Tracing disorder across theories of autism,empathy, and mental health care

Abstract

Categories of mental disorders are generally understood through a biomedical paradigm of clinical research, diagnosis, and intervention. Here, diagnoses operate as professional tools, facilitating care organization and information exchange across diverse social contexts. In this article, I focus on how the diagnosis of autism-spectrum disorder operates in this manner. Autism conceived as a biomedical disorder is then contrasted with proposals by the neurodiversity movement, who understand core qualities of autism as alternative expressions of otherwise normal processes of brain development. Finally, I supplement these conversations with insights from Gerald Edelman’s theory of neural plasticity and Felix Guattari’s paradigm of ethico-aesthetic care. Understood together, these allow mental disorders and community care generally to be reconceived in terms of networks of expressive, embodied, and dynamically embedded rhythms that transcend individual persons. This serves, additionally, to illustrate a concept of empathy that traverses neurological, psychological, and sociocultural domains.     

New evidence about effects of reproductive variables on child mortality in sub-Saharan Africa

There is still considerable uncertainty about how reproductive factors affect child mortality. This study, based on Demographic and Health Survey data from 28 countries in sub-Saharan Africa, shows that mortality is highest for firstborn children with very young mothers. Other children with young mothers, or of high birth order, also experience high mortality. Net of maternal age and birth order, a short preceding birth interval is associated with above average mortality. These patterns change, however, if time-invariant unobserved mother-level characteristics of importance for both mortality and fertility are controlled for in a multilevel–multiprocess model. Most importantly, there are smaller advantages associated with longer birth intervals and being older at first birth. The implications of alternative reproductive ‘strategies’ are discussed, taking into account that if the mother is older at birth, the child will also be born in a later calendar year, when mortality may be lower.     

Divorce and parity progression following the death of a child: A register-based study from Finland

Most studies that have examined whether a child’s death influences parental relationship stability have used small-scale data sets and their results are inconclusive. A likely reason is that child loss affects not only the risk of parental separation, but also the risk of having another child. Hence parity progression and separation must be treated as two competing events in relation to child loss. The analysis in this paper used Finnish register data from 1971 to 2003, covering over 100,000 married couples whose durations of both first marriage and parenthood could be observed. We ran parity-specific Cox regressions in which process time started from the birth of each additional child. All marriages included women of childbearing age, none of whom had experienced any child death on entering the analysis. We find that child loss only modestly influences the divorce risk, whereas its effect on the risk of parity progression is considerable.     

再论“四二一”结构:定义与研究方法

"四二一"结构是中国低生育率背景下家庭结构与代际关系的一种特殊表达,既反映了20世纪70年代以来计划生育政策广泛推行对中国家庭的深刻影响,又揭示了中国现阶段婚姻家庭乃至未来人口发展的特点与趋势。目前这一领域的研究虽然已经取得一系列的进展,但在概念界定与使用的方法上仍缺乏共识,导致研究结论的分歧和研究拓展的迟滞。在中国社会剧烈变动的形势下,"四二一"结构是研究中国的计划生育政策、独生子女问题,以及家庭结构与代际关系变动的一个良好的载体和切入点。     

性别因素与脆弱儿童的长期照顾

性别因素对脆弱儿童的长期照顾的影响主要体现在以下方面:第一,在父死母嫁的情况下,女孩更容易被带入新的家庭,融入新的家庭中,成为其成员;而男孩则更容易被留在原生家庭中,形成与祖父母之间的隔代抚养关系。第二,在收养方面,女孩更容易被收养从而进入正常的家庭环境。以上这些状况的形成与亚洲地区男孩的性别偏好有非常重要的关系,这对于目前的社会福利政策与社会照顾体系提出了新的要求,需要采取一系列的措施与政策。如:通过现有的社会救助体系对祖父母—孙子女的隔代抚养关系给予支持与照顾;充分发挥社区作用,为脆弱儿童提供支持与保护;充分发挥儿童福利院的作用,为脆弱儿童提供专业支持和心理、情感指导,与家庭、社区相结合,共同为脆弱儿童的成长提供支持。     

“I'm Not Supporting His Kids”: Nonresident Fathers' Contributions Given Mothers' New Fertility

The authors examined whether nonresident fathers provide informal support to their children and whether support stops if their ex‐partner goes on to have a child with a new man. A logistic regression analysis of longitudinal survey and administrative data for 434 women who received welfare in Wisconsin showed that fathers are less likely to provide informal support when their ex‐partner has a child with a new partner. Alternative models that control for unobserved characteristics suggest somewhat different results, providing stronger evidence of declines in support that can be shared across family members than in support that can be directed to a particular child.     

Life Course Status and Exchanges of Support Between Young Adults and Parents

The authors investigated intergenerational support exchanges in relation to young adults' life course status. In a sample of 2,022 young adults (ages 18–34 years) in The Netherlands, single young adults reported receiving more advice from parents than married young adults, and those with children of their own received more practical support. Married young adults and young adults with children provided less support to parents than, respectively, single young adults and young adults without children. Congruent with the life course perspective, the authors' findings suggest that the intergenerational support network is both durable and flexible, responding to the resources and needs associated with an individual's life course status.     

Traditional versus Western perceptions of mental illness: women of Moroccan origin treated in an Israeli mental health center

This paper focuses on the problems encountered in providing Westernized psychiatric treatment to a population with traditional healing beliefs. The sample comprised women of Moroccan origin living in Israel undergoing treatment for psychiatric disorders (N=38), and their treating psychiatrists (N=9). Ethnographic interviews were conducted among both groups. The results revealed that the symptoms, perceptions of the illness, and problems encountered in the therapeutic relationship differed across three age groups, young women (20–30 years), more mature women (31–42 years), and older women (43–60 years). While cultural conflict appeared to affect the development of mental illness in each group, this was most pronounced among women in the middle age range. Moreover, problems in the therapeutic alliance were greatest in this age group. The data from the therapists indicated that they maintained a Western perspective in both their understanding and diagnoses of these patients' illnesses. The different perspectives of the therapists and each of the three groups of women are discussed. It is concluded that professionals treating traditional populations must avoid imposing Western standards, and consider the treatment in the context of cultural beliefs. The developmental stages of the individual, and the stage of acculturation must also be taken into account if treatment is to be effective.     

Readiness for college engagement among students who have aged out of foster care

This study compares self-reported readiness to engage in college between a sample of 81 college freshmen who aged out of foster care prior to or while attending a large four-year public university and the national freshman population. Results indicate that students from foster care are significantly different from their non-foster-care peers in their readiness to engage in college. The results also show that foster youth are less well prepared academically upon entering college and this performance gap persists through the first semester of college. These findings are examined in the context of the current literature on foster youth. Limitations of the study and implications for future research and practice are discussed.