A transcultural perspective on women and madness: The case of the mystical affliction

The paper seeks to examine spirit possession in women of traditional societies and syncretic subcultures as a symptom of personal maladjustment and as a form of social protest based on psychosocial, role-related pressures. This is accomplished by consideration of predisposing, precipitating and reactive factors involved in the possession reaction. Analysis of four case histories and availability of cross-cultural data indicate that the precipitation of pathological possession is rooted in the oppressive nature of the female role and that stresses experienced by traditional women are not unlike the difficulties of women in developed, industrialized societies. The possession response, however, is colored by traditional beliefs and superstitions; consequently, hysterical and anxiety symptoms are interpreted in light of the magical model of disease with the pathological reaction attributed to possession by malevolent spirits.     

Between welfare medicine and mainstream entitlement: Medicaid at the political crossroads

As the new century begins, the Medicaid program is arguably at a political crossroads. Over the 1980s and 1990s, policy makers enacted major expansions in Medicaid coverage, offering significant new health benefits to poor women and children and other constituencies. In elite rhetoric and political framing, Medicaid was increasingly cast as a broad-based social welfare entitlement of value to all Americans, including middle-class citizens. Some health care advocates began viewing Medicaid expansions as a potential path to achieving universal coverage in the United States. Yet Medicaid remains a means-tested program that has been repeatedly threatened with policy retrenchment. In this essay, we scrutinize Medicaid's current status and future possibilities from a historical-institutional perspective by tracing its complex evolution since its enactment in the Social Security Amendments of 1965. Our core claim is that decisions made at the time of Medicaid's original adoption have fundamentally set the matrix for struggles over the program's unfolding development. We demonstrate that key ambiguities embedded in the 1965 act created largely unintended opportunities for policy entrepreneurs to broaden Medicaid's scale and scope as well as foreseeable vulnerabilities that must be overcome if Medicaid is to realize its full potential.     

The effects of psychiatric and “biological” labels on lay sentencing and punishment decisions

Objectives

This research, using focal concerns perspective on sentencing, examines how and why psychiatric labels, and having diagnoses biologically “labeled,” affect sentencing beliefs. Dimensions of public stigma toward psychiatric illnesses are hypothesized to mediate sentencing views.

Methods

This is a 2?×?2 partially-crossed, between-subjects multifactorial experiment with a lay sample (n=?1213), presenting mediation analyses.

Results

Four psychiatric labels (Attention Deficit Hyperactivity Disorder, behavioral-variant Frontotemporal Dementia, High Functioning Autism, Borderline Intellectual Disability) led to significant beneficial effects on sentencing (less prison/rehabilitation support) as mediated by decreased stigmatization regarding lack of treatability, social acceptance, and personal responsibility. One biological “label” (Pedophilic Disorder) was mediated by decreased stigmatization (dangerousness), resulting in less prison support.

Conclusions

Data support effects of psychiatric labeling on sentencing under focal concerns. As no psychiatric labels resulted in increased discriminatory sentencing and, instead, led to decreased discriminatory sentencing behavior, psychiatric labeling may reduce punitiveness and bolster non-punitive sentencing beliefs. Biological labeling, aside from Pedophilic Disorder, may not affect sentencing.

     

The Crisis of German Social Democracy Revisited

This article analyses the dramatic electoral decline of German social democracy since 2003. It argues that the SPD's decision, under the leadership of former Chancellor Gerhard Schröder, to engage in welfare state retrenchment and labour market deregulation during the ‘Hartz reforms’ (2003–05) demoralised the SPD electorate. The SPD subsequently lost half of its former electoral coalition, namely blue‐collar voters and socially disadvantaged groups, while efforts to gain access to centrist and middle‐class voters have failed to produce any compensating gains. While the SPD's decline from a large to a mid‐sized party is part of a larger transformation of the German party system, no political recovery is possible for social democracy without a fundamental change of strategy, namely efforts to regain former voters by offering credible social welfare and redistributive policies. The SPD will not be able to delegate such policies in a ‘convoy model’ to other parties, such as the Left Party; nor will a modest ‘correction’ of the earlier course, such as has been attempted since 2009 under the leadership of current party chairman Sigmar Gabriel, be sufficient to recover lost electoral ground.     

Mental health and substance abuse insurance parity for federal employees: How did health plans respond?

A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than coverage for general medical services. While mental health advocates view insurance limits as evidence of discrimination, adverse selection and moral hazard can also explain these differences in coverage. The intent of parity regulation is to equalize private insurance coverage for mental and physical illness (an equity concern) and to eliminate wasteful forms of competition due to adverse selection (an efficiency concern). In 2001, a presidential directive requiring comprehensive parity was implemented in the Federal Employees Health Benefits (FEHB) Program. In this study, we examine how health plans responded to the parity directive. Results show that in comparison with a set of unaffected health plans, federal employee plans were significantly more likely to augment managed care through contracts with managed behavioral health "carve-out" firms after parity. This finding helps to explain the absence of an effect of the FEHB Program directive on total spending, and is relevant to the policy debate in Congress over federal parity.     

The German Federal Election of 2017: How the Wedge Issue of Refugees and Migration Took the Shine off Chancellor Merkel and Transformed the Party System

The 2017 German federal election delivered dramatic electoral decline of the two traditional main parties, the Christian Democrats (CDU/CSU) and the Social Democratic Party (SPD), who had governed Germany in a ‘grand coalition’ government since 2013. The main reason for this outcome was the decision by Chancellor Angela Merkel to open Germany's borders for refugees and migrants, an unprecedented policy that abandoned border controls and remained in place between September 2015 and March 2016. This article focuses on how the refugee and migration problem subsequently turned into a wedge issue, splitting most German political parties and handing a major election victory to the main critics of Merkel's decision, namely the rightist Alternative for Germany (AfD) and the right‐wing liberals of the Free Democratic Party (FDP). Rather than explaining these developments in isolation, the article highlights how past welfare state retrenchment and fear over future economic prosperity make significant groups of the electorate, including former supporters of left‐of‐centre parties, lose confidence in the ability of the political system to deliver stability and social integration.