Re-Visioning Attention Deficit Hyperactivity Disorder (ADHD)

Constructionist notions have become commonplace in theoretical discussions of the self, but are seldom translated into consideration of specific social work practice concerns such as ADHD. Explorations of ADHD, on the other hand, typically emphasize a narrow, medically-oriented symptom picture that is devoid of the psychosocial context in which the so-called symptoms emerge. A transactional approach to the understanding of ADHD is advanced. This article promotes a link between constructionism and social work's psychosocial or person-in-environment perspective. Such a perspective supports approaches to the assessment of ADHD that illuminate larger cultural messages and their constraining influence on individual meaning-making. Intervention, conducted at multiple levels, must be geared to the establishment of more hopeful and affirming narratives.     

Validating quality indicators. Quality as relationship between structure, process, and outcome

Theory and research have not kept pace with the growing interest in evaluating quality of mental health care, resulting in the use of unvalidated quality indicators. A framework for validating quality indicators is offered by which quality is viewed as the relationship between service structures, processes, and outcomes. Adoption of this framework will facilitate the measurement of quality using valid indicators and should be useful to agencies in their continuous quality improvement efforts. Valid information about the quality of mental health care services will help purchasers and consumers make more informed health care decisions.     

Implementation and process evaluation of a student "school-as-community" group. A component of a school-based drug abuse prevention program

Little documentation exists regarding the functioning of formalized adolescent groups as drug abuse prevention agents. Two studies are described that were conducted at high schools whose students are at high risk for drug abuse. Twenty-one schools were randomly assigned to one of three conditions: (a) standard care, (b) classroom drug abuse education only, or (c) classroom plus school-as-community. Results of the first study indicated that the school-as-community component--which involved weekly meetings and periodic events at seven schools--was implemented as planned, drug abused focused, and perceived as productive in discouraging drug abuse. In the second study, staff in the classroom plus school-as-community condition self-reported involvement in the greatest number of community activities across the school year, compared with staff from the other two conditions. These two studies support the feasibility of formalized groups of high-risk youth to promote drug-free events.     

Rethinking assimilation and ethnicity: the Chinese in Thailand

US theoretical models of assimilation of ethnic groups within a larger culture usually assume a unilinear, unidimensional process, which is simplistic, does not account for the persistence of ethnicity, and oversimplifies the process of social change. The argument is advanced that ethnic identity is both primordial and situational (a private sense that is self-maintaining, cumulative, deepening, and self-affirming). Typically, a person has one primary ethnic identity, but where ethnic boundaries overlap, there is instrumental identity. Chinese in Thailand mostly adopt Thai values, speak the Thai language, go to Thai schools, join Thai associations, and celebrate Thai religious festivals. Their secondary identity as Chinese is integrated into their associations with other Chinese and in the home through the use of the Chinese language. Their Chinese identity appears also in ancestor worship. There are symbiotic relationships between native Thais and Chinese Thais along class lines. The Chinese are known to have great financial and economic resources, while the Thais have political and administrative control. These differences with the power elites separate the Chinese from the Thais and interfere with assimilation. The power is balanced. If the Chinese gained in political and administrative power, the balance would be upset, and the interests of both groups would be threatened. The view of Whitten and Whitten acknowledges that individuals and groups act to make the best of the situation and are not merely victims of social forces. Actions are maintained and resisted. The important consideration in theory-building is not the terms of assimilation but the terms specifying the conduct of the group as a whole and as individuals in daily social interactions. The theoretical discussion focuses on border crossings, the Skinner view of the Chinese, bilingualism and cultural education, socioeconomic organizations, occupational differences, and religion, tradition, and ethnic identification.     

The design of organizations and the right to act

Recent innovations in the structure of formal organizations suggest possible directions for the design of schools to bring about high achievement. The structure of output-driven in contrast to administratively-driven schools is described, and designs are described which address both the goal of high achievement and the goal of reduced inequality.An earlier version of this paper was presented as the author's Sorokin Lecture at the annual meeting of the Eastern Sociological Society, Boston, March 1993.     

Social determinants of life expectancy]

"Life expectancy and mortality increasingly are analyzed in the context of social factors. This study analyzes the impact of social position, marital status, and religious confession on cohort life expectancy. The analysis is based on [German data from the] Socio-Economic Panel Survey, wherein proxy-interviewee's parents have been used to estimate cohort mortality. Results confirm a lower mortality risk of the upper classes and of married persons. However, as opposed to other studies, Catholics do not have a lower, but even a higher mortality risk." (SUMMARY IN ENG)