Thursday, August 9, 2007

Today's our final day! Good luck to everyone on the final and on your further endeavors at UW-Madison and beyond!

I am pleased to announce that the online encyclopedia created by our class is now available for viewing.

Wednesday, August 8, 2007

Today's our last day of regular class, before Thursday's final exam. Mainly, we will review for the exam and do some administrative things (e.g., course evaluations). Here are a couple of topics that we didn't get to cover formally during the class (and won't be on the exam), but are still worth discussing briefly.

(1) Public policies and laws can be formulated to help families alleviate stress. Examples include the federal Family and Medical Leave Act to allow parents to spend time with newborn or sick children. Another example is the New Jersey state law requiring screening of pregnant women and new mothers for postpartum depression. These are discussed in our class encyclopedia, which still has a little way to go before all of the entries are posted on the web.

I teach a graduate course at Texas Tech called "Family Law and Public Policy." If you'd be interesting in checking out the resources there, here is the link.

Also, right here in HDFS at UW-Madison, Prof. Karen Bogenschneider is one of the nation's leading experts on family policy. The website for her Family Impact Seminars, which she provides to policymakers, is available here.

(2) The other topic is what Harvard political scientist Robert Putnam (and others) call "social capital." The idea is that by getting to know one's neighbors and getting involved in the community, quality of life can be improved (e.g., people looking out for each other's houses). The website associated with Putnam's book Bowling Alone, which deals with the decline of social capital in the U.S. in recent decades, is available here.

Monday, August 6, 2007

Tuesday, for our final substantive topic before Wednesday's review session and Thursday's final exam, will we look at how stress may lead to physical illness. Here is an overall conceptual model I created, which you can click on to enlarge (I can really get going with clip art!). The studies we look at will feature variations on this basic model, tailored to the health phenomena being studied.


Specifically, we will look at...

Stress and the immune system (Cohen & Williamson, 1991, from Cohen's lab page)

Stress/depression and cardiovascular disease (from here)

Stress/anxiety and pregnancy (from research by one of my faculty mentors when I was an undergraduate at UCLA, Christine Dunkel-Schetter)

During some earlier units, when we were talking about racism, I mentioned how there had been a lot of recent research on racism as a stressor, and its health consequences. Here's an article I found from the Boston Globe. It mentions both major pathways from stress to disease, physiological and behavioral. It also talks about how researchers have used the “controlled conditions of the laboratory.”

Finally, several general sources on stress, hormones, and disease progression are available from the Wikipedia, Society for Neuroscience, News Target, Medical News Today, and the Mayo Clinic.

Sunday, August 5, 2007

On Monday, students will be e-mailing me their entries for our class's online encyclopedia project, which I will be posting on the web in the coming days. For the first half of class, each student will say a few words about his or her write-up.

Just as a miscellaneous item, today's (Sunday) Wisconsin State Journal has an article entitled "Grandparents Get the Kids." The article discusses the stress and coping aspects of being the primary caregiver for one's grandchild, particularly in situations where the child has special needs.

The last hour or so of class, we will have our discussion of Chapter 4, pertaining to coping with death and dying, plus pp. 60-64 of Chapter 3, on caregiving. As the questions from Group C come in, I will post them below...

Do you think losing a parent or caregiver at different stages in your life would be more stressful (i.e. losing a parent/caregiver during childhood versus losing a parent/caregiver during adolescence or emerging adulthood, etc.)? How could this impact different age groups’ lives?

It may be more difficult for a child who does not understand death to deal with a loss. They are perhaps too young to understand it -- however, do you think some sort of "death/grief education" is important at a young age so as to structure better coping and beliefs in young/emerging adulthood? Who is in the best position to "provide" such education to the young?

I believe that everyone has their own relationship with the idea of death, that forms from a young age -- from one's own experiences (or lack thereof) with death. Do you think that a single incident of death is able to completely change one's entire relationship with death? Why or why not?

Families in the United States deal with conflicting notions of death: Death is invisible and privatized versus death is shoved in our face by media. What factors contributed to the construct of these two concepts and what affect do they have on families? (p.77-78).

In the book, it talks about many reports on the deaths of famous people and how those tragedies leave viewers with illusions of intimacy and grieving. It says that, "Individuals who did not personally know the deceased can go through rituals of mourning…" (p. 77). So, how does this virtual grief differ from the actual grief? And how do these two affect people differently?

With the desensitization of death, illness, and violence in the media, how is it possible that death is still a taboo subject in Western culture?

Wednesday, August 1, 2007

The first part of Thursday's class will introduce the subject matter on aging, family caregiving, death and dying. During the second half, UW-Madison HDFS Department Chair and Professor Linda Roberts will speak regarding some of her research. Dr. Roberts is a longtime friend and colleague of mine, going back to the early 1990s when we were both working on alcohol studies at the Research Institute on Addictions, in Buffalo, NY.

The following article presents an excellent overview of many relevant issues:

Haley, W.E., Allen, R.S., Reynolds, S., Chen, H., Burton, A., & Gallagher-Thompson, D. (2002). Family issues in end-of-life decision making and end-of-life care. American Behavioral Scientist, 46, 284-298.

The article begins with the statement that, “Family members are involved in every aspect of end-of-life decision making and care,” and goes on to discuss several areas. Two areas I want to examine are caregiving and end-of-life decision-making. Here are some excerpts from the article:

ON CAREGIVING

Families have been found to provide the majority of care for individuals with chronic illness.

…projects [focusing on care of patients with either cancer or dementia] found rates of psychological distress in caregivers to be two to three times higher than those in general community populations regardless of the nature of the illness for which care was being provided

Although providing extensive caregiving is certainly more stressful than providing occasional caregiving, studies of primary caregivers of patients with dementia and cancer generally find that objective measures of the amount of care provided do not explain much of the variability in caregiver distress…

…despite the large number of studies on caregiving and its associated stresses, it should be noted that very little of the research literature to date has focused on caregiving near the end of life.

ON END-OF-LIFE DECISION-MAKING

Concerning end-of-life decisions… individuals may make formal advance directives, specifying their wishes for end-of-life care and/or designating someone (usually a family member) as their surrogate decision maker in the event that they are incapacitated. Even with a formal advance directive, it is necessary for family members to be aware of this document and insist that it is implemented when patients face a health crisis.

Family members are often key decision makers regardless of patients' prior preferences concerning end-of-life care... Dying patients may even prefer that family members make final decisions. Terry and colleagues (1999) found that a majority (54%) of terminally ill patients would select their surrogate's treatment decision rather than the treatment outlined in their own advance directive.

Family members are often asked by health care professionals to propose a decision that is based on what they believe the patient would have wanted. A growing body of research, however, shows that surrogate preferences can be an inaccurate reflection of the patient's actual treatment wishes…. Specifically, familial surrogates tend to overestimate the frequency with which patients would like to receive aggressive or invasive treatment near the end of life…

This separate PowerPoint slide show by Haley has a lot of background on caregiving, and death and dying (see slide 29, in particular). Much of the rest of the slideshow pertains to interventions to help caregivers.

The Wikipedia has some informative pages on advance directives and hospice/palliative care.

On the topic of bereavement, two useful resources are the University of Michigan’s Changing Lives of Older Couples (CLOC) study, and the stage-theory study we discussed earlier (Maciejewski and colleagues, “An empirical examination of the stage theory of grief”, for which there’s a link in the bibliography section below).

Tuesday, July 31, 2007

Tomorrow, we will take up finances and poverty as sources of family stress.

One thing we'll go over is this article about spouses' materialism and marital quality (the article mentions the research contributions of a Texas Tech graduate student whom I know) . The finding of this research, which supports the role of perception/appraisal as in the ABC-X model, is that attitudes toward money and material goods are important, not just the actual amount of money a couple has.

Another article that offers some "food for thought" is this one about Oregon governor Ted Kulongoski. In his effort to draw attention to hunger in his state and beyond, the governor earlier this year spent a week on a $21 food budget (the average weekly food-stamp allocation in his state).

While we were discussing the Kulongoski story, I was reminded of the study of Chicago “Food Deserts” (areas with no nearby supermarkets, but plentiful fast food places) and the apparent health implications of these geographic factors.

The second part of the class will be devoted to a discussion of the readings on work-family balance and economic stress. In particular, the section in Chapter 9 from the bottom of page 209 to the top of 211 seems to fit well with a systems-theory approach. The questions, from Group B, will be posted as they come in...

This chapter talks about how economic stress can impact the function of families. On page 211 the author lists several resources that buffer ethnic minority groups against economic stress. Drawing from our discussion about generational dissonance, how might that affect a family's ability to handle economic stress? Are there any buffers against generational dissonance?

The book says that although minorities have an economic disadvantage, "ethnic minorities also have resources, such as particular family structures, family dynamics, value systems, and child rearing practices, that traditionally have served as buffers against economic stress" (Bartholomae & Fox, p.211). Although this may be true, do you feel that there is a great advantage when minorities are surrounded by other minorities who also experience economic disadvantage? Or would it be beneficial if minorities are by others who have good income earnings and don't live in poverty?

Pertaining to how the living arrangements of low-income people are geographically distributed, we discussed the demolition of the Cabrini-Green housing project in Chicago and the attempts to provide vouchers to outgoing residents so they could live in new dwellings, many of which are fancy units near the old site. Here are some relevant articles, from CBS News, the New York Times, Chicago Business, Northwestern University, and UW-Eau Claire (some of these reports are several years old).

In Chp 9, in the section of Ethnic Minority pg 211, the book talks about "how compared to whites, members of ethnic minority groups have lower income earnings and greater rates of poverty, placing them at a distinct economic disadvantage. However, ethnic minority groups also have specific resources that traditionally have served as buffers against economic stress" Explain in further detail these types of resources for particular family structures that are different than non-ethnic minority groups and how they can serve as "buffers" against economic stress...Any disadvantages to these resources?

According to the book, ethnic minority groups earn less on average than whites. Yesterday, we learned that indeed, racism, plays a part in how employers select their employees. How can this discrepancy be remedied? Do you think that racially considerate policies like affirmative action place more expectations on ethnic minority employees (like the example with working mothers)? How does the chronic stress that occurs due to racism compare to the stress derived from economic hardship?

"Children who experience economic stress have been found to exhibit greater levels of depression and aggression, more impulsive and antisocial behaviors, decreased levels of self-esteem, and diminished school performance" (p. 212). What can parents do to help prevent the family's economic stress from negatively affecting their children?

Sybil has already submitted several comments relating to work, family, and financial planning, which we can use for discussion.

Also, given that Social Security came up during our class discussion, this document provides some long-term estimates of what the program will be able to pay out in the coming decades, even if no changes are made to existing law. Another good overview of the situation is available here.

Monday, July 30, 2007

Our topic for Tuesday is the stress -- but also personal growth -- that may result from trying to balance work and family (sometimes also called work-life balance, considering that some people have not started their own families). Our readings include an online paper by Kossek (available in the links section on the right) and pages 367-370 from the textbook. These readings highlight several key issues in the study of work-family-life:

*The work-family interface is usually discussed in terms of "conflict," given that the number of hours in the day is limited and time spent in one domain seemingly cannot be spent in the other. However, there is also a line of argument that one domain can enrich the other, for example, if satisfaction from the job makes one more pleasant at home.

*The types of stress typically studied both in the workplace and at home are interpersonal conflict (e.g., arguments) and overload (e.g., having a lot of tasks to get done).

*Work-family balance has been studied in both directions -- how what happened at work affects the family, and how what goes on in the family may carry over to work.

*Researchers study both within-person effects (how a person's day at work affects the same person at home, or vice versa) and crossover from one person to another. Examples of the latter include how one parent's experience at work during the day affects his or her interactions at home with the spouse or children.

*Many research findings differ according to the gender and social class of the individuals involved.

*Individuals' psychological/personality traits also appear to play a role in moderating the impact of stressors. In other words, having a certain trait (e.g., a sense of mastery or control) may dampen or buffer the connection between a stressful event and one's distress level, whereas other traits (e.g., neuroticism) may exacerbate the connection.

*Modern issues of technology (e.g., telecommuting) and globalization will likely have implications for work and family roles.

Here are a couple of other interesting lines of research:

Kathleen Fuegen, who studied with one of my Michigan grad school classmates, University of Kansas professor Monica Biernat, found evidence in a laboratory experiment suggesting that mothers face discrimination in the workplace.

Here are two additional links to augment the information on the Fuegen and Biernat research. This is a summary of a similar type of study -- using identical resumes -- but where the names of job applicants were designed to be either European-American or African-American sounding. Also, this page from my Texas Tech research methods site explains the logic of the experimental method for demonstrating causality.

A faculty colleague of mine at Texas Tech, Anisa Zvonkovic, studies a particular form of work-family balance, namely the lives of people who spend long amounts of time away from home, such as flight attendants and individuals who work in commercial fishing. She is now launching a new project to expand this research.

***

A topic that came up today in our discussion of mental health and that would also appear to have implications for work-family balance is the increase in recent decades of college women's adoption of stereotypically "masculine" traits. This research has been done by Jean Twenge of San Diego State University, and is summarized in her book Generation Me.

What Dr. Twenge did was locate as many studies, published between the 1970s and 1990s, as she could find that reported male and female means on measures of gender roles (masculinity and femininity). To keep things as consistent as possible, so that era was the only thing differing between the studies, she included only studies that used the most prominent measures of gender roles and only those that studied college students. She found 103 samples, which cumulatively consisted of 28,920 students. This excerpt from her book describes the results of her cross-temporal comparison:

The "masculine" scale items included words like competitive, independent, never give up easily, self-reliant, forceful, and ambitious. Sure enough, college women endorsed these traits at a higher rate with every passing year. More than 50% of 1990s women scored as "masculine" on the scale, compared to only 20% of early 1970s women... The change was so large that by the early 1990s men's and women's scores on the scale of so-called masculine traits were indistinguishable (p. 193).