When caregiving ends: the course of depressive symptoms after bereavement

This study describes depressive symptoms among caregivers following bereavement and connects these trajectories to earlier features of caregiving using life course and stress process theory. Data are from a six-wave longitudinal survey (five years) of spouses and adult children caring for someone with Alzheimer's Disease. The analytic subsample (N = 291) is defined by death of the care-recipient after the baseline interview. A latent class mixture model is used to identify distinctive clusters of depressive symptoms over time. Of the four trajectories identified, three represent stable symptom levels over time, with two-thirds being repeatedly symptomatic (medium symptom levels), compared to two smaller groups of repeatedly asymptomatic (effectively absent of symptoms) and repeatedly distressed (severe symptoms). In contrast, about one in five caregivers experiences improved emotional well-being over time, the temporarily distressed, who progress from severe to moderate symptom levels. Caregivers with few symptoms before bereavement tend to maintain these states afterwards, but emotionally distressed caregivers tend to become more distressed. Role overload before bereavement substantially increases the odds of following an unfavorable trajectory afterwards, whereas self-esteem and socioemotional support play protective roles. These results demonstrate that caregivers are not uniform in their emotional responses to bereavement, but follow several distinct trajectories. These trajectories are linked to their previous experiences as caregivers, in particular exposure to stressors and access to resources. These findings suggest that intervention during caregiving may facilitate adaptation following death of a loved one.     

Exploring the prevalence and correlates of methamphetamine use: findings from Sacramento's ADAM program

Anecdotal reports have suggested that the use and abuse of methamphetamine is increasing in the United States. To date, however, few scholarly works have explored the prevalence and correlates of methamphetamine use in the United States. To address this limitation, a secondary analysis was undertaken with data collected through the Arrestee Drug Abuse Monitoring (ADAM) Program. An examination of methamphetamine-positive rates among ADAM arrestees interviewed between 1991 and 2001 identified that its use is concentrated within the Western part of the United States. Supplementary analyses of Sacramento arrestees indicated that 71% were diagnosed as needing some form of alcohol or other drug treatment. Compared to those arrestees who were detected methamphetamine-negative, methamphetamine-positive arrestees in Sacramento were three times as likely to be white and to have been diagnosed in need of drug treatment. Implications for drug control policy are discussed.     

Room assignment-rent division: A market approach

A group of friends consider renting a house but they shall first agree on how to allocate its rooms and share the rent. We propose an auction mechanism for room assignment-rent division problems which mimics the market mechanism. Our auction mechanism is efficient, envy-free, individually-rational and it yields a non-negative price to each room whenever that is possible with envy-freeness.We would like to thank seminar participants at Barcelona, Boston College, Duke, Koç, Málaga, MIT, Michigan, NYU, conference participants at the First Brazilian Workshop of Game Theory Society (Sao Paulo 2002), SED 2002-Conference on Economic Design (New York City 2002), The Sixth International Meeting of the Society for Social Choice and Welfare (Pasadena 2002), an anonymous referee for their comments and Ahmet Alkan, Selçuk Karabati, Bari Tan, nsan Tunali for insightful discussions. Sönmez gratefully acknowledges the research support of KoçBank via the KoçBank scholar program and Turkish Academy of Sciences in the framework of the Young Scientist Award Program via grant TS/TÜBA-GEBP/2002-1-19. Any errors are our own responsibility.     

Cognitive-behavioral therapy for obsessive-compulsive disorder: review of treatment techniques

Obsessive-compulsive disorder (OCD) is a chronic, impairing condition with an estimated lifetime prevalence in adults of 2.5%. Controlled treatment trials have demonstrated that cognitive-behavioral therapy (CBT) is an effective intervention for OCD. However, many individuals diagnosed with OCD do not receive appropriate, empirically validated interventions, perhaps due to limited knowledge of CBT among mental health practitioners. This article provides a review of CBT for OCD. Issues related to treatment delivery and assessment are presented and highlighted by an individual example.     

Demographic and situational factors affecting injury, resistance, completion, and charges brought in sexual assault cases: what is best for arrest?

This study examines demographic and situational factors in an effort to predict whether or not a complainant was injured, used resistance, experienced a completed assault, and whether charges were brought against the offender. If the accused had consumed alcohol or drugs, he was almost seven times more likely to be arrested. The complainant was six times more likely to report rape completion if she had consumed alcohol or drugs and if the complainant fell unconscious at any time during the attack she was significantly less likely to use a resistance strategy. The complainant's use of a compliance strategy at any time during the assault positively predicted not using a physical resistance strategy and sexual assault completion. The reporting of injury positively predicted use a physical resistance strategy and sexual assault completion. If the assault was completed, it was less likely that charges were pressed. Implications of these findings are discussed, and directions for future research are offered.     

The potential of the SSI program to reduce poverty among the elderly

Is it more effective to reduce poverty among the elderly by increasing the benefits paid by the Supplemental Security Income (SSI) program or by increasing eligibility for the program? This paper answers that question from a policymaker's perspective. At given program cost levels, we compare the potential reduction in poverty from increasing benefit levels to the potential reduction associated with a variety of policy proposals that would increase eligibility for the program. This paper employs a microsimulation model containing an eligibility and benefits calculator, a participation model, and an optimization algorithm. The data are from the Survey of Income and Program Participation supplemented by the administrative records of the SSI program. The results show that increasing eligibility by relaxing the restrictions of the means tests can be more effective in reducing poverty than raising benefit levels.     

Ticking fast or ticking slow, through Shc must you go?

Circumstantial evidence places the p66 isoform of the adapter protein Shc in a position to mediate the accelerated aging phenotype displayed by mice expressing shortened forms of the tumor suppressor protein p53. We present a model in which p66(shc) may be responsible for integrating signals from the p53 pathway with signals from the insulin-like growth factor-1/Daf pathway in mammals. A full understanding of how interactions between p53 and p66(shc) affect longevity will require the production of animals with mutations in the genes encoding both proteins.     

Parent-child connections: the essential component for positive youth development and mental health, safe communities, and academic achievement

A continuing parent-youth bond throughout adolescence and young adulthood is the foundation for genuine emotional health, academic achievement, and healthy developmental trajectories and the antidote to youth violence.     

Processes of adjustment in organized out-of-school activities: opportunities and risks

Participation in organized out-of-school activities leads to long-term psychosocial and educational benefits for young people. Now we're learning which features of these activities best support individual children.     

When spacing out brings clarity. Mental lapses serve as diagnostic clue for type of dementia

NEW YORK CITY--Everyone has slow-witted moments: entering a room only to forget why, putting ice cream into the fridge, or blanking out on how to use the microwave. Some clinicians think that periodic mental lapses might help diagnose dementia with Lewy bodies (DLB), a scourge that kills brain cells (see DLB Case Study), although not all experts agree. Now, scientists have found that some cognitive blunders crop up more frequently in patients with DLB than in those with Alzheimer's disease (AD) or in healthy elderly individuals, according to work presented here on 15 January 2004 at an American Medical Association briefing for media.