Differences in familism values and caregiving outcomes among Korean, Korean American, and White American dementia caregivers.

Recent theories have suggested that burden and distress among dementia caregivers may be higher in American culture, which emphasizes individualism, and lower in cultures with higher levels of familism. However, immigrants may experience higher levels of burden because of acculturation with attendant values, conflicts and stresses. Forty-four Korean caregivers and 32 Korean American caregivers were compared with 54 White American caregivers on sociodemographic variables, familism, burden, anxiety, and depression. Familism was highest in Korean caregivers and lowest in Whites, with Korean Americans in the middle. Koreans and Korean Americans reported higher levels of burden. Koreans showed higher levels of depression and of anxiety than White American caregivers, with Koreans and Korean Americans higher than Whites on anxiety. These results suggest a need for greater specificity in theories about familism values, with attention to the specific meaning of familism in different cultures.     

The role of familism in stress and coping processes among African American and White dementia caregivers: effects on mental and physical health.

OBJECTIVE: To explore how familism, burden, and coping styles mediate the relationships between ethnicity and the mental and physical health of caregivers. DESIGN: A probability sample of 65 White and 95 African Americans respondents caring for an older family member with dementia was used to test hypotheses from a sociocultural stress and coping model using path analysis. MAIN OUTCOME MEASURES: Measures of caregivers' health included subjective health, self-reported diseases, blood pressure, and heart rate. Mental health measures included self-reported depression and psychological symptoms. RESULTS: Contrary to the hypothesis, familism had an adverse effect on outcomes and was related to low education levels rather than to African American ethnicity. A buffering effect of active coping between being African American and diastolic blood pressure was found even after controlling for levels of education. CONCLUSIONS: Findings supported a core stress and coping model in which more behavior problems of care recipients were associated with poorer mental health of caregivers via greater burden and more use of avoidant coping. Results also demonstrate that this core model can be extended to physical health.     

The longitudinal effects of early behavior problems in the dementia caregiving career

Using multiregional, 3-year data from early career dementia caregivers, this study determines how behavior problems that occur early in the caregiving career influence time to nursing home placement and change in burden and depression over time. A Cox proportional hazards model indicated that caregivers who managed frequent behavior problems earlier are more likely to institutionalize. After controlling for important time-varying covariates in a series of growth-curve models, caregivers who were faced with severe, early behavior problems reported greater increases in burden and depression over the 3-year study period. The findings suggest the need to consider experiences early in the dementia caregiving career when accounting for key longitudinal outcomes and also emphasize the importance of attrition when attempting to model the health implications of informal long-term care over time.     

A comparison of African American and White American veteran MMPI-2 profiles

The present study compared a matched sample of 180 African American and 180 White American veterans who completed the MMPI-2 as a part of their evaluation while receiving inpatient psychiatric treatment. Findings indicated no significant multivariate or univariate effects associated with race on the basic validity and clinical scales, a significant multivariate effect but no significant univariate effects associated with race across the supplementary scales. Overall the two groups had very similar mean profiles across the basic validity, clinical, and supplementary scales. Comparison of the two groups on the content scales yielded a significant multivariate and significant univariate effects with African Americans scoring higher on the FRS, BIZ, CYN, and ASP scales. Because the two groups differed in terms of frequency and type of drug abuse, follow-up 2 x 2 univariate analyses of variance were conducted for the FRS, BIZ, CYN, and ASP content scales comparing participants classified in terms of presence or absence of a primary or secondary drug abuse diagnosis by race. A significant main effect associated with drug abuse was obtained for ASP. Results are discussed and considered in light of earlier research on the MMPI-2 and race. Content scale differences are also discussed in terms of possible differences in worldview.     

The onset of dementia caregiving and its longitudinal implications

This study examined patterns of entry into the caregiving role and how onset influences outcomes pertinent to the caregiving process. Using 3-year longitudinal data, the present analysis classified dementia caregivers into 1 of 4 onset sequences: those whose entry into caregiving was defined by diagnosis, those who first recognized symptoms and then obtained a diagnosis, those caregivers who first recognized symptoms and then provided care, and those who provided care prior to diagnosis or recognition. Analyses revealed that respondents who experienced a less abrupt entry into caregiving were less likely to institutionalize their relatives and reported greater decreases in well-being. The findings point to the dynamic process that defines entry into caregiving and emphasize that how individuals assume caregiving roles have implications long after onset.     

Other race recognition: a comparison of black American and African subjects

The ability of black American and black African men to recognize previously seen white male faces was assessed. Relationships between recognition, performance scores and quality of interracial experience were also examined. Black American participants (n = 10) performed significantly better and made fewer false responses than the Nigerian participants (n = 10). Significant positive relationships were found between performance scores and interracial experience. Differential use of cues for discriminating white male faces by both groups was also found.     

"Outsider Within" the Firehouse: African American and White Women Firefighters

Prior findings regarding (a) the subordination of African American women firefighters through imposed exclusion, (b) expanded definitions of tokenism and workgroup composition, and (c) the omnirelevance of race/ethnicity in Black women's perceptions of work experiences are extended to White women firefighters. A nationwide sample of 24 White women firefighters completed a 20-page survey and 1 hr interview developed from these previous findings. Both groups experienced insufficient instruction, hostility, silence, hyper-supervision, lack of support, and stereotyping and supportive as well as strained relationships with coworkers. Specific enactments of these global commonalties often varied along racial/ethnic lines. The present data, which start with the experiences of Black women then examine the experiences of White women, model an important methodological approach for understanding difference.     

Stories of family caregivers of people with dementia in Greece: Implications for counselling

A substantial body of literature has identified high rates of burden, psychological morbidity, social isolation, health and financial difficulties among dementia caregivers. The present qualitative study adopted an Interpretive Phenomenological Analysis approach in order to explore the lived experiences of dementia family caregivers within the Greek sociocultural context. The sample was purposive and consisted of 10 women dementia family caregivers from Athens and Thessaloniki. Individual in-depth interviews were conducted and analysed according to IPA. The participants’ personal accounts included themes related to ethical/existential and cultural aspects of family caregiving; changes in family relationships; impact of the caregiving experiences; sources of support and help seeking; positive and meaningful aspects of the care experience. The research findings are discussed in the context of Gilligan’s moral psychological theory, and cultural dimensions of family caregivers. Implications for counselling interventions aiming at supporting caregivers are presented.     

Economic pressure in African American families: a replication and extension of the family stress model

This study of 422 two-caregiver African American families, each with a 10-11-year-old focal child (54% girls), evaluated the applicability of the family stress model of economic hardship for understanding economic influences on child development in this population. The findings generally replicated earlier research with European American families. The results showed that economic hardship positively relates to economic pressure in families. Economic pressure was related to the emotional distress of caregivers, which in turn was associated with problems in the caregiver relationship. These problems were related to disrupted parenting practices, which predicted lower positive child adjustment and higher internalizing and externalizing symptoms. The results provide significant support for the family stress model of economic hardship and its generalizability to diverse populations.     

Perceptions of occupational prestige: Differences between African American and White college students

The present study examined perceptions of occupational prestige among university students. One hundred and twenty-four African American and 174 White students rated the prestige levels of 36 occupations evenly sampled from the six RIASEC types and three levels of prestige. Results indicated that there was a significant difference in perception of occupational prestige. African Americans reported more prestige for R, S, E, and C occupations than did Whites. For African Americans there was a positive relation between endorsement of the centrality of African American identity and prestige ratings R, A, S, and E. These results suggest that perceptions of prestige vary across and within ethnicity and also provide additional insight into how prestige might influence African American students' occupational selection.     

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.     

Family interactions and the course of schizophrenia in African American and White patients

Relatives' critical and intrusive behavior with patients, patients' odd or unusual thinking with relatives, and the course of schizophrenia were examined. Seventy-one African American and White patients (each with 1 relative) completed 2 problem-solving discussions. Relatives' critical and intrusive behavior with patients and patients' odd or unusual thinking with relatives were assessed, and patients were followed for 2 years. For African American patients, high levels of relatives' critical and intrusive behavior were associated with better outcome. For White patients, low levels of both relatives' critical and intrusive behavior and patients' odd or unusual thinking with relatives were associated with better outcome. The results suggest that during family interactions, seemingly negative behaviors may be perceived as a sign of caring and concern by African Americans. For Whites, the combination of patients' odd or unusual thinking with relatives and relatives' critical and intrusive behavior toward patients may be especially predictive of an adverse course.     

Global positive expectancies in adolescence and health-related behaviours: longitudinal models of latent growth and cross-lagged effects

Constructs representative of global positive expectancies (GPE) such as dispositional optimism and hope have been theoretically and empirically linked to many positive mental and physical health outcomes. However such expectancies' health implications for adolescents, as well as their trajectory over time, are less well understood than for adult populations. This study tested whether GPE predict the key indicators of adolescents' future physical health status, their health-related behaviours. A prospective longitudinal study design was employed whereby a diverse population-based cohort (N?=?744; mean age at baseline?=?12) completed three surveys over approximately 18 months. Rigorous tests of causal predominance and reciprocal effects were conducted through latent growth and cross-panel structural equation models. Results showed GPE systematically decreased during the course of the study, yet higher initial levels of GPE predicted less alcohol drinking, healthier food choice and greater physical activity over time. GPE's protective relationships towards health protective behaviours (vs. health risk behaviours that also included tobacco smoking) appear more independent from depressive symptomatology, and the primary findings were robust across socio-demographic groups.     

Two Worlds: African American Men's Negotiation of Predominantly White Educational and Occupational Worlds

Negotiating 2 worlds, a predominantly White opportunity structure and one's community of origin, often produces distress among persons of color. in this qualitative study, the author examines the perspectives and competencies of African American men who negotiate 2 worlds and suggests that bicultural competence may facilitate participation in the opportunity structure while maintaining identification with one's racial group. Desenvolverse en dos mundos, una estructura de oportunidades predominantemente Blanca y la propia comunidad de origen, genera con frecuencia angustia entre las personas de color. En este estudio cualitativo, el autor examina las perspectivas y competencias de varones Afroamericanos que se desenvuelven en dos mundos distintos y sugiere que la competencia bicultural puede facilitar su participación en la estructura de oportunidades, manteniendo a la vez la identificación con el propio grupo racial.     

Attributions and Race Are Critical: Perceived Criticism in a Sample of African American and White Community Participants

The current investigation had two principal goals: (a) to examine whether attributions regarding the intentions underlying criticism from one’s relative predict perceived criticism from that relative and (b) to explore differences between African Americans and Whites in attributions and perceived criticism. A new measure, the Attributions of Criticism Scale, was employed in the present study to assess attributions of perceived criticism. Results showed that the attributions scale demonstrated good psychometric properties in a sample of African American (n = 78) and White (n = 165) community participants. As hypothesized, attributions were correlated with perceptions of criticism. When racial differences in attributions and perceived criticism were explored, results showed that African Americans made more positive attributions but also perceived more destructive criticism than Whites. No racial differences were observed on overall and constructive criticism, but there was some evidence to suggest that African Americans made more negative attributions than Whites. However, these results were inconsistent across recruitment method. Taken together, these findings suggest that positive and negative attributions are important factors in the perception of criticism and that mean levels of attributions and perceived criticism may differ by race. Possible explanations for effects as well as clinical implications and directions for future research are considered.     

Spelling and dialect: Comparisons between speakers of African American vernacular English and White speakers

One characteristic of African American vernacular English (AAVE) is final obstruent devoicing, where the final consonant of a word likerigid is pronounced more like /t/ than /d/. To determine whether this dialect characteristic influences adults’ spelling, African American and White college students spelled words such asrigid andballot, pronounced by either a speaker of their own dialect or a speaker of the other dialect. African Americans, especially those who often devoiced final /d/, were more likely than Whites to confused andt. Both African American and White spellers made mored/t confusions when the words were spoken by an African American experimenter than by a White experimenter. Thus, the different phonological systems of AAVE and White speakers can cause them to make different types of spelling errors. Discussions of AAVE and literacy have focused on its syntax, but its phonology must also be considered.     

Frontal lobe dementia and subcortical vascular dementia: a neuropsychological comparison

We compared the performance of 40 patients with frontal lobe dementia to that of 40 patients with subcortical vascular dementia (80 patients including, 46 men and 34 women) in a set of tasks assessing attentional, executive, and behavioural tasks. The frontal lobe dementia represents an important cause for degenerative disruption and is increasingly recognised as an important form (up to 25%) of degenerative dementia among individuals of late-middle-age. The main involvement is the frontal-subcortical pathway, which is the final target of impairment even in subcortical vascular dementia. A wider involvement of the cortical (decisional) layers in frontal dementia, in contrast with the prominent and widespread involvement of the subcortical pathways (refinement and corrections programs) creates the different profiles of the two groups. Frontal patients have more difficulties in abstract reasoning, focusing attention, and implementing strategies to solve problems. They exhibit more profound behavioural alterations in personality and social conduct and show only moderate depression, and a total lack of insight concerning their dinical condition. In contrast, the patients with subcortical vascular dementia have poor general cognitive functions, high insight, and important depression and apathy as the principal and most salient characteristic of their behavioral conduct.