Valuing families' preferences for drug treatment: a discrete choice experiment.

BACKGROUND AND AIMS: The burden on family members of those who are dependent on illicit drugs is largely unidentified, despite the presence of significant negative financial, health and social impacts. This makes it difficult to provide appropriate services and support. This study aimed to assess the preferences for treatment attributes for heroin dependence among family members affected by the drug use of a relative and to obtain a measure of the intangible economic benefit. DESIGN: Discrete choice experiment. Data were analysed using mixed logit which accounted for repeated responses. SETTING: Australia. PARTICIPANTS: Eligible participants were Australian residents aged 18+ years with a relative with problematic drug use. Complete data on 237 respondents were analysed; 21 invalid responses were deleted. MEASUREMENTS: Participant preference for likelihood of staying in treatment, family conflict, own health status, contact with police and monetary contribution to a charitable organization providing treatment. FINDINGS: All attributes were significant, and the results suggest that there was a preference for longer time in treatment, less family discord, better own health status, less likelihood of their relative encountering police and, while they were willing to contribute to a charity for treatment to be available, they prefer to pay less, not more. In order of relative importance, participants were willing to pay an additional A$4.46 [95% confidence interval (CI) = 3.33-5.60] for treatment which resulted in an additional 1% of heroin users staying in treatment for longer than 3 months, A$42.00 (95% CI = 28.30-55.69) to avoid 5 days per week of family discord, A$87.94 (95% CI = 64.41-111.48) for treatment options that led to an improvement in their own health status and A$129.66 (95% CI = 53.50-205.87) for each 1% decline in the chance of police contact. CONCLUSIONS: Drug treatment in Australia appears to have intangible benefits for affected family members. Families are willing to pay for treatment which reduces family discord, improves their own health, increases time in treatment and reduces contact with police.

Monetary reinforcement for self-monitoring of blood glucose among young people with type 1 diabetes: evaluating effects on psychosocial functioning.

AIMS: To explore the auxiliary psychosocial effects of a monetary reinforcement intervention targeting self-monitoring of blood glucose among young people with Type 1 diabetes. METHODS: Sixty young people with Type 1 diabetes, HbA1c concentrations between 58 and 119 mmol/mol (7.5-13.0%), and average self-monitoring of blood glucose <4 times per day were randomized to either enhanced usual care or a 24-week intervention of monetary rewards for self-monitoring of blood glucose and associated behaviours (e.g. uploading glucose meters). Data were collected from the young people and their parents at baseline, during the intervention (6, 12 and 24 weeks) and after the intervention (36 weeks). RESULTS: Linear mixed models were used to evaluate the intervention effects on psychosocial outcomes, adjusting for corresponding baseline levels and potential moderation by baseline level. The intervention reduced diabetes distress at week 6 among young people who had average and high baseline distress. It also reduced diabetes distress at weeks 12 and 24 among those with low baseline distress. The intervention also reduced young person-reported diabetes-related family conflict and diabetes-related interference among those with high baseline scores in these areas; however, the intervention worsened young person-reported diabetes interference among those with low baseline interference. Effects were medium-sized and time-limited. CONCLUSIONS: Findings indicate predominantly positive impacts of monetary reinforcement interventions on psychosocial outcomes, although effects varied by outcome and time point. Whereas early improvements in diabetes distress were observed for all who received the intervention, improvements in other areas varied according to the level of psychosocial challenge at baseline. Incorporating psychosocial interventions may bolster and maintain effects over time.

Conjugalidade e gestão do orçamento doméstico: um estudo qualitativo / Conjugality and management of the household budget: a qualitative study

Este artigo é um relato de pesquisa qualitativa de mestrado, cujo objetivo é descrever como casais não clínicos percebem as dificuldades e as divergências ao lidar com o orçamento doméstico. Foram realizadas entrevistas semiestruturadas com seis casais, com e sem filhos, com até cinco anos de casamento. Os resultados mostraram que as divergências estão relacionadas aos custos dos produtos e ao grau de autonomia de cada cônjuge nas decisões de compras. Questões culturais como gênero e o consumismo influenciam o modo de lidar com o dinheiro, além da repetição intergeracional de comportamentos e de padrões de interação familiar. O conhecimento sobre tais dinâmicas contribui para a compreensão por parte de psicólogos e de terapeutas de casais da dimensão financeira no casamento, bem como para a estruturação de futuras práticas terapêuticas, educativas e preventivas em situações de conflitos conjugais.(AU)

This article is a qualitative research report of a master's degree, whose purpose is to describe how non-clinical couples meet the struggle and divergences when dealing with the household finances. Six couples, with and without children, that has been married for up to five years were interviewed. The results have shown that the divergences are related to the price of products and each partner's self-sufficiency in making shopping decisions. Cultural factors like gender and consumption affect their money management, besides the intergenerational repetition of behavior patterns and family interaction. Insight about these dynamics contributes to the understanding of the marriage's financial dimension by therapists and psychologists, as well as to developing future therapeutic, preventive and educational methods in marital conflict situations.(AU)

The Case for Insurance Reimbursement of Couple Therapy.

A case is made for why it may now be in the best interest of insurance companies to reimburse for marital therapy to treat marital distress. Relevant literature is reviewed with a considerable focus on the reasons that insurance companies would benefit from reimbursing marital therapy - the high costs of marital distress, the growing link between marital distress and a host of related physical and mental health problems, as well as the availability of empirically supported treatments for marital distress. This is followed by a focus on the major reasons insurance companies cite for not reimbursing marital therapy, along with a discussion of advances in several growing bodies of research to address these concerns. Main arguments include the direct medical offset costs of couple and family therapy (including for high utilizers of health insurance), and the fact that insurance companies already find it cost effective to reimburse for prevention of other health and psychological problems. This is followed by implications for practitioners and researchers.

Intimate Partner Violence in the Great Recession.

In the United States, the Great Recession was marked by severe negative shocks to labor market conditions. In this study, we combine longitudinal data from the Fragile Families and Child Wellbeing Study with U.S. Bureau of Labor Statistics data on local area unemployment rates to examine the relationship between adverse labor market conditions and mothers' experiences of abusive behavior between 2001 and 2010. Unemployment and economic hardship at the household level were positively related to abusive behavior. Further, rapid increases in the unemployment rate increased men's controlling behavior toward romantic partners even after we adjust for unemployment and economic distress at the household level. We interpret these findings as demonstrating that the uncertainty and anticipatory anxiety that go along with sudden macroeconomic downturns have negative effects on relationship quality, above and beyond the effects of job loss and material hardship.

A vida amorosa de mulheres financeiramente independentes / Love life of financially independent women

O presente artigo buscou compreender como a independência financeira feminina influencia na vida amorosa das mulheres, considerando que ocorreram mudanças significativas nos papéis exercidos por elas com a conquista do mercado de trabalho. Para tanto, foi realizado estudo de caso coletivo com cinco mulheres financeiramente independentes, com idade entre trinta e quarenta e cinco anos, através de entrevistas individuais, com roteiros semiestruturados. Entre os principais resultados, destaca-se que a independência financeira parece influenciar nos relacionamentos amorosos, desde a escolha do parceiro até a decisão da separação. Bem como, parece ter contribuído para tornar o casal menos tolerante, aumentando à dificuldade de resolução de conflitos. E ainda, a independência financeira das mulheres parece interferir no adiamento do projeto de ter filhos, devido à dedicação aos estudos e à vida profissional.(AU)

This article aimed at understanding how women´s financial independence influences on their love lives, considering that there are meaningful changes in the roles played by them as they have gained their space in the labor market. For this purpose, the study was carried out with financially independent women, aged between 30 and 45, through individual interviews, with a semi-structured interview script. Among the main results, it is highlighted that the financial independence seems to influence on their love relationships, from choosing the partner to separation decision making. As well, it seems to have contributed to make the couple less tolerant, increasing the difficulty of solving conflicts. In addition, the women´s financial independence seems to interfere with anticipating the project of having children, due to their dedication to studies and to their professional life.(AU)

Bring the subjective back in: resource and husband-to-wife physical assault among Chinese couples in Hong Kong.

Resource theory constitutes important explanations of spousal violence in culturally diverse societies. This article extends the theory by adding several subjective indicators: husband's financial strain and the couple's appraisal of each other's financial and nonfinancial contributions to family. We examined the role of these subjective dimensions of resource in spousal violence against the backdrop of other predictors, including the husband's absolute socioeconomic resources, the wife's economic dependence, and relative resource differences between the husband and wife. The findings not only partly support absolute and relative resource theories but also suggest the salient role of subjective indicators of resources on husband-to-wife physical assault.

Financial stress, parent functioning and adolescent problem behavior: an actor-partner interdependence approach to family stress processes in low-, middle-, and high-income families.

The family stress model proposes that financial stress experienced by parents is associated with problem behavior in adolescents. The present study applied an actor-partner interdependence approach to the family stress model and focused on low-, middle-, and high-income families to broaden our understanding of the pathways by which the financial stress of mothers and fathers are related to adolescent outcomes. The study uses dyadic data (N = 798 heterosexual couples) from the Relationship between Mothers, Fathers and Children study in which two-parent families with an adolescent between 11 and 17 years of age participated. Path-analytic results indicated that in each of the families the association between parents' financial stress and problem behavior in adolescents is mediated through parents' depressive symptoms, interparental conflict, and positive parenting. Family stress processes also appear to operate in different ways for low-, middle-, and high-income families. In addition to a higher absolute level of financial stress in low-income families, financial stress experienced by mothers and fathers in these families had significant direct and indirect effects on problem behavior in adolescents, while in middle- and high-income families only significant indirect effects were found. The financial stress of a low-income mother also had a more detrimental impact on her level of depressive feelings than it had on mothers in middle-income families. Furthermore, the study revealed gender differences in the pathways of mothers and fathers. Implications for research, clinical practice, and policy are also discussed.

Reciprocal prospective associations between depressive symptoms and perceived relationship with parents in early adolescence.

OBJECTIVE: Adolescent depressive symptoms are associated with difficult family relationships. Family systems and interpersonal theories of depression suggest that this association could reflect a circular process in which symptoms and family functioning affect each other over time. Few longitudinal studies have tested this hypothesis, and the results of these studies have been equivocal. In this study, we examine reciprocal prospective associations in early adolescence between depressive symptoms and 2 important aspects of parent-child relationships: communication and conflict. METHODS: Participants were 3862 students who annually filled out self-reports. Path analysis was used to examine prospective associations between depressive symptoms and perceived communication and conflict with parents from the age of 12 to 13 and 14 to 15 years. Independence of these associations was assessed by controlling for family context (parental separation and family socioeconomic status) and adolescent behaviour problems (delinquent behaviours and substance use). Sex differences were evaluated with multiple group analysis. RESULTS: Reciprocal prospective associations were found between depressive symptoms and perceived conflict with parents, but not between depressive symptoms and communication with parents. Depressive symptoms were found to predict poorer communication with parents over time, but communication was not predictive of lower depressive symptoms in subsequent years. All paths were sex-invariant and independent from family context and behaviour problems. CONCLUSION: This study highlights the importance of considering the potential impact of adolescent symptomatology on parent-child relationships and suggests that reciprocity may characterize the association between depressive symptoms and negative aspects of parent-child relationships. The role of adolescent perceptions in the interplay between depressive symptoms and family relationships remains to be clarified.

Chronic family economic hardship, family processes and progression of mental and physical health symptoms in adolescence.

Research has documented the relationship between family stressors such as family economic hardship and marital conflict and adolescents' mental health symptoms, especially depressive symptoms. Few studies, however, have examined the processes whereby supportive parenting lessens this effect and the progression of mental health and physical health symptoms in adolescence. The present study investigates the influences of chronic family economic hardship on adolescents' multiple health problem symptoms (i.e., symptoms of anxiety, and depression and physical complaints) through parents' marital conflict, and supportive parenting; it also examines how there adolescents' health problems mutually influence one another throughout adolescence. We used Structural Equation Modeling to analyze data from a longitudinal sample of European American mothers, fathers, and target adolescents (N = 451, 53% female) to examine direct and indirect effects. Findings generally supported the hypothesized model. Chronic family economic hardship contributed to mental and physical health problems of adolescents. This influence largely was mediated through supportive parenting. Moreover, supportive parenting buffered marital conflict on depressive symptoms of adolescents. Also, there was a tendency for females to show more stable depressive symptoms than males. The study demonstrates key mediating pathways and additional moderating influences based on the family stress model and also highlights the importance of improving health resources for adolescents.

Maternal age, investment, and parent-child conflict: a mediational test of the terminal investment hypothesis.

Drawing on the evolutionary terminal investment hypothesis and Trivers' (1974) parent-offspring conflict theory, we advance and evaluate a mediational model specifying why and how maternal age, via mating effort and parental investment, affects mother-child conflict. Data from a longitudinal study of 757 families indicate that (a) older maternal age predicts lower mating effort during the child's first 5 years of life, and (b) thereby, higher maternal investment in middle childhood when the child is around 10 years old. (c) Higher maternal investment, in turn, forecasts less child-perceived mother-child conflict in adolescence (age 15). These results proved robust against theoretically relevant covariates (family resources, parity, maternal education, and maternal personality characteristics) and in the context of an autoregressive model. Study limitations are noted and results are discussed in terms of the unique contributions of an evolutionary perspective to the determinants-of-parenting literature.

Financial satisfaction and financial stressors in marital satisfaction.

Using a sample of 310 married respondents from one U.S. Midwestern state, a test was conducted to examine the association of financial satisfaction and financial stressors in a spouse's decision to stay married to the same person or leave the relationship. The role of demographic and socioeconomic variables, religiosity, psychological constructs, financial satisfaction, and financial stressors as factors influencing marital satisfaction was tested. Financial stressors were measured using a list of financial stressors adapted from the literature. Financial satisfaction was measured with a one-item scale. The Kansas Marital Satisfaction Scale was used as a validation tool to assess whether individuals would marry or not marry again. Religiosity and financial satisfaction were positively associated with marital satisfaction. A negative interaction between financial satisfaction and financial stressors was also noted. Findings suggest that respondents who are financially satisfied tend to be more stable in their marriages.

Intra-household conflicts in migration decisionmaking: return and pendulum migration in Morocco.

By analyzing the migration behavior and transnational residential strategies of first-generation, aging migrants from a particular Moroccan sending region, this study contributes to a conceptual critique of migration theories that identify the household as the most relevant decisionmaking unit. It highlights the role of intra-household power inequalities and conflicts in migration decisionmaking as well as the effects of migration decisions for intra-household power relations. Many labor migrants who left Morocco to work in Europe in the 1960s and 1970s did not realize their wish to return but instead ended up reunifying their families at the destination. An increasing proportion adopts a pendulum migration strategy to reconcile their own wish to retain strong ties with Morocco with the reluctance of children and spouses to return. Migrants who unilaterally decided not to reunify their families usually return after their active working life. However, this unilateral decision also blocks legal entry into Europe for their children, which has generated considerable intergenerational tensions.

Family transitions and juvenile delinquency.

There is a large body of research that shows children from non-intact homes show higher rates of juvenile delinquency than children from intact homes, partially due to weaker parental control and supervision in non-intact homes. What has not been adequately addressed in the research is the influence of changes in family structure among individual adolescents over time on delinquent offending. Using the first and third waves of the National Youth Study, we assess the effect of family structure changes on changes in delinquent offending between waves through the intermediate process of changes in family time and parental attachment. Although prior research has documented adolescents in broken homes are more delinquent than youth in intact homes, the process of family dissolution is not associated with concurrent increases in offending. In contrast, family formation through marriage or cohabitation is associated with simultaneous increases in offending. Changes in family time and parental attachment account for a portion of the family formation effect on delinquency, and prior parental attachment and juvenile offending significantly condition the effect of family formation on offending.

Muslim women and foreign prostitutes: victim discourse, subjectivity, and governance.

In this article, we juxtapose the ways "Muslim women" and "foreign prostitutes" are commonly constituted as victims in media and politics. We analyze the functions of these two prototypical female victims in terms of the role they play in epitomizing "the problems of globalization" and in reinforcing the existing social and political structures. Victim discourse, when tied to the transnational proliferation of the sex industry and of (radical) Islam, has depoliticizing effects because it places nonindividual causes of victimization outside of "our" polity and society and casts the state as protector and neutral arbiter of national and global inequalities, marginalization, and social conflict.

The problem of dependency: immigration, gender, and the welfare state.

This article discusses the regulation of marriage migration to Norway through an analysis of the subsistence requirement rule which entails that a person who wants to bring a spouse to Norway must achieve a certain level of income. Policy-makers present two main arguments for this regulation. First, the subsistence requirement is a means to prevent forced marriage. Second, its aim is to prevent family immigrants from becoming a burden on welfare budgets. The major concern of both these arguments is that of dependency, either on the family or on the welfare state. The article investigates the representations of the "problems" underpinning this specific policy proposal and argues that the rule in question, and immigration policy more generally, needs to be analyzed with reference to the broader concerns and aims of welfare state policy and gender equality policy.