Managing children's and adolescents' medical complaints amid parent conflict: Strategies and tools for professionals

Children and adolescents who are having difficulty coping with stress often present with complaints of physical discomfort. Effective treatment approaches exist for many of these issues. Among high-conflict parents, however, children's medical issues can become another canvas for conflict, with parents focused more on blaming one another for the child's distress than on options for assisting the child. Professionals can be drawn into the conflict to such a degree that they overlook essential steps for addressing and managing these issues. The authors present a research-informed model for managing medical and psychophysiological issues amid parental conflict.     

Influence of Perpetrators' Account on Nurses' Recognition and Reporting of Child Abuse

Suspected perpetrators may attempt to influence the professional's recognition and reporting of child abuse by providing an account that explains or justifies their behavior or the child's injury. A factorial survey design was employed in which a random sample of nurses (N = 1038) judged vignettes that included systematic variations of types of accounts and selected case characteristics. In comparison to the other characteristics of the case, perpetrator accounts had little impact on nurses recognition and reporting of child abuse. Only two types of accounts influenced the nurses' responses, and from the perspective of the suspected perpetrator they backfired, resulting in greater recognition and reporting of abuse. Interaction terms constructed of accounts and situational variables had little impact on nurses' judgments when sexual abuse was involved, but resulted in both higher and lower recognition and reporting scores when physical and emotional acts were judged.     

How Do I Feel About Feelings? Emotion Socialization in Families of Depressed and Healthy Adolescents

Emotional and cognitive changes that occur during adolescence set the stage for the development of adaptive or maladaptive beliefs about emotions. Although research suggests that parents’ behaviors and beliefs about emotions relate to children’s emotional abilities, few studies have looked at parental socialization of children’s emotions, particularly in families with depressed adolescents. The present study examined associations between parent and adolescent meta-emotion philosophies (MEP), defined as thoughts, reactions, and feelings about their own emotions. Additionally, adolescent depressive status was tested as a moderator of relationships between parents’ and adolescents’ MEP. One hundred and 52 adolescents, aged 14–18 (65.8% female), and their parents (148 mothers, 106 fathers) participated in a study on emotion socialization in families of depressed and healthy adolescents. Depressed adolescents (n = 75) and matched healthy adolescents (n = 77) were recruited based on research criteria for mental health status. The sample was largely Caucasian (82%) and of middle socioeconomic class status. Results indicated that mothers’ and fathers’ MEP about their children’s emotions were associated with adolescents’ MEP, although parents’ MEP about their own emotions was unrelated to adolescents’ MEP. Fathers’ MEP about children’s emotions made unique contributions to adolescents’ MEP across both adolescent groups. Adolescents’ depressive status moderated the relationship between mothers’ and adolescents’ MEP such that mothers’ MEP was particularly relevant for depressed adolescents. The continued influence of parents in the emotional lives of adolescents is discussed as well as differences in emotion socialization in families with depressed and healthy adolescents.     

Detecting Spillover Effects: Design and Analysis of Multilevel Experiments

Interpersonal communication presents a methodological challenge and a research opportunity for researchers involved in field experiments. The challenge is that communication among subjects blurs the line between treatment and control conditions. When treatment effects are transmitted from subject to subject, the stable unit treatment value assumption (SUTVA) is violated, and comparison of treatment and control outcomes may provide a biased assessment of the treatment’s causal influence. Social scientists are increasingly interested in the substantive phenomena that lead to SUTVA violations, such as communication in advance of an election. Experimental designs that gauge SUTVA violations provide useful insights into the extent and influence of interpersonal communication. This article illustrates the value of one such design, a multilevel experiment in which treatments are randomly assigned to individuals and varying proportions of their neighbors. After describing the theoretical and statistical underpinnings of this design, we apply it to a large‐scale voter‐mobilization experiment conducted in Chicago during a special election in 2009 using social‐pressure mailings that highlight individual electoral participation. We find some evidence of within‐household spillovers but no evidence of spillovers across households. We conclude by discussing how multilevel designs might be employed in other substantive domains, such as the study of deterrence and policy diffusion.     

A randomized clinical trial of tailored interventions for health promotion and recidivism reduction among homeless parolees: outcomes and cost analysis

Objectives

This study conducted a randomized controlled trial with 600 recently released homeless men exiting California jails and prisons.

Methods

The purpose of this study was to primarily ascertain how different levels of intensity in peer coaching and nurse-partnered intervention programs may impact reentry outcomes; specifically: (a) an intensive peer coach and nurse case managed (PC-NCM) program; (b) an intermediate peer coaching (PC) program with brief nurse counseling; and (c) the usual care (UC) program involving limited peer coaching and brief nurse counseling. Secondary outcomes evaluated the operational cost of each program.

Results

When compared to baseline, all three groups made progress on key health-related outcomes during the 12-month intervention period; further, 84.5 % of all participants eligible for hepatitis A/B vaccination completed their vaccine series. The results of the detailed operational cost analysis suggest the least costly approach (i.e., UC), which accounted for only 2.11 % of the total project expenditure, was as effective in achieving comparable outcomes for this parolee population as the PC-NCM and PC approaches, which accounted for 53.98 % and 43.91 %, respectively, of the project budget.

Conclusions

In this study, all three intervention strategies were found to be comparable in achieving a high rate of vaccine completion, which over time will likely produce tremendous savings to the public health system.

     

Equal Rights vs. Special Rights: Rights Discourses,Framing, and Lesbian and Gay Antidiscrimination Policy in Washington State

This study argues that rights discourse influences heterosexual public opinion in Washington State. We tested this through a survey experiment conducted in the 2011 Washington Poll. We broke interviewees into three groups, with each group exposed to a different frame: a pro–lesbian and gay equal rights frame, an anti–lesbian and gay special rights frame, and a control or no frame. Immediately following the treatment, we asked interviewees if they agreed with a pro–lesbian and gay policy: changing state antidiscrimination law to encompass those who identify as lesbian and gay. Overall, this study concludes that a special rights frame dampens support among some while an equal rights frame has no effect. Respondents who indicated that they were against same‐sex marriage even more strongly opposed altering antidiscrimination policy to include sexual orientation when confronted with an equal rights frame than when confronted with the special rights frame or no frame at all.