Spouse

Abstract: ContextThere is strong consensus that caring for an elderly individual with disability is burdensome and stressful to many family members and contributes to psychiatric morbidity. Researchers have also suggested that the combination of loss, prolonged distress, the physical demands of caregiving, and biological vulnerabilities of older caregivers may compromise their physiological functioning and increase their risk for physical health problems, leading to increased mortality.ObjectiveTo examine the relationship between caregiving demands among older spousal caregivers and 4-year all-cause mortality, controlling for sociodemographic factors, prevalent clinical disease, and subclinical disease at baseline.DesignProspective population-based cohort study, from 1993 through 1998 with an average of 4.5 years of follow-up.SettingFour US communities.ParticipantsA total of 392 caregivers and 427 noncaregivers aged 66 to 96 years who were living with their spouses.Main Outcome MeasureFour-year mortality, based on level of caregiving: (1) spouse not disabled; (2) spouse disabled and not helping; (3) spouse disabled and helping with no strain reported; or (4) spouse disabled and helping with mental or emotional strain reported.ResultsAfter 4 years of follow-up, 103 participants (12.6%) died. After adjusting for sociodemographic factors, prevalent disease, and subclinical cardiovascular disease, participants who were providing care and experiencing caregiver strain had mortality risks that were 63% higher than noncaregiving controls (relative risk [RR], 1.63; 95% confidence interval [CI], 1.00-2.65). Participants who were providing care but not experiencing strain (RR, 1.08; 95% CI, 0.61-1.90) and those with a disabled spouse who were not providing care (RR, 1.37; 95% CI, 0.73-2.58) did not have elevated adjusted mortality rates relative to the noncaregiving controls.ConclusionsOur study suggests that being a caregiver who is experiencing mental or emotional strain is an independent risk factor for mortality among elderly spousal caregivers. Caregivers who report strain associated with caregiving are more likely to die than noncaregiving controls.

Abstract: People have a tendency to marry within their social group or to marry a person who is close to them in status Although many characteristics play a role in the choice of a spouse, sociologists have most often examined endogamy and homogamy with respect to race/ethnicity, religion, and socioeconomic status I first give an overview of hypotheses on the causes of endogamy and homogamy The various hypotheses that have been suggested in the literature can be distinguished as arguments about three more general factors: (a) the preferences of marriage candidates for certain characteristics in a spouse, (b) the interference of “third parties” in the selection process, and (c) the constraints of the marriage market in which candidates are searching for a spouse Second, I summarize empirical research by answering four questions: (a) To what extent are groups endogamous and how do groups differ in this respect? (b) How has endogamy changed over time? (c) Which factors are related to endogamy? (d) How do various d

Abstract: Current emphasis on early case finding, outpatient care, and on longitudinal studies of asymptomatic patients has focused attention on the community adjustment of psychiatric patients. Thus, simple and inexpensive methods such as self-report scales, which allow the routine assessment of patient adjustment, are potentially useful. The derivation and testing of such a method, the Social Adjustment Scale Self-Report, is described. This scale covers the patient's role performance, interpersonal relationships, friction, feelings and satisfaction in work, and social and leisure activities with the extended family, as a spouse, parent, and member of a family unit. Self-report results based on 76 depressed outpatients were comparable to those obtained from relatives as well as by a rater who interviewed the patient directly.