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PubMed2000

Establishment and epitope analysis of allo-specific cytotoxic T lymphocytes at a tumor site recognizing a spouse's HLA-A0206 molecule.

PROBLEM: The molecular basis of allo-reactivity in reproductive immunity has not been fully clarified. METHOD OF STUDY: Cytotoxic T lymphocytes (CTLs) were established from tumor-infiltrating lymphocytes (TILs). The allo-reactivity of the CTLs against various tumor cell lines or human leukocyte antigen (HLA)-A allele-transfected COS-7 cells was measured by 51Cr-release or interferon-gamma production assay. RESULTS AND CONCLUSIONS: We have established CTLs reacting to an HLA-A0206 molecule that matched a spouse's HLA-A allele from the TILs of a 68-year-old multiparous patient with gastric cancer. The amino acids at positions 66 and 88 in the alpha1 domain of HLA-A0206, both of which were common in the other HLA-A2 subtypes, were involved in the recognition by the CTLs. Endogenous peptides in the groove were not involved in the recognition. These results suggest the presence of long-lasting memory CTLs raised by the reproduction process, and may facilitate a better understanding of the molecular basis of allo-recognition during reproduction.

Aged↗
PubMed2005

Midlife suicide risk, partner's psychiatric illness, spouse and child bereavement by suicide or other modes of death: a gender specific study.

STUDY OBJECTIVE: To describe gender specific suicide rates associated with partner's psychiatric disorder, loss of a spouse, or child by suicide or other causes, being a parent, and marital status. DESIGN: Nested case-control study. Information on causes of death, psychiatric admission, marital status, children, and socioeconomic factors was obtained from routine registers. SETTING: Denmark. PARTICIPANTS: 9011 people aged 25-60 years who committed suicide; 180 220 age-gender matched controls; 111 172 marital partners; 174 672 children. MAIN RESULTS: The suicide risk in women whose partner had been first admitted with a psychiatric disorder after 31 December two years earlier was 6.9 (95% CI 3.6 to 13.0), whereas their male counterpart experienced a risk of 3.9 (2.7 to 5.6); p value gender difference = 0.39. Men who had lost their partner by suicide or other causes of death experienced a suicide risk of 46.2 (18.3 to 116.4) and 10.1 (6.5 to 15.8), respectively; the analogous risk among women were about one third: 15.8 (6.6 to 37.4) and 3.3 (1.5 to 7.2), respectively. Child bereavement by suicide or other causes imposed an approximate twofold risk increase in their parents, whereas being a parent was protective in women. Except for widows (1.6, 1.2 to 2.0) and widowers (3.0, 2.3 to 3.9) the suicide risk associated with being separated (2.0, 1.8 to 2.3), divorced (1.8, 1.7 to 2.0), never married (1.4, 1.3 to 1.6), cohabitant (1.2, 1.1 to 1.3) was virtually the same in the two sexes. CONCLUSIONS: The suicide risk is associated with partner psychiatric illness. Conjugal bereavement is particularly indicative of suicide in men, and spousal suicide is particularly indicative of suicide. Child bereavement is associated with parental suicide, while being a parent is protective against suicide in women.

Adult↗
PubMed1995

New insights on the emotional response of cancer patients and their spouses: where do they find help?

Reports the results of a questionnaire survey designed to discover relationships of the emotional responses of cancer patients and their spouses to variables of age, gender, and church attendance. Claims that contemporary high-tech health care developments tend toward a process of despiritualization, and that one-on-one spiritual relationships seldom occur with physicians, nurses, or pastors. Notes that pastors need to assume a greater role as spiritual leaders, encouraging all members of the health care team to contribute to healing the whole person.

Age Factors↗
PubMedDate not supplied

Assessing the offending activity of criminal domestic violence suspects: offense specialization, escalation, and de-escalation evidence from the Spouse Assault Replication Program.

OBJECTIVE: Over the past quarter century, intimate partner violence research has occupied an increasingly important position in the research agenda of criminology, public policy, and public health. Yet, a number of questions about the criminal careers of domestic violence offenders remain unresolved. This study attempts to determine (1) the extent to which criminal domestic violence offenders specialize in violence, and (2) whether the severity of an offender's attacks against the same victim increase, decrease, or stay about the same over time. METHODS: Data from the Spouse Assault Replication Program (SARP) are used to address two questions corresponding to different features of the criminal careers of domestic violence offenders. RESULTS: The specialization analysis reveals that the majority of domestic violence offenders with prior official criminal records have been involved in nonviolent forms of criminal behavior in addition to domestic violence. The escalation analysis identifies groups of escalators and de-escalators as well as individuals who engage in stable low-level aggression and stable high-level aggression. CONCLUSIONS: Few SARP domestic violence offenders have been specializing exclusively in violence. There is also a heterogeneous mix of offenders who escalate and de-escalate the severity of their attacks over the short-term follow-up periods. Few studies have presented data consistent with the present study's findings. A longitudinal analysis of the criminal careers of domestic violence offender subtypes is critical for future research.

Criminal Law↗
PubMed2000

Predictors of treatment dropout from a spouse abuse abatement program.

This study evaluated predictors of dropout among men who began and attended at least 1 session of a cognitive-behavioral, skills training oriented spouse abuse abatement counseling program. Based on prior research, a number of demographic, criminal justice, partner violence pattern, and personality characteristics were studied. Dropout prediction was assessed at 2 phases of program participation, during assessment (early drop) and during intervention (late drop). Overall, few of the variables studied predicted dropout. Early dropout was predicted by high rates of police contact for violent crimes, failure to self-report an alcohol problem, and paranoid personality characteristics. Late dropout was predicted by both high and moderate levels of police contact for violent crimes, and borderline personality characteristics. An Age x Violent Crime interaction suggested that young violent offenders are more likely to complete treatment. The overall model accounted for only 7.15% of the variance. Clinical and research implications are discussed.

Adult↗
PubMed1999

Grief in spouse and children caregivers of dementia patients.

Caring for a family member with dementia involves loss and inevitable grief during the illness duration. The purpose of this study was to determine the patterns of grief of caregivers of family members with dementia and the relationship of those patterns to the losses and experiences of the caregivers. Participants were 22 spouse caregivers and 11 adult children caregivers of family members with dementia. Caregivers' experiences were measured using visual analog scales and grief using The Grief Experience Inventory. Caregivers' perceptions of the level of affection before the illness and the satisfaction of the marriage before the illness were inversely related to grief symptoms. Grief symptoms were also related to participants' perceptions of loss of the future. Caregivers' emotional distress includes reaction to the losses they are encountering long before their care recipients die.

Adaptation, Psychological↗
PubMed1997

A comparison of hospice and hospital care for people who die: views of the surviving spouse.

To compare the quality of inpatient care for dying people in St Christopher's Hospice, London and nearby hospitals in 1994 and make comparisons with earlier studies of the same setting, interviews were undertaken with spouses of people who had died from cancer in these settings, matched by age and sex. The subjects comprised 66 people who had died in 1994, 33 of whom had died in the hospice, 33 in local hospitals. The mean age was 70.2, 61% were male. The hospice group were more likely to know that they were dying and less likely to be admitted as emergencies. Treatment for pain, breathlessness and nausea from both sources provided relief in almost all cases. Most information about the illness was given by hospital doctors before hospice care occurred. Where it occurred, communication by hospice staff was judged better than that by hospital doctors. Staff in hospitals were more likely to be judged 'very busy'. Hospice respondents were less likely to want improvements, and more likely to judge the institution as being 'like a family'. Earlier studies had shown a trend for symptom control to have improved in hospitals but for difference in the psychosocial climate to favour the hospice, By 1994, this latter difference was still obtained. We stress the role of hospital staff and general practitioners in helping patients accept a terminal prognosis, so that better-planned care can proceed. The busy public atmosphere of some hospital wards may not be conducive to the good care of dying people.

Aged↗
PubMed1995

Perceived health and functional status among spouse caregivers of frail older persons.

This national interview study examined the health impact of caring for frail elders in a sample of 437 spouse caregivers. The principal findings were that (a) caregiver emotional strain was the strongest common predictor of both poor perceived health and functional limitations, (b) wife caregivers' poor health was associated with care recipients' perceived unmet needs and increased depression, (c) husband caregivers' poor health status was predicted by longer caregiving duration, and (d) non-White wife caregivers reported poorer perceived health than did their White counterparts.

Activities of Daily Living↗
PubMed2003

Developing cohesion in court-mandated group treatment of male spouse abusers.

Cohesion in group treatment of spouse abusers plays an important and often overlooked role. Involuntary abuser groups can benefit from cohesion, but due to their unique structure, cohesion may develop differently than in voluntary psychotherapy groups. Initially, abuser groups may develop premature levels of cohesion that can make group members unwilling to express conflict, develop intimacy, and take responsibility for their actions. Understanding the abuser personality and the unique characteristics of involuntary abuser groups can shed light on why cohesion develops the way it does and the importance it plays in abuser groups. Developing effective interventions that target premature cohesion can help the group members express conflict, develop intimacy, and take responsibility for their actions, thus bringing about therapeutic levels of cohesion.

Criminal Law↗
PubMed1999

Effects of caregiver communication on the outcomes of requests in spouses with dementia of the Alzheimer type.

Three clinical and three matched nonclinical couples were studied for the effectiveness of their discourse in eliciting outcomes to requests made. Caregivers in the clinical couples were less likely to achieve successful outcomes than dominant communicators in the nonclinical couples. In studying the context for the requests, differences could not be attributed to the degree of concreteness of reference that was used by caregivers of spouses with Dementia of the Alzheimer type. More abstract and less abstract references were equally likely to be responded to by two of the three clinical couples. Differences in the styles of communication by the caregivers contributed to outcomes and reflected a self-reported degree of strain or comfort in the couples' relationships. Suggested is a method of study of outcomes that could be used in clinical assessment and intervention for nonresponsiveness and noncompliance with dementia patients.

Activities of Daily Living↗
PubMed2000

Factors associated with spouses moving away from their military installation during an overseas deployment.

During overseas deployments, many spouses and families move away from their initial military installation, usually to live with or near relatives. Relatively little has been known about those who move away even though the issue is of importance to the military because its support systems are designed on the assumption that family members are living in proximity to those support systems. The purpose of this research was to describe the characteristics of those who actually moved away during a deployment compared to those who stayed but wanted to leave and to those who stayed. Results generally fit a social exchange model of reasons for moving, staying, or wanting to move but staying. High stress appears to lead to a desire to move but other factors act as barriers or facilitators to actually moving. Military family support did not predict moving away or staying. Implications for military support services are discussed.

Adult↗
PubMed2000

The family and alcohol: effects of excessive drinking and conceptualizations of spouses over recent decades.

There is much debate in the addiction literature about the extent to which excessive drinking affects nondrinking family members. The issue is considered in this review by examining and evaluating research relating to the effects of drinking on children, family systems, and partners of drinkers. The latter group have, historically, been blamed and apologized for their partner's drinking, although more recent theories have adopted a stress and coping paradigm, thus normalizing individuals and their behaviors. Conceptualizations of spouses over the last five decades are described and evaluated in the second part of the review. Finally, the review considers the impact of the recent stress and coping paradigm on clinical interventions for excessive drinkers and their families, and suggestions are made for future research.

Adaptation, Psychological↗
PubMed1995

Psychological symptomatology in spouses and adult children of alcoholics: an examination of the hypothesized personality characteristics of codependency.

The concept of codependency has been advanced to explain certain psychological traits purported to be characteristic of spouses and adult children of alcoholics. To test the validity of this hypothesized syndrome, 97 female subjects living with either an alcoholic (SA), a psychiatric patient (SP), or dentistry patient (SD) were studied; approximately 50% of subjects had a positive family history (FH+) for alcoholism. All subjects were administered an extensive battery of psychological tests. The results revealed significantly greater levels of psychological symptomatology among the SA and FH+ subjects, in part consistent with the hypothesized symptomatology of codependency.

Adult↗
PubMed1995

Exploring widows' experiences after the suicide of their spouse.

1. The widow of a spouse who committed suicide must cope with issues related to depression, anger, blame, guilt, and the stigma associated with suicide that makes recovery from this type of loss different for the survivors. 2. The predominant need of widows and widowers of suicide victims was to talk in an environment of acceptance and understanding, which could only be provided by other people who have had the same kind of experience. 3. There is no precise formula that exists to guide caregivers when assisting survivors of suicide victims, however suggestions include communicating with compassion; demonstrating care and concern; accepting the individual's grief; and offering and providing information.

Adaptation, Psychological↗
PubMedDate not supplied

Shared health behaviors among older Mexican American spouses.

OBJECTIVE: To assess the association of health behaviors among husbands and wives. METHODS: Cohort study of 553 Mexican American couples aged 65 years or older from the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE). Multivariate regression analyses test the association of body mass index, smoking, and alcohol consumption among husbands and wives. RESULTS: Body mass index is positively associated among couples. Risk of smoking or drinking was higher if the partner had ever smoked or drank alcohol. CONCLUSION: Health behaviors are associated among older Mexican American couples. Intervention efforts should be directed at both spouses.

Aged↗
PubMed2006

[Group therapy for men who are violent towards their spouse: dropout from treatment].

It is now known that group treatment dropout rate for men who are violent towards their spouse constitutes a problem. The goal of this study is to verify if a link exists between attrition in a treatment for violent men and both partners's personal (age, revenue, substance abuse, having been subjected to violence as children) and marital variables (dyadic adjustment, anger, attribution, attachment style and violent behavior). Eighty men enrolled in a group treatment for marital violence have been recruited. Correlational analysis showed us that age is the only variable correlated with treatment dropout. The younger the participants, the most likely they were to drop out of the group therapy. These results will be further discussed.

Adult↗
PubMed1999

Reports of spouse abuse in the U.S. Army Central Registry (1989-1997).

OBJECTIVE: To report the distributions and characteristics of spouse abuse victims and offenders in the U.S. Army Central Registry from 1989 to 1997. METHOD: Case and population data were tabulated using SAS procedures. RESULTS: There were 61,827 initial substantiated cases, 5,772 subsequent incidents, and 3,921 reopened cases. Victim rates varied between 8 and 10.5 per 1,000 married persons. About 82% of victims and offenders were between the ages of 18 and 31 years. The racial distribution of married active duty white and black victims and offenders was greatly different from that of the married active duty population. The proportion of female victims increased from initial (67%) to subsequent (71%) to reopened cases (75%). CONCLUSIONS: U.S. military populations provide unique opportunities to study family violence because of the socioeconomic "floor" under service members and their families. Comparisons between military and civil populations on precipitating circumstances, case assessment and definition, and treatment efficacy would be fruitful areas for research.

Adolescent↗
PubMed1991

Examining the dynamics of spouse abuse: an alternative view.

Spouse abuse continues to be a great problem in our society. Much of the literature about the problem, however, assumes that the roles of perpetrator and victim are always fixed, with the man as perpetrator and the woman as victim. This perception is understandable if the injuries received are the focus of attention, and the sole informant about the violence is the person who has most often been the recipient of injuries. On occasions when both partners are interviewed, a different perception of violent relationships is likely to emerge. Violence can be viewed as occurring along a continuum. One extreme is represented as mutual combat, in which both partners play a role in the escalation of conflict. The other extreme follows the traditional concept of battering where the woman is victimized by the man. Primary care practitioners are in a position to assist clients who are in violent relationships and to help them learn more functional problem-solving skills. This article focuses on methods of identifying violent couples and teaching them how to interrupt the cycle of violence.

Decision Trees↗