Social contagion of mental health: evidence from college roommates

Transmission of Mental Disorders in Adolescent Peer Networks

Importance

Previous research indicates that mental disorders may be transmitted from one individual to another within social networks. However, there is a lack of population-based epidemiologic evidence that pertains to the full range of mental disorders.

Objective

To examine whether having classmates with a mental disorder diagnosis in the ninth grade of comprehensive school is associated with later risk of being diagnosed with a mental disorder.

Design, Setting, and Participants

In a population-based registry study, data on all Finnish citizens born between January 1, 1985, and December 31, 1997, whose demographic, health, and school information were linked from nationwide registers were included. Cohort members were followed up from August 1 in the year they completed ninth grade (approximately aged 16 years) until a diagnosis of mental disorder, emigration, death, or December 31, 2019, whichever occurred first. Data analysis was performed from May 15, 2023, to February 8, 2024.

Exposure

The exposure was 1 or more individuals diagnosed with a mental disorder in the same school class in the ninth grade.

Main Outcomes and Measures

Being diagnosed with a mental disorder during follow-up.

Results

Among the 713 809 cohort members (median age at the start of follow-up, 16.1 [IQR, 15.9-16.4] years; 50.4% were males), 47 433 had a mental disorder diagnosis by the ninth grade. Of the remaining 666 376 cohort members, 167 227 persons (25.1%) received a mental disorder diagnosis during follow-up (7.3 million person-years). A dose-response association was found, with no significant increase in later risk of 1 diagnosed classmate (HR, 1.01; 95% CI, 1.00-1.02), but a 5% increase with more than 1 diagnosed classmate (HR, 1.05; 95% CI, 1.04-1.06). The risk was not proportional over time but was highest during the first year of follow-up, showing a 9% increase for 1 diagnosed classmate (HR, 1.09; 95% CI, 1.04-1.14), and an 18% increase for more than 1 diagnosed classmate (HR, 1.18; 95% CI, 1.13-1.24). Of the examined mental disorders, the risk was greatest for mood, anxiety, and eating disorders. Increased risk was observed after adjusting for an array of parental, school-level, and area-level confounders.

Conclusions and Relevance

The findings of this study suggest that mental disorders might be transmitted within adolescent peer networks. More research is required to elucidate the mechanisms underlying the possible transmission of mental disorders.

The use and misuse of the SCOFF screening measure over two decades: a systematic literature review

PURPOSE

The SCOFF questionnaire was designed as a simple, memorable screening tool to raise suspicion that a person might have an eating disorder. It is over 20 years since the creation of the SCOFF, during which time it has been widely used. Considering this, we wish to review the use of the SCOFF in peer-reviewed scientific journals, and to assess whether it is being used appropriately in the manner in which it was originally devised and tested.

METHODS

The Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were followed, and all search strategies and methods were determined before the onset of the study. PubMed and Wiley Online Library were searched using the terms SCOFF and eating. Two reviewers were involved in the reviewing process. Criteria for appropriate use of the SCOFF were formalised with the tool's original authors.

RESULTS

180 articles were included in the final review. 48 articles had used the SCOFF appropriately, 117 articles inappropriately and 15 articles had been mixed in the appropriateness of their use.

CONCLUSION

This systematic review highlights the inappropriate use of the SCOFF in diverse languages and settings. When used correctly the SCOFF has made a significant contribution to the understanding of eating disorders and its simplicity has been applauded and led to widespread use. However in over two-thirds of studies, the use of the SCOFF was inappropriate and the paper highlights how and in what way it was misused, Guidelines for the appropriate use of the SCOFF are stated. Future validation and avenues of research are suggested.

LEVEL OF EVIDENCE

Level I.

Impact of living with an adult with depressive symptoms among households in the United States

BACKGROUND

The effect of depressive symptoms on individuals has been widely studied but their impact on households remains less explored. This study assessed the humanistic and economic impact of living with an adult with depressive symptoms on adults without depressive symptoms among households in the United States (US).

METHODS

The Medical Expenditure Panel Survey (MEPS) Household Component database was used to identify adults without depressive symptoms living in households with ≥1 adult with depressive symptoms (depression household) and adults without depressive symptoms living in households without an adult with depressive symptoms (no-depression household). Weighted generalized linear models with clustered standard errors were used to compare total income (USD 2020), employment status, workdays missed, quality of life (QoL), and healthcare resource utilization (HRU) between cohorts.

RESULTS

Adults without depressive symptoms living in a depression household (n = 1699) earned $4720 less in total annual income (representing 11.3% lower than the average income of $41,634 in MEPS), were less likely to be employed, missed more workdays per year, and had lower QoL than adults without depressive symptoms living in a no-depression household (n = 15,286). Differences in total annual healthcare costs and for most types of HRU, except for increased outpatient mental health-related visits, were not significant.

LIMITATIONS

Data is subject to reporting bias, misclassification, and other inaccuracies. Causal inferences could not be established.

CONCLUSION

The economic and humanistic consequences of depressive symptoms may extend beyond the affected adults and impact other adult members of the household.

Ethnic networks in neighborhoods affect mental health: Evidence from a quasi-random assignment of applicants in the public social housing system

This paper examines the impact of residence-based ethnic networks on mental health; such networks are defined as the concentration of residents from the same country of origin in a neighborhood. To estimate the effect, we utilize administrative registry data, together with data on quasi-random assignment of apartments to non-Western households with housing needs to various neighborhoods. After controlling for individual characteristics, time-invariant neighborhood characteristics, and general practitioners (GP) fixed effects, we find that a 1-percentage-point increase in the concentration of residence-based co-ethnics (RBCEs) increases the probability of being treated with psychiatric medications by 0.7-percentage point over a 5-year period after the assignment. With 19% of the population being treated with psychiatric medications the year before assignment, the result translates into an effect size of 3.7%. The results indicate that relatively high concentrations of co-ethnics treated with psychiatric medications increase the probability of being treated with psychiatric medications. The positive impact on treatment with psychiatric medication reflects an increase in the demand for these drugs when moving into a neighborhood with neighbors of the same ethnicity. If new residents are in good mental health condition when moving, these results suggest that moving into a neighborhood with a high co-ethic concentration worsens mental health status. However, as the population in this study is a vulnerable group an increase in treatment with psychiatric medications likely reflects that untreated mental health problems are treated, and the mental health status improved. The group of non-Western immigrants in this study differs significantly from the population in general, thus, results may not be generalized to all non-Western immigrants.

Examining how well economic evaluations capture the value of mental health

Health economics evidence informs health-care decision making, but the field has historically paid insufficient attention to mental health. Economic evaluations in health should define an appropriate scope for benefits and costs and how to value them. This Health Policy provides an overview of these processes and considers to what extent they capture the value of mental health. We suggest that although current practices are both transparent and justifiable, they have distinct limitations from the perspective of mental health. Most social value judgements, such as the exclusion of interindividual outcomes and intersectoral costs, diminish the value of improving mental health, and this reduction in value might be disproportionate compared with other types of health. Economic analyses might have disadvantaged interventions that improve mental health compared with physical health, but research is required to test the size of such differential effects and any subsequent effect on decision-making systems such as health technology assessment systems. Collaboration between health economics and the mental health sciences is crucial for achieving mental-physical health parity in evaluative frameworks and, ultimately, improving population mental health.

Staff perspectives on poor mental health in secondary school students: an increasing problem handled with insufficient resources

Introduction

An increasing number of schools are recognizing the importance of addressing students' mental health based on the association with educational outcomes and long-term health. The school organization and the members of the school staff play important but, in several ways, challenging roles in this work. The purpose of this study was to explore views of staff from schools and school health services on mental ill health among students and their own role in detecting and managing it.

Methods

A qualitative study was conducted in a sparsely populated municipality in northern Sweden. In total, 40 participants from three secondary schools and the school health services participated either in focus groups or individual interviews. Participants were teachers, assistants, school nurses, school counselors and psychologists. Data were analyzed using thematic analysis.

Results

The analysis revealed the main theme Student mental ill health: an increasing problem handled with insufficient resources and two subthemes, i.e., Uncertainty in interpreting students' signs of mental ill health and the need to clarify roles and establish a supportive organization.

Conclusions

It was concluded that school staff were uncertain regarding how to interpret signs of mental ill health among students and required better knowledge and more resources to help students with mental ill health. A clearer organization and consensus regarding support for students with mental ill health were also necessary in light of the division of responsibilities between school staff and the school health services.

Understanding the role of depressive symptoms in academic outcomes: A longitudinal study of college roommates

Rising rates of depression among adolescents raise many questions about the role of depressive symptoms in academic outcomes for college students and their roommates. In the current longitudinal study, we follow previously unacquainted roommate dyads over their first year in college (N = 245 dyads). We examine the role of depressive symptoms of incoming students and their roommates on their GPAs and class withdrawals (provided by university registrars) at the end of the Fall and Spring semesters. We test contagion between the roommates on both academic outcomes and depressive symptoms over time. Finally, we examine the moderating role of relationship closeness. Whereas students' own initial levels of depressive symptoms predicted their own lower GPA and more course withdrawals, they did not directly predict the academic outcomes of their roommates. For roommates who form close relationships, there was evidence of contagion of both GPAs and depressive symptoms at the end of Fall and Spring semesters. Finally, a longitudinal path model showed that as depressive symptoms spread from the student to their roommate, the roommate's GPA decreased. The current work sheds light on a common college experience with implications for the role of interventions to increase the academic and mental health of college students.

Mental health and labor supply: Evidence from Canada

This study investigates the relationship between mental health and employment using an instrumental variable approach with the 2012 Canadian Community Health Survey-Mental Health. Using a family member's mental health problem(s) as an instrument for poor mental health, the estimates reveal that poor mental health significantly reduces employment outcomes. These findings are robust to various specifications, such as an alternative instrument and a relaxation of the exclusion restriction assumption. In addition, the relationship is driven mainly by men and younger workers. Moreover, the findings suggest that the relationship is mediated by a decline in cognitive abilities, such as difficulties in concentration and motivation, and social relations with acquaintances and friends. Finally, the estimates show that this phenomenon is contagious: poor mental health has a significant spillover effect on coworkers' mental health in workplaces. This study demonstrates the importance of mental health illness in Canada and other developed countries.

Social contagion, violence, and suicide among adolescents

PURPOSE OF REVIEW

Social Contagion is defined as the spread of behaviors, attitudes, and affect through crowds and other types of social aggregates from one member to another. Adolescents are prone to social contagion because they may be especially susceptible to peer influence and social media.In this article, we provide a brief review of the most recent findings on social contagion, violence, and suicide among adolescents.

RECENT FINDINGS

Recent evidence support social contagion in gun violence, bullying, cyberbullying, violent offending, and suicide, but is inconclusive on the role of violent video game exposure on aggressive behavior.

SUMMARY

The mechanisms underlying the contagion effect of violence and suicide are currently unclear. It has been argued that social learning, identification with significant others, and the normalization of specific norms play a role. All these mechanisms require understanding social contagion as a complex interaction between individual, relational and social factors. This is key if the social contagion perspective is to be used not only to investigate negative outcomes, but also as a framework for promoting prosocial attitudes and behaviors. Additionally, more research is needed on psychosocial interventions and public policies to minimize the potential spillover effect of violence and suicide.

The demand for health turns 50: Reflections

The year 2022 is the 50th anniversary of the publication of my demand for health model in "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy 80(2): 223-255, and in The Demands for Health: A Theoretical and Empirical Investigation, NBER Occasional Paper 119 New York: Columbia University Press for the NBER. To mark that occasion, this editorial focuses on the history of the model and its impacts on the field of health economics.

Does depression co-occur within households? The moderating effects of financial resources and job insecurity on psychological contagion

The empirically related psychopathologies of stress and depression exact an enormous economic toll and have many physical and behavioral health effects. Most studies of the effects of stress and depression focus on their causes and consequences for a single, focal individual. We examine the extent to which depression, as indicated by filling antidepressant prescriptions (SSRI and Benzodiazepines), co-occurs across spouses, constituting a negative spillover effect. To better understand the conditions that affect within-household contagion of depression, we examine whether the stress and uncertainty occasioned by job change and financial stress (net worth) increases spillover effects among spouses.

We use panel data from various Danish administrative registers from the year 2001–2015 with more than 4.5 million observations on more than 900,000 unique individuals and their spouses from Danish health registers.

Spouses in a household with their partner using antidepressants have a 62.1% higher chance of using antidepressants themselves, with the one year lagged effect being 29.3% and a two-year lagged effect of 15.1%. The effects become larger by 14.8% contemporaneously and 20% in the two-year lagged model if the focal individual changed employers. There was also a substantively unimportant effect of lower financial wealth to increase inter-spousal contagion.

Social distance and stigma towards persons with serious mental illness among medical students in five European Central Asia countries

The study investigated behavioral measures of social distance (i.e., desired proximity between self and others in social contexts) as an index of stigma against those with mental illness among medical students in the Republic of North Macedonia, Turkey, Azerbaijan, Kazakhstan, and Poland, using the Reported and Intended Behavior Scale (RIBS), a standardized, self-administered behavioral measure based on the Star Social Distance Scale. The students' responses to standardized clinical vignettes on schizophrenia, and depression with suicidal ideation, were also assessed. A total of 257 North Macedonian (females, 31.5%; 1-4 grades, 189; 5-6 grades, 68); 268 Turkish (females, 43.3%; 1-4 grades, 90; 5-6 grades, 178); 450 Kazakh (females, 28.4%, 71.6%; 1-4 grades, 312; 5-6 grades, 138); 512 Azerbaijani (females, 24%; 1-4 grades, 468; 5-6 grades, 44; females, 24%), and 317 Polish (females, 59.0%; 1-4 grades, 208; 5-6 grades, 109) students were surveyed. The responses on the RIBS social distance behavior measures did not improve with advancing medical school grade, but students across all sites viewed schizophrenia and depression as real medical illnesses. The results support the development of enhanced range of integrated training opportunities for medical student to socially interact with persons with mental illness sharing their experiences with them.

Interpersonal Conflicts in the Unit Impact the Service Quality Rated by Customers: The Mediating Role of Work-Unit Well-Being

Social dynamics at work are crucial for understanding how internal processes in an organization are related to their performance and productivity. Following the Service-Profit Chain (SPC) theory, this study analyses, at the work-unit level, how interpersonal conflicts are related to service quality in the hospitality and tourism industry through the shared experience of well-being in the work unit. In other words, we examine the mediating role of two main aspects of work-related well-being in the unit (job satisfaction and burnout) on the relationship between interpersonal conflicts in the unit and customers’ perceptions of service quality. To do so, we conducted a cross-sectional survey study that collected data from 398 service employees (91 work units) and 1233 customers from three and four-star hotels with restaurant in Spain. Using path analysis in Structural Equation Models, our results supported a full mediation model at the work-unit level: interpersonal conflicts in the work unit are related to customers’ service quality perceptions through the work-unit’s well-being (job satisfaction and burnout). Therefore, our findings extend the SPC theory by integrating group dynamics and employees’ experiences, which should be enhanced through occupational health-oriented policies and practices to increase service quality. In this sense, this study has implications for the development of intervention programs aiming at improving the occupational well-being and quality of service in hospitality and tourism settings.

The Werther effect of celebrity suicides: Evidence from South Korea

Since 2003 Korea has experienced the highest suicide rate among OECD countries. One of the societal risk factors that triggers suicide is the contagious nature of suicide. This paper empirically examines the effect of celebrity suicide reports on subsequent copycat suicides, using daily suicide data and information of highly publicized suicide stories in Korea from 2005 to 2018. The findings from the Poisson regression model suggest that the number of public suicides soars after media reports on celebrity suicides. On average, the number of suicides in the population increased by 16.4% within just one day after the reports. Further analysis reveals that female and younger subgroups are more likely to be affected by celebrity suicides. Moreover, the public reacts more strongly to suicide incidents of celebrities of the same gender and even imitates the methods of suicide used by celebrities. This paper highlights the significance of careful and responsible media coverage of suicide stories to prevent copycat suicide. For policymakers, it is crucial to implement regulations not only for traditional media but also for new media where younger people can freely access unfiltered information.

Coronavirus Trauma and African Americans' Mental Health: Seizing Opportunities for Transformational Change

The COVID-19 pandemic is a natural disaster of historic proportions with widespread and profound psychological sequelae. African Americans fall ill and die more than whites from COVID and more survivors and loved ones face psychological risk. African Americans also experience greater personal, social, and financial stress even when not personally touched by COVID illness, and they are again vulnerable as COVID diminishes African American community’s capacity for mutual support. Enactment of the American Rescue Act of 2021 can moderate if not eliminate African Americans’ greater adversity and greater psychological challenge; other provisions can move the mental health treatment system beyond its previous failure to reach African Americans as it constructively responds to the crisis that COVID presents. From outreach through trusted community actors and institutions for meeting African Americans’ needs of varying intensity and duration, and by providing a spectrum of evidence supported interventions—culturally adapted as needed—newfound success can mark a turning point toward new approaches and lasting success.

The Developmental Process of Peer Support Networks: The Role of Friendship

This study investigated the characteristics and development of peer support networks in an effort to unravel the role of friendship in this developmental process. The relationships between friendship networks and peer support networks were explored, and the influence of dyadic and triadic friendships on the development of peer support relationships was examined. Two waves of data were collected among a sample of adolescents in six Chinese junior high schools (n = 913 students from 28 classrooms; mean age = 14.13 years; 50.49% boys), and classroom friendship networks and peer support networks were analyzed. The results showed that peer support networks were sparse, hierarchical, and sex-segregated. Furthermore, peer support networks and friendship networks partially overlapped. Friends tended to have similar support-seeking and support-providing ties. Longitudinal multiplex social network analysis revealed that peer support networks changed moderately over time, and friendships played various roles in the development of peer support networks. Dyadic friendships improved the formation of peer support ties. A mutual friend improved the formation of support relationships between two students when the mutual friend chose the two students as friends, but a mutual friend also hindered or had no effects on the formation of support relationships in other cases. The implications for educators to improve peer support networks are presented, and directions for future research are discussed.

The social contagion of student engagement in school

Student engagement is a strong predictor of academic achievement and overall school success. Much of the research on engagement has focused on the role of personal psychological antecedents and social factors related to one’s teachers. Relatively fewer studies have focused on the influence of one’s classmates. Drawing on prior work on social contagion, this study aimed to examine whether classmates’ engagement influences one’s engagement. Questionnaires were administered to 848 secondary school students nested within 30 classes. Two waves of data were collected seven months apart. Multilevel modelling showed that a student’s Time 2 engagement was positively predicted by his/her classmates’ engagement at Time 1, providing evidence for the social contagion of engagement. These findings held even after controlling for autoregressor effects and other relevant covariates such as demographic factors and achievement goals. Our results suggest that students’ engagement in school is contagious and could be transmitted among classmates.

Siblings of Individuals With Eating Disorders: A Review of the Literature

Eating disorders (EDs) are serious psychopathologies characterized by a persistent disturbance in eating or eating-related behavior. Studies have shown EDs' detrimental consequences not only for patients, but also for their families. Nevertheless, a specific group that has so far been neglected, in both the research and clinical fields, are siblings of individuals with EDs. In an effort to identify this population's needs, and to facilitate effective prevention and treatment, this paper aims to review the existing literature on the subject, and examine siblings' personal experience, ways of coping, and levels of psychopathology. PubMed and PsycNet databases were searched with no publication date restrictions, yielding 26 relevant papers. Studies were categorized according to common themes they addressed, and subsequently summarized by highlighting common features, as well as information unique to each study. Several themes emerged, including emotional well-being, psychopathology, social consequences, family dynamics, and coping strategies. Results show that EDs experienced by one individual have significant effects on one's siblings, such as a decrease in quality of life, social isolation, and elevated familial strain. In several studies siblings were found to have elevated levels of psychopathology and EDs related symptoms. Nevertheless, findings' nature and magnitude were highly varied. The review indicates the need for further studies that will examine possible intra- and interpersonal moderating factors for EDs' impact on well-being among siblings, and take into consideration the substantial heterogeneity in studies conducted thus far. Additionally, this review highlights the need for novel and effective interventions, specifically targeting this at-risk group.

The Emergence of Risk Communication Networks and the Development of Citizen Health-Related Behaviors during the COVID-19 Pandemic: Social Selection and Contagion Processes

Amid the novel coronavirus pandemic, a variety of public health strategies have been implemented by governments worldwide. However, the fact that strict government mandates focus on physical distancing does not mean that social connectedness for voluntary risk communication among citizens should be sacrificed. Furthermore, we lack an understanding of citizens' behaviors regarding the voluntary adoption of public health measures and the control of mental wellbeing in the age of physical distancing. Key variables in the response to the global pandemic are the emergence of risk deliberation networks, voluntary compliance with government guidelines, and the restoration of citizens' subjective health. However, little is known about how citizens' health-related behaviors coevolve with social connections for sharing information and discussing urgent pandemic issues. The findings show that selection and social influence mechanisms coexist by affecting each citizen's health-related behaviors and community-led risk discourses in the face of the urgent health crisis.

Collegian help seeking: the role of self-compassion and self-coldness

BACKGROUND

Researchers have identified a two-factor structure of self-compassion (i.e. self-compassion and self-coldness). To date, no research has examined each of these constructs' role in collegian professional help-seeking intention.

AIM

The current study sought to assess the role of self-compassion and self-coldness in collegian professional help-seeking intention, accounting for other theoretically and empirically-supported help-seeking constructs.

METHOD

Participants included 9349 collegians recruited as part of the national 2015-2016 Healthy Minds Study archival dataset. A logistic regression was conducted to examine the unique contributions of self-compassion and self-coldness in predicting professional help-seeking intention, controlling for key help-seeking variables.

RESULTS

A test of the full model against a constant only model was statistically significant, which indicated that the predictors collectively distinguished between collegians who intended to seek help from a professional clinician compared to those who did not. The Wald criterion indicated that both self-compassion and self-coldness were uniquely associated with intention to seek professional help. Self-compassion increased and self-coldness decreased the probability of seeking professional help.

CONCLUSIONS

The study highlights the importance of self-compassion and self-coldness in collegian help-seeking intention. These findings can inform specific outreach efforts targeting both self-compassion and self-coldness.

Roommate effects in health outcomes

We use randomized roommate assignment in dormitories in a college in Kolkata in India to examine peer effects in weight gains among roommates. We use administrative data on weight, height, and test scores of students at the time of college admission and then survey these students at the end of their first and second years in college. We do not find any significant roommate specific peer effect in weight gain. Our results rather suggest that an obese roommate reduces the probability that the other roommates become obese in subsequent years. We examine potential mechanism using survey data on students' eating habits, smoking, exercise, and sleeping patterns. We find that obese roommates sleep longer, which in turn improves the sleep pattern of others, which might explain the weak negative effect of obese roommates on the weight of others in the same room.

The Role of Ego Networks in Compulsive Exercise Behavior Among a Sample of College Sorority Women

Background: Compulsive exercise (CE) is a harmful form of exercise that elevates the risk of developing/sustaining clinical eating disorders. College-aged sorority women are especially prone to CE. Due to the pronounced impact social relationships have on college students’ behavior, this study aims to examine personal networks and CE among a sample of sorority women through an egocentric network analysis.Methods: A total of 204 women in a sorority from a large, private university in the southeastern United States completed a cross-sectional survey in spring 2015. Descriptive and regression analyses were conducted on demographic, attribute, and ego network data.Results: Relationships with siblings, significant others, and roommates were protective against CE in this sample. Conversely, body dissatisfaction and exercise frequency predicted CE.Conclusions: Findings suggest that social relationships can impact CE behaviors in this sample. Along with promoting body satisfaction and healthy exercise, public health efforts should focus on facilitating close interpersonal relationships, especially between sorority women and siblings, significant others, and roommates.

Affective stimuli in behavioural interventions soliciting for health check-up services and the service users' socioeconomic statuses: a study at Japanese pachinko parlours

Editor’s note

The study reported in this article examines a health intervention that uses gendered stereotypes of the nursing profession and suggestive uniforms that play on women’s sexuality to encourage people to engage in health checkups. The intervention was not under the control of the authors and the study was approved by an institutional research ethics board. The Journal of Epidemiology & Community Health condemns the use of sexism, gender and professional stereotypes and other forms of discriminatory or exploitative behaviour for any purpose, including health promotion programs. In light of concerns raised about this paper (see eLetters with this paper), we are conducting an audit of our review process and will put in place measures to ensure that the material we publish condemns sexism, racism and other forms of discrimination and embodies principles of inclusion and non-discrimination.

Estimating sibling spillovers in health: Evidence on symptoms

This paper estimates the sibling spillover effect in health symptoms using a sample of US adolescents from the National Longitudinal Study of Adolescent Health dataset. The research design of this paper is to restrict the sample to sibling pairs who are separated between schools, where one enters high school and the other middle school. Because of school separation, sibling pairs face independent health shocks from own school peers. The identification strategy further exploits variations in individual health across symptoms to control for unobserved individual heterogeneity, which flexibly partials out family correlated effects. Estimation results show that the sibling spillover effect is large as a one-standard-deviation increase in one sibling's frequency of developing a stomach ache or a loss of appetite increases the other sibling's frequency of having the same symptom by about 55% of a standard deviation. Further investigation suggests that the effect is not due to spillovers in drinking alcohol or depression, but probably due to the spread of contagious illnesses like the stomach flu.

Physiological attunement in mother–infant dyads at clinical high risk: The influence of maternal depression and positive parenting

A growing number of research studies have examined the intradyadic coregulation (or attunement) of hypothalamus–pituitary–adrenal axis functioning in mothers and their children. However, it is unclear how early this coregulation may be present in dyads at clinical high risk and whether certain factors, such as maternal depression or positive parenting, are associated with the strength of this coregulation. The present study examined cortisol attunement within mother–infant dyads in a high-risk sample of 233 mothers who received treatment for psychiatric illness during pregnancy and whose infants were 6 months old at the study visit. Results showed that maternal and infant cortisol covaried across four time points that included a stressor paradigm and a mother–infant interaction task. Greater maternal positive affect, but not depression, predicted stronger cortisol attunement. In addition, infants’ cortisol level following separation from the mother predicted mothers’ cortisol level at the next time point. Mothers’ cortisol level following the separation and the laboratory stress paradigm predicted infants’ cortisol levels at each successive time point, over and above infants’ own cortisol at the previous time point. These findings suggest that maternal and infant cortisol levels influence one another in a bidirectional fashion that may be temporally and context dependent.

Happy classes make happy students: Classmates' well-being predicts individual student well-being

Student well-being has mostly been studied as an individual phenomenon with little research investigating how the well-being of one's classmates could influence a student's well-being. The aim of the current study was to examine how the aggregate well-being of students who comprise a class could predict students' subsequent well-being (Time 2 well-being) after controlling for the effects of prior well-being (Time 1 well-being) as well as key demographic variables such as gender and age. Two studies among Filipino secondary school students were conducted. In Study 1, 788 students from 21 classes participated; in Study 2, 404 students from 10 classes participated. For Study 1, questionnaires assessing students' life satisfaction, positive affect and negative affect were administered twice seven months apart. For Study 2, the well-being questionnaires were administered twice, three months apart. Hierarchical linear modeling was used with level 1 (Time 1 individual well-being, gender, and age) and level 2 (class well-being) predictors. Results across the two studies provided converging lines of evidence: students who were in classes with higher levels of life satisfaction and positive affect were also more likely to have higher life satisfaction and positive affect at Time 2. The study indicated that the well-being of a student partly depends on the well-being of their classmates providing evidence for the social contagion of well-being in the classroom context.

Spillover Effects in Health Service Use: Evidence From Mental Health Care Using First-Year College Housing Assignments

Spillover effects in health service use may represent an important externality of individual treatment decisions and are important for understanding the consequences of interventions to improve access to health care. This study is the first to our knowledge to examine causal spillover effects for mental health service use. We exploit the natural experiment of first-year student housing assignments at two universities using survey data that we collected. When the peer group is defined at the roommate level, we do not find any spillover effects on service use. When the peer group is defined at the hall level, we find positive spillover effects--peers' service use increases one's own service use--and this effect is driven by individuals with prior experience with mental health services. We also find some evidence that the mechanism behind this effect is improved beliefs about treatment effectiveness.

The impact of lifetime suicidality on academic performance in college freshmen

BACKGROUND

While suicidal thoughts and behaviors (STB) among college students are common, the associations between STB and academic performance are not well understood.

METHODS

As part of the World Mental Health Surveys International College Student project, web-based self-reported STB of KU Leuven (Leuven, Belgium) incoming freshmen (N=4921; response rate=65.4%) was collected, as well as academic year percentage (AYP), and the departments to which students belong. Single- and multilevel multivariate analyses were conducted, adjusted for gender, age, parental educational level, and comorbid lifetime emotional problems.

RESULTS

Lifetime suicide plan and attempt upon college entrance were associated with significant decreases in AYP (3.6% and 7.9%, respectively). A significant interaction was found with average departmental AYP, with STB more strongly associated with reduced AYP in departments with lower than higher average AYP.

LIMITATIONS

Limited sample size precluded further investigation of interactions between department-level and student-level variables. No information was available on freshman secondary school academic performance.

CONCLUSIONS

Lifetime STB has a strong negative association with academic performance in college. Our study suggests a potential role for the college environment as target for treatment and prevention interventions.

Affect and well-being similarity among older Indian spouses

OBJECTIVES

Previous work suggests that husbands and wives are likely to share affective states so that depression or happiness in one spouse is predictive of depression or happiness in the other. Studies that have examined spousal affect similarity, however, have been concentrated in the Western world where the meaning of marriage may be different than it is in other cultural contexts. Marriage in India, unlike that in the United States, is focused on the extended family so that love and intimacy between spouses are downplayed. This study examined affect and well-being similarity between 603 older married couples in India using pilot data from the Longitudinal Aging Study of India.

METHOD

We ran linear regression models to assess the relationship between the well-being states of husbands and wives using dyadic observations for four different measures: depressive symptoms, dissatisfaction with daily life, social isolation, and overall life satisfaction.

RESULTS

Across all four measures, the well-being scores of one spouse were positively and significantly associated with the well-being scores of the other. These associations did not vary by marital satisfaction, but were slightly stronger for respondents reporting poor health.

CONCLUSION

Our increased understanding of social connectedness has prompted a shift from the consideration of single individuals to a broader understanding of individuals in the context of their social environments. The results of this study suggest that interventions designed to foster well-being among older adults in India might benefit from a focus on couples as a unit rather than individuals.

Peer influence processes for youth delinquency and depression

This study explores the multiple factors that account for peer influence processes of adolescent delinquency and depression using data from Waves I and II of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Random-effects longitudinal negative binomial models were used to predict depression and delinquency, controlling for social connection variables to account for selection bias. Findings suggest peer depression and delinquency are both predictive of youth delinquency, while peer influences of depression are much more modest. Youth who are more connected to parents and communities and who are more popular within their networks are more susceptible to peer influence, while self-regulating youth are less susceptible. We find support for theories of popularity-socialization as well as weak-ties in explaining social network factors that amplify or constrain peer influence. We argue that practitioners working with youth should consider network-informed interventions to improve program efficacy and avoid iatrogenic effects.

Applying Farr's Law to project the drug overdose mortality epidemic in the United States

Background

Unintentional drug overdose has increased markedly in the past two decades and surpassed motor vehicle crashes as the leading cause of injury mortality in many states. The purpose of this study was to understand the trajectory of the drug overdose epidemic in the United States by applying Farr’s Law. Farr’s “law of epidemics” and the Bregman-Langmuir back calculation method were applied to United States drug overdose mortality data for the years 1980 through 2011 to project the annual death rates from drug overdose from 2012 through 2035.

Findings

From 1980–2011, annual drug overdose mortality increased from 2.7 to 13.2 deaths per 100,000 population. The projected drug overdose mortality would peak in 2016–2017 at 16.1 deaths per 100,000 population and then decline progressively until reaching 1.9 deaths per 100,000 population in 2035.

Conclusion

The projected data based on Farr’s Law suggests that drug overdose mortality in the United States will decline in the coming years and return to the 1980 baseline level approximately by the year 2034.

Electronic supplementary material

The online version of this article (doi:10.1186/s40621-014-0031-2) contains supplementary material, which is available to authorized users.

Hope, friends, and subjective well-being: a social network approach to peer group contextual effects

Research on adolescence has previously shown that factors like depression and burnout are influenced by friendship groups. Little research, however, has considered whether similar effects are present for variables such as hope and subjective well-being. Furthermore, there is no research that considers whether the degree of hope of an adolescent's friends is associated with well-being over the individual's level of hope. Data were collected in 2012 from a sample of 15-year-olds (N = 1,972; 62% Caucasian; 46% identified as Catholic; 25% had professional parents) from the East Coast of Australia. Findings suggest that individuals from the same friendship group were somewhat similar in hope and well-being. Multilevel structural equation modeling indicated that friendship group hope was significantly related to psychological and social well-being.

Peer effects on risky behaviors: new evidence from college roommate assignments

Social scientists continue to devote considerable attention to spillover effects for risky behaviors because of the important policy implications and the persistent challenges in identifying unbiased causal effects. We use the natural experiment of assigned college roommates to estimate peer effects for several measures of health risks: binge drinking, smoking, illicit drug use, gambling, having multiple sex partners, suicidal ideation, and non-suicidal self-injury. We find significant peer effects for binge drinking but little evidence of effects for other outcomes, although there is tentative evidence that peer effects for smoking may be positive among men and negative among women. In contrast to prior research, the peer effects for binge drinking are significant for all subgroups defined by sex and prior drinking status. We also find that pre-existing risky behaviors predict the closeness of friendships, which underscores the significance of addressing selection biases in studies of peer effects.