Alternative solutions to the problem of selection bias in an analysis of federal residential drug treatment programs

In an evaluation of prison-based residential drug treatment programs, the authors use three different regression-based approaches to estimating treatment effects. Two of the approaches, the instrumental variable and the Heckman approach, attempt to minimize selection bias as an explanation for treatment outcomes. Estimates from these approaches are compared with estimates from a regression in which treatment is represented by a dummy variable. The article discusses the advantage of using more than one method to increase confidence in findings when possible selection bias is a concern. Three-year outcome data for 2,315 federal inmates are used in analyses where the authors separately examine criminal recidivism and relapse to drug use for men and women. Statistical tests lead the authors to conclude that treatment reduces criminal recidivism and relapse to drug use. The treatment effect was largest when the inference was based on the Heckman approach, somewhat smaller when based on the instrumental variable approach, and smallest when based on the traditional dummy variable approach. Treatment effects for females were not statistically significant.     

The influence of religious and ethnic differences on marital intimacy: intermarriage versus intramarriage

The influence of religious and ethnic differences on marital intimacy was examined by administering the Personal Assessment of Intimacy in Relationships and a demographic/attitudinal questionnaire to 25 Jewish couples (intramarried) and 25 couples with one Jewish partner (intermarried). All couples were childless and in the first 5 years of their first marriage. Results indicated that the groups did not differ regarding couple level of intimacy, similarity of intimate experience, or mutual understanding. However, in-depth interviews revealed differences in the pathways by which these two groups arrived at a similar level of intimacy. Intramarried couples appear to experience greater personal similarity and mutual understanding rooted in their ethnic bond, which aids the development of intimacy. Intermarried couples appear to find that the very process of negotiating ethnic differences leads to greater mutual understanding and intimacy. These findings indicate that clinicians and religious leaders should not assume that intermarriage constrains levels of intimacy. Nor should it be assumed that intramarriage assures high intimacy.     

A troubling triangle. An exploration of loneliness, helplessness, and boredom of residents of a veterans home

1. Lack of companionship, no opportunity to care for others, and little variety result in the problems of loneliness, helplessness, and boredom for many nursing home residents. 2. Loneliness, helplessness, and boredom may be even greater challenges than physical and functional problems for individuals in nursing homes. 3. Through clinical research and practice innovations, nursing has an opportunity to take a leading role in increasing information about emotional and functional issues that affect the quality of life for nursing home residents.     

A randomized trial of emotion-focused therapy for couples in a training clinic

Forty married couples participated in a randomized trial comparing 8 weekly sessions of emotion-focused therapy (EFT) for couples to a group of couples who were placed on an 8-week waiting list. A composite marital satisfaction score was created from scores on the Dyadic Adjustment Scale, Positive Feelings Questionnaire, and Personal Assessment of Intimacy in Relationships scale. Controlling for pretest scores, participants in the treatment group had significantly higher levels of marital satisfaction after 8 weeks than wait-list participants. Supplementary analyses identified variables associated with gains in therapy and with dropping out of the study.     

Maximizing learning outcomes by videotaping nursing students' interactions with a standardized patient

1. Videotaping is a beneficial instructional methodology to help undergraduate students develop awareness of their strengths and opportunities for growth in therapeutic interactional skills. 2. Educational interventions with undergraduate students provide an opportunity to involve doctoral students in vital instruction, research, and knowledge dissemination through publication and presentation. 3. Allowing novice nurses to view their interactional skills with a simulated patient can reduce the anxiety they experience in first therapeutic encounters with assigned patients. 4. Continuous quality improvement in educational methodology is dependent on listening carefully to students who have invaluable feedback to offer and making appropriate correction as indicated.     

Marijuana use and depression

The primary goal of this study is to examine the association between marijuana use and adult depressive symptomatology. The key independent variables examined are age of marijuana initiation, frequency of current marijuana use, the use of other licit and illicit drugs, and whether marijuana was used to cope with problems. The relationships among these variables are assessed using data from the Young Men and Drugs Survey (n = 1,941), a nationally representative sample of men from the 1944-1954 birth cohort. Results show that early marijuana initiation appears to be weakly associated with increased depression in adulthood. This effect, however, is mediated by educational attainment, employment status, marital status, and other drug use, notably alcohol and tobacco use. Adult frequency of marijuana use is not significantly associated with increased depression in adulthood. Finally, marijuana users who use the drug to cope with problems are more depressed than those who do not use to cope with problems.     

Abuse, support, and depression among homeless and runaway adolescents

This study examines the effectiveness of social support networks on psychological well-being among 602 homeless and runaway adolescents. The respondents were interviewed in shelters, drop-in centers, and on the streets in cities of four Midwestern states (Missouri, Iowa, Nebraska, and Kansas). The path model was used to test the direct effect of family abuse and precocious independence on adolescent depressive symptoms and indirect effects through social support networks. Results indicate that although abusive family origins contribute directly to depressive symptoms there are indirect effects of family abuse and early independence through social support networks. Family abuse and early independence drive homeless adolescents to rely on peers for social support. While support from friends on the street reduces depression, association with deviant peers increases depression.     

The role of adversity and stress in psychopathology: some evidence and its implications for theory and research

Three lines of research--studies of extreme situations, epidemiological investigations of relations between socioeconomic status (SES) and psychiatric disorders, and a quasi-experimental test of the social causation-social selection issue raised by the epidemiological findings--provide strong evidence that environmental adversity is important in the occurrence not only of post-traumatic stress disorder (PTSD) but also of other types of psychopathology, including major depression, alcoholism, substance use disorders, antisocial personality disorder, and nonspecific distress. Leads from this triad of studies are developed into a basic proposition about the nature of the role of adversity and stress. The core of this proposition is that the likelihood of onset of the above types of disorder increases with two factors: (1) the proportion of the individual's usual activities in which uncontrollable negative changes take place following a major negative event; and (2) how central the uncontrollable changes are to the individual's important goals and values. The role of environmental adversity in bringing about these uncontrollable changes varies with gender, ethnic/racial status, and SES in our own and other modern, urban societies. The types of psychopathology that develop and their course vary with both the types of adversity (e.g., whether life threat is involved) and with the personal predispositions of the individuals who experience the adversity and stress (e.g., family history of particular types of psychopathology).     

Policy challenges for child welfare in the new century

Recent changes in public policy reflect increased efforts to scapegoat poor women and children and to polarize the objectives of child protection and family preservation. This article challenges various stakeholders in the child welfare field to move beyond the quick-fix solutions and bureaucratic overregulation precipitated by horror stories of child abuse in the media. The new century presents an opportunity to pursue differential intervention strategies that protect children while empowering poor families and communities.