Improving safer sex measures through the inclusion of relationship and partner characteristics.

This article describes the development of a safer sex algorithm, which considers the characteristics of a woman's relationship and the HIV risk profile of herself and her primary partner. A sample of 306 low-income, predominantly African American women was recruited to participate in a study of the effectiveness of a sexual health seminar. These women were interviewed three times, at one month prior to seminar administration, three months after the seminar and again nine months after the seminar. Data from these women indicate that using an algorithm that considers the probability of HIV transmission between partners decreases the measured prevalence of unsafe sex in this population by about 17% and lowers the estimate of the average number of unsafe incidents by about four incidents in three months. The algorithm results in measures with adequate levels of temporal stability, which are similar to the more commonly used measure, vaginal or anal intercourse without a condom.

Sexual preference for child and aggressive stimuli: comparison of rapists and child molesters using auditory and visual stimuli.

154 Ss were tested using penile plethysmography as part of intake into a voluntary inpatient sex offender treatment program. The testing protocol included slide stimuli of nude males and females in four age categories ranging from age 1 to adult; audiotaped descriptions of sexual activity with children of both genders which included fondling, sexual contact with no resistance, coercive sexual contact, sexual assault, nonsexual assault, and consensual sexual contact with an adult; videotaped depictions of rape of an adult woman, nonsexual assault of an adult woman and consensual sexual involvement with an adult woman, and audiotaped descriptions that paralleled the videotapes. The results indicated that child molesters (male victim) show a decidedly more offense related arousal profile than either child molesters (female victim) or rapists, and that the profiles of child molesters (female victim) and rapists are remarkably similar, although statistically significantly different from each other. Rapists respond significantly more to rape and nonsexual assault than either of the two child molester groups, with child molesters with female victims responding more than those with male victims. In all three groups, the highest level of noncoercive adult responding was to women, with differences among offense groups present for visual stimuli, but not in response to auditory stimuli. Overall, the patterns of results are similar whether they are based on composites across stimulus modality or on the individual stimuli.

The utility of the Megargee-Bohn typology in a forensic psychiatric hospital.

The utility of the Megargee-Bohn MMPI typology (Megargee & Bohn, 1979) was examined in 1007 male forensic psychiatric inpatients. The 10 profile types were identified although the proportions differed as expected from the original sample. Comparison of demographic, clinical, and forensic characteristics revealed significant differences between 9 of the profile types. Our findings indicate that the typology can reliably and usefully describe different categories of patients in our setting. The typology can also be used to make inferences about treatment needs. Our findings support the continued development of an MMPI-based actuarial system for criminal populations as has been done for psychiatric populations.

Ethnic differences on the MMPI Overcontrolled-Hostility Scale.

The effects of race and the validity of Megargee, Cook, and Mendelsohn's (1967) Overcontrolled-Hostility (O-H) Scale were examined using 412 male forensic psychiatric inpatients. Regression analysis using the total study sample indicated that the only predictor of O-H score was race, with Black patients scoring higher than White patients. In fact, Black patients scored at least 5 T scores higher than the White patients, and approximately 43% of the Black patients received O-H scores greater than 69. The race effect could not be explained by prehospitalization employment status or education. Pattern of criminal history and clinical problems were examined via analyses of variance (ANOVAs) in a subsample of 224 subjects. None of the descriptors of the overcontrolled-hostile personality were identified as related to O-H scores. The results of this study suggest that Black patients are more likely to be incorrectly labeled as overcontrolled-hostile personalities.

The self-concept of homeless adolescents.

Thirty adolescents who had lived away from home for at least six months were compared on self-concept with 120 adolescents living at home. The latter group was divided into equal numbers of adolescents who were employed, unemployed, school students, and college students. The Offer Self-image Questionnaire for Adolescents was used to measure self-concept. Other measures used were the Beck Depression Inventory, the Hopelessness Scale of Beck et al.,and the Rotter Internal External Locus of Control Scale. These were used to examine the relationship between deficits in self-concept and psychopathology. Environmental factors such as family relationships, employment, school achievement, and friendships were also examined. It was found that homeless adolescents demonstrated significant deficits in five areas of self-concept and a specific pattern of deficits was related to hopelessness. Results were discussed with reference to the theory that acting-out behavior mitigates the impact of affective disturbance on self concept.

Caffeine intakes of children from a biracial population: the Bogalusa Heart Study.

To investigate caffeine intake patterns in children, dietary intakes were examined for a biracial sample of 1,284 infants and children. Twenty-four-hour dietary recalls were completed by parents of children aged 6 months and repeated at ages 1, 2, 3, and 4 years; children 10 years old served as their own respondents and were surveyed at ages 13, 15, and 17 years. The sample was 60% white and 40% black. Additional cohorts of 10-year-olds (no. = 686) were studied for temporal trend. Whites consumed significantly more caffeine than blacks as early as 1 year and persisted at a higher intake level from 2 to 17 years. This trend continued whether intake was measured in total milligrams, milligrams per 1,000 kcal, or milligrams per kilogram body weight. Significant sex differences in caffeine intakes per 1,000 kcal occurred among 15- and 17-year-olds (girls greater than boys). Peak periods of consumption occurred at ages 2, 3, 13, and 17. Snacks contributed large quantities of caffeine, particularly for 10-year-olds. Most frequent sources of caffeine were regular carbonated beverages, chocolate-containing foods, and tea. Mean intakes of caffeine for 10-year-olds were consistent from 1973 to 1982. Those observations document caffeine intakes beginning early in life.

Characterization of a comprehensive type A measure for children in a biracial community: the Bogalusa Heart Study.

To evaluate the development of Type A-like behavior in children, responses to the Hunter-Wolf Instrument were studied in 2128 children in Bogalusa, Louisiana, a biracial community. Test-retest reliability measures were generated by retesting a random subsample of 387 children 2 weeks after the initial testing. Norms were tabulated for each of the age, race, and sex groups. Increases in total and subscale scores with age were noted except for the Hostility subscale, which decreased dramatically in the older groups. White males had higher average scores during the entire period than other groups and scored significantly higher than other groups on subscales, created from principal-components analysis, measuring Eagerness and Hostility. Low test-retest correlations were observed in children younger than 13 years of age. Of the four race-sex groups studied, white males appear to accrue the highest risk for coronary heart disease from type A-like behavior.

Cardiovascular risk factors and their modification in children.

Normal levels and trends of cardiovascular disease risk factors in childhood have been well documented by numerous epidemiologic surveys. Expected levels of blood pressure, lipids and lipoproteins, and body size can be determined by the child's physician using race- and gender-specific grids. These grids allow for the identification and follow-up of children with high-risk profiles. Evidence of increased left ventricular mass and vascular changes in renal arteries in association with childhood blood pressure level along with atherosclerotic fatty streak and fibrous plaque development in the aorta and coronary arteries shows that children with elevated risk factors are at risk for early target organ damage. These data demonstrate the potential importance of early intervention on the natural history of cardiovascular disease. Based on our own data from the Bogalusa population, as well as evidence from other epidemiologic investigations in children, the following recommendations can be made, regardless of the risk factor variable under consideration: Cardiovascular disease risk factor variables should be measured carefully and in a serial manner to classify a child as abnormal. Serial measurements serve to reduce the effect of regression to the mean and increase the predictive value of the measurements. The misclassification of normal children into the high-risk category can be avoided by serial and replicate observations. Interventions that have attendant side effects (for example, pharmacologic therapy for high blood pressure) have to be measured against the effectiveness of diet, exercise, and other aspects of primary prevention. Risk factor levels consistently greater than the ninetieth percentile deserve medical attention. Care should be taken prior to using specific grids of normal levels of cardiovascular disease risk factors in children. The measurement techniques employed on individuals should be similar to those used by the epidemiologic study to generate the grids in a reference population. The grids should become part of the child's permanent medical record, as they provide a rapid visual assessment of the cardiovascular disease risk profile over time. High-risk trackers may require more intensive follow-up and will allow for early intervention and an assessment of the efficacy of the intervention program. In conclusion, cardiovascular disease risk factor screening in childhood is quick, effective, and inexpensive. The potential payoff in prevention of adult cardiovascular disease is enormous and allows the physician to provide more comprehensive care to a pediatric population.