Factitious Illness by Proxy: Understanding Underlying Psychological Processes and Motivations

Children are put at risk of emotional and physical harm when parents seek unnecessary medical care. Understanding why parents seek medical interventions that create risk for their children requires us to consider how past experiences, and the mental representations of these experiences influence current behaviour. Past experiences of danger affect how parents interpret ‘dangerous’ situations in the present and how they organise protection of their child. This article demonstrates how the notion of mental representations (that dispose parents to act in particular ways) can assist in engaging, assessing and treating parents who display factitious illness by proxy behaviour. When classified using the Dynamic‐Maturational Method, the Adult Attachment Interview (AAI) allows both assessment of implicit and explicit representations and also understanding of the developmental process through which parents have learnt to attribute meaning to information and to organise their behaviour. In this case study, psychosocial assessment of the family included an AAI with each parent. The use of this assessment tool both aided the therapy team in the process of case formulation and intervention planning, and had therapeutic value in and of itself. We argue that treatment is more likely to be effective if the parents and professionals have a shared understanding of the parents' intentions and the developmental process that led to unsafe behaviour, which requires change.     

HOW DO ELECTORAL SYSTEMS AFFECT FISCAL POLICY? EVIDENCE FROM CANTONAL PARLIAMENTS, 1890–2000

Using a new data set on Swiss cantons since 1890, we analyze how the adoption of proportional representation affects fiscal policy. In line with economic theory, we show that proportional systems shift spending toward broad goods (like education and welfare benefits) but decrease spending on geographically targetable goods (like roads). We find little evidence that proportional representation increases the overall size of government. An analysis of the underlying theoretical mechanisms reveals that proportional representation increases electoral turnout, left‐wing representation, and political fragmentation. These changes in political representation explain a substantial share of the rise in education spending, but a small share of the rise in welfare spending or the decline in road expenditures.     

Community Wildfire Events as a Source of Social Conflict*

Abstract The literature notes that natural disasters, including wildfires, that damage human settlements often have the short‐term effect of “bringing people together.” Less recognized is the fact that such events can also generate social conflict at the local level. This study examines the specific sources of such social conflict during and after community wildfire events. Examining qualitative data generated from six case studies of wildfires in the American West, we suggest that integrating the theories of Weber, Giddens, and Habermas with community interaction theory provides a context for understanding such conflict. Rationalized forms of interaction and problem solving imposed by extra‐local organizations during and after wildfire events are often resisted by local actors who are also inhibited from acting due to local capacity limitations. Thus, conflict occurs when social relations are disembedded by non‐local entities, and there is a perceived loss of local agency.     

Employment motivations of farm spouses

In the study reported here, reasons for working off the farm and reasons for not working off the farm are examined as a function of gender and socioeconomic characteristics. Women are significantly less likely than men to work off the farm to supplement farm income, and significantly more likely to work off the farm for personal reasons. A logistic regression analysis finds that men, those employed fulltime off the farm, and those with lower household incomes are most likely to cite economic reasons for working off the farm. Men are nearly twice as likely as women to cite time constraints as the primary reason for not working off the farm, while only women cite family responsibilities. Logistic regression reveals that men, those with higher household incomes, and those with livestock operations are most likely to cite lack of time as the primary reason for not working off the farm.Patricia J. Wozniak is Associate Professor in the Department of Experimental Statistics, Louisiana State University, Baton Rouge, LA 70803. Her research interests include family life and family economics, as well as the application of statistics to the social sciences. She received her Ph.D. in Psychology from the University of Wisconsin—Milwaukee.Kathleen K. Scholl is Senior Coordinator of the Economics Team of the Public Policy Institute at the American Association of Retired Persons, 1909 K Street NW, Washington, DC 20049. She received her Ph.D. from Purdue University.     

Nonverbal behavior in families with adolescents

In fifty-three families, mothers, fathers and one adolescent were videotaped discussing two issues relevant to the adolescent's behavior: the aspects of their behavior they could change, and rules appropriate to life in the family. Family members later watched these videotapes and rated themselves and each other every 15 seconds on levels of perceived anxiety, involvement, strength and friend-liness. From these videotapes, each family member's behavior was also coded for the use of smiles, various face and head movements and gestures. Results revealed that adolescents looked frequently at both parents, but parents looked even more at each other and the adolescent. Adolescents smiled more than their parents, while mothers smiled and nodded their heads more than fathers. More nonverbal expresivity occurred in conversations between parents and daughters than between parents and sons, although these results were mainly due to the behavior of fathers with daughters. Ratings of involvement by parents were related to the adolescent's nonverbal behaviors, but other ratings were not. Mothers rated adolescents as more involved when they used more head up movements and nods. Fathers rated adolescents as more involved when they gazed and smiled more.     

Violence Exposure and Drug Use in Central American Youth: Family Cohesion and Parental Monitoring as Protective Factors

Associations between witnessing serious violence and drug use, and the protective influences of family cohesion and parental monitoring, were investigated among 9,840 adolescents (50.5% female, M age=15.29 years, SD=1.76) living in Panama and Costa Rica. After accounting for demographics and parental and sibling substance use, witnessing serious violence was associated with greater drunkenness, tobacco use, number of illicit drugs used, and problems with drugs and alcohol. In every analysis, exposure to violence was associated with more drug use, while family cohesion and parental monitoring attenuated risk. Further, family cohesion and parental monitoring exerted a protective‐stabilizing effect on number of illicit drugs used and on problems with drugs and alcohol. There were few interactions with age. Implications for prevention are discussed.     

CHANGING FAMILIES/CHANGING COMMUNITIES

Scholars writing about community in recent years have been more likely to lament its passing than celebrate its exemplars. What's missing in this recent revival of interest in community is a systematic link with work–family issues and, in particular, an explicit recognition that women's and men's work–family lives have changed dramatically in the post-World War II era. We investigate the consequences of structural shifts in our family and work lives for a sample of elite, managerial women in dual-earner marriages, a population for whom work and family concerns are both immediate and salient. Understanding changing definitions of, and trends in, family and work can provide a useful lens through which we can profitably address recent debates about the decline or resurgence of community and civic society. Our findings suggest that, although conceived differently than in previous decades, family remains central to our respondents’ sense of community and structures their civic engagement. In contrast with previous generations of women, however, work is also important, for defining women's sense of self and community and for offering an alternative venue for community service.     

Heretical Social Movement Organizations and Their Framing Strategies*

This article is an exploratory study of heretical social movement organizations (HSMOs) and the challenges that they face in framing their issue positions. It examines how identity communities’ core issue positions serve to demarcate the boundaries of authentic group membership, making “heretics” out of community organizations that have contrary positions. It also analyzes how these organizations finesse their heretical status by utilizing specific framing strategies. It illustrates these processes using data on two social movement organizations involved in the American abortion controversy, Catholics for a Free Choice, a Catholic pro‐choice organization, and Feminists for Life of America, a feminist pro‐life organization, during the period between 1972 and 2000. I begin by demonstrating the Catholic and feminist communities’ use of an abortion litmus test to maintain community boundaries. I, then, describe the two organizations’ use of value amplification and boundary framing to frame their “heretical” issue positions both within and against their identity communities, respectively. I conclude by discussing the trend toward orthodoxy in many identity communities and the role of heretical social movement organizations in challenging this trend.     

Trauma, coping resources, and family functioning in emergency services personnel: A comparative study

In this study a sample of male, shift-working, operational ambulance officers were compared with a group of male shift-workers from a range of occupations in which exposure to traumatic events was not inherent in the role ( N = 71). Three dimensions of family functioning were examined: intimacy, conflict, and parenting styles, with respect to occupational type (i.e. work-related exposure to trauma) and accounting for personal resources (coping). Personal resources were found to have a significant impact on the dimensions of family functioning. Furthermore, differences emerged in the pattern of coping between the two groups. Ambulance officers demonstrated a more varied repertoire of personal resources than the control group. Social support was found to be the sole predictor of intimacy and conflict levels in the control sample. However, in the ambulance group social support was predictive of intimacy levels, rational-cognitive strategies were predictive of conflict levels, and self-care, social support, and rational-cognitive strategies were all significantly correlated with the three dimensions of family functioning.