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PubMed1986

Validity of familial subtypes of primary unipolar depression. Clinical, demographic, and psychosocial correlates.

We examined the psychosocial, demographic, and clinical correlates of familial subtypes of primary unipolar depression. Our findings supported the hypothesis that depression spectrum disease is a variant of neurotic depression, whereas familial pure depressive disease overlaps with endogenous depression. Patients with depressive spectrum disease experienced more life events, had more marital separations and divorces, had poorer social support, more frequently made a nonserious suicide attempt, and had a less characteristic endogenous symptom profile than patients with familial pure depressive disease. Consistent with our previous report on the relationship between dexamethasone suppression test results and familial subtyping, the broadness of the criteria used to diagnose the patients' first-degree relatives affected the strength of the association between the familial subtypes and the dependent variables.

Adult↗
PubMed1986

An adoption study of genetic and environmental factors in drug abuse.

In a sample of 242 male and 201 female adoptees who had been separated at birth from biologic parents, adult adoptee diagnoses of alcohol abuse, drug abuse and antisocial personality were correlated with biologic and environmental factors. Three etiologic relationships with drug abuse were found: drug abuse was highly correlated with antisocial personality, which in turn was predicted from antisocial biologic background; a biologic background of alcohol problems predicted increased drug abuse in adoptees who did not have antisocial personalities; and environmental factors of divorce and psychiatric disturbance in the adoptive family were associated with increased drug abuse.

Adoption↗
PubMed1991

Depression among alcoholics. Relationship to clinical and cerebrospinal fluid variables.

Although depression is common among alcoholics, its determinants are poorly understood. Among 339 alcoholics, 111 (33%) had a history of major depression. Depressed, compared with never-depressed alcoholics, had a higher daily alcohol intake, more lifetime diagnoses of other anxiety and affective disorders and drug abuse, more had attempted suicide, and more reported alcoholism in both parents. Depressed alcoholics also had significantly lower cerebrospinal fluid levels of the dopamine metabolite homovanillic acid and of gamma-aminobutyric acid. Among subgroups of depressed alcoholics, secondary compared with primary depressives were more often divorced, of lower social status, with an earlier onset of alcoholism, and higher Michigan Alcohol Screening Test scores. Secondary depressives also had significantly lower cerebrospinal fluid concentrations of homovanillic acid than never depressed alcoholics. These results suggest that certain psychosocial variables, alcohol consumption, and neurochemical variables may be specifically associated with depression in alcoholics.

Adult↗
PubMed1994

DSM-III-R generalized anxiety disorder in the National Comorbidity Survey.

BACKGROUND: Nationally representative general population data are presented on the current, 12-month, and lifetime prevalence of DSM-III-R generalized anxiety disorder (GAD) as well as on risk factors, comorbidity, and related impairments. METHODS: The data are from the National Comorbidity Survey, a large general population survey of persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States. DSM-III-R GAD was assessed by lay interviewers using a revised version of the Composite International Diagnostic Interview. RESULTS: Generalized anxiety disorder was found to be a relatively rare current disorder with a current prevalence of 1.6% but was found to be a more frequent lifetime disorder affecting 5.1% of the US population aged 15 to 45 years. Generalized anxiety disorder was twice as common among women as among men. Multivariate logistic regression analysis showed that being older than 24 years, separated, widowed, divorced, unemployed, and a homemaker are significant correlates of GAD. Consistent with studies in treatment samples, we found that GAD was frequently associated with a wide spectrum of other mental disorders, with a lifetime comorbidity among 90.4% of the people who had a history of GAD. CONCLUSION: Contrary to the traditional view that GAD is a mild disorder, we found that the majority of people with GAD, whether they were comorbid or not, reported substantial interference with their life, a high degree of professional help seeking, and a high use of medication because of their GAD symptoms. Although lifetime GAD is highly comorbid, the proportion of current GAD that is not accompanied by any other current diagnosis is high enough to indicate that GAD should be considered an independent disorder rather than exclusively a residual or prodrome of other disorders.

Adolescent↗
PubMed1999

Adverse childhood experiences and smoking during adolescence and adulthood.

CONTEXT: In recent years, smoking among adolescents has increased and the decline of adult smoking has slowed to nearly a halt; new insights into tobacco dependency are needed to correct this situation. Long-term use of nicotine has been linked with self-medicating efforts to cope with negative emotional, neurobiological, and social effects of adverse childhood experiences. OBJECTIVE: To assess the relationship between adverse childhood experiences and 5 smoking behaviors. DESIGN: The ACE Study, a retrospective cohort survey including smoking and exposure to 8 categories of adverse childhood experiences (emotional, physical, and sexual abuse; a battered mother; parental separation or divorce; and growing up with a substance-abusing, mentally ill, or incarcerated household member), conducted from August to November 1995 and January to March 1996. SETTING: A primary care clinic for adult members of a large health maintenance organization in San Diego, Calif. PARTICIPANTS: A total of 9215 adults (4958 women and 4257 men with mean [SD] ages of 55.3 [15.7] and 58.1 [14.5] years, respectively) who responded to a survey questionnaire, which was mailed to all patients 1 week after a clinic visit. MAIN OUTCOME MEASURES: Smoking initiation by age 14 years or after age 18 years, and status as ever, current, or heavy smoker. RESULTS: At least 1 of 8 categories of adverse childhood experiences was reported by 63% of respondents. After adjusting for age, sex, race, and education, each category showed an increased risk for each smoking behavior, and these risks were comparable for each category of adverse childhood experiences. Compared with those reporting no adverse childhood experiences, persons reporting 5 or more categories had substantially higher risks of early smoking initiation (odds ratio [OR], 5.4; 95% confidence interval [CI], 4.1-7.1), ever smoking (OR, 3.1; 95% CI, 2.6-3.8), current smoking (OR, 2.1; 95% CI, 1.6-2.7), and heavy smoking (OR, 2.8; 95% CI, 1.9-4.2). Each relationship between smoking behavior and the number of adverse childhood experiences was strong and graded (P<.001). For any given number of adverse childhood experiences, recent problems with depressed affect were more common among smokers than among nonsmokers. CONCLUSIONS: Smoking was strongly associated with adverse childhood experiences. Primary prevention of adverse childhood experiences and improved treatment of exposed children could reduce smoking among both adolescents and adults.

Adolescent↗
PubMed1981

The influence of stress upon symptom structure.

Evaluated the influence of stress on the factor structure of symptoms in a nonclinical population. A random sample of 299 persons in the process of divorcing were subdivided into those high and low on stressful life events. Separate factor analyses of symptoms for each group provided evidence that stress does affect symptom structure. Ruminative Depression was the only stable factor. Two anxiety factors from the low stress group merged into one factor among the high stressed, while agitated depression appeared only in the low stress condition. A factor suggestive of stress response syndrome was evident among the high stressed.

Adult↗
PubMedDate not supplied

Marital status and age at natural menopause: considering pheromonal influence.

Married women generally report a later mean age at menopause. The results reported here, from a study carried out in Greene County, New York, are no exception. Married and widowed women report a later mean age at natural menopause compared to single and divorced women (P < 0.05). To better understand the relationship between marital status and age at menopause, possible mechanistic and confounding variables are examined, in particular parity, sexual activity, smoking habits, level of education, and income. Parity and income 10 years prior to interview are significant factors, along with marital status, that explain part of the variation in age at natural menopause. An alternative explanation is the pheromonal influence of a male in the household. This would explain the consistency of results across populations. This pilot study supports further biochemical investigation.

Age Factors↗
PubMed1991

Psychological effects of custody disputes on children.

This two-group, repeated measures examination of the psychological impact of child custody contests on children reports a subset of data from an ongoing longitudinal study of 95 children and their parents from 43 divorcing families. The authors report clinical observations concerning children's experience of custody litigation, as well as comparisons of baseline and post-test responses of contested and uncontested groups on measures of locus of control, separation anxiety and family concept. Contested children exhibited significantly greater internality of control orientation than the normative sample. Contested children's test scores also suggested significantly less separation anxiety and significantly more positive family concept than the uncontested group at post-test. The implications of these unanticipated findings are discussed.

Adult↗
PubMed1987

Predictors of life outlook of older single women.

The purpose of this study was to examine whether personal and social factors differentiate between widowed, divorced or separated, and never married older women, and predict the life outlook of older single women. A secondary analysis of data from a subsample of the older single women (n = 816) in the 1975 National Survey of the Aged was undertaken. Significant differences between groups were found: never married women were better educated, healthier, less lonely, and had a more positive life outlook than widows. The model predicted 29% of the variance in life outlook. Health and loneliness had the strongest effects on life outlook when predictors were compared.

Aged↗
PubMed1980

Life difficulties, coping, and the use of medical services.

A retrospective study of 124 "healthy" females was designed to explore the components of high use of medical services. Analysis of data from medical records and responses to survey and in-depth interview questions showed that poor, less educated, separated or divorced women were likely to feel that their social resources were only nominally effective in mediating between them and the pressures of life difficulties. It was found that such women used health services for vague, unorganized symptoms more frequently than women whose situations were less burdened.

Adaptation, Psychological↗
PubMed1978

The Shetland Islands: the effects of social and ecological change on mental health.

The authors review the literature concerning the mental health and social effects of industrialization, urbanization and the transition from a rural to an industrial society. They point out the need for prospective and longitudinal studies. To illustrate a working model of the type of research needed, the authors describe a long-term study now underway in the Shetland Islands. This research investigates the effects that rapid social and ecological change (from the North Sea oil developments) will have on the islanders. To test the hypothesis that the changes, associated with the construction of Europe's largest oil port in these previously isolated rural islands, will have a deleterious effect on the Shetlanders' health and way of life, a prospective study has been initiated that contains two sub-studies. The General Survey involves monitoring reported data on ecological, epidemiological and sociological change and is intended to provide an overview of the general impact of the oil developments. The Individual Survey involves interviewing two populations (total N = 533) and is designed to examine individuals' reactions to change and variables associated with those reactions. The target population live in a conservation region where they are not likely to be directly affected by the oil developments. Baseline findings are presented from the General Survey concerning psychiatric morbidity, crime, divorce and suicide and from the Individual Survey that focus on the prevalence of medical and psychiatric symptoms and illnesses.

Adaptation, Psychological↗
PubMed1995

Marital status and earnings in developed countries.

"When estimating earnings equations for men in the United States, a dichotomous variable for whether or not the man is currently married is often included as a regressor. The coefficient estimate for this variable is most usually large and significant. However, there is rarely much discussion of the marriage effect. This effect is central to this study, which contributes to the understanding of this statistical association in two ways. First, it shows that the relationship exists in almost all of the fourteen developed countries examined and across several different time periods. Controlling for age, and, when available, education, race/ethnicity, hours worked, and location, marriage differences in annual earnings in favor of currently married males range from 0% to 30%. Second, it finds that there are important differences between those who are separated, divorced, widowed, and never married."

Age Factors↗
PubMed1990

Business cycles and fertility dynamics in the United States: a vector autoregressive model.

"Using vector-autoregressions...this paper shows that fertility moves countercyclically over the business cycle....[It] shows that the United States fertility is not governed by a deterministic trend as was assumed by previous studies. Rather, fertility evolves around a stochastic trend. It is shown that a bivariate analysis between fertility and unemployment yields a procyclical picture of fertility. However, when one considers the effects on fertility of early marriages and the divorce behavior as well as economic activity, fertility moves countercyclically."

Americas↗
PubMed1989

The demographics of inequality.

"This paper presents a survey of recent literature on the effects of demographic variables on economic inequality. First, a number of conceptual and methodological questions are raised and discussed. They pertain to what is meant by inequality, what the range of demographic variables is, and how variable and endogenous are the demographic variables most widely used. The paper then turns to a review of empirical works on the distributive incidence of the following demographic variables: baby boomers entering the job market, aging population, variable fertility and mortality rates, internal and external migrations, divorce and widowhood, and finally donations and bequests. It appears that a lot of caution is needed when assessing the incidence of any demographic variable changing the size of the population because in this case standard inequality measures yield conflicting signals." The geographical focus is on developed countries.

Birth Rate↗
PubMed1991

United States public policy and the elderly: the disproportionate risk to the well-being of women.

"Cross-sectional comparisons show that poverty among the aged in the United States has dropped dramatically over the last two decades. We use longitudinal data to identify economic events associated with unfavorable economic outcomes and to trace the influence of these events on women and men at different ages. We find that while social insurance programs appear to prevent severe financial hardship from the most frequent work-related events, they are far less effective in cushioning the economic impact of widowhood and divorce, especially for women. We suggest a number of policy changes that would provide some measure of social insurance against adverse family-related events."

Adult↗
PubMed1990

An epidemiologic investigation of potential risk factors for suicide attempts.

This is a report of new research on suicide attempts, based on an analysis of data from the Epidemiologic Catchment Area surveys in the United States. Risk of making a suicide attempt during a 1-2 year observation interval in the early 1980s was estimated in relation to selected personal and behavioral attributes of 13,673 study participants who completed baseline and follow-up interviews for these surveys. Being an active case of Major Depression was associated with increased risk of suicide attempt (estimated relative odds, RO = 41; 95% CL = 6.46-262), as was active alcoholism (RO = 18; 95% CL = 2.75-118) and being separated or divorced (RO = 11; 95% CL = 1.64-77). Being a user of cocaine was associated with increased risk of making a suicide attempt (RO = 62; 95% CL = 2.51-1528), but illicit use of marijuana, sedative-hypnotics, or sympathomimetic stimulants was not (P greater than 0.30). Educational achievement was inversely associated with risk of suicide attempt at a marginal level of statistical significance (P = 0.068). These multivariable conditional logistic regression results were obtained by applying a conventional epidemiologic strategy with post-stratification of subjects into homogeneous risk sets. Limitations of the study data and the analytic strategy are discussed in relation to directions for future epidemiologic field surveys.

Adult↗
PubMed1985

Parental separation/divorce and adolescents: an examination of factors mediating adaptation.

This study examined the relationship between differences in current adjustment as they related to a number of demographic, personal, and situational factors for 65 late adolescents/young adults who had experienced this life transition. Utilizing multiple regression analyses, several factors emerged as particularly salient mediators of the adolescents' postdivorce adjustment, including distance from home, coping style, family cohesion, conflict and organization, and the use of family members for support. The importance of clarifying the role of psychological and situational mediating factors in order to understand the consequences of parental divorce and to organize preventive and ameliorative efforts for this population is discussed.

Adaptation, Psychological↗
PubMed1987

Ongoing postdivorce conflict and child disturbance.

This paper reports on the disturbed behavior of children who are subject to entrenched parental disputes over their custody and care after separation and divorce. The 56 children who varied in racial and socioeconomic origin were 4 to 12 years old at entry into the study. They were assessed at two points: at the time of the custody dispute and 2.5 years later. The extent of the child's involvement in the dispute and the amount of role reversal between parent and child predicted total behavior problems and aggression at the time of the legal dispute. These same factors, together with the rate of verbal and physical aggression between parents, predicted total behavior problems, depression, withdrawn/uncommunicative behavior, somatic complaints, and aggression at the 2-year follows-up. There were no main effects for sex and age. However, at the 2-year mark, girls in high-conflict families were more depressed and withdrawn, and older children in high-conflict situations had more somatic complaints and were more aggressive. The findings are considered in the light of a number of etiological mechanisms by which parental conflict affects children.

Aggression↗