René F. W. Diekstra

Child Sexual Abuse and Emotional and Behavioral Problems in Adolescence: Gender Differences

OBJECTIVE To compare sexually abused boys with sexually abused girls and with their non-sexually abused counterparts with regard to (1) the type of mental health problems they experience; and (2) the number and patterns of such problems. METHOD The sample comprised 745 secondary school students, aged 12 to 19 years, with a self-reported history of sexual abuse (151 boys and 594 girls) and 745 matched students without such a history. Sexually abused and non-sexually abused boys and girls were compared with regard to four problem categories: emotional problems, aggressive/criminal behaviors, addiction-risk behaviors, and suicidality. RESULTS A larger proportion of sexually abused adolescents than nonabused adolescents reported problems in the separate categories and in a combination of problem categories. Sexually abused boys had considerably more emotional and behavioral problems, including suicidality, than their female counterparts. There were differences between the specific combinations of problem categories reported by sexually abused girls and boys. These differences could not be attributed to the finding that sexually abused boys were more often the victim of concurrent physical abuse than sexually abused girls. CONCLUSIONS The results suggest that although there was a strong association between being sexually abused and the existence of a multiple problem pattern in both sexes, the aftermath for boys might be even worse or more complex than for girls.

Perceived Social Support from Family, School, and Peers : Relationship with Emotional and Behavioral Problems among Adolescents

OBJECTIVE To examine (1) the extent to which negative perceptions of support from family, school, and peers differ with regard to their impact on emotional and behavioral problems and (2) the extent to which negative perceptions of multiple social support systems are related to the presence of multiple emotional and behavioral problems in adolescence. METHOD The sample comprised 476 high school students, aged 16 to 18 years: 119 without any emotional and behavioral problems, 119 with emotional problems only, 119 with behavioral problems only, and 119 with emotional and behavioral problems. Possible differences between the subgroups were tested with regard to the perceived social support from family, school, and peers, and with regard to the number of negatively perceived support systems. RESULTS Whereas a negative perception of school was shown to be specifically related to behavioral problems and a negative perception of peers specifically to emotional problems, a negative perception of the family appeared to be strongly related both to emotional and behavioral dysfunction. A strong accumulating effect was found for multiple negatively perceived social environments. CONCLUSIONS The results suggest a dominant role of negatively perceived family support. Therefore, to prevent emotional and behavioral problems in adolescence it is of paramount importance to identify families at risk at the earliest possible stage and to provide training and support for the parents involved.

The Specificity of Psychological Characteristics of Adolescent Suicide Attempters

Using a semistructured interview, psychological characteristics were gathered from three groups of adolescents: 48 suicide attempters, 66 depressed, and 43 nondepressed adolescents who never attempted suicide. Various characteristics reported in literature discriminated the attempters from the normal group but not from the depressed group. These characteristics probably are not specific for adolescent suicide attempters. Even when a discriminant analysis was applied, the suicide attempters showed many similarities with the depressed adolescents, although both these groups could be separated from the normal group. Using follow-up data, the quadrants created by the axes appeared to have more implications for prevention than for the a priori group membership.

Understanding and Preventing Teacher Burnout: Do Teachers Burn Out More Easily? A Comparison of Teachers with Other Social Professions on Work Stress and Burnout Symptoms

It is well known that teachers have a demanding and in many cases stressful job. Work overload (Van Ginkel, 1987), lack of autonomy (Jackson, Schwab, and Schuler, 1986), disrespect, inattentiveness and low sociability with pupils (Friedman, 1995d), lack of support from colleagues and management (Brissie, Hoover-Dempsey, and Bassler, 1988), and loss of status of the teaching profession (Friesen and Sarros, 1989) are only a few examples of the stressors that teachers have to cope with. These and other work-stressors appear to manifest themselves in teachers as physical and psychological problems. Premature retirement is the fate of the greater number of Dutch teachers; teachers still active in their job show high rates of sick leave in comparison to workers in many other professions, especially teachers older than fifty (Van Ginkel, 1987). Because of the thoroughly interpersonal character of the teaching job (which demands from the teacher the ability to manage extensive and often intensive contacts with pupils), teachers are also vulnerable to the common burden of the so-called social professions (i.e., jobs characterized by many interactions with other people that place high demands on the social skills of their professionals): burnout (e.g., Maslach, 1982a). Burnout among teachers was the focal topic of the study reported here, in which a sample of about one thousand teachers is compared with members of other social professions on burnout symptoms and, in an attempt to explain the obtained differences in burnout, on work stressors and social support.

Suicide and attempted suicide in general practice, 1979–1986

ABSTRACT– Using data from the Continuous Morbidity Registration Sentinel Stations over the period 1979–1986, the authors tried to determine the incidence and the characteristics of patients in general practice who attempted or committed suicide. Almost half of the suicide attempts and suicides had contacted their general practitioner (GP) shortly before the suicidal act. A minority of these cases were recognized by the GP as having a high suicide risk. In almost 70% of the suicides and 58% of the suicide attempters the GPs reported the existence, currently or previously, of a depressive episode. About half of both the suicides and the suicide attempters had been treated or seen by mental health professionals or social workers. Given the fact that suicide and suicide attempt are relatively rare events in general practice, and given the fact that for the patients who contact their GP shortly before the suicidal act, it is not at all certain whether they present clearly recognizable signs of suicide risk at that time, the authors conclude that GPs cannot play an important role in the prevention of suicidal behaviour.

LEIPAD, an Internationally Applicable Instrument to Assess Quality of Life in the Elderly

A questionnaire to assess quality of life in the elderly was developed under the auspices of the European office of the World Health Organization. Stages in construction of the instrument, which was designed for international application, particularly at the primary level, are described. The latest version of the questionnaire is composed of 49 self-assessment item, 31 of which can be grouped into 7 subscales: Physical Function, Self-Care, Depression and Anxiety, Cognitive Functioning, Sexual Functioning, and Life Satisfaction. The remaining 18 items serve as moderators for assessing the influence of social desirability factors and personality characteristics on the individual scores for the 7 core instrument subscales. The questionnaire has been administered to 586 individuals aged 65 years and over recruited in communities in Italy (Padua and Brescia), the Netherlands (Leiden), and Finland (Helsinki). The main psychometric characteristics of the instrument, together with its concurrent validity with the Rotterdam Questionnaire, are illustrated.

A population-based survey of the characteristics of high school students with and without a history of suicidal behavior

In a sample of 570 15‐ and 16‐year‐old normal high school students, the characteristics of those with and without a history of suicidal behavior were compared. In a written inquiry, information was obtained on family background, emotional and behavioral problems, sexual and physical abuse and suicidal thoughts and behavior. Differences between the students with and without a history of suicidal behavior were statistically analyzed for boys and girls separately by a matched control design. The results for both boys and girls indicated that the experience of sexual abuse, feelings of loneliness, depressed mood, low self‐esteem and the use of drugs were particularly strongly related to suicidal thoughts and behavior; for girls, physical abuse and for boys, low self‐reported academic achievement appeared to be clearly related aspects. Furthermore, the strong interrelations between all of these variables is underlined, suggesting a multi‐problem background of youngsters with a history of suicidal behavior.

Efficacy of Rational-Emotive Therapy: A Quantitative Analysis.

Meta-analysis of 28 controlled studies on the efficacy of rational-emotive therapy (RET) showed RET to be superior to placebo and no treatment but equally effective in comparison with other types of treatment such as combination therapies and systematic desensitization. No support was found for the view that RET with a main or balanced emphasis on behavioral techniques is more efficacious than RET with a primarily or exclusively cognitive approach. However, given the heterogeneity of the set of studies and its relatively small sample size, interpretations of results have to be made with caution, particularly because evidence was found for a relationship between study characteristics and magnitude of effect size. For the sake of meta-analysis, outcome studies should be required to report at least the means and standard deviations for all experimental groups.

Consultations for research in suicidology

Science means research. Current research in suicidology, however, needs development. Therefore, a task force was established by the International Academy for Suicide Research (IASR) to make recommendations for future study of suicide. These consultations are offered only as current thoughts to assist, not only in research, but also to aid in preventing suicide.

An examination of the job demand-control-support model with various occupational strain indicators

Abstract In this study the Job Demand-Control-Support model is examined using four occupational strain indicators: (psycho) somatic complaints, psychological distress, job dissatisfaction, and absenteeism. In two samples from the Dutch working population (total n=4000), the results of three strain indicators support the iso-strain hypothesis: high time pressure, low control, and low social support are associated with lower well-being. For absenteeism the iso-strain hypothesis is not confirmed, as this outcome is only associated with low control and low social support. Analyses examining the potential buffering effects of control and support on the impact of high demands indicate that various forms of control can moderate the impact of high demands, but only consistently do so in circumstances of high supervisor support. The main conclusion on the basis of these results is that the focus should not exclusively be on job control. The social support dimension should be included in future research on occupational stress, as well as in efforts to create ‘healthier work’.