Victor Lidz

Adolescents with psychopathic characteristics in a substance abusing cohort: treatment process and outcomes.

Psychopathy is a condition with important consequences both for individuals who experience it and for the communities in which they live. Although the assessment of psychopathy among adolescents remains controversial, some evidence suggests that the affective and behavioral traits of adult psychopathy begin to emerge in childhood (B. B. Lahey & A. Kazdin, 1990) and continue across the lifespan (A. E. Forth, S. D. Hart, & R. D. Hare, 1990). The present study used the Psychopathy Checklist: Youth Version (PCL:YV; A. E. Forth, S. D. Kosson, & R. D. Hare, in press) to retrospectively assess psychopathic characteristics, treatment process, and outcomes of 64 individuals referred for treatment to a substance abuse program for adjudicated adolescents. This study focused on the relationship between psychopathic characteristics and treatment process and outcome variables, including attrition rates, quality of participation, substance use throughout treatment, clinical improvement, and 12-month recidivism rates. Psychopathic characteristics were negatively related to treatment process and outcome variables, including attrition, participation, substance use, and clinical improvement. Psychopathic characteristics were positively related to the number of arrests in the 12 months following treatment completion. Implications for treatment and future research with adolescents displaying psychopathic characteristics are discussed.

Predictors and Correlates of Psychopathic Characteristics in Substance Abusing Adolescents

This study retrospectively examined the predictors and correlates of 64 adolescents with psychopathic characteristics, as measured by scores on the Psychopathy Checklist: Youth Version (PCL:YV), referred for treatment to a substance abuse program for adjudicated adolescents. First, we examined the variables of Attention Deficit Hyperactivity Disorder, severity of childhood abuse/neglect, and severity of parental drug dependence in predicting psychopathic characteristics. Second, we investigated the association of psychopathic characteristics with substance use, drug trafficking, depression, and anxiety. Severity of childhood abuse and neglect significantly predicted psychopathic characteristics. Psychopathic characteristics were not associated with the correlates of substance use, depression, or anxiety. Implications for treatment and future research with adolescents displaying psychopathic characteristics are discussed.

Learning from Disappointing Outcomes: An Evaluation of Prevocational Interventions for Methadone Maintenance Patients

To increase rates of employment and improve overall rehabilitation in methadone maintenance treatment, three prevocational trainings, Vocational Problem Solving, Job Seekers Workshop, and the two combined, were evaluated as adjunctive services. Between March 1995 and April 1998, subjects in treatment were interviewed at baseline, randomly assigned to one of the trainings, and followed up at 6 and 12 months postbaseline. None of the three models produced significantly greater employment or better overall rehabilitation. Experience from the study suggests that closer integration of prevocational training with treatment, individualizing efforts to meet training needs, and providing support during job-finding and early job-holding might improve program effectiveness.

Correlates of HIV Risk Among Female Sex Partners of Injecting Drug Users in a High-Seroprevalence Area

Abstract Risk factors for HIV infection were examined in 520 female sex partners (SPs) of injecting drug users (IDUs); 16% tested HIV positive (40% among former IDUs). In multivariate analyses, sex trade was associated with lower risk of HIV infection, whereas race, age, history of pneumonia or genital herpes, high self-rated AIDS risk, and IDU history were related to greater risk. Among women with no IDU history, cohabitation with a SP (not trading sex) predicted higher risk; having a female SP was also associated with higher risk. Secondary analyses suggest that total unprotected contacts with IDUs and both sex trade and cohabitation might account for these findings. The data suggest that, for female SPs of IDUs, reducing numbers of sex partners per se may not confer adequate protection from HIV. For women in committed relationships with IDUs, interventions should address contextual factors in relationships that elevate risk and complicate prevention.

Changes in HIV risk behavior among injecting drug users : the impact of 21 versus 90 days of methadone detoxification

Objective: To evaluate the hypothesis that long‐term methadone detoxification would produce greater HIV risk reduction among injecting drug users (IDU) than short‐term detoxification. Design: Random assignment to 21 or 90 days of free detoxification. Setting: Storefront offices in two cities, with referrals to outpatient methadone detoxification. Participants: Out‐of‐treatment IDU (n = 1803), recruited through street outreach and word of mouth, between April 1990 and March 1991. Of these, 62.6% were successfully located for 6‐month follow‐up. Main outcome measures: Self‐reported drug injection and sexual practices at baseline and follow‐up. Results: Substantial reductions in risk behavior were observed at follow‐up. Substantial percentages of subjects reported less frequent drug injection (54%), use of shooting galleries (85%), needle‐sharing (67%), and number of sex partners (73%), and more frequent use of bleach to disinfect needles (67%) and condom use (31%). There were no significant differences in behavioral change between 21 and 90‐day treatment, and subjects who entered treatment did not report significantly greater risk reduction than untreated subjects. Discriminant analyses showed a marginal effect for duration of treatment on risk reduction, although results were inconsistent. Conclusions: Large scale behavioral risk reduction appears to be occurring in this population regardless of treatment condition. In minimal service methadone detoxification, subjects treated under a longer‐term detoxification protocol demonstrated no greater risk reduction than those receiving short‐term detoxification.

The Meaning of Rationality in the Social Sciences

The paper starts with a presentation of three interrelated theses based on conceptual differentiations needed to account for the semantic complexity of the concept of rationality. The first thesis relates to the concept of observer’s rationality. The logic of observation does not differ in respect to different types of object. Therefore rationality in the social sciences is in accordance with scientific rationality in general. The second thesis argues that the rationality of the observer is sufficient for economic and sociological inquiry, as demonstrated by the example of time series analysis. The third thesis refers to particular characteristics of human action that pertain to analysis in the social sciences. In many cases rationality of the observer in economics and sociology is tied to an assumption that the actor behaves with rationality (subjective rationality) in selecting the ends of action and the norms regulating social relationships. The three theses are then discussed in a context of reexamination of the works of historically important theorists, including the physiocrats, Bentham , Marx , Marshall , and Pareto , as well as more general methodological and philosophical traditions. (Eds.)

Experimental evaluation of a vocationally integrated therapeutic community

Purpose – Retrospective studies of therapeutic community (TC) treatment for drug abuse found reductions in drug use, criminality, and increased work participation after treatment completion. These studies have also shown treatment benefits, even without completion, are correlated with days of stay in residential treatment. However, others have found that high rates of early leaving from TC treatment reduce the proportion of clients with positive outcomes, raise the total cost per treated client, and lower the treatment benefit-to-costs ratio. The purpose of this paper is to describe an experimental approach to raising the days in residential treatment using earlier vocational access for clients. Design/methodology/approach – The current study used a random assignment design to compare earlier integration of on-site vocational training in a vocationally integrated therapeutic community to off-site vocational training initiated after one year of residence in a traditional therapeutic community. Findings – T...

Talcott Parsons on full citizenship for African Americans: retrospective interpretation and evaluation

In this essay in the Thinking Citizenship Series, Lidz evaluates the contributions of Talcott Parsons for thinking about citizenship and race relations in twentieth century America.

Uniform Standards for Substance User Treatment Research: An Example from Germany for the United States and Other Countries

It is only through reasoned, accurate treatment evaluation research that its effectiveness can be assessed. The value of these data can be limited, however, by variability of methods and noncomparability of data. This is not the case, however, in other western countries. Germany has developed and is using a set of research and publication standards which speak to many of these deficiencies. These standards, described here in some detail, can serve as a model for regular, uniform, and universal data collection, thus allowing for some meaningful comparisons and assessments of in-situ treatment and the individuals receiving it.

Editors’ Introduction: The Harvard Rationality Seminar

This introductory chapter explains the intellectual and historical background of the collaboration between Joseph A. Schumpeter and Talcott Parsons that led to their joint faculty seminar on rationality. A section on the history of the seminar provides information on presenters, other participants, and on the sequence of the seminar events as well as summarizing the original papers that Schumpeter, Parsons, Alfred Schutz , the sociologist Wilbert Moore , the economist Rainer Schickele , and the psychoanalyst Robert Waelder contributed to the seminar. A further section reconstructs the failed attempt by Schumpeter and Parsons to publish the proceedings and a second attempt by Richard Grathoff and Walter M. Sprondel in the course of their editions in English and German of the Schutz/Parsons letter exchange. Abstracts of essays in the section on Current Perspectives are provided by the authors and therefore not summarized in the introduction.