Reciprocity: A Predictor of Mental Health and Continuity in Elderly People's Relationships? A Review

Table 1

Studies covered in this paper.

Author’s name	Year	Type of study	Nationality	Sample groups	Sample age (≥ or/M)	Size (𝑁)	Type of social support	Measures of reciprocity	Outcome variable
Silverstein et al.	2002	Longitudinal (27 y) 1971–1997 Six waves Questionnaires	USA, California; middle and working classes	Elderly parents children Intergenerational	1971–1997: Children: 19 y–43 y Parents: 45 y–72 y	𝑁=501 children	Emotional support; Practical support; Informational support	Dichotomously scored (0: “not provided”; 1: “provided”) each indicator and summed them to create an additive scale ranging from 0 to 5 at each time period, which were statistically analyzed.	Continuity
Becker et al.	2003	Longitudinal (5 y); Five waves Open-ended and semi-structured interviews	USA—four ethnic groups	Elders and their children/family Intergenerational	≥50 y	𝑁=270 elderly	“What kinds of support or assistance do elders provide to family members and vice versa?”	Comparison of coded answers of provision and receiving support	Continuity
Klein Ikkink et al.	1998	Longitudinal (3 y) 1992–1995; Two waves Mailed questionnaires	The Netherlands—Dutch ethnic group	The elders. Family subgroups, friends, neighbors, and acquaintances	≥55 y; M: 68 y	𝑁=408	Instrumental support	Reciprocity variables were constructed by subtracting the support received by the support given.; A negative score indicated “overbenefiting”; 0 meant “balance”; a positive score indicated “underbenefiting”.	Continuity
Klein Ikkink et al.	1999	Longitudinal (3 y) 1992–1995; Three waves Face-to-face interviews	The Netherlands—Dutch ethnic group	The elders. Family subgroups, friends, neighbors, and acquaintances	≥55 y; M: 68 y	𝑁=2057	Emotional support; Instrumental support	Reciprocity variables were constructed by subtracting the support received by the support given. A negative score indicated “overbenefiting”; 0 meant “balance”; a positive score indicated “underbenefiting”.	Continuity
Antonucci et al.	1987	Cross-sectional; Personal interview	USA	Elders; All members of a sampled household 70 y and older were interviewed	≥50 y; (Range 50–95)	𝑁=718	Network structure (i.e., network size) and functional support to the ten most important network members (NM) regarding confiding, respect, caring, talking about health.	Respondents (NM) were asked to identify each network member from whom they received each type of support as well as whom they provided each type of support. Functional support where NM provided support was coded as 1. NM who did not provide support to the focal person were coded as 0.	Continuity Convoy model
Ingersoll-Dayton et al.	1988	Cross-sectional; Personal interview	USA	Elders and their friends; All members of a sampled household 70 y and older were interviewed	≥50 y; (Range 50–95)	𝑁=718	Amount of perceived reciprocity: number who received support and number who provided support; Network demand; General well-being.	If the functional supports were calculated as zero, this indicated a reciprocal relationship.; A positive number were coded as receiving more. A negative number were coded as giving more.	Continuity Life satisfaction Negative affect
Lewittes	1989	Cross-sectional; Two studies: (1) Quantitative; (2) Qualitative	USA; Long Island and New York City area White and black women	Elderly women and their friends (1) Questionnaire study; (2) Interviews of both members of four friendship pairs	≥65 y	(1) 𝑁=169; (2) 𝑁=8 (four friend-ship pairs)	(1) Quantitative: Emotional support-Intimacy, Activity, Practical help; (2) Qualitative: Emotional support-Intimacy, Activity, Practical help	Relationships are measured in terms of the equity of exchange input and exchange outcome and the gains and losses of each person in the relationship	Continuity Making new friends
James et al.	1984	Longitudinal (4 y) 1978–1982; Participants observation Interview	Ireland; Three coastal hamlets	Elderly inhabitants and their close family members, remote kin, neighbors, and parental caretakers	≥60 y	𝑁=70	All kinds of social interaction and social support: Emotional support; Instrumental support; Social companionship	A life history method—collecting detailed qualitative information Interview focusing on particular economic and social variables, that is, questions about the degree of interaction (i.e., reciprocity) with close family, their neighbors, and kin.	Continuity
de Vugt et al.	2003	Longitudinal (2 y); Questionnaire Interview	The Netherlands	Female and male spouse caregivers of consecutively referred patients with dementia	Caregiver: M = 68.3 (SD 7.9); Patient: M = 71.6 (SD 7.6)	𝑁=53 (male = 22; female = 31)	The quality of the relationship was measured by four items: General closeness, Communication, Similarity of views about life, and Degree of getting along.; Interviews reporting on changes in their relationship since the onset of dementia	Analysis of the difference between baseline and the followup questionnaires and interviews. Description of relational changes since the onset of dementia	Relationship changes (i.e., reciprocity) Continuity of the relationship
Hooker et al.	2000	Cross-sectional; Questionnaire Interview	USA; New York	Female and male spouse caregivers for patients with Alzheimer’ (AD) and Parkinson’ diseases (PD)	Caregivers AD: M = 71 y; Caregivers PD: M = 67y	𝑁=175 spouse caregivers; AD 𝑁=88 (male = 36; female = 52); PD 𝑁=87 (male = 32; female = 55)	Coping strategies: Problem-Focused coping; Social support coping; Emotion-focused coping; Depression; Anxiety	Analysis of answers from the questionnaires and the interview	Marital satisfaction. Mental health Continuity
Neufeld et al.	1998	Longitudinal (18 months) Three waves In-depth interviews; Focus-group discussion	Canada	Male caregivers of cognitively impaired (primarily AD) older adults. Caregivers relationship to care recipient, family, and friends	≥60 y (range 33 to 87 y)	𝑁=22 caregivers	Describing a typical day; Describing give-and-take in all their relationships and the support they received from and gave to others	Coding and analysis of the presence or absence of reciprocity, the context in which reciprocity occurred, characteristics of reciprocity, and the consequent feelings of the caregiver were coded, and analyzed	Continuity
Bear	1990	Longitudinal Two waves; At entry in an RCH resident and six months after entering an RCH Face-to-face interviews	USA; Florida	The elderly and their relations to their family and friends chosen upon emotional bonding and tie content	≥60 y	𝑁=81	Measurement of network density, reciprocity, intensity, and material linkages; The year prior to their RCH entry, retrospectively, by their present entry period and six months later	Reciprocity was measured by the proportion of each resident’s network material links (financial, assistance (including past assistance from the residents), gifts) that are reciprocated	Continuity
Knesebeck; et al.	2003	Cross-sectional; Telephone interviews	Germany; USA	Elderly and their relationship to their marital life (or partnership); The parent-children exchange	≥60 y	𝑁=1290; Germany 𝑁=682; USA; 𝑁=608	Emotional support; Practical support; Experience regarding reciprocity/nonreciprocity of their most important social relationships	The effort-reward-model: (effort spent –“high cost” and rewards received –“low gain”)	Mental health; Depressive symptoms: CES-D scale
McMunn; et al.	2009	Cross-sectional	England	The elderly	M = 62 y	𝑁=5384	“Caring for others” defined as emotional and instrumental social support	The effort-reward model	Mental Health: Quality of life—CASP-scale; Life satisfaction—SLS-scale Depressive symptoms—CES-D scale
Wahrendorf et al.	2006	Cross-sectional; Face-to face-interviews	Ten European countries (Austria, Germany, Sweden, The Netherlands, Spain, Italy, France, Denmark, Greece, and Switzerland)	The elderly	≥50 y	𝑁=22000	“Care for a sick or disabled adult”; “Provide help to family, friends, or neighbors”	The effort-reword model	Mental health: Quality of life—CASP-scale Depressive symptoms—CES-D scale
Liang et al.	2001	Cross-sectional	USA Different counties	The elderly and their relationships with their friends, neighbors, and relatives	≥65 y	𝑁=1103	Emotional support; Tangible support; Informational support	Assessed composites measures of both support received and given	Mental health: Depressive symptoms—CES-D scale
Roberto et al.	1986	Cross-Sectional Interview	USA	The elderly and their relationship with their best friend	≥65 y; M = 73.8 y	𝑁=110	Emotional support; Instrumental support; Social companionship	Making an equity score based on a modified version of the Walster Global Measure of Participants’ perceptions of Inputs, Outcomes, and Equity/Inequity: Scores less than zero were “overbenefited”.; Scores equal to zero were “equitable benefited”.; Scores greater than zero were “underbenefited”.	Mental health: Relationship Distress—“Austin’s Total Mood Index”
Rook	1987	Cross-sectional	USA; Los Angeles	Elderly widowed women and their relationships with their social network, in particular with friends and family members	≥60 y; M = 72 y	𝑁=120	Emotional support; Instrumental support; Social companionship	Numbers of positive inputs received and positive inputs provided were computed as two measures. A difference score was computed by subtracting these two measures: 0 represented an “equitable exchange pattern”; a positive score indicated an “overbenefited” position; and a negative score indicated an “underbenefited” position.	Mental health/Social satisfaction: Loneliness—UCLA and SFL scales; Psychological well-being (Bradburn, 1969); Quality of life (Campbell et al., 1976)
Nemoto	1998	Cross-Sectional Telephone Interview and questionnaires	USA	Japanese American elderly resided in New York	≥55 y; M = 71 y	𝑁=50	Emotional support; Instrumental support	Reciprocity norms were identified by asking respondents to rate their perception of the reciprocal behaviors in each function of social support on a 7-point response scale	Mental health: Life satisfaction (Rapkin et al., 1992); Scale of depressive symptoms (α =  .80)
Wentowski	1981	Anthropological study Structured interviews Participant observation	USA Cities from the industrial complexes in southern USA	The elderly and their exchanges to persons in different roles in their social network	≥55 y; M = 71 y	𝑁=50	Identify exchange strategies within the personal networks of transference of goods services, emotional support and the cultural rules of reciprocity directing these exchanges.	Identifying the cultural rules governing reciprocity as the basis for constructing exchange strategies	Mental health: Degree of independence; Degree of self-worth