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Results for “Coercion”

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PubMed2007

The impact of sexual coercion on psychological, physical, and sexual well-being in a representative sample of Australian women.

It is well established that, compared to other women, women who have been forced or frightened into unwanted sexual activity have poorer psychological, physical, and sexual health. However, it is not clear whether particular experiences of sexual coercion, such as younger age when coerced or number of times coerced, are more likely to lead to poorer health status. This study of a representative sample of Australian women aged 16-59 years was designed to examine such associations. Of the 9134 women recruited for the study, 885 (21%) had been sexually coerced, which was defined as being forced or frightened into unwanted sexual activity. This study showed that any experience of sexual coercion was associated with poorer psychological, physical, and sexual health. The data revealed no consistent associations between health status and particular characteristics of sexual coercion, such as the age when women were coerced, the number of times they had been coerced, or the time since being coerced. Two of the few significant findings were that women who had been coerced more than once reported significantly greater psychosocial distress, and that women first coerced when aged 13-16 reported poorer physical well-being than women first coerced at younger or older ages. There was no significant association between whether women had consulted a psychologist or other professional counselor and better health status. The absence of consistent associations between health status and particular characteristics of sexual coercion indicates a need for care and support services for all women who have been sexually coerced.

Adolescent↗

PubMedDate not supplied

Perceived coercion and need for hospitalization related to psychiatric admission.

Psychiatric hospitalization constitutes a moment of major stress to the point that occurrences of posttraumatic stress disorders have been described. Feelings of coercion are usual, whatever the legal status of admission. Patients may also consider afterwards that they needed hospitalization even if they refused it initially. A cross-sectional survey has been conducted among the inpatients of a Swiss psychiatric hospital to assess their subjective view of admission with emphasis on legal status, perceived coercion and need for hospitalization. Eighty-seven questionnaires were completed and analyzed. Results indicated that 74% of patients felt that they had been under pressure to be hospitalized, whether or not they were involuntarily admitted. Seventy percent felt their admission was necessary. More involuntary patients reported a subjective lack of improvement. Clinicians could decrease feelings of coercion of their patients while discussing need for hospitalization, legal status and subjective feeling of coercion as different dimensions. An argument is presented to favor positive pressure from social environment over legal involuntary commitment in many hospitalizations.

Acute Disease↗

PubMed2004

The relationship of legal coercion to readiness to change among adults with alcohol and other drug problems.

Prior research on legally coerced treatment for substance abuse tends to find no difference between coerced and non-coerced clients with respect to treatment retention and treatment outcomes. There is less known about the relationship between coercion and a client's motivation to change. We considered the relationship of legal coercion and readiness to change among 295 consecutive admissions to five publicly funded outpatient treatment programs. A logistic regression analysis indicated that legal coercion was associated with greater readiness to change after controlling for addiction severity, prior treatment history, and gender. Persons entering treatment due to legal coercion were over three times more likely to have engaged in recovery-oriented behavior in the month preceding admission. Entering treatment more prepared to benefit from the experience could contribute to outcomes that are more positive.

Adult↗

PubMed2000

Coercion and restrictions in psychiatric inpatient treatment.

To find out to what extent coercion and restrictions are used in psychiatric inpatient treatment and with which patient characteristics the use of coercion is associated. To this end, the hospital records of 1,543 admissions (six-month admission samples) to the psychiatric clinics in three Finnish university towns were evaluated by retrospective chart review. The study clinics provide all psychiatric inpatient treatment for the working-age population in their catchment areas. Use of coercion and restrictions was recorded in a structured form. Coercion and restrictions were applied to 32% of the patients. Mechanical restraints were used on 10% of the patients, and forced medication on 8%. Compared to international statistics the figures in the current study are high.

Adolescent↗

PubMed2001

Experiences of coercion in psychiatric care as narrated by patients, nurses and physicians.

AIM: The aim of the study was to increase understanding of psychiatric patients', nurses' and physicians' experience of coercion, in relation to their own and the other parties' experiences. METHODS: Seven triads of patient, nurse and physician narrated their experiences of the same coercive event. The 21 interviews were analysed focusing on narrative elements. RESULTS: The nurse and physician narratives revealed that they felt unable to connect with the patients, while the patients told us that they wanted more human contact with nurses and physicians. All three parties expressed the belief that interpersonal relationships and the human contact were important. The nurses and physicians stated that knowing the patient made them feel easier about using coercion and that their actions were less violating for the patient. The patients stated that human contact alleviated their feeling of discomfort and made them feel more secure when subjected to coercion. CONCLUSION: The salient aspect described by all three parts was the importance of human contact and having a mutual relationship. These findings indicate a need for more dialogue between patients and staff. The dialogue should aim at making staff understand patients' feelings better regarding coercion and at informing the patients about the coercive measures.

Adult↗

PubMed2005

Opening up: psychiatric nurses' experiences of participating in reflection groups focusing on the use of coercion.

Psychiatric staff report that the use of coercion towards patients in psychiatric care engenders feelings of discomfort and conflicts. The aim of this study was to describe psychiatric nurses' experiences of participating in reflection groups focused on the use of coercion, in relation to their views regarding systematic clinical supervision and staff support. Twenty-one nurses who had participated in reflection groups were interviewed retrospectively. The structured interview focused on: (i) their views of clinical supervision and support in general; (ii) their views of clinical supervision and support specifically concerning the use of coercion; and (iii) their experiences of participating in groups reflecting the use of coercion. Nurses were largely positive about participating in reflection groups, as expressed in the subthemes: having time for reflection; being confirmed; gaining new perspectives; sharing fellowship with colleagues; and relating more effectively to patients. Complications concerning participation in the reflection groups and other forms of clinical supervision as reported by nurses were: providing time for participation; having a common aim; being vulnerable in difficult situations; and assuming that the need for supervision and support could indicate that they were not coping with their job.

Adult↗

PubMed2003

Perceived coercion and treatment adherence in an outpatient commitment program.

The authors investigated whether mental health inpatients' perceptions of coercion were associated with postdischarge treatment adherence. Patients eligible for New York's outpatient commitment program were interviewed and their perceptions of coercion measured during hospitalization and at one, five, and 11 months after discharge. Medication and clinical treatment adherence were measured at the three postdischarge interviews. Among the 117 participants who completed at least one follow-up interview, higher perceived coercion scores were correlated with greater self-reported adherence to clinical treatment at the one-month follow-up but not with participants' greater self-reported adherence at subsequent follow-ups or with providers' ratings of participants' adherence. Perceived coercion scores were positively correlated with participants' self-reported adherence to injected medications.

Aftercare↗

PubMed2005

Justifying coercion.

A grounded theory study of psychiatric nurses' experiences of administering medication to involuntary psychiatric patients revealed a basic social process of justifying coercion. Although the 17 nurses interviewed all reported success at avoiding the use of coercion, each had an individual approach to using the nurse-patient relationship to do this. However, all the nurses used the same process to reconcile themselves to using coercion when it became necessary. This has three stages: assessment of need; negotiation; and justifying and taking coercive action. Two critical junctures--decision to engage and impasse - determine the progression from one stage to the next. The process of justifying coercion allows a nurse to engage in behavior generally disapproved of while retaining a self-image of a 'good' nurse.

Adaptation, Psychological↗

PubMed2002

[Use and registration of coercion in psychiatry in the new millennium].

INTRODUCTION: The Danish Mental Health Act of 1989 emphasized that the use of coercion should be recorded. The National Board of Health has published statistics on this issue since 1990. This study investigates the use of coercive measures at all Danish psychiatric departments from 1990 to 1998. MATERIAL AND METHODS: The official statistics published by The National Board of Health was collected and analyzed. RESULTS: There was an increase in the use of forced medication and mechanical restraint. No increase was found in the use of involuntary commitment or detention. DISCUSSION: Some of the increase found as regards forced medication and mechanical restraint could be due to problems in recording the correct number of episodes. The Mental Health Act does not take into account problems concerning elderly with dementia. Extralegal coercion or hidden coercion can take place outside a psychiatric ward, for instance in nursing homes or somatic departments. More empirical studies in this area are needed before the decision to record extralegal coercion is taken.

Coercion↗

PubMed2005

[Coercion in psychiatry: current knowledge and perspectives].

Coercion is still frequently used in psychiatry and tends to be considered a necessity, when a patient at risk has lost his/her ability to judge. The aim of this article is to report and discuss current scientific knowledge on this topic. The different steps associated with coercion contribute, along with the illness, to the degree of stress experienced by the patient and might compromise his/her level of adherence to the treatment offered. Clinicians need to consider three dimensions: the coercion applied, the legal status and the subjective feeling of coercion. Pressure that is symbolically negative, positive or legal is exerted on the patients, thereby raising questions about the development of alternatives to the use of coerced treatment. The introduction of the advance directives to Swiss cantonal laws could give rise to different forms of collaboration that are more acceptable to patients.

Coercion↗

PubMedDate not supplied

[Does contemporary pharmacotherapy limit coercion in psychiatry? Preliminary results].

AIM: The goal of the present study was to examine whether contemporary psychopharmacotherapy (atypic neuroleptics) can have an impact on the patient's compliance and limit coercion (involuntary admission to hospital, coercive measures). METHOD: 71 adult inpatients with diagnoses of the schizophrenia spectrum (F20 group according to ICD-10) admitted to psychiatric hospital were observed. 41 of them were treated with atypic neuroleptics before hospitalization and 30 with typical ones. Data about their pharmacotherapy before hospitalization, compliance, history of disease and coercion used during hospitalization were gathered and analysed by means of chi square Pearson's and Mann-Whitney's tests. RESULTS: There were no significant differences in non-compliance, the type of admission to hospital and frequency of coercion measures used during hospitalization between groups of patients receiving atypic and typical antipsychotics. However, the group with atypic neurolepitics was nearly significantly more adherent to therapy than the typical ones. CONCLUSIONS: Results of the study did not confirm the impact of atypic neuroleptics on compliance and coercion connected with admission to hospital. A long-term study with an increased number of patients is needed to confirm the results of this study.

Adult↗

PubMed1979

The effect of constructive coercion on the rehabilitative process. A study of the employed alcoholics in an alcoholism treatment program.

Two groups of employed men in an alcoholic rehabilitation program--one referred through an organized policy of constructive coercion and the other volunteer--were compared to test the efficacy of constructive coercion in the rehabilitation process. It was found that the patients referred by constructive coercion were younger, had fewer psychosocial problems, had a higher percentage who were abstinent and had higher rates of compliance with follow-up. A policy of constructive coercion allows earlier identification of workers with alcohol problems and improves the chances for a positive treatment outcome.

Adult↗

PubMed1997

Sexual coercion in gay/lesbian relationships: descriptives and gender differences.

A sample of 162 gay males and 111 lesbians (N = 273) completed a survey measuring the frequency of sexually coercive acts occurring within gay and lesbian relationships. Several hypotheses were proposed to clarify earlier findings and to explore gender differences in the data. Contradicting earlier studies' findings that lesbians experience sexual coercion at higher rates than gay men, the results of this study suggest lesbians are not more likely than gay men to be classified as victims of sexual coercion. Gay men also were found to experience a significantly higher mean number of coercive experiences. Other analyses specific to the type of coercion experienced and the severity of the sexual coercion outcomes (penetration) revealed no gender differences, however. Limitations and directions for future research are discussed.

Coercion↗

PubMed1998

Perceived coercion related to psychiatric comorbidity and locus of control in institutionalized alcoholics.

One-hundred and four alcoholics, 73 men and 31 women, were treated at Karlsvi Rehabilitation Center between November 1990 and December 1992. Fifty-eight subjects were compulsorily treated and 46 voluntarily treated. Experiences of negatively perceived coercion were assessed in the beginning of treatment and at discharge after 5-6 months by using the semi-structural interview according to Eriksson-Westrin. Locus of control was measured by using the Swedish version of the Rotter-scale for external/internal attribution. Axis I psychiatric comorbidity was assessed according to the Structural Clinical Interview, DSM-III-R (SCID). Ninety-one percent of the compulsorily committed and 56% of the voluntarily admitted subjects reported violations of integrity or negatively perceived coercion during treatment (p < 0.001); women to a higher extent than men (93%/70%, respectively; p < 0.01). At the discharge interview 87% of the compulsorily treated subjects and 52% of the voluntarily treated subjects still reported that the coercive experiences were wrong or violating to personal integrity. Female subjects were less inclined to justify earlier reported coercive examples than male subjects (0%/8%, respectively; p < 0.05). Coercive implementation fait accompli was reported in 70%, persuasion in 21% and threat in 9% of the cases. No experiences of force were reported. Subjects with an internal locus of control reported negatively perceived coercion to a higher extent than subjects with an external locus of control (84%/22%, respectively; p < 0.001). Internally oriented subjects were also less inclined to justify the coercive experiences at the discharge interview than externally oriented subjects (2%/14%, respectively; p < 0.01). Prevalence of psychiatric comorbidity was high (78%). Reports of negatively perceived acts of coercion and locus of control were unrelated to psychiatric comorbidity. Sixty-seven percent of the subjects were homeless. Homelessness was unrelated to locus of control, coercive reports and psychiatric comorbidity.

Adult↗

PubMed1997

Sexual selection in Japanese macaques I: female mate choice or male sexual coercion?

Mate choice is defined as a behavioural pattern in one sex which increases the probability of fertile matings with certain members of the opposite sex. The chosen sex may use force, however, to coerce matings from reluctant members of the choosing sex. In a confined group of Japanese macaques, Macaca fuscata fuscatahoused at the Primate Research Institute of Kyoto University, Japan, behavioural and endocrine data were combined to assess the validity of several mate-choice behaviours and the potential influence of sexual coercion. Preliminary evidence was found for both female mate choice of males and male sexual coercion of females. Both female proximity maintenance towards males and male aggression towards females were correlated with an increase in fertile matings. Most male aggression appeared to be the by-product of increased time spent in proximity due to female proximity maintenance, but some male aggression appeared to be sexual coercion. These results are interpreted in light of recent research on male sexual coercion, and a tentative model of mate choice for this species is proposed.1997The Association for the Study of Animal Behaviour

Journal Article↗

PubMed2005

The difficulty of coercion: a response to de Almeida.

The sentence The secretary began the memo requires specifying what event the secretary began, because the memo does not refer to an event. McElree, Traxler, Pickering, Seely, and Jackendoff (2001) and Traxler, Pickering, and McElree (2002) found evidence from both self-paced reading and eye-tracking that such sentences caused processing difficulty, and thus argued that people "coerced" the object to refer to an event (e.g., writing the memo). de Almeida (2004) reports two self-paced reading experiments that failed to replicate some aspects of previous studies, and thereby argued against coercion during comprehension. A new experiment demonstrates coercion costs using new items, and provides evidence of coercion cost with de Almeida's stimuli. We conclude that coercion does cause processing difficulty.

Cognition↗

PubMed2000

SEXUAL HEALTH, REPRODUCTIVE HEALTH, SEXUAL COERCION, AND PARTNER ABUSE INDICATORS IN A CANADIAN OBSTETRICS AND GYNAECOLOGY OUTPATIENT POPULATION.

OBJECTIVES: to assess prevalence and correlates of sexual health, reproductive health, sexual coercion, and partner abuse in a Canadian obstetrics and gynaecology outpatient population, and to determine whether women who report concerns in these areas have ever discussed them with their physicians. METHODS: a self-administered questionnaire was completed by 409 women (93.8% response rate) attending two hospital-based obstetrics and gynaecology outpatient clinics in a mid-size Canadian city. RESULTS: significant, prevalent, and clinically neglected sexual health, reproductive health, sexual coercion, and partner abuse concerns were reported, including: chronic and troubling dyspareunia (37%), dysmenorrhea (47%), and premenstrual syndrome (57%), infrequent breast self-examination (53%), inconsistent contraceptive use despite the desire not to conceive (41%), inconsistent condom use among those with multiple sexual partners (82%), sexual dysfunction (76% reported at least one sexual function concern), and a history of sexual coercion (23%) and physical partner abuse (19%). Only a small minority of women who reported sexual or reproductive health or sexual coercion or partner abuse concerns had ever discussed these concerns with their physician. CONCLUSION: these findings provide an empirical profile of significant and prevalent, but clinically neglected, women's health concerns. The findings suggest the need for increased clinical attention to the range of problems surveyed.

Journal Article↗

PubMed1999

Sexual Coercion in India: an exploratory analysis using demographic variables.

A 14-item Sexual Coercion Inventory (SCI) was administered to an urban university sample in Western India. Twenty-six percent of the sample reported a total of 160 incidents of sexual coercion ranging in severity from unwanted kissing to sexual intercourse. The most common outcome was intercourse and was followed by kissing and fondling. No gender differences were discovered regarding victim status or types of coercion tactics experienced. A MANOVA analysis found no overall gender effect, but marital status and protected class membership did have a significant effect with people who are married and protected class members reporting more sexual coercion. Reasons for the lack of an overall gender effect and limitations of this research are discussed.

Adult↗