A thirty-year follow-up of treatment effects.
A thirty-year follow-up of treatment effects.
复制标题
对治疗效果进行三十年的跟踪。
作者：
J. Mccord
VioLit 摘要： 目的：McCord 的这项研究旨在追踪 1942 年之后参与剑桥-萨默维尔青年研究的受试者。犯罪行为、健康、生活方式和信仰/态度是主要调查对象。方法：最初的研究是一项准实验设计，跟踪了 253 名问题男孩和 253 名匹配的对照者，这些对照者是由各种公共来源选出的，并被确定为“困难”或“一般”。男孩根据年龄、犯罪倾向、家庭背景和家庭环境进行配对，然后随机分配到实验组和对照组。治疗开始于 1939 年，当时受试者年龄为 5-13 岁（中位数为 10.5），平均持续 5 年（除了 1941 年因辅导员短缺而退出该项目的受试者）。辅导员平均每月拜访该家两次，并鼓励家庭向该计划寻求帮助。这些援助包括家庭咨询、辅导、医疗和/或精神护理、夏令营以及与童子军、基督教青年会或其他社区项目的联系。对照组仅在提供有关自己的信息的情况下参与。每组都包括来自“困难”组和“一般”组的男孩。作者进行的这项研究是三十年后对参与原始研究的男性的后续研究。官方记录（法庭记录、精神病院记录、酒精治疗中心的统计数据和生命统计数据）和个人联系人被用来获取有关剑桥-萨默维尔青年研究的长期影响的信息。后续行动于 1975 年和 1976 年进行。通过电话、城市名录、机动车登记、结婚和死亡记录以及研究人员的直觉，找到了这些人。找到了 480 名男子（95%）；其中 48 人 (9%) 已死亡，340 人 (79%) 居住在马萨诸塞州。调查问卷邮寄给治疗组的 208 名男性和对照组的 202 名男性。问卷内容涵盖家庭、职业、饮酒、健康、态度等主题。治疗组的前成员被问及治疗计划对他们有何帮助（如果有的话）。治疗组有 113 名男性 (54%) 和对照组有 122 名男性 (60%) 对调查问卷进行了答复。居住在马萨诸塞州以外的男性显着（p=调查结果/讨论：在各种犯罪行为指标上对治疗组和对照组进行了比较。除了犯罪预防局对青少年所犯罪行的非官方记录外，法院定罪是评估犯罪行为的标准。在官方和非官方指标上，各组中青少年犯罪的人数几乎相等。在“困难”和“一般”区别的维度上，也没有差异。成年后，治疗组有 119 人犯有轻微罪行，49 人犯有严重侵害财产或人身罪。对照组有 126 人犯有严重罪行，治疗组有 29 人犯有严重罪行，对照组有 25 人在 25 岁以后犯有严重罪行。严重犯罪的数量、首次实施严重犯罪的年龄或未实施严重犯罪的年龄均无差异，研究组中 78% 的犯罪者至少实施过两次犯罪，而对照组中的 67% 的犯罪者在酗酒、压力相关疾病和过早死亡方面没有差异。与对照组相比，治疗组中提到自己酗酒或通过 CAGE 测试判断为酗酒的男性比例显着更高（17% 对 7%）。在因非酒精问题而在精神病院接受治疗的男性中，绝大多数接受过治疗的男性被诊断出患有较严重的疾病（71%），而对照组则被诊断出患有较轻的诊断（67%）。与对照组相比，治疗组报告了与压力相关的疾病，特别是在家庭和工作方面，唯一显着差异是白领专业人士的数量（对照组为 43%，治疗组为 29%），并且总体而言，对照组在工作中的声望水平显着较高，治疗组中表达不满的人数显着增加（p=0.02）。大多数参加过治疗计划的男性（2/3）表示，该计划帮助他们摆脱了麻烦，并使他们更加守法。 作者的建议：作者建议对干预计划采取谨慎的态度。制定新计划时应注意通过使用强制性评估的试点项目造成的潜在损害：这项研究是一项最著名的犯罪预防实验的后续研究，令人惊讶的是，作者在参与该计划三十年后发现了治疗组的负面影响。事实证明，可能存在自我选择偏差，这使得调查结果难以推广到普通人群，而面对面访谈甚至电话访谈会增加一些可信度。第三，数据收集可能会更加严格（例如，使用联邦调查局犯罪记录作为犯罪活动的额外衡量标准）。这项研究于 1978 年发表，从那时起，对原始数据进行另一次后续研究或重新分析，看看治疗是否有效或相反效果，将会很有帮助。（CSPV 摘要 - 版权所有 © 1992-2007 科罗拉多大学行为科学研究所暴力研究和预防中心）KW - 马萨诸塞州 KW - 地理。地点 KW - 长期 KW - 犯罪行为 KW - 犯罪 KW - 诊断 KW - 后续研究 KW - 问题行为 KW - 生命历程 KW - 预防 KW - 营养健康 KW - 意识形态 KW - 观念 KW - 生活方式 KW - 青少年罪犯 KW - 男性罪犯 KW - 成年罪犯
VioLit summary: OBJECTIVE: This study by McCord was designed to follow up the subjects who had participated in the Cambridge-Somerville Youth study after 1942. Criminal behavior, health, lifestyle, and beliefs/attitudes were primary subjects of inquiry. METHODOLOGY: The original study was a quasi-experimental design which followed 253 problem boys and 253 matched controls who were selected by various public sources and identified as "difficult" or "average." Boys were paired by age, delinquency-prone histories, family background, and home environments and then randomly assigned to the experimental and the control group. Treatment began in 1939 when the subjects were 5-13 (median, 10.5) and continued for an average of 5 years (except those dropped from the program during 1941 because of counselor shortage). Counselors visited the home an average of twice a month and encouraged families to call on the program for assistance. This assistance included family counseling, tutoring, medical and/or psychiatric attention, summer camps, and connection with Boy Scouts, YMCA, or other community programs. The control group only participated insofar as they gave information about themselves. Each group included boys from "difficult" and "average" groups. The study this author conducted was a follow-up, thirty years later, on the men who had participated in the original study. Official records (court records, mental hospital records, statistics from alcohol treatment centers, and vital statistics) and personal contacts were used to obtain information about the long-term effects of the Cambridge-Somerville Youth Study. The follow-up took place in 1975 and 1976. The men were located using telephone calls, city directories, motor-vehicle registration, marriage and death records, and researcher intuition. 480 (95%) of the men were located; 48 (9%) of these had died and 340 (79%) were living in Massachusetts. Questionnaires were mailed to 208 men from the treatment group and 202 men from the control group. The items in the questionnaire covered the topics of family, occupation, drinking, health, and attitudes. Former members of the treatment group were asked how (if at all) the treatment program had been useful to them. Responses to the questionnaire were received from 113 men in the treatment group (54%) and 122 men in the control group (60%). Men who lived outside of Massachusetts were significantly (p= FINDINGS/DISCUSSION: The treatment and control groups were compared on a variety of measures for criminal behavior. With the exception of Crime Prevention Bureau records for unofficial crimes committed by juveniles, court convictions served as the standard by which criminal behavior was assessed. Almost equal numbers of each groups had committed crimes as juveniles on both official and unofficial measures. On dimensions of "difficult" and "average" distinctions, there were also no differences. As adults, equal numbers (168) had been convicted for some crime. From the treatment group, 119 committed minor crimes, and 49 had committed serious crimes against property or person as adults. For the control group, 126 had committed minor crimes, and 42 had committed serious crimes. 29 of the treatment group and 25 from the control group had committed serious crimes after age 25. When comparing adult criminal records controlling for juvenile records, there was no evidence that the treatment program had any effect. There were no differences in number of serious crimes committed, age at which the first crime was committed, age at which first serious crime was committed, or age after which no serious crime was committed. Chi-square revealed that a significantly higher proportion of criminals from the treatment group committed more than one crime. 78% of the treatment group committed at least two crimes versus 67% of the control group who had. Dimensions of health that were evaluated were alcoholism, stress-related diseases, and early death. There were no differences in mental hospitalization/alcohol treatment between the groups. A significantly higher proportion of the treatment group mentioned that they were alcoholic or were judged by the CAGE test be alcoholic when compared to the control group (17% versus 7%). Of those men who had received treatment in mental hospitals for non-alcoholic problems, a significant majority of the men who had been in the treatment group were diagnosed with more serious diagnoses (71%) whereas the control group was diagnosed with less serious diagnoses (67%). A significantly higher proportion of the men from the treatment group reported stress-related diseases than the control group, particularly for heart trouble. In comparisons of family and work, the only significant difference was in the number who were white collar professionals (43% for the control group, 29% for the treatment group) and, in general, the control group had a significantly higher level of prestige in their jobs. Among blue-collar workers, a significantly greater number of the treatment group expressed dissatisfaction (p=.02). There were no significant differences in authoritarianism, political orientation, or identification of the best periods of their lives. The majority of the men (2/3) who had been in the treatment program reported that it had been helpful to them, and some responded that the program had helped keep them out of trouble and made them more law-abiding. In general, the author concluded that the program did not, according to objective measures, improve the lives of the treatment group. AUTHOR'S RECOMMENDATIONS: The author suggested a cautious stance to intervention programs, though it is also suggested that new programs should be developed with attention to the problems of potential damage through the use of pilot projects with mandatory evaluations. EVALUATION: This study serves as an interesting follow-up to one of the best known experiments in delinquency prevention. It is surprising to see the negative effects the author found in the treatment group thirty years after being in the program. This study, however, cannot make a strong empirical claim that the program did not work. First, the initial selection and identification of youth casts doubts on the original methodology. Additionally, the present study relies upon mailed questionnaires. It has been shown that there is a likely self-selection bias which makes findings difficult to generalize to the population which confounds the usual difficulties with mailed questionnaires. Face-to-face interviews or even telephone interviews would add some credibility. Thirdly, the data collection could have been tightened up (for example, using FBI rap sheets as an additional measure of criminal activity). Finally, the data analysis techniques do not provide for an adequate level of control to establish the causal linkages which one would want to see. Additional analyses using regression techniques would have been helpful. This study was published in 1978, and methodology has improved since then. It would be insightful to do another follow-up or a reanalysis of the original data to see if the lack of effect or opposite effects of treatment hold. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado) KW - Massachusetts KW - Geographic Location KW - Long-Term KW - Criminal Behavior KW - Delinquency KW - Diagnosis KW - Follow-Up Studies KW - Problem Behavior KW - Life Course KW - Prevention KW - Nutrition-Health KW - Ideology KW - Perceptions KW - Lifestyle KW - Juvenile Offender KW - Male Offender KW - Adult Offender