Commentary: The Public Health Consequences of an Industry-Influenced Psychiatric Taxonomy: “Attenuated Psychotic Symptoms Syndrome” as a Case Example

Determining the distribution of psychiatric disorders and developing sound preventive and intervention practices are pressing public health issues. Since at present mental disorders lack biological markers, psychiatric taxonomies must grapple with how best to address issues of validity and reliability. With the increasing congruence between the International Classification of Diseases (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) (American Psychiatric Association, 2010 American Psychiatric Association. 2010. Diagnostic and Statistical Manual of Mental DisordersProposed Revisions, Fifth, Washington, D.C: American Psychiatric Association.  [Google Scholar]), it is imperative that decisions regarding the inclusion of new disorders be research-based and not unduly influenced by industry. The first draft of DSM-V, recently made public, has created a firestorm of controversy, for the DSM's nomenclature of disease or other pathology not only affects such disparate domains as jurisprudence and insurance claims but is also an instrument designed to facilitate research on psychopathology.     

Staff Support Groups in the Helping Professions: Principles,Practice, and Pitfalls by Hartley,P., & Kennard,D. (Eds.)

The topic of discharge from inpatient psychiatric units is written about frequently. However, inpatient groups which focus on discharge issues are rarely discussed. This paper briefly reviews the literature on discharge issues groups with the finding that while long-term psychiatric units focus on patients' feelings about leaving the hospital, existing acute adult psychiatric unit groups do not. An alternative model, the Discharge Issues Group which does allow for patients to express their feelings about discharge, is presented. Two case examples are cited to illustrate how the group functions.     

Ego Psychological Contributions to Understanding Psychopharmacology and Clinical Practice in Social Work Education

Due to increasing evidence that supports the efficacy of combined pharmacology and psychotherapy in the treatment of multiple psychiatric disorders, an educational focus on integrated approaches is growing in social work and related fields. However, there are few guiding clinical theoretical models that can help students integrate pharmacology and clinical issues. The authors propose that ego psychology can advance clinical knowledge by helping students understand pharmacological issues and integrate pharmacotherapy with psychotherapy. Assessing ego functions in response to medication referral and use contributes to enhanced assessment and treatment.     

National,independent oversight: Reinforcing the safety net for human subjects research*

National, independent oversight is vital to resolve the problems and inconsistencies in oversight of human subjects research. Three key functions that must be considered in any proposal for such a mechanism are (1) issue spotting, (2) guidance on identified issues, and (3) sampling and follow‐up. The 1998 report and recommendations of the National Bioethics Advisory Commission concerning research involving persons with mental disorders that may affect decisionmaking capacity address these functions in part, but application is limited to a small segment of the research population. Incorporation of these three key functions in a formal, national, independent oversight process is necessary in order to ensure accountability and maintain public trust in research.     

"Involving interface": an extended mind theoretical approach to roboethics

In 2008 the authors held "Involving Interface," a lively interdisciplinary event focusing on issues of biological, sociocultural, and technological interfacing (see Acknowledgments). Inspired by discussions at this event, in this article, we further discuss the value of input from neuroscience for developing robots and machine interfaces, and the value of philosophy, the humanities, and the arts for identifying persistent links between human interfacing and broader ethical concerns. The importance of ongoing interdisciplinary debate and public communication on scientific and technical advances is also highlighted. Throughout, the authors explore the implications of the extended mind hypothesis for notions of moral accountability and robotics.     

"Risk" and UK Pension Reform

“Risk” is a word that has become common currency in the financial services industry in general, and in the pensions industry in particular. This article critically examines its use in the context of the current debate about UK pension reform. “Risk” is used by a broad spectrum of interests to discuss a wide range of pension issues in a variety of contexts. The article outlines key theoretical perspectives on the nature and construction, or conceptualization, of risk. Their relevance to debate and policy initiatives, particularly public pension policy, is examined. It is suggested that current government policy is failing to carry with it those to whom the policy applies; that reforms implicitly, if not explicitly, underestimate the importance of “security”; and that failure to conduct a much broader debate about the fundamental notions of work, retirement, saving and security may simply condemn the UK to interminable pension reform.     

The Mental Health of Adolescent Girls with Depressed Mothers: The Mediating Role of the Perception of Parental Styles

Maternal depression, its effects on mothers’ interactions with their children, and the different mechanisms of emotional and psychological disorders’ transaction to children have been surveyed for the last few decades of research. The aim of this research was to find the mediating role of the perception of parental styles between the maternal depression symptoms and the mental health of their daughters. The participants included 284 mothers and their daughters from 8 different schools chosen randomly. Mothers completed the Beck Depression Inventory-II and examined using differential diagnosis interview based on DSM-V while adolescents completed the Parenting Style Questionnaire and Symptom Check List 90-R. The results showed the mediating role of the perception of authoritative and authoritarian styles of parenting (p?≥?0.0001). Also, depression symptoms in mothers could predict the perception of parental styles. Additionally, the perception of authoritative and authoritarian parenting could predict the mental health of adolescents.     

Education and Public Attitudes toward Science: Implications for the "Deficit Model" of Education and Support for Science and Technology

Objective . By critically examining the deficit model, this research attempts to grasp the multifaceted relationships between education and public attitudes toward science. Methods .It analyzes a series of nationwide surveys of public attitudes toward science conducted over a decade. Results . First, respondents' levels of education and levels of scientific knowledge make independent contributions to public attitudes toward science. Second, college (and postgraduate) majors have very weak effects on public attitudes toward science. Third, education is a much weaker predictor of public attitudes toward controversial scientific research, compared to its strong influence on science in general. Conclusions . Although education may indeed enhance public support for science in general, it may not help much to reduce tensions around politicized, controversial scientific research. For scientific controversies, gender might be a more important variable than education.     

Determinants of stated willingness to pay for public goods: A study in the headline method

Respondents were shown brief statements (“headlines”) referring to various threats to the environment or to public health, and other public issues. An intervention to deal with each problem was also introduced by a single sentence. Some respondents were asked to indicate their willingness to pay for the interventions by voluntary contributions. Others indicated their opinion of the intervention on a conventional rating scale, rated the personal satisfaction of contributing to it, or rated the importance of the problem. Group averages of these response measures were obtained for a large set of issues. Computed over issues, the rank-order correlations between the different measures were very high, suggesting that group averages of WTP and of other opinion statements are measures of the same public attitudes. Observed preference reversals and violations of monotonicity in contributions are better explained by a concept of attitude than by the notion of economic value that underlies the contingent valuation method. Contributions and purchases do not follow the same logic. Possible implications for the contingent valuation method are discussed.     

The political orientation of Blacks and Whites: Converging,diverging, or remaining constant?

This paper examines the extent to which patterns of public opinion between Blacks and Whites have converged, diverged, or remained constant since the late1970s. It explores how trends in public opinion reflect a decline in the role of race in the formation of pubic opinion. The findings show a slight convergence of public opinion between Blacks and Whites on some issues and stabilization on others depending of the nature of the issue. The data also showed that the magnitude of difference on most issues, other than those related to race, rarely constituted anything more than a gap in public opinion and not a gulf of chasm. The fact that significant differences continue to exist between Blacks’ and Whites’ public opinions suggest that race is still a significant indicator of opinion position.     

Public Willingness to Utilize Psychiatric Social Work Services

This paper reports the results of a survey of New Orleans residents concerning knowledge about and willingness to utilize the services of psychiatric social workers. The research was inspired by the complaints of some psychiatric social workers that the public neither understands nor utilizes their services. Analysis of the survey findings indicates that this assessment is only partially correct. The public does possess a general knowledge of psychiatric social work and does grant the occupation relatively high prestige. Twenty-five percent of the sample could imagine themselves ulilizing the clinician's services. However, only one variable explored in this research is directly linked to use propensity: family contact with psychiatric social workers. The implications of this finding for increasing public use of clinical services are discussed.     

Beyond Women,Children, and Families: Gender,Representation, and Public Funding for the Arts*

Objectives. Research on the impact of female legislators has found that in their voting records women in elective office tend to be more liberal and more supportive of issues of concern to women, children, and families than are men, differences that conform to gender stereotypes held by voters. This article examines another well‐established gender stereotype that is not linked to the traditional concerns of women as conventionally defined by scholars: that women in public office will be more supportive of the arts. Method. The 40 votes taken on arts legislation in the U.S. House of Representatives, 1983–2002, are examined using negative binomial regression in a model that includes district and personal characteristics. Results. Democratic Party membership and support, citizen ideology, urban residence, and gender are significant factors in explaining support for public funding for the arts. Female representatives are more likely than their male colleagues to support the arts, a finding that primarily reflects the greater support of Republican women for the arts in comparison with their male counterparts. Conclusion. This study suggests that substantive representation of women by female elected officials may extend to more policy issues than previous research has documented. Research on issues that are recognized as gendered (e.g., arts policy) but are not traditionally defined as women's issues is an area for further exploration.     

Treating Older Persons with Severe Mental Illness in the Community: Impact of an Interdisciplinary Geriatric Mental Health Team

Little information is available concerning community-based interventions to treat the growing number older persons with severe mental illness. This study examined treatment efficacy of a specialized interdisciplinary geriatric mental health team (mental health geriatric interdisciplinary teams or MHGITs) for 69 older clients with severe mental disorders. Depression, life satisfaction, health, and psychiatric and medical hospitalization data were gathered. A decrease in depressive symptoms and in psychiatric hospitalizations, and an increase in life satisfaction at 6 months were found. No change in health nor medical hospitalizations were reported. This study provides preliminary support for the feasibility and efficacy of a MGHIT approach in treating older community-dwelling adults with severe mental illnesses. Implications for social workers are discussed.     

Psychiatric Non-institutionalisation: Whose Needs are Served?

This article outlines the social problems experienced by persons with a chronic psychiatric disability, and their families. The disabled person's lifestyle is characterised by poor social and vocational skills, poverty, inadequate accommodation and alienation. Many of these problems increase the dependence of the disabled person, emotionally and financially, on their family of origin. The author suggests that these social problems will only be ameliorated if family members are provided with active support and information, and if hospital and community services are integrated and complementary. The disabled person's quality of life can only be improved by accessible intensive social and vocational rehabilitation programs. As these issues are not being comprehensively addressed at the present time family self-help organisations such as the Association of Relatives and Friends of the Mentally III (ARAFMI) will need to politicise their plight.     

Morality Politics vs. Political Economy: The Case of School-Based Health Centers

Objective . Scholars continue to debate whether morally charged political issues constitute a distinct type of policy question or produce essentially the same political dynamic as public controversies lacking an overt moral dimension. The debate will not be resolved until scholars test the determinants of putative morality policies with predictors drawn both from morality politics theory and from the socioeconomic factors that account for the distribution of many other public policies. This study reports such a test. Methods . We analyze data from our national survey of directors of school-based health centers. We use ordinary least squares regression models to predict the level of reproductive health care services provided to adolescents. Results . Service levels were influenced not only by cultural considerations, as morality politics theory would anticipate, but also by the same socioeconomic forces that account for policy levels in other domains. Conclusions . Policy for morality issues appears different from that for nonmorality issues but less distinctive than commonly imagined.     

Ethics of research design

Discussions of ethical issues in research involving human subjects most usually provoke concerns about valid informed consent procedures. However, considering the recognized limitations of informed consent, arguably the way a study is designed is a more consequential concern for subject well‐being. This paper summarizes ethical issues in the design of clinical research, with reference to historic and current guidelines. Special attention is given to randomized clinical trials (RCTs) and psychiatric research.     

行政的“疆域”与行政法的功能

行政的范围 ,既取决于不同时代 ,不同社会经济条件下 ,人们对“公共物品”的需求 ,同时也取决于人们对政府权力的成本—效益的认识。在传统社会 ,人们对“公共物品”的需求量较小 ,政府管的事自然不多 ;在现代社会 ,人们对“公共物品”的需求量大增 ,政府的职能和行政的范围是不是就应该和必然无限地扩张呢 ?行政国家、全能政府在为人们部分解决了现代社会发生的许多复杂问题 (如“市场失灵”问题 )以后 ,又导致了大量的更为复杂的问题 (如政府腐败、社会腐败问题 )。于是 ,“有限政府” ,政府权力向社会 (“第三部门”)转化的方案提出来了。政府权力转化为社会公权力后 ,行使社会公权力的行为还属不属“行政”的范畴 ,应否受行政法的规范和控制 ?行政法的功能是什么 ?管理论、控权论、平衡论对之有不同的看法。现代行政法在纠正传统行政法片面强调管理或片面强调控权的偏向后 ,正逐步形成以规范和控制行政权为手段 ,以服务行政相对人和保护行政相对人合法权益为目的的法律规范体系     

Psychology of Promoting Environmentalism: Promoting Environmentalism

This issue of the Journal of Social Issues focuses on the psychology, sociology, and public policy of global environmental issues. The goals of the issue are (1) to describe the current state of the environment and environmentalism, (2) to present new theories and research on environmentalattitudes and behaviors, and (3) to explore obstacles and ethical considerations in promoting proenvironmental action. The following brief introduction places this issue within a context of preceding JSI issues, provides a framework for the articles, and highlights several recurring themes that occur throughout the issue.     

An assessment of the performance of Italian public historical archives: Preservation vs utilisation

Economists have paid an increasing attention to the estimation of efficiency in the public sector. Archives constitute an exception notwithstanding their cultural and historical relevance. This paper is, to the best of our knowledge, the first attempt to fill this lacuna. The analysis of the performance of archives raises theoretical issues because their outputs have characteristics of a pure public good (preservation) and of a private service (utilisation). Moreover, the trade-off between the long and short-run goals of, respectively, preservation and utilisation is central in most public policies concerning heritage. We address this issue by studying the efficiency of public historical archives (PHAs) in Italy, over the period 2011–2012. We use Data Envelopment Analysis (DEA) and implement one-stage and two-stage approaches to investigate PHAs’ performance in the management of their different and potentially conflicting functions. Our analysis shows that PHAs perform better in the preservation function, considering the objectives and constraints they face.     

Reversing "the inadvertent nationalization of fatherhood": The British Child Support Act 1991 and its consequences for men, women and children

During the 1980s, with the growth in divorce, remarriage and births outside marriage, men's responsibilities for children and their mothers have been reviewed. In Great Britain, the Child Support Act 1991, following a decade in which the number of lone parents increased by 50 per cent and the proportion claiming state benefit increased from one-half to two-thirds, is attempting to shift lone mothers from dependence on the State to dependence on the biological father of their children. This has raised controversial issues concerning women's and children's claims on the State as citizens in their own rights; the balance between a man's private duty to maintain and provide care for children (by maintaining their mother) and his public duty to reimburse the State for doing so; and the legitimacy of trade-offs between claims on family "property" and claims to maintenance previously exercised in the courts. The individualistic system of English family law, in contrast to the law in Scotland and continental Europe, is part of the context within which these changes are taking place. So, too, is the fall in economic activity rates of lone mothers, which are among the lowest in the European Union.