EXPERIMENTS WITH THE MIDDLE RESPONSE ALTERNATIVE IN SURVEY QUESTIONS

A series of experiments shows (1) that people are significantlymore likely to select the middle response alternative on anissue when it is explicitly offered to them as part of the questionthan when it is omitted; (2) that merely mentioning that thereis a middle alternative, in the preface to the question, makesit more likely that respondents will select it, even thoughit is not offered to them as an explicit choice; (3) that theorder in which the middle alternative is presented in the question—inthe middle or last position—can make a significant differencein the results, but that a "recency bias" does not occur invariably,or consistently; and (4) that people who select a middle responsealternative when it is offered would not necessarily answerthe question in the same way as other respondents if forcedto choose sides on the issue.     

The Vitalizing and the Revitalizing Experience of Reliability: The place of touch in psychotherapy

A particular psychotherapeutic procedure described by the authors as The Vitalizing and the Revitalizing Experience of Reliability, is used as an adjunct to enhance the effectiveness of the treatment. Characteristically, it is a nonmanipulative, nonseductive procedure used during particular stressful times with certain patients—adults as well as children—to facilitate a confirmation of the self as separate from others. It should also instill in the patient a feeling of increased safety and reliability as well as promoting basic trust in self and others with the ultimate goal of reintegration of a fragmented ego. Such an adjunct can take various forms. The one described here is a highly controversial one, physical touch. Two clinical examples are given which emphasize transferential and countertransferential considerations. The paper describes the delicate balance between discipline and flexibility required by the therapist.This paper was presented to the Psychoanalytic Psychologists of Long Island, 1985 and to the New York State Society of Clinical Social Work Psychotherapists, Nassau County Chapter, 1985.     

RESPONSE-TIME MEASUREMENT IN SURVEY RESEARCH A METHOD FOR CATI AND A NEW LOOK AT NONATTITUDES

The paper introduces a methodology for measuring accuratelythe time it takes respondents to answer questions in computer-assistedtelephone surveys. The methodology, which is completely invisibleto respondents, comprises a computer "clock," capable of timingresponses with millisecond accuracy, and a "voice-key" thatconverts sounds emitted by respondents into signals capableof triggering the computer clock. Response times to questionson a range of attitude questions, including stable and unstableattitudes, were measured. The results revealed orderly normsin the latencies associated with various types of survey questions.The latencies associated with the expression of stable and unstableattitudes are discussed in the context of the notion of "nonattitudes"and shed new light on this controversial thesis. Overall, ourresults demonstrate that response latencies can be measuredprecisely and reliably in telephone surveys and that the datafrom such measurement open new windows on the cognitive dynamicsof survey responses.     

Family ties and economic stability concerns of migrant labour families in Jordan

74 labor migrant families from various socioeconomic classes in Amman, Jordan were interviewed to examine changes in relationships among family members, extended family, and neighbors and their concerns about economic stability in the host country, Jordan, and the world market. Another purpose was to determine how current migration policies of the Arab oil-producing countries which prohibit labor migrants from bringing their families to the host country affect labor migration among families. The families consisted of either those who did or did not accompany the labor migrant. Overall labor migration affected unaccompanied families more than accompanied families, e.g., only 19% of the unaccompanied families reported increased family unity compared with 56% of accompanied families. Problems within unaccompanied families increased in 43% of the cases but in only 6% of the accompanied families. Many of these problems resulted in children dropping out of school which reflected the control fathers had within the family, separation, or divorce. Yet labor migration reduced family ties with extended family members and neighbors almost equally for both groups. Accompanied families were not as concerned about economic stability in Jordan as unaccompanied families (38% vs. 50%). Perhaps these families tended not to invest remittances received from the labor migrants working in Arab oil-producing countries in Jordan. Both groups were quite concerned about the economic stability in the host countries (66% and 72%, respectively) and the world market (59% and 62%, respectively), however. Since family unity suffers when families do not accompany labor migrants, it is suggested that oil-producing nations that depend on foreign labor should guarantee family unity as a human right.     

Problems in measuring role strains and social functioning in relation to psychological symptoms

The problems that people experience in social roles can be regarded as either causes or consequences of psychological symptoms. To reflect one of these possibilities, Pearlin et al. (1981) developed measures of "role strains" which are considered sources of psychopathology. To reflect the other position, Dohrenwend et al. (1981) constructed measures of "role functioning" which are seen as consequences of psychopathology. We show that the measures developed by these two teams of investigators are similar in content and show substantial empirical overlap despite the different meanings attributed to them. In an effort to understand whether these highly correlated measures assess, "role strain" or "role functioning," we conduct an exploratory analysis of marital and housework role problems, using a small panel sample of New York City residents. Specifically, we use instrumental variables to identify reciprocal effects between psychological distress and each role area. We find that the relationship between housework role problems and distress is more consistent with Pearlin et al.'s interpretation, whereas the relationship between marital problems and distress is more consistent with that of Dohrenwend et al. Investigators interested in measuring either role strain or role functioning must bear in mind the strong possibility of contamination from the other construct.     

Bringing baby home: a comprehensive case management program for obstetrical services

Originally presented to the Society of Home Health Care Management of the American College of Physician Executives at its November 16, 1993, meeting in Tucson, Ariz., the program described in this article was the winner of the College's 1994 Innovations Award in Medical Quality Management, sponsored by Merck Sharp & Dohme. The program shows the potential of case management for both improvement in the quality of care and containment of costs for a managed care population with a substantial Medicaid segment. This article is part of a continuing series on innovative programs in home health care.     

Delivery and funding are provincial matters in Canada

The following article is one of a series that deal with the provision of health care services around the world. Other countries in the series include Germany, Italy, Japan, Mexico, the Netherlands, and the United States. Countries scheduled for coverage in the series include Austria, France, Singapore, Spain, and the United Kingdom. The countries are described using a grid of characteristics so that comparisons may be made more easily. All of the analyses, along with further comparative data, will be gathered into a freestanding book to be published later in the year. Dr. Mendoza serves as editor for the project.     

IRS offers safe harbor in physician employment contracts

Last year, the Internal Revenue Service (IRS) issued Revenue Procedure 93-19 (Rev. Proc. 93-19), which provides guidelines regarding service and other contracts involving facilities financed with tax-exempt bonds. Rev. Proc. 93-19 creates four "safe harbors" for certain contracts signed by tax-exempt organizations that will not jeopardize the organizations' tax-exempt bond interest. Those guidelines and methods for complying with them are the subject of the following article. "Health Law" is a regular feature of Physician Executive contributed by Epstein Becker & Green. Mark Lutes of the law firm's Washington, D.C., offices serves as editor of the column.