Commentary: answers and questions in the sociology of mental health

This commentary speaks to several issues that arise from the papers in this special issue. Two articles--Kessler (2002) and Mirowsky and Ross (2002)--focus on a major measurement issue: dimensional versus diagnostic-type assessments. One topic requires greater attention: the correspondence of these measures with the underlying states they supposedly measure--constructs in the psychometric tradition and empirically defined illnesses in the medical or psychiatric tradition. Conclusions about the nature of these unobserved states remain tentative at this time. Three articles--Keyes (2002), Schwartz (2002), and Umberson, Williams, and Anderson (2002)--address the expansion of mental health outcomes. The existing reliance on emotional distress is problematic for sociological research because a single disorder is not a good proxy for estimates of the overall mental health consequences of social arrangements. Although these papers present diverse and sometimes conflicting perspectives, collectively they demonstrate that no one approach to outcomes is best for all research questions.     

Overcoming hopelessness and social isolation: the ENGAGE model for working with neglecting families toward permanence

The Adoption and Safe Families Act of 1997 (ASFA) mandates policies designed to increase the frequency and speed with which permanency is achieved for children in the child welfare system. ASFA's focus is on child safety, permanency, and well-being. The expectation that parents correct neglectful conditions within specified time frames places an increased ethical responsibility on child welfare staff. Carrying out this responsibility requires vigorous and innovative approaches to engaging and working with neglectful families. Drawing on a well-established conceptual framework for understanding the determinants of effective parenting, the authors derive the ENGAGE (Engagement, Needs assessment, Goal setting, Assessment of progress, Goal achievement, Ending work) model for achieving permanency within the policy structure. The model incorporates creative client engagement, assessment of family needs, mutual goal setting, the goal achievement process, termination, and aftercare.     

Sex and Gender in the 1970s

The late 1960s through the early 1970s was a time of profound social change both in American society and in sociology. Sociological attention shifted from social pathology to deviant subcultures and to labeling processes, shifting again by the 1990s to the study of social control. Many ethnographic studies of homosexuality were undertaken in the 1960s and 1970s in the tradition of labeling and stigma, including Laud Humphreys' Tearoom Trade (1970) and my Identity and Community in the Gay World (Warren 1974). Male ethnographers in particular were often stigmatized along with the deviants they studied, while the women (including me) were sometimes discouraged from doing graduate-level sociology at all. Thirty years later, the terrains of gender, sexuality and stigma have changed, yet pockets of pro-stigma resistance remain. Even in the 2000s, the stigma of homosexuality has not entirely disappeared. And, above all, the essentializing categories of homosexual, bisexual and heterosexual remain firmly entrenched in public discourse, sociological analysis, homophobia and gay activism.     

Collecting loss

ABSTRACT

‘Collecting Loss’ develops themes from Pleasures Taken (Mavor, Duke University Press, 1995) with an emphasis on the fetishization of photographs and old clothes (exemplified, on the one hand, in Elin O'Hara Slavick's own girlhood dresses that she has stitched with haunting memories of her childhood, and on the other hand in the lush photographs taken by Sally Mann and the Victorian photographer Clementina Hawarden). As Christian Boltanski has written: ‘What they [clothing and photographs] have in common is that they are simultaneously presence and absence. They are both an object and a souvenir of a subject, exactly as a cadaver is both an object and a souvenir of a subject.’ Reading an old photographic album made by her own grandmother against other maternal collections of plenitude (whether they be old clothes or photographs or domestic bric-a-brac), Mavor reveals how such accumulated goods are made to fill in for the pangs of loss: lost childhoods, lost family histories, lost memories, lost friends. Mixing corporeality and critical theory, Mavor engages with Emily Apter's notion of ‘maternal collectomania’ as a site of provocative meanings worthy of placement alongside more conventional discourses on visual representation and collecting.     

On a multiple endpoints testing problem

In a clinical trial comparing drug with placebo, where there are multiple primary endpoints, we consider testing problems where an efficacious drug effect can be claimed only if statistical significance is demonstrated at the nominal level for all endpoints. Under the assumption that the data are multivariate normal, the multiple endpoint-testing problem is formulated. The usual testing procedure involves testing each endpoint separately at the same significance level using two-sample t-tests, and claiming drug efficacy only if each t-statistic is significant. In this paper we investigate properties of this procedure. We show that it is identical to both an intersection union test and the likelihood ratio test. A simple expression for the p-value is given. The level and power function are studied; it is shown that the test may be conservative and that it is biased. Computable bounds for the power function are established.     

Sociocultural Contexts of Time to First Sex Among Hispanic Adolescents

This investigation examines the sociocultural influences on risk of first sex among a representative sample of Hispanic (primarily of Mexican origin) teens living in Los Angeles County. Teen acculturation (measured as language of interview) moderates the effects of gender on risk of sex, with less acculturated teens exhibiting the greatest gender difference. Teens living with both biological parents have significantly lower risk of sex and the effect of family acculturation (measured as generational status) operates through teens' language of interview. Neither measure of parent‐youth relationship (socioemotional support, parental control) is significant. Hispanic teens living in low‐density Hispanic neighborhoods have significantly higher risk of sex than do teens living in neighborhoods with higher levels of ambient hazards. The results highlight the importance of characterizing sociocultural influences at multiple levels of aggregation.     

Differentiation of Self and the Process of Forgiveness: A Clinical Perspective for Couple and Family Therapy

In this article we explore the role of differentiation of self in facilitating forgiveness in the context of couple and family relationships. Differentiation is defined from the Bowen perspective as the ability to connect with others without being excessively emotionally reactive to the ebb and flow inherent in all significant relationships (being able to connect to others yet also being able to self‐regulate). Forgiveness is described as the releasing of an emotional injury via a complex psychological and relational process that is less an act of will than a discovery or possibility through understanding and empathy. Differentiation of self is related to emotional intelligence and empathy. The developmental and relational benefits of such are illustrated and discussed. A rationale for viewing differentiation and forgiveness in a contextual, historical, and relational attachment paradigm is suggested. Relevant clinical cases illustrate the dynamics of differentiation and forgiveness as discovery in the context of an understanding and empathic relational environment.     

REGULATING WORKERS COMPENSATION: THE MEDICO LEGAL EVALUATION OF INJURED WORKERS IN VICTORIA

Sociological research on occupational injury has been dominated by perspectives from the social organisation of work and the labour process. What is missing from this literature is an explanation of the actual experiences at the individual worker within the processes of legitimation of occupational injury. This study explores the experiences of injured workers as they move through the medico-legal process. Medical reports and clients perspectives were used to expose the positions of doctors, insurance companies, lawyers and workers compensation bureaucrats as they form a complex intersection of power and interest in the regulation of injured workers. In particular, the conflicting roles of doctors as both gatekeepers and service providers were highlighted in the maintenance of stigmatised damaged workers.