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Psychosocial contributors to mental and physical health in patients with systemic lupus erythematosus.

OBJECTIVE: To delineate psychosocial and systemic lupus erythematosus (SLE)-related medical factors that contribute to the mental and physical health of SLE patients. METHODS: In a cross-sectional study, 44 women completed standardized instruments assessing daily hassles, social support, psychologic distress, and quality of life and underwent a physician examination to assess disease activity and disease damage. Four multiple linear regression analyses were computed to identify factors associated with the following outcomes: patient-perceived psychologic distress and global physical health and physician-assessed disease activity and damage. Variables entered into the regression analyses were: hassles severity, types of social support, SLE disease activity and damage, age, disease duration, education, ethnicity, and global psychologic distress (for the outcomes of self-perceived global physical health and disease activity and damage). RESULTS: The best model explaining global psychologic distress included hassles severity and self-esteem social support. The best model explaining patients' perceptions of their global physical health included hassles severity and tangible social support. Psychologic distress accounted for a significant proportion of variance in both disease activity and damage. CONCLUSION: High stress (assessed by hassles severity), poor social support, and psychologic distress--potentially modifiable variables--are associated with the mental and physical health of SLE patients.

Adult↗

The contribution of personality characteristics to the relationship between social support and perceived physical health.

Although a great deal of research has been conducted on the relationship between social support and physical health, the contribution of personality characteristics to this relationship has rarely been assessed. Structural equation modeling was employed to derive and test a model of the direct and indirect relationships between personality characteristics, social network size, the perceived availability of support, socially supportive behaviors, and perceived physical health with a sample of Pennsylvania adults. Significant paths indicate that individuals who perceive themselves as affiliative and as help seekers and help givers report larger social networks, receive more socially supportive behaviors, and perceive that more support is available to them. The perception that support is available shared a direct relationship with perceived physical health. The utility of including multiple measures of social support and personality characteristics related to receiving support in investigations of the relationship between social support and physical health is discussed.

Adult↗

Psychological distress in grandmother kinship care providers: the role of resources, social support, and physical health.

OBJECTIVE: The purpose of the present study was to investigate predictors of psychological distress in grandmother kinship care providers. More specifically, it was hypothesized that social support, family resources, and physical health would predict psychological distress in grandmothers raising grandchildren. METHOD: One hundred and two grandmothers raising grandchildren in parent-absent homes completed the Brief Symptom Inventory, Short Health Form-36, Family Resource Scale, Family Support Scale, and a questionnaire requesting background and demographic data. RESULTS: Results indicated that psychological distress was predicted by family resources, participants' physical health, and to a lesser extent, social support. CONCLUSION: The findings indicate that family resources, social support, and physical health affected psychological distress in grandmothers raising grandchildren. Grandmothers who reported fewer resources, less social support, and poorer physical health tended to experience higher levels of psychological distress. This study suggests that greater attention be given to interventions aimed to decrease psychological distress and improve the financial resources and physical health of grandmothers raising grandchildren.

Adult↗

Is there an association between rumination and self-reported physical health? A one-year follow-up in a young and an elderly sample.

Cross-sectional studies have suggested an association between rumination and subjective health. The aim of the present study was to investigate in a longitudinal design whether rumination was related to self-reported physical health. A total of 96 young (age range 20-35) and 110 elderly (age range 70-85) participants completed questionnaires measuring rumination, negative affect, life events, and self-reported physical health at baseline and at 1-year follow-up. Multiple linear regressions showed a significant association between self-reported physical health at time I only for the elderly and negative affect mediated the association. At follow-up, rumination was significantly associated with self-reported physical health only for the young and the association was only partly mediated by negative affect. In conclusion, rumination is associated with poorer self-reported physical health, but the association depends on the age of the individual as well as time span studied.

Adaptation, Psychological↗

Socio-economic and school factors of psychological and physical health in Siberian schoolchildren.

Cultural influences on psychological and physical health were examined in a sample of Russian schoolchildren in Novosibirsk. To evaluate the children's behaviour the translated short form of the Child Behaviour Checklist was given out to mothers. A School Adjustment Scale and the Rutter Teacher Questionnaire were completed by teachers and one total score was derived from the Rutter Health Questionnaire for children. Children from disturbed families had worse school adjustment and more behavioural problems. Acute respiratory diseases were more frequent in children from large families, while the mother's education level was a protective factor. Academic attainment was positively related to parents' education, CBCL Somatic Complaints and the occurrence of psychosomatic and inflammatory diseases, and negatively related to Externalising Problems. The CBCL Somatic complaints score was the key variable in the prediction of most physical health variables. Overall, the findings show the significance of academic attainment for a child's physical and psychological health. Low academic attainment tends to be connected with Externalising Problems, while higher attainment could be connected with somatisation and physical illness.

Adolescent↗

Physical health problems in depressed and nondepressed children and adolescents of parents with opiate dependence.

The increased risk of physical health problems in adult depressed patients has been shown in numerous studies. A recent study of the offspring of depressed parents found similar associations. The purpose of this study is to examine the strength and specificity of the association between depression and physical health problems in children and adolescents whose parents are dependent upon opiates. The sample consisted of offspring ages 6-17 (mean age 11 years) of opiate addicts who had a history of major depressive disorder (MDD; n = 28); other mood disorders (n = 31); no history of mood disorders but other psychiatric disorders (n = 92); or no history of psychiatric disorder (n = 127). Detailed psychiatric assessment and medical history of the offspring by direct interview with the offspring and an informant were obtained blind to parental diagnosis. After controlling for possible confounders, there was an increased risk of dermatological disorders, headache, other neurological/neuromuscular disorders, bronchitis, other respiratory disorders and hospitalizations for nonsurgical procedures in offspring with MDD, as compared to nonpsychiatrically ill controls. The offspring with other mood disorders had a slightly elevated risk. Major depression in children and adolescents whose parents are dependent on opiates is associated with increased risk of physical health problems. This finding is consistent with other reports and the timing of the physical health problems requires further study.

Adolescent↗

The Association between self-reported discrimination, physical health and blood pressure: findings from African Americans, Black immigrants, and Latino immigrants in New Hampshire.

The relationship between perceived racial discrimination and both blood pressure and perceived physical health has been documented among African Americans. However, this association has not been well-studied for Black or Latino immigrants. We used multiple regression analysis with a cross-sectional sample of 666 African Americans, Black immigrants, and Latino immigrants from the New Hampshire Racial and Ethnic Approaches to Community Health 2010 Initiative to assess the relationship between discrimination and measures of physical health and blood pressure. The study found evidence of a significant U-shaped relationship between discrimination and systolic blood pressure for all three cohorts. Evidence was also found supporting a negative linear relationship between discrimination and physical health. In addition, the association between discrimination and physical health was attenuated for Latinos compared with the other groups. Future research should evaluate how factors associated with acculturation or cumulative exposure to discriminatory stressors may affect the protective resources of immigrants.

Adolescent↗

Ten-year follow-up of adolescent-onset anorexia nervosa: physical health and neurodevelopment.

To study the development of physical health and some neuromotor functions in anorexia nervosa (AN) 51 individuals (48 females, three males) with a mean AN onset of 14 years, recruited after community screening, were followed prospectively together with 51 age-, sex-, and school-matched individuals without AN (controls). About 10 years after AN onset, all individuals were examined in respect of physical health and neurodevelopment. There were no deaths. Weight and height had normalised, except in three participants with persistent AN. Significantly more participants with AN had a physical complaint/disorder, including hirsutism. This might be a long-term complication in weight restored AN. Dysdiadochokinesis occurred almost exclusively among individuals with former AN in accordance with our previous studies.

Adolescent↗

An analysis of health physics employee recruitment activity: 1977-82.

Monthly listings of the Health Physics Society Placement Center from 8/77 to 6/82 were tabulated and analyzed for the temporal and regional trends in various areas of health physics. Almost half of listing employers advertised only a single position in 5 yr. Civilian nuclear power and its associated industrial support accounted for approximately half of the total positions available. Total annual employer and position listings increased sharply several months after the Three Mile Island incident. Activity has remained elevated since that time, and appears to have reached a plateau within the past year. A wide variety of professional positions were advertised in each region of the U.S. Recent data on numbers of graduating health physicists, plus a reasonable estimate of the number of new positions made available in recent years, imply current regional shortages of adequately trained personnel, particularly in the Far West, Rocky Mountain and South Central regions, but possibly also nationwide.

Health Physics↗

Predictors of physical health: toward an integrated model of genetic and environmental antecedents.

People in higher-income groups tend to experience better physical health, yet this does not appear to be the direct result of access to medical care. This has prompted a search for psychological factors more likely to be present in high-income environments that might help to explain the relationship. Physical health has been associated with a number of such psychological measures including positive affect and well-being, negative affect and neuroticism, positive social relationships, and perceived control. Building from recent findings of moderation of genetic variance in physical health by income and perceived control, we explore the genetic and environmental relationships among all these variables in a nationwide U.S. twin sample. These relationships suggest possible mechanisms by which psychological characteristics, behaviors, physical health, and environmental circumstances could be influenced by common groups of genes with varying degrees of activity in different environments. We discuss the implications of such mechanisms for differential expression of genetic variation in the population and suggest ways in which consideration of such effects can inform gerontology research.

Causality↗

Can culture help explain the physical health effects of caregiving over time among African American caregivers?

OBJECTIVES: The purposes of this study were to longitudinally examine the health outcomes of 107 African American caregivers who provided care to their elderly dependent family members and to determine the role of culture in predicting health outcomes. METHODS: With use of the stress and coping model of Pearlin and colleagues (1990) as a guide, the direct effects of background characteristics and stressors and the direct and mediating effects of resources (including culture) on two caregiver health outcomes (i.e., psychosocial health and physical functioning) were analyzed with hierarchical multiple regression analyses. RESULTS: Similar to other studies, we found that combinations of caregiver background characteristics, stressors, and resources at wave 1 had direct effects on African American caregivers' health outcomes at wave 3. Unlike previous studies, where culture was not measured, we found that cultural beliefs and values did help to explain health outcomes for African American caregivers. Specifically, culture justifications for caregiving, baseline psychosocial health, and caregiving mastery predicted wave 3 psychosocial health. Caregiver education, number of morbidities, and physical functioning at wave 1 were associated with physical functioning at wave 3. DISCUSSION: The findings from this study have implications for future studies, particularly in regard to cultural beliefs and values among African American caregivers.

Black or African American↗

Ambulatory monitoring and physical health report in Vietnam veterans with and without chronic posttraumatic stress disorder.

This study investigated the associations among PTSD, ambulatory cardiovascular monitoring, and physical health self-reports in 117 male Vietnam combat veterans (61 with PTSD and 56 without PTSD). PTSD was associated with health symptoms and number of current health conditions beyond the influence of several covariates. PTSD was associated with greater systolic blood pressure variability, and an elevated percentage of heart rate and systolic blood pressure readings above baseline. Higher mean heart rate and an elevated percentage of heart rate above baseline were associated with physical health symptoms. None of the ambulatory monitoring variables mediated the association between PTSD and physical health outcomes. Findings suggest that the interrelationships among ambulatory autonomic responses, PTSD, and physical health deserve more research attention.

Blood Pressure↗

Combat stress reactions, posttraumatic stress disorder, cumulative life stress, and physical health among Israeli veterans twenty years after exposure to combat.

This study examined the association of initial combat stress reaction (CSR), chronic post-traumatic stress disorder (PTSD) and cumulative life stress on physical health 20 years after the 1982 war with Lebanon, in a sample of 504 Israeli veterans of the war. Two groups were assessed: male veterans who fought and suffered from CSR and a matched group of male veterans from the same units who did not exhibit such reactions. Twenty years following the war, participants were asked to rate their general physical health status, report health complaints and risk behaviors, and were screened for PTSD. CSR and, to a greater extent, PTSD, were found to be associated with general self-rated health, chronic diseases and physical symptoms, and greater engagement in risk behaviors. CSR and PTSD were also related to greater cumulative life stress since the war. Both negative and positive life events were independently related to most of the physical health measures but did not account for the associations of CSR and PTSD with poorer health. Tests of the interactions between CSR, PTSD and life stress in their association with physical health and risk behaviors showed that PTSD suppressed the effects of additional life stress (negative life events had a weaker effect on health among participants with PTSD).

Adult↗

What are the costs of marital conflict and dissolution to children's physical health?

Do parental marital conflict and dissolution influence the risk trajectory of children's physical health risk? This paper reviews evidence addressing this question in the context of understanding how early environmental adversities may trigger a succession of risks that lead to poor health in childhood and greater risk for chronic health problems in adulthood. We first review existing evidence linking marital conflict and dissolution to offspring's physical health outcomes. Next, we provide evidence supporting biopsychosocial pathways that may link marital conflict and dissolution with accelerated health risk trajectories across the lifespan. Specifically, we posit that consequential to the stresses associated with marital conflict and disruption, parenting practices are compromised, leading to offspring deficits in affective, behavioral, and cognitive domains. These deficits, in turn, are hypothesized to increase health risk through poor health behaviors and by altering physiological stress-response systems, including neuroendocrine, cardiovascular, and neurotransmitter functioning. On the basis of the available direct evidence and theoretically plausible pathways, it appears that there is a cost of marital conflict and disruption to children's health; however, more comprehensive investigations are needed to further elucidate this relationship. In the final section, we address limitations in the current literature and identify research that is needed to better evaluate the association between marital conflict and dissolution and children's physical health.

Child↗

Stressful life events and physical health.

PURPOSE OF REVIEW: This review summarizes the findings of recent researches from selected empirical and nonempirical publications focused on stressful life events and physical health. RECENT FINDINGS: The findings can be divided into biological, psychological, and social issues concerning the important relationship between stressful life events and physical health. Growing evidence in the field of psychoneuroimmunology contributes to the understanding of the mechanisms by which stressful events affect physical health. The interactions between behavior, central nervous system, and endocrine system that might cause immunosuppression is the most fascinating finding in modern medicine, and its implications are important for the prevention and treatment of somatic illnesses. Trauma, abuse, and stressful events have been studied extensively, especially among vulnerable groups such as children, women, caregivers, and combatants. Risk factors and resilience were the focus of attention of some authors as well as the behavioral intervention for coping with stressful events. SUMMARY: The findings support old observations and case reports of a close link between stressful life events and physical health and emphasize the necessity of early recognition and timely management of stress-induced illnesses. Psychosomatic approach, multidimensional diagnostics, and treatment should be sine qua non in the integrated care of affected people and should improve their quality of life.

Brain↗

Mental and physical health of caregiving spouses: development of a causal model.

This study modeled the causal relationship between physical health and depression among a sample of 315 people providing home care for a spouse who had been diagnosed as having Alzheimer's disease. In addition to significant stability paths and correlations among variables at any one point in time, significant lagged paths were found in which depression (1) predicted physical health (2), depression (2) predicted physical health (3), and depression (1) predicted burden (2). Contrasting the overall model for husband and wife caregivers over a 6-month period indicated that the model was significant for wives but not for husbands.

Aged↗

Influence of stroke survivor characteristics and family conflict surrounding recovery on caregivers' mental and physical health.

BACKGROUND: Stroke recovery is a dynamic process for stroke survivors, and shorter lengths of stay in healthcare settings shift the care of the survivors to family caregivers. The physical and mental sequelae after stroke and the family's response to this catastrophic event may have deleterious effects on caregivers. OBJECTIVE: To examine the influence of stroke survivors' motor function, their memory and behavior changes, and the family conflict surrounding stroke recovery on the mental and physical health of caregivers during the subacute recovery period. METHODS: This cross-sectional, correlational study used baseline data from family caregivers (n = 132) and first-time stroke survivors enrolled in a larger multisite study. RESULTS: The caregivers were primarily White (71%), female (74%), college-educated (73%) spouses (80%) of survivors. Most of the caregivers (66%) reported family conflict. The caregivers from families with lower family functioning scores reported worse mental health. The caregivers reported lower mental health when they were caring for stroke survivors with a combination of high memory/behavior changes and low motor function (R =.30). Family conflict appears to exacerbate the impact of memory and behavior changes on caregiver mental health. Higher caregiver education and no major health problems were associated with better caregiver physical health (R =.36). Caregiver physical health was not associated with family functioning or stroke survivor memory and behavior changes. CONCLUSIONS: These results indicate that memory and behavior changes of stroke survivors and family conflict surrounding stroke recovery are important considerations for assessment during the poststroke recovery period.

Activities of Daily Living↗