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Biomedical subjects

D A Chiriboga

Publications and source records attributed to D A Chiriboga.

At least 19 recordsLinked to original sources
PubMed1999

Disability in older adults. 3: Policy implications.

Several models of disability proposed in recent years share many common elements and are helping to direct research and inform practice. One new development is that disablement, a concept that emphasizes the impairments--handicap continuum, is now being implemented by concepts related to enablement. Enablement focuses attention on the capacity for rehabilitation. Coincidentally, a new generation of functional assessment measures has evolved that allow greater sensitivity not only to levels of disability but also to levels of ability. Together, the new models and tools hold promise of providing a more sensitive evaluation of rehabilitation efforts and a more accurate forecasting of future needs.

Activities of Daily Living↗
PubMed1994

Comparison of mental status tests: implications for Alzheimer's patients and their caregivers.

Most existing measures commonly used to determine cognitive dysfunction in demented persons exclude important pieces of information. In an effort to address this deficiency, many Alzheimer's disease programs have combined items from the Blessed Information, Orientation, Memory and Concentration Test with those of the more established Mini-Mental State Exam. While the expansion may be clinically helpful, results are typically presented in the form of summary scores that ignore the issue of multidimensionality. Drawing upon data from 201 elderly patients afflicted with Alzheimer's disease and their adult child caregivers, this study examined the factorial structure of the combined Blessed Folstein Instruments. The factor-derived scores are compared with summary scores in terms of their association with functional status of the patients and with caregiver stress and burden.

Adult↗
PubMed1985

An empirical taxonomy of symptom types among divorcing persons.

This study generated and assessed an empirical taxonomy of symptom profiles or types in a nonclinical population. Three hundred and thirty men and women who recently had separated from their marital partners were interviewed and completed a variety of instruments. Cluster analysis of factors derived from one such instrument, a symptom checklist, yielded a provisional classification of respondents into nine types. The latter were examined for differences in socio-economic characteristics as well as several variables suggested in the literature to predict or help explain symptom formation: Feelings of control, self-concept, social stressors, and current morale. Results indicated three types to be relatively well off despite the potentially stressful conditions inherent in divorce. The Overwhelmed and the Somatic depressives, in contrast, demonstrated multiple signs of dysfunction. The findings indicate the value of applying empirical classification procedures to at-risk populations in the community.

Adaptation, Psychological↗
PubMed1984

Social stressors as antecedents of change.

The potential importance of social stressors as shapers of long-term change in adult functioning has been recognized in recent theoretical work. This paper evaluated the impact of several types of stressors, including life events, transitions, hassles, and societal problems such as war or economic depression on happiness and symptoms. The role of selected social and psychological characteristics also was explored. Respondents included 62 men and 72 women who were interviewed four times over an 11-year period. Life stage, symptoms, and self-criticism at baseline were found to predict subsequent stress history, and the stress measures themselves were intercorrelated over time. In the prediction phase of the study, the stress measures made the greatest contribution to the prediction of happiness for both men and women, whereas both initial symptom level and social stressors contributed to the prediction of symptoms manifest at the 11-year follow up.

Adaptation, Psychological↗
PubMed1982

Antecedents of symptom expression during marital separation.

Examined the role of possible antecedents of psychological symptoms among 310 recently separated men and women. Hierarchical set regression analysis indicated that socio-demographic variables generally are unrelated to symptom expression, although age, gender, length of marriage, and length of separation did predict either agitated depressive or stress symptoms. Several dimensions of social stressors contributed to the prediction of one or more of six symptom factors, but symptoms also were associated with current psychological well-being. These results suggest that the symptomatology of divorcing persons can be partitioned into that which is consequent to the disruptive conditions encountered in divorce and that which may reflect characteristic levels of mental health.

Adaptation, Psychological↗
PubMed1982

The demand for dental health.

This study evaluates the determinants of demand for dental health in the context of an econometric model where dental health and dental care are jointly endogenous. The theoretical analysis is based on the application of economic theory to production activities occurring at the individual or household level. A number of hypotheses concerning the change in demand for home and market dental care with respect to price and income changes are posited and empirically tested. Additional hypotheses concerning the relation between dental care and dental health are also examined statistically while controlling for a variety of sociodemographic and economic factors. One of the key empirical findings is that the net price elasticity for dental services is quite low (-0.2) for this sample of individuals with high dental insurance coverage.

Dental Care↗
PubMed1982

Adaptation to marital separation in later and earlier life.

In recent years, the divorce rate has increased markedly for people of all ages. Whereas the consequences of the divorce experience for those in young adulthood have received considerable attention, relatively little is known about their impact on older adults. This paper evaluates the psychosocial functioning of recently separated men and women (N = 310) ranging in age from 20 to the 70s. Included in the analyses were measures of morale, psychiatric symptoms, time perspective, self-reported physical health, social disruption, personal disruption, and divorce-induced upset. The older respondents exhibited more psychosocial distress than did the younger, whereas sex differences suggested that men and women have different vulnerabilities.

Adaptation, Psychological↗
PubMed1982

An examination of life events as possible antecedents to change.

The focus of this paper is on stress events as possible antecedents of stability and change in adulthood. At baseline the life span sample consisted of 52 high school seniors, 50 newlyweds, 54 middle-aged parents, and 60 persons facing retirement. Contacted at three points over a 5-year interval, these men and women were questioned about their emotional experiences and symptomatology. Exposure to stress events during the past year was assessed at the third contact. Repeated measurement analysis of variance statistics indicated that the emotions and symptoms of women were more affected by exposure to stress; men changed more as a function of time than of stress. There was also evidence that psychological characteristics of both sexes may predispose them toward greater or lesser exposure to stress.

Adult↗
PubMed1981

The influence of stress upon symptom structure.

Evaluated the influence of stress on the factor structure of symptoms in a nonclinical population. A random sample of 299 persons in the process of divorcing were subdivided into those high and low on stressful life events. Separate factor analyses of symptoms for each group provided evidence that stress does affect symptom structure. Ruminative Depression was the only stable factor. Two anxiety factors from the low stress group merged into one factor among the high stressed, while agitated depression appeared only in the low stress condition. A factor suggestive of stress response syndrome was evident among the high stressed.

Adult↗
PubMed1980

Divorce at midlife: psychic dangers of the liminal period. Part I. Empirical considerations.

The literature suggests that those in the second half of life may be more vulnerable to the traumas associated with divorce. In this paper a rites of passage model derived from anthropology was used to help explicate their greater vulnerability. The focus was on liminality, a quality of ambiguity and disconnectedness in life often manifest when persons are leaving the married state but are not as yet divorced. The subjects were newly-separated men and women aged 20--26. When indicators of liminality were quantified, it was found that they were strongly associated with maladaptation, and that the middle aged subjects showed evidence of greater liminality than was the case with younger respondents.

Adult↗
PubMed1980

Divorce at midlife: psychic dangers of the liminal period. Part II. Clinical considerations.

This paper presents the results of a clinical investigation into middle divorce. The second of a two part series, it explores the impact of liminality: the "betwixt and between" state often found among a newly-separated of all ages. This state may occur at more than one point in the divorce process, and is associated with heightened trauma. A therapeutic intervention procedure, the divorce ritual, is suggested as a means of ameliorating the effects of liminality.

Adult↗
PubMed1979

The empty nest process in mid-life men and women.

A combined clinical and field investigation studied the effects of the empty-nest phase of parenthood on morale and activity level. Data from the clinical study were obtained from two psychotherapy groups conducted for mid-life women, and the field data were obtained from a 5-yr longitudinal study of life stages. Results indicated an increase in morale during the unfolding of the empty nest and suggested that the so-called "crisis" of the empty nest may be more myth than reality.

Adult↗
PubMed1979

Dimensions of adult self-concept.

A 70-item adjective checklist was administered to four groups of adults as part of a longitudinal study of psychosocial change during four normative transitions. Data gathered at two times with a five-year interval were cluster analyzed separately. Six clusters were extracted from the first set of data, 7 from the second, with minor changes in dimensionality: all 6 original clusters had counterparts in the second analysis, but some dimensional change was seen in all but one cluster. The argument is made that although such dimensional change is often treated as error or completely ignored in longitudinal research, this inattention can lead to serious problems in the interpretation of results.

Adolescent↗
PubMed1978

Evaluated time: a life course perspective.

Evaluated time is a dimension of time perspective which has received minimal attention from researchers; it subsumes those constructs dealing with the affective tone, or feelings, placed upon different points of the life cycle. Using data from a cross-sectional study of 216 men and women aged 16 to 67, a variety of approaches to the study of evaluated time were examined. Evaluations were found to differ by the respondents' stage of life and by sex, with older respondents and women generally being more optimistic in their perceptions of later life. For example, while all the younger respondents viewed old age more negatively than other periods, older respondents drew a distinction between the young old and the old old. The former period was protrayed as a time of continued satisfaction.

Adaptation, Psychological↗