Living through exposure to toxic psychiatric orthodoxies: exploring narratives of people with 'mental health problems' who are looking for employment on the open labour market

This article explores lived experiences and insights of five people with long-term 'mental health problems', focusing on their search for employment in a disabling society. In our qualitative, inductive analysis we investigate why it seems almost impossible to attain a status as respected adult workers. We present five central findings: (1) losing the game before it starts; (2) internalizing the vicious circle of victim blaming; (3) from control overload to a life with inadequate supports; (4) from crushed dreams back to passive inactivity; (5) signs of resilience and resistance. In meaningful dialogue survivors give voice to alternative and plural epistemological grounds of life with 'madness'. In our concluding reflections we argue that psychiatric discourses, what we term toxic psychiatric orthodoxies, silence, disable and construct survivors as unemployable.     

A protective estimator for longitudinal binary data subject to non-ignorable non-monotone missingness

Summary.  In longitudinal studies missing data are the rule not the exception. We consider the analysis of longitudinal binary data with non-monotone missingness that is thought to be non-ignorable. In this setting a full likelihood approach is complicated algebraically and can be computationally prohibitive when there are many measurement occasions. We propose a 'protective' estimator that assumes that the probability that a response is missing at any occasion depends, in a completely unspecified way, on the value of that variable alone. Relying on this 'protectiveness' assumption, we describe a pseudolikelihood estimator of the regression parameters under non-ignorable missingness, without having to model the missing data mechanism directly. The method proposed is applied to CD4 cell count data from two longitudinal clinical trials of patients infected with the human immunodeficiency virus.     

A novel approach to estimation of the time to biomarker threshold: applications to HIV

In longitudinal studies of biomarkers, an outcome of interest is the time at which a biomarker reaches a particular threshold. The CD4 count is a widely used marker of human immunodeficiency virus progression. Because of the inherent variability of this marker, a single CD4 count below a relevant threshold should be interpreted with caution. Several studies have applied persistence criteria, designating the outcome as the time to the occurrence of two consecutive measurements less than the threshold. In this paper, we propose a method to estimate the time to attainment of two consecutive CD4 counts less than a meaningful threshold, which takes into account the patient‐specific trajectory and measurement error. An expression for the expected time to threshold is presented, which is a function of the fixed effects, random effects and residual variance. We present an application to human immunodeficiency virus‐positive individuals from a seroprevalent cohort in Durban, South Africa. Two thresholds are examined, and 95% bootstrap confidence intervals are presented for the estimated time to threshold. Sensitivity analysis revealed that results are robust to truncation of the series and variation in the number of visits considered for most patients. Caution should be exercised when interpreting the estimated times for patients who exhibit very slow rates of decline and patients who have less than three measurements. We also discuss the relevance of the methodology to the study of other diseases and present such applications. We demonstrate that the method proposed is computationally efficient and offers more flexibility than existing frameworks. Copyright © 2016 John Wiley & Sons, Ltd.     

Estimating the reliability of repeatedly measured endpoints based on linear mixed‐effects models. A tutorial

There are various settings in which researchers are interested in the assessment of the correlation between repeated measurements that are taken within the same subject (i.e., reliability). For example, the same rating scale may be used to assess the symptom severity of the same patients by multiple physicians, or the same outcome may be measured repeatedly over time in the same patients. Reliability can be estimated in various ways, for example, using the classical Pearson correlation or the intra‐class correlation in clustered data. However, contemporary data often have a complex structure that goes well beyond the restrictive assumptions that are needed with the more conventional methods to estimate reliability. In the current paper, we propose a general and flexible modeling approach that allows for the derivation of reliability estimates, standard errors, and confidence intervals – appropriately taking hierarchies and covariates in the data into account. Our methodology is developed for continuous outcomes together with covariates of an arbitrary type. The methodology is illustrated in a case study, and a Web Appendix is provided which details the computations using the R package CorrMixed and the SAS software. Copyright © 2016 John Wiley & Sons, Ltd.     

Pseudo-likelihood inference for clustered binary data

The maximum likelihood procedure to estimate paraneters of a model has scveral attractive properties including the existence of the covariance matrix which yield asymptotic covariances: for a sample size N the asymptotics are in general of order 1/N. Here we give an asymptotic for the skewness of the distribution of the maximum likelihood estimator of a parameter; this is of order 1/ n2 and this expression is new. Applications relate to the parameters of (i) the Poisson, binomial, and normal density. (ii) the gamna density and (iii) the Beta debsity. Other application are being considered. The expression for the asymptotic skowness at one phase of the study tured out to be unusually complicated involving the asymptotic expressions for variance and bias. When these were identified a much simpler compact expression appeared which we now describe. The work is a much improved treatment of the subject described in Shenton and Bowman (Mariunm likelihood estimation in small samples, Griffin. 1977).     

The meta-analytic framework for the evaluation of surrogate endpoints in clinical trials

For a number of reasons, surrogate endpoints are considered instead of the so-called true endpoint in clinical studies, especially when such endpoints can be measured earlier, and/or with less burden for patient and experimenter. Surrogate endpoints may occur more frequently than their standard counterparts. For these reasons, it is not surprising that the use of surrogate endpoints in clinical practice is increasing.     

Ties that tear apart: The social embeddedness of strategic alliance termination

Strategic alliances between firms are inherently unstable, and many alliances fail before the planned termination date. Most studies of the instability of strategic alliances focus on internal factors, such as tensions between alliance partners. In the present study social networks, in particular the centrality of firms in an alliance network, are considered as factors explaining alliance instability. The study examines 1061 ICT-alliances that were formed in the period 1975–1989. As expected, it was found that differences in centrality increase alliance instability. Contrary to the expectation, the sum of centralities of firms in an alliance does not affect alliance instability.     

Marginal Correlation in Longitudinal Binary Data Based on Generalized Linear Mixed Models

This work aims at investigating marginal correlation within and between longitudinal data sequences. Useful and intuitive approximate expressions are derived based on generalized linear mixed models. Data from four double-blind randomized clinical trials are used to estimate the intra-class coefficient of reliability for a binary response. Additionally, the correlation between such a binary response and a continuous response is derived to evaluate the criterion validity of the binary response variable and the established continuous response variable.     

Nonignorable Attrition in Multi-Period Panels With Refreshment Samples

In panel surveys, some observation units drop out before the end of the observation period. This panel attrition should not be ignored if it is related to the variables of interest. Hirano, Imbens, Ridder, and Rubin proposed the additively nonignorable (AN) attrition model to correct for the potential selectivity of the attrition in panels with two periods. If a refreshment sample is available in the second period, their model nonparametrically just-identifies the population distribution and the observation probability. We propose the sequential additively nonignorable attrition model that just-identifies the population distribution and the sequence of observation hazards for panels with more than two periods.     

Psychotropic drug classification based on sleep–wake behaviour of rats

Summary.  The aim of the paper is to present methodology for the classification of potential psychotropic drugs on the basis of their activity. We first sketch the background of this class of drugs and then zoom in on so-called pharmacoelectroencephalogram studies. These data pose some statistical challenges. For classification purposes, we propose a flexible hierarchical discriminant analysis tool, allowing us to take the specific nature of the drug class into account, as well as the features of the mixed models, in combination with fractional polynomials, fitted to the electroencephalogram data. The method is evaluated against the background of existing methods. The method's performance is studied by using a comprehensive analysis of a large electroencephalogram data set.