The epidemiology of schizophrenia among Caribbean-born and first- and second-generation migrants in Britain

The study of migrants in their new environments is often a useful means of investigating environmental influences on health. Migrants have been found to develop higher rates of mental illness compared to their counterparts who remain at home. These deleterious effects of migration have been attributed to selection factors and stressful life experiences. Migration from an agricultural and traditional society to an urban industrial society where value systems can be demanding, often leads to role strain and role conflict. These kinds of incongruities are the beginning of a series of stressful experiences that contribute to poor health/mental health status. The extent to which one experiences stress is dependent on a number of factors. First, it depends on the perceived difference between home and the new environment. Second, it depends on the cultural homogeneity of the new environment, that is, the extent to which the migrant is readily assimilated into the new culture or is able to maintain a traditional lifestyle by living in an ethnic enclave, and the psychological resources available to successfully access services in the new environment. This paper examines the rates, incidence, and prevalence of schizophrenia found in Caribbean-born immigrants to Britain, and first- and second-generation people of Caribbean background born in Britain. It is argued that Afro-Caribbean people in England are overrepresented in the diagnosis of schizophrenia. Factors that may contribute to this finding range from unemployment, social disadvantage status, social adversity, racism in the health and criminal justice systems, and misdiagnosis.This paper was completed when the author served as Distinguished Visiting Professor-William Patterson College, Wayne, New Jersey.     

ADDITIVE MODELS WITH PREDICTORS SUBJECT TO MEASUREMENT ERROR

This paper develops a likelihood‐based method for fitting additive models in the presence of measurement error. It formulates the additive model using the linear mixed model representation of penalized splines. In the presence of a structural measurement error model, the resulting likelihood involves intractable integrals, and a Monte Carlo expectation maximization strategy is developed for obtaining estimates. The method's performance is illustrated with a simulation study.     

Childhood parental loss and adult depression

Previous research demonstrates convincingly that childhood parental deaths and parental divorces have implications for adult well-being as defined by levels of depression, educational attainment, early age at marriage, and risk of divorce. What this research has failed to examine are the interconnections among these outcomes. Specifically, are the socioeconomic and marital outcomes of parental loss implicated in the observed higher levels of depression? This analysis takes a first step in answering this question. Using data from a sample of 1,755 married men and women, I estimated regression models which examine the extent to which adult socioeconomic status and current marital quality mediate and/or modify the loss-depression relationship. Parental divorce was strongly related to socioeconomic and marital outcomes. Furthermore, current marital quality contributed importantly to understanding the higher levels of depressed mood observed among persons from divorced homes. Parental death was much more weakly related to socioeconomic and marital outcomes, and these outcomes played little role in explaining its relationship to depression. Finally, all of these relationships were stronger among women than men. These findings support the utility of life-course approaches to understanding adult mental health.     

Small Business Success Among Men- and Women-Owned Firms in Rural Areas1

Abstract Rural women have difficulty finding good jobs. Ownership of small businesses offers an alternative but the sales and income of women-owned firms are significantly lower than those of men-owned firms. Compared with men, women owners are more likely to operate smaller and newer businesses; however, these differences do not completely account for the gap in gross sales between men- and women-owned businesses. The strongest influences on business success are firm size, corporate status, and industrial sector. Though significant, the owner's gender is less important than these organizational characteristics. The factors influencing success of small businesses generally are the same for men- and women-owned businesses. More research on business networks and the start-up phase of small businesses is necessary for a better understanding of the sources of gender differences in success.     

Clinical work with adolescents and their parents during family transitions: Transference and countertransference issues

This paper describes specific transference and counter-transference issues that commonly emerge in therapeutic work with adolescents and parents who are in the midst of family transitions such as divorce and remarriage. Psychoanalytic understanding and definitions of transference and countertransference are applied to short-term family-centered cases in which the parent-adolescent relationship is at particular risk. Case vignettes are presented in order to illustrate how transference and countertransference may guide or interfere with clinical interventions that are especially indicated with adolescents whose family structure has changed. Such interventions as well as the use of consultation are briefly described.At the time this paper was prepared, Ms. Springer was Associate Director and a senior clinician at the Center for the Family in Transition in Corte Madera, California. Funds for the research and clinical work that provided the basis for this paper were supplied by grants from the San Francisco Foudation. An earlier version of this paper was presented at the 66th Annual Meeting of the American Orthopsychiatry Association, New York City, March 31–April 4, 1989.     

Domains of convergence for the EM algorithm: a cautionary tale in a location estimation problem

The EM algorithm is a popular method for maximizing a likelihood in the presence of incomplete data. When the likelihood has multiple local maxima, the parameter space can be partitioned into domains of convergence, one for each local maximum. In this paper we investigate these domains for the location family generated by the t-distribution. We show that, perhaps somewhat surprisingly, these domains need not be connected sets. As an extreme case we give an example of a domain which consists of an infinite union of disjoint open intervals. Thus the convergence behaviour of the EM algorithm can be quite sensitive to the starting point.