Mary Ann Parris Stephens

Affective and cognitive antecedents to eating episodes in bulimia and binge eating

The present study investigated seven antecedents to the binge-purge cycle proposed by Orleans and Barnett (1984), including restraint, stress, mood, thoughts of food, fatigue, hunger, and dichotomous cognitions. For 1 week, 19 bulimics, 15 binge eaters, and 20 normal control subjects recorded detailed information about these antecedent conditions and the types and quantities of food consumed for each eating episode. Results indicated that prior to their binge episodes, bulimics reported significantly greater stress, preoccupation with food, and negative mood than binge eaters reported prior to their binges and normal controls reported prior to all of their eating episodes. Both bulimics and binge eaters reported greater dichotomous cognitions prior to binge episodes than normal controls experienced prior to all of their eating episodes. Comparisons of the antecedents to eating episodes which bulimics and binge eaters regarded as nonbinge episodes with all eating episodes of the control group indicated that although bulimics and binge eaters experienced significantly greater negative moods than normal controls prior to their nonbinge episodes, only bulimics experienced significantly greater dichotomous cognitions prior to these eating episodes. Theoretical and clinical implications of these findings are discussed.

Centrality of women's multiple roles: beneficial and detrimental consequences for psychological well-being.

Theorists have proposed that greater centrality (personal importance) of a social role is associated with better psychological well-being but that role centrality exacerbates the negative effects of stress in that same social role on well-being. The present study found evidence to support both hypotheses in a sample of 296 women who simultaneously occupied the roles of parent care provider, mother, wife, and employee. Greater centrality of all four roles was related to better psychological well-being. As predicted, wife centrality exacerbated the effects of wife stress on life satisfaction, and employee centrality exacerbated the effects of employee stress on depressive symptoms. Contrary to prediction, centrality of the mother role buffered women from the negative effects of mother stress on depressive symptoms. These findings point to an aspect of role identity that can benefit well-being but that has complex effects in the context of role stress.

Negative reactions to received spousal care: predictors and consequences of miscarried support.

This study focused on the negative reactions of older women with osteoarthritis to the receipt of instrumental support (i.e., physical assistance) from their husbands and the effects of such negative reactions on the womens psychological well-being and self-care. Applying a person-environment fit model, the authors predicted that womens negative reactions to spousal support would be determined by the fit between this support and the personal centrality (importance) of being functionally independent. Consistent with this prediction, women who received high levels of support from the husband and for whom being functionally independent was not highly central reacted less negatively to this support. More negative reactions to spousal support were related to greater concurrent depressive symptomatology and fewer self-care behaviors. In addition, negative reactions were predictive of the womens increased depressive symptomatology and decreased life satisfaction. Findings illustrate a useful theoretical approach to the examination of support from family caregivers.

Respite for Dementia Caregivers: The Effects of Adult Day Service Use on Caregiving Hours and Care Demands

The objective of this study was to determine whether adult day service use was related to decreases in primary caregiving hours (i.e., the time caregivers spent on activities of daily living/instrumental activities of daily living and behavior problems for care recipients) and care recipient function for these domains. Three-month longitudinal data from the Adult Day Care Collaborative Study (N = 400) were used. Adult day service users reported greater decreases in hours spent on behavior problems when compared to nonusers, even after controlling for baseline differences between the two groups. In addition, adult day service users reported decreased frequency of behavior problems in their relatives who attended adult day programs. The findings suggest that adult day services, if used over time, are effective in restructuring caregiving time and may offer potential benefits not only to family caregivers but to community-residing older adults who have dementia as well.

Family health psychology.

Family health psychology - an introduction and overview. Part 1 Families and prevention: health cognitions in families the role of families in the prevention of physical and mental health problems preventive intervention and family coping with a childs life - threatening or terminal illness. Part 2 Family systems, social ecology and chronic pediatric illness - conceptual, methodological and intervention issues: couples coping with chronic and catastrophic illness physical and psychological illness as correlates of marital disruption. Part 3 Families and intervention: integrating theroy and practice in psychological intervention with families of children with a chronic illness family systems medicine - new opportunities for psychologists family therapy in the context of AIDS.

Stress of parent care: positive and negative effects of women's other roles.

The present study focused on 296 women who were primary caregivers to an ill or disabled parent or parent-in-law and who simultaneously occupied 3 other roles as mother, wife, and employee. All women lived in separate households from their impaired parent and had at least 1 child 25 years of age or younger living at home. It was predicted that stress in the roles of mother, wife, and employee would exacerbate the effects of stress in the parent care role on psychological well-being (depression and life satisfaction) and that rewards in these 3 additional roles would buffer the effects of parent care stress. For all 3 additional roles, findings supported the stress exacerbation hypothesis. In contrast, only the employee role supported the stress-buffering hypothesis. These findings underscore the complex relationships that often exist between womens multiple role experiences and their psychological well-being.

Employed family caregivers of cognitively impaired elderly: An examination of role strain and depressive symptoms

This paper compares employed and non-employed caregivers of cognitively impaired elderly family members. Using two competing positions derived from role theory, role conflict and role expansion, we explored whether holding the positions of both caregiver and worker led to greater role overload and psychological role conflict, or provided an outlet that helps caregivers better manage the demands placed on them. We found no differences between employed and non-employed caregivers on measures of role overload, worry and strain, and depression. For working caregivers, however, greater conflict on the job was associated with higher role overload and worry and strain while beneficial work experiences were only weakly associated with lower role overload and worry and strain. There was an interaction effect between positive work experiences and role overload when predicting depressive symptoms. These results provide some support for role conflict, but also suggest that caregivers may vary considerably in how they adapt to multiple roles.

Patterns of adult day service use by family caregivers: A comparison of brief versus sustained use.

Low service use by family caregivers of dementia patients was examined by comparing brief and sustained users of Adult Day Services (ADS). Caregivers whose relative used ADS briefly were more likely to be spouses, had less education, and were caring for more severely impaired relatives than sustained users. They also were experiencing more role captivity, but fewer depressive symptoms. These results suggest that brief users have often waited until their relatives problem is severe before trying ADS.

Mastery in women's multiple roles and well-being: adult daughters providing care to impaired parents.

The current study focused on 296 adult daughter caregivers who were simultaneously providing care to an impaired parent, mothers to children living at home, wives, and employees. How mastery (perceived competence and control) in each of these 4 roles was related to well-being was examined. Women experienced higher levels of mastery in the employee role than in any other role. After controlling for household income and dispositional optimism, only employee mastery contributed unique variance to physical health, but mastery in each of the 4 roles contributed unique variance to either depression or life satisfaction. Results also suggest that womens satisfaction with life was related to an accumulation of mastery across roles. The study expands previous research by revealing that mastery in womens additional roles can supplement the benefits of mastery stemming from parent care.

Older Adults' Recovery From Surgery for Osteoarthritis of the Knee: Psychosocial Resources and Constraints as Predictors of Outcomes

The authors investigated psychosocial resources (positive support, active coping) and psychosocial constraints (negative support, avoidant coping) as predictors of improvement in the health of 63 older adults undergoing surgery for osteoarthritis of the knee. Following surgery, patients and social partners are motivated both to strive for the appetitive goal of recovery (approach), and to protect themselves from pain and impairment (avoidance). The authors assessed resources and constraints 6 weeks after surgery as predictors of outcomes (improvement in knee pain, knee functioning, and psychological well-being) 6 months after surgery. The constraints patients encountered early in recovery were strong predictors of poor recovery. Although resources were associated with some improvement, these effects were largely accounted for by constraints.