Mothers' Psychological Adjustment Following Disaster Affecting Their Children

The authors investigated the psychological adjustment of 37 British women whose adolescent children survived the cruise ship Jupiter's sinking in 1988, about 6 years previously. They compared these women with a group of widows (N = 18) and a group of women who had suffered no major negative life event (N = 15). Psychological adjustment of the 37 women was assessed with the Schedule for Affective Disorders and Schizophrenia Lifetime Version (SADS-L; R. L. Spitzer & J. Endicott, 1975) and various standard questionnaires. The women whose children had been involved in the disaster were found to have suffered a greater number of incidents of psychological distress in the period since the disaster than the women who had suffered no major negative life events but fewer incidents of psychological distress than the widows. The significance of these findings and clinical implications are discussed.     

Psychological adjustment of children in the pretransplant phase of bone marrow transplantation: Relationships with parent distress,parent stress,and child coping

Families of 22 children preparing to undergo bone marrow transplantation (BMT) provided information concerning parent-reported major negative life stress, child coping strategies, parental psychological symptomatology, and child adjustment. Immediately prior to BMT, children and families are confronted with multiple stresses which challenge the child's coping and strain the parents' ability to assist the child with coping. Hence, stress, parental adjustment (distress), and child coping may be important factors affecting the child's overall psychological adjustment. Results showed that 15–25% of children and parents experienced clinically significant levels of psychological distress. Parent and child psychological distress were closely related. Major negative life stresses experienced by the parent and use of avoidant coping by the child significantly predicted child adjustment problems in the pretransplant period. Coping skills interventions targeting avoidant coping and management of parental stress/distress may reduce child psychosocial risk prior to BMT.     

THE PSYCHOLOGICAL SIGNIFICANCE OF "HOME" TO OLDER WIDOWS

Elderly widows are increasingly choosing to remain alone in their homes following the deaths of their husbands. For a number of reasons they are a more vulnerable group than married older women, and thus were expected to have less positive attitudes toward being homeowners. In the present study widows (N = 70) who live alone were compared to married women (N = 74) who who lived with only their husbands. Both groups lived in single-family dwellings. Subjects responded to an empirically derived Likert-type scale which measures four factors relating to "attachment to hom". Results indicated that widows had significantly higher scores on the Traditional Family Orientation factor and on the Competence in a Familiar Environment factor. One explanation of these findings is that the home may take on new meanings for widows as they reflect on earlier family experiences or as they discover that they can competently manage an independent lifestyle for themselves.     

PTSD symptoms of mothers following occurrence of a disaster affecting their children

This study investigated the PTSD symptoms of 37 mothers whose adolescent children had been directly involved in a disaster, the Jupiter sinking in 1988. This group included mothers whose children were (a) not diagnosed with Posttraumatic Stress Disorder and (b) were diagnosed with Posttraumatic Stress Disorder. The measure used was the Posttraumatic Stress Disorder Symptom Scale. Women whose children were involved in the disaster presented PTSD symptoms. 35% (n = 13) were diagnosed with PTSD 3 mo. after the disaster, and 89% (n = 3) of them were diagnosed with PTSD 6 yr. afterward. This effect was greater in the subgroup whose children had developed traumatic stress disorder following the disaster.     

Adjustment in aging: the roles of life stress, hassles, and self-efficacy

This study examines the relationship of life stress, daily hassles, and perceived self-efficacy to adjustment in a community sample of 32 men and 32 women between ages 65 and 75. In a structured interview, negative life change events, daily hassles, self-efficacy, depression, psychosomatic symptoms, and negative well being were assessed. Both negative life events and daily hassles were related to psychological distress and physical symptoms for men, and hassles were associated with psychological distress and physical symptoms for women. An inverse relationship between self-efficacy and maladjustment was also found. Hassles showed the most powerful relationship to distress.     

The Distress of Citizen-Children with Detained and Deported Parents

In immigration enforcement, many undocumented immigrants with children are often detained and deported. But it is their US-born citizen-children that have been overlooked in immigration debates and enforcement policies and practices. Citizen-children are at risk for negative psychological outcomes when families are fractured and destabilized by arrest, detention, and deportation. The children risk being torn from their parents and, often, their undocumented siblings. To add to the small but growing empirical base on the effects of living under the threat of deportation and actual deportation of parents, we compared the psychological status of three groups of citizen-children: (1) a group living in Mexico with their deported parents; (2) a group in the US with parents affected by detention or deportation; and (3) a comparison group of citizen-children whose undocumented parents were not affected by detention or deportation. We compared children on self-report and parent-report measures of behavioral adjustment, depression, anxiety, and self-concept. Across the three groups we found elevated levels of distress, and differences between children who had experienced a parent’s detention or deportation and those who had not. We discuss findings in the context of children’s clinical needs, future research, and implications for immigration enforcement policy and practices.     

A threshold model of social support, adjustment, and distress after breast cancer treatment

This study examined a threshold model that proposes that social support exhibits a curvilinear association with adjustment and distress, such that support in excess of a critical threshold level has decreasing incremental benefits. Women diagnosed with a first occurrence of breast cancer (N = 154) completed survey measures of perceived support (Social Provisions Scale), quality of life (Functional Living Index--Cancer), adjustment (Psychological Adjustment to Illness Scale) and psychological distress (Brief Symptom Inventory) approximately 3 weeks after surgical treatment and 8-16 months later. Consistent with a threshold model, multiple regression analyses suggested a significant curvilinear relationship between social support and distress at Time 1 and Time 2 and between social support and adjustment at Time 2. Consistent with this model, the significant bivariate correlations between social support and outcomes were accounted for almost entirely by women in the lowest quartile of support. Social support among women in the highest 3 quartiles was unrelated or only marginally related to adjustment and distress.     

Risk Factors,Self-Attributions,and Adjustment Problems Among Victims of Sexual Coercion1

College women (N= 125) were surveyed about their experiences with sexual coercion. Forty-two percent of the sample reported one or more coercive incidents involving completed intercourse (26%) or attempted intercourse (16%). Only 6% of these incidents were reported to police or campus authorities. Of the victims, 92% knew their assailants, at least casually. A combination of demographic, sexual history, and personality characteristics predicted 21 % of the variance in experience with sexual coercion. The variables most highly associated with reported victimization were frequency of sexual activity and religiosity; women who were more sexually active and who attended religious services less often were more likely to report experiencing sexual coercion than were women who were less sexually active and who attended religious services more often. A combination of situational and attitudinal variables predicted 52% of the variance in victim attributions. The variables most highly correlated with attributions were degree of victim assertiveness and the type of force used by the assailant; less assertive women and women who had been coerced by the use of economic or psychological force made relatively more internal attributions about the coercion incidents they had been involved in than did women who were more assertive and women who had been coerced by means of physical force. Finally, a combination of situational and attitudinal variables predicted 34% of the variance in victim-reported adjustment problems following the coercion incident. The use of economic or psychological force, greater physical injury, and relative acceptance of interpersonal violence were associated with more severe adjustment problems, whereas the use of physical force, less physical injury, and relative rejection of interpersonal violence were associated with less severe adjustment problems. The implications of these results for the reduction of acquaintance assault and for the counseling of victims are discussed.     

The Experience of Caregiving Among Mothers of Adults Suffering from Psychotic Disorders: Factors Associated with Their Psychological Distress

To identify correlates of psychological distress among multiple indicators, 99 women with adult children suffering from a psychotic disorder were interviewed. The women, who were recruited through hospitals and self-help groups, represented different socioeconomic levels. A face-to-face standardized interview was conducted, mainly in the participants' homes. Multiple hierarchical regression analysis showed that dimensions of burden and social support were strongly associated with distress reported by the participants. The negative interactions that participants had with their main confidant or spouse constituted a more powerful correlate than their perception of the quality of this relationship. Furthermore, a perception of their own health as poorer is a strong correlate of their distress. Since no control group was studied simultaneously, these results suggest, but do not prove, the presence of differences between mothers of adults with psychotic disorders and other mothers.     

Early childhood experiences and current emotional distress: what do they tell us about aspiring psychologists?

Motivation underlying the career choice of mental health professionals may include a desire to resolve personal psychological distress from childhood or the need to continue the caretaking role held in the family (A. DiCaccavo, 2002; J. D. Guy, 1987). The authors examined whether psychology students whose future vocational aspirations lie in the clinical domain (N = 40) differed from psychology students with no clinical aspirations (N = 35) and from business students (N = 91) in reported childhood experiences and current psychological functioning. Psychology students who wanted to work in the clinical domain reported higher rates of perceived childhood sexual abuse and neglect as compared with both psychology students with no clinical aspirations and business students. They also reported more parentification experiences between the ages of 14 years and 16 years as compared with business students. There were no significant differences between groups in reported levels of current negative emotions.     

Emotional response to abortion: a critical review of the literature

Anti-abortion groups in the US cite the existence of a post-abortion syndrome--a sense of loss, emptiness, and grief similar to that reported by trauma survivors. Although research on the longterm effects of induced abortion is marred by methodological errors, most studies have found no adverse psychological sequelae; rather, there appears to be a sense of relief and opportunity for personal growth. Nevertheless, there is a small group of women who do experience emotional distress after abortion and it is important to identify the demographic, social, and psychological factors that place women at risk of such a reaction. In terms of demographic factors, young age (adolescence), low or nulliparity, 2nd-trimester procedures, and Catholicism have been characteristics of women who suffered post-abortion depression. Of the social variables that have been examined, a lack of support from significant others (parents or partner) has been linked in some studies to emotional distress after abortion. A relatively consistent finding is that women who feel coerced to abort or are ambivalent about their decision at the time of the procedure are most likely to experience regret, depression, and anger. Women whose coping style involves avoiding responsibility are also prone to post-abortion distress. As noted, the literature does not support the contention that abortion causes longterm trauma. On the other hand, given the fact that 1.5 million abortions take place each year in the US, the existence of some post-abortion distress in even as small percentage of acceptors is enough to indicate a need for pre- and post-abortion counseling to help women determine the meaning of the experience and own their decisions.     

Maternal coping strategies and emotional distress: results of an early intervention program for low birth weight young children

Several questions were examined with Infant Health and Development Program (IHDP) data (N = 843). Are effects of intervention services found for maternal emotional distress and coping strategies, and are these effects different for different groups of mothers? Do maternal distress, coping, and life events moderate (or mediate) the intervention effects reported earlier for children's test scores and behavior problems (IHDP, 1990)? The intervention reduced maternal distress, especially for women with less than a high school education. Maternal distress did not moderate or mediate the influence of the intervention on child outcomes. Maternal coping was not influenced by the intervention and did not moderate the influence of the intervention on child outcomes. Life events moderated the influence of the intervention on children's test scores; the intervention was more effective for children whose mothers had fewer life events.     

A path analysis of factors associated with distress among first-degree female relatives of women with breast cancer diagnosis.

Patterns and predictors of psychological distress in first-degree female relatives (N = 624) of newly diagnosed breast cancer patients were explored. First-degree female relatives who were high monitors reported greater cancer-specific and general distress than did low monitors. Greater optimism was associated with lower cancer-specific distress. Optimism's effect on general distress was moderated by women's level of monitoring. Greater optimism was associated with lower general distress for both high and low monitors, but the effect was stronger for high monitors than for low monitors. Avoidance and engaged coping were associated with higher distress. A close relationship with the cancer patient was related to higher cancer-specific distress but lower general distress. Further understanding of the process of adjustment in these women awaits longitudinal study.     

A randomized clinical trial of a brief, problem-focused couple therapy for depression

The aim of this study was to evaluate a brief couple therapy for depression targeted for mildly discordant or nondiscordant couples struggling with the negative impact of depression. Subjects included women with major depression or dysthymia who had husbands without clinical depression. Thirty-five couples were randomly assigned to the 5-week intervention (n = 18) or a waitlist control group (n = 17), and followed up 1 and 3 months later. Results showed a significant effect of treatment in reducing women's depressive symptoms, with 67% of women improved and 40% to 47% recovered at follow-up, compared to only 17% improved and 8% recovered among women in the control group. Treatment was also effective in secondarily improving women's marital satisfaction, reducing husbands' levels of psychological distress and depression-specific burden, and improving both partners' understanding and acceptance of depression. The treatment was implemented in five 2-hour sessions, representing an efficient, cost-effective approach. Findings support the growing utility of brief, problem-focused couple interventions that simultaneously target depression, relational functioning, and psychological distress experienced by the loved ones of depressed persons.     

Stress-Induced Cardiomyopathy and Psychological Wellbeing 1 Year After an Acute Event

Stress cardiomyopathy (SCM) typically presents similar symptoms to acute myocardial infarction (AMI). However, these symptoms differ when it comes to a transient and completely reversible myocardial dysfunction, which is frequently precipitated by acute stressful events, occurring in the absence of plaque rupture and coronary thrombosis. The purpose of this study was to investigate health-related quality of life (HRQL) and emotional burden subsequent to cardiac events in SCM patients. Thirty-seven SCM patients were compared with 37 matched AMI patients. All selected patients were assessed for HRQL and psychological distress at baseline and 1-year after the acute event. After controlling for covariates, scores on the Psychological General Well Being Index indicated that depressed mood had increased in both groups, but the increase for SCM patients was greater than for AMI patients. The AMI group displayed greater decreases than the SCM in physical quality of life and in total cardiac-related health quality of life. The percentage of patients with psychological distress increased significantly more in the SCM group than in the AMI group, and it made no difference whether the triggering event was emotional or physical. Our results suggest that, despite the more favorable medical prognosis of SCM patients, their cardiac condition being transient and resolving completely in few weeks, the psychological impact associated with their condition is more negative 1 year later than in the case of AMI patients whose medical prognosis is less favorable, and this difference is independent of type of trigger event.     

Predictors of relationship adjustment among couples coping with a high risk of developing breast/ovarian cancer

This study investigated the association between supportive and collaborative processes and dyadic adjustment in 94 women at increased risk of breast/ovarian cancer and their partners. Participants were recruited through two familial cancer clinics. They completed mailed, self-report questionnaires that included measures of psychological distress, dyadic adjustment (consensus, cohesion and satisfaction) and couple predictor variables (perceived support and team approach). Most couples reported average-to-high levels of consensus, cohesion and satisfaction, with a small proportion of couples (6.4%) reporting scores that reached clinically significant levels of dyadic distress. Greater perceived support was associated with better dyadic consensus and satisfaction, and dyadic cohesion and satisfaction were higher among couples who reported greater use of a team approach. General distress did not moderate the association between dyadic coping and relationship quality. There were no significant relationships between intra-couple congruence on support or team approach, and dyadic adjustment. Most couples had a functional relationship in the face of the current health stressor, although a subgroup may be at elevated risk of negative psychological consequences, including further relationship strain. The results highlight that dyadic coping strategies are important factors involved in the quality of couples' relationship following genetic counselling for breast/ovarian cancer risk.     

Coping with Crises: An Examination of the Impact of Traumatic Events on Religious Beliefs

The impact of traumatic events on empirical and metaphysical assumptions was examined, by comparing assumptions of a group of 25 persons who had recently experienced a major stressor with assumptions of a group of 25 persons who had not had such an experience. Each group was composed of 22 women and 3 men, with a mean age of 20 years. Participants completed written measures assessing level of adjustment, empirical world assumptions, religious motivation, and religious and spiritual experiences. Naturalistic interviews were conducted with the trauma group. The trauma group obtained significantly higher scores on symptoms of psychological distress but did not differ in evaluations of the empirical world as predictable, safe, or controllable. Interviews suggested that the metaphysical assumptions were not challenged by trauma; rather, they provided a framework for understanding and coping with trauma.     

Trajectories of Adjustment to Couple Relationship Separation

To test a stress‐diathesis model of adjustment to separation, the current study describes the trajectories of different aspects of separation adjustment in people formerly married or cohabiting, and moderators of those trajectories. A convenience sample of 303 recently separated individuals (169 women; 134 men) completed assessments of their emotional attachment to the former partner, loneliness, psychological distress, and coparenting conflict at two time points 6 months apart. Multilevel modeling of the overlapping multicohort design was used to estimate the trajectories of these different aspects of adjustment as a function of time since separation, marital status, gender, presence of children from the relationship, who initiated separation, social support, and anxious attachment. Attachment to the former partner, loneliness, and psychological distress were initially high but improved markedly across the 2 years after separation, but coparenting conflict was high and stable. Adjustment problems were similar in men and women, and in those formerly married or cohabiting, except that reported coparenting conflict was higher in men than women. Low social support and high anxious attachment predicted persistent attachment to the former partner, loneliness, and psychological distress. Coparenting conflict is a common, chronic problem for many separated individuals, and individuals with certain psychological vulnerabilities also experience chronic personal distress.     

Identity Distress Among Youth Exposed to Natural Disasters: Associations with Level of Exposure,Posttraumatic Stress,and Internalizing Problems

Identity distress involves intense or prolonged upset or worry about personal identity issues including long-term goals, career choice, friendships, sexual orientation and behavior, religion, values and beliefs, and group loyalties. Research suggests that trauma exposure and subsequent posttraumatic stress disorder (PTSD) symptoms may negatively affect identity development and psychological adjustment. However, little is known about their specific associations with identity distress and internalizing problems among disaster-exposed adolescents. This study aimed to examine these associations in a sample of 325 adolescents (60% female; 89% African American) who experienced a major natural disaster and its aftermath. The results indicated that identity distress was positively associated with age, hurricane exposure, PTSD symptoms, and internalizing problems. Linear regression analyses also showed that identity distress was uniquely associated with internalizing symptoms and that there was an indirect effect of hurricane exposure on identity distress via PTSD symptoms. PTSD symptoms moderated the link between identity distress and internalizing symptoms, with a significant positive slope found for youth with more PTSD symptoms. Findings were generally consistent with previous work and predictions, and they add to the extant knowledge about identity distress by providing data on the linkages among disaster exposure, posttraumatic stress, and internalizing problems in adolescents.     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition.