Immunocognitive Model of Depression Secondary to Anxiety in Adolescents

There is evidence that anxiety precedes the onset of depression and that rumination contributes to this risk pathway in adolescence. This study examined inflammatory biomarkers as mediators in a risk model of depressive symptoms secondary to anxiety symptoms among adolescents who ruminate. A sample of 140 adolescents (52% female, 54% African American, 40% Caucasian, 6% biracial, mean age at T1?=?16.5 years, SD?=?1.2 years) provided blood samples on two visits (T1 and T2; mean time between T1 and T2?=?13.5 months, SD?=?5.9 months). Self-report anxiety, depression, and rumination measures were given at T1 and the depression measure was given again at a third visit (T3, mean months since T1?=?26.0 months, SD?=?9.0 months). Higher anxiety predicted more interleukin-6, but not more C-reactive protein, for adolescents with high levels of rumination. Moderated mediation analyses (N for analysis after removing cases with missing data and outliers?=?86) indicated that interleukin-6, but not C-reactive protein, at T2 mediated the relationship between anxiety symptoms at T1 and depressive symptoms at T3, conditional on rumination. Anxiety and rumination interacted such that, as rumination increased, anxiety predicted greater inflammation and depressive symptoms. These results demonstrate that established cognitive vulnerabilities for the development of depressive symptoms secondary to anxiety symptoms in adolescence might indirectly operate though biological mechanisms such as inflammation. In addition to highlighting risk factors and potential treatment targets for depression, this study suggests a potential biological mechanism underlying the effects of psychotherapies that reduce rumination on negative affect (e.g., cognitive behavioral therapy).     

Government capacity to contract: health sector experience and lessons

Using case-study material of contracting for clinical and ancillary services in the health care sector of developing countries, this article examines the capacities required for successful contracting and the main constraints which developing country governments face in developing and implementing contractual arrangements. Required capacities differ according to the type of service being contracted and the nature of the contractor. Contracting for clinical as opposed to ancillary services poses considerably greater challenges in terms of the information required for monitoring and contract design. Yet, in some of the case-studies examined, problems arose owing to government's limited capacity to perform even very basic functions such as paying contractors in a timely manner and keeping records of contracts negotiated. The external environment within which contracting takes place is also critical; in particular, the case-studies indicate that contracts embedded in slow-moving, rule-ridden bureaucracies will face substantial constraints to successful implementation. The article suggests that governments need to assess required capacities on a service-by-service basis. For any successful contracting, basic administrative systems must be functioning. In addition, there should be development of guidelines for contracting, clear lines of communication between all agents involved in the contracting process, and regular evaluations of contractual arrangements. Finally, in cases where government has weak capacity, direct service provision may be a lower-risk delivery strategy. © 1998 John Wiley & Sons, Ltd.     

Culture Change Refined and Revitalized: The Road Show and Guides for Pragmatic Action

Despite a declining interest in the relationship between leadership, culture, and performance in the scholarly literature, culture change is alive and well among leaders in the public sector as a means to improve performance. This essay reviews the trajectory of culture studies and proposes a modest model of organizational culture that sets aside many of the conceptual and methodological arguments about culture, focusing instead on what leaders actually do to change culture. The model is examined in the context of organizational culture change efforts in the city of Alexandria, Virginia. Several practical and theoretical insights are offered from this pragmatic and leadership‐focused approach to culture.     

Reconfiguring Law: An Ethnographic Perspective from Botswana

Using two marital disputes, this article examines women's experiences in bringing legal claims regarding family property in Botswana. It highlights the ways women draw on diverse economic and social resources available to them through their differing positions within gendered social networks that shape daily life and affect the ability to access and manipulate a legal system incorporating Tswana customary law and European law. The divergent discourses among women and between women and men document how the administrative and theoretical separation of legal systems does not extend to people's uses of the law in arranging their own lives. This analysis challenges the formalist model of legal pluralism by demonstrating that legal arguments are constructed from the gendered social and economic facts of individuals'lives that traverse the legal categories of European and customary law. It also contributes to feminist legal scholarship by explicitly marking the links among gender, power, and law.     

Perceived Support and Internalizing Symptoms in African American Adolescents: Self-Esteem and Ethnic Identity as Mediators

Existing research leaves a gap in explaining why African American adolescents do not exhibit more anxiety and depression than other youth, at the same time that they experience more contextual risk factors. The current study examined the roles of social support as well as possible mediators self-esteem and ethnic identity (sense of belonging to one’s ethnic group) in reducing internalizing symptoms in 227 African American adolescents (mean age = 12.55). Structural equation models indicated that self-esteem and ethnic identity partially mediated the relation between social support and depression. For depression, ethnic identity accounted for more of the social support effect for males, whereas self-esteem had more impact for females. The mediation model for anxiety was supported in females, with self-esteem more important than ethnic identity. The results suggest that ethnic identity and self-esteem function as important links in how social support reduces internalizing symptoms in African American youth. Assistant Professor, Clinical Psychology, Loyola University Chicago. Received Ph.D. in Psychology from The University of Memphis. Current interests include coping and resilience in African American youth and the role of family characteristics in children and adolescents’ stress and coping processes. Teaching Associate, School of Education and Social Policy, Northwestern University. Received Ph.D. in Psychology from University of Rhode Island. Research interests include ethnic identity in African American youth and the effects of exposure to violence on well-being. Assistant Professor, Human Development and Social Policy, Northwestern University. Received Ph.D. in Psychology from University of California, Riverside. Primary research examines the nature and effects of socialization, father’s involvement, and how they interact with gender, race, and SES to impact youths’ academic and social development. Professor, Clinical and Developmental Psychology, Loyola University Chicago. Received Ph.D. in Human Development from the University of Chicago. Current research interests include the developmental stage of adolescence with a focus on the daily experience of urban African American young adolescents and how this relates to their psycho- social well being. Dr. Richards served as a Predoctoral Adolescent Fellow (1979–1981) and Postdoctoral Adolescent Fellow (1984–1985) at the Clinical Research Training Program in Adolescence in Chicago, IL, which was co-directed by Dr. Daniel Offer., Loyola University Chicago, 6525 N. Sheridan Rd., Chicago, IL, 60626 USA Visiting Professor, Humphrey Institute of Public Affairs; President, University of Minnesota and Global Philanthropy Alliance. Received Ph.D. in Measurement, Evaluation, and Statistical Analysis from the University of Chicago. Research interest is in adolescent development. Dr. Petersen served as Coordinator of the Clinical Research Training Program in Adolescence (1978–1982) and Associate Director (1976–80) and Director (1980–82) of the Laboratory for the Study of Adolescence at Michael Reese Hospital and Medical Center (Chicago, IL) where Dr. Daniel Offer served as Director of the Department of Psychiatry. Dr. Petersen and Dr. Offer collaborated on numerous research papers while working together at Michael Reese Hospital., University of Minnesota and Global Philanthropy Alliance USA     

Issues in Program Budgeting

Funding arrangements for human service programs are often complex, particularly when intergovernmental financing is involved. There are two financial arrangements used by human services administrators to assure that money budgeted is spent as intended. Reallocation of unspent funds among jurisdictions and carryover to the following year of unspent balances are examined in this article based on examples drawn from two programs in Minnesota.