No abstract

This article examines the role of adolescent social relationships in fostering the occurrence and co-occurrence of depression and substance abuse, using two waves of data from a community sample of adolescents (N = 900). Multinomial logistic response models were estimated to identify the extent to which risk and protective features of youths' family and peer relations were differentially linked with depressive symptoms, substance abuse, and their co-occurrence. Taking a within-person, configurational approach to adolescent adaptation, contrasts involved four subgroups of adolescents: those high on both depressed mood and substance abuse, those who experience neither problem, those evidencing high levels of depressive symptoms only, and those high on substance abuse only. Risk for depressive symptoms was differentiated by its association with conflict and lack of support in the friendship domain. Substance abuse was associated with negative peer pressure, but these youth were otherwise little different from youths with no problems. Whereas co-occurrence of depression and substance use was associated with more difficulties in both the family and peer environments, the most distinctive risk was that of low family support. Discussion centers on the developmental antecedents of co-occurring problems and family relations during adolescence.

This article critically discusses theoretical and methodological issues raised by psychological androgyny research and theory. A number of problematic assumptions shared by this approach and the previous masculinity/femininity approach are detailed. The first part of the article considers whether inventories devised to tap general sex stereotypes should be used as individual personality measures. Alternative forms of cognitive structures, linking sex, other person features, and behavioral rules, are described and hypothesized to have sex-differentiating effects on behavior. The second part of the article discusses problems created by the persistent use of indicators of adaptation and mental health as criterion variables in research on sex identity and sex roles. It is suggested that a psychological theory of sex identity and sex roles should recognize the fact that sex is a structural feature of situations and of ongoing organizations of life experience. In a society in which sex plays a role in the very structuration of experience, the notion of psychological androgyny, with its implication of freedom from sex-related social and biological effects on personality and behavior, is arbitrary.

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 feasible 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.

BACKGROUND: Bariatric surgery is one of few obesity treatments to produce substantial weight loss but only a small proportion of medically-eligible patients, especially men and racial minorities, undergo bariatric surgery. OBJECTIVE: To describe primary care patients' consideration of bariatric surgery, potential variation by sex and race, and factors that underlie any variation. DESIGN, SETTING, AND PATIENTS: Telephone interview of 337 patients with a body mass index or BMI > 35 kg/m 2 seen at four diverse primary care practices in Greater-Boston. MEASUREMENTS: Patients' consideration of bariatric surgery. RESULTS: Of 325 patients who had heard of bariatric surgery, 34 % had seriously considered surgery. Men were less likely than women and African Americans were less likely than Caucasian patients to have considered surgery after adjustment for sociodemographics and BMI. Comorbid conditions did not explain sex and racial differences but racial differences dissipated after adjustment for quality of life (QOL), which tended to be higher among African American than Caucasian patients. Physician recommendation of bariatric surgery was independently associated with serious consideration for surgery [OR 4.95 (95 % CI 2.81-8.70)], but did not explain variation in consideration of surgery across sex and race. However, if recommended by their doctor, men were as willing and African American and Hispanic patients were more willing to consider bariatric surgery than their respective counterparts after adjustment. Nevertheless, only 20 % of patients reported being recommended bariatric surgery by their doctor and African Americans and men were less likely to receive this recommendation; racial differences in being recommended surgery were also largely explained by differences in QOL. High perceived risk to bariatric surgery was the most commonly cited barrier; financial concerns were uncommonly cited. LIMITATIONS: Single geographic region; examined consideration and not who eventually proceeded with bariatric surgery. CONCLUSION: African Americans and men were less likely to have considered bariatric surgery and were less likely to have been recommended surgery by their doctors. Differences in how obesity affects QOL appear to account for some of these variations. High perceived risk rather than financial barrier was the major deterrent for patients.