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.     

Further explorations in empowerment theory: An empirical analysis of psychological empowerment

Developed empowerment theory and replicated previous research on citizen participation and perceived control. Few investigators have designed studies that specifically test empowerment theory. This research further extends a theoretical model of psychological empowerment that includes intrapersonal, interactional, and behavioral components, by studying a large randomly selected urban and suburban community sample and examining race differences. Results suggest that one underlying dimension that combines different measures of perceived control may be interpreted as the intrapersonal component of psychological empowerment, because it distinguishes groups defined by their level of participation in community organizations and activities (behavioral component). The association found between the intrapersonal and behavioral components is consistent with empowerment theory. Interaction effects between race groups and participation suggest that participation may be more strongly associated with the intrapersonal component of psychological empowerment for African Americans than for white individuals. Implications for empowerment theory and intervention design are discussed. The authors express appreciation to Steven Rosenstone who was the Principal Investigator for the Detroit Area Study from which the data for our study is based. We also thank Deborah A. Salem and the anonymous reviewers for their thoughtful comments on earlier drafts of this paper.     

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.     

Commentary on “Can a good philosophical contribution be made just by asking a question?”

This paper explains some of the reasoning behind “Can a Good Philosophical Contribution Be Made Just by Asking a Question?,” a paper which consists solely in its title and which is published in the same issue of the journal as the present paper. The method for explaining that reasoning consists in making available a lightly edited version of a letter the authors sent to the editors when submitting the title-only paper. The editors permitted publication of that paper on the condition that the authors also separately publish a version of that letter; the present paper aims to fulfil that condition.     

Ambiguity attitudes in qualitative contexts: The role of prior beliefs

Most studies of ambiguity aversion rely on experimental paradigms involving monetary bets. Thus, the extent to which ambiguity aversion occurs outside of such contexts is much less understood, particularly when the situation cannot easily be reduced to numerical terms. The present work seeks to understand whether people prefer to avoid ambiguous decisions in a variety of different qualitative domains (e.g., work, family, love, friendship, exercise, study, and health), and, if so, to determine the role played by prior beliefs in those domains. Across three studies, we presented participants with 24 vignettes and measured the degree to which they preferred risk to ambiguity in each. We also asked them for their prior probability estimates about the likely outcomes in the ambiguous events. Ambiguity aversion was observed in the vast majority of vignettes, but at different magnitudes. It was predicted by whether the vignette involved gain or loss as well as by people's prior beliefs; however, the heterogeneity between people meant that the role of prior beliefs was only evident in an individual-level analysis (i.e., not at the group level). Our results suggest that the desire to avoid ambiguity occurs in a wide variety of qualitative contexts but to different degrees for different people and may be partially driven by unfavorable prior estimates of the likely outcomes of the ambiguous events.     

Social support from weak ties: Insight from the literature on minimal social interactions

When people face difficult life events, such as cancer or bereavement, they fare better when they receive support. These “experiencers” are likely to seek and receive support from a wide range of people, from close others to acquaintances. Indeed, the social support literature has long acknowledged the value of having a diverse support network. Research suggests that experiencers often perceive “weak ties” (i.e., acquaintances) as sources of support, and that experiencers sometimes prefer to get support from weak ties rather than strong ties. Providing support can be challenging for all kinds of supporters, however weak ties may be more likely than strong ties to allow worries about their inability to provide effective support to stop them from providing any support at all, thus depriving experiencers of opportunities for additional support. In this paper, we focus on the fact that often the provision of support occurs via a social interaction. We draw on the social psychology literature on minimal social interactions to suggest reasons why potential weak tie supporters might doubt their ability to provide effective support, and to generate advice to encourage potential supporters to reach out. Finally, we suggest future areas of research, with the ultimate goal of helping to expand the support that is available for people experiencing difficult life events.