A tutorial on automatic post-stratification and weighting in conventional and regression-based norming of psychometric tests.

Norm scores are an essential source of information in individual diagnostics. Given the scope of the decisions this information may entail, establishing high-quality, representative norms is of tremendous importance in test construction. Representativeness is difficult to establish, though, especially with limited resources and when multiple stratification variables and their joint probabilities come into play. Sample stratification requires knowing which stratum an individual belongs to prior to data collection, but the required variables for the individual's classification, such as socio-economic status or demographic characteristics, are often collected within the survey or test data. Therefore, post-stratification techniques, like iterative proportional fitting (= raking), aim at simulating representativeness of normative samples and can thus enhance the overall quality of the norm scores. This tutorial describes the application of raking to normative samples, the calculation of weights, the application of these weights in percentile estimation, and the retrieval of continuous, regression-based norm models with the cNORM package on the R platform. We demonstrate this procedure using a large, non-representative dataset of vocabulary development in childhood and adolescence (N = 4542), using sex and ethnical background as stratification variables.

Reducing the Bias of Norm Scores in Non-Representative Samples: Weighting as an Adjunct to Continuous Norming Methods.

We investigated whether the accuracy of normed test scores derived from non-demographically representative samples can be improved by combining continuous norming methods with compensatory weighting of test results. To this end, we introduce Raking, a method from social sciences, to psychometrics. In a simulated reference population, we modeled a latent cognitive ability with a typical developmental gradient, along with three demographic variables that were correlated to varying degrees with the latent ability. We simulated five additional populations representing patterns of non-representativeness that might be encountered in the real world. We subsequently drew smaller normative samples from each population and used an one-parameter logistic Item Response Theory (IRT) model to generate simulated test results for each individual. Using these simulated data, we applied norming techniques, both with and without compensatory weighting. Weighting reduced the bias of the norm scores when the degree of non-representativeness was moderate, with only a small risk of generating new biases.

Societal Biases, Institutional Discrimination, and Trends in Opioid Use in the USA.

History has demonstrated cyclical trends in opioid use in the USA, alternating between high rates of prescribing driven by compassion and marketing and restrictive prescribing driven by stigma and fear of precipitating addiction and other harms. Two under-recognized yet powerful forces driving these trends are societal biases against individuals who use and are addicted to drugs, as well as a recognized social determinant of health, institutional discrimination. In the context of these influential forces, which are often based on racist and classist ideologies, we examine the history of opioid use in the USA from the 1800s when the vast majority of those addicted to opioids were middle- to upper-class women to the present-day white-washed narrative of the opioid crisis. As the demographics of those affected by opioid use and addiction has started to shift from white communities to communities of color, we cannot allow the preliminary success observed in white communities to obscure rising mortality rates from opioids in black and Latinx communities. To do so, we highlight ways to prevent racist and classist ideologies from further shaping responses towards opioid use. It is important to acknowledge the long history that has influenced responses to opioid use in the USA and take active steps towards promoting a sense of compassion towards all individuals who use and those who are addicted to drugs.

Entitled to Addiction?: Pharmaceuticals, Race, and America's First Drug War.

This article rethinks the formative decades of American drug wars through a social history of addiction to pharmaceutical narcotics, sedatives, and stimulants in the first half of the twentieth century. It argues, first, that addiction to pharmaceutical drugs is no recent aberration; it has historically been more extensive than "street" or illicit drug use. Second, it argues that access to psychoactive pharmaceuticals was a problematic social entitlement constructed as distinctively medical amid the racialized reforms of the Progressive Era. The resulting drug control regime provided inadequate consumer protection for some (through the FDA), and overly punitive policing for others (through the FBN). Instead of seeing these as two separate stories-one a liberal triumph and the other a repressive scourge-both should be understood as part of the broader establishment of a consumer market for drugs segregated by class and race like other consumer markets developed in the era of Progressivism and Jim Crow.

Recurring Epidemics of Pharmaceutical Drug Abuse in America: Time for an All-Drug Strategy.

Observers describe today's "epidemic" of pharmaceutical drug abuse as a recent phenomenon, but we argue that it is only the most recent of three waves stretching back more than a century. During each wave, policies have followed a similar pattern: voluntary educational campaigns, followed by supply-side policing and--sometimes--public health responses that would today be understood as "harm reduction." These experiences suggest that only broad-based application of all three approaches to users of all drugs (not just pharmaceutical drugs) can produce a reduction in drug-related harm rather than merely shifting it from one type of drug to another. This has rarely happened because policy has been shaped by the racially charged division of drug users into deserving and morally salvageable victims, or fearsome and morally repugnant criminals.

Blockbusters and controlled substances: Miltown, Quaalude, and consumer demand for drugs in postwar America.

In 1955 Carter Products launched its new tranquilizer Miltown with a huge marketing blitz; Miltown soon became one of America's earliest "blockbuster" celebrity drugs. In 1981, federal agents shut down a network of "stress clinics" and arrested the owners, medical staff, and other personnel for illegally trafficking in the sedative Quaalude; Quaalude soon became a "Schedule I Controlled Substance." Both of these stories are familiar, indeed archetypal, moments from America's postwar medical system. As the Miltown example reminds us, this fundamentally commercial system was built on the creation and courting of consumer demand for medical products and services, particularly drugs. As the Quaalude example shows, however, this system also incorporated tools for reining in excessive consumer demand. Together the two episodes affirm an enduring irony of the American medical system: the need for regulatory campaigns to tame lively markets for drugs that had become popular, in part, because of advertising campaigns. This article uses the Miltown and Quaalude sagas to explore the issue of consumer demand for prescription medicines, arguing that efforts to stoke or quash that demand have shaped (and linked) America's medical system and its drug control regimes.

Hidden in plain sight marketing prescription drugs to consumers in the twentieth century.

Although the public health impact of direct-to-consumer (DTC) pharmaceutical advertising remains a subject of great controversy, such promotion is typically understood as a recent phenomenon permitted only by changes in federal regulation of print and broadcast advertising over the past two decades. But today's omnipresent ads are only the most recent chapter in a longer history of DTC pharmaceutical promotion (including the ghostwriting of popular articles, organization of public-relations events, and implicit advertising of products to consumers) stretching back over the twentieth century. We use trade literature and archival materials to examine the continuity of efforts to promote prescription drugs to consumers and to better grapple with the public health significance of contemporary pharmaceutical marketing practices.