Commentary on Mills’ “toward a theory of myth”

In his provocative article on theorizing about myth, Jon Mills kindly cites my own work on the subject. Let me confine my remarks to his comments on me. I now see, thanks to Mills, how confusing some of my statements have perhaps been.     

Transitioning Transgender: Investigating the Important Aspects of the Transition: A Brief Report

The purpose of this study is to identify important aspects of the transition to facilitate decision-making and improved care for transgender patients by transition-care providers. A survey was used to identify transition aspects deemed significant by transgender persons. Among transgender women, the most important transition elements were legal gender change, hormone therapy, breast augmentation, frontal bone setback, and removal of body hair, and among transgender men, change of dress/clothing, name and legal gender change, speech therapy, hormone therapy, chest reconstruction and breast binding. This information is useful to physicians as they care for transgender patients to better offer transition-related counseling.     

Assessing and communicating heterogeneity of treatment effects for patient subpopulations: Panel discussion on considerations in design and analysis

Clinical trials are primarily conducted to understand the average effects treatments have on patients. However, patients are heterogeneous in the severity of the condition and in ways that affect what treatment effect they can expect. It is therefore important to understand and characterize how treatment effects vary. The design and analysis of clinical studies play critical roles in evaluating and characterizing heterogeneous treatment effects. This panel discussed considerations in design and analysis under the recognition that there are heterogeneous treatment effects across subgroups of patients. Panel members discussed many questions including: What is a good estimate of the treatment effect in me, a 65-year-old, bald, Caucasian-American, male patient? What magnitude of heterogeneity of treatment effects (HTE) is sufficiently large to merit attention? What role can prior evidence about HTE play in confirmatory trial design and analysis? Is there anything described in the 21st Century Cures Act that would benefit from greater attention to HTE? An example of a Bayesian approach addressing multiplicity when testing for treatment effects in subgroups will be provided. We can do more or better at understanding heterogeneous treatment effects and providing the best information on heterogeneous treatment effects.     

The high cost of neglecting children: The need for a preventive policy agenda

Millions of children in the United States suffer from poor care and inadequate services due to neglectful national social policy. More than 13 million children live in poverty and its negative consequences, at great individual and social cost. This paper outlines the need to seriously advocate for a preventive policy approach to child welfare and presents a blueprint for individual and collective political action. The cost-effectiveness and social benefits of preventive policies are demonstrated. Social workers understand the value of prevention in working with children and families, and are needed to advocate on the policy-making level for a preventive policy agenda.     

Envelope Theorems for Arbitrary Choice Sets

The standard envelope theorems apply to choice sets with convex and topological structure, providing sufficient conditions for the value function to be differentiable in a parameter and characterizing its derivative. This paper studies optimization with arbitrary choice sets and shows that the traditional envelope formula holds at any differentiability point of the value function. We also provide conditions for the value function to be, variously, absolutely continuous, left‐ and right‐differentiable, or fully differentiable. These results are applied to mechanism design, convex programming, continuous optimization problems, saddle‐point problems, problems with parameterized constraints, and optimal stopping problems.     

The Mirrlees Approach to Mechanism Design with Renegotiation (with Applications to Hold‐up and Risk Sharing)

The paper studies the implementation problem, first analyzed by Maskin and Moore (1999), in which two agents observe an unverifiable state of nature and may renegotiate inefficient outcomes following play of the mechanism. We develop a first‐order approach to characterizing the set of implementable utility mappings in this problem, paralleling Mirrlees's (1971) first‐order analysis of standard mechanism design problems. We use this characterization to study optimal contracting in hold‐up and risk‐sharing models. In particular, we examine when the contracting parties can optimally restrict attention to simple contracts, such as noncontingent contracts and option contracts (where only one agent sends a message).     

Early psychosocial risk factors and postnatal parental reflective functioning

Psychosocial factors have been found to relate to parental reflective functioning (PRF), a parent's ability to mentalize about themselves and their child. Relations between maternal psychosocial risk factors and PRF were investigated in a community sample. A sample of mothers (n = 146) was assessed for risk factors when infants were 6 months, infant temperament was assessed using an observational measure, and PRF was assessed with the Parent Development Interview-Revised (PDI). PRF was measured again with the Parental Reflective Functioning Questionnaire (PRFQ) when children were 4 years (n = 105) and 5 years (n = 92), with an additional sample of mothers (n = 48) tested at these two timepoints. Results showed that in infancy, total maternal psychosocial risk related to lower PDI-PRF; regression analyses highlighted low socioeconomic status, unplanned pregnancy, and low maternal anxiety as independent predictors of lower PDI-PRF. PDI-PRF scores at 6 months did not relate to PRFQ scores, but PRFQ subscales showed stability over time from age 4–5. Results are discussed with regard to the impact of maternal psychosocial risk and infant temperament on PRF and the stability and concordance of PRF measures.