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Simple Summary: Breast cancer is a shared experience for diagnosed mothers and their young adult caregiving daughters (YACDs). They struggle to talk about cancer and receive no guidance for navigating challenging but critical care conversations. Daughters in young adulthood also tend to avoid cancer-related talk, which is associated with poorer biopsychosocial outcomes, whereas openness between mothers and daughters is tied to better biopsychosocial outcomes. We sought to determine mothers' and YACDs' most challenging topics as well as their preferred strategies that help them engage in these discussions, while also exploring associations between openness/avoidance and their psychosocial outcomes. Results highlight how mother–daughter communication approaches (i.e., avoidance and openness) intersect with their psychological distress and relational satisfaction. Collectively, findings demonstrate that if we are to promote better psychosocial outcomes for diagnosed mothers and their caregiving daughters, we must recognize the influential role their communication plays in their well-being. For many diagnosed mothers and their daughters, breast cancer is a shared experience. However, they struggle to talk about cancer. This is particularly true when the daughter is in adolescence or young adulthood, as they tend to be more avoidant, which is associated with poorer biopsychosocial outcomes. When daughters are their mother's caregivers, daughters' burden and distress are heightened. Young adult caregiving daughters (YACDs) are the second most common family caregiver and encounter more distress and burden than other caregiver types. Yet, YACDs and their diagnosed mothers receive no guidance on how to talk about cancer. Thirty-nine mother/YACD pairs participated in an online survey to identify challenging topics and strategies for talking about cancer, and to explore associations between openness/avoidance and psychosocial outcomes. YACDs and mothers reported the same challenging topics (death, treatment-related issues, negative emotions, relational challenges, YACDs' disease risk) but differed on why they avoided the topic. YACDs and mothers identified the same helpful approaches to navigate conversations (openness, staying positive, third-party involvement, avoidance). Avoidance was correlated with more distress whereas openness was correlated with better psychosocial outcomes. These results provide a psychosocial map for a mother-YACD communication skills intervention, which is key to promoting healthy outcomes. [ABSTRACT FROM AUTHOR]

Aim: To explore the relationship between filial obligation and caregiver depression across cultures. Design: Systematic review and meta‐analysis. Methods: Twelve databases were reviewed for dissertations and peer‐reviewed articles on filial obligation and caregiver depression among adult children, published before January 2020. In total, 476 titles and abstracts were retrieved. Final analysis included six studies; of these, four were included in the meta‐analysis. Results: Fixed‐effects model indicated that a stronger perception of filial obligation was associated with increased depressive symptoms among caregivers across cultures (β = 0.14, 95% CI [0.04, 0.24], p < 0.01, N = 394). However, a non‐significant effect size in the correlation between these two variables was found in samples predominated by Caucasian and mixed‐blood caregivers (r = 0.03, 95% CI [−0.03, 0.10], p > 0.05, N = 880). Therefore, caregivers' perceptions of filial obligation should be clinically assessed and normalised to reduce their depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: The changes in demographic and family structures have weakened the traditional norms of filial piety and intergenerational relationships dramatically. This study aims to examine the dynamic association between financial support of adult children to their parents and informal care provision in China and its differences in household registration, residence arrangement and community-based care services. Methods: Data was derived from the 2008–2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), which is a longitudinal survey of a nationally representative sample of individuals aged 60 and over. Random effects model was used to assess the association between financial support and informal care provision of adult children to their parents. Results: It was found that financial support showed an upward trend while informal care provision showed a download trend from 2008 to 2018. The result indicated a significant and negative association between financial support and informal care provision of adult children to their parents (B = -0.500, 95% confidence interval (CI) = -0.761 to -0.239). And the association was significant among elderly people who were from urban areas (B = -0.628, 95% CI = -0.970 to -0.287), co-resided with adult children (B = -0.596, 95% CI = -0.939 to -0.253), and had community-based services (B = -0.659, 95% CI = -1.004 to -0.315). Conclusion: Financial support was negatively associated with informal care provision of adult children to their parents in China, and the association has differences in household registration, residence arrangement and community-based care services. It is suggested that policymakers should prioritize planning interventions for elderly care services and establish a family caregiver support system. [ABSTRACT FROM AUTHOR]

In this study, we seek to clarify whether the present-day experience of psychological distress among adults whose parents suffered from mental illness is related to their childhood experiences of abuse and neglect and their provision of emotional care for their parents during their school-age years. To this end, a web-based cross-sectional study was conducted. A total of 120 participants over the age of 20 who attended a self-help group responded (50% response rate); of these, 94 had a parent diagnosed with a mental illness, and these participants were included for data analysis purposes. Of the 94 respondents, 65 (69.2%) were highly distressed, as measured by a Kessler (K) 6 measure of ≥5. A logistic regression analysis revealed that the experience of providing emotional care for parents during school-age childhood was significantly related to high levels of distress in adulthood (OR = 3.48; 95% CI 1.21–9.96). For children of parents with mental illnesses, the effects of providing emotional care for parents during childhood may include long-term psychological distress. For this reason, mentally ill parents raising children need visiting community nurses or other professionals to provide emotional care on behalf of their children. [ABSTRACT FROM AUTHOR]

We examine older partnered parents’ time spent with adult children in biological and step families, treating time together as an indication of relationship strength. Using a unique national sample of U.S. time diaries from the Panel Study of Income Dynamics, we investigate time with all adult children combined and with each adult child. We find that time together depends on family structure and parent–adult child dyadic relationship type embedded in family structure. In analyses of all adult children combined, an older parent is more likely to spend time with adult children in biological families than in stepfamilies only when there is no shared biological child in the stepfamily. In dyadic analyses, a parent’s tie with an adult child who is a biological child of both partners is stronger in stepfamilies than in biological families. Moreover, among stepfamilies, ties are not uniformly stronger with biological children relative to stepchildren; differences emerge only in more complex families when each partner has biological children from previous relationships. Our findings challenge the view that ties with older parents are always weaker with stepchildren in stepfamilies and point to the importance of considering parent–child relationships in the broader family context. [ABSTRACT FROM AUTHOR]

Objective: To study differences by sperm donor type in the psychological adjustment of the U.S. National Longitudinal Lesbian Family Study (NLLFS) offspring across three time periods from childhood to adulthood.Design: U.S.-based prospective cohort study.Setting: Paper-and-pencil questionnaires and protected online surveys.Patient(s): A cohort of 74 offspring conceived by lesbian parents using an anonymous (n = 26), a known (n = 26), or an open-identity (n = 22) sperm donor. Data were reported when offspring were ages 10 (wave 4), 17 (wave 5), and 25 (wave 6).Intervention(s): None.Main Outcome Measure(s): Achenbach Child Behavior Checklist administered to lesbian parents when offspring were ages 10 and 17 and the Achenbach Adult Self-Report administered to offspring at age 25.Result(s): In both relative and absolute stability, no differences were found in internalizing, externalizing, and total problem behaviors by donor type over 15 years. However, both externalizing and total problem behaviors significantly declined from age 10 to 17 and then increased from age 17 to 25. Irrespective of donor type, among the 74 offspring, the large majority scored continuously within the normal range on internalizing (n = 62, 83.8%), externalizing (n = 62, 83.8%), and total problem behaviors (n = 60, 81.1%).Conclusion(s): The results reassure prospective lesbian parents and provide policy makers and reproductive medicine practitioners with empirical evidence that psychological adjustment in offspring raised by lesbian parents is unrelated to donor type in the long term. [ABSTRACT FROM AUTHOR]

Background: Patients with bone metastases often are unable to complete quality of life (QoL) questionnaires, and cohabitants (such as spouses, domestic partners, offspring older than 18 years, or other people who live with the patient) could be a reliable alternative. However, the extent of reliability in this complicated patient population remains undefined, and the influence of the cohabitant's condition on their assessment of the patient's QoL is unknown.Questions/purposes: (1) Do QoL scores, measured by the 5-level EuroQol-5D (EQ-5D-5L) version and the Patient-reported Outcomes Measurement Information System (PROMIS) version 1.0 in three domains (anxiety, pain interference, and depression), reported by patients differ markedly from scores as assessed by their cohabitants? (2) Do cohabitants' PROMIS-Depression scores correlate with differences in measured QoL results?Methods: This cross-sectional study included patients and cohabitants older than 18 years of age. Patients included those with presence of histologically confirmed bone metastases (including lymphoma and multiple myeloma), and cohabitants must have been present at the clinic visit. Patients were eligible for inclusion in the study regardless of comorbidities, prognosis, prior surgery, or current treatment. Between June 1, 2016 and March 1, 2017 and between October 1, 2017 and February 26, 2018, all 96 eligible patients were approached, of whom 49% (47) met the selection criteria and were willing to participate. The included 47 patient-cohabitant pairs independently completed the EQ-5D-5L and the eight-item PROMIS for three domains (anxiety, pain, and depression) with respect to the patients' symptoms. The cohabitants also completed the four-item PROMIS-Depression survey with respect to their own symptoms.Results: There were no clinically important differences between the scores of patients and their cohabitants for all questionnaires, and the agreement between patient and cohabitant scores was moderate to strong (Spearman correlation coefficients ranging from 0.52 to 0.72 on the four questionnaires; all p values < 0.05). However, despite the good agreement in QoL scores, an increased cohabitant's depression score was correlated with an overestimation of the patient's symptom burden for the anxiety and depression domains (weak Spearman correlation coefficient of 0.33 [95% confidence interval 0.08 to 0.58]; p = 0.01 and moderate Spearman correlation coefficient of 0.52 [95% CI 0.29 to 0.74]; p < 0.01, respectively).Conclusion: The present findings support that cohabitants might be reliable raters of the QoL of patients with bone metastases. However, if a patient's cohabitant has depression, the cohabitant may overestimate a patient's symptoms in emotional domains such as anxiety and depression, warranting further research that includes cohabitants with and without depression to elucidate the effect of depression on the level of agreement. For now, clinicians may want to reconsider using the cohabitant's judgement if depression is suspected.Clinical Relevance: These findings suggest that a cohabitant's impressions of a patient's quality of life are, in most instances, accurate; this is potentially helpful in situations where the patient cannot weigh in. Future studies should employ longitudinal designs to see how or whether our findings change over time and with disease progression, and how specific interventions-like different chemotherapeutic regimens or surgery-may factor in. [ABSTRACT FROM AUTHOR]

Objective: To study how adult offspring in planned lesbian-parent families relate to their unknown or known donors.Design: Qualitative analyses of the sixth wave of online surveys from a longitudinal study of adult offspring in planned lesbian families, enrolled at conception.Setting: Community-based United States national study.Patient(s): The 76 participants were 25-year-old donor insemination (DI) offspring whose lesbian parent(s) enrolled in a prospective longitudinal study when these offspring were conceived.Intervention(s): None.Main Outcome Measure(s): Offspring were asked about donor type, feelings about permanently unknown donor, satisfaction with and role of known donor, whether relationship with known donor was ongoing, and age of meeting open-identity donor.Result(s): This cohort (n = 76) of DI offspring with lesbian parents was among the first generation to reach adulthood. Thirty participants had permanently unknown donors and most participants felt comfortable about not knowing them. Sixteen participants had open-identity donors they had not met. Thirty had currently known donors-met in childhood (n = 22) or after open-identity donor disclosure (n = 8)-of whom two thirds had ongoing relationships with donors, half considered their donors as acquaintances, and nearly half had good feelings about their relationship, although a minority expressed conflicted feelings.Conclusion(s): This study of adult DI offspring from planned lesbian families shows that those who knew their donors mainly felt positively about these relationships. Qualitative analyses offered insight into offspring-donor relationships, whose numbers are increasing due to historical and demographic trends. [ABSTRACT FROM AUTHOR]

Background: The increasing number of older people and the dissemination of health information via the Internet have emerged and both are challenging to Chinese society. Available online health information highlights the importance of decision making processes, specially in relation to the elderly who almost have no online presence and depend on their adult children's help. The researchers mostly focus on parents' health information search for their children, however, they overlook the adult children's intention to use online health information for their aged parents.Objective: This study fills this gap by extending the Theory of Planned Behavior (TPB) to identify the determinants of adult children's intention to use online health information for their aged parents.Method: Relying on survey method, the data were collected from teachers and students at different participating Universities in Wuhan, China. The Partial Least Squares (PLS), a structural equation modeling technique, was employed to test the research model.Results: This study found that attitude, subjective norm, perceived behavioral control and risk (p<0.05) were the predictors of intention to use online health information, whereas, trust (p>0.05) was not listed among the predictors.Conclusions: This study is a significant addition to the literature, in that it confirms the utility of the TPB with additional variables in predicting adults' children intention to use online health information for their aged parents. [ABSTRACT FROM AUTHOR]

Objective: To report findings from 10 years of requests from adults eligible to obtain their open-identity sperm donor's information.Design: Analysis of archived family and donor data. Semistructured interviews at information releases.Setting: Not applicable.Patient(s): A total of 85 DI adults requesting 43 donor identities; program data on 256 DI families.Intervention(s): None.Main Outcome Measure(s): We identified [1] demographic predictors of requesting donor identities, [2] information release timing and length, and [3] request motives.Result(s): Just >35% of eligible DI adults requested their donor's identity. Adults ranged from 18-27 years, requesting at median age 18 years. More women than men requested. Proportionally fewer adults requested when they had heterosexual-couple parents, and proportionally more when they had one rather than two parents. In interviews, the common theme was wanting to know more about the donor, especially about shared characteristics. Most adults planned to contact their donor. More than 94% of adults had donors who were open to contact; adults expressed modest expectations about this contact.Conclusion(s): In 2001, the first adults became eligible to obtain their open-identity sperm donor's information. Ten years of identity requests at one program indicates that information about one's donor is important to a significant proportion of these DI adults. Most requested their donor's identity soon after becoming eligible, suggesting some urgency to wanting the information. Interview data highlighted the role of donor information in helping adults better understand themselves and their ancestry. Findings hold important implications for practice and policy. [ABSTRACT FROM AUTHOR]

Parental alcohol use disorders (AUDs) have been conceptualized as a chronic stressor that can lead to deleterious long-term outcomes in children of individuals with AUDs. Yet, while many individuals are detrimentally affected by their parents’ problematic alcohol use, and go on to manifest psychological problems, others do not. How individuals cope with the stress of having a parent with an AUD is believed to be an important moderator of this differential outcome. This study assessed whether individuals’ alcohol-specific coping styles predicted alcohol use, positive or negative life events, and depression, using a sample of 465 college students, of whom 20% were adult children of individuals with alcohol use disorders, colloquially known as adult children of alcoholics (ACOAs), and a battery of well-validated, self-report measures. Participant ACOAs reported less ‘engaged’ and ‘total’ alcohol- specific coping strategies and more ‘withdrawal’ alcohol-specific coping strategies than their non adult children of alcoholics (NACOAs) counterparts. Across participants, women reported more ‘engaged’, ‘tolerant/inactive’, and ‘total’ coping than men. Although ACOAs reported significantly more negative life events, which predicted more passive coping styles, they did not differ significantly from NACOAs on measures of problematic alcohol use or depression, supporting theories of resilience in ACOAs regardless of their alcohol-specific coping styles. For NACOAs, ‘tolerant’ coping predicted greater depression and alcohol-related problems; ‘engaged’ coping predicted fewer alcohol problems. Results suggest that ACOAs cope differently with problematic alcohol use among relatives and friends compared with NACOAs and are more likely to experience negative life events. Additionally, alcohol-related coping strategies have more predictive utility in NACOAs than ACOAs. [ABSTRACT FROM AUTHOR]

Attention deficit/hyperactivity disorder (ADHD) persists into young adulthood for many individuals. For some, the challenges associated with ADHD can impact success in school, work, and relationships. Difficulty achieving independence can result in some young adults with ADHD failing to "leave the nest" at a socially appropriate time. Family relations can become strained as parents try to support and encourage their young adult child, while also trying to manage their own mixed feelings and meet their own developmental needs. Research suggests that breaking this cycle of young adult dependence is most successful when parents change their focus from trying to change the young adult to changing their own behavior. Two models for this process are described herein. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to explore and describe the experience of adult Korean children who are caregivers for parents institutionalized with dementia. Methods: Participants were fourteen adult children caregivers of elders institutionalized with dementia. Data were collected through in-depth unstructured interviews with individual participants from August to November, 2012. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Strauss and Corbin's Grounded Theory Method. Results: From open coding, 67 concepts, 29 sub-categories, and 14 categories were identified. Analysis revealed that the core category of the experience of adult children caring for their parents institutionalized with dementia was 'enduring the role of a prop' consisting of four phases: initial turmoil, exploration, role adjustment, and acclimation. To manage the role of a prop, participants utilized various action/interactional strategies such as overcoming the unfamiliarity, overseeing the nursing home care, and counterbalancing the caring roles. As a result, participants experienced ambivalence towards the existence of parents with dementia, changes in family relationships, altered viewpoint towards nursing homes, and restructuring of life. Conclusion: In-depth understanding of the experience will guide nurses to promote effective interventions in order to better support the Korean family caregivers of parents institutionalized with dementia. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to investigate the psychometric properties of the Portuguese version of the Posttraumatic Growth Inventory (PTGI) and relate posttraumatic growth with psychological morbidity. This is a cross-sectional study with a sample of 214 adult children of cancer patients. Additionally, a comparison group was recruited with 78 participants without a chronically ill parent. Measures of distress, posttraumatic stress disorder (PTSD) symptoms, and posttraumatic growth were collected. The original five-factor structure of the PTGI was maintained, with satisfactory internal consistency. The reorganization of the items in five factors was similar to the solution found in the original PTGI study, except for four items. Positive correlations between posttraumatic growth and PTSD symptoms/distress were significant. Women showed significantly higher posttraumatic growth. Adult children with parental cancer, and with probable PTSD, showed higher scores on the PTGI. Regression analysis revealed that PTSD symptoms were associated with higher posttraumatic growth, after controlling for demographic and clinical variables. Analysis with the comparison group showed that differences in posttraumatic growth were observed as a function of a shattered experience. This study confirmed the multidimensionality of the posttraumatic growth construct, underscoring the importance of considering the subjective nature of the shattered event, and the experience of emotional distress with parental cancer. [ABSTRACT FROM AUTHOR]

Background Long-standing theory suggests that quality of the mother's (or primary caregiver's) interaction with a child is a key determinant of the child's subsequent resilience or vulnerability and has implications for health in adulthood. However, there is a dearth of longitudinal data with both objective assessments of nurturing behaviour during infancy and sustained follow-up ascertaining the quality of adult functioning. Methods We used data from the Providence, Rhode Island birth cohort of the National Collaborative Perinatal Project (mean age 34 at follow-up, final N=482) to conduct a prospective study of the association between objectively measured affective quality of the mother-infant interaction and adult mental health. Infant-mother interaction quality was rated by an observer when infants were 8 months old, and adult emotional functioning was assessed from the Symptom Checklist-90, capturing both specific and general types of distress. Results High levels of maternal affection at 8 months were associated with significantly lower levels of distress in adult offspring (1/2 standard deviation; b=-4.76, se=1.7, p<0.01). The strongest association was with the anxiety subscale. Mother's affection did not seem to be on the pathway between lower parental SES and offspring distress. Conclusion These findings suggest that early nurturing and warmth have long-lasting positive effects on mental health well into adulthood. [ABSTRACT FROM AUTHOR]

People linked through social ties are known to have interdependent health. Our aim was to investigate such collateral health effects in the context of offspring mortality after a parent's death in children aged 10-59 years. The data (N = 3,753,368) were from a linked-registers database that contains the total Swedish population. In minor children, we found elevations in mortality risks associated with a parent's death. Adult offspring experienced a reduced mortality risk recently after a parent's death, which over time approached, and in some instances even exceeded, that of the general population. Mother's death tended to have a stronger influence than father's death, unnatural parental deaths had a stronger effect than natural ones, and male offspring were more vulnerable than female offspring. [ABSTRACT FROM AUTHOR]

This section discusses a blog post about topics including the changing social role of fathers and the death of Andrew Madoff, son of Ponzi schemer Bernard Madoff, due to mantle-cell lymphoma.

A personal narrative is presented which explores the author's experience of the time when his father was suffering from dementia.