A longitudinal study of the psychosocial impact of stroke on primary support persons

We investigated longitudinally the effects of a stroke on the social support systems and well-being of the patient's primary support person, both acutely and as the condition stabilized. Individuals who had suffered a first stroke and a primary support person participated in two waves of data collection, carried out in 6-month intervals beginning 7 weeks after the stroke. Our data show that the prevalence of depressive symptoms is from 2 1/2 to 3 1/2 times higher than rates found among representative samples of middle-aged and elderly populations. Mean level of depression did not change over time, although level of optimism declined significantly. Multiple regression analyses showed that levels of depression and perceived burden in support persons are highly related to aspects of the stroke such as its severity, and that demographic variables such as age and income play a relatively minor role in attenuating these relations in the acute adjustment phase. However, from 7 to 9 months after the stroke, well-established demographic variables such as health, income, and age were significant predictors of depression. Individuals who were older and who had good health and higher incomes were least depressed.     

Justice and care: The implications of the Kohlberg-Gilligan debate for medical ethics

Carol Gilligan has identified two orientations to moral understanding; the dominant ‘justice orientation’ and the under-valued ‘care orientation’. Based on her discernment of a ‘voice of care’, Gilligan challenges the adequacy of a deontological liberal framework for moral development and moral theory. This paper examines how the orientations of justice and care are played out in medical ethical theory. Specifically, I question whether the medical moral domain is adequately described by the norms of impartiality, universality, and equality that characterize the liberal ideal. My analysis of justice-oriented medical ethics, focuses on the libertarian theory of H.T. Engelhardt and the contractarian theory of R.M. Veatch. I suggest that in the work of E.D. Pellegrino and D.C. Thomasma we find not only a more authentic representation of medical morality but also a project that is compatible with the care orientation's emphasis on human need and responsiveness to particular others.     

Counseling: A conversion experience

In this article, the experience of conversion, which is usually delegated to the realm of spiritual studies, is applied to the counseling experience. It is posited that a person who goes through a successful counseling process will experience a turning around, will cease leading life in a dysfunctional way, and will move forward in a manner by which the person experiences life in a new perspective. This new perspective brings the person wholeness and balance.     

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 differential validity of hyperactivity/attention deficits and conduct problems among mentally retarded children

The independence of hyperactivity, attention deficits, and conduct problems among mentally retarded children was addressed using factors of the Conners' Teacher Rating Scale-39 (CTRS-39) and the more recently developed IOWA Conners' inattention/overactivity (IO) and aggression (A) subscales. CTRS-39 ratings were obtained for children of normal intelligence and for mentally retarded children. Differences between the groups were examined as were intercorrelations of the Conners' factors and IOWA subscales. Conduct problems proved to be less strongly associated with hyperactivity and attention deficits among mentally retarded children compared to children of normal intelligence. However, attention problems and conduct problems may be associated with mental retardation in general. Implications of these data and CTRS scoring system recommendations for mentally retarded children are discussed.     

Life Satisfaction of Single Middle-Aged Professional Women

This study examined 10 factors and their relation to the life satisfaction of single middle-aged professional women. The proposed regression model, which included job satisfaction, gender identity, locus of control, social support, health, financial resources, leisure-time activities, sexual satisfaction, and regrets regarding life circumstances, was explored through a questionnaire. Questionnaires were administered to single professional women in higher education institutions. Responses were received from 152 women. Performance on life satisfaction was significantly explained by recourse to the variables of job satisfaction, internal locus of control, regrets regarding life circumstances, sexual satisfaction, and leisure-time activities.     

Teaching the Rescorla-Wagner model using STELLA-II

Although the Rescorla-Wagner model is widely taught in learning courses, most textbooks present a simplified version that does not contain all of its parameters. On the basis of Rescorla and Wagner 1972) and the Turbo PASCAL program by Lachnit, Schneider, Lipp, and Kimme! (1988), we created a simulation using STELLA-II, an icon-based program by High Performance Systems, Inc. We argue that this simulation facilitates teaching the complete Rescorla-Wagner model. Using trans-switching (Kimmel & Ray, 1978; Lachnit, 1986; Murrin & Kimmel, 1986) as an example, we demonstrate the effectiveness of the STELLA-II version of the Rescorla-Wagner model as a heuristic tool.