Both female and male persons with MS are at increased risk for various forms of physical, sexual, and disability-specific abuse. An ongoing study revealed a subset of respondents in which the caregiver acknowledged mistreatment of the person with MS, but that person either denied or minimized mistreatment Methods: In an effort to understand this phenomenon, we conducted 4 focus groups of male caregivers, female caregivers, male persons with MS, and female persons with MS (total n=15). Data were analyzed using qualitative methodology Results: Results included the surprising finding that, despite participants having been identified as recipients or perpetrators of mistreatment, all denied any form of abuse in the focus group setting. We concluded that attitudes toward mistreatment in these discrepant couples varied based on gender. Specifically, male caregivers may disclose abuse as a cry for help, whereas female caregivers may feel such behavior is justified because of the perceived provocations of the person with MS. Women with MS appeared reluctant to acknowledge abuse because they feared loss of their primary relationship; while men with MS calculated that putting up with a certain amount of mistreatment was worthwhile Conclusion: More attention should be paid in identifying and understanding this subset of persons with MS and their informal caregivers. © 2012 Elsevier B.V. All rights reserved.

Adult Protective Services (APS) workers in California investigate complaints of elder abuse and must determine the validity of a complaint with minimal guidelines. It is unclear whether APS workers reach similar conclusions given cases with similar circumstances. To assess variation in case findings and reasons for them, we used data from monthly reports of completed investigations, and investigation outcomes from all 58 California counties from September 2004 to August 2005, telephone interviews with 54 of 58 counties, and site visits to 17 counties. We also compared the data from 2004-2005 with more recent data from 2013. Large variability was found from county to county in the proportions of cases found to be conclusive, inconclusive, and unfounded. The combined analyses revealed significant differences in how individual APS workers interpret definitions of different types of case outcomes, varying skill and experience of the APS workers, individual and county agency factors, and other reasons that influence variability in case findings. Widespread inconsistencies in the outcomes of elder abuse investigations raise issues to be addressed on multiple levels, including the use of APS data for developing policy, standardizing training of APS workers, and seeking just outcomes for the victims of elder abuse.

Behavioral perinatology is as an interdisciplinary area of research that involves conceptualization of theoretical models and conduct of empirical studies of the dynamic time-, place-, and context-dependent interplay between biological and behavioral processes in fetal, neonatal, and infant life using an epigenetic framework of development. The biobehavioral processes of particular interest to our research group relate to the effects of maternal pre- and perinatal stress and maternal-placental-fetal stress physiology. We propose that behavioral perinatology research may have important implications for a better understanding of the processes that underlie or contribute to the risk of three sets of outcomes: prematurity, adverse neurodevelopment, and chronic degenerative diseases in adulthood. Based on our understanding of the ontogeny of human fetal development and the physiology of pregnancy and fetal development, we have articulated a neurobiological model of pre- and perinatal stress. Our model proposes that chronic maternal stress may exert a significant influence on fetal developmental outcomes. Maternal stress may act via one or more of three major physiological pathways: neuroendocrine, immune/inflammatory, and vascular. We further suggest that placental corticotropin-releasing hormone (CRH) may play a central role in coordinating the effects of endocrine, immune/inflammatory, and vascular processes on fetal developmental outcomes. Finally, we hypothesize that the effects of maternal stress are modulated by the nature, duration, and timing of occurrence of stress during gestation. In this paper, we elaborate on the conceptual and empirical basis for this model, highlight some relevant issues and questions, and make recommendations for future research in this area.