sizes were generally in the medium range). After our intervention, adolescents were more confident in their ability to resist drug use, and parents were more confident in their ability to impact their adolescents' risky behaviors. Parents and adolescents both reported being highly satisfied with this intervention. These results warrant further investigation of the FCU with incarcerated adolescents and their families in a controlled clinical trial. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Association of parental psychological and behavioral factors and children's syncope.

The authors examined the associations between parental variables and child syncope (fainting). Children ages 7 to 18 years undergoing tilt-table testing for neurocardiogenic syncope (NCS) at a pediatric cardiac center served as participants (N = 56). Results revealed that fathers' shortness of breath and overall psychological distress were significantly related to syncope frequency and emergency room (ER) visits for girls. Mothers' overall psychological distress, depressive symptoms, and shortness of breath were associated with boys' frequency of syncope and ER visits. Fathers' psychological factors were highly correlated with syncope for the children diagnosed negative for NCS. The frequency of children's syncope was higher in stepfamilies than in homes with both biological parents, and the correlations between children's syncope and the stepfathers' psychological symptoms were greater than for the children and their biological fathers in intact families. The role of parental psychological factors on child syncope is supported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes, connaissances et comportements des parents québécois en regard de la pratique des jeux de hasard et d'argent chez les jeunes.

The present study assessed the attitudes, knowledge, and behaviours of parents regarding youth gambling. The randomized sample consisted of 597 parents of children aged 5 to 17 years. The telephone survey was conducted by a professional survey firm. Results indicate that most parents are cognisant about problem gambling among youths. Findings further indicate that parents have accurate and realistic attitudes toward youth gambling. Interestingly, these findings suggest that parents tend to overestimate the prevalence of problem gambling among youths, and underestimate the probability that their own child has gambled and that he/she may have a gambling problem. The majority of parents approve the implementation of prevention programs in schools and many would be interested in participating in such activities if they were offered to adults. This study underscores the pertinence of informing parents about youth gambling and highlights their openness towards and preferences regarding prevention interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States

OBJECTIVE: To provide a single source for the best available estimates of the national prevalence of arthritis in general and of selected musculoskeletal disorders (osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, the spondylarthropathies, systemic lupus erythematosus, scleroderma, polymyalgia rheumatica/giant cell arteritis, gout, fibromyalgia, and low back pain). METHODS: The National Arthritis Data Workgroup reviewed data from available surveys, such as the National Health and Nutrition Examination Survey series. For overall national estimates, we used surveys based on representative samples. Because data based on national population samples are unavailable for most specific musculoskeletal conditions, we derived data from various smaller survey samples from defined populations. Prevalence estimates from these surveys were linked to 1990 US Bureau of the Census population data to calculate national estimates. We also estimated the expected frequency of arthritis in the year 2020. RESULTS: Current national estimates are provided, with important caveats regarding their interpretation, for self-reported arthritis and selected conditions. An estimated 15% (40 million) of Americans had some form of arthritis in 1995. By the year 2020, an estimated 18.2% (59.4 million) will be affected. CONCLUSION: Given the limitations of the data on which they are based, this report provides the best available prevalence estimates for arthritis and other rheumatic conditions overall, and for selected musculoskeletal disorders, in the US population.     

Childhood cancer: a two-year prospective study of the psychological adjustment of children and parents

OBJECTIVE: To follow prospectively the psychological adjustment of young children, parents, and families during the first 2 years after the children's diagnosis of cancer. METHOD: Children aged 2 to 5 years with cancer diagnoses and their parents and families (n = 38) were assessed immediately after diagnosis, 1 year after diagnosis, and 2 years after diagnosis. At each assessment, the psychological adjustment of the children and their families was compared with the adjustment of a cohort of children and families in the general community (n = 39). RESULTS: Children with cancer and their parents experienced significantly more emotional distress than children and parents in the community during the period immediately after diagnosis. However, the number of problems experienced by the children with cancer and their parents declined during the first year after the children's diagnosis and stabilized at a level comparable with that found among children and parents in the general community. CONCLUSION: Although the results are consistent with reports that suggest that in the longer term the prevalence of psychological problems among children with cancer is similar to that found among children in the general community, they also highlight the considerable distress experienced by children and parents during the period immediately after the children's diagnosis.     

Occupational injuries among workers with disabilities: the National Health Interview Survey, 1985-1994

CONTEXT: As the baby boom generation ages, more people will be working with disabilities, but we have little information regarding how disabilities affect risk for occupational injury. OBJECTIVE: To test the hypothesis that work-limiting disabilities in general and hearing and visual impairments in particular are risk factors for occupational injuries. DESIGN: Retrospective cohort study. SETTING: The National Health Interview Survey (NHIS), 1985 to 1994. PARTICIPANTS: The 459827 participants in the NHIS from 1985 to 1994 who listed "working" as their primary activity, who were not farmers, and who were between 18 and 65 years of age. MAIN OUTCOME MEASURE: Occupational injuries in the year preceding the interview causing a residual impairment at the time of interview. RESULTS: After adjusting for occupation, self-employment, and age, occupational injury was associated with preceding work disability (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.19-1.56); blindness (OR, 3.21; 95% CI, 1.32-7.85); deafness (OR, 2.19; 95% CI, 1.17-4.12); hearing impairment (OR,1.55; 95% CI, 1.29-1.87); upper extremity impairment (OR, 1.46; 95% CI, 1.05-2.05); and arthritis (OR, 1.34; 95% CI, 1.07-1.68). Visual impairment was not associated with a significantly increased risk (OR, 1.37; 95% CI, 0.87-2.17). CONCLUSIONS: Workers with disabilities, especially sensory impairments, appear to have an elevated risk for occupational injury. Further research in the design and evaluation of improved workplace accommodations for workers with these disabilities is needed.