THE EFFICACY AND EFFECTIVENESS OF MARITAL AND FAMILY THERAPY: A PERSPECTIVE FROM META-ANALYSIS

This article reviews the major findings from a multiproject meta-analysis of the effects of marital and family therapy (MFT). Across 163 randomized trials, MFT demonstrates moderate, statistically significant, and often clinically significant effects. No orientation is yet demonstrably superior to any other, nor is MFT superior to individual therapy. Cost effectiveness information is scant in these 163 studies, but supportive. Randomized experiments yield very different answers from nonrandomized experimental studies of the effects of MFT, calling into question whether we should mix the two in reviews. We have also found several new differences in the ways that marital therapy (MT) and family therapy (FT) studies are conducted, making them harder to compare. Finally, important questions still exist about whether any psychotherapy, including MFT, yet has sufficient information about how well research generalizes to everyday clinical practice.     

Scheduling Updates of Probabilistic Risk Assessments: The Arkansas Nuclear One-Unit 1 Experience

This paper presents the results of a study that identified how often a probabilistic risk assessment (PRA)should be updated to accommodate the changes that take place at nuclear power plants. Based on a 7-year analysis of design and procedural changes at one plant, we consider 5 years to be the maximum interval for updating PRAs. This conclusion is preliminary because it is based on the review of changes that occurred at a single plant, and it addresses only PRAs that involve a Level 1 analysis (i.e., a PRA including calculation of core damage frequency only). Nevertheless, this conclusion indicates that maintaining a useful PRA requires periodic updating efforts. However, the need for this periodic update stems only partly from the number of changes that can be expected to take place at nuclear power plants–changes that individually have only a moderate to minor impact on the PRA, but whose combined impact is substantial and necessitates a PRA update. Additionally, a comparison of two generations of PRAs performed about 5 years apart indicates that PRAs must be periodically updated to reflect the evolution of PRA methods. The most desirable updating interval depends on these two technical considerations as well as the cost of updating the PRA. (Cost considerations, however, were beyond the scope of this study.)     

Toward a formal theory of interactive resocialization: The case of adoptive parenthood

Resocialization is pulled out of its structuralist roots and recast into an interactionist framework. Building on a substantive theory of the resocialization experience of becoming an adoptive parent, three theoretical properties of interactionist resocialization are presented. These can be summarized as involving unlearning and relearning some aspects of a core identity; the interpretation and active reconstruction of that identity which has reciprocal effects on all actors involved; and finally, the effects of both situational and trans-situational norms that give shape to the resocialization experience. Suggestions are made for other substantive areas of research that could be used for comparative analysis in order to further refine a formal theory of interactionist resocialization.     

Comparison of three estimators of the number of species

We consider estimation of the number of cells in a multinomial distribution. This is one version of the species problem: there are many applications, such as the estimation of the number of unobserved species of animals; estimation of vocabulary size, etc. We describe the results of a simulation comparison of three principal frequent-ist' procedures for estimating the number of cells (or species). The first procedure postulates a functional form for the cell probabilities; the second procedure approxi mates the distribution of the probabilities by a parametric probability density function; and the third procedure is based on an estimate of the sample coverage, i.e. the sum of the probabilities of the observed cells. Among the procedures studied, we find that the third (non-parametric) method is globally preferable; the second (functional parametric) method cannot be recommended; and that, when based on the inverse Gaussian density, the first method is competitive in some cases with the third method. We also discuss Sichel's recent generalized inverse Gaussian-based procedure which, with some refine ment, promises to perform at least as well as the non-parametric method in all cases.     

HIV-infected woman. Illness cognition assessment.

1. Special attention is particularly important in addressing the mental health needs of HIV-infected women. These needs may involve issues such as concerns about present or future pregnancy; child-rearing, often as single parents; poverty, illicit drug use or addiction; and the potential lack of support services. 2. Diagnosis of HIV infection in women may be overlooked, as the clinical signs that routinely trigger the suspicion of HIV illness in men are often interpreted to reflect depression or psychological factors, such as stress or overwork, rather than raise the suspicion of HIV infection in women. 3. Understanding a woman's illness cognition is an important component of designing strategies that can enhance coping. The picture a woman generates regarding her illness is a composite of her experiences and responses, and determines to a large extent what she will do in response to her illness.     

The effect of 1980s tort reform legislation on general liability and medical malpractice insurance

A large number of states adopted tort reforms in the mid-1980s to limit the dramatic surge in insurance losses and premiums. Evidence based on liability insurance data by state indicates that these reforms substantially influenced general liability insurance. The levels of losses, premiums, and loss ratios (a measure of insurance profitability) all reflected the impact of the reforms. The large-scale reform efforts in 1986 were particularly influential. Medical malpractice insurance was much less sensitive to the reform efforts.     

Determinants of housing quality: A comparison of white,African-American,and Hispanic single-parent women

This study examines housing quality among three groups of single-parent women: white, African-American, and Hispanic. Three indicators of housing quality—crowding, affordability, and satisfaction—are used to discover the extent to which these groups experience housing problems. This study also explores differences and similarities in the factors that precipitate problems in housing quality for these three groups of single parents. Findings suggest important differences and similarities in the nature of housing quality problems among white, African-American, and Hispanic single-parent women. The specified variables explained about 20% of the variance in crowding, housing affordability, and housing satisfaction. On measures of objective and subjective housing quality, white single mothers are better housed than their African-American or Hispanic counterparts. Hispanic single mothers have the largest housing cost burden and average more persons per household than the other groups. African-Americans are twice as likely as either group to live in low-quality housing and reported the lowest average satisfaction with their housing. Her research interests include housing and neighborhood assessment and women and public policy issues. She has recently published articles inUrban Affairs Quarterly andHousing and Society on housing and neighborhood assessment criteria among black urban households and the housing cost burden of various groups of female-headed households. She received her Ph.D. from Ohio State University. Her research interests include the housing adjustment behavior of women and public policy. She has recently completed her thesis on the role of noncustodial parents in determining the quality of life of their children. She is also the recipient of the Tessie Agan Award for research excellence from the American Association of Housing Educators for a paper titled “Unterstanding Constraints and Residential Satisfaction among Low-Income Single-Parent Families.”     

Assessing reoffense risk with juvenile sexual offenders

This article summarizes a two-year study of juvenile sexual offenders in Washington. Both community-based and institution-based treatment programs were evaluated. A typical profile of the juvenile sexual offender is offered, as well as recidivism data from a mean 20-month follow-up period.