Advance directives and the persistent vegetative state in Victoria: a human rights perspective

With advances in medical technology, it is now possible to sustain the life of a person in a persistent vegetative state (PVS) until a decision is made to withhold or withdraw life-sustaining treatment. Who makes that decision? Under the Medical Treatment Act 1988 (Vic) there is no legally enforceable right for a person to choose, in advance, what intervention that person will and will not accept if he or she ends up in a PVS. The best that can be achieved is that a person can appoint an agent who is empowered to refuse medical treatment on the person's behalf in the event of incompetence. It is suggested that this mechanism ignores two fundamental human rights: self-determination and the inherent right to dignity. This article proposes the development of an advance directive mechanism that provides for a person to refuse, in advance, specified intervention, thereby respecting fundamental human rights and alleviating the existing need for an agent to second-guess a person's desires and best interests.     

Perception of and Satisfaction with Relationship Power,Sex, and Attachment Styles: A Couples Level Analysis

Eighty heterosexual dating couples provided information about their gender, individual histories of abuse in their current relationship, attachment styles, perception of and satisfaction with relationship power. Partner report of physical abuse was the dependent variable. APIM actor results suggest that an individual's gender interacts with perceived level of relationship power and satisfaction with relationship power for physical abuse. Both dimensions of attachment interacted with perceived relationship power for physical abuse. Partner effects were also found. One's partner's sex interacted with perceived power and satisfaction with relationship power. Finally, the partner's avoidant attachment interacted with satisfaction with relationship power. These findings generally replicate and extend the work of H. M. Ronfeldt, R. Kimerling, and I. Arias (1998, J. Marriage Fam. 60: 70–78) by showing how attachment styles, perception of relationship power, and satisfaction with relationship power are related in predicting aggression against a romantic partner.     

Cognitive-behavioral rehabilitation for high-risk violent offenders: an outcome evaluation of the violence prevention unit

Rehabilitation programs for adult violent offending are still novel, and few published studies examine the recidivism outcomes of those who complete such programs. This study describes a New Zealand prison program for high-risk violent men. The program is intensive and cognitive behavioral. Preliminary outcome data are presented for three indices during 2 or more years of follow-up: nonviolent reconviction, violent reconviction, and subsequent imprisonment. In comparison with untreated offenders, treated men were less likely to be reconvicted of a violent offense, and those who were took longer to fail. There was also a 12% difference in favor of the treated men on the two other indices, nonviolent reconviction and reimprisonment. The authors conclude that the program shows early promise and that further evaluation with a larger sample of treated men will be important in clarifying whether the program is having a differential impact on violent versus nonviolent offending.     

Coparent Support and Conflict in African American Single Mother-Headed Families: Associations With Maternal and Child Psychosocial Functioning

This longitudinal investigation examined main and interactive effects of coparent support and conflict on mother and child adjustment in 248 low-income, African American, single mother-headed families. The findings indicated that coparent conflict was a more robust predictor of mother and child maladjustment both cross-sectionally and longitudinally than was coparent support. Moreover, findings revealed that coparent conflict and support interacted to predict one parenting behavior, monitoring, both cross-sectionally and longitudinally. Coparent relationships characterized by high levels of support and low levels of conflict were associated with the highest levels of parental monitoring behavior, whereas coparent relationships characterized by low levels of support and high levels of conflict were associated with the lowest levels of monitoring. The findings highlight the importance of examining both positive and negative aspects of coparent relationships in this at-risk, but understudied, group.     

Reasons for Returning to Abusive Relationships: Effects of Prior Victimization

Studies have demonstrated that women with a history of childhood sexual abuse (CSA) are at increased risk of revictimization, but research has not yet examined whether a history of CSA may affect patterns of remaining in or returning to abusive relationships in adulthood. This study examines the impact of a CSA history on decisions to return to abusive relationships in a sample of 104 adult domestic violence survivors. Participants were interviewed about the number of times that they had previously separated from and returned to their abusive partner, the factors that influenced their decision to return (both psychological/internal and environmental/external factors), and their perceived likelihood of returning in the future. As predicted, CSA survivors (n = 34) reported a significantly greater number of past separations than non-CSA survivors (n = 70). CSA survivors were also significantly more likely to report that their decisions to return were influenced by emotional attachment to the batterer. CSA survivors did not perceive themselves to be at greater risk of returning in the future, suggesting that they may be more likely to underestimate their vulnerability to returning to the battering relationship. Clinical implications of the findings are discussed.     

Revisiting the role of communication in adolescent intimate partner violence

A growing literature suggests that communication strategies can promote or inhibit intimate partner violence (IPV). Research on communication is still needed on a group ripe for early IPV intervention: high school-aged adolescents. This article revisits our previous analyses of young female reproductive clinic patients (Messinger, Davidson, & Rickert, 2011) by examining how the adolescent and young adult respondents differ. To explore replicability of the adolescent results across populations, they are compared to 487 adolescent female students sampled from four urban high schools. Across samples, all communication strategies were used more frequently within violent relationships. Multivariate analysis identified escalating strategies used and received as being positively associated with physical violence used and received in all three samples. Regarding verbal reasoning and temporary conflict avoidance, substantial differences appeared between the young adult and adolescent clinic samples, and results from the adolescent clinic sample were largely replicated with the adolescent school sample, suggesting that young adult samples in this literature are not adequate proxies for adolescents.     

Do Women Representatives Regender Legislative Bureaucracy? Assessing the Effect of Representative Sex on Women's Presence among US Congressional Staff

Achieving greater female presence in influential positions is a commonly discussed strategy for gender reform in institutions such as the US Congress. Using theory adapted from research on gender in the workplace, this study examines whether women representatives, as ‘managers’ of congressional offices, alter patterns of gender representation in Congress by hiring and promoting more women staffers compared with men representatives. Cross-sectional logistic regression analyses of staffer sex during the 110th and 111th Congresses (2007–10) reveal a positive relationship between women representatives and female presence on congressional staffs. However, the relationship does not hold with respect to the most influential staff positions. These findings provide only limited support for theories that women representatives act as ‘change agents’ by directly facilitating opportunities for women, and highlight the importance of exploring alternative strategies for empowering women and regendering legislative institutions.     

Effectiveness of modified therapeutic community treatment within a medium-secure service for personality-disordered offenders

There is debate as to whether secure hospital treatment for offenders with personality disorder can be effective relative to criminal justice interventions. This study examines the evidence for long-term treatment of such offenders in hospital within in a modified therapeutic community model including accredited offending behaviour programmes. A panel sample of 47 patients were followed up on measures of violence risk (HCR-20, VRS) and symptom severity (SCL90-R). Intention-to-treat analysis with reliability thresholds showed significant positive change between assessment and discharge in both violence risk (VRS) and symptoms (SCL90-R) indicating a positive treatment effect. Threshold effects for treatment effectiveness seemed to occur at 1?year of treatment for risk and 3?years for symptom reduction.