The strengths model in long-term care: linking cost containment and consumer empowerment

In this study we examined the following: (1) frequencies of remarrying or becoming romantically involved for widows and widowers during the first 2 years of widowhood; (2) attitudes toward dating and remarriage among the recently widowed, and their evolution; (3) identifiable factors which predict the development of new romances, such as sex, age, income, and level of education; and (4) the psychological well-being of those widows and widowers involved in romances compared to those who were not. The San Diego Widowhood Project was a prospective study in which 249 widows and 101 widowers who were identified through San Diego County death certificates completed detailed questionnaires 2, 7, 13, 19, and 25 months after their spouses' deaths. The main outcome measures for this study were marital and romance status, attitudes toward romance at several time points, demographic predictors of romance status, and self-reported measures of psychological well-being. By 25 months after the spouse's death 61% of men and 19% of women were either remarried or involved in a new romance. Women expressed more negative feelings about forming new romantic relationships. Younger age was a predictor of becoming involved in a new romance for women, and higher monthly income and level of education were predictors for men. Greater psychological well-being was highly correlated with being remarried or in a new romance 25 months after the spouse's death. It may be helpful for family, friends, and therapists to know that dating and remarriage are common and appear to be highly adaptive behaviors among the recently bereaved.     

A re-examination of widowhood and morale

Previous research has suggested widowed status to be associated with lower morale or life satisfaction. The effects of marital status on morale relative to five covariates (health, income, age, family interaction, and employment status) were examined with 232 widowed and 363 married women aged 45-74, drawn in a multistage stratified area probability sample of Los Angeles County. Analysis of covariance was utilized with a six-item, factor analyzed measure of morale. Parallel analyses were performed for each of three ethnic groups (blacks, Mexican-American, and white) to examine specific ethnic patterns. In the total sample, poor health was associated with significantly lower morale among widowed than among married women. The analysis with age showed the widowed group catching up and surpassing their married peers on morale at higher ages. Controlling for income and employment status eliminated differences between the marital status groups on morale scores. Higher family interaction was positively associated with morale in both groups, but married women were consistently higher on morale regardless of level of interaction. Most ethnic differences were not significant, but family interaction appeared to be crucial among Mexican-American widows. The findings suggest that lower morale scores found among the widowed may be partly attributable to other factors commonly associated with this status and not due to the role of widowhood per se.     

Age and sex differences in the mental health of older persons.

Administered the Trait Anxiety scale of the State-Trait Anxiety Inventory, a depression scale, and a general well-being scale to 2,051 respondents (aged 55+ yrs) to explore the age and sex relationships in the scales and the effects of age and sex when other correlated variables are considered. Results show that mental health was curvilinearly related to age with high symptom scores obtained in both 55–59 and 85–89 yr olds and lowest in 60–69 yr olds. Sex interacted with marital status, with higher symptoms among males in the never-married category and in females among the widowed and the married categories. When data were adjusted for correlations among these and other variables, the relationships between mental health with age and sex changed. In males, symptoms were unrelated to age, and in females, symptoms decreased with age down to the 80–84 yr old group. In the adjusted data, married females had lower symptoms than males. (43 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging and bereavement

This paper compares the grief responses of widows and widowers of different age groups over the 1st year of bereavement. The results strongly suggest that older widows and widowers perceive themselves as adjusting better to their loss and suffering from less depression and fewer anxiety symptoms than their younger counterparts. Furthermore, the oldest widows/widowers demonstrate the most consistent improvement in their levels of distress over time. Thus, when it comes to coping, older persons are not at the disadvantage that certain stereotypes and "clinical wisdoms" have previously suggested. Seniors are every bit as adaptive and able to cope with the severest forms of stress as anyone else, and they are, if anything, less prone to depression than are younger individuals.     

Effects of social interaction and children's relative inputs on older women's psychological well-being.

Sampled 719 White females, ages 60–75 yrs; half of the Ss were widows and half were currently married, living with a spouse. For each marital-status group, half were childless and half had living children. Results reveal that contact with relatives, friends, and associates was more important for Ss' well-being than contact with children and that well-being was enhanced by quality of interaction. Perceived quality of child contact appeared to be influenced by Ss' perceptions of other social relationships. Weak support for equity theory explanations of relationship satisfaction was found. For Ss with children the amount of interaction appeared unimportant whereas for childless Ss the amount and quality of contact with others was positively related to well-being. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital status of caregiving daughters and co-residence with dependent parents

The role of caregiving daughters' marital status is examined as it relates to their sharing households with disabled elderly parents. Married daughters fared best in well-being, income, and social support. Never-married women were the most likely to have never moved out of the parental home. Separated/divorced caregivers, more than the married and widowed, had moved into the parent's home rather than the reverse and widowed daughters had lived in re-formed joint households longest. The main reason for re-forming shared households was disability of the parent. Among other reasons were death or withdrawal of previous caregiver and financial problems, with separated/divorced daughters the most likely to mention finances.     

My children and me: Midlife evaluations of grown children and of self.

215 midlife parents (mean age 53.7 yrs) were interviewed about how their adult children (mean age 27.6 yrs) had "turned out." These assessments were then related to parents' views of themselves. Perceived accomplishments and adjustment of children were expected to be positively linked with parents' well-being (e.g., self-acceptance, environmental mastery, purpose in life), and social comparisons were hypothesized to contribute to the link between parents' assessments of children and their own well-being. Multiple regression analyses revealed that children's perceived adjustment significantly predicted 6 of 7 well-being outcomes for mothers and fathers. Children's attainment was less strongly linked with parental outcomes. Personal comparisons were significant negative predictors: Parents who saw their children as better adjusted than themselves had lower well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A co-twin--control study of response to widowhood

The effects of long-term and recent conjugal bereavement were investigated in a sample of 2,104 Swedish twins followed between 1984 and 1993. In co-twin-control analyses, the bereaved twin experienced significantly more depressive symptoms, more loneliness, and less life satisfaction than the married co-twin. This association existed for recently widowed (< 3 years) of both sexes. Long-term widowed (> 5 years) reported more loneliness than married individuals, and for women there was also a difference in life satisfaction. There were no effects of bereavement on perceived physical health. Individual analyses, which included all respondents regardless of the co-twin's bereavement status, showed the same pattern of results. There was also evidence for an anticipation effect of widowhood indicated by elevated depressive symptoms prior to the spouse's death. Finally, longitudinal analyses showed that it is more stressful to be bereaved when young-old than old-old, but revealed no age differences in adaptation.     

Remarriage as a coping response for widowhood.

Consideration and use of remarriage as a response to cope with the death of a husband were examined in 39 women who had been widowed and had subsequently remarried, 192 widows who had considered remarriage but had not yet remarried, and 420 widows who had not considered remarriage. Controlling for age, we found that women who had remarried reported fewer current concerns than did the other two groups. Furthermore, we found that women who retrospectively recalled the most concerns immediately after the death of the spouse were the ones who eventually remarried. The remarried group believed that they were experiencing significantly fewer concerns now than they had after the spouse's death; the women who had not considered remarriage believed that they were experiencing the same number of concerns now as before; and those women who had considered remarriage believed that they were experiencing significantly more concerns. Implications for remarriage as a coping mechanism for widowhood and the relation of age to remarriage decisions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of marital role problems and the self-concept on wives' depressed mood.

Evaluated the mutual contribution of role interaction problems and self-concept to the depressed mood of wives in the marital relationship, using a linear recursive model incorporating path analysis and multiple regression. A random sample of married couples was interviewed, including 85 couples that had a child or children younger than 6 yrs old and in which the wife was less than 45 yrs old; 88 couples with a child or children aged 6–18 yrs, the wife being of any age; 81 couples with no children at home and the wife aged 45–59 yrs; and 82 couples with no children at home and the wife older than 60 yrs old. Roles selected to measure interaction problems included cooking, housekeeping, companionship to spouse, and caring for children. Role disagreement, depressed mood, and wives' self-concepts and the actual and perceived appraisals of the husbands for the wives were measured. Results indicate that the path model proposed a causal effect of marital role disagreement and reflected self-concept on wives' depressed mood. The key variable in the model was wives' perceptions of husbands' evaluations, which had a direct effect on wives' mood and mediated much of the effect of role disagreement on wives' depressed mood. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivation, self-determination, and person€nvironment fit as predictors of psychological adjustment among nursing home residents.

Applied self-determination theory to the regulation of everyday behavior in later life. Nursing home residents with more self-determined motivational orientations displayed higher levels of psychological adjustment. However, the effects of opportunities for self-determination available in the environment were less straightforward and were moderated by motivational styles. Specifically, residents with self-determined motivational styles were better adjusted when they lived in homes that provided opportunities for freedom and choice, whereas residents with less self-determined motivational styles were better adjusted when they lived in high constraint environments. The findings support person-environment fit models of adjustment in old age. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Situational constraint as a moderator of the locus of control-adjustment relationship.

Posited that the degree of specific constraint imposed by an environment mediates the relationship between locus of control and adjustive behaviors and attitudes. Indices of developmental adjustment, the Life Satisfaction Index, the Self-Acceptance Scale, and activity level were used to assess 2 groups of elderly individuals along with a generalized measure of locus of control. 96 Ss (median age, 74 yrs) lived in a retirement village where residents met their own basic needs; 70 Ss resided in a retirement home where basic needs were met by the staff. It was found that (a) the level of internal control across Ss related to the nature of the setting in which Ss were residing; (b) Ss in the low-constraining environment believed in internal control similar to college-age samples, whereas those in the high-constraining setting believed much more strongly in external control; (c) expectancy for internal control correlated with developmental adjustment, satisfaction, positive self-concept, and maintenance of activity only in the low-constraining setting. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

L'attachment à l'age scolaire et le développement des troubles de comportement.

The purpose of this longitudinal study was to examine the association between the mother–child attachment relationship and behavioural problems among a test group of 120 Francophone Canadian children from mixed social and economic backgrounds. The Strange Situation protocol was used to measure attachment styles when the children were between the ages of 5 and 7 yrs. Each child's behavioural difficulties were assessed by his or her educator or teacher during 3 developmental periods: 3–5 yrs, 5–7 yrs, and 7–9 yrs. Results show that disorganized insecure attachment is associated with an increased risk of developing exteriorized and interiorized behavioural troubles between the ages of 5 and 7. The authors also observed exteriorized behavioural problems among children with anxious-ambivalent attachment, especially in the 3–5 age group. Avoidant children, usually assessed positively, received exteriorization scores during the 5–7 period which were significantly below those of securely attached children. Avoidant boys also exhibited more interiorized symptoms during this time-frame. Analyses of the persistence of behavioural problems also showed increased risk among disorganized and ambivalent children with secure or avoidant attachment styles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood molestation: Variables related to differential impacts on psychosexual functioning in adult women.

To examine factor contributing to the differential adjustment of women sexually molested as children, 3 groups of 30 women aged 18–65 yrs each were recruited to participate in this study: (a) a clinical group consisting of women seeking therapy for problems associated with childhood molestation, (b) a nonclinical group of women molested as children who had never sought therapy and considered themselves to be well adjusted, and (c) a control group who had not been molested. The clinical group was significantly less well adjusted than either the nonclinical or control group on measures of psychosexual functioning and the MMPI. In addition, clinical Ss differed significantly from nonclinical group Ss in terms of (a) age at which last molestation occurred and (b) frequency and duration of molestation. It is proposed that differences in adult adjustment may be mediated by emotional responses evoked at the time of the incident(s), which in turn can be linked to the frequency and duration of molestation and to developmental factors associated with the age of last molestation. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age, sex, marital status and suicide: an empirical study of east and west

The relationships among age, sex, marital status and suicidal behaviour in Australia and Hong Kong showed disparity in age-specific suicide rates among the four marital status groups, never married, married, widowed and divorced, for both sexes in the two locations. Examining the coefficients of preservation suggested the coefficient for never married to married in all cases was larger than 1, except for the groups of teenagers aged 15-19 years for both sexes and of elderly women aged 60 years or over in Hong Kong. The widowed or divorced groups have lower suicide rates than the married women among the elderly in Hong Kong. Hong Kong women seem not to have been benefited in marriage as much as men. Responsibility and workload in married life rather than low social status are the likely reasons for the relative high female suicide rate in Hong Kong. Possible cultural and environmental factors which are somewhat speculative (yet to be confirmed) are discussed.     

New measure of daily coping: Development and preliminary results.

Developed a new measure of coping with daily problems for use in longitudinal studies with repeated assessments. Development began with a checklist of specific coping behaviors and cognitions taken from existing questionnaires, but adequate levels of internal consistency could not be achieved for items grouped into rationally derived coping categories. A study in which the checklist items were sorted into the categories showed that particular behaviors or cognitions could represent different types of coping. This led to the development of a questionnaire with an open-ended response format. This brief questionnaire was used by 60 married couples (mean age of husbands 43 yrs; mean age of wives 40 yrs) for 21 consecutive days. Sex of respondent and problem appraisal were associated with amount and type of coping. A moderate amount of within-S consistency in coping with the same problem over time was also observed. Implications of the developmental studies and attributes of the new assessment are discussed. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rejection and depression: Prospective and contemporaneous analyses.

Explored the relationship of parental rejection during childhood and manifestations of depression both then and in young adulthood in 3 studies. In Study 1, 427 Ss were seen in 2 waves at the ages of 8 and 19 yrs. In the 1st wave, the parents of these Ss were also interviewed with a childrearing questionnaire that included a measure of rejection. In the 2nd wave, the Ss, then 19 yrs old, were administered the MMPI—D subscale. In the 2nd study, the contemporaneous relationship between maternal rejection and childhood depression was investigated. The identical measure of rejection used in the prospective study was administered to 245 mothers, and 4 measures of depression—peer ratings, self-ratings, teacher's ratings, and mother's ratings—were obtained for their children (mean age 10.11 yrs). The 3rd study, conducted with 508 mothers and their children (mean age 9.78 yrs) replicated the significant findings of the contemporaneous study. Findings support the hypothesis that deprivation in the generic sense ranging from the death of 1 or both parents to rejection or even parental disharmony is an etiological factor in adult depression. (47 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

La nature et les corrélats de l'attachement au sein des relations de couple.

Studied the relationship between different styles of attachment (i.e., comforting, avoidant, and anxious-ambivalent) and marital adjustment. Ss were 248 heteresexual adults (mean age 36.7 yrs) who had been married or living together for a mean period of 11 yrs. All Ss completed 2 measures of attachment style and a scale assessing dyadic adjustment. Multiple regression analysis was used to determine interactions between attachment style and marital adjustment, and the convergent validity of the 2 measures of attachment style was analyzed. French versions of the Dyadic Adjustment Scale (G. B. Spanier, 1976) and 2 attachment style questionnaires (C. Hazan and P. R. Shaver, 1987) and (M. Mikulincer et al, 1990) were used. (English abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vécu expérientiel et développement intellectuel et éthique chez la femme québécoise d'aujourd'hui.

Studied the role of experience in the intellectual and ethical development (IED) of women beginning a program of higher education in Quebec. Based on the assumption that recent changes in the role of women in society would affect this development, W. G. Perry's (1970) scale for the measurement of adult IED was modified accordingly and used as a basis for assessing the Ss' development. Human subjects: 22 female Canadian adults (23–65 yrs) (mean age 33.5 yrs) (newly registered university students from various disciplines) (10 were single, 9 were married, and 3 were divorced). Ss were divided into 3 age groups: 20–29 yrs, 30–44 yrs, and 45 yrs and over. Each S individually participated in a semiformal interview investigating her thoughts on "the role of women in society," and on "education and knowledge." Qualitative and quantitative analyses were performed on the results. (English abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)