The matryoshka: The three-generation soviet family in Israel

Among the 200,000 immigrants who entered Israel in 1990 were a considerable number of families headed by single mothers. Their most prominent feature was the fact that a three-generation system—a single Soviet mother, her own mother, and a single child—formed the family unit. Rooted in changes occurring in the Soviet family life cycle over the past 70 years, this configuration is uniquely self-contained. This article is an early inquiry into a new family structure that will become part of the social fabric of the multi-ethnic society in Israel. The challenge will be to help in the absorption process by recognizing, encouraging, and facilitating the strengths this type of family brings with it and to plan support networks to substitute for those left behind.A previous version of this article was presented at the Third World Family Therapy Congress, June 2–6, 1991, Jyvaskyla, Finland.     

Primary health care for women: What is it and who provides it?

Recent federal policy has highlighted historically underrecognized women's health issues. Women comprise the majority of the population, especially the elderly. Women's health care needs, utilization patterns, and outcomes vary from those of men, and often among each other. Primary health care services for women are multidisciplinary and emphasize prevention, education, and early intervention as well as treatment. Psychologists and other primary health care providers can collaborate to provide their services in a cost-effective manner that optimizes quality of care and comprehensive health care.     

Evaluating pediatric psychology consultation services in a medical setting: An example

We examined the nature of referrals to a health center-based pediatric psychology service from 1990 to 1993 and assessed the satisfaction of health professionals with these services. Archival evaluation of 1467 records showed that over half of the consultation requests came from general pediatrics, pediatric neurology, and surgical services and that 70% of the psychological services were delivered on an outpatient basis. The most frequent referrals were for cognitive/neuropsychological evaluation and externalizing behavior problems. Pediatric psychology trainees were involved in 94% of the consultations. Survey of health professionals (n = 143) indicated very high overall satisfaction with the quality of services delivered. Presenting problems yielding the greatest likelihood for future consultation requests were behavior problems, child abuse, coping with illness, and depression/suicide. Results are discussed in the context of previous evaluations of pediatric psychology services and recommendations for future evaluation research.     

Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Mental health service utilization among Puerto Rican children ages 4 through 16

This paper examines those children receiving mental health services in Puerto Rico, their demographic and psychosocial characteristics, and describes service providers and nature of facilities. The survey was done on a probability sample of children ages 4 through 16 across the island of Puerto Rico (N=777). Need for services was clinically defined as presence of a DSM-III diagnosis and functional impairment. The overall rate of service utilization for Puerto Rican children was 6% (26.2% of definite cases and 5.1% of probable cases). In most cases services were provided by psychologists and/or social workers, and they were mainly provided in schools and general medical facilities. In over 60% of the children assessed as cases, who did not receive services, the reason, given by the parent was that they considered the problem not serious. Factors associated with service utilization were measures of psychopathology, teacher's perceived need, and parental rates of criticism and hostility. These findings suggest that there is a need for more research on the motivating factors for service use (impairment and parental criticism). Teachers could benefit from receiving special training to help them readily recognize behavioral problems in children, communicate them to parents and set up services alternatives.     

Social integration and social support in a life crisis: Effects of macrosocial change in east Germany

This process evaluation study examined what variables moderate and mediate treatment effects on days in stable housing and client satisfaction for homeless mentally ill clients. In general, demographic characteristics did not moderate either outcome variable. Housing contacts, entitlement contacts, mental health contacts, and supportive services were significant mediators of the treatment effect on days in stable housing. Program contacts, mental health contacts, and supportive services were significant mediators of client satisfaction. The authors thank the National Institute of Mental Health for their financial support (MH43248, MH42357) for this project, Dorothy Gano for word processing and editorial assistance, and Gitry Heydebrand, Melissa Dannelet, Betty Tempelhoff, Ruth Smith, and Laeeq Ahmad for assisting in the interviews of clients. We are also appreciative of the cooperation given to us by the staffs of Malcolm Bliss Mental Health Center, St. Patrick's Center, the Community Advocacy and Support Alliance Program, and the St. Louisemergency shelters. Finally, we thank all of the participants in this study; we hope that their homelessness has now ended. (The conclusions presented in this paper are the sole responsibility of the authors and do not necessarily reflect official National Institute for Mental Health policy.)     

The total workload of male and female white collar workers as related to age, occupational level, and number of children

A questionnaire assessing various aspects of paid as well as unpaid forms of productive activity was mailed to stratified samples of male and female white collar workers, approximately matched for educational and occupational level. Data from 501 men and 679 women employed full time revealed traditional gender differences in terms of main responsibility for household duties, child care etc. In keeping with this, women reported higher levels of work overload, stress and conflict than men, which increased significantly with the number of children at home. The various stress indices reached a peak between the ages of 35 and 39. Men reported more autonomy in their paid work whereas women reported more control at home. Men and women at the upper managerial levels reported more control over their total work situation and less conflict between demands.     

A spanish translation and validation of the daily stress inventory and a comparison of the level of stress experienced by three culturally distinct hispanic groups

Two studies were conducted, the first to establish a valid Spanish version of the Daily Stress Inventory (DSI). A second study was conducted using the bilingual version of the DSI to assess differences in the level of stress experienced by three selected Hispanic groups: (a) very Hispanic/Hispanic-oriented bicultural, (b) true bicultural, and (c) Anglo-oriented bicultural/very Anglicized as determined by the adapted version of the Acculturation Rating Scale for Mexican Americans (ARSMA). It was expected that stress levels would be highest for the least acculturated group. The results of the first study indicate that the Bilingual DSI scores are highly correlated with the scores of the original DSI when both instruments are responded to simultaneously by fully bilingual individuals. In Study 2, the initial data analyses showed no difference in the level of stress reported by Hispanics at different levels of acculturation as measured by the ARSMA. When a median-split method was employed, differences in the DSI I/E measures between the two groups were significant, suggesting that acculturation level may be related to stress level.