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PubMed2002

Testing hypothesized predictors of change in conjoint behavioral alcoholism treatment for men.

BACKGROUND: The model on which alcohol-related Behavioral Couples Therapy (ABCT) is based posits three primary domains related to alcohol consumption: individual factors, the quality and nature of the spouse's response to alcohol-related situations, and the nature and quality of the couple's marital interactions. METHODS: This study tested the model underlying ABCT in a sample of 68 male alcoholics and their partners, who completed at least five sessions of a 15-session outpatient treatment study in which they received ABCT. Couples were assessed at baseline, during treatment, and for 6 months after treatment completion. Stepwise multiple regression was used to test specific predictors derived from the ABCT model. RESULTS: Some support was provided for each component of the ABCT model. Individual drinker variables predicted drinking outcomes, both during and after treatment. Specifically, greater drinking severity and drinking frequency at baseline predicted poorer drinking outcomes. Older client age and more education predicted less frequent but more intense drinking. Spouse coping was related primarily to measures of drinking intensity, rather than drinking frequency. Less intense drinking during treatment was predicted by greater spousal use of problem solving and social support to deal with problems and less use of self-blame, wishful thinking, and avoidance. After treatment, however, spouse coping had a less consistent relationship to drinking intensity. In the marital domain, drinking during treatment was unrelated to pretreatment marital satisfaction measures. However, in the 6 months after treatment, men's ability to remain abstinent was predicted by the quality of the pretreatment marital relationship, and the intensity of their drinking was predicted by the degree of their marital happiness immediately after treatment. CONCLUSIONS: Results provided substantial support for the ABCT model, particularly in relationship to the role of the spouse in affecting heavy drinking.

Adult↗
PubMed1988

Evolutionary social psychology and family homicide.

Homicide is an extreme manifestation of interpersonal conflict with minimal reporting bias and can thus be used as a conflict "assay." Evolutionary models of social motives predict that genetic relationship will be associated with mitigation of conflict, and various analyses of homicide data support this prediction. Most "family" homicides are spousal homicides, fueled by male sexual proprietariness. In the case of parent-offspring conflict, an evolutionary model predicts variations in the risk of violence as a function of the ages, sexes, and other characteristics of protagonists, and these predictions are upheld in tests with data on infanticides, parricides, and filicides.

Age Factors↗
PubMed2002

The effect of widowhood on older adults' social participation: an evaluation of activity, disengagement, and continuity theories.

PURPOSE: This study evaluated how levels of social participation change as a result of late-life widowhood. Social participation is a multidimensional construct incorporating both formal (e.g., meeting attendance, religious participation, and volunteer obligations) and informal (e.g., telephone contact and social interactions with friends) social roles. DESIGN AND METHODS: Using data from the Changing Lives of Older Couples study, analyses compared widowed persons to continuously married control participants to evaluate whether widowhood affects older adults' levels of social participation. RESULTS: Widowed persons had higher levels of informal social participation than nonwidowed persons, whereas formal social participation levels were comparable between the two groups. Social participation levels decrease before the death of a spouse, primarily because of poor spousal health, and increase following the loss, because of increased support from friends and relatives. IMPLICATIONS: Maintaining continuity in the realm of social participation is a strategy older adults use to cope with spousal loss; however, not all widowed persons have the same resources to alter their levels of social participation.

Adaptation, Psychological↗
PubMed1995

The determinants of coparenting in families with toddler boys: spousal differences and daily hassles.

In order to advance understanding of the phenomenon of coparenting, naturalistic observations of firstborn sons were undertaken when they were 15 months of age at a time when both parents were home and family life was demanding. Narrative records of coparenting events were scored to determine the frequency with which parents supported and undermined each other and to test two hypotheses pertaining to individual differences in coparenting: that greater differences between spouses in demographic factors, personality, styles of relatedness and child-rearing attitudes would forecast more unsupportive and less supportive coparenting; and that the adverse effects of such spousal differences would be amplified by high levels of family stress, as indexed by frequency and intensity of daily hassles. Both hypotheses received support and are discussed in turn.

Adult↗
PubMedDate not supplied

Breastfeeding triplets: the at-home experience.

The unprecedented rise in higher-order multiple (HOM) births and the subsequent increase in parents who want to breastfeed their babies presents community health nurses (CHNs) with complex challenges. The extraordinary diversity of the triplet breastfeeding experience once all infants are settled at home is illustrated through findings from a survey of nine mothers of triplets. Parents revealed how they managed the feedings over the multiples' first year: type of feedings (breast, expressed breast milk [EBM], formula); scheduled and demand feedings; adequacy of milk supply; frequency and duration of feedings; consecutive and simultaneous feedings; nighttime with three; weaning; effects of breastfeeding on their bodies and well-being; challenges and stresses; and spousal, family, and health professional attitudes and support. A number of strategies that CHNs can utilize are suggested. These include working with individual families as well as forming partnerships with parents of multiples' support groups, multiple birth associations, interested health professionals, and the community sector. It is through these actions that the accessibility, coordination, and quality of health, multiple birth education, and social support services can be strengthened and healthy public policies implemented which address the unique and enormous demands experienced by HOMs' families.

Breast Feeding↗
PubMed2005

The role of marital quality in physical health during the mature years.

OBJECTIVE: This study examined the role of marital quality in the physical health of mature adults. METHOD: Participants were from the National Survey of Midlife Development in the United States aged 50+ years who were in their first marriage. Five dimensions of marital quality and four indicators of physical health were used. RESULTS: Regression analyses indicated that marital quality indices accounted for a significant amount of explained variance in physical health. Most notably, higher levels of negative spousal behaviors uniquely contributed to physical health, predicting more physical symptoms, chronic health problems, and physical disability, and poorer perceived health. DISCUSSION: The occurrence of negative spousal behaviors was consistently associated with poorer physical health. The negativity effect observed regarding the costs and benefits of social support in general also applies to the context of marriage in that negative spousal behaviors outweigh positive spousal behaviors in contributing to mature adults' physical health.

Adult↗
PubMed1996

Articulating subtype differences in self and relational experience among alcoholic men using structural analysis of social behavior.

L. Benjamin's (1984) structural analysis of social behavior (SASB) system was used as the organizing framework within which to characterize the phenomenology of self and other relationship experience among subtypes of alcoholic men. Within the context of a community-based study of psychopathology, groups of antisocial alcoholic (AAL), nonantisocial alcoholic (NAAL), and nonalcoholic (control) men completed ratings of their introject (self-concept) and spousal experience. Group differences in demography and psychopathology provided strong support for subtype variations among alcoholic men that could not be attributed to global differences in adaptive functioning. SASB data showed consistency in circumplex ordering across the groups in ratings of self-experience and in ratings of the spousal relationship. AAL men were the most self-neglecting, blaming, and least trusting, and control men were the most relationally connected, with NAAL men falling in between. Despite the importance of the subtyping distinction, in some areas, alcoholism, regardless of subtype, was the core differentiating factor.

Adult↗
PubMed1989

Spouse criticism and support: their association with coping and psychological adjustment among women with rheumatoid arthritis.

Examined whether psychological adjustment of women with rheumatoid arthritis would be related to the support and criticism the patient received from the husband. Interviews were conducted with the husbands of 103 women with rheumatoid arthritis. Spouse interviews were content coded for critical remarks. Wives completed a revised version of the Ways of Coping Scale and a scale of the perceived supportiveness of the spouse. Husbands completed rating scales assessing their perceived vulnerability to illness and the degree of burden they experienced in providing assistance to their wives. Path analyses revealed that patient adjustment was significantly related to the attitude of the spouse. Patients with a highly critical spouse engaged in more maladaptive coping behaviors and reported a poorer psychological adjustment. Independent of spousal criticism, patients who perceived their spouse as being supportive engaged in more adaptive coping. A path model was fit to the data that suggested that the spouse may affect adjustment indirectly through influencing the patient's selection of adaptive or maladaptive coping responses.

Activities of Daily Living↗
PubMed2002

An examination of crossover and spillover effects of spousal and expatriate cross-cultural adjustment on expatriate outcomes.

Integrating work-family and cross-cultural adjustment literatures, the researchers proposed and tested a spillover and crossover model of expatriates' cross-cultural adjustment with reciprocal relationships. Spillover effects refer to the influence that expatriate attitudes in a particular domain (e.g., work) have on attitudes in other domains (e.g., nonwork), whereas crossover effects refer to the influence of expatriate attitudes on the spouse's attitudes (and vice versa). Data collected from Japanese expatriates, their spouses, and their superiors strongly supported both spillover and crossover effects between expatriate and spousal cross-cultural adjustment. In addition, expatriates' cross-cultural adjustment was found to be related to satisfaction, which, in turn, was found to be negatively related to expatriates' intention to return to their homeland early.

Adaptation, Psychological↗
PubMed2001

Group support for couples coping with a cardiac condition.

BACKGROUND/RATIONALE: Support groups of peers were designed to convey support specific to stressful situations encountered by persons with a first-time myocardial infarction and by their spouse or partners. There were no previous published support intervention studies focused on the couple. Survivors and spouses (n=28) participated in a pilot study which tested the effect of a 12-week support group intervention. DESIGN: The support groups for couples were cofacilitated by a peer and professional. The facilitators recorded field notes, while participants completed weekly diaries about the intervention activities. Following the intervention, participants were interviewed individually and facilitators were interviewed jointly about the perceived effect of the intervention and influencing factors. This article focuses on the facilitators' and participants' perceptions of intervention processes and outcomes. FINDINGS: Support processes in the group included social comparison, social learning, and social exchange. Three types of support--emotional, information, and affirmation--were provided. All participants were satisfied with the support intervention and referred to the positive effect on their coping, confidence, outlook, and spousal relationship. Factors that influenced the intervention effect were participant input, cofacilitation, similarity of group members, and the provision of information and support. CONCLUSIONS: Future interventions could consider similarity of peers, leadership, and optimum timing and duration.

Adaptation, Psychological↗
PubMed2006

Comparison of spousal with other donor groups: Study of a single center.

In coping with the shortage of living-related and cadaveric donor groups for renal transplantation, and in the fear of organ marketing, spousal donors are considered an invaluable potential source. Survival rates have been reported to be as high as even some related groups. This study evaluated 1039 renal transplantations up to 2003. Patient survival rates in different donor groups were determined using the Kaplan-Meier method. The 3-year patient survival rates were 93% for kidneys from 61 spouses; 92% for kidneys from 433 living-related donors; 91% for kidneys from 427 living-unrelated (excluding spouses) donors; and 90.5% for 118 cadaveric kidneys. Such results were consistent with many other reports which consistently showed that spousal donors were at least as good as living-related donors, representing a reliable source in cases of organ shortage. The high survival rate of spousal donors is probably related to their strong emotional support.

Adult↗
PubMed1998

Spousal caregivers' activity restriction and depression: a model for changes over time.

In this paper we examine the effects of increasing as well as decreasing caregiving demands on depressive symptomatology. In addition, we focus on spousal caregivers' activity restriction as an explanatory mechanism for changes in depressive symptomatology in the caregiving context. Two databases are used to answer our research questions. An increase of caregiving demands is assessed in study 1, which includes prospective data on 127 spousal caregivers of stroke, hip fracture, congestive heart failure and myocardial infarction patients. A decrease of caregiving demands is examined in study 2, which includes prospective data on 110 spousal caregivers of bypass operation patients. The results generally support the hypothesis that an increase in caregiving demands results in increased depressive symptomatology, while a decrease in caregiving demands reduces depressive symptomatology. The results also support the notion of activity restriction as a critical mediator of changes in depressive symptoms. Cross-sectionally it mediates the association between caregiving and depressive symptomatology, and longitudinally it contributes to changes in depressive symptomatology in both samples.

Activities of Daily Living↗
PubMedDate not supplied

Widowhood and other demographic associations of pain in independent older people.

OBJECTIVES: To determine if psychosocial factors, as suggested by the demographic variables of widowhood and living alone, are associated with pain, particularly severe pain, in a representative sample of independent older people. DESIGN: One thousand older people (65+) randomly selected from independent residents living in a major city were surveyed about their health status (Health Status of Older People Study). Demographic characteristics, including age, gender, education, income, living alone, widowhood, and childlessness, were analyzed by logistic regression for their association with pain report of differing severity. Path analysis was used to confirm the association with pain severity and further define the role of mood disturbance in mediating this relationship. RESULTS: The prevalence of any pain report for the preceding 12 months was 56.3%. This was reduced when using more restrictive criteria, such that moderate-to-severe pain "at worst" and "at present" was found in 48.7% and 4.1% of the sample, respectively. After adjusting for type 1 error rate, the status of living alone was primarily associated with moderate-to-severe pain at worst, and being a widow(er) was associated with moderate-to-severe pain at present. The latter association had an estimated odds ratio greater than 3 and was characterized by more recent bereavement. Using path analysis, the model that severe pain was secondary to mood disturbance of widowhood, particularly recent bereavement, was tested and confirmed. The model explained 17% of the variance of pain severity in widow(er)s. CONCLUSION: The mood disturbance related to spousal bereavement aggravates pain in older people. This lends support to the biopsychosocial model of pain.

Aged↗
PubMed1999

Spousal caregiving when the adult day services center is closed.

Of those spousal caregivers who identified a time when they most needed assistance, morning or afternoon time periods appeared to be most problematic. Spousal caregivers who reported receiving respite time on the weekends identified adult children as the informal support person most often available. However, more than half of the caregivers reported having no respite time during the weekend. Differences in the ways spousal caregivers spent their respite time on the weekends, if available, varied by gender, length of tenure as a caregiver, and age.

Aged↗
PubMed2003

A review of sex differences in sexual jealousy, including self-report data, psychophysiological responses, interpersonal violence, and morbid jealousy.

The specific innate modular theory of jealousy hypothesizes that natural selection shaped sexual jealousy as a mechanism to prevent cuckoldry, and emotional jealousy as a mechanism to prevent resource loss. Therefore, men should be primarily jealous over a mate's sexual infidelity and women over a mate's emotional infidelity. Five lines of evidence have been offered as support: self-report responses, psychophysiological data, domestic violence (including spousal abuse and homicide), and morbid jealousy cases. This article reviews each line of evidence and finds only one hypothetical measure consistent with the hypothesis. This, however, is contradicted by a variety of other measures (including reported reactions to real infidelity). A meta-analysis of jealousy-inspired homicides, taking into account base rates for murder, found no evidence that jealousy disproportionately motivates men to kill. The findings are discussed from a social-cognitive theoretical perspective.

Affective Symptoms↗
PubMed1999

Facing the challenge: household responses to HIV/AIDS in Mumbai, India.

How households and families respond to AIDS is of fundamental importance when it comes to designing programmes and interventions to provide support and care to people living with HIV disease. Where household and family responses are negative, different kinds of interventions may be needed from those where responses are more supportive. This paper reports on findings from an in-depth study of household and family responses to HIV and AIDS in India. Using individual and couple interviews, data were collected on the ways in which care and support were offered (or denied) to people living with HIV and AIDS. Findings show that responses are greatly influenced by prevailing gender relations, with men being responded to more positively than women, as well as other variables such as social status. The quality of responses is also influenced by pre-existing patterns of support and discord within the family. Where trust is high and spousal conflict slight, for example, HIV and AIDS are reacted to more positively than when there is mistrust and inter-spousal conflict. Suggestions are made concerning programme and intervention development so as to strengthen existing responses, and to maximize the success of home-based care.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Moderators of stress in parents of children with autism.

Parents of children with autism experience more stress and are more susceptible to negative outcomes than parents of children with other disabilities. The present work examines the relationship between stressors, social support, locus of control, coping styles, and negative outcomes (depression, social isolation, and spousal relationship problems) among parents of children with autism. Fifty-eight parents completed surveys. Results indicated that several coping styles corresponded to negative outcomes. Furthermore, the relationship between stressors and negative outcomes was moderated by social support and coping style. Results are discussed in relation to applications for clinical practice.

Adaptation, Psychological↗
PubMed2001

Atherogenic lipoprotein profile in families with and without history of early myocardial infarction.

In this study we compared several parameters characterizing differences in the lipoprotein profile between members of families with a positive or negative family history of coronary artery disease (CAD). In addition to regular parameters such as the body mass index (BMI), total plasma cholesterol (TC), low density (LDL-C) and high density (HDL-C) cholesterol and triglycerides (TG) we estimated the fractional esterification rate of cholesterol in apoB lipoprotein-depleted plasma (FER(HDL)) which reflects HDL and LDL particle size distribution. A prevalence of smaller particles for the atherogenic profile of plasma lipoproteins is typical. Log (TG/HDL-C) as a newly established atherogenic index of plasma (AIP) was calculated and correlated with other parameters. The cohort in the study consisted of 29 young (< 54 years old) male survivors of myocardial infarction (MI), their spouses and at least one offspring (MI group; n=116). The control group consisted of 29 apparently healthy men with no family history of premature CAD in three generations, their spouses and at least one offspring (control group; n=124). MI families had significantly higher BMI than the controls, with the exception of spouses. Plasma TC did not significantly differ between MI and the controls. MI spouses had significantly higher TG. Higher LDL-C had MI survivors only, while lower HDL-C had both MI survivors and their spouses compared to the controls. FER(HDL) was significantly higher in all the MI subgroups (probands 25.85+/-1.22, spouses 21.55+/-2.05, their daughters 16.93+/-1.18 and sons 19.05+/-1.33 %/h) compared to their respective controls (men 20.80+/-1.52, spouses 14.70+/-0.98, daughters 13.23+/-0.74, sons 15.7+/-0.76 %/h, p<0.01 to p<0.05). Log(TG/HDL-C) ranged from negative values in control subjects to positive values in MI probands. High correlation between FER(HDL) and Log (TG/HDL-C) (r=0.80, p<0.0001) confirmed close interactions among TG, HDL-C and cholesterol esterification rate. The finding of significantly higher values of FER(HDL) and Log (TG/HDL-C) indicate higher incidence of atherogenic lipoprotein phenotype in members of MI families. The possibility that, in addition to genetic factors, a shared environment likely contributes to the familial aggregation of CAD risk factors is supported by a significant correlation of the FER(HDL) values within spousal pairs (control pairs: r=0.51 p<0.01, MI pairs: r=0.41 p<0.05).

Adolescent↗