Pragmatic post‐structuralism (II): an outcomes evaluation of a stopping violence programme

This paper reports features of a distinctly post‐structuralist ‘outcome evaluation’ of a New Zealand stopping violence programme for men who have assaulted their spouses. Through analysis of pre‐ and post‐programme interviews it was found that the men's accounts of their violence shifted as a consequence of their participation in and exposure to the programme's discursive resources. Overall the men's accounts demonstrated movement towards taking greater ownership and responsibility for their actions. However this trend was not universal and was mitigated through other pre‐programme discursive resources. Copyright © 2001 John Wiley & Sons, Ltd.     

Joseph and His Brothers: A Biblical Paradigm for the Optimal Handling of Traumatic Stress

The long-lasting effects of emotional trauma and the important role of unconscious emotional defenses have become increasingly recognized only in the past century. Yet their role is actually manifest, although still overlooked, in one of the most well-known of biblical stories. This paper presents the story of Joseph and his brothers, and the important lessons it teaches about unconscious defenses and the optimal handling of emotional trauma.     

Palm Beach County Child Abuse and Neglect System Redesign: Initial Process Evaluation

For the families in Palm Beach County who entered the child abuse and neglect system as a result of having a child placed into emergency shelter, their experience was that the system was frequently intimidating, confusing, and fragmented. The reaction of the children and their families to this system was often defensiveness and resistance. To increase the system's effectiveness, it was redesigned and privatized. The redesigned system included centralized shelter placement, a comprehensive assessment, independent service coordination, and treatment service provision within a managed care model. By emphasizing family involvement and quality service provision, the goal was to increase voluntary participation and improve family outcomes. Based on initial data, it appears that the redesigned system has been successfully implemented and has made notable progress toward meeting its system flow timeframes. The initial data also indicate that high percentages of families are participating in and are satisfied with the system, that children are spending less time in shelter placements, and that only one family has reentered the system.     

Bullying at work: a discussion of definitions and prevalence, based on an empirical study

The past 15 years have witnessed a growing interest in studies of bullying in the area of work and organizational psychology, but the results of research on this topic seem to indicate very wide variations in the prevalence of bullying. The range of differences may be primarily due to the utilization of different categories and operationalizations of the concept. The aim of this study is to discuss definitions and delimitations of the phenomenon known as bullying, and to demonstrate empirically how the prevalence of bullying can be determined by the way in which it is defined and delimited. On the background of a discussion of some current definitions of bullying and a survey of some central research results on its rate of occurrence, this study presents the results of a study of 3,024 public-sector employees. The results showed that 1.0% of the sample reported that they had been bullied weekly during the previous six months, while 4.7% reported themselves as having been exposed to acts of bullying with the same frequency and for the same period of time. If we change the criteria from "weekly" to "2-3 times a month" the prevalences rise to 3.7% and 26.9%. Based on observations of bullying the prevalence is 3.3%. The results are discussed with reference to other studies that are comparable in terms of delimitations and rates of occurrence and it is concluded that the prevalence is at the same level as these.     

The Ecology of Adolescent Substance Abuse Service Utilization

This paper presents an ecological-community model toward the explanation of variation in patterns of substance abuse (SA) service utilization among adolescents who are enrolled in Tennessee's Medicaid program (TennCare). Guided by a theoretical framework that draws from the social ecology work of Bronfenbrenner and health services utilization models promoted by Aday and Andersen, we apply a social indicators approach toward explaining the impact of community ecology on identification of SA and treatment engagement. Both county-level rates and individual-level treatment utilization are examined and hierarchical linear modeling is incorporated to examine the individual-in-community phenomenon. This study is an expansion of previous service utilization research and suggests that explanations of youth's service utilization must necessarily include not only individual, familial, and service system characteristics, but community factors, as well.     

Self-Reported Depression in Mothers of Children Who Have Experienced Sexual Abuse

The Beck Depression Inventory-II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) was administered to 164 biological mothers of sexually abused children to determine the psychometric characteristics of the BDI-II and to estimate the prevalence of self-reported depression in this population. The study also sought to ascertain whether the mothers’ BDI-II total scores were correlated with various psychosocial characteristics of the mothers and their children. It was found that there was only one dimension underlying the 21 BDI-II responses, and the internal consistency of the BDI-II total scores was high. Twenty-six percent of these mothers had scores indicative of clinical depression. The mothers’ BDI-II total scores were significantly correlated with their husbands’ or paramours’ having sexually abused their children and their ratings of the children’s internalizing behaviors. These results were discussed as supporting the use of the BDI-II with mothers of sexually abused children to measure self-reported depression.     

Psychological trauma and PTSD symptoms as predictors of substance dependence treatment outcomes

Psychological trauma and post-traumatic stress disorder (PTSD) may complicate and reduce the effectiveness of treatment for substance use disorders (SUDs). This study assessed trauma history and symptoms of simple and complex PTSD at baseline in a randomized trial of contingency management (CM) compared to standard treatment (ST) with 142 cocaine- or heroin-dependent outpatients. History of exposure to each of eight types of psychological trauma was unrelated to treatment outcome, except for witnessed assaults and emotional abuse. Complex PTSD symptoms were inversely associated with short-term treatment outcomes, and PTSD symptoms were positively related to long-term outcome, independent of the effects of demographics, psychological distress, baseline substance use status, and treatment modality. Complex PTSD symptoms warrant further study as a potential negative prognostic factor in SUD interventions.     

Childhood physical and sexual abuse and lifetime number of suicide attempts: a persistent and theoretically important relationship

BACKGROUND: Research to date has indicated that childhood abuse is associated with suicide, though little research has examined the unique contribution of specific types of abuse to suicidal behavior. We predict that childhood physical and violent sexual abuse will have a greater effect on suicide attempts than molestation and verbal abuse. METHODS: The National Comorbidity Survey data were used to test these predictions while controlling for a number of psychiatric and psychosocial variables. RESULTS: As expected, childhood physical and violent sexual abuse showed similar effects on lifetime suicide attempts, which were stronger than the effects of molestation and verbal abuse. LIMITATIONS: This was a cross-sectional, retrospective study, so true causality cannot be shown. Some measurement limitations exist. Additionally, effect sizes were small but still significant. CONCLUSIONS: While all forms of childhood abuse are troubling and create risk for future psychopathology and suicidality, the present study indicates that childhood physical and violent sexual abuse should be seen as greater risk factors for future suicide attempts than molestation and verbal abuse.     

Doubt in the psychoanalysis of a paedophile

In this single case study, I will address the question of how incestuous sexual abuse causes doubt of three distinct types: (1) honest doubt that is essential to the pursuit of knowledge; (2) inherent doubt that can result from a trauma that leaves the victim's mind fragmented and confused; and (3) the sadistic imposition of doubt intended to deceive, disorient and attack unbearable knowledge in the victim or another person familiar with the abuse (in this case, the analyst and the victim's later victims). During the course of my psychoanalysis of a paedophile, it became clear that this third form of doubt played an integral role in the patient's sexual abuse of children, a role I will link to the nature and function of paedophilia and to the experience of working psychoanalytically with a paedophile.