Susan Robinson-Whelen

Distinguishing Optimism From Pessimism in Older Adults: Is It More Important to Be Optimistic or Not to Be Pessimistic?

Confirmatory factor analysis revealed that the Life Orientation Test (LOT) consisted of separate Optimism and Pessimism factors among middle-aged and older adults. Although the two factors were significantly negatively correlated among individuals facing a profound life challenge (i.e., caregiving), they were only weakly correlated among noncaregivers. Caregivers also expressed less optimism than noncaregivers and showed a trend toward greater pessimism, suggesting that life stress may affect these dispositions. Pessimism, not optimism, uniquely predicted subsequent psychological and physical health; however, optimism and pessimism were equally predictive for stressed and nonstressed samples. By exploring optimism and pessimism separately, researchers may better determine whether the beneficial effects of optimism result from thinking optimistically, avoiding pessimistic thinking, or a combination of the two.

Coping with chronic pain: a comparison of two measures.

&NA; Cognitive‐behavioral models of chronic pain hypothesize that how a person copes with pain influences how well he or she adjusts to the pain. Several measures have been developed to assess pain coping, but no studies have yet examined whether these measures are complementary or redundant. In the current study, two pain coping measures (the Chronic Pain Coping Inventory, CPCI, and the Coping Strategies Questionnaire, CSQ) were completed by a large number (N=564) of primarily male veterans referred to a chronic pain program. Regression analyses indicated that the CPCI scales did not contribute unique variance to the prediction of depression over and above the CSQ scales. The CSQ Catastrophizing scale was the single most powerful predictor of depression, although several other CSQ scales (Coping Self‐Statements, Diverting Attention, and Increasing Behavioral Activities) also contributed. Both the CPCI and the CSQ contributed unique variance to the prediction of disability, although the CPCI scales appear to be more strongly related to disability than the CSQ scales. The CPCI Guarding scale was the single most powerful predictor of disability of all the coping responses assessed in this study. Other scales predicting disability were the CPCI Seeking Social Support, the CSQ Catastrophizing, and the CSQ Increasing Behavioral Activities. While both CSQ and CPCI contribute unique but modest variance to the prediction of pain severity, the CSQ Catastrophizing scale was the single most powerful predictor of pain severity. The findings of this study are consistent with cognitive‐behavioral models of pain. Future research will need to determine whether changes in coping responses (catastrophizing and guarding, in particular) merely reflect, or actually influence, adjustment to chronic pain. In the meantime, clinicians would be wise to give these coping responses particular attention in chronic pain programs.

Long-term caregiving: what happens when it ends?

Data from a longitudinal study were used to examine what happens to caregivers in the years after their cognitively impaired spouse dies. Comparisons of 42 current caregivers, 49 former caregivers, and 52 noncaregivers over a 4-year period showed that former caregivers did not improve on several measures of psychological well-being. Although former caregivers experienced decreases in stress and negative affect, their scores on depression, loneliness, and positive affect did not rebound to levels comparable to noncaregivers and, in fact, remained similar to those of current caregivers up to 3 years after caregiving had ceased. The most consistent predictors of postcaregiving outcomes were social support and intrusive-avoidant thinking about caregiving. The data suggest that some consequences of long-term caregiving may be long-term as well. The needs of former spousal caregivers warrant greater attention both in research and in practice.

Interpersonal Violence and Women With Disabilities: Analysis of Safety Promoting Behaviors

Very little information exists related to the interpersonal violence safety promoting behaviors of women with disabilities. Information about women’s use of safety promoting behaviors was gathered from 305 disabled and deaf women who completed an anonymous Audio Computer-Assisted Self-Interview. Exploratory factor analyses revealed factors related to seeking abuse-related safety information, building abuse-related safety promoting skills, using relationship support, planning for emergencies, taking legal action, and managing safety in personal assistance relationships. Four of these factors demonstrated significant relationships to women’s experience of different forms of abuse and their perpetrator’s characteristics.

The reliability and validity of a structured interview for the assessment of infectious illness symptoms

Respiratory infections are the leading cause of morbidity in community populations. We developed a structured interview based on the Health Review (Roseet al., Psychosom. Med. 40: 142–165, 1978) to provide a simple method for periodic assessment of infectious illness, particularly upper respiratory infections. Congruence between interview data and physician diagnoses demonstrated excellent agreement regarding the presence or absence of an infection. Subjects who showed a clinically significant increase in antibody titers to an influenza virus vaccine reported fewer than half as many respiratory infections in the subsequent year as subjects who did not show a significant response. Interrater and test-retest reliabilities were satisfactory. These data support the reliability and validity of this method of assessing infectious illnesses.

Development of Measures of Abuse Among Women With Disabilities and the Characteristics of Their Perpetrators

Three hundred and five women with diverse disabilities completed an anonymous audio computer—assisted self-interview designed to increase women’s awareness of abuse. Data were also collected regarding abuse experienced in the past year and the risk characteristics of their perpetrators. Overall, 68% reported some type of abuse. Preliminary evidence for the validity and reliability of questions to assess abuse and perpetrator risk characteristics was found. Latent class analysis revealed four distinct classes of abuse experiences: sexual abuse, physical abuse, multiple forms of abuse, and minimal abuse and three classes of perpetrator risk characteristics: controlling characteristics, noncontrolling characteristics, and minimal risk characteristics.

Overweight and obesity in women with physical disabilities: associations with demographic and disability characteristics and secondary conditions.

BACKGROUND This cross-sectional study was designed to examine weight in association with demographic and disability characteristics and secondary conditions in a sample of community living women with physical disabilities. METHODS 443 predominantly ethnic minority women with physical disabilities were recruited through public and private health clinics and community organizations. They completed questionnaires including measures of body mass index and a health conditions checklist. RESULTS Data showed that nearly three-quarters of the sample were overweight (26.6%) or obese (47.6%) with 14% extremely obese. Obesity was highest among middle aged women (aged 45-54, 52.7%; aged 55-64, 52.5%; compared to aged 18-44, 37.8%; or aged ≥65, 39.1%). Black (84.0%) and Hispanic women (83.8%) were more likely to be overweight or obese compared to non-Hispanic white women (56.7%). Women with joint and connective tissue diseases and women with more extensive functional limitations were more likely to have excess weight. Disability factors were more strongly associated with excess weight than demographic factors other than age. Weight classification was significantly related to whether or not the women had ever had diabetes or blood pressure problems. Diabetes was reported 4 times as often as among women in general (36.3% versus 8.9%), and hypertension nearly twice as often (56.2% versus 30.9%). CONCLUSIONS These findings indicate extremely high rates of overweight and obesity in women with physical disabilities, a growing population greatly in need of effective weight management interventions. Overweight and obesity in combination with disability in women was associated with disproportionately high rates of diabetes and hypertension.

Subjective stress in male veterans with spinal cord injury

We undertook a telephone survey to examine perceived stress among 165 veterans with spinal cord injury (SCI) who received care from a Department of Veterans Affairs Medical Center. Measures included Perceived Stress Scale, Hassles Scale, Center for Epidemiologic Studies Depression Scale, Short-Form State-Trait Anxiety Inventory, Satisfaction with Life Scale, and Short-Form Interpersonal Support Evaluation List. The mean perceived stress score for our sample of veterans with SCI (17.3) was higher than the means for men from the general population (12.1) and nonveteran men with SCI (13.9). Physical abilities, health, and financial issues were frequently reported hassles. Stress was related positively to depressive symptomatology and anxiety and negatively to life satisfaction. The association of hassles with measures of psychological well-being was partially mediated by perceived stress. The association of perceived stress with depression and anxiety varied as a function of social support, suggesting that those with low social support are the most vulnerable to the negative impact of stress on their psychological well-being. Stress management programs designed specifically to meet the needs of veterans with SCI are needed.

Health practices of veterans with unilateral lower-limb loss: Identifying correlates.

Persons with a nontraumatic lower-limb amputation are at high risk of losing their contralateral limb in the years postamputation. In this study, veterans with a unilateral lower-limb amputation participated in a survey about health beliefs and health practices known to affect risk of amputation (foot care and smoking). Most participants reported good foot-care practices (93% checked the top of their foot, 73% checked the bottom of their foot, 75% checked between their toes, and 72% washed their foot daily); however, a small percentage engaged in important foot-care practices less than once a week (2% checked the top of their foot, 7% checked the bottom of their foot, and 7% checked between their toes less than once a week). In addition, nearly a third still smoked. The belief in ones ability to engage in good foot care and the belief that good foot care reduces the risk of future foot problems were significantly correlated with foot-care practices. In addition, psychological well-being (life satisfaction) was significantly related to foot care and smoking status. Longitudinal research is needed to identify determinants of health behaviors to better direct intervention efforts.

Efficacy of a Computerized Abuse and Safety Assessment Intervention for Women With Disabilities: A Randomized Controlled Trial

OBJECTIVE To evaluate the effects of a computerized disability-specific abuse assessment intervention on abuse awareness, safety self-efficacy, and safety promoting behaviors of women with diverse disabilities. RESEARCH DESIGN A randomized control group design was used, with the intervention group completing the assessment intervention both at Time 1 (T1) and 3 months later at Time 2 (T2) and control participants completing it for the first time at T2. Analyses compared intervention and control groups at T2 and evaluated change over time in intervention group participants. The relationship between outcome variables (abuse awareness, safety self-efficacy, safety behaviors) was also explored. RESULTS The intervention group had greater abuse awareness than the control group at T2, and abuse awareness increased from T1 to T2 among women in the intervention group, particularly among women who had experienced little or no abuse in the past year. Both abuse awareness and safety self-efficacy were significantly related to safety behaviors. CONCLUSIONS The computerized program offers promise as a nonthreatening method of conducting abuse assessments among women with disabilities while also serving as an intervention to enhance abuse awareness.