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Biomedical subjects

A G Billings

Publications and source records attributed to A G Billings.

At least 19 recordsLinked to original sources

Life stressors and social resources: an integrated assessment approach.

The Life Stressors and Social Resources Inventory (LISRES) is described. The inventory provides an integrated assessment of an individual's life context. It taps both relatively stable and new aspects of life stressors and social resources in eight domains: physical health, home/neighborhood, financial, work, spouse/partner, children, extended family, and friends. The indices were developed on data obtained at two points in time from groups of depressed patients, alcoholic patients, arthritic patients, and healthy adults. The indices are internally consistent, moderately intercorrelated, and relatively stable over time. In addition, they are predictably related to changes in respondents' functioning. Although more developmental work is needed, the LISRES has some potential clinical and research applications and may be helpful in examining the process of stress and coping.

Adaptation, Psychological↗

Psychosocial risk and resistance factors among children with chronic illness, healthy siblings, and healthy controls.

Psychosocial risk and resistance factors within the domains of parental functioning, family stressors, and family resources were examined as predictors of psychological adjustment and physical problems in juvenile rheumatic disease patients (N = 93), their healthy siblings (N = 72), and demographically matched healthy controls (N = 93). Family socioeconomic status and background variables showed few consistent relationships with child functioning. However, a constellation of risk and resistance factors tended to show comparable associations with functioning for patients, siblings, and controls. Higher parental depression and medical symptoms and more family stressors, sibling problems, and burden of illness on the family predicted more problems among the patients. These relationships held when disease duration and severity were controlled. For the siblings, increased parental and patient dysfunction, more family stressors, and less family cohesion and expressiveness were associated with more problems. Although the associations were not as strong, mothers' depression and lack of family cohesion and expressiveness also were related to more adjustment problems among the control children. These findings imply that there may be a general association between certain risk and resistance factors and childhood adaptation.

Child↗

Psychosocial adaptation in juvenile rheumatic disease: a controlled evaluation.

Juvenile rheumatic diseases are serious chronic illnesses potentially capable of disrupting a child's development and functioning. This study examined the psychosocial functioning of 43 children with severe rheumatic disease as compared to that of 52 children with a milder or inactive form of rheumatic disease. Both patient groups also were compared to 93 healthy children from demographically matched families. Data were obtained from parent reports, from physician evaluation, and, for children who were old enough, from self-reports. The severe patient group showed more parent-reported psychological and physical problems than both the mild patient group and the healthy controls. Compared to the mild group, the severe group also missed more days of school due to illness. Older children in the severe group were more likely to miss school due to illness and to participate in fewer social activities with their families and friends than the controls; however, the older children reported comparable mood and functioning in other areas. An expanded model is proposed to examine risk and resistance factors predictive of psychological and social dysfunction among children with severe chronic disease.

Adaptation, Psychological↗

Children of parents with unipolar depression: a controlled 1-year follow-up.

An earlier cross-sectional study indicated that children's health and adjustment is at risk when their parents are depressed. Here, we report the associated longitudinal changes in children and families when parental depression either remits or continues. Comparisons are made among three groups established at a 1-year follow-up: previously depressed parents whose symptoms have remitted (N = 34 remitted parents), previously depressed parents who continue to be depressed (N = 23 nonremitted parents), and sociodemographically matched control families (N = 95). Although remitted parents and their family social environments improved, their children were still functioning more poorly than children of controls. Both the children and the families of nonremitted parents continued to function more poorly than controls. A social-environmental framework indicates that parents' functioning as well as family stressors and resources are concurrently and predictively linked to children's health.

Adolescent↗

Psychosocial functioning of siblings of children with rheumatic disease.

The potential impact of an ill child on other siblings in the family was examined by comparing 72 siblings of children with rheumatic disease with 60 siblings of healthy children from demographically matched families. Psychosomatic, behavioral, emotional, and social problems, as reported by both the parents and the siblings, were investigated. Although siblings of patients with rheumatic disease generally were functioning as well as siblings of healthy children, they reported having more allergies and asthma. A set of vulnerability and protective factors was tested as predictors of sibling functioning. Cohesive and expressive family environments in which mothers and patients with rheumatic disease were functioning adequately promoted better adaptation among the siblings.

Adaptation, Psychological↗

Coping, stress, and social resources among adults with unipolar depression.

We used a stress and coping paradigm to guide the development of indices of coping responses and to explore the roles of stress, social resources, and coping among 424 men and women entering treatment for depression. We also used an expanded concept of multiple domains of life stress to develop several indices of ongoing life strains. Although most prior studies have focused on acute life events, we found that chronic strains were somewhat more strongly and consistently related to the severity of dysfunction. The coping indices generally showed acceptable conceptual and psychometric characteristics and only moderate relationships to respondents' sociodemographic characteristics or to the severity of the stressful event for which coping was sampled. Coping responses directed toward problem solving and affective regulation were associated with less severe dysfunction, whereas emotional-discharge responses, more frequently used by women, were linked to greater dysfunction. Stressors, social resources, and coping were additively predictive of patient's functioning, but coping and social resources did not have stress-attenuation or buffering effects.

Adaptation, Psychological↗

Chronic and nonchronic unipolar depression. The differential role of environmental stressors and resources.

There appear to be strong variations in the association between psychosocial factors and the onset and course of depressive disorders. To explore a possible correlate of such variation, we consider whether the role of social-environmental factors may differ between patients with a recurrence of unipolar depression and a recent history of prior treatment (termed chronic patients), patients with unipolar depression but without a recent prior treatment episode (termed nonchronic patients), and a demographically matched group of nondepressed controls. Both chronic and nonchronic patients experienced more stressors and reported fewer social resources than nondepressed controls, but the two patient groups did not differ on these factors. However, correlational analyses indicated that stressors and social resources were significantly related to functioning among nondepressed controls and nonchronic patients, but not among chronic patients. These findings support the value of specifying subgroups of individuals for whom depression is most strongly related to psychosocial factors.

Adaptation, Psychological↗

Comparisons of children of depressed and nondepressed parents: a social-environmental perspective.

Several lines of evidence indicate that a parent's depression may be a significant health and adaptational risk factor for his or her children. In a controlled comparison, children of 133 depressed parents had significantly more symptoms of emotional, somatic, and behavioral impairment than did children of 135 nondepressed parents. Additional results suggest that the more negative milieu found among families of depressed parents was a mediator of the effects of parental depression. A social-environmental perspective helped to identify aspects of parents' functioning, family stressors, and resources that were related to children's health. Variations in these stressors and resources were strongly related to the probability of disturbance among children of depressed parents.

Adolescent↗

Psychosocial processes of recovery among alcoholics and their families: implications for clinicians and program evaluators.

This paper provides an overview of a program of research that has focused on the role of extratreatment factors in the process of recovery and relapse among treated alcoholic patients and their families. Consistent with a systems perspective, patients who controlled their drinking showed improvements in nondrinking aspects of their functioning and members of their families showed improved adjustment as well. Moreover, the posttreatment functioning of these recovered families was comparable to that of a matched nonalcoholic community group. In contrast, relapsed alcoholics and their family members suffered from multidimensional impairments. Extratreatment factors such as environmental stressors, coping responses, and social resources had as much influence on the recovery process as did patients' treatment experiences. New procedures to assess these extratreatment factors are described and methods by which clinicians and researchers can use the resulting information to improve treatment outcome and the specificity of program evaluations are discussed.

Adaptation, Psychological↗

Social-environmental factors among light and heavy cigarette smokers: a controlled comparison with nonsmokers.

Support for the importance of psychosocial influences on smoking is limited because the evidence is primarily based on intervention studies which deal with self-selected and thus unrepresentative samples of smokers. There have been few comparisons with nonsmokers on these factors. In this study, we examine the role of psychosocial factors among a representative community sample of smokers and nonsmokers. Heavy smokers were distinguished from nonsmokers by only slightly higher levels of environmental stressors, less supportive social resources, and poorer psychological functioning. Light smokers did not differ from nonsmokers on these factors. Although stressors and resources were correlated with psychological functioning across all respondents, such relationships were not significantly stronger for either heavy or light smokers. These results suggest that psychosocial influences may have differential relevance during the different phases of smoking behavior such as initiation, maintenance, and cessation.

Adult↗

Social support and functioning among community and clinical groups: a panel model.

This study examined the relationship between social support and personal functioning in a longitudinal assessment of a representative sample of community men and women. Although there was considerable temporal stability in several indices of support and personal functioning, changes in levels of support during the follow-up period were associated with changes in functioning. These relationships varied according to the individual's gender and the source of support. Family support was more strongly related to functioning among women, while work support was more strongly related to functioning among men. In comparable analyses on patients recovering from alcoholism, levels of support and functioning were more variable over time, and changes in family support were somewhat more strongly related to changes in functioning. The findings are discussed in light of a perspective that considers the role of environmental stressors and resources in adaptation.

Adaptation, Psychological↗

Children of alcoholics during the recovery process: alcoholic and matched control families.

Children of relapsed and recovered alcoholic patients were compared with children from sociodemographically matched control families on a set of indices of emotional and physical status. The children of relapsed alcoholics evidenced more symptoms of emotional disturbance than did the control children. In contrast, the children of recovered alcoholics were functioning as well as the control children. Additional analyses showed that the emotional status of children was related to the emotional, physical, and occupational functioning shown by their alcoholic and their nonalcoholic parent, as well as to family life stressors.

Adolescent↗

The role of coping responses and social resources in attenuating the stress of life events.

The nature of individual coping responses to stressful life events was explored in a representative adult community sample. Two approaches to the classification of coping strategies were operationalized. Using these measures, small but significant gender and contextual differences in coping were identified. Mood and symptom levels were related to coping responses and to quantitative and qualitative measures of social resources. Measures of coping and social resources attenuated the relationship between undesirable life events and personal functioning.

Adaptation, Psychological↗