The therapy alliance: a moderator in therapy outcome for families dealing with child abuse and neglect

The role of the therapy alliance in therapy outcome for families dealing with child abuse and neglect was examined using the family as the unit of analysis. The alliance was tested as a moderator in relationship to posttreatment levels of symptom distress and physical violence. Results show that the bonds, goals, and tasks subscale scores are significantly related to posttreatment levels of symptom distress and that the goals subscale score is significantly related to posttreatment level of violence. There is an interaction between bonds and level of violence at intake, suggesting that the greater the level of violence at intake, the more important the bonds domain.     

Gun possession among Massachusetts batterer intervention program enrollees

Batterers with access to firearms present a serious lethal threat to their partners. The purpose of this exploratory study is to estimate the prevalence of and risk markers for gun possession among Massachusetts men enrolled in batterer intervention programs. The authors found that 1.8% of the men reported having a gun in or around their home. Those most likely to report having a gun were White, earned 25,000 US dollars or more per year, had served in the military, engaged in problem gambling, and had attempted homicide or threatened their partner with a firearm. Recommendations for strengthening relevant gun laws both within and outside of Massachusetts are discussed.     

Alternative medicine and herbal use among university students

In this study, the authors investigated the predictors of complementary and alternative medicine (CAM) and herbal supplement use among university students. They investigated demographic factors, trait affectivity, symptom reports, and individuals' worries about modernity as potential contributors to use of CAM and herbals. The authors surveyed 506 undergraduates at a large southeastern state universityand administered the following questionnaires to participants in a group setting: a CAM survey, an herbal use survey, a negative affect (NA) and positive affect (PA) scale, Modern Health Worries scale, and the Subjective Health Complaint scale. Overall, 58 % of the participants had used at least one type of CAM, and 79 % of the students had used at least one herbal substance in the past 12 months. A hierarchical regression determined that increased age, female gender, flu-like symptoms, musculoskeletal symptoms, pseudoneurological symptoms, and modern health worries were significantly related to students' CAM use. Herbal use was related to increased age, musculoskeletal, pseudoneurological, and gastrointestinal symptoms.     

Are Adult Patients More Tolerant of Treatment Risks Than Parents of Juvenile Patients?

Understanding patient-specific differences in risk tolerance for new treatments that offer improved efficacy can assist in making difficult regulatory and clinical decisions for new treatments that offer both the potential for greater effectiveness in relieving disease symptoms, but also risks of disabling or fatal side effects. The aim of this study is to elicit benefit-risk trade-off preferences for hypothetical treatments with varying efficacy and risk levels using a stated-choice (SC) survey. We derive estimates of "maximum acceptable risk" (MAR) that can help decisionmakers identify welfare-enhancing alternatives. In the case of children, parent caregivers are responsible for treatment decisions and their risk tolerance may be quite different than adult patients' own tolerance for treatment-related risks. We estimated and compared the willingness of Crohn's disease (CD) patients and parents of juvenile CD patients to accept serious adverse event (SAE) risks in exchange for symptom relief. The analyzed data were from 345 patients over the age of 18 and 150 parents of children under the age of 18. The estimation results provide strong evidence that adult patients and parents of juvenile patients are willing to accept tradeoffs between treatment efficacy and risks of SAEs. Parents of juvenile CD patients are about as risk tolerant for their children as adult CD patients are for themselves for improved treatment efficacy. SC surveys provide a systematic method for eliciting preferences for benefit-risk tradeoffs. Understanding patients' own risk perceptions and their willingness to accept risks in return for treatment benefits can help inform risk management decision making.     

Employment Patterns of Less-Skilled Workers: Links to Children’s Behavior and Academic Progress

Using data from five waves of the Women’s Employment Survey (WES; 1997–2003), we examine the links between low-income mothers’ employment patterns and the emotional behavior and academic progress of their children. We find robust and substantively important linkages between several different dimensions of mothers’ employment experiences and child outcomes. The pattern of results is similar across empirical approaches—including ordinary least squares and child fixed-effect models, with and without an extensive set of controls. Children exhibit fewer behavior problems when mothers work and experience job stability (relative to children whose mothers do not work). In contrast, maternal work accompanied by job instability is associated with significantly higher child behavior problems (relative to employment in a stable job). Children whose mothers work full-time and/or have fluctuating work schedules also exhibit significantly higher levels of behavior problems. However, full-time work has negative consequences for children only when it is in jobs that do not require cognitive skills. Such negative consequences are completely offset when this work experience is in jobs that require the cognitive skills that lead to higher wage growth prospects. Finally, fluctuating work schedules and full-time work in non-cognitively demanding jobs are each strongly associated with the probability that the child will repeat a grade or be placed in special education.     

Drug markets,violence, and the need to incorporate the role of race

While race has proven to be a critical variable in the sociological understanding of multiple social outcomes, scholars have yet to fully appreciate the nature by which it shapes drug‐related violence. Empirical responses to the 1980s urban proliferation of illicit drugs generally relied on systemic explanations of drug market violence and how participants, by virtue of social positioning, are unable to use the criminal justice system to address grievances. Contrarily, the contingent causation hypothesis suggests that drug markets engender violence in settings where socioeconomic conditions are already favorable for violence. In spite of the contributions of these two themes, we argue that both represent oversimplifications of the complex ways by which race structures drug‐related violence. To truly understand drug market violence, the dominant narrative of emerging research must contextualize the proliferation of illicit drugs within the socio‐historical context of race and institutional racism. Only if and when that happens will the field move towards realistic solutions to ameliorate this social problem.     

Public Perceptions of Regulatory Costs,Their Uncertainty and Interindividual Distribution

Public perceptions of both risks and regulatory costs shape rational regulatory choices. Despite decades of risk perception studies, this article is the first on regulatory cost perceptions. A survey of 744 U.S. residents probed: (1) How knowledgeable are laypeople about regulatory costs incurred to reduce risks? (2) Do laypeople see official estimates of cost and benefit (lives saved) as accurate? (3) (How) do preferences for hypothetical regulations change when mean‐preserving spreads of uncertainty replace certain cost or benefit? and (4) (How) do preferences change when unequal interindividual distributions of hypothetical regulatory costs replace equal distributions? Respondents overestimated costs of regulatory compliance, while assuming agencies underestimate costs. Most assumed agency estimates of benefits are accurate; a third believed both cost and benefit estimates are accurate. Cost and benefit estimates presented without uncertainty were slightly preferred to those surrounded by “narrow uncertainty” (a range of costs or lives entirely within a personally‐calibrated zone without clear acceptance or rejection of tradeoffs). Certain estimates were more preferred than “wide uncertainty” (a range of agency estimates extending beyond these personal bounds, thus posing a gamble between favored and unacceptable tradeoffs), particularly for costs as opposed to benefits (but even for costs a quarter of respondents preferred wide uncertainty to certainty). Agency‐acknowledged uncertainty in general elicited mixed judgments of honesty and trustworthiness. People preferred egalitarian distributions of regulatory costs, despite skewed actual cost distributions, and preferred progressive cost distributions (the rich pay a greater than proportional share) to regressive ones. Efficient and socially responsive regulations require disclosure of much more information about regulatory costs and risks.