ANTIPSYCHOTIC DRUGS: SCIENCE, PRACTICE, AND CULTURE

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The candidate is a psychiatrist-historian whose long-term career goal is to probe fundamental questions about how clinical practices-especially the care of the chronic mentally ill-are shaped by the clinical sciences and sociocultural factors. The candidate's immediate career goals are to become an independent researcher capable of employing a variety of health services research, statistical, and qualitative methods to answer questions of immediate policy, scientific, and clinical importance. Research career development plan: To accomplish these career goals, the applicant proposes a career development plan that involves: 1) course work in quality of care, statistics, qualitative methods, and the sociology of science; and 2) in- depth supervision in the quantitative and qualitative analysis of clinical practices and the clinical science of antipsychotic medications from 1954 to 1994. Description of research project: The research will examine patient records from a VA, state, and university based hospital, as well as treatment-outcome literature, psychiatric textbooks, psychiatric newsletters, and pharmaceutical industry publications. Melding qualitative and quantitative methods, the overall goal of the project is to understand the ways in which clinical science informs clinical decisions by way of a historical examination of antipsychotic drugs. The specific aims are: 1. Assess real world clinical practices in terms of a) patterns of antipsychotic drug use; and b) physicians' determinations of treatable psychiatric disease and effective outcome as shaped by cultural and scientific values and beliefs. 2. Assess clinical science in terms of a) its scientific evolution; b) its meaning to researchers; and c) its social and cultural values. Environment: The proposed training and research will take place at the UCLA Health Services Research Center, one of the country's leading centers for health services research. It also has close institutional and research affiliations with the Rand Corporation.