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Parenting through change: an effective prevention program for single mothers.

This randomized experimental prevention study (a) evaluated the effectiveness of a parent-training program in a sample of 238 divorcing mothers with sons in Grades 1-3 and (b) provided an experimental test of coercion theory. The intervention produced reductions in observed coercive parenting, prevented decay in positive parenting, and generally improved effective parenting practices in comparisons of mothers in experimental and control groups. Moreover, coercion theory was supported. Improved parenting practices correlated significantly with improvements in teacher-reported school adjustment, child-reported maladjustment, and mother-reported maladjustment. The intervention indirectly benefitted child outcomes through improved parenting practices for a model based on child report and, to a lesser extent, on teacher report. The intervention did not produce direct effects on child outcomes.

Adult↗

Marital processes predictive of later dissolution: behavior, physiology, and health.

Seventy-three married couples were studied in 1983 and 1987. To identify marital processes associated with dissolution, a balance theory of marriage was used to generate 1 variable for dividing couples into regulated and nonregulated groups. For studying the precursors of divorce, a "cascade" model of marital dissolution, which forms a Guttman-like scale, received preliminary support. Compared with regulated couples, nonregulated couples had (a) marital problems rated as more severe (Time 1); (b) lower marital satisfaction (Time 1 and Time 2); (c) poorer health (Time 2); (d) smaller finger pulse amplitudes (wives); (e) more negative ratings for interactions; (f) more negative emotional expression; (g) less positive emotional expression; (h) more stubbornness and withdrawal from interaction; (i) greater defensiveness; and (j) greater risk for marital dissolution (lower marital satisfaction and higher incidence of consideration of dissolution and of actual separation).

Arousal↗

Major life events and minor stressors: identifying mediational links in the stress process.

Whether the relationship between major life events and distress is mediated through minor stressors was examined in three stress groups: those who (a) experienced the death of a spouse, (b) divorced, or (c) were the parent of a child with asthma. Each of these major stress groups was compared with a control group. Path analyses conducted by aggregating the data cross major stress groups indicated that major life events exert both a direct influence on distress and an indirect influence through minor stressors. On the other hand, the nature of the mediational relation linking major life events with psychological distress through minor stressors was found to vary as a function of the major life stress situation under consideration. Methodological and theoretical implications for the study of stress processes are discussed.

Adaptation, Psychological↗

Marital history at midlife as a predictor of longevity: alternative explanations to the protective effect of marriage.

The association between marital history at midlife (in 1950) and mortality (as of 1991) was studied in a group of intelligent, educated men and women (N = 1,077) who participated in the Terman Life-Cycle Study initiated by Lewis Terman in 1921. Results confirm that consistently married people live longer than those who have experienced marital breakup but suggest that this is not necessarily due to the protective effects of marriage itself. Individuals who were currently married, but had previously experienced a divorce, were at significantly higher mortality risk compared with consistently married individuals. Furthermore, individuals who had not married by midlife were not at higher mortality risk compared with consistently married individuals. Part of the relationship between marital history and mortality risk may be explained by childhood psychosocial variables, which were associated with both future marital history and mortality risk.

Adolescent↗

Child adjustment in joint-custody versus sole-custody arrangements: a meta-analytic review.

The author meta-analyzed studies comparing child adjustment in joint physical or joint legal custody with sole-custody settings, including comparisons with paternal custody and intact families where possible. Children in joint physical or legal custody were better adjusted than children in sole-custody settings, but no different from those in intact families. More positive adjustment of joint-custody children held for separate comparisons of general adjustment, family relationships, self-esteem, emotional and behavioral adjustment, and divorce-specific adjustment. Joint-custody parents reported less current and past conflict than did sole-custody parents, but this did not explain the better adjustment of joint-custody children. The results are consistent with the hypothesis that joint custody can be advantageous for children in some cases, possibly by facilitating ongoing positive involvement with both parents.

Adaptation, Psychological↗

Adjusting to change: linking family structure transitions with parenting and boys' adjustment.

This study examined links between family structure transitions and children's academic, behavioral, and emotional outcomes in a sample of 238 divorcing mothers and their sons in Grades 1-3. Multiple methods and agents were used in assessing family process variables and child outcomes. Findings suggest that greater accumulations of family transitions were associated with poorer academic functioning, greater acting-out behavior, and worse emotional adjustment for boys. However, in all three cases, these relationships were mediated by parenting practices: Parental academic skill encouragement mediated the relationship between transitions and academic functioning, and a factor of more general effective parenting practices mediated the relationships between transitions and acting out and emotional adjustment.

Adaptation, Psychological↗

Long-term effectiveness of behavioral versus insight-oriented marital therapy: a 4-year follow-up study.

Four-year follow-up data regarding marital status and marital accord were obtained for 59 couples receiving either behavioral (BMT) or insight-oriented (IOMT) marital therapy in a controlled outcome study. Although no significant group differences had been observed between the 2 treatment conditions at either termination or 6-month follow-up, by 4-year follow-up a significantly higher percentage of BMT couples had experienced divorce (38% for BMT couples compared with 3% for IOMT couples). Results are compared with previous outcome research in this area, and recommendations are made for further research.

Behavior Therapy↗

Can group interventions facilitate forgiveness of an ex-spouse? A randomized clinical trial.

This study evaluated the effectiveness of 2 versions of an 8-session forgiveness group intervention for divorced individuals. Participants (randomized, n=192; analyzed, n=149) were randomly assigned to a secular forgiveness condition, a religious forgiveness condition, or a no-intervention comparison condition. Measures of forgiveness and mental health were obtained at pretest, posttest, and 6-week follow-up. Participants in both intervention conditions increased significantly more than comparison participants on self-reported forgiveness of an ex-spouse and understanding of forgiveness. Participants in the secular condition showed a greater decrease in depressive symptoms than comparison participants. Intrinsic religiousness did not moderate intervention effects.

Adult↗

Premarital education, marital quality, and marital stability: findings from a large, random household survey.

One of the limitations of experimental studies on the effectiveness of premarital education is the reliance on samples of mostly White, middle-class couples. In contrast, although survey methods allow only weak inferences about causal relations, representative surveys can yield important information about use and estimated effects across a diverse population. Using a large random survey of 4 middle American states, the authors found that participation in premarital education was associated with higher levels of satisfaction and commitment in marriage and lower levels of conflict-and also reduced odds of divorce. These estimated effects were robust across race, income (including among the poor), and education levels, which suggests that participation in premarital education is generally beneficial for a wide range of couples.

Adult↗

Predicting marital distress and dissolution: refining the two-factor hypothesis.

Measures of communication, hostility, and neuroticism taken from 85 couples from Germany before marriage were used to predict marital outcomes 5 years later. Hostility and neuroticism discriminated between couples who separated or divorced after 5 years and those who remained married, whereas communication discriminated between married-satisfied and married- dissatisfied couples. Only hostility and neuroticism predicted marital satisfaction at 18 months, suggesting that these factors contribute to rapid, early declines in marital functioning. The authors conclude that poor communication alone cannot account for the full range of marital outcomes and that skill-based models of marriage can be strengthened by considering relatively rare exchanges between partners (e.g., aggression) and their enduring vulnerabilities (e.g., neuroticism).

Communication↗

Children and their fathers after parental separation.

This two-year longitudinal study of 121 6-12-year-old children in the custody of their mothers following parental separation examined main and interacting effects of child's age and gender, frequency and regularity of visitation, father-child closeness, and parental legal conflict on children's self-esteem and behavioral adjustment at two time points. Predictors were found to have different implications for different groups of children and for children in different situations. Findings suggest the futility of seeking simple answers to whether ongoing contact with fathers following divorce is beneficial or detrimental for children.

Adaptation, Psychological↗

Clinical interventions with latency-age children of high conflict and violence.

Children who live in divorced families where conflict is high are often witness to intermittent or frequent verbal or physical aggression between their parents. A theoretical framework and a group treatment model with case vignettes are presented for understanding and intervening with latency-age children of such parents.

Child↗

Social trauma as related to cancer of the breast.

A number of writers, primarily in the field of psychophysiology, have suggested that breast cancer may be related to a variety of untoward psychological states and that these may be related in turn to having experienced misfortune in the social milieu. Other research has indicated that endocrine function may figure in the etiology of this disease. For these reasons, we wished to examine the relationship between the experiencing of social trauma which could induce endocrine effect and the development of cancer of the breast. We hypothesized that breast cancer cases, more often than controls, would have encountered traumatic incidents in their social milieu in the 5-year period prior to the diagnosis of their disease.Three hundred and fifty-two breast cancer cases and 670 controls with other types of cancer and non-neoplastic diseases of organs other than the breast and genitalia from Roswell Park Memorial Institute were interviewed. Comparisons were made concerning the extent to which the subjects and their immediate and extended families incurred such life events as death, divorce, illness, economic want, residential mobility, and feelings of being upset. No difference was found between the breast cancer cases and the controls either in the experiencing of single events or cumulative numbers of events by themselves or by members of their families. There may be events of a different type, not studied here, which are related to the development of cancer of the breast.

Adult↗

[Effects of depressive disorders on objective life quality criteria].

OBJECTIVE: This study examines the extent to which depression affects specific objective life quality parameters. The respective life quality parameters were investigated on a long-term basis and concern the social and material resources of those persons surveyed. METHOD: The database used for statistical evaluations originates from the longitudinal survey "Zurich Study" initiated in 1979. In this work the evaluations are limited to those persons who participated in all six structured interviews which took place between 1979 and 1999 (278 of initially 591 Persons). The effects of depression on the objective parameters of life quality were analyzed by linear and logistical regressions. RESULTS: According to this study, people suffering from depression show disadvantages regarding their living situation and their civil status. Among them one finds increased divorce and separation quota and they live more frequently alone than persons without depressive disorders. CONCLUSIONS: The findings refer to possible social withdrawal tendencies among people suffering from depression. Social withdrawal tendencies should be counteracted as far as possible by upholding or developing a network of firm contacts and relationships. Special attention should be paid in the therapy of depression patients to working out strategies for solving marriage crises or relationship conflicts.

Adult↗

[Physicians as patients--on the problem of the mentally ill physician].

The phenomenon of mentally ill physicians is hardly noticed in Germany today-a fact that possibly indicates a taboo. This investigation is to reveal the importance of the subject by referring to the findings of several major studies. Epidemiological data turn out to be of little reliability regarding for instance the number of impaired physicians with a range between 0.5-46%. Addiction and substance abuse can be found in 90% of all cases of mental illness. Increased suicide (3-4x), divorce (20x) and addiction rates (according to some authors 30-100x) in comparison with the average population emphasise the necessity of further investigation. These facts imply the question whether doctors are mentally more vulnerable than their patients. Special difficulties in treating doctor-patients deserve attention as only little is known how appropriate "iatrotropic" (psycho-)therapy can be carried out effectively.

Alcoholism↗

[Psychological considerations in the wish for refertilization].

51 women asking for refertilization were evaluated by means of a half-standardized questionnaire before laparoscopy. Special attention was directed towards the psychological situation at the time of sterilisation as well as the reasons for refertilization desired. In addition the Giessen-test was performed as standardized psychological personality inventory. In general, the sterilization was initiated by the women because of social, financial or marital difficulties. In 2/3 of the females sterilization was performed in association with other gynecological or obstetrical procedures. Most of the women did not have any kind of adequate psychological or social counseling. The desire for refertilization was mainly caused by changes in the personal situation. 29 of 51 women reported to have a new partner, 27 of them after divorce or separation, two after the previous partner's death. Ten women reported the loss of a child, however, 12 women desired refertilization without any obvious change in their private situation. In conclusion, it appeared that refertilization was desired and experienced as a real need as well as a result of a conflict in the women's self-understanding expressed by a tendency towards depression.

Adaptation, Psychological↗

Repeated sexual abuse allegations: a problem for primary care providers.

Sexual abuse of children is a problem of epidemic proportions in the United States. Primary care providers, including pediatric nurse practitioners, are increasingly presented with the problem of alleged sexual abuse in their patients, and primary care providers typically find it difficult to perform medical evaluations of children for sexual abuse. Having a child present repeatedly with sexual abuse concerns that cannot be substantiated is a stressful and frustrating experience for primary care providers. A case study is presented that illustrates the complexity and difficulty of one such case. A review of the literature will discuss the impact of divorce and Munchausen syndrome by proxy on repeated allegations of sexual abuse. Implications for practice are discussed, and a plan that addresses repeated sexual allegations in primary care settings is outlined.

Child Abuse, Sexual↗

The development of structural complexity in the child's concept of family: the effect of cognitive stage, sex, and intactness of family.

Twenty-eight boys and 28 girls at each of the Piagetian preoperational, concrete operational, and formal operational cognitive stages were given an interview focusing on their concepts of family. Half of each group were from intact families, and half were from divorced families. Interviews were scored for two structural aspects of the concept of family: conceptual level, and use of dimensions that structure the concept. The complexity of children's concepts was strongly related to cognitive stage and, to a lesser degree, to sex. Frequency of use of concept dimensions was strongly affected by general developmental level, though not specifically cognitive stage, and by intactness of family, but to a lesser degree by sex. Specific information is provided on the effect of these factors on perceptions of family composition, parental roles, and breadth of family activities.

Adolescent↗