Edward is a slightly overweight, 45 year old Latino American man. His wife, Sarah, is a thin, 27 year old Chinese American woman. The couple has recently married. Edward has 2 children from a former marriage, a 22 year old son and 18 year old daughter. Both children are away at college and both their mother and Edward have been active in their lives. Both Edward and Sarah were raised in culturally traditional homes. The problem the couple presents with is that Sarah wants her own children and Edward does not. Edward says he's had his family and is ready for grandchildren in a few more years. Sarah has always wanted a family of her own and says that Edward knew this when they married. Edward says, "well, I changed my mind." Sarah begins to cry and says, "perhaps this marriage was a mistake." You notice Edward controlling his anger. Sarah was born in Taiwan, but her family immigrated to the United States when Sarah was 2 years old. She had an older brother that was killed in a drug related crime in the United States when Sarah was only 10 years old. She is the only surviving sibling. Sarah's parents have never been the same since the death of her brother. She feels that grandchildren would bring great joy to her mother and father. She tells you that her world would shatter if she is not able to have children of her own. Edward was raised by his mother and maternal grandmother who were strict Catholics. His father was an alcoholic who "came and went when it was convenient for him." He has 2 older brothers and 3 younger sisters, all married with children. Edward tells you that he loves Sarah and thought about having more children but decided against it. He hopes that she can accept his family as her own. He says her parents rely too much on Sarah for their happiness and that it is time that Sarah lives her own life.

1. Health psychology is concerned with how psychosocial factors relate to the promotion and maintenance of health, and with the causation, prevention, and treatment of illness. Considering Sarah's culture and background, what health related issues might you see and why?
2. Given the prevalence for alcohol related problems and noted hostility in Edward, as well as his cultural background, what health related issues might you see and why?
3. Self-esteem is one's overall assessment of one's worth as a person. Research indicates that cultural values and gender differences are determinants of self-esteem. In consideration of this research, how would you describe Edward in regard to self-esteem? What about Sarah?
4. Self-Regulation is the process of directing and controlling one's behavior. Self-efficacy refers to people's conviction that they can achieve specific goals that should lead to expected outcomes. How might this describe what you are seeing with both Edward and Sarah?