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A meta-analysis of regional correlates of homicide rates in 8 nations revealed consistent associations of homicide rates with divorce, suicide and unemployment rates, per capita income, and population size.
The aim of this pilot study was to ascertain the frequency of alcohol misuse among the elderly (> 65) psychiatric referrals. Consecutive referrals to a suburban elderly psychiatric team were screened for alcohol misuse by using the CAGE questionnaire as a part of psychiatric assessment. Gamma-glutanyl transpeptidase (GGT) was measured in those showing evidence of alcohol misuse. Frequency of alcohol misuse in the elderly was found to be low. Alcohol misuse was associated with raised GGT, depression, being divorced/ widowed and living alone.
This article suggests that the growth of European states, the decline of familism, and the rise of individualism generated the institutionalization of judicial separation and divorce. Time-series analyses of France (1852-1908) reveal a persistent negative association between separation/divorce and domestic homicide, especially among males. Neither indicators of economic change nor trends in the wider pattern of violent crime account for the relationship. Although marital dissolution is a negative correlate of premeditated domestic homicide, the rate of separation/divorce is directly associated with spontaneous domestic homicide, for both females and males and may indicate that abandoned spouses can become homicidal.
BACKGROUND: Genetics and environmental conditions early in life are known to influence height. However, evidence is restricted to studies conducted at a specific age, and thus the effect on the entire growth trajectory has been neglected. OBJECTIVE: The objective was to determine when parental height and factors early in offspring life start to affect offspring height, when these variables have the strongest effect, and whether these variables persist to adulthood. DESIGN: Longitudinal data from the 1958 British birth cohort (all of whom were born during 1 wk in March 1958), including height measurements at 7, 11, 16, and 33 y of age, were analyzed by using multivariate multilevel response models. RESULTS: Parental height, birth weight, maternal smoking during pregnancy, breastfeeding, parental divorce, and socioeconomic factors were all significantly associated with childhood height, but their effects differed thereafter. Parental height and birth weight were most strongly associated with offspring height, and their effects persisted (adjusted increase in adult height: 2 cm for 1 SD of maternal or paternal height, or 1 kg of birth weight). Socioeconomic disadvantage (manual social class, large family size, and overcrowded households) was associated with substantial deficits of 2-3 cm (adjusted estimates) in height at 7 y. Catch-up growth was apparent but was insufficient to overcome the initial insult on growth; the adjusted deficit was as high as 1 cm in adulthood. CONCLUSIONS: Children from disadvantaged backgrounds have a delayed pattern of growth before the pubertal spurt, which is followed by catch-up growth. The health consequences of this pattern of growth need to be examined in future studies.
OBJECTIVES: This study tests whether childlessness is significantly related to greater loneliness or depression among older adults, both alone and in conjunction with marital status. METHODS: Using data from the 1988 National Survey of Families and Households, the relative circumstances of community-dwelling, permanently childless adults and biological parents (with at least one surviving child), 50-84 years old, are compared. Multivariate models are used to test the effects of parental status and combined marital-parental statuses on loneliness and depression, controlling for sociodemographic characteristics. RESULTS: Results of multivariate analyses show no significant, direct effect of childlessness, though a marginally significant effect appears for women. However, small but significant differences are observed within a typology combining marital and parental statuses. Widowed men and women report higher levels of loneliness and depression than married parents regardless of parental status. Divorced parents are also significantly more vulnerable. The subjective well-being of never married, childless men and women is indistinguishable from that of their married peers. DISCUSSION: The results confirm earlier studies, indicating that childlessness is not necessarily linked with diminished subjective well-being among older adults. However, marital status represents an important context within which to understand and evaluate the experience of parental status.
OBJECTIVES: This study explored the role of mode and unexpectedness of death, age, race, and marital status on psychological symptoms for widows approximately 6 months after their husbands' deaths. METHODS: Midwestern samples were drawn from death/divorce records for 276 Black and White women aged 19-74 whose husbands had died from homicide, suicide, or accidental death; 276 matched natural death widows; 188 separated/divorced women. RESULTS: Mode of death was not related to psychological symptoms. Contrary to expectation, widows of the men who had died from long-term natural illnesses exhibited more distress than widows of men who had died from violent and sudden, natural deaths combined. Indicative of their heightened overall symptoms, widows were more distressed than divorced women. Middle-aged and younger widows were more distressed than older ones. White widows reported more symptoms than Blacks in violent but not natural deaths. Black widows whose spouses had died from suicide had higher psychological distress on some indicators, supporting the greater stigma of suicide among Black persons. DISCUSSION: Results of smaller studies on the minimal role of mode of death in bereavement are supported, but more research on age, race, and "off-time" deaths in short- and long-term adjustment is needed.
We report the case of an artificial donor insemination couple experiencing sudden infant death of their 8-month-old child. Six months after the incident, the couple were investigated by means of an extensive interview, a repertory grid investigation and the Family Assessment Measure, as well as at 6 years after the incident by an extensive interview. The results show the importance of the diagnosis of male infertility and the preceding fertility treatment for coping with the death of their child. Six months after the incident, acute feelings associated with bereavement are mixed with feelings of anger and shame, apparently due to the experience of infertility. However, secrecy and shame associated with male infertility and donor insemination make it impossible for the couple to communicate their feelings to each other or to friends and relatives; furthermore, they decline psychological counselling. Repertory grid investigation and the Family Assessment Measure point to significant problems within the partnership. Six years after the incident, the couple's relationship is destabilized and both partners plan to divorce. We suggest a possible link between donor insemination secrecy and difficulties with coping. We discuss implications for couple counselling and emphasize the necessity for an improved legal framework for donor insemination in Germany.
BACKGROUND: Relative risk of death from causes amenable to health services' intervention was studied in a case-control design to ascertain regional and social class differences. METHODS: The data were 2091 deaths from amenable causes and 8364 randomly drawn living controls in 1980-1986 in the seven health districts in Helsinki, Finland. Logistic regression was used to adjust relative risk estimates for age, sex and marital status. RESULTS: Adjustments decreased the risk ratios. Compared with the Southern District, the Middle District had significantly higher adjusted relative risk (RR = 1.4; 95% confidence interval [CI]: 1.1-1.7). People with no address had even higher relative risk (RR = 3.1; 95% CI: 2.3-4.2). Compared with social group I, increased relative risks were found in social group II (RR = 1.3; 95% CI: 1.1-1.6), group III (RR = 2.0; 95% CI: 1.6-2.4), group IV (RR = 1.9; 95% CI: 1.5-2.5) and group VI (RR = 8.5; 95% CI: 6.9-10.6). Males had higher relative risk than females (RR = 2.4; 95% CI: 2.1-2.8). Of the dead with no address, 29% were pensioners and 41% had been registered unemployed or occupation was unknown; 48% were single and 17% divorced. CONCLUSIONS: Our results suggest that regional inequalities in health care between various districts in Helsinki are small. However, to a large extent two overlapping groups, social group VI and people with no address, seem to delineate a deprived group likely to need special help from health care.
BACKGROUND: The aims of the present study are to analyse the association between marital status at age 24, 29, 34, and 39 years and subsequent mortality in a cohort of men born in 1953 (sensitive period); to study the impact of number of years married, number of years divorced/widowed, and number of marital break-ups on mortality (cumulative effect), and to examine whether these effects were independent of marital status at age 39 (proximity effect). METHODS: Prospective birth cohort study with follow-up of mortality from 1992 to 2002. Participants were 10891 men born within the metropolitan area of Copenhagen, Denmark. Marital status in 1992 as well as start and termination of all previous marital status events from 1968 to 1992 were retrieved from the Danish Civil Registration System. MAIN OUTCOME MEASURES: Were hazard ratios (HR) for all-cause mortality from age 40 to 49 years. RESULTS: We found a strong protective effect of being married compared with never being married or divorced/widowed at every age. The association increased in strength with increasing age. Number of years divorced was associated with increased mortality risk in a dose-dependent manner at age 34 and 39 years. One or more marital break-ups was associated with higher mortality, whereas increasing number of years married was associated with lower mortality. Inclusion of current marital status attenuated the strength of the associations but most of them remained statistically significant. CONCLUSIONS: Marital status and cumulated marital periods, especially cumulated periods divorced/widowed are strong independent predictors of mortality among younger males.
BACKGROUND: The belief that husbands desert wives who have breast cancer is not uncommon and may be a source of stress for women confronting this disease. To assess the validity of this belief, we examined the role of breast cancer as a determinant of marital breakdown by comparing the frequencies of marital breakdown among women with breast cancer and among control women from Quebec City and surrounding regions. METHODS: Secondary analyses were performed on data collected from women who were newly diagnosed with nonmetastatic breast cancer in 1984 or during the period from 1990 through 1992 and then interviewed 3 months, 18 months, and 8 years after diagnosis (1984 cohort) or interviewed 2 weeks, 3 months, and 12 months after diagnosis (1990-1992 cohort). Population-based control subjects (four groups) were recruited through random-digit dialing and from participants in the Quebec Health Surveys for 1987 and 1992. Eligible subjects were those who were living with a spouse at the time of interview and those who reported divorce or separation in the time periods examined. Marital breakdown in the past 12 months and 5 years and current marital satisfaction and adjustment were assessed. All P values are two-sided. RESULTS: Marital breakdown was never higher in women with breast cancer than in control women. Among women with breast cancer, low marital satisfaction within 3 months of diagnosis predicted further marital difficulties (a breakdown-P = .02 at 12-month interview and P = .01 at 18-month interview; low marital satisfaction- P<.0001 at 12-month interview and P = .005 at 18-month interview). CONCLUSIONS: For the times studied, breast cancer does not appear to be associated with marital breakdown among Quebec women. Marital difficulties occurred mainly among the small proportion of women who probably already had marital difficulties when diagnosed.
The association between presumed protective factors and social risk factors for hospitalization and mortality was studied during a 14-year follow-up period in a cohort of 8,168 Swedish men aged 18-20 years at baseline. Using Cox regression analysis, the authors found that five protective factors (high social class, home well-being, school well-being, good emotional control, and self-perceived good health) were associated with lower risks of hospitalization and death. Four social risk factors (contact with police or child welfare authorities, running away from home, having divorced parents, and ever using narcotics) were significantly associated with increased risk of hospitalization and mortality. The relative hazard decreased with the number of protective factors and increased with the number of social risk factors, almost linearly. The relative hazard was 0.24 for hospitalization among those with six protective factors and 0.24 for mortality for those with five or six protective factors. The relative hazard for hospitalization was 3.09 among those with five social risk factors compared with those with none, while for mortality the relative hazard among those with four or five social risk factors was 5.74 compared with those with none. While these results indicate strong cumulative effects for both the social risk factors and the protective factors, the associations of individual factors with the two outcome measures were generally reduced in models which simultaneously adjusted for all factors, which presumably indicates collinearity among the factors. There was only limited support for a buffering, or interacting, effect between the risk factors and the protective factors.
Adverse childhood experiences--especially inadequacies in early parental care--are associated with elevated rates of both acute and chronic psychosocial disorders in adult life. In most instances, adverse outcomes are confined to a minority of children exposed; variations in the severity or pervasiveness of early risk, individual differences in susceptibility, and interactions with later stressors are all thus likely to be important in mediating effects. At present, knowledge of intervening processes is limited, and dependent on retrospective studies of adult samples or short-term longitudinal findings in childhood. We review current evidence on the long-term outcomes of prenatal divorce, childhood maltreatment, and institutional rearing, and on the early antecedents of depression and antisocial behaviour in adult life, to highlight possible interviewing mechanisms. Most long-term sequelae seem likely to depend on a series of shorter-term links, some running through elevated risks of continued environmental adversity, others through psychological vulnerabilities and problems in social relationships.
This is an analysis of marital dissolution in Italy, with a focus on the life events and socioeconomic factors that put individuals at high risk of a marital breakup. The author notes that Italian society still largely conforms to traditional conjugal models and attitudes toward cohabitation and divorce. "Women most exposed to the risk of marital disruption seem to be those who married very young, who have had no more than one child, who are better educated, who have full-time jobs and who reside in large towns in the north-west of Italy. In addition, a woman who cohabits with her partner before marrying him is more likely to separate than a woman entering marriage directly."
Fifty-one burn patients were studied in a retrospective manner to determine the effects of the burn injury on their ability to return to their pre-burn physical and social status. The results of this study indicate that: 1) 79% of the patients were able to return to work or school, though 45% required a change in work and 25% were not able to continue with their peer groups in school; 2) the average time of disability was 6 months; 3) there was a significant psychological morbidity as demonstrated by self-confessed depression, juvenile delinquency and divorce. There is a need for awareness of these problems so that proper counseling can be offered to the burn patient and his family both during his hospitalization and after discharge.
Court records of 358 divorce cases involving children from matched counties in two states with opposite legal presumptions concerning joint legal custody were reviewed. The impact of such presumptions upon actual custody awards was examined, as well as the correlation between demographic and other custody arrangement variables and joint legal and physical custody in both states. It was found that the existence of a presumption concerning joint legal custody affected legal but not physical custody award patterns. Significant correlations were discovered between joint custody and the presence of specific language in court orders concerning parental rights/responsibilities and financial support for children; parental education; gender of plaintiff; welfare agency involvement and defendants' requests for custody. Implications of these findings are discussed.
OBJECTIVE: The various legal and ethical issues that may arise in the context of divorce proceedings when custody of a child is disputed are noted. A latent issue in such cases pertains to the treatment records of the parents, as well as the child, if any of the parties have ever been in any type of psychiatric treatment or mental health therapy. The principal parties may seek access to each others' records, and courts and attorneys may do so as well. METHOD: The issues that arise are explored by way of hypothetical clinical cases, as well as a consideration of leading appellate cases from different legal jurisdictions. RESULTS: Access to psychiatric treatment records is often handled in diverse ways by clinicians in disputed custody proceedings. Their clinical experience offers little to guide them in this confusing area. To complicate matters, legal rulings may differ from one jurisdiction to another as well as within one jurisdiction. Positions taken vary along a continuum from the extremes of advocating that all past and current psychiatric treatment records be made available in such disputes, to no records being made available. CONCLUSIONS: In the state of current confusion and risk for psychiatrists, as well as past and present patients, a proposal is made that only when issues of "parental fitness" are raised should consideration be given to the release of psychiatric treatment records, in contrast to the traditional rule of "best interests of the child," which would continue to operate in other areas of family disputes.
OBJECTIVE: To investigate factors that may modify the effect of separation/divorce on youth suicide. METHOD: A case-control, psychological autopsy study of 120 of 170 consecutive suicides younger than age 20 and 147 community age-, sex-, and ethnic group-matched controls living in the greater New York area was conducted. Fifty-eight suicide victims and 49 community controls came from nonintact families of origin, indicating the permanent separation/divorce of the biological parents. Potential modifiers of separation/divorce include youth's age at separation, custodial parent's remarriage, nonresidential parent's frequency of contact, parent-child relationships, and parental psychopathology. RESULTS: The relatively small impact of separation/divorce was further diminished after accounting for parental psychopathology. An interaction of separation/divorce and the father-child relationship emerged. CONCLUSION: The dramatic increase in youth suicide during the past three decades seems unlikely to be attributable to the increase in divorce rates.
Previous reports from treated psychiatric populations have reported a higher risk of mental illness among married females; however, community surveys often do not show this prevalence. Three referral groups, consisting of 488 subjects who were mentally ill but not seeking psychiatric treatment, provided a third type of population. For both sexes, combined drug and alcohol abusers were more likely to be divorced than to be married when compared to the rest of the study population (p less than .05). Both schizophrenia and drug and alcohol abuse showed differential findings by marital status and by sex, with the likelihood of more mentally ill females than males being married in these treatment populations.