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Results for “Coercion”

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PubMed1998

Organizational features affecting the use of coercion in the administration of psychiatric care.

Historically, the use of coercion in psychiatric hospital admissions, and research on such use, have reflected social circumstances that impact on psychiatric care. Currently, the social emphasis on cost-saving in the U.S. and corresponding shifts in the organization, financing, and management of psychiatric and mental health care, have begun to affect research on the use of coercion in psychiatric admissions. Such research has begun to incorporate hospital organizational dynamics which affect the use of coercion in these admissions. The authors propose that this emphasis should be expanded into a comprehensive research agenda that examines the most pertinent organizational features affecting the use of coercion in psychiatric hospital admissions.

Attitude to Health↗

PubMed1993

Sexual coercion experience and help-seeking behavior of college women.

In a study of 656 college women enrolled in elective health education classes at three midwestern universities, results showed that 42% of the women had been victims of sexual coercion in dating situations while in college. Seventy percent of those who had experienced sexual coercion had intercourse when they did not want to as a result of overwhelming arguments and pressure. Only 28% of the sexual coercion victims sought any type of help. Of those who sought help, 75% sought help from a friend. Because the experience of victimization can disrupt various aspects of women's lives, it is important that victims seek help in their attempts to cope successfully after the sexually coercive event. If campus help providers--administrators, educators, residence hall staff, and health center personnel--are more aware of the incidence and dynamics of sexual coercion, they can be more effective in encouraging college student victims to seek the help they need.

Adolescent↗

PubMed2004

The experience of sexual coercion among young people in Kenya.

CONTEXT: Studies of sexual behavior among young people in the developing world have generally neglected the circumstances in which sex takes place, most often assuming that when young people have sex, it is wanted and consensual. The few published studies on non-consensual sex have often used highly selective samples, ignoring the experience of males and of married young people. METHODS: A 2001 population-based survey of young people in Nyeri, Kenya, included a special module on sexual coercion. Descriptive data and multivariate analysis are used to explore the prevalence and patterns of sexual coercion among married and unmarried males and females aged 10-24. RESULTS: Among the sexually experienced respondents, 21% of females and 11% of males had experienced sex under coercive conditions. Most of the perpetrators were intimate partners, including boyfriends, girl friends and husbands. In a multivariate logistic regression, females who had ever been married and those who did not live with a parent or spouse had a significantly elevated risk of sexual coercion (odds ratios, 2.6 and 3.1, respectively); sexual coercion was associated with having had multiple sexual partners and with having had a reproductive tract infection (2.2 and 2.5). Males who had been coerced into sex were significantly more likely than those who had not to have had a first partner who was older by at least five years (82.9). CONCLUSION: Reproductive health programs for young people need to address non-consensual sex, including the special needs of males and of married females.

Adolescent↗

PubMed2002

Prevalence of wife rape and other intimate partner sexual coercion in a nationally representative sample of women.

This article provides a national estimate of wife rape and various other types of sexual coercion by a spouse or intimate partner. Findings from a 1997 national probability sample revealed that 34% of women were victims of some type of sexual coercion with a husband or partner in their lifetime. Of these women, 10% experienced rape by a current partner. This rate increased to 13% when only victims of rape by a current husband were included, which is consistent with previous studies on wife rape. Other findings reveal that women had unwanted sex with a current spouse or partner in return for a partner's spending money on them (24%), because they thought it was their "duty" (43%), after a romantic situation (29%), after the partner begged and pleaded with them (26%), and after their partner said things to bully them (9%). The importance of examining a continuum of sexual coercion is discussed and findings are compared and contrasted with other prevalence rates for sexual coercion in marriage.

Adolescent↗

PubMed1997

[Patients' evaluation of coercion in a psychiatric department. Interview studies in psychiatric departments for adult patients at the Hillerød hospital].

During an 11 month period, use of coercion was prospectively registered in a psychiatric department. Of all patients who had been subjected to coercion 36% were (n = 86) interviewed subsequently. Eleven percent of the interviewed patients did not know, that they had been submitted to coercion, 22% did not know the reason and 30% did not agree with the motivation for the decision. Forty-seven percent were satisfied with the information they had been given concerning how to complain of their treatment, 50% were satisfied with their adviser and 70% were satisfied with their overall admission. Sixty-five percent accepted that there should be a law allowing the use of coercion in psychiatry.

Adult↗

PubMed1993

Patient, family, and staff perceptions of coercion in mental hospital admission: an exploratory study.

Little is known about the coercive pressures brought to bear on psychiatric patients in the hospitalization process. Significant methodological hurdles stand in the way of this research. Most notably, reliable and valid methods of ascertaining and quantifying perceptions of coercion have not been developed. This report summarizes the findings of an exploratory study designed to gather data needed to refine the conceptualization and measurement of coercion. Multiple perspectives on admission incidents for forty-three patients (26% of whom were involuntarily hospitalized) were obtained. Patients were administered research interviews and completed a self-administered inventory shortly after the admission decision. The admitting clinician and a family member involved in the admission were administered parallel interviews. In addition, focus groups comprised of outpatients, former patients, family members, and clinical staff were conducted to uncover the terminology and description of coercion commonly used. The implications of these preliminary quantitative and qualitative findings for future research are discussed.

Adult↗

PubMed2006

Time-course of semantic composition: the case of aspectual coercion.

We examine the time-course of semantic structure formation during real-time sentence comprehension. We do this through the lens of aspectual coercion, a semantic combinatorial operation that lacks morpho-syntactic reflections, yet is indispensable for sentence interpretation. We describe two experiments. Experiment 1 replicates the results of a previously published study (Piñango, Zurif, & Jackendoff, Journal of Psycholinguistic Research, 28(4), 395-414 1999) showing that the cost of implementing aspectual coercion is detectable as late as 250 ms after the operation is licensed. Experiment 2 expands the window of observation by revealing that the implementation of aspectual coercion is not detectable immediately upon its being licensed, that is, at the point at which the syntactic representation is assumed to be fully formed. These findings suggest a dissociation in the integration of information, in which semantic composition--even mandatory and automatic semantic composition-takes time to develop after it is syntactically licensed to do so.

Coercion↗

PubMed2006

Intimate partner violence and sexual coercion among pregnant women in India: relationship with depression and post-traumatic stress disorder.

BACKGROUND: Intimate partner violence (IPV) is prevalent in most parts of the world. It is also prevalent during pregnancy. METHODS: This study assessed the prevalence of IPV during pregnancy and evaluated its relationship with mental health outcomes, including depression and post-traumatic stress disorder (PTSD). Pregnant women (n=203) attending an antenatal clinic in a public hospital in Bangalore were assessed for presence of IPV as well as depressive, somatic, PTSD symptoms and life satisfaction. RESULTS: Self-reported physical violence in the last year was reported by 14% of women, psychological abuse by 15%, and sexual coercion by 9%. One-half of these women reported ongoing abuse during pregnancy. Depression, somatic, and PTSD symptoms were higher in those with a history of abuse or sexual coercion, and life satisfaction was poorer in those with any form of violence. Among those reporting a history of sexual coercion, severity of violence was related to increased psychiatric morbidity. Alcohol abuse in the spouse was a predictor of the presence and severity of abuse. LIMITATIONS: The study was conducted in a single clinic in southern India which is a large country with very diversified populations. CONCLUSION: The experience of intimate partner violence and its mental health consequences are quite prevalent in India which is a culture where gender disparities are normative and pregnancy is a particularly vulnerable period.

Adolescent↗

PubMed1998

How people get into mental health services: stories of choice, coercion and "muddling through" from "first-timers".

Previous work examining how individuals enter mental health treatment comes either from the health services utilization tradition, which implicitly assumes that clients make decisions to seek care, or from the socio-legal perspective, which examines how clients are forced into care. This paper draws from the Network-Episode Model to systematically consider the different social processes through which people come to enter psychiatric treatment by exploring the "stories" told by individuals making their first major contact with the mental health system. We combine the use of qualitative and quantitative methods to examine data from the Indianapolis Network Mental Health Study, a longitudinal study of individuals in treatment at the largest public and voluntary facilities in the city. We analyze detailed self-reports of how they came to use mental health services, classifying these stories as "choice," "coercion," or "muddling through". Using multinomial logit analyses, we examine how factors such as gender, race and diagnosis shape the types of stories that individuals tell. The preliminary results indicate that fewer than half of the stories (45.9%) match the notion of choice underlying the dominant utilization theories. Almost a quarter of respondents (22.9%) report coercion and nearly one-third (31.2%) tell stories that lack a clear agent. Diagnosis and social networks tap differences in how individuals experience entry into care. Individuals diagnosed with bipolar disorder or who have larger, closer social networks are more likely to tell stories of coercion. We discuss the theoretical, methodological, and clinical implications of findings drawn from this examination of clients' stories.

Adult↗

PubMed1999

Factors associated with coercion in entering treatment for alcohol problems.

Although the importance of coercion in entry to treatment for alcohol problems is recognized, few studies have focused on different types and levels of coercion among heterogeneous groups of clients entering treatment agencies. This paper describes demographic and problem characteristics associated with various sources and levels of coercion. More than 40% (n = 377) of individuals entering a representative sample of a county's HMO, public, and private indemnity-based non-DUI alcohol treatment services (n = 927) indicated they received an ultimatum to enter treatment from at least one person. The most common source of an ultimatum to enter treatment was from family members (n = 222), followed by the legal system (n = 78), and healthcare professionals (n = 55). Respondents experiencing pressure to enter treatment reported that ultimatums from more than one source were common. Individuals entering treatment who were most likely to report being coerced were white, young adults (age 18-39), and married or living with a partner. When controlling for demographic characteristics and problem severity, family problem severity and legal problem severity predicted having received an ultimatum to enter treatment. Alcohol and drug problem severity were not related to receiving a treatment ultimatum.

Adolescent↗

PubMed2003

The contribution of parents and siblings to antisocial and depressive behavior in adolescents: a double jeopardy coercion model.

A dual coercion model of family processes associated with the development of antisocial and depressive behavior during adolescence was assessed, using an at-risk sample of families and children. Consistent with the model, involvement in family coercion during childhood and adolescence increased both boys' and girls' risk for antisocial behavior in adolescence and girls' risk for depressive behavior. Coercive family processes served as a link between older and younger siblings' antisocial behavior. Childhood exposure to maternal depression predicted boys' and girls' depressive behavior 10 years later, but this association was not mediated by coercion. The data suggest that family risk factors and processes for antisocial development are similar for boys and girls but pathways to depression may be gender specific.

Adolescent↗

PubMed1997

The validity of mental patients' accounts of coercion-related behaviors in the hospital admission process.

Although the recent development of a measure for perceived coercion has led to great progress in research on coercion in psychiatric settings, there still exists no consensus on how to measure the existence of real coercive events or pressures. This article reports the development of a system for integrating chart review data and data from interviews with multiple participants in the decision for an individual to be admitted to a psychiatric hospital. The method generates a "most plausible factual account" (MPFA). We then compare this account with that of patients, admitting clinicians and other collateral informants in 171 cases. Patient accounts most closely approximate the MPFA on all but one of nine dimensions related to coercion. This may be due to wider knowledge of the events surrounding the admission.

Adult↗

PubMed2006

Initiation, desistance, and persistence of men's sexual coercion.

Patterns of sexually coercive behavior were examined among 266 Asian American and 299 European American men over 1 year. Noncoercer (n = 358), desister (n = 120), initiator (n = 39), and persistent (n = 48) sexually coercive groups were identified. The strongest predictor of sexual coercion was past sexual coercion. Persistent sexual coercers were higher than the other groups in delinquency and hostile masculinity and were nearly twice as likely to engage in laboratory sexual harassment. Loss of face attenuated self-reported sexual coercion and laboratory sexual harassment risk among Asian Americans and attenuated only laboratory sexual harassment risk among European Americans. These findings suggest that the heterogeneity of sexually coercive behavior and ethnicity are important research and clinical considerations.

Adult↗

PubMed2004

Coercion in psychiatric care - patients' and relatives' experiences from four Swedish psychiatric services.

The aim of this study was to explore possible regional differences in the use of coercion in psychiatric care as experienced by patients and relatives. At four psychiatric care settings in different parts of Sweden, 138 committed and 144 voluntarily admitted patients were interviewed at admission using the Nordic Admission Interview. At discharge or, if the care episode was still ongoing, after 3 weeks of care, a follow-up patient interview and an interview with 162 relatives of these patients took place. In one of the centers, where involuntarily admitted patients were treated without locking the doors of the wards, the patients reported less coercion at admission than in the other three centers. Regarding the patients' reports of the use of coercive measures, personal treatment and outcome of care, and concerning the relatives' experiences, few differences were found between centers among committed and voluntarily admitted patients, respectively. Coercion in psychiatric care, as reported by patients and relatives, was not always legally based, and many of the patients reported they felt violated during the admission process. Only a minority of patients and relatives reported participation in treatment and care planning, as regulated by law. Still, a majority of both committed and voluntarily admitted patients reported they had been well treated by the personnel at admission as well as during the stay at the ward, and that they had been improved in their mental health after the psychiatric care episode.

Coercion↗

PubMed2003

Factors associated with probation officers' use of criminal justice coercion to mandate alcohol treatment.

Alcohol problems are widespread among individuals in county criminal justice probation systems. However, it is unclear why only a small fraction of these problem drinkers receive treatment. In this study, self-administered questionnaires were mailed to 145 probation officers in nine California counties to identify factors that predicted probation officers' use of coercion to mandate alcohol treatment. The questionnaire measured characteristics of probation officers, characteristics of their caseloads, and perceptions about their departments. Principle components analysis combined some of the items into six factor-based scales. Multiple regression analyses identified two significant predictors of use of coercion into treatment: a belief that treatment was effective and a belief that one's peers in the department were using coercion frequently. Implications for increasing treatment entry of probationers with drinking problems include educating probation officers about the effectiveness of substance abuse treatment in general and about coerced treatment in particular. Probation departments are encouraged to develop management styles that facilitate shared normative beliefs about assessing and managing alcohol problems among probationers.

Adult↗

PubMed2006

Social control and coercion in addiction treatment: towards evidence-based policy and practice.

BACKGROUND: Social pressures are often an integral part of the process of seeking addiction treatment. However, scientists have not developed conclusive evidence on the processes, benefits and limitations of using legal, formal and informal social control tactics to inform policy makers, service providers and the public. This paper characterizes barriers to a robust interdisciplinary analysis of social control and coercion in addiction treatment and provides directions for future research. APPROACH: Conceptual analysis and review of key studies and trends in the area are used to describe eight implicit assumptions underlying policy, practice and scholarship on this topic. FINDINGS: Many policies, programmes and researchers are guided by a simplistic behaviourist and health-service perspective on social controls that (a) overemphasizes the use of criminal justice systems to compel individuals into treatment and (b) fails to take into account provider, patient and public views. CONCLUSIONS: Policies and programmes that expand addiction treatment options deserve support. However, drawing a firm distinction between social controls (objective use of social pressure) and coercion (client perceptions and decision-making processes) supports a parallel position that rejects treatment policies, programmes, and associated practices that create client perceptions of coercion.

Attitude to Health↗

PubMed2007

Perceived coercion and change in perceived need for admission in patients hospitalized for eating disorders.

OBJECTIVE: Ambivalence toward treatment is characteristic of eating disorders, and patients are often admitted to inpatient programs under pressure from clinicians, family, friends, educators, or employers. This study evaluated patient perceptions of the admissions process and perceived need for hospitalization and assessed whether these perceptions remain stable in the short term. METHOD: A total of 139 patients with eating disorders completed a 13-item self-report scale on the admission experience when they were admitted to a behavioral inpatient specialty program and again 2 weeks into their hospitalization. RESULTS: Patients with anorexia nervosa reported higher levels of perceived coercion and pressure and a lower sense of procedural justice than did those with bulimia. Patients under 18 (N=35) reported more perceived coercion than did adult patients (N=104), and a trend was noted for them to disagree that they needed hospitalization. Perceptions of coercion, of pressure by others toward hospitalization, and of procedural justice were stable in the short term. However, of the 46 patients (30 of them adults) who initially did not endorse needing admission, 20 patients (17 of them adults) changed their minds by 2 weeks into hospitalization and agreed that they needed hospital admission. CONCLUSIONS: Nearly half of patients with eating disorders who denied a need for treatment on admission converted to acknowledging that they needed to be admitted within 2 weeks of hospitalization. Since treatment avoidance is associated with poor outcome, these findings suggest a need for studies assessing the long-term outcome and ethics of pressuring patients with eating disorders into treatment.

Adolescent↗

PubMed2004

College women's experiences of sexual coercion: a review of cultural, perpetrator, victim, and situational variables.

The literature on college women's experiences with sexual coercion is reviewed, with an emphasis on work published since 1990. Sexual coercion is defined as any situation in which one person uses verbal or physical means (including the administration of drugs or alcohol, with or without the other person's consent) to obtain sexual activity against consent. We argue that coercive sexual behavior among college students can best be understood within the context of other sexual behaviors and values on college campuses. Significant definitional and methodological problems are identified and discussed. Important victim, perpetrator, and situational variables are identified and discussed. These include attitudes toward women, beliefs about sexual behavior (including rape-supporting beliefs and values), communication problems, coercion-supporting peer groups (including fraternities and athletics), concepts of masculinity and femininity, sexual promiscuity, and alcohol.

Aggression↗