Parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China

The objective of this study was to examine the relationship between parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China. In this study, cross-sectional data were collected from 755 AIDS orphans (296 double orphans and 459 single orphans), 466 vulnerable children living with HIV-infected parents, and 404 comparison children in China. The trusting relationship with current caregivers was measured with a 15-item scale (Cronbach's α?=?0.84) modified from the Trusting Relationship Questionnaire developed by Mustillo et al. in 2005 (Quality of relationships between youth and community service providers: Reliability and validity of the trusting relationship questionnaire. Journal of Child and Family Studies, 14, 577-590). The psychosocial measures include rule compliance/acting out, anxiety/withdrawal, peer social skills, school interest, depressive symptoms, loneliness, self-esteem, future expectation, hopefulness about future, and perceived control over the future. Group mean comparisons using analysis of variance suggested a significant association (p?相似文献   

Communal Behaviors and Psychological Adjustment of Family Caregivers and Persons With Spinal Cord Injury

OBJECTIVE: Examined the influence of mutual communal behaviors on the adjustment reported by persons with spinal cord injury (SCI) and their family caregivers. Previous research has found that persons who have a history of mutually communal behaviors in relationships may react differently to relationship changes after an acquired physical disability than dyads with few communal behaviors. METHOD: Family caregivers and persons with SCI were administered measures of mutual communal behaviors, depression, and life satisfaction. Structural equation modeling was used to test the relations among caregivers' communal behaviors and care recipients' communal behaviors, depression, and life satisfaction. RESULTS: Caregiver and care recipient reports of communal behaviors were not significantly correlated. Significant paths indicated that care recipients' communal behavior scores were positively associated with their life satisfaction, and care recipients' depression was inversely associated with their life satisfaction. Caregivers' communal behavior scores were unrelated to their self-reported adjustment. CONCLUSIONS: Caregiver-care recipient dyads may differ in their perceptions of communal behaviors in their relationships. Although care recipient reports of communal behavior may be related to their life satisfaction, communal behaviors may not serve a similar function among caregivers of persons with SCI.     

Burden, depression, and anxiety in caregivers of people with amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is a progressive and fatal neurodegenerative disease caused by the degeneration of motor neurons. The burden for ALS caregivers is quite high. There are still few studies that have investigated the emotional impact of ALS care. We conducted a cross-sectional study among 40 ALS caregivers, assessing general worries, burden of care, depression, anxiety, perception of social support, and patients' severity of disease. Caregiver burden, depression, and anxiety were positively related with each other, and all these variables had a negative relation with social support. Patient's loss of physical functions was positively related with caregiver burden, anxiety, and somatic expression of depression. Caregivers expressed worries for their own health conditions. Given these results, we consider the hypothesis of an emotional-somatic impact of ALS care. The implications and limitations are discussed.     

Unemployment,Self-Esteem,and Depression: A Social Comparison Theory Approach

A social comparison theory approach to the relation between unemployment, self-esteem, and depression was tested using a cross-sectional questionnaire design (N = 88). Personal attributes were used as the domain of comparison, and four types of comparisons-intrapersonal, interpersonal, intragroup, and intergroup-were operationalized. Employment status affected the salience of intrapersonal comparisons. Comparisons with the past self were highly predictive of psychological distress among unemployed respondents, whereas comparisons with the ideal self predicted distress among the employed. Individual-level and group-level social comparisons had different associations with the dependent measures for unemployed respondents. Intrapersonal and interpersonal comparisons were significantly related to depression and self-esteem scores, whereas intragroup and intergroup comparisons were related only to self-esteem. Social comparisons with unemployed people were related to reduced depression levels among employed respondents. Results also showed that unemployed people had more negative social comparison scores relative to their employed counterparts. Results are discussed in terms of recent developments in social comparison theory. Suggestions for future research are outlined.     

Examining the feasibility of the integrated hope scale in American college students

The Integrated Hope Scale (IHS) provides a multi-dimensional evaluation of factors common across measures of hope, examining social relationships, trust and confidence, perspectives of the future, and a lack of hopefulness. Despite promise for the instrument’s utility, research on the IHS is sparse has been limited to non-English-speaking populations, requiring translated items, and the cross-cultural transportability of hope constructs has previously been raised. Predominant theories of hope used in American populations have been criticized for not measuring important aspects that are included within the IHS. Using confirmatory factor analysis and latent class analysis, this study explored the IHS’s structural integrity and interpretive potential using a regionally and racially diverse sample of American college students. Results suggest that the IHS offers a valid global assessment of hope as well as for targeted measurement of discrete areas identified by instrument factor scores. The IHS also shows promise in differentiating individuals according to their level of hopefulness.     

Depression, self-esteem, loneliness, and social support among adolescent mothers participating in the new parents project

The purpose of this pilot study was to examine levels of depression, self-esteem, loneliness, and social support, and the relationships between these variables, among adolescent mothers participating in the New Parents Project (formerly called the Young Parents Project). The sample consisted of 21 adolescent mothers recruited from three primary health care practices in different Midwestern cities. It was found that depression scores were in the high range (CES-DC > 15) for 53% of the participants. Strong, significant relationships were found, except between depression and self-esteem. The implications for enhancement of the New Parents Project, so as to better meet the psychological needs of adolescent mothers, are discussed.     

流动儿童歧视知觉与心理健康水平的关系及其心理机制

为了探讨流动儿童所感受到的歧视对他们心理健康水平的影响, 以及应对方式和自尊在其中所起的作用, 从北京市公立学校和打工子弟学校选取1164名流动儿童、从公立学校选取525名北京儿童、从流动儿童主要来源地的农村选取568名农村儿童作为被试, 采用问卷调查的形式, 测查了流动儿童感受到的歧视、他们的心理健康水平(社交焦虑、孤独感、抑郁)、应对方式和自尊。研究发现: (1) 流动儿童所感受到的社会歧视在学校类型、流动性上存在显著的差异, 打工子弟学校的流动儿童得分显著高于公立学校的, 流动性高的儿童得分显著高于流动性低的, 但在性别上不存在显著差异, 也不存在学校类型与性别和流动性的交互作用; (2) 流动儿童的心理健康水平在性别、学校类型和流动性上存在显著的差异, 女孩、来自公立学校的流动儿童、流动性高的儿童的心理健康水平显著差于与之相对应的被试, 除在社交焦虑和抑郁上存在学校类型和性别的交互作用外, 在孤独感上不存在学校类型和流动性的交互作用; (3) 不同类别儿童在心理健康水平上存在显著差异, 流动儿童在社交焦虑、孤独感上最差; (4) 除消极应对与自尊、积极应对与抑郁相关不显著外, 歧视、心理健康水平、应对方式、自尊两两之间都相关非常显著; (5) 歧视知觉对心理健康水平有显著的直接影响, 也通过应对方式和自尊对心理健康水平产生显著的影响。自尊不仅在歧视知觉与心理健康水平之间起到显著的部分中介作用, 在应对方式和心理健康水平之间也起到了显著的部分中介作用。     

Self-esteem reconsidered: unstable self-esteem outperforms level of self-esteem as vulnerability marker for depression

Previous studies have built up evidence that an unstable self-esteem is associated with vulnerability to depression and that it outperforms level of self-esteem as a predictor for symptoms of depression. However, most of these studies have used student samples exclusively to investigate the role of self-esteem instability in depression vulnerability. Our present study used samples of currently depressed inpatients, formerly depressed individuals, and never-depressed controls to investigate the relationship between self-esteem instability and depression. In addition, we examined the predictive validity of self-esteem instability in predicting future depressive symptoms. The results indicate that self-esteem instability is associated with depression and vulnerability to depression. Furthermore, self-esteem instability interacted with perceived stress variability and depressed mood variability in predicting future depressive symptomatology at six months follow-up. These results are in line with the diathesis-stress model and support the hypothesis that self-esteem instability might be more important than level of self-esteem in predicting vulnerability to depression.     

Rural Hispanic Adolescents at Risk for Depressive Symptoms

Levels of depression among rural Hispanic adolescents were assessed. Psychological factors affecting depression were examined. Included were family characteristics, measured by the Background Information Questionnaire; self-esteem, by the Piers-Harris Children's Self-Concept Scale; perceived stress level, by the Hispanic Children's Stress Inventory; acculturation, by the Cuellar Acculturation Index; and depression levels, by the Center for Epidemiological Studies-Depression Scale. Results revealed moderate to severe depression symptomatology among 33% of the subjects, and mild depression symptoms among 17%. Two family structure variables, birth order and number of brothers, were significantly related to depression. Gender was an important predictor of depression, as was self-esteem. Higher stress scores were related to higher levels of depression.     

The clergy as advocates for the severely demented

The author sets forth the argument that pastoral caregivers ought to consider expanding their traditional role of ministering to dementia patients by pressing the issue of whether appropriate medication might significantly lessen the suffering of these persons. After discussing and documenting the current understanding regarding the nature of pain, the author outlines several advocacy, ethical, and procedural issues that could be included in providing pastoral care to this population, at the same time not miminizing more traditional faith-based activities.     

Representing the Good: Pastoral Care in a Secular Age

In ‘a secular age’ (Taylor 2007), pastoral care is no longer exclusively associated with specific religious traditions and communities. Pastoral caregivers who work in secular institutions provide care to religious and nonreligious people alike, and in several Western societies the term pastoral care is used in relation to nonreligious (humanist) care. In secular contexts, the term ‘pastoral care’ is often replaced by the term ‘spiritual care.’ Spiritual care, however, is provided by various professionals, so pastoral caregivers face the challenge of developing adequate and convincing language to explain what is distinctive about their work. In this article, the authors turn to philosophical language in order to develop a conceptual understanding of pastoral care that does not depend on the specific worldview—religious or nonreligious—of either pastoral caregivers or receivers of pastoral care. Using the work of Taylor (1989, 2007) and Murdoch (1970), we explain pastoral care as engaging with people’s attempts to orient in ‘moral space’ and the distinctive quality of pastoral care as ‘representing the Good.’ Murdoch associates ‘the Good’ with a secular idea of transcendence that is both a movement beyond the ego and an engagement with the reality of human vulnerability, suffering, and evil. We argue that pastoral caregivers who ‘represent the Good’ have the task not only of supporting the existential and spiritual processes of individuals but also of promoting dialogue and social justice and of critiquing dehumanizing practices in the organizations in which they work and in society at large.     

Depressive thinking and depression: relations with personality and social resources

The mechanisms by which social supports and personality variables may buffer against psychopathology are not well understood. We studied depression, depressive cognitions, social supports, and self-esteem in a sample of 68 spouse-caregivers of patients with Alzheimer's Disease in an attempt to identify possible buffering mechanisms of the latter two variables. Specifically, we hypothesized that the well-known relation of depressive cognitions to depression would vary as a function of satisfaction with social supports and with level of self-esteem. Hierarchical multiple regression analyses conducted to predict depression revealed significant and independent main effects for depressive cognitions (p less than .01), social supports (p less than .025), and self-esteem (p less than .001), with depressive cognitions associated with higher depression and the other two variables associated with reduced depression (R2 = .53 for the three main effects). In addition, the relation of depressive cognitions with depression varied substantially depending on the level of social supports (p less than .01); caregivers with high levels of depressive cognitions had high levels of depression only if social supports were low (R2 = .61 including interaction). Self-esteem and depressive cognitions showed a similar interaction, but it failed to reach significance. Analyses to determine whether self-esteem and social supports were directly associated with lower depressive cognitive activity yielded a main effect for self-esteem only (p less than .03). Thus, whereas social supports and self-esteem were directly associated with lower depression, only the social supports variable was further associated with reduced depression because it apparently buffered the impact of depressive thinking. Self-esteem was also indirectly associated with lower depression via its relation with lower depressive thinking. Implications of our results for cognitive theories of depression and for the psychosocial mechanisms of stress buffering are discussed.     

Chronic stress and depressive disorders in older adults

Current and lifetime rates of Diagnostic and Statistical Manual (rev. 3rd ed.) disorders were compared in 86 older adults caring for a spouse with a progressive dementia and 86 sociodemographically matched control subjects. Dementia caregivers were significantly more dysphoric than non-care givers. The frequencies of depressive disorders did not differ between groups in the years before care giving, and there were no group differences in first-degree relatives' incidence of psychiatric disorder. During the years they had been providing care, 30% of care givers experienced a depressive disorder (major depression, dysthymia, or depression not otherwise specified) versus 1% of their matched controls in the same time period. Only two care givers who met criteria during care giving had met criteria for a depressive disorder before care giving, and family history was not even weakly related to the identification of at-risk care givers. In contrast to these group differences in depressive disorders, there were no significant differences in other Axis I disorders either before or during care giving. Thus, the chronic strains of care giving appear to be linked to the onset of depressive disorders in older adults with no prior evidence of vulnerability.     

Same-sex attraction, homosexual orientation, and gay identity: a three-tier distinction for counseling and pastoral care

Given recent prevalence estimates most pastoral caregivers and counselors will work with persons who experience same-sex attraction (SSA). Many of the people who experience SSA will report such a consistency in the directionality and intensity of their attractions that they think of themselves as having a homosexual orientation. Others will integrate their experiences of SSA into a gay identity. What can facilitate pastoral care and counseling is an intentional use of this three-tier distinction: experiences of SSA, homosexual orientation, and gay identity. A discussion of this three-tier distinction is followed by specific suggestions for utilizing this conceptual framework as a resource in pastoral care and counseling.     

Negotiating reality after physical loss: hope, depression, and disability.

The utility of different reality negotiation strategies among 57 persons who had traumatically acquired severe physical disabilities was examined. It was predicted that a sense of goal-directed determination ("agency"; Snyder, 1989) would predict lower depression and psychosocial impairment scores soon after injury. To meet the demands of rehabilitation and social integration, however, it was hypothesized that a sense of ability to find ways to meet goals ("pathways") would predict lower depression and psychosocial impairment among persons who had been disabled for a longer period. The expected interaction was significant in the prediction of psychosocial impairment but not of depression. The sense of pathways was predictive of impairment and depression regardless of the time since injury. Results suggest that in the reality negotiation process the different components of hope as defined by Snyder have salient effects on perceptions of ability to function in social capacities.     

Relationship Between Family Dynamics of Caregivers, Depression, and the Likelihood of Institutionalization of Alzheimer's Patients

This study examined the relationship between family dynamics (as measured by the Family Adaptability and Cohesion Evaluation Scale-FACES III), depression, feelings of burden and institutionalization in spouse caregivers (N = 197) of Alzheimer's Disease (AD) patients. All data was previously collected at the New York University Medical Center's Aging and Dementia Research Center between 1987 and 1991. Although no significant results were found between family dynamics and the likelihood of institutionalization, a post-hoc analyses found that AD spouse caregivers with higher scores on family cohesion experienced significantly less burden and depression than caregivers with lower cohesion scores. Implications for future research examining family cohesion, depression, and feelings of burden in AD spouse caregivers are discussed.     

老年人自尊、希望和抑郁关系的纵向研究

为考察老年人自尊、希望与抑郁间的关系,本研究对281名老年人进行为期一年的追踪调查。相关分析及纵向中介分析结果表明:(1)自尊和希望与老年人的抑郁显著负相关,老年人自尊和希望显著正相关。(2)自尊正向预测老年人的希望,老年人的希望负向预测抑郁。(3)希望在自尊对老年人抑郁的影响中起中介作用。本研究结果揭示了希望是自尊对老年人抑郁产生效应的重要机制变量。这些结果对于减缓老年人抑郁,促进老年心理健康具有一定的实践价值。     

城市贫困中学生自豪感、外显自尊与抑郁状态的关系

采用情境式自豪感问卷、青少年外显自尊和流调中心用抑郁量表,以城市非贫困生为对照,对400名城市贫困生的自豪感、外显自尊与抑郁状态进行考察。结果发现:(1)城市贫困生随年龄的增长,自豪感和外显自尊呈下降趋势,抑郁状态受年龄的影响不显著。女生自豪感程度显著高于男生,外显自尊和抑郁状态的性别差异不显著;(2)城市贫困生自豪感、外显自尊水平显著低于非贫困生。贫困生自豪感与外显自尊呈显著正相关,与抑郁状态呈显著负相关。整体自尊、学业自尊与人际自尊对自豪感的预测作用显著;(3)人口社会学变量中父母亲工作、文化水平、身体状况以及家庭经济收入对自豪感、外显自尊、抑郁状态有不同程度的影响。     

Anxiety and Depression in Patients with Amyotrophic Lateral Sclerosis and Their Caregivers

A large number of studies have investigated a variety of psychological aspects in people with Amyotrophic Lateral Sclerosis, but there is still considerable uncertainty concerning the actual morbidity, in particular for anxiety. We aim to evaluate depression levels and anxiety disposition in ALS patients and their caregivers, in comparison to healthy controls. We conducted a cross-sectional comparison between people with ALS, their caregivers and a non-clinical control group in order to evaluate anxiety and depression levels. 40 ALS patients, their caregivers and 40 healthy adult subjects completed the Beck Depression Inventory II (BDI-II) and the State-Trait Anxiety Inventory—Y2 scale (STAI). We compared overall and single item scores in order to find differences between the three groups. BDI-II scores were significantly different between groups. Depression scores were higher for patients than for healthy controls, in both somatic and psychological sub-scales. Caregivers presented higher levels of psychological depression in comparison with healthy controls, and lower scores of somatic depression in comparison to patients. No differences were found in trait anxiety levels comparing the three groups. ALS patients and their caregivers developed more depression related symptomatology than the non-clinical sample. However, susceptibility to anxiety for both patients and caregivers seemed to be at a normal level.     

Self-conscious emotions and depression: rumination explains why shame but not guilt is maladaptive

Feelings of shame and guilt are factors associated with depression. However, studies simultaneously investigating shame and guilt suggest that only shame has a strong unique effect, although it is not yet clear which psychological processes cause shame and not shame-free guilt to be related to depression. The authors hypothesized that shame, in contrast to guilt, elicits rumination, which then leads to depression. Therefore, in this study we investigated event-related shame and guilt, event-related rumination, and depression among 149 mothers and fathers following family breakup due to marital separation. Data were analyzed using latent variable modeling. The results confirm that shame but not guilt has a strong unique effect on depression. Moreover, the results show that the effect of shame is substantially mediated by rumination. The results are discussed against the background of self-discrepancies and self-esteem.