Intimate violence and black women's health.

After reviewing the literature on health effects of intimate violence, we report secondary analyses of responses of 439 black women who participated in the Commonwealth Fund's national survey on women's health. Lower income women were more likely to experience partner violence but not childhood abuse; and income group was related to self-esteem, depressive symptoms, and perceived health status. Childhood physical and sexual abuse and partner violence were intercorrelated; both abuse history and partner violence were related to greater risk for depressive symptoms, lower life satisfaction, and lower perceived health care quality. Partner violence was also related to lower self-esteem and perceived health status. Sexually abused women had more difficulties in interpersonal relationships, including lower perceived health care quality even with self-esteem and depressive symptoms controlled. Implications for prevention, training, and future research as well as methodological issues in research on violence against black women are discussed.

Sociocultural and psychological factors in American Indian drug use: implications for treatment.

Use of alcohol and other drugs has been acknowledged as a serious problem among American Indian populations. This study was designed to 1) compare female and male American Indian substance users in residential treatment on psychological (self-esteem, depression, attributional style) and sociocultural (demographics, personal drug use history, family history, acculturation) variables, and 2) examine relationships of the psychological and sociocultural variables with program completion. Results showed that females experienced more family dysfunction (family members misuse of substances, and emotional, physical, and sexual abuse) than males. Both females and males showed positive change on the psychological measures from treatment entry to treatment completion. The factors predicting dropout before program completion were divorce, use of cocaine and depressants, and living in foster care as a child. Implications for prevention, intervention, and training of treatment service providers are discussed.

Male violence against women. Current research and future directions.

This Psychology in the Public Forum section, authored by the American Psychological Association's Committee on Women in Psychology's Task Force on Male Violence Against Women and by Senator Joseph Biden, examines the prevalence, impact, and public policy dimensions of physical assault, sexual assault, and sexual harassment of women. This introduction reviews common themes that emerge from the articles that follow. It concludes by emphasizing that the problem of violence against women cannot be fully understood, let alone solved, by focusing exclusively on individual psychology. Only by changing the social and cultural institutions that have given rise to the problem can a lasting solution be achieved.

Childspacing intervals and abortion among blacks and whites: a brief report.

Although physical, psychological, and social problems for children born to women denied abortion have been identified, little attention has been paid to the role that close childspacing might play in contributing to those problems. Small childspacing intervals (less than two years) have been linked to numerous physical, psychological, and social problems for mother and child. Using secondary analysis, this study examines the characteristics of 596 mothers who sought abortions in 1987 by race and age. Nearly 25% of these mothers had at least one child under two years of age. Abortion patients with such young children were more likely to be Black and have low incomes than abortion patients with older children. More than half of the mothers studied had more than two children. The findings suggest that a substantial number of children born to women denied access to abortion would be closely spaced, with the resulting adverse health consequences falling more heavily on subpopulations of abortion patients already at higher risk for negative perinatal and neonatal outcomes.

PIP: 1 out of every 2 abortion seekers have been identified as mothers already; little attention has been directed to the consequences for these women, who also may have close child spacing and poor reproductive outcomes, of denial of access to legal abortion. Child spacing of less than 2 years has been associated with diminution of the physical and mental health of mothers and infants. Births to single mothers have been associated with lower birth weights, which involve higher risk for health, psychological, and social problems. Black unmarried mothers have been found to be at higher risk for poor birth outcomes. In this examination, chi square and cross tabulations were used to assess the impact of access to abortion on child spacing for mothers at high risk for unfavorable birth outcomes. 1987 data from 30 abortion providers and 686 mothers were obtained from the Alan Guttmacher Institute on abortion patients provided by nonhospital facilities that performed at least 409 abortions performed annually in the United States. The results indicated that 1 out of 4 mothers already had a child under the age of 2 years, of whom black mothers were a larger proportion. More than 1 out of 2 mothers already had 2 or more children. The majority of mothers were single heads of households, which varied from 65% for white mothers aged 20-45 years to 100% of black mothers aged 15-19 years. Low income ($11,000/year) was reported by more than 1 out of 3 mothers. Of all the mothers, the findings show that large proportions of all mothers grouped by income, age, household head status, and ethnicity were at risk by one or more characteristics. Those mothers with children under 2 years of age were significantly more likely to have been teenagers, black, and have low incomes. Mothers with a child under 2 years of age had more than 2 children and had lower income. A more thorough examination of the multiple factors and risk for lack of access to abortion is needed, since adverse consequences affect more heavily on subpopulations of women at higher risk for negative pregnancy outcomes.

[Complications and risk factors of ileo-anal anastomosis with reservoir for ulcero-hemorrhagic rectocolitis associated with primary sclerosing cholangitis]. / Complications et facteurs de risque de l'anastomose iléo-anale avec réservoir pour rectocolite ulcéro-hémorragique associée à une cholangite sclérosante primitive.

The study determined predictive factors for postoperative complications and outcome after ileal pouch-anal anastomosis in patients with ulcerative colitis and primary sclerosing cholangitis. Patients with ulcerative colitis and primary sclerosing cholangitis treated by colectomy and ileostomy are at high risk of troublesome bleeding from peristomal varices. Postoperative complications and outcome were assessed in 40 patients with ulcerative colitis and sclerosing cholangitis who received in ileal pouch-anal anastomosis between January 1981 and February 1990. Immediate postoperative and remote ileoanal anastomosis-related complications were high but related directly to the severity of liver disease. No patient had perianastomotic and bleeding. In patients with both ulcerative colitis and primary sclerosing cholangitis, ileal pouch-anal anastomosis is safe and is not associated with perianastomotic bleeding.

Psychological factors in abortion. A review.

Psychological research is increasingly involved in debates regarding abortion. While recognizing the diversity of ethical and moral issues intertwined with abortion, the American Psychological Association (APA) has focused its involvement on psychological factors, most recently by appointing an expert panel to review the literature on psychological effects. This article notes the history of APA involvement and reports on the panel's conclusions. It presents evidence that abortion is not likely to be followed by severe psychological responses and that psychological aspects can best be understood within a framework of normal stress and coping rather than a model of psychopathology. Correlates of more negative responses following abortion are also discussed.

Psychological responses after abortion.

A review of methodologically sound studies of the psychological responses of U.S. women after they obtained legal, nonrestrictive abortions indicates that distress is generally greatest before the abortion and that the incidence of severe negative responses is low. Factors associated with increased risk of negative response are consistent with those reported in research on other stressful life events.

Overview: forging research priorities for women's mental health.

After a decade of reports underscoring the inadequacy of existing scientific knowledge for understanding gender differences in mental disorder and its treatment, the National Institute of Mental Health has developed a women's mental health research agenda with five priority areas for research: diagnosis and treatment of mental disorder, mental health issues for older women, violence against women, multiple roles, and poverty. This overview highlights some of the major findings in each of these five areas and introduces the more in-depth treatment given in this Psychology in the Public Form section to the areas of violence, poverty, and multiple roles. It also underscores the importance of identifying sources of gender bias in all mental health research. Women's mental health issues have become officially recognized as part of the NIMH research agenda. Only time and continued monitoring will determine how these official policy priorities will become translated into actual funding and research initiatives.

Immunocytochemical localization of lysosomal beta-galactosidase in rat liver.

beta-galactosidase is a ubiquitous lysosomal hydrolase that specifically cleaves terminal beta-galactosyl residues from glycoproteins, glycosaminoglycans, oligosaccharides, and glycolipids. To study the intracellular distribution of this enzyme, we prepared a specific polyclonal antibody to lysosomal beta-galactosidase by immunizing rabbits with a highly purified preparation of beta-galactosidase from rat liver. Using this antibody we employed an immunocytochemical technique (protein A coupled to horseradish peroxidase and diaminobenzidine cytochemistry) and showed that beta-galactosidase is present in all hepatocytes of the rat liver. All types of lysosomes, the rough endoplasmic reticulum, and the specialized region of smooth endoplasmic reticulum known as GERL showed immunoreactivity. This in situ distribution suggests that these organelles are involved in the biosynthesis and intracellular sorting of this lysosomal enzyme.

Inequality and women's mental health: an overview.

Complex processes of sex bias and sex-role stereotyping continue to detract from the quality of mental health services to both sexes, but particularly to women because of their disadvantaged status. Understanding how such processes can simultaneously create barriers to service access and facilitate inappropriate treatment is essential to ensuring quality mental health services. Ameliorating the problems of women as providers and consumers in the mental health delivery system will require a sophisticated understanding of the nature of those problems and a firm commitment to creative solutions. The ethical mandate to address the institutional structures of inequality extends to all persons who are part of the mental health delivery system.

American family: looking good.

PIP: The American family is becoming stronger because marriage and parenthood are becoming options, not mandates. Previously nearly 95% of Americans were married, a higher percentage than any other country except India. Often people become parents for the wrong reasons, such as parents of the couple wanted grandchildren or the feeling that one must have a baby to have meaning in life. Later marriage is seen as eventually lowering the divorce rate because adults will be mature. Increased use of contraception, and abortion as a last resort, is reducing the number of unplanned, unwanted children who may be abused. Reminders of the motherhood mandate are traditional houses in the suburbs far from jobs. Traditionally commuting times for women have been less than for men, presumably to allow them to spend more time with the children. It is also suggested that schools give realistic courses on parenting and emphasize that having children is not for everyone.^ieng