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May 11, 2010

Divorce and Ideology?

Posted by Nathen under alcohol abuse, Americans, battering, Democrats, divorce, drug abuse, education, family values, headlines, marriage, National Public Radio, social class, statistics, unintended pregnancy
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I listened to a story on NPR a couple days ago about a how high divorce rates and teen-pregnancy rates are correlated to the state’s political ideology. Republican states have significantly more divorce and teen pregnancy. In fact, as a whole, the US divorce rate has been holding steady since the mid-90s, while the “red state” divorce rates (and teen-pregnancy rates) continue to rise. That means the blue states make up the difference and their rates are falling. NPR speculated that it’s because in family-values states, people get married earlier because of social pressure or so they can have sex, but choose badly because they don’t know themselves as well as they would several years later, when Democrats tend to get married. They also note that states that are swinging Democratic, like New Hampshire, are starting to have less divorce and teen pregnancy too.

It makes some sense, though I wouldn’t have guessed it. There are a couple of things not made explicit in the story that I wonder about. First, I wonder if the Republican fixation on “family values” issues is being driven by this phenomenon; to someone living in a Republican state, divorce and teen pregnancy are really pressing issues, because their ideology and behavior are not matching up. It could even be a vicious cycle: Values driving divorce driving values…. Second, I wonder how much of this has to do with money. Social class, really. Red states tend to be poorer, and poverty puts serious stress on a marriage. And poverty is correlated with a lot of other stressors, like substance abuse, domestic violence, and child abuse. Also, they mention that the demographic whose divorce rates are dropping the most are women who have graduated from college. I’ve been attending a state university for a few years now, and I can tell you that it’s not full of poor people. These kids (‘ parents) have money.

 

May 9, 2010

The Adverse Childhood Experiences Study

Posted by Nathen under alcohol abuse, battering, children, death, depression, disease, divorce, drug abuse, family assessment, lists, mental illness, neglect, parenting, physical abuse, predicting the future, rape, sexual assault, sexually transmitted disease, smoking, suicidality, unintended pregnancy
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I’m learning about child abuse and neglect in my Child and Family Assessment class. Today I read about the ACE study, by the US Center for Disease Control. It is a huge study, with over 17,000 participants, where they gathered information about childhood abuse, neglect, and household dysfunction, and then proceeded to see what health outcomes and behaviors they could predict with that information. It turns out they can predict a lot. They’ve published 50 articles on the study and the research is ongoing–they are continuing to collect health information as the participants in the study age. I’ll present a few of their findings below. For more, see the ACE Study.

Here are some of their findings. I’ll paste in the definitions of the categories of adverse childhood experiences below. Strong correlations were found with the following:

  • alcoholism and alcohol abuse (4 or more categories of ACE meant 4-12 times increase)
  • chronic obstructive pulmonary disease (that is, lung disease)
  • depression (4 or more categories of ACE meant 4-12 times increase)
  • fetal death
  • health-related quality of life (way more inactivity, severe obesity, bone fractures)
  • illicit drug use
  • ischemic heart disease (IHD)
  • liver disease
  • risk for intimate partner violence
  • multiple sexual partners (4 or more categories of ACE correlated with 50 or more sexual partners)
  • sexually transmitted diseases (STDs) (4 or more categories of ACE meant 4-12 times increase)
  • smoking
  • suicide attempts (4 or more categories of ACE meant 4-12 times increase)
  • unintended pregnancies

Here are the kinds of abuse, neglect, and dysfunction they asked about, quoted from the site:

Abuse

Emotional Abuse:
Often or very often a parent or other adult in the household swore at you, insulted you, or put you down and/or sometimes, often or very often acted in a way that made you think that you might be physically hurt.

Physical Abuse:
Sometimes, often, or very often pushed, grabbed, slapped, or had something thrown at you and/or ever hit so hard that you had marks or were injured.

Sexual Abuse:
An adult or person at least 5 years older ever touched or fondled you in a sexual way, and/or had you touch their body in a sexual way, and/or attempted oral, anal, or vaginal intercourse with you and/or actually had oral, anal, or vaginal intercourse with you.

Neglect

Emotional Neglect1

Respondents were asked whether their family made them feel special, loved, and if their family was a source of strength, support, and protection. Emotional neglect was defined using scale scores that represent moderate to extreme exposure on the Emotional Neglect subscale of the Childhood Trauma Questionnaire (CTQ) short form.

Physical Neglect1

Respondents were asked whether there was enough to eat, if their parents drinking interfered with their care, if they ever wore dirty clothes, and if there was someone to take them to the doctor. Physical neglect was defined using scale scores that represent moderate to extreme exposure on the Physical Neglect subscale of the Childhood Trauma Questionnaire (CTQ) short form constituted physical neglect.

Household Dysfunction

Mother Treated Violently:
Your mother or stepmother was sometimes, often, or very often pushed, grabbed, slapped, or had something thrown at her and/or sometimes often, or very often kicked, bitten, hit with a fist, or hit with something hard, and/or ever repeatedly hit over at least a few minutes and/or ever threatened or hurt by a knife or gun.

Household Substance Abuse:
Lived with anyone who was a problem drinker or alcoholic and/or lived with anyone who used street drugs.

Household Mental Illness:
A household member was depressed or mentally ill and/or a household member attempted suicide.

Parental Separation or Divorce:
Parents were ever separated or divorced.

Incarcerated Household Member:
A household member went to prison.

 

May 5, 2010

Assessing Sexual or Physical Abuse

Posted by Nathen under alcohol abuse, drug abuse, drugs, family assessment, family therapy, lists, parentification, physical abuse, practicum, sexual abuse, statistics, suicidality, violence
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Another unfortunately common situation I will have to assess for in the families I see (in addition to drug & alcohol abuse, domestic violence and many other things) is sexual or physical abuse. One of my texts (Patterson’s Essential Skills in Family Therapy: From the First Interview to Termination) estimates that 1 in 5 women and 1 in 9 men were sexually abused as kids. My other practicum text, Brock & Barnard’s Procedures in Marriage and Family Therapy, gives this list of indicators of abuse(p. 52):

The presence of an alcoholic parent

The family with poor mother-daughter connections/bonds

A mother who is very dependent either psychologically or physically as the result of illness or accident

A father who appears to be very controlling and possessive of his daughter(s)

An acting-out adolescent girl engaging in sexual promiscuity or suicidal gestures who is a frequent runaway or drug abuser

A child who appears to be very overresponsible and parentified in the family context