Forty-four caregivers to spouses with a diagnosis of Alzheimer's disease provided a stressed subject population considered at high risk for depression. Unlike more typical unidirectional measures of perceived social support quality, subject ratings were elicited separately as to how helpful as well as how upsetting each network member was in five different support categories. Correlations between perceived network "upset" and depression (Beck Depression Inventory) were highly significant, while in no case did perceived "helpfulness" relate to depression. Using stepwise multiple regression, the set of five support category Upset ratings predicted depression better than did helpful/upset ratios, which in turn predicted depression better than the Helpfulness ratings as a group. The implications of these findings for the conceptualization of social support and its measurement are discussed.
This study evaluated secondary prevention approaches for young adults (N= 36, mean age 23 years) at risk for alcohol problems. Subjects were randomly assigned to cognitive-behavioral alcohol skills training, a didactic alcohol information program, or assessment only. The skills program included training in blood alcohol level estimation, limit setting, and relapse prevention skills. All subjects maintained daily drinking records during the 8-week intervention and for 1 week at each follow-up. Repeated measures MANOVA found a significant reduction over 1-year follow-up in self-reported alcohol consumption for the total sample. For all drinking measures, the directional findings consistently favored skills training. Despite overall reductions, most subjects continued to report occasional heavy drinking.
This study tested several predictions derived from the reformulated learned helplessness (RLH) depression model, and from recent critiques of that model, in a longitudinal study of spouses caring for a husband or wife with Alzheimer's Disease. During initial interviews spouse caregivers (n = 68) rated the uncontrollability of important upsetting events related to their spouse's disease and were scored on an index of internal-external causal attribution (CA) for those events. In addition, at both the initial and follow-up interviews (n = 38) about 10 months later, caregivers were rated for depression, and anxiety and hostility. The latter were included to test the specificity of the loss of control/causal attribution model to depression. Results indicated that the indices of loss of control and CA were more consistently related to depression than to anxiety or hostility, although hostility was related to CA attributions. Correlations of the loss of control and CA variables with depression remained significant after controlling for a measure of the spouse's objective disability. In hierarchical regression analyses, perceived loss of control and its interaction with CA significantly predicted follow-up depression after controlling for initial depression. The interaction showed that loss of control combined with an internal attribution predicted higher depression than did either one alone. Last, a measure of optimistic orientation and of loss of control over personal reactions to one's spouse (measures suggested in critiques of the RLH model) generally added to variance accounted for by the loss of control and CA variables and their interaction. The importance of including specific uncontrollable events when studying the RLH model is emphasized.A central tenet of the reformulated learned deficit, specifically depression, is also prehelplessness (RLH) model of depression dieted. Abramson et al. (1978) proposed that (Abramson, Seligman, & Teasdale, 1978) is some individuals, when confronted with perthat the experience of noncontingency be-ceived loss of control, are predisposed to an tween important aversive events and one's expectation of future uncontrollability (and attempts to control such events lead to cog-consequent depression) as a result of their nitive and motivational deficits. Furthermore, causal attributions. According to the RLH if the perceived noncontingency or uncon-model, individuals prone to learned helplesstrollability is transformed into an expectation ness depression tend to attribute important of future uncontrollability, then an emotional bad outcomes to internal, global, and stable factors (Abramson et al., 1978;Seligman, Abramson, Semmel, & Von Baeyer, 1979). Preparation of this article was supported in part by Support for the RLH model of depression grants from the Center on Aging, National Institute of in humans is mixed (e.g., Coyne & Gotlib, Mental Health (MH33779), and from the University of 1983; Peterson & Seligman, 1984; Zuroff, ^T^htndtfjlSt^^^ > 981 >-Although the predicted associati...
Attention deficit hyperactivity disorder (ADHD) is an important issue for the physician taking care of athletes since ADHD is common in the athletic population, and comorbid issues affect athletes of all ages. The health care provider taking care of athletes should be familiar with making the diagnosis of ADHD, the management of ADHD, and how treatment medications impact exercise and performance. In this statement, the term "Team Physician" is used in reference to all healthcare providers that take care of athletes. These providers should understand the side effects of medications, regulatory issues regarding stimulant medications, and indications for additional testing. This position statement is not intended to be a comprehensive review of ADHD, but rather a directed review of the core issues related to the athlete with ADHD.
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