Recent research consistently reports that persistent poverty has more detrimental effects on IQ, school achievement, and socioemotional functioning than transitory poverty, with children experiencing both types of poverty generally doing less well than never-poor children. Higher rates of perinatal complications, reduced access to resources that buffer the negative effects of perinatal complications, increased exposure to lead, and less home-based cognitive stimulation partly account for diminished cognitive functioning in poor children. These factors, along with lower teacher expectancies and poorer academic-readiness skills, also appear to contribute to lower levels of school achievement among poor children. The link between socioeconomic disadvantage and children's socioemotional functioning appears to be mediated partly by harsh, inconsistent parenting and elevated exposure to acute and chronic stressors. The implications of research findings for practice and policy are considered.

Socioeconomic disadvantage and child development

Objectives: The empirical basis for theories and common wisdom regarding how to improve appropriate use of research evidence in policy decisions is unclear. One source of empirical evidence is inte...

Health policy-makers' perceptions of their use of evidence: a systematic review.

The massive scale on which social problems are conceived precludes innovative action because bounded rationality is exceeded and dysfunctional levels of arousal are induced. Reformulation of social issues as mere problems allows for a strategy of small wins wherein a series of concrete, complete outcomes of moderate importance build a pattern that attracts allies and deters opponents. The strategy of small wins incorporates sound psychology and is sensitive to the pragmatics of policymaking. There is widespread agreement that social science research has done relatively little to solve social problems (Berger, 1976; Cook, 1979; Kohn, 1976). Common to these assessments is the assumption that social science is best suited to generate solutions, when in fact it may be better equipped to address how problems get denned in the first place. A shift of attention away from outcomes toward inputs is not trivial, because the content of appropriate solutions is often implied by the definition of what needs to be solved. To focus on the process of problem definition is to incorporate a more substantial portion of psychology, specifically, its understanding of processes of appraisal, social construction of reality, problem finding, and definition of the situation. Whether social problems are perceived as phenomena that have a serious negative impact on sizable segments of society (Kohn, 1976, p. 94), as substantial discrepancies between widely shared social standards and actual conditions of life (Merton, 1971), or as assertions of grievances or claims with respect to alleged conditions (Spector & Kitsuse, 1977, p. 75), there is agreement that they are big problems. And that's the problem. The massive scale on which social problems are conceived often precludes innovative action because the limits of bounded rationality are exceeded and arousal is raised to dysfunctionally high levels. People often define social problems in ways that overwhelm their ability to do anything about them. To understand this phenomenon, consider the following descriptions of the problems of hunger, crime, heart disease, traffic congestion, and pollution. To reduce domestic hunger we grow more food, which requires greater use of energy for farm equipment, fertilizers, and transportation, adding to the price of energy, which raises the cost of food, putting it out of the price range of the needy. To solve the problem of soaring crime rates, cities expand the enforcement establishment, which draws funds away from other services such as schools, welfare, and job training, which leads to more poverty, addiction, prostitution, and more crime. To ward off coronary heart disease, people who live in cities spend more time jogging and cycling, which exposes their lungs to more air pollution than normal, increasing the risk of coronary illness. To ease traffic congestion, multilane highways are built, which draws people away from mass transit so that the new road soon becomes as overcrowded as the old road. To reduce energy use and pollution, cities invest in mass transit, which raises municipal debt, leading to a reduction in frequency and quality of service and an increase in fares, which reduces ridership, which further raises the municipal debt (Sale, 1980). When social problems are described this way, efforts to convey their gravity disable the very resources of thought and action necessary to change them. When the magnitude of problems is scaled upward in the interest of mobilizing action, the quality of thought and action declines, because processes such as frustration, arousal, and helplessness are activated. Ironically, people often can't solve problems unless they think they aren't problems. If heightened arousal interferes with diagnosis and action, then attacking a less arousing \"mere problem\" should allow attention to be broader and action to be more complex. Responses that are more complex, more recently learned, and more responsive to more stimuli in changing situations usually have a better chance of producing a lasting change in dynamic problems. To recast larger problems into smaller, less arousing problems, people can identify a series of controllable opportunities of modest size that produce visible results and that can be gathered into synoptic solutions. This strategy of small wins addresses social problems by working directly on their construction and indirectly on their resolution. Problems are constructed to stabilize arousal at moderate intensities where its contribution to performance of complex tasks is most beneficial. 40 January 1984 • American Psychologist Copyright 1984 by the American Psychological Association, Inc. Vol. 39, No. I, 40-49 Arousal and Social Problems The following analysis of small wins assumes that arousal varies among people concerned with social problems, but tends to be relatively high, which affects the quality of performance directed at these problems. Arousal is treated as a generic concept under which is assembled a variety of findings that cohere because of their mutual relevance to the Yerkes-Dodson Law (Broadhurst, 1959). Although arousal mechanisms are neither simple nor unidimensional, they do seem to be localized in at least two physiological sites (reticular formation, limbic system), are visible under conditions of sensory deprivation, produce differences in the quality of learning and performance, and have observable physiological effects. The specific effects of arousal on performance associated with the Yerkes-Dodson Law are that (a) there is an inverted-U relationship between arousal and the efficiency of performance with increasing levels of arousal, first improving and then impairing performance and (b) the optimal level of arousal for performance varies inversely with task difficulty. Even though these coarse propositions have been amended, tuned more finely, and differentiated, they remain basic principles in which an analysis of social problem solving can be anchored. Key assertions for the present analysis culled from previous investigations of arousal and performance include the following: 1. Arousal coincides with variation in degrees of activation and varies along at least two dimensions, energy-sleep and tension-placidity (Eysenck, 1982; Thayer, 1978a, 1978b). 2. As arousal increases, attention to cues becomes more selective and this editing is especially detrimental to performance of difficult tasks (Easterbrook, 1959, although this generalization has received mixed support. See Baddeley, 1972; Pearson & Lane, 1983; Weltman, Smith, & Egstrom, 1971, for representative work). 3. At relatively high levels of arousal, coping responses become more primitive in at least three ways (Staw, Sandelands, & Dutton, 1981): (a) people who try to cope with problems often revert to more dominant, first learned actions; (b) patterns of responding that have been learned recently are the first Tom Peters's (1977) original description of small wins was a crucial point of departure for this formulation. Subsequent discussions with Peters, as well as with Linda Pike, Richard Thaler, Joseph McGrath, Sharon McCarthy, David Anderson, Marianne LaFrance, and students and faculty of the Psychology Department at Rice University contributed to my understanding of this phenomenon and I am grateful to all of them for their help. Requests for reprints should be sent to Karl E. Weick, Cornell University, Graduate School of Administration, Malott Hall, Ithaca, New York 14853. ones to disappear, which means that those responses that are most finely tuned to the current environment are the first ones to go; and (c) people treat novel stimuli as if they are more similar to older stimuli than in fact they are, so that clues indicating change are missed. To invert this list, highly aroused people find it difficult to learn a novel response, to brainstorm, to concentrate, to resist old categories, to perform complex responses, to delegate, and to resist information that supports positions they have taken (Holsti, 1978). When these findings are focused on problem solving, they suggest that to call a problem serious is to raise arousal, which is appropriate if people know what to do and have a well-developed response to deal with the problem. This is analogous to the situation of a simple task, the performance of which improves over a considerable range of activation because selective attention does not delete the few cues that are essential for performance. High arousal can improve performance if it occurs after a person has decided what to do and after she or he has overlearned how to do it. To call a problem minor rather than serious is to lower arousal, which is also appropriate if people don't know what to do or are unable to do it. If we assume that most people overlook the fine-grain detail of problems, think only in terms offeree as a response (Nettler, 1980), and overlook minor leverage points from which the problem might be attacked, then it is clear they have neither the diagnoses nor the responses to cope. This means that people need lower arousal to keep diagnostic interference at a minimum and to allow for the practice of relatively complex skills. To keep problem-related arousal at modest intensities, people need to work for small wins. Sometimes problem solving suffers from too little arousal. When people think too much or feel too powerless, issues become depersonalized. This lowers arousal, leading to inactivity or apathetic performance. The prospect of a small win has an immediacy, tangibility, and controllability that could reverse these effects. Alinsky (1972, pp. 114-115) persuaded a demoralized neighborhood group to picket for reinstatement of Infant Medical Care, which he knew would be granted if they merely asked. Organizing for the protest, making the demand, and then receiving what they asked for energized people who had basically given up. Examples of Small Wins Small wins have been designed a

https://psycnet.apa.org/journals/amp/39/1/40.pdf

Small wins: Redefining the scale of social problems.

Social support interventions: do they work?

Psychological capital with components of hope, self-efficacy, optimism, and resiliency has recently emerged as a core construct in taking positive psychology to the workplace. A distinguishing feat...

/pdf/experimental-analysis-of-a-web-based-training-intervention-5b3z2j2vu7.pdf

Experimental Analysis of a Web-Based Training Intervention to Develop Positive Psychological Capital

Rapid and far-reaching technological advances are revolutionizing the ways in which people relate, communicate, and live their daily lives. Technologies that were hardly used a few years ago, such as the Internet, e-mail, and video teleconferencing, are becoming familiar methods for modern communication. Telecommunications will continue to evolve quickly, spawning telehealth applications for research and the provision of clinical care in communities, university settings, clinics, and medical facilities. The impact on psychology will be significant. This article examines the application of developing technologies as they relate to psychology and discusses implications for professional research and practice.

http://psycnet.apa.org/journals/amp/55/4/407.pdf

The coming of age of telecommunications in psychological research and practice.

The behavioral health care needs of rural communities.

In the past 5 years there has been a growing interest among psychology practitioners in obtaining prescription privileges, and relevant policy documents have reflected increasing support from the APA. The nonphysician health manpower literature has demonstrated that a wide range of professionals can be trained to prescribe medications competently, while maintaining quality of care; within federal agencies, psychologists have legally prescribed medications. Ongoing debates in Hawaii and in the U.S. Department of Defense may be laying the foundation for psychology's training and practice agenda for the 1990s. Were psychologists to have this clinical privilege, many societal needs--including addressing the longstanding problems of excessive medication of elderly persons and quality care for the chronically mentally ill and for persons residing in rural areas--could be met.

Prescription privileges. Psychology's next frontier?

A general deterioration is occurring in the quality of life of rural Americans, and it is affecting the quality of health and mental health service delivery. About 24% of the U.S. population lives in nonmetropolitan areas where the citizens are older, less well educated, have lower incomes, and are more homogeneous in terms of race and ethnicity. Medicare and private insurance discriminate against rural services in their reimbursement policies, and there is a shortage of health personnel in rural areas. However, there has been renewed congressional action to meet rural needs. Both the House and Senate have established rural caucuses, and an Office of Rural Health Policy has been established in the federal executive branch. Legislative successes were achieved between 1985 and 1988. Rural initiatives will provide psychology with unique opportunities in the next several years.

Rural America. Unique opportunities for health care delivery and health services research.

As the profession of psychology has matured, serious interest has surfaced over the past decade in obtaining prescription privileges within the practitioner community. Other nonphysician disciplines have exercised this clinical responsibility for years, significantly improving their ability to comprehensively serve current and new populations. Efforts are underway to develop appropriate and viable training modules. The primary objection expressed by medicine is once again that our practitioners will become "public health hazards." Not surprisingly, resistance to change exists within psychology's training programs. However, the power to prescribe represents the authority to ensure that psychotropic medications are appropriately utilized, if used at all, and will ensure that psychology's practitioners can address society's pressing needs.

Patrick H. DeLeon

Papers

The coming of age of telecommunications in psychological research and practice.

The behavioral health care needs of rural communities.

Prescription privileges. Psychology's next frontier?

Rural America. Unique opportunities for health care delivery and health services research.

Prescription privileges for psychologists