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PubMed1999

The narcissistic scenarios of parenthood.

The authors begin by pointing out that Freud always considered parent-child relations in terms of the child's psychic development and took little account of the parents' experience of the relationship and its psychic effects on them. They recall Freud's distinction between the anaclitic and narcissistic modes of relationship and show how these are unconsciously embodied and enacted in varying proportions in the cases observed in their own clinical practice of therapeutic consultations with parents and young children. After a review of the relevant psychoanalytic literature, the authors present their concept of the narcissistic scenarios of parenthood, which include parental projection on to the child, parental counter-identification, a specific aim and a relational dynamic that is acted out. Depending on the individual situation, the effects may help to structure the developing psyche or, if the narcissistic element is excessive, they may be pathological. The authors consider the literature on the application of psychoanalysis to therapeutic interventions with parents and children, stressing the technical importance of establishing a therapeutic focus. These ideas are illustrated by a detailed case history showing the interaction between a mother and a 4-year-old girl and how it was modified by a short therapy. The differences between interpretation in this situation and in the classical psychoanalytic setting are explained, and the paper ends with some comments on the transmission of psychic elements from generation to generation.

Adult↗

PubMed1996

Risk factors associated with negative interactions between family caregivers and elderly care-receivers.

This article reports the findings from a study of factors related to negative interactions between elderly care-receivers, recently discharged from a hospital stay, and their family caregivers. Negative interactions are measured as over conflicts between the caregiver and care-receiver, and reported levels of upset with the caregiver. Respondents were forty-one patients aged fifty-six to ninety years. Feeling like a "thing" more than a "person" was significantly associated with higher levels of conflict, and the availability of a confidante was significantly associated with lower levels of conflict. With respect to upset ratings, more psychological distress and feeling like a "thing" were associated with more upset, and adequate social support, as well as the availability of a confidante were associated with lower upset ratings.

Aged↗

PubMed2006

An investigation of potential Holocaust-related secondary traumatization in the third generation.

This study investigated whether grandchildren of Holocaust survivors placed in concentration camps were more prone to PTSD symptoms than grandchildren of Jewish non-immigrants (native-born) and grandchildren of Non-Jewish immigrants. It has been well established that PTSD symptoms can be transmitted from Holocaust survivor parents to their children. Previous research has not yet established whether an identical transmission of PTSD symptoms can occur from the second generation to the third. The measures employed in conducting this study were the Secondary Trauma Scale (STS), the Impact of Events Scale-Revised (IES-R), the State-Trait Anxiety Inventory (Form Y) (STAI), and a Modified Stroop Procedure which was comprised of colored Holocaust trauma-related words, positive words, neutral words and obsessive compulsive disorder words. Results indicate that all three groups exhibited longer response latency for the PTSD Holocaust-related stimuli card thereby indicating an increased sensitivity across all populations regardless of race or religion. The grandchildren of Holocaust survivors and the grandchildren of Non-Jewish immigrants scored significantly higher than the grandchildren of Jewish Americans on the Secondary Trauma Scale as well as the Avoidance subscale of the IES-R. This finding suggests a possible immigration effect for these groups. There were no other significant differences across the other measures employed in this study. These conclusions can be construed as persuasive evidence that, with respect to Holocaust-induced secondary trauma, the residual impact is diminished to such an extent by the third generation that the differences between grandchildren of Holocaust survivors and the overall population are statistically non-significant.

Adolescent↗

PubMed2001

Older people and AIDS: quantitative evidence of the impact in Thailand.

Discussions of the AIDS epidemic rarely consider the impact on older people except as infected persons. Virtually no systematic quantitative assessments exist of the involvement of parents or other older generation relatives in the living and caretaking arrangements of persons with AIDS in either the West or the developing world. We assess the extent of such types of involvement in Thailand, a country where substantial proportions of elderly parents depend on adult children for support and where co-residence with an adult child is common. Interviews with local key informants in the public health system in rural and urban communities provided quantitative information on a total of 963 adult cases who either had died of AIDS or were currently symptomatic. The results indicate that a substantial proportion of persons with AIDS move back to their communities of origin at some stage of the illness. Two-thirds of the adults who died of an AIDS-related disease either lived with or adjacent to a parent by the terminal stage of illness and a parent, usually the mother, acted as a main caregiver for about half. For 70%, either a parent or other older generation relative provided at least some care. The vast majority of the parents were aged 50 or more and many were aged 60 or older. This extent of older generation involvement appears to be far greater than in Western countries such as the US. We interpret the difference as reflecting the contrasting epidemiological and socio-cultural situations in Thailand and the West. The fact that older people in Thailand, and probably many other developing countries, are extensively impacted by the AIDS epidemic through their involvement with their infected adult children has important implications for public health programs that address caretaker education and social and economic support.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Transgenerational persistence of education as a health risk: findings from the Women Physicians' Health Study.

OBJECTIVE: Whereas the effect of socioeconomic status (SES) on morbidity and mortality is well known, little is known about its transgenerational persistence. METHODS: We studied SES and health data from the U.S. Women Physicians' Health Study (WPHS). WPHS studied 4,501 women physicians, a group with relatively homogeneously high income, occupational prestige, and educational attainment. RESULTS: In logistic regression models controlling for age and ethnicity, those with better educated mothers ate more fruits and vegetables and were less likely to have a gun in their home; those with better educated fathers were more likely to have a regular physician. There was no significant difference by parents' educational levels in exercise habits, fat consumption, compliance with prevention recommendations, current health status, or history of smoking, hypertension, or dyslipidemia. CONCLUSIONS: Parents' (especially mothers') educational levels affect their adult children's health habits and outcomes, even if those adult children are physicians. However, at least among physicians, this differential is small after only one generation of improved SES.

Adult↗

PubMed1995

Marital status of caregiving daughters and co-residence with dependent parents.

The role of caregiving daughters' marital status is examined as it relates to their sharing households with disabled elderly parents. Married daughters fared best in well-being, income, and social support. Never-married women were the most likely to have never moved out of the parental home. Separated/divorced caregivers, more than the married and widowed, had moved into the parent's home rather than the reverse and widowed daughters had lived in re-formed joint households longest. The main reason for re-forming shared households was disability of the parent. Among other reasons were death or withdrawal of previous caregiver and financial problems, with separated/divorced daughters the most likely to mention finances.

Adaptation, Psychological↗

PubMed1998

Perceived self-efficacy and grandparenting.

OBJECTIVES: This study identifies grandparents who feel efficacious in their role and the consequences of such beliefs for actual involvement with an adolescent grandchild. METHODS: The sample of 883 grandparents comes from two related studies of rural families, the Iowa Youth and Families Project and the Iowa Single Parent Project. Our research questions are answered by testing a series of bivariate and multivariate regression models. RESULTS: Results show much variability in perceptions of being able to influence one's grandchild. Church attendance, knowledge of one's own grandparents, a farm history, a strong grandparent-parent bond, proximity, and having fewer grandchildren emerged as significant predictors of grandparents' perceptions of efficacy. Grandparents with strong self-efficacious beliefs play an active role in the lives of their grandchildren. DISCUSSION: With an increasing number of grandparents taking responsibilities for their grandchildren, a greater understanding of the experiences and resources that enhance their sense of personal efficacy in this role warrants priority in generational studies.

Adolescent↗

PubMedDate not supplied

The "traditional" American family: implications for marketing.

The American family has undergone a major transition over the past several decades. While the relative importance of married couples predominates, there has been a steady increase in the proportion of adults who are divorced, and widowhood continues to increase in line with the evergrowing aged U.S. population. Among the changes in the family structure are a declining role for two-parent families with children more single-parent households and an increasing role for grandparents in many family situations. Within the two-parent family there are changes as well with more working mothers, an increase in women householders and, in some cases, more involvement in the child-rearing process on the part of the male parent. The traditional two-parent family, nevertheless, retains considerable economic clout, benefiting from two working marriage partners.

Adolescent↗

PubMed1995

A review of the historical and social processes contributing to care and caregiving in Chinese families.

The purpose of this paper is to review the literature on caring and caregiving in Chinese families in relation to the contribution made by historical and social processes. The beliefs and traditions of care appearing in the professional and popular literature are explored to enable comparison with recent research from Hong Kong, China and the United Kingdom. Caring emerges as profoundly complicated and ambivalent, drawing on notions of morality, obligation, love, kinship and gender responsibility. Furthermore, caring in contemporary Chinese families in Hong Kong appears to have more similarities than differences with western families, possibly due to changing kinship networks. Such conclusions have particular relevance for nursing in the light of recent policy directives in Hong Kong promoting the role of the families in caring for their dependent members based on the assumption that families can and will care.

Aged↗

PubMed1994

Cultural transmission of a sign language when deafness is caused by recessive alleles at two independent loci.

Two unlinked autosomal loci are assumed to affect the ability to hear in such a way that homozygosity for the recessive allele at either locus causes deafness. The five deaf genotypes are subject to the same negative selection due to a lower likelihood of marriage, but unmarried deaf persons remain socially active and participate in the cultural transmission of sign languages. Marriages are assortative for deafness or for hearing, and mutation occurs irreversibly from the dominant to recessive allele at each locus at the same rate. At mutation-selection balance, the fully polymorphic equilibrium is symmetrical. Based on this genetic model, we consider the relative importance of various forms of cultural transmission as they affect the persistence of sign languages. Horizontal transmission is shown to be effective when deaf children are able to interact with many peers. This observation is especially pertinent if assortative meeting of deaf children occurs, for example, at schools for the deaf. Oblique transmission can also be effective, but the literature suggests that this kind of transmission plays only a minor role. It is necessary, however, that some form of cultural transmission occur between generations. Thus, vertical transmission is a critical factor, despite the fact that parent-child transmission is often interrupted due to the recessive inheritance of deafness. In particular, the contribution of vertical transmission is enhanced by assortative mating for deafness.

Child Development↗

PubMed1995

Sleep in Korea: a developmental perspective.

Sleep is an ubiquitous phenomenon. It is a developmental product, being subjected to the vicissitudes of human behavior and culture. The author will attempt to elaborate on sleep, sleep disorders, and sleep medicine in Korea from various developmental perspectives (i.e. personal, national and scientific). Korea is a rapidly developing industrialized nation and is now experiencing immense cultural changes which force individuals to change their behavior and value systems. For example, shift working is becoming increasingly popular and early working hours are being adopted by more companies as a measure to win competitions in the international market. In the clinical setting it is observed very easily that patients develop and maintain disturbed sleep-wake rhythm and its consequences. More obstructive sleep apnea, presumably due to obesity, are observed and studied in sleep clinics. The nuclear family system, an inevitable outcome of industrialization, produces some profound difference in sleeping arrangement such as children's earlier separation from parental or grandparental sleeping environment. The question is how these and other industrialization-related changes may affect the incidence and the manifestation of sleep and sleep disorders. In the background there is emerging interest in healthy sleep and sleep disorders, exemplified by increasing coverage of the topics in the mass media and the publication business. Development of sleep medicine/research per se also involves a developmental perspective. Interests in sleep and sleep disorders began sporadically decades ago in Korea and are now actively being organized mainly by the Korean Association of Sleep Medicine and Psychophysiology as a unified developing force. Understanding of sleep and of sleep disorders is not complete without in-depth understanding of culture, philosophy, and tradition from developmental perspectives. Traditional ideas and wisdom from the past are the unavoidable resources for further understanding sleep and developing sleep researches/medicine in Korea as well as in Asia.

Health Knowledge, Attitudes, Practice↗

PubMed2004

Assessing health-related quality of life among older people in rural Bangladesh.

The purpose of this study was to review instruments of health-related quality of life (HRQoL) to identify an instrument appropriate for elderly people in rural Bangladesh. In addition, it hypothesizes that it is important to include physical, psychological, social, spiritual, economic, and environmental dimensions when assessing HRQoL in this group. Sixteen generic instruments found through PubMed were reviewed with regard to content and construct. None of the reviewed instruments fully met the criteria required in the intended context. In-depth interviews were conducted with 11 elderly people in rural Bangladesh to explore the dimensions of HRQoL they considered important. Content analysis of the interview transcripts supported the hypothesis that all six dimensions were important. Suggestions for a new HRQoL instrument appropriate for elderly people in rural Bangladesh are presented.

Activities of Daily Living↗

PubMed2004

Tending and befriending: the intertwined relationships of quilters.

Using the convoy model of social relations, we explored the contributions of quilting activities to the relationships of middle- and older-aged women in three distinct groups: Amish, Appalachian, and Latter Day Saints. Semi-structured interviews were conducted with ten women from each group and analyzed qualitatively using McCracken's five-step method for analysis of long interviews. We found that these women had considerable horizontal and vertical connections to others. Specifically, they exhibited generativity by teaching their skills to others, building bonds with grandchildren through quilting, and leaving legacies through their quilts. Many developed friendships with other quilters that provided social support to deal with life challenges. Additional study of the contributions of mid-late life women's leisure activities to their social milieu, personal development, and well-being is needed.

Adult↗

PubMed2003

Ifs, maybes and butts: factors influencing staff enforcement of pupil smoking restrictions.

Levels of pupil smoking are reported to be associated with the extent to which school staff consistently enforce smoking restrictions. Little is known, however, about factors which might motivate or discourage staff from doing so. Following analysis of interviews conducted with 27 members of school personnel purposively selected from two Scottish secondary schools serving relatively deprived communities, this paper identifies various issues that hinder staff intervention when confronted with pupil smoking. Both schools had no-smoking policies. In each, staff assumed or understood that smoking within the buildings was forbidden, yet were unsure about how far the bans extended. While the risk of fire in the school buildings prompted staff to intervene when smoking was witnessed indoors, where this risk was absent, decisions were largely context dependent or motivated by personal and professional values. Concerns about staff-pupil relationships, attention to pupils' wider welfare, lack of authority and staff levels of discomfort were salient issues inhibiting intervention. Implications for smoking policies and their enforcement are discussed. The concept of the Health Promoting School is considered in the light of the findings and inherent tensions highlighted.

Adolescent↗

PubMed1999

The changing moral economy of ancestor worship in a Chinese emigrant district.

This paper describes the reciprocal influences between Anxi County Fujianese, whose families and clans have migrated to Singapore, and their ancestral villages in Fujian, China. The Singaporeans bring wealth and cultural capital to their poor relations in rural China. Their participation is crucial for local socioeconomic development. Besides bringing material support and globalizing values and lifestyles, they also reinvigorate and transform the local religious tradition. They, in turn, reaffirm and even remake their own ethnic and regional identity. The complex outcome illustrates the fact that China's social change under economic reforms and global influence is, in its huge rural core, not merely a matter of infrastructural, market, and social welfare improvements, but involves exchange and transformation in meanings of rituals and experiences. We can see that kinship and religion are not unchanging aspects of the cultural tradition that are separate from programs of modernity. Indeed, modernity and tradition appear to be inseparable, and they may reveal that the recipe for effective community projects requires a vital tie between cultural, social, and interpersonal processes.

Attitude↗

PubMed1994

Filial piety, authoritarian moralism, and cognitive conservatism in Chinese societies.

In the present study, I examined the role of Confucian filial piety in relation to parental attitudes, the function of personality, and social cognition, using data assembled from 11 samples of adults and students in Hong Kong and Taiwan. Results showed that (a) filial attitudes tend to be moderately associated with parental attitudes and child training that emphasize obedience and indebtedness to one's parents, impulse control, and proper conduct; (b) people endorsing traditional filial and/or child-training attitudes tend to be poorer in verbal fluency, to adopt a passive, uncritical, and uncreative orientation toward learning, to hold fatalistic, superstitious, and stereotypic beliefs, and to be authoritarian, dogmatic, and conformist; and (c) parents' attitudes rooted in filial piety tend to result in high rigidity and low cognitive complexity in their children. The results support the contention that filial piety underlies both authoritarian moralism and cognitive conservatism.

Adolescent↗

PubMed2002

Observing mother-child relationships across generations: boundary patterns, attachment, and the transmission of caregiving.

Grounded in both attachment and family systems theories, this study is one of the first to examine how relationship patterns observed in mothers' current relationships with their own mothers are recreated in their relationships with their infants. Mostly white, middle-class families (N = 55), including maternal grandmothers, mothers, and infants, were observed when infants were 6, 9, and 18 months old. At 6 months, mothers and grandmothers completed self-report assessments and worked together on discussion tasks. These interactions were coded using the Boundary Assessment Coding System, developed for the present study, which assessed three relational patterns: disengagement, balance, and entanglement. At 9 months, mothers were rated on sensitivity and intrusiveness while playing with and feeding their infants; and, at 18 months, infant-mother attachment was assessed using the Strange Situation. Multiple regression analyses revealed, as predicted, that mothers who remembered being accepted by their mothers as children and who were in highly balanced relationships with their own mothers currently were more sensitive and less intrusive with their 9-month-old infants. Further, discriminant function analyses indicated that memories of acceptance, high levels of balance, and low levels of disengagement differentiated secure from insecure attachment, whereas memories of overprotection and high levels of entanglement distinguished resistant from secure and avoidant attachment. Discussion focuses on the theoretical hypothesis that mothers internalize relationship strategies experienced with their own caregivers and recreate these patterns with their infants.

Adult↗

PubMed2002

Naturally occurring mentoring in Japan and the United States: social roles and correlates.

Although the word "mentor"has traditionally been used to describe a relationship between an older adult and a younger person, recent work has extended its usage to relationships with peers and groups rather than with individuals and uncoupled the instrumental and affective qualities of the role. This paper examines (a) the extent to which adolescents' relationships with significant others in different social roles are characterized by mentoring and (b) the extent to which mentoring and other relationship functions covary. Adolescents' naturally occurring social relationships are explored in two very different contexts-Japan and the United States-that differ in the norms and patterning of social interactions. College students (N = 365) used questionnaires to describe the extent to which relations with significant others were characterized by mentoring. Results indicate striking similarity in the patterning of results in the two countries and support the traditional view of mentoring. Mentoring is most likely to occur in relationships with adults (especially parents), rather than with peers, and with same-gender, rather than other-gender associates. Mentoring by parents appears to covary with other aspects of positive relationships, but be more independent in relationships with unrelated adults or peers. Although more of the variability in experienced mentoring is attributed to differences between associates than to differences between adolescents in both the United States and Japan, this is especially true of the United States. Results suggest that although "classic" mentoring is most common in both countries, mentoring is somewhat less constrained by social role differences in Japan than is in the United States.

Adolescent↗