The Illness Experience of Veterans With Dementia: Perceived Measures Related to Depressive Symptoms

Recent work has examined how individuals with dementia (IWDs) experience their illness, although few studies have looked at IWDs who report heightened depressive symptoms, a key well-being outcome. Stressing the ability of IWDs to self-report and guided by the Stress Process Model for Individuals with Dementia, this study examined the relationships between depressive symptoms and various aspects of the illness experience including objective cognition, perceived memory difficulty, perceived functional difficulty, and dyadic relationship strain. The sample includes IWDs with mild to severe dementia who are veterans (N=69). Significant positive correlations emerged between depressive symptoms and several measures of the illness experience: perceived cognition (r=.48, p<.001), perceived function (r =.43, p<.001), and dyadic relationship strain (r=.32, p=.01). In contrast, objective cognition, measured by a modified version of the Blessed Orientation Memory Concentration test, was not significant (r =-.06, p=.63). A multiple regression found the total variance explained by all independent variables was 32% (R2=.32, F(4,68)=7.58, p<.001), with perceived memory difficulty (B=.26, p<.01) and dyadic relationship strain (B=.25, p=.04) accounting for unique and significant variance in depressive symptoms. A mediation analysis indicated perceived memory difficulty fully mediated the relationship between perceived functional difficulty and depressive symptoms. Findings highlight the importance of IWDs perceptions of their illness experience for psychosocial well-being outcomes, such as depressive symptoms. Findings add to the literature by showing the importance of IWDs perceptions of their illness and their impact on well-being outcomes. Results also demonstrate the utility and feasibility of including self-reported data from IWDs in research studies.

Racial Differences in Early Parental Death, Midlife Life Problems, and Relationship Strain With Adult Children

Objectives Black Americans typically experience the death of a parent earlier in the life course than do non-Hispanic whites, and early parental death is known to hinder subsequent relationship outcomes. Whether early parental death may contribute to racial differences in midlife family relationships and the role midlife adults’ current life problems play remain unexplored. Method Using multilevel modeling, we examined how timing of parental death is associated with relationship strain with adult children and whether the association differs by midlife adults’ life problems in Black (n = 166) and non-Hispanic white (n = 467) families from the Family Exchanges Study. Results Losing a parent in childhood was associated with more relationship strain with adult children for Black midlife adults, but not for their non-Hispanic white counterparts. Among the bereaved, earlier timing of parental death was associated with more relationship strain with adult children only for Black midlife adults. In both bereaved and non-bereaved sample, participants’ recent physical-emotional problems exacerbated the link between timing of parental death and relationship strain with adult children for Black midlife adults. Discussion Experiencing the death of a parent in the early life course can be an added structural disadvantage that imposes unique challenges for Black Americans in midlife. Policies and programs aimed at supporting bereaved children may benefit relationships with their own children later in life, and addressing physical-emotional problems in midlife may be a viable intervention point for those midlife adults who experienced the death of a parent in the early life course.

What makes It Difficult to keep an Intimate Relationship: Evidence From Greece and China

Keeping an intimate relationship is challenging, and there are many factors causing strain. In the current research, we employed a sample of 1,403 participants from China and Greece who were in an intimate relationship, and we classified 78 difficulties in keeping an intimate relationship in 13 factors. Among the most common ones were clinginess, long work hours, and lack of personal time and space. Clinginess was reported as a more common source of relationship strain by women, while bad sex was reported as a more common source of relationship strain by men. Fading away enthusiasm, bad sex, infidelity and children were reported as more important by older participants, while lack of personal time and space, and character issues were reported as more important by younger participants. The factor structure was similar in the Greek and in the Chinese cultural contexts, but there were also differences. In addition, there were significant interactions between the sample and the sex. For instance, for the non-monogamous factor, men gave higher scores than women in both samples, but the difference was much more pronounced in the Greek sample.

SUPPORTING FAMILY CAREGIVERS: HOW DOES RELATIONSHIP STRAIN OCCUR IN CAREGIVING DYADS? A QUALITATIVE STUDY

Family members and spouses are usually the primary caregivers for older adults. Providing direct care can be stressful, strenuous, and time-consuming for caregivers, potentially leading to frustration and anger towards care recipients. This can be detrimental to the relationship quality of the caregiving dyad. Though caregiver strain and burden have been extensively studied, there is limited information on the development of relationship strain. To explore how relationship strain occurs between caregivers and care recipients, 8 focus groups (N=62) and 8 semi-structured telephone interviews were conducted with caregivers in Los Angeles, inquiring about relationship quality with their care recipients and when frustration and anger occurs. Inductive coding was used to create coding schemas. Findings showed that most caregivers reported relationship strain occurring after taking on the caregiving role, and frustration and anger arose when providing ADLs, especially during bathing and toileting. Although these caregivers had initially experienced strain in their relationships, a recurring theme that emerged was that they developed strategies to decrease frustration and anger and improve the quality of their relationships with their care recipients. Direct communication with caregivers is important in designing a structured and effective intervention. These findings help inform an intervention for new caregivers to help them identify what can lead to relationship strain, as well as teach them reliable strategies to manage frustration and anger towards their care recipients.

The Vicarious Effects of Discrimination: How Partner Experiences of Discrimination Affect Individual Health

Little is known about how discriminatory experiences are associated with interpersonal relationships—specifically whether one person’s experience of discrimination has psychological effects on their partner and their relationship (i.e., vicarious effects). Using dyadic data analyses, we examined actor and partner effects of discriminatory experiences on self-rated health, chronic illness, depression, and relationship strain in a sample of 1,949 couples (3,898 participants). Actor and partner discrimination were associated with poorer health, greater depression, and greater relationship strain. These effects were mediated by higher levels of relationship strain. Our findings provide insight into the effects of direct and vicarious experiences of discrimination on interpersonal relationships.

The vicarious effects of discrimination: How partner experiences of discrimination affect individual health

Little is known about how discriminatory experiences are associated with interpersonal relationships—specifically whether one person’s experience of discrimination has psychological effects on their partner and their relationship (i.e., vicarious effects). Using dyadic data analyses, we examined actor and partner effects of discriminatory experiences on self-rated health, chronic illness, depression, and relationship strain in a sample of 1,949 couples (3,898 participants). Actor and partner discrimination were associated with poorer health, greater depression, and greater relationship strain. These effects were mediated by higher levels of relationship strain. Our findings provide insight into the effects of direct and vicarious experiences of discrimination on interpersonal relationships.

Family Relationships and Well-Being

Family relationships are enduring and consequential for well-being across the life course. We discuss several types of family relationships—marital, intergenerational, and sibling ties—that have an important influence on well-being. We highlight the quality of family relationships as well as diversity of family relationships in explaining their impact on well-being across the adult life course. We discuss directions for future research, such as better understanding the complexities of these relationships with greater attention to diverse family structures, unexpected benefits of relationship strain, and unique intersections of social statuses.