Sexual Orientation,Relationships with Parents,Stress, and Depressive Symptoms among Adults

Disparities in depressive symptoms as a function of sexual orientation have been well documented, but less is known about their origins. This study examines whether, even in adulthood, less favorable parental relationships are associated with disparities in depressive symptoms as a function of sexual orientation. Cross-sectional data were drawn from Wave IV of the National Longitudinal Study of Adolescent to Adult Health. Gay, lesbian, and bisexual (GLB) participants reported lower quality parental relationships, greater stress, and more depressive symptoms than did heterosexual participants. Lower quality parental relationships were associated with higher stress. Higher stress and lower quality parental relationships were associated with more depressive symptoms. GLB individuals reported lower father relationship quality and higher stress, which partially mediated the association of sexuality and depressive symptoms. Lesbian and bisexual women reported lower mother relationship quality and higher stress, which fully mediated the association of sexuality and depressive symptoms. While no differences in mother relationship quality existed for men, mother relationship quality was more strongly associated with depressive symptoms for gay and bisexual men than for heterosexual men. Even in adulthood, greater stress and depressive symptoms among GLB individuals were at least partially accounted for by less favorable parental relationships.     

Re‐examining Cultural Contradictions: Mothering Ideology and the Intersections of Class,Gender, and Race

Hays argues the dominant ideology of mothering in the United States is intensive mothering. Women embracing this ideology are completely devoted to their children and cultural contradictions of motherhood make it difficult to juggle work and family. Rothman argues further that ideologies of patriarchy, technology, and capitalism shape our notions of mothering. I explore these ideologies in this paper, paying careful attention to the labor performed by mothers – paid, childcare, and reproductive. Finally, using surrogacy as an example of how these ideologies interact, I argue that Rothman’s identifications of ideologies helps explain how the cultural contradictions of motherhood vary among mothers based on race and class.     

Supervising family therapy trainees in primary care medical settings: context matters

The purpose of this article is to identify and describe four essential skills for effective supervision of family therapy trainees in primary care medical settings. The supervision skills described include: (1) Understand medical culture; (2) Locate the trainee in the treatment system; (3) Investigate the biological/health issues; and (4) Be attentive to the self-of-the-therapist. Recommendations are also made to help supervisors become better prepared for the questions medical family therapy trainees bring to supervision.     

Viewpoint: observations on scaled average bioequivalence

The two one-sided test procedure (TOST) has been used for average bioequivalence testing since 1992 and is required when marketing new formulations of an approved drug. TOST is known to require comparatively large numbers of subjects to demonstrate bioequivalence for highly variable drugs, defined as those drugs having intra-subject coefficients of variation greater than 30%. However, TOST has been shown to protect public health when multiple generic formulations enter the marketplace following patent expiration. Recently, scaled average bioequivalence (SABE) has been proposed as an alternative statistical analysis procedure for such products by multiple regulatory agencies. SABE testing requires that a three-period partial replicate cross-over or full replicate cross-over design be used. Following a brief summary of SABE analysis methods applied to existing data, we will consider three statistical ramifications of the proposed additional decision rules and the potential impact of implementation of scaled average bioequivalence in the marketplace using simulation. It is found that a constraint being applied is biased, that bias may also result from the common problem of missing data and that the SABE methods allow for much greater changes in exposure when generic-generic switching occurs in the marketplace.     

UPPER BOUNDS FOR EFFICIENCY FACTORS IN BLOCK DESIGNS

Upper bounds are derived for efficiency factors in block designs with particular types of variety or block concurrence matrices. These bounds compare favorably with existing upper bounds.     

Tape-recorded cuing for time-sampled observations of nonverbal behavior

While much research on nonverbal components of social interaction effectively employs film or videotape recording, a variety of circumstances preclude their use. For those situations that require direct observation of ongoing interactions, a simple technique is proposed that facilitates the reliable judgment of diverse behaviors on a time-sampling basis. This particular technique involves the tape-recorded cuing of exact observation times and instructions, which direct the observer's visual attention to the critical behaviors of specific subjects. The implementation of this technique in one setting and its potential application are briefly discussed.The author wishes to thank Paul Ekman for his comments on an earlier draft of this paper.     

Spiritual issues in family therapy: a graduate-level course

With the advent of the biopsychosocial approach in family therapy, the domain of spiritual issues is increasingly being recognized as important to families. This article will describe a graduate-level seminar on Spiritual Issues in Family Therapy at the University of San Diego that offers family therapy students the opportunity to examine issues of spirituality, religion, and meaning and their place in therapy. One premise of the course is that research has demonstrated that most clients consider their spiritual life to be relevant to personal problems and would prefer a therapist who is comfortable with such topics. The goals of the course include (1) training in opening a dialogue with individuals and families about spiritual issues and discerning when referral may be appropriate; (2) expanding an awareness of wisdom traditions through use of comparative religions material; and (3) identifying from current practice many of the spiritual issues that may arise in the clinical setting.     

An evaluation of a client-centered case management program for elder abuse

ABSTRACT Short-term outcomes of a case management program for competent, community-dwelling abused elderly persons were assessed. The intervention provided by Case Managers consisted of five components: (a) helping the client set long and short-term goals, (b) providing information about services and legal rights, (c) explaining and discussing options to decrease abuse, (d) supporting the client in deciding to take action or not, and (e) involving others in the plan of care. Retrospective data were collected from 26 client records. Intervention outcomes were assessed by determining the number of cases in which abuse was eliminated or decreased at case closure and the reasons for case closure. In 34.6% of the cases, abuse was completely eliminated, while in 30.8% of cases there was some improvement in the situation.