Vulnerabilities and stresses of families of children with Congenital Zika Virus Syndrome

Objective: to identify situations of vulnerability and accumulation of tensions in the care of the child with Congenital Zika Virus Syndrome. Methods: qualitative study, in which 40 mothers of children with Congenital Zika Virus Syndrome participated. The research instruments used were a semi-structured interview, construction of genograms and ecomaps and field diary notes. The collected data were submitted to content analysis in the thematic modality. Results: the main situations identified were caring alone for the child with Congenital Zika Virus Syndrome; conflicts with the partner or marital separation; family abandonment; absence or health problems with other children; and financial difficulties. Conclusion: vulnerabilities, family conflicts, and financial difficulties were considered sources of family tension and stress when facing expenses with medications and treatments, revealing racial and socioeconomic disparities in the access to health care.

854 Sexsomnia in a Divorce Proceeding and its Custody Implications

Introduction Sexsomnia is a NREM parasomnia under the subtype of Confusional Arousals, defined as abnormal sexual behaviors emerging from partial arousals during slow-wave sleep. Case reports suggest that is more common in men. Precipitating factors include Obstructive Sleep Apnea, insufficient sleep, alcohol and fatigue/stress and history of NREM parasomnias. Report of case(s) A 37-year-old male with bruxism (using mouth guard) and anxiety for 7 years, who presented to the sleep clinic for a second opinion to discuss concerns around the safety of his children due to his sleep related sexual behavior. Sexsomnia was first noted with the stressors related to becoming a parent (fostering children and having biological children). Sexual behavior reported by the couple was mostly provoked with spouse’s touch during sleep. Behaviors ranging from fondling to aggressive sexual intercourse were reported to occur 1 to 3 times/week. There were no injuries during episodes which only occurred in the bedroom with the spouse and the patient was amnestic of his behavior. Due to marital discord provoked by other stressors, he began to sleep alone in the basement. A video-polysomnogram revealed no parasomnia, sleep apnea, or other sleep arousal disorders. Normal REM with atonia was observed. The patient was treated with Duloxetine 20mg for anxiety after the initial sleep visit. His condition contributed to marital separation. In the divorce proceedings, the spouse argued for denial of visitation rights related to his sleep-sexual behaviors noting that the children may be at risk. After separation, his anxiety and stress levels lowered in conjunction with therapy and medication. Follow up after 2 months found the patient asymptomatic. He placed an alarm on his bedroom door, to alert him and others during sleep. There are no published reports to provide a prediction as to whether his condition would-be supporting restrictions in overnight visitation by the foster and biological children. Conclusion In this case, there was a precedent condition (bruxism) and precipitating stress and anxiety, known to provoke NREM parasomnia. The absence of polysomnographic evidence is not unusual. Forensic repercussions, in particular prospective calculations of risk, are poorly described in the literature. Support (if any):

Spouses’ Employment Situations and Marital Separation in Germany: A Dyadic Perspective

Previous research shows that men’s and women’s employment situations can affect the stability of marital unions, but results differ by country context and different measurements. This study models the effect of spouses’ employment situations on the risk of divorce. It focuses on time aspects and financial aspects, resulting from the employment situation of married spouses in Germany. A broad variety of employment indicators measured in a dyadic perspective lead to an array of hypotheses about marital stability. Event history models on the German Socio-Economic Panel (SOEP) data show mixed evidence for spouses’ permanency of the job and their relative income. Marriages of couples with higher income are more stable. In addition, the spouses’ employment situation does not seem to affect marital stability. The study shows that the precarious job characteristics, which can destabilize marriages in analysis at the individual level, become blurred in analyzing dyads in a 1.5-earner society.

The Different Ways of Implementing Shared Physical Custody in the French Context

Drawing on quantitative contextual data, this largely qualitative study comprehensively explores the different ways of obtaining shared physical custody (SPC) in France. I show that the choice of SPC depends on the historical context in which the marital separation occurred. I distinguish three ways of entering into SPC: situations of parental disagreement settled by law, situations in which a third party intervened in the decision, and situations of parental agreement. In this final category, I discuss the category of agreement itself, showing that behind seemingly obvious, though far from explicit, ways of reasoning lie processes of influence and negotiation occurring between separated mothers and fathers.

The Economic Consequences of Marital Separation for Parents in New Zealand: Insights from a Large Administrative Dataset

Marital separation, especially when dependent children are involved, is a significant and disruptive event that often involves considerable changes in living standards. This article uses a newly available dataset to provide, for the first time, estimates of the short- to medium-term economic impacts of marital separation for parents of dependent-aged children in New Zealand. Unlike most similar studies, which are based on relatively small samples of separating individuals drawn from panel surveys, we exploit a large database of longitudinal tax and welfare records. This allows us to examine the economic consequences of separation for approximately 16,000 New Zealand parents and carers of dependent-aged children who separated in a 12-month period. The analysis applies propensity score matching, combined with difference-in-differences estimation, to estimate impacts. We find an average 29 per cent first-year decline in equivalised incomes for separating women and a 15 per cent average rise for men. In both cases, the effects persist to the end of the study period three years after separation. Our results also show a significant rise in poverty rates for both men and women, relatively small changes in employment and earnings, and a large increase in welfare receipts among the women.

Marital separation and contact with primary healthcare services for mental health problems: a register-based study

Background Marital separation is associated with mental health problems, but little is known about how this translates into healthcare use. In this study, we examine the relationship between marital separation and primary healthcare use for mental health problems. Methods We used data covering the period from 2005 to 2015 from the Norwegian Population Register, Statistics Norway’s Educational Registration System and the Norwegian Health Economics Database. Data were analyzed using logistic regression analysis. To control for time invariant characteristics, we estimated fixed-effect models. Results Marital separation was associated with increased contact with primary healthcare services for mental health problems (MH-consultations). The prevalence of MH-consultations peaked during the year of marital separation. MH-consultations were more common following marital separation than prior to the separation. This pattern remained significant in the fixed-effect models. Conclusions Men and women who experienced marital separation were more likely to consult primary healthcare services for mental health problems than those who remained married. Our study suggests that several mechanisms are in play. The prevalence of MH-consultations of those who eventually separated were higher several years prior to the separation. This lends support to selection mechanisms, whereas the sharp rise in the prevalence of MH-consultations around the time of marital separation coupled to higher levels several years after separation, indicate that marital separation induces both transient stress and leads to more lasting strain.

Contact With an Ex-Partner Is Associated With Psychological Distress After Marital Separation

In this study, we examined the association between naturalistically observed in-person contact with an ex-partner and separation-related psychological distress (SRPD). One hundred twenty-two recently separated adults were assessed using the Electronically Activated Recorder on three occasions across 5 months. The association between in-person contact with an ex-partner, as a between-person variable, and concurrent SRPD was not reliably different from zero, nor was the time-varying effect of in-person contact. However, more frequent in-person contact with an ex-partner predicted higher SRPD 2 months later, above and beyond the variance accounted for by concurrent in-person contact, demographic, relationship, and attachment factors. Follow-up analyses showed that this effect was present only for people without children; a 1 SD increase in in-person contact offset and slowed the predicted decline in SRPD over 2 months by 112%. In our discussion, we emphasize new ways to think about the role of in-person contact in shaping adults’ psychological adjustment to separation over time.