Judith R. Porter

The effect of vitiligo on sexual relationships

To study the effect of vitiligo on interference with sexual relationships, we surveyed 158 patients by questionnaire. Although a majority of patients reported a negative impact on sexual relationships, most patients felt embarrassment when showing their body or meeting strangers. The majority of patients who reported a negative impact on sexual relationships attributed the problems to their embarrassment. Those who were particularly affected were those with low self-esteem, men, those to whom appearance is important, and single persons. Dermatologists should be especially alert to the effects of disfigurement and should attempt to assist patients with this problem.

Psychological reaction to chronic skin disorders: a study of patients with vitiligo.

Diseases that cause physical handicaps can seriously interfere with the life of a patient. Some disorders such as vitiligo cosmetically disfigure patients without producing any physical disabilities. The effects of such diseases as vitiligo on the life of a patient have not been widely investigated. The investigation reported here utilized a questionnaire survey to focus on emotional disturbances caused by vitiligo and on the factors that differentiated patients who cope well from those who cope poorly with this stress. The results indicate that the cosmetic disfigurement of a seemingly inconsequential skin disease also can seriously disrupt the lives of a large number of patients. Those who cope well with their disfigurement have higher self-esteem than a matched control group without the disorder. Those who cope poorly have significantly lower self-esteem, which suggests that response to disfiguring diseases is affected by basic ego strength. Younger patients and those individuals in the lower socioeconomic groups show especially poor adjustment. A number of suggestions for better patient care are offered.

A Comparison of Latino, Black, and Non-Hispanic White Attitudes Toward Homosexuality

Latinos, Blacks, and non-Hispanic Whites are compared on two dimensions of attitudes toward homosexxuality utilizing a cumulated file from the General Social Survey. Latinos do not differ from Whites and are more tolerant thati Blacks on the morality dimension of attitudes toward homosexuality but are less tolerant than either of the other groups on the dimension measuring approval of civil liberties for homosexuals. There are no differences in attitudes toward homose-xuality between Mexican Americans and other Latinos. The theoretical and practical implications of these findings are discussed.

Racial Variation in Reaction to Physical Stigma: A Study of Degree of Disturbance by Vitiligo Among Black and White Patients*

The effect of race on reaction to impaired appearance is explored in a sample of 158 patients with vitiligo, a disfiguring skin disease. Blacks and Whites do not differ in degree of disturbance by the disorder. Psychological coping resources and variables related to negative labeling of the stigma are associated with variation in degree of disturbance. Self-esteem and perceived stigmatization are associated significantly with degree of disturbance among both Blacks and Whites. Gender, age, and visibility of the condition are not related to difference in degree of disturbance within either race, although there is some evidence that they may have an indirect relationship to degree of disturbance. Importance of appearance is associated with degree of disturbance for Whites only, because of the threat of the depigmentation induced by vitiligo to the racial identity of Blacks. The implications of these findings for theory and practice are discussed.

Children coping with impaired appearance: Social and psychologic influences

Coping with impaired appearance presents difficulties for children. This study is based on interviews of children with vitiligo, a disfiguring disorder that involves depigmentation of the skin, and focuses on social and psychologic factors that predict effectiveness of coping. Age plays an extremely important part in adjustment, with the junior high school years especially traumatic. Change of location or situation also is a predictor of stress. Children who develop other competencies that build self-esteem cope well with the disorder. These and other factors are explored in depth, and strategies for helping child patients with disfiguring disorders are suggested.

Age patterns in the development of children's gender-role stereotypes

This study examined the effect of the positive/negative quality of a gender-role stereotype on the age at which very young children are willing to associate the behavior with a member of a particular sex. The results indicate that, in comparison to 5- and 6-year olds, 4-year-old children are reluctant (1) to associate positive gender-role stereotypes with opposite-sex figures as well as (2) to accept negative stereotypes as characteristic of their own sex. In addition, a majority of the children in the sample associated with their own sex the gender-role stereotypes that are highly valued in the preschool and the school environment.

Children's gender-role stereotypes: A sociological investigation of psychological models

This study investigates sociologically the predictions of the cognitive developmental, the social learning, and the interactive models of gender-role development. We examine the effect of a variety of variables on gender-role stereotyping among a sample of 1264 four-, five-, and six-year-old children enrolled in preschool programs in a major metropolitan area. Age, sex, and race are found to be significantly related to childrens gender stereotypes. With age, children increasingly associate stereotypical behavior patterns with the male and female gender roles. Children are also found to demonstrate a higher degree of gender-role stereotyping with regard to members of their own sex. An age/sex interaction effect indicates that the tendency of children to demonstrate a higher degree of same-sex stereotyping is most pronounced among four-year-olds. Finally, black children are found to be less gender-typed in their images of males and females than are white children. These data suggest that the interactive model, including both social and cognitive factors, is the best explanation of these data and should be further investigated.

The Street/Treatment Barrier: Treatment Experiences of Puerto Rican Injection Drug Users

This study describes, through ethnographic interviews, the treatment experiences of Puerto Rican long-term heroin users who are at extremely high risk for HIV infection and the barriers they perceive to drug treatment. On the basis of this information we suggest policy recommendations for increasing drug treatment access for Puerto Rican long-term injectors of heroin. It is critical that Puerto Rican populations access drug treatment facilities given their risk factors for HIV infection and the high rate of poverty in Puerto Rican communities that exacerbates drug use.

The effect of a racially consonant medical context on adjustment of African-American patients to physical disability.

The effect of a racially consonant medical context on reaction to physical handicap stemming from disease is explored in a sample of 90 African-American patients with vitiligo, a disfiguring skin disorder. The adjustment of sixty-nine patients in a predominantly black hospital setting is compared to that of twenty-one patients in a predominantly white hospital setting. The patients in the predominantly black clinic, where the physicians, staff, and clientele are African-American, show significantly better adjustment than do African-American patients in a medical context that is primarily white. Interviews with a random sample of one-third of the patients in each clinic show that patients are significantly more positive to black physicians and a black hospital setting and that other patients of the same race provide informal networks of support, as does the predominantly African-American community in which the hospital is located. Implications for both medical theory and practice are suggested on the basis of these findings.

Bridge to services: drug injectors' awareness and utilization of drug user treatment and social service referrals, medical care, and HIV testing provided by needle exchange programs.

Using qualitative interviews conducted in 1999, we examine awareness and use of drug user treatment and social service referrals, medical care, and HIV testing provided by needle exchange programs (NEPs) among injectors who use NEPs (N = 26) and injectors who get their syringes from other sources (N = 20). A four-category typology of NEP service knowledge and use emerges from these interviews: “Active involvement”—use of services; “Steppingstone”—no use of services but knowledge that specific services are available; “Vague awareness”—nonspecific knowledge of service availability; and “Unaware:—no awareness of the service provision function of NEPs. We describe patterns of distribution of respondents among these categories and suggest policy implications.