Correlates of depression in self-neglecting older adults: A cross-sectional study examining the role of alcohol abuse and pain in increasing vulnerability

ABSTRACT

Self-neglect among older adults results in increased morbidity and mortality rates. Depression is strongly linked to self-neglect and when untreated, severely complicates management of health and functional outcomes. The study aims to identify factors correlated with depression to inform approaches to service recruitment and retention that improve long-term outcomes. The sample included urban community-dwelling older adults (n = 96) 65 years of age and older with Adult Protective Services-substantiated self-neglect. All participants completed a range of validated cognitive, functional, and self-report demographic and clinical measures around health and mental health functioning. A secondary data analysis using multivariable logistic regression revealed that a positive screen for alcohol abuse, low self-rated health, and higher self-reported pain were associated with significantly higher odds of self-reported depression. Further research is needed to understand the temporality between these correlates and depression and to inform prevention and intervention practices for self-neglecting older adults.     

Conceptual Model and Map of Psychological Abuse of Older Adults

Psychological abuse of older adults is a hidden and pervasive problem that is not well conceptualized nor well measured. Goals. The goals were to (a) conceptualize psychological abuse using three-dimensional concept maps, and (b) develop theoretical models. Methods. Statements describing the construct were generated by local and national panels. These were sorted and rated using Concept Systems software whereby the concepts were depicted as a map. Results. The concept maps guided development of theoretical hierarchies. Significance. Theoretical models may help to develop measures to estimate prevalence better and may enable more precise screening for triage into appropriate interventions.     

Ethnosemiotics: Some personal and theoretical reflections

The question of how individual memory fits, or more accurately, does not fit with history is at the heart of this paper on Maryse Condé’s novel Heremakhonon about Veronica Mercier, a character who was born in Guadeloupe, lived in Paris and travels to West Africa in search of an ancestry that was interrupted by slavery. Suggesting that readings that focus on Mercier as a character are limited in approach, it reads the novel as a staging of time and is attentive to the gaps between thought and speech, between memory and history, between Guadeloupe and Africa, and between women’s personal sexual pleasure and the impersonal reproductive body that interrupt the narrative. The central character’s personal quest for her African roots – for ‘niggers with ancestors’, for Africa as a singular lost object, which necessarily involves ignoring the subaltern – is nuanced by the novel’s deployment of heterogeneous time.     

Goal-Directed Supervision of Social Work Students in Field Placement

Abstract

Permanency Planning for Children , by Anthony N. Maluccio, Edith Fein, and Kathleen A. Olmstead. London: Tavistock Publications, 1986. Reviewed by Donald Brieland

Feminist Visions for Social Work , edited by Nancy Van Den Bergh and Lynn B. Cooper. Silver Spring, MD: National Association of Social Workers, 1986. Reviewed by Cleo S. Berkum, DSW

People and Contexts: Social Development from Birth to Old Age , by Henry S. Maas. Englewood Cliffs, NJ: Prentice-Hall, Inc. 1984. Reviewed by Harris Chaiklin

Case Management in Human Service Practice by Marie Weil, James M. Karls, and Associates. San Francisco: Jossey-Bass Publishers, 1985. Reviewed by Doman Lum

Law and the Mental Health System: Civil and Criminal Aspects , by Ralph Reisner. St. Paul, MN: West Publishing Co., 1985. Reviewed by Wynne Sandra Korr

Testing the Social Safety Net , by Martha R. Burt and Karen J. Pittman. Washington, DC: The Urban Institute, 1985. Reviewed by Julia M. Watkins     

Using E-Health Programs to Overcome Barriers to the Effective Treatment of Mental Health and Addiction Problems

E-Health programs for mental illness and addictive behaviors have recently emerged as potentially useful self-help resources. Health care professionals will soon have the option of referring clients to free-to-end-user online, expert-moderated e-health programs as complementary means of assisting clients. Such programs will have significant implications for developing improved stepped models of care. This article describes various e-health programs and lessons learned related to access, promotion, user demographics, and patterns of use. In addition, validation procedures, effectiveness and attrition rates, fitting and tailoring, and qualitative analyses of social networks are described. It is difficult to validate e-health programs that are completely anonymous and do not require registration, personal interaction, or membership fees. As competition emerges in the budding e-health industry, best practice guidelines will need to be developed for collecting data and evaluating the utility of these programs.     

Technology and Obsessive Compulsive Disorder: An Interactive Self-Help Website for OCD

Obsessive Compulsive Disorder (OCD) is a neurobiological illness characterized by unwanted thoughts and/or images followed by repetitive rituals. About 5 million Americans live with Obsessive Compulsive Disorder. OCD is a manageable illness when proper interventions are utilized. Treatment for OCD is limited due to the lack of adequately trained professionals and the high costs of treatment. Cognitive behavioral therapy (CBT) in conjunction with exposure with response prevention (ERP) is the most effective intervention modality available for OCD. To address the treatment gap, an online, interactive self-help website was developed for those living with OCD without access to an effective intervention. This report will explore development of the OCD Challenge website and future implications of its use.     

Parental Speech at 6 Months Predicts Joint Attention at 12 Months

In a prospective longitudinal study of a representative community sample (N = 264), mothers' references to infants' mental states were coded during a topic‐sharing task in the home at 6 months. Joint attention behaviour was assessed in the laboratory at 12 months. Individual joint attention skills (gaze following, gaze alternating, and declarative pointing) were significantly inter‐correlated, with a single factor accounting for 68% of the variance. Mothers' references to infants' mental states at 6 months predicted infants' joint attention at 12 months. The association was not explained by sociodemographic characteristics of the family, the mother's mental state, or by the quantity or acoustic properties of her speech. However, variability in pitch of maternal speech was an independent predictor of the infants' later joint attention skills. Taken together, these findings suggest that mothers' infant‐directed speech fosters infants' attentive participation in topic‐sharing interactions, which in turn provide an important arena in which joint attention skills develop over the first year of life.     

“It's About Us”: Marital Adjustment and Marital Adaptation in Couples Who Adopt Children From the Child Welfare System

This article examines, using grounded theory methodology, the marital relationships of couples who adopted children from the child welfare system. Twenty-two spouses in four focus groups reported initial marital adjustment that featured husbands' support of their wives' initiation of adoption and management of child needs. About one half of these couples also developed time together and mutual influence to achieve a state of marital adaptation characterized by deeper intimate connection. Professionals are encouraged to understand the potential course of development of these marital relationships and to integrate attention to marital development into service throughout the entire adoption process.     

The Relationship Between Self and Activity in the Context of Artists Making Art

Art is an activity that has historically invited self-reflection, self-immersion, and self-exploration—for example, in self-portraits, exhibitions, experimentation with media—and that as such may open a window onto the relationship between self and activity. In this article, we describe two cases studies involving observation of and interviews with two artists to explore what it feels like to invest oneself in an activity emotionally, cognitively, sensuously, and reciprocally to “make oneself” through this activity. These case studies highlight the importance of authenticity in both the activity of making art and the making of self through making art. The implications for agency, emotion, and ethical activity are analysed and some of the implications for a sociocultural approach to activity discussed.