Intimate Partner Violence as a Risk Factor for Mental Disorders: A Meta-Analysis

This article reviews literature on the prevalence of mental health problems among women with a history of intimate partner violence. The weighted mean prevalence of mental health problems among battered women was 47.6% in 18 studies of depression, 17.9% in 13 studies of suicidality, 63.8% in 11 studies of posttraumatic stress disorder (PTSD), 18.5% in 10 studies of alcohol abuse, and 8.9% in four studies of drug abuse. These were typically inconsistent across studies. Weighted mean odds ratios representing associations of these problems with violence ranged from 3.55 to 5.62, and were typically consistent across studies. Variability was accounted for by differences in sampling frames. Dose-response relationships of violence to depression and PTSD were observed. Although research has not addressed many criteria for causal inferences, the existing research is consistent with the hypothesis that intimate partner violence increases risk for mental health problems. The appropriate way to conceptualize these problems deserves careful attention.     

拜登政府执政后的重大国际问题笔谈

由于美国国内政治极化严重,恢复经济、控制疫情、弥合国内社会撕裂等成为拜登政府的当务之急。而且由于特朗普政府时期的一些对外政策具有一定的社会基础,美国两党在一些领域也有共识,所以在一些重大国际问题上,拜登政府的立场和政策将以延续为主、调整为辅。同时,鉴于拜登阵营的建制派背景,其在国际问题上将更注重以多边主义和国际合作的方式推进相关政策。具体而言,在亚太安全领域,拜登政府对特朗普政府政策的延续将大于变化;美欧关系将有所拉近;中美俄和美欧俄战略三角关系的调整将对美俄关系未来产生影响。拜登政府以重振美国国际领导权为重要目标,对多边主义国际秩序将产生较大影响。在全球卫生治理领域,拜登政府将努力消除特朗普政府时期外交政策的负面影响。在重返亚太区域经济一体化问题上,美国短期内不会有实质性行动。在科技产业领域,特朗普政府时期的政策基调将得到延续,中国需努力遏制双方关系恶化的势头,为自身发展营造稳定的外部环境。     

从人格特质及心理健康水平预测护士职业适应

本文运用了人格检查法及心理健康量表调查了168名护士,并与有关资料对比,旨在了解护士人格特质及心理健康水平与职业适应的预测关系。研究发现,敏感性、世故性、忧虑性、紧张性人格特质与躯体化、人际关系敏感、抑郁、焦虑、敌对、恐怖、精神病性症状呈现显著正相关;自律性人格与躯体化呈现显著负相关。结论认为,人格特质与心理健康相关,据此可预测职业适应情况。     

健康方面的性别不平等与贫困

健康方面的性别不平等主要体现在妇女的健康状况和保健质量处于劣势、家庭内部营养品分配的不平等及生育和节育手术的不平等三个方面。健康方面的性别不平等影响了妇女的生计选择;减少了她们获取外界信息的机会;因多胎生育增加了孩子的抚养成本;也导致妇女妇科病增多,难以承担繁重的体力劳动,造成家庭贫困。而贫困进一步加剧了健康方面的性别不平等。     

INCARCERATION AND POPULATION HEALTH IN WEALTHY DEMOCRACIES*

Everywhere you look, incarceration seems to be doing harm. Research has implicated incarceration not only in worse outcomes for individuals, their families, and their communities but also in growing inequality. Yet incarceration may not always harm society—even if it does harm those who experience it. To consider this possibility, I build an argument demonstrating how the macro‐level consequences of incarceration may be distinctively harmful in the United States, focusing on the incarceration–health relationship as one indicator of a broader phenomenon. I then test my hypothesis by using an unbalanced panel data set including 21 developed democracies (N = 414) and a series of ordinary least‐squares models predicting three measures of population health as a function of incarceration. Models including only a main effect of incarceration demonstrate an inverse association between changes in incarceration and changes in population health. Models including an incarceration by U.S. interaction, however, indicate that the population health consequences of changes in incarceration are far worse in the United States than elsewhere. Taken together, the results indicate that the United States is exceptional for both its rate of incarceration and its effects of incarceration, although it is unclear what drives this exceptionalism in effects.     

The social,relational and mental health characteristics of justice-involved men in the south-west England

The aim of this article is to describe the social, relational and mental health characteristics of a sample of offenders serving prison or community sentences in the south-west England. About 100 adult male offenders were screened for anxiety and depressive disorders, post-traumatic stress disorder (PTSD), drug and alcohol dependence, and likely personality disorder using validated instruments. Fifty-eight per cent of the sample reported at least one common mental health problem, of these only 26% reported receiving treatment. Participants exposed to traumatic events and/or participants with past mental health problems were more likely to score positive for current common mental health problems. Our study identified factors that may increase the risk of a first episode or recurrent anxiety and/or depression for offenders. Health and criminal justice services should create partnerships and develop interventions that address the risk factors which lead and/or contribute to offenders' mental health difficulties.     

Stigma and discrimination in mentally disordered offender patients – a comparison with a non-forensic population

High levels of stigma and discrimination are reported by individuals with mental health problems. Aim: To assess self-reported levels of stigma and discrimination in forensic psychiatric patients, with psychotic illness, compared with general adult psychiatric patients with psychosis. Hypothesis: Individuals with a history of violent offending, as well as severe mental illness, report more stigma and discrimination, than non offender patients, as a result of them being perceived as dangerous and unpredictable. Method: Experiences of stigma and discrimination were compared in 32 forensic and 32 non-forensic general psychiatric patients, with schizophrenia or schizoaffective disorder, using the Stigma and Discrimination Scale (DISC). Results: Stigma and discrimination were widely reported by all patients, particularly affecting relationships with family, intimate relationships and friendships. No significant difference emerged between the forensic and non-forensic patients, in experienced or anticipated stigma. Conclusions: We suggest that the lower level of psycho pathology, longer inpatient stays and intensive rehabilitation for forensic patients may reduce the extent to which these patients experience stigma and discrimination.     

Learn,Frame and Deploy? Cross-National Policy Ideas and Comparisons in Turkey’s Health Reform

Comparative analysis in health policy not only helps us learn about the organization of health care systems and reforms in other countries but also addresses the difficulties of drawing cross-national policy lessons. This case study on the Turkish health reform of 2003 focuses on the national policy discourse to identify how cross-national ideas and comparative analyses are used by policymakers and other key stakeholders. Building on the ideational perspectives and Kingdon’s streams approach, it explores agenda setting and ideological framing activities. The results provide evidence for the political nature of the process whereby cross-national ideas were deployed in domestic policy battles.     

Going It Alone or Playing to the Crowd? A Critique of Individual Budgets and the Personalisation of Health Care in the English National Health Service

The introduction of individual budgets into English health care is a recent example of the pervasive drive towards personalisation in welfare sector organisation and delivery. As a heavily centralised and highly bureaucratic institution, the National Health Service (NHS) is an obvious target for personalisation. On the other hand, as a symbol of solidarity and nationhood it retains a powerful place within the collective psyche, such that radical reform might expect to encounter resistance. This paper analyses the assumptions that are inherent in personalisation and raises concerns over its ability to transform health‐care services. At the heart of these concerns is the tension between appeals to tailored service provision and empowerment on the one hand, and promotion of a strong social contract, public trust in institutions, and collective identity on the other. Lessons are drawn for personalisation in other sectors and settings.     

Consent to Treatment for Transgender Youth: The Next Chapter – Bell & Anor v The Tavistock and Portman NHS Foundation Trust & Ors

In September 2021, the Court of Appeal reversed the controversial decision of Quincy Bell v Tavistock and Portman NHS Trust in a victory for transgender rights. At first instance, the Divisional Court had set a high legal threshold for transgender children to attain Gillick competence to consent to treatment with puberty blockers – effectively restricting access to treatment for many. On appeal, the Court of Appeal held that children are capable in law of giving valid consent to treatment for gender dysphoria, and court authorisation would not be routinely required before children could access such treatment. This note considers the implications of the Court of Appeal decision for the law on minors and consent to medical treatment in the transgender health context.