María Oliva Márquez-González, Andrés Losada, and Rosa Romero-Moreno
Dementia caregiving is associated with negative physical and psychological health consequences. Multicomponent, behavioural, and psychotherapeutic interventions for reducing caregivers’ distress, particularly the cognitive-behavioural ones, present the greatest effect sizes, but nevertheless these effects are only moderate. The third wave of behavioural therapies and, specifically acceptance and commitment therapy (ACT), offers interesting therapeutic tools aimed at fostering the acceptance of aversive internal experiences and the commitment to personal values. Given the chronic nature of the caregiving situation and the unchangeability of many of its elements (e.g. feeling sadness or grief), ACT represents a promising and potentially helpful therapeutic approach to help dementia caregivers to decrease their emotional distress. Very few studies have so far analysed the efficacy of ACT or some of its components (e.g. mindfulness) in this population, but these provide some preliminary support for the utility of this approach in improving caregivers’ psychological well-being. Assuming the need for further research in order to consider ACT as an empirically validated therapy for dementia caregivers, in this chapter we analyse, in the context of caregiving, the psychological processes highlighted in the ACT model of psychopathology, such as experiential avoidance, describing examples of them in cases of caregivers we have assisted in our clinical work, and outlining ACT-based therapeutic strategies that we have found useful on a clinical basis for modifying them.
Acculturation and Alcohol Use Among Hispanic and Asian American College Students: What Do We Know and Where Could We Go?
Byron L. Zamboanga, Cara C. Tomaso, and P. Priscilla Lui
Many college students, are susceptible to alcohol use and related problems, including Hispanic and Asian Americans. A potential factor contributing to this risk is acculturation, which can be defined as the process of psychological, behavioral, social, and cultural change and adaptation that occurs when individuals or groups from different cultural backgrounds come in contact. This chapter provides a narrative review of the literature examining acculturation and alcohol use among these populations. One key theme to emerge from this review is that the exact direction of the association between these variables is unclear and therefore should be considered with caution. While the existing evidence is relatively limited, gender and, to some extent, ethnic group membership appear to moderate the association between acculturation and alcohol use. Several methodological issues pertaining to the study of acculturation, future research directions, and implications for intervention and prevention are discussed.
Ana F. Abraído-Lanza, Karen R. Flórez, and Rachel C. Shelton
Despite the many health benefits of physical activity (PA), the majority of Latinos do not meet recommended levels of PA. This chapter provides an overview of research on acculturation and PA among adult Latinos in the United States. It identifies gaps in knowledge concerning the association between acculturation and different types of PA, the joint effects of socioeconomic position and acculturation on PA, and research on gender. It suggests several areas for further research related to acculturation and PA, including an exploration of norms, social networks, and broader social contexts. It concludes that although the bulk of evidence indicates that greater acculturation is associated with increased PA, more complex research designs and greater methodological and conceptual rigor are needed to move forward research in this area.
Kelly B. Haskard-Zolnierek and Summer L. Williams
This chapter outlines the ways in which depression and other mental health issues influence adherence and health-behavior change. Patient adherence and health-behavior change are defined and described. Common mental health issues including depression and anxiety are described as well as the prevalence of nonadherence to treatment for these conditions. Next, comorbidity of physical and mental health issues are discussed, such as depression co-occurring with various chronic diseases, providing evidence of the effects of mental health on adherence and health-behavior change. The mechanisms for the relationship of mental health to adherence and health-behavior change are discussed through the framework of the information-motivation-strategy model, with adherence being affected due to cognitive factors, motivational factors, and resource-related factors. The chapter concludes with a discussion of what health-care professionals can do to address and reduce this barrier to adherence and health-behavior change.
Adjustment to Chronic Illness and Disabilities: Theoretical Perspectives, Empirical Findings, and Unresolved Issues
Hanoch Livneh and Erin Martz
Chronic illnesses and disabilities (CID) are integral parts of life, and their likelihood of occurrence increases with one's age. The experience of CID invariably necessitates personal adaptation to both the individual's diminished functional capacities and their altered interactions with the physical and social environments. The field of psychosocial adaptation (PA) to CID has exponentially grown during the past 30 years and can be conveniently collapsed into two broad domains, namely, conceptual and empirical approaches to the study of PA to CID. The conceptual approach is mostly rooted in extensive clinical observations of individuals following the aftermath of CID onset and has led to the development of numerous theoretical frameworks of PA to CID and coping with CID. Here, we provide a review of the most influential conceptual models of PA to CID. The empirical literature is examined in this chapter by focusing on those studies that have directly sought to investigate the relationships (albeit not necessarily causal in nature) among a wide range of sociodemographic characteristics, CID-linked factors, personality attributes and coping strategies, and environmental influences (these four classes of variables are typically considered as predictors, mediators or moderators), and measures of PA to CID (the latter commonly regarded as outcomes). Due to space restrictions, our review of the empirical literature only focuses on certain types of CIDs, namely, spinal cord injuries, cancer, and multiple sclerosis. This chapter concludes with a discussion of those issues that need to be addressed by future researchers in the field of adaptation to CID.
Tammy Chung and Kristina M. Jackson
Alcohol is the substance most commonly used by youth. Problematic alcohol use can be considered a developmental disorder, which typically has its origins in an individual’s genetic liability, temperament, and experiences in childhood and adolescence. To provide a context for the emergence of alcohol use in adolescence, this chapter briefly reviews biological substrates of risk that include genetic liability and processes of developmental maturation (e.g., puberty, brain development). The chapter then addresses the prevalence of alcohol use and alcohol-related problems in adolescence, trajectories of youth alcohol use, and internalizing and externalizing behavior pathways associated with adolescent alcohol use. Risk and protective factors influencing adolescent alcohol use are discussed as targets to guide developmentally informed prevention and intervention.
Adolescent Cultural Contexts for Substance Use: Intergroup Dynamics, Family Processes, and Neighborhood Risks
Seth J. Schwartz, Sabrina E. Des Rosiers, Jennifer Unger, and José Szapocznik
This chapter reviews the role of cultural processes in substance use and other health problems among adolescents. The chapter focuses on Hispanics because of their status as both a minority group and an immigrant group, and because Hispanics have been a “lightning rod” for political discourse about immigration and US national identity. The core argument is that intergroup processes such as social dominance and system justification are responsible, at the population level, for unequal allocation of social resources—which, in turn, creates health disparities. These intergroup processes compound the effects of more proximal contexts such as individual, family, and neighborhood. It is argued that interventions to combat the social/cultural determinants of health disparities should be multilevel, including individual-, family-, community-, and population-level strategies.
Kenneth J. Sher, Julia A. Martinez, and Andrew K. Littlefield
Alcohol use disorders (AUDs), alcohol abuse and alcohol dependence, are among the most prevalent mental disorders in the United States and elsewhere. Controversy exists with respect to the optimal way of classifying these disorders and the boundaries between normal and abnormal drinking. Although AUDs can occur over much of the life span, from an epidemiological perspective it is largely a disorder of adolescence and young adulthood. Many who experience AUDs “mature out” of them as they age and acquire adult roles and, perhaps, as a function of normal personality. However, a significant minority of individuals fails to mature out, and some individuals develop AUDs later in adulthood. There are a number of etiological pathways associated with developing an AUD; foremost among them is a pathway shared with other externalizing disorders such as conduct disorder, adult antisociality, and other substance dependence. However, pathways associated with internalizing disorders and with individual differences in alcohol effects also exist. All of these pathways likely involve major genetic and environmental determinants. Given the etiological pathways that have been documented, it is not surprising that AUDs are often comorbid with other mental disorders. A number of approaches to the prevention and treatment of AUDs have been developed that are effective. Additionally, basic research is setting the stage for further advances in both behavior and drug treatments of AUDs.
This chapter provides an overview of the research into anxiety, stress, and worry during the perinatal period. It provides information on rates of disorders and of high levels of anxiety and their impact. Examples of the content of several anxiety disorders, both during pregnancy and the postpartum period, are given. Causes and risk factors for anxiety are discussed, together with its course over the perinatal period. Mention is made of specific perinatal studies looking at treatment for anxiety, and the author provides ideas on areas for future research. However, all of this information is tempered by an important caveat, in which the author suggests that much of the research that has been conducted in this area is, in fact, flawed.
Anastasia M. Raymer and Leslie J. Gonzalez Rothi
Neurologic damage affecting the left cerebral hemisphere leads to impairments in comprehension and expression of language in the verbal modality (aphasia) and in the written modality (dyslexia and dysgraphia). Impairment patterns take various forms, differing in the fluency/nonfluency of verbal output and integrity of auditory comprehension, repetition, and word retrieval abilities. The divergent classifications of aphasia allow reflection on neural and psychological correlates of specific aspects of language processing in verbal and written modalities. Neurologic damage affecting the right cerebral hemisphere can lead to changes in social and prosodic communication, speaking to the role of the right hemisphere in language processing. Patterns of language breakdown following neurologic injury have implications for assessment and intervention for affected individuals. Whereas perspectives vary on interpretation of the language breakdown across disciplines, this volume’s purpose is to facilitate interactions across disciplines to improve the lives of those with aphasia and related communication disorders.