Different Statistical Approaches to Develop a Guideline for Improvement of Caregiver’s Mental Health

Caregiver burden is common, and improvement of caregivers’ mental health could lead to better quality of care and well-being for both caregivers and care recipients. We investigate ways to develop a guideline to enhance caregiver’s mental well-being by applying and comparing regression tree and ensemble tree models. Data comes from the 2017 National Health and Aging Trends Study and National Study of Caregiving. Dementia caregivers’ (n=945) aspects of caregiving, care activities, support environment, and participation along with basic demographics and health are considered. First, insignificant predictors are preselected using linear regression with backward selection, which will not be included in the tree models. Using the predetermined predictors that are not excluded in the backward selection method, regression tree and ensemble tree models are generated to predict emotional difficulty of caregivers. The regression tree with the preselected predictors predicts caregivers with low to moderate levels of overload and high levels of joy being with their care recipient associated with the lowest level of emotional difficulty. On the other hand, if caregivers have high levels of overload and low to moderately high levels of positive affect, this is linked with the highest level of emotional difficulty. Ensemble tree models showed similar results with lower error measures. Using tree-based methods can help determine the most important predictors of caregiver mental health. Easily interpretable results with applicable decision rules can provide a guideline for intervention developers.

Caregivers' Medical Care Provision at Patient End-of-Life: Associations with Emotional Difficulty and Gains

Family caregivers play crucial roles in patient care and medical decision making, especially at end-of-life (EOL). Yet, most research focuses on caregivers’ burden, with little attention to rewards that make for a fulfilling EOL care experience. We consider caregiver involvement at EOL and associations with caregiver stress and gains. Data are drawn from the 2017 National Study of Caregiving’s last month of life and core interviews which includes caregivers (n=283) for a nationally representative sample of Medicare eligible older adults, and questions caregivers about their care provision and EOL experience. We consider indicators of caregivers’ involvement in medical decision making and support received from providers as predictors of caregivers’ emotional difficulty and gains at EOL utilizing linear regressions controlling for demographic characteristics. Caregivers were 60.7 years of age on average, 72.5% female, 21.3% non-white, and 11% were spousal partners. Making medical decisions was associated with increased emotional difficulty at EOL (B=0.93, SE=0.24, p<.001). In contrast, more caregiving gains were associated with having care decisions align with the CG’s wishes (B=-0.64, SE=0.30, p<.05), being more informed by providers (B=0.41, SE=0.16, p<.05), helping the care recipient with anxiety or sadness (B=0.69, SE=0.28, p<. 05), and surprisingly, feeling that care decisions were made without their input (B=0.82, SE=0.29, p<.01). Being more involved and informed in care was associated with both positive and negative caregiver outcomes at EOL. Understanding caregiver emotional difficulty and gains at EOL are critical for identifying how clinicians can better support caregivers at EOL and improving the caregiving experience.

Comparison of Perceptual Reasoning Skills and Mental Health Problems between Deaf and Normal-Hearing Adolescents in a Semi-inclusive setting in Ibadan, Nigeria

Background: Adolescents with hearing loss are often faced with poor cognitive and executive functions, and increased prevalence of mental health problems. The study compared the perceptual reasoning skills (PRI) and mental health problems of deaf adolescents with those of their age- and sex- matched hearing counterparts.Methods: It was a comparative cross-sectional study of a total population (102) of deaf adolescents, who were matched for age and sex with 102 normal hearing adolescents. The PRI of the participants was assessed using the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV). Mental health problems were assessed with the parents’ and teachers’ versions of the Strengths and Difficulties Questionnaire (SDQ). Descriptive statistics, chi square test and correlation co-efficient were done. Significant level was set at p-value < 5%.Results: The PRI scores ranged from 41-106 across both groups; 58.8 % of the deaf and 41.2% of the hearing adolescents scored 69 and below on the WISC and this difference was statistically significant (p = 0.033). The PRI scores had no significant relationship with the audiometric scores of the deaf participants (r = -0.177; p = 0.076). The PRI scores in the deaf participants were inversely related to hyperactivity assessed by the teacher (r = -0.354), emotional difficulty assessed by both teachers (r = -0.221) and parents (r = -0.280) and peer problems assessed by the teachers (r = -0.329).Conclusion: Deaf participants in this study showed significantly lower level of nonverbal IQ and higher level of behavioural difficulties compared with their hearing counterparts.

Soothing Movements

This chapter argues that after 1914 French modernist composers and performers embraced a neoclassical, repetitive, perpetual-motion-oriented musical style—often termed style dépouillé—to help themselves and others cope with trauma somatically. Examination of psychological, scientific, and medical discourse on the mental, emotional, and physical benefits of rhythmic bodily movement in nineteenth- and early twentieth-century French texts provides a broader context for understanding the interwar popularity of music pedagogue Émile Jaques-Dalcroze’s eurhythmics, a popular interwar musical practice based on the understanding of musical movement as emotionally transformative. Analysis of compositions in the style dépouillé, situated within the context of trauma studies, Dalcroze’s influence, and musicians’ commentaries on how these pieces made them feel, reveals that the challenging musique dépouillée repertoire engaged musicians’ bodies in rhythmically regular corporeal movements and provided them opportunities to process and perform the emotional difficulty of trauma.

Caregiver Report of the Utilization of School-Based Services and Supports Among Clinically Anxious Youth

Despite the high prevalence of and documented impairment associated with pediatric anxiety disorders, less than half of youth access mental health services. This study examined (a) the utilization of eight school services and supports (e.g., seen a school counselor for a mental health reason, placement in a special class for a behavior or emotional difficulty) and (b) demographic (gender, age) child clinical (anxiety severity and impairment) and family (parent psychopathology, caregiver strain) predictors of service utilization. Participants included 208 anxious youth between ages 6 to 18 years ( M = 10.92, SD = 3.29, 51% male, 64% White) who were enrolled in a school-based randomized controlled trial for anxiety treatment; only baseline data were used for this study. Parents, children, teachers and independent evaluators completed measures of the above predictors. Results indicated that less than half (48%) of youth received school services for anxiety. Several predictors of higher total service utilization were identified. Youth with comorbid externalizing behaviors were more likely to be referred for and receive school-based services. Consistent with published data in community samples, less than half of anxious youth received needed services. Results suggest a need for improvements in school assessments and service referral mechanisms for students with anxiety.

Implicit Theories of Emotion, Goals for Emotion Regulation, and Cognitive Responses to Negative Life Events

Why do some people routinely respond to emotional difficulty in ways that foster resilience, while others habitually engage in responses associated with deleterious consequences over time? This study examined relations between emotion controllability beliefs and goals for emotion regulation (ER) with peoples’ multivariate profile of cognitive ER strategy use. Cluster analysis classified 481 university students (81% female) as adaptive, maladaptive, or low regulators based on their multivariate profile of engagement in five adaptive and four maladaptive cognitive ER strategies. A discriminant function analysis predicting the multivariate profiles supported that lower emotion controllability beliefs and lower performance-avoidance goals for ER significantly distinguished maladaptive regulators from adaptive regulators. Moreover, lower learning, performance-avoidance, and performance-approach goals for ER significantly distinguished low regulators from maladaptive and low regulators. Taken together, findings support that emotion-related beliefs and goals may help to clarify why some people habitually engage in more adaptive patterns of cognitive ER in response to negative life events than others.

Returning a Puppy for Dog Guide Training: Factors That Affect Grief in Puppy Raisers and the Decision to Foster Again

Introduction: Guiding Eyes for the Blind (GEB) breeds, raises, and trains dogs to serve as guides for people with visual impairments (i.e., those who are blind or have low vision). Their puppy raising program enlists volunteers to foster puppies for a year or more, providing socialization, basic skills training, and comfort, so they will grow into confident dogs. The volunteers must ultimately return these dogs to Yorktown Heights, New York, to begin training. For raisers, the emotional toll of this parting can be great. Methods: Utilizing the 2017 GEB Puppy Raiser Survey data, this study analyzed factors that might affect emotional grief and the decision to continue to raise puppies. Cross-tabulation and ordinal regression analyses examined the associations of puppy raiser demographics (i.e., gender, age, marital status, and employment), organizational integration (i.e., number of dogs raised for GEB, perceptions on how well GEB supports raisers in returning a dog, belief that they are part of the GEB community, and formation of friendships), and goal attainment (perceptions on how well GEB communicated progress in training, whether they raised a dog accepted for guide training, and whether they attended a graduation ceremony) with self-reported emotional difficulty, recovery time, and likelihood of raising another puppy. Results: Although the demographics of the raiser had minimal effect on emotional difficulty, recovery time, and likelihood of raising again, factors that measured organization integration and goal attainment were associated with grief and continued participation. Discussion: Raiser demographics are not strong predictors of grief and continued raising; however, a welcoming organization that communicates effectively will inspire volunteers’ commitment. Implications: With a growing need for assistance dogs and puppy raisers, identifying and addressing the challenges that these volunteers face is critical if skilled and dedicated raisers are to be recruited and retained.

Race Differences in Characteristics and Experiences of Black and White Caregivers of Older Americans

Background and Objectives Racial disparities in health and socioeconomic characteristics of older adults have implications for the experiences of their family and unpaid caregivers, but knowledge to date has primarily drawn from convenience samples. Using a population-based sample, we examine associations between caregiver race and caregiving-related effects. Research Design and Methods Study participants include white (n = 992) and black (n = 556) respondents to the 2015 National Study of Caregiving who assisted community-dwelling older adults with disabilities who participated in the National Health and Aging Trends Study. Guided by Pearlin’s Stress Process Model, hierarchical logistic regression models were constructed to examine race differences in caregiving-related effects after adjusting for caregiving context, stressors, and resources. Results Relative to white caregivers, blacks more often provided in excess of 40 hr of care per week (54.3% vs 38.6%) and more often cared for an older adult with dementia (27.1% vs 20.7%) who was living below the federal poverty line (31.7% vs 11.9%) or was Medicaid-eligible (42.2% vs 11.8%). Black caregivers more often used supportive services (32.9% vs 24.8%). In fully adjusted regression models, black caregivers were more likely to report gains and less likely to report emotional difficulty than whites. Service utilization did not attenuate caregiving-related emotional difficulty or participation restrictions, regardless of race. Discussion and Implications Findings highlight caregiving disparities and counterintuitive differences in experiences and indicate the importance of identifying supports such as paid family leave and faith and community-based programming to better support community-dwelling low-income older adults and their family and unpaid caregivers.

Perception of Importance of Emotional Support under Stress and Characteristics of Individual’s Social Network

The article gives the concept of emotional support as a social support component shown in stress and coping problem field; it focuses on the problem of relations between the socio-psychological traits of one’s social network and the value of emotional support. The goal is to confirm the interplay between a person’s social network while under stress with situations of different complexity levels. It is assumed that there is a connection between the social and psychological qualities of the network with stressful situations of high and medium levels of emotional complexity. The study involves 196 men and women (17-60 years old; average age - 37 years old, SD = 12.5). Among the methods there is authors’ questionnaire and the G. Perry’ Social Network technique (1990). The results show that there are relationships between the qualities of a person’s social network (breadth, structure) and its estimates of the value of emotional support in stressful situations of medium and high levels of emotional difficulty. It has been found that the emotional support is most important from people from the social network of the personality in the situations of loss, and the least important in the following situations: “reconciliation of spouses”, “end of loan payments” and others. If a person has many friends included into their social network, they value less emotional support in situations of “birth of a child” and “personal success”. People appreciate the importance of the emotional support more if they receive it from their spouse in the situation of “dismissal from work”; from the colleagues the emotional support is the most important in the situations of “dismissal” and “change of position”. At the same time, the statistically significant associations of the social and psychological qualities of the social network and the value of support for an individual in everyday life/emotionally simple situations have not been revealed.

Associations Among Resilience, Stress, Depression, and Internet Gaming Disorder in Young Adults

Background and Aims: Using gaming to escape emotional difficulty has been suggested to be a candidate mechanism contributing to Internet gaming disorder (IGD). This study evaluated the associations among resilience, perceived stress, depression, and IGD. Methods: A total of 87 participants in an IGD group and 87 participants in a control group were recruited into this study. IGD was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders. Stress levels, resilience, and depression were measured by a self-reported questionnaire. Results: The IGD group had a lower resilience, higher perceived stress, and depression than the control group. Hierarchical regression analysis demonstrated that resilience was associated with IGD when perceived stress was controlled. After depression was controlled, resilience and perceived stress were not associated with IGD. Among the IGD group, those with low resilience had higher depression. Furthermore, discipline was the resilience characteristic associated with IGD. Conclusions: Low resilience was associated with a higher risk of IGD. IGD individuals with low resilience had higher depression. Depression was more associated with IGD than resilience. Depression assessments and stress coping interventions should be provided for individuals with IGD who exhibit low resilience or high stress.