Profiles in Problem Solving: Psychological Well-Being and Distress Among Persons with Diabetes Mellitus

Although social problem-solving abilities have been consistently associated with indicators of behavioral health, this work has been largely confined to tests of specific theoretical issues. Research has yet to demonstrate how the separate elements of the social problem-solving model relate to different patterns of adjustment, particularly among persons who live with chronic disease. We studied the occurrence of different profiles of social problem-solving abilities observed among persons living with diabetes mellitus. We then examined differences between clusters on measures of life satisfaction and depression. Results indicate that distinct profiles in problem-solving abilities do occur and these groupings can be distinguished by their different patterns of adjustment. Implications for theoretical models of problem solving and clinical assessment and interventions for persons with diabetes are discussed.     

Family Caregivers of Women with Physical Disabilities

Cross-sectional, correlational analyses of data from two separate studies were conducted to examine the correlates of adjustment among family caregivers of women with disabilities. Participants included 40 caregivers of women with spinal cord injuries in the first study and 53 caregivers of women with cerebral palsy, traumatic brain injury, and other neuromuscular disabilities in the second study. It was hypothesized that a negative problem-solving style would be associated with greater caregiver distress in both studies, and that caregiver adjustment would be associated with care recipient depression in the second study. As expected, results indicated that a higher negative orientation toward solving problems was associated with caregiver depression and lower well-being. However, in the second study, caregiver characteristics were not associated with care recipient depression. These data indicate that considerable variability exists in caregiver adjustment. Methodological limitations and the implications for research, service, and policy formation are! discussed.     

Family Caregivers of Persons With Spinal Cord Injury: Predicting Caregivers at Risk for Probable Depression

OBJECTIVE: To determine the percentage of family caregivers of persons with spinal cord injury (SCI) with probable depression and to test the hypothesis that dysfunctional problem-solving abilities would be significantly predictive of risk status after taking into account important demographic characteristics and caregiver health. DESIGN: Correlational and logistic regression analyses of data collected in a cross-sectional design. PARTICIPANTS: Eighteen men and 103 women caregivers (mean age of caregivers = 45.66 years, SD = 12.88) of individuals with SCI. MAIN OUTCOME MEASURE: The Inventory to Diagnose Depression. RESULTS: Nineteen caregivers (15.7%) met criteria on the Inventory to Diagnose Depression for a major depressive disorder. A dysfunctional problem-solving style was significantly predictive of caregiver depression, regardless of the severity of physical impairment of the care recipient or the physical health of the caregiver and caregiver demographic variables. CONCLUSIONS: The percentage of caregivers with probable depressive disorder may parallel that observed among persons with SCI, using a more conservative self-report measure designed to assess symptoms associated with a depressive syndrome. Family caregivers with a dysfunctional problem-solving style and assisting individuals with more severe injuries may have probable depression.     

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

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

The Social Psychology of Caregiving: Physical and Psychological Costs of Providing Support to the Disabled1

The emphasis of much of the existing research on social support-health relationships has been on the availability and impact of support on the recipient, but social psychologists have paid little attention to the costs to the caregiver of providing that support. In an earlier study (Schulz & Decker, 1985), we found that the long-term coping of individuals experiencing chronic disability as a result of spinal-cord injury was facilitated by the availability of a primary support person, or caregiver. In this study we examined the determinants of well-being of the primary caregiver of the middle-aged and elderly spinal-cord-injured persons. Psychological well-being, life satisfaction, and depression were the dependent measures. The availability of social support, social contact, and feelings of control over one's life were important determinants of caregiver well-being, even after controlling for health and income. In addition, the amount of time spent each day assisting the disabled person was a strong independent correlate of depression, and the extent to which the caregiver felt burdened by the victim was significantly and negatively related to life satisfaction. These results are discussed in the context of a comprehensive stress-coping model. Since data were available from both disabled individuals and their primary support persons, we had the unique opportunity to compare the perspectives of both those giving and receiving daily care. We found no relationship in levels of psychological well-being and depression reported by the disabled person and caregiver; however, caregivers attributed to the victims affective levels similar to their own.     

The Caregivers of Stroke Patients: An Investigation of Factors Associated with Depression

Caregivers of the elderly and infirm are often under more stress and report lower life satisfaction than matched groups of noncaregivers. Forty caregivers of stroke patients (usually a spouse) were interviewed an average of 9 months poststroke to determine the factors associated with poorer caregiver adjustment. Four classes of variables were expected to be related to depression in caregivers: level of functioning of the patient, caregiver perceptions of increased work and burden due to the stroke, the quality of the patient-caregiver relationship, and caregivers' interpretations of their situation. Background characteristics were also measured. As predicted, variables in each class were significantly related to depression. Multiple regression analysis showed three significant independent predictors of caregiver depression. Caregivers are more depressed if the patient is more physically impaired, if caregivers report disharmony in the family, and if they have lesser perceptions of hope Ways to apply these findings to the development of interventions to ameliorate caregiver depression are discussed.     

FOCUS on the Family Caregiver: A Problem‐Solving Training Intervention

Problem‐solving interventions have documented effectiveness in treating distress among a variety of clientele. The authors discuss the application of training in social problem solving with family caregivers of persons who have incurred severe physical disabilities. Specifically, the authors outline training procedures (i.e., Project FOCUS) that enable counselors to assist family caregivers in developing effective problem‐solving skills that may translate to increased wellness for each caregiver, and by extension, their care recipients.     

Social problem‐solving,perceived stress,depression and life‐satisfaction in patients suffering from tension type and migraine headaches

This study aimed at investigating social problem solving, perceived stress, depression, and life‐satisfaction in patients with tension type and migraine headaches. Forty‐nine migraine and 42 tension type headache patients (n = 91) consenting to participate were compared to a total of 49 matched healthy control group. Participants filled in a questionnaire consisting self‐report measures of problem solving, perceived stress, depression and life satisfaction. They were also asked about headache duration, frequency, pain severity, psychiatric treatment and sense of control in one's life. T‐tests, chi‐square, analysis of variance, logistic regression analysis and Pearson product moment correlation coefficient procedures were used to analyze the data. Tension type headache patients reported having had more frequent headaches than the migraine patients but migraine patients reported having had more intense pain than the tension type headache patients. Instances of psychiatric treatment were more common among tension type headache patients than the migraine and the control group. Compared to the healthy controls, headache patients displayed a deficiency in problem solving, higher levels of perceived stress and depression. Levels of problem solving skills in headache patients were related inversely to depression, perceived stress and the number of negative life events but problem solving skills of headache patients was related positively to life‐satisfaction. The findings from this study suggested that cognitive behavioral problem solving therapy or training might be a viable option for reducing levels of stress and depression, and to increase life‐satisfaction in patients suffering from primary headache.     

Helping or Hovering? The Effects of Helicopter Parenting on College Students’ Well-Being

Parental involvement is related to many positive child outcomes, but if not developmentally appropriate, it can be associated with higher levels of child anxiety and depression. Few studies have examined the effects of over-controlling parenting, or “helicopter parenting,” in college students. Some studies have found that college students of over-controlling parents report feeling less satisfied with family life and have lower levels of psychological well-being. This study examined self-determination theory as the potential underlying mechanism explaining this relationship. College students (N = 297) completed measures of helicopter parenting, autonomy supportive parenting, depression, anxiety, satisfaction with life, and basic psychological needs satisfaction. Students who reported having over-controlling parents reported significantly higher levels of depression and less satisfaction with life. Furthermore, the negative effects of helicopter parenting on college students’ well-being were largely explained by the perceived violation of students’ basic psychological needs for autonomy and competence.     

Correlates of spirituality and well-being in a community sample of people living with HIV disease

While the past several years have witnessed an increase in the amount of research examining the spiritual perspectives of people living with HIV/AIDS, this literature is still insufficient to guide the conceptualization and development of spiritually based interventions to improve the life quality of people living with HIV illness. The present study assessed a community sample of 275 persons living with HIV disease to examine relationships among their spirituality, quality of life, perceptions of social support, and coping and adjustment efforts. This study found relationships between social support, active problem solving, life satisfaction, and gender and race with higher levels of spirituality among people living with HIV/AIDS. Mental health providers may need to routinely include assessments of spirituality and religious practices. Caregivers, faith communities, and mental health providers will need to assist in developing supportive environments that enhance the spiritual life and social well-being of people living with HIV infection. Additionally, caregiver training programs will need to focus on spiritual practices as a means of establishing a support system that increases the psychosocial well-being of people living with HIV/AIDS.     

Family Management of Pediatric Cancer: Links with Parenting Satisfaction and Psychological Distress

Research has long acknowledged the disruptions posed by pediatric cancer diagnosis and treatment to family life. Nonetheless, the mechanisms through which the family response influences parents’ mental health in this adverse context are not fully understood. The main goal of the present study was to examine the direct and indirect links, via parenting satisfaction, between family condition management and psychological distress of parents of children with cancer. Participants were 201 parents (86.6% mothers) of children/adolescents diagnosed with cancer who completed self‐report questionnaires assessing family condition management (family life difficulty and parental mutuality), parenting satisfaction, and psychological distress (anxiety and depression). Structural equation modeling was used to test the proposed mediation model. The results showed that parenting satisfaction mediated the association between both the family condition management dimensions (family life difficulty and parental mutuality) and depression. Specifically, greater family life difficulties and lower parental mutuality were associated with lower parenting satisfaction, which, in turn, was associated with higher levels of depression. Additionally, greater family life difficulties and lower parental mutuality were directly linked to higher levels of anxiety. Multigroup analyses suggested that the model was valid across patient age groups (children vs. adolescents) and treatment status (on vs. off‐treatment). These findings reinforce the need for family‐ and parent‐based interventions in the pediatric oncology field. Interventions that target families’ difficulties and promote their resources are likely to foster parenting satisfaction and psychological adjustment.     

Stress, appraisal, coping, and social support as predictors of adaptational outcome among dementia caregivers

A stress and coping model was used to study predictors of individual differences in caregiver adaptation. A total of 54 family caregivers of elderly dementia patients completed interviews and questionnaires assessing the severity of patient impairment and caregiving stressors; caregiver appraisals, coping responses, and social support and activity; and caregiver outcomes, including depression, life satisfaction, and self-rated health. Correlational and regression analyses supported the utility of the stress and coping model. Appraisal, coping responses, and social support and activity were significant predictors of caregiver outcome, even when severity of caregiving stressors was statistically controlled. The importance of a multidimensional approach to assessing caregiver outcomes was supported by regression analyses indicating that each caregiver outcome was predicted by different patterns of stressors, appraisal, coping, and social support and activity. Results are discussed in terms of a stress and coping model of caregiving, and clinical implications for work with caregiving families.     

Insight into the Parenthood Paradox: Mental Health Outcomes of Intensive Mothering

Though people often report wanting to have children because they think it will make them happier, much research suggests that parenting is associated with decreased well-being. Other studies have found that parenting is related to increased life satisfaction. The goal of this study was to provide insight into this paradox by investigating the relationship between a specific way of parenting, intensive parenting, and maternal mental health. An online survey was completed by 181 mothers with children ages 5 and under. Intensive mothering beliefs correlated with several negative mental health outcomes. Controlling for perceived family social support, the belief that women are the essential parent was related to lower life satisfaction and believing that parenting is challenging was related to greater depression and stress. The results of this study suggest that aspects of intensive mothering beliefs are detrimental to women’s mental health. It may not be parenting per se, but specific and particularly intensive ways of parenting, that relate to negative mental health outcomes.     

Social Support from Family and Friends and Subjective Well-Being of Older African Americans

This study examines the impact of informal social support from family and friends on the well-being of older African Americans. Analyses are based on a nationally representative sample of older African Americans from the National Survey of American Life (n = 837). Three measures of well-being are examined: life satisfaction, happiness and self-esteem. The social support variables include frequency of contact with family and friends, subjective closeness with family and friends, and negative interactions with family. Results indicate that family contact is positively correlated with life satisfaction. Subjective closeness with family is associated with life satisfaction and happiness and both subjective closeness with friends and negative interaction with family are associated with happiness and self-esteem. There are also significant interactions between family closeness and family contact for life satisfaction, as well as friendship closeness and negative interaction with family for happiness. Overall, our study finds that family and friend relationships make unique contributions to the well-being of older African Americans. Qualitative aspects of family and friend support networks (i.e., subjective closeness, negative interactions) are more important than are structural aspects (i.e., frequency of contact). Our analysis verify that relationships with family members can both enhance and be detrimental to well-being. The findings are discussed in relation to prior research on social support and negative interaction and their unique associations with well-being among older African Americans.     

Perfectionistic Self‐Presentation and Trait Perfectionism in Social Problem‐Solving Ability and Depressive Symptoms

This study examined social problem solving and perfectionistic self‐presentation, and assessed whether social problem solving mediates the association between perfectionism and depression. A sample of 200 community members completed measures of perfectionistic self‐presentation, trait perfectionism, social problem‐solving ability, and depression. Correlational analyses confirmed that perfectionistic self‐presentation and socially prescribed perfectionism are both associated with a negative problem‐solving orientation. Tests of mediating effects revealed that negative problem‐solving ability mediates the associations of socially prescribed perfectionism and perfectionistic self‐presentation with depressive symptoms, particularly among women. The findings support further exploration of mediational models linking perfectionism, problem‐solving ability, and depression and suggest that people who display high perfectionistic self‐presentation are particularly vulnerable to stress and distress and should benefit from problem‐solving training.     

Artists' vulnerability to psychopathology: Towards an integrative cognitive perspective

A relationship is commonly reported between high levels of artistic creativity and mental health problems (e.g., depression or psychosis), and it is now becoming clearer that the divergent cognitive style associated with creativity has commonalities with some of the processes involved in the development and maintenance of some psychological difficulties. Our aim was to investigate the nature of this cognitive style. More specifically, we considered the profile of probabilistic reasoning and associated problem solving abilities, as both of these mechanisms have been found to be integral to major forms of clinical dysfunction. We assessed levels of creative potential, mood, probabilistic reasoning, and problem solving abilities in 66 arts and 85 science undergraduate volunteers. As predicted, art students showed higher levels of creative potential and experienced lower levels of mood than their science peers. Differences in probabilistic reasoning were observed which are in keeping with the pattern reported to be present in those suffering with psychosis in that they tended to ‘jump to conclusions’. Art students also displayed both poorer problem solving abilities and self‐appraisal of their problem solving skills. Our results extend previous findings associated with the mediating role of cognitive processes in the relationship between creativity and some forms of psychopathology. Implications for the prevention and treatment of psychological difficulties in the creative are highlighted.     

Using a new taxonomy to combine the uncombinable: integrating results across diverse interventions

Researchers have examined numerous psychosocial and behavioral interventions intended to alleviate distress among family caregivers of persons with dementia. Many of these interventions are complex, combining numerous treatment components. Although some multicomponent interventions have been successful in reducing caregiver distress, the impact of specific elements of these interventions on outcomes is not known. The article presents results of an analytic approach that allows researchers to describe the individual elements of multicomponent interventions and to examine the relationships between those components and outcomes. This approach is successfully applied to interventions being evaluated in the Resources for Enhancing Alzheimer's Caregiver Health (REACH) program. The results indicate that actively targeting caregiver behavior is effective in achieving positive outcomes with respect to caregiver depression.     

Self-appraisal, life satisfaction, and retrospective life choices across one and three decades.

This research investigated the relationship of a self-appraisal of having lived up to one's intellectual abilities at midlife (average age of 49 years) with life satisfaction and retrospective life choices 1 and 3 decades later among 383 participants in the Terman Study of the Gifted. Study 1 showed that participants who reported living up to their intellectual abilities were higher in satisfaction with occupational success, satisfaction with family life, and joy in living 11 years later. Study 2 showed that participants who reported living up to their abilities were higher in overall life satisfaction and were less likely to report that they would make different life choices in work or family life 3 decades later. In an integrative structural equation model, the relation between the midlife self-appraisal of having lived up to intellectual abilities and overall satisfaction at age 80 was mediated by life satisfaction discrepancy at age 61.     

Caregiver Attributions for Late‐Life Depression and Their Associations with Caregiver Burden

Late‐life depression (LLD) has detrimental effects on family caregivers that may be compounded when caregivers believe that depressive behaviors are volitional or within the patient's capacity to control. In this study we examined three person‐centered caregiver attributions that place responsibility for LLD on the patient (i.e., character, controllability, and intention), and the impact of such attributions on levels of general caregiver burden and burden specific to patient depressive symptoms. Participants were 212 spouses and adult children of older adults enrolled in a depression treatment study. Over one third of caregivers endorsed character attributions, which significantly predicted greater levels of both general and depression‐specific burden. Intention attributions were significantly associated with general burden, but not depression‐specific burden. Contrary to our expectation, controllability attributions did not predict either type of burden. Our findings suggest that the assessment of family caregiver attributions for LLD may be useful in identifying caregivers at risk for burden and subsequent health effects, as well as those who may need education and support to provide effective care to a vulnerable population of older adults.     

The role of romantic attachment and self‐criticism and dependency for the relationship satisfaction of community adults

This article aims to investigate the role of romantic attachment versus the personality dimensions related to self‐definition and relatedness for relationship satisfaction. Self‐report instruments measuring romantic attachment, self‐criticism and dependency, severity of depression, negative life events and relationship satisfaction were administrated to 266 community adults. As expected, results showed that secure romantic attachment was positively and insecure romantic attachment was negatively associated with relationship satisfaction, and this was the case even when controlling for self‐criticism and dependency, severity of depression and negative life events. Implications of these findings for couple therapy are discussed.