Treating distressed couples with coexisting mental and physical disorders: directions for clinical training and practice

Relationship difficulties frequently coexist with significant emotional, behavioral, and physical health problems in one or both partners. Moreover, couple therapists report individual emotional and behavioral disorders as among the most difficult problems that they encounter in clinical practice. In this article, we summarize empirical evidence regarding the association between relationship distress and the onset, course, and treatment of mental and physical health problems. Based on these findings, we propose five critical implications for clinical training and the practice of couple therapy.     

Foresight activities in the U.S.A.: Time for a re-assessment?

This article reports on a brief, informal, reconnaissance study of ‘foresight’ activities now being conducted in the private sector and the Federal government. Such activities include: external environmental assessment, internal organizational assessment, direction setting, definition, and selection of base and contingent plans, implementation, performance evaluation and feedback. The study involved the reading and analysis of the existing literature and discussions with over 50 people in diverse private and public sector organizations. The objective was to determine what foresight activities are being done, how, by whom, with what results, and what are the implications and options.     

Medicaid Expansions and Fertility in the United States

Beginning in the mid-1980s and extending through the early to mid-1990s, a substantial number of women and children in the United States gained eligibility for Medicaid through a series of income-based expansions. Using natality data from the National Center for Health Statistics, we estimate fertility responses to these eligibility expansions. We follow Currie and Gruber (2001) and measure changes in state Medicaid-eligibility policy by simulating the fraction of a standard population that would qualify for benefits in different states and different time periods. From 1985 to 1996, the fraction of women aged 15–44 who were eligible for Medicaid coverage for a pregnancy increased more than 20 percentage points. When we use a state and year fixed-effects model with a limited set of covariates, our estimates indicate that fertility increases in response to Medicaid expansions. However, after we include fixed effects for demographic characteristics, the estimated relationship diminishes substantially in size and is no longer statistically significant. We conclude that there is no robust relationship between Medicaid expansions and fertility.     

A Prophet in his Hometown? the Academic Reception of Thomas Piketty’s “Capital in the Twenty-First Century” Across Disciplines in France and in the United States

This article analyzes the reception of Thomas Piketty’s “Capital in the twenty-first century” from September 2013 to June 2015 in France, where it was first released, and in the United States, by academics who come from a variety of disciplines. We discuss the “spontaneous sociology” offered by some of the actors of this reception and analyze, using their remarks as a starting point, the major predictors of the content of an academic review of Piketty. Our results highlight the strong effect of passing time on the content of the reviews – three clear phases can be identified in the reception of the book showing a “proteus effect” pattern. They also emphasize the importance of understanding how academic disciplines structure the debate – much more so than the country of residence. In fact, most of the opinions academics express on Piketty’s book are tied to their departmental affiliations. We look at how this link articulates the intellectual structures of the disciplines with field theory. Our results suggest a strong autonomy of the social scientific field from more general public concerns.     

Brexit and Global Wealth Chains

One vision of a post Brexit Britain is of a political economy sustained by highly flexible labour markets, light touch regulation, and a hyper competitive low-tax regime. This article focuses on the tax element, evaluating the prospects of this vision’s realization on the basis of the attributes of the British political economy, the substance of the Britain’s new found freedoms and the forces at play in the European and international regulatory environment. Britain is seeking a smooth transition via a strategy of upgrading and expanding national position in global wealth chains (GWCs). Occupying space in GWCs requires a series of careful balancing acts between making a tax offer attractive to mobile capital and maintaining revenue, designing a low-tax regime and staying within the boundaries of accepted practice established by multilateral rules and norms, and between multiple, often conflicting, goals that Britain must simultaneously pursue as it leaves the European Union. With hard Brexit, Britain will pursue this vision, but these balances are likely to prove illusive.     

Bayesian hierarchical duration model for repeated events: an application to behavioral observations

This article presents a continuous-time Bayesian model for analyzing durations of behavior displays in social interactions. Duration data of social interactions are often complex because of repeated behaviors (events) at individual or group (e.g. dyad) level, multiple behaviors (multistates), and several choices of exit from a current event (competing risks). A multilevel, multistate model is proposed to adequately characterize the behavioral processes. The model incorporates dyad-specific and transition-specific random effects to account for heterogeneity among dyads and interdependence among competing risks. The proposed method is applied to child–parent observational data derived from the School Transitions Project to assess the relation of emotional expression in child–parent interaction to risk for early and persisting child conduct problems.     

Maternal work hours and adolescents’ School outcomes among low-income families in four urban counties

We examine how changes in maternal work hours affect adolescent children's school participation and performance outcomes using data from interviews in 1998 and 2001 with approximately 1700 women who, in May 1995, were welfare-reliant, single mothers of adolescents living in neighborhoods of concentrated poverty in Cuyahoga (Cleveland), Los Angeles, Miami-Dade, and Philadelphia counties. Analyses control for a broad array of mothers' characteristics, including their psychological and physical health, experiences with domestic violence and substance abuse, as well as unobserved time-invariant characteristics. In fixed-effects models, we find unfavorable effects of increased maternal work hours on three of six outcomes: skipping school, performing above average, and parental contact about behavior problems. Adolescent-aged sons seem to be particularly sensitive to changes in mothers' hours of work.     

Reliability of self-reported contraceptive use and sexual behaviors among adolescent girls

This study examines two issues relevant to adolescents' self-reported sexual and contraceptive use behaviors: reliability of partner-referent reports versus 3 and 6 month reports, and test-retest reliability of reports completed over a 2 week period. Data are from 196 13 to 18 year old girls recruited into this study while they south reproductive care from health clinics in a metropolitan area. All participants reported having had sexual intercourse during the past 6 months. Twice over a 2 week interval, participants completed the same paper and pencil surveys. The survey presented questions about sexual behavior and contraceptive use using 3 sequential frames of reference: within the past 6 months, within the past 3 months, and by specific sexual partners in the past 6 months. Findings demonstrate that adolescent girls can reliably report sexual behavior and contraceptive use over a 6 month interval. Study findings have implications for future research utilizing adolescents' self-reported sexual and contraceptive use behaviors.     

Stress, health, and the life course: some conceptual perspectives

This article proposes several conceptual perspectives designed to advance our understanding of the material and experiential conditions contributing to persistent disparities in rates of morbidity and mortality among groups unequal in their social and economic statuses. An underlying assumption is that these disparities, which are in clear evidence at mid- and late life, may be anchored to earlier circumstances of the life course. Of particular interest are those circumstances resulting in people with the least privileged statuses having the greatest chances of exposure to health-related stressors. Among the stressors closely linked to status and status attainment are those that continue or are repeated across the life course, such as enduring economic strain and discriminatory experiences. Also taking a long-range toll on health are circumstances of stress proliferation, a process that places people exposed to a serious adversity at risk for later exposure to additional adversities. We suggest that this process can be observed in instances of trauma, in early out-of-sequence transitions, and in the case of undesired changes that disrupt behaviors and relationships in established roles. Effective effort to close the systemic health gaps must recognize their structural underpinnings.     

Social work with Bosnian Muslim refugee children and families: a review of the literature

More than two million Bosnian Muslims were ethnically cleansed in the Balkan region; of these, 200,000 were killed while the others were forced to flee their homes and become refugees. This article focuses on the influence of societal and cultural values coupled with wartime experiences on the transition of Bosnian refugee families to their new countries. Consideration is given to culturally competent theoretical frameworks and practice principles social workers can use to assist Bosnian Muslim children and families in their adaptation process within their resettlement communities.