Psychosocial risk and resistance factors among children with chronic illness,healthy siblings,and healthy controls

Psychosocial risk and resistance factors within the domains of parental functioning, family Stressors, and family resources were examined as predictors of psychological adjustment and physical problems in juvenile rheumatic disease patients (N=93), their healthy siblings (N=72), and demographically matched healthy controls (N=93). Family socioeconomic status and background variables showed few consistent relationships with child functioning. However, a constellation of risk and resistance factors tended to show comparable associations with functioning for patients, siblings, and controls. Higher parental depression and medical symptoms and more family Stressors, sibling problems, and burden of illness on the family predicted more problems among the patients. These relationships held when disease duration and severity were controlled. For the siblings, increased parental and patient dysfunction, more family Stressors, and less family cohesion and expressiveness were associated with more problems. Although the associations were not as strong, mothers' depression and lack of family cohesion and expressiveness also were related to more adjustment problems among the control children. These findings imply that there may be a general association between certain risk and resistance factors and childhood adaptation.This research was supported in part by NIH Multipurpose Arthritis Center Grant AM20610, NIMH Grant MH16744, and Veterans Administration Medical and Health Services Research and Development Service Research funds. Jan Gottlieb provided valuable help in all phases of the research. We appreciate the help of the staff of the Pediatric Rheumatology Clinic at Children's Hospital at Stanford and the families who participated in this study.     

Successful Development: Childhood Antecedents of Adaptive Psychosocial Functioning in Adulthood

The study was part of the Jyväskylä Longitudinal Study of Personality and Social Development. Data on developmental background for 131 women and 130 men consisted of variables for (1) emotion regulation at age 8, (2) cognitive–motivational orientation at age 14, and (3) family circumstances, and data on adult outcomes for variables concerning psychosocial functioning at age 36. Links between the childhood and adulthood variables were investigated using the LISREL model which consisted of two parts, the measurement model and the structural equation model. Two correlating latent factors emerged from adult outcomes for men and women: Social Functioning, consisting of external criteria for successful development (stability of career line, controlled drinking, socialization) and Psychological Functioning, consisting of internal criteria (self-esteem and psychological well-being). Only Social Functioning was explained by developmental background. High emotion regulation in childhood was a more robust antecedent of good social functioning in men than in women.     

Relational and psychological mediators of change in low‐income couples' perceived health

Experimental tests of the association between relationship functioning and physical health are limited. Although associations are hypothesized to be partially mediated through improved psychological functioning, tests are mostly limited to lab‐based studies. The present study evaluated relational and psychological mediators of change in perceived health in a sample of 742 low‐income couples (1,484 individuals) who participated in a randomized controlled trial of two online relationship education programs and a waitlist control group. Results partially supported the Strengths and Strains Model of Relationships and Physical Health. Relationship functioning and some psychological functioning were mediators of change in perceived health. Future research is needed to understand how relationship functioning improved perceived health through mediators other than psychological functioning tested here.     

Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy white women.

This preliminary study compared the associations between objective and subjective socioeconomic status (SES) with psychological and physical variables among 157 healthy White women, 59 of whom subsequently participated in a laboratory stress study. Compared with objective indicators, subjective social status was more consistently and strongly related to psychological functioning and health-related factors (self-rated health, heart rate, sleep latency, body fat distribution, and cortisol habituation to repeated stress). Most associations remained significant even after controlling for objective social status and negative affectivity. Results suggest that, in this sample with a moderately restricted range on SES and health, psychological perceptions of social status may be contributing to the SES-health gradient.     

Predictors of Psychological Well-Being of Adolescents’ Parents

Informed by theories about processes in families with adolescent children, this study examined the contribution of self-perceived decline in physical and cognitive functioning related to midlife, marital satisfaction, and parent–child conflict to psychological well-being of parents of young adolescents. Parental well-being was conceptualized within Ryff’s multidimensional model, which encompasses six dimensions: Autonomy, Self-Acceptance, Environmental Mastery, Positive Relationships with Others, Personal Growth, and Purpose in Life. In examining relationships between parental well-being and supposed predictors, sociodemographic variables (parental age and education), perceived general life stress, and perceived available social support were controlled for. Participants were Croatian mothers (N?=?356) and fathers (N?=?328) whose oldest child was transitioning to adolescence. Overall, the patterns of associations between the studied predictors and well-being dimensions were similar for mothers and fathers. The main finding of the study was that individual differences in the psychological well-being of adolescents’ parents may be more attributable to self-perceived midlife changes (particularly for mothers) and marital satisfaction (particularly for fathers) than to perceived level of parent–adolescent conflict.     

General self‐efficacy in various domains of human functioning: Evidence from five countries

Based on social‐cognitive theory ( 1 Bandura, 1997), this paper examined whether perceived self‐efficacy is a universal psychological construct that accounts for variance within various domains of human functioning. Perceived self‐efficacy is not only of a task‐specific nature, but it can also be identified at a more general level of functioning. General self‐efficacy (GSE) is the belief in one's competence to tackle novel tasks and to cope with adversity in a broad range of stressful or challenging encounters, as opposed to specific self‐efficacy, which is constrained to a particular task at hand. The study aimed at exploring the relations between GSE and a variety of other psychological constructs across several countries. Relations between general self‐efficacy and personality, well‐being, stress appraisals, social relations, and achievements were examined among 8796 participants from Costa Rica, Germany, Poland, Turkey, and the USA. Across countries, the findings provide evidence for associations between perceived general self‐efficacy and the selected variables. The highest positive associations were with optimism, self‐regulation, and self‐esteem, whereas the highest negative associations emerged with depression and anxiety. Academic performance is also associated with self‐efficacy as hypothesized. The replication across languages or cultures adds significance to these findings. The relations between self‐efficacy and other personality measures remained stable across cultures and samples. Thus, perceived general self‐efficacy appears to be a universal construct that yields meaningful relations with other psychological constructs.     

Transactional Paths Between Children and Parents in Pediatric Asthma: Associations Between Family Relationships and Adaptation

The particular challenges posed by pediatric asthma may have a negative impact on the adaptation of children and their parents. From a transactional approach it is important to examine how reciprocal links between children and parents contribute to explain their adaptation and under which conditions these associations occur. This cross-sectional study aimed at examining the direct and indirect links between children’s and parents’ perceptions of family relationships and adaptation, separately (within-subjects) and across participants (cross-lagged effects), and the role of asthma severity in moderating these associations. The sample comprised 257 children with asthma, aged between 8 and 18 years-old, and one of their parents. Both family members completed self-reported questionnaires on family relationships (cohesion and expressiveness) and adaptation indicators (quality of life and psychological functioning). Physicians assessed asthma severity. Structural Equation Modeling was used to test within-subjects and cross-lagged paths between children’s and parents’ family relationships and adaptation. The model explained 47 % of children’s and 30 % of parents’ adaptation: family relationships were positively associated with adaptation, directly for children and parents, and indirectly across family members. Asthma severity moderated the association between family relationships and health-related quality of life for children: stronger associations were observed in the presence of persistent asthma. These results highlight the need of including psychological interventions in pediatric healthcare focused on family relationships as potential targets for improving children’s and parents’ quality of life and psychological functioning, and identified the children with persistent asthma as a group that would most benefit from family-based interventions.     

Positive Psychological Functioning and the Biology of Health

Most research considers both psychological and physical health with a disease perspective by focusing on poor psychological functioning or disease outcomes. However, identifying attributes that support adaptive functioning may inform approaches to achieving health beyond what we learn from studying risk factors that accelerate deterioration. Recent evidence suggests that positive psychological functioning contributes to attaining optimal physical health. We evaluate the current state of knowledge on the relationship between positive psychological functioning and physical health, defining health beyond solely the absence of disease. We further consider when positive psychological functioning begins to exert effects on health, whether it has direct effects on biological processes or serves primarily to buffer the effects of stress, and whether it is associated with health outcomes and biological processes beyond those that reflect the absence of deterioration and disease. We propose some key directions for future research including the assessment of positive psychological functioning, positive biological functioning, and optimal health, the value of multi‐system measures, and the potential of “omics” to provide novel insights into biological mechanisms underlying associations between positive psychological functioning and physical health.     

Daily hassles,marital functioning and psychological distress among community-dwelling older couples

ObjectivesThis study attempts to examine the association between stress induced by daily hassles, marital functioning and psychological distress among a sample of older couples living at home without assisted living facilities. Moreover, the study looks to assess the moderator role of marital functioning on the association between stress and psychological distress.MethodsThe study included a representative sample of 508 older couples living at home where at least one spouse was aged 65 years or older. To take into account of the non-independence of the data, dyadic analyses were conducted.ResultsFor men, marital functioning and stress induced by daily hassles explained the variance of psychological distress 4.71% and 2.56% respectively. For women, these variables explained 10.96% and 2.43% respectively of this variance. Results found also that marital functioning can play a protective role between the association of stress and psychological distress among men, but not for women. Men with lower marital functioning present a significant higher level of psychological distress when they present stress than those who do not have stress. For those with high marital functioning, no significant differences have been found on psychological distress between those groups.ConclusionStress induced by daily hassles and marital functioning are significantly related to psychological distress among older people, and, for men, marital functioning can play a protective role in the association between those variables.     

Recollections of parental style and perceptions of current family functioning at age 50

It is hypothesized that recollections of an individual's parental behaviour towards them is associated with their view of their current family functioning. This hypothesis was tested for using data provided by 213 men and 270 women drawn at age 50 from the Newcastle Thousand Families Study. Relationships between retrospective reports of parental behaviour during childhood and perceptions of current family functioning at age 50 were investigated using a univariate regression analysis in order to explore the relationship between scores on the Parental Bonding Instrument (PBI) and the McMaster Family Assessment Device (FAD). Where a significant association was observed the relationship between subscale scores was further examined using a multivariate regression analysis including gender and self‐reported psychological well‐being (as measured by the General Health Questionnaire‐ GHQ) as covariates. Several statistically significant associations between PBI and FAD subscale scores were observed. Four of these remained statistically significant once gender and self‐reported psychological well‐being were adjusted for. In this population sample, aspects of recalled parental behaviour were associated with the health of current family functioning in several domains as reported by the FAD. These associations appear to be partly mediated by current psychological well‐being.     

Health-related quality of life in chronic fatigue syndrome: predictors of physical functioning and psychological distress

This study investigated health-related quality of life (HRQoL; physical functioning and psychological distress) in an Australian chronic fatigue syndrome (CFS) population. The aims of the study were to compare HRQoL in those with CFS to the normal population, and to investigate the extent to which sociodemographic (age, gender, partner status, education), illness-related (illness duration, symptom frequency), and fatigue severity (physical, mental) variables predicted HRQoL. A total of 139 people meeting CFS criteria completed questionnaires. HRQoL was assessed using standardised measures of distress and physical functioning. Compared with norms, those with CFS obtained significantly lower scores on all physical functioning areas, whereas 63% of participants reported clinically significant psychological distress. Hierarchical regression analyses indicated that physical fatigue severity and symptom frequency were the strongest predictors of deficits in physical domain HRQoL. Physical HRQoL outcomes were also predicted by mental fatigue severity, older age, and female gender. All predictors were unrelated to psychological distress apart from weak positive associations with physical fatigue and symptom frequency. Results identify a potent set of predictors of HRQoL and show that CFS has a pervasive negative impact on quality of life, particularly physical and psychological functioning.     

A systematic review of psychoneuroimmunology-based interventions

Psychoneuroimmunology-based interventions are used to attenuated disease progression and/or side effects of pharmacological treatment. This systematic review evaluates the different therapeutic and/or clinical psychoneuroimmunology-based interventions associated to both psychological, neuroendocrine and immunological variables. The review was conducted for all English, Portuguese and Spanish language articles published between 2005 and 2015. Independent investigators analyzed 42 studies concerning human psychoneuroimmunology-based interventions. Decreased levels of cortisol, epinephrine and norepinephrine (stress-related hormones) were associated to interventions like yoga, meditation, tai chi, acupuncture, mindfulness, religious/spiritual practices, cognitive behavior therapy, coping and physical exercises. Moreover, those interventions were also associated to reductions in inflammatory processes and levels of pro-inflammatory cytokines in cancer, HIV, depression, anxiety, wound healing, sleep disorder, cardiovascular diseases and fibromyalgia. Despite the associations between PNI variables and clinical/therapeutic interventions, only one study evidenced significant effects on a disease progression.     

Models of family functioning and their contribution to patient outcomes in chronic pain

This paper analyzes the relationship between family functioning and chronic pain, and evaluates a model which integrates the role of family variables with the pain-coping process in patients with rheumatoid arthritis (RA) and fibromyalgia (FM). Family variables, assessed by subscales of the Family Environment Scale (FES), and different components of the pain-coping process varied significantly in their contribution to pain, psychological functioning, and disability in these two chronic pain disorders. High system maintenance control and low independence contributed significantly to pain in RA and FM, respectively, while low family cohesiveness contributed to psychological disturbances in FM subjects. Lack of promotion of activity and recreation in the family was associated with greater disability in both groups. In addition to family variables, helplessness proved to be a potent predictor of pain and psychological functioning in both groups, and disability in FM subjects. Pain-coping had its predominant influence on pain. As an exploratory test of the model, the data confirm the importance of examining this integrated framework in longitudinal, prospective studies, and its potential utility in clinical assessment and intervention.This research was supported by a Multipurpose Arthritis and Musculoskeletal Diseases Center grant AR40770 from the National Institute of Arthritis and Musculoskeletal Diseases at the University of California, San Diego. Portions of this paper were presented at the convention of the American Psychological Association, August 1992, in Washington, DC, and at the meeting of the Society of Behavioral Medicine, March 1993, in San Francisco.The authors gratefully acknowledge Teresa A. Krall, M.A., and Karen Schoenfeld-Smith, M.A. for their valuable assistance in statistical analysis for this article.     

Adaptive family functioning and emotion regulation capacities as predictors of college students' appraisals and emotion valence following conflict with their parents

This study examined whether the relationship between college students' adaptive family functioning and the valence of emotions following recent conflict with their parents is mediated by both distal constructs (psychological coping resources and mood regulation expectancies) and the more proximal construct of cognitive appraisals about the desirability or undesirability of the conflict experience. Participants were 609 undergraduate students enrolled in a large, US southwestern university. The results of applying proposed mediational models to these data, developed for both paternal and maternal conflict, suggested theoretically meaningful associations between the antecedent construct of adaptive family functioning, mediating variables of coping resources, mood regulation expectancies, and cognitive appraisals, and the outcome variable of emotional valence. The results of this study may be useful in identifying psychological resources and patterns of thinking about stressful events that affect emotional reactions.     

Fatigue,emotional functioning,and executive dysfunction in pediatric multiple sclerosis

Objective: Fatigue, depression, anxiety, and executive dysfunction are associated with multiple sclerosis (MS) in adults. Existing research suggests similar problems in pediatric MS, but relationships between these variables have not been investigated. This study investigates the associations between executive functioning and fatigue, emotional functioning, age of onset, and disease duration in pediatric MS.

Methods: Twenty-six MS or Clinically Isolated Syndrome (CIS) patients, ages 7 to 18, were evaluated through a multidisciplinary demyelinating diseases clinic. Participants completed neuropsychological screening including Verbal Fluency, Digit Span, and Trail-Making Test. Parents completed rating forms of behavioral, emotional, and executive functioning. Patients and parents completed questionnaires related to the patient’s quality of life and fatigue. Pearson’s correlation coefficients were calculated to investigate relationships between fatigue, emotional functioning, and executive functioning, as well as to examine correlations between parent and child reports of fatigue.

Results: Rates of parent-reported anxiety, depression, fatigue, and executive dysfunction varied widely. Means were below average on the Trail-Making Test and average on Verbal Fluency and Digit Span, though scores varied widely. Various fatigue and emotional functioning indices—but not age of onset or disease duration—significantly correlated with various performance-based measures of executive functioning.

Conclusion: Results indicate pediatric MS is associated with some degree of fatigue, emotional difficulties, and executive dysfunction, the latter of which is associated with the two former. Notably, age of onset and disease duration did not significantly correlate with executive functioning. Results advance understanding of psychological and clinical variables related to neurocognitive outcomes in pediatric MS.     

The mediating and moderating effects of differentiation of self on body mass index and depressive symptomatology among an American college sample

Differentiation of self – a core construct of Bowen's (Bowen, M. (1978). Family therapy in clinical practice. New York: Jason Aronson) family systems theory – was examined as a possible predictor of psychological health and physical health and as a mediator and moderator of the relation between overall functioning and psychological health and physical health. A total of 818 American college students participated (mean age?=?23.72, SD?=?4.79) in this study. Differentiation of self was correlated and was predictive of psychological health, as measured by the Beck depression inventory, and physical health, as measured by body mass index (BMI). A multivariate multiple regression model revealed that differentiation of self partially mediated the effects of overall functioning on depressive symptomatology and on BMI. Results from a hierarchical regression model showed that differentiation of self moderated the relation between overall functioning and depressive symptomatology but did not moderate the relation between overall functioning and BMI. Taken together, these preliminary findings provide initial evidence of the importance of the associations between family systemic factors (differentiation of self) and psychological and physical health factors among American college populations.     

Dysfunctional body investment versus body dissatisfaction: Relations with well-being and controlled motivations for obesity treatment

In this study, we investigated the associations between body image and psychological well-being, exploring the mediating role of controlled regulation for entering obesity treatment. In addition, we analyzed whether investment body image was more strongly associated with controlled regulation (and subsequent well-being) compared to evaluative body image. These analyses were performed controlling for baseline BMI effects. Participants were 139 overweight women (age: 38.0 ± 6.7 year; BMI: 32.0 ± 4.1 kg/m²) entering treatment. Evaluative and investment body image, controlled regulation, and psychological well-being were assessed. Body image investment was positively associated with controlled regulation; evaluative body image was not. Controlled regulation was negatively associated with self-esteem and psychological functioning. Controlled regulation partially mediated the effects of body image investment on self-esteem, but did not mediate its effects on psychological functioning. Results suggest that dysfunctional body image investment might undermine well-being within overweight women, partly by increasing controlled regulation for entering obesity treatment. Discussion focuses on the importance of enhancing body image and autonomy during treatment to improve well-being and weight outcomes.     

Is expressive suppression always associated with poorer psychological functioning? A cross-cultural comparison between European Americans and Hong Kong Chinese

The habitual use of expressive suppression as an emotion regulation strategy has been consistently linked to adverse outcomes in a number of domains, including psychological functioning. The present study aimed to uncover whether the suppression-health relationship is dependent on cultural context, given differing cultural norms surrounding the value of suppressing emotional displays. We hypothesized that the negative associations between suppression and psychological functioning seen in European Americans would not be seen among members of East Asian cultures, in which emotional restraint is relatively encouraged over emotional expression. To test this hypothesis, we asked 71 European American students and 100 Chinese students from Hong Kong to report on their use of expressive suppression, life satisfaction, and depressed mood. A moderation analysis revealed that expressive suppression was associated with adverse psychological functioning for European Americans, but not for Chinese participants. These findings highlight the importance of context in understanding the suppression-health relationship.     

Ecological Correlates of Family Functioning

Guided by ecological theory, we empirically explored how parents' psychological functioning, social relationships, and demographic characteristics related to family functioning. Our sample of 197 participants included both neglectful and control families. We found statistically significant associations between the predictor variables (i.e., maternal personal maturity, depression, stressful life events, social support, family of origin difficulties, education, income) and family functioning as rated by mothers, caseworkers familiar with the families, and observers who coded family interaction tasks. However, the exact pattern of significant associations differed as a function the rater of family health.     

Longitudinal direct and indirect pathways linking older sibling competence to the development of younger sibling competence

A 4-wave longitudinal model tested direct and indirect links between older sibling (OS; M = 11.7 years) and younger sibling (YS; M = 9.2 years) competence in 152 rural African American families. Data were collected at 1-year intervals. At each wave, different teachers assessed OS competence, YS competence, and YS self-regulation. Mothers reported their own psychological functioning; mothers and YSs reported parenting practices toward the YS. OS competence was stable across time and was linked with positive changes in mothers' psychological functioning from Wave 1 to Wave 2. Mothers' Wave 2 psychological functioning was associated with involved-supportive parenting of the YS at Wave 3. OS Wave 2 competence and Wave 3 parenting were indirectly linked with Wave 4 YS competence, through Wave 3 YS self-regulation. Structural equation modeling controlled for Wave 1 YS competence; thus, the model accounted for change in YS competence across 3 years.