The intersection of extreme poverty and familial mental health in the United States

Approximately 22% of children in the United States live in poverty, with high rates of caregiver depression and child disruptive behavior disorders (DBD). The current study aims to explore the relationships between living in extreme poverty and both child and parent mental health. Data are comprised of findings from the first effectiveness study of the 4Rs and 2Ss intervention, in addition to preliminary data from an implementation study currently underway (n = 484). Families with an annual income of less than $9,999 reported significantly greater child DBD scores and prevalence of clinically significant levels of caregiver depressive symptoms compared to income levels over $10,000. Findings support the recommendation for parental mental health to be attended to within the context of child mental health services.     

Caregiver‐endorsed strategies to improving sexual health outcomes among foster youth

Foster youth are at an increased risk of unintended pregnancies and sexually transmitted infections (STIs) compared with peers. We conducted 11 semistructured focus groups with 86 foster and kinship caregivers in three child welfare jurisdictions to understand their strategies for monitoring and communicating with youth in foster care around sexual health topics, with the overall goal of developing a training for caregivers to reduce STI and unintended pregnancies among youth in foster care. We used thematic analysis to analyse the data. Three main themes emerged: (1) strategies to communicate with youth about sexual health (trust‐building, open/direct communication, tailoring information to each individual youth, creative conversation‐starters, and self‐education), (2) strategies for monitoring youth (e.g., tailoring monitoring to youth development/characteristics, clearly communicating rules, co‐development of rules, spending time with youth/friends/friends' parents, using technology, using a social support system), and (3) other strategies to promote positive youth development (advocating for youth, engaging youth in goal‐setting). Trainings that provide caregivers with (1) information on sexual health and normal adolescent development and (2) strategies and skills to help caregivers engage in open, evidence‐informed communication, and monitor youth in a tailored, developmentally‐informed manner are likely to improve reproductive health and other outcomes among youth in foster care.     

再论清代皇室之乳保

清代皇室乳母、保母属宫廷仆妇群体，是宫廷女性的重要组成部分。从性别视角再研究清代皇室之乳保，详细辨析乳母、保母称谓及职责的不同；阐释了皇室乳保与皇子女之间存在的稳固的亲情关系和伦理关系，以及由此形成的乳保群体在宫廷中身份地位的特殊性。她们充分利用这种特殊身份，突破自身的性别和阶级局限，提升其在家庭中的地位，发展起以女性为核心的家族体系。在为自己家族带来“特权”的同时，乳保群体也对清代皇族的家事和国事产生一定影响。     

Foster Caregiver Motivation and Infant Attachment: How do Reasons for Fostering Affect Relationships?

This study reports the results of the effects of types of caregiver motivation to foster parent on the security of attachment of infants in care. Using the Motivations for Foster Parenting Inventory and the Ainsworth Strange Situation Procedure, the differences in motivation of kin and non-kin caregivers and the effects of motivation on security of attachment of 46 infants is reported. Result found that motivations to foster, such as the desire to increase family size, and social concern for the community, were significant predictors for secure attachment; while reasons for fostering such as spiritual expression, adoption, and replacement of a grown child, were predictors of insecure attachment. Research and practice implications are discussed. Susan A. Cole is an Assistant Professor, School of Social Work, University of Illinois-Urbana-Champaign.     

The Impact of Dementia:

Even though only one person in the marital relationship is likely to have the diagnosis, demenita really has two victims-the inflicted spouse and the caregiver. Research on both these 'victims' to date, has been largely restricted to furthering an understanding of the issues from a medical and stress/burden perspective. Only limited attention has been given to addressing the psychodynamic issues which evolve in reaction to the disease process. These issues however, have important implications on service needs and utilization and warrant exploration. Self psychology offers a promising framework for doing this. The purpose of this article is to examine the impact of dementia on the marital unit using this theoretical perspective.     

BOOK REVIEWS

No abstract available for this article.     

Social Contract,Communities and Guardians

This paper examines the way that different notions of social contract and community change the way in which we can look at the obligations guardians have to their charges. A brief analysis of the underpinnings of autonomy based (minimalist) and beneficence based (non-minimalist) ethics is given and the consequences of such points of view are scrutinized. This paper argues that the minimalist ethic is flawed in theory as well as practice. The consequences for guardians of these theories is sketched.     

Understanding the association between time spent caregiving and well-being among employed adults: testing a model of work–life fit and sense of community

This study examines factors associated with work–life fit and sense of geographic community as mediators of the negative association between caregiving demands and well-being among employed informal caregivers. Data were drawn from a larger project assessing well-being among residents of three mid-size cities in Ontario, Canada. A subsample was selected of informal caregivers who worked for pay for at least eight hours/week (n?=?276). Caregiving demands were measured by time spent caring for an adult who was a relative, friend, or neighbour. Well-being followed a holistic conceptualization advanced by the Canadian Index of Wellbeing. The more time spent caregiving, the lower participants’ well-being ratings were. This association was mediated by perceived time adequacy, income adequacy, and sense of community, such that the more time participants spent caregiving, the lower their ratings of these three resources. This explained the initial association of caregiving hours with reduced well-being. Enhanced well-being was more strongly associated with sense of community than any other factor, which supports the importance of the community domain in understanding well-being among employed caregivers and suggests its further testing with other population groups. Policy implications for employers and community organizations are provided.     

Patterns of family service needs and caregiver–child relationships among families at risk of child welfare involvement

Caregivers at risk of involvement in the child welfare system report high levels of need for multiple types of services, and their children have high levels of mental health need. Caregivers from families with more service needs, as well as unmet needs, are less likely to be engaged with child welfare services and may have diminished capacity to care for their child. This study takes a family‐centered approach by using latent class analysis to identify patterns of both caregiver and child service needs among families at risk of child welfare involvement. Using data from the LONGSCAN consortium (N = 957), we identified 4 classes of service needs among child welfare‐involved families. We then examined differences between the 4 classes based on demographics, maltreatment histories, unmet service needs, and caregiver–child relationship. The caregivers were split fairly evenly among the 4 classes: low needs, medical needs, poverty support, and high needs. There were significant differences between classes on assessed variables, with higher levels of needs associated with diminished caregiver–child relationships.     

Factors Associated With Caregivers’ Use of Support Services and Caregivers’ Nonuse of Services Sought

Informal caregivers may face barriers accessing services like respite care, training, and support groups. Using multinomial logistic regression, I modeled caregivers’ probability of using all services sought (“all services used”) and nonuse of any services sought (“any unused services”) as a function of caregiver and care-recipient characteristics. Care-recipient health and function, especially dementia and need for medical task assistance, were associated with all services used and any unused services, and any unused services were more likely among adult children caring for their parents, caregivers of Black and Hispanic older adults, caregivers providing intensive care, caregivers living in metropolitan areas, and residents of states that spend more on increasing access to caregiver services under the National Family Caregiver Support Program. Regularly scheduled caregiving was associated with higher likelihood of all services used, but not with any unused services. Steps should be taken to increase access for caregivers who provide intensive care, care to dementia patients, or assistance with medical tasks and for Hispanic families.