Seymour Martin Lipset: The social uses of anomaly

Let me preface my remarks by saying that we are here to honor a living, breathing colleague. My great concern, and in this I am sure that I speak for my colleagues as well, is that any imputation of a postmortem be avoided. Indeed, I would like to believe that Marty will review these various contributions and make his own assessments-critical or approvingly. The fact that he is not present in this conference hall should not deter us from speaking frankly and forthrightly. Marty merits nothing less. What binds us all is the sure knowledge that the work of Lipset speaks to us in personal as well as professional ways. That he has touched so many of us in both the private and public realms is itself a testimonial of the magnitude of his contribution to the field of political sociology. So it is in that spirit of a collégial dialogue that I offer these remarks. Let us hope that a year from now a session of one person can be held, at which S. M. Lipset will provide rebuttals and responses to those of us herein gathered. His most recent work in the field is Behemoth: Main Currents in the History and Theory of Political Sociology. The two major sources for traching the written works of Seymour Lipset are contained in Reexamining Democracy: Essays in Honor of Seymour Martin Lipset, edited by Gary Marx and Martin Diamond. Newberry Park, California: Sage Publishers. 1992, especially pp. 332–355. For work done by Lipset after 1991; as embodied in his later work, see Lipset's essay on “Steady Work: An Academic Memoir,” Annual Review of Socialogy: Greenwich, CT: JAI Press, 1996, pp. 1–27. My reference to works mentioned in the narrative can be found in either of these bibliography sources.     

No wonder social workers feel uncomfortable in court

The present article assesses the adversary systemper se and asks the question, Is there any place for courtroom antics and histrionics in cases involving children? Social workers are uncomfortable before the august body of thecourt, not because of any lack of education or knowledge on their part but because of the nature of the adversary process itself.     

Zusammenfassungen

Ohne Zusammenfassung German translations by Monika Lütke-Daldrup.     

A modified random-effect procedure for combining risk difference in sets of 2×2 tables from clinical trials

Summary Meta-analyses of sets of clinical trials often combine risk differences from several 2×2 tables according to a random-effects model. The DerSimonian-Laird random-effects procedure, widely used for estimating the populaton mean risk difference, weights the risk difference from each primary study inversely proportional to an estimate of its variance (the sum of the between-study variance and the conditional within-study variance). Because those weights are not independent of the risk differences, however, the procedure sometimes exhibits bias and unnatural behavior. The present paper proposes a modified weighting scheme that uses the unconditional within-study variance to avoid this source of bias. The modified procedure has variance closer to that available from weighting by ideal weights when such weights are known. We studied the modified procedure in extensive simulation experiments using situations whose parameters resemble those of actual studies in medical research. For comparison we also included two unbiased procedures, the unweighted mean and a sample-size-weighted mean; their relative variability depends on the extent of heterogeneity among the primary studies. An example illustrates the application of the procedures to actual data and the differences among the results. This research was supported by Grant HS 05936 from the Agency for Health Care Policy and Research to Harvard University.     

Sexual identity in the ghetto

The more things change, the worse they get.Presented April 18, 1991, Duke University, at the Department of Psychiatry's Grand Rounds, this paper condenses, integrates and updates the author's earlier publication. Acknowledgement and thanks for funding and professional sponsorship of the four research studies this paper draws from are selectively due to the Eugene and Agnes E. Meyer Foundation, the Edgar Stern Family Fund, The National Institute for Mental Health, the Baltimore-Washington Institute for Psychoanalysis and the Department of Psychiatry, Children's Hospital National Medical Center.     

Differences in preferred level of arousal in two sub-groups of problem gamblers: A preliminary report

Twelve problem poker machine players and thirteen horse race gamblers (20 males and 5 females; age range 28–69) completed a series of questionnaires which assessed levels of anxiety, their preferred state of arousal and their motivations to gamble. As predicted, problem poker machine gamblers were found to be more anxious and reported avoiding arousal more frequently than the horse race gamblers. Alternately, problem horse race gamblers were found to prefer heightened levels of arousal and appeared to gamble to achieve these optimal levels of arousal. However, there was no difference between the groups on proneness to boredom. The present results provide evidence which is consistent with the Reversal theory and its application to the field of problem gambling.     

Screening for patients with alcohol problems: severity of patients identified by the CAGE.

Primary care physicians are well situated to identify patients with substance abuse problems and motivate them to seek appropriate assistance, but active programs are the exception. A study in a community setting was undertaken to assess the CAGE (the first letters of key words in a series of four questions about drinking: cut down; annoyed; guilty; and eye-opener), instrument in the routine screening for alcohol problems in both new and established patients. The screening process identified subjects for a pilot evaluation of a motivational interview designed to encourage problem-solving behavior. This article focuses on the screening results and the use of the CAGE instrument. During June and July of 1990, 687 patients of two primary care physicians belonging to a large group practice were asked to complete a health questionnaire that included the CAGE. Those who responded affirmatively to at least two of the four CAGE questions were requested to participate in follow-up assessment of problems associated with alcohol and health. The type and severity of alcohol problems experienced by patients who scored positive on the CAGE are described. Prevalence of a positive score on the CAGE was 8.6 percent with males, smokers, and blue collar and unemployed persons being more likely to score positive. The positive predictive value was .68. Primarily, persons with moderate alcohol problems were identified. Results show that the CAGE instrument is a useful screening device for identifying those with mild to moderate substance abuse problems, increasing the opportunity for intervention prior to serious medical complications. The instrument is easily administered, and has demonstrated relatively high levels of sensitivity and specificity. When combined with assessment and motivational interviews, the CAGE shows promise in the secondary prevention of substance abuse and related health problems.