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This review revises the sociocultural stress and coping model for culturally diverse family caregivers proposed in 1997 by Aranda and Knight. Available research on the influence of cultural values on the stress and coping process among family caregivers supports a common core model that is consistent across ethnic groups and that links care recipients' behavior problems and functional impairments to caregivers' burden appraisals and health outcomes. Familism as a cultural value appears to be multidimensional in its effects, with obligation values often being more influential than family solidarity. The effects of cultural values and other ethnic differences in stress and coping appear to involve social support and coping styles rather than burden appraisals. Implications of the revised model for research and practice are discussed. Key Words: Caregiver burden--Culture--Ethnicity--Familism--Social support--Stress and coping. doi: 10.l093/geronb/gbp096.

We examined how mood and activation of old age schema influenced attentional focus on physical symptoms in older adults. Seventy-one individuals aged 60 years or above participated in an experiment that manipulated mood and old age schema. They completed a modified Stroop task that measured attentional bias to physical symptoms. Controlling for baseline processing speed, the two variables had significant main and interaction effects on attentional focus on symptoms. Sad mood and old age schema independently minimized the bias to avoid attending to symptoms. When combined, these two variables contributed to greater attentional focus on symptoms. These findings highlight psychological influences on current attention to symptoms. Key Words: Aging--Mood--Physical symptoms.

Purpose: This study investigated direct and indirect effects of caregiver status on the physical health of Korean American caregivers in terms of caregiver coping styles and the quantity and the quality of informal social support. Design and Methods: Using a sample of 87 caregivers and 87 matched noncaregivers, we analyzed a path model, employing both subjective (self-reported general health) and objective (blood pressure and cortisol levels) health indicators. For the intervening variables the path model employed coping styles and two aspects of social support (the quantity of informal social support and the quality of informal social support). Results: Our findings supported the association of caregiver status with poor health outcomes among Korean American caregivers. Of interest, the adverse effects of caregiver status on the physical health of caregivers were reported only with objective health markers (blood pressure and cortisol levels), not with subjective health indicators. The proposed indirect effects of caregiver status were supported only for cortisol levels, through the quality of informal social support. Implications: The demonstration of the physical health effects of caregiving in one of the nation's fastest growing ethnic groups, and the finding that these physiological effects occur without self-reported poor health, call attention to a potentially serious health problem in an understudied group providing family care to frail older family members. Key Words: Blood pressure, Caregiving, Cortisol, Ethnicity, Self-reported general health

In this study we assessed the new transactional stress and social support model, postulating the role of neuroticism, ethnicity, familism, and social support in perceived burden in dementia caregivers. We used a convenience sample (N = 77) of African American and White dementia caregivers. Results substantiated interrelationships among social support variables, and the influence of perceived positive social support on burden. Neuroticism was related to the perception of positive social support and burden. Results corroborated the model, focusing on neuroticism and quality of social support in modeling perceived burden in family caregivers. Findings call attention to the role of presumably long-standing individual differences in neuroticism that influence caregiver appraisals of stress and social support.

Even though state governments assume public responsibility for persons with dementia, formal analysis of state laws concerning individuals with Alzheimer's disease and other forms of dementia has been rare, We responded to this by collecting and evaluating state legislation targeted towards individuals with dementia. These laws were collected by searching online statutory archives and were defined by the type of action, year of passage, and legislative purpose. Out research revealed that the legislatures have targeted an average of slightly more than five actions towards persons with dementia. We also discovered that the earliest legislative act targeting individuals with dementia was passed by South Dakota in 1939, and by the end of the 1997 sessions, 49 state legislatures had enacted at least one targeted law. We sorted the variety of legislative actions into eight categories and illuminated how the purposes of these laws differed from one state legislature to the next. This research expands knowledge concerning state policies targeting people with dementia, introduces a reliable method of collecting state laws, and contributes to the advocacy effort made on behalf of persons with dementia. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678 E-mail address: Website: KEYWORDS. Alzheimer's, dementia, public policy, state government, legislative intent

Research into the emotional effect of natural disasters on older people is presented, using the Northridge earthquake of 1994 in CA. The effect on older people and people with experience of earthquakes is recorded.

Mood induction techniques are used with older adults to successfully mimic the symptoms of clinical depression. A new study seeks to validate the use of mood induction on older people. A group of 222 older people were exposed to mood induction procedures and compared with 20 controls and 17 older adults with clinical depression. It is shown that the mood induction procedure can give experimental control of moods in older adults.

The authors review the literature on ethnic minority caregivers and suggest that ethnicity and culture play a significant role in the stress and coping process for Latino caregivers. Caregivers of older Latinos face special challenges in the caregiving for individuals at higher risk for specific chronic diseases, who are disabled at earlier ages, and who have more functional disabilities. Ethnicity and culture can also influence the appraisal of stress events, the perception and use of family support, and coping behaviors. Socioeconomic class and minority group status are discussed as additional sources of variation in the caregiver stress and coping model. Key Words: Culture, Caregiving, Stress and coping, Latinos, Hispanics, Social support

A study of two explanations of gender differences in caregiver distress showed that both attentiveness to emotions and varying use of coping styles can explain differences caused by gender in psychological aspects of caregiving. Male caregivers were more reluctant than female caregivers to admit their feelings of distress. Female caregivers also tended more to use avoidant coping styles than male caregivers. Research on caregiver distress should focus more on individual differences than gender difference as these variables can affect caregivers of both genders.

The articles on psychosocial interventions and respite care for caregivers in eight journals on gerontology and caregiving research over a 10-year period ending 1990 were reviewed. These sources were supplemented by four databases. Studies involving both the measurement of caregiver stress and a comparison group that did not receive intervention were selected. The results showed that respite interventions and individual psychosocial intervention were moderately effective. Group psychosocial intervention was even less effective.

Older psychiatric patients tend to be admitted to inpatient clinics rather than offered outpatient mental health programs. The older patients stay in the inpatient psychiatric unit longer and use more services, compared with younger patients. The increased incidence in organic brain disease may account for these trends. However, the current approach for managing older psychiatric patients results from certain misconceptions and inadequacies. It is commonly believed that older psychiatric patients suffer from organic brain disease and will not benefit from outpatient mental health services. In addition, there is a lack of understanding between caseworkers of elders and those of the mental health system. Finally, the current approach for managing elderly psychiatric patients is unprepared for complex problems of coexisting medical and psychiatric disorders. An intensive case management approach was based on the assumption that elderly psychiatric patients could benefit from interventions under certain conditions. Beginning at admission to the psychiatric hospital, intensive efforts would be coordinated by one person, who would maintain a continuous relationship with the patient throughout the hospitalization and following discharge. Caseworkers should have full knowledge of the mental health system and the network of services for elderly people, as well as the ability to coordinate and understand both psychiatric and medical problems. Thirty-six elderly persons, admitted to a county inpatient unit, were offered an intensive case management program for five months. The length of stay in the inpatient unit decreased from 27 days before the start of the program to 12 days during the period of psychosocial intervention. The duration of stay in the inpatient unit did not change considerably for younger patients. Older patients tended to be first-time admissions and had primarily functional versus organic (physical) diagnoses. It was estimated that the reduction in length of stay would result in a savings of $6,750 for each admission of an older patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

The perceived homonegativity and mental health result in groups of American and African American gay men in three age groups were studied to find out the presence of stigma-competence among them. Results showed that African American older adult gay men did not experience very high levels of negative mental health outcomes.

Results of an investigation into the memory of older adults, showed that they recalled memories better when in a sad mood than that of younger adults. But these results have shown only a partial support for developmental effects on mood congruence derived from Socioeconomical Selectivity Theory (SST).

Purpose: This study examined the formation of state government policies concerning persons with dementia. In particular, we identified variables associated with the passage of pertinent state laws by testing three theoretical models of policy formation: the iron triangle, the policy system, and an integrated model. Methods: We sampled 44 states and counted the number of laws concerning individuals with dementia that passed during the 1998 legislative sessions. We constructed nine independent variables to represent the three theoretical models of state policy formation. Then the number of legislative actions were regressed onto each model. Results: The integrated model that consisted of political actors, legislative features, and environmental inputs met goodness-of-fit criteria for a maximum likelihood regression analysis ([chi square]/df = 1.55). The advocacy effort of the Alzheimer's Association, number of legislative champions, supply of special care beds for persons with dementia, and recent policy activity were related significantly with increased legislative activity concerning individuals with dementia. Implications: Policy responses concerning persons with dementia increasingly have been created within state governments, and we identified variables associated with the passage of pertinent state laws. This research also contributed to the advancement of comparative state policy research by contrasting the three theoretical models of policy formation. Key Words: Alzheimer's disease, Public policy, State governments

A sociocultural stress and coping model to explain emotional distress among caregivers of family members who have dementia across ethnic and cultural groups is presented and explored in a sample of 41 African American and 128 non-African American caregivers. In this sample, African American caregivers reported lower levels of burden but equal levels of depression and anxiety. In the structural equation model, previous reports that African Americans' lower appraisal of caregiving as burdensome resulted in lower levels of emotional distress were confirmed. However, in this model, this pathway was counterbalanced by a tendency of African American caregivers to use emotion-focused coping and, therefore, increase emotional distress. African American caregivers were also younger and in poorer health, factors which tend to increase both burden and emotional distress outcomes. As suggested by the sociocultural stress and coping model, the influences of ethnic group variables on stress and coping processes are complex and multidirectional.

It has been suggested that burden and distress amongst dementia caregivers may be higher in American culture. Korean and Korean American caregivers were compared with white American caregivers on familism, burden, depression and anxiety. Familism was found to be highest amongst Korean caregivers and lowest in Whites, and Koreans and Korean Americans reported higher rates of burden. Koreans exhibited higher rates of depression and anxiety than white American caregivers.