医疗保障制度改革过程中的价值取向问题及其影响

随着社会主义市场经济体制的建立,我国传统的劳保医疗制度和公费医疗制度已越来越不适应社会发展的要求,呈现出诸多弊端,亟待改革。作为一项公共政策,医疗保障制度在改革与完善的过程中应根据科学行政的要求对政策的价值取向进行深入分析,以便顺利实施改革的各项方案。分析医疗保障制度改革中所涉及的各方面的价值观及其对改革的影响,希望唤起政策制定者对不同群体利益的关注,从而保证政策体系的稳定。     

Effectiveness of the ‘Hold me Tight’ Relationship Enhancement Program in a Self‐referred and a Clinician‐referred Sample: An Emotionally Focused Couples Therapy‐Based Approach

While evidence‐based couple therapies are available, only a minority of troubled couples seek help and they often do this too late. To reach more couples earlier, the couple relationship education (CRE) group program “Hold me Tight” (HmT) based on Emotionally Focused Couples Therapy (EFCT) was developed. This study is the first to examine the effectiveness of HmT. Using a three‐wave (waiting period, treatment, and follow‐up) within‐subject design, HmT was delivered to 79 self‐referred couples and 50 clinician‐referred couples. We applied a comprehensive outcome measure battery. Our main findings were that (1) self‐referred couples significantly improved during HmT on all measures, that is relationship satisfaction, security of partner‐bond, forgiveness, daily coordination, maintenance behavior, and psychological complaints, with a moderate‐to‐large mean effect size (d = .63), which was maintained (d = .57) during the 3.5 month follow‐up; (2) in clinician‐referred couples, who were vulnerable in terms of insecure attachment status and psychopathology, the improvement during HmT was moderate (d = .42), but this was reduced during the 3.5‐month follow‐up to a small effect (d = .22); (3) emotional functioning (typical HmT target) as well as behavioral functioning (typical Behavioral Couples Therapy‐based CRE target) improved during HmT; and (4) individual psychological complaints, although not specifically targeted, were reduced during HmT. These findings suggest that HmT is a promising intervention for enhancement of relationship functioning. Clinical implications are discussed.     

Is Political Conservatism Adaptive? Reinterpreting Right‐Wing Authoritarianism and Social Dominance Orientation as Evolved,Sociofunctional Strategies

The Dual Process Model (DPM) explains prejudice and political conservatism as functions of Right‐Wing Authoritarianism (RWA) and a Social Dominance Orientation (SDO; Duckitt, 2001). From an evolutionary perspective, such orientations may represent specific adaptations to coalitional competition in the ancestral environment (Sinn & Hayes, 2016). Supporting this view, recent research suggests the two orientations represent divergent strategies, with RWA pursuing an honest‐cooperator strategy and SDO a deceptive, cooperation‐mimicking strategy (Heylen & Pauwels, 2015). In two studies, we examine additional evidence for an adaptationist interpretation of DPM. Utilizing life history theory, Study 1 finds that RWA reflects the predicted “slow” strategy by endorsing planning and control, investment in family relationships, altruism, and religiosity. In contrast, SDO reflects a “fast” strategy by devaluing planning and control, secure relationships, and altruism. Utilizing rank management theory, Study 2 finds that RWA reflects a prosocial orientation, endorsing coalition building and social networking while rejecting deception and manipulation. In contrast, SDO reflects an exploitive orientation, rejecting coalition building and networking but endorsing ruthless self‐advancement and deceptive tactics. These findings support an adaptationist revision of RWA to recognize its prosocial, honest‐cooperator dimension and of SDO to recognize proself, “dark” tactics seeking power within groups.     

Stepfamily Relationship Quality and Children's Internalizing and Externalizing Problems

The stepfamily literature is replete with between‐group analyses by which youth residing in stepfamilies are compared to youth in other family structures across indicators of adjustment and well‐being. Few longitudinal studies examine variation in stepfamily functioning to identify factors that promote the positive adjustment of stepchildren over time. Using a longitudinal sample of 191 stepchildren (56% female, mean age = 11.3 years), the current study examines the association between the relationship quality of three central stepfamily dyads (stepparent–child, parent–child, and stepcouple) and children's internalizing and externalizing problems concurrently and over time. Results from path analyses indicate that higher levels of parent–child affective quality are associated with lower levels of children's concurrent internalizing and externalizing problems at Wave 1. Higher levels of stepparent–child affective quality are associated with decreases in children's internalizing and externalizing problems at Wave 2 (6 months beyond baseline), even after controlling for children's internalizing and externalizing problems at Wave 1 and other covariates. The stepcouple relationship was not directly linked to youth outcomes. Our findings provide implications for future research and practice.     

Stimulus control depends on the subjective value of the outcome

Stimuli that provide information about likely future reinforcers tend to shift behavior, provided a reliable relation between the stimulus and the reinforcer can be discriminated. Stimuli that are apparently more reliable exert greater control over behavior. We asked how the subjective value (measured in terms of preference) of reinforcers associated with stimuli influences stimulus control. Five pigeons worked on a concurrent chains procedure in which half of all trials ended in a smaller reinforcer sooner, and the other half in a larger reinforcer later. In Signaled trials, the color and flash duration on the keys in the initial link signaled the outcome of the trial. In Conflicting probe trials, the color and the flash duration signaled conflicting information about the outcome of the trial. Choice in Signaled trials shifted toward the signaled outcome, but was never exclusive. In Conflicting probe trials, control was divided idiosyncratically between the 2 stimulus dimensions, but still favored the outcome with the higher subjective value. Thus, stimulus control depends not only on the perceived reliability of stimuli, but also on the subjective value of the outcome.     

Standing in the gap: ref lections on translating the Jung‐Neumann correspondence

This paper considers the experience of translating the correspondence between C.G. Jung and Erich Neumann as part of the Philemon series. The translator explores the similarities between analytical work and the task of translation by means of the concepts of the dialectical third and the interactional field. The history and politics of the translation of analytic writing and their consequences for the lingua franca of analysis are discussed. Key themes within the correspondence are outlined, including Jung and Neumann's pre‐war exploration of Judaism and the unconscious, the post‐war difficulties around the publication of Neumann's Depth Psychology and a New Ethic set against the early years of the C.G. Jung Institute in Zurich, and the development of the correspondents’ relationship over time.