INSTITUTIONAL LAYERING IN GOVERNING HEALTHCARE QUALITY

Since the 1980s, regulated markets and New Public Management have been introduced in the public sector across the world. How they have affected existing governance mechanisms such as self‐regulation and state regulation has remained largely unexplored, however. This article examines the origins and consequences of institutional layering in governing healthcare quality. Dutch health care, where a market‐based system has been introduced, is used as a case study. The results show that this market‐based system did not replace but modified existing institutional arrangements. As a result, hospitals have to deal with the fragmentation of quality demands. Using the concept of institutional layering, this study shows how different arrangements interact. As a consequence, the introduction of a certain policy reform will work out differently in different countries and policy sectors. Our ‘archaeological’ study in this layering can be seen as an example of how such incremental change can be studied in detail.     

Political Corruption and Institutional Stability

This article is the first to statistically examine the reciprocal relationship between formal political institutions and political corruption. We argue that political corruption is an informal institution that allows nondemocratic leaders to build political support, act as a substitute for liberalizing concessions in the formal institutions of the state, and thereby extends the longevity of non-democratic regimes. Yet, whereas high corruption level will prevail in nondemocratic regimes, we expect the electoral constituency in democratic regimes to have the formal power to curb political corruption. We demonstrate that these expectations hold by estimating a dynamic multinomial regression model on data for 133 countries for the 1985–2008 period. Our model shows that high-corruption autocracies and hybrid regimes are more stable than their low-corruption counterparts, but that low-corruption democracies are more stable than high-corruption ones. For autocratic and hybrid regimes, the stability is due both to corruption making the formal institutions more resistant to democratization and that the formal institutions prevent reductions in corruption. Consistent democracies, on the other hand, are able to reduce corruption and become more stable as a result.     

Not Worth the Fuss After All? Cross-sectional and Prospective Data on Violent Video Game Influences on Aggression, Visuospatial Cognition and Mathematics Ability in a Sample of Youth

The United States Supreme Court’s recent decision relating to violent video games revealed divisions within the scientific community about the potential for negative effects of such games as well as the need for more, higher quality research. Scholars also have debated the potential for violent games to have positive effects such as on visuospatial cognition or math ability. The current study sought to extend previous literature by using well-validated clinical outcome measures for relevant constructs, which have generally been lacking in past research. Cross-section data on aggression, visuospatial cognition, and math achievement were available for a sample of 333 (51.7 % female) mostly Hispanic youth (mean age = 12.76). Prospective 1-year data on aggression and school GPA were available for 143 (46.2 % female) of those youth. Results from both sets of analysis revealed that exposure to violent game had neither short-term nor long-term predictive influences on either positive or negative outcomes. A developmental analysis of the cross-sectional data revealed that results did not differ across age categories of older children, preadolescents or adolescents. Analysis of effect sizes largely ruled out Type II error as a possible explanation for null results. Suggestions for new directions in the field of video game research are proffered.     

Sleep Disturbance and Depressive Symptoms in Adolescence: The Role of Catastrophic Worry

Depression is a common and debilitating disorder in adolescence. Sleep disturbances and depression often co-occur with sleep disturbances frequently preceding depression. The current study investigated whether catastrophic worry, a potential cognitive vulnerability, mediates the relationship between adolescent sleep disturbances and depressive symptoms, as well as whether there are gender differences in this relationship. High school students, ages 16–18, n = 1,760, 49 % girls, completed annual health surveys including reports of sleep disturbance, catastrophic worry, and depressive symptoms. Sleep disturbances predicted depressive symptoms 1-year later. Catastrophic worry partially mediated the relationship. Girls reported more sleep disturbances, depressive symptoms, and catastrophic worry relative to boys. The results, however, were similar regardless of gender. Sleep disturbances and catastrophic worry may provide school nurses, psychologists, teachers, and parents with non-gender specific early indicators of risk for depression. Several potentially important practical implications, including suggestions for intervention and prevention programs, are highlighted.     

Different Stressors, Different Strategies, Different Outcomes: How Domain-Specific Stress Responses Differentially Predict Depressive Symptoms Among Adolescents

As a time of notably increased stress and a marked rise in depressive symptoms, adolescence is a key period in which to examine how stress is related to mental health outcomes. Many studies examine stress as a unitary construct; however, research suggests that how adolescents respond to stress within different domains may differentially predict depression. The current study used an 8-week weekly diary design to assess how adolescents’ cognitive appraisals, rumination, and co-rumination in response to dependent, independent, social, and nonsocial stressors differentially predicted depressive symptoms. Participants were 111 high school students (72 % female) ages 14–19 years (mean age 16.4). Results indicated that rumination and co-rumination about dependent and social events, rather than independent or nonsocial events, prospectively predicted depressive symptoms. Negative cognitive appraisals prospectively predicted depressive symptoms regardless of domain. This study provides support for the hypothesis that adolescents’ responses to stress in different domains differentially predict depressive symptoms.     

Non-Suicidal Self-Injury and Depressive Symptoms During Middle Adolescence: A Longitudinal Analysis

Previous research has shown a consistent positive association between non-suicidal self-injury and depressive symptoms. However, the direction of the effects has not been examined. To understand whether non-suicidal self-injury predicts depressive symptoms or vice versa, we examined the relations between non-suicidal self-injury and depressive symptoms across three waves of self-report data collected 1 year apart from 506 Swedish adolescents (47 % girls; M age = 13.21; SD = .57) who were attending 7th grade at the onset of the study. The results suggest that depressive symptoms predict increases in non-suicidal self-injury 1 year later between the first and second waves of the study. Between the second and third waves of the study depressive symptoms and non-suicidal self-injury were significantly correlated indicating co-occurrence with no direction of effect rather than depressive symptoms predicting non-suicidal self-injury or vice versa. Group comparisons revealed no differences for boys and girls. The findings help clarify the relationships between non-suicidal self-injury and depressive symptoms during middle adolescence.     

The Impact of Emotional Disturbances on the Arrest Trajectories of Youth as They Transition into Young Adulthood

This article identifies the arrest trajectories of youth from ages 12 through 24 years old and tests hypotheses derived from Moffitt’s developmental taxonomic theory of crime concerning the impact of various emotional disturbances on the specific trajectories of the youth involved. The study uses exclusively administrative data sets and includes a gender and racially diverse sample of 10,360 youth (30.7 % females) who were arrested at least once between ages 12 and 24 in the early 2000s. Latent class growth analysis was employed in order to identify distinct arrest trajectories of youth in the sample. Multinomial logistic regression was used to identify diagnostic and other characteristics associated with membership in the specific trajectories predicted by Moffitt’s theory. Five trajectory classes were identified, 3 of which were consistent with taxonomic theory including high and classic adolescence limited trajectory classes and a “snared adolescence limited class” described more recently by Moffitt. The distribution of youth among the 5 classes was very different for those with and without emotional disturbances. Youth with emotional disturbances in their late adolescent years were more likely to fall into the high arrest trajectory class and much less likely to fall into the low arrest trajectory class. Compared to youth without an emotional disturbance, youth with psychotic disorders were more than twice as likely to fall into the high as into the low arrest trajectory class. Youth with disruptive behavior disorders were more than twice as likely to fall into the high and intermediate classes as into the low trajectory class. Anxiety and depressive disorders were not associated with significantly greater likelihood of falling into any one of the trajectory classes. Youth in the snared adolescence limited class were more likely than those in the classic adolescence limited class to be male, black versus white and in the foster care enrollment category lending some support to Moffitt’s conceptualization of this class as an adolescence limited class composed of youth who are snared by involvement in the criminal justice and or social services systems. Implications of these results for public policy and the study of adolescence are discussed.     

Involved-Vigilant Parenting and Socio-Emotional Well-being Among Black Youth: The Moderating Influence of Natural Mentoring Relationships

Positive relationships with parents and nonparental adults have the potential to bolster Black adolescents’ socio-emotional well-being. Though each type of intergenerational relationship has been linked to more positive youth outcomes, few studies have examined the interactive influences of parenting and natural mentoring relationships on the socio-emotional development of Black youth. In the current study, we examined associations between involved-vigilant parenting and the psychological well-being and social skills of Black early adolescents (n = 259; 58 % female; mean age = 13.56, SD = .96) across types of natural mentoring relationships. Using K-means cluster analysis, we identified two types of mentoring relationships (less connected and more connected) based on relationship length, involvement, closeness, and frequency of contact. Youth with more connected mentoring relationships (n = 123) had higher psychological well-being and social skills than youth with no mentor (n = 64) or less connected mentors (n = 72). Youth without a natural mentor and youth with less connected mentors did not differ in their levels of social skills or psychological well-being. Structural equation modeling was conducted to determine if associations between involved-vigilant parenting and youths’ psychological well-being and social skills varied among youth with a more connected mentoring relationship in comparison to youth without a mentor or with a less connected mentor, controlling for participants’ gender, age, school, and parental education. The positive associations between involved-vigilant parenting and adolescents’ psychological well-being and social skills were weaker among adolescents with a more connected mentoring relationship in comparison to their peers without or with a less connected mentoring relationship. These results suggest that youth may be more strongly influenced by involved-vigilant parenting in the absence of a strongly connected natural mentoring relationship.