Parental Divorce and Interpersonal Trust in Adult Offspring

It has been proposed that recent increases in parental divorce have inhibited the development of trust among offspring. This proposition is tested by examining whether parental divorce is associated with offspring trust in parents, intimate partners, and others. Data come from the Marital Instability Over the Life Course Study. Results reveal that although parental divorce is negatively associated with trust, these effects largely disappear once the quality of the past parent‐teen relationship is taken into account. The one exception is trust in fathers where children of divorce remain at higher risk of mistrust. Trust in parents, intimates, and others is strongly linked to positive parent‐teen relationships regardless of parental divorce. Contemporary relationship experiences also influence trusting intimates and others.     

The Use of E‐mail in the Therapy Process

The therapeutic letter has a long history, with roots in psychoanalytic work and continuing application in family therapy. The advent of e‐mail has allowed another form for therapeutic written communication which, while incorporating the benefits of therapeutic letters, adds to these. It has also opened up some potential risks. This article incorporates a brief review of the literature covering therapeutic written communication and offers a case example where e‐mail was used as an adjunct in face‐to‐face therapy with a client who experienced attachment difficulties. This therapy was informed by systemic and psychoanalytic traditions. The authors explore a variety of technical matters including the timing and crafting of e‐mail responses, the integration of written communication with face‐to‐face therapy, impact on the therapeutic relationship and management of crisis. Ethical issues such as confidentiality and duty of care are also considered.     

Parent‐Adolescent Involvement: The Relative Influence of Parent Gender and Residence

The 1995 wave of the Add Health study is used to investigate the relative influence of parent gender and residence on patterns of parental involvement with adolescents. Adolescent reports (N =17,330) of shared activities, shared communication, and relationship quality with both biological parents are utilized. A multidimensional scaling analysis reveals that parent gender explains most of the variance in parent‐adolescent involvement, with residential status playing a secondary yet a fundamental role in accounting for these patterns. Resident mothers who do not live with adolescents’ biological fathers engage in the broadest range of activities with their children. Unpartnered resident fathers display patterns of parenting that are as similar to mothers as they are to other fathers.     

Neutralizing marginally deviant behavior: Bingo players and superstition

Bingo is one of the most popular and most accepted forms of gambling in the United States today. Yet, despite its popularity, many bingo players are not completely comfortable with the moral rightness of their actions. This participant observation and interview study spanning a 5 year period shows how bingo players use superstitious strategies, such as feelings, hunches and psi, attitudes, and luck to neutralize their marginally deviant behaviors.     

When You Can't Afford to Leave Home: Clinical Implications of Economic Realities

Young adults entering the job market are finding that, despite strong corporate profits, economic growth is not trickling down to worker earnings, and federal policies are moving from the notion of entitlement to one of blame (Uchitelle, 1996, Sec. 4, p. 1). Adolescence is becoming increasingly confusing, since for many Americans economic opportunity is more fantasy than reality. This article highlights the declining opportunity for young adults and points out the limitations of existing adult developmental theory, both of which call for altered treatment conceptualizations that include the clinician operating as an anthropologist and utilizing the concepts of relationship-differentiation and response/ability from Stone Center writings.     

Physician perceptions of medical malpractice and defensive medicine

Using judgments obtained in interviews with 33 Massachusetts physicians, the annual statewide volume of expenditures incurred for defensive medical reasons in 1982 was estimated to be $1.0 billion, 12% of all medical care expenditures. Estimates for the nation were $37 billion, 14% of expenditures. Nationally, 180,000 cesarean deliveries were thought to be performed for defensive motives. In their own institutions, respondents judged 43% of all skull x-rays following injury to be medically justified, 30% to be defensive medicine, 16% to be placebos, and 11% to be physician misjudgments. In considering the economic and noneconomic costs of medical malpractice procedures, the dollar costs of insurance were considered most serious, followed closely by defensive medicine, unfairness, and poorer relations with patients. Thirty-two percent of the responsibility for the negative aspects of malpractice processes was assigned to lawyers, 21% to physicians, 18% to legislatures and courts, 16% to patients, and 13% to insurance companies.     

Evaluating alternative approaches to strategic planning

The question which, unfortunately, often goes unanswered, is whether a company's process of corporate planning is optimal. Furthermore, even if they wished to answer such a question there is little in the literature which can provide them with a direct, and explicit evaluative model. This paper examines the development of planning and the many different contributors towards its theoretical underpinning. Whilst recognizing that planning is a field which is a ‘semantic's jungle’ the authors carefully pick their way through the mine-field of misunderstanding and misquotation and clearly establish a base-line for evaluation and indeed propose a detailed methodology. It is hoped that this paper will be a fore-runner of many which will assist the executive in his important evaluative role concerning alternative planning approaches.     

A Comparative Pharmacokinetic Estimate of Mercury in U.S. Infants Following Yearly Exposures to Inactivated Influenza Vaccines Containing Thimerosal

The use of thimerosal preservative in childhood vaccines has been largely eliminated over the past decade in the United States because vaccines have been reformulated in single‐dose vials that do not require preservative. An exception is the inactivated influenza vaccines, which are formulated in both multidose vials requiring preservative and preservative‐free single‐dose vials. As part of an ongoing evaluation by USFDA of the safety of biologics throughout their lifecycle, the infant body burden of mercury following scheduled exposures to thimerosal preservative in inactivated influenza vaccines in the United States was estimated and compared to the infant body burden of mercury following daily exposures to dietary methylmercury at the reference dose established by the USEPA. Body burdens were estimated using kinetic parameters derived from experiments conducted in infant monkeys that were exposed episodically to thimerosal or MeHg at identical doses. We found that the body burden of mercury (AUC) in infants (including low birth weight) over the first 4.5 years of life following yearly exposures to thimerosal was two orders of magnitude lower than that estimated for exposures to the lowest regulatory threshold for MeHg over the same time period. In addition, peak body burdens of mercury following episodic exposures to thimerosal in this worst‐case analysis did not exceed the corresponding safe body burden of mercury from methylmercury at any time, even for low‐birth‐weight infants. Our pharmacokinetic analysis supports the acknowledged safety of thimerosal when used as a preservative at current levels in certain multidose infant vaccines in the United States.