Caregiver-patient dyads: Documenting the verbal instructions caregivers provide in joint cognitive tasks

Thirty spousal caregivers and their partners (who had been diagnosed as having primary degenerative dementia) jointly performed four cognitive tasks: Block Design (from the WAIS-R), the Token Test, and two memory tasks. Two of the tasks were unstructured, and two were structured. Caregivers served as the instructor on all tasks. Interactions were videotaped. Results showed that caregivers provided appropriate verbal instructions to a greater extent on the unstructured nonverbal task (Block Design) than on the unstructured memory task. Results are discussed in terms of implications for dyadic cognition research and intervention in dementia.     

Brief report: Filial anxiety in mothers and daughters: Cross-validation of Cicirelli's (1988) Filial Anxiety Scale

This study replicated and extended prior research on filial anxiety by examining two generations of women in the same families. Eighty-five mothers and daughters completed several measures assessing filial anxiety, general anxiety, family relationships, self-efficacy in caregiving, filial responsibility, and perceived health. Results showed an exact replication of Cicirelli's (1988) two-factor solution of the Filial Anxiety Scale (FAS) for the middle-aged mothers, but a three-factor solution and some item overlap across factors for the undergraduate daughters. Mothers and daughters scored similarly on most of the other measures. Correlational results indicated that the different dimensions of the FAS relate differently with the other measures. Results are discussed in terms of the need for additional scale development with younger adults and in terms of the broader context of the correlational findings.     

Biological Bases of Maternal Attachment

In recent years, there has been growing interest in investigating the processes affecting caregiving behavior. Recent studies of human and nonhuman primates have suggested that hormones can account, at least in part, for changes in caregiving motivation during pregnancy and the postpartum period and for variability in caregiving motivation and behavior among individuals. Although hormones may not be the primary determinants of caregiving, future research cannot afford to overlook the contribution that biological processes can make to normative and pathological attachment and parenting.     

Chronic Sorrow in Caregiving Spouses of Patients with Alzheimer's Disease

The article focuses on the concept of chronic sorrow in a sample of individuals with Alzheimer's disease (AD) and their caregiving spouses. A study was designed to determine the long-term grief or chronic sorrow that develops in caregiving spouses and to increase knowledge of the nature of chronic sorrow. Utilizing the Burke Nursing Consortium for Research on Chronic Sorrow questionnaire and Lindgren's (1996) study as a prototype, the author discovered that repetitive feelings of sorrow and distress appear in caregivers when major disruptive changes occur in their lives due to the persistent demands caused by the illness. Continual coping skills are needed to keep caregivers from being mentally, emotionally, and physically depleted. The findings of this study are consistent with Lindgren's 1996 study of chronic sorrow in persons with Parkinson's disease.     

Caregiving styles and anxiety among couples: coping versus not coping with cardiac illness

Background and Objectives: partners’ caregiving efforts are not always beneficial to both recipient and provider. Bowlby’s conceptualization of caregiving style as a stable predisposition may clarify such caregiving effects. The relationship between caregiving style (compulsive and sensitive) and anxiety among couples coping with cardiac illness and a matching control group not coping with cardiac illness were assessed. We hypothesized that one’s compulsive caregiving would associate positively, and one’s sensitive caregiving would associate negatively, with one’s and one’s partner’s anxiety across contexts (cardiac and non-cardiac) and gender. Design: A comparative design of 131 couples with a diagnosis of husbands’ acute cardiac syndrome and 68 matched couples in the community was applied. Methods: The Adult Caregiving Questionnaire and the Brief Symptoms Inventory were administered. Results: Structural equation modeling revealed that one’s compulsive caregiving was positively associated with one’s anxiety, across most contexts. Multi-group analyses revealed that the associations between one’s compulsive caregiving and one’s partner’s anxiety levels differed depending on gender and context. Conclusions: The distress which emerges in an individual who takes on a caregiving role and in his/her partner seems to result not only from the demands of the concrete caregiving situation but also from one’s and one’s partner’s developmental history.     

Resources for resilient caregiving by parents of children with schizophrenia in Swaziland: A multiple case study

This study reports on the care-provisioning experiences of parents (n = 6; females = 5) raising children with schizophrenia in a rural Swazi setting. The parents were individually interviewed at their homes on caregiving aspects such as burden, coping, quality of life, expressed emotions and social support of their child with schizophrenia. Data were thematically analysed. Parent carers of children with schizophrenia reported to have personal resources for resilient caregiving such as motivation for caring, and caregiving satisfaction. They perceived compassion gains from improved quality of life for their children through the caregiving experiences. Findings suggest a need for public mental health education and provision of welfare support of parents’ personal resources for resilient caregiving.     

Caregiving representations in war conditions: Associations with maternal trauma,mental health,and mother–infant interaction

Risk features in mothers’ caregiving representations remain understudied in dangerous environments where infants most urgently need protective parenting. This pilot study examines the feasibility of a novel coding system for the Parent Development Interview (PDI) interview (ARR, Assessment of Representational Risk) in assessing 50 war-exposed Palestinian mothers’ caregiving representations. First, we explored the content and structure of risks in the representations. Second, we examined associations between the high-risk representations, mothers’ pre- and postnatal exposure to traumatic war events (TWE), depressive and post-traumatic stress disorder (PTSD) symptoms, and self-rated emotional availability (EA) with their 1-year-old infants. Following three dimensions of high-risk caregiving representations were identified: self/dyadic dysregulation, unavailable, and fearful. Mothers’ prenatal depressive symptoms were associated with dysregulating and fearful representations, and their postnatal PTSD with fearful representations. TWE were not associated with the high-risk representations. Moreover, mothers of boys reported more fearful representations, and mothers with financial difficulties reported more unavailable representations. TWE and high-risk representations were not associated with EA. However, qualitative analysis of the representations indicated risks in the mother–infant relationship. Further, older mothers and mothers with postnatal PTSD reported lower EA. Cultural variance in caregiving representations and the use of self-report measures among traumatized mothers are discussed.     

Validation of the AMBIANCE-brief: An observational screening instrument for disrupted caregiving

Resulting from a community-identified need for a well-validated indicator of caregiving difficulties for use in practice settings, a brief form of the Atypical Maternal Behavior Instrument for Assessment and Classification System (AMBIANCE) was developed for use as a screening instrument. Prior to its dissemination, this study aimed to assess the feasibility, reliability, and validity of the AMBIANCE-Brief. Adolescent mother–infant dyads (N = 69) participated in the Strange Situation Procedure, as well as play sessions with and without toys. Maternal disrupted caregiving was coded from the play sessions using the AMBIANCE and AMBIANCE-Brief. The AMBIANCE-Brief demonstrated convergent validity with the AMBIANCE in the play session with toys (r = .65, p < .001) and without toys (r = .61, p < .001). Concurrent validity of the AMBIANCE-Brief was also demonstrated in relation to infant attachment disorganization in the play session with toys (r = .36, p < .05) and without toys (r = .32, p < .01). These findings suggest a shorter protocol for assessing disrupted caregiving may be feasible and valid for use in community settings. Future studies are in progress to train community practitioners in the use of the AMBIANCE-Brief and to evaluate their reliability.     

Sensitive Caregiving Fosters the Comprehension of Speech: When Gestures Speak Louder than Words

Despite a variety of theoretical arguments to the contrary, sensitive caregiving makes an important contribution to the comprehension and emergence of speech. This research, informed by social ecological realism, documented that during the prelinguistic and one-word periods, caregivers routinely provided additional perceptual structure to their infants following communicative breakdowns. This sensitive adjusting of subsequent messages to infants contributed significantly to reaching a common understanding. Caregivers also modified their verbal messages in subsequent turns by making them more specific. In contrast, however, these elaborations did not contribute to achieving a practical consensus regarding ongoing events. These results suggest that the social ecological realist approach informing this research has important implications for theory, reviewing past empirical findings and future research. © 1996 John Wiley & Sons, Ltd.     

Ambiguous Loss in Transnational Families’ Adolescents: An Exploratory Study in Ecuador

In psychosocial migration literature, the perspective of ambiguous loss has been relevant to articulate personal and relational experiences in the context of transnational families and ongoing separation. Most studies have focused on adult members’ experiences of transnational families, but research exploring ambiguous loss in adolescents whose parents have migrated is still lacking. The present study aimed to explore adolescents’ lived experiences of parental migration. In a pilot explorative study, 14 adolescents with at least one parent who migrated were interviewed about their lived experiences of transnational parent-child relationships and ongoing parent-child separation. Data analysis identified four themes in participants’ accounts: practices of separation creating confusion; current relationship with migrant parents permeated by ambiguity; distrustful representations of migrant parents; and family and social dynamics reactivating the pain of loss. The findings reveal how in the context of parental migration, patterns of separation and ongoing relational processes, compounded by the uncertainty of reunification and an exclusionary social fabric, constitute core elements that shape adolescents’ lived experiences of parent-child relationships characterized by ambiguity.