Blessed be the Children: A Case–Control Study of Sexual Abusers in the Catholic Church

Individuals working in churches and other youth-serving institutions have a unique level of access to children, yet the problem of sexual abuse in institutional settings has received scant research attention. To address this gap, we analyzed data from a large sample of clergy (N = 1,121) and applied a social–ecological model of offending to identify risk factors for sexual abuse perpetration. Using a case–control study design that compared clergy sexual abusers with three control groups of clergy, this study focuses specifically on individual-, relationship-, and community-level factors associated with a higher risk of abuse in professional populations. Findings revealed that clergy sexual abusers tended to have more truncated pre-seminary dating histories, and that their dating and sexual partners were more likely to have been male than female. Self-reported sexual abuse history was associated with a greater likelihood of sexual abuse perpetration among clergy. Clergy abusers tended to be more involved with youth and adolescents in their ministries; however, they were observed to relate less well to youth and adolescents than their clergy counterparts. Given widespread changes in our cultural understanding of abuse as well as more specific changes in the organizational approach to seminary education, these differences underscore the role that youth-serving institutions and society can have in the primary prevention of child sexual abuse. Copyright © 2015 John Wiley & Sons, Ltd.     

Futility in Chronic Anorexia Nervosa: A Concept Whose Time Has Not Yet Come

Comparatively little scholarly attention has been given to the question of futility in chronic psychiatric disorders, with the exception of a small body of work on so-called end-stage anorexia nervosa (AN). A review of this literature provides the background for a critical examination of whether the concept of futility has any clinically meaningful, ethically justifiable, and legally defensible application to AN. In this article, the arguments for and against futility judgments in AN are analyzed with special emphasis on determinations of capacity in this serious mental illness. Parallels between the futility disputes in medical and psychiatric disorders, where applicable, will be drawn to further illuminate whether or not the concept that continued psychiatric treatment for AN is ever truly futile.     

Child and Family Emotional Functioning: A Cross-National Examination of Families from China and the United States

Scant research has examined links between particular emotion socialization processes and child emotion functioning cross-nationally. In this study, we assessed a sample of 55 families from the United States (U.S.; 28 boys and 27 girls) and 49 families from China (27 boys and 22 girls) on family emotional expressiveness and children’s emotional experiences and regulation. Results indicated that children and families from the U.S. reported greater emotional expressiveness than their Chinese counterparts. Children from the U.S. also reported greater undercontrolled emotion than Chinese youth. Family expression of positive emotion was related to effortful emotion regulation in U.S. youth only, whereas family expression of negative emotion was associated with undercontrolled emotion for both U.S. and Chinese children. Our findings advance context-specific models of emotional development by illustrating similarities and differences in emotional functioning among U.S. and Chinese families. From a clinical perspective, the findings suggest that practitioners should consider the cultural variations of emotion communication within families when conducting both assessment and therapy.     

Review of State Medication Policies/Guidelines Regarding Psychotropic Medications in Public Schools

It is currently estimated that up to 6 million children take psychotropic medications for the treatment of mental health problems. The highest prevalence rates (50–76 %) are typically found among students with special needs, especially among those with ADHD and emotional disturbance. The Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973 require medications be administered by schools whenever it is deemed necessary for the child to have access to educational services. However, these requirements do not extend to all students, nor do they provide guidance regarding the safest and most efficacious manner in which psychotropic medications should be administered. The authors reviewed existing state medication policies and guidelines to assess the level of guidance currently provided to school staff. Results showed the vast majority of states (48) provided guidance related to the administration of medications to students, with slightly fewer (44) states discussing required documentation procedures. Surprisingly, only 15 states addressed monitoring students for adverse side effects of medications, and even fewer (11) states specifically discussed psychotropic medication in their policies/guidelines. The vast majority (42) of states also addressed requirements for the safe and proper storage of medications, while slightly more than half of all states (31) provided any guidance regarding training of unlicensed personnel (e.g., secretaries) who frequently administer medications to students. The authors highlight several model guidelines/policies and review recommendations for best practice.     

The Complexity of Quest in Emerging Adults’ Religiosity,Well‐Being,and Identity

The construct of quest as measured by the Quest Scale raises complexities that this study addressed with online surveys measuring religiosity, ego identity, and well‐being of graduates from two Christian colleges. Intrinsic questers (those above the scale midpoint in intrinsic and quest scores but below the extrinsic midpoint) made up over half of those high in intrinsic religiosity and did not differ in Christian orthodoxy, religious identity, religious coping, or well‐being from the pure intrinsics (those high in intrinsic religiosity). Indiscriminately pro‐religious questing individuals (those high in intrinsic and extrinsic religiosity and quest) were less religious and showed poorer coping than intrinsic questers. Quest appears to be a reasonable measure of religious orientation, improving prediction of Christian orthodoxy, religious identity, and religious coping, and was more highly correlated with ego identity exploration than with stress. In association with intrinsic religiosity quest does not appear to indicate weak religiosity or poor well‐being. Instead, intrinsic questers may pursue a distinctive developmental trajectory, a path of existential searching by which emerging adults manage the demands of contemporary culture while maintaining a mature faith.     

Family‐Based HIV and Sexually Transmitted Infection Risk Reduction for Drug‐Involved Young Offenders: 42‐Month Outcomes

This study tested a family‐based human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention approach integrated within an empirically supported treatment for drug‐involved young offenders, Multidimensional Family Therapy (MDFT). A randomized, controlled, two‐site community‐based trial was conducted with 154 youth and their parents. Drug‐involved adolescents were recruited in detention, randomly assigned to either MDFT or Enhanced Services as Usual (ESAU), and assessed at intake, 3, 6, 9, 18, 24, 36, and 42‐month follow‐ups. Youth in both conditions received structured HIV/STI prevention in detention and those in MDFT also received family‐based HIV/STI prevention as part of ongoing treatment following detention release. Youth in both conditions and sites significantly reduced rates of unprotected sex acts and STI incidence from intake to 9 months. They remained below baseline levels of STI incidence (10%) over the 42‐month follow‐up period. At Site A, adolescents who were sexually active at intake and received MDFT showed greater reduction in overall frequency of sexual acts and number of unprotected sexual acts than youth in ESAU between intake and 9‐month follow‐ups. These intervention differences were evident through the 42‐month follow‐up. Intervention effects were not found for STI incidence or unprotected sex acts at Site B. Intensive group‐based and family intervention in detention and following release may reduce sexual risk among substance‐involved young offenders, and a family‐based approach may enhance effects among those at highest risk. Site differences in intervention effects, study limitations, clinical implications, and future research directions are discussed.     

Using modeling and rehearsal to teach fire safety to children with autism

We evaluated the efficacy of an instructional procedure to teach young children with autism to evacuate settings and notify an adult during a fire alarm. A multiple baseline design across children showed that an intervention that included modeling, rehearsal, and praise was effective in teaching fire safety skills. Safety skills generalized to novel settings and maintained during a 5‐week follow‐up in both training and generalization settings.     

Developing physical activity interventions for youth with cystic fibrosis and congenital heart disease: Learning from their parents

Despite the benefits of physical activity for youth with cystic fibrosis (CF) and congenital heart disease (CHD), most are insufficiently active. More information is required on how to facilitate physical activity in these populations. Although there are no studies that provide information about participation in CF and CHD youth from the perspective of parents, the involvement of caregivers may be an important facilitator to physical activity in youth with chronic diseases.

Objective

This qualitative study explored how the parents of youth with CF and CHD experience physical activity, and parents commented on both their own and their child’s physical activity.

Methods

Twenty-nine parents from a CHD and CF clinic participated in a semi-structured interview, and a thematic analysis of the transcribed data was undertaken.

Results

Parents discussed the numerous benefits and barriers associated with physical activity for both child and self. Role modeling was a critical social process to overcoming barriers. Parents experiences were situated within the broader family context characterized by a prevailing sense of stress and complexity.

Conclusion

By illustrating how the parents of youth with CF and CHD understand the role of physical activity in their and their child’s life, this study provides valuable information regarding the development of interventions to increase physical activity among children with CF and CHD.     

From "in the air" to "under the skin": cortisol responses to social identity threat

The authors examined women's neuroendocrine stress responses associated with sexism. They predicted that, when being evaluated by a man, women who chronically perceive more sexism would experience more stress unless the situation contained overt cues that sexism would not occur. The authors measured stress as the end product of the primary stress system linked to social evaluative threat-the hypothalamic-pituitary-adrenal cortical axis. In Study 1, female participants were rejected by a male confederate in favor of another male for sexist reasons or in favor of another female for merit-based reasons. In Study 2, female participants interacted with a male confederate who they learned held sexist attitudes or whose attitudes were unknown. Participants with higher chronic perceptions of sexism had higher cortisol, unless the situation contained cues that sexism was not possible. These results illustrate the powerful interactive effects of chronic perceptions of sexism and situational cues on women's stress reactivity.