Family Intervention and Health Care Costs for Kansas Medicaid Patients with Schizophrenia

Despite a number of studies investigating the effect of pharmacotherapy on treatment costs for schizophrenia patients, there has been little attention given to the effect of family intervention. In this study, data from the Kansas Medicaid system were used to analyze healthcare costs for 164 schizophrenia patients who had participated in family intervention. Structural equation modeling was used to test two competing views of the role of family intervention in treatment. The results showed that a model including direct and indirect effects of family intervention provided a better fit to the data. Family intervention had a significant indirect effect on general medical costs (through other psychological treatment) that showed a savings of $586 for each unit increase in the provision of these services. In addition, the total indirect effects for family intervention showed a $580 savings for general medical costs and $796 for hospitalization costs (for each unit increase).     

Insecure Attachment Behavior and Partner Violence: Incorporating Couple Perceptions of Insecure Attachment and Relational Aggression

Intimate partner violence and insecure attachment are therapeutically relevant concepts when working with couples. The link between attachment and intimate partner violence has been examined in the literature, but an area of aggression that often goes unexamined is relational aggression, or using third parties as a means of being aggressive toward a partner. We asked how participants' attachment behaviors were related to their own and partners' relational and physical aggression. We used structural equation modeling to estimate actor–partner interdependence among these relationships in 644 heterosexual couples. Results indicated significant partner paths from attachment to relational aggression, as well as significant actor paths between relational aggression and physical aggression. Implications were discussed. Data for this study were collected from the RELATE assessment.     

Sexual practices and the duration of last heterosexual encounter: findings from the Australian longitudinal study of health and relationships

This study investigated the association between sexual practices and duration of a sexual encounter. Using data from a population-based computer-assisted telephone survey of 8,656 Australians aged 16 to 64 years, four distinct patterns of sexual practices among respondents were found: "basic sexual encounter" (involving mainly kissing, cuddling, stroking one's partner and being stroked, and vaginal intercourse), "basic sexual encounter plus oral sex," "all assessed sexual practices" (all sexual behaviors included in the survey), and "mainly vaginal intercourse" (characterized by lower levels of kissing, cuddling, and stroking). For both men and women, respondents classified in the basic sexual encounter plus oral sex, and all assessed sexual practices clusters reported significantly longer durations than those in the basic sexual encounter group, whereas respondents in the mainly vaginal intercourse cluster reported shorter durations. These differences were found even after allowing for demographic differences in sexual duration-specifically, age and partner type of the most recent opposite-sex partner. These findings add to the understanding of what typically happens in a sexual encounter. Overall, longer sexual encounters appear to be associated with the inclusion of the least common sexual practices-namely, oral sex and self-stimulation.     

Using agency data for evidence-based programming: a university-agency collaboration

Agencies providing residential treatment are encouraged, or even mandated, to collect outcomes data and to implement evidence based practices, yet little guidance has been provided on how to do so using agency administrative data that are collected on an ongoing basis. We examined data on Child and Adolescent Functional Assessment Scale (CAFAS) scores for 1608 admissions to a residential treatment center from 2002 through 2008. CAFAS scores were measured every 90 days, providing multiple CAFAS scores for each individual. Results demonstrated that on average residents improved in functioning over time. Sensitive to the evolving needs of residents who had been entering the program, the treatment center made significant program changes in 2006 to attempt to better serve residents through a broad array of specialized programming. Compared to the overall results, the analysis suggested that residents who entered the program since October 2006 appeared to have made larger improvements in their CAFAS scores. Results were derived by employing multilevel models appropriate for estimating growth trajectories with repeated measures data. Conversations with agency staff suggested that using administrative data, and advanced statistical models, were extremely helpful for organizational decision making and evidence-based programming.     

News coverage of child sexual abuse and prevention, 2007-2009

News media coverage of child sexual abuse can help policymakers and the public understand what must be done to prevent future abuse, but coverage tends to focus on extreme cases. This article presents an analysis of newspaper coverage from 2007 to 2009 to describe how the daily news presents and frames day-to-day stories about child sexual abuse. When child sexual abuse receives news attention, the stories focus primarily on the criminal justice details of a specific incident rather than contextual information about causes of and solutions to child sexual abuse, and prevention is rarely addressed. We offer suggestions for strategies that advocates can use to help reporters improve news coverage so that it better contextualizes child sexual abuse and links it to prevention policies.     

Predictors of Treatment Outcome Among Asian Pathological Gamblers (PGs): Clinical,Behavioural, Demographic,and Treatment Process Factors

Research on predictors of treatment outcome among pathological gamblers (PGs) is inconclusive and dominated by studies from Western countries. Using a prospective longitudinal design, the current study examined demographic, clinical, behavioural and treatment programme predictors of gambling frequency at 3, 6 and 12-months, among PGs treated at an addiction clinic in Singapore. Measures included the Hospital anxiety and depression scale, gambling symptom assessment scale (GSAS), personal well-being index (PWI), treatment perception questionnaire and gambling readiness to change scale. Treatment response in relation to changes in symptom severity, personal wellbeing and abstinence were also assessed. Abstinence rates were 38.6, 46.0 and 44.4 % at 3, 6 and 12-months respectively. Significant reductions in gambling frequency, GSAS, and improvement in PWI were reported between baseline and subsequent outcome assessments, with the greatest change occurring in the initial three months. No demographic, clinical, behavioural or treatment programme variable consistently predicted outcome at all three assessments, though treatment satisfaction was the most frequent significant predictor. However, being unemployed, having larger than average debts, poor treatment satisfaction and attending fewer sessions at the later stages of treatment were associated with significantly poorer outcomes, up to 1-year after initiating treatment. These findings show promise for the effectiveness of a CBT-based treatment approach for the treatment of predominantly Chinese PGs. Clinical implications and suggestions for future research are discussed. Taken together, the findings suggest early treatment satisfaction is paramount in improving short-term outcomes, with baseline gambling behaviour and treatment intensity playing a more significant role in the longer term.     

A Theoretical Comparison of Relational Maintenance and Closeness as Mediators of Family Communication Patterns in Parent-Child Relationships

This investigation sought to elaborate Koerner and Fitzpatrick’s theory of family communication by testing two theoretical models of family communication patterns (FCP), child-to-parent inclusion of the other in the self (IOS), and relational maintenance. Participants included 374 young adults recruited from two universities in different regions of the United States. Results best supported a model positioning maintenance as a mediator of the association between FCP and IOS, as compared to an alternative model with IOS as a mediator of the association between FCP and maintenance. These findings extend Koerner and Fitzpatrick’s theory by highlighting communication as the means by which overarching family schemas influence relationship-specific schemas; additionally, they commend the self-expansion model as a useful theoretical approach to relational maintenance behavior in family contexts.     

‘Je suis socialiste et quinziste’: rugby,wine and socialism in the Aude since 1976

In the Languedoc, the intersections between rugby, wine and socialism give telling insights into the value and significance of regional identity. At the end of the 1970s, the Languedoc's wine industry and rugby were facing up to the challenges of modernisation; the responses which emerged drew upon the principles of regional identity drawn from the ‘banal nationalism’ of wine-drinking, left-voting rugby players in local administrations and at the head of powerful trade unions. The cross-over between board-room and locker-room helped to accent regional responses to change and modernization, ensuring that regional heritage remained potent and ready to be communicated.     

How Mood and Task Complexity Affect Children's Recognition of Others' Emotions

Previous studies examined how mood affects children's accuracy in matching emotional expressions and labels (label‐based tasks). This study was the first to assess how induced mood (positive, neutral, or negative) influenced five‐ to eight‐year‐olds' accuracy and reaction time using both context‐based tasks, which required inferring a character's emotion from a vignette, and label‐based tasks. Both tasks required choosing one of four facial expressions to respond. Children responded more accurately to label‐based questions relative to context‐based questions at the age of five to seven, but showed no differences at the age of eight, and when the emotional expression being identified was happiness, sadness, or surprise, but not disgust. For the context‐based questions, children were more accurate at inferring sad and disgusted emotions compared with happy and surprised emotions. Induced positive mood facilitated five‐year‐olds' processing (decreased reaction time) in both tasks compared with induced negative and neutral moods. Results demonstrate how task type and children's mood influence children's emotion processing at different ages.     

‘I shouldn’t be living there because I am a sponger’: negotiating everyday geographies by people with learning disabilities

Learning disability policy has for some time been framed by the goal of inclusion which purports to enable people with learning disabilities to lead a ‘life like any other’ person. This article examines the extent to which this is the case in England, by tracing the lived experiences of people with learning disabilities within their communities. The article draws on two interlinked qualitative studies involving interviews that examined their local place-based experiences of inclusion and exclusion. The findings reveal ‘moments of inclusion’ and opportunities for social encounter from peer support, but these were situated amidst wider experiences of exclusion and harassment.