Longitudinal determinants of consistent condom use by partner type among young injection drug users: the role of personal and partner characteristics.

We investigated the longitudinal influence of individual-, relationship- and social-level factors on condom use by partner type among young injections drug users (IDUs) enrolled in the Collaborative Injection Drug Users Study-III/Drug Users Intervention Trial (CIDUS-III/DUIT) from 2002 to 2004. Based on longitudinal analysis using generalized estimating equations (GEE), consistent condom use with main partners was more commonly reported among males and those with greater self-efficacy for condom use; main partner's desire for pregnancy and needle sharing were negatively associated with consistent condom use. Among those with casual partners, having fewer sex partners was associated with consistent condom use. Positive attitudes toward condom use and partner norms supporting condom use were associated with greater consistent condom use with both partner types. These findings suggest that intervention strategies targeting individual- and partner-level factors may provide avenues for intervening upon sexual risks among young IDUs.

Correlates of consistent condom use with main partners by partnership patterns among young adult male injection drug users from five US cities.

This paper examined correlates of consistent condom use with a main partner among heterosexual male injection drug users (IDUs). Using data from a multi-site sample of young IDUs, we identified 1770 sexually active men of whom 24% (429/1770) reported an exclusive main female sex partner and 49% (862/1770) reported both main and casual female sex partners. Consistent condom use with a main partner was low among men with an exclusive main partner and those with multiple partners (12% and 17%, respectively). In multivariate analysis, consistent condom use with a main partner across partnership patterns was directly associated with anticipating a positive response to requests for condom use and by partner support of condom use; consistent condom use was inversely associated with a main partner's pregnancy desires. Among men with an exclusive main partner, consistent condom use was also inversely associated with needle sharing with a main partner. Among men with multiple partners, consistent condom use with a main partner was inversely associated with injecting with a used needle and intimate partner violence. The low prevalence of consistent condom use with main female partners among heterosexually active male IDUs indicates an increased risk for HIV transmission between men and their primary sex partners. Interventions for heterosexual males that are geared toward increasing condom use in primary relationships are warranted.

Female and male undergraduates' attributions for sexual offending against children.

This study examined gender differences in undergraduates' attributions for child sex offending. One hundred and sixty-four undergraduates were asked to give the reasons why they think men sexually offend against children and to rate them using Benson's Attributional Scale across four dimensions: stability, locus, controllability and globality. A Grounded Theory methodology was applied to these reasons and a set of nine categories derived from the data. The results showed that undergraduates' reasons for child sexual abuse strongly parallel contemporary scientific theories of abuse, and that there were significant gender differences in the frequency with which participants cited various types of reasons given for sexual abuse. Females endorsed significantly more victim reasons than males, and also more power and control reasons than did males. In contrast, males endorsed significantly more sexual reasons for offending than did females. Furthermore, significant gender differences were found between the ways in which participants construed the reasons for sexual abuse, with females seeing the phenomenon as significantly more stable and internal than males. No significant gender differences were found on the dimensions of controllability and globality.

Metabolic control and psychological sense of control in women with diabetes mellitus. Alternative considerations of the relationship.

PURPOSE: Identifying psychological strategies to buffer the adverse outcomes in people with diabetes mellitus (DM) remains a priority for many health professionals. While 'locus of control' (LOC) has been repeatedly investigated to this end, research findings are contradictory. The development of more complex appraisals of psychological control, and the utilization of control inventories deriving from such analyses, presents a way forward from such contradictions. METHODS: Employing such a measure, this study examines the relationship between metabolic control and psychological sense of control in 96 women with DM. RESULTS: Optimal metabolic control is significantly associated with overall sense of control, while poor metabolic control was significantly associated with experiences of loss of psychological control and feelings of inadequacy. Furthermore, poor metabolic control was significantly associated with reduced control in the specific domains of interpersonal relationships and bodily functions. CONCLUSIONS: Multidimensional control inventories enable a more complex appraisal of the relationship between metabolic control and psychological control, and in doing so, provide a way forward from problems arising from reliance on LOC constructs. Interventions for DM management relying on aspects of psychological control need to target domains beyond traditional issues of self and bodily functions.

Interpersonal competency in sex offenders.

The major theoretical frameworks all invoke, often implicitly, social competency deficits as part of their causal explanations for sexual aggression. In this article, the authors review the evidence for this general position, noting both that social competency is not best seen as being equivalent to social skill and that domain specificity is likely to be important. They argue that intimacy, empathy, and cognitive distortions are likely to be the most salient domains in the area of sexual aggression. Recent use of attachment theory to conceptualize intimacy suggests that this approach may have more utility in both classification and intervention planning. An information processing view of empathy, together with likelihood of situational constraints on deficits, has usefully advanced this area. The possible relationships between such deficits and cognitive distortions are noted. Current literature on cognitive distortions is also briefly reviewed. Finally, suggestions for a helpful research agenda are made.

Sexual offenders' implicit planning: a conceptual model.

In recent years empirical research, clinical observation, and theoretical models about sexual offending have emphasized the importance of problem solving and decision making throughout different phases in the offense chain. This work suggests that sometimes offense planning is explicit, systematic, and analytical, while at other times it appears to be implicit and intuitive. The latter style of decision making has been called seemingly unimportant decisions. We attempt to provide an explanation of offenders' implicit decision making and suggest two social cognitive mechanisms capable of generating these types of decisions. We believe that implicit decision making in offenders has the appearance of automaticity, that is, decision making that is implicit, fast, relatively autonomous, frequently associated with a lack of control, effortless, and occurring without conscious awareness. Drawing from diverse theoretical sources, we hypothesize that these types of decisions are generated by underlying automatic goal dependent action plans. More specifically, we suggest that there are at least two types of automatic goal dependent plans evident in offenders' decision making: offense scripts and mental simulations. We draw implications for generating future hypotheses and provide suggestions for future research.

Cognitive distortions in sex offenders: an integrative review.

Clinicians and researchers have noted that maladaptive beliefs and distorted thinking play an important role in facilitating or justifying sexual offenses. There have been a number of attempts to describe the nature of these beliefs and to develop ways of measuring them, but in the absence of any integrating theory. We suggest that an understanding of the cognitive processes underlying the initiation, maintenance, and justification of sexual offending is a vital prerequisite to the development of successful treatment programs. In this paper, we use a social cognition framework to review the literature on the role of cognition in sexual offending. Pertinent research in the sexual offending domain, specifically cognitive products, information processing, cognitive change, and the impact of affective and motivational factors on cognitive processes, is described and related to the social cognitive approach. Implications for future research and clinical practice are discussed in light of the major issues and problems highlighted in our review.

Rape and rapists: theory and treatment.

The sexual assault of adult women is noteworthy by its huge social and personal cost to the victims, their families, and ultimately society as a whole. The past decade has seen burgeoning research and clinical interest regarding child molesters but a lack of equivalent effort concerning rapists. Rapists are significantly different from child molesters. While considerable heterogeneity exists within this group, there is a lack of distinctiveness when compared to the wider population of serious criminal offenders. These two features of rapists have implications both for research and treatment. We also argue that despite the advances of the last decade this has been in terms of theory proliferation rather than integration, and that major explanatory gaps remain. In particular, there is a need for more middle-level theory that articulates mechanisms and can underpin treatment. Current treatment approaches have typically been developed for child molesters, and while there has been a significant increase in comprehensiveness and sophistication, the evidence for treatment efficacy with rapists remains tentative. Treatment programs need to be tailored to the specific needs of rapists and to the issues of treatment engagement and completion. We conclude with a variety of suggestions for the research agenda over the next decade.

The abstinence violation effect in child molesters.

The reformulation of the abstinence violation effect (AVE) is briefly described together with the empirical support for the construct. Twenty-six incarcerated male child molesters were assessed, using the Differential Emotions Scale and the Attributional Dimension Scale, at three points (high-risk, lapse, and relapse) while they listened to an audiotaped recording of a description of their most typical offense chain. Eighteen Ss experienced an AVE at the point of relapse and 7 as a result of lapse. There were significant increases in most negative emotions and decreases in interest over the relapse chain. There were significantly higher disgust, contempt, hostility, fear, shame, shyness and anger scores reported by those showing an AVE. Conversely, the AVE group showed significantly lower scores for joy and surprise. There were no significant differences on any of the 4 attributional dimensions across the relapse process but those showing an AVE reported significantly more uncontrollability and higher stability scores. The significance of these results for clinical practice are discussed.

The abstinence violation effect in bulimia nervosa.

Bulimia nervosa often follows a chronic and relapsing course. To understand relapse in this disorder, we highlight cognitive processes underlying the binge/purge cycle. Links are drawn between cognitions, causal perceptions, and the binge/purge cycle in a reformulation of the abstinence violation effect with a special focus on attributions. This reformulation is then applied to the lapse-relapse transition in bulimia nervosa. Finally, theoretical and clinical implications of the reformulation are presented.

Micromechanics of bone strength and fracture.

The mechanical properties of bone were modeled in the context of a filled polymeric composite containing a collagenous matrix and a hydroxyapatite filler. The longitudinal and transverse moduli of cortical bone as a composite with perfect alignment of filler particles were calculated to be 34.5 and 5.3 GPa, respectively. When considering that particle orientation is arranged within a distribution about the long axis, moduli close to the experimentally measured values are achieved. The calculated tensile strength of 1.7 GPa is higher than the experimental values, which may be attributable to intrinsic sample flaws and biological heterogeneity. The mode of tensile failure in this model is particle-matrix debonding, which may explain fatigue or stress fractures. Overall, the filled composite model of bone helps explain the roles of mineralization fraction, particle shape and orientation, and other attributes of the constituent phases in understanding the tensile properties. The fundamentals of bone behavior in compression are less well understood. It is proposed that incorporation of an inorganic phase in bone was teleologically necessary for vertebrates to achieve adequate levels of compressive strength.

The abstinence violation effect in sex offenders: a reformulation.

It is argued that the central issue in the treatment of sexually aggressive behavior is the tendency to relapse shown by offenders. A model of the relapse process is presented along with what is described as its central feature, the abstinence violation effect (AVE). This construct is critically examined and its shortcomings identified. A brief description of Weiner's attributional theory is provided and this is used to reformulate the AVE. The advantages of the reformulated AVE are described, as are the clinical implications. Suggestions are then made for future research.

The effects of masturbatory reconditioning with nonfamilial child molesters.

Abel and Annon's (Reducing deviant sexual arousal through satisfaction, Denver, Colo., 1982) suggested combination of 'directed masturbation' and 'satiation' to alter deviant sexual preferences, was applied to 10 nonfamilial child molesters. Post-treatment assessments revealed significant reductions in deviant arousal as was expected, but unfortunately there were also reductions in appropriate arousal although these changes did not achieve statistical significance. The results are discussed in terms of their meaning but it is concluded that empirical support for these clinically popular procedures remains weak.

Premenstrual syndrome in hysterectomized women: mood and physical symptom cyclicity.

In 36 hysterectomized women presenting with PMS, a daily record of eight mood states and five physical symptoms was kept during 109 ovarian cycles. Premenstrual tension (PMT) was estimated at a point 92% through the ovarian cycle after fitting a five-term Fourier series to the data. Although significant mood and physical-symptom swings were common (present in 71% and 69% of cycles respectively), the incidence of symptoms late in the luteal phase (PMT) was low (36%). In nine women no PMT was detected, in twenty-two women PMT was sporadic, and in five there was evidence of the consistent appearance of both mood and physical symptom-related PMT. Symptoms clustered significantly around a point 85% through the ovarian cycle for moods, and 83% for physical symptoms; this differs significantly from the 92% observed in menstruant women with PMS and is consistent with the removal of a factor associated with menstrual onset, which may contribute to the symptoms perceived by women as PMT.

Behavior management of infant sleep disturbance.

Using a nonconcurrent multiple baseline design, we evaluated the effects of extinction and stimulus control on nighttime sleep disturbances exhibited by 7 infants. Results showed that frequency and duration of night wakings decreased for all subjects, with corresponding improvements reflected through changes in responses to the sleep behavior scale. Observed improvements maintained at 3 and 24 months posttreatment.

Assessment of the significance and severity of premenstrual tension--I. A new model.

A method is proposed for analysing daily mood scores for premenstrual tension (PMT) in single menstrual cycles by fitting an approximation function consisting of the first two harmonics of a Fourier series. On the basis of harmonic analysis of 133 cycles of daily mood scores obtained from women perceiving themselves to have the premenstrual syndrome (PMS), the severity of PMT is taken to be the difference between the mean and the fitted function at a point 92% of the way through the menstrual cycle. The significance of the severity is calculated statistically. Significant PMT was detected in 70% of the 133 cycles; this compared with an 8% incidence in women who considered that they did not have PMS. The method improves on previously described methods for detecting PMT by: (1) using statistical criteria; (2) modelling cycles with asymmetric and double peaks; (3) using a difference rather than a ratio as the severity estimate; (4) smoothing the data and (5) giving valid estimates when data points are missing. There was no evidence for the presence of distinct periodicities with wavelengths less than half that of the menstrual cycle.

The premenstrual syndrome: selection of women for treatment trials.

Statements made at interview by 31 women presenting with the premenstrual syndrome (PMS) were compared with the moods and physical symptoms reported daily during the next 6 menstrual cycles. Diagnosis was confirmed in 21 women (premenstrual tension (PMT) present in greater than or equal to 5/6 cycles), not substantiated in two (PMT in less than or equal to 1/6 cycles) and in doubt in eight. Placebo treatment was associated with a significant over-all reduction in both the incidence and the severity of mood-related PMT, but had no clear effect on premenstrual physical symptoms; women with PMT in 5 cycles were usually placebo-resistant. Criteria are proposed for the selection of women for treatment trials based on their response to placebo.

Serological assessment of rubella during pregnancy.

In 45 patients with rubella-like illnesses during pregnancy serological tests showed that the clinical diagnosis had been accurate in only 20. Since only 16 of these patients had presented for laboratory investigations within a week of the onset of symptoms, the value of haemagglutination-inhibition tests was considerably reduced; the diagnosis in these cases was confirmed by complement-fixation and rubella-specific IgM tests.Of 172 patients exposed to a rubella-like illness, only 17 were seronegative; 105 sought advice within two weeks of exposure, and therefore the haemagglutination-inhibition antibody tests were useful in determining immunity. Since the clinical diagnosis of rubella was proved incorrect in a number of cases, these pregnancies were saved. Hence both doctors and patients should report both exposure to and rubella-like illnesses as early as possible, so that laboratory investigations may be carried out without delay.