Changes in social support as mediators of the impact of a psychosocial intervention for spouse caregivers of persons with Alzheimer's disease.

The spouse caregivers of 406 patients with Alzheimer's disease were randomly assigned to an enhanced counseling and support intervention or to a usual care control condition. Structured interviews were conducted to assess changes in social support and psychosocial outcomes for the 312 caregivers who provided care in the home for at least 1 year. The number of support persons, satisfaction with the support network, and support persons' assistance with caregiving all increased significantly as a function of the intervention. Structural equation models indicated increased satisfaction with the social support network mediated a significant proportion of the intervention's impact on caregiver depression. A portion of this mediated effect was further mediated by changes in caregiver stress appraisals. Implications for strengthening intervention programs for spouse caregivers of individuals with Alzheimer's disease are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, social support, and distress in a statewide population of persons with AIDS in New Jersey

This study examined the effects of stress, social support, and health status on distress in a sample of 79 persons with AIDS in New Jersey. The study used New Jersey's AIDS Registry as a geographically based list sampling frame, with data gathered through in-person interviews. The study examined the effects of health status (operationalized as symptom burden), stress (operationalized with a stressful-life-events scale), social support from friends, and social support from family on depression as measured by the Center for Epidemiological Studies-Depression (CES-D) scale. We examined the differential effects of friend support and of family support at differing levels of stressful life events. Results indicate that health status and stressful life events both have substantial impact on distress. Friend support reduced distress under lower-stress conditions, while family support reduced distress under high-stress conditions. These results suggest that social support from peers is critical for emotional well-being of persons with HIV in many circumstances, but that in periods of crisis family support becomes a more important determinant of emotional well-being.     

Objective determinants of perceived social support.

Examined objective characteristics of people's social networks as determinants of the perceived availability of social support in 50 60–88 yr olds and in 71 18–35 yr old mothers of 1-yr-olds. Number of network members and frequency of contact with network members, computed separately for kin and nonkin were examined as predictors of loneliness (as measured by the UCLA Loneliness Scale), overall social support, and the 6 components of social support proposed by R. Weiss (1974). Kin were found to be more effective providers than nonkin of some aspects of social support. Network characteristics were better predictors of perceived social support for the elderly than for the mothers, but a maximum of 30% of the variance in perceived social support was attributable to the objective network characteristics in either sample. It is recommended that future research on the determinants of perceived social support consider actual interpersonal behaviors, their contexts, and personality characteristics that affect the facilitation and interpretation of supportive behaviors. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meeting the social service needs of persons with AIDS: hospices' response

A national sample of 148 directors of hospice social service departments (or persons most familiar with the delivery of social services in the hospice) participated in an exploratory study investigating the effects of the acquired immune deficiency syndrome (AIDS) epidemic on the delivery of hospice social services. Findings suggest, as does the literature, that the psychosocial needs of persons dying from AIDS present different challenges than those of traditional hospice patients. Furthermore, the results indicate the need for greater collaborative efforts among community agencies as well as specific and ongoing training for staff and volunteers who work with persons with AIDS (PWAs). Implications for the delivery of hospice social services to this population are discussed.     

Family functioning and social support in the adaptation of caregivers of children with sickle cell syndromes

OBJECTIVE: To examine moderating effects of family functioning and social support on the relationship of child-related stressors to caregivers' psychological adaptation in a sample of caregivers of children with a chronic illness. METHOD: Participants were 67 caregivers of children and adolescents with sickle cell syndromes. We conducted MANOVAs and subsequent effect size calculations to determine if family functioning would buffer the effects of caring for difficult-to-manage children with this illness. RESULTS: Findings supported a moderator effect of family functioning on the association of children's externalizing behavioral problems to caregivers' symptoms of hostility. Greater levels of cohesive and adaptive family functioning buffered the potential detrimental effects of caring for children perceived as hard to manage. No significant associations were obtained between measures of caregivers' psychological adaptation and the severity of their children's disease. CONCLUSIONS: We make recommendations for family systems interventions, particularly for caregivers of children with behavior problems.     

Satisfaction with social support during crisis: Intimacy and self-esteem as critical determinants.

Satisfaction with social support was studied longitudinally in 113 17–40 yr old Israeli women following the outcome of both normal and medically complicated pregnancies (delivery by cesarean section, delivery of an infant weighing under 2 kg, or spontaneous abortion before the 3rd trimester). Ss were interviewed concerning the size of their social networks, the number of friends and family members in their networks, perceived intimacy with spouse, and perceived intimacy with at least 1 friend and 1 family member. Included in the interviews were measures of self-esteem, intimacy, social network structure, and satisfaction with support. Findings show that greater intimacy with spouse and with friends was related to greater satisfaction with support received during the crisis period. Intimate ties contributed to satisfaction with support independent of self-esteem, social network parameters, and type of pregnancy outcome. Social network parameters and pregnancy outcome were not related to satisfaction with support. Among Ss low in self-esteem, greater intimacy with family was related to lower satisfaction with support if the Ss lacked intimate ties with spouse or a friend. Clinical and social psychological theories regarding reaction to aid are discussed. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of functional impairment and social support on depressive symptoms in persons with diabetes.

Tested the hypothesis that, among patients with higher levels of illness-related impairment, adequate social support would act as a buffer against depression. 158 Ss (aged 17–78 yrs) with insulin-dependent diabetes mellitus completed the Beck Depression Inventory, a health status measure, and 2 measures of social support. Depressive symptoms correlated positively with functional impairment and negatively with adequacy of social support. In addition, social support moderated depression in the face of greater impairment such that, among Ss who reported the most illness-related functional disabilities, adequate support provided a relative protection from depression. Individuals with inadequate support seem to be most at risk for depression when disability related to illness increases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family caregivers of persons with spinal cord injury: Predicting caregivers at risk for probable depression.

Objective: To determine the percentage of family caregivers of persons with spinal cord injury (SCI) with probable depression and to test the hypothesis that dysfunctional problem-solving abilities would be significantly predictive of risk status after taking into account important demographic characteristics and caregiver health. Design: Correlational and logistic regression analyses of data collected in a cross-sectional design. Participants: Eighteen men and 103 women caregivers (mean age of caregivers = 45.66 years, SD = 12.88) of individuals with SCI. Main Outcome Measure: The Inventory to Diagnose Depression. Results: Nineteen caregivers (15.7%) met criteria on the Inventory to Diagnose Depression for a major depressive disorder. A dysfunctional problem-solving style was significantly predictive of caregiver depression, regardless of the severity of physical impairment of the care recipient or the physical health of the caregiver and caregiver demographic variables. Conclusions: The percentage of caregivers with probable depressive disorder may parallel that observed among persons with SCI, using a more conservative self-report measure designed to assess symptoms associated with a depressive syndrome. Family caregivers with a dysfunctional problem-solving style and assisting individuals with more severe injuries may have probable depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The AIDS epidemic: caring for caregivers

AIDS has become a global health problem for individuals, families and health care providers. This disease has a tremendous impact on the physical and psychological well-being of these groups. Nurses are on the front line providing physical care and support for these patients and their families; but nurses also need support and caring as they carry out their important nursing roles. This article addresses the effects of AIDS on nurses and presents a model for nursing administrators to establish and maintain a supportive, caring environment for nurses.     

Sources of social support and burnout, job satisfaction, and productivity.

Social support has been identified as an important correlate of a variety of work outcomes. Support from different sources, including family, coworkers, and supervisors, was examined in 211 traffic enforcement agents (92 men, 119 women). Outcomes included subjective variables (burnout and job satisfaction) and an objective measure of productivity (number of summonses). Support was negatively associated with burnout and positively associated with satisfaction and productivity. A cluster of support variables accounted for 7% of the variance in burnout and productivity and 12% of the variance in job satisfaction. Family support was more closely associated with burnout than with satisfaction or productivity, whereas immediate supervisor support was related to satisfaction and productivity but not burnout. Results suggest that support may be associated with work-related outcomes through multiple pathways. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social problem-solving abilities, social support, and adjustment among family caregivers of individuals with a stroke.

ABSTRACT. Objective: To investigate the unique contributions of social problem solving abilities and social support in the prediction of aspects of caregiver adjustment. Study Design: Correlational procedures were used to determine the unique contributions of social problem-solving abilities and social support in the prediction of caregiver depression, health, and life satisfaction. Mediating factors were examined with correlational and regression analyses. Participants: Caregivers of individuals who had a stroke (20 African Americans and 20 Caucasians). Main Outcome Measures: The general health scale from the Short-Form Health Survey and measures of life satisfaction and depression. Results: Social support was the best predictor of caregiver life satisfaction. Perceived control over emotions when solving problems was the best predictor of caregiver depressive behavior and health. Social problem-solving abilities were associated with caregiver depressive behavior and health; social support did not mediate these relationships. Conclusions: Problem-solving interventions may be most appropriate for the treatment and prevention of caregiver depression and health problems. Social support programs may be indicated for caregiver life satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problem-solving appraisal and the effects of social support among college students and persons with physical disabilities.

Tested the hypothesis that the appraisal of one's own ability to solve problems would moderate the effects of social support among 2 distinct samples. In the 1st study, college students completed measures of depression, problem-solving appraisal, and social support. Although both predictor variables were significantly associated with depression, the 2 did not significantly interact in the prediction of depression. In the 2nd study, persons who had sustained severe physical disabilities completed the same independent measures and questionnaires of depression and psychosocial impairment. Problem-solving appraisal and social support were predictive of both criterion variables. The 2 independent variables significantly interacted in the prediction of psychosocial functioning. Results are discussed as they pertain to the effects of social support, with particular focus on persons who may have a higher frequency of contact with institutionalized and formal sources of support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological consultation to persons with AIDS.

Consultation to persons concerned about or infected by the human immunodeficiency virus (HIV) or who have developed the acquired immune deficiency syndrome (AIDS) is relatively new to psychologists. This article is an introductory overview to assist psychologists in understanding the infection, to reflect on any personal biases that may impede successful rendering of care, to understand some psychological responses by patients that are common to various stages of the illness, and to recognize potential clashes of complex individual and societal issues, in order to provide more informed consultation and psychological interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intimates as agents of social support: Sources of consolation or despair?

Proposed that people's intimates may insulate them against self-discrepant feedback. 17 male and 18 female undergraduates who possessed low or high self-esteem (targets), as determined by their scores on a social behavior inventory (SBI) pretest, reported to the laboratory accompanied by persons with whom they were involved in intimate relationships (intimates). Intimates completed a series of questions concerning their perceptions of the target, including a measure of congruency. Some intimates perceived targets in a manner that was congruent with targets' self-conceptions; others perceived targets in a manner that was incongruent with targets' self-conceptions. Targets then completed a bogus Thematic Apperception Test (TAT) and received bogus feedback that was discrepant with their self-esteem. Targets then interacted with either their intimate or a stranger, and again completed the SBI. Findings reveal that, as expected, targets changed their self-ratings in the direction of the discrepant feedback when they interacted with either an incongruent intimate or a stranger but not when they interacted with a congruent intimate. Congruent intimates were just as effective in insulating low self-esteem targets against positive feedback as they were in insulating high self-esteem individuals against negative feedback. The more targets discussed the feedback, the less self-rating change they experienced. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Congruence of depressive symptom appraisal between persons with stroke and their caregivers.

Objectives: To determine congruence of depressive symptom appraisal between persons with stroke and their caregivers and the influence of caregiver and clinical characteristics of stroke recovery on the congruence of symptom appraisal. Design: Cross-sectional using baseline data from a multisite caregiving study. Participants: 130 caregiver-person with stroke dyads. Main Outcome Measures: Five items from the Stroke Impact Mood subscale (= .72) and 6 items from caregivers' appraisals of depressive symptoms of persons with stroke on the Memory and Behavior Problems Checklist (= .61) were used to compare caregiver and person with stroke depressive symptom appraisal. Results: Most dyads were incongruent in their appraisals of depressive symptoms in the person with stroke. Dyads were congruent primarily when they perceived that the person with stroke had an absence of depressive symptoms. Caregiver gender, caregiver depressive symptoms, person with stroke antidepressant use, and time since stroke were important factors influencing congruence. Conclusion: Specific information regarding depressive symptoms after stroke should be targeted to both persons with stroke and their family caregivers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pain characteristics and their management in persons with AIDS

Discussion of pain problems in persons with AIDS has been limited in medical and nursing literature, yet pain is a major source of suffering and concern for patients. Common pain characteristics are described in 100 persons with CDC-defined AIDS, using the 1987 definition. The two most frequently cited types of pain for both drugs users and nondrug users with AIDS were abdominal pain and neuropathic pain. Drug users experienced pain due to esophagitis and headaches more frequently than nondrug users, while nondrug users experienced Kaposi's sarcoma-related pain more often. Treatment responses were individualized, with drug users requiring more frequent use of opiates. General treatment strategies are suggested with special emphasis on the unique needs of PWAs.