Appraisals of control and predictability in adapting to a chronic disease

In a sample of 92 patients with rheumatoid arthritis, we examined interrelations among various control appraisals, illness predictability, psychosocial adjustment, mood, and illness status. Perceiving greater personal control over the disease and symptoms and perceiving greater health-care-provider control over symptoms were associated with greater illness predictability. Patients reported more personal control over their symptoms than over the course of the disease and thought that their health care providers had more control over disease course than they did themselves. Multiple regression analyses showed that perceiving greater personal control over one's medical care and treatment was associated with positive mood and psychosocial adjustment. Negative mood was also associated with the belief that providers have greater control over the patient's daily symptoms. Patients who had a more severe disease and expressed greater personal control over its course reported greater mood disturbance and were rated as exhibiting less positive adjustment, but those who had more severe daily symptoms and expressed greater personal control over their symptoms reported less mood disturbance. These findings are discussed in terms of the possible benefits of patients' active participation in their care and the implications of perceiving personal and others' control over more or less controllable aspects of the illness, especially when the illness is more severe.     

Low Rates of African American Participation in Genetic Counseling and Testing for BRCA1/2 Mutations: Racial Disparities or Just a Difference?

Low rates of genetic counseling among African American women have generated concerns about disparities; however, to the extent that women's decisions to accept or decline counseling are consistent with their values, then lower participation may reflect preferences and not disparities. We evaluated the extent to which women were satisfied with their decision about participating in genetic counseling for BRCA1/2 mutations and identified variables that were associated significantly with satisfaction. Prospective study of decision satisfaction with 135 African American women who had a minimum 5% prior probability of having a BRCA1/2 mutation. Decision satisfaction was evaluated one month after women were offered participation in genetic counseling using a structured questionnaire. Women were satisfied with their participation decision; more than 80% reported that their decision was consistent with their family values. However, women who declined pre-test counseling had significantly lower satisfaction scores. Our findings highlight the importance ensuring that racial differences that are due to preferences and values are not misclassified as disparities in order to identify and address the root causes of disparate treatment.     

The Effect of Professional Partnership on the Development of a Mutual-help Organization

The effects of partnership between Schizophrenics Anonymous (SA, a mutual-help organization) and the Mental Health Association in Michigan (MHAM, a professionally staffed advocacy organization) on SA's growth and development were explored. Following the initiation of a formal partnership, SA groups were more available throughout the state, more likely to be associated with formal mental health settings, and less likely to have leaders who had been participants in other SA groups. Groups with consumer leaders had significantly greater longevity than groups with professional leaders. Changes in the organizational structure and process of SA were also identified. SA leaders reported that SA moved from a collective to a more bureaucratic structure. As a result, there was greater consistency, administrative capacity, and response capacity. This enhanced capacity came with costs reported by SA leaders. The leadership role of SA members became less defined. SA members expressed concerns about the more hierarchical structure of SA's organization, decreased consumer control, increased professional involvement in SA, and an excessive focus on group development as opposed to group maintenance. Mental Health Association in Michigan staff reported that MHAM was also impacted by the partnership, both with regard to internal functioning and external perception. Implications for effective partnerships between mutual-help and professional organizations are discussed.     

Organization-Level Predictors of Sustained Social Movement Participation

Long‐term sustained participation represents one of the most important resources available to community organizations and social movement organizations (SMOs). The participatory literature on community and SMOs has identified a host of individual‐level factors that influence participation beyond initial engagement, and has more recently identified contextual factors that influence participation. This study builds upon current understandings of participation in SMOs by examining how sustained participation in movement activities is affected by two qualities of SMO settings: repertoire of organizational activity, and equality of staff contact with organization members to cultivate and facilitate individual participation. To this end, we employ multi‐level regression techniques to examine longitudinal data on participation within 50 local chapters of a national congregation‐based community organizing federation. We find that the conduct of organizational activities previously shown to increase levels of participation among individual persons does not necessarily lead to increases in aggregate or organization‐level participation. Further, we find that conditions of unequal staff contact among organization members represent a notable drag on organization‐level participation over time. Our findings suggest that organizers and organizational leaders may well see greater levels of participation in their organizations by simply re‐distributing resources and opportunities more equitably within their organizations.     

Negative consequences of community group participation for women's mental health and well‐being: Implications for gender aware social capital building

Participation in community groups is argued to be an important way to create health‐promoting social capital. However, relatively little attention has been paid to the ways in which gender affects the health promotion potential of participation. This paper reports on a qualitative study of women's experiences of participation in a diverse range of community groups, and considers how such involvement can potentially have a negative impact upon mental well‐being. In‐depth interviews were conducted with 30 women in Adelaide, South Australia. Women's accounts of their group involvement reflected that their identities as mothers were particularly important in shaping their participation. Some women reported difficulties in combining group involvement with their family responsibilities. Stress attached to negotiating social interaction within groups was also raised as an issue. It was found that participation can reinforce gender inequality and potentially have severe negative consequences for mental health, issues that need to be considered alongside the potential health benefits. The findings are considered in light of Bourdieu's critical conceptualization of social capital. Copyright © 2008 John Wiley & Sons, Ltd.     

Order in the home: Family routines moderate the impact of financial hardship

The study examined whether frequency of adolescent reported family routines moderated the relation between caregivers' perceptions of financial resources and adolescents' behavioral and academic outcomes among a sample of inner-city African American families. The sample consisted of 115 adolescents (average age = 15.95) and their female caregivers participating in a large scale study on African American family life. The results revealed a significant main effect of financial resources and family routine on adolescent outcomes, such that an increase in both was related to less delinquency and more favorable academic outcomes. Family routines moderated the relation between financial resources and adolescent outcomes. Specifically, the study revealed that the link between lack of financial resources and negative adolescent outcomes was diminished for youth in high-routine homes. Alternatively, family routines did not have a significant impact on youth from high-resource homes. Results highlight the importance of organization and predictability for economically disadvantaged youth and families.     

The impact of college‐level sex education on sexual knowledge,attitudes, and practices: The knowledge/sexual experimentation myth revisited

In recent years, many persons have opposed sex education believing that such courses will lead to increased participation in sexual intercourse by young people, but their fears are not supported by most previous research. The influence of sex education material integrated into functional marriage and family courses, however, has not been the subject of in‐depth, scientific investigations.

An anonymous questionnaire was administered to never‐married undergraduate students enrolled in a college‐level marriage and family course at a state university. A pretest and post‐test design was utilized with experimental groups of 50 women and 26 men and comparison groups of 60 women and 28 men.

The findings indicate that the sex education content had a significant impact on the experimental groups, especially for women. Substantial increases in knowledge regarding abortion and contraception, more favorable attitudes toward masturbation, and frequency of masturbation were reported by experimental group women as contrasted with comparison group women. Experimental group men indicated increased knowledge about female hygiene and contraception in contrast to comparison group men. From these findings, sex educators should be able to better meet the criticisms of sex education opponents given this greater understanding of the impact of sex education material on the sex lives of their students.     

The effects of ordinal load on incidental temporal learning

How can we grasp the temporal structure of events? A few studies have indicated that representations of temporal structure are acquired when there is an intention to learn, but not when learning is incidental. Response-to-stimulus intervals, uncorrelated temporal structures, unpredictable ordinal information, and lack of metrical organization have been pointed out as key obstacles to incidental temporal learning, but the literature includes piecemeal demonstrations of learning under all these circumstances. We suggest that the unacknowledged effects of ordinal load may help reconcile these conflicting findings, ordinal load referring to the cost of identifying the sequence of events (e.g., tones, locations) where a temporal pattern is embedded. In a first experiment, we manipulated ordinal load into simple and complex levels. Participants learned ordinal-simple sequences, despite their uncorrelated temporal structure and lack of metrical organization. They did not learn ordinal-complex sequences, even though there were no response-to-stimulus intervals nor unpredictable ordinal information. In a second experiment, we probed learning of ordinal-complex sequences with strong metrical organization, and again there was no learning. We conclude that ordinal load is a key obstacle to incidental temporal learning. Further analyses showed that the effect of ordinal load is to mask the expression of temporal knowledge, rather than to prevent learning.     

Caregiver Involvement in the Intensive Mental Health Program: Influence on Changes in Child Functioning

We examined behavioral markers of caregiver involvement and the ways in which family participation was related to treatment outcomes in 47 elementary school children with SED enrolled in a school-based intensive mental health program. Measures of caregiver involvement included therapeutic home visits, attendance at therapeutic meetings, completion of ratings on the daily point sheet, and extra communications with the therapeutic team on the point sheet. Greater initial impairment was associated with greater caregiver involvement. Greater caregiver involvement was linked to improvement in child thought processes, increased ability to provide emotional and social supports for the child, and greater overall child functioning at discharge. Our findings also reflected increased therapists’ attempts to provide additional in-home services in cases where caregivers demonstrated a decline in their ability to provide for their children’s physical and material needs, or in which therapists discovered that the family functioning was more impaired than what was initially assessed. We provide a case study that exemplifies many of these findings.     

Statistical learning in a serial reaction time task: access to separable statistical cues by individual learners.

The ability of adult learners to exploit the joint and conditional probabilities in a serial reaction time task containing both deterministic and probabilistic information was investigated. Learners used the statistical information embedded in a continuous input stream to improve their performance for certain transitions by simultaneously exploiting differences in the predictability of 2 or more underlying statistics. Analysis of individual learners revealed that although most acquired the underlying statistical structure veridically, others used an alternate strategy that was partially predictive of the sequences. The findings show that learners possess a robust learning device well suited to exploiting the relative predictability of more than I source of statistical information at the same time. This work expands on previous studies of statistical learning, as well as studies of artificial grammar learning and implicit sequence learning.     

Saccade launch site as a predictor of fixation durations in reading: comments on Hand, Miellet, O'Donnell, and Sereno (2010)

An important question in research on eye movements in reading is whether word frequency and word predictability have additive or interactive effects on fixation durations. A fair number of studies have reported only additive effects of the frequency and predictability of a target word on reading times on that word, failing to show significant interactions. Recently, however, Hand, Miellet, O'Donnell, and Sereno (see record 2010-19099-001) reported interactive effects in a study that included the distance of the prior fixation from the target word (launch site). They reported that when the saccade into the target word was launched from very near to the word (within 3 characters), the predictability effect was larger for low frequency words, but when the saccade was launched from a medium distance (4-6 characters from the word) the predictability effect was larger for high frequency words. Hand et al. argued for the importance of including launch site in analyses of target word fixation durations. Here we describe several problems with Hand et al.'s use of analyses of variance in which launch site is divided into distinct ordinal levels. We describe a more appropriate way to analyze such data-linear mixed-effect models-and we use this method to show that launch site does not modulate the interaction between frequency and predictability in two other data sets.     

Evaluating the Impact of Elder Cottage Housing on Residents and Their Hosts

Family members who wish to have their older relatives live with them often encounter obstacles that make such an arrangement unworkable. Proponents of the Elder Cottage, and its variant, the Homecare Suite, suggest that many of these obstacles can be avoided with Elder Cottage use. The purpose of this study was to evaluate the impact of Elder Cottages on a variety of resident and host outcomes. A nonequivalent comparison group design was used. Thirty-one treatment group residents and their hosts received Elder Cottages whereas 24 comparison group residents and their hosts remained on a waiting list. Results showed that residents using Elder Cottages reported significantly greater satisfaction with their housing, increased independence, more telephone contacts with friends and family, improved relationships with hosts, more accessible housing, and less formal service use than those in the comparison group. Similarly, hosts in the treatment group reported significantly greater satisfaction with the residents' housing and less stress in their caregiving roles than those in the comparison group. In addition, fewer Elder Cottage hosts than comparison group hosts engaged in caregiver-related driving. Answers to short-answer questions mirrored the quantitative findings. These results provide substantial optimism with respect to the Elder Cottage as a housing option for older adults, although interviews with housing specialists suggested that families will need financial and caregiving assistance for this option to be viable.     

Role of Religious Attendance and Identity Conflict in Psychological Well-being

A sample of individuals who identified as gay or lesbian were administered measures of church attendance, their religious organization’s view of homosexuality, perceived conflict between religious faith identity and sexual orientation identity, social support, depression, and generalized anxiety. Among participants who rated their church as rejecting of homosexuality, greater frequency of attendance was related to a higher incidence of GAD symptoms, but not depression. No correlation was found for those attending accepting faith communities. Those who attend rejecting faith communities attended services less often, experienced greater identity conflict, and reported significantly less social support than those of the Accepted group. Regression analyses indicated that identity conflict and social support did not fully account for the relationship between attendance and GAD symptoms. Overall, findings from the current study support previous suggestions that participation in conservative or rejecting religious communities may adversely affect the emotional well-being of GL individuals.     

Infant illness severity and family adjustment in the aftermath of NICU hospitalization

Up to 15% of parents have an infant who will spend time in a neonatal intensive care unit (NICU). After discharge, parents may care for a medically fragile infant and worry about their development. The current study examined how infant illness severity is associated with family adjustment. Participants included parents with infants who had been discharged from the NICU 6 months to 3 years prior to study participation (N = 199). Via a Qualtrics online survey, parents reported their infants’ medical history, parenting stress, family burden, couple functioning, and access to resources. Multivariable regression analyses revealed that more severe infant medical issues during hospitalization (e.g., longer length of stay and more medical devices) were associated with greater family burden, but not stress or couple functioning. Infant health issues following hospitalization (i.e., medical diagnosis and more medical specialists) were associated with greater stress, poorer couple functioning, and greater family burden. Less time for parents was associated with increased stress and poorer couple functioning. Surprisingly, parents of infants who were rehospitalized reported less stress and better couple functioning, but greater family burden. Family-focused interventions that incorporate psychoeducation about provider−patient communication, partner support, and self-care may be effective to prevent negative psychosocial sequelae among families.     

Parental role participation and perceptions of responsibility for children's school adjustment

This research examined the effects of parental participation in work and family roles on perceptions of responsibility for their children's school adjustment. We hypothesized that mothers would be perceived as being more responsible than fathers, and that participation in nontraditional work and family roles would influence perceived responsibility. Contrary to the first hypothesis, college student subjects perceived fathers as being more responsible than mothers for good adjustment, but not for poor adjustment. Consistent with hypotheses, role participation influenced perceptions of responsibility, but only for mothers. Divorced mothers were credited less and blamed more for school adjustment than married mothers, especially when they worked outside the home. Implications of the findings for future research on role participation are discussed.     

Associations Between Family Environment, Parenting Practices, and Executive Functioning of Children with and Without ADHD

We examined the relationships between executive functioning, family environment, and parenting practices in children diagnosed with ADHD as compared to children without ADHD. Participants were parents (N = 134) of 6- to 12-year-old ADHD and non-ADHD-diagnosed children. Compared to the control group, parents of children diagnosed with ADHD reported their children as exhibiting greater problems with behavioral control and metacognitive abilities, and described their family environments as less organized and higher in family conflict. Family environment and parenting practices were not correlated with behavioral control or metacognitive abilities in children with ADHD. In children without ADHD, higher levels of family cohesion, organization, and expressiveness, and lower levels of family conflict, were significantly correlated with greater behavioral control. Higher levels of family cohesion and organization were significantly and positively associated with regulation of metacognitive abilities in children without ADHD. In general, aspects of the family environment and parental limit setting appear to be associated with the development of executive functions in children not diagnosed with ADHD; however, family environment and parenting practices were not associated with executive functions in children diagnosed with ADHD.     

Adolescent pregnancy: effects of family support, education, and religion on the decision to carry or terminate among Puerto Rican teenagers

Why do some pregnant teenagers decide to carry to term while others terminate their pregnancy? This study examined the influence of family relationships and support, religion, and education on the decision to carry or to abort. A nonrandom sample of 43 pregnant Puerto Rican teenagers (21 who carried and 22 who aborted) were interviewed in 1982 using a 34-item interview schedule. It was found that girls in the carry group were more significantly influenced and supported by family and friends than were those in the abort group. Fathers were the least influential persons in both carry and abort groups, while mothers were the most influential in the carry group, and sisters in the abort group. Brothers, boyfriends, and best friends were more influential for carry girls than for abort girls. Contrary to expectations, girls in the abort group reported a greater degree of religiosity than did those in the carry group. Further, girls who received strong support from family and friends reported a higher degree of satisfaction with their decision than did those who received less support. Finally, girls in the abort group were more likely to continue their education than were those in the carry group. Overall, the findings of this study have immediate implications for research and counseling services. Practitioners should focus on the girls in conjunction with their families in order to achieve better results in both treatment and preventive services.     

A Pilot Study of a Brief Motivational Intervention to Enhance Parental Engagement: A Brief Report

Although research has shown that multi-systemic interventions (MSIs) improve youth psychosocial functioning, MSI dissemination has been hampered by low levels of parent participation. The current pilot project was designed to examine the effectiveness of a brief motivational interviewing (MI) protocol to increase parental engagement in an MSI for youth suspended from middle and high school. Preliminary findings suggest that parents who received brief MI were more likely to attend a parent-training workshop and reported greater satisfaction with the parenting workshops than parents who did not. Parents in the brief MI group also reported a relatively high level of satisfaction with the MI procedures. Implications for future research and MSIs are discussed.     

Predictors of exercise program participation in older women

Abstract

This study examined predictors of exercise program participation in females aged 60 to 89 years of age. Fifty-five exercise program participants and 50 non-exercising subjects were assessed on potential group predictor variables. Univariate analyses indicated that the Exercise compared to the Non-Exercise group had a stronger belief that they did not receive enough exercise in their everyday lives and in the health value of exercise, greater self-efficacy and enjoyment of exercise, and less physical discomfort associated with exercise. The Exercise group perceived exercise programs to be more available and greater family support to participate. Medical advice to exercise and exercise history did not differ significantly between groups. A logistic regression analysis indicated that of the variables assessed, belief that one is not receiving enough exercise in daily life and exercise availability were the most powerful predictors of exercise group membership. The implications of these findings for the promotion of exercise in older women are discussed.