Family Relationships and Well-Being

Predictors of Depressive Symptoms and Post Traumatic Stress Disorder Among Women Engaged in Commercial Sex Work in Southern Uganda

This study examined the factors associated with depressive symptoms and post traumatic depressive disorder (PTSD) among economically vulnerable women engaged in commercial sex work (WESW) in southern Uganda. Baseline data from a longitudinal cluster randomized study involving 542 self-identified WESW (18-55 years), recruited from 19 HIV hotspots were analyzed. Hierarchical linear regression modelling was utilized to estimate individual, family-level and economic-level predictors of depressive symptoms and PTSD. Family cohesion, sex work stigma, HIV status, financial distress, household assets, number of children and number of household income earners, were associated with PTSD. Similarly, family cohesion, number of people in the household, HIV status, sex work stigma, financial distress, and household assets, were associated with depressive symptoms. Women engaged in commercial sex work are at a higher risk of HIV and poor mental health outcomes. Sex work stigma and financial distress elevate levels of depressive symptoms and PTSD, over and above an individual's HIV status. Family and economic-level factors have the potential to mitigate the risk of poor mental health outcomes. As such, integrating stigma reduction and economic strengthening components in the programming targeting WESW-a key population, may be critical to address their mental health outcomes.

The Utility of Solution-Oriented Strategies to Support Grandparents Raising Grandchildren

Objectives: The purpose of this article is to evaluate the effectiveness of a psychosocial intervention program to improve the health and social psychological outcomes for grandparents raising grandchildren using the theory of Selection, Optimization, and Compensation (Baltes, P. B., & Baltes, M. M. (1990). Psychological perspectives on successful aging: The model of selective optimization with compensation. In P. B. Baltes & M. M. Baltes (Eds.), Successful aging: Perspectives from the behavioral sciences (pp. 1-34). Cambridge University Press. doi:10.1017/CBO9780511665684.003). Methods: Fifty-two grandparents were randomly assigned either to a 6-session solution-oriented goal-setting program or to a waiting list control condition who subsequently received the intervention. Results: Grandparents in the intervention group, in comparison to the waiting list control group, reduced their level of depression, improved their parental efficacy, overall psychosocial adjustment, and increased their ability to choose effective goals. For the most part, findings were replicated in the waiting list control analyses. Discussion: While these findings are consistent with previous studies using psychosocial interventions with parents and grandparent caregivers, they also provide support for strength-based proactive behavioral approaches to improve the quality of life of grandparent caregivers.

The Psychological Impact of the COVID-19 Pandemic on Dentists in Germany

Since the announcement of the coronavirus 2019 (COVID-19) outbreak as a pandemic, several studies reported increased psychological distress among healthcare workers. In this investigation, we examined the association between psychological outcomes and various factors among German dentists. Dentists from all German federal states were invited to participate in this study through a self-administered online questionnaire between July and November 2020. This questionnaire collected information on demographics, Depression Anxiety Stress Scales (DASS-21), and the Impact of Events Scale-Revised (IES-R) instrument. The associations displayed between demographic and psychological outcomes of depression, anxiety, stress, intrusion, avoidance, and hyperarousal were evaluated. Seven-hundred-and-thirty-two dentists participated in the survey and reported overall scores of (4.88 ± 4.85), (2.88 ± 3.57), (7.08 ± 5.04), (9.12 ± 8.44), (10.68 ± 8.88) and (10.35 ± 8.68) for depression, anxiety, stress, intrusion, avoidance, and hyperarousal, respectively. For females, being between 50-59 years of age, being immune deficient or chronically ill, working at a dental practice, and considering the COVID-19 pandemic a financial hazard were reported as significant associated factors (p < 0.05) with higher DASS-21 and IES-R scores. These findings underline the aspects which need to be taken into attention to protect the mental wellbeing of dentists in Germany during the crisis.

The Other Student Debt Crisis: How Borrowing to Pay for a Child's College Education Relates to Parents' Mental Health at Midlife

OBJECTIVES

More parents are borrowing to help their children pay for college. These loans may be a source of financial stress and worry, which could influence parents' mental health. We determine whether child-related educational debt is associated with worse mental health among parents and if fathers are more sensitive to this debt than mothers, given potential gender differences in financial decision-making and relationships with adult children.

METHOD

Data come from the National Longitudinal Survey of Youth 1979, a nationally representative sample of persons born between 1957 and 1964. We used the Center for Epidemiologic Studies Depression Scale and the Short Form-12 Mental Health Component Score to assess mental health. We restricted our sample to parents who had at least one biological child attend college and who were interviewed at age 50, when mental health was assessed (n = 3,545).

RESULTS

Among fathers, having any child-related educational debt versus none was associated with fewer depressive symptoms, but having greater amounts of child-related educational debt was associated with more depressive symptoms and worse mental health. No relationship was found for mothers.

DISCUSSION

Our findings indicate that the student debt crisis may also have mental health implications for aging parents, particularly for fathers.

Multidimensional factors affecting care needs in daily living among community-dwelling older adults: A structural equation modelling approach

AIMS

To develop a model illustrating the factors that can influence care needs in daily living (CNDL) of older adults and the pathways between these.

BACKGROUND

The care needs in community-dwelling older adults have increased sharply. A better understanding of the elderly's CNDL would thus help policymakers define which types of support and services should be given.

METHODS

A multicentre study with structural equation modelling was conducted in this study. We recruited 3,448 community-dwelling older adults in China by using a stratified random cluster sampling technique.

RESULTS

Physical and mental health was the strongest predictor of CNDL. Both age and living situation had positive effects on CNDL, while economic factors, social support and family support were the major risk factors for CNDL.

CONCLUSION

The presented model provides a better understanding of how to address CNDL in the targeted population. The older adults who are the oldest, low-income, non-empty nesters, and with poor self-rated health or the signs of loneliness should be firstly targeted for daily assistance.

IMPLICATIONS FOR NURSING MANAGEMENT

Using this model could provide health authorities and managers with the information of distinguishing between the priority group and the strategies for easing the caregiving burden in older adults care, and thus improving resource utilization.

A Decrease in Psycho-Emotional Health in Middle-Aged Russian Women Associated with Their Lifestyle

(1) Background: The present study is aimed to determine the predicting role of objective (lifestyle) and subjective factors of middle-aged women’s psycho-emotional health such as their relations with parents, attachment and separation types. Women who are overloaded with professional and family roles have high stress level, their indicators of psychological well-being and emotional level decrease when they have to give everyday care to their elderly parents. (2) Methods: The research sample has two empirical groups. Sample of Study 1 includes middle-aged women (n = 61) aged 38–56 (M = 48.1, SD = 3.5); sample of Study 2 includes middle-aged women (n = 85) aged 33–52 (M = 40.6, SD = 3.1): married (70.5%) and divorced (29.5%), having children of 14–28 years old; giving everyday care to elderly parents for more than 1.5 yrs. Some live separately (62.3 %), or have to cohabitate with parents (37.7%). All women evaluate their life situation as difficult and manifest signs of high psycho-emotional stress. We used methods adapted for the Russian-speaking sample: getting socio-demographic information, an interview; The scales of psychological well-being; Attachment style and Interpersonal Guilt Questionnaires (study 1); Psychological Separation Inventory, Purpose-in-Life Test, projective methods (study 2), mathematical statistics. (3) Results: A number of factors and indicators of women’s psycho-emotional health decrease in the situation of role overload have been identified. Among the factors there are four main types of women’s relationships with parents: Anxious closeness; Ambivalence of feelings; Secondary relationship with parents; Alienation, predicting of psycho-emotional health that are reducing or enhancing their personal resources. Besides, a type of separation of an adult woman from her mother predicts her level of well-being. (4) Conclusions: The study confirms that middle-aged Russian women’s psycho-emotional health depends on contextual factors (difficult role-overloaded lifestyle) and factors integrating women‘s relations towards parents, attachment, guilt and separation. Types of middle-aged women’s relationships with parents contribute to their psychoemotional health in a different way.

Psychological well-being during COVID-19 lockdown: Insights from a Saudi State University's Academic Community

OBJECTIVES

Measures to control the on-going COVID-19 pandemic such as quarantine and social distancing, together with information overload about the sporadic spread of the disease have negatively impacted many individuals' mental and psychosocial health. This study aimed to investigate the prevalence of self-reported mental health parameters and the coping mechanisms of employees and students in a Saudi State University.

METHODS

An online survey in both Arabic and English was launched targeting students, staff and faculty of King Saud University from May 11 to June 6, 2020, the peak of Saudi Arabia's nationwide lockdown. A total of 1542 respondents (726 males and 816 females) aged 20-65 years old participated.

RESULTS

Majority of the respondents claimed to have suffered from anxiety (58.1%), depression (50.2%) and insomnia (32.2%) during the lockdown. On average, 65.3% respondents agreed that family bond strengthened during lockdown. Those in the highest quartile of family bonding score (Q4) were 41% [odds ratio (OR) and 95% confidence interval (CI) of 0.59 (0.39-0.87), p < 0.001] and 59% [OR 0.41 (CI 0.27-0.64), p < 0.001] were less likely to be anxious and depressed, respectively, even after adjusting for covariates. This independent and significant inverse association was more apparent in females than males.

CONCLUSION

Self-reported acute mental health disorders were common within the academic community during the COVID-19 lockdown. Strength of family bonding as a coping mechanism was instrumental in preserving mental well-being, especially in females.

The 2019 Universiti Teknologi MARA, Malaysia Staff Survey: Determining the Level and Predictors of Quality of Life

Experiencing good quality of life (QOL) among university staff is extremely crucial to ensuring academic excellence; however, there are limited data on factors that contribute to QOL among university staff. This study aims to determine the level and the predictors for good QOL among university staff. The consenting participants were selected using a stratified sampling method. Participants who had fulfilled the selection criteria were provided with socio-demographic, medical illness, job factor, and family background questionnaires. QOL and psychological well-being (depression, anxiety, and stress) were assessed using the World Health Organization Quality of Life brief version (WHOQOL-BREF) and Depression, Anxiety, and Stress Scale (DASS-21) questionnaires, respectively. A total of 278 staff (mean ± SD age: 38.84 ± 7.85 years, 44.2% males, 82.7% married) had participated in this study. This study found that participants had low QOL in the domains of physical health [P-QOL] (11.2%), psychological health [PSY-QOL] (9.7%), social relationships [SR-QOL] (19.1%), and environment [E-QOL] (14.4%). The predictors of P-QOL were depression, medical illness, and number of dependents, while those of PSY-QOL were work promotion, depression, medical illness, and number of dependents. Additionally, the predictors of SR-QOL were campus location, depression, and work promotion, while those of E-QOL were age, level of education, depression, work promotion, and medical illness. Depression significantly affected all domains of QOL. Younger participants without medical illness and those with tertiary level of education had increased odds of having good QOL. Participants having dependents without work promotion and employed in suburban areas had decreased odds of having good QOL. The relevant authority should be identified and then assist staff with difficulties to ensure the staff benefited from having a good QOL.

Multigenerational social support in the face of the COVID-19 pandemic

Research documents high levels of instrumental, financial, and expressive support exchanges within multigenerational families in the 21st century. The COVID-19 pandemic poses unique challenges to support exchanges between the generations; however, the pandemic may provide opportunities for greater solidarity within families. In this review, we draw from theoretical perspectives that have been used to study family relationships to understand the implications of the pandemic for multigenerational families: the life course perspective, the intergenerational solidarity model, and rational choice/social exchange theory. We review literature on multigenerational relationships in the United States and discuss how established social support patterns and processes may be altered by the COVID-19 pandemic. We reflect on how the impact of the COVID-19 pandemic on multigenerational relationships may vary by gender, race, ethnicity, and socioeconomic status. Finally, we provide directions for future researchers to pursue in order to understand the lasting impacts of the COVID-19 pandemic on multigenerational ties.

The potential role of cortisol as a biomarker of physiological interdependence in romantic couples: A systematic review

Significant evidence supports the link between relationships and health including the potential for interpartner regulation of intrapersonal physical and mental homeostasis. Physiological interdependence is proposed as a term to summarize the adaptive process in which partners demonstrate physiological contagion that evolves with repetition to create a new homeostatic state regulating individual physiological functioning. Through a systematic review consistent with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P), the present study reviewed the literature examining the interdependent role of diurnal cortisol with romantic couples. The literature search yielded thirteen articles that included statistical modeling testing interdependence between partners in a couple and at the individual level. Five themes emerged from the literature including cortisol synchrony, cortisol and health, cortisol and emotions, cortisol and internal relationship factors, and cortisol and factors external to the romantic relationship. Findings suggest a potential for romantic partners to regulate one another's emotional and physiological states, but this process may not be present in both partners. More research is needed to substantiate a regulatory role as the current literature supports correlations.

Multi-dimensional effects of the COVID-19 pandemic considering the WHO's ecological approach

At the end of 2019, a new virus named SARS-CoV-2 emerged in China, provoking coronavirus disease 2019 or COVID-19. Self-isolation and quarantine as key strategies to overcoming the spread of the disease have had major, micro, and macroscopic consequences. This commentary, therefore, seeks to review critical factors impacting the COVID-19 pandemic through the spectrum of levels, categorising effects in the WHO's ecological framework (individual, relational, community, and societal aspects). We further describe the management of the crisis at each level to help guide health personnel, communities, governments, and international policymakers in understanding how their actions fit into a larger picture as they seek to manage the crisis.

Marital Quality and Well-Being Among Older Adults: A Typology of Supportive, Aversive, Indifferent, and Ambivalent Marriages

A large body of work has linked marital quality to the health and well-being of older adults, but there is a lack of agreement on how to best measure dimensions of marital quality. Drawing on a stress-process life course perspective, we construct a typology of marriage type that captures the synergistic relationship between positive and negative marital qualities and health. Using data from Wave 1 (2005/2006) and Wave 2 (2010/2011) of the NSHAP survey from the United States, we examine the association between supportive, aversive, ambivalent, and indifferent marriages for older adults that remained married over the study period on multiple indicators of well-being (depression, happiness, and self-rated health; N = 769 males and 461 females). Results suggest that older adults in aversive marriages reported lower happiness (men and women) and physical health (men). There was less evidence that those in ambivalent and indifferent marriages reported worse well-being.

Chinese women's health and wellbeing in middle life: Unpacking the influence of menopause, lifestyle activities and social participation

OBJECTIVES

To examine Chinese middle-aged women's health and wellbeing and the associated biosocial correlates.

STUDY DESIGN

This study used a cross-sectional design, including selected retrospectively collected information on the final menstrual period, drawn from the 2013 wave of the China Health and Retirement Longitudinal Study (CHARLS). Women aged 45 to 59 were selected.

MAIN OUTCOME MEASURES

Factor analysis of 16 menopausal symptom ratings yielded four different and independent measures of pre-/peri-menopausal and early postmenopausal women's health. These were: negative mood (feel frustrated, sad, lonely, worried, bored, angry, tired and stressed), positive emotions (feel enthusiastic, content and happy), musculoskeletal pain (shoulder/neck pain, knee and other joint pain, and back pain), and sleep and memory problems (trouble sleeping and poor memory).

RESULTS

Menopausal status was positively associated with sleep and memory problems, whilst the number of years since the final menstrual period was positively associated with musculoskeletal pain. In contrast, lifestyle activities and social participation were linked to positive emotions. The association between selected biosocial factors and negative mood was not significant after controlling for other demographic and social background factors.

CONCLUSIONS

Musculoskeletal health as well as sleep and memory problems are positively associated with menopausal biological factors amongst Chinese mid-life women. Maintaining active social engagement contributes to positive wellbeing among middle-aged women.

The Association Between Electronic Device Use During Family Time and Family Well-Being: Population-Based Cross-Sectional Study

Background

Electronic devices (eDevices) may have positive or negative influences on family communication and well-being depending on how they are used.

Objective

We examined eDevice use during family time and its association with the quality of family communication and well-being in Hong Kong Chinese adults.

Methods

In 2017, a probability-based 2-stage random sampling landline telephone survey collected data on eDevice use in daily life and during family time (eg, family dinner) and the presence of rules banning eDevice use during family dinner. Family communication quality was rated from 0 to 10 with higher scores being favorable. Family well-being was calculated as a composite mean score of 3 items each using the same scale from 0 to 10. The associations of family communication quality and well-being with eDevice use in daily life and during family time were estimated using beta-coefficient (β) adjusting for sociodemographics. The mediating role of family communication quality in the association between eDevice use and family well-being was analyzed.

Results

Of the 2064 respondents (mean age 56.4 [SD 19.2] years, 1269/2064 [61.48%] female), 1579/2059 (76.69%) used an eDevice daily for a mean of 3.6 hours (SD 0.1) and 257/686 (37.5%) used it for 30+ minutes before sleep. As much as 794/2046 (38.81%) often or sometimes used an eDevice during family time including dinner (311/2017, 15.42%); 713/2012 (35.44%) reported use of an eDevice by family members during dinner. Lower family communication quality was associated with hours of eDevice use before sleep (adjusted β=–.25; 95% CI –0.44 to –0.05), and often use (vs never use) of eDevice during family dinner by oneself (adjusted β=–.51; 95% CI –0.91 to –0.10) and family members (adjusted β=–.54; 95% CI –0.79 to –0.29). Similarly, lower family well-being was associated with eDevice use before sleep (adjusted β=–.26; 95% CI –0.42 to –0.09), and often use during family dinner by oneself (adjusted β=–.48; 95% CI –0.83 to –0.12) and family members (adjusted β=–.50; 95% CI –0.72 to –0.28). Total ban of eDevice use during family dinner was negatively associated with often use by oneself (adjusted odds ratio 0.49; 95% CI 0.29 to 0.85) and family members (adjusted odds ratio 0.41; 95% CI 0.28, 0.60) but not with family communication and well-being. Lower family communication quality substantially mediated the total effect of the association of eDevice use time before sleep (61.2%) and often use at family dinner by oneself (87.0%) and by family members (67.8%) with family well-being.

Conclusions

eDevice use before sleep and during family dinner was associated with lower family well-being, and the association was substantially mediated by family communication quality. Our results suggest that interventions on smart use of eDevice may improve family communication and well-being.

Motivations for Relationships as Sources of Meaning: Ghanaian and South African Experiences

Afrocentric paradigms reflect assumptions of the overarching importance of interconnectedness and social bonds in meaningful experiences. It is, however, not known if types of relatedness vary in importance as meaning sources in the subjective experiences of laypeople, or what the reasons are that they ascribe to the importance of relationships. The empirical and theoretical substantiation of philosophical assumptions is needed to provide a scientific basis for appropriate well-being interventions in African contexts. Therefore, this study aimed to empirically explore the relative importance of various types of relationships as sources of meaning and in particular why relationships are important to laypeople in relatively collectivist African contexts. Using a bottom-up qualitative approach with quantification of responses, this study explored how prominently relationships featured as meaning sources compared to other domains of life and then, in particular, the motivations for the importance of various types of relationships as found in four African samples: a Ghanaian urban group (n = 389), a South African multicultural, English-speaking urban group (n = 585), and two South African Setswana-speaking groups (n = 512 rural, n = 380 urban). Findings showed that the relational domains of life, namely, family, interpersonal relations, spirituality/religion, and community/society, made up a large proportion of responses on what provides meaning in life−in particular family and spirituality/religion with community/society occurring the least. The reasons for meaning experienced in various relationship types included domain-typical relational descriptors, such as contributions made or rewards received. However, many intrapersonal motives also emerged: inner well-being, happiness, joy, a sense of competence, and own growth. Material needs and harmony also surfaced as motivations for relational importance. Findings are aligned with African philosophical perspectives as far as the importance of relationships and the value attached to spirituality/religion are concerned, but contributed additionally by showing that different types of relationships vary in importance: close relationships are more important than community/societal relationships. Unearthing the reasons for the importance of relationships points toward a dialectic pattern of African individualism–collectivism in which independent and interdependent orientations flow together. Such knowledge is vital for the promotion of mental health and well-being in these contexts.

Sex, Age, Race/Ethnicity, Veteran Status, and the Likelihood of Reporting Cardiovascular Conditions in the National Health Interview Survey

BACKGROUND

This study explores the likelihood of reporting the presence of cardiovascular health conditions in the National Health Interview Survey, with a focus on the moderating effects of veteran status, race/ethnicity, age, sex, and functional status.

METHOD

Data from the 2012-2015 National Health Interview Survey examine 5 cardiovascular health conditions/risk factors (hypertension, coronary heart disease, heart conditions, stroke, and heart attack).

RESULTS

Age, sex, and functional status moderate the relationship between veteran status and cardiovascular conditions. Veterans who are younger (veteran × age) have a higher risk of reporting 1 cardiovascular condition compared with veterans who are older (relative risk [RR], 0.99; 95% confidence interval [CI], 0.99-0.99). Veterans with functional limitations (veteran × functional status) are at a lower risk of reporting 3 or more cardiovascular conditions compared with veterans with no functional limitations (RR, 0.73; 95% CI, 0.56-0.95). Interaction variables in the model (veteran × sex) show that female veterans had a higher risk than did female non-veterans of reporting 3 or more cardiovascular conditions compared with male veterans versus male non-veterans (RR, 0.71; 95% CI, 0.53-0.95). Race/ethnicity does not moderate the likelihood of reporting cardiovascular disease conditions in this sample.

CONCLUSION

This study demonstrates that previous military service is linked to the reporting of cardiovascular disease conditions by using nationally representative data to examine the moderating effects of veteran status on the relationship between race/ethnicity, sex, functional status, and age and cardiovascular disease for veterans living in the general US population. The findings suggest a waning healthy soldier effect for the youngest American veterans and indicate that female veterans' cardiovascular health is at greatest risk.

Moving beyond living arrangements: the role of family and friendship ties in promoting mental health for urban and rural older adults in China

Objective: This study examines the interplay among living arrangements, social networks, and depressive symptoms among Chinese older adults.Methods: Data are derived from the 2014 baseline survey of the China Longitudinal Aging Social Survey (CLASS), which provides a sample of older Chinese who had been married and had children (N = 7,662). This study examines the association between living arrangements and depressive symptoms (measured as CES-D scale, 0-18) of older adults, and addresses the moderating role of social networks (measured as family ties and friendship ties, 0-15) on this perceived association.Results: Our results show that older adults who live both with a spouse and adult children report superior mental health than those living alone (β = 1.240, p < 0.001), but no differences are seen from those living only with a spouse or children. Older adults living alone in rural areas are also more disadvantaged in comparison to those living alone in urban places (β = 0.535, p < 0.05). However, we find that the undesirable consequences associated with depression of older adults living alone can be reduced or even eliminated when older adults have strong friendship ties in rural China (β = -0.145, p < 0.01). We also find that for rural older adults living only with children, their mental health is highly contingent on their family ties, that is, they are extremely disadvantaged when having weak family ties, but benefit most significantly from strong family ties (β = -0.137, p < 0.05).Conclusions: Associations between living arrangements and mental health in later life are contingent on older adults' social networks, and these moderating effects vary between rural and urban China.

I need to be who I am: a qualitative interview study exploring the needs of people with dementia in Norway

OBJECTIVE

Many people with dementia receive community services. These services are often based on the needs of informal caregivers and professional caregivers' assessment. User involvement and participation are main objectives in the Norwegian National Dementia Plan 2020. To enhance user involvement and individual tailoring of healthcare services, more information is required about the needs of people with dementia. The aim of this study was to explore the experienced needs of people with dementia in order to facilitate user involvement in provided services.

METHODS

An explorative cross-sectional study design was used. We performed semistructured interviews with people with dementia who were recruited from all regions of Norway. The sample comprised 35 participants diagnosed with dementia. The interviews were audio-recorded and transcribed, and the data material was analysed using a qualitative content analysis.

RESULTS

Three main categories emerged from the interviews: (1) to stay connected; (2) to be active and participate; and (3) to live for the moment. The overarching theme was: the need to be who I am.

CONCLUSIONS

People with dementia participating in the study were heterogeneous regarding wants and requirements. Most of them expressed the need and wish to hold on to who they are. Close and robust relations with family and friends can give significant support to people with dementia. However, living with dementia might put considerable strain on relations. Services should provide support to enhance relationships, encourage existing networks to remain stable and facilitate participation in meaningful activities for people living with dementia.

Well-being in parents of children with cancer: The impact of parental personality, coping, and the child's quality of life

The aim of the study was to investigate the impact of parental personality, coping, and the child's quality of life on the well-being of parents of children treated for cancer. The study included 99 parents (63 mothers and 36 fathers), 41 parents during child's intensive treatment, 23 parents whose child completed intensive treatment, and 25 parents of children who completed treatment at least five years ago. The results of multivariate study have confirmed the predictive role of parental personality (especially Neuroticism); emotion-focused coping styles, and the child's quality of life (especially physical functioning) on parental well-being. About 60% of the variance in parental well-being can be attributed to the predictors. Assessing parental personality functioning and coping styles can help us identify those parents who are less emotionally stable, more prone to emotionally focused coping styles, and most likely to experience poorer well-being. Improved assessment may contribute to the development of further psychological interventions.

Intensive Mothers, Cautionary Tale Fathers: Adult Children's Perceptions of Parental Influence on Health

Parents strongly influence children's health, yet how parents continue to shape the health of midlife adult children remains unknown. Moreover, while most adults are married by midlife, research has failed to identify the effects of parent-in-law relationships on midlife adult wellbeing. Using interviews with 90 individuals in 45 marriages, we investigate how midlife adults perceive the influence of parents and parents-in-law on adult child health. Findings reveal that particularly mothers and mothers-in-law positively influence child's health via support during, or in anticipation of, illness and injury. The health experiences of parents and in-laws, particularly fathers/in-law, become cautionary tales preparing adult children for future health issues. Yet, parents/in-law also have negative influence on adult children during midlife due to parents' compounding health needs. We use family systems theory to show how parents/in-laws are intertwined in ways that influence health during children's midlife that has ramifications into later life.

Family Strain Predicts Subsequent Depressive Symptoms in Middle-aged Adults: Hope Mediates and Self-compassion Moderates the Relation

INTRODUCTION

Interpersonal strain is linked with depressive symptoms in middle-aged adults. One possible mechanism accounting for this relation is a reduction in hope, defined as the belief in one's capacity both to reach and to generate a variety of ways to obtain goals. The strength of the strain-depressive symptoms relation is not uniform across individuals, however, pointing to the likelihood that individual differences in the ability to successfully navigate relationship strain play a role in mitigating its negative effects. One potential moderator of the strain - depressive symptoms relation is self-compassion, which encompasses the capacity to respond to one's own negative thoughts and experiences in a kind and nonjudgmental way. Although theory and empirical evidence suggest that self-compassion is protective against the impact of stress on mental health outcomes, little research has investigated how self-compassion operates in the context of relationship strain. In addition, few studies have examined psychological mechanisms by which self-compassion protects against mental health outcomes, depression in particular. Thus, this study examined 1) the extent to which hope mediates the relation between family strain and depressive symptoms, and 2) whether these indirect effects are conditional on self-compassion in a community sample of middle-aged adults.

METHODS

Self-reported family strain, self-compassion, hope, and depressive symptoms were assessed in a community sample of 762 middle-aged adults aged 40-65. Follow-up measures of depressive symptoms were assessed approximately 20 months later.

RESULTS

Results from structural equation models indicated that hope mediated the relation between family strain and depressive symptoms and the indirect effect was conditional on levels of self-compassion. For individuals high versus low in self-compassion, strain-related declines in hope predicted smaller increases in depressive symptoms.

DISCUSSION

Taken together, the findings suggest that family strain may lead individuals to experience less hope and subsequent increases in depressive symptoms. However, a self-compassionate attitude may serve as a resilience resource, weakening the hope - depressive symptoms relation, a finding that holds promise for future research on the development and refinement of self-compassion interventions.

The Rio Health Gym Program: Daily life, leisure and health of older adults

Abstract Objective: to identify the activities performed by older adults as part of the Rio Health Gym Program in their daily lives, and analyze the contributions of these practices to their health and quality of life. Method: a qualitative, exploratory and descriptive study was conducted using interviews with 30 older adults who attended a health center in the city of Rio de Janeiro (RJ). Lexicographic analysis was performed using the Alceste software program. Results: five lexical classes were generated. Physical and leisure activities comprised classes 2 and 3. The statements that made up the lexical classes showed that older adults carried out their daily activities with autonomy and independence. According to their assessment, the activities promote the integration of participants, increase social participation and benefit health and quality of life. They attribute their proactivity to participation in the social group. Conclusion: the activities bring diversity to daily living, increase socialization and leisure opportunities, and consequently improve the health of older people by facilitating social relationships.

The Association between Living Status Transitions, Behavior Changes and Family Relationship Improvement among Methadone Maintenance Treatment Participants in Guangdong, China

The quality of family relationships is important for individual and family well-being. Improving family relationships is also an important goal in methadone maintenance treatment (MMT). Little is known about factors associated with the improvement of family relationships among MMT clients. This study aimed to identify factors associated with family relationship improvement in MMT. We retrospectively analyzed existing data from 2006 to 2014 at 15 MMT clinics in Guangdong, China, including 2171 subjects with 4691 follow-ups. Generalized estimating equations were used to investigate the association between living status transitions, behavior changes and family relationship improvement, with covariates controlled for. Family relationship improvement was found in 23.1% of all follow-up intervals. Participants who began living with family, living on a regular wage, and gained employment were more likely to have improved family relationships. The quality of family relationships also improved among participants who ceased contact with drug-addicted fellows, ceased drug use, and those who were sexually active. These results suggest that improvement in living status, positive changes in drug use, and sexual activity are associated with family relationship improvement and corresponding interventions may be developed to facilitate clients' recovery.

Roles of egos' and siblings' perceptions of maternal favoritism in adult children's depressive symptoms: A within-family network approach

It is well documented that intergenerational ties play important roles in adults' well-being. However, most studies focus on the impact of individuals' own perceptions of their ties without considering whether family members' assessments of these ties affect well-being. We address this question using data from 296 adult children nested within 95 later-life families in which all offspring were interviewed. Applying a mixed-method within-family approach, we explored whether the effect of perceived maternal favoritism on depressive symptoms was increased when siblings shared ego's perceptions. Multilevel regression analyses revealed that ego's own perceptions predicted depressive symptoms, but only among daughters. Siblings' perceptions that egos were most close to mothers did not affect the well-being of daughters or sons. Qualitative analyses suggested that differential effects of perceived favoritism by gender reflected differences in the meaning sons and daughters associated with being favored children. Favored daughters were more likely than favored sons to report that they were emotional caregivers to their mothers; this pattern was especially strong when siblings reinforced egos' perceptions of being "best suited" for this role. These findings emphasize the salience of egos' own perceptions, relative to those of family network members, in shaping role embracement and psychological well-being, especially among women.

Development of Subjective Well-Being in Adolescence

Despite the importance of subjective well-being (SWB) for students' mental and physical health, there is a lack of longitudinal studies investigating the development of SWB in adolescents and what factors are associated with it over time. The present study seeks to shed further light on this question by investigating adolescents longitudinally. A sample of German academic tracks students (N = 476) from five schools were followed longitudinally over a time period of 30 months with four measurement points from Grade 11 to Grade 13. Alongside the longitudinal assessment of SWB (mood and life satisfaction), a range of other factors were also assessed at t1 including; demographic factors (sex, age, socio-economic status (HISEI)), intelligence, grades (report cards provided by the schools), personality (neuroticism, extraversion) and perceived parental expectations and support. Latent growth curve models were conducted to investigate the development of SWB and its correlates. On average, mood and life satisfaction improved at the end of mandatory schooling. However, students significantly differed in this pattern of change. Students' life satisfaction developed more positively if students had good grades at t1. Furthermore, even though introverted students started with lower life satisfaction at t1, extraverts' life showed greater increases over time. Changes in mood were associated with socio-economic background; the higher the HISEI the more positive the change. As social comparisons in school performance are almost inevitable, schools should intervene to buffer the influence of school grades on students' SWB.

Why Singles Prefer to Retire Later

This study goes beyond a purely financial perspective to explain why single older workers prefer to retire later than their partnered counterparts. We aim to show how the work (i.e., its social meaning) and home domain (i.e., spousal influence) contribute to differences in retirement preferences by relationship status. Analyses were based on multiactor data collected in 2015 among older workers in the Netherlands (N = 6,357) and (where applicable) their spouses. Results revealed that the social meaning of work differed by relationship status but not always as expected. In a mediation analysis, we found that the social meaning of work partically explained differences in retirement preferences by relationship status. We also show that single workers preferred to retire later than workers with a “pulling” spouse, earlier than workers with a “pushing” spouse, and at about the same time as workers with a neutral spouse.

The relationship between acceptance of cancer and distress: A meta-analytic review

Acceptance of cancer has long been recognized as playing a critical role in psychological adjustment to the illness, but its associations with distress outcomes have not been quantitatively reviewed. Informed by coping theory and third wave conceptualizations of acceptance, we first propose an integrated model of acceptance of cancer. Then we examine the strength of the relationships between acceptance of cancer and general and cancer-specific distress in cancer patients and potential moderators of these relationships. CINAHL, Embase, MEDLINE, PsycINFO, PsycARTICLES, and Web of Science databases were searched. Random-effects meta-analyses were conducted on 78 records (N = 15,448). Small-to-moderate, negative, and significant relationships were found between acceptance of cancer and general distress (r = -0.31; 95% CI: -0.36 to -0.26, k = 75); cancer-specific distress (r = -0.18; 95% CI: -0.21 to -0.14, k = 13); depressive symptoms (r = -0.25; 95% CI: -0.31 to -0.19, k = 41); and anxiety symptoms (r = -0.22; 95% CI: -0.30 to -0.15, k = 29). Age, marital status, and stage of cancer were identified as significant moderators. Findings suggest that acceptance of cancer may be important to target in interventions to reduce general and cancer-specific distress in cancer patients. Future research should focus on developing multifaceted measures of acceptance and identifying theory-based psychological and social processes that lead to greater acceptance.

Does Acculturation Matter? End-of-Life Care Planning and Preference of Foreign-born Older Immigrants in the United States

Background and Objectives

Advance care planning (ACP) is a critical component of health care affecting the quality of later life. Responding to the increase in the older immigrant population in the United States, this empirical study explored the racial/ethnic gaps in ACP behaviors among older immigrants and examined the end-of-life (EOL) care planning and preferences of foreign-born immigrant older adults focusing on race/ethnicity, acculturation, health need factors, and enabling social factors (financial capability, public assistance, and informal supports) after controlling predisposing factors (sociodemographic characteristics).

Research Design and Methods

Using a subsample from the National Health and Aging Trends Study 2011 and 2012, hierarchical logistic regression models of the EOL plan and preferences were examined with 50 multiple imputation data sets (n = 232).

Results

Descriptive statistics reveal lower ACP engagement of immigrants from racial/ethnic minority groups. In logistic models, however, only Black immigrants were less likely than Whites to have EOL conversations. Among acculturation factors, age at immigration was only negatively associated with having a durable power of attorney for health, but not significantly associated with other ACP behaviors. Instead, health and social factors, primarily need in health and informal support (i.e., number of coresidents and receiving financial help from family members), were associated with different types of ACP components. Receiving public assistance (i.e., receiving Medicaid and SSI) were positively associated with EOL treatment preferences.

Discussion and Implications

Older foreign-born immigrants, in general, showed lower ACP engagement than the overall older population. Moreover, minority immigrants were lower on ACP engagement than both White immigrants. This study highlights the need for formal and informal assistance for enhancing EOL planning for older immigrants. Adding to the culturally competent approach, policy efforts should address social and health factors that accrued throughout individuals’ life spans and affect older immigrants’ EOL preparation and care.

Personal psychological resources mediate parent-child relationship and mental health among left-behind children

Discrepant findings on the impact of parental migration on left-behind children's (LBC) psychological health have been noted in the literature. While several studies have shown the negative effects of parental migration, burgeoning research has demonstrated contradictory findings. The present study aimed to clarify this issue by examining the association between family resources and mental health as mediated by personal psychological resources (PPRs). A sample comprised of 466 LBC (aged 11-17 years) answered a set of questionnaires assessing parent-child relationship, PPRs, and mental health symptoms. The results showed that PPRs, particularly emotional resources, significantly mediated the link between family resources and mental health. This suggests that LBC who have rich family resources (i.e., close parent-child relationship) have lower mental health problems due to higher emotional resources (i.e., satisfaction in life). Conversely, those who reported having poor family resources experienced a lower level of PPRs (i.e., emotional well-being), which in turn, increased their risk of having psychological distress. The "caravanning" of resources from family to personal resources is vital in protecting LBC's mental health.

Internet Use and Preventive Health Behaviors Among Couples in Later Life: Evidence from the Health and Retirement Study

Background and Objectives

The aim of this study was to examine the link between internet use and preventive health behaviors. We focused on couples to examine whether there were cross-partner associations between internet use and preventive health behaviors.

Research Design and Methods

The data for this study came from the 2010 and 2012 waves of the Health and Retirement Study and the sample consisted of 5,143 pairs of coupled-individuals. Preventive health behaviors included cancer screenings (mammogram and prostate tests), cholesterol tests, and flu shots. Logistic multilevel actor-partner interdependence models were employed to test the study hypotheses.

Results

Internet use was associated with a higher likelihood of receiving prostate exams and cholesterol tests for husbands, net of demographic and health characteristics, and insurance status. We found that wives' internet use was associated with a higher likelihood of receiving flu shots and prostate exams for husbands, but husbands' internet use was not associated with wives' preventive health behaviors.

Discussion and Implications

Research linking internet use and preventive health behaviors is important because such behaviors are associated not only with health of the older population but also with substantial reductions in health care expenditures. Our findings suggested that internet use of older adults is associated with their own preventive health behaviors, as well as their spouses' preventive health behaviors. Interventions and programs to facilitate older adults' preventive health behaviors should consider couple-based approaches.

Well-being in dementia: a cross-sectional dyadic study of the impact of multiple dimensions of strain on persons living with dementia and their family care partners

ABSTRACTBackground and Purpose:The impact of dementia-related stressors and strains have been examined for their potential to threaten the well-being of either the person with dementia or the family care partner, but rarely have studies considered the dyadic nature of well-being in dementia. The purpose of this study was to examine the dyadic effects of multiple dimensions of strain on the well-being of dementia care dyads.

METHODS

Using multilevel modeling to account for the inter-relatedness of individual well-being within dementia care dyads, we examined cross-sectional responses collected from 42 dyads comprised of a hospitalized patient diagnosed with a primary progressive dementia (PWD) and their family care partner (CP). Both PWDs and CPs self-reported on their own well-being using measures of quality of life (QOL-Alzheimer's Disease scale) and depressive symptoms (Center for Epidemiological Studies Depression Scale).

RESULTS

In adjusted models, the PWD's well-being (higher QOL and lower depressive symptoms) was associated with significantly less strain in the dyad's relationship. The CP's well-being was associated with significantly less care-related strain and (for QOL scale) less relationship strain.

CONCLUSIONS

Understanding the impact of dementia on the well-being of PWDs or CPs may require an assessment of both members of the dementia care dyad in order to gain a complete picture of how dementia-related stressors and strains impact individual well-being. These results underscore the need to assess and manage dementia-related strain as a multi-dimensional construct that may include strain related to the progression of the disease, strain from providing care, and strain on the dyad's relationship quality.

In Our Lives and Under Our Skin: An Investigation of Specific Psychobiological Mediators Linking Family Relationships and Health Using the Biobehavioral Family Model

The objective of this study was to use the Biobehavioral Family Model (BBFM) to delineate which psychophysiological variables link romantic and family relationship satisfaction variables to health outcomes. Data from individuals who reported being partnered from the second wave of the National Survey of Midlife Development in the United States (MIDUS II), Project 4 (n = 812) were used to test a structural equation model which explored which psychophysiological variables potentially mediated associations between positive and negative family emotional climate variables and disease activity. This model found that current and past family variables had larger associations with the psychophysiological variables than romantic partner variables; depressive symptoms, anxiety, and inflammation partially mediated associations between family relationships and health; and, contrary to the hypotheses, romantic partner and family support were linked to worse health outcomes. However, the findings should be viewed with regard to the cross-sectional design of the study. Overall, the findings support the use of the BBFM as a model that can guide clinical interventions.

Can Spouses Buffer the Impact of Discrimination on Depressive Symptoms? An Examination of Same-sex and Different-sex Marriages

Discrimination due to personal characteristics (e.g., gender, sexuality, appearance) is a common yet stressful experience that is detrimental to mental health. Prior work has not considered how spouses in same- and different-sex marriages help each other cope with discrimination despite the importance of marriage for managing stress and adversity. We analyze survey data collected from both spouses in same-sex and different-sex marriages within the United States (N=836 individuals) to examine whether support from spouses weakens the impact of discrimination on depressive symptoms. Results suggest that discrimination contributes to depressive symptoms, but greater support from spouses buffers the mental health consequences of discrimination. Individuals in same-sex marriages report more spousal support than do individuals in different-sex marriages, even after accounting for experiences of discrimination. Same-sex couples may get needed spousal support, whereas women married to men receive the least spousal support and may be vulnerable to stressors that challenge mental health.

Family status and later-life depression among older adults in urban Latin America and the Caribbean

Rapid fertility declines in Latin American and Caribbean countries since the 1960s have contributed to smaller family sizes among the current cohorts of older adults. This may have mental health implications in these societies as the family unit is highly valued as a source of social support. Utilising data from the 2000 Survey of Health, Well-being and Aging in Latin America and the Caribbean (SABE), this study examines the association between parental status, marital status and the likelihood of experiencing depressive symptoms among adults 60 years and older in seven cities within Latin America and the Caribbean (N = 9,756): Buenos Aires, Bridgetown, São Paulo, Santiago, Havana, Mexico City and Montevideo. Results from multivariate logistic regressions indicate that parental status is not significantly associated with depressive symptoms. Nonetheless, unmarried older adults, both those living alone and those living with others, are more vulnerable to experiencing depressive symptoms than their married counterparts. Marriage is especially protective for older adults in Havana and Montevideo. Older adults’ perceived income adequacy significantly moderates the relationship between marital status and depressive symptoms. Other significant covariates, such as experiencing disability and comorbidity, showed positive associations with depressive symptoms. While families may still represent a critical component for the mental health of older adults, broader investments in health across the lifespan are needed to improve individual psychological wellbeing.