Views on Aging: How Caring for an Aging Parent Influences Adult Daughters’ Perspectives on Later Life

Approximately 24 million Americans provide informal (unpaid) care to a family member or friend who is disabled or ill. The most common informal caregiving relationship is that of an adult child providing assistance to an elderly parent. Women in midlife represent most of the unpaid caregivers for older adults, yet little is known about how providing care affects women’s beliefs about and desires for their own aging. The purpose of this study was to understand how being a caregiver affected adult daughters’ perspectives on their own late life. In-depth interviews were conducted with a diverse sample of 15 women between the ages of 50 and 65 who were providing care to an ill and disabled parent or parent-in-law. Analysis of the qualitative data revealed that caregivers were affected by the caregiving experience in five ways: gaining awareness, provoking fears, providing a comparison for current functioning, providing firsthand knowledge about aging, and providing an example of how to age. This study offers an alternative perspective on the well-documented negative consequences of caring for an older person, suggesting that caregiving encourages personal growth for adult daughters in midlife.     

Parent Care in the Context of Women's Multiple Roles

This article addresses the multiple roles held by women involved in parent care and the ways in which these roles affect the women's well-being. Research on women's roles (including that of caregiver) has been guided by two opposing perspectives, the scarcity hypothesis and the expansion hypothesis. Findings from our studies of role quality, role combinations, and role spillover have provided abundant evidence that the lives of these women cannot be easilycaptured by either the scarcity or the expansion hypothesis alone.     

Training Pediatric Psychologists for Perinatal Behavioral Health Services in a Pediatric Hospital

Although pediatric hospitals specialize in providing care to children and adolescents, at The Children’s Hospital of Philadelphia (CHOP), our team has been providing behavioral health services for two unique parent populations—parents with a child in the Newborn Infant Intensive Care Unit and pregnant women carrying fetuses with specific birth defects and receiving prenatal care in the Center for Fetal Diagnosis and Treatment. A new training program was developed to expand the scope of pediatric psychologists’ practice to include perinatal behavioral health services, specifically for these two unique parent populations served at CHOP. The program includes direct service provision for adult mental health concerns, as well as education and support to help families cope with the existing medical conditions. This article describes the training program and its implementation as a model of training for other pediatric hospitals. The roles of psychologists embedded in these units and hospital privileges are discussed.     

Role of siblings in adult daughters' anticipation of caregiving

Despite extensive research regarding adult daughters' experiences as caregivers to aging parents, little attention has been paid to how adult daughters anticipate future caregiving roles. The current study examines the impact of sibling networks on the caregiving anticipation of 103 adult daughters. Factors influencing the expectation and amount of support adult daughters anticipate include daughters' birth order and proximity to their mothers. Characteristics of the sibling networks, including percentage of sisters within the family, are also important to care anticipation.     

发展性阅读障碍与小脑异常：小脑的功能和两者的因果关系

发展性阅读障碍(下文简称为"阅读障碍")不仅会影响个人的终身发展,还会对社会造成沉重的经济负担,深入探讨相关的神经机制,对实现阅读障碍的早期预测和干预十分重要。以往关于阅读障碍神经机制的模型多集中于大脑,近些年的研究发现,阅读障碍也与小脑异常有关,但到目前为止我们仍不清楚两者的关系。通过总结最新的研究进展,我们发现小脑在阅读障碍中可能发挥着多种功能,且小脑异常与阅读障碍可能互为因果。在此基础之上,我们提出了"阅读中小脑与大脑的功能映射假说",旨在从一个全新的角度揭示小脑与阅读的关系,以及两者与大脑的关系。相关内容对全面揭示阅读障碍的神经机制,以及小脑在高级认知加工中的作用,具有重要的启示意义。     

Caregivers’ Level of Trust in Their Children's Health Care Providers

Trust in healthcare providers is associated with clinical outcomes among adult patients. Children with disabilities have complex health needs that place stress on caregivers. Consequently, they are increasingly likely to rely on their children's health care providers to ensure children's health care needs are met. However, no studies have explored factors affecting caregivers’ trust in their children's providers. We assessed caregivers’ trust in their children's providers and identified predictive factors of trust. The results indicate that children's disability condition, functional status, age, the providers’ specialty, and the type of health care plan are significant predicators of caregiver's trust. Specifically, caregivers of children with emotional/behavioral disabilities and children with poor physical or emotional/behavioral functioning reported less trust in their children's providers compared to caregivers of children without physical disabilities or no disability and those having higher levels of physical or emotional/behavioral functioning. In addition, caregivers of younger children had more trust compared to caregivers of older children. Caregivers of children enrolled in a managed care plan for physical health care reported less trust compared to caregivers of children in other organizational arrangements. Finally, caregivers reported more trust in physical health providers compared to mental health providers.     

Change in depressive symptoms among daughter caregivers: an 18-month longitudinal study.

This longitudinal study investigates, over an 18-month period, the caregiving experience of a probability sample of 115 daughters who provided care to an aging parent. The levels of depressive symptoms manifested by these daughters were relatively low, with only 23.5% scoring in the clinical range during the study. Nevertheless, there was substantive change in depressive symptoms among the daughters during the 18 months. Daughters with higher levels of mastery were more likely to use problem-focused coping strategies, which led to reductions in depression, whereas daughters with lower levels of mastery were more likely to use emotion-focused coping, which led to increased levels of depression. Mastery was higher when the caregiving role was shared with a sibling: it was lower if the daughter had other caregiving responsibilities and if the parent care recipient had elevated levels of behavior problems.     

Social roles, basic need satisfaction, and psychological health: the central role of competence

The authors propose that competence need fulfillment within valued role domains (i.e., spouse, parent, worker) will account, in part, for associations between autonomy and relatedness need fulfillment and psychological health. Testing these assertions in cross-sectional and longitudinal surveys of women in two independent community samples, the findings are the first to formally examine whether the satisfaction of competence needs within social roles accounts for associations between other types of need satisfaction and affective outcomes as well as depressive symptomology. Evidence supporting the hypothesis was stronger when examining individuals' affective health as compared to their depressive symptoms. Implications of the findings are discussed with regard to need fulfillment within social roles.     

Intergenerational effects of the Holocaust: patterns of engagement in the mother-daughter relationship

The present study explored the quality of engagement between mothers and adult daughters. Daughters of Holocaust survivors, European immigrants, and nonimmigrants were compared on mothers' protectiveness and care during their daughters' first 16 years, and on daughters' individuation from the family of origin. The survivor group perceived themselves as less individuated from both their parents than the other two groups. However, daughters in the three groups reported feeling equally intimate with their parents. There were no significant group differences found on intergenerational intimidation or competing loyalties. There was a tendency for mothers in the survivor group to be perceived as more indulgently protective. These findings suggest that the relationship between survivor mothers and their daughters may be characterized by a lower degree of individuation, though not at the cost of intimacy.     

Effectiveness of parent counselling in eating disorders

ABSTRACT

Eating Disorders (ED) are often severe illnesses entailing a heavy burden for families. Family therapy is recommended for young patients, but only a few studies have investigated therapeutic interventions with families tailored also to adult and longstanding patients. We recruited 87 families with daughters affected by an ED, aiming to assess the effectiveness of eight sessions of parent counselling. The primary outcome was the improvement of parents' coping abilities to achieve more effective support skills. Before treatment, 54% of parents showed poor coping resources whereas 43.7% of the sample improved after parent counselling. Parents with good coping resources responded significantly better to this treatment. Although future research is warranted, these preliminary findings support the effectiveness of parent counselling in ED.     

Pain: Biopsychosocial Mechanisms and Management

Traditionally, pain has been viewed as a sensory event warning of tissue damage or illness. This explanation fails to account for many of the experiences of people suffering from clinically painful conditions. Over the past two decades, a new biopsychosocial perspective on pain has emerged. This perspective emphasizes that pain is a dynamic process that not only is influenced by biological, psychological, and social mechanisms of pain, but also produces biological, psychological, and social changes that can affect future responses to pain. This review presents findings from recent studies of the biological, psychological, and social mechanisms of pain and discusses the implications of these findings for pain research, assessment, prevention, and treatment, as well as for health care policy.     

Stress, Rewards, and Change in the Centrality of Women’s Family and Work Roles: Mastery as a Mediator

Although research suggests that stress and rewards experienced in a social role are associated with changes in the centrality (or personal importance) of that role over time, little attention has been given to the mechanisms that account for this relationship. This study was conducted to examine change in role mastery as a mediator in the relationship between changes in role experiences (stress and rewards) and changes in centrality among 195 women who simultaneously occupied the roles of parent care provider, mother, wife, and employee. Regression analyses indicated that increases in parent care, mother, and employee stress eroded mastery in those roles. In addition, increases in rewards were associated with a bolstered sense of mastery in each of the four roles. Mastery was found to be a mediating mechanism in the relationship between stress/rewards and centrality in one of the four roles examined, the employee role. However, changes in womens perceptions of mastery were unrelated to the extent to which women changed the importance of their three family roles. These findings extend prior research by demonstrating that mastery is a mechanism through which stress and rewards are associated with centrality in the employee role.     

Young and Poor: The Well-Being of Adolescent Girls Living in Families Receiving Temporary Assistance for Needy Families Program

We present our findings on the current well-being of 125 adolescent girls living in families receiving Temporary Assistance for Needy Families Program (TANF) in terms of their health, mental health, and substance abuse status, academic performance, and teenage behaviors. This mixed-method study included separate structured face-to-face interviews with each adolescent and her mother. In addition, 20 daughters were randomly selected and completed more in-depth qualitative interviews. The findings suggest that generally the daughters were in good physical health although they reported mental health problems at about twice the rate that would be expected in a general pediatric sample. Further, about 3–5% of the daughters had a potential serious substance abuse problem. With respect to school, about 28% were not currently attending school although the majority of daughters who were attending school maintained a B average or better. Nearly two-thirds of the daughters reported being sexually active and almost 17% of the adolescents had children of their own, much higher than the 2.9% national rate of girls in this age cohort. While many of these daughters life circumstances may not be optimal, findings from both the quantitative and qualitative interviews with both mothers and daughters indicate that these daughters possess many strengths, abilities, and desires.     

Episodic emotions of Tshivenda cultural community mothers towards their adolescent children’s pregnancies

This study explored Tshivenda mothers’ emotional reactions to the learning of unplanned pregnancies of their adolescent daughters. Ten purposively selected mothers with early parent adolescent children were informants (age range = 40 to 55 years). They responded to semi-structured face-to-face interviews on their reactions to the learning of the pregnancies of their daughters. The interview data were thematically analysed. Findings suggest the mothers experienced anger and embarrassment, objective and subjective burdens supporting their early parent daughter, and fears for the health of their mother-to-be daughters. The mothers reported to cope with pregnancy of their daughters by religion supplication, acceptance and social support, as well as open communication with their adolescent daughters about the pregnancies.     

Parents’ experiences of starting and maintaining exercise: A qualitative systematic review

We conducted a systematic review of qualitative studies investigating the experiences of parents in relation to their uptake and maintenance of exercise, focusing on aerobic endurance-type exercise (e.g., running, cycling, swimming). The review aimed to synthesize qualitative findings relating to the motives, barriers, facilitators, emotions, and support of parents, and to suggest applied implications. Electronic bibliographic databases (Web of Knowledge, Google Scholar, Scopus, Academic Search Complete, and PsychArticles) were searched with relevant keywords to identify published peer-reviewed journal articles. Articles were included if they used a qualitative methodology to collect and analyse the data, and if they involved parents (of at least one child up to age 18) engaging in one or more type of aerobic endurance-type exercise from a position of limited fitness and parenthood. Ten studies were included in the final review, which used a narrative synthesis of data. Findings unique to the parent population were identified: parents were motivated to exercise as they believed it made them a better parent; mothers found it difficult overcoming the ‘ethic of care’; both mothers and fathers experienced the emotion of guilt, although its impact differed between parent roles; parenthood was associated with low confidence; and parents reported a lack of social support and self-regulatory capacity. These findings also reflect wider social determinants of health, in their racialized, gendered, and classed nature. To support parents in maintaining exercise uptake, the findings suggest that practitioners should promote reasons for exercise that align with parents’ core values to facilitate autonomous motivation.     

Young Women’s Accounts of Caregiving,Family Relationships,and Personal Growth When Mother Has Mental Illness

Family members often serve as the primary source of care and support for loved ones living with mental illness. Although existing research has examined the role of parents and well siblings in providing care to adult children with mental illness, relatively little is known about the caregiving experiences of adult children with a parent with a psychiatric disability. Guided by a life course perspective, the present qualitative study examined first-person accounts of 10 young women attending college (ages 18–22) who were raised by a mother living with mental illness (depression, bipolar, or schizophrenia). Participants completed individual semi-structured interviews in which they described their experiences of caregiving, role reversal, and felt obligation towards mother, their ties to father and siblings, and their views of the impact of maternal mental illness on their lives. Overall, young adults’ accounts of their relationship with mother could be characterized as either predominately positive or predominately negative. In general, participants’ accounts of their caregiving experiences, views of felt obligation, and supportiveness of family ties differed depending on their reports of the overall quality of the mother–daughter relationship. Adult daughters described positive impacts of maternal mental illness on their own lives, regardless of their accounts of relationship quality with their mothers.     

HOW PATIENTS COMMUNICATE ABOUT THEIR ILLNESS

This article presents two empirical investigations of how patients communicate about their illness. A review of the literature on provider-patient communication is offered. From this review, we conclude that we know intuitively more about the interaction between health care providers and their patients than the research literature has revealed. A series of research questions are advanced concerning the patient's communicative contributions to the provider-patient relationship. The first study offers evidence of distinct patient-communication typologies. How patients communicate about their illness is also closely related to how they utilize the health care system. The second study uses independent raters to validate patient self-reports about their communication behavior. The findings suggest that how patients communicate to health care providers is a factor worthy of further study. Several specific avenues for future research are discussed in light of these findings.     

Relationships Among Emerging Adult Psychological Problems,Maltreatment, and Parental Psychopathology: Moderation by Parent–Child Relationship Quality

Current research supports clear relationships between parental psychopathology, parental maltreatment, and emerging adult child psychopathology. Less research has examined how the role of the parent–child relationship influences these existing associations. The current study tested two models that examined the moderating effect of parent–child relationship quality on parental psychopathology and emerging adult mental health as well as the effect on parental maltreatment and emerging adult mental health. It was expected that high parent–child relationship quality would buffer against the negative effects of parental psychopathology and maltreatment while enhancing the effects of functional parenting characteristics. Participants included 1,452 emerging adults, predominantly Caucasian (73.3%) college students who completed surveys on their mental health, recent experienced maltreatment, and their parents’ mental health problems. Results suggested lowest rates of mental health problems for emerging adults were associated with higher parent–child relationship quality and lower parental psychological problems, whereas negative outcomes were associated with higher parental psychopathology, regardless of parent–child relationship quality. Additionally, physical maltreatment was associated with lower rates of mental health concerns in the context of higher mother-daughter relationship quality. Results emphasize the continuing impact of the parent–child relationship, particularly the mother-daughter relationship, on emerging adults’ mental health. Moreover, the current study demonstrates the continuing influence of parents on their emerging adult children.     

Traditional and Nontraditional Women's Attributions of Responsibility to Physically Resistive and Nonresistive Rape Victims1

This research examined the interactive effect of women observers' sex-role attitudes and a victim's use of physical resistance on perceptions of victim responsibility for a sexual assault. Women read one of two rape scenarios in which a victim either did or did not physically resist a rapist's attack and made judgments concerning victim responsibility. The observers were categorized as being either traditionally conservative or nontraditionally profeminist in their attitudes toward women and their roles in society. An analysis of responsibility judgments indicated that traditional women perceived a victim who resisted the attack as being more responsible for her own victimization than did nontraditional women, whereas nontraditional women assigned more responsibility to a victim who did not resist than did traditional women. These results are considered from a sex-role socialization perspective; the implications of these findings for legal and health care professionals are discussed.