Reconstructing Hymens or Constructing Sexual Inequality? Service Provision to Islamic Young Women Coping with the Demand to be a Virgin

In Islamic culture, there is an imperative demand that women should be virgins on their wedding night. Service providers in The Netherlands are increasingly confronted by Islamic young women who find themselves in serious difficulties because they are no longer virgins, and are about to enter a forced or arranged marriage. These young women report a diversity of problems such as loneliness, social isolation, depression, despair, suicidal feelings, identity problems and serious conflicts with parents. In this article we focus attention on the circumstances that can result in these types of difficulties, and also critically consider the kinds of help that young Islamic women are given. Attention is paid to the question of whether existing forms of service provision, especially surgical reconstruction of the hymen, take sexual and other inequalities into account.     

Mapping Men's Mental Health

The central theme of this paper is that men are at one and the same time both damaged and damage-doing. The process of being damaged through the agency of masculinity predisposes men to exploit, dominate and abuse—not only as boys, as partners and fathers, but as priests, teachers, therapists, lawyers, nurses, psychologists and psychiatrists. Mental health services need to see both aspects of this male equation: a focus on male abuse alone leads to punishment, containment and, very likely, the continuation of abuse; a focus on male damagedness alone preserves the ideology of male unaccountability. However, evidence reviewed here suggests that most traditional psychiatric services fail to acknowledge the impact of inequalities on men's mental health as comprehensively as they fail to acknowledge the impact of these inequalities on the mental health of women. This is a significant problem, and we suggest ways that a gendered analysis of masculinity can be used to help address this deficit. This analysis is used to develop a map of men's mental health that not only accommodates traditional categories of mental health difficulty, but other important consequences of the close association between masculinity and sexuality inequality, especially the use of violence and the capacity to do harm. This analytical framework also invites consideration of the invisibility of male distress, the disallowing and desensitizing of ‘vulnerability, and their submersion in a kind of psychology of entitlement. Finally, we consider the implications of this mapping exercise for mental health services and for working with men.     

A Longitudinal Analysis of Family Empowerment and Client Outcomes

We examined the relationship between family empowerment, parent satisfaction, and mental health outcome across time. Based on the Vanderbilt Family Empowerment Project Model, increased empowerment should lead to positive changes in client outcomes. Data consisted of the Family Empowerment Scale (FES), which was used to assess the caregiver's perception of empowerment, Child and Adolescent Functional Assessment Scale (CAFAS), which measures the degree of disruption in the youth's current functioning, Client Satisfaction Questionnaire (CSQ), and demographic information gathered from families receiving services from a county mental health service system at intake and discharge. The results showed that the CAFAS and CSQ were related to empowerment at intake and discharge. Results also indicated significant increases in the knowledge subscale of the FES and the CAFAS and moderate increases in the advocacy subscale of the FES and the CSQ. We discuss the implications of these findings for systems of care, such as stronger parent-professional relationships.     

校园排斥对初中生内外化问题的影响:同伴关系与核心自我评价的中介作用

该研究探讨了校园排斥和初中生内外化问题的关系,结合资源保存理论,进一步考察同伴关系（条件性资源）与核心自我评价（人格特质资源）对该效应的链式中介作用。采用青少年校园现实受排斥量表、同伴关系量表、核心自我评价量表、焦虑抑郁量表和外化行为倾向量表,对辽宁省2所中学540名初中生进行调查。结果表明：（1）校园排斥对于初中生的内化及外化问题均具有正向预测作用;（2）同伴关系、核心自我评价在校园排斥与内化问题中起完全中介作用,而在校园排斥与外化问题中起部分中介作用。具体而言,校园排斥通过三条路径影响内外化问题：一是同伴关系的单独中介作用;二是核心自我评价的单独中介作用;三是同伴关系—核心自我评价的链式中介作用。     

校园排斥对初中生外化问题行为的影响：有调节的中介效应

为考察初中生外化问题行为的心理机制,研究采用青少年行为自陈量表、青少年遭受校园排斥问卷、领悟社会支持量表、冷酷无情特质量表对黑龙江、福建两省的1284名初中生进行调查。结果表明：（1）校园排斥对初中生的外化问题行为具有正向预测作用;（2）冷酷无情特质在校园排斥与外化问题行为之间具有中介作用;（3）领悟社会支持调节了初中生冷酷无情特质对校园排斥与外化问题行为中介过程的后半段路径。研究结果为初中生群体的校园排斥、冷酷无情特质、领悟社会支持和外化问题行为之间的动态关系提供了有效的数据支持。     

A Case Study of the Implementation of Outcomes-Based Funding Within a Local United Way System: Some Implications for Practicing Community Psychology

This case study provides an overview of significant organizational change within the United Way system in Franklin County/Columbus, Ohio. Franklin County is a major urban center with a population approaching 1 million. The implementation of outcomes-based funding proved to be a critical factor that served to promote change within the local United Way system. Adoption of outcomes-based funding principles resulted in significant shifts in United Way funding and major policy changes. A chronology of events and stakeholder reactions over a multiyear period are reviewed. The implications of this effort to initiate major, system-level change for the practice of community psychology are discussed.     

Expanding Mental Health Services to Older High-Utilizing HMO Patients: A Pilot Study

Background: Expanded mental health benefits were offered to older HMO patients who were high medical utilizers. Outcomes of interest were use of services, subjective well-being, and psychopathology. Methods: Sixty-nine (25 male, 44 female) patients age 55 or above seeking frequent outpatient medical care completed the SF-36 health survey and the revised Symptom Check List (SCL-90-R). Patients were assigned to usual care, health education, or expanded mental health benefit conditions. Results: Patients showed high initial levels of psychopathology and distress. Over the 6 months of the study, patients in the expanded benefits group made a mean of 11.5 visits to mental health professionals versus a mean of 3.4 visits by usual care patients. Patients in the expanded benefits group showed significant improvement in SF-36 General Health and Mental Health well-being scores. Patients in the health education group showed no improvement. Patients in the usual care group showed improvements in Vitality scores. Psychopathology summary scores showed improvement for both usual care and enhanced benefit groups. Conclusions: Mental health treatment may improve well-being and reduce psychopathology in older high-utilizing patients. Creativity will be needed in expanding access to mental health services for this population.     

Parents' Experiences with Genetic Counseling After the Birth of a Baby with a Genetic Disorder: An Exploratory Study

Little is known about factors determining which families utilize genetic counseling services. We conducted semistructured interviews with parents of four children born with cystic fibrosis (CF) and ten with Down's syndrome (DS) to ascertain reasons for using, or not using, genetic counseling services in the state of Victoria, Australia. We also explored the usefulness of genetic counseling for the families who had experienced it, and the perceived role of genetic counseling. All mothers of children with CF see a genetic counselor as part of a structured education program following diagnosis through newborn screening. Information overload was identified by them as an important problem. There is no specific program for families of children with DS. Six of them had received genetic counseling and four had not, either because it was not specifically offered to them or because they did not pursue it in the context of misconceptions about its purpose. The timing of the offer of genetic counseling is important and needs to take into account parents' coping strategies after diagnosis. Several parents commented on the favorable aspects of counseling, including getting information they needed to deal with the diagnosis and relief of guilt. Better awareness of genetic counseling by referring physicians, and providing counseling at more than one visit, may contribute to a more effective service.     

Confirming satisfaction as an attitude within the service‐buying process

This paper presents research that uses cognitive and affective semantic differential scales to construct an attitude measuring instrument to be used in the services domain in the context of long applications to buy a service. The scales measure ‘Attitude to the Application Process’ (AAP) which represents satisfaction, as an internal ‘buying process’ attitude, which moderates the buying intention. Data collected over a three‐year period between 1996‐9, was analysed using exploratory and confirmatory factor analyses. The results provide evidence of a robust and useful cognitive scale. Although there were anomalies in the exploratory and confirmatory analysis of the affective scale, a robust scale is presented which represents either one or two factors. The whole measuring instrument of 14 items was developed as a means to access applicant attitudes during the application process to university — an extended and extreme application situation for first‐time consumers. The results identify that the instrument is sound and can be used in its original or modified form, depending on the context of the service‐process monitoring situation. The scales represent aspects of attitude not dealt with extensively in the literature and measure the perception of the application process as simple, open, friendly and helpful. These aspects of satisfaction mirror three attributes of service quality: assurance, responsiveness and empathy identified in previous research. Copyright © 2001 Henry Stewart Publications.