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Spouses and unrelated friends of probands as controls for stroke genetics studies.

To plan a multisite, ischemic stroke genetic study, stroke patients were surveyed about the availability and characteristics of a convenience sample of spouse/friend controls. 65% of all stroke-affected probands reported a living spouse. A more detailed survey was conducted at the University of Virginia, Charlottesville, Va., USA: 51% of stroke patients reported a living, stroke-free spouse who would be willing to serve as a control, and 49% reported having a stroke-free friend who would be willing to serve as a control. Overall, 75% of stroke patients reported at least 1 individual willing to participate as a control. Cases without an identified control were more likely to be non-white (48%) than were cases with a control (13%; p = 0.00004). Cases were older than controls (67.3 vs. 59.2 years; p = 0.000002), and a greater proportion of cases than controls were male (57 vs. 33%; p = 0.0002). Without proper attention to matching, the use of a spouse/friend convenience sample would result in imbalances in basic demographic characteristics.

Adult↗

Characteristics of male spouse abusers consistent with personality disorders.

Researchers and clinicians have tended to minimize the role of psychological characteristics of male spouse abusers, which has restricted the selection of potentially appropriate treatment interventions. A review of clinical literature on psychological characteristics of male batterers, including some studies incorporating psychometric testing, suggests that many of the characteristics of batterers are consistent with DSM-III criteria for personality disorders. Several authors have defined subtypes of batterers, which can be associated with specific types of personality disorders. Treatment programs for male spouse abusers should address the specific problems presented by patients with personality disorders, including alcohol-abusing batterers, a particularly difficult group to treat.

Alcoholism↗

Effects of psychoeducational intervention for married patients with bipolar disorder and their spouses.

The relative benefit of adding a structured psychoeducational intervention to standard medication treatment for married patients with bipolar disorder and their spouses was assessed. Patients were randomly assigned to receive either medication management or medication management plus a marital intervention with their spouses for an 11-month period. Patients' symptoms, functioning, and adherence to their medication regimens were measured at study entry and at 11 months. Significant effects favoring the combined treatments were observed for overall patient functioning but not for symptom levels. The marital intervention was associated with improved medication adherence. Combined psychosocial and medication treatment does not affect patients' symptom levels beyond the effects of medication alone, but it does result in significant incremental gains in overall patient functioning.

Bipolar Disorder↗

Predictors of decreased self-care among spouse caregivers of older adults with dementing illnesses.

This study describes the health behaviors (alcohol consumption, exercise, sleep patterns, smoking, and weight maintenance) of a sample of older adult spouse caregivers (N = 233) and investigates the predictors of decreased self-care since caregiving began. Multiple regression results indicate that caregivers who experience greater developmental burden, report a greater number of depressive symptoms, perform a greater number of activities of daily living (ADL) tasks in caregiving and spend more hours in a day providing care, and who have lower self-efficacy for both self-care and spouse care are at greater risk for negative health behavior change. Results have implications for the identification of caregivers who may be particularly vulnerable to the negative health impact of caregiving.

Aged↗

Male caregivers of spouses with Alzheimer's disease: risk factors and health status.

Caregiving for persons with Alzheimer's disease (AD) has been shown to pose a challenge to the health of the spousal caregiver. Because most of the caregiving literature focuses on the female caregiver, there is some question about the generalizability of such literature to the male caregiver. This report focuses on male caregivers of spouses with AD and represents a subsample from a larger descriptive study that examined the relationship between risk factors and the health status of spousal caregivers. Twenty-nine male caregivers affiliated with Alzheimer's organizations in Pennsylvania and Ontario, Canada, returned mail surveys. On average, physical health symptoms increased by one-third when comparing pre- and post-caregiving data. Caregivers also were experiencing moderate to severe depression and burden. Male caregivers generally rated their physical health as fair to excellent and exhibited fewer than expected physical health symptoms. Caregiver health was related to perceptions of stress surrounding the provision of activities of daily living (ADL) assistance, the frequency of behavioral problems, perceptions of stress associated with the AD spouse's dysfunctional behaviors, and satisfaction with leisure opportunities. The identification of the role that caregiver perceptions of stressfulness associated with caregiving and the need for leisure satisfaction offer important implications for community-based education and respite services to maintain health status for spousal caregivers.

Activities of Daily Living↗

Perceptions of family caregivers' psychosocial behavior when communicating with spouses who have Alzheimer's disease.

The literature for caregivers of persons with Alzheimer's disease (AD) notes the importance of attending to the linguistic and psychosocial dimensions of communication. The objective of this study was to investigate the relationship between psychosocial aspects of caregivers' behavior and communication outcomes for persons with AD and their spousal caregivers. In the first part of the study, we selected 40 segments of audio-recorded conversations between persons with AD and their spouses. We then asked 20 healthy seniors who were not caregivers to listen to and read the conversation segments and evaluate each segment along four psychosocial dimensions. They were also asked to independently rate how smooth the communication was in each segment. We hypothesized that when caregivers' speech is perceived to be respectful, caring, not controlling, and/or it ascribes competence to their spouses, it would be associated with more effective communication. Our results supported these hypotheses in that communication was more likely to be rated higher in smoothness when the content and manner of caregivers' speech were perceived to have positive psychosocial qualities. The findings have implications for training caregivers on effective psychosocial behavior when interacting with persons who have AD.

Aged↗

Consensual validity parameters of the Zuckerman-Kuhlman personality questionnaire: evidence from self-reports and spouse reports.

One way of validating questionnaire responses is correlating them with ratings made by external assessors who know the ratee well: This is known as consensual validity. In this study, we assessed the consensual validity of the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ; Zuckerman, 2002; Zuckerman, Kuhlman, Joireman, Teta, & Kraft, 1993). A multitrait-multimethod matrix of self-reported and spouse reported personality ratings was used to establish convergent and discriminant validity by means of Campbell and Fiske's (1959) evaluative criteria. Self-reports of 86 men and 85 women were correlated with their spouses' reports. Intraclass correlations ranged from .47 to .63 for the 5 dimensions, providing strong evidence of convergent and discriminant validity. The results obtained favor the use of the ZKPQ as a valid self-report measure of personality traits.

Adult↗

Predictors of emotional strain among spouse and adult child caregivers.

This study used data from the 1999 National Long Term Care Survey to examine predictors of emotional strain between spouse and adult child caregivers using the frameworks of role theory and the stress process model. Secondary data analysis examined if and how emotional strain differed between the groups and what the predictors of emotional strain were for each group. Common group predictors of emotional strain were elder's disruptive behaviors, caregiver's perceived overload, family disagreement, limitations on the caregiver's life, and utilization of personal coping strategies by the caregiver. There were predictors unique to spouse's emotional strain but elders' race and respite availability were unique predictors of adult child caregiver's emotional strain. Ways in which predictors of emotional strain can be used to design effective and efficient social work interventions are discussed.

Adaptation, Psychological↗

Patterns of mutual and nonmutual spouse abuse in the U.S. Army (1998-2002).

The pattern and severity of substantiated mutual and nonmutual spouse abuse between U.S. Army enlisted personnel and their spouses was determined for 1998 to 2002. The number of nonmutual and mutual abuse victims was equal in 1998, but by 2002 there were about twice as many non mutual as mutual victims. The rate per thousand of mutual abuse decreased by 58% while that of nonmutual abuse decreased by 13%. The rate per thousand of female victims was always greater than male victims for non-mutual abuse and the severity of abuse of female victims was always more severe than male victims. The active duty female had the highest risk of becoming a victim. These patterns of mutual and nonmutual domestic abuse in the U.S. Army suggest that prevention and educational approaches could be developed that would be useful to prevention specialists and to clinicians as the Army pursues avenues to reduce domestic violence.

Adult↗

The internal validity of the index of spouse abuse in African American women.

This study investigated the internal validity of the Index of Spouse Abuse (ISA) (Hudson & McIntosh, 1981) in a sample of 583 African American women who sought health care at a tertiary care hospital in Atlanta, Georgia. Three models were tested with confirmatory factor techniques: (a) Hudson and McIntosh's original Index of Spouse Abuse two factor model; (b) Campbell, Campbell, Parker, and Ryan's three factor model (Campbell, Campbell, King, Parker, & Ryan, 1994); and (c) an alternative model of physical and nonphysical abuse. This alternative model is based in part on Tolman's conceptualization of psychological abuse as a construct comprised of two related but distinct factors: controlling and emotionally abusive behaviors (Tolman, 1999). Results show that the alternative model fits the data better than the first two models. Findings support the continued use of the ISA, but with proposed modifications.

Adolescent↗

Relationship between transmission of Porphyromonas gingivalis and fimA type in spouses.

BACKGROUND: Porphyromonas gingivalis is one of the major microbial pathogens associated with chronic periodontitis. To eradicate such pathogens by periodontal therapy, it is essential to clarify the source of infection. Recent findings suggest that the genotype of the fimbriae is one of the important factors in infection by P. gingivalis. The objectives of the present study were to investigate the transmission of P. gingivalis between spouses and to determine the relationship between P. gingivalis fimA type and colonization. METHODS: A total of 14 couples were selected to investigate the transmission of P. gingivalis and its association with the fimA types. To examine the distribution of fimA type in the general population, 32 subgingival plaque samples from 47 patients with periodontitis were also tested. The transmission of P. gingivalis strains was determined by using pulsed field gel electrophoresis (PFGE). P. gingivalis strains isolated from the couples and subgingival dental plaque samples were studied for fimA classification. RESULTS: The PFGE patterns of P. gingivalis strains from matched husbands and wives were identical for six of the 14 couples. In five of these six couples (83.3%), P. gingivalis strains harboring the type II fimA gene were present. The proportion of type II fimA in the strains isolated from couples with probable intrafamilial transmission was significantly higher than that in patients with periodontitis or in the group of samples isolated from one member of a couple. CONCLUSION: This study suggests that fimA type II, even though widely distributed in patients with periodontitis, may be an important factor in the transmission of P. gingivalis between spouses.

Adult↗

Ischemic stroke risk and passive exposure to spouses' cigarette smoking. Melbourne Stroke Risk Factor Study (MERFS) Group.

OBJECTIVES: This study investigated the association between ischemic stroke risk and passive exposure to cigarette smoking. METHODS: Risk factors among 452 hospitalized cases of first-episode ischemic stroke were compared with 452 age- and sex-matched "neighbor-hood" controls. RESULTS: The risk of stroke was twice as high for subjects whose spouses smoked as for those whose spouses did not smoke (95% confidence interval = 1.3, 3.1), after adjustment for the subject's own smoking, heart disease, hypertension, diabetes, and education level. These results were confirmed when analysis was limited to those who never smoked. CONCLUSIONS: These findings provide evidence that spousal smoking may be a significant risk factor for ischemic stroke.

Aged↗

Central nervous system cancers in first-degree relatives and spouses.

The increasing incidence of high-grade astrocytomas in the elderly, the associations between these malignancies and environmental factors, and case reports suggesting a familial component to these tumors prompted this study of primary brain tumors in first-degree relatives and spouses. This article describes the findings in 154 patients from 72 consecutive families accrued to the National Familial Brain Tumor Registry from 1991 to 1996. Medical records, pathological slides, and demographic data were reviewed for each identified case. Parents and children were affected in 33 families, siblings in 27, and husbands and wives in 12. The median age of the patients was 50.5 years, 55% were men, and 70% had high-grade astrocytomas. The pattern of tumor occurrence in this population is different from most familial cancers. These tumors did not involve multiple generations or occur at an unusually early age. In addition, the cases tended to cluster in time, with 47% of the familial and 50% of the husband-wife cases occurring within a 5-year span. In families with an affected parent and child, the diagnosis was made in the child before the parent in 45% of the cases. Prognostic factors for these patients appear to be similar to that reported for typical high-grade astrocytomas. This study demonstrates that primary brain tumors can occur in families without a known predisposing hereditary disease. The ages of these patients, the clustering of cases in time, the few affected generations, and the occurrence of brain tumors in spouses suggest that environmental exposures may be important in the etiology of this neoplasm. Although this hypothesis requires further study, it is plausible given the known associations in animals and humans between high-grade astrocytomas and radiation, toxic chemicals, and viruses.

Adult↗

Status of U.S. military retirees and their spouses toward achieving Healthy People 2010 objectives.

PURPOSE: To assess the status of U.S. military retirees and their spouses 38 to 64 years of age relative to select Healthy People 2010 objectives and to identify sociodemographic characteristics associated with select health behaviors. DESIGN: Cross-sectional analyses with self-reported standardized measures from the U.S. Department of Defense Population Health Survey, 2003. SETTING: The continental United States. SUBJECTS: U.S. military retirees and their spouses 38 to 64 years of age. MEASURES: Data for this study were self-reported responses to the Population Health Survey. Dichotomous variables were created to indicate whether each Healthy People 2010 objective had been met. Each objective was measurable with the survey by using the definitions set forth in Healthy People 2010. These objectives included healthy weight and obesity based on body mass index (height and weight); daily fruit, vegetable, and grain-product consumption; physical inactivity, moderate physical activity, and vigorous physical activity; binge drinking; cigarette use; and smoking-cessation attempts. RESULTS: The study population did not meet any of the Healthy People 2010 objectives included in this study. Sociodemographic characteristics that were associated with this result included being male, not having a college degree, and a less-than-excellent self-reported general health status. CONCLUSION: Health-promotion interventions are needed to improve the health status of this population and to achieve the goals set forth in Healthy People 2010.

Adult↗

[Social network and social support for married women and their spouses].

This study investigated various psychological aspects of social networks of married women and their spouses A survey data for 259 women and 185 men were analyzed, and main findings were as follows: 1. With marriage, support agents of women and men change extensively in their social networks. Wives have more variety in support agents within their social network, through children to their friends' parents. On the other hand, husbands' agents are likely to be confined to their wives and children. 2. Wives and husbands are similar in that their first choice for seeking advice is their spouse. A friend is the second choice for both of them. While parents, brothers and sisters serve as wives' third choice, there is no third for husbands. 3. Enrichment of wives' social network, based on a well-functioning relationship with husbands, leads to a lower degree of social isolation experienced by them.

Adult↗

Dropout and completion of treatment among spouse abusers.

This study examines a population of spouse abusers undertaking a treatment program. Its purpose was to identify the variables associated with dropout and completion of treatment and to build a predictive model. Data were collected on 286 men who began group treatment in one of eight community programs in the province of Quebec, Canada. Results show that men who complete treatment are older, better educated and have better economic conditions than men who drop out. They also have a more stable family life, have been in a relationship for a longer period of time and have more children with their actual spouse. Men who completed treatment showed more commitment, better working capacities and a higher level of agreement with their therapists, thus developing a stronger therapeutic alliance. Support provided by people in the environment was significantly related to treatment completion. Social and judicial pressures were not related to completion.

Adult↗

An examination of the physical health, health care use, and psychological well-being of spouses of people with fibromyalgia syndrome.

The present study compared the physical and mental health and the health care use of spouses of patients with fibromyalgia syndrome (FS group; n = 135) with that of spouses of healthy individuals (n = 153). FS group participants reported lower health and affective states and scored higher on depression, loneliness, and subjective stress than comparison group participants (p < .017). Husbands in the FS group who reported more illness impact and whose wives reported worse sleep quality and less self-efficacy had more psychological difficulties. No differences were found in health care costs between groups. These findings suggest that chronic illness in a partner may negatively affect an individual's physical and mental health.

Analysis of Variance↗

Gastric cancer mortality in the spouses of patients who died from gastric cancer.

BACKGROUND: There is evidence to support the hypothesis that the main determinants of gastric carcinogenesis act in childhood and adolescence. Based on the assumption that husband and wife share many of these factors (dietary habits and other exogenous exposures) only in adult life, the aim of the study was to demonstrate that the spouses of patients who died from gastric cancer (GC) are not at increased risk of GC death. METHODS: The study was conducted on data from the province of Forlì (north eastern Italy). The anonymous GC death records provided by the Italian National Statistics Bureau for the years 1969-1988 were matched by month/year of birth, sex, marital status, month/year and place of death with those of the population registries in the area. The subjects identified had a total of 2720 wives or husbands. Gastric cancer mortality observed in the cohort of spouses was compared with that of the general population using the standardized mortality ratio (SMR), calculated by applying the sex-, age-, and time period-specific mortality rate in the population to the appropriate person-years at risk in the cohort. RESULTS: The cohort yielded a total of 22 414 person-years. The SMR was 1.1 (95% CI : 0.9-1.5) with a value of 0.9 (95% CI : 0.6-1.5) among males and 1.2 (95% CI : 0.9-1.7) among females. CONCLUSION: The study provided further evidence that the main events in gastric carcinogenesis occur before adult life.

Adult↗