Paulette Marie Gillig

“Why Doesn't She Just Leave?”: A Descriptive Study of Victim Reported Impediments to Her Safety

Responses of victims at a domestic violence advocacy center indicate that barriers exist to seeking help that are often overlooked by many mental health professionals. This descriptive study retrospectively examined 485 victim surveys gathered in a domestic violence advocacy center (Artemis Center for Alternatives to Domestic Violence) in Dayton, Ohio, over 12 months. Various reasons for returning included lack of money (45.9%, n = 184), lack of a place to go (28.5%, n = 114), and lack of police help (13.5%, n = 54). Reasons for returning indicated that barriers prevented the victim from being safe. The Barrier Model as proposed by N. Grigsby and B. Hartman (Grigsby, N. & Hartman, B. 1997, Psychotherapy 31: 465–497) is used as a vehicle to explain these findings. This model incorporates four concentric rings with the victim in the center as the innermost ring. The rings in order of external to internal represent the environmental barriers, family and social role expectations, and the psychological impact of the abuse.

Humiliation, Manipulation, and Control: Evidence of Centrality in Domestic Violence Against an Adult Partner

This paper describes two related studies. Study 1 is a literature review of existing adult partner domestic violence assessment scales. Results of the review revealed that the scales varied on the available amount of empirical evidence for validity and reliability. More importantly, results showed that the content of the scales focused most heavily on the physical abuse aspects of domestic violence. Study 2 is a factor analysis performed on the results of 64 items taken from the Artemis Intake Questionnaire, a clinically relevant tool constructed by treatment providers used in working with the victims of domestic violence. Results indicate that reported humiliation and blame of the victim accounted for the largest amount of variance, followed by controlling the victim, and then physical violence. Results of this factor analysis suggest that greater emphasis must be put on factors other than physical violence in the construction of future domestic violence scales.

A Comparison of Staff and Patient Perceptions of the Causes and Cures of Physical Aggression on a Psychiatric Unit

Objective: The purpose of the study was to compare staff versus patient perceptions of the causes and emotional impact of verbal and physical aggression on a psychiatric inpatient unit, and the corrective measures each group would endorse. Methods: Fifty-four patients and 32 nursing staff members responded to similar questions about physical and verbal aggression. They also reported their emotional responses to aggression and steps they would endorse to reduce aggression at the medical center. Data was analyzed by chi-square tests for proportion comparisons between groups. Results: “Verbal Abuse” was viewed an important contributor to physical aggression. Staff stressed patient substance abuse and violent lifestyles. Patients focused on the use of involuntary procedures and cultural differences between patients and staff. Conclusions: Patients endorsed more restrictive safety measures as long as the measures such as metal detectors and searches were applied to staff and visitors, as well as patients. Patients requested more input into decision-making processes through patient-staff workgroups.

Medical student abuse: perceptions and experience

Summary. A questionnaire containing 18 vignettes of common clinical educational situations with potentially abusive treatment of medical students and a 10‐item attitude assessment about abusive behaviour were administered to the first‐and fourth‐year medical students at a mid‐west US university medical school. The first‐ and fourth‐year groups did not differ significantly on perceived abusiveness of most of the vignettes, although several of the individual vignettes were perceived significantly differently by the two groups. As hypothesized, the fourth‐year students had experienced such situations more frequently. Attitudes towards abusive behaviour did not differ between the two groups. The authors contrast teaching interactions perceived as educationally useful and not abusive with those seen as abusive and not useful and offer explanations for the differences observed. Finally, the possible implications of the results for medical education are discussed.

A residency training in rural psychiatry.

ObjectiveThis article describes a residency training program that incorporates a rural didactic curriculum and rural clinical training.MethodsResidents participate in didactic seminars and a rural clinical rotation.ResultsIn this jointly funded (academic-state-agency) model, faculty members from a community-based medical school train psychiatric residents at a rural clinic. This model differs from a primary care model because it is a direct care model and not a consultation model.ConclusionLocations near medical schools that are within driving distance of a rural or rural/manufacturing community could use this model. It would require modification (including telemedicine) where greater distances are involved or where faculty clinical work must be done at the medical school site to support a university-based hospital or clinic.

Incentives for Teaching Psychiatry

A questionnaire was sent to chairs and faculty in 137 academic departments of psychiatry regarding the methods used to promote teaching and their perceived value. The incentives most often used included promotion and retention, nomination to committees, and peer recognition. Least often used were bonuses and a designated teachers’ career track. Chairs and their faculty often disagreed as to whether some incentives were being used at all Recognition of teaching excellence was generally most highly valued as a useful incentive. Clarification of the nature and purpose of teaching incentives would likely improve their effectiveness.

Community vs. Private-Practice Psychiatrists: Lifestyle and Role as Related to Career Track

Around the late 1970s, the proportion Tasman, 1991; Clark & Vaccaro, 1987; Olafson, Klerman, & Pincos, 1993). Curof psychiatrists working in community mental health centers fell sharply. Some aurently, although some psychiatrists avoid even managed-care settings, others choose thors suggested that this was due to a change in psychiatrists’ roles in the public to work entirely in the public mental health sector. mental health system, which resulted in job dissatisfaction among all psychiatrists On the basis of the literature, we expected that psychiatrists currently working (Windle, Poppen, Thompson, & Marvella, 1988; Flaskeryd, 1986; Goldberg, Riba, & in community mental health centers would report a different “job description” than would psychiatrists in private, non-managed-care settings, and therefore would rePaulette Marie Gillig, M.D., Ph.D., is a Professor of Psychiatry in the Department of Psychiatry, port different reasons for choosing these School of Medicine, at Wright State University respective settings. We anticipated that in Dayton, Ohio. Ronald Markert, Ph.D.; David these choices would be based in part on Bienenfeld, M.D.; William Klykylo, M.D.; John lifestyle considerations, and in part on difRudisill, Ph.D.; Jerald Kay, M.D.; and James Bourgeois, O.D., M.D., also were affiliated with fering ideologies of the proper profesthe Department of Psychiatry at Wright State sional role of a psychiatrist (Baker & University. Baker, 1999). This research was supported by an educational research grant to Professor Gillig at Wright State University in Dayton, Ohio, from the Ohio Department of Mental Health. METHOD Address for correspondence: Paulette Marie Gillig, M.D., Ph.D., Professor of Psychiatry, Participants were a convenience sample Wright State University School of Medicine, of 272 full-time practicing psychiatrists seP.O. 927, Dayton, OH 45401. E-mail: pgillig@ your-net.com. lected from the American Psychiatric As-