Diagnosis and the dole: the function of illness in American distributive politics

This article argues that the concept of illness has certain properties that make it a convenient administrative device for managing a need-based redistributive system in a society whose primary distributive system is based on work. These properties--cultural acceptance of illness as a legitimate excuse for not working, objective standards for identifying illness, and restrictiveness--have led to the widespread use of illness as an eligibility criterion for many social benefits, including cash transfers, services, privileges and exemptions. Paradoxically, the traditional rationales for using illness as one of the keystones of categorical welfare policy are eroding, yet welfare programs based on illness certification are growing rapidly. To explain this anomaly, the author suggests that medical certification as a distributive mechanisms serves certain latent political functions, such as allowing welfare programs to be responsive to political unrest, siphoning off opposition to controversial policies by the granting of medical exemptions to intense opponents, are reducing political conflict by using physicians as arbiters.     

The Structure and Stability of Externalizing and Internalizing Problem Behavior During Early Adolescence

The first aim of this study was to examine the structure of externalizing and internalizing problem behavior during early adolescence. Our second aim was to determine the stability of these problems for boys and for girls over time. A total of 650, 13–14-year-olds filled out (an expanded version of) the Youth Self-Report [YSR; Manual for the Youth Self-Report and 1991 Profile. Department of Psychiatry, University of Vermont, Burlington] 2 times with a 1-year interval. By using confirmatory factor analyses (CFA) to test a series of competing models, a hierarchical model provided the best representation of the structure of problem behavior at both Time 1 and Time 2: externalizing and internalizing problem behavior represent distinct aspects but the model also demonstrates the existence of comorbidity at a higher level. This model appeared to be stable over time for both boys and girls. The relative stability of problem behavior was found to be high for boys and girls. Absolute stability for both externalizing and internalizing problems appeared to be higher for boys scoring in the lower range of problem behavior. Senior Researcher, Utrecht University, The Netherlands. Received PhD in social sciences, University of Amsterdam. Major research interests include problem behavior, family relations, and peer relations during adolescence. Full Professor, Utrecht University, The Netherlands. Received PhD in social sciences: child and family studies, from University of Nijmegen. Major research interests include adolescent social development, problem behavior, and family relations during adolescence. Assistant Professor, University of Amsterdam, The Netherlands. Received PhD in psychology, University of Amsterdam. Major research interests include family influence on childhood illness and problem behavior.