Screening for patients with alcohol problems: severity of patients identified by the CAGE.

Primary care physicians are well situated to identify patients with substance abuse problems and motivate them to seek appropriate assistance, but active programs are the exception. A study in a community setting was undertaken to assess the CAGE (the first letters of key words in a series of four questions about drinking: cut down; annoyed; guilty; and eye-opener), instrument in the routine screening for alcohol problems in both new and established patients. The screening process identified subjects for a pilot evaluation of a motivational interview designed to encourage problem-solving behavior. This article focuses on the screening results and the use of the CAGE instrument. During June and July of 1990, 687 patients of two primary care physicians belonging to a large group practice were asked to complete a health questionnaire that included the CAGE. Those who responded affirmatively to at least two of the four CAGE questions were requested to participate in follow-up assessment of problems associated with alcohol and health. The type and severity of alcohol problems experienced by patients who scored positive on the CAGE are described. Prevalence of a positive score on the CAGE was 8.6 percent with males, smokers, and blue collar and unemployed persons being more likely to score positive. The positive predictive value was .68. Primarily, persons with moderate alcohol problems were identified. Results show that the CAGE instrument is a useful screening device for identifying those with mild to moderate substance abuse problems, increasing the opportunity for intervention prior to serious medical complications. The instrument is easily administered, and has demonstrated relatively high levels of sensitivity and specificity. When combined with assessment and motivational interviews, the CAGE shows promise in the secondary prevention of substance abuse and related health problems.     

Myth,allegiances, and the study of social control

That sociology subscribes to certain popular myths and has aligned itself with the welfare of some groups over others complicates research into social control. This is especially so when the research deals with stereotypes and their effects on differential legal treatment. That the discipline has historically taken sides regarding certain commonly held stereotypes and been supportive of certain groups, means that findings that challenge those stereotypes or that are viewed as detrimental to the supported groups are brought into question. Our research on a regulatory mechanism of social control—the Black Book, a list of persons excluded from licensed gaming in Nevada because of their perceived threat to the industry—is illustrative of these complications. Our findings that the Black Book is largely symbolic and is applied discriminatorily challenge not only beliefs in its efficacy but certain myths and allegiances within sociology. That a group sociologically identified with the problem was discriminated against, and that a well-protected group elicited preferential treatment at the hands of regulators who identify with them have been particularly problematic for the acceptance of the findings. We argue here that debunking myth and value neutrality are essential to scientific endeavor and should override such disciplinary tendencies toward the tolerance and protection of some groups over others. Her research has dealt with aspects of culture, organized crime, and social elites. She is currently working on a book on high society and thoroughbred racing. His publications have dealt with issues of labeling and secondary deviation, the role of stereotypes in the legal process, and the legal reaction to corporate crime.     

Public Perceptions about Food Safety in the United States and Japan1

Abstract Consumer concerns over pesticide residues and food additives have been growing in industrialized societies, including the United States and Japan. However, little comparative research has been carried out to determine which household characteristics may be significantly associated with these heightened concerns, and whether or not the same factors are useful for understanding variation in these worries in more than one society. This paper examines food safety attitudes in Seattle, Washington, and Kobe, Japan, and discovers that while the absolute level of expressed concern is higher in Kobe, the predictive power of household characteristics in explaining attitudinal differences within countries is similar. Implications for rural areas and future research on family structures in capitalist societies are discussed.     

Mean squares in saturated fractional designs revisited

In a previous paper (Bissell, 1989) some suggestions were offered for interpreting mean squares in saturated fractional designs where no independent estimate of experimental error is available. One of the methods leads to a simple numerical test of homogeneity which provides an objective accompaniment to half-Normal plotting of effects (Daniel, 1959) in 2n designs or exponential plotting of mean squares (Bissell, 1989) in 3n designs. A table of percentage points for a convenient test statistic is provided in this paper.     

TESTING SPHERICITY UNDER A MIXTURE MODEL

The robustness of Mauchly's sphericity test criterion when sampling from a mixture of two multivariate normal distributions is studied. The distribution of the sphericity test criterion when the sample covariance matrix has a non-central Wishart density of rank one is derived in terms of Meijer's G-functions; its distribution under the mixture model is then deduced. The robustness is studied by computing actual significance levels of the test under the mixture model using the critical values under the usual normal model.     

Maintaining the connection: Parenting as a noncustodial father

The purpose of this study was to identify relevant factors associated with the noncustodial father's frequency of contact with his child following divorce. The findings of the research revealed that a combination of demographic, personal characteristics, and psychosocial factors are related to the father's frequency of contact with the child.     

The social worker as psychoanalyst

This paper examines the development of social workers as psychoanalysts to determine whether psychoanalysis is a legitimate function of social work. Historically, social work has found psychoanalytic theory helpful. However, it is generally understood that for the caseworker to competently practice psychoanalytic psychotherapy, advanced training is necessary. Although many social workers have availed themselves of this opportunity, the profession continues to believe that the practice of psychoanalysis is incompatible with social work. This is based upon an inaccurate conception of psychoanalysis. Since the social work psychoanalyst is concerned with the client's adaptation to the environment, his or her practice can easily be defined as clinical social work.     

Children's gender- and age-based categorization in similarity and induction tasks

The present studies examined children's and adults' preferences for gender- or age-based categorization using similarity and inductive inference tasks. Four-year-olds, 6-year-olds, and adults looked at pictures of people and decided which of two was more like a target (similarity condition) or which shared a novel age- or gender-related property with the target (inference condition). Age or gender-based matches were possible. The results are consistent with previous findings that gender-based classification decreases with age. However, they also demonstrate that children use gender more for judging similarity than for making inferences about novel properties. Distinct patterns emerge from the two tasks: 6-year-olds and adults in both conditions categorize more by age than gender; 4-year-olds categorize by gender more than age in the similarity task, but by age more in the induction task. Only adults differentiated by property in the inference condition. These findings suggest that the salience of gender categories cannot entirely be attributed to their inductive potential. Gender has a salience beyond what would be predicted by its power for directing novel generalizations.     

Naturally occurring play patterns in groups of latency aged children

This study examines the influence of the socialization of aggression among different gender and social class groupings and the influence of psychosocial stage on cognitive developmental play preferences among groups of school aged children. Observations of 143 play groups were coded for play preference (symbolic play, practice play, games with rules) and play performance (cooperative or competitive). Findings of the log-linear data analysis suggest a middle class and masculine bias in Piaget's cognitive model (i.e., that as age increases children prefer more games with rules). This model held only for middle class and affluent boys. Girls (both latency and prepubertal) and lower socioeconomic groups tended to prefer practice play. Girls were more likely to play cooperatively; boys more likely to play competitively. Implications for theory development and clinical practice are explored.