How Can I Become More Secure?: A Grounded Theory of Earning Secure Attachment

The purpose of this study was to develop a grounded theory of earning secure attachment. This study included 15 women and 5 men who met the criteria of having a self-reported history of attachment insecurity and demonstrated evidence of earned security. The grand tour research question, How do adults with a history of insecure attachment earn security?, was explored using constructivist grounded theory and semi-structured interviews emphasizing processes of positive attachment change. The results describe a process model of change hinging on three interrelated categories: meta-conditions of positive attachment change, making intrapsychic changes, and making interpersonal changes. Clinical implications include the importance of clients committing to the process, clients working with a clinician trained in trauma-focused therapy, and clinicians being surrogate attachment figures for clients.     

Testing for Causal Effects in a Generalized Regression Model With Endogenous Regressors

A unifying framework to test for causal effects in nonlinear models is proposed. We consider a generalized linear‐index regression model with endogenous regressors and no parametric assumptions on the error disturbances. To test the significance of the effect of an endogenous regressor, we propose a statistic that is a kernel‐weighted version of the rank correlation statistic (tau) of Kendall (1938). The semiparametric model encompasses previous cases considered in the literature (continuous endogenous regressors (Blundell and Powell (2003)) and a single binary endogenous regressor (Vytlacil and Yildiz (2007))), but the testing approach is the first to allow for (i) multiple discrete endogenous regressors, (ii) endogenous regressors that are neither discrete nor continuous (e.g., a censored variable), and (iii) an arbitrary “mix” of endogenous regressors (e.g., one binary regressor and one continuous regressor).     

On the Bootstrap of the Maximum Score Estimator

This paper shows that the bootstrap does not consistently estimate the asymptotic distribution of the maximum score estimator. The theory developed also applies to other estimators within a cube‐root convergence class. For some single‐parameter estimators in this class, the results suggest a simple method for inference based upon the bootstrap.     

Education and the changing shape of the income gradient in health

Research on the social determinants of health has increasingly sought to understand the relative importance of different features of socioeconomic status. Much of the ensuing debate has wavered between education and income, with recent research leaning increasingly toward income. This research has not, however, consistently explored interactions between different features of socioeconomic status and, in trying to understand the independent effects of different components of socioeconomic status, may have missed important features of socioeconomic position. With an eye toward examining how features of socioeconomic status combine and coalesce, this paper examines variation in the income-health association by level of education. Theories derived both from medical sociology and health economics suggest synergistic interactions between income and education, but they are unclear as to the direction and magnitude of these interactions. Results from two large and nationally representative data sets (the 1996-1997 Community Tracking Study and the 1972-2000 General Social Survey) indicate that the positive relationship between income and health varies substantially in both its strength and shape by level of education. Education improves health, and its effects are larger at lower levels of income. Moreover, education reduces the strength and curvature of the income-health relationship. Consequently, those with more education have better health for all levels of income, and fewer income-based disparities exist among the well educated than among the less well educated. The linear "gradient" relationship between income and health is, thus, more characteristic of groups with higher levels of education. Additional analyses indicate that these interactions existed in the United States in each of the last three decades. The results are discussed in light of theory regarding the perpetuation of health disparities, as well as current debates regarding the apparent incompatibility of distributive versus aggregative goals in health policy.     

Factors influencing middle and high schools' active parental consent return rates

The authors examined factors influencing the return rates for attempting to collect active parental consent forms from 21,123 students in the 7th through 10th grades in 41 middle and high schools. Overall return rates from middle schools were higher than from high schools. Schools that offered high levels of staff support for collecting consent forms had higher return rates. Procedures where the consent form was attached to a school form that parents had to complete and return to the school yielded the highest return rate. Implications for how researchers can obtain a high parent consent form return rate are discussed.     

The Impact of the Therapist's Curiosity on the Treatment Process of Children and Adolescents

Therapists bring their own initiative, interest, and wonder—their professional curiosity—into treatment sessions. Some children and adolescents pull away in reaction to this curiosity, bristling or withdrawing, if only for a moment. This can happen abruptly, even in response to the first hello, but most often it occurs subtly, over the course of treatment. These children and adolescents may be replaying the ruptures in relationships they experienced when they have expressed their own initiative and curiosity to important others in their lives. Therapists need to utilize opportunities to understand the dynamics, explore where the original ruptures may have occurred, and bring the experience into therapeutic focus. Case vignettes illustrate these dynamics.     

Misgivings of medicine?: African Americans' skepticism of psychiatric medication

Research has consistently documented black-white differences in rates of voluntary psychiatric treatment that cannot be reduced entirely to differences in either need or access. A variety of explanations have been offered for the gap that remains, but the empirical testing of alternative propositions has thus far been minimal. Using the 1998 General Social Survey's Pressing Issues in Health and Medical Care module (n = 1,387), I find consistent and substantial black-white differences in a variety of beliefs about psychiatric medications, one of the most common treatments for mental illness, and the predisposition to use them. Specifically, blacks express less willingness to use psychiatric medications themselves or to administer them to a child for whom they are responsible. Neither socioeconomic status, knowledge, religious involvement, nor trust in medicine appears to explain this reluctance. Rather, it stems almost entirely from blacks' beliefs about psychiatric medications' efficacy and side-effects. The results indicate, first, that researchers should not assume that African Americans will use psychiatric medications at rates similar to whites if offered equal access. Second, the results indicate that blacks' skepticism of psychiatric medications may be rooted in specific beliefs about psychiatric medications, rather than general ideologies about medical practice. Health beliefs about psychiatric treatment, therefore, will continue to play an important role in understanding race differences in the use of psychiatric medications.     

预期寿命增长、年龄结构改变与我国国民储蓄率

人口年龄结构趋于老龄化和人均预期寿命逐步增长是目前我国人口发展的两个典型特征,而年龄阶段不同,个人的收入、消费与储蓄行为也不同。基于生命周期理论,在选定相关分析指标的基础上,文章使用我国省际平衡面板数据,实证分析了我国人口预期寿命增长和年龄结构改变对国民储蓄率的影响。分析结论表明,人口预期寿命增长提高了我国国民储蓄率;不考虑时间效应时,幼年人口负担比提高会减少国民储蓄率,而老年人口负担比提高会增加国民储蓄率;在考虑时间效应时,幼年人口负担比提高会增加国民储蓄率,而老年人口负担比提高会减少国民储蓄率。对此,文章给出了合理的解释。通过使用多种估计方法,我们发现所得到的结论是基本稳健的。     

Preliminary evaluation of contingent meals and telephone use to improve evidence-supported family therapy session attendance in mothers referred by Child Protective Services for substance abuse

Persons referred by Child Protective Services (CPS) for substance abuse evidence high rates of nonattendance to therapy sessions, taxing systems of care and exacerbating outcomes. This study examined the influence of two telephone-based incentive programs on therapy session attendance in mothers who were referred by CPS for substance abuse. After baseline therapy session attendance was established in an evidence-based clinic that incorporated a telephone engagement intervention (Phase I), participants were provided free cellular telephones with limited minutes and permitted to order free meals delivered by the therapist during upcoming sessions (Phase II). The third phase was similar to Phase II, but participants were provided unlimited minutes. Results indicated that participants’ attendance was significantly improved when meals and cellular telephone minutes were contingent on attendance. Although the percentage of sessions attended by participants during Phase III was higher than Phase II, unlimited minutes and meals did not significantly enhance attendance relative to limited minutes and meals. Session attendance for significant others of these participants was significantly higher during Phase III as compared with Phase I. Session attendance of significant others was statistically similar between Phase I and II and between Phase II and Phase III. Study implications and recommendations for future research and practice are discussed in light of the findings.