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PubMed1988

The relationship between marital intimacy, perceived strain and depression in spouse caregivers of dementia sufferers.

This study explored the quality of marital relationship between dementia sufferers and their spouse caregivers. It assessed the quality of the relationship (level of intimacy) prior to the onset of dementia and also at the time of the study. Caregivers who experienced lower levels of marital intimacy, both currently and before the onset of dementia, were found to have higher levels of perceived strain and depression. The decline in intimacy following the onset of dementia was estimated from the difference between the levels of past and present intimacy. Caregivers who experienced a greater loss of intimacy had a higher level of depression, but did not show evidence of increased perceived strain. It is speculated that a poor premorbid relationship makes caregiving more stressful because of a greater difficulty in performing the caregiving role. In addition, it is suggested that a poor premorbid relationship or high loss of intimacy acts as a vulnerability factor, predisposing the caregiver to depression.

Aged↗
PubMed1989

Cognitive style and perceived control in spouse caregivers of dementia sufferers.

The study investigated the cognitive style and perception of control in co-resident spouse caregivers of dementia sufferers and their association with psychological adjustment. Depression and strain were significantly correlated with the caregivers' perception that the stress they were experiencing would continue and the expectation that it would affect all areas of their lives. However, the correlations between these factors and depression were no longer significant after partialling out the caregivers' rating of the behavioural disabilities and disturbances of the dementia sufferer. Depression and strain were significantly correlated with the caregivers' perceived lack of control over their own emotional reaction and over the dementia suffers' behaviour.

Adaptation, Psychological↗
PubMed1990

Coping resources and depression in the caregiving spouses of Alzheimer patients.

This study deals with the self-rated impact of caring for a spouse with Alzheimer's disease at home. Impacts on the caregiver's marriage, work, recreation and mood were investigated as a function of the patient's disability level and of the coping resources which caregivers reported were available to and/or used by them. The patient's disability level had a more negative impact on the caregiver's marriage and recreation than did the coping resource variables whereas the reverse was true for work. The caregiver's work was the only life area in which the availability and mobilization of coping resources influenced the caregiver's level of depression. To clarify these results, additional regression analyses were conducted separately for homemakers and employed subjects. While mobilized coping resources (social activity level and homemaking activity level) were correlated with depression among homemakers, none of the indicators of mobilized coping resources was correlated with depression among workers. These findings suggest that the role in which stress occurs is an important factor in understanding stress and the coping process.

Adjustment Disorders↗
PubMed1991

Essential hypertension: hostility, psychiatric symptoms and marital stress in patients and spouses.

Scores on self-report questionnaire measures of hostility, psychiatric symptoms, marital dissatisfaction, and assertion discomfort/behaviour were compared for male (n = 26) and female (n = 25) patients with essential hypertension and their spouses, and matched normotensive controls. Correlations and factor analysis revealed clinically meaningful associations between elevated psychiatric symptoms, hostility, and assertive behaviour. These differed for male and female patients, especially regarding assertive behaviour. The findings suggest that communication training might be helpful for a sizeable proportion of married patients with essential hypertension.

Adult↗
PubMed1976

Marital therapy when one spouse has a primary affective disorder.

The authors explain why marital disharmony when one spouse has a primary affective disorder is difficult to treat but suggest that such couples can be treated successfully if the therapist is flexible and sets realistic goals. Because of the variability of the disease and the many unsubstantiated etiologies associated with it, the authors recommend a modified general system theory approach to treatment that includes a combination of psychotherapy and somatotherapy.

Bipolar Disorder↗
PubMed1978

The grieving spouse.

Loss of a spouse presents serious risks to the psychological and physical health and well-being of the survivor. This is particularly true for women. Physical disease, hospitalization, and mortality in widows all exceed expected rates. The author reviews the phases of mourning, the factors related to pathological grief, and the ways in which grief is resolved. He describes widow-to-widow care systems, which seem to have substantial merit. Pastoral counseling and in some cases psychiatric care and medication can be helpful, but time is the greatest healer of all.

Adaptation, Psychological↗
PubMed1981

A comparison of nonpatient and bipolar patient-well spouse couples.

The authors compared responses of 16 couples, in which one partner had a diagnosis of remitted bipolar illness, to a lengthy self-report questionnaire (KDS-15) designed to assess many aspects of marital adjustment with those of 16 matched nonpatient couples. The bipolar patient-well spouse couples had marital adjustments closely resembling those of the nonpatient couples; three of four global ratings of satisfaction failed to discriminate between the two groups. Perceptions of the courtship, first year of marriage, and the degree to which the marriage had met expectations were also similar for both groups.

Adjustment Disorders↗
PubMed1984

Depression in the spouses of demented patients.

The authors present three cases of depression requiring hospitalization in spouses of patients with progressive dementia. They discuss the stress of caring for demented people and the need for clinicians to inquire about depressive symptoms in care givers.

Aged↗
PubMed1989

CSF GABA in caregiver spouses of Alzheimer patients.

The authors studied CSF gamma-aminobutyric acid (GABA) in 14 Alzheimer patients and nine age-matched normal subjects. The five normal subjects who were wives of the demented patients had higher CSF GABA concentrations than the four normal subjects without demented spouses.

Alzheimer Disease↗
PubMed1995

Complicated grief and bereavement-related depression as distinct disorders: preliminary empirical validation in elderly bereaved spouses.

OBJECTIVE: This study sought to determine whether a set of symptoms interpreted as complicated grief could be identified and distinguished from bereavement-related depression and whether the presence of complicated grief would predict enduring functional impairments. METHOD: Data were derived from a study group of 82 recently widowed elderly individuals recruited for an investigation of physiological changes in bereaved persons. Baseline data were collected 3-6 months after the deaths of the subjects' spouses, and follow-up data were collected from 56 of the subjects 18 months after the baseline assessments. Candidate items for assessing complicated grief came from a variety of scales used to evaluate emotional functioning (e.g., the Hamilton Depression Rating Scale, the Brief Symptom Inventory). The outcome variables measured were global functioning, medical illness burden, sleep, mood, self-esteem, and anxiety. RESULTS: A principal-components analysis conducted on intake data (N = 82) revealed a complicated grief factor and a bereavement-depression factor. Seven symptoms constituted complicated grief: searching, yearning, preoccupation with thoughts of the deceased, crying, disbelief regarding the death, feeling stunned by the death, and lack of acceptance of the death. Baseline complicated grief scores were significantly associated with impairments in global functioning, mood, sleep, and self-esteem in the 56 subjects available for follow-up. CONCLUSIONS: The symptoms of complicated grief may be distinct from depressive symptoms and appear to be associated with enduring functional impairments. The symptoms of complicated grief, therefore, appear to define a unique disorder deserving of specialized treatment.

Age Factors↗
PubMed1991

Warming up to a cold-sick spouse.

This paper has examined the cold-sick/love-sick pattern of a couple's interaction and presented a schema for intervening with the less accessible, but pivotal partner--usually the husband. The importance of carefully attending to the wife's needs, expectations, wishes, and frustrations has been understood. She is not to be considered an ace-in-the-hole. Acknowledging her needs, while gently urging her husband out of his protective covering will enhance a therapist's ability to enter the relationship system. The love-sick spouse need not frighten off a therapist, and if her rage is reframed as a desperate cry for help, she may be more approachable. While difficult to engage, the cold-sick partner can be reached if his discomfort is acknowledged and his defenses initially honored. With carefully plotted and sensitive attempts to form an alliance with each partner, these couples can be engaged in successful treatment.

Dependency, Psychological↗
PubMedDate not supplied

Discourse-derived perspectives: differentiating among spouses' experiences of caregiving.

A method of constant comparative analysis was used to code open-ended interviews with 132 spouse caregivers regarding their experiences in caregiving. Results of this analysis yielded 69 qualitative code categories. We used these categories to compare the caregivers on several groupings that the literature has identified as providing meaningful ways to differentiate among caregivers. We used the qualitative responses to compare the caregivers by caregiver gender care-recipient dementia severity, and duration of caregiving. Results partly confirmed previous findings that wife caregivers are more distressed than husbands, but the results also indicated these caregivers were more similar than dissimilar The other analyses likewise indicated greater similarities than dissimilarities in the caregiving experience. We next continued the analysis and, using the coding categories as a springboard, identified four distinct patterns for construction of the meaning of the caregiving experience in the caregivers' discourse. These discourse-derived framing categories, applicable in about three-quarters of the caregivers, offered other ways to distinguish among caregivers. Further analysis of these robust groupings' showed important differences among the groups. These framing categories suggest ways to differentiate among caregivers, based on their perception of their role in the caregiving situation, ways that might point the way to intervention strategies for each of the groupings.

Aged↗
PubMed1985

Psychological profile of the spouse of the female agoraphobic patient. Personality and symptoms.

It has been contended that psychological characteristics of the partner of the agoraphobic patient are important factors in the development and maintenance of the patient's symptoms. To examine this hypothesis, male partners of female agoraphobics were compared with those of non-phobic psychiatric patients and of normal controls on a total of 48 measures referring to several symptom complexes and traits, including defensiveness. The partners of agoraphobics as a group were not found to be more defensive or psychologically more disturbed than their control counterparts. Additional within-couple analyses across groups showed spouses in the control couples to be more comparable to each other than were agoraphobics and their partners-a finding which was attributed to the highly elevated scores of the agoraphobic patients.

Adult↗
PubMed1988

Psychiatric morbidity in spouses of women admitted to a mother and baby unit.

The spouses of 40 women admitted to a psychiatric Mother and Baby Unit were interviewed to detect psychiatric morbidity, and aspects of their social and marital functioning. This group was compared with 25 men whose wives had not shown obvious psychiatric disorder in the puerperium. Psychiatric morbidity, using DSM-III (American Psychiatric Association, 1980) criteria, was present in 42% of the index group, and 4% of the comparison group. The main diagnoses were major depressive episode and generalised anxiety disorder. This was associated with poorer marital and social function in the index group. Male psychopathology after delivery has been studied little but may be significant in the management of postpartum syndromes.

Anxiety Disorders↗
PubMed1993

Sequence comparisons of HTLV-I from HAM/TSP patients and their asymptomatic spouses.

We amplified and sequenced portions of the human T-lymphotropic virus type I (HTLV-I) (U3), pol, env, and pX provirus regions (1212 bp per person) from peripheral blood lymphocytes (PBL) of two married couples (case 1 and case 2). Both husbands are patients with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and the wives are asymptomatic HTLV-I carriers. We selected these regions because the LTR and env regions of murine retrovirus models have been involved in determining tissue tropism. In addition, the predominant immunogenic epitope for HTLV-I-specific cytotoxic T cells obtained from circulating PBL of HAM/TSP patients was localized in the HTLV-I pX region. Our aim was to examine variations in these HTLV-I regions between affected and asymptomatic spouses. In the HTLV-I regions studied, we detected no sequence variation between each couple. These data do not favor the hypothesis that neurotropic mutants of HTLV-I are involved in the pathogenesis of HAM/TSP.

Base Sequence↗
PubMed1986

Group meetings for parents and spouses of bone marrow transplant patients.

To reduce the stress and social isolation of being the parent or spouse of a patient hospitalized for bone marrow transplantation (BMT), a support group for family members was established. Sharing the common experience of the BMT procedure was valuable to family members despite differences in patient's age or disease, relationship to the patient, or socio-economic status. Recommendations are made to include similar groups in planning to meet the psychosocial needs of family members at other centers where patients are treated with high-risk, high intensity procedures.

Adolescent↗
PubMed1989

Marital interaction and the health and well-being of spouses.

This study examines the extent to which the various dimensions of marital interaction are associated with differences in health status of spouses measured by the use of medical services and self-reported health and well-being. Dimensions of marital interaction and health and well-being measures with most covariation are identified and the relative effect of the quality of marital interaction on the health and well-being of husbands and wives are assessed. The study population includes 1004 married couples. Medical record and survey data for each respondent are linked for the analysis. The findings do support the hypothesis that the quality of marital interaction is related to the health of marital partners.

Adult↗