Signs of attachment disorders and social functioning among early adolescents with a history of institutional care

■ Aims The aim of this article is to investigate the problem formulations – the preconceptions about causes and effects and the possible solutions to the problems of alcohol abuse – that characterized the compulsory institutional care of alcohol abusers in Sweden in the 20th century. The article focuses on problem formulations that actually were practised in the institutions. ■ Methods & Data The main source material is to be found in the archives of four institutionalized care establishments and consists of official reports, correspondence, supply estimates, circulars for consideration and – above all – patient records. From this material you can learn about the institutions' struggle for autonomy, expansion and legitimacy, and also about the clients' characteristics and how the clients were viewed. The study of the archives allows you to form a picture of the problem formulations that affected the activities in the institutions directly, a picture that goes beyond the more abstract expectations preferred by official reports and legislation. ■ Results Within the compulsory institutional care actually carried out, the problem formulations that were stipulated in the gender-neutral legislation and vague regulations became gender-specific and precise. The treatment of alcohol abusers was a class and gender related project, aiming not only at encouraging male diligence and the fulfilling of a man's maintenance obligation but also at female virtuousness and concern for the family. ■ Conclusions The history of alcohol abusers' treatment shows that alcohol itself has been a secondary factor in problem definitions which have let themselves be attached – via perceived links with either cause or effect – to more overarching social issues in Sweden. The concerns of emergent family policy in the 1940s, the developmental optimism and scientistic passions of the 1950s, and the systemically critical protest movements of the 1970s are all clearly reflected in trends within social care services for alcohol abusers – albeit much more often at the level of discourse than of praxis.

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A History of Scottish Child Protection Law

10.3366/edinburgh/9781474444170.001.0001 ◽

2020 ◽

Author(s):

Kenneth McK. Norrie

Keyword(s):

Child Protection ◽

Juvenile Court ◽

Institutional Care ◽

Child Victims ◽

Contemporary World ◽

History Of ◽

A Minor ◽

Statutory Control ◽

Radical Shift

This book explores the development of Scottish child protection law from its earliest days in the poor law, tracing the changing assumptions that underlay child protection processes, and the radical shift of emphasis from private (charitable) endeavour to public (local authority) duty. This book looks at the developing legal processes for removing children from abusive or neglectful environments, explores how child offenders and child victims came to be dealt with in the same processes, and examines the reasons why Scots law has managed to continue to cleave its own procedural path in the contemporary world. It explores both processes and outcomes, explaining how the juvenile court evolved into the children’s hearing, and it examines the substantive continuities between the various orders that could be made over children. The regulation of boarding out and fostering of children is compared with the regulation of institutional care, and the evolution of aftercare provisions is explained. The book also offers an analysis of the (dubious) legal basis for the Imperial practice of sending troubled children to the colonies, as part of a deliberate policy of spreading British “stock” across the world. The final chapter traces the origins and statutory control of the practice of adoption of children, from its days as an informal arrangement through its early manifestation as a minor action changing status to its present position as the most radical order that a court of law can make.

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Introduction

Battle-scarred ◽

10.7228/manchester/9781526124807.003.0001 ◽

2018 ◽

pp. 1-20

Author(s):

David J. Appleby ◽

Andrew Hopper

Keyword(s):

Civil War ◽

Military Medicine ◽

Institutional Care ◽

Modern Medicine ◽

Epidemic Disease ◽

Societal Culture ◽

Early Modern Medicine ◽

History Of ◽

Complex Relationships ◽

Historical Origins

The introduction surveys the historical and historiographical contexts which underpin and link the various chapters in Battle-Scarred, before outlining the questions and topics covered in the chapters. By adumbrating trends in military historiography and the history of early modern medicine, the editors highlight how the contributors have utilised potential synergies between these two sub-disciplines in order to make a series of significant contributions to the study of military medicine and war-related welfare. The chapters are arranged in three sections: the first section considers attitudes towards the bodies of the slain and efforts to control epidemic disease in civil-war garrisons; the second brings together professional, political and literary aspects of military medicine; whilst the third explores the complex relationships between war, societal culture, welfare and memorialisation. The editors argue that by examining the myriad ways in which English and Scottish people at various levels of society responded to the trauma and stress of civil war, the volume will help foster a more rounded approach to military history, and a sounder grasp of the historical origins of modern British attitudes towards war-related institutional care.

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Microscopic colitis impacts quality of life in older people

BMJ Case Reports ◽

10.1136/bcr-2018-228092 ◽

2019 ◽

Vol 12 (6) ◽

pp. e228092 ◽

Cited By ~ 2

Author(s):

Olayinka Ayodele Ogundipe ◽

Amy Campbell

Keyword(s):

Quality Of Life ◽

Faecal Incontinence ◽

Institutional Care ◽

Microscopic Colitis ◽

Faecal Calprotectin ◽

Treatment Considerations ◽

Faecal Urgency ◽

History Of ◽

Rectal Biopsies

This report describes a frail 92-year-old woman with dementia who presented with a year’s history of chronic watery non-bloody diarrhoea. She had abdominal bloating, weight loss, faecal urgency, nocturnal stools and developed faecal incontinence. Her serum C reactive peptide and faecal calprotectin were elevated. Flexible sigmoidoscopy was macroscopically normal, but demonstrated histological features of microscopic colitis (MC) in sigmoid colon and rectal biopsies. Polypharmacy was reviewed for possible medication-induced MC. Ranitidine, donepezil and simvastatin were discontinued. She was started on oral budesonide with improvement in the abdominal and bowel symptoms. Stool frequency and consistency normalised, and the faecal incontinence resolved with treatment. The outcomes were an improved quality of life, reduced functional dependency, reduced carer strain and avoidance of premature transition from her home into a long-term/institutional care setting. We briefly review terminology, basic epidemiology, notable associations, the importance of establishing a diagnosis and some treatment considerations for MC.

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Childhood sexual and physical abuse: age at exposure modulates impact on functional outcome in early psychosis patients

Psychological Medicine ◽

10.1017/s0033291715000690 ◽

2015 ◽

Vol 45 (13) ◽

pp. 2727-2736 ◽

Cited By ~ 46

Author(s):

L. Alameda ◽

C. Ferrari ◽

P. S. Baumann ◽

M. Gholam-Rezaee ◽

K. Q. Do ◽

...

Keyword(s):

Functional Outcome ◽

Social Functioning ◽

Physical Abuse ◽

Early Psychosis ◽

Global Assessment Of Functioning ◽

Functional Impairments ◽

Functional Level ◽

History Of ◽

The Impact

BackgroundEvidence suggests a relationship between exposure to trauma during childhood and functional impairments in psychotic patients. However, the impact of age at the time of exposure has been understudied in early psychosis (EP) patients.MethodTwo hundred and twenty-five patients aged 18–35 years were assessed at baseline and after 2, 6, 18, 24, 30 and 36 months of treatment. Patients exposed to sexual and/or physical abuse (SPA) were classified according to age at the time of first exposure (Early SPA: before age 11 years; Late SPA: between ages 12 and 15 years) and then compared to patients who were not exposed to such trauma (Non-SPA). The functional level in the premorbid phase was measured with the Premorbid Adjustment Scale (PAS) and with the Global Assessment of Functioning (GAF) scale and the Social and Occupational Functioning Assessment Scale (SOFAS) during follow-up.ResultsThere were 24.8% of patients with a documented history of SPA. Late SPA patients were more likely to be female (p= 0.010). Comparison with non-SPA patients revealed that: (1) both Early and Late SPA groups showed poorer premorbid social functioning during early adolescence, and (2) while patients with Early SPA had poorer functional level at follow-up with lower GAF (p= 0.025) and lower SOFAS (p= 0.048) scores, Late SPA patients did not.ConclusionOur results suggest a link between exposure to SPA and the later impairment of social functioning before the onset of the disease. EP patients exposed to SPA before age 12 may present long-lasting functional impairment, while patients exposed at a later age may improve in this regard and have a better functional outcome.

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Predictors of survival with Alzheimer's disease: a community-based study

Psychological Medicine ◽

10.1017/s0033291700028191 ◽

1995 ◽

Vol 25 (1) ◽

pp. 171-177 ◽

Cited By ~ 40

Author(s):

Carol Jagger ◽

Michael Clarke ◽

Andrew Stone

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Institutional Care ◽

Community Based ◽

Risk Of Death ◽

Increased Risk ◽

History Of ◽

Group A ◽

Study Population ◽

Heavy Alcohol Use

SynopsisFactors associated with reduced survival were investigated in elderly people diagnosed as having Alzheimer's disease (AD) and in those free of dementia at diagnosis. The study population comprised 155 people free of dementia and 222 with AD; all were aged 75 years and over and were part of a two-stage prevalence study of dementia during 1988 in Melton Mowbray, Leicestershire. An increased risk of death was found for those with a history of heavy alcohol use, lower cognitive function, a history of heart failure and those in institutional care, these factors acting in the same manner for persons free of dementia and those with AD. For the non-demented group a greater risk of death was found with increasing age and for those with a history of cancer. A greater risk of death was found for males with AD compared to females with the risk increasing over time. The longer survival of women over men may explain the sex differences found in the prevalence of AD without accompanying differences in incidence.

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Prospective study of risk factors for suicidal behavior in individuals with anxiety disorders

Psychological Medicine ◽

10.1017/s0033291712002504 ◽

2012 ◽

Vol 43 (7) ◽

pp. 1465-1474 ◽

Cited By ~ 7

Author(s):

L. A. Uebelacker ◽

R. Weisberg ◽

M. Millman ◽

S. Yen ◽

M. Keller

Keyword(s):

Anxiety Disorder ◽

Suicide Attempt ◽

Depressive Disorder ◽

Anxiety Disorders ◽

Prospective Study ◽

Physical Health ◽

Social Functioning ◽

Suicide Attempts ◽

Past History ◽

History Of

BackgroundAnxiety disorders are very common and increase risk for suicide attempts. Little is known about predictors of increased risk specifically among individuals with anxiety disorders. The purpose of this study was to investigate whether specific anxiety disorders and other co-morbid psychiatric disorders, physical health, or work or social functioning increased the future likelihood of a suicide attempts among individuals with anxiety disorders.MethodIn this prospective study, 676 individuals with an anxiety disorder were followed for an average of 12 years.ResultsAs hypothesized, we found that post-traumatic stress disorder, major depressive disorder (MDD), intermittent depressive disorder (IDD), epilepsy, pain, and poor work and social functioning all predicted a shorter time to a suicide attempt in univariate analyses. In multivariate analyses, baseline MDD and IDD were independent predictors of time to suicide attempt, even when controlling for a past history of suicide attempt. No specific anxiety disorder was an independent predictor of time to attempt in this anxiety-disordered sample. Adding baseline physical health variables and social functioning did not improve the ability of the model to predict time to suicide attempt.ConclusionsMood disorders and past history of suicide attempts are the most powerful predictors of a future suicide attempt in this sample of individuals, all of whom have an anxiety disorder.

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