The assessment of child abuse potential and the prevention of child abuse and neglect: A policy analysis

A frequently advocated strategy for increasing the efficiency of child abuse prevention programs is to deliver prevention services to "high-risk" populations. This article critically reviews procedures for the reliable and valid assessment of child abuse potential within an ecological perspective. Factors that limit the usefulness of child abuse risk assessment are discussed. These factors include the uncertain criteria of child abuse and neglect, the low base rate of the phenomenon, and the financial and social costs of such procedures. Finally, the prevention implications of the current and future state of the art in child abuse risk assessment are considered and preventive interventions that do not depend on individual case risk screening are advocated.     

A reanalysis of the influence of a "friendly visitor" program

A paper in the American Journal of Community Psychology (AJCP), by Reinke, Holmes, and myself, reported the results of a study of the influence of a friendly visitor program on the cognitive functioning and morale of elderly individuals. The program was reported to have had a significant multivariate effect on a combination of cognitive and morale measures and significant univariate effects on memory, self-perceived health, and activity director's ratings. Being intrigued by the memory finding, I conducted a follow-up study to further investigate the effect of a visitation program on cognitive functioning. In this second study the dependent measures included all of the cognitive variables included in the original study as well as some additional memory variables. The visitation program in the follow-up study had no effect on any of these measures. As a result of my failure to obtain a significant memory effect such as that reported in Reinke et al. (1981), I reanalyzed the data from the original study. In my reanalysis, the only significant effect was a borderline univariate effect for self-perceived health; the multivariate effect did not approach significance. On the basis of my inability to produce the results reported in Reinke et al. when I reanalyzed the original data, I must conclude that the friendly visitor program did not have the effects attributed to it in the original report.     

The precaution adoption process

This article presents a critique of current models of preventive behavior. It discusses a variety of factors that are usually overlooked-including the appearance of costs and benefits over time, the role of cues to action, the problem of competing life demands, and the ways that actual decision behavior differs from the rational ideal implicit in expectancy-value and utility theories. Such considerations suggest that the adoption of new precautions should be viewed as a dynamic process with many determinants. The framework of a model that is able to accommodate these additional factors is described. This alternative model portrays the precaution adoption process as an orderly sequence of qualitatively different cognitive stages. Data illustrating a few of the suggestions made in the article are presented, and implications for prevention programs are discussed.     

Pure agraphia and Gerstmann's syndrome as a visuospatial-language dissociation: an experimental case study

A right-handed man suffered a left parieto-occipital cerebral infarction, causing agraphia with Gerstmann's syndrome but without major aphasia, alexia, or apraxia. Oral spelling was superior to written spelling. Experiments were performed involving (1) analysis of errors in writing, (2) tasks of visual imagery, and (3) identifying letters drawn without leaving a visual trace. The results suggest that the agraphia and Gerstmann's syndrome are due to a dissociation of language skills and visuospatial skills caused by a dominant parieto-occipital lesion.     

Selective impairment of phonation: A case study

A 47-year-old right-handed man underwent craniotomy for clipping of an aneurism at the trifurcation of the left middle cerebral artery. Subsequently, he suffered a left hemisphere CVA after which his speech and language resembled that of Broca's aphasia with accompanying apraxia of speech. Medical, behavioral, and acoustical data amassed over a period of several months indicated numerous contraindications to traditional diagnoses of Broca's aphasia, apraxia of speech, and dysarthria. Ultimately, it was determined that the patient had a selective impairement of phonation or laryngeal apraxia. This was illustrated dramatically when he was taught to use an electrolarynx which allowed him to bypass his disrupted phonatory system. Speaking with the electrolarynx, the patient communicated normally. Any semblance of Broca's aphasia disappeared. Supralaryngeal articulation was normal; apraxia of speech behaviors were absent. This case report indicates that dissociation of oral and laryngeal gestures due to brain injury is possible. Mechanisms underlying such a dissociation for this case are reviewed. The possibility of discrete center lesions in the frontal motor association area causing different types of apraxia of speech is discussed.     

Powers, causation, and modality

A complex theory concerning powers, natures, and causal necessity has emerged from the writings of P. H. Hare, E. H. Madden, and R. Harré. In the course of rebutting objections that other critics have raised to the power account of causation, I correct three of its genuine difficulties: its attempt to analyze power attributions in terms of conditional statements; its characterization of the relation between something's powers and its nature; and its doctrines concerning conceptual necessity. The resulting interpretation of causal modalities is then subsumed under a more general power account of modality, related at a number of points to considerations concerning powers, and further illustrating their philosophical importance.     

Religion,Type A behavior,and health

In a study of air traffic controllers, religious differences are found in the way Type A behavior is associated with several health status indicators. Associations between the Jenkins Activity Survey (JAS) and physical illness incidence, health-promotive behavior, diastolic and systolic blood pressure, subjective distress and impulse control problems, and alcohol consumption are examined by religious attendance, religious affiliation, and change in affiliation. Findings confirm that Type A does not vary significantly by religion. However, there are several significant findings between Type A and various health indicators. Type A is associated with illness incidence, overall and more strongly in several religion, subgroups. Type A and alcohol consumption are related positively in Protestants and converts, and negatively in churchgoing Catholics. Type A is related to impulse control problems in churchgoing Protestants and to subjective distress in churchgoing Catholics. Finally, in individuals with weak or no religious ties, Type A is associated with lower blood pressure. This last finding suggests that in some people (for example, the irreligious or unchurched), the coronary-prone behavior pattern may have cardiovascular effects which are salutary in at least one respect.The authors wish to thank Dr. Kyriakos S. Markides and Laura A. Ray for their assistance with this study. Address requests for reprints to Dr. Levin at the Institute of Gerontology, 300 North Ingalls, Ann Arbor, MI 48109.