Biomedical subjects

Linda L Marshall

Publications and source records attributed to Linda L Marshall.

4 recordsLinked to original sources

PubMed2005

Physical and mental health outcomes of women in nonviolent, unilaterally violent, and mutually violent relationships.

Despite equivocal findings on whether men or women are more violent, the negative impact of violence is greatest for women. To determine how gender asymmetry in perpetration affects women's health status, we conducted a study in two phases with 835 African American, Euro-American, and Mexican American low-income women in Project HOW: Health Outcomes of Women. In Phase 1, we used severity and frequency of women's and male partners' violence to create six groups: nonviolent (NV), uni-directional male (UM) perpetrator, uni-directional female (UF) perpetrator and, when both partners were violent, symmetrical (SYM), male primary perpetrator (MPP), and female primary perpetrator (FPP). The MPP group sustained the most threats, violence, sexual aggression, and psychological abuse. They also reported the most fear. Injury was highest in the MPP and FPP groups. In Phase 2, we examined group differences in women's health status over time for 535 participants, who completed five annual interviews. Surprisingly, women's health in the MPP and FPP violence groups was similar and generally worse than if violence was uni-directional.

Adult↗

PubMed2004

Childhood and adolescent sexual abuse of community women: mediated effects on psychological distress and social relationships.

Possible mediators of sexual abuse severity were tested on the basis of D. Finkelhor and A. Browne's (1985) traumagenic dynamics model with 178 low-income African American, European American, and Mexican American community women interviewed for Project HOW: Health Outcomes of Women. This subsample reported contact sexual abuse before the age of 18 years. Severity was level of force, number of perpetrators, relationship to perpetrator, and age at first assault. As expected, structural equation modeling showed powerlessness, and stigmatization largely mediated the effects of sexual abuse severity on women's psychological distress in adulthood. Powerlessness also mediated the effects of severity on maladaptive social relationships. The expected path from betrayal to relationships was nonsignificant. Overall, the results support extension of D. Finkelhor and A. Browne's model. Possible interventions are addressed.

Adolescent↗

PubMed2002

Cross-validation by downweighting influential cases in structural equation modelling.

In the social and behavioural sciences, structural equation modelling has been widely used to test a substantive theory or causal relationship among latent constructs. Cross-validation (CV) is a valuable tool for selecting the best model among competing structural models. Influential cases or outliers are often present in practical data. Therefore, even the correct model for the majority of the data may not cross-validate well. This paper discusses various drawbacks of CV based on sample covariance matrices, and develops a procedure for using robust covariance matrices in the model calibration and validation stages. Examples illustrate that the CV index based on sample covariance matrices is very sensitive to influential cases, and even a single outlier can cause the CV index to support a wrong model. The CV index based on robust covariance matrices is much less sensitive to influential cases and thus leads to a more valid conclusion about the practical value of a model structure.

Behavioral Sciences↗

PubMed2002

Extension of the behavioral model of healthcare utilization with ethnically diverse, low-income women.

OBJECTIVE: Psychosocial vulnerabilities were added to a model of healthcare utilization. This extension was tested among low-income women with ethnicity addressed as a moderator. DESIGN: Structured interviews were conducted at 2 points in time, approximately 1 year apart. The constructs of psychosocial vulnerability, demographic predisposing, barriers, and illness were measured by multiple indicators to allow use of Structural Equation Modeling to analyze results. The models were tested separately for each ethnic group. SETTING: Community office. PARTICIPANTS: African-American (N = 266), Euro-American (N = 200), and Mexican-American (N = 210) women were recruited from the Dallas Metropolitan area to participate in Project HOW: Health Outcomes of Women, a multi-year, multi-wave study. Face-to-face interviews were conducted with this sample. Participants had been in heterosexual relationships for at least 1 year, were between 20 and 49 years of age, and had incomes less than 200% of the national poverty level. MAIN OUTCOME MEASURES: Healthcare utilization, defined as physician visits and general healthcare visits. RESULTS: Illness mediated the effect of psychosocial vulnerability on healthcare utilization for African Americans and Euro-Americans. The model for Mexican Americans was the most complex. Psychosocial vulnerability on illness was partially mediated by barriers, which also directly affected utilization. CONCLUSIONS: Psychosocial vulnerabilities were significant utilization predictors for healthcare use for all low-income women in this study. The final models for the 2 minority groups, African Americans and Mexican Americans, were quite different. Hence, women of color should not be considered a homogeneous group in comparison to Euro-Americans.

Adult↗