Risk Factors for Infant Mortality in Nineteenth-Century Sweden

This study examines risk factors for infant mortality using individual-level data from a sample of parishes in northern Sweden in the nineteenth century. Sweden is of particular interest because of its unusually regular pattern of infant mortality decline during the century. We follow a sample of women longitudinally through their successive pregnancies and observe the mortality experience of each child. Exploratory and multivariate logistic regression analyses reveal an important intra-familial dimension to infant mortality that appears from the early stages of a woman's reproductive career. In addition, multivariate analyses by birth-order group suggest that ignoring intra-familial correlations of infant mortality may result in incorrect inferences. Siblings' shared probabilities of dying as infants suggest that high-birth-order children were not necessarily disadvantaged in any systematic way.     

H. S. Sullivan and “Interpersonal Learning”

Although many of the basic tenets of Harry Stack Sullivan’s interpersonal theory have been incorporated into the Relational School of psychoanalysis, Sullivan’s original ideas about clinical practice are, in many respects, distinct from the intersubjective perspective of relational psychotherapists. Using three case examples that addressed a similar clinical problem, Sullivan’s approach to clinical practice will be contrasted with contemporary relational approaches.     

“Road Warriors” on “Hair-Tragger Highways”: Cultural Resources and the Media's Construction of the 1987 Freeway Shootings Problem*

Media constructions of social problems usually rework the claims of activists and other primary claimsmakers. However, the news media acted as primary claims-makers in discovering and reporting the 1987 Los Angeles freeway violence problem. The press drew upon cultural resources in constructing this problem, applying a conventional template for social problems stories and using familiar imagery to depict freeway shootings. The social organization of claimsmaking, as well as contingencies in the histories of individual campaigns, affect the choice of cultural resources used to construct social problems.     

A model of the ring-recovery reporting process for the Cape Griffon Gyps coprotheres

By their very nature, statistical models are constructed on the basis of a number of simplifying assumptions. It is usual to assume that all the individuals in a 'group' or 'cohort' have similar survival, recovery or reporting probabilities. From a number of earlier studies of the Cape Griffon Gyps coprotheres in southern Africa, it is clear that there have been many violations of these assumptions of homogeneity. To get a better understanding of the process whereby a dead ringed bird is found and reported, an analysis was undertaken of 575 recoveries from 7130 individuals ringed as nestlings. From a series of univariate generalized linear models, it was found that the proportion of ringed birds reported dead varied with the following factors: (1) ring prefix (representing different grades and thicknesses of aluminium): there was considerable variation in reporting rate between cohorts fitted with different ring prefix series used; (2) metal type: birds fitted with monel metal rings were reported at a rate twice that of those bearing aluminium rings; (3) colour rings: recoveries of birds with colour rings were much more likely to be reported than birds with only a metal ring; (4) epoch: the reporting rate has increased steadily from the 1950s through to the mid-1980s. All of these factors are confounded and so a number of multivariate generalized linear models were constructed. It was found that the variations in the cohort-specific reporting rate could be described well by a model including factors for metal-ring type and the presence or absence of colour rings. Using the tougher monel metal ring along with a set of colour rings more than doubles the reporting rate and their continued use is strongly recommended for future studies. The year-to-year variations could be accounted for by this model but the colony of ringing did not enter the model. The models used were based on two assumptions: (i) the reporting rate was constant for all individuals within a given cohort and (ii) the recoveries were complete. It is argued that the results are congruent with these assumptions. There is now a clearer model of the manner in which the ring-recovery reporting process proceeds and this has opened the way to building a more realistic statistical model to estimate survival in the Cape Griffon.     

Community-based management of psychotic clients: The contributions of D. W. and Clare Winnicott

While the term management connotes images of impersonal care, D. W. Winnicott repeatedly used this term to describe the responsive environmental holding that is central to all human development. Influenced by observations of how normal mothers and families address the physical and psychic needs of children, he and his wife, Clare, a distinguished British social worker, operationalized this concept in finding and supporting facilitating environments with a wide range of disturbed children and adults. Using case material from a contemporary community program for the mentally ill, this paper will review the Winnicotts' important, but often neglected, perspectives on the environmental management of psychotic adults.Presented at the Washington School of Psychiatry, January 14, 1989. I would like to thank Janice Quiter and the Archives of Psychiatry of The New York Hospital-Cornell Medical Center for their assistance in researching the D. W. Winnicott collection.     

On Learning and Teaching Family Therapy

This paper explores some ideas about the process of learning to be a family therapist. It considers the questions: how does one learn to think like a family therapist? How is family therapy best taught? How is it learned? The author's experiences in learning and teaching are described. It is argued that family therapy differs from other approaches to therapy in some fundamental respects, and that learning to ‘be’ a family therapist is a different kind of task than learning to be a practitioner of other therapeutic approaches. The paper examines some key theoretical constructs, especially the idea of ‘levels’ of thinking, which are seen as central to both the learning and practice of family therapy.