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Revista Colombiana de Psiquiatria... 2023Wives of military personnel in action living on bases located in areas of armed conflict in Colombia before the peace negotiations with the Revolutionary Armed Forces of...
INTRODUCTION
Wives of military personnel in action living on bases located in areas of armed conflict in Colombia before the peace negotiations with the Revolutionary Armed Forces of Colombia (FARC), were first-hand observers of the war, their husbands' participation in the war and the consequences and effects of the combat in which others participated.
OBJECTIVE
To offer a hypothesis regarding these women's experience of direct trauma and characterise the dimensions of their experience as observers of the suffering of others.
METHODS
Qualitative study and secondary discourse analysis in intentional snowball sampling of wives of military personnel (officers and chiefs) with whom semi-structured interviews were conducted.
CONCLUSIONS
Direct trauma is not the sole cause of psychosomatic and psychopathological consequences; the experience of constantly observing the suffering and deaths of others also generates a cumulative effect that can affect physical and mental health. This experience is called passive trauma.
Topics: Humans; Female; Military Personnel; Mental Health; Spouses; Colombia
PubMed: 38008676
DOI: 10.1016/j.rcpeng.2021.09.003 -
CMAJ : Canadian Medical Association... Nov 2021
Topics: Bereavement; Death; Female; Humans; Male; Parent-Child Relations; Professional-Family Relations; Spouses
PubMed: 34750180
DOI: 10.1503/cmaj.211127 -
BMJ Military Health Feb 2022Service members and their families have endured significant stressors over the past 19 years in support of the nation's engagement in the wars in Iraq and Afghanistan.... (Review)
Review
Service members and their families have endured significant stressors over the past 19 years in support of the nation's engagement in the wars in Iraq and Afghanistan. 'Resilience' is the term most commonly used to describe the military spouse and military-connected child. However, due to a paucity of research on military families, little is known about the impact of spousal/parental military service on the military family. The ability of the healthcare provider is critical to ensuring the success of the military spouse and military-connected child. Providers can support the physical and psychological health needs of military families through (1) identification of military family members in clinical practice and (2) providing culturally competent care that correlates the unique lifestyle and physical and psychological health exposures associated with spousal/parental military service. Historically, in the United States, there has been a proud legacy of generational military service in families-upwards of 80% of new recruits have a family member who has served in the military. The leading factor associated with retention of the service member on Active Duty or in the Reserve or National Guard is the satisfaction of the at-home spouse. Disenfranchising the military spouse and lack of services and support for military-connected children could create a gap in meeting recruitment goals creating a threat to national security in the United States.
Topics: Afghanistan; Child; Humans; Mental Health; Military Family; Military Personnel; Spouses; United States
PubMed: 33785586
DOI: 10.1136/bmjmilitary-2020-001735 -
Journal of the American Medical... Sep 2023A large body of literature addresses experiences of spouse and adult-children caregiver of individuals with dementia (IWDs) but has not examined the role and strength of...
OBJECTIVES
A large body of literature addresses experiences of spouse and adult-children caregiver of individuals with dementia (IWDs) but has not examined the role and strength of social networks in associations between spouses and adult-children caregivers' experience. Based on the stress process model, we aimed to explore the strength levels of social networks and their association with spouses/adult-children caregivers for IWDs.
DESIGN
A cross-sectional study.
SETTING AND PARTICIPANTS
A questionnaire-based survey was conducted with a total of 146 family caregivers of IWDs (78 adult-child, and 68 spouses) in China.
METHODS
Data collection comprised 4 sections: (1) care-related stressors (dementia stage, neuropsychiatric symptoms); (2) caregiver context; (3) social network, using the Lubben Social Network Scale; and (4) caregiving experience, using the short-form Zarit Burden Interview and 9-item Positive Aspects of Caregiving Scale. Linear regression, mediation model analysis, and interactive analysis were performed to explore the mechanisms of associations between variables.
RESULTS
Spouses had weaker social network strength (β = -0.294, P = .001) and reported greater positive aspects of caregiving (β = 0.234, P = .003) than adult-children caregivers; no significant difference was found between them for caregiver burden. Mediation analysis suggests that associations between caregiver type and caregiver burden are indirect-only mediation effects of social networks (β = 0.140, 95% CI = 0.066-0.228). The social network strength suppressed the association between caregiver type and positive aspects of caregiving. The caregiver type/social network interaction statistically significantly (P = .025) affected the "positive aspects": a stronger social network was associated with more positive aspects of caregiving among the spouse subgroup (β = 0.341, P = .003).
CONCLUSIONS AND IMPLICATIONS
Social networks mediate responses to caregiving experiences among different care provider types and are vital intervention targets, especially for spousal caregivers. Our results can serve as references for identifying caregivers for clinical intervention.
Topics: Humans; Adult; Spouses; Caregivers; Cross-Sectional Studies; Stress, Psychological; Dementia
PubMed: 37236264
DOI: 10.1016/j.jamda.2023.04.006 -
PLoS Genetics Nov 2021Spousal comparisons have been proposed as a design that can both reduce confounding and estimate effects of the shared adulthood environment. However, assortative...
Spousal comparisons have been proposed as a design that can both reduce confounding and estimate effects of the shared adulthood environment. However, assortative mating, the process by which individuals select phenotypically (dis)similar mates, could distort associations when comparing spouses. We evaluated the use of spousal comparisons, as in the within-spouse pair (WSP) model, for aetiological research such as genetic association studies. We demonstrated that the WSP model can reduce confounding but may be susceptible to collider bias arising from conditioning on assorted spouse pairs. Analyses using UK Biobank spouse pairs found that WSP genetic association estimates were smaller than estimates from random pairs for height, educational attainment, and BMI variants. Within-sibling pair estimates, robust to demographic and parental effects, were also smaller than random pair estimates for height and educational attainment, but not for BMI. WSP models, like other within-family models, may reduce confounding from demographic factors in genetic association estimates, and so could be useful for triangulating evidence across study designs to assess the robustness of findings. However, WSP estimates should be interpreted with caution due to potential collider bias.
Topics: Adult; Body Mass Index; Cohort Studies; Female; Humans; Male; Sexual Behavior; Spouses; United Kingdom
PubMed: 34735433
DOI: 10.1371/journal.pgen.1009883 -
Diabetes Care Jun 2021We investigated the risk of depression and anxiety in people whose spouse did or did not have diabetes. We also examined associations between depression and anxiety and...
OBJECTIVE
We investigated the risk of depression and anxiety in people whose spouse did or did not have diabetes. We also examined associations between depression and anxiety and severity of spouse's diabetes.
RESEARCH DESIGN AND METHODS
We analyzed prospective self-reported data about diagnosed depression/anxiety and diabetes in cohabiting couples in the national Panel Study of Income Dynamics (PSID) during 1999-2017 ( = 13,500, 128,833 person-years of follow-up, median follow-up 8.1 years). We used Poisson models to estimate incidence and incidence rate ratios (IRRs) of depression/anxiety, according to spouse's diabetes status overall and by severity of diabetes.
RESULTS
Age-, sex-, and race-adjusted incidence of depression/anxiety was 8.0/1,000 person-years (95% CI 6.5, 9.6) among those whose spouse had diabetes and 6.5/1,000 person-years (95% CI 6.0, 6.9) among those whose spouse did not have diabetes. Those whose spouse had diabetes had higher risk of depression/anxiety (IRR 1.24 [95% CI 1.01, 1.53]). Those whose spouse had diabetes-related limitations in daily activities (IRR 1.89 [95% CI 1.35, 2.67]) and diabetes combined with other chronic conditions (IRR 2.34 [95% CI 1.78, 3.09]) were more likely to develop depression/anxiety, while those whose spouse had diabetes with no limitations or additional chronic conditions had incidence of depression/anxiety similar to that of subjects whose spouses did not have diabetes.
CONCLUSIONS
People living with a spouse with diabetes are at higher risk of developing depression/anxiety than people whose spouse does not have diabetes; this risk is driven by the severity of the spouse's diabetes. Strategies to address the impacts of diabetes on families need to be devised and tested.
Topics: Anxiety; Depression; Diabetes Mellitus; Humans; Incidence; Prospective Studies; Spouses
PubMed: 33863752
DOI: 10.2337/dc20-2652 -
American Journal of Health Promotion :... Mar 2021Clergy have influence on the health of congregations and communities yet struggle with health behaviors. Interventions tailored to their occupation-specific demands and...
PURPOSE
Clergy have influence on the health of congregations and communities yet struggle with health behaviors. Interventions tailored to their occupation-specific demands and unique needs may provide a solution. Qualitative methods were used to identify opportunities and resources for the development of an effective obesity-related program for clergy.
APPROACH
Ninety-minute focus groups were held with clergy (3 groups) and spouses (3 separate groups). Discussion explored: Program target(s); Opportunities and barriers that influence diet, physical activity, and stress-reduction practices; Empowering and culturally relevant health promotion strategies.
SETTING
All study activities took place in Memphis, TN.
PARTICIPANTS
Eighteen clergy and fourteen spouses participated. All clergy were male, all spouses were female.
METHOD
Previous research with clergy informed the interview guide and the PEN-3 framework aided in organizing the coding of clergy and spouse focus groups. Focus groups were audio recorded and transcripts analyzed using NVivo® 12.
RESULTS
Themes included: 1) Intervention targets-clergy, spouses, congregations; 2) Opportunities and barriers-making time, establishing boundaries, church traditions, individuals who support and hinder behavior change; 3) Intervention strategies-tools for healthy eating, goal setting, camaraderie, combining face-to-face with eHealth modalities.
CONCLUSION
The relationship between clergy, spouse, and congregation make it important for obesity-related programs to target the unique needs of both clergy and spouses. Strategies should focus on healthy eating and personal connections no matter the modality used.
Topics: Clergy; Female; Focus Groups; Health Promotion; Humans; Male; Obesity; Spouses
PubMed: 32985232
DOI: 10.1177/0890117120960574 -
JAMA Network Open Apr 2024Although cardiovascular disease (CVD) is a known risk factor for depression, evidence is lacking regarding whether and to what extent a spouse's CVD is associated with...
IMPORTANCE
Although cardiovascular disease (CVD) is a known risk factor for depression, evidence is lacking regarding whether and to what extent a spouse's CVD is associated with the subsequent mental health of individuals.
OBJECTIVE
To examine the association between CVD onset in spouses and subsequent depression.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study examined 277 142 matched married couples enrolled in the Japan Health Insurance Association health insurance program between April 2015 and March 2022, covering approximately 40% of the working-age population in Japan. Index individuals (primary insured) whose spouses (dependent) experienced incident CVD between April 2016 and March 2022 were 1:1 matched to controls whose spouses did not experience CVD. Matching was based on age, sex, income, or the onset date of the spouses' CVD. Data analysis was conducted from April 2016 to March 2022.
EXPOSURE
Spousal onset of CVD between fiscal years 2016 and 2021. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes were used to identify the composite CVD outcomes (stroke, heart failure, and myocardial infarction).
MAIN OUTCOMES AND MEASURES
Multivariate Cox proportional hazards models were used to investigate the association between spouses' new-onset CVD and individuals' depression, adjusting for sociodemographic characteristics and comorbidities of index individuals (diabetes, hypertension, and CVD) and spouses (diabetes, hypertension, and depression). Subgroup analyses were conducted according to sex, age, income levels, and history of CVD.
RESULTS
Among 277 142 matched pairs of married couples, 263 610 (95.1%) had a male index individual; the mean (SD) age of index individuals was 58.2 (10.2) years. A new onset of depression was observed in 4876 individuals (1.8%). In multivariable Cox models, there was an association between the spouse's CVD and the individuals' depression (hazard ratio, 1.13 [95% CI, 1.07-1.20]). The subgroup analysis found no evidence of heterogeneity in sex, age, income level, or CVD history. The results were consistent when additionally adjusted for health behaviors (smoking, alcohol consumption, physical activity, and use of antihypertensive drugs) and objectively measured physical health conditions (body mass index, blood pressure, cholesterol levels, glucose levels, and estimated glomerular filtration rate) (hazard ratio, 1.16 [95% CI, 1.06-1.28]).
CONCLUSIONS AND RELEVANCE
In this nationwide cohort study of matched couples, a spouse's onset of CVD was associated with an increased risk of an individual's depression. These findings highlight the importance of preventive care for mental health disorders in individuals whose spouses experience incident CVD.
Topics: Humans; Male; Middle Aged; Spouses; Cohort Studies; Depression; Hypertension; Myocardial Infarction; Diabetes Mellitus
PubMed: 38607629
DOI: 10.1001/jamanetworkopen.2024.4602 -
Neuropsychological Rehabilitation Sep 2023This is the first study to estimate the prevalence and predictors of spouse and patient perceptions of global/overall personality change (PC) in patients with multiple...
OBJECTIVES
This is the first study to estimate the prevalence and predictors of spouse and patient perceptions of global/overall personality change (PC) in patients with multiple sclerosis (MS).
METHODS
69 clinic patients and their spouses completed parallel measures of perceived PC and semantic differential scales measuring pre-MS and current specific behaviours. We correlated perceived personality changes with the following measures of perceived physical, cognitive, emotional, and social functioning: MS Impact Scale, MS Neuropsychological Questionnaire, Beck Depression Inventory-FastScreen; Hospital Anxiety and Depression Scale; Family Questionnaire, McMaster Assessment Device; and Social Provisions Scale.
RESULTS
Spouses and patients reported comparable levels of substantial change. Both associated PC with patient distress, perceived cognitive impairment, spouse distress, and poorer family functioning. Spouse, but not patient, PC ratings predicted severity of physical symptoms and social support. Principal component analysis of semantic differential ratings yielded a Compassionate Empathy component correlating with PC within spouse, but not patient, data.
CONCLUSIONS
These partially overlapping potential triggers for spouse and patient PC judgments raise questions about the extent they overlap with clinicians' criteria for PC, since spouses did not link impulsivity with PC. It is also suggested that the initial focus of treatment of PC should focus on partner-agreed changes.
Topics: Humans; Spouses; Judgment; Social Support; Personality; Multiple Sclerosis
PubMed: 35857651
DOI: 10.1080/09602011.2022.2101478 -
International Journal of Language &... Jul 2020Communication is at the heart of relationships, especially for couples. When language is altered, as it is in aphasia, communication in couples can be affected.
BACKGROUND
Communication is at the heart of relationships, especially for couples. When language is altered, as it is in aphasia, communication in couples can be affected.
AIMS
To explore how members of a couple perceive the impact of aphasia on their communication.
METHODS & PROCEDURES
Nine French-speaking couples participated in the study. One member of each couple had chronic stroke-related aphasia, which varied in type and severity. The 18 participants took part in individual semi-structured interviews to understand their perspective on communication within their couple. The interviews were recorded, transcribed and analysed with a qualitative thematic analysis.
OUTCOMES & RESULTS
Three main themes emerged: (1) experiencing limitations in conversation; (2) assuming changed speaking and listening roles; and (3) experiencing new emotions, feelings and reactions in communication. Couples experienced diminished frequency and duration of conversations as well as restrained topics after the onset of aphasia. Ten participants reported that each member's communication role of listener versus speaker had changed, and that the person with aphasia became a less active participant. Communication was described as 'positive' before aphasia and 'fine' to 'difficult' following aphasia. Persons with aphasia and spouses expressed experiencing difficulties managing emotions related to communication. Frustration and caution towards the other member of the couple had been associated with aphasia. In addition, five spouses reported that they refrained from initiating discussions on specific topics in order to maintain a positive relationship with the person with aphasia.
CONCLUSION & IMPLICATIONS
The results describe some of the consequences of aphasia on communication in couples. Clinicians could use interviews to understand the impact of aphasia on a couple's communication. This may help to design communication partner training (CPT) that better aligns with the particular needs of couples living with aphasia, acknowledging the importance of emotional dimensions of relationships. What this paper adds What is already known on the subject The general psychosocial impacts of aphasia on persons with aphasia and spouses are known. Their conversations have been described and used as a focus for CPT. However, CPT may be difficult to implement in clinical settings. What this paper adds to the existing knowledge This paper provides in-depth descriptions of perceived changes in relational or transactional communication by the PWA and their spouse. The frequency, duration and topics of conversations changed and emotions such as frustration and caution appeared. Participants assumed changed speaking and listening roles. What are the potential or actual clinical implications of this work? The participants' description of communication could be used by speech-language pathologists when conducting CPT to illustrate how aphasia affects communication in couples. Emotions emerging as a result of changes in communication following aphasia should be assessed before CPT and could be a starting point to work on communication. This could support clients' commitment in CPT.
Topics: Aged; Aged, 80 and over; Aphasia; Female; Humans; Interpersonal Relations; Male; Middle Aged; Qualitative Research; Speech-Language Pathology; Spouses; Stroke
PubMed: 32400928
DOI: 10.1111/1460-6984.12537