These articles were judged by independent raters using a 56-item rating system designed to analyze methodological and assessment issues of empirical investigations. The objectives of this review to summarize the current findings; to provide a comprehensive critique of the investigations, highlighting methodological problems with the present literature and assessment concerns; and to propose directions for future research. The review underscored the contributions of early empirical studies and outlines an agenda for more systematic and programmatic research with a need for more careful consideration of definitional, subject variable, familial stress, and reactive vs. long-term effect issues. 2 tables and 43 references. (Author abstract modified)