Parental contexts of adolescent self-esteem: A developmental perspective

Relationships between parental behaviors and adolescent self-esteem were analyzed in a group of 95 early adolescents from multiple settings. The study was designed to investigate hypotheses regarding associations between observed parental interactions (e.g., accepting and devaluing) and adolescent self-esteem. Parents' verbal interactions with their adolescents were assessed through application of the constraining and enabling coding system to transcribed family discussions, generated through a revealed differences procedure. Adolescent self-esteem was measured with the Coopersmith Self-Esteem Inventory. Parent interaction-self-esteem associations were examined in the pooled sample, as well as in specific sub-groups based on gender, health, and ego development (measured by the Washington University Sentence Completion Test). Boys had more numerous associations between their self-esteem and parental interactions than girls, and psychiatrically ill boys had particularly high associations. Parental interactions were found to be most strongly related to adolescent self-esteem for adolescents at the lowest levels of ego development. Our findings are consistent with the view that increasing individuation in self-esteem regulation occurs during adolescent development, such that adolescents at higher levels of ego development evaluate themselves more independently of parental feedback than do their less mature peers.This study was supported through a Research Training Grant No. MH16259 (Dr. Isberg) from the NIMH, a grant from the National Institute of Child and Human Development (NICHD Grant No. 5 R01 HD18684-02), and a Research Scientis Development Award No. 5 K-02-MH-70178 (Dr. Hauser) from the NIMH.Received M.D. from Harvard University. Currently studying adolescent development and working with the school consultation program of the Massachusetts Mental Health Center.Received M.D. from Yale University and Ph.D. from Harvard University (Psychology). Currently studying family contexts of adolescent development.Received M.D. from The University of Chicago. Currently studying psychological consequences of diabetes mellitus.Received Ed. D. from Harvard University (School of Education). Currently studying family coping processes in response to stressful events.Received Dipl. Psych. from Freie Universitat, Berlin (Clinical Psychology). Currently studying relationships between psychopathology and development among adolescent psychiatric patients.Received Ph.D. from Ohio State University (Psychology). Current interests in assessing ego development and family systems.Received Ph.D. from the University of Miami (Clinical Psychology). Research interests in family studies and adolescent development.     

Positional Asphyxia in Opioid-Related Deaths: Is It Being Overlooked?

The contribution of positional asphyxia in opioid-related deaths is currently unknown. Diagnostic criteria for positional asphyxia include finding the decedent in a position that does not allow for adequate respiration and an inability to extricate themselves from the position due to various conditions. Our primary objective was to assess whether positional asphyxia and the resulting airway compromise were a contributing factor to death due to the toxic effects of opioids. We evaluated 225 deaths where the death scene investigation contained adequate information to evaluate for positional asphyxia and performed a Pearson chi-square test to determine if the proportion of deaths found in an airway compromising position was higher when opioid(s) caused the death. The proportion of decedents found in a potential airway compromising position was greater when the death was related to opioid use (p < 0.0001). Further, narrowing the dataset to decedents who were definitely in an airway compromising position [Yes (24.49%) vs. No (11.02%)] showed a statistically significant association between positional asphyxia and deaths related to opioid use (p = 0.0021). Carefully documenting the position in which the decedent was initially found may be a significant factor in accurate reporting and in harm reduction efforts to decrease the opioid mortality rate.     

Differentiation of Antemortem and Postmortem Appendicular Fractures Using Magnetic Resonance Imaging Signal Intensity Changes in Bone and Soft Tissues,

Intraosseous T1-weighted (T1W) and short-tau inversion recovery (STIR) magnetic resonance imaging (MRI) signal intensity changes—so-called bone marrow edema—may be able to differentiate antemortem and postmortem fractures in human forensic imaging. The primary objective of this study was to investigate this hypothesis using an animal model. Three juvenile Landrace pigs were anesthetized and underwent MRI of both tibiae and both radii using a 1.5 T magnet. T1W, T2-weighted (T2W), STIR, and T2* sequences were included. Antemortem fractures were induced in both tibiae and postmortem fractures in both radii, and MRI was repeated. Two board-certified radiologists blinded to fracture group jointly evaluated the images for intraosseous and soft tissue signal intensity changes. Sensitivity (Se) and specificity (Sp) in identifying antemortem fractures were calculated based on intraosseous, soft tissue, and combined intraosseous and soft tissue signal intensity changes. Intraosseous and soft tissue signal intensity changes, when present, were hyperintense in all sequences. Intraosseous hyperintensity in T1W and T2W sequences yielded Sp of 100% for antemortem fractures. Regardless of sequence, soft tissue hyperintensity was comparatively more sensitive than intraosseous hyperintensity. Sensitivity for each sequence could be maximized by assessment of soft tissue and intraosseous hyperintense signals together; for the T1W sequence, such assessment optimized diagnostic utility yielding a Se of 100% and Sp of 83%. In summary, MRI—particularly the T1W sequence—can differentiate antemortem and postmortem fractures and may be a useful adjunct to the forensic analyses of fractures.     

Empowering women through the positive birth movement

Childbirth has been positioned as a life changing event that has profound long-term psychological effects upon women. This paper adopts a community psychology approach to explore the role that the Positive Birth Movement (PBM) may have in tackling negative birth experiences by supporting women before and after birth. Six women who all regularly attend UK-based PBM meetings and had given birth to at least one child participated in one to one semi-structured interviews designed to explore the support they received before, during and after their birth, as well as their experiences with the PBM. A Foucauldian inspired discourse analysis explores themes relating to the lack of support and information provided by the NHS and the function of the PBM as a transformative community space which offers social support and information. Within these themes a focus on neoliberalism, choice and the woman’s position as an active consumer of health care is critically discussed. It is argued that the PBM has the potential to prepare women for positive birth experiences but more attention needs to be paid to the wider contexts that limit women’s ability to make ‘free’ choice.     

Missed Opportunities and New Risks: Penal Policy in England and Wales in the Past Twenty‐Five Years

This paper discusses trends in criminal justice and penal policy over the past twenty‐five years. This period has been characterised as a time of penal populism, which originated in the failure of the 1991 Criminal Justice Act, and the competition between the main political parties to be ‘tough on crime’. However, this is not the only trend to be found in penal policy. There has continued to be a strong undertow of support for rehabilitation and community penalties, including restorative justice. There has been pressure from the left as much as the right to take domestic violence, sexual offences against women and children, and hate crimes more seriously. There have been pressures to meet performance targets—which gradually transformed into calls to build the legitimacy of the justice system. Finally, there have been pressures to privatise criminal justice agencies. These various impulses have sometimes amplified and sometimes counteracted the pressures towards tough penal policy. If the period of intense penal populism ran from 1993 to 2007, inertia in the system has ensured that there have been no significant attempts to row back from tough policies, and to reassert the values of penal parsimony. Given that money has been tight since 2007 and crime has continued to fall, this must amount to a lost opportunity of significant proportions.     

Using military forces under international auspices and democratic accountability

This article reports on a research project that deals with howto ensure democratic accountability when military forces areused under the auspices of international institutions. The internationalcommunity has developed a range of ways in which military forcescan be used. States have also decided that in some cases militaryforces can be deployed to pacify intra-state as well as inter-stateconflicts. States have developed a mixed system to deal withthe issues of democratic accountability. Although military operationsare conducted under the auspices of international institutions,states maintain control over decisions to deploy their troops. Democraticcontrol and accountability have been maintained through national institutionsand procedures. International authorization, preferably by theUN Security Council, is important to establish internationaland domestic legitimacy, but it is not the essential mechanismfor ensuring democratic accountability.