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Social relationships between adults are complex. They enable people to derive information, affection, and assistance from one another; to learn and convey knowledge about their history; to acquire and maintain self-identity; and to regulate affect (Carstensen, 1992). Most social relationships that include an adult are the product of a lifetime of associations; many have the potential to affect such far-reaching outcomes as physical health and psychological well-being. Virtually all social relationships between adults have the potential to be affected by illness and disability.
In this research paper we review what is known about social relationships between adults. We focus exclusively on social relationships in which all parties are adults and concentrate on those in which at least one person would be considered elderly. Not included, therefore, are relationships between parents and adolescent children and those between grandparents and young grandchildren. We take a life-course perspective on social relationships in this review, meaning that we are concerned with how individuals change over time and how their transitions are linked to the people with whom they maintain close relationships. More specifically, in this research paper we focus on adult social relationships between (a) spouses, (b) parents and their children, (c) siblings, and (d) friends. We examine these bonds both within the context of health and of disability, reviewing conceptual frameworks as well as empirical literature. We concentrate on reviewing critical themes, highlighting recently published literature, and identifying key research questions and findings. On the basis of our review of the state of the art, we conclude by making recommendations for future directions that the next generation of knowledge about social relationships between adults should take.
Theories about social relationships between adults generally have sought to predict those aspects of social relationships that are stable over the life course and those that change. They have also been concerned with predicting how social relationships can help to explain psychological well-being.
Convoys of Social Relationships
One of the earliest theoretical frameworks to focus on interpersonal relationships from a life-course perspective was that proposed by Kahn and Antonucci (1980). Their central proposition was that social support is important to individual well-being throughout the life course, both for its direct contributions and for its ability to moderate the effects of stress. They define social support as interpersonal transactions that include one or more of the following elements: affect, affirmation, and aid.
Based on theories of attachment and of roles, Kahn and Antonucci developed the concept of convoys. They conceptualized an individual as moving through the life cycle surrounded by a set of other people to whom he or she is related by the giving or receiving of social support. An individual’s convoy at any point in time, they suggest, consists of the set of people on whom he or she relies for support and those who rely on him or her for support.
Kahn and Antonucci (1980) suggested that relationships between individuals could be symmetrical, with an exchange of approximately equal amounts of support, or asymmetrical, with one individual providing more support to the other. Furthermore, they contended that a person’s requirements for social support at any given time are jointly determined by properties of the situation and of the person. They suggested that either too much support or too little support could be detrimental to an individual.
Convoys are conceptualized as being dynamic and lifelong in nature.Although some components will most likely change over time, others will remain stable across time and situations. Kahn andAntonucci suggest that losses and gains in convoys could have a variety of causes, including death, betrayal, changes in role, or location. For additional information about the structure and function of convoys among older Americans, readers are referred to Antonucci and Akiyama (1987).
Socioemotional Selectivity Theory
Consistent with Kahn and Antonucci’s theory, Carstensen (1991, 1992) proposed the socioemotional selectivity theory, which posits that reduced rates of social interaction in later life are the result of lifelong selection processes by which people strategically and adaptively cultivate their social networks to maximize social and emotional gains and minimize their risks. The theory is rooted in the functions of social contact; it proposes that although these basic functions remain consistent across the life span, one’s place in the life cycle influences the salience and effectiveness of specific functions. Carstensen contends that over the life course there is a reduced likelihood that interaction with casual social partners will be rewarding, whereas interaction with a select group of significant others becomes increasingly more valuable.
In an empirical test of the model, Fredrickson and Carstensen (1990) studied the salience of information potential, potential for future contact, and affective rewards from social partners among adolescents, middle-aged people, and healthy and infirm elderly people. They found that adolescents placed the greatest emphasis on the potential for future contact and gathering information about social partners to know them better, whereas elderly people placed the greatest emphasis on the potential for positive rather than negative affect in social interactions. Results provide strong support for the socioemotional selectivity theory, which maintains that reductions in social contacts across the life span reflect increasing selectivity in one’s choice of social partners. Although rates of interaction with acquaintances decline steadily from early adulthood on, interactions in significant relationships increase. The findings that interactions with a core group of social partners from whom people derive affective gains become more frequent, satisfying, and emotionally close over the adult life course, while interactions with more casual social contacts provide fewer affective rewards and become less satisfying and frequent support the socioemotional selectivity theory.
In a more recent study Lansford, Sherman, and Antonucci (1998) examined the socioemotional selectivity theory within and across three historical cohorts, from samples interviewed in 1957, 1976, and 1980. Data from three cohorts of national representative samples were analyzed to determine whether respondents’satisfaction with the size of their social networks differed by age, cohort, or both. Results support socioemotional selectivity theory, with more older adults than younger adults reporting feeling satisfied with the current size of their social networks rather than wanting larger networks.
Weiss’s Theory of Social Provisions
- Weiss (1974) developed an elegant theory about provision of support from kin and from nonkin. He maintains that individuals require six key social provisions in order to maintain well-being and to avoid loneliness. These provisions include those that are assistance-related (reliable alliance, guidance) and those that are non–assistance-related (social integration, reassurance or worth, nurturance, attachment). These components, provided by primary group relationships (characterized by closeness, warmth, and commitment), provide the total perceived support to people and supply distinctive benefits to them. People lacking each social provision experience negative effects. For example, a person lacking attachment would experience emotional isolation. Someone lacking social integration would experience social isolation.
- Weiss (1974) maintains that social relationships tend to become specialized in their provisions. As aresult, individuals must maintain a number of different relationships in order to maintain psychological well-being. Some of these provisions typically are provided by family members, and others typically are provided by friends. Reliable alliance or instrumental support is most often provided by family members. Weiss states that instrumental support is often provided by family regardless of the level of mutual affection or whether one has reciprocated in the past. Guidance—especially important in timesofstress—isprovidedbysignificantotherswhoareseen as trustworthy and authoritative. Friendships offer provisions associated with a community of interest such as social integration. Reassurance of worth is provided by relationships that support a person’s competence in a social role, such as colleagues in the workplace or family members at home. Nurturance is provided by a relationship in which an individual takes responsibility for the well-being of another. Attachment-providing relationships tend to be an exception where specialization is concerned. The marital relationship is defined by its sense of attachment, yet attachment can also be provided by relationships with other family members or close friends.
- Weiss’s (1974) model holds that multiple needs must be satisfied by an individual’s support network. Moreover, he contends that there is probably an element of almost every relational provision in each supportive relationship. Weiss’s theoretical model has received substantial empirical support (Cutrona & Russell, 1987; Felton & Berry, 1992; Mancini & Simon, 1984).
Four critical questions have been the focus of scholars of adult social relationships. They are (a) Do relationships with family and with friends have different effects on people, (b) Can social relationships have negative as well as positive effects on people, (c) Does the quantity or quality of social support best predict well-being, and (d) Can social relationships reduce the risk of functional decline and mortality? Recent literature regarding the status of each question is summarized in the following discussions.
Do Relationships With Family and With Friends Have Different Effects on People?
Ties to both family and friends are important. Data consistently indicate that although family members are close and intimate members of most elderly people’s network, friends are named as the people with whom they enjoy spending time, engage in leisure activities, and have daily or frequent contact. The proportion of same-sex friends reported does not change across age groups from the teen years through old age. Although the absolute number of social relations is smaller in succeeding age groups, the role of friends remains important throughout life (Davis & Todd, 1985).
There are, however, different roles for family and friends. Friends are expected to provide companionship and shortterm crisis intervention, whereas family members are expected to provide more significant resources in areas such as financial matters, health, tasks of daily living, discussion of family problems when necessary, and long-term support for chronic needs (Cantor, 1979; Connidis & Davies, 1990).
Research for two decades has consistently found that friends are more important to the psychological well-being of adults than are family members (Adams & Blieszner, 1995; Antonucci & Akiyama, 1995; Lynch, 1998; Pinquart & Sorensen, 2000). At the same time, adults who have no family or who have poor relationships with family have much lower levels of general well-being than do others (M. G. Thompson & Heller, 1990).
Several explanations have been offered to explain this empirical finding. One explanation provided by Antonucci (1985) suggests that it is a function of obligatory versus optional relationships. Family relationships are obligatory; friend relationships are optional. Family should be available; thus, their absence is felt as a deficit. Friends do not have to be available; therefore, their presence is so much more a benefit. A second explanation is grounded in the fact that family relationships are ascribed, whereas relationships with friends are chosen. People cannot choose or substitute their parents, siblings, and children, even when these relationships are a constant source of stress. In contrast, people establish and maintain friendships by mutual choice based on a consensus of common experiences, interests, values, affection, and reciprocity. The feeling of being desirable elicited by friendship relations enhances well-being and builds selfesteem. A third explanation focuses on the extent to which relationships can be severed. Relationships with family members clearly are more difficult to sever; this—combined with the fact that people of all ages are more likely to report that family members get on their nerves than do friends (Antonucci & Akiyama, 1995)—may make relationships with friends more important to psychological well-being. Fourth, the effect may be a function of the fact that friends are typically members of the same age group and often share personal characteristics, cohort experiences, and lifestyles. Compared with younger family members, higher similarity in values and experiences may promote a higher satisfaction with friendship than with family relationships. Finally, Larson, Mannell, and Zuzanek (1986) suggest that relationships with friends are more likely than relationships with family members to be characterized by positive interactions. Friends are more often a source of enjoyment and socializing; as such, they are a more significant source of satisfaction. Family members, on the other hand, are more likely to be responsible for providing day-to-day physical and emotional assistance and to serve as sources of security and insulation against threats and losses. In this role, family relationships contribute to well-being within a global time frame, as a general state dependent on an individual’s overall security and satisfaction. Friends, in contrast, primarily influence immediate well-being.
Can Social Relationships Have Negative as Well as Positive Effects on People?
Although a great deal of research has focused on the positive effects that social support can have on adults, recently researchers have urged greater attention to the negative side of informal social relationships. At issue has been the question of whether positive or negative social exchanges have a greater impact on older adults’ health and well-being. Since Rook (1984) demonstrated that social relationships can adversely influence the psychological well-being of older adults, several investigators have examined the effects of both positive and negative social ties in later life (IngersollDayton, Morgan, & Antonucci, 1997; Okun & Keith, 1998). Rook (1990, 1994), reviewing this literature, concludes that negative and positive social exchanges are unrelated to one another, and that the detrimental effects of negative social exchange are more potent than are the beneficial effects of positive social exchanges. More recently Rook (1997) has shown that negative social exchanges are related to more life stress and less supportive networks. Her findings led her to conclude that both personal characteristics (such as daily mood and self-esteem) and life context (such as the experience of stressful life events) influence older people’s vulnerability to negative social exchanges.
Recent results from research by Okun and Keith (1998) suggest that the picture may be more complicated. Among a sample of respondents aged 60–92 years old, they found that positive social exchanges with children cushioned the adverse effects of negative social exchanges with both one’s spouse and other relatives and friends. Furthermore, when these older adults experienced negative social exchanges with children, positive social exchanges with other relatives and friends were especially helpful. An interesting result was that this relationship was not found in a younger sample of respondents.
Does the Quantity or Quality of Social Support Best Predict Well-Being?
Most adults are entrenched in social relationships with people who are important to them. Although social isolation is rare, its effects are devastating in terms of poorer mental and physical health as well as increased likelihood of morbidity and mortality (Berkman & Syme, 1979; Chappell & Badger, 1989).
Extensive research has examined the importance of a single, close, personal relationship. The importance of a confidant as a buffer against decrements that include role loss and reduction of social interaction was first introduced by Lowenthal and Haven (1968). Availability of a confidant has been associated with higher morale and lower levels of loneliness and social isolation in old age (Wenger, Davies, & Shahtahmasebi, 1995). Having someone in whom one can confide seems to be equally important for men and women (Slater, 1995).
Older people who lack confidants report more psychological distress and higher rates of depression (Hays et al., 1998). There is no evidence that widowhood affects levels of confidant support (Dean, Matt, & Wood, 1992). In a study that controlled for health behaviors and other confounders (age, race, education, health conditions), Michael, Colditz, Coakley, and Kawachi (1999) identified elements of a woman’s social network as significant predictors of her functional status. Strong predictors of high functioning among older women were having close friends and relatives and the presence of a confidant.
The existence of a special confidant is especially important to unmarried older people without close relatives, who rely on these relationships to satisfy the need for intimacy and emotional security (Gupta & Korte, 1994). Longitudinal research by Wenger and Jerrome (1999) revealed that although marital status and parenthood are important factors in the nature of the confidant relationship, over a 16-year period most older people changed confidants, usually as a result of increased dependency, disability, or death. Daughters are preferred over sons as confidants; sisters are preferred over brothers.
Research indicates that there are differences in the adult friendships of men and women. Women tend to have more intimate friendships than do men; men have a greater tendency to focus their friendships around activities (Antonucci, 1990). In addition, whereas women are more likely to have a female friend as a confidant, men are more likely to rely on their spouse as a confidant (Hess & Soldo, 1985). These gender differences are characteristic throughout the life course (P. H. Wright, 1989).
Agreat deal of research has examined the number of close ties that adults have. Wellman and Wortley (1989) found that adults have between four and seven close, supportive intimates. In their national sample of men and women over 50 years of age, Antonucci and Akiyama (1987) reported an average of 3.5 very close intimates and 3.5 close intimates. More recently, Antonucci, Akiyama, and Lansford (1998) report that the average number of close relationships named by men and women age 50 and older was 3.65. Women had significantly more close social relations than did men.
The relationship between the number of close ties and psychological well-being is complex. Antonucci et al. (1998) found that for women, the larger the number of close social relations, the less happy they reported being. For men no such association existed. These findings are consistent with Turner and Troll’s (1994) caution that the effects on women of having more social ties may not always be positive.
The quality of social relations rather than the structural characteristics of these relations has the most significant effect on well-being (Antonucci & Jackson, 1987; Oxman, Berkman, Kasl, Freeman, & Barrett, 1992). People who are not satisfied with their social relations report higher levels of depressive symptomatology at all ages than do those who are satisfied. This is consistent with Carstensen’s (1991) theory of optimization, suggesting that as people age, they are increasingly selective about the relationships in which they choose to invest.
Can Social Relationships Reduce the Risk of Functional Decline and Mortality?
Social relationships have been associated with a host of health outcomes in adults, including a lower risk of mortality, cardiovascular disease, cancer, and functional decline (Berkman, 1995; House, Landis, & Umberson, 1988). These benefits appear to persist into late life (Oxman et al., 1992; Seeman, 1996; Unger, McAvay, Bruce, Berkman, & Seeman, 1999). They have also been shown to improve survival and recovery followingacutemedicalconditions(Berkman,Leo-Summers, & Horwitz, 1992; Glass, Matchar, Belyea & Feussner, 1993; Jenkins, Stanton, & Jono, 1994; Wilcox, Kasl, & Berkman, 1994). Recent research by Mendes de Leon et al. (1999) reveals that being embedded in social relationships reduces the risk of functional disability and enhances recovery from functional disability.
These protective effects of social relationships may result from several processes. They include provision of access to information about health and health care services (Bloom, 1990), encouragement of health behaviors (Bovbjerg et al., 1995; Mermelstein, Cohen, Lichtenstein, Kanmark, & Baer, 1986), provision of tangible aid (Thoits, 1995), provision of emotional support to facilitate coping with life stress (Thoits, 1995), enhancement of feelings of self-esteem and control (Krause&Borawski-Clark,1994),andinfluencesonneuroendocrine or immune functioning (Seeman et al., 1994; Uchino, Cacioppo, & Kiecolt-Glaser, 1996).
Consistent research indicates that widowhood has more harmful effects on cardiovascular morbidity and mortality for men than for women (Berkman et al., 1993; Seeman, 1996). In a recent study, Unger et al. (1999) found that social relationships had a stronger effect on functional status for men than for women. These investigators also found stronger protective effects of social relationships among respondents with lower levels of physical performance.
Social Relationships in the Context of Health
The section that follows presents state-of-the-art information about the social relationships of normal, healthy adults.
Although the overwhelming majority of adults marry, significant changes during the past several decades characterize the patterns of marriage, divorce, widowhood, and remarriage. Cherlin and Furstenberg (1994) report that one third of adults can now expect to marry, divorce, and remarry during their lifetimes.
Married men and women have better psychological wellbeing than do their unmarried peers (Gove, Style, & Hughes, 1990; G. R. Lee, Seccombe, & Shehan, 1991). Research by Marks (1996) suggests that the pattern may in fact be more complex. She found that separated or divorced women, widowed women, and single men were significantly more distressed than were their married counterparts. However, women who had never married by midlife were not significantly different from married women on ratings of psychological distress. Although she concludes that being single at midlife appears to be more problematic for men than for women, she cautions that results are far from conclusive.
For decades cross-sectional research consistently indicated that marital satisfaction changed over the course of time, with satisfaction being high at the beginning of the marriage, lower during the child-raising years, and then high again after the children leave home (Orbuch, House, Mero, & Webster, 1996). More recently, however, evidence seems to be mounting suggesting that marital satisfaction drops markedly over the first 10 years of marriage and then drops more gradually in the ensuing decades. Analyses by Glenn (1998), for example, fail to support the widespread belief that marriages tend to improve at midterm and that the later years of marriage are the golden ones. Rather, his findings strongly suggest that the differences in marital satisfaction between midterm and long-term marriages are largely a function of cohort differences.
The majority of older adults evaluate their marriages as happy or very happy, and marital adjustment seems to be stable over time in enduring relationships (Huyck, 1995). Levenson, Carstensen, and Gottman (1993) revealed that compared with middle-aged couples, older couples evidenced reduced potential for conflict and greater potential for pleasure. It remains unclear, however, whether this observed change is cohort-specific; due to divorce, which removes those who were unhappy at earlier ages; to the empty nest, which gives couples the opportunity to attend more closely to their relationships; or to characteristics that increase with marital duration, such as shared memories and knowledge of one another. Longitudinal research has shown that over time husbands report greater marital happiness and more affection than do wives (Field, Minkler, Falk, & Leino, 1993).
Much has been learned about marriages by studying those relationships that survive the test of time. One of the first studies of marriages lasting at least 50 years was conducted by Roberts (1979). He reports that significant elements in long-lasting marriages include independence, commitment, companionship, and qualities of caring. In a similar vein, Lauer, Lauer, and Kerr (1990) report that people in long-term marriages identified the following as important to their marriages: being married to someone they liked as a person and enjoyed being with; commitment to the spouse and to the institution of marriage; a sense of humor; and consensus on matters including aims and goals in life, friends, and decision making. Husbands and wives were similar in their views.
Goodman (1999a) reports that spouses in long-term marriages felt that intimacy and avoidance of hostile control were more important than autonomy. Goodman (1999b) also found that spouses in long-term marriages characterized by higher levels of reciprocity rated their marriages as most positive.
Retirement represents a major life transition that has the potential to affect the marriage. Although much of the current literature on retirement has been characterized by its almost exclusive focus on individuals, some recent research has begun to examine the ways in which marital relationships affect retirement as well as the effect that retirement has on marriage (Szinovacz & Ekerdt, 1995). Demographic changes in the past century have created a situation in which more people than ever before make the retirement transition as members of couples (Szinovacz, Ekerdt, & Vinick, 1992). A growing number of couples face the retirement of both spouses. Issues such as how couples time their labor force exits in relation to one another and how they anticipate and adapt to each other’s retirement have gained the attention of researchers.
Retirement timing is affected by marital status, spouse’s employment, and family obligations. Married men are more likely than are nonmarried men to be employed at all ages. Among women, however, nonmarried and divorced women tend to delay retirement. They are also more likely than are married women to report plans for postponed retirement or plans not to retire at all (Hatch & Thompson, 1992; Morgan, 1992). Married women frequently adjust their retirement to coincide with that of their husbands, thus retiring relatively early (Hurd, 1990). Some literature suggests that spouses time their retirement in relation to one another and tend to opt for joint retirement unless adverse circumstances preclude or render that option too costly (O’Rand, Henretta, & Krecker, 1992). There is some evidence that when a husband retires before his wife does, marital strain may occur (G. R. Lee & Shehan, 1989; Szinovacz, 1989).
Being married at retirement yields more positive retirement attitudes, higher retirement satisfaction, and better postretirement adaptation than does being unmarried (Atchley, 1992; Seccombe & Lee, 1986). Social and emotional support from spouses is particularly important for married men (Szinovacz, 1992).
The relationship between retirement and division of household work has been well studied. Studies consistently find that retirement does not substantially alter the preretirement division of household work along traditional gender lines. Rather, partners remain responsible for their respective feminine and masculine tasks (Szinovacz, 1989). There is, however, research suggesting that some retired husbands participate more in household work after retirement than they did before retirement. For these couples, the division of labor becomes more egalitarian after retirement (Dorfman, 1992). An egalitarian division of labor seems to be gratifying to couples in retirement (Hill & Dorfman, 1982). Research by Keith and Schafer (1986, 1991) found that too much help from husbands may induce marital tensions. They found that the husband’s presence in the wife’s domain as well as his increased scrutiny of her housework performance can increase perceptions of conflict and disenchantment among both partners.
A growing body of research discourages the idea that retirement is a serious threat to marital quality (Atchley, 1992; Szinovacz & Ekerdt, 1995). Rather, it seems that marital quality is stable across the retirement transition. Retirement does, however, have positive as well as negative affects on marriages. Positive changes brought about by retirement include increased freedom to develop joint endeavors, increased companionship, fewer time pressures, and a more relaxed atmosphere at home (Szinovacz & Ekerdt, 1995). Negative changes are evident predominantly from wives’ complaints about husbands’ being underfoot, a lack of privacy, and too much togetherness (Dorfman & Hill, 1986; Vinick & Ekerdt, 1991).
Ties between parents and their adult children have been the subject of study of Bengtson and his colleagues at the University of Southern California. Their longitudinal study, begun in 1971, of three-generation families led to the development of a theory of intergenerational family solidarity (Bengtson & Roberts, 1991). According to that theory, intergenerational solidarity is marked by six essential components. They are association or contact, affection or emotional closeness, consensus or agreement, function or instrumental support and source sharing, familism or normative obligations, and opportunity structures for family interaction. Empirical tests of the theory have demonstrated its usefulness for understanding the nature and quality of relationships between parents and adult children (Parrott & Bengtson, 1999; Whitbeck, Hoyt, & Huck, 1994) and the effects of family relationships on the well-being of older adults (Starrels, Ingersoll-Dayton, & Neal, 1995).
Because the lives of parents and their adult children are connected in significant ways for as long as both generations are alive, life-course transitions experienced by members of one generation can have consequences for members of the other generation. Kaufman and Uhlenberg (1998) report that parental divorce and declines in parents’health lead to deteriorating parent-child relationships. Similarly, problems in a child’s marriage cause strain in parent-child relationships.
A good deal of research has sought to understand whether the relationships between parents and adult children are more important to the parents or to the children. The developmental stake hypothesis posited by Bengtson and Kuypers (1971) suggests that young adult children and their parents vary in their perception of generational relations based on their location within the family lineage and their developmental stage. Specifically, young adults need to perceive large differences in values and attitudes among family lineage members as they develop an identity separate from that of their parents.At the same time, middle-aged parents have a need to perceive closer ties with their adolescent and young adult children as they strive to achieve generativity and enjoy the fruits of their parenting efforts. Thus, according to the developmental stake hypothesis, members of the older generation should perceive less distance between the generations than do members of the younger generation. The developmental stake hypothesis has been supported by several studies of intergenerational ties (Lynott & Roberts, 1997) More recently, Giarrusso, Stallings, and Bengtson (1995) presented the term intergenerational stake to emphasize that the stake refers to relationships between generations. Their analysis of changing perceptions of affectual solidarity among middle-generation parents and their adult children support the concept of an intergenerational stake.
Relationships between parents and their adult children are marked by mutual reliance across the generations (Umberson, 1992). Both generations prefer to live apart from one another; when the generations do live together, however, there has been controversy regarding whether they do so more because of the parent’s or the child’s needs. Aquilino (1990) and Ward, Logan, and Spitze (1992) present data indicating that parental needs are irrelevant to coresidence and that it is characteristics of adult children that lead to these arrangements. Furthermore, Aquilino (1990) reports that when parents and adult children live together, they usually reside in the parent’s rather than the child’s home. G. R. Lee and Dwyer (1996), however, caution that these findings may be unique to young-old people and their adult children, while the picture is quite different for very old people. Their analysis, similar to findings by Crimmins and Ingegneri (1990), and Soldo, Wolfe, and Agree (1990), indicates that in addition to children’s characteristics (marital status, employment status), the probability of coresiding with adult children is increased by parents’advanced age, failing health, and absence of a spouse.
The accomplishments of adult children have significant effects on the well-being of their parents. Research by Ryff, Schmutte, and Lee (1996) revealed that parents’well-being is linked to assessments of how their children have turned out, how the accomplishments of these children compare with those of their parents, and the extent to which the parents see themselves as responsible for their children. Parents felt better about themselves when they saw their children as doing well. However, parents who felt that their children were doing better than they themselves had done as young adults had lower levels of well-being. Parents who evaluated their children as less successful reported lower levels of responsibility and had the lowest levels of well-being.
Much has been written about filial responsibility. Early research by Seelbach (1984) investigated the extent to which older parents expected their children to assist them in times of need, live near or share a home with them, have contact with them, and provide various forms of emergency assistance. This research found that holding expectations of high filial responsibility was inversely related to morale of the older parents. An interesting analysis contrasting expectations for filial responsibility from the perspective of multiple generations of women by Brody, Johnsen, and Fulcomer (1984) revealed that although each successively younger generation expressed more egalitarian attitudes about the appropriateness of both sons’and daughters’providing parental care than the previous one, all respondents believed that children should be available to help parents when help is needed.
In the United States, parents and their adult children usually have frequent contact with one another (Troll, Miller, & Atchley, 1979), and even where geographic distance is considerable, they usually maintain contact (Dewit, Wister, & Burch, 1988). In addition to being in contact with one another, parents and their adult children are often involved in extensive exchange networks with one another (G. R. Lee & Ellithorpe, 1982). On the whole, older parents continue to provide support of various kinds to their adult children and are more likely to give help to than to receive help from their adult children (Riley & Foner, 1968) until forced by health declines to stop.
The sibling bond occupies a unique position among family relationships. It has the potential to last longer than any other human relationship; it includes people who share a common genetic, cultural, and experiential heritage; and because it is an ascribed rather than an achieved role, it remains part of an individual’s identity regardless of changes in marital status, place of residence, or financial well-being (Bedford, 1996a, 1996b; Cicirelli, 1995). Yet despite the sibling bond’s centrality within an individual’s life, research about adult sibling relationships has received little scholarly attention, especially when contrasted with the vast number of studies that have examined spouse and parent-child relationships (Campbell, Connidis, & Davies, 1999; Goetting, 1986).
Sibling relationships vary over the life course. After intense relations in childhood and adolescence, siblings tend to withdraw into families of procreation in adulthood, but come closer together again as their children leave home and their spouses die (Campbell et al., 1999; Goetting, 1986; T. R. Lee, Mancini, & Maxwell, 1990). Research regarding relationships among siblings during middle and old age varies in its conclusions about the strength of ties between siblings.
Most studies of the relationships between adult siblings indicate that these relationships are characterized by supportiveness, concern, and mutual affection (Cicirelli, 1995, 1996; Miner & Uhlenberg, 1997), yet these relationships are expressed differently from the way they were in early childhood (Cicirelli, 1988; Scott, 1990). In terms of exchange, some studies find that adult siblings exchange many services and have frequent contact (e.g., Wellman & Wortley, 1989), whereas other studies find evidence of limited support and contact (Avioli, 1989). When instrumental aid is exchanged between adult siblings, the situation is ordinarily temporary in duration, aid is received reluctantly, and it is accepted only if assistance from a spouse or adult child is not available (Avioli, 1989; Cicirelli, 1991). Both Cicirelli (1995) and Ross and Milgram (1982) found that the frequency of contact and kinds of involvement adult siblings have with one another are volitional and dependent on circumstances. Siblings stand ready to help one another in time of need and provide a sense of companionship and support when there is a crisis or serious family problem (Connidis, 1994).
Sibling support is especially important for unmarried adults, for older people, and for people experiencing shortterm crises (Campbell et al., 1999; Connidis, 1989). Nonetheless, direct care by one sibling for another in middle or old age is the exception rather than the rule. Research indicates that most older people have at least one living sibling (Cicirelli, 1996) and that they see their siblings at least several times a year. Very few siblings actually lose contact with one another.
In general, adults express positive feelings about their sibling relationships, with gender (females higher than males) and race (African Americans higher than European Americans) affecting feelings of intimacy, congeniality, and loyalty (Bedford, 1995; Cicirelli, 1995; Miner & Uhlenberg, 1997). Relationships with sisters are particularly important in old age, whether it is a sister-sister or brother-sister relationship (Cicirelli, 1996).
Sibling rivalry is low throughout adulthood and old age. Rivalry is greatest between pairs of brothers and least between cross-sex siblings (Cicirelli, 1985). Research by Bedford (1992) suggests that the sibling relationship waxes and wanes depending on critical events, including marriage or divorce, changing interests, employment change, relocation, illness and death, behavior and achievement of children, and family arguments.
In contrast to most primary social relationships, those between friends are marked by their voluntary nature. Scholars have been interested in understanding how friendships are formed and maintained. They have also analyzed friendship networks (Blieszner & Adams, 1992). Adams and Blieszner (1994) presented an integrative conceptual framework for studying adult friendships. The framework posits that the social structural and psychological aspects of individual characteristics operate together to shape behavioral motifs, which in turn influence friendship patterns. However, very few empirical studies of adult friendships exist.
Research on friends has focused on describing the effects of various personal characteristics on friendship patterns. Fischer and Oliker (1983) found that middle-aged men tend to have a larger number of friends and middle-aged women tend to have friendships that are more intimate. Friendship patterns are likely to change as people make life-course transitions (Allan & Adams, 1989) or as they mature (Brown, 1991). L. Weiss and Lowenthal (1975) found that older adults—more than middle-aged or younger ones— tended to have complex, multidimensional friendships. Adult friendship networks tend to be homogeneous in terms of occupational status, ethnicity, age, marital status, income, education, gender, and religion (Fischer, 1982; Laumann, 1973).
Social Relationships in The Context of Illness and Disability
As indicated previously, social relationships between adults are marked by varying degrees of reciprocity and interdependence. When an adult suffers from illness or disability, the nature of most of the social relationships in which he or she is engaged changes dramatically. Although a vast literature has focused on the effects that illness and disability have on the mental health of caregivers (Schulz, O’Brien, Bookwala, & Fleissner, 1995), less attention has been paid to the effects that chronic illness and disability have on social relationships. The next section reviews what is known about relationships between spouses, parents and children, siblings, and friends in the context of illness and disability.
When a person becomes ill or disabled and requires assistance, this aid is generally provided by one primary caregiver. Shanas’s (1979) observation that caregivers respond following a “principle of substitution” still rings true. The hierarchy of caregivers begins with a spouse. In the absence of a spouse, an adult daughter generally assumes the role of primary caregiver. Sons and daughters-in-law play significant roles when daughters and spouses are not available. Other family members and friends play the role of caregiver when alternatives are not available, although there is evidence that the caregiving role becomes less intense as the caregiver becomes more removed from the care receiver.
There has been some discussion in the literature about how the quality of the relationship between caregiver and care recipient affects various outcomes. One of the few theoretical perspectives to examine the role that quality of relationship has on outcomes was posited by Lawrence, Tennstedt, and Assmann (1998). Their perspective suggested that quality of the relationship would play a significant role as mediator or moderator of the relationship between primary stressors and caregiver well-being. Empirically they found that relationship quality had a direct effect on outcomes, with higher levels of relationship quality related to lower levels of depression. The mediating and moderating roles of relationship quality were more modest. Relationship quality mediated the linkage between problem behaviors and role captivity, a finding that Lawrence et al. (1998) explain as due to problem behaviors’ causing a decrease in relationship quality because of increased role captivity. Townsend and Franks (1995) found evidence that the quality of relationships between adult child caregivers and their elderly parents mediated the impact of the parents’ impairment on the adult children’s well-being.
Chronic illness can affect marital status, marital satisfaction, marital quality, and marital interaction (Burman & Margolin, 1992) by shifting the core relationship. The literature examining a link between the onset of chronic illness and divorce is equivocal, with some studies finding that divorce is more prevalent among individuals with chronic illness, whereas others find that the divorce rates of persons with chronic illness do not differ from those in the general population (Revenson, 1994). Rolland (1994) has suggested that the onset of chronic illness forcefully challenges the emotional and physical boundaries of a couple’s relationship. Maintaining emotional connection and knowing how to help one another and how to build the other’s self-esteem are important processes in achieving good marital functioning in illness.
Litman (1979) posited that strong marriages become stronger and weak marriages deteriorate in the face of chronic illness. An alternative hypothesis is that close families become severely strained and less enmeshed relationships are better able to adapt to illness. Empirical studies suggest that although some couples report that their marriages become stronger during the course of illness (Fuller & Swensen, 1992), other couples become overwhelmed by the demands of the illness. Wallerstein and Blakeslee (1995) suggest that change of any kind has the potential to strengthen or weaken marriage depending on the transactional patterns developed to meet illness tasks or challenges.
Husbands and wives experience unique stresses as a result of living with a person who is chronically ill. Spouses occupy a dual role when one member has a chronic illness. They are the primary providers of support to the ill person and they are also the family members who need support as they cope with illness-related stressors. Revenson (1994) has suggested that some of the stresses emanate directly from caregiving—spouses are inextricably involved in decisionmaking about treatment and day-to-day care. Other stresses emerge from the need to restructure family roles and responsibilities as the disease progresses. Still other stresses are filtered through the lens of the individual’s experience, as in the case of a spouse who feels helpless at seeing his or her partner in pain.
The chronic illness of a spouse can be particularly challenging when the concomitant role responsibilities lie outside of traditional gender roles. For example, when married women are afflicted with disabling illness such as rheumatoid arthritis or multiple sclerosis, husbands need to take on a greater share of household chores. Similarly, some wives of men whose employment is terminated by disability find that they need to work outside the home.
Spouses are the first line of defense when it comes to caregiving. They provide love and affection as well as tangible assistance with day-to-day responsibilities and special needs created by treatment regimens; validate the patient’s emotions or coping choices; help their partners reappraise the meaning of the illness; and share the existential and practical concerns about how the illness may affect the marriage and family in the future. Frail older people who are cared for by spouses are likely to be more impaired and in greater need of long-term care than are those assisted by other informal caregivers (Hess & Soldo, 1985). Studies focusing on spouse caregivers reveal that although women do not necessarily provide more hours of care than do men, they tend to provide more intimate types of care, have more frequent contacts, and more often have to deal with disruptive and aggressive behaviors (L. K. Wright, Clipp, & George, 1993). When men do care for an impaired spouse, they are more likely to receive outside sources of assistance than when women provide care to an impaired spouse (Johnson & Catalano, 1983).
Spouses of individuals with chronic illness often experience depression and anxiety, marital communication difficulties, sleeping disorders, problems at work, and compromised immune system functioning (Coyne & Smith, 1991; Elliot, Trief, & Stein, 1986; Kiecolt-Glaser et al., 1987). Some research has found that spouses of ill persons experience even greater levels of distress than their partners do (Coyne, Ellard, & Smith, 1990) and that this distress persists over time (Michela, 1987).
Because sexual intimacy is often important within the marital relationship, chronic illness has the potential to dramatically alter this relationship. Research across a number of different illness conditions has documented decreased sexual desire and activity, interference with sexual performance, and increased dissatisfaction with sexual functioning (Andersen, Anderson, & DeProsse, 1989).
Much of the research that has examined changes in the marital relationship in the context of disability has focused on people who are coping with cognitive impairment. These studies reported that significant declines in marital intimacy and quality were associated with the caregiving role (Blieszner & Shifflett, 1990; Morris, Morris, & Britton, 1988; L. K. Wright, 1991). Theories invoked to explain these changes include social exchange, equity theory, and role theory. Social exchange and equity theories suggest that persons who become caregivers will experience less marital happiness than will noncaregivers because of the inequities in benefits and costs associated with the caregiving role (Buunk & Hoorens, 1992). Role theory suggests that marriages coping with chronic illness and caregiving may “suffer a crisis because of the resulting challenge to the established role and myths that maintained the system” (S. C. Thompson & Pitts, 1991, p. 121). Russo and Vitaliano (1995) found that caregiver spouses reported significantly more changes in their marital relationship over time than did noncaregivers. Burman and Margolin (1992) found that spousal illness can affect marital quality and marital interaction. Townsend and Franks (1997) found that greater cognitive impairment of a spouse (but not greater functional impairment) was related to less emotional closeness between spouses. Booth and Johnson (1994) reported that health declines in a spouse were associated with declining marital happiness and with an increase in proneness to divorce.
Tower, Kasl, and Moritz (1997) contend that cognitive impairment can alter the marital relationship in a number of ways. Cognitive decline in a partner can result in changes in personality, mood regulation, behavior, memory, planning, reason, and judgment, all of which have the capacity to interfere with maintenance of empathic connections in close relationships. Cognitive decline can represent the loss of a resource, loss of emotional closeness, and change in the meaning of dependency. Tower et al. (1997) suggest that coping with the cognitive impairment of a spouse may be far more difficult when the couple is emotionally close than when a less intense relationship characterizes the couple. They posit that continuation of mutual closeness in the context of a spouse’s severe impairment may represent a failure in adaptation. There is some evidence that close couples are more affected by changes in a spouse than are less close couples (Tower & Kasl, 1996). Tower et al. (1997) found that marital closeness moderated the impact of a wife’s cognitive impairment, with husbands in close marriages affected more strongly than husbands in less close marriages. These effects were not found for wives.
The nature and intensity of distress experienced by spouses of persons with chronic illness may be linked to the particular challenges presented by a particular diagnosis (Revenson, 1994). The emotional turmoil experienced by spouses of cancer patients parallels the concerns expressed by patients, focusing on fears of recurrence and death (van der Does & Duyvis, 1989). Spouses of heart disease patients, concerned about a second—possibly fatal—infarction, walk a tightrope between being supportive and protective of their partner, yet not trying to be too controlling and solicitous, and minimizing or hiding their fears and concerns from their spouses (Coyne & Smith, 1991). Studies of patients with rheumatoid arthritis, a highly painful and disabling condition, but one with low life-threat, suggest that the greatest burden is in the areas of social and leisure activities, family activities, sex, and taking on additional household responsibilities as the patient becomes more disabled (Newman & Revenson, 1993).
Cannon and Cavanaugh (1998) describe the changes that ensue for couples when one member develops chronic obstructive pulmonary disease. They find that when illness alters system inputs and increases stress, interpersonal stress and tension may disorganize system functioning. As the patient experiences dyspnea, both partners may limit social activities in order to reduce demands on the patient. As a consequence, opportunities fostering support and self-worth are lost, and feelings of sadness, depression, and guilt can occur. Over time, demands on marital functioning spiral upward as physical functioning declines for the patient and support outside the marital dyad decreases. The physical changes may interfere with each spouse’s perceptions and responses to the other’s behaviors and expressed feelings, emotions, and thoughts. Over time the health of both spouses as well as their relationship may become jeopardized.
Marital functioning in chronic illness is altered by the increasing demands of illness-related tasks (Cannon & Cavanaugh, 1998). Corbin and Strauss (1984) describe the need for collaboration between partners in the concurrent management of their individual life trajectories and the chronic illness trajectory.
Little is known about how the marital relationship is altered when one member of the couple is dying and the end of the relationship is near. Research on cancer patients and their spouses describes an increase in the expression of affection (Rait & Lederberg, 1989) and an increase in problems in the relationship caused by the stress of cancer (Knakal, 1988; Pederson & Valanis, 1988). Swensen and Fuller (1992) found that husbands and wives coping with cancer reported expressing more love to each other after the diagnosis of cancer and more love than did a comparison group not coping with a life-threatening health condition. There were no differences in marriage problems reported by the two groups of spouses. Cancer couples reported feeling less committed to one another after the diagnosis of cancer, suggesting that a process of anticipatory grief and “letting go” had begun.
In the absence of a spouse, an adult daughter usually assumes responsibility for caring for a disabled parent (Horowitz, 1985a). Although sons do participate in parent care, they typically become primary caregivers only when there is not an available female sibling (Horowitz, 1985b). Of the caregiving sons surveyed by Horowitz (1985b), 88% were either only children, had only male siblings, or were the only child geographically available. Moreover, when sons were identified as the primary caregiver, they were more likely than were daughters to rely on their spouses for additional support, less likely to provide as much overall assistance to their parents, and less likely to help with “hands-on” tasks such as bathing and dressing. Dwyer and Coward (1991), in a multivariate analysis, found that even after controlling for a variety of factors known to influence the relationship between gender and the provision of care to impaired elders (age, gender, and level of impairment of the elder; marital status, age, employment status, and proximity of the adult child), daughters were 3.22 times more likely than sons to provide assistance with activities of daily living (ADL) and 2.56 times more likely to provide assistance with instrumental activities of daily living (IADL).
Although the stereotypical model of help for elderly parents is that of one adult daughter who assumes the entire burden of providing help to elderly parents, there is evidence suggesting that in many families adult siblings share parent care responsibilities more equitably. Matthews and her colleagues (Matthews, Delaney, & Adamek, 1989; Matthews & Rosner, 1988) examined the helping behaviors of the entire sibling subsystem. Pairs of sisters in a two-child family tended to share responsibility for both tangible help and moral support to their parents, with an almost equal division when both sisters were employed. In larger families, sisters tended to provide regular, routine help to the parents or to help in a backup capacity, whereas help provided by brothers tended to be limited to a few areas of male expertise, to be sporadic, or to be nonexistent. Coward and Dwyer (1990) also found that brothers from mixed-gender sibling networks provided significantly less help to parents than did their sisters, but that brothers from single-gender siblings provided approximately as much help as did sisters from single-gender sibling relationships. Dwyer, Henretta, Coward, and Barton (1992) found that a given adult child’s initiation or cessation of help to an impaired elderly parent was dependent on the helping behaviors of that child’s siblings. Cicirelli (1992) reports that in about half the families he studied, all siblings coordinated their efforts in providing care to disabled parents. In about a fourth of the families there was partial coordination of efforts, and in the remaining fourth of the families each sibling helped with care as he or she wished, independently of the others.
Although the overwhelming majority of literature about the effects of disability on parent-child relationships has centered on situations in which the parent becomes ill, there is growing attention to understanding parent-child relationships of adult children with chronic disability. As parents of chronically disabled children enter old age, they face not only the health problems and social changes experienced by their age peers, but they also must confront the challenges associated with the needs of their aging child. As time passes, the situation ensues in which there is increased likelihood that the older adult child may require care from very old parents who themselves may require care. Because of differences in life expectancy between men and women—as well as the tendency for the current cohort of women to have assumed the primary role of lifelong caregiver—mothers of chronically disabled adult children are more likely than fathers are to find themselves in the role of primary caregiver.
The trend towards deinstitutionalization has resulted in parents—especially mothers—having long-term caregiving responsibilities for their severely disabled adult children suffering from developmental disability or from severe mental illness, including schizophrenia (Fujiura & Braddock, 1992; Lefley, 1987). Although the majority of empirical studies have focused on the effects that these caregiving relationships have on the caregiving parents (Greenberg, Seltzer, & Greenley, 1993; Pruchno, Patrick, & Burant, 1996), it is likely that relationship quality and reciprocity between parent and adult play important roles.
Although people with disabilities and poor health generally do not turn to their siblings for support, among people who never married and those who are widowed, help from siblings often becomes the first line of defense (Johnson & Catalano, 1981). Gold (1989) reports that sisters both give and receive more help than do brothers. Gold also found that when people stopped providing assistance to their siblings, it was because their own health had declined.
Although friendships remain important to well-being into late life, certain concomitants of age—especially old age— have been shown to negatively affect friendship relationships. Poor health, especially when it involves functional limitations, has a negative impact on friendships (Allan & Adams, 1989; Mendes de Leon et al., 1999).
Little scholarly research has examined the conditions under which friends become caregivers, the extent to which they provide care, and for whom care is provided. Himes and Reidy (2000) suggest that the role of friends in caregiving is important from two perspectives. First, in some instances friends provide the bulk of care and are an important source of support. Although friends may constitute a small part of the national informal care network, for some individuals they may be a vital source of assistance (Cantor, 1979). Second, the role of friends may increase over time if families become unable or unwilling to provide the level of care needed by frail and disabled family members.
When illness strikes, friends are more likely to provide support when family support is not an option, when shortterm assistance is needed, when the need for help is unpredictable, or when it is convenient. Cantor (1979) found that nonrelatives, both friends and neighbors, were a valuable source of care for those without family members. Unmarried older women rely more on their friends for both emotional and instrumental support than do their married peers (Roberto & Scott, 1984). Friends often provide emotional support to one another (Adams & Blieszner, 1989; Roberto, 1996). They generally provide only limited instrumental support, with the most common type of help being transportation (Roberto, 1996; Roberto & Scott, 1984). Furthermore, research indicates that friends help with transportation when they can do so conveniently, or in an emergency when no one else is available. They also help with home repairs, with shopping or errands, and with household tasks. Reinhardt (1996) documented the importance of friendship support independent of family support to people adapting to chronic visual impairment.
Using data from the National Survey of Families and Households, Himes and Reidy (2000) examined the roles that friends play in the provision of care. They found that among caregivers, women providing care to a friend are more likely to be age peers and less likely to be employed or married than were family caregivers. Friends were less likely than were family members to take on care responsibilities when those responsibilities conflicted with other roles. Additionally, when friends do provide care, they provide that care for shorter periods of time and for fewer hours.
Losing Social Relationships
Much can be understood about the value of social relationships from research that has examined reactions to lost social relationships. Loss of a significant social relationship can affect the structure and dynamics of other relationships (Perkins, 1990). A death in the family, for example, may lead to increased closeness or strain in relationships among surviving family members.
In the United States, the marital relationship can be terminated either by death or by divorce. With age, the likelihood of divorce decreases, whereas the likelihood of death of a spouse increases. However, women are more likely to experience divorce and less likely to experience widowhood today than they were 30 years ago.
In 1998, 19.4 million adults—representing 9.8% of the adult population—were divorced (Lugaila, 1998). Divorce is prevalent in the United States, with projections suggesting that almost half of all marriages will end in divorce (Cherlin, 1992; Furstenberg, 1990). Marital disruption is not randomly distributed. The risk of divorce in first marriages is far higher for younger couples than for those marrying after their early twenties (Furstenberg, 1990). Similarly, high-school dropouts have twice the rate of marital breakup as those with at least some college, and the rate of divorce is about 50% higher among African Americans than among European Americans (Castro-Martin & Bumpass, 1989). Second marriages have a higher risk of divorce than do first marriages (McCarthy, 1978).
A great deal of research has addressed the extent to which divorce is predictable. Gottman and Levenson (2000) contend that there are two periods critical to the survival of a marriage: the first 7 years of the marriage, during which half of all divorces occur (Cherlin, 1992); and at midlife, when people often have young teenage children. The set of variables that predicted early divorcing was different from the set that predicted later divorcing. Negative affect during conflict predicted early divorcing, but it did not predict later divorcing. In contrast, the lack of positive affect in events of the day and conflict discussions predicted later divorcing but not early divorcing.
Research consistently indicates that people who are divorced experience lower levels of psychological well-being than do people who are married (Aseltine & Kessler, 1993; Davies, Avison, & McAlpine, 1997; Marks & Lambert, 1998). Wang and Amato (2000) found that adjustment to divorce was positively associated with income, dating someone steadily, remarriage, having favorable attitudes toward marital dissolution prior to divorce, and being the partner who initiated the divorce. Economically, divorce has more severe implications for women than for men (Furstenberg, 1990).
Divorce has been called a transitional family status because eventually nearly 75% of divorced men and 60% of divorced women reenter marriage (Spanier & Furstenberg, 1987). Men remarry more quickly than do women, in large measure due to the greater availability of marriage partners.
When a spouse dies, the survivor must not only adjust to the loss of a close relationship, but also manage the daily decisions and responsibilities that were once shared by both spouses (Wortman, Kessler, & Umberson, 1992). Consistent evidence indicates that widowhood is associated with reduced psychological health (Stroebe & Stroebe, 1987). Most research finds that within the first few months of bereavement, recently widowed people show worse mental health than do married controls (Gallagher-Thompson, Futterman, Farberow, Thompson, & Peterson, 1993; Lund, Caserta, & Dimond, 1993).
It is unclear, however, how long these effects last. Although longitudinal studies typically find that widowed and married people are similar to one another after a year or two (Gallagher-Thompson et al., 1993; Harlow, Goldberg, & Comstock, 1991; Lund et al., 1993; Mendes de Leon, Kasl, & Jacobs, 1994), cross-sectional studies typically find that widowed individuals score higher on depression scales than do married people even 4 years postdeath (Lehman, Wortman, & Williams, 1987; Zisook & Shuchter, 1986).
Using a prospective research design that contrasted the experiences of twins—one who experienced widowhood and one who did not—Lichtenstein, Gatz, Pedersen, Berg, and McClearn (1996) found that widowhood had both short-term and long-term effects on psychosocial health. They found that recently bereaved individuals of both sexes reported more loneliness and depressive symptoms and less satisfaction with life compared to their married twins. These twin control analyses also indicated that among women, the married twin experienced greater well-being than did her long-term bereaved twin, even after 5 years of widowhood. Results from this study show that long-term widowed individuals who have been bereaved an average of 17 years for women and 13 years for men still have lower psychosocial health than do married individuals. These investigators found that widowhood had no effects on self-rated health status.
All losses, however, are not equal. An interesting analysis by Carr et al. (2000) concludes that adjustment to widowhood is most difficult for those experiencing high levels of warmth and instrumental dependence and low levels of conflict in their marriages.
An issue that has been the subject of many studies is whether widowhood is more traumatic for men or for women. Widowhood is a more common experience among women than among men. Although some studies report no gender differences in the psychological consequences of widowhood (Faletti, Gibbs, Clark, Pruchno, & Berman, 1989; Lund, Caserta, & Dimond, 1989), others found widowed women to be more distressed than widowed men (L. W. Thompson, Gallagher, Cover, Galewski, & Peterson, 1989). Most studies, however, have found widowhood to have a more adverse effect on men than on women (G. R. Lee, DeMaris, Bavin, & Sullivan, 2001; Mendes de Leon, Kasl et al., 1994). G. R. Lee et al. (2001) explain that this effect is largely due to the comparatively low levels of depressive symptoms among married men. Although widowed men and women experience similar rates of depressive symptomatology, for men, marriage is such a strong barrier to the symptoms of depression that the end of marriage results in higher rates of depression.
One of the most common deaths faced by adults is the death of a parent. Demographers report that the death of a mother is most likely to occur when children are between the ages of 45 and 64 and that the death of a father is most likely to occur when children are between the ages of 35 and 54 (Winsborough, Bumpass, & Aquilino, 1991). Annually, approximately 5% of the U.S. population experiences this type of loss (Moss & Moss, 1983).
Researchers have examined the impact of death of a parent on their middle-aged children’s emotions (Norris & Murrell, 1990; Scharlach, 1991). Scharlach (1991) found that adult children had a range of persistent emotional responses to their parent’s death, including being upset, crying, having painful memories, experiencing loneliness, and being preoccupied with thoughts of their parent. Research by Douglas (1990–1991), Kowalski (1986), Robbins (1990), and Scharlach (1991) examined the extent to which death of a parent affects the sense of self experienced by their middleaged children.
Another aspect of bereavement that has been examined is family relationships. Umberson (1995), studying a national sample, found that marital quality is negatively affected by the death of a parent. Compared with nonbereaved individuals, individuals who have recently experienced the death of a mother exhibit a greater decline in social support from their partner and an increase in their partner’s negative behavior. Compared with nonbereaved individuals, individuals who have recently experienced the death of a father exhibit a greater increase in relationship strain and frequency of conflict, as well as a greater decline in relationship harmony; similar findings are reported by Douglas (1990–1991) and Guttman (1991). Rosenthal (1985) found that if the deceased parent had a central role in the family, that person’s death caused a ripple effect in the same and younger generations. Fuller-Thomson (2000) reports that people who have experienced the death of at least one parent and those who have a parent in ill health are more likely to report that they do not get along well with a sibling.
A number of background characteristics of adult children and their parents have been associated with bereavement. Scharlach (1991) and Moss, Moss, Rubinstein, and Resch (1993) found that younger adult children were more affected by grief than were older adult children. Scharlach found that children with higher levels of income and education were more affected by a parent’s death than were those with lower socioeconomic status. Moss, Resch, and Moss (1997) report that daughters expressed more emotional upset, somatic response, and continuing ties with their deceased parent than did sons, whereas sons reported more acceptance of their parent’s death than did daughters.
Adults generally have siblings throughout their lives. When an adult dies there is often a surviving sibling to grieve over the loss. Moss and Moss (1986, 1989) identified three intertwined themes experienced by adults who lose a sibling to death: impact on the personal meaning of death, threat to self, and shifts in family alignments. They contend that when a sibling dies, the survivor often experiences feelings of personal vulnerability to death. Because siblings are members of the same generation, sibling deaths—except among those who are extremely old—are perceived as “off time.” The sense of vulnerability may be especially strong for the last surviving sibling. Death of a sibling has the potential to require a shift in the expectations and goals that the survivor has for him- or herself. It can also alter the unity of the family and realign family relationships. It can lead to a redistribution of roles and a shift in family expectations as family members renegotiate relationships with one another.
Death of a friend has received very little research attention. Sklar and Hartley (1990) used the term hidden grief to describe friends who silently grieve the death of close friends. They suggest that these forgotten mourners are at increased risk for complications of bereavement because they may experience the social and emotional transformations of bereavement while they are forced to suffer the lack of institutional outlets that act as supports for the transformations. The degree of grief and mourning that follow the death of a friend varies as a function of the age of the friends and the intensity and centrality of the friendship (Kemp, 1999).
Although a great deal is known about social relationships between adults, scientists have only begun to scratch the surface regarding our understanding of these relationships and the effects that they can have. Conceptual thinking about social relationships has been anchored in descriptions of how social relationships change over time. The concept of a convoy of supportive people—some of whom change over time, others who remain stable, surrounding an individual as he or she ages—is compelling. That reduced rates of social interaction in later life are the result of a lifelong selection process by which people strategically use these convoys to maximize rewards and minimize risk suggests the active role that people take in making and breaking social relationships.
Relationships with close family members and with friends are different. They have different functions and different effects on people. Yet little is known about the processes through which these relationships affect psychological wellbeing. Future studies examining this issue are needed.
One of the striking conclusions about the current state of the art regarding social relationships in adulthood and aging is the extent to which there is consistency in findings across the empirical studies. Although on the one hand this similarity is reassuring, one wonders whether it represents a true picture of social relationships or whether it is a function of the homogeneity of people who have participated in the research.There has been very little attention to diversity in studies of social relationships in adulthood. As a result, it is unclear whether these findings can be generalized to people of different races, socioeconomic classes, and ethnic backgrounds. One very exciting area for future research is exploration of the extent to which these findings generalize to diverse populations.
One of the most compelling aspects of research about social relationships in adulthood and aging is that these relationships can have negative as well as positive effects on people. The tendency for too much support to be as detrimental as too little is intriguing and begs for further research. Questions such as How much support is too much? await future study. More research is needed to understand how negative social relationships develop, how people cope with them, and how they change over time.
Despite the overwhelming number of research studies that have examined social relationships in adulthood and aging, the current knowledge base is marked by its uneven understanding of these primary associations. Not surprisingly, relationships between spouses and those between parents and children have received the greatest attention. However, our understanding of the importance of sibling relationships and of relationships between friends is in its infancy. Questions about the role of lifelong friends and of relatively newfound friends abound, as do questions about the ways in which brothers and sisters affect the lives of one another. As research begins to unravel more about these relationships, it will be critical to do so with an understanding of the other significant social relationships in which individuals are entwined. The importance of friends and siblings for unmarried people has been hinted at. These relationships will be especially important to study in the future.
Certainly a great deal remains to be learned about the endings and loss of social relationships. Although much is known about the effects of divorce, death of a spouse, and death of a parent, little is known about the end of sibling and friend relationships.
Research about social relationships in health and research about these relationships in illness have developed relatively independently of one another. Yet, it is important to understand how relationships change as health changes. In order to better understand these transitions, prospective studies of social relationships are needed. By studying the social relationships of people who have illnesses that have different trajectories and different effects on patients, greater understanding of how illnesses create changes in social relationships will ensue.
Finally, it is interesting that although by definition, social relationships include multiple actors, the overwhelming majority of research about social relationships has relied on data collected from individuals. A more comprehensive understanding of social relationships in adulthood and aging requires that data be collected from multiple perspectives and analyzed from a group—rather than an individual— perspective. For example, a more complete picture of the effects of illness on the marital dyad would collect and analyze data from both the patient and the spouse, and greater understanding of parent-child relationships would derive from studies that collect and analyze data from both generations.
A number of unresolved issues remain regarding adult social relationships. Their significance to the psychological and physical well-being of individuals has been documented, but we have only begun to scratch the surface regarding our understanding of the processes by which these effects ensue. Whereas the focus of the previous several decades of research has been on identifying the importance of social relationships to individuals, the challenge for the next generation of research is to examine how these intricate associations develop and why they have such powerful and intricate effects.
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