Challenges in Multidisciplinary Systematic Reviewing: A Study on Social Exclusion and Mental Health Policy

In the clinical sciences, systematic reviews have proved useful in the aggregation of diverse sources of evidence. They identify, characterize and summate evidence, but these methodologies have not always proved suitable for the social sciences. We discuss some of the practical problems faced by researchers undertaking reviews of complex and cross‐disciplinary topics, using the example of mental health and social exclusion. The barriers to carrying out social science and cross‐disciplinary reviews are reported and some proposals for overcoming these barriers are made, not all of them tried and tested, and some of them controversial. Using a mapping approach, a wide‐ranging search of both clinical and social science databases was undertaken and a large volume of references was identified and characterized. Population sampling techniques were used to manage these references. The challenges encountered include: inconsistent definitions of social phenomena, differing use of key concepts across research fields and practical problems relating to database compatibility and computer processing power. The challenges and opportunities for social scientists or multidisciplinary research teams carrying out reviews are discussed. Literature mapping and systematic reviews are useful tools but methods need to be tailored to optimize their usefulness in the social sciences.     

Divorce and Emerging Adult and Young Women: Building Foundations for Self-Development

Informed by consensual qualitative research methodology, the experiences of nine divorced emerging and young adult women were analyzed. Prior to marriage, themes of feeling unmoored, in transition, and without an anchor shaped their narratives. Lack of self-reflection and evaluation predisposed the participants to making decisions based on partial and “convenient” truths. Unfolding processes led the majority of the women to revisit their premarital selves, engage with the emotional work that was deferred, and build foundations that were growth enhancing. Implications for counselors and related professionals are discussed.     

Cohabitors’ Reasons for Living Together,Satisfaction with Sacrifices,and Relationship Quality

The purpose of our study was to identify both negative and positive associations of cohabitation with relationship quality. Using a sample of 280 cohabitors, we examined how reasons for cohabitation (i.e., spending time together, testing the relationship, and convenience) are associated with relationship quality (i.e., commitment, satisfaction, ambivalence, and conflict) as moderated by satisfaction with sacrifices. Results showed that a higher score on spending time together as a reason for cohabitation was linked with greater commitment and satisfaction and lower ambivalence and conflict, even when cohabitors reported lower satisfaction with sacrifices. In contrast, a higher score on testing the relationship as a reason for cohabitation was linked with more ambivalence regardless of the level of satisfaction with sacrifices. Finally, a higher score on convenience as a reason for cohabitation was linked with lower commitment, including when cohabitors reported lower satisfaction with sacrifices. Collectively, our results are important in demonstrating the positive and negative aspects of cohabitation in association with relationship quality and when satisfaction with sacrifices moderates such associations.     

Increasing Migration,Diverging Communities: Changing Character of Migrant Streams in Rural Thailand

This paper studies how increasing migration changes the character of migrant streams in sending communities. Cumulative causation theory posits that past migration patterns determine future flows, as prior migrants provide resources, influence, or normative pressures that make individuals more likely to migrate. The theory implies exponentially increasing migration flows that are decreasingly selective. Recent research identifies heterogeneity in the cumulative patterns and selectivity of migration in communities. We propose that this heterogeneity may be explained by individuals’ differential access to previously accumulated migration experience. Multi-level, longitudinal data from 22 rural Thai communities allow us to measure the distribution of past experience as a proxy for its accessibility to community members. We find that migration becomes a less-selective process as migration experience accumulates, and migrants become increasingly diverse in socio-demographic characteristics. Yet, selectivity within migrant streams persists if migration experience is not uniformly distributed among, and hence not equally accessible to, all community members. The results confirm that the accumulation and distribution of prior migrants’ experiences distinctly shape future migration flows, and may lead to diverging cumulative patterns in communities over time.     

The Treadmill of Production and the Positional Economy of Consumption

The theory of the treadmill of production highlights how the constant search for economic growth leads to advanced economies being stuck on a “treadmill,” where their well‐being is not improved by economic growth, yet the impacts of this pursuit of growth causes massive, unsustainable environmental damages. In interrogating the specific driving force that keeps the irrational system of the treadmill so powerfully in place, the theory of the treadmill of production focuses on how those who control the production process, corporations, are the primary agents driving the treadmill, while also highlighting how the state and workers generally continue to provide support for the treadmill's continued reproduction. In thinking about ways to begin to unwind the treadmill, there is a clear need to explore why workers, who are also consumers and citizens, continue to support (reluctantly or not) the treadmill of production. Through an analysis of the positional economy of consumption, this paper identifies key stakes that individual consumers have in expanding their income and consumption levels through the treadmill of production, despite the widespread inefficacy of the treadmill to increase aggregate satisfaction levels. This theory of the positional economy of consumption identifies the structural forces that lock individuals into increasing their income and levels of “defensive consumption” merely to maintain their existing levels of social practices and the well‐being generated from them, thus further supporting the reproduction of the treadmill of production. La théorie de l'‘engrenage de la production’ (‘treadmill of production’) démontre en quoi la recherche constante de croissance économique enferme les économies avancées dans un ‘engrenage’, où leur bien‐être n'est pas amélioré par la croissance économique, mais où les impacts de la poursuite de la croissance se traduisent par des dommages environnementaux massifs et irréparables. En analysant les forces spécifiques qui préservent ce système avec autant de pouvoir, cette théorie insiste sur l'importance de ceux qui contrôlent le processus de production (les corporations) en tant que principaux agents appuyant cet ‘engrenage’, tout en soulignant comment, d'une manière générale, l'Etat et les travailleurs persistent à soutenir sa perpétuation. En pensant aux manières d'arrêter cet ‘engranage’, il y a un besoin évident d'étudier pourquoi les travailleurs, qui sont aussi consommateurs et citoyens, persistent à soutenir (à contrec?ur ou pas) cet ‘engrenage’ de la production. Grâce à une analyse de l'économie positionnelle de la consommation, cet article identifie les principaux intérêts qu'ont les consommateurs individuels à augmenter leurs revenus et leurs niveaux de consommation au sein de cet engrenage de la production, en dépit de son inefficacité générale à améliorer les niveaux de satisfactions agrégés. Cette théorie de l'économie positionnelle de la consommation identifie les forces structurelles qui enferment les individus dans une recherche d'augmentation de leurs revenus et de leurs niveaux de ‘consommation défensive’, seulement pour maintenir leurs niveaux actuels de pratiques sociales et le bien‐être qui en découle, contribuant ainsi à reproduire l'engrenage de la production.     

“There is Just a Different Energy”: Changes in the Therapeutic Relationship with the Telehealth Transition

Clinical Social Work Journal - The therapeutic relationship (TR), including its therapeutic frame, is the foundation of the therapeutic endeavor. In response to the COVID-19 pandemic and the rapid...     

Risk society and the distribution of bads: theorizing class in the risk society

Ulrich Beck states in the Risk Society (1992) that the rise of the social production of risks in the risk society signals that class ceases to be of relevance; instead the hierarchical logic of class will be supplanted by the egalitarian logic of the distribution of risks. Several trenchant critiques of Beck's claim have justified the continued relevance of class to contemporary society. While these accounts have emphasized continuity, they have not attempted to chart, as this paper will, how the growing social production of risk increases the importance of class. This paper argues that it is Beck's undifferentiated, catastrophic account of risk that undergirds his rejection of class, and that by inserting an account of risk involving gradations in both damages and calculability into Beck's framework, his theory of risk society may be used to develop a critical theory of class. Such a theory can be used to reveal how wealth differentials associated with class relations actually increase in importance to individuals’ life‐chances in the risk society. With the growing production and distribution of bads, class inequalities gain added significance, since it will be relative wealth differentials that both enables the advantaged to minimize their risk exposure and imposes on others the necessity of facing the intensified risks of the risk society.     

Burden‐of‐illness vaccine efficacy

In recent years, many vaccines have been developed for the prevention of a variety of diseases. Although the primary objective of vaccination is to prevent disease, vaccination can also reduce the severity of disease in those individuals who develop breakthrough disease. Observations of apparent mitigation of breakthrough disease in vaccine recipients have been reported for a number of vaccine‐preventable diseases such as Herpes Zoster, Influenza, Rotavirus, and Pertussis. The burden‐of‐illness (BOI) score was developed to incorporate the incidence of disease as well as the severity and duration of disease. A severity‐of‐illness score S > 0 is assigned to individuals who develop disease and a score of 0 is assigned to uninfected individuals. In this article, we derive the vaccine efficacy statistic (which is the standard statistic for presenting efficacy outcomes in vaccine clinical trials) based on BOI scores, and we extend the method to adjust for baseline covariates. Also, we illustrate it with data from a clinical trial in which the efficacy of a Herpes Zoster vaccine was evaluated.     

Relational Sacrifices about Intimate Behavior and Relationship Quality for Expectant Cohabitors

ABSTRACT

Using interdependence theory, we examined how relational sacrifices specific to intimacy were associated with positive (commitment, satisfaction, love, and maintenance) and negative (ambivalence and conflict) relationship quality among expectant, unmarried cohabitors (n = 69 individuals), because this group may struggle relationally. We examined how often individuals made sacrifices for their partners and their partners’ perceived awareness of their sacrifices (i.e., individuals’ perceptions that their partners are aware that intimate sacrifices had been made for them) for both members of the couple using Actor Partner Independence Models. We controlled for children from previous relationships, unplanned pregnancy, gender, education, and race/ethnicity. Results showed that frequency of intimate sacrifices was not associated with any aspects of relationship quality. Instead, as expected, perceived partner awareness of intimate sacrifice was associated with greater commitment, satisfaction, love, and maintenance for individuals; lower ambivalence for individuals; and lower conflict for both individuals and their partners. These results suggest that for expectant cohabitors, perceived partner awareness of intimate sacrifices is central to achieving more positive, and less negative, relationship quality.     

Geographic information systems, spatial network analysis, and contraceptive choice

How does family planning accessibility affect contraceptive choice? In this paper we use techniques of spatial analysis to develop measures of family planning accessibility, and evaluate the effects of these geographically derived measures in a multilevel statistical model of temporary method choice in Nang Rong, Thailand. In our analyses we combine spatial data obtained from maps and Global Positioning System (GPS) readings with sociodemographic data from surveys and administrative records. The new measures reveal (1) important travel time effects even when family planning outlets are close by; (2) independent effects of road composition; (3) the relevance of alternative sources of family planning supply; and (4) the importance of the local history of program placement.