Life Stress and Depression in University Students: Clinical Illustrations of Recent Research

Abstract

Through the use of case vignettes, this paper demonstrates the clinical relevance of findings from previously reported research conducted at the University of Toronto. These published studies link life stress to depression in university students. Three psychosocial factors—a family history of psychiatric illness, stressful life events, and lack of social support—are found to be significantly related to depressive symptoms. A fourth psychosocial factor, childhood or adolescent loss of a nurturing person, was not significantly related to the occurrence of depression. However, that factor remains an important therapeutic focus for a number of depressed students. In addition, the absence of at least a single confidant and certain life events (recent loss of a significant person, changes in living arrangements or academic situation, and financial problems) were identified as specific risk factors for depression. Although depression experienced by students is often serious enough to warrant professional intervention, only a minority seek professional help. The majority of those who do seek help are women; male students are less likely to associate somatic symptoms with emotional problems and are less willing to seek psychiatric help. The four case studies presented illustrate the clinical relevance of these research findings.     

Case‐Based Research in Family Therapy

Traditionally, case‐based research has not been considered as scientific by many in the field due to the lack of controlled conditions and objectivity. However, case‐study material may be more effective than once believed in educating family therapists. Future implications of the role of case studies in family therapy research are considered, including the manner in which case studies might be designed to be more rigorous so that they can serve as the basis for drawing causal inferences in clinical cases, and at the same time, provide family therapists with useful information to improve their skills. A discussion section highlights the future direction of case‐based research in the family therapy literature and how it may be used as an effective learning tool.     

Sexuality attitudes: the impact of trauma

This study examines the relationship between traumatic events and attitudes toward sexuality. Our results show that suffering trauma is related to more accepting attitudes concerning sexuality. Generally, people who suffer negative events, many of which are traumatic, are more likely to see both pornography and having a homosexual friend or family member as acceptable. Traumatic events that are sex-related or related to other physical assault proved to be most significant in the prediction of sexuality attitudes for women only. The results are specified by gender: Trauma predicts attitudes toward pornography for women but not for men, and traumatic events are associated with attitudes concerning homosexuality for women. These results are discussed in light of the previous research, and suggestions for future research made.     

Sexuality attitudes: The impact of trauma

This study examines the relationship between traumatic events and attitudes toward sexuality. Our results show that suffering trauma is related to more accepting attitudes concerning sexuality. Generally, people who suffer negative events, many of which are traumatic, are more likely to see both pornography and having a homosexual friend or family member as acceptable. Traumatic events that are sex‐related or related to other physical assault proved to be most significant in the prediction of sexuality attitudes for women only. The results are specified by gender: Trauma predicts attitudes toward pornography for women but not for men, and traumatic events are associated with attitudes concerning homosexuality for women. These results are discussed in light of the previous research, and suggestions for future research made.     

RESEARCH IN FAMILY THERAPY: A GRADUATE LEVEL COURSE

Training in family therapy research must move beyond traditional methods courses. This paper describes a five-unit course which (a) reviews the fundamentals of research methodology and grounds the student in the history of psychotherapy research in general; (b) gives an overview of family research through detailed analysis of major review articles; (c) covers instrumentation tools and techniques; (d) critically evaluates key investigations in the field; and (e) examines the challenges of the "new epistemologies" for family therapy research. Learning activities are described for each unit that engage the student in such a way that the learning of research might be enjoyable as well as interesting. The paper may also be employed as a guide for self-study in family therapy research.     

THE ROLE OF TIME FRAME IN THE ASSESSMENT OF FAMILY FUNCTIONING

The purpose of this study was to evaluate how the stated time frame of family questionnaires can influence the individual's report of family events and relationships. Three whole-family assessment procedures were administered to a large sample of intact families under two conditions—when the respondent was asked to describe his/her family "in general" and "during the past week". Major findings indicated that (a) reports of family relationships reflected the same overall evaluation regardless of time frame, (b) the number or degree of positive endorsements was greater on the "in general" than the "past week" format, and (c) the impact of time frame varied greatly as a function of instrument. Explanations and implications of these findings are discussed.     

Two lives in transition: Agency and context for assisted living residents

This research uses data on two “focal case” individuals residing in one residential care/assisted living (RC/AL) facility, collected as part of a larger ethnographic study exploring later-life transitions, including those leading to the moves into housing and care settings. In-depth examination of the 10-year transition histories of these two women highlights the major erosion of autonomy with advancing frailty, illness, and relocation into supportive housing. A second major theme is that an understanding of the contemporary events and challenges for these two individuals is substantially enhanced by nesting them within the temporal context of earlier life events, including personal relationships, social events, and preferences. Individual history, elicited from resident, family, staff and professional views, serves to contextualize current choices and reactions to key events. As researchers, adding this temporal context moves our understanding of their identities well beyond a simplistic snapshot view as “resident” in AL.     

Therapeutic Maps For Therapeutic Mazes: The ‘Time Sphere’ as an Interventive Mapping of Family Movements in Context

In this paper I want to describe the use of a technique which I have termed the ‘Time Sphere’. The combination of a life cycle model with the chronological mapping of closeness–distance has allowed for useful consideration of various relational events not previously explored by the family or therapist. By sharing the information visually with the client family we are able to explore context, family of origin influences and life cycle transitions within an extended family model. Ultimately my hope is to develop this model further as a creative means of exploring how family patterns and relationships are repeated, and how context is ultimately the key to understanding. To preserve confidentiality, my ‘case’ is an amalgam of several real client families.     

Protecting persons in family therapy research: an overview of ethical and regulatory standards

Family therapists are expected to engage in ethical and responsible research, while maintaining rigorous ethical standards and adhering to federal regulations that require protection for research participants. We present a short historical overview of the significant events and ethical controversies leading to the formulation of current regulations in human subject research and review. Federal regulations and guidelines, including issues of informed consent, special populations, and conflict of interest are reviewed. A short list of recommendations to assist family therapists in staying abreast of contemporary research protocol is provided.     

Financial management: Development of scales

This study is a contribution to the development of family resource management scales, specifically financial management scales. Principal axis factor analysis, with varimax rotation, is used to assess underlying relationships in 23 family resource management variables related to time and money resources. Reliability and content, construct, and criterion-related validity of the scales are assessed. Two scales that are reliable and have some degree of validity are developed: frequency of financial problems and frequency of financial management. The scales could be used in future research, teaching, or counseling to organize financial management concepts.Preparation of this research was supported in part by the Illinois Agricultural Experiment Station. Data were collected in conjunction with the cooperative regional research project NC-182, Family Resource Utilization as a Factor in Determining Economic Well-Being of Rural Families. Cooperating states are Arizona, California, Illinois, Indiana, Iowa, Kansas, Michigan, and Minnesota.She received her Ph.D. from the University of Illinois; her current research interests include gender roles, family financial management, and economic well-being.Her current research interests include family financial management and consumer bankruptcy. She received her Ph.D. from the University of Missouri.Her current research interests include the economic well-being of various family forms. She received her Ph.D. from the University of Illinois.She received her Ph.D. from the University of Illinois. Her research interests are economic well-being and quality of life.     

Migration and household/family structure: Puerto Ricans in the United States

"The analyses in this research were intended to demonstrate the advantages of utilizing microdata from [U.S.] census sources for examining migration status and related household and family structures. By asking for the self-identification of ethnic origin, in this case Spanish/Hispanic origin, a census is able to trace not only first generation migrants by different durations of residence, but also later generations. The flexibility afforded by microdata tape files enables [the authors] to further examine multilevel effects of migration and family patterns. In this present example, the widespread nature of family instability among persons of Puerto Rican origin in the New York/New Jersey area has been noted." (summary in FRE, SPA)     

Integrative module-based family therapy: application and training

The field of marriage and family therapy is currently at a crossroads. The challenge for contemporary therapists is how to incorporate the wisdom of previous models with the accountability that comes from evidence-based practice. The Integrative Module-Based Family Therapy treatment model provides a formalized series of steps that clinicians can use in their case planning and implementation. It is based on nine clinically relevant modules for assessment and intervention that are consistent with current best practices and empirically supported treatments. It thus meets the need for a structured family therapy practice and training approach that is respectful of the "art" of family therapy while still adhering to the principles of the "science" of evidence-based treatment.     

Private lives and public programs: an Australian longitudinal study of the elderly

Major late life events, reported in the Dubbo longitudinal study of older Australians, are used to examine the interaction of private lives with public programs. First, the data indicate strong supportive effects of publicly funded income, health, and aged care programs in reducing family burdens from major life changes. In particular, financial crises were rarely mentioned, directly or indirectly, as major threats. Next, the central role of informal social support in these events is demonstrated, first, as in previous studies, family support was responsive to risky events and to aging itself. Also, in new findings, one-third of surviving elderly respondents coped with the burdens of family crises as a substantial proportion of the "major" life changes that occurred over 13 years of the study. Within the security and support provided by the Australian welfare system, and with strong social networks, families with older persons in the Dubbo study manage multiple, major life changes. With rapid population aging, the development of more, and more easily accessible, services for a growing population of older people is a priority. The critical challenge will be to harmoniously grow public financing, private funding, and informal caregiving to deal with the growing burden arising from an aging society.     

Capital Usage in Adverse Situations: Applying Bourdieu’s Theory of Capital to Family Farm Businesses

The paper applies Pierre Bourdieu’s theory of capital to explore how farming family businesses respond to critical changes by using different forms of capital. The paper tells the story of three cases from the United Kingdom (UK): case one lost the entire farm business in the 2001 Foot and Mouth Disease (FMD) crisis; case two the family had to overcome the sudden death of the farmer; and in case three the farmer was diagnosed with a terminal illness. The results indicate that levels of economic capital are adversely affected, whilst social and symbolic capitals are important in assisting family members to cope and continue the business operations. The paper raises questions for future research and provides interesting findings for those involved with family business.     

Cultural and Class Values In Family Process

Based on the sociological research of Kohn (1977), several clinical and theoretical perspectives on the family are criticized for paying insufficient attention to class and cultural distinctions both in constructing normative images of the family and in conceptualizing therapeutic intervention. It is suggested that the "democratic" model of healthy family interaction is, to some degree, class- and culture-specific so that sociologically undifferentiated views of the family are likely to prove ethnocentric. Family therapists are therefore urged to be attentive to sociodynamic as well as psychodynamic factors present within both family and therapeutic interactions.     

A Use of Social Exchange Theory in Family Crisis Intervention*

This paper explores the practical application of social exchange theory in conceptualizing a working hypothesis in family crisis intervention. It is hypothesized that the range of exchange content in a family crisis situation is proportional to the frequency of negative communication. The contention is made that offering specific behavioral exchange equivalents to family members based on need-response patterns allows for resolution of the family conflict. A case example illustrates support for the hypothesis and implications for future empirical research in family crisis studies are noted.     

Clinical family assessment: applying structured measurement procedures in treatment settings*

This article describes the use of a battery of structured family measurement procedures to conduct systematic, comprehensive assessments of families who enter treatment. The measures are derived from family research and include self-report questionnaires and structured observation of family interactions. The assessment is multimodal, and examines the entire family unit, the marital subsystem, the individual family members, and the larger social context affecting a family. Two case examples are presented which demonstrate how the structured assessment data are combined with clinical theory and other information about a family to generate initial hypotheses about the functioning of the family system and likely avenues for therapeutic intervention.     

Utilization of Family Photos and Movies in Family Therapy

This article discusses a technique the authors have designated Family Photo Reconnaisance. They describe the rationale for and process of utilizatizing family photographs and movies in family therapy sessions to evoke past events and memories and to uncover feelings about these occurrences and the people involved in them. Through their utilization, how one has changed over time is vividly seen. Who is missing from the constellation and when they "dropped out of the family orbit becomes obvious as do distorted memories. Family members reexperiencing the past together around their photographs come to better appreciate one another's current feelings and behavior and often are enabled to gain mastery over unresolved conflicts.     

(Ap)parent Boundaries: Parents' Boundary Work at Cultural Events for Families with Children Adopted from China

Abstract

The adoption of children from China by American families represents a rich case study for an expanding sociological literature on boundaries: it brings to life many of our most salient borders and highlights their very permeability. This paper represents one aspect of a larger research project on parents' efforts to bridge perceived ethnocultural boundaries within the China adoptive family. Through ethnographic fieldwork and semistructured, in-depth interviews, I examine parents' interpretations of and participation in Chinese cultural events organized by and for China adoptive families. These events are significant sites for social research on boundaries because they: (1) appear to assume permeable ethnocultural borders; and (2) bring previously incoherent individuals together as a bounded group. Drawing on classic and contemporary theories of ethnic identification and collective identity, I reveal how parents activate existing symbolic and social boundaries and create new symbolic and social boundaries in their efforts to construct community. In particular, I demonstrate how previously incoherent parents cohere as a bounded community by actively distinguishing themselves from “authentic” Chinese/Chinese American referents and the “imagined community” of biological families. Likewise, I reveal how the community's boundaries and cultural events both mask and alienate a growing percentage of the China adoption contingent: African American and Asian American China adoptive parents, lower-middle-class and working-class China adoptive parents, and the adoptive parents of Chinese sons. Through this case-based analysis, I add general theoretical and methodological contributions to the diffuse boundaries literature.