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Alcohol and other drugs: the response of the political and medical institutions.

Formal and informal social control in shaping individual behaviors toward the use of alcohol and other drugs is discussed. Emphasis is placed on formal social control as it occurs in two major institutions. The state, which embodies the political and legal structures of the society is discussed in terms of the social control of some of the consequences of drinking, such as public drunkenness, alcoholism, operating vehicles with specific blood alcohol levels, and crime and alcohol use. The medical institution's involvement in alcohol and drug control is discussed in terms of the physician's role in diagnosing alcohol and drug dependent individuals. Two contemporary cases, those of pregnant addicts and alcohol-related organ transplant patients, illustrate the significant interactions between the responses of the political and medical institutions, and the broader influences that help shape these responses.

Alcoholism

Prohibition or liberalization of alcohol and drugs? A sociocultural perspective.

The "war against drugs," and calls for increasing restrictions on the availability of alcoholic beverages, reflect a resurgence in the popularity of mandated formal controls and suspicion of informal controls. A small, but increasing countercurrent recommends various forms of liberalization of access to alcohol and drugs. Both viewpoints are being promulgated for their efficacy in reducing and/or preventing a broad range of problems "associated with" (and often assumed to be caused by) psychoactive substances. In the absence of rigorous empirical evidence on the subject, critical examination of prior experience in the United States, and of analogous experiences in other cultures, provides a range of relevant "natural experiments." The association of alcohol and cocaine with various problems varies markedly from culture to culture and from time to time within a single culture. The definition of "abuse" problems is evidently based on social constructions rather than reflecting the epidemiology of public health and social welfare. Formal and informal controls are not mutually exclusive and can be complementary. A broader view of education and of controls could result in fruitful natural experiments among jurisdictions within this country, and lessen alcohol and drug problems at the same time.

Alcoholism

Faculty/student perception of organizational climates in the schools of nursing, Oyo State, Nigeria.

This study examined the influence of educational status and gender on the faculty and students' perceptions of their school climates. A self-designed questionnaire was used to elicit information from the 385 subjects (320 students and 65 tutors). Analysis using the t-test technique revealed that there were no significant differences at the 0.05 level of probability in the perceptions of: (a) faculty and students on climate variables "thrust" (t = 0.31) and "control" (t = 1.19); and (b) both sexes on climate variables "thrust" (t = 1.69), "control" (t = 1.13) and "disengagement" (t = -0.53). The conclusion therefore, is that educational status and gender have little or no influence on the peoples' perception of their school climates.

Educational Status

Multiple suicide attempts and informal labeling: an exploratory study.

Attempted suicide is considered to be a form of deviant behavior. Multiple suicide attempts are evaluated within the labeling perspective. Specifically, it is determined if labeling theory can explain acts of repeated suicide attempts as a form of deviance. Two hypotheses are created to test the influence of informal labeling on multiple suicide attempts. Family and friends constitute the categories most important in informal labeling. Labeling by them is measured through a series of behavioral scales. It is hypothesized that the greater the labeling by each of these categories, the greater the likelihood of recurrence of attempted suicide. It is also predicted that the greater the "self concept as suicidal," the greater the likelihood of recurrence. Labeling by family and friends was found to be significantly related to repeat. Conclusions about the relationship between "suicidal self-concept" and repeat were not drawn.

Adult

Performance of psychiatric hospital discharges in strict and tolerant environments.

Community mental health professionals are greatly concerned with the type of social environment most conducive to helping patients remain outside psychiatric institutions and improving the quality of their lives in the community. This paper examines the tolerance of deviance characterizing significant others in the patients' environment as it relates to community tenure and selected measures of performance and quality of life of the older patient in the community. A possible role is suggested for differential tolerance of deviance in the lives of patients discharged from psychiatric hospitals. Although it would appear that patients may return to the hospital at a higher rate from low tolerance environments, it may be that for patients who remain in the community, the quality of life may be better in low tolerance environments in terms of social interaction and life satisfaction. The deviance model is of value in the continuing efforts to understand the role of the social environment in the community life of discharged patients.

Attitude

Person perception and the Berkowitz paradigm for the study of aggression.

Three experiments in person perception were conducted to investigate the conditions under which naive observers label an actor as aggressive and to ascertain how this label affects the reactions of the observers to the actor. These studies were performed by exposing subjects to written descriptions of Berkowitz's much-used paradigm for the study of aggression in order to additionally demonstrate that naive observers do not label in the same way as do research psychologists. In Experiment 1 the hypothesis was confirmed that harm-doing behavior is labeled as aggression only when it is antinormative. When harm doing was justified by the instigation or attack of another person, its use did not lead to the actor being labeled as aggressive. In Experiment 2 it was found that violation of the limits imposed by the experimenter on the number of shocks that could be used by actors led observers to characterize them as aggressive even when their action was justified by the prior instigation of the other party. Violation of two norms led to a more aggressive rating of the actor than did the violation of only one norm. Experiment 3 showed that actors who are labeled as aggressive are disapproved of and avoided by observers. The results of these studies are discussed in terms of the ecological validity of Berkowitz's research paradigm and metatheoretical implications for the scientific study of harm-doing behavior.

Aggression

Sibling influences on adolescent drug use: older brothers on younger brothers.

This study was designed to examine sibling influences on adolescent drug use. The sample was composed of 278 white, predominantly middle-class male college students and their oldest brothers. Self-administered questionnaires were taken separately by the students and their brothers. The findings indicated that the oldest brother's personality and the sibling relationship had an influence on the younger brother's drug use. Three hypothesized mechanisms that supported the findings, the Personality Influence Mechanism, the Genetic Temperament Connection, and the Environmental Reactive Mechanism were discussed.

Adolescent

Mental health mystification and social control.

The field of mental health suffers from an abundance of technical jargon. The major social issues that touch upon mental health are debated in these technical terms, but persons most affected by the issues are left out of the debate. Hence, professionals have come to serve as an exclusionary buffer between human anguish and social policy.

Humans

Psychiatry and psychotherapy as political processes.

Therapy is applied politics. From hospitalizing a patient to offering psychoanalytic insight, a therapist's every action reflects his own attitudes toward political issues, including individual freedom vs. state control, or capitalism versus socialism. Ultimately every therapy implements some utopian political vision against which the client will measure his own success and failure in the therapy.

Attitude of Health Personnel

Some implications of variations in techniques of group therapy for social controls.

Variations in techniques of group psychotherapy are related to the clients' ego strength. Clients with developmental or pathological ego deficit have different needs for social controls than those with good ego endowment. This paper illustrates differential use of such controls in three areas. 1. Constacy of the treatment milieu as a frame of reference: For patients with good ego endowment, time and place of group meetings should be kept constant to allow them to look inwards and permit experience of feelings hitherto avoided. A patient is described who, following a break-through of feelings in the group, attempted to disrupt the therapy by usurping control over time and place of sessions. Holding time and place of group meetings constant allows patients with ego deficit to anticipate events and helps them build additional controls over impulses. Responses of borderline patients to changes in the treatment milieu are described. 2. Control of group interactions: Matching group members for ego strength is considered essential. Clinical vignettes illustrate contrasts in group interactions considered therapeutic for patients with ego deficit and those with good ego endowment. Techniques for the first group include ritualising the group process, emphasis on reality rather than fantasy and dilution of inter-patient rapport; techniques that aid patients with good ego endowment to relinquish pathological controls include support of basic questions concerning the individual's identity, free flow of fantasy, tolerance of tension, silences or strong ventilation of affect and facilitating observations from patients concerning the process of interaction. 3. Relationship to the leader: For patients with developmental or pathological ego deficit, it is essential that the therapist be ready to set limits and lend defences when the patient's controls fail. Patients with good ego endowment often have too much control. It follows that the therapist will intervene, clarify and provide structure in the first group much more frequently than in groups for psychoneurotics. For patients with ego deficit the relation to the therapist may have to be moderated lest it further weaken ego boundaries. Such patients often need personal distance. Transference to the institution, to the treatment milieu and to the group as a concrete object provides these patients with a natural means of distancing relationships. The therapist should attempt to fit into this series. He should be highly visible in the benign exercise of his professional function. Rapport should be kept stable and primarily positive even after termination of treatment. In contrast, groups of patients with good ego endowment may relate to the therapist more intensively if he is less visible. These patients, unless they can move back and forth between positive and negative rapport, can hardly be said to be working. They will often attempt to control rapport with the therapist by splitting the transference...

Adult