Life Circumstances and Personal Resources as Predictors of the Ten-Year Course of Depression

A 10-year naturalistic study of 313 patients who entered treatment for unipolar depression and a community comparison group of 284 nondepressed adults was conducted. We compared life stressors, social resources, personal resources, and coping among patients who were remitted (N = 76), partially remitted (N = 146), or nonremitted (N = 91). Compared with the controls and the remitted patients, the partially remitted and nonremitted patients consistently experienced more life stressors and fewer social resources, were less easygoing, and relied more on avoidance coping. A less easygoing disposition, fewer close relationships, and more reliance on avoidance coping were associated with higher odds of experiencing a course of partial remission or nonremission. In addition, more depressive symptoms and medical conditions predicted nonremission.     

Context and coping: Toward a unifying conceptual framework

After offering a conceptual framework to unify the domains of context and coping, some conclusions are drawn about the underlying patterns of social climate and the characteristics of growth-promoting environments. New directions of research on the dynamics of the environmental system are described. The conceptual framework is used to exemplify ways to explore the stress and coping process in regard to such issues as stress and resource predictors of adaptation, stress prevention and resistance, and cross-situational influences. The foregoing material then highlights implications of a social ecological perspective for conducting conceptually informed evaluation research and changing and improving community settings. Finally, such conceptual problems as person-environment matching and the need to formulate unified perspectives of stressors and resources are discussed to identify promising ways to spark the maturation of community psychology.     

Evaluating health care work settings: A holistic conceptual framework

Abstract

After offering a systems perspective that considers a diversity of job-related and personal factors, we discuss the determinants and impacts of health care work climates and how staff morale and performance can influence the treatment milieu and quality of patient care. We also describe the physical features, organizational structure and policies, and suprapersonal and task factors that help to shape health care work climates. We then review research on the connections between work climate and staff morale and performance, the interplay of work climate factors, and the role of personal factors in these relationships. Finally, we orovide some ideas about how to improve health care work settings and focus on some promising new research directions.     

Resource loss, resource gain, and depressive symptoms: a 10-year model.

This study examined a broadened conceptualization of the stress and coping process that incorporated a more dynamic approach to understanding the role of psychosocial resources in 326 adults studied over a 10-year period. Resource loss across 10 years was significantly associated with an increase in depressive symptoms, whereas resource gain across 10 years was significantly associated with a decrease in depressive symptoms. In addition, change in the preponderance of negative over positive events across 10 years was inversely associated with change in resources during the period. Finally, in an integrative structural equation model, the association between change in life events and depressive symptoms at follow-up was completely mediated through resource change.     

Life stressors, personal and social resources, and depression: a 4-year structural model

By extending earlier stress-resistance research with a 1-year time lag, findings with 254 adults show that adaptive personality characteristics and positive family support operate prospectively over 4 years in predicting reduced depression, even when prior depression is controlled. By strengthening knowledge about the determinants and mediational role of coping, the results demonstrate in a 2-group LISREL analysis that the pattern of predictive relations differs under high and low stressors. Under high stressors, personal and social resources relate to future psychological health indirectly, through more adaptive coping strategies. Under low stressors, these resources relate directly to psychological health. The results support the idea that such resources play a causal role in maintaining psychological health, and they suggest the potential for a general, adaptively oriented framework applicable to adjustment under both high and low stressors.     

Children of parents with unipolar depression: A controlled 1-year follow-up

An earlier cross-sectional study indicated that children's health and adjustment is at risk when their parents are depressed. Here, we report the associated longitudinal changes in children and families when parental depression either remits or continues. Comparisons are made among three groups established at a 1-year follow-up: previously depressed parents whose symptoms have remitted (N = 34 remitted parents), previously depressed parents who continue to be depressed (N = 23 nonremitted parents), and sociodemographically matched control families (N = 95). Although remitted parents and their family social environments improved, their children were still functioning more poorly than children of controls. Both the children and the families of nonremitted parents continued to function more poorly than controls. A social-environmental framework indicates that parents' functioning as well as family stressors and resources are concurrently and predictively linked to children's health.     

Preferences of older adults and experts for policies and services in group living facilities

The Policy and Program Information Form-Ideal Form (POLIF-I) was developed to assess preferences of older adults for the policies and services of group living facilities. Compared with older community residents (n = 205), congregate apartment residents (n = 229) prefer facilities that have higher behavioral standards, deemphasize supportive services and formal avenues for resident influence, and emphasize privacy. In contrast to older respondents, experts (n = 44) prefer settings with lower behavioral standards, more supportive services, more resident input, and more privacy. Sociodemographic characteristics (marital status, occupation, education, age, gender) and functional ability are weakly associated with the policy and service preferences of older respondents. The POLIF-I has several applications, including examination of the congruence between residents' preferences and the actual policies and services of group living facilities.     

Iraq and Afghanistan Veterans’ Experiences Living with their Parents after Separation from the Military

When military service members separate from the military, many return to their families of origin, living with their parents for a period of several weeks to years. While research with veterans and their spouses has documented the particular strain of this reintegration period on veterans and their partners, little research to date has examined veterans’ experiences living with their parents. The present study sought to fill this research gap by investigating veterans’ experiences living with their parents using qualitative, in-depth interviews with Iraq and Afghanistan veterans in California. Overall, veterans appreciated the instrumental and emotional support their parents provided when they separated. However, in some cases, living with parents also produced conflict and strain. In situations where adult veteran children had difficulty with the transition to civilian life or returned with mental health problems, parents were often the first to identify these problems and to support their children in accessing appropriate care. We analyze these findings in light of family systems theory, identifying ways in which adult veteran children continue a process of differentiation while living with their parents and maintaining emotional connectedness. We suggest ways that clinicians can better support veterans and their parents through the reintegration period and recommend that programming for military families explicitly include parents of service members in addition to conjugal families.