Motivational reserve: motivation-related occupational abilities and risk of mild cognitive impairment and Alzheimer disease

Midlife motivational abilities, that is, skills to initiate and persevere in the implementation of goals, have been related to mental and physical health, but their association with risk of mild cognitive impairment (MCI) and Alzheimer's disease (AD) has not yet been directly investigated. This relation was examined with data from the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). A total of 3,327 nondemented participants (50.3% of a randomly selected sample) aged 75-89 years were recruited in primary care and followed up twice (after 1.5 and 3 years). Motivation-related occupational abilities were estimated on the basis of the main occupation (assessed at follow-up II) using the Occupational Information Network (O* NET) database, which provides detailed information on worker characteristics and abilities. Cox proportional hazards models were used to evaluate the relative risk of developing MCI and AD in relation to motivation-related occupational abilities, adjusting for various covariates. Over the 3 years of follow-up, 15.2% participants developed MCI and 3.0% developed AD. In a fully adjusted model, motivation-related occupational abilities were found to be associated with a reduced risk of MCI (HR: 0.77; 95% CI: 0.64-0.92). Motivation-related occupational abilities were associated with reduced risk of AD in ApoE ε4 carriers (HR: 0.48; CI: 0.25-0.91), but not in noncarriers (HR: 0.99; CI: 0.65-1.53). These results suggest that midlife motivational abilities are associated with reduced risk of MCI in general and with reduced risk of AD in ApoE ε4 carriers. Revealing the mechanisms underlying this association may inform novel prevention strategies for decelerating cognitive decline in old age.     

Perceived stress in prodromal Huntington disease

This study examines perceived stress and its relationship to depressive symptoms, life changes and functional capacity in a large sample of individuals who are positive for the Huntington disease (HD) gene expansion but not yet diagnosed. Participants were classified by estimated proximity to HD diagnosis (far, mid, near) and compared with a non-gene-expanded comparison group. Persons in the mid group had the highest stress scores. A significant interaction between age and time since HD genetic testing was also found. Secondary analyses using data from a different data collection point and including a diagnosed group showed the highest stress scores in the diagnosed group. Possible explanations and implications are discussed.     

Maternal Depressive Symptoms and Child Social Preference During the Early School Years: Mediation by Maternal Warmth and Child Emotion Regulation

This longitudinal study examined processes that mediate the association between maternal depressive symptoms and peer social preference during the early school years. Three hundred and fifty six kindergarten children (182 boys) and their mothers participated in the study. During kindergarten, mothers reported their level of depressive symptomatology. In first grade, teachers rated children’s emotion regulation at school and observers rated the affective quality of mother-child interactions. During second grade, children’s social preference was assessed by peer nomination. Results indicated that mothers’ level of depressive symptomatology negatively predicted their child’s social preference 2 years later, controlling for the family SES and teacher-rated social preference during kindergarten. Among European American families, the association between maternal depressive symptoms and social preference was partially mediated by maternal warmth and the child’s emotion regulation. Although the relation between maternal depressive symptoms and children peer preference was stronger among African American families than Europrean American families, its mediation by the maternal warmth and child’s emotion regulation was not found in African American families.     

HIV prevention with persons with mental health problems

The HIV seroprevalence rate among persons with mental health problems (PMHP) is substantially higher than that of the general population in the United States. This study examines the efficacy over 12 months of an HIV prevention program with 99 individuals attending outpatient mental health clinics who were randomly assigned to receive either: (a) a seven-session, small-group intervention of Project LIGHT (Living in Good Health Together); or (b) a one-session video intervention. Regression analyses of data from 87% of the sample interviewed at 1-year follow-up revealed that intervention group membership was associated with significantly fewer sexual risk acts. A significant intervention effect for condom use was found for 72% of the sample who were African American, but not for Latino or Caucasian participants. Results from this study suggest that HIV risk reduction groups such as Project LIGHT may have utility in public mental health care settings.     

The self-help clearinghouse concept: An evaluation of one program and its implications for policy and practice

Many clearinghouses have been organized within the last decade to promote mutual aid and to provide referral information about self-help groups to potential members. Few of the assumptions that underpin the operation of these programs have been evaluated, however. This paper presents an evaluation of the Self-Help Information Service, a clearinghouse integrated with a generic information and referral service. The results were generally positive with respect to operator and consumer satisfaction, community responsiveness, and the system's capacity to undertake numerous service and research functions. They also pointed up several changes that might be made to improve the system's impact. It is concluded that a new practice specialty might be developed within a clearinghouse context, and that the clearinghouse concept might serve as one cornerstone of a funding policy that supports the self-help approach.