Evaluating the seven-item Center for Epidemiologic Studies depression scale short-form: a longitudinal U.S. community study

Fetal Exposure to Tobacco Metabolites and Depression During Adulthood: Beyond Binary Measures

BACKGROUND

Sibling studies of maternal smoking during pregnancy and subsequent risk of depression have produced mixed results. A recent study identified not considering the amount of maternal smoking and age of onset as potentially masking a true association. We examine these issues and also the amount of maternal smoking during pregnancy as a determinant of the severity of depressive symptoms.

METHODS

We analyzed data from the community-based National Longitudinal Survey of Youth (US, 1994-2016). Mothers reported smoking during pregnancy (none, <1 pack/day, ≥1 pack/day). We assessed offspring's lifetime depression (i.e., ≥8 symptoms) and symptom counts with the Centers for Epidemiologic Studies Depression scale. We estimated the risk of these two outcomes in the full sample (n = 7172) and among siblings (n = 6145) using generalized linear mixed-effects models with random intercepts by family and family-averaged means for sibling analyses.

RESULTS

Among siblings, we observed dose-dependent elevations for both risk of depression (smoking during pregnancy <1 pack/day adjusted risk ratio [aRR] = 1.18; 95% confidence interval [CI] = 1.07, 1.30; smoking ≥1 aRR = 1.36; 95% CI = 1.19, 1.56) and severity of depressive symptoms (smoking <1 pack/day aRR = 1.12; 95% CI = 1.08, 1.16); smoking ≥1 pack/day aRR = 1.25; 95% CI = 1.18, 1.31). Among both samples, the P for trend was <0.01. In analysis limited to offspring diagnosed before age 18, results for severity were attenuated.

CONCLUSIONS

This evidence supports the existence of an independent association between maternal smoking during pregnancy and both the risk of depression and the severity of depressive symptoms. The results highlight the utility of considering the amount of smoking, severity of symptoms, and age of onset.

Prospective trajectories of depression predict mortality in cancer patients

An ever-growing body of empirical evidence has demonstrated the relationship between depression and cancer. The objective of this study was to examine whether depression trajectories predict mortality risk above and beyond demographics and other general health-related factors. Participants (n = 2,345) were a part of the Health and Retirement Study. The sample consisted of patients who were assessed once before their cancer diagnosis and thrice after. Depressive symptoms and general health-related factors were based on self-reports. Mortality risk was determined based on whether the patient was alive or not at respective time points. Latent Growth Mixture Modeling was performed to map trajectories of depression, assess differences in trajectories based on demographics and general health-related factors, and predict mortality risk. Four trajectories of depression symptoms emerged: resilient (69.7%), emerging (13.5%), recovery (9.5%), and chronic (7.2%). Overall, females, fewer years of education, higher functional impairment at baseline, and high mortality risk characterized the emerging, recovery, and chronic trajectories. In comparison to the resilient trajectory, mortality risk was highest for the emerging trajectory and accounted for more than half of the deaths recorded for the participants in emerging trajectory. Mortality risk was also significantly elevated, although to a lesser degree, for the recovery and chronic trajectories. The data highlights clinically relevant information about the depression-cancer association that can have useful implications towards cancer treatment, recovery, and public health.

Short-term dynamics of loneliness and depressive symptoms: Gender differences in older adults

BACKGROUND

Previous research examining the relationship between loneliness and depressive symptoms often treated these constructs as static traits rather than dynamic states. The current study focused on the short-term, prospective link between loneliness and depressive symptoms, while also analyzing potential gender differences.

METHODS

We modeled panel data from seven bi-weekly assessments gathered in the FRequent health Assessment In Later life (FRAIL70+) study. At baseline, the sample size amounted to N = 426 community-dwelling older adults aged 70 years or older in Austria. The relationship between loneliness and depressive symptoms was analyzed using a latent change score modeling framework.

RESULTS

As regards depressive symptoms, women showed higher initial levels and more change across the three months than men. Loneliness did not considerably change across time for both sexes. Moreover, greater levels of loneliness at a given point in time were associated with an accelerated increase in depressive symptoms two weeks later in women but not in men.

CONCLUSION

Loneliness appeared to be a potential determinant of future increases in depressive symptoms. The varying effects observed between men and women suggest potential gender differences in short-term fluctuations of depressive symptoms and their underlying mechanisms.

The association between vaping and health behaviors among undergraduate college students in the United States

Objective: To examine the association between vaping and health behaviors (physical activity, fruit and vegetable consumption, sleep, cigarette use, alcohol consumption) and mental health among college students. Methods: Socio-demographic characteristics, vaping, health behaviors, perceived stress, and depressive symptoms of undergraduates enrolled at a large university located in the Northeast of the United States were assessed via an online survey. Results: Of all participants (n = 1775), less than a fifth (n = 314, 17.7%) reported any vaping in the past month. More men reported vaping than women (23.2% vs. 14.5%). Those who vaped reported fewer nights of restful sleep and greater alcohol consumption. Those who smoked and binge drank were more likely to report vaping. Perceived stress was greater among women who vaped, and depressive symptoms were greater among those who vaped regardless of gender. Conclusions: Vaping was associated with smoking, alcohol consumption, and poorer mental health among young adults.

Exploring the relationship between depression and delinquency: a sibling comparison design using the NLSY

Relative to the general population, adolescents with psychiatric disorders such as major depression disorder are incarcerated (and reincarcerated) at higher rates. Current research is mixed on whether this association is a cause, consequence, or the product of selection. For example, aggression can lead to more depressive symptoms, yet depression is associated with antisocial behaviors (e.g., delinquency). To better understand the relationship between depression and delinquent behavior, we used the discordant kinship model to examine data from sibling pairs in the National Longitudinal Surveys of Youth 1979, a nationally representative study. By explicitly modeling within- and between-family variance, we reduced the influence of genetic and shared-environmental confounds on our analysis. Our results suggest that the relationship between depression and delinquency is not causal, but rather a product of selection.

The working life expectancy of American adults experiencing depression

OBJECTIVES

To estimate the working life expectancies (WLE) of men and women with depression, examining depression by symptom trajectories from the late 20s to early 50s, and to estimate WLE by race/ethnicity and educational attainment.

METHODS

Data from 9206 participants collected from 1979 to 2018 in the US National Longitudinal Survey of Youth 1979 cohort were used. Depression was measured using the Center for Epidemiologic Studies Depression Scale Short Form at four time points (age 28-35, age 30-37, age 40, and age 50). Labor force status was measured monthly starting at age 30 until age 58-62. Depressive symptom trajectories were estimated using growth mixture modeling and multistate modeling estimated WLE from age 30-60 for each gender and depressive symptom trajectory.

RESULTS

Five latent symptom trajectories were established: a persistent low symptom trajectory (n = 6838), an episodic trajectory with high symptoms occurring before age 40 (n = 995), an episodic trajectory with high symptoms occurring around age 40 (n = 526), a trajectory with high symptoms occurring around age 50 (n = 570), and a persistent high symptom trajectory (n = 277). The WLE for men at age 30 was 30.3 years for the persistent low symptom trajectory, 22.8 years for the episodic before 40 trajectory, 19.6 years for the episodic around age 40 trajectory, 18.6 years for the episodic around age 50 trajectory, and 13.2 years for the persistent high symptom trajectory. Results were similar for women. WLE disparities between depression trajectories grew when stratified by race/ethnicity and education level.

CONCLUSIONS

Roughly a quarter of individuals experienced episodic depressive symptoms. However, despite periods of low depressive symptoms, individuals were expected to be employed ~5-17 years less at age 30 compared to those with low symptoms. Accessible employment and mental health disability support policies and programs across the working life course may be effective in maintaining work attachment and improving WLE among those who experience depression.

How our longitudinal employment patterns might shape our health as we approach middle adulthood-US NLSY79 cohort

Recent labor market transformations brought on by digital and technological advances, together with the rise of the service economy since the 1980s, have subjected more workers to precarious conditions, such as irregular work hours and low or unpredictable wages, threatening their economic well-being and health. This study advances our understanding of the critical role employment plays in our health by examining how employment patterns throughout our working lives, based on work schedules, may shape our health at age 50, paying particular attention to the moderating role of social position. The National Longitudinal Survey of Youth-1979 (NLSY79), which has collected 30+ years of longitudinal information, was used to examine how employment patterns starting at ages 22 (n ≈ 7,336) might be associated with sleep hours and quality, physical and mental functions, and the likelihood of reporting poor health and depressive symptoms at age 50. Sequence analysis found five dominant employment patterns between ages 22 and 49: "mostly not working" (10%), "early standard hours before transitioning into mostly variable hours" (12%), "early standard hours before transitioning into volatile schedules" (early ST-volatile, 17%), "mostly standard hours with some variable hours" (35%), and "stable standard hours" (26%). The multiple regression analyses indicate that having the "early ST-volatile" schedule pattern between ages 22 and 49 was consistently, significantly associated with the poorest health, including the fewest hours of sleep per day, the lowest sleep quality, the lowest physical and mental functions, and the highest likelihood of reporting poor health and depressive symptoms at age 50. In addition, social position plays a significant role in these adverse health consequences. For example, whereas non-Hispanic White women reported the most hours of sleep and non-Hispanic Black men reported the fewest, the opposite was true for sleep quality. In addition, non-Hispanic Black men with less than a high school education had the highest likelihood of reporting poor health at age 50 if they engaged in an employment pattern of "early ST-volatile" between ages 22 and 49. In comparison, non-Hispanic White men with a college degree or above education had the lowest likelihood of reporting poor health if they engaged in an employment pattern of stable standard hours. This analysis underscores the critical role of employment patterns in shaping our daily routines, which matter to sleep and physical and mental health as we approach middle adulthood. Notably, the groups with relatively disadvantaged social positions are also likely to be subject to nonstandard work schedules, including non-Hispanic Blacks and people with low education; hence, they were more likely than others to shoulder the harmful links between nonstandard work schedules and sleep and health, worsening their probability of maintaining and nurturing their health as they approach middle adulthood.

Cumulative Disadvantage or Strained Advantage? Remote Schooling, Paid Work Status, and Parental Mental Health during the COVID-19 Pandemic

During the COVID-19 pandemic, parents experienced difficulties around employment and children's schooling, likely with detrimental mental health implications. We analyze National Longitudinal Survey of Youth 1997 data (N = 2,829) to estimate depressive symptom changes from 2019 to 2021 by paid work status and children's schooling modality, considering partnership status, gender, and race-ethnicity differences. We draw on cumulative disadvantage theory alongside strained advantage theory to test whether mental health declines were steeper for parents with more disadvantaged statuses or for parents with more advantaged statuses. Parents with work disruptions, without paid work, or with children in remote school experienced the greatest increases in depressive symptoms, with steepest increases among single parents without paid work and single parents with children in remote school (cumulative disadvantage), fathers without paid work (strained advantage), and White parents with remote school (strained advantage). We discuss the uneven impacts of the pandemic on mental health and implications for long-term health disparities.

Multidimensional social support and associations between COVID-19 stress and depressive/anxiety outcomes among Hispanic/Latinx and White first-year college students

Objective: The COVID-19 pandemic has led to greater depression and anxiety among college students. Social support may alleviate this risk. We examined how social support from family, friends, and romantic partners may influence internalizing psychopathology outcomes associated with COVID-19-related stressful events. Participants: Participants were first-years (N = 425, 34.8% Hispanic/Latinx, 74.9% female) enrolled in a United States public university. Methods: Participants completed an online survey in Fall of 2020. Linear regression models examined associations between COVID-19 stressors, social support, depressive and anxiety symptoms, and differences between White and Hispanic/Latinx students. Results: Reported COVID-19 stressors were associated with elevated depressive and anxiety symptoms and higher among Hispanic/Latinx students. Family and friend support were negatively associated with both internalizing outcomes. Partner support was negatively associated with depression and more predictive among White students whereas friend support was for Hispanic/Latinx students' anxiety. Conclusions: These findings demonstrate the importance of social connectedness during the COVID-19 pandemic.

Well-Being Implications of Digital Social Multitasking in Adolescent Friendship: A Latent Profile Analysis

Adolescents' phone use during face-to-face interactions (i.e., digital social multitasking [DSMT]) has gained increasing attention because of its prevalence as well as implications for well-being. However, most studies have focused on only one dimension of the behavior and relied on variable-centered approaches. Informed by the DSMT framework, we adopted a person-centered approach to identify different groups of adolescents based on their levels, perceptions, and motives of phone use during face-to-face interactions with friends. We also examined how these groups differed in five well-being variables (loneliness, depressive symptoms, digital stress, friendship quality, and satisfaction of basic psychological needs). A total of 517 adolescents (Mage = 14.83, standard deviation [SD] = 1.93; 50 percent female) completed an online survey. Three profiles were identified: the Intentional (low levels, quite positive perceptions, motivated for clear goals), the Embracers (high levels, highly positive perceptions, strong motives), and the Unimpressed (low levels, low positive perceptions, low motives). The Embracers scored the highest on both positive and negative indicators of well-being, whereas the Unimpressed scored the lowest on all well-being scales. The Intentional appeared to be the most adaptive group. Implications are discussed.

COVID-19 Related Stressors, Parent-Child Relationship, and Alcohol Use and Mental Health Profiles Among White and Hispanic/Latinx First-Year College Students

Transitioning to college during the novel coronavirus disease 2019 (COVID-19) pandemic may increase risk for alcohol use and mental health problems. We examined how COVID-19 related stressors and parent-child relationships are independently and interactively associated with alcohol use and mental health profiles in a sample of first-year college students (N = 425, 34.8% Hispanic/Latinx; 74.9% female) who completed an online survey in October 2020. Latent profile analysis identified four profiles: well-adjusted (53.2%), mental health problems only (21.6%), alcohol use only (17.4%), and comorbid (7.8%). COVID-19 related stressful events increased risk of being in the alcohol use only and comorbid profiles, whereas COVID-19 related worries increased risk of being in the mental health problems only profile. Parent-child relationship quality lowered risk of being in the mental health problems only and the comorbid profiles. In addition, parent-child relationship quality moderated the role of COVID-19 related worries such that COVID-19 related worries were associated with lower odds of being in the comorbid profile when parent-child relationship quality was high but not when parent-child relationship quality was low. Strengthening parent-child relationship quality appears important for promoting college students' well-being.

Risk factors for newly-developed cardiovascular disease and quality of life during the COVID - 19 pandemic: an analysis of the English longitudinal study of ageing

INTRODUCTION

The COVID-19 pandemic had a wide range of effects on the English population, including on health and quality of life due to the subsequent lockdown restrictions set.

AIMS

To investigate longitudinal changes in developing cardiovascular disease (CVD) and how that affects quality of life from pre-pandemic and during two lockdowns in England, in adults aged 50 years and above, and what factors are associated with this.

METHODS

Wave 9 of the core English Longitudinal Study of Ageing (ELSA) and Waves 1 and 2 of the ELSA COVID-19 sub-study were used to investigate the factors associated with developing CVD between timepoints, and what factors alongside CVD are associated with quality of life.

RESULTS

Higher age and depression were associated with newly-developed CVD from pre-COVID to both COVID sub-study waves. Additionally, body mass index (BMI) increased odds of CVD and physical activity decreased odds. Non-White ethnicity, depression, females, and developing CVD were lower associated with quality of life. Decreased age and increased physical activity were associated with higher quality of life.

DISCUSSION

Ethnicity was not associated with newly-developed CVD but was associated with quality of life. Other factors of importance include age, depression, gender, and physical activity. Findings are informative for future risk stratification and treatment strategies, especially while the COVID-19 pandemic is ongoing.

Working Around the Clock: The Association between Shift Work, Sleep Health, and Depressive Symptoms among Midlife Adults

Shift work is an integral part of living in a 24-hour society. However, shift work can disrupt circadian rhythms, negatively impacting health. Guided by the Stress Process Model (SPM), this study examines the association between shift work and depressive symptoms and investigates whether sleep health (duration, quality, and latency) mediates this relationship among midlife adults. Utilizing data from the National Longitudinal Survey of Youth 1979 cohort (N = 6,372), findings show that working evening, night, and irregular shifts is associated with increased depressive symptoms. The results also show that part of the association between shift work and depressive symptoms among night and irregular shift workers, is indirect, operating through short sleep during the week and on the weekend. Although shift work can negatively affect mental health, getting more restorative sleep may mitigate part of the harmful mental health consequences of non-standard work schedules.

A cross-sectional analysis of work schedule notice and depressive symptoms in the United States

The implementation of last-minute work scheduling practices, including fluctuations in work hours, shift cancellations, and short notice, reflects a new norm in employment in the United States. This study aimed to investigate whether work schedule notice of ≤2 weeks was associated with high depressive symptoms. We used data from the 2019 cycle of the National Longitudinal Survey of Youth 1997 (N = 4963 adults aged 37-42 years). Using adjusted gender-stratified modified Poisson models, we tested the association between schedule notice (≤2 weeks, >2 weeks, consistent scheduling) and high depressive symptoms. Presence of high depressive symptoms was assessed using the 7-item Center for Epidemiologic Studies Depression (CES-D) Short-Form scale and defined as CES-D-SF ≥8. Respondents reporting >2 weeks schedule notice (versus ≤2 weeks) were disproportionately non-Hispanic Black or Hispanic and resided in the South and/or in a rural area. High depressive symptoms were 39% more prevalent among women with schedule notice of ≤2 weeks compared to those with >2 weeks notice (Prevalence Ratio [PR]: 1.39, 95% Confidence Interval (CI): 1.07, 1.80). We did not observe an association among men (PR: 1.06, 95% CI: 0.75, 1.50). Schedule notice of ≤2 weeks was associated with a greater burden of high depressive symptoms among US women. Policies to reduce precarious work scheduling practices should be further evaluated for their impacts on mental health.

Prior Incarceration Is Associated with Poor Mental Health at Midlife: Findings from a National Longitudinal Cohort Study

BACKGROUND

People with mental illnesses and people living in poverty have higher rates of incarceration than others, but relatively little is known about the long-term impact that incarceration has on an individual's mental health later in life.

OBJECTIVE

To evaluate prior incarceration's association with mental health at midlife.

DESIGN

Retrospective cohort study PARTICIPANTS: Participants from the National Longitudinal Survey of Youth 1979 (NLSY79)-a nationally representative age cohort of individuals 15 to 22 years of age in 1979-who remained in follow-up through age 50.

MAIN MEASURES

Midlife mental health outcomes were measured as part of a health module administered once participants reached 50 years of age (2008-2019): any mental health history, any depression history, past-year depression, severity of depression symptoms in the past 7 days (Center for Epidemiologic Studies Depression [CES-D] scale), and mental health-related quality of life in the past 4 weeks (SF-12 Mental Component Score [MCS]). The main exposure was any incarceration prior to age 50.

KEY RESULTS

Among 7889 participants included in our sample, 577 (5.4%) experienced at least one incarceration prior to age 50. Prior incarceration was associated with a greater likelihood of having any mental health history (predicted probability 27.0% vs. 16.6%; adjusted odds ratio [aOR] 1.9 [95%CI: 1.4, 2.5]), any history of depression (22.0% vs. 13.3%; aOR 1.8 [95%CI: 1.3, 2.5]), past-year depression (16.9% vs. 8.6%; aOR 2.2 [95%CI: 1.5, 3.0]), and high CES-D score (21.1% vs. 15.4%; aOR 1.5 [95%CI: 1.1, 2.0]) and with a lower (worse) SF-12 MCS (-2.1 points [95%CI: -3.3, -0.9]; standardized mean difference -0.24 [95%CI: -0.37, -0.10]) at age 50, when adjusting for early-life demographic, socioeconomic, and behavioral factors.

CONCLUSIONS

Prior incarceration was associated with worse mental health at age 50 across five measured outcomes. Incarceration is a key social-structural driver of poor mental health.

Moderate Alcohol Consumption and Depression: A Marginal Structural Model Approach Promoting Causal Inference

OBJECTIVE

Moderate alcohol consumption is associated with decreased risk for depression, but it remains unclear whether this is a causal relationship or a methodological artifact. To compare the effects of consistent abstinence and occasional, moderate, and above-guideline alcohol consumption throughout early to middle adulthood on depression at age 50, the authors conducted a secondary analysis of the National Longitudinal Survey of Youth 1979 cohort and employed a marginal structural model (MSM) approach.

METHODS

Baseline was set at 1994, when individuals were ages 29-37. The MSM incorporated measurements of alcohol consumption in 1994, 2002, and 2006, baseline and time-varying covariates, and repeated measurements with the Center for Epidemiologic Studies Depression Scale-Short Form (CES-D-SF). A total of 5,667 eligible participants provided valid data at baseline, 3,593 of whom provided valid outcome data. The authors used all observed data to predict CES-D-SF means and rates of probable depression for hypothetical trajectories of consistent alcohol consumption.

RESULTS

The results approximated J-curve relationships. Specifically, both consistent occasional and consistent moderate drinkers were predicted to have reduced CES-D-SF scores and rates of probable depression at age 50 compared with consistent abstainers (CES-D-SF scores: b=-0.84, 95% CI=-1.47, -0.11; probable depression: odds ratio=0.58, 95% CI=0.36, 0.88 for consistent occasional drinkers vs. abstainers; CES-D-SF scores: b=-1.08, 95% CI=-1.88, -0.20; probable depression: odds ratio=0.59, 95% CI=0.26, 1.13 for consistent moderate drinkers vs. consistent abstainers). Consistent above-guideline drinkers were predicted to have slightly increased risk compared with consistent abstainers, but this was not significant. In sex-stratified analyses, results were similar for females and males.

CONCLUSIONS

This study contributes preliminary evidence that associations between moderate alcohol consumption and reduced risk for depression may reflect genuine causal effects. Further research using diverse methodologies that promote causal inference is required.

The Contributions of Social Stressors and Coping Resources to Psychological Distress Among Those Who Experienced Furlough or Job Loss Due to COVID-19

The COVID-19 pandemic precipitated a global economic recession resulting in widespread unemployment and worker furloughs. Using national survey data (n = 2,000), this study examines whether and how employment-based discrepancies in financial strains, anticipatory stressors, and personal coping resources contribute to elevated psychological distress among those who experienced involuntary job displacement due to COVID-19. Disaggregating displaced workers into those who were furloughed and those who lost their job due to the pandemic, I find that both groups report more depressive symptoms and anger than the stably employed and respondents whose unemployment is not COVID-related. Greater financial strains and smaller reserves of coping resources contribute in varying degrees to heightened levels of distress found among displaced workers, however, anticipatory stress about economic security is the predominant factor driving disparities in psychological distress. These findings, and the central role of anticipatory stressors in shaping employment-based differences in mental health during the pandemic, are discussed.

The long-term effect of the Earned Income Tax Credit on women's physical and mental health

Using a novel method, and data from the National Longitudinal Survey of Youth 1979 (NLSY79), we estimate the cumulative, long-term, causal effect of Earned Income Tax Credit (EITC) eligibility on women's physical and mental health at age 50. We find that an increase in lifetime eligible EITC benefits is associated with long-term improvements in physical health, such as reduced occurrence of activity-limiting health problems and reduced reported diagnoses of mild and severe diseases. We explore intermediate health behaviors and outcomes, and find that an increase in lifetime eligible EITC benefits increases the number of hours worked and access to employer-sponsored health insurance, and decreases body mass index in the short-term. We find no significant effects of the EITC on mental health at age 50. Finally, we find that White women benefit disproportionately from the EITC in terms of mobility-related health issues, while Black and Hispanic women benefit in terms of lung-related illnesses like asthma, as well as cancer and stroke.

Examining the impact of economic abuse on survivors of intimate partner violence: a scoping review

Background

Economic abuse is a unique form of intimate partner violence (IPV) and includes behaviors that control a survivor’s ability to acquire, use, and maintain resources. These tactics can result in someone becoming economically dependent on their partner and may limit their ability to leave the relationship and establish independence. The aim of this study was to conduct a scoping review focused on the impact of economic abuse on survivors of IPV.

Methods

A total of 14 databases were reviewed, which resulted in 35 peer-reviewed manuscripts for inclusion in the study. Manuscripts were included if they were: written in English, published since the year 2000, focused specifically on the impact of economic abuse perpetrated by an intimate partner, economic abuse was measured as an independent variable, and if economic abuse was looked at separately from other forms of IPV. Both convenience and population-based samples were included in the review. Information was extracted using a data charting form. The data were analyzed using a combination of grouping techniques and constant comparison methods to identify key findings.

Results

Studies found significant associations between economic abuse and a range of outcomes, such as mental and physical health, financial impacts, parent-child interactions, and quality of life. The most frequently examined were mental health, followed by financial issues.

Conclusions

Limitations of these studies included a lack of longitudinal research and a focus on heterosexual relationships with male-perpetrated violence toward female survivors. Study findings highlight the wide-ranging potential impacts of economic abuse on survivors and the need for additional research to better understand potential outcomes and implement and evaluate interventions to address them.

Speaking of State of Mind: Maternal Mental Health Predicts Children's Home Language Environment and Expressive Language

Maternal depression and anxiety are potential risk factors to children's language environments and development. Though existing work has examined relations between these constructs, further work is needed accounting for both depression and anxiety and using more direct measures of the home language environment and children's language development. We examined 265 mother-infant dyads (49.6% female, Mage = 17.03 months) from a large city in the Western United States to explore the relations between self-reports of maternal depression and anxiety and observational indices of the home language environment and expressive language as captured by Language Environment Analysis (LENA) and parent-reported language comprehension and production. Results revealed maternal depressive symptoms to be negatively associated with home language environment and expressive language indices. Maternal anxiety symptoms were found to be negatively associated with children's parent-reported language production. These findings provide further evidence that maternal mental health modulates children's home language environments and expressive language.

Associations of state-level and county-level hate crimes with individual-level cardiovascular risk factors in a prospective cohort study of middle-aged Americans: the National Longitudinal Survey of Youths 1979

BACKGROUND

There have been long-standing debates about the potential health consequences of hate crimes over and above other types of crimes. Besides the direct consequences for victims, less is known about whether hate crimes have spillover effects onto the health of local residents.

METHODS

We drew data on cardiovascular disease risk factors from middle-aged Americans in the National Longitudinal Survey of Youths 1979 and on hate crimes from the FBI's Uniform Crime Reports. Employing multivariable logistic regression, we estimated the associations between changes in state/county-level all and group-specific hate crime rates from 2000 to 2006 and incident individual-level diabetes, hypertension, obesity and depressive symptoms from 2008 to 2016. All models controlled for individual-level sociodemographic factors and financial strain, county-level and state-level changes in the total crime rate, the percentage of non-Hispanic Black and Hispanic/Latino residents, and median household income, as well as state-level changes in the percentage of residents aged 65 years or older and the unemployment rate.

RESULTS

1-SD increases in state-level all and race/ethnicity-based hate crime rates were associated with 20% (OR 1.20, 95% CI 1.05 to 1.35) and 15% higher odds (OR 1.15, 95% CI 1.01 to 1.31) of incident diabetes, respectively. At the county level, a 1-SD increase in the all hate crime rate was linked to 8% higher odds (OR 1.08, 95% CI 1.00 to 1.16) of obesity, while a 1-SD increase in the race/ethnicity-based hate crime rate was associated with 8% higher odds (OR 1.08, 95% CI 1.01 to 1.15) of obesity and 9% higher odds (OR 1.09, 95% CI 1.02 to 1.17) of hypertension. We found no significant associations for depressive symptoms, and no interactions between race/ethnicity-based hate crime rates and individual-level race/ethnicity.

CONCLUSION

Living in areas with higher hate crime rates may confer higher odds of hypertension, diabetes and obesity.

COVID-19 bereavement, depressive symptoms, and binge drinking

The COVID-19 pandemic has caused the death of over half a million Americans, leaving in its wake widespread grief and despair. Using national survey data (n ​= ​1998) and a treatment-weighting strategy, this study examines how COVID-19 bereavement associates with depressive symptoms and binge drinking. After adjustment for non-random exposure to COVID-19 bereavement, I find that respondents who have lost someone close to them to the virus report greater depressive symptomology and more frequent binge drinking. Among essential workers, the loss of a close tie to COVID-19 exacerbates these associations, with bereavement posing stronger effects for depressive symptoms and binge drinking for members of this group. The implications of these findings for the long-term mental health of the bereaved and those most vulnerable to the virus are discussed.

Impact of type of reconstructed residence on social participation and mental health of population displaced by disasters

After disasters, people are often forced to reconstruct or move to new residences. This study aimed to reveal the association between the types of reconstructed residences and psychosocial or psychiatric conditions among the population. A total of 1071 adult residents in a coastal town, whose houses were destroyed by the tsunami caused by the Great East Japan Earthquake, enrolled in the study five years after the disaster. The type of reconstructed post-disaster residences (reconstructed on the same site/disaster-recovery public condominium/mass-translocation to higher ground/privately moving to remote areas) and the current psychosocial indicators were investigated. The results revealed that individuals living in public condominiums showed significantly worse scores on the Lubben Social Network Scale-6 (p < 0.0001) and the Center for Epidemiologic Studies Depression Scale (p < 0.0001), and slightly worse scores on the Kessler Psychological Distress Scale (p = 0.035) and the Impact of Event Scale-Revised (p = 0.028). Lower psychosocial indicator scores in the public condominium group were more remarkable in younger adults aged < 65 years. Insomnia evaluated using the Athens Insomnia Scale was not different among the four residential types. In summary, residents moving into disaster-recovery public condominiums are likely to have less social interaction, be more depressed, and may need additional interventions.

Risk factors for depression during the COVID-19 pandemic: a longitudinal study in middle-aged and older adults

BACKGROUND

The COVID-19 pandemic and resultant social restrictions have had widespread psychological ramifications, including a rise in depression prevalence. However, longitudinal studies on sociodemographic risk factors are lacking.

AIMS

To quantify longitudinal changes in depression symptoms during the pandemic compared with a pre-pandemic baseline, in middle-aged and older adults, and identify the risk factors contributing to this.

METHOD

A total of 5331 participants aged ≥50 years were drawn from the English Longitudinal Study of Ageing. Self-reported depression symptoms in June/July 2020 were compared with baseline data from 2-3 years prior. Regression models investigated sociodemographic and lifestyle variables that could explain variance in change in depression.

RESULTS

Within-participant depression scores increased significantly from pre-pandemic levels: 14% met the criteria for clinical depression at baseline, compared with 26% during the pandemic. Younger age, female gender, higher depression scores at baseline, living alone and having a long-standing illness were significant risk factors. Gender-stratified regression models indicated that older age was protective for women only, whereas urban living increased risk among women only. Being an alcohol consumer was a protective factor among men only.

CONCLUSIONS

Depression in UK adults aged ≥50 years increased significantly during the pandemic. Being female, living alone and having a long-standing illness were prominent risk factors. Younger women living in urban areas were at particularly high risk, suggesting such individuals should be prioritised for support. Findings are also informative for future risk stratification and intervention strategies, particularly if social restrictions are reimposed as the COVID-19 crisis continues to unfold.

Multiple Mediating Effects of Conflicts With Parents and Self-Esteem on the Relationship Between Economic Status and Depression Among Middle School Students Since COVID-19

This study explores associations between perceived economic status and depression among middle school students during COVID-19 in the context of conflict with parents and self-esteem. Data were collected in South Korea in the fall of 2020. A total of 328 middle school students were included, and a multiple mediator model was employed to examine the multiple mediating effects. Middle schoolers' household economic status was negatively associated with their conflict with parents. Conflict with parents was negatively related to middle school students' self-esteem. Indirect effects of perceived economic status via conflict with parents were significantly associated with depression. The indirect effect of perceived economic status via both conflict with parents and self-esteem was related to depression. Government subsidies should temporarily be expanded to improve households' economic status to potentially improve middle school students' depression and to enhance relationships between children and their parents during the COVID-19 pandemic. Further, extra financial support from the government should be focused on poor households with children in order to address family conflict, self-esteem, and depression among middle school students.

Early Impacts of Room to Grow: A Multifaceted Intervention Supporting Parents and Children Age Zero to Three

Children experiencing poverty or low incomes fare worse than their more advantaged peers on a host of developmental and educational outcomes. Interventions have focused on strengthening parenting in families with young children, when supports appear to be most critical. But most parenting programs for low-income families fail to address parents' economic needs, which almost always take precedence relative to broader educational or developmental goals. In this article, we describe the early results of a multifaceted intervention aimed at supporting parents, infants, and toddlers in the first three years of life. The Room to Grow program provides parents, primarily mothers, with support from a clinical social worker, connections to community referrals, and up to $10,000 in material support for the baby in the form of in-kind assistance such as clothes, books, toys, strollers, and other necessities. The current study examines proximal outcomes of the intervention after one year using a randomized controlled trial evaluation design. The study finds that early impacts on proximal outcomes are uniformly positive, especially with regards to the presence of books and developmental goods in the home, developmentally-oriented parenting outcomes, and reduced stress and aggravation in the domain of parenting.

Structural Racism and Immigrant Health: Exploring the Association Between Wage Theft, Mental Health, and Injury among Latino Day Laborers

Background

Although wage theft has been discussed primarily as a labor and human rights issue, it can be conceptualized as an issue of structural racism with important consequences for immigrant health.

Objectives

The objectives of this study were to: 1) identify sociodemographic, employment, and stress-related characteristics that increase Latino day laborers' odds of experiencing wage theft; 2) assess the association between wage theft and serious work-related injury; 3) assess the association between wage theft and three indicators of mental health-depression, social isolation, and alcohol use-as a function of wage theft; and 4) assess serious work-related injury as a function of wage theft controlling for mental health.

Methods

Secondary data analyses were based on survey data collected from 331 Latino day laborers between November 2013 and July 2014. Regression analyses were conducted to test the relationships described above.

Results

Approximately 25% of participants reported experiencing wage theft and 20% reported serious work-related injury. Wage theft was associated with working in construction and was initially associated with work-related injury. Wage theft was not significantly associated with mental health indicators. The association between wage theft and injury became non-significant when controlling for the mental health variables.

Conclusions

The hardship and stress associated with wage theft incidents may ultimately lead to more frequent injury. Although we expected an association of wage theft with mental health, we found vulnerability to physical health as indicated by injury incidents. Thus, our basic premise was partially supported: wage theft may act as a stressor that stems from conditions, in part, reflecting structural racism, making workers vulnerable to poorer health.

Prospective Predictors of Receiving Disclosures of Intimate Partner Violence and Sexual Assault Among College Students

OBJECTIVE

Previous research has indicated that many undergraduates receive disclosures of sexual assault and intimate partner violence (IPV) from their peers; however, much of this research has been cross-sectional. The present study assessed the extent to which demographic characteristics and victimization history predicted whether participants received disclosures over the subsequent 6 months. Directional hypotheses assessed whether psychological symptoms and attitudes predicted, or were consequences of, disclosures at follow-up.

METHOD

College students (n = 867) from a broader treatment intervention study completed pretest (Time 1) and 6-month follow-up surveys (Time 2).

RESULTS

Individuals who reported new disclosures at follow-up (56%) were more likely to be women, have previous experience receiving either sexual assault or IPV disclosures, and have experienced sexual assault or IPV victimization in their lifetime and across the follow-up period. Sexual orientation did not predict receipt of disclosures at follow-up; intervention group did not moderate these relationships. Results of longitudinal structural equation models found that although higher Time 1 posttraumatic stress disorder symptoms and depressive symptoms predicted disclosure status at follow-up, Time 1 disclosure status did not predict subsequent increases in posttraumatic stress disorder and depressive symptoms. Attitudinal variables were not significantly associated with disclosures reported at Time 1 or follow-up.

CONCLUSIONS

Findings suggest the importance of attending to personal experiences of victimization within interventions aiming to improve responses to disclosure. Although individuals with higher distress are more likely to receive subsequent disclosures, disclosure does not appear to lead to increases in long-term psychological distress.

More Frequent Internet Use during the COVID-19 Pandemic Associates with Enhanced Quality of Life and Lower Depression Scores in Middle-Aged and Older Adults

Concerns have been raised regarding middle-aged and older adults' mental health during the coronavirus outbreak. The aim of the current study was to characterise associations between internet use (frequency and purpose), depression symptoms and Quality of Life (QoL) during the pandemic, in individuals aged 55-75. Data (N = 3491) were drawn from the English longitudinal study of ageing (ELSA) cohort study collected in June/July 2020 (while social distancing measures were in place). Associations with frequency of use were tested using analysis of covariance (ANCOVAS), controlling for covariates such as wealth and education. Type of internet use (for communication, information search) was also analysed amongst frequent users. Significant effects of frequency of use were observed (p = 0.01 for depression, p < 0.001 for QoL), with lower depression symptoms and higher QoL scores amongst more frequent users. Regarding purpose of use, those who reported using the internet for communication purposes had higher QoL. However, use for health-related or Government services information searching was associated with more depression symptoms. Results provide important information regarding the potential benefits of internet use for middle-aged and older people, suggesting that strategies to increase internet usage (particularly for communication) might benefit middle-aged and older adults' mental health and counter isolation as the coronavirus crisis continues to evolve.

Randomized trial of exercise on depressive symptomatology and brain derived neurotrophic factor (BDNF) in ovarian cancer survivors: The Women's Activity and Lifestyle Study in Connecticut (WALC)

OBJECTIVES

Depression is one of the most prevalent mental disorders, and rates are higher among cancer survivors than the general population, and higher in ovarian cancer patients compared to cohorts of other cancer survivors. Physical activity has been associated with lower depressive symptoms in cancer survivors, yet no trial has examined this association in women with ovarian cancer. We examined the effect of exercise on depression symptomatology and serum brain derived neurotrophin factor (BDNF) which has been associated with depression, in women with ovarian cancer.

METHODS

We conducted a 6-month home-based randomized trial of exercise vs. attention-control (AC) in 144 ovarian cancer survivors. Depressive symptomatology was measured via the Center for Epidemiologic Studies Depression Scale (CES-D). Serum total and free BDNF was measured at baseline and 6-months. Student's t-statistic and mixed-model repeated measures analysis was used to evaluate six-month change between arms in CES-D scores and BDNF.

RESULTS

Women were 57.3 ± 8.6 (mean ± SD) years old, 1.7 ± 1.0 years post-diagnosis with a baseline CES-D score of 11.79 ± 10.21. The majority (55%) were diagnosed with stage III/IV ovarian cancer. CES-D scores decreased in the exercise arm by 2.7 points (95% CI: -4.4, -0.9) or a 21% decrease compared to a 0.3 point decrease (-2.2, 1.5) (3% decrease) in the AC arm (P = 0.05). There was no difference in change in total or free BDNF between the exercise and AC arms.

CONCLUSIONS

Ovarian cancer survivors are able to exercise at recommended levels, and exercise was associated with a significant reduction in depressive symptomatology.

Peer-Assisted Lifestyle (PAL) intervention: a protocol of a cluster-randomised controlled trial of a health-coaching intervention delivered by veteran peers to improve obesity treatment in primary care

INTRODUCTION

Among US veterans, more than 78% have a body mass index (BMI) in the overweight (≥25 kg/m²) or obese range (≥30 kg/m²). Clinical guidelines recommend multicomponent lifestyle programmes to promote modest, clinically significant body mass (BM) loss. Primary care providers (PCPs) often lack time to counsel and refer patients to intensive programmes (≥6 sessions over 3 months). Using peer coaches to deliver obesity counselling in primary care may increase patient motivation, promote behavioural change and address the specific needs of veterans. We describe the rationale and design of a cluster-randomised controlled trial to test the efficacy of the Peer-Assisted Lifestyle (PAL) intervention compared with enhanced usual care (EUC) to improve BM loss, clinical and behavioural outcomes (aim 1); identify BM-loss predictors (aim 2); and increase PCP counselling (aim 3).

METHODS AND ANALYSIS

We are recruiting 461 veterans aged 18-69 years with obesity or overweight with an obesity-associated condition under the care of a PCP at the Brooklyn campus of the Veterans Affairs NY Harbor Healthcare System. To deliver counselling, PAL uses in-person and telephone-based peer support, a tablet-delivered goal-setting tool and PCP training. Patients in the EUC arm receive non-tailored healthy living handouts. In-person data collection occurs at baseline, month 6 and month 12 for patients in both arms. Repeated measures modelling based on mixed models will compare mean BM loss (primary outcome) between study arms.

ETHICS AND DISSEMINATION

The protocol has been approved by the Institutional Review Board and the Research and Development Committee at the VA NY Harbor Health Systems (#01607). We will disseminate the results via peer-reviewed publications, conference presentations and meetings with stakeholders.

TRIAL REGISTRATION NUMBER

NCT03163264; Pre-results.

Shades of Blue and Gray: A Comparison of the Center for Epidemiologic Studies Depression Scale and the Composite International Diagnostic Interview for Assessment of Depression Syndrome in Later Life

BACKGROUND AND OBJECTIVES

Psychiatric research lacks the equivalent of a thermometer, that is, a tool that accurately measures mental disorder regardless of context. Instead, the psychometric properties of scales that purport to assess psychopathology must be continuously evaluated. To that end, this study evaluated the diagnostic agreement between the eight-item Center for Epidemiologic Studies Depression Scale (CESD-8) and the Composite International Diagnostic Interview-short form (CIDI-SF) in the Health and Retirement Study (HRS).

RESEARCH DESIGN AND METHODS

Data come from 17,613 respondents aged >50 from the 2014 wave of the HRS. Kappa coefficients were used to assess the agreement between the 2 instruments on depression classification across a range of thresholds for identifying case status, including variation across subgroups defined by age, race/ethnicity, and gender.

RESULTS

The point prevalence of depression syndrome estimated by the CESD was higher than that estimated by the CIDI-SF (CESD: 9.9%-19.5% depending on the cutoff applied to the CESD vs CIDI-SF: 7.7%). Assuming CIDI-SF as the gold standard, the CESD yielded a sensitivity of 56.2%-70.2% and specificity of 84.7%-94.0% across the range of cutoffs. The agreement on depression classification was weak (κ = 0.32-0.44).

DISCUSSION AND IMPLICATIONS

Depression cases identified by the CESD have poor agreement with those identified by the CIDI-SF. Conceptually, psychological distress as measured by the CESD is not interchangeable with depression syndrome as measured by the CIDI-SF. Population estimates of depression among older adults based on the CESD should be interpreted with caution.

Prospective associations between US state-level corruption and individual-level cardiovascular risk factors among middle-aged Americans: The National Longitudinal Survey of Youths 1979

OBJECTIVES

To estimate the associations between US state-level corruption and risk factors for cardiovascular disease, one of the leading causes of mortality and morbidity in the nation.

METHODS

We used a US nationally-representative sample of middle-aged adults from the National Longitudinal Survey of Youths 1979 and data from the Corruption in America Survey to estimate the associations between state-level illegal (private gains) corruption and legal (political gains) corruption in 2013 and individual-level risks of incident diabetes, hypertension, obesity, and depression between 2014 and 2016.

RESULTS

Medium and higher levels of illegal corruption were associated with odds ratios (ORs) of 1.75 (95% CI 1.06-2.88) for incident diabetes and 1.70 (95% CI 1.15-2.51) for incident hypertension, respectively. Furthermore, a higher level of legal corruption was associated with ORs of 1.84 (95% CI 1.08-3.13) for diabetes and 1.58 (95% CI 1.05-2.38) for hypertension. No consistent associations were observed for obesity or depression.

CONCLUSIONS

Our findings suggest that higher levels of corruption contribute to increased risks of developing diabetes and hypertension. Investing resources into fighting corruption may be means to reduce the national burden of cardiovascular disease.

Intergenerational Coresidential Patterns by Young Adult's and Their Mother's Mental Health and Substance Use

Intergenerational coresidence is at a 30-year high. Studies find that economic, familial, and demographic factors shape the likelihood of this arrangement. We use NLSY79 and NLSY79YA data (2000-2014; N = 3,092) to examine how the mental health and substance use of both adult children and their mothers matter for coresidential biographies, estimating risks of moving out of and returning to their mothers' households. Adult children who drink, smoke, or have more depressive symptoms, or whose mothers drink or smoke, are more likely to leave their mother's household; adult children with more depressive symptoms and who smoke are more likely to return. Our findings show that children's and mothers' health are key determinants of coresidential patterns, suggesting that it is not just family arrangements that impact health but health that impacts family arrangements. As intergenerational coresidence increases, researchers should continue to look beyond economic, familial, and demographic determinants of coresidence to health dynamics.

Association of Adult Depression With Educational Attainment, Aspirations, and Expectations

Introduction

Social factors across one’s lifespan may contribute to the relationship between low educational attainment and depression, but this relationship has been understudied. Previous studies assessing the association between educational attainment and depression did not fully account for prior common determinants across the life course and possible interactions by sex or race/ethnicity. It is also unclear whether the link between educational attainment and depression is independent of the role of aspired educational attainment or expected educational attainment.

Methods

We used generalized linear log link models to examine the association between educational attainment at age 25 and depression at age 40 in the National Longitudinal Survey of Youth 1979 cohort, adjusting for confounders and mediators from childhood, adolescence, and adulthood.

Results

Members of each educational attainment group were less likely to be depressed at age 40 than those with less education. After adjusting for educational aspirations and educational expectations, the risk ratios became closer to the null. Neither sex nor race/ethnicity interacted with educational attainment. Additionally, low educational expectations in adolescence, but not low educational aspirations, was associated with a higher risk of depression at age 40.

Conclusion

Our study provides a nuanced understanding of the role of education, educational expectations, and educational aspirations as part of education’s effect on risk of depression after controlling for a thorough set of confounders and mediators. Our findings may help advance the study of social determinants of depression.

Changes in the depression gender gap from 1992 to 2014: Cohort effects and mediation by gendered social position

The depression gap (i.e., higher rates of depression among women than men) represents an important mental health disparity in the US. Differences in gendered social position (i.e., the roles, responsibilities, and opportunities available to women and men), which have been changing since the mid-20th Century may contribute to this gender gap. The present study examined the evidence for a changing depression gap across birth cohorts and tested the extent to which any changes over time were mediated by changes in relative social position between women and men. Data were from the National Longitudinal Surveys. The depression gap was defined as differences in mean CESD scores for women vs. men. The analytic sample included 13,666 respondents interviewed from 1992 to 2014. Hierarchical mixed models estimated the magnitude of the gender depression gap over time, its association with 10-year birth cohort (range: 1957-1994), and whether any variation was mediated by ratios among women relative to men of obtaining a college degree, being employed full-time, and the average number of hours spent doing housework per week, three indicators of gendered social position. There was a linear decrease in the depression gap by 0.18 points across birth cohort (95% CI = -0.26, -0.10). The results of the mediation analysis estimated that an increasing ratio of college degree attainment mediated 39% of the gender depression gap across cohorts (95% CI = 0.18, 0.78). There was no evidence of mediation due to changing employment or housework ratios. These findings partially support the hypothesis that the depression gap is changing over time and is meaningfully related to the social environment. Understanding the social causes of the depression gap can illuminate the fundamental processes through which depression disparities may be perpetuated or attenuated over time and may aid in the identification of strategies to reduce them.

State-Level Income Inequality and County-Level Social Capital in Relation to Individual-Level Depression in Middle-Aged Adults: A Lagged Multilevel Study

In the US, the incidence of depression and suicide have followed escalating trends over the past several years. These trends call for greater efforts towards identifying their underlying drivers and finding effective prevention strategies and treatments. One social determinant of health that plausibly influences the risk of depression is income inequality, the gap between the rich and poor. However, research on this association is still sparse. We used data from the National Longitudinal Survey of Youth 1979 and the US Census to investigate the multilevel lagged associations of state-level income inequality with the individual-level odds of depression in middle-aged adults, controlling for state- and individual-level factors. We also examined the independent associations of county-level social capital with depression and explored whether it mediated the income inequality relationship. Higher income inequality at the state level predicted higher odds of individual-level depression nearly 2 decades later [OR for middle vs. lowest tertile of income inequality = 1.35 (95% CI: 1.02, 1.76), OR for highest vs. lowest tertile = 1.34 (95% CI: 1.01, 1.78)]. This association was stronger among men than women. Furthermore, there was evidence that county-level social capital independently predicted depression and that it mediated the income inequality association. Overall, our findings suggest that policies attenuating levels of income inequality at the US state level and that leverage social capital may protect against one's likelihood of developing depression.

Smoking to cope: Addictive behavior as a response to mental distress

Individuals with mental health problems smoke at far higher rates than their peers, and have done for decades. This paper explores a potential explanation: smoking as a means to cope with distress. The proposed "coping response" framework is assessed by analyzing how adolescents respond to two events known to trigger acute mental distress: violent crime victimization and death of a non-family member the respondent felt close to. Consistent with a coping response, these shocks yield statistically significant increases in first cigarette use, recent smoking, and daily smoking, with greater initiation responses among those who are depressed at baseline, and dampened responsiveness among those facing higher cigarette taxes. Back-of-the-envelope estimates suggest that differential responsiveness to adverse events by baseline depression explains 5% of first cigarette use in this sample, and almost a third of the gap in adolescent smoking initiation between those in the highest and lowest terciles of depression scores.

Parenting paused: Pathological video game use and parenting outcomes

For most people, playing video games is a normal recreational activity, with little disruption to gamers' emotional, social, or physical health and well-being. However, for a small percentage of gamers, video gaming can become pathological (Fam, 2018). Substantial research has examined pathological gaming in teens and young adults (Cheng, Cheung, & Wang, 2018; Choo, Gentile, Sim, Khoo, & Liau, 2010), yet pathological gaming in adults (c.f. Holgren, 2017), especially in the context of parenthood, has been relatively ignored. The current study sought to address this limitation by studying associations between pathological gaming characteristics and parenting outcomes in a sample of men and women who have had a child in the last year. Fathers spent more time than mothers playing video games and displayed more pathological video gaming tendencies. Pathological gaming for mothers and fathers was related to increased depressive symptoms. Depressive symptoms mediated the relationship between pathological gaming and decreased feelings of parental efficacy, perceived parental competence, increased parenting stress, and increased perceived impact of parenting. Pathological video game playing was also directly related to decreased feelings of parental efficacy for mothers and fathers. Implications of the results and directions for future research are discussed.

Life-Course Trauma and Later Life Mental, Physical, and Cognitive Health in a Postapartheid South African Population: Findings From the HAALSI study

Objective: To investigate the relationships between exposure to life-course traumatic events (TEs) and later life mental, physical, and cognitive health outcomes in the older population of a rural South African community. Method: Data were from baseline interviews with 2,473 adults aged ≥40 years in the population-representative Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) study, conducted in 2015. We assessed exposure to 16 TEs, and used logistic regression models to estimate associations with depression, post-traumatic stress disorder (PTSD), activities of daily living disability, and cognitive impairment. Results: Participants reported an average of 5 (SD = 2.4) TEs over their lifetimes. Exposure was ubiquitous across sociodemographic and socioeconomic groups. Trauma exposure was associated with higher odds of depression, PTSD, and disability, but not with cognitive health. Discussion: Results suggest that TEs experienced in earlier life continue to reverberate today in terms of mental health and physical disability outcomes in an older population in rural South Africa.

Cumulative Effects of Doubling Up in Childhood on Young Adult Outcomes

Living in a doubled-up, or shared, household is a common experience. Nearly one-half of children in the United States double up at some point during childhood, yet we know little about the cumulative effects of these households on children. This study estimates the effects on young adult health and educational attainment of childhood years spent in three doubled-up household types: (1) those formed with children's grandparent(s), (2) those formed with children's adult sibling(s), and (3) those formed with other extended family or non-kin adults. Using marginal structural models and inverse probability of treatment weighting-methods that account for the fact that household composition is both a cause and consequence of other family characteristics-I find that doubling up shapes children's life chances, but the effects vary depending on children's relationships with household members. Childhood years spent living with nongrandparent extended family or non-kin adults are associated with worse young adult outcomes, but coresidence with grandparents is not significantly associated with young adult outcomes after selection into these households is accounted for, and coresidence with adult siblings may be beneficial in some domains. By studying the effects of coresidence with adults beyond the nuclear family, this research contributes to a fuller understanding of the implications of family complexity for children.

Developing a Family Achievement Guilt Scale Grounded in First-Generation College Student Voices

As the first in their families to attend college, first-generation students plausibly experience family achievement guilt-socioemotional distress related to "leaving family members" to attend college. Family achievement guilt is little studied but a promising indicator of student outcomes. The present work used psychometric methods to develop the family achievement guilt scale. First-generation (46.6%) and continuing-generation (i.e., at least one parent has a 4-year degree, 53.4%) students completed a 41-item guilt measure online. Exploratory factor analysis revealed four factors, including guilt related to Leaving Family Behind, Having More Privileges, Becoming Different, and Experiencing Pressures about not being successful. The scale yielded good internal and test-retest reliability. Moreover, guilt predicted greater engagement in family roles and interdependent motives for college, even after controlling for general negative affect. In measuring guilt in psychometrically sound ways, we validate the voices of first-generation college students and alert institutions to adjust how they serve students.

Household food insecurity is associated with depressive symptoms: results from a Mexican population-based survey

The objective of this cross-sectional study was to assess the relationship between food insecurity and depression in the Mexican population. We used data from the 2012 health and nutrition survey (ENSANUT), which is representative of the Mexican population. Food insecurity was determined by the Latin American and Caribbean Food Security Scale (ELCSA). Depressive symptoms were evaluated using the Center for Epidemiological Studies Depression Scale Short-Form (CES-D-SF). Adjusted logistic regression analyses and ANCOVA were used. Out of 33,011 participants, 5788 (18%) had high depressive symptoms and 24,098 (73%) experienced food insecurity. The adjusted logistic regression analysis showed that, participants with mild food insecurity, (OR = 1.47,95% CI = 1.27 to 1.71), moderate food insecurity (OR = 2.14,95% CI = 1.85 to 2.47) and severe food insecurity (OR = 3.01,95% CI = 2.51 to 3.60,) were more likely to have high depressive symptoms than food secure participants. Participants with moderate food insecurity (OR =1.45, 95% CI = 1.28 to 1.64) and severe food insecurity (OR =2.04, 95% CI = 1.76 to 2.37) were more likely to suffer from depression as compared to participants with mild food insecurity. Participants with severe food insecurity were more likely (OR=1.41, 95% CI = 1.21 to 1.65) to suffer from depression compared to participants with moderate food insecurity. This paper provides an overview of the complex problem of food insecurity and mental health. Despite the unknown causality, the analysis suggests a strong association between depression and food insecurity. This problem calls for much more attention from the scientific community. Given the high prevalence of depression and the high prevalence of household food insecurity in Mexico, the implementation of successful public health programs to improve food security is necessary.

County-level housing affordability in relation to risk factors for cardiovascular disease among middle-aged adults: The National Longitudinal Survey of Youths 1979

BACKGROUND

Housing is a fundamental social determinant of health yet housing affordability has diminished over much of the twenty-first century. Research on housing affordability as a determinant of health is limited, but studies to date have shown correlations with mental health. However, few studies have examined the relationship between housing affordability and risk factors for cardiovascular disease, the leading cause of morbidity and mortality among Americans.

METHODS

Using a nationally-representative sample of middle-aged adults from the National Longitudinal Survey of Youths 1979 (NLSY79) and exploiting quasi-experimental variation before and after the Great Recession, we estimated the associations between the change in median county-level percentage of household income spent on housing (rent/mortgage) between 2000 and 2008 and individual-level risks of incident hypertension, obesity, diabetes, and depression from 2008 to 2014. We employed conditional fixed effects logistic regression models to reduce bias due to time-invariant confounding.

RESULTS

Each percentage point increase in county-level median percentage of household income spent on housing was associated with a 22% increase in the odds of incident hypertension (OR = 1.22, 95% CI = 1.06 to 1.42; p = 0.01), a 37% increased odds of obesity (OR = 1.37, 95% CI = 1.00-1.87; p = 0.049), and a 15% increased odds of depression (OR = 1.15, 95% CI = 1.01-1.31; p = 0.03), controlling for individual- and area-level factors. These associations were stronger among renters than homeowners, and among men compared to women.

CONCLUSIONS

Our findings suggest that lower levels of housing affordability contribute to worse risk profiles for cardiovascular disease. Policies that make housing more affordable may help to reduce the population burden of cardiovascular disease.