Marital distress and mental health care service utilization.

Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for specific sectors of treatment providers, including psychiatrist, other mental health provider, other medical provider, and religious services provider. Interviews were used to assess past-year service utilization and presence of anxiety, mood, and substance use disorders. Results: Approximately 12% of married individuals sought help for problems with their emotions, nerves, or substance use during the 12 months preceding the interview. Marital distress was significantly associated with (a) overall mental health service utilization and service utilization provided by each of the sectors of providers when controlling for demographic variables and (b) overall mental health service utilization and receiving treatment from a psychiatrist when additionally controlling for past-year anxiety, mood, or substance use disorders. There was little evidence that the associations between marital distress and service utilization were moderated by gender or presence of psychiatric disorders. Conclusion: The finding that marital distress is associated with greater mental health care service utilization suggests that clinicians should assess both individual and relationship factors among individuals presenting for treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acculturation, enculturation, and Asian American college students' mental health and attitudes toward seeking professional psychological help.

In the present study, we tested a theoretically and empirically derived partially indirect effects acculturation and enculturation model of Asian American college students' mental health and attitudes toward seeking professional psychological help. Latent variable path analysis with 296 self-identified Asian American college students supported the partially indirect effects model and demonstrated the ways in which behavioral acculturation, behavioral enculturation, values acculturation, values enculturation, and acculturation gap family conflict related to mental health and attitudes toward seeking professional psychological help directly and indirectly through acculturative stress. We also tested a generational status moderator hypothesis to determine whether differences in model-implied relationships emerged across U.S.- (n = 185) and foreign-born (n = 107) participants. Consistent with this hypothesis, statistically significant differences in structural coefficients emerged across generational status. Limitations, future directions for research, and counseling implications are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Expectant parents' representations of early attachment relationships: Associations with mental health and family history.

The association between adult representations of early attachment relationships and history of individual and family mental health was examined in a sample of 233 expectant mothers and fathers. As predicted, security of attachment was linked to mental health. Parents classified as Preoccupied were more likely than other parents to report suicidal ideation, whereas parents classified as Unresolved more- often reported suicidal ideation, emotional distress, and substance abuse. With respect to family history, Unresolved and Preoccupied attachment classifications were significantly related to child abuse involving a relative and parental separation or divorce. These findings support theoretical conceptualizations regarding the link between adult attachment and mental health in middle-class American adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping With Intergenerational Family Conflict Among Asian American College Students.

Two coping strategies--problem solving and social support seeking--were hypothesized to differentially moderate the effects of intergenerational family conflict on well-being and adjustment in a college sample of 117 Asian American young adult children. Results indicated that social support served as a protective-stabilizing factor that buffered the effects of family conflict on positive affect and somatic distress. Problem-solving coping served as a protective-reactive factor that had a positive effect on positive affect when family conflict was low and a negative effect when family conflict was high. The potential implications of these findings for counseling and conducting research on Asian American college students are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trauma, Depression, Coping, and Mental Health Service Seeking Among Impoverished Women.

The authors examined the relationship among trauma, coping, depression, and mental health service seeking in a probability sample of sheltered homeless and low-income housed women. Results highlight the diversity of trauma. In a longitudinal analysis, women who lived in shelters or experienced major violence had a twofold increase in their risk of depression over the 6-month follow-up. In a cross-sectional analysis, childhood sexual abuse, living in a shelter, physical violence, childhood physical abuse, and death or injury of a friend or relative predicted avoidant coping and symptoms of depression. Active coping and depression predicted mental health service seeking among traumatized women. Modifying coping strategies may ameliorate some of the negative impact of trauma and potentially enhance mental health service use among at-risk women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Roles of perceived sexist events and perceived social support in the mental health of women seeking counseling.

The authors of the present study contribute to research on the role of sexist events in women's mental health by examining the sexism-distress relation (a) with a sample of women who are seeking mental health services and (b) in the context of the additional roles of perceived social support in positive self-appraisal (i.e., empowerment and self-esteem) and psychological distress. A path analysis was conducted with data from 157 women who were seeking counseling services. Results supported the generalizability of previously observed links between the frequency of perceived sexist events and psychological distress. Results also indicated that the sexism-distress link was significant in the context of an additional significant indirect relation of perceived social support with psychological distress, which was mediated through empowerment but not through self-esteem. Implications for future research and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Daily family conflict and emotional distress among adolescents from Latin American, Asian, and European backgrounds.

The authors employed a daily diary method to assess daily frequencies of interparental and parent–adolescent conflict over a 2-week period and their implications for emotional distress across the high school years in a longitudinal sample of 415 adolescents from Latin American, Asian, and European backgrounds. Although family conflict remained fairly infrequent among all ethnic backgrounds across the high school years, its impact on emotional distress was significant across ethnicity and gender. In addition, parent–adolescent conflict significantly mediated the association between interparental conflict and emotional distress. These associations were observed at both the individual and the daily levels, providing evidence for both the chronic and episodic implications of family conflict for adolescents’ emotional adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The mental health costs and benefits of giving social support.

Is giving support neutral, beneficial or costly to mental health? The authors identified 2 types of support--companionship and help--and conceptualized their provision as emotional labor. Companionship involves showing care to people, building feelings of happiness, pride, and belonging, whereas help involves assisting with feelings of distress, anger, and conflict and is potentially much more stressful. Using survey data (N=398), the authors found that companionship and help showed opposite associations with support givers' mental health; companionship was associated with fewer depressive symptoms, whereas help was associated with more. Social support helps recipients cope with stress and distress, but it may also affect people who give it, with consequences depending on the type of support given. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Daily work–family conflict and alcohol use: Testing the cross-level moderation effects of peer drinking norms and social support.

In the current study, we conducted daily telephone interviews with a sample of Chinese workers (N = 57) for 5 weeks to examine relationships between daily work–family conflict and alcohol use. Drawn from the tension reduction theory and the stressor–vulnerability model, daily work–family conflict variables were hypothesized to predict employees’ daily alcohol use. Further, social variables (i.e., peer drinking norms, family support, and coworker support) were hypothesized to moderate the relationship between work–family conflict and alcohol use. Results showed that daily work-to-family conflict but not family-to-work conflict had a significant within-subject main effect on daily alcohol use. In addition, there was significant between-subject variation in the relationship between work-to-family conflict and alcohol use, which was predicted by peer drinking norms, coworker support, and family support. The current findings shed light on the daily health behavior consequences of work–family conflict and provide important theoretical and practical implications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental Health of Lesbian, Gay, Bisexual, and Heterosexual Siblings: Effects of Gender, Sexual Orientation, and Family.

Self-identified lesbian, gay male, and bisexual (LGB) individuals were recruited via convenience sampling, and they in turn recruited their siblings (79% heterosexual, 19% LGB). The resulting sample of 533 heterosexual, 558 lesbian or gay male, and 163 bisexual participants was compared on mental health variables and their use of mental health services. Multilevel modeling analyses revealed that sexual orientation predicted suicidal ideation, suicide attempts, self-injurious behavior, use of psychotherapy, and use of psychiatric medications over and above the effects of family adjustment. Sexual orientation was unrelated to current psychological distress, psychiatric hospitalizations, and self-esteem. This is the 1st study to model family effects on the mental health of LGB participants and their siblings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes toward professional counseling among Asian-American college students: Acculturation, conceptions of mental illness, and loss of face.

The present study attempted to examine the influence of culture-bound barriers such as acculturation status, loss of face, and conception of mental health on the attitudes of Asian American college students (n = 134) toward seeking professional psychological help. An adapted Acculturation Attitude Scale (AAS; U. Kim, 1988), Zane's (1991) Loss of Face Scale (LOFS), a 10-factor Conception of Mental Health Scale (CMHS; Nunnally, 1961), and a modified version of the Attitudes Toward Seeking Professional Psychological Help Scale (ATSPPHS) with four subscales (Fischer & Turner, 1970) were used in this study. Results support the hypothesis that acculturation and conceptions of mental health were significantly correlated with attitudes toward mental health services. Loss of face was also significantly correlated with attitudes of being open to professional counseling. Implications for mental health professionals working with Asian Americans are highlighted. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Health and turnover of working mothers after childbirth via the work–family interface: An analysis across time.

This study examined organizational levers that impact work–family experiences, participant health, and subsequent turnover. Using a sample of 179 women returning to full-time work 4 months after childbirth, we examined the associations of 3 job resources (job security, skill discretion, and schedule control) with work-to-family enrichment and the associations of 2 job demands (psychological requirements and nonstandard work schedules) with work-to-family conflict. Further, we considered subsequent impact of work-to-family conflict and enrichment on women's health (physical and mental health) 8 months after women returned to work and the impact of health on voluntary turnover 12 months after women returned to work. Having a nonstandard work schedule was directly and positively related to conflict, whereas schedule control buffered the effect of psychological requirements on conflict. Skill discretion and job security, both job resources, directly and positively related to enrichment. Work-to-family conflict was negatively related to both physical and mental health, but work-to-family enrichment positively predicted only physical health. Physical health and mental health both negatively influenced turnover. We discuss implications and opportunities for future research. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Intergenerational Family Conflict and Coping Among Hmong American College Students.

Problem solving and social support, as different styles of coping with intergenerational family conflict, were examined among 86 Hmong American college students. Problem solving and social support were hypothesized to differentially moderate the effects of family conflict on psychological adjustment. Furthermore, the effects of attributions of blame on the adjustment of Hmong American college students were examined. Results indicate that social support buffered and problem solving enhanced the negative effects of family conflict on symptoms of distress but not on affect. Additionally, there were significant interaction effects between family conflict and self-blame on distress. Specifically, students who were more likely to blame themselves reported higher levels of distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of deployment on U.S. military families.

Several recent articles have explored the effects of military deployment on U.S. service members' mental health outcomes. Although increased attention has also begun to focus on the effects of deployment on military families, providing a conceptualization for the mechanisms of this process can help organize existing information and inform future efforts. In this article we seek to draw greater attention to the effects of deployment on service members and to provide an overview of recent literature on the impact of deployment on service members and military families. A further goal is then to provide one conceptual perspective—a model of family stability—that may help inform our understanding of the impact of military deployment on families. Beyond informing research, the issues presented in this article have far-reaching consequences not only for American military families and their current mental health and primary care providers but also for practitioners in the broader mental health community who will be increasingly called upon to provide services to this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A preliminary investigation of family coping styles and psychological well-being among adolescent survivors of Hurricane Katrina.

The relation between family coping styles and psychological well-being was compared for adolescents (12-17 years) displaced by Hurricane Katrina and currently living in a relocation camp (n = 50) and nonaffected adolescents (n = 31) matched on age, race, and socioeconomic status. Adolescents in the Katrina sample reported a family mobilizing strategy that reflected an increased reliance and seeking of extra-familial, community-based support but lower self-esteem and more symptoms of distress and depression. Follow-up analyses suggested that the relations between group differences in participants' hurricane-related trauma experiences and greater psychological distress may be mediated in part by the family coping strategy; exposure to increased levels of community-provided support may have unintended consequences on adolescents' psychological health. These results highlight the importance of future research on both potential benefits and costs of family coping styles in adolescents affected by a large-scale disaster. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Caregiving from the recipient's perspective: Negative reactions to being helped.

This study investigated predictors of negative reactions to assistance provided to a physically disabled spouse (n?=?276, M age: 76.6 years) and the consequences that negative reactions may have for the mental health of the care recipient. Nearly 40% of recipients reported some emotional distress in response to help they received. Fatalistic attitudes, perceived control, and lower self-esteem predicted greater helping distress, whereas lower self-esteem, fatalistic beliefs, and marital conflict were especially likely to lead to helping distress for those who received higher levels of assistance. Helping distress was also found to predict depression as much as 1 year later, suggesting that there may be long-term consequences of negative reactions to assistance. These findings have important implications for the study of caregiving and the relationship between physical impairment and depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality, coping, and family resources in stress resistance: A longitudinal analysis.

A longitudinal analysis was conducted in which stress-resistance factors in the areas of personality, coping, and family support assessed at an initial testing were used to predict psychological and physical adjustment 1 yr later, controlling for initial adjustment. 245 men (mean age 46.8 yrs) and 248 women (mean age 44 yrs) in randomly selected families in the San Francisco Bay area were surveyed on psychosomatic symptoms and depression, negative life changes, personality characteristics, avoidance coping, and family support. Findings show that feelings of self-confidence, an easy-going disposition, a disinclination to use avoidance coping, and the availability of family support operated jointly to protect Ss from negative psychological consequences of life stress. For women, stress resistance was related to emotional and physical distress; for men, resistance was associated with emotional distress. Negative life changes predicted depression and psychosomatic complaints in both sexes even when initial distress was considered. Results support previous research on the causal role of stress resistance in emotional and physical health. (38 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Economic pressure in African American families: A replication and extension of the family stress model.

This study of 422 two-caregiver African American families, each with a 10-11-year-old focal child (54% girls), evaluated the applicability of the family stress model of economic hardship for understanding economic influences on child development in this population. The findings generally replicated earlier research with European American families. The results showed that economic hardship positively relates to economic pressure in families. Economic pressure was related to the emotional distress of caregivers, which in turn was associated with problems in the caregiver relationship. These problems were related to disrupted parenting practices, which predicted lower positive child adjustment and higher internalizing and externalizing symptoms. The results provide significant support for the family stress model of economic hardship and its generalizability to diverse populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Siblings of military servicemembers: A qualitative exploration of individual and family systems reactions.

How does having a sibling in the military affect young adults? Despite increasing attention to the challenges faced by spouses and children of servicemembers, the siblings of servicemembers have been largely ignored in the existing literature. This qualitative investigation uses unstructured narratives to explore siblings' perceptions of changes in their lives and changes in the family of origin associated with having a family member enlist in the United States military. Thematic analyses revealed an acute period of conflict followed by reorganization, awareness of the parents' distress, changes in the emotional climate of the family, shifts in family roles, admiration for the military sibling, and increased meaning and purpose for the family following the servicemember's enlistment. Computer-assisted text analyses revealed both positive and negative emotional expressions associated with the siblings' military service. For professional psychologists who come into contact with siblings of servicemembers, it is important to recognize that military enlistment can have ripple effects and complicate other common individual and family stresses. More generally, it is important to provide siblings and the family of origin with information about what to expect during and after the servicemember's enlistment, especially since these families may lack support from and contact with others going through similar transitions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Coping with intergenerational family conflict: Comparison of Asian American, Hispanic, and European American college students.

Using a stress-coping framework, the authors examined indirect and direct coping strategies as potential mediators in the relationship between intergenerational family conflict and psychological distress in Asian American, Hispanic, and European American college students. Asian American college students reported the highest likelihood of family conflict. Students from all cultural groups also used direct coping slightly more often than they did indirect coping. Only indirect coping mediated the effect of family conflict on distress for Asian Americans and European Americans, but it did so in the opposite direction than hypothesized. For these two cultural groups, indirect coping fully accounted for the variance shared between family conflict and psychological distress. For Hispanics, indirect coping partially mediated the effect of family conflict on psychological distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)