State regulation of managed care: fragments of reform

State legislatures consider numerous bills to regulate managed care organizations. After identifying the legal, political, and economic barriers to state reform efforts, the paper assesses recent types of state regulation, particularly mandated benefits and disclosure requirements. Two prerequisites to future reform, coalition building and the diffusion of information about managed care, are analyzed.     

On seeing oneself as “left out”: The chronically complaining patient in psychotherapy

A clinical observation regarding patients who complain about feeling left out and/or second best provides the framework for this paper. What is expressed is a form of separation anxiety coupled with a loser self-concept. It is suggested that these patients represent a milder form of the moral masochism. Early theoretical formulations include Freud and his emphasis on the superego and Reich's emphasis on the masochist's fear of being left alone. Kramer's little man phenomenon is an example of a more current theoretical formulation which takes account of the complexities of the ego, and composite self and identity in the clinical phenomena observed. A case of a latency-aged child is provided.     

Public knowledge,attitudes, and beliefs about homeless people: Evidence for compassion fatigue?

Media reports suggest that the public is becoming impatient with the homeless—that so-called “compassion fatigue” has gripped the nation. This characterization of public sentiment could have important policy consequences—restrictive measures can be justified by growing public impatience, and progressive housing policies seem infeasible within a hostile climate of opinion. But evidence to support the compassion fatigue notion is anecdotal. We examine the issue by tracking the results of public opinion polls and by reporting detailed evidence from a nationwide random-digit dial telephone survey (N=1,507) concerning knowledge attitudes and beliefs about homeless people. To be sure, the public sees homelessness as an undesirable social problem and wants something done about it. However, although the homeless are clearly stigmatized, there is little evidence to suggest that the public has lost compassion and is unwilling to support policies to help homeless people.     

Compound word effects differ in reading,on-line naming,and delayed naming tasks

Bimorphemic compound words (e.g.,blueberry), bimorphemic suffixed words (e.g.,ceaseless), and monomorphemic controls (e.g.,arthritis) were read in neutral sentence contexts in Experiment 1. The main result revealed longer first fixation durations on compound words than on control and suffixed words. Different effects emerged when naming tasks were used. An on-line naming task revealed substantially shorter naming latencies for compound words than for control and suffixed words. Naming latencies for compound and control words were equivalent in a delayed naming task. These results indicate that on-line naming latencies and word-viewing durations may yield diverging results. They also suggest that activation of constituent words of compound words occurs independently from the specification of conventional word meanings.     

Social-Cognitive and Behavioral Correlates of Aggression and Victimization in Boys' Play Groups

A contrived play group procedure was utilized to examine the behavioral and social-cognitive correlates of reactive aggression, proactive aggression, and victimization via peers. Eleven play groups, each of which consisted of six familiar African-American 8-year-old boys, met for 45-min sessions on five consecutive days. Social-cognitive interviews were conducted following the second and fourth sessions. Play group interactions were videotaped and examined by trained observers. High rates of proactive aggression were associated with positive outcome expectancies for aggression/assertion, frequent displays of assertive social behavior, and low rates of submissive behavior. Reactive aggression was associated with hostile attributional tendencies and frequent victimization by peers. Victimization was associated with submissive behavior, hostile attributional bias, reactive aggression, and negative outcome expectations for aggression/assertion. These results demonstrate that there is a theoretically coherent and empirically distinct set of correlates associated with each of the examined aggression subtypes, and with victimization by peers.     

Sensitivity to grammatical structure in so-called agrammatic aphasics

Comprehension failures in agrammatic aphasics, as well as their difficulties in sentence construction, have been attributed to an underlying deficit involving the retrieval of syntactic structure. In this study we show that four agrammatic patients display a remarkable sensitivity to structural information, as indicated by their performance on a grammaticality judgment task. These results indicate significant sparing of syntactic knowledge in agrammatism, and suggest that the sentence comprehension disturbances in these patients do not reflect loss of the capacity to recover syntactic structure. In particular, accounts of the comprehension deficit in agrammatism that implicate a failure to exploit information carried by the closed class (function word) vocabulary are called seriously into question. Alternative explanations of the comprehension problem in agrammatism are explored.     

Differences in temporal appearance associated with activity in the chromatic and achromatic systems

The temporal appearances of spatially coincident increments that activate the chromatic or achromatic system are different. Whereas near-threshold stimuli that are detected by the chromatic system appear to come on gradually, increments detected by the achromatic system appear to flash or step on. This difference in perception is consistent with previous reports that show differences in the temporal properties of the two systems.     

Preparing dichotic tapes using a digital music synthesizer

Digital music synthesizers represent audio signals in the form of binary coded numbers. These binary coded numbers can be manipulated by the operator, thereby altering the audio signal in a variety of ways. The present article describes how these capabilities can be used to produce perfectly aligned dichotic tapes in which the stimulus items are matched on all extraneous (timbre, amplitude, duration) factors.     

Out-of-home placement of children: Selected issues and prospects for the future

This paper describes the recent trends in the child welfare and children's mental health systems and their implications for public policy. Despite the rhetoric calling for preserving families and treating children and youth in their own homes, the best available evidence indicates that the rates of out-of-home placement are increasing at an alarming rate. More concerted and comprehensive efforts are needed if this trend is to be reversed in the near future.