Update on medications for the treatment of anxiety

It is interesting to note that antidepressants are widely represented in the medications used to treat the anxiety disorders. This has led to speculation about the role of depression, particularly subclinical forms being manifested as anxiety disorders. The specificity of diagnostic categories suggests that, at least for the moment, medications have a very specific and circumscribed role in the treatment of anxiety. This suggests that the difficulties of many anxious patients are not effectively treated with medication or that medication has only a short-term role at best. The next column will review health problems associated with psychotropic treatments for anxiety and discuss strategies for creating a "wedge," ie, introducing adjunct learning experiences along the anxiety gradient in conjunction with pharmacotherapy.     

The employment contract: A test of the transaction cost theory

This paper tests some predictions derived from Williamson's transaction cost theory of the organization of work, which holds that the form of the employment relationship is determined largely by the idiosyncrasy of work—that is, the nature of skills and knowledge used in production. It examines the occurrence of theoretically relevant provisions in collective bargaining agreements in the United States and finds they are related to a contract-level proxy for idiosyncrasy (based on bargaining structure) as predicted by the theory. An analysis of an individual-level variable, the difficulty of finding a comparable job, provides some additional support. Finally, several alternative explanations of the results are considered, and it is argued that none are consistent with the evidence. The analysis thus finds strong, if necessarily provisional, support for the theory.     

The prevalence rates of pathological gambling: A look at methods

Planning the gambling environment requires protection of the public's health, safety and welfare. Whereas most public gaming provisions and statutes address the public's fears of organized crime as well as some welfare needs, rarely do they safeguard the public's health regarding the spread of the mental disease known as pathological gambling. Measurement of the prevalence and incidence of this disease would enable policy planners to evaluate both the state's responsibility for an epidemic and the adequacy of publicly funded treatment programs. The purpose of this paper is to examine the methods which underlie three different estimates of the prevalence rate of pathological gambling and to critique them in the light of sound epidemiological procedure. In 1975, the Institute for Social Research (ISR) of the University of Michigan conducted a national survey and a survey of the state of Nevada on behalf of the U.S. Commission on a National Policy Toward Gambling. Using discriminant function analysis coupled with subjective inspection of cases in the at-risk pool, the researchers estimated rates of probable and potential pathological gamblers. In 1984 and 1985, this author surveyed residents in the Delaware Valley and the state of Ohio using the cumulative clinical signs method which also posited rates of probable and potential pathological gamblers. In 1986, researchers at the Office of Mental Health for the State of New York employed a formal screening device to survey residents and proposed a rate of probable pathological gamblers and a rate of problem — although not pathological — gamblers. All three approaches produced different estimates. The utility of prevalence and incidence rate research in this field is threatened by a lack of consensus about the proper epidemiological procedure to be employed in arriving at these estimates. There is also confusion about the distinction between a probable and a potential pathological gambler. The planning purpose, method, validity and reliability of prevalence rate research about pathological gambling are addressed in this paper.     

Some quantitative concepts of value and utility from a utilitarian point of view

This paper clarifies and interprets some basic quantitative concepts of value, utility and utility function from a utilitarian point of view. First, I discuss the question as to whether value is objective or subjective. I hold that value is subjective and statistical in nature (although from the various subjective values of a certain object a norm can usually be obtained). Second, I emphasize the distinction between use value and exchange value in relation to utility. Third, I propose a law of diminishing incremental interest, which refers to the incremental (marginal) utility of money. Fourth, I identify the utility of money with the von Neumann-Morgenstern utility. Fifth, I question the necessity of the usual normalization of utility functions and the restricted linear transformation (and the consequent concept of strategic equivalence). Sixth, I discuss in detail the terminal values and utilities of a utility function from a philosophical rather than mathematical point of view, particularly the boundedness of a utility function and the magnitudes of V ₀ and U ₀. Finally, I conclude that, in order to be able to have interpersonal comparisons of utility, utility should have the same dimension as value rather than no dimension, and the normalization problem should be reconsidered in the light of terminal values and utilities.     

From making to being the excuse: An analysis of deception and verbal/nonverbal issues

Excuse-making is defined, and the issues of deception and verbal/nonverbal presentations are discussed in regard to the excuse process. Subsequently, the deception and verbal/nonverbal issues are described in greater detail in the context of whether the excuse occurs temporally after a negative outcome (retrospective), before a negative outcome (anticipatory), or as part of the characterological makeup of the person (incorporated). Going from retrospective to anticipatory to incorporated excuses, it is concluded that the role of nonverbal factors increases. Likewise, in the progression from making to being the excuse, it is argued that self- and other-deception also become more pervasive.     

The developmental implications of migration from and between small island nations

This article discusses the role of migration in relieving population pressures, thus making continuing development possible, using small nations in the Caribbean and the South Pacific as examples. The Caribbean islands and many Pacific islands have used out-migration to ease population pressures in this century. Surplus labor has been emerging in various Caribbean nations, independent of the international marketing problems of plantation agriculture. Rural populations alienated from plantations have had to make do on questionable and/or remote land. Population surpluses appear to originate in rural areas, but little evidence exists to suggest that those surpluses are the basis for the emigration patterns of the Caribbean islands. Emigration does not solve population problems because when ambitious, skilled workers leave their country, their actions have little to do with the existence of domestic surplus labor and their leaving may do little to facilitate domestic labor absorption. Thus, if mini-states wish to sustain their hopes of economic expansion, they must find the means to employ their surplus labor. Since mainly skilled migrants leave, their going may actually slow development and retard opportunities for labor absorption. Population movements internal to the Caribbean region may further complicate surplus labor and/or population problems. If protective entry requirements impede normal inter-island relations, they may interfere with developmental processes. In general, migration is not a feasible strategy for population control for small island nations. While temporary migration has a more positive impact than other forms of migration, problems do exist. For example, temporary migration 1) can impose significant economic costs on the source-country, and 2) may result in the source country being unable to capitalize on its initial investment in training and education of temporary migrants. In conclusion, import substitution through cooperation between small island nations, production for export where feasible, and more attention to more sophisticated international service linkages hold a better prospect for material progress than relying on the export of surplus populations.     

INTERVIEWING OLDER ADULTS: MODE COMPARISON USING DATA FROM A FACE-TO-FACE SURVEY AND A TELEPHONE RESURVEY

A face-to-face survey conducted in 1984 with a sample of 1491residents of the Detroit metropolitan area (including an oversampleof older adults) and a reinterview of a random subset of theserespondents by telephone were used to compare the two modesof data collection across two age levels. Except for a tendencytoward a disproportionately large number of DK answers and adisproportionately large amount of interviewer assistance onthe telephone, respondents 60 years of age and older did notexhibit larger mode differences than did respondents under 60.For both age groups, response distributions were rather similar,suggesting little effect of mode. Likewise, response style differedlittle by mode, while a higher proportion of missing data (i.e.,"I don't know" answers) was given on the telephone. The responserate for the telephone reinterview was 90%, somewhat lower forolder than younger persons. The findings support the feasibilityof using the telephone for reinterviewing older adults.     

On estimating census undercount in small areas

"Net undercount rates in the U.S. decennial census have been steadily declining over the last several censuses. Differential undercounts among race groups and geographic areas, however, appear to persist. In the following, we examine and compare several methodologies for providing small area estimates of census coverage by constructing artificial populations. Measures of performance are also introduced to assess the various small area estimates. Synthetic estimation in combination with regression modelling provide the best results over the methods considered. Sampling error effects are also simulated. The results form the basis for determining coverage evaluation survey small area estimates of the 1900 decennial census."     

Catholicism and the Philippine population problem

"The Philippines has two characteristics which differentiate if from other countries in Southeast Asia. It is the only predominantly Christian country in the region and it has one of the highest rates of population growth. Non-Catholic Christians make up only about 9 per cent of the population compared with around 82 per cent for Roman Catholics. Given the Catholic Church objections to both contraception and abortion, it is not illogical to hypothesize a relation between the religious composition of the population and its rate of population growth."