Judith A. Cook

Beyond Methodology: Feminist Scholarship as Lived Research.

1. Back to the Future: A Look at the Second Wave of Feminist Epistemology and Methodology Mary Margaret Fonow and Judith A. Cook 2. The Man of Professional Wisdom Kathryn Pyne Addelson 3. Learning from the Outsider Within: The Sociological Significance of Black Feminist Thought Patricia Hill Collins 4. WomenOs Research or Feminist Research? The Debate Surrounding Feminist Science and Methodology Maria Mies 5. Quantitative and Qualitative Methods in the Social Sciences: Current Feminist Issues and Practical Strategies Toby Epstein Jayaratne and Abigail J. Stewart 6. Race and Class Bias in Qualitative Research on Women Lynn Weber Cannon, Elizabeth Higginbotham, and Marianne L.A. Leung 7. Researching the WomenOs Movement: We Make Our Own History, But Not Just As We Please Verta Taylor and Leila J. Rupp 8. Objectivity and Truth: Problems in Doing Feminist Research Joan Acker, Kate Barry, and Johanna Esseveld 9. Separate but Equivalent: Equal Pay for Work of Comparable Worth Ronnie Steinberg and Lois Haignere 10. The Different Worlds of Women and Men: Attitudes toward Pornography and Responses to Not a Love Story-A Film about Pornography Pauline B. Bart, Linda N. Freeman, and Peter Kimball 11. Household Resources and U.S. Womens Work: Factors Affecting Gainful Employment at the Turn of the Century Christine E. Bose 12. Women in Agriculture: Counting the Labor Force in Developing Countries Ruth Dixon-Mueller 13. Coauthorship, Gender, and Publication among Sociologists Kathryn B. Ward and Linda Grant 14. Feminist Research, Feminist Consciousness, the Experiences of Sexism Liz Stanley and Sue Wise 15. Sharing Feminist Research with Popular Audiences: The Book Tour Laurel Richardson Contributors Index

An analysis of the definitions and elements of recovery: a review of the literature.

As mental health recovery gains traction, many people have put forward varying definitions. Few attempts have been made to create a dimensional analysis of the recovery literature that assesses the growing consensus about what recovery is or what its definition should entail. This paper incorporates an ecological framework to take the individuals life context into account while emphasizing both the reestablishment of ones mental health (i.e., first order change) and the mitigation of the oppressive nature of barriers imposed by the greater community (i.e., second order change) so that people may experience social integration and community inclusion.

Depressive Symptoms and AIDS-Related Mortality Among a Multisite Cohort of HIV-Positive Women

OBJECTIVES We examined associations between depressive symptoms and AIDS-related mortality after controlling for antiretroviral therapy use, mental health treatment, medication adherence, substance abuse, clinical indicators, and demographic factors. METHODS One thousand seven hundred sixteen HIV-seropositive women completed semiannual visits from 1994 through 2001 to clinics at 6 sites. Multivariate Cox and logistic regression analyses estimated time to AIDS-related death and depressive symptom severity. RESULTS After we controlled for all other factors, AIDS-related deaths were more likely among women with chronic depressive symptoms, and symptoms were more severe among women in the terminal phase of their illness. Mental health service use was associated with reduced mortality. CONCLUSIONS Treatment for depression is a critically important component of comprehensive care for HIV-seropositive women, especially those with end-stage disease.

Effects of depressive symptoms and mental health quality of life on use of highly active antiretroviral therapy among HIV-seropositive women.

This study examines the effects of depressive symptoms and mental health quality of life on utilization of highly active antiretroviral therapy (HAART) among HIV-seropositive women. Data were collected biannually from 1996 through 1998 in a prospective cohort study. Women reported use of antiretroviral therapy, health and mental health status, demographics, and social and behavioral factors; CD4 count and viral load also were assessed. Random effects regression models estimated the longitudinal effects of depressive symptoms and mental health quality of life on the probability of HAART utilization, controlling for clinical indicators (CD4 count, viral load, symptom presence), demographics (race, age, education), behavioral factors (drug/alcohol use, clinical trials participation), service features (insurance status, mental health service utilization), and study site. High levels of depressive symptoms and poor mental health quality of life were found, and they significantly reduced the probability of HAART utilization. Receiving mental health services significantly increased the probability of utilizing HAART. HIV-seropositive women characterized as being in poor mental health were less likely to use HAART, whereas those receiving treatment of mental health difficulties were more likely to use HAART. These findings suggest that efforts to enhance womens access to psychological treatment may increase their use of the latest HIV therapies.

Crack cocaine, disease progression, and mortality in a multicenter cohort of HIV-1 positive women.

Background:Longitudinal associations between patterns of crack cocaine use and progression of HIV-1 disease are poorly understood, especially among women. This study explores relationships between crack use and HIV-1 disease outcomes in a multicenter cohort of infected women. Methods:Subjects were 1686 HIV-seropositive women enrolled at six US research centers in the Womens Interagency HIV Study. Approximately 80% were non-white and 29% used crack during the study period. Cox survival and random regression analysis examined biannual observations made April 1996 through September 2004. Outcome measures included death due to AIDS-related causes, CD4 cell count, HIV-1 RNA level, and newly acquired AIDS-defining illnesses. Results:Persistent crack users were over three times as likely as non-users to die from AIDS-related causes, controlling for use of HAART self-reported at 95% or higher adherence, problem drinking, age, race, income, education, illness duration, study site, and baseline virologic and immunologic indicators. Persistent crack users and intermittent users in active and abstinent phases showed greater CD4 cell loss and higher HIV-1 RNA levels controlling for the same covariates. Persistent and intermittent crack users were more likely than non-users to develop new AIDS-defining illnesses controlling for identical confounds. These results persisted when controlling for heroin use, tobacco smoking, depressive symptoms, hepatitis C virus coinfection, and injection drug use. Conclusion:Use of crack cocaine independently predicts AIDS-related mortality, immunologic and virologic markers of HIV-1 disease progression, and development of AIDS-defining illnesses among women.

Medically Eligible Women Who Do Not Use HAART: The Importance of Abuse, Drug Use, and Race

OBJECTIVES We investigated the prevalence and characteristics of HIV-positive women who do not report highly active antiretroviral therapy (HAART) use. METHODS We analyzed HAART use among 1165 HIV-positive participants in the Womens Interagency HIV Study. RESULTS Between October 1, 2000, and March 31, 2001, 254 women with clinical indications for HAART reported not using it, 635 reported HAART use, and 276 had no clinical indications. In multivariate analysis, using crack/cocaine/heroin and a history of abuse decreased the likelihood of using HAART, whereas being White increased it. CONCLUSIONS One of 4 women for whom HAART was indicated reported not using HAART. Childhood sexual abuse prevention, more intensive abuse treatment, and continuing drug treatment may enhance HIV disease treatment of women.

Clinical factors associated with employment among people with severe mental illness: Findings from the employment intervention demonstration program

Research has shown that supported employment programs are effective in helping psychiatric outpatients achieve vocational outcomes, yet not all program participants are able to realize their employment goals. This study used 24 months of longitudinal data from a multisite study of supported employment interventions to examine the relationship of patient clinical factors to employment outcomes. Multivariate random regression analysis indicated that, even when controlling for an extensive series of demographic, study condition (experimental versus control), and work history covariates, clinical factors were associated with individuals’ ability to achieve competitive jobs and to work 40 or more hours per month. Poor self-rated functioning, negative psychiatric symptoms, and recent hospitalizations were most consistently associated with failure to achieve these employment outcomes. These findings suggest ways that providers can tailor supported employment programs to achieve success with a diverse array of clinical subpopulations.

Who "Mothers" the Chronically Mentally Ill?

The purpose of this analysis is to explore how the shift to community residence and treatment has influenced mothers who care for their mentally ill young adult offspring. Home visits with clients and their families were used to gather interview, questionnaire, and observational data from 49 parents residing with a psychiatrically disabled child at the time of the latters entry into a psychiatric rehabilitation program. Results indicated a high level of emotional distress on the part of both mothers and fathers. Mothers reported significantly higher degrees of anxiety, depression, fear, and emotional drain, even following the introduction of a series of control variables measuring parents education, ethnicity, age, the illness length, and the offsprings gender. Application of a feminist analysis to these data suggests a theoretical and clinical approach based on understanding the meaning of the childs illness to mothers themselves, along with an awareness of what is involved in caring for severely mentally ill individuals. Such an approach may be used by clinicians to avoid well-documented tendencies in the psychotherapeutic professions toward mother-blaming and maternal scapegoating, and to formulate effective ways to support women and their families in caring for a mentally ill offspring.

Initial Outcomes of a Mental Illness Self-Management Program Based on Wellness Recovery Action Planning

OBJECTIVE This study examined changes in psychosocial outcomes among participants in an eight-week, peer-led, mental illness self-management intervention called Wellness Recovery Action Planning (WRAP). METHODS Eighty individuals with serious mental illness at five Ohio sites completed telephone interviews at baseline and one month after the intervention. RESULTS Paired t tests of pre- and postintervention scores revealed significant improvement in self-reported symptoms, recovery, hopefulness, self-advocacy, and physical health; empowerment decreased significantly and no significant changes were observed in social support. Those attending six or more sessions showed greater improvement than those attending fewer sessions. CONCLUSIONS These promising early results suggest that further research on this intervention is warranted. Confirmation of the efficacy and effectiveness of peer-led self-management has the potential to enhance self-determination and promote recovery for people with psychiatric disabilities.

Demographic Characteristics and Employment Among People with Severe Mental Illness in a Multisite Study

People with psychiatric disabilities experience disproportionately high rates of unemployment. As research evidence is mounting regarding effective vocational programs, interest is growing in identifying subgroup variations. Data from a multisite research and demonstration program were analyzed to identify demographic characteristics associated with employment outcomes, after adjusting for the effects of program, services, and study site. Longitudinal analyses found that people with more recent work history, younger age, and higher education were more likely to achieve competitive employment and to work more hours per month, while race and gender effects varied by employment outcome. Results provide strong evidence of demographic subgroup variation and need.