A Couple-Based Approach to the Reduction of PTSD Avoidance Symptoms: Preliminary Findings

This study reports preliminary findings regarding the feasibility and efficacy of a novel couple-based treatment, named Strategic Approach Therapy (SAT), for reducing avoidance symptoms of posttraumatic stress disorder (PTSD). Six male Vietnam combat veterans diagnosed with PTSD and their cohabitating marital partners participated in 10 weeks of SAT treatment. Self-report, clinician ratings, and partner ratings of PTSD symptoms were obtained before the first session and after the tenth session of treatment. Veterans reported statistically significant reductions in self-reported, clinician-rated, and partner-rated effortful avoidance, emotional numbing, and overall PTSD severity. These data indicate that SAT offers promise as an effective treatment for PTSD avoidance symptoms.     

Managing the Peace: Exorcising Colonial Ghosts

Public Organization Review -     

Ecological inference in the social sciences

Ecological inference is a problem of partial identification, and therefore precise conclusions are rarely possible without the collection of individual level (identifying) data. Without such data, sensitivity analyses provide the only recourse. In this paper we review and critique recent approaches to ecological inference in the social sciences, and describe in detail hierarchical models, which allow both sensitivity analysis and the incorporation of individual level data into an ecological analysis. A crucial element of a sensitivity analysis in such models is prior specification, and we detail how this may be carried out. Furthermore, we demonstrate how the inclusion of a small amount of individual level data from a small number of ecological areas can dramatically improve the properties of such estimates.     

Alleviating linear ecological bias and optimal design with subsample data

Summary.  We illustrate that combining ecological data with subsample data in situations in which a linear model is appropriate provides two main benefits. First, by including the individual level subsample data, the biases that are associated with linear ecological inference can be eliminated. Second, available ecological data can be used to design optimal subsampling schemes that maximize information about parameters. We present an application of this methodology to the classic problem of estimating the effect of a college degree on wages, showing that small, optimally chosen subsamples can be combined with ecological data to generate precise estimates relative to a simple random subsample.     

Diagnosis-related group system. Can we still earn a living caring for sick people?

Medicare and Medicaid patients are starting to enroll in managed care organizations, as government tries to lower costs of caring for the elderly, disabled, and poor. Because they are the most likely to be sick, taking care of them imposes serious risks on hospitals and medical groups. The federal government uses the diagnosis-related group (DRG) system to reimburse hospitals. The system depends on physicians documenting diagnoses and complications. Physicians see illness as unpredictable, and so feel that detailed documentation of severity is futile. The government and health plans nevertheless follow case mix index and create hospital and physician profiles, relying on the existing imperfect system. For providers to be recognized for the value they add to the care of the sick, physicians must learn to use the DRG system to best advantage, or risk being driven out of business.     

Trials of the postmodern

Abstract

The criminal courtroom is an important institutional site where a modernist epistemology works hard to keep the postmodern disturbance of such concepts as ‘truth’ and ‘reality’ at bay. Nevertheless, some popular television programs exploit the imagistic conditions of postmodernity in order to volatilize the truths certified as final ones by criminal courts. Similarly, in the first trial of the LAPD officers who beat Rodney King, the prosecution team exploited the instability of truth in a mediatized society in order to resignify events whose meanings had previously been configured quite differently. This essay examines these events as manifestations of cultural and political contestation in an image-saturated society where the modernist ‘reality principle’ has dissolved and been replaced by a mediatizing process of resimulation and resignification.     

Prenatal Maternal Anxiety and Depression Predict Negative Behavioral Reactivity in Infancy

The effects of maternal antenatal and postnatal anxiety and depression on infant negative behavioral reactivity were examined in a sample of 22 mother‐infant pairs. Maternal anxiety and depression were assessed by standardized measures during the third trimester of pregnancy and postpartum. Infant negative behavioral responses to novelty were assessed using a previously validated measure at 4 months of age. Maternal anxiety and depression during the prenatal, but not the postnatal period, were related to infant negative behavioral reactivity to novelty. These data illustrate that prenatal maternal psychological state can exert persisting influences on human infant behavior.