The psychological effects of a major national trauma are not limited to those who experience it directly, and the degree of response is not predicted simply by objective measures of exposure to or loss from the trauma. Instead, use of specific coping strategies shortly after an event is associated with symptoms over time. In particular, disengaging from coping efforts can signal the likelihood of psychological difficulties up to 6 months after a trauma.

Millions of people witnessed early, repeated television coverage of the September 11 (9/11), 2001, terrorist attacks and were subsequently exposed to graphic media images of the Iraq War. In the present study, we examined psychological- and physical-health impacts of exposure to these collective traumas. A U.S. national sample ( N = 2,189) completed Web-based surveys 1 to 3 weeks after 9/11; a subsample ( n = 1,322) also completed surveys at the initiation of the Iraq War. These surveys measured media exposure and acute stress responses. Posttraumatic stress symptoms related to 9/11 and physician-diagnosed health ailments were assessed annually for 3 years. Early 9/11- and Iraq War–related television exposure and frequency of exposure to war images predicted increased posttraumatic stress symptoms 2 to 3 years after 9/11. Exposure to 4 or more hr daily of early 9/11-related television and cumulative acute stress predicted increased incidence of health ailments 2 to 3 years later. These findings suggest that exposure to graphic media images may result in physical and psychological effects previously assumed to require direct trauma exposure.

Traditional investigations of caregiving link it to increased caregiver morbidity and mortality, but do not disentangle the effects of providing care from those of being continuously exposed to an ailing loved one with serious health problems. We explored this possible confound in a national, longitudinal survey of elderly married individuals (N = 3,376). Results showed that spending at least 14 hr per week providing care to a spouse predicted decreased mortality for the caregiver, independently of behavioral and cognitive limitations of the care recipient (spouse), and of other demographic and health variables. These findings suggest that it may be premature to conclude that health risks for caregivers are due to providing active help. Indeed, under some circumstances, caregivers may actually benefit from providing care.Approximately 21% of the U.S. adult population provides unpaid care to an adult over age 18 (Pandya, 2005, par. 2). There is a growing consensus that caregiving is harmful to physical health, so public-policy researchers have recommended that caregivers receive "relief from the relentless work of family caregiving and its debilitating effects" (Feinberg et al., 2004, Recommendation 3). As reported by Riess-Sherwood, Given, and Given (2002), the physical health consequences of providing care "have been so striking that federal legislation has been enacted to begin granting financial relief to those who provide care in the home in the hopes that this would relieve some of the health effects" (p. 111). These recommendations are based, in part, on evidence that caregivers may experience problems with immune regulation (e.g., see Vitaliano, Zhang, & Scanlan, 2003, for an overview), and Address correspondence to Stephanie L. Brown, Division of General Medicine, 300 N. Ingalls, Room 7D-13, Ann Arbor, MI 48109, stebrown@med.umich.edu. SUPPORTING INFORMATION Additional Supporting Information may be found in the on-line version of this article: Table S1 Table S2 Please note: Wiley-Blackwell are not responsible for the content or functionality of any supporting materials supplied by the authors. Any queries (other than missing material) should be directed to the corresponding author for the article. However, empirical evidence of worsened physical health among caregivers comes from studies that often equate providing active help with being continuously exposed to an ailing loved one with serious health problems (e.g., Christakis & Allison, 2006;Vitaliano et al., 2003). Christakis and Allison, for example, linked caregiving to increased mortality risk on the basis of increased mortality rates among individuals whose spouse had been hospitalized, as opposed to individuals who provided more hours of care to a spouse. In instances like these, it is impossible to know whether the adverse health consequences are due to stress arising from active helping (e.g., hours of care provided to another person), or to other features of the caregiving context that may be harmful, such as anticipatory bereavement ...

Being a caregiver for an ill or disabled loved one is widely recognized as a threat to the caregiver’s quality of life. Nonetheless, research indicates that helping behavior, broadly construed, promotes well-being. Could helping behavior in a caregiving context promote well-being as well? In the present study, we used ecological momentary assessment to measure active helping behavior and both positive and negative affect in 73 spouse caregivers. Results indicate that when controlling for care recipient illness status and functional impairment and caregiver “on call” caregiving time, active helping predicted greater caregiver positive affect— especially for individuals who perceived themselves as interdependent with their spouse. In addition, although both helping and on-call time predicted greater negative affect for caregivers who perceived low interdependence, helping was unrelated to negative affect among caregivers perceiving high interdependence. Helping valued loved ones may promote caregivers’ well-being.

Helping others predicted reduced mortality specifically by buffering the association between stress and mortality.