Associations of social support and hardiness with mental health among mothers of adult children with intellectual disability.

BACKGROUND: The study was conducted with mothers of adult children with developmental disabilities and had two aims: (1) to examine the mental health, resources and stress among mothers who keep their adult child at home vs. those who choose placement in a community arrangement; and (2) to assess the associations of mothers' resources and stress with mental health. METHOD: A sample of 100 mothers (mean age 60.67 years) of adult children with intellectual disability, 50% of whom had been placed in a community arrangement were asked to complete questionnaires measuring mental health, stress, hardiness and social support. RESULTS: The comparisons between mothers who had placed their adult child in a community arrangement and those who had kept their child at home showed no significant differences for most indicators. Mental health, stress, hardiness and social support were highly intercorrelated, as expected, and hierarchical regression analyses indicated independent effects of stress, hardiness and out-of-home placement on mental health. CONCLUSIONS: The findings suggest that strengthening personal and social resources of mothers of adult children with developmental disabilities may be beneficial for their mental health.

Self-determination and mental retardation: is there an association with living arrangement and lifestyle satisfaction?

Self-determination and lifestyle satisfaction of 80 adults with mild or medium mental retardation living in group homes or their parents' homes were examined. They were assessed in regard to self-determination, as indicated by choices made in the domestic, financial, health, social, and work domains. Lifestyle satisfaction with residence, the community, associated services, and employment was also assessed. Results show that those from group homes were lower on self-determination but higher on lifestyle satisfaction, providing support for the commitment to normalization and community inclusion to enhance lifestyle satisfaction. However, questions about the extent to which people with mental retardation are afforded decision-making opportunities and self-determined behavior remain. We suggest that service providers and caregivers should encourage and create such opportunities.

Coping with breast cancer: patient, spouse, and dyad models.

OBJECTIVE: The objectives of this study were 1) to assess similarities and differences between patients with breast cancer and their spouses in terms of coping strategies and adjustment (psychosocial and psychological) to cancer and 2) to investigate the pattern of relationships between the patients' and spouses' coping strategies and between each of these strategies and the patient's adjustment to the illness using three types of models: patient, spousal, and dyadic coping. METHODS: Seventy-three patients with breast cancer and their spouses completed questionnaires that measured distress (Brief Symptom Inventory), psychosocial adjustment, and coping strategies. RESULTS: The patients' distress was greater than their spouses', but a similar level of psychosocial adjustment was reported. The patients used more strategies involving problem-focused coping than their spouses. The use of emotion-focused coping, which included ventilation and avoidance strategies, was highly related to distress and poor adjustment on the part of the patient. The spouses' emotion-focused coping and distress were related to that of the patients. Dyad emotion-focused coping measures were highly associated with the patients' distress and adjustment. CONCLUSIONS: Spousal and dyad coping are important factors in a patient's adjustment to breast cancer.

From bedside nursing to managerial roles: changing occupational perceptions of nursing students.

This longitudinal study examined changes in the occupational perceptions of nursing students studying in a non-traditional undergraduate nursing program. The respondents, 210 first- and second-year nursing students, completed a questionnaire measuring the perceived importance of traditional and non-traditional nursing interventions and values. Questionnaires were administered at the beginning and at the end of the academic year. Students studying in a more traditional program comprised the control group. The results show that certain traditional nursing activities and values are perceived as more important by first-year students compared with second-year students in both programs, whereas the perceived importance of non-traditional activities is higher among second-year students. The preference for non-traditional interventions is stronger among students in the non-traditional nursing program. The results are discussed with regard to the gradual effect of nursing education on students' occupational perceptions.

Coping strategies, life style changes, and pessimism after open-heart surgery.

A mail questionnaire was completed by 171 patients two to 20 months after undergoing coronary artery bypass graft surgery (CABG). The post-CABG period was characterized by fewer working hours, a higher level of physical exercise, a reduction in smoking, and more appropriate nutritional habits, compared with the preoperation period. At the same time, the anxiety level of post-CABG patients was higher than that measured in a community sample. Post-CABG high psychological distress (anxiety and mood states) and low functional capacity were associated with high levels of pessimism and ineffective emotion-focused coping strategies. These results may be used by social workers in devising psychological interventions aimed at improving post-CABG patients' quality of life and bolstering their coping strategies.

Denial of HIV/AIDS and preventive behaviour among Israeli adolescents.

A national sample of 1082 Israeli adolescents, aged 14-18, was questioned on the following topics: Respondents' sexual habits and HIV/AIDS prevention behaviours, HIV/AIDS-related knowledge and attitudes, and six kinds of HIV/AIDS-related denial. The main results showed that infrequent condom use was associated with a high level of denial, denial of personal relevance and of responsibility being the most salient. These results suggest that denial may constitute a major factor in HIV/AIDS-related risk behaviours, with implications for intervention programmes aimed at adolescents.

Evaluation of an innovative curriculum: nursing education in the next century.

The present research focused on an interim evaluation of a new nursing curriculum made by first- and second-year undergraduates. Study 1 examined the assessments made by 90 students of the new, actual programme of their studies, as well as an ideal one, on 21 bipolar criteria reflecting the developing changes in health care practices and higher educational processes in western society. The results of study 1 indicated that students perceived the actual programme as compatible with health care changes, but lacking in terms of the learning process. Study 2 investigated the same assessments among 105 registered nurses who evaluated the traditional nursing programme under which they were trained as well as an ideal one. The results of study 2 showed that registered nurses perceived past curricula as lower than the ideal on both health care and process of learning. The results of this interim evaluation imply that the new nursing curriculum follows health care trends, but a shift in the educational process is required.

The subjective organization of input and output events in memory.

In order to study the organization of memory for self-performed actions, 80 participants were presented with 20 action phrases for ten consecutive study-test cycles. Enactment was manipulated both in the input phase and in the output phase by having participants say or enact the phrases during encoding and/or during testing. Enactment at input or output generally enhanced both the quantity and the accuracy of recall and also improved output monitoring. More important, subjective organization, as indexed by the tendency to recall the same two phrases successively across repeated recall tests, was significant for all conditions, even on the first pair of trials, and increased systematically with repeated study-test cycles. Enactment neither impaired nor enhanced the amount of organization, and in all conditions a positive correlation was obtained between recall and subjective organization. Some commonalities in the nature of memory organization were found across all conditions. The results suggest that enactment may lead to more differentiated memory traces, resulting in more accurate recall. Although subjective organization was clearly observed when enactment was involved, its contribution to the enhancement of recall deserves further examination.

Experimental induction and termination of acute psychological stress in human volunteers: effects on immunological, neuroendocrine, cardiovascular, and psychological parameters.

The present research investigated the effects of controlled experimental manipulations of stress on biological and psychological reactions. Fifty young adult male volunteers were exposed to a 12-min period of stress induced by the threat of an unavoidable, painful electric shock. A 12-min period without this threat preceded or followed the stress period. Blood was drawn during the 4th and the 12th minute of each period. Anticipatory threat led to significant elevations in the proportions and cytotoxic activity of natural killer (NK) lymphocytes, plasma epinephrine levels, pulse rate, and reported level of tension, and to a reduction in the CD4/CD8 ratios. The no-threat period induced a return to baseline values for epinephrine, pulse rate, and tension, and lower than baseline levels for cytotoxic activity of NK lymphocytes, within a similarly short time span. The findings underline the rapidity with which physiological changes may transpire in the course of a brief and acute period of psychological stress, and the rapidity of their reversal upon relief from the stressor.

Studies in psychoneuroimmunology: psychological, immunological, and neuroendocrinological parameters in Israeli civilians during and after a period of Scud missile attacks.

Twenty-two male volunteers in Jerusalem were subjected to a battery of psychological tests at the height of the Iraqi Scud missile attacks on Israeli cities during the 1991 Persian Gulf War and again after the cessation of hostilities. Venous blood samples were taken at each time point. The separated mononuclear cells and plasma were cryopreserved, and a spectrum of immunological and neuroendocrine assays were performed on the preserved samples. Psychological testing indicated levels of anxiety were higher during the war than they were after the war ended, and both anxiety and anger during the hostilities were significantly elevated in comparison with prewar data. During the war, specific war-related pressures were greater than everyday pressures, and problem-focused coping was more evident than emotion-focused coping. Natural-killer cell activity and cell-mediated lympholysis were significantly elevated during the war, as were plasma levels of adrenocorticotrophic hormone, neurotensin, and substance P. The only biological test parameter found to be reduced during the war period was mononuclear cell thymidine incorporated in nonstimulated cultures.

Encoding information for future action: memory for to-be-performed tasks versus memory for to-be-recalled tasks.

What is the nature of the representation underlying memory for future tasks such as calling the doctor or buying milk? If this representation consists of a verbal instruction that is translated into action at the time of retrieval, then memory should be better when tested via verbatim recall of the instruction than when tested via actual performance. Three experiments rejected this possibility, indicating better memory for a perform mode of report than for a recall mode of report. This was true in Experiment 1 in which subjects saw a series of verbal instructions (e.g., "move the eraser," "lift the cup," "touch the ashtray"), with advance information regarding the mode of report required during testing. In Experiment 2, the advance cue was valid only in 75% of the trials. Memory depended more heavily on the expected mode of report than on the actual mode of report, suggesting that the perform superiority is due to processes that occur during encoding. In Experiment 3, subjects learned 20 phrases depicting minitasks. More tasks were remembered by subjects tested via performance than by subjects tested via verbatim recall. A second part of Experiment 3 also indicated superior memory when a perform test was expected, regardless of which mode of report was actually required. The results were compared with the finding that subject-performed tasks are better remembered than are their verbal instructions, which suggests that the representation underlying memory for future assignments may take advantage of the imaginal-enactive properties of the envisaged acts. Other possible differences between memory for to-be-recalled tasks and memory for to-be-performed tasks are discussed.

Automatic and directed search processes in solving simple semantic-memory problems.

The cognitive processes involved in simple semantic-memory problems were investigated in four experiments. On each trial of Experiments 1 and 2, two stimulus words were presented, with the instructions to find a third word (i.e., the solution) that, when coupled with each of the stimuli, would yield two word pairs used in everyday language (e.g., surprise and birthday, for which the solution is party). The results of the two experiments indicated that informing the subject whether the solution constituted the first or the second element in the word pairs facilitated both likelihood and speed of solution attainment. In addition, solution attainment was relatively high for items based on frequently used word pairs (Experiment 1) and for items in which the stimuli appear, in everyday language, in a small number of word pairs (Experiment 2). In Experiment 3, the subjects were required to produce word pairs containing one of the two stimulus words from the items used in Experiment 2. Solution production was facilitated by rehearsing the second stimulus word of the specific item. The conclusion, supported by a post hoc analysis of the results of Experiments 2 and 3 (Experiment 4), was that indirect priming from one stimulus word may facilitate solution production from a searched word. These results are interpreted in terms of automatic and controlled processes, and their relevance to two different models for retrieval from semantic memory is discussed.