Terry L. Mills

Parental explanatory models of ADHD: gender and cultural variations.

This study describes parents’ explanatory models of Attention Deficit Hyperactivity Disorder (ADHD) and examines model variation by child characteristics. Children with ADHD (N = 182) were identified from a school district population of elementary school students. A reliable coding system was developed for parental responses obtained in ethnographic interviews in order to convert qualitative into numerical data for quantitative analysis. African-American parents were less likely to connect the school system to ADHD problem identification, expressed fewer worries about ADHD-related school problems, and voiced fewer preferences for school interventions than Caucasian parents, pointing to a potential disconnect with the school system. More African-American than Caucasian parents were unsure about potential causes of and treatments for ADHD, indicating a need for culturally appropriate parent education approaches.

Comorbid depressive symptomatology: isolating the effects of chronic medical conditions on self-reported depressive symptoms among community-dwelling older adults

Advances in medical technology and surgical knowledge have greatly extended the life expectancy of older individuals with chronic disabilities. Among the older adult population the prevalence of comorbid chronic illness and depressive symptoms has often been investigated. Yet there continues to be a lack of understanding about the consequences of specific chronic illnesses on depressive symptoms. Using cross-sectional data while simultaneously controlling the effects of various socioenvironmental, demographic, and other factors, this study analyzed the prevalence of self-reported depressive symptoms in relation to chronic illness. The cumulative effect of medical comorbidity and the specific effect of individual chronic illnesses were examined. The sample consisted of 359 older white Americans aged 55-93. Overall, the findings show that self-reports of depressive symptoms were greater among those individuals who also reported digestive disorders, respiratory ailments, and heart problems. These results suggest that for older white Americans these three chronic conditions may present a greater mental health burden than other chronic illnesses.

The Impact of Dyadic Social Support on Self-Efficacy and Depression After Radical Prostatectomy

Objectives: To assess the effect of one-on-one peer support at enhancing self-efficacy and decreasing depression in older men treated by radical prostatectomy for prostate cancer. Methods: Six weeks after surgery, 72 men (M age = 60) were randomly assigned to a treatment (n = 37) or control group ( n = 35). Treatment group participants were paired to form dyads with a trained support partner who had similar treatment and related side effects; control group participants received usual health care. Dyads met 8 times over 8 weeks to discuss concerns and coping strategies. Results: At posttest, the treatment group had significantly higher self-efficacy than the controls (M = 328.89 and M = 304.54, respectively) and significantly less depression (M = 0.92 and M = 2.49, respectively). Depression outcomes remained significant when controlling baseline self-efficacy and social support (F = 4.845, p = .032). Discussion: Findings confirm pilot study results and are theoretically consistent with the self-efficacy enhancing nature of vicarious experience described by Bandura in self-efficacy theory.

Cultural Variations in Parental Health Beliefs, Knowledge, and Information Sources Related to Attention-Deficit/Hyperactivity Disorder

This study explores cultural variance in parental health beliefs, knowledge, and information sources related to attention-deficit/hyperactivity disorder (ADHD). Structured interviews were completed by a representative community sample of 1,615 parents, including an ADHD knowledge and perceptions survey, behavioral questionnaires, and inquiries about ADHD detection and treatment. Most parents had heard about ADHD and considered themselves knowledgeable about it but were unaware of relevant school services; those who were aware rated their knowledge levels as low. Compared to their Caucasian counterparts, African American parents reported less ADHD awareness and lower self-rated knowledge. They experienced fewer cues to action, such as receiving ADHD information from teachers or reading media accounts. Furthermore, they made more etiological attributions to sugar intake and expected less benefit from treatment. Study findings suggest a compelling need for more culturally appropriate approaches to educating African American parents about the causes and treatment options for ADHD.

Differences in the Indicators of Depressive Symptoms Among a Community Sample of African–American and Caucasian Older Adults

Depression among older adults is a major public health concern in the U. S. Yet, time and again this condition goes undiagnosed, or attributed to other causes. Despite being treatable, few individuals older than age 65 are treated for this disorder. Using a community sample of 404 African–American and Caucasian older adults, the aim of this study was to identify the sources of racial group variance in self-reports of depressive symptoms. Descriptive and multivariate analyses reveal no racial/ethnic differences in the mean level of depressive symptoms, but differences in the correlates of self-reported depression, as well as differences in the distribution of individual indicators of depressive symptoms.

Physical and emotional predictors of depression after radical prostatectomy.

Radical prostatectomy commonly results in urinary, sexual, and bowel dysfunction that bothers men and may lead to depressive symptomatology (hereafter depression) that occurs at a rate 4 times greater for men with prostate cancer than healthy counterparts. The purpose of this study was to assess depressive symptoms in men shortly after radical prostatectomy and to identify associated risk factors. Seventy-two men were interviewed 6 weeks after surgery. Measured were depression (Geriatric Depression Scale), self-efficacy (Stanford Inventory of Cancer Patient Adjustment), social support (Modified Inventory of Socially Supportive Behaviors), physical and emotional factors (UCLA Prostate Cancer Index), and social function (SF-36 subscale). Results indicate that men with high self-efficacy and less sexual bother were 45% and 55% less likely to have depressive symptoms, respectively. Findings from this study add to the limited amount of information on the complex relationship between prostate cancer treatment and depression in men.

A critical review of research on the mental health status of older African-Americans

This paper summarises current research on the mental health status of older African-Americans with a specific focus on late-life depression, one of the most common forms of mental disorder among older persons. Social gerontologists have brought to the forefront the need to consider the impact of historical eras, cohort location, and lifecourse development when studying various dimensions of the ageing process. Unfortunately, this type of theorising is still in its infancy, and has not been widely applied to the general population and all dimensions of health, let alone investigations into the mental health status of older African-Americans. Virtually none of the empirical studies we reviewed adequately address the historical, biographical, or structural factors related to the mental health status of older African-Americans. We suggest that to understand contemporary manifestations of racial presumptions, there must be an appreciation of the historical antecedents. African-Americans live with the corrosive effects of a legacy of slavery that presumed black inferiority. The identification of salient factors of risk and resilience among this population is critical to developing effective intervention and mental health maintenance programmes. By emphasising the socio-historical influences on the mental health of older African-Americans, we can develop a greater understanding of this populations mental health needs; thus paving the way for improved mental health services and a reduction in mental health disparities.

Skipped generation families : Sources of psychological distress among grandmothers of grandchildren who live in homes where neither parent is present

Abstract Today, more than at any period in U.S. history, more grandparents are raising their grandchildren. In many instances, the biological parents are absent from these grandparent-headed households for a variety of reasons. Although grandfathers and grandmothers both serve in the role of surrogate parents, grandparent caregiving can be seen as a “womens issue” when examined from the broader sociological context of gender. Using data from the National Survey of Americas Families, this study examined factors associated with the frequency of feelings of psychosocial distress among grandmother caregivers of grandchildren in skipped generation families. Multivariate regression models indicate that for these grandmothers, being Black and living in the Midwest, having a family income below the poverty level, having Medicaid or SCHIP coverage, not receiving Welfare payments for childcare, and having a usual place for health care were all associated with more frequent feelings of psychosocial distress. On the other hand, being married, receiving social services help with childcare, grandmothers perception of less parenting burden, and living below poverty in the Midwest were associated with less frequent feelings of psychosocial distress.

Positive Portrayal of Grandparents in Current Children's Literature

Childrens books have the potential to affect cultural norms and attitudes about older adults in many ways. The purpose of this study was to investigate the portrayal of grandparents in childrens literature. Sixty-four childrens books published since 1985 were randomly selected and content analyzed. In general, there was an overwhelming positive portrayal of grandparents in these books. Positive grandparent characteristics such as independence and happiness were depicted in a majority of the books the authors examined. Other characteristics such as wisdom and understanding were portrayed in slightly less than a majority of the stories. Although some of the stories depicted grandparents with various disabilities, physical impairment did not detract from the positive depiction of the grandparent. Future research might investigate the variance in the portrayal of grandparents along racial/ethnic and gender lines. For example, how are grandparents from various demographic groups portrayed in terms of status, wisdom, functional abilities, or equity?

Lives in Isolation: Stories and Struggles of Low-income African American Women with Panic Disorder

Research evidence points to the existence of racial‐ethnic disparities in both access to and quality of mental health services for African Americans with panic disorder. Current panic disorder evaluation and treatment paradigms are not responsive to the needs of many African Americans. The primary individual, social, and health‐care system factors that limit African Americans’ access to care and response to treatment are not well understood. Low‐income African American women with panic disorder participated in a series of focus‐group sessions designed to elicit (1) their perspectives regarding access and treatment barriers and (2) their recommendations for designing a culturally consistent panic treatment program. Fear of confiding to others about panic symptoms, fear of social stigma, and lack of information about panic disorder were major individual barriers. Within their social networks, stigmatizing attitudes toward mental illness and the mentally ill, discouragement about the use of psychiatric medication, and perceptions that symptoms were the result of personal or spiritual weakness had all interfered with the participants’ treatment seeking efforts and contributed to a common experience of severe social isolation. None of the focus‐group members had developed fully effective therapeutic relationships with either medical or mental health providers. They described an unmet need for more interactive and culturally authentic relationships with treatment providers. Although the focus‐group sessions were not intended to be therapeutic, the women reported that participation in the meetings had been an emotionally powerful and beneficial experience. They expressed a strong preference for the utilization of female‐only, panic disorder peer‐support groups as an initial step in the treatment/recovery process. Peer‐support groups for low‐income African American women with panic disorder could address many of the identified access and treatment barriers.