Commentary: The Public Health Consequences of an Industry-Influenced Psychiatric Taxonomy: “Attenuated Psychotic Symptoms Syndrome” as a Case Example

Determining the distribution of psychiatric disorders and developing sound preventive and intervention practices are pressing public health issues. Since at present mental disorders lack biological markers, psychiatric taxonomies must grapple with how best to address issues of validity and reliability. With the increasing congruence between the International Classification of Diseases (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) (American Psychiatric Association, 2010 American Psychiatric Association. 2010. Diagnostic and Statistical Manual of Mental DisordersProposed Revisions, Fifth, Washington, D.C: American Psychiatric Association.  [Google Scholar]), it is imperative that decisions regarding the inclusion of new disorders be research-based and not unduly influenced by industry. The first draft of DSM-V, recently made public, has created a firestorm of controversy, for the DSM's nomenclature of disease or other pathology not only affects such disparate domains as jurisprudence and insurance claims but is also an instrument designed to facilitate research on psychopathology.     

Building a More Connected DSMB: Better Integrating Ethics Review and Safety Monitoring

Data and Safety Monitoring Boards (DSMBs) have become an increasingly common feature of clinical trial oversight, yet a paucity of legal or ethical frameworks govern these Boards’ composition or operation, or their relationship with other actors with monitoring responsibilities. This paper argues that prevailing structural gaps are impeding harmonized systems for monitoring the ongoing ethical acceptability of clinical trials. Particular tensions stem from DSMBs’ sweeping discretion in deciding whether and when to recommend that a trial should be terminated or amended based on safety and efficacy information. This discretion becomes especially challenging in light of DSMBs’ monopoly over emerging trial data, which prevents Institutional Review Boards, sponsors, and investigators from participating in certain pivotal and ethically charged decisions. To address these disconnects, I advocate for strengthened pre-trial and post-trial communication in addition to innovative strategies to support DSMB decision making through the life of a trial.     

Childhood health and labor market inequality over the life course

The authors use data from the Health and Retirement Study's Earnings Benefit File, which links Health and Retirement Study to Social Security Administration records, to estimate the impact of childhood health on earnings curves between the ages of 25 and 50 years. They also investigate the extent to which diminished educational attainment, earlier onset of chronic health conditions, and labor force participation mediate this relationship. Those who experience poor childhood health have substantially diminished labor market earnings over the work career. For men, earnings differentials grow larger over the early to middle career and then slow down and begin to converge as they near 50 years of age. For women, earnings differentials emerge later in the career and show no evidence of convergence. Part of the child health earnings differential is accounted for by selection into diminished educational attainment, the earlier onset of chronic disease in adulthood, and, particularly for men, labor force participation.     

Disciplining an Unruly Field: Terrorism Experts and Theories of Scientific/Intellectual Production

“Terrorism” has proved to be a highly problematic object of expertise. Terrorism studies fails to conform to the most common sociological notions of what a field of intellectual production ought to look like, and has been described by participants and observers alike as a failure. Yet the study of terrorism is a booming field, whether measured in terms of funding, publications, or numbers of aspiring experts. This paper aims to explain, first, the disjuncture between terrorism studies in practice and the sociological literature on fields of intellectual production, and, second, the reasons for experts’ “rhetoric of failure” about their field. I suggest that terrorism studies, rather than conforming to the notion of an ideal-typical profession, discipline, or bounded “intellectual field,” instead represents an interstitial space of knowledge production. I further argue that the “rhetoric of failure” can be understood as a strategy through which terrorism researchers mobilize sociological theories of scientific/cultural fields as both an interpretive resource in their attempts to make sense of the apparent oddness of their field and their situation, and as schemas, or models, in their attempts to reshape the field. I conclude that sociologists ought to expand our vision to incorporate the many arenas of expertise that occupy interstitial spaces, moving and travelling between multiple fields.     

Childhood and adolescent violent victimization and the risk of young adult intimate partner violence victimization

Using a nationally representative sample of participants, this study investigates childhood victimization in the home and adolescent violent victimization in the community on the risk of being a victim of intimate partner violence (IPV), general violence, or both during early adulthood. The study findings indicate being left home alone and being physically abused during childhood, and adolescent violent victimization in the community had strong independent effects on an individual's likelihood of becoming a victim of IPV, general violence, or both in early adulthood. The study findings suggest a consistent pattern of victimization across the life course, and intervention programs need to be developed that address the specific needs of children and adolescents at high risk for home and community violent victimization.     

Pathological Gambling and Posttraumatic Stress Disorder: A Study of the Co-Morbidity versus Each Alone

This report is the first empirical study to compare pathological gambling (PG), posttraumatic stress disorder (PTSD), and their co-occurrence. The sample was 106 adults recruited from the community (35 with current PG; 36 with current PTSD, and 35 with BOTH). Using a cross-sectional design, the three groups were rigorously diagnosed and compared on various measures including sociodemographics, psychopathology (e.g., dissociation, suicidality, comorbid Axis I and II disorders), functioning, cognition, life history, and severity of gambling and PTSD. Overall, the PG group reported better psychological health and higher functioning than PTSD or BOTH; and there were virtually no differences between PTSD and BOTH. This suggests that it is the impact of PTSD, rather than comorbidity per se, that appears to drive a substantial increase in symptoms. We also found high rates of additional co-occurring disorders and suicidality in PTSD and BOTH, which warrants further clinical attention. Across the total sample, many reported a family history of substance use disorder (59%) and gambling problems (34%), highlighting the intergenerational impact of these. We also found notable subthreshold PTSD and gambling symptoms even among those not diagnosed with the disorders, suggesting a need for preventive care. Dissociation measures had mixed results. Discussion includes methodology considerations and future research areas.     

The After-School Corporation's approach to expanded learning

The After-School Corporation developed the Expanded Learning Time (ELT/NYC) initiative out of the most effective elements of after-school programs, charter schools, and other expanded learning strategies.     

The importance of end-of-life care in nursing home settings is not diminished by a disaster

The emphasis in disaster situations is on preserving life, and this goal is both appropriate and laudable. There is a risk, however, that the needs of people who are dying can become lost when there is a sudden surge of people needing acute intervention. There are significant ethical considerations inherent in society's prioritization of care needs across the acute, rehabilitative, and palliative spectrum in general, let alone in a disaster situation. These ethical conundrums are not the focus of this article. Rather, we anchor our discussion on the assumption that care needs are equally valid, and our purpose is to explore the issues that impact the provision of quality end-of-life care in nursing home settings for those who require this care when a disaster occurs. Nursing home residents, in particular, are at heightened risk for experiencing negative disaster-related outcomes due to compromised physical or mental health that requires skilled nursing care. Moreover, within the already vulnerable nursing home population are many people who are receiving palliative end-of-life services when a disaster strikes. Education and training in end-of-life services for nursing home staff, disaster emergency responders, and other lay people is vital to build capacity for adapting the delivery of these services in disaster situations in the interest of equity and human rights. Given the present lack of guidance in the literature as to what end-of-life care looks like when adapted to the context of disaster response, there is also a pressing need for research to inform this discussion. The purpose of this article is to draw attention to this topic and highlight some of the critical issues, gaps, and opportunities.     

Sharing the wealth: The effect of siblings on adults’ wealth ownership

Inequality in wealth has been well-documented, but its causes remain uncertain. Family processes in childhood are likely to shape adults' wealth accumulation, but these factors have attracted little attention. I argue that family size matters: children from larger families accumulate less wealth than do those from smaller families. Siblings dilute parents' finite financial resources and nonmaterial resources, such as time. This diminishment of resources reduces educational attainment, inter vivos transfers, and inheritance. Reduced educational attainment and transfers alter financial behavior; saving; and, ultimately, adults' wealth. I demonstrate that sibship size is associated with lower overall wealth in adulthood and that parents' resources and education, respondent's education, financial transfers, and financial behavior all mitigate the effect of siblings. Sibship size also reduces the likelihood of receiving a trust account or an inheritance and decreases home- and stock ownership. The findings provide important insights into early family processes that shape wealth accumulation and inequality.