Family Relationships and Familial Responses to Health Issues: Volume 8A

The extent to which current relationships with extended kin affect the likelihood that adult family members experience negative life events – such as serious psychological problems, financial difficulties, addictions, or criminal behavior – has received little attention in life course research, which typically focuses on the occurrence and timing of “normal” life events – that is, events occurring in almost every life course (e.g., marriage, parenthood, educational enrollment, employment).

This study used prospective data from a nationally representative panel study on Dutch families. A series of clustered logistic regression models were estimated for the separate types of negative events, while a post-estimation command was used to compare and combine effects across models.

We show that the likelihood to experience negative life events is indeed affected by the relationships one currently has with extended kin. Moreover, by distinguishing different characteristics of family relationships in our analyses, we were able to unravel the mechanisms through which they exert an influence. Current family relationships provide feelings of integration, a sense of meaning, and act as a source of support that can be mobilized if needed.

Given the impact negative life events have on individuals and families, as well as the costs they impose upon society, our results look promising for further advancing our understanding of the risks and the protective factors affecting the development of negative events in the lives of adults.

With almost half of college undergraduates engaging in friends with benefits relationships (FWBRs), the current study sought to explore the sexual decision making strategies and potential physical and psychological health outcomes behind these relationships.

Using self-report measures, Study 1 asked 207 undergraduates to rate the importance of motivations, maintenance rules, and future outcomes of FWBRs in their own personal experience and for other men and women. Study 2 sampled 142 undergraduate women who were asked to indicate the percentage of time they engaged in sexual behavior under the influence of alcohol or marijuana and the frequency with which they used safe sex practices in an FWBR.

Both genders appeared equally motivated to begin an FWBR; however women reported establishing permanence rules and avoiding over-attachment in the relationship as significantly more important than men. Men were more likely to prefer that the FWBR remain unchanged, however both genders agreed that a transition to a committed relationship was unlikely. Alcohol use was not significantly more prevalent in an FWBR, nor was the likelihood of practicing safe sex.

Both studies employed the use of self-report surveys from a single university and were subject to social desirability.

Quantitatively examining young adults’ reasoning behind choosing to engage in FWBRs provided insight into their overarching fear of “being hurt” and their preference for “easy access” to sexual experiences. These trends may suggest a shift in dating patterns and a preference for avoiding the emotional complexities of a committed, monogamous relationship.

The purpose of this study was to survey parents who have Multiple Sclerosis (MS) and examine issues surrounding their parenting.

Qualitative surveys were used to collect data.

Findings from the study include three themes: (a) They needed to know; (b) Involving children with treatment; and (c) I can’t do this alone. Discussion of findings and conclusions and recommendations for parents, physicians, and future studies are presented.

Data for the study was collected through self-reports and limited demographic data was collected.

Continued research on MS is needed, especially in the area involving children in at-home treatments and children as caregivers. Children can be a challenging population to investigate, yet as evidenced in this study, children are being involved in MS treatments of their parents. A greater, more in-depth look at the role of a child as caregiver is warranted.

To conduct an exploratory mixed-methods study of attitudes toward extramarital relationships in the context of spousal Alzheimer’s disease.

We present descriptive analyses of quantitative data from the National Social, Health, and Aging Project and of qualitative comments posted online by readers of newspaper articles that focus on extramarital relationships in the context of caring for a spouse with Alzheimer’s disease.

Analyses of the quantitative data indicate the Alzheimer’s caregivers report more negative attitudes toward extramarital sex in the context of spousal Alzheimer’s disease. However, this difference is driven by non-spousal caregivers’ attitudes; spousal caregivers have substantially less negative attitudes. Analyses of public comments suggest that those who are most negative are focused on traditional religious and family values. Those who express less negative attitudes espouse a compassionate pragmatism that makes allowances for caregiver needs in the context of managing the difficulties of the spouse-caregiver role.

Quantitative data are limited by the small number of Alzheimer’s caregivers; qualitative analyses are based on a convenience sample of online comments.

Findings can inform future research, educational initiatives for professionals, the media, and people living with Alzheimer’s disease and their family members.

The number of individuals living with Alzheimer’s disease and spousal caregivers will increase as the Baby Boomer generation ages. Norms regarding extramarital relationships in the context of caring for a spouse with Alzheimer’s disease are evolving.

Little social scientific research examines attitudes toward extramarital relationships in the context of spousal Alzheimer’s disease.

This study examines the impact of work-to-family conflict (WFC) on depression for employed husbands and wives in Japan, the moderating role of own psychological family involvement in the relationship between WFC and depression, and the moderating role of spouses’ family and job involvement in the relationship between WFC and depression.

We use a matched sample of Japanese employed husbands and wives to examine the relationships between inter-spousal dynamics about work–family conflict and psychological well-being.

We found that (1) the effect of WFC on depression was larger for wives, (2) husbands’ and wives’ own psychological family involvement did not moderate the relationship between WFC and their depression, and (3) spousal family and job involvement operated as a moderator only for husbands. While WFC reduced husbands’ depression when their wives were highly involved in their jobs psychologically and behaviorally, WFC increased husbands’ depression when their wives were highly involved in family at both psychological and behavioral levels.

Employers need to take into account the importance of looking simultaneously at the ways employed husbands and wives work when trying to understand how workplace conditions may be changed to ameliorate psychological well-being for spouses.

This study suggests that an experience of conflict between work and family is likely to deteriorate the psychological well-being for employed husbands and wives in non-Western contexts like Japan. Furthermore, spousal involvements in family and work domains are likely to play moderating roles in the relationship between WFC and depression.

This chapter explores the relationships between 12 single mothers with breast cancer and their children, a subtheme of a larger qualitative study.

Qualitative data were collected via interviews. The study used the ecological systems theoretical framework to explain findings.

In speaking with women about how they constructed and altered their social networks post-diagnosis, many talked about their relationships with their children. This chapter explains how these mothers discussed their diagnoses with their children in age-appropriate ways; how they relied on their children during treatment for informational and emotional support; and how relationships with their children changed during treatment and recovery.

Based on findings from this study, family scientists, public health professionals, and oncology care providers may have a better understanding of the specific concerns and experiences related to the children of breast cancer patients without partners.

This study yields new information about the support needs of single breast cancer patients and their children, and offers insight into what researchers and medical teams can do to better support families affected by breast cancer.

Guided by a life course theoretical perspective, this study aimed to examine associations between providing caregiving for a young or adult son or daughter with special needs and multiple dimensions of physical health status among married midlife and older adults, as well as moderation of these associations by gender and marital quality (i.e., marital strain).

Regression models were estimated using data from 1,058 married adults aged 33–83 (National Survey of Midlife in the U.S. (MIDUS), 2005).

Parental caregiving for a young or adult child with special needs (in contrast to no caregiving) was linked to poorer global health and more physical symptoms among both fathers and mothers. Father caregivers reported slightly more chronic conditions than noncaregiving men, regardless of marital quality. By contrast, mother caregivers reported a much higher number of chronic conditions when they also reported a high level of marital strain, but not when they reported a low level of marital strain.

Overall, results provide evidence from a national sample that midlife and older parents providing caregiving for a child with special needs are at risk for poorer health outcomes, and further tentatively suggest that greater marital strain may exacerbate health risks, particularly among married mother caregivers.

The purpose of this study was to explore how mothers with an ADHD child living in the household experience, perceive, and manage family communication.

A qualitative research design study was employed where in-depth interviews were conducted amongst nine married mothers who have an ADHD child.

Three themes emerged from the interview data: managing internal relations, managing stigma, and difficulties in managing the communication process. Mothers communicate with their ADHD child differently than their non-ADHD children, as conversations with the ADHD child are often unpredictable, negative, and erratic. They specifically experience these conversation patterns when giving directions, during times of discipline, and when the child acts impulsively or cannot focus.

Mothers are not always open about their child’s ADHD with nonfamily members as they are afraid of the stigma that is attached to the condition. Mothers recognize the difficulties in the communication process as they spend a considerable amount of time on their child’s ADHD issues, and their time given to others in the family may be compromised. They also recognize that because of the amount of stress and emotional burnout they feel from having an ADHD child, they need emotional and pragmatic support from family, friends, and professionals. The mothers who receive the least amount of emotional support from their spouses also feel the highest amounts of stress.

Using Andersen’s (1968) behavioral model of health services use as a guiding conceptual framework, this study examined how receipt of family-centered care relates to the perceived family challenges for families of children with autism spectrum disorder (ASD).

Data from the 2009–2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) were analyzed for 812 parents of children with ASD.

Multiple regression analyses provided substantive statistical evidence that a child’s race, the adequacy of a family’s insurance, and the stability of child’s health care needs significantly contributed to predicting his or her receipt of family-centered care. Further results suggested a relationship between receipt of family-centered care and the perception of challenge for these families; families receiving family-centered care perceive fewer challenges and feel less unmet need for child health services.

Family-centered professionals provide critical voices in the development of policies and programs geared toward improving the health outcomes of children with ASD and their families.

Older adults and their families, geriatricians and gerontological practitioners, other health care providers, and social policy makers are invested in finding ways to prevent health and safety problems so that older adults can remain in their homes safely and independently. Family life education and problem-prevention programs designed for older adults are cost-effective ways of trying to avoid or prevent problems before they occur. The purpose of this chapter is to describe the use of multiple segment factorial vignettes as an educational method to promote safety and health.

Multiple segment factorial vignettes (MSFVs) are short stories comprised of two to five separate segments. In research, MSFVs have been used to study attitudes, values, beliefs, and behaviors. MSFVs also have potential for use in interventions with individuals, couples, and families. We present an example of the use of MSFVs in an intervention project in which we taught the family members and friends of older adults who lived alone how to use MSFVs in collaborative problem-solving with older adults about maintaining their independence safely in their homes. The MSFV method was easily learned by project participants, readily individualized to fit the situations of older individuals, and the participants enjoyed using them.

MSFVs were effective in changing behaviors and cognitions of older adults.

We present issues to consider for practitioners who want to develop and utilize MSFVs in interventions. Examples of MSFVs as interventions are presented and limitations to MSFVs are discussed.

I discuss the formal attention deficit hyperactivity disorder (ADHD) diagnosis process and whether the Black–White differences found in this process are the results of unmet needs or conscious decisions.

First, I offer a new analytic framework for understanding the “ADHD process.” The proposed framework breaks ADHD diagnoses down into three stages: the informal diagnosis, the formal diagnosis, and treatment. This approach reveals certain racial trends in the ADHD literature. Second, I use the 2007 National Health Interview Survey (total n = 75,764) to address racial differences.

I find that blacks are less likely to hold a formal ADHD diagnosis than whites. Third, nested logistic models reveal that this racial difference is not explained by health insurance status, family income, or family educational level. New explanatory models for the black–white difference in ADHD should stray from a strict reliance on the “unmet need” discourse, and instead focus on other factors that may affect the decision-making process in diverse families.

This chapter makes three contributions to the wider literature on ADHD and race.