Morton A. Lieberman

The stress process.

This study uses longitudinal data to observe how life events, chronic life strains, self concepts, coping, and social supports come together to form a process of stress. It takes involuntary job disruptions as illustrating life events and shows how they adversely affect enduring role strains, economic strains in particular. These exacerbated strains, in turn, erode positive concepts of self, such as self-esteem and mastery. The diminished self-concepts then leave one especially vulnerable to experiencing symptoms of stress, of which depression is of special interest to this analysis. The interventions of coping and social supports are mainly indirect; that is, they do not act directly to buffer depression. Instead, they minimize the elevation of depression by dampening the antecedent process.

Changes in Depression Following Divorce: A Panel Study.

The relationship between marital status and psychological well-being has been subject to conflicting interpretations. In this paper, panel data are analyzed to assess the impact of changes in marital status on psychological well-being. Data from a large metropolitan Chicago sample are used to examine changes in depressive affect in a group of adults divorced during the four years between interviews, and to compare them with people who have remained married. Those who would subsequently divorce were not significantly more depressed at the first time point than those who would remain married. Four years later, however, the newly divorced had become significantly more depressed. This increase in depression is mediated by greater economic problems, the perception that ones standard of living has deteriorated, and the lesser availability of close, confiding relationships. These findings suggest that despite its increased frequency, divorce remains an event that brings economic and emotional hardship to many; the greater depressive affect of the unmarried reflects the worsened life conditions they experience.

Self-help on-line: an outcome evaluation of breast cancer bulletin boards.

Many breast cancer patients find help from on-line self-help groups, consisting of self-directed, asynchronous, bulletin boards. These have yet to be empirically evaluated. Upon joining a group and 6 months later, new members (N= 114) to breast cancer bulletin boards completed measures of depression (CES-D), growth (PTGI) and psychosocial wellbeing (FACT-B). Improvement was statistically significant on all three measures. This serves as a first validation of Internet bulletin boards as a source of support and help for breast cancer patients. These boards are of particular interest because they are free, accessible and support comes from peers and not from professional facilitators.

THE IMPACT OF SELF‐HELP GROUPS ON THE MENTAL HEALTH OF WIDOWS AND WIDOWERS

Thirty-six widowers and 466 widows were studied over a one-year period to determine the impact of self-help groups on their mental health. Participants were compared to similarly bereaved psychotherapy patients as well as to those who sought no formal help. Significant positive changes were found to have occurred only for those who participated actively in the self-help groups.

Problems in Assessing Prevalence and Membership Characteristics of Self-Help Group Participants:

Relying on secondary analysis of three surveys, this study examines the prevalence of self-help group (SHG) use. Two of the surveys are based on large household probability samples (Epidemiological Catchment Area and Mellinger-Balter surveys) and the third on the population of self-help groups in California. Based on the best available survey information, an estimated 7.5 million adults participated in a SHG during 1992. Self-help group use for mental health problems appears to be a predominately White, middle-class phenomenon. Use of services is overlapping; those who seek out help do so in multiple service delivery modalities. Highlighted in this article are the problems of accurately assessing SHG participation based on current survey information.

Does help help? The adaptive consequences of obtaining help from professionals and social networks

This study reports on a longitudinal analysis of changes in adaptation associated with seeking help on a representative sample of Chicago area adults who had experienced one of three transitions or four crises during the interval between 1972 and follow-up 1976--77 interviews. For each event, respondents are classified into three groups according to their help-seeking behavior: those who went to professionals, those who went only to their social networks, and those who had the event but sought no help. Nine measures of adaptation are used: symptoms of anxiety and depression and strains and stresses in four role areas. Statistical controls equate the groups on demographic characteristics, perceived stress, personal resources, access to help, and elapsed time since the event. There are no consistent statistical significant differences among the groups. No evidence is found that help-seeking has positive adaptive consequences. The findings are not likely to result from an inadequate sample, outcome measures, or statistical controls, but could result from insufficient information on the kind, quality, and duration of the help provided.

Adaptive Processes in Late Life

This chapter presents a model for predicting adaptational success/failure of the elderly under crises. The predictive framework examines the elderly from the perspectives of resources, current functioning, social support, life stress, crises management techniques, degree of threat, threat and loss management strategies, and amount of current stress. The framework is used to examine the question: Why do some individuals adapt better than others to the crises associated with the last phase of life? The nature and effects of two central crises are empirically assessed: loss and adaptive demands. Findings from four studies representing 870 elderly before and after they underwent radical shifts in living arrangements (the stress situation) are discussed in regard to: (a) differential effects of loss-related crises and crises generated from situations demanding change in previous coping strategies and life styles; (b) differences between successful adaptive strategies of the aged contrasted to those of younger populations; and (c) the relative predictive power of the various social and psychological indices in predicting failures of adaptation.

Online Support Groups for Parkinson's Patients

Abstract (A) Will PD patients participate in online, professionally led support groups? (B) What are their demographics characteristics and PD severity? (C) Are such groups beneficial? (D) Should patients be grouped for stage of disease? Depression and quality of life were assessed. Sixty-six people were assigned to a 20-week, professionally facilitated online support group. Participants were assigned to one of 2 group types based on patient similarity: homogeneous and heterogeneous. PD patients appear to readily enroll in online groups. Compared to PD patients in traditional support groups, the online were younger, less depressed and had higher quality of life. Dropouts (39%) were high. Overall, patients showed improved quality of life; no overall changes were observed in depression. Participants in the homogenous groups reported a significant decrease in depression.

Brief group psychotherapy for the spousally bereaved: a controlled study.

A consecutive sample of mid- and late-life bereaved spouses were randomly assigned to treatment and no-treatment groups. Two hypotheses were tested: (1) that brief group psychotherapy during the early stages of loss would facilitate adjustment assessed by measures of mental health, positive psychological states, social role, and mourning; and (2) that positive effects would be maximized for subjects who were more distressed psychologically. Although group participants, compared with untreated controls, did over 1 year show modest improvement on role functioning and positive psychological states, overall the study failed to find substantial support for the two major hypotheses. Both experimental and control groups showed improvement over the year, particularly on measures of mental health and mourning. Differential benefit was not observed for the high-risk group.

A group therapist perspective on self-help groups.

The author provides an overview of self-help groups in terms of their origins, growth, scope, and effectiveness, and then compares these groups with professionally conducted psychotherapy groups. A framework for evaluating group helping systems is proposed which includes five principal dimensions: the helping group as a social microcosm; technological complexity/simplicity; psychological distance/closeness between helper and helpee; specificity/generality of help methods; and differentiation versus nondifferentiation among participants. The author concludes his article by recommending four strategies for how group therapists can contribute to self-help groups.