Depression, Psychological Resources, and Health-Related Quality of Life in Older Adults 75 and Above

The purposes of this study were (1) to compare psychological resources and health-related quality of life between two groups of community-dwelling elders, 75 years of age and older, with similar chronic illnesses, but with varying levels of depression, and (2) to examine the relationships among depression, psychological resources, and health-related quality of life. Fifty-two elders (14 men and 38 women) were divided into mildly (n = 18) and severely (n = 34) depressed groups based on their depression scores. There were no significant differences between the two groups for demographic and illness characteristics. There were significant differences for number of medications, mastery, health perceptions, mental health functioning, and well-being. Severely depressed elders had poorer health perceptions, and decreased mastery, functioning, and well-being as compared with mildly depressed elders. An explanatory model was developed using factor analysis that fit the data well. Health perceptions and mastery had direct influences on depression, and depression directly impacted well-being.     

Elder Mistreatment among Chinese and Korean Immigrants: The Roles of Sociocultural Contexts on Perceptions and Help-Seeking Behaviors

The purpose of this study was to identify dimensions of elder mistreatment in Chinese and Korean immigrant communities and to increase sociocultural understanding of such mistreatment by elucidating the complexities of abuse embedded in unique social and cultural contexts. In-depth interviews were conducted with 20 local professionals working primarily in Asian elderly advocacy, and six focus group discussions were conducted involving 60 community members in the San Francisco Bay area. Five dimensions of elder mistreatment were identified: psychological abuse, neglect by a trusted person, financial exploitation, physical abuse, and sexual abuse. In general, fewer Korean community member participants reported having observed physical or financial abuse than Chinese groups, but they reported greater knowledge of situations involving psychological abuse, neglect by a trusted person, and sexual abuse. The contexts of cultural influences and immigration and acculturation were salient themes that shaped participants’ subjective perceptions and beliefs about elder abuse and hence help-seeking behaviors.     

Psychometric Evaluation of the Japanese Version of the Elder Life Adjustment Interview Schedule for Depression

The Elder Life Adjustment Interview Schedule (ELAIS) was developed as an age- and culture-sensitive assessment device for depression and 9 environmental, behavioral, and health correlates (Schlatter et al., 1993, J. MARC Res. 1: 27–42). The psychometric adequacy of the ELAIS has been demonstrated with samples of elder Americans of Asian, Caucasian, and Native Hawaiian ancestry (Dubanoski et al., 1996, J. Clin. Gerospsychol. 2: 247–262). This study reports on the reliability and construct validity of a translated Japanese version. Participants were 55 community-dwelling elders living in the areas surrounding Maebashi, Japan. The ELAIS contains 14 scales of which 9 represent theoretical predictors of depression. The 2 Environmental Condition scales measure life events and social support. The 4 Behavioral Competency scales measure recreational activity, assertiveness, self-reinforcement, and perceived control. The 3 Health Factor scales measure perceived health, functional ability, and objective health. The 5 Other scales measure demographics, depression, life satisfaction, cognitive functioning, and response style. Results yielded acceptable internal consistency and stability reliability coefficients for all but 1 of the subscales on the ELAIS (informational social support). Construct validity support was found for the Depression scale and 6 theoretical predictors, including life events, recreational activity, assertiveness, self-reinforcement, functional ability, and objective health. Treatment and prevention implications for the cross-ethnic multivariate assessment of depression among elders are discussed.     

Toward a Better Understanding of Psychological Well‐Being in Dementia Caregivers: The Link Between Marital Communication and Depression

To read this article's abstract in both Spanish and Mandarin Chinese, please visit the article's full‐text page on Wiley InterScience ( http://interscience.wiley.com/journal/famp ). Dementia research has frequently documented high rates of caregiver depression and distress in spouses providing care for a partner suffering from dementia. However, the role of marital communication in understanding caregiver distress has not been examined sufficiently. Studies with healthy couples demonstrated an association between marital communication and the partners' psychological well‐being, depressiveness, respectively (e.g., Heene, Buysee, & Van Oost, 2005 ). The current study investigates the relationship between caregiver depression and communication in 37 couples in which the wives care for their partners with dementia. Nonsequential and sequential analyses revealed significant correlations between caregiver depression and marital communication quality. Caregivers whose husbands used more positive communication reported less depression and distress. Additionally, caregiver depression was negatively correlated with rates of positive reciprocal communication indicating dependence between the couples' interaction patterns. This study is one of the first to illustrate the relevance of spousal communication in understanding caregiver distress and depression.     

Family,friend, and neighbour child care providers and maternal well‐being in low‐income systems: An ecological social perspective

Integrating theory from the family ecological systems and social support literatures with findings from child care research, in this study we develop and test a model relating family, friend, and neighbour (FFN) child care provider characteristics to perceived child care quality (provider reports of caregiving behaviours, mother‐provider caregiving relationship) and maternal well‐being (work‐family conflict, depressive symptoms). Results from phone interviews with 187 FFN providers receiving public subsidies indicated that even after controlling for familial status or household income, caregiver perceptions of higher quality care were associated with higher education levels, greater attachment to child care as a job; and lower provider depressive symptoms. After controlling for familial status, data analysed from a subset of 51 mother‐provider pairs, indicated that mothers using care from providers who reported higher quality parent‐caregiver social relationships reported lower work‐family conflict and depressive symptoms. This study suggests mothers who have providers with whom they have good caregiving interactions may experience positive social support and psychological crossover dynamics associated with mother well‐being.     

Depression and quality of informal care: a longitudinal investigation of caregiving stressors

This research examined longitudinal associations between caregiving stressors, caregiver depression, and quality of care. Informal caregivers of elderly care recipients were interviewed at baseline (N = 310) and again one year later (N = 213). Hierarchical regression analyses indicated that increases in caregiving stressors (i.e., caregiver physical health symptoms, caregiver activity restriction, and care recipient controlling and manipulative behavior) were related to increased caregiver depression. In turn, increased caregiver depression and decreased caregiver respectful behavior predicted increases in potentially harmful behavior. These results extend previous cross-sectional findings and indicate that changes in caregiving stressors, caregiver depression, and caregiver respect over time may signal that intervention is warranted in order to forestall or prevent poor quality of care.     

Negative and positive health effects of caring for a disabled spouse: longitudinal findings from the caregiver health effects study

Data from the first 2 waves of the Caregiver Health Effects Study (n = 680) were analyzed to examine the effects of changes in caregiving involvement on changes in caregiver health-related outcomes in a population-based sample of elders caring for a disabled spouse. Caregiving involvement was indexed by levels of (a) spouse physical impairment, (b) help provided to the spouse, and (c) strain associated with providing help. Health-related outcomes included perceived health, health-risk behaviors, anxiety symptoms, and depression symptoms. Increases in spouse impairment and caregiver strain were generally related to poorer outcomes over time (poorer perceived health, increased health-risk behaviors, and increased anxiety and depression), whereas increased helping was related to better outcomes (decreased anxiety and depression). Results suggest that caring for a disabled spouse is a complex phenomenon that can have both deleterious and beneficial consequences.     

Sexual risk as an outcome of social oppression: data from a probability sample of Latino gay men in three U.S. cities

Based on data from a probability sample of 912 Latino gay men in 3 U.S. cities, a multivariate model of sexual risk was tested, including experiences of homophobia, racism, and poverty as predictors. Participants reported multiple instances of verbal and physical abuse, rude mistreatment, and discrimination on account of their sexual orientation and their race or ethnicity. Many reported experiences of poverty, such as inability to pay for basic necessities of food or shelter. Men who reported more instances of social discrimination and financial hardship were more psychologically distressed and more likely to participate in "difficult" sexual situations, as predicted. Participation in difficult sexual situations mediates the effects of social oppression and psychological distress on sexual risk behavior.     

Demographic factors,childhood maltreatment and psychological functioning among university students' in Ghana: A retrospective study

This study retrospectively investigates the influence of child (i.e., gender), care‐giver (e.g., who grew up with), household size (i.e., number of siblings grew up with) and community (i.e., rural versus urban) factors on childhood maltreatment, as well as the impacts of maltreatment on psychological functioning. A cross‐sectional survey and self‐report methodology is used to gather data from 300 students of the University of Ghana. The results show that being a male, growing up in rural areas, living with more than 3 siblings in the same household and being raised by both biological parents have significant main effects on childhood maltreatment. Analyses of the interaction effects show that living with more than 5 siblings in a rural household with “other” parents (i.e., non‐biological parents) has a significant effect on physical abuse. Furthermore, males from rural households consisting of more than 3 siblings and who did not grow up with both biological parents endorsed significantly more physical abuse and physical neglect, compared with the females. With respect to the psychological outcome, childhood maltreatment significantly predicts and account for significant variance in depression (34%), self‐efficacy (18%) and life satisfaction (22%). The findings and the implications of the study are briefly discussed.     

Trauma and autobiographical memory specificity in depressed inpatients

Research on autobiographical memory has shown that clinical depression is associated with a difficulty in retrieving specific autobiographical memories in response to cue words. This study examined the relation between lack of autobiographical memory specificity and self-reported trauma in a group of depressed adults (N = 23). In addition to the Autobiographical Memory Test (AMT; Williams & Broadbent, 1986) participants completed a number of questionnaires assessing the presence of traumatic experiences in the past, level of depression and neuroticism. The number of specific responses was not related to depression severity, but was significantly associated with the presence and severity of reported physical abuse. Participants who had been victim of physical abuse were less specific than participants who had not been confronted with such physical adversities. The results are discussed in the context of a functional hypothesis about the developmental relations between memory specificity, trauma and depression.     

Reduction of caregiver burden in Alzheimer's disease by treatment with galantamine

Alzheimer's disease is a progressive condition characterized by a loss of cognition, altered behavior, and a loss of functional ability, such as bathing, dressing, toileting, and organizing finances. Family and friends provide nearly three quarters of all care for patients with Alzheimer's disease. This informal care results in significant burden to caregivers. Caregiver burden is the set of physical, psychological or emotional, social, and financial problems that family members may experience when caring for impaired older adults. Caregivers of Alzheimer's disease patients report higher rates of physical symptoms, mortality, depression, and fatigue, as well as adverse effects on employment compared with those who are not caregivers for Alzheimer's disease patients. In many cases, the same family members are responsible for both out-of-pocket expenditures and caregiving duties. For this article, a MEDLINE search using the key words "caregiver and Alzheimer's disease" and "cost and Alzheimer's disease" was performed. The purpose of this article is to review the literature on caregiver burden, the components of caregiver burden, effects of caregiving on the health of caregivers, the cost of Alzheimer's disease on the caregiver and society, and the benefits attainable with treatment.     

Psychological Distress in Caregivers of Liver and Lung Transplant Candidates

Although organ transplantation represents a stressful experience for the entire family, surprisingly little research has focused on the adjustment of caregivers. The purpose of this study was to examine what caregivers report to be the greatest benefits and stressors pretransplant, the prevalence of psychological distress and caregiver strain in pretransplant caregivers as compared to normative populations, and the physical, psychological, and demographic variables that predict distress. Fifty-two caregivers of transplant candidates (28 liver and 24 lung) completed a series of questionnaires, including the Psychosocial Adjustment to Illness Scale (PAIS-SR), SF-36 Health Survey, Caregiver Strain Index (CSI), and qualitative questions about benefits and stressors. The most commonly reported benefit of being a caregiver could be categorized as Helping the Patient, and the most common stressors were associated with Uncertainty/Waiting/Fears. Compared to normative samples of caregivers of patients with Alzheimer's disease, caregivers of liver transplant candidates reported more caregiver strain; there were no differences for lung transplant caregivers. Caregiver social functioning was found to be the only significant predictor of caregiver distress, with those caregivers who report greater distress also reporting extreme and frequent interference with normal social activities. Implications of these findings for psychological interventions are discussed.     

An advocacy intervention program for women with abusive partners: Six-month follow-up

Presented the 6-month follow-up findings of an experimental intervention designed to provide postshelter advocacy services to women with abusive partners. The intervention involved randomly assigning half the research participants to receive the free services of an advocate, 4 to 6 hours per week, for the first 10 weeks postshelter. One hundred forty-one battered women were interviewed about their experiences immediately upon their exit from a domestic violence shelter: 95% of the sample were interviewed 10 weeks thereafter (postintervention), and 93% were successfully tracked and interviewed 6 months later. At the 6-month follow-up, participants in both groups reported increased social support, increased quality of life, less depression, less emotional attachment to their assailants, and an increased sense of personal power. Although women in both groups reported some decrease in physical abuse over time, there were no statistically significant differences between those with and those without advocates, and abuse continued to be a problem for many women. Those who were still involved with their assailants continued to experience higher levels of abuse and had been more economically dependent upon the men prior to entering the shelter. Women who had worked with advocates continued to report being more satisfied with their overall quality of life than did the women in the control group. The authors thank the Editor and anonymous reviewers for their helpful comments. Thanks also to all present and past staff of the Community Advocacy Project, who helped in data collection and analyses. This work was supported by National Institute of Mental Health Grant 1R01 MH 44849.     

Emotional Abuse: Correlates to Abuse Among College Students

Emotional abuse, also known as psychological maltreatment, is a significant health problem. Long-term outcomes of emotional abuse are quite negative and include physical and mental health disorders. The present study examined emotional abuse and correlates to such abuse among college students. The American College Health Association–National College Health Assessment II was completed by study participants at one urban, Midwestern university. A total of 777 students participated in the survey. Greater than one in 10 (10.7%) students reported being emotionally abused in the past year. The final logistic regression model found being female, being an older student, recent marijuana use, and being so depressed it was difficult to function were significant predictors of emotional abuse. Study findings suggest it may be important to screen high-risk students for emotional abuse as part of mental health treatment or other medical screenings. Given that one in 10 students experienced past year emotional abuse, it may also be crucial to raise awareness of emotional abuse on college campuses.     

Child, Family and Case Characteristics: Links with Service Utilization in Physically Abused Children

We investigated the relationships between child, familial, and case characteristics and mental health and medical health care service utilization by physically abused children. Participants included 26 parents or caregivers of 37 Medicaid-eligible children who had substantiated cases of physical abuse. Children whose female caregivers reported a greater number of stressors were more likely to receive mental health care. Furthermore, children not living with the maltreating caregiver were more likely to receive medical health care services. Results are discussed in terms of factors that may account for these links, and the similarities of these findings with those of service utilization in general and clinical child samples.     

Perception and Help-Seeking Intention of Intimate Partner Violence in Later Life: An International Perspective

This study examines whether elderly Koreans recognize a scenario of intimate partner violence as such and whether they would seek help in the given situation of elder mistreatment (EM). Two cohorts of Korean elders (one immigrant and one Korea-based), each numbering 124 participants, were recruited using a quota sampling strategy. The study used a mixed method approach, employing a hypothetical scenario, and patriarchy theory informed the study. Findings revealed low perception of the vignette as EM and low help-seeking intention in both cohorts. Among the immigrant cohort, intention to seek help was greater among respondents who were female, demonstrated lower adherence to traditional values, and perceived the vignette as EM. Among the Korea-based cohort, the only significant factor was recognition of the scenario as EM. Development of culturally competent and geographically specific practice and intervention is urgently needed, particularly among elders who have greater adherence to traditional cultural values.     

Childhood trauma and parental bonding among Japanese female patients with borderline personality disorder

The present study explored the relationship between borderline personality disorder (BPD) and childhood trauma and perceived parental behaviours among a sample of Japanese female outpatients. Participants were 45 female patients who were diagnosed with BPD and 45 female patients with a diagnosis of other nonorganic psychological disorders (aged 19 to 53). The participants completed surveys that assessed recollection of childhood abuse and neglect, perceived parental-rearing behaviours, and symptoms of BPD. MANOVAs and logistic regression analyses were conducted in order to analyse the data. The results showed that the patients with BPD reported more severe forms of childhood traumas, including emotional, physical, and sexual abuse and emotional and physical neglect, than did the non-BPD patients. This is consistent with previous findings in North America that have reported higher prevalence and greater severity of various childhood traumas in individuals with BPD compared with those with non-BPD disorders or nonclinical samples. This study also found that the patients with BPD recalled both of their parents as more overprotective/controlling and less caring than did the non-BPD patients. Last, logistic regression analyses found significant predictors of BPD diagnosis were reported emotional abuse and neglect as well as perceived paternal overprotection. Overall, these results indicate that whereas psychological risk factors in Japan are similar to those reported elsewhere, the same pathology can emerge from somewhat different causal pathways.     

Definition of Financial Abuse: A Culture-Centered Construct among Korean Elders

One of the critical issues in addressing financial abuse in Korea is the absence of an appropriate definition voiced by the elderly. This study is designed to explore how Korean elders define financial abuse in given social and cultural contexts. Face-to-face, in-depth interviews were conducted with 124 elders, aged 60 to 79, residing in Korea. The results of qualitative data analysis using grounded theory revealed that a vast majorty of Korean elderly respondents defined financial abuse as lack of provision of financial support to elder parents, and a small portion of respondents defined it as financial exploitation by adult children. The definition of financial abuse reflects cultural beliefs based on filial piety about financial expectations within the parent–child relationship. Education on financial abuse for both elders and their adult children and establishment of income support programs are urgently needed efforts to increase the financial well-being of elderly Koreans.     

Obscene telephone calls to children: a retrospective field study

Studied a sample of 24 Danish children selected from a larger group of 56 children who had received obscene telephone calls from a single adult offender to ascertain the psychological consequences of this form of sexual abuse. The sample is unusual in that the source of the abuse was the same for all of the children, and none of them had records of prior or concurrent abuse from other sources. Almost all children suffered significant psychological consequences from these calls, those who obeyed the caller's demands experiencing more serious consequences than those who did not. A comparison was made with the consequences suffered by an additional group of 7 children who had experienced direct physical sexual abuse by the same offender.