Spouse Control and Type 2 Diabetes Management: Moderating Effects of Dyadic Expectations for Spouse Involvement

For married patients, chronic illness management often includes involvement of their spouses. We examined expectations regarding spouse involvement in the health of a partner with type 2 diabetes (N = 139 couples) from the perspectives of the patient and spouse. Partners' dyadic expectations and spouses' gender were posited to moderate spouses' diet‐related control and patients' diet adherence. Among male patients, when both partners shared an expectation for spouse involvement greater diet‐related spouse control was associated with better diet adherence of patients. In contrast, when expectations for spouse involvement were not shared, greater spouse control by wives was associated with poorer diet adherence. Dyadic expectations for spouse involvement did not moderate the association between spouse control and diet adherence among female patients. Findings suggest that shared expectations for spouse involvement can facilitate spouses' attempts to improve patients' dietary adherence, especially among male patients and their wives.     

Parent–adolescent dyads: association of parental autonomy support and parent–adolescent shared diabetes care responsibility

Purpose Parent–adolescent shared responsibility for diabetes care is advocated by experts to achieve beneficial diabetes and psychosocial outcomes for adolescents with type 1 diabetes. Parental autonomy support may be a way to facilitate this sharing. In this dyadic study, we examined parental diabetes‐specific autonomy support experienced by adolescents with type 1 diabetes and their parents (n= 89 dyads), and its association with their experience of shared diabetes care responsibility. Methods Path analysis was used to test an Actor–Partner Interdependence Model for parental autonomy support effects on shared responsibility. This was a secondary analysis of data from 89 parent–early/mid‐adolescent dyads. Results Actor effects were identified. Parents' and adolescents' perceptions of parental autonomy support were associated with their respective reports of shared diabetes care responsibility. One partner effect was identified. Adolescents' reports of parental autonomy support were associated with parents' reports of shared responsibility. Parents and adolescents held similar views of autonomy support but discrepant views of shared responsibility. Older adolescents perceived less parental autonomy support. Conclusion Increasing parental autonomy support may facilitate parent–adolescent sharing of diabetes care responsibility. Adolescent and parent perceptions influence each other and need to be considered when working with them to strengthen parental autonomy support.     

Dyadic Parenting and Children's Externalizing Symptoms

We explore dyadic parenting styles and their association with first‐grade children's externalizing behavior symptoms in a sample of 85 working‐class, dual‐earner families. Cluster analysis is used to create a typology of parenting types, reflecting the parental warmth, overreactivity, and laxness of both mothers and fathers in two‐parent families. Three distinct groups emerged: Supportive Parents, Mixed‐Support Parents, and Unsupportive Parents. Results indicate that dyadic parenting styles were related to teacher‐reported externalizing symptoms for boys but not for girls.     

The impact of childhood abuse history, domestic violence and mental health symptoms on parenting behaviour among mothers in Japan

Background To assess the impact of childhood abuse history, domestic violence experiences and mental health symptoms on the parenting behaviour of mothers in Japan who have separated from violent husbands or partners. Methods A self‐administered questionnaire survey was conducted on a sample of mothers (n= 304) and their children (n= 498) residing in 83 mother–child homes in Japan. The survey assessed the mothers' childhood abuse history (physical, psychological and sexual abuse and neglect history), domestic violence experiences, current mental health symptoms (dissociative, depressive and traumatic symptoms) and parenting behaviours after moving into the homes to separate from a violent husband or partner. Results The mothers' childhood abuse history and experience of domestic violence were not associated with their not playing with their children. In contrast, the mothers' dissociative and depressive symptoms were significantly associated with not playing with their children. Although there was no association between the mothers' total childhood abuse history and not praising their children, their childhood physical abuse history was significantly associated with their not praising their children. The dissociative and depressive symptoms were also associated with no praise. Interestingly, the experience of domestic violence showed an inverse association with no praise. Conclusions Mental health symptoms, more specifically dissociative and depressive symptoms, are associated with a decrease in parenting quality. Mothers who were physically abused as children are less likely to praise their own children, independent of maternal mental health symptoms. In contrast, mothers who experienced domestic violence but subsequently separated from their violent husbands or partners are more likely to praise their children. The treatment of mental health symptoms, particularly dissociative and depressive symptoms, therapy for childhood abuse history and separation from violent husbands or partners might be effective ways to enhance the quality of parenting in Japan.     

Impact of Coping Resources on the Well‐Being of Custodial Grandmothers and Grandchildren

The authors blended elements from the Stress Process Model and the Family Stress Model to investigate the direct and indirect effects of custodial grandmothers' (CGMs') coping resources (i.e., active strategies, passive strategies, and social support) on their psychological distress, their parenting practices, and their grandchild's internalizing and externalizing symptoms. Participants included African American and White CGMs (N = 733, M_age = 56) who provided full‐time care to a grandchild (M_age = 9.8). Structural equation modeling revealed that social support and active coping were related to lower CGM distress and less ineffective parenting, whereas passive coping was associated with increased distress and more ineffective parenting. Ineffective parenting had direct effects on grandchildren's outcomes, whereas CGM coping resources had direct effects on ineffective parenting and indirect effects (through ineffective parenting) on grandchildren's externalizing and internalizing difficulties. The authors conclude that CGM coping resources affect the psychological well‐being of both generations.     

Diabetes stigma,parent depressive symptoms and Type-1 diabetes glycemic control in India

ABSTRACT

Diabetes distress and stigma have been associated with worse patient outcomes in developed countries. However, diabetes stigma has not been studied in low and middle-income countries where clinical practices differ, diabetes awareness is lower, and families face different challenges for supporting children with Type 1 Diabetes (T1D). This study assessed the relationship between parental depression and diabetes stigma with a child’s glycemic control in a clinic-based survey in Nagpur, India. The association between self-reported T1D stigma, depressive symptoms, and child’s measured glycemic control (HbA1C) was assessed with data from 165 of the parents of school-aged (aged 5+) children receiving clinical T1D care at an urban nonprofit organization that provides free clinical care to children with Type-1 Diabetes (T1D) in India. Parents with moderate/severe depressive symptoms who experience stigma associated with their child’s diabetes had children with significantly worse glycemic control than parents with no/mild depressive symptoms who experience the same amount of stigma. Higher reports of stigma were associated with an average of 0.65 points higher HbA1C (β = 0.65, 95% Confidence Interval (CI): 0.18, 1.13) for parents with moderate/severe than parents with mild/no depressive symptoms. Indian parents with depressive symptoms who face social stigma associated with their child’s diabetes have children with worse T1D outcomes.     

Marital Happiness and Psychological Well‐Being Across the Life Course*

Abstract: Using data from six waves of the Study of Marital Instability over the Life Course (N = 1,998), we conducted a latent class analysis to test for distinct marital happiness trajectories. We found three distinct marital happiness trajectories: low, middle, and high happiness. Initial levels of life happiness were strongly associated with membership in the marital happiness trajectories and with various demographic and attitude‐related control variables. Using fixed effects regression with time‐varying covariates, we also found that marital happiness trajectory membership was associated with subsequent changes in both life happiness and depressive symptoms. All respondents experienced a decrease in life happiness between Wave 1 and the end of their observed time in their marriage, but respondents in the high marital happiness trajectory experienced the smallest decline. Respondents in both the high and middle marital happiness trajectories also experienced a decline in depressive symptoms across time. Intervention and policy implications are discussed.     

The association of illness perceptions with depressive symptoms and general psychological distress in parents of an offspring with autism spectrum disorder

BackgroundRaising a child with an autism spectrum disorder (ASD) is a severe stressor and parents often present high levels of depression. Depression is associated with illness perceptions but this association has not been studied in parents of ASD offspring.ObjectiveWe aimed to assess the prevalence of psychological distress symptoms and their associations with illness perceptions in parents with an ASD offspring.MethodsIn 111 parents of ASD offspring we assessed depressive symptoms (PHQ-9), illness perceptions (B-IPQ) and general psychological distress (GHQ-28). Multiple linear and logistic regressions were used to assess their independent associations.ResultsThe prevalence of parental clinically significant depressive symptoms was 34.2%, while 55% presented clinically significant levels of general psychological distress. Younger parents and those with lower financial resources had greater psychological distress and more severe depressive symptoms. Parents felt that the condition impacted their lives and believed it would be chronic. Their beliefs about the consequences and the chronicity of the disorder were significant independent correlates of their psychological distress and depressive symptoms severity.ConclusionsThese findings indicate that a remarkable proportion of parents with an ASD offspring present clinically significant depressive symptoms, which were associated with illness perceptions relevant to the consequences and the chronicity of the disorder. Our data encourage psychotherapeutic interventions aiming to support parents to deal with the consequences and chronicity of their offspring's disorder, in order to reduce parental psychological distress.     

Maternal Perspectives on Deployment and Child–Mother Relationships in Military Families

Using survey data from 292 mothers married to members of the U.S. military, the authors examined relations among military deployment factors, quality of maternal care, and child attachment behavior with the mother. The results revealed that maternal perceptions of quality of care, mothers' depressive symptoms, and fathers' involvement when not deployed were significantly associated with children's attachment behavior. In addition, fathers' combat exposure was negatively associated with children's attachment behavior. Mothers' quality of care partially mediated the association between fathers' involvement and children's attachment behavior as well as the association between mothers' depressive symptoms and children's attachment behavior. A notable finding of this study was that deployment‐related factors were both directly and indirectly related to children's attachment.     

Couples Experiencing Financial Strain: What We Know and What We Can Do

Although much has been written about how to help couples negotiate regarding different spending styles or risk tolerance levels, less has been said about ways in which therapists can assist couples to understand each other's experience of distress regarding financial issues and find constructive individual and dyadic ways to reduce the distress. Given the importance of this topic in today's unstable global and national economies, this article reviews empirical findings regarding the effects of financial strain on couples' relationships as well as the effectiveness of individual and dyadic coping strategies. The authors discuss options for intervening professionally with couples experiencing financial strain and provide assessment and treatment guidelines using stress theories and evidence‐based cognitive‐behavioral couple interventions.     

Custodial Grandmother‐Grandfather Dyads: Pathways Among Marital Distress,Grandparent Dysphoria,Parenting Practice,and Grandchild Adjustment

An adaptation of the Family Stress Model was examined using structural equation modeling with data from 193 custodial grandmother‐grandfather dyads. The model's measurement and structural components were largely invariant by grandparent gender. For grandmothers and grandfathers alike, the effects of their psychological and marital distress on grandchildren's adjustment difficulties were mediated by dysfunctional parenting. The effects of family‐related contextual forces on grandchildren's adjustment were also indirect through direct effects on grandparents' psychological and marital distress.     

Relationship Quality and Changes in Depressive Symptoms Among Urban,Married African Americans,Hispanics, and Whites

Bivariate analyses showed that continuously married urban African American, non‐Hispanic White, and Hispanic fathers and mothers reporting greater marital support and less relational control experienced a decrease in depressive symptoms. Multiple regression showed a stronger association between concurrent marital support and decreased depressive symptoms for mothers than fathers. African American and Hispanic fathers reporting higher levels of spousal relationship support when children were infants reported a larger decrease in depressive symptoms when children were age 3 compared to non‐Hispanic Whites. Relationship control at age 3 was positively related to increased depressive symptoms among all groups except African American fathers and White mothers. African American and Hispanic fathers with marital problems may need additional support services.     

Dyadic and Triadic Family Interactions as Simultaneous Predictors of Children's Externalizing Behaviors

The purpose of this study was to investigate the relationship between dyadic and triadic family interactions and their association with the development of children's externalizing behaviors. Data were obtained from a longitudinal study of family interactions (N = 125), followed from before parents had their first child until children were 7 years old. Family interactions (marital, father–child, mother–child, and triadic mother–father–child) were observed in separate interaction tasks when children were 24 months old as predictors of children's externalizing behaviors at age 7 (n = 71 children). Results demonstrated that the triadic measure of competitive coparenting and the dyadic mother–child interaction characterized by negative emotional socialization related to children's later externalizing behavior, even after controlling for covariates and effects of all other family interaction variables. Results emphasize the importance of examining the family holistically and provided new information for designing more effective whole‐family interventions to reduce the development of children's externalizing behaviors.     

Psychological distress among female spouses of male at-risk drinkers.

The consequences of alcoholism on the mental health of spouses of lifetime at-risk drinkers are only known from studies on alcoholics already in treatment. A retrospective analysis was conducted using data from a Quebec community health survey. The purpose of this study was twofold. First, our goal was to ascertain the mental health of female spouses living with a male lifetime at-risk drinker. Secondly, we wanted to examine the relationship between male lifetime at-risk drinkers (aged 30-54 years) and the psychological distress of their nondrinking female spouses. Lifetime at-risk drinking, for the purposes of this study, was defined as having at least two positive answers to the CAGE questionnaire. Couples wherein both spouses were deemed not at-risk for problem drinking by the CAGE instrument (0 or 1 positive answer) formed the control group. Psychological distress was measured using the Indice de Détresse Psychologique de l'Enquête Santé Québec (Préville, M., Boyer, R., Potvin, L., Perreault, C., & Légaré, G. (1992). La détresse psychologique: détermination de la fiabilité et de la validité de la mesure utilisée dans l'enquête Santé Québec. Cahier de recherches #7, Montréal, Santé Québec.). It measures symptoms of anxiety, depression, aggressivity, and cognitive impairments. Scores of >or=22 (out of 100) were indicative of a high level of psychological distress. This study confirmed higher levels of psychological distress in female spouses of male lifetime at-risk drinkers in the general population. An exploratory study examined the association between the psychological distress of female spouses and each of the following nine independent variables: male partner lifetime at-risk drinker, stressful life events, job situation, socioeconomic status, perceived health status, presence of children less than 15 years, length of the marital relationship, presence of a confidant, and availability of social support. Lifetime at-risk drinking is a risk factor for the spouse's psychological distress. An examination of the demographic characteristics related to alcohol intake in male lifetime at-risk drinkers is also described in this study.     

Traditional Gender Role Orientation and Dyadic Coping in Immigrant Latino Couples: Effects on Couple Functioning

The main goal of this study was to examine from a systemic‐transactional stress perspective (Bodenmann, 1997) whether a more traditional gender role orientation may affect psychological aggression and relationship satisfaction directly and indirectly by decreasing supportive (partner's efforts to help the other partner cope with stress) and common dyadic coping (partners' conjoint efforts to cope with stress) among first‐generation immigrant Latino couples. Structural equation modeling results from 104 couples indicate that the extent to which Latino men hold traditional gender role views and the extent to which those views differ from their female partners' may increase the risk for psychological aggression and relationship dissatisfaction directly, but also indirectly by reducing the couple's common dyadic coping and to some extent the male supportive coping. Latinas' traditional gender role views do not relate to either partner's psychological aggression or relationship satisfaction. The article discusses gender differences and research and clinical implications.     

Rural adolescents' help-seeking intentions for emotional problems: the influence of perceived benefits and stoicism

Objective: This study explores the factors that influence adolescents' help‐seeking intentions. Specifically, the study investigates the extent to which perceived benefits of help seeking, stoicism, gender and symptoms of psychological distress are associated with intentions to seek professional help for emotional problems. Design and setting: A cross sectional self‐report questionnaire was administered to adolescents recruited from seven high schools in rural towns in the Riverina region of New South Wales. Participants: A total of 778 adolescents were recruited. The sample included 373 male and 404 female participants between 13 and 18 years of age. Main outcome measure(s): Participants completed an anonymous self‐report questionnaire designed to measure help‐seeking intentions in the advent that they were to experience emotional problems, psychological distress symptoms, perceived benefits of help seeking and stoicism. Results: In all, 17% of male participants and 29% of female participants reported they would be likely to seek help from doctors if they were to experience emotional problems. In total, 15% of male participants and 23% of female participants reported they would be likely to seek help from other health care professionals. Multiple regression analysis suggested that adolescents are more likely to seek help from professionals if they perceive help seeking as beneficial (t = 12.91; P < 0.001). Female particpants reported that they were more likely to seek help than male participants (t = 2.69; P = 0.01). Conclusions: Findings suggest that adolescents are reluctant to seek professional help if experiencing emotional problems, because they do not believe professional help seeking is beneficial. Improving adolescents' beliefs about the benefits of professional help seeking might be a key strategy for increasing their use of professional health services to address mental health problems.     

Family Economic Hardship and Progression of Poor Mental Health in Middle‐Aged Husbands and Wives

Using prospective data from 370 middle‐aged husbands and wives during a 12‐year period, we investigated the intra‐individual and dyadic influence of family economic hardship on the levels of depressive symptoms of husbands and wives over their middle years. The results suggest that family economic hardship during the early middle years contributes to a subsequent increase in depressive symptoms of husbands and wives. Consistent with stress‐process theory, economic hardship influences depressive symptoms directly and indirectly through its influence on self‐esteem. The results also provided evidence for the scar hypothesis, which suggests that depression predicts subsequent level of self‐esteem and forms a reciprocal process between depressive symptoms and self‐esteem over time. In sum, for both husbands and wives, our findings showed that depressive symptoms progress over the middle years through a self‐perpetuating reciprocal process between self‐esteem and depression initiated by early family economic hardship and through cross‐spouse influences involving self‐esteem and depressive symptoms.     

Romantic Partner and Biological Father Support: Associations with Maternal Distress in Low‐Income Mexican‐Origin Families

Paternal support is often linked to lower levels of maternal psychological distress; however, research has seldom considered the increasing numbers of Mexican‐origin families with a romantic partner social (RPS) father (i.e., mothers' partners who are not formally identified as stepfathers). This study applied a bioecological systems framework to test linkages between support from RPS fathers and maternal depressive symptoms and parenting stress and to consider whether nonresident biological father support and instrumental social support moderate these associations. Using data from the Fragile Families and Child Wellbeing Study, the authors analyzed a subsample of Mexican‐origin mothers (N = 76) with 3‐year‐old children. Findings indicated that maternal perceptions of support from RPS fathers were inversely related to depressive symptomatology only when mothers also perceived high levels of support from biological fathers, and the relationship with the RPS father began recently. Neither RPS nor biological father support was associated with maternal parenting stress.     

Psychological distress is associated with a range of high‐priority health conditions affecting working Australians

Background: Psychological distress is growing in prevalence in Australia. Comorbid psychological distress and/or depressive symptoms are often associated with poorer health, higher healthcare utilisation and decreased adherence to medical treatments. Methods: The Australian Work Outcomes Research Cost‐benefit (WORC) study cross‐sectional screening dataset was used to explore the association between psychological distress and a range of health conditions in a sample of approximately 78,000 working Australians. The study uses the World Health Organization Health and Productivity Questionnaire (HPQ), to identify self‐reported health status. Within the HPQ is the Kessler 6 (K6), a six‐item scale of psychological distress which strongly discriminates between those with and without a mental disorder. Potential confounders of age, sex, marital status, number of children, education level and annual income were included in multivariate logistic regression models. Results: Psychological distress was significantly associated with all investigated health conditions in both crude and adjusted estimates. The conditions with the strongest adjusted association were, in order from highest: drug and alcohol problems, fatigue, migraine, CVD, COPD, injury and obesity. Conclusions: Psychological distress is strongly associated with all 14 health conditions or risk factors investigated in this study. Comorbid psychological distress is a growing public health issue affecting Australian workers.     

Mental health consequences of unintended childlessness and unplanned births: Gender differences and life course dynamics

The discordance between fertility intentions and outcomes may be associated with mental health in the general population. This requires data directly linking individuals' fertility intentions with their outcomes. This study brings together two streams of research on fertility and psychological distress to examine whether unintended childlessness and unplanned births are associated with psychological distress, compared with intended childlessness and planned births. We also examine whether unintended childlessness and unplanned births are differently associated with distress at two stages of the individuals' life course: in early and late 30s. As women are more directly affected by the decline in fertility with age and the experience of motherhood is more central to women's identity, we also examined gender differences in these associations. Thus, we examined the association between four possible fertility events (planned and unplanned births, intended and unintended childlessness) and psychological distress of men and women, at two different stages over the life course (early and late 30s). We used longitudinal data from the US National Longitudinal Study of Youth 1979 (N = 2524) to link individuals' fertility intentions and outcomes to evaluate the association of depressive symptoms (CES-D) with four possible fertility events occurring in two-year intervals, for men and women separately. Contrary to our first hypothesis, unintended childlessness and unplanned births were not associated with psychological distress for women. Among men, only unplanned births in their early 30s were associated with increases in psychological distress. We did not find support for our second hypothesis that unintended childlessness and unplanned births have a different association with psychological distress for men and women and as a function of the stage of life. These findings are discussed in the context of previous literature in this area.