Network interventions: do they work?
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Biomedical subjects
Publications and source records attributed to C I Cohen.
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New York City homeless aged men living on the Bowery and in single-room occupancy hotels were contrasted using Bogue's model of skid row social formation. Because of their commonality of being unattached urban males, it had been assumed that they would exhibit similar characteristics and modes of adaptation. It is shown that homelessness is not a uniform category, nor can these men always be easily distinguished from the general populace. Only sociability criteria differentiated these men as a group from their nonhomeless age peers suggesting the appropriateness of an interactive conceptual framework for homelessness. Regression analysis revealed that three of Bogue's four criteria differentiated between Bowery and single-room occupancy men, with the socioeconomic being the most powerful data set. There were also important differences in the way each group handled their social world. The ability of these men to adapt to other environments is discussed.
Normal men exhibited more characteristics of borderline personality disorder than did normal women on a questionnaire. In light of that finding, the authors suggest that labeling processes may be a contributing factor in the overrepresentation of women among patients diagnosed as borderline.
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In mapping social networks, investigators have confronted the following choices in the selection of an instrument to assess networks: (1) qualitative versus quantitative approaches; (2) subjective versus objective criteria; (3) synchronic versus diachronic descriptions. Evolving out of fieldwork with discharged mental patients, the Network Analysis Profile was designed to resolve these methodological dilemmas. Although it has not been completely successful in meeting this goal, the Network Analysis Profile offers distinct advantages over other instruments. A description and an illustration of its use are provided.
The results of a study comparing the structure and function of the social networks of a group of first-admission schizophrenics with those of a group of multiple-admission schizophrenics are presented. Structurally, the networks of the first-admission patients are larger and more interconnected. Functionally, their networks have a greater percentage of multiplex and nondependent links. On the basis of these data, it is concluded that the most dramatic changes in social networks develop after the patient's first hospitalization. The dissolution of the patient's network is attributed to the antagonistic attitudes and reactions of those close to the patient, as well as to the patient's impaired social competence. Schizophrenia seemingly is a network crisis not only for the individual but for the network as a whole. It is suggested that active intervention at the time of the first psychotic episode may be helpful in avoiding network collapse and the patient's resultant social isolation.
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In general, the gerontological literature has characterized the inner-city elderly, especially those aged residing in single room occupancy hotels, as "isolates" or "loners". However, it is proposed that the notion of isolation is largely a myth and that many studies have been hampered by inadequate research instruments. This paper illustrates: 1) The severe limitations of the traditional measures of determining sociability; 2) How social network analysis can overcome many of the deficiencies of other methods; and 3) How a synthesis of the anthropological and sociological approaches to network analysis can optimize data collection and provide culturally meaningful information.
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The elderly who reside in single-room occupancy (SRO) hotels often have been depicted as "isolates," lacking the interest or ability to engage primary or secondary support systems. This characterization has not enhanced understanding of how the SRO aged are able to survive in the community. With the use of network analysis techniques, this study demonstrates the inaccuracy of the assertion that these old persons lack significant social support. The data pointed to differences in network size, complexity, intensity, connectedness, and directionality in relation to varying degrees of physical and psychiatric health.
Full mouth periodontal surgery, while not a routine procedure, is invaluable in treating a sizable population that otherwise could not be treated. A series of 150 cases has been analyzed to determine who utilizes these procedures and why. The author feels that this is a valuable modality that will become more common.
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A high level of social contacts has been recognized as one of the main predictors of outcome in schizophrenia. However, a variety of issues concerning the sociability of schizophrenics still need to be clarified. Focusing on ex-mental patients residing in a large Manhattan hotel, an analysis is made of the relationship between several social network variables, psychopathology, and rehospitalization. The findings indicate that: (1) Schizophrenics have significantly fewer linkages than nonpsychotics, but even the most impaired schizophrenics are not totally isolated. (2) Within the schizophrenic spectrum there are differences with respect to network size, complexity, directionality, and interconnectedness. (3) Rehospitalization is dependent upon two factors, degree of psychopathology and hotel network size.