“I Won't Back Down?” Complexity and Courage in Government Executive Decision Making

Senior government executives make many difficult decisions, but research suggests that individual cognitive limitations and the pathologies of “groupthink” impede their ability to make value‐maximizing choices. From this literature has emerged a normative model that Irving Janis calls “vigilant problem solving,” a process intended for the most complex decisions. To explore its use by senior public officials, the authors interviewed 20 heads of subcabinet‐level organizations in the U.S. federal government, asking how they made their most difficult decisions. The initial focus was on whether they employed a vigilant approach to making decisions that were informationally, technically, or politically complex. Most executives identified their single most‐difficult decision as one that required courage; they often made such courageous decisions after personal reflection and/or consultation with a small number of trusted advisors rather in ways that could be described as vigilant. The different approaches for making complex decisions, compared with those involving courage, are discussed and a contingency model of effective executive decision making is proposed that requires leaders (and their advisors) to be “ambidextrous” in their approach.     

Modelling the dynamics of support for a right-wing populist party: the case of UKIP

Similar to a number of other right-wing populist parties in Europe, Great Britain's United Kingdom Independence Party (UKIP) has experienced increased public support in recent years. Using aggregate data from monthly national surveys conducted between April 2004 and April 2014, time series analyses demonstrate that the dynamics of UKIP support were influenced by a combination of spatial and valence issues. A spatial issue, Euroscepticism, was fundamental, with UKIP support moving in dynamic equilibrium with changing public attitudes towards EU membership. In addition, widespread anti-immigration sentiment and dissatisfaction with the performance of the Conservative–Liberal Democrat coalition government combined with the “oxygen of publicity” to propel UKIP's surge. The political context after the 2010 general election helped as well by enabling UKIP to benefit from valence considerations. Many voters continued to doubt the competence of the major opposition party, Labour, while the Liberal Democrats were part of the government and, hence, unavailable as a protest vehicle. Since many of the forces driving UKIP support are beyond its control, the party's prospects are highly uncertain.     

Compulsory treatment with clozapine: a retrospective long-term cohort study

BACKGROUND: Clozapine is the gold standard in treatment of treatment-resistant psychotic patients. We know little about the effects of compulsory treatment in patients unwilling to accept the necessary treatment. AIMS: To assess the effectiveness, tolerability and safety of compulsory treatment with clozapine (CTC). METHOD: A cohort of 17 consecutive patients given compulsory treatment with clozapine were rated retrospectively by their treating psychiatrists on the basis of their case notes. RESULTS: CGI-S decreased significantly over time until last observation after a mean of more than 15 months. No patient deteriorated as measured by CGI-I. At last observation as many as ten of the 11 patients still on clozapine were classified as much to very much improved. The degree of custodial restriction at last observation showed improvement in 11 patients and no change in six. No serious adverse events were observed. CONCLUSION: A trial of compulsory treatment with clozapine showed this treatment to be feasible, effective, safe and well tolerated.     

The Relationship between Homelessness and Behavior Problems among Youth in North Texas: a Brief Report

This study sought to examine the relationship between homelessness and behavior problems among a community-based sample of youth in North Texas. Data were obtained from a cross-sectional, probability sample of households and a targeted sample of homeless families in Dallas, Texas, with children older than 5 years old (N?=?5232). Parents were asked to report five behavior problems on behalf of their children including arrest or trouble with police, academic problems, behavior problems at school, suspension, and suicide attempts. Logistic and negative binomial regression procedures were used to examine the relationship between homelessness and behavior problems. Youth exposed to homelessness were 36% (OR?=?1.63; 95% CI 1.00–1.85) more likely to exhibit any kind of behavior problems than youth who had never experienced homelessness. Homeless youth had 5.51 times the odds of arrest (95% CI 2.60–11.68), 1.74 times the odds of academic problems (95% CI 1.24–2.43), and more than 3 times the odds of suicide attempts (95% CI 1.46, 7.61) than youth who had never been homeless. Homelessness was associated with higher rates of problem behavior, including arrests, academic problems, and suicide attempts. Because homeless youth are commonly enrolled in school and present at health care clinics and emergency departments, clinics and schools may aid in the identification of homeless youth, as well as referral to care. In this way, clinicians may help reduce the burden of behavioral problems that disproportionately affect homeless youth.