Long-term psychosocial effects of parental divorce: a follow-up study from adolescence to adulthood

Longitudinal evidence of the influence of early life circumstances, family characteristics, social ties and psychological distress on healthy behaviours of Brazilian adults: The Pro-Saude cohort study

BACKGROUND

This study examined the influence of early life circumstances, family characteristics, social ties and psychological distress in adulthood on adult's health-related behaviours.

METHODS

A cohort study (Pro-Saúde Study) involving technical and administrative civil servants at university campuses in Rio de Janeiro State, Brazil was conducted in Rio de Janeiro, Brazil. Data from 2155 adults were collected at baseline (1999) and after a 13-year period (2012-13). Family characteristics at 12 years of age were assessed retrospectively in 1999. Gender, marital status, living situation, social support, social networks of relatives and psychological distress were also measured in 1999. Data collection in 2012-13 included information about marital status, social networks of relatives, cigarette smoking, fruit and vegetable consumption and physical exercise. A conceptual model testing the relationships between variables was assessed through structural equation modelling.

RESULTS

Female gender (β = 0.043), better social networks of relatives in 1999 (β = 0.053) and 2012-13 (β = 0.069) and low psychological distress (β = -0.048) directly predicted less smoking. Better social networks of relatives in 2012-13 was directly linked to higher consumption of fruits (β = 0.045) and vegetables (β = 0.051) and being physically active (β = 0.070). Low psychological distress directly predicted higher fruit consumption (β = -0.040). Family characteristics at 12 years-old, marital status and living with other people were linked indirectly with health behaviours through social networks, social support and psychological distress.

CONCLUSIONS

Adults with better early life family and social circumstances, and those who were married reported positive health behaviours through indirect pathways. Stronger social ties and lower psychological distress represented the pathways by which early life circumstances and relationship status influenced positive health behaviours.

Association between childhood family structure and health-related quality of life at middle age: A longitudinal study of Northern Finland Birth Cohort 1966

AIMS

This longitudinal study evaluated the association between childhood family structure and health-related quality of life (HRQoL) at middle age.

METHODS

The data on childhood family structure at the age of 14 years ('two-parent family', 'one parent not living at home/no information on father' and 'father or mother deceased') and HRQoL (measured by 15D (15-dimensional)) at the age of 46 were collected from the Northern Finland Birth Cohort 1966 using postal questionnaires. We used the binary logistic regression model to estimate the associations between childhood family structures and the lowest 15D quartile (reference: all other quartiles). The associations were adjusted for offspring mothers' factors during pregnancy (mothers' educational and occupational status).

RESULTS

Of the 6375 participants, the offspring belonging to the 'one parent not living at home/no information on father' family structure subgroup had higher odds ratio of belonging to the lowest 15D quartile than the offspring of 'two-parent families' (adjusted odds ratio (OR) 1.76, 95% confidence interval (CI) 1.31-2.36, p<0.001 for females; adjusted OR 1.86, 95% CI 1.28-2.70, p=0.001 for males). There were no statistically significant associations between the 'father or mother deceased' subgroup and the lowest 15D quartile among the offspring.

CONCLUSIONS

A single-parent family origin (due to reasons other than parental death) in childhood was significantly associated with impaired HRQoL at middle age. These results provide new perspectives for understanding the long-standing associations on living in a single-parent family.

Association between childhood family structure and longitudinal health behaviour changes in adulthood -Northern Finland birth cohort 1966 study

BACKGROUND

Childhood family structure is considered to play a role in person's health and welfare. This study investigated the relationships between the longitudinal changes of adult health behaviours and childhood family structure.

METHODS

From Northern Finland Birth Cohort 1966 questionnaires, we collected data on childhood family structure at the age of 14 ('two-parent family', 'one parent not living at home/no information on father', and 'father or mother deceased'), and on health behaviours (smoking, alcohol consumption and physical activity status) at the ages of 31 and 46. We used the multinomial logistic regression model to estimate the unadjusted and adjusted associations between childhood family structures and the longitudinal changes between 31 and 46 years of health behaviours (four-category variables).

RESULTS

Of the study sample (n = 5431; 55.5% females), 7.1% of the offspring were represented in the 'One parent not living at home/no information on father' subgroup, 6.3% in the 'Father or mother deceased' subgroup and 86.6% in the 'Two-parent family'. 'One parent not living at home/no information on father' offspring were approximately twice as likely to smoke (adjusted OR 2.19, 95% CI 1.70-2.81) and heavily consume alcohol (adjusted OR 1.99, 95% CI 1.25-3.16) at both times in adulthood, relative to not smoking or not heavily consume alcohol, and compared with 'two-parent family' offspring. We found no statistically significant associations between childhood family structure and physical activity status changes in adulthood.

CONCLUSIONS

Our findings suggest that the offspring of single-parent families in particular should be supported in early life to diminish their risk of unhealthy behaviours in adulthood.

Parental Divorce in Childhood and the Accelerated Epigenetic Aging for Earlier and Later Cohorts: Role of Mediators of Chronic Depressive Symptoms, Education, Smoking, Obesity, and Own Marital Disruption

We examine effects of parental divorce on epigenetic aging in later adulthood for two birth cohorts: one born in the early 20th century and the other born in the later 20th century. Using data from the Health and Retirement Study (n = 1,545), we examine the relationship between parental divorce in childhood and accelerated epigenetic aging in older adulthood as indicated by the Dunedin methylation Pace of Aging score. We assess how this relationship is mediated by chronic depressive symptoms, education, lifetime smoking, body mass index (BMI), and an older adult's own divorce. The mean age of the earlier cohort is 85.8 (SD = 3.9) and that of the later cohort is 60.2 (SD = 2.8). We find that parental divorce was related to faster aging in the later-born cohort, and that 56% of this relationship (b = 0.060) was mediated by chronic depressive symptoms (b = 0.013), lower education levels (b = 0.005), and smoking (b = 0.019). For the earlier cohort, there was no effect of parental divorce on epigenetic aging. Parental divorce in childhood may have lasting effects on later-life health, as reflected in the rate of epigenetic aging. However, the effects and mechanisms of this relationship differ across cohorts living in different social environments.

Relationship between caregiver adverse childhood events and age of autism spectrum diagnosis

BACKGROUND

The age at which children are diagnosed with autism spectrum disorder (ASD) has not significantly decreased in the past 20 years. Adverse childhood events (ACEs) experienced by caregivers of autistic children may predict delays in caregivers attending ASD diagnostic evaluations, negatively impacting the age at which the child is diagnosed with ASD. The purpose of this study was to further explore the caregiver delay response by analyzing recurring events common in caregivers of children at risk for ASD.

METHODS

We used a quantitative research design with convenience sampling to categorize caregivers of children referred for an ASD diagnostic evaluation into three groups based on their ACEs score and medical history.

FINDINGS

A higher percentage of caregivers with four or more ACEs compared to the national average was noted. Parental separation or divorce, verbal aggression, emotional abuse, and parental alcohol or substance abuse occurred most frequently, and the latter predicted a prolonged time in attending the diagnostic evaluation.

DISCUSSION

ACEs experienced by caregivers of children with ASD may delay the age of ASD diagnosis. Further investigation into the effect of ACEs on caregivers' mental health status and executive functioning is warranted to develop best practice for assisting caregivers in ASD recognition, diagnosis, and care management.

APPLICATION TO PRACTICE

Clinicians should consider caregiver ACEs score when referring a child for a diagnostic developmental evaluation. Resources to address caregiver mental health needs should be provided at the onset of the referral process to increase the likelihood of caregiver adherence.

Parental Divorce Process and Post-Divorce Parental Behaviors and Strategies: Examining Emerging Adult Children's Attachment-Related Anxiety and Avoidance

The main goal of this study was to examine the role of parental behaviors during both the process of divorce and the post-divorce period on emerging adult children's attachment-related anxiety and avoidance. Specifically, we analyzed how recalled coparental respect and cooperation, interparental conflict, positive parenting strategies, and both parents' emotional state and instability from adult children's perspective during the divorce process and the post-divorce period were associated with emerging adult children's current attachment representations. Our sample consisted of 173 emerging adults (Mage = 22.01). The results of this study demonstrate that paternal coparental respect and cooperation along with freedom provided by the mother to talk about the father during the divorce process and post-divorce period were both related to lower attachment-related avoidance. Our findings also confirm a significant link between some paternal positive attitudes during the divorce process (i.e., freedom provided by the father to talk about the mother) and low attachment-related anxiety. Overall, the results of this research confirm that beyond divorce perse, several variables surrounding the divorce process better explain variations in adult children's attachment representations, which contribute to better comprehending the effects of parental divorce.

Jumping back onto the giants' shoulders: Why emotional memory should be considered in a network perspective of psychopathology

Clinical psychology finds itself with a paradox: On the one hand, there is abundant empirical evidence showing that aversive experiences increase the risk for psychopathology. In fact, a learning and memory framework forms the foundation of numerous psychological theories and treatments. For example, various CBT approaches aim to target maladaptive emotional memories (e.g., schemas or cognitions) that are deemed to lie at the core of mental health conditions. On the other hand, a new approach - the network theory - is gaining ground, which ignores underlying causes for mental disorders and instead dictates a focus on symptoms and their causal interactions. While radical shifts are sometimes necessary in science, we argue why completely neglecting common causes, such as emotional memory, is not justified. We critically discuss the strengths and limitations of the network approach: While its transdiagnostic nature and recognition of symptom interactions have the potential to invigorate the field, the framework is merely descriptive, its concepts not well defined, and its clinical utility still to be established. To move forward, we propose an incorporation of latent constructs into the network model, starting with clearer definitions and operationalisations of concepts in both network and latent variable models.

Potential Sociodemographic Predictors of Childhood Anxiety Disorders: A Cross-Sectional Study

Background:

Previous studies have shown that the prevalence of anxiety among primary school students in rural areas is relatively high. Also, this stage is a critical developmental stage of academic life. Childhood anxiety disorders lead to significant disruption and interference with other aspects of life, including behavioral, emotional, cognitive, and academic achievement.

Aims:

This study aimed to find the frequency of 6 subtypes of anxiety disorders and to determine the potential sociodemographic factors of anxiety disorders among primary school students in a rural area of Malaysia.

Methods:

This was a cross-sectional study in which 411 students answered the Spence Children’s Anxiety Scale-Child version (SCAS-C). Descriptive analyses elucidated at-risk students, and multivariate analysis of variance and multiple linear regression presented potential predictors of anxiety disorders.

Results:

The most common abnormal level was for social phobia (SP) (n = 109/18.6%), and the least common were panic/agoraphobia (n = 85/14.1%) and physical injury fears (PIF) (n = 82/13.6%). Multivariate analysis of variance revealed that age ( P < .05), gender ( P < .05), father’s employment ( P < .05), and mother’s educational level (EL) P < .05) were predictors of overall anxiety. A Tukey post-hoc test revealed that older children are more likely to suffer from overall anxiety, separation anxiety (SA), SP, and obsessive-compulsive problems. Children of low-income families were less likely to suffer from SA than those of middle-income families. Children of stay-at-home mothers were less likely to suffer from overall anxiety, SA, and SP than mothers who worked more than 8 h per day. Multiple linear regression could predict 6 models of anxiety based on sociodemographic factors.

Conclusion:

According to our findings in this study, promoting mental health by providing preventive strategies and screening programs is more recommended for students with sociodemographic risk factors for anxiety disorders.

Adolescents' mental health problems increase after parental divorce, not before, and persist until adulthood: a longitudinal TRAILS study

Parental divorce is one of the most stressful life events for youth and is often associated with (long-lasting) emotional and behavioral problems (EBP). However, not much is known about the timing of the emergence of these EBP in adolescents relative to the moment of parental divorce, and its longitudinal effects. We therefore assessed this timing of EBP in adolescents of divorce and its longitudinal effects. We used the first four waves of the TRacking Adolescent's Individual Lives Survey (TRAILS) cohort, which included 2230 10-12 years olds at baseline. EBP were measured through the Youth Self-Report (YSR), as internalizing and externalizing problems. We applied multilevel analysis to assess the effect of divorce on EBP. The levels of both internalizing and externalizing problems were significantly higher in the period after parental divorce (β = 0.03, and 0.03, respectively; p < 0.05), but not in the period before divorce, with a persistent and increasing effect over the follow-up periods compared to adolescents not experiencing divorce. Adolescents tend to develop more EBP in the period after parental divorce, not before. These effects are long-lasting and underline the need for better care for children with divorcing parents.

Stress, development and mental health study, the follow-up study of Finnish TAM cohort from adolescence to midlife: cohort profile

PURPOSE

This cohort profile describes the Stress, development and mental health study (TAM), which is a cohort study investigating risk and protective factors as well as longitudinal associations regarding mental health and well-being from adolescence to midlife. This interdisciplinary cohort study operates, for example, in the fields of public health, social medicine, psychiatry and the life course perspective.

PARTICIPANTS

In 1981 (n=2242, 98.0% of the target population), 1982 (n=2191, 95.6%) and 1983 (n=2194, 96.7%) during school classes, surveys were conducted to all Finnish-speaking pupils (mostly born 1967) in the Tampere region in Finland. Participants of the school study at age 16 in 1983 (n=2194) comprised the base population for the longitudinal data and were followed-up using postal questionnaires in the years 1989, 1999, 2009 and 2019 at ages 22 (n=1656, 75.5% of the age 16 participants), 32 (n=1471, 67.0%), 42 (n=1334, 60.8%) and 52 (n=1160, 52.9%).

FINDINGS TO DATE

The self-reported questionnaires include information on physical and mental health (eg, depression and mood disorders, anxiety disorders), health behaviour and substance misuse (eg, alcohol, tobacco and exercise), socioeconomic conditions, psychosocial resources (eg, self-esteem), social relationships and support, life events, etc. The numerous studies published to date have examined mental health and various factors from several perspectives such as risk and protective factors, individual developmental paths (eg, trajectories) and pathway models (mediation and moderation).

FUTURE PLANS

Current and future research areas include, for example, longitudinal associations between mental health (eg, depressive symptoms, self-esteem) and (1) substance use (alcohol and tobacco), (2) family transitions (eg, parenthood, relationship status) and (3) retirement. Next follow-up is planned to be conducted at the latest at age 62 in 2029. Before that it is possible to link the data with cause-of-death register.

Mother-Child and Father-Child Relationships in Emerging Adults from Divorced and Non-Divorced Families

The main aim of this study was to analyze the associations between parental divorce and interparental conflict with the quality of parent-child relationships. Specifically, we analyzed trust, communication and alienation in both father-child and mother-child relationships in a sample of 1078 Spanish emerging adults from divorced and non-divorced families. The interaction between parental divorce and conflict was also analyzed. In support of our expectations, parental divorce was associated with lower trust and communication, along with higher alienation in father-child and mother-child relationships. When interparental conflict was included, parental conflict was more strongly associated with lower trust and communication in mother-child relationships, and higher alienation in both mother-child and father-child relationships. However, parental divorce was still associated with low trust and communication with fathers, when interparental conflict and the interaction between parental divorce and conflict were added. In summation, our results suggest that both parental divorce and conflict should be taken into account in the study of the consequences of family-related stress variables on adult children’s wellbeing. These findings add to the current literature and contribute to better comprehend the effects of parental divorce and conflict on both mother-child and father-child affective relationships in an understudied cultural context. The implications, limitations and future research recommendations are discussed.

Parental divorce and offspring smoking and alcohol use: a systematic review and meta-analysis of observational studies

OBJECTIVE

This study was conducted to investigate the relationship between parental divorce and smoking and alcohol consumption in offspring, which is based on a systematic review method and ultimately meta-analysis. Method: In a systematic search, three databases were selected. The manuscripts were searched based on the keywords and the time limit for the search was published manuscripts in English until November 2020. For the relationship between parental divorce and smoking/alcohol use in offspring, one main analysis, and four analyses based on sex, study design, adjusted level, and continents were performed. Result: Forty-three studies were synthesized from the collection of manuscripts. The odds of smoking in offspring whose parents were separated was 1.45 (CI 1.37-1.54) and this odds in men was equal to 1.38 (CI 1.11-1.71; Z = 2.91; p = 0.004; I² = 81.5%) and in women, 1.78 (CI 1.51-2.10; Z = 6.88; p < 0.001; I² = 69.6%). The odds of alcohol use in offspring whose parents were separated was 1.43 (CI 1.15-1.77) and this odds in men was equal to 1.69 (CI 1.16-2.47; Z = 2.73; p = 0.006; I² = 99.6%) and in women 1.79 (CI 1.07-2.99). Discussion: The findings of the present study can be used in health-related policies, prevention, and clinical interventions. This study was a subject with limitations, also.

The role of stress and absence: How household member incarceration is associated with risky sexual health behaviors

Sexual health is a critical indicator of wellbeing with consequences for population health. However, little is known about whether and how household member incarceration affects the sexual health behaviors of young adults. This study seeks to assess the association between household member incarceration and sexual health behaviors and provides an initial test of mechanisms. Drawing upon data from the NLSY97, this study estimates the association between household member incarceration and sexual health behaviors using linear probability models, and then re-estimates these associations using two alternative comparison groups; 1) youth who experienced other forms of stress, and 2) youth who experienced other forms of family absence. Results indicate that household incarceration is positively associated with a higher risk of reporting sexual intercourse with an intravenous drug user net of individual and family characteristics and is negatively associated with condom use net of individual but not family characteristics. The results also show that the associations between household member incarceration and sexual health behaviors may be attributable, at least in part, to the well documented stress associated with incarceration. Yet, the results provide little evidence that absence is a pathway linking household member incarceration to risky sexual health behaviors. It is possible that household member incarceration is linked to deleterious outcomes for youth through different mechanisms than parental incarceration given the differing roles of parents versus other adults in the home. Future research should explore the pathways linking household member incarceration to health risks for youth and consider household member incarceration as a unique family stressor.

[Parental Separation - Is the Accumulation with Other Adverse Childhood Experiences the Main Burden? Analysis of a Representative Sample of the German Population]

INTRODUCTION

Adverse childhood experiences (ACEs) tend to co-occur. The more forms of childhood adverse are experienced, the higher are the psychological and physical impairments in adulthood. The present study therefore examines the extent to which the experience of parental separation is related to the risk of other forms of ACEs and the extent to which the accumulation of ACEs is related to impairment in adulthood.

METHODS

A cross-sectional analysis of a representative sample of the German population from the age of 18 onwards was performed (N=2466; mean age=49.5 years (18-93); f: 1368 (55.5%); m: 1098 (44.5%)). The demographic data were assessed by interview, the remaining data were collected by questionnaires. Current depressive and anxiety symptoms self-perceived somatic health and life quality were assessed, while ACEs were assessed retrospectively by the Adverse Childhood Experiences (ACE)-Questionnaire.

RESULTS

Child maltreatment and mental illness of household members, substance abuse of household members, incarceration of household members and violence against the mother were more frequent when participants reported separation of parents. Parental separation was not associated with an increased rate of psychological impairment and, in women, physical impairment when no other forms of ACEs were present.

CONCLUSION

Children and adolescents whose parents have separated more often experience other forms of ACEs than their peers. It seems to be this accumulation of ACEs that is associated with impairments in adulthood.

Parenting behaviors, marital discord and the mental health of young females: a cross-sectional study from Saudi Arabia

BACKGROUND

Divorce is considered a sentinel event influencing the economic, psychosocial and physical health of the family as a whole. Research shows a negative impact of parental marital discord (PMD) on the psychological health and social well-being of children. Only one study from Saudi Arabia has assessed educational and social attainment among young females, and the children were school girls aged 12-16 years.

OBJECTIVES

Explore the relationship between parental marital discord and depression, anxiety, stress, social support and self-esteem of the female child. We also studied the parenting behaviors and their association with the psychosocial health of adolescents.

DESIGN

Cross-sectional questionnaire.

SETTINGS

Women's university in Saudi Arabia.

SUBJECTS AND METHODS

REDCap was used for collecting data through email invitations sent to all students at the university. Data on family structure, parental relationship, self-esteem and psycho-social health was collected.

MAIN OUTCOME MEASURES

Depression, anxiety, stress, self-esteem and social support of the adolescent. Parenting behaviors of both parents were also assessed.

SAMPLE SIZE

296.

RESULTS

The mean (SD) age of participants was 20.5 (2.4) years (median 20.0, IQR 19-22). The frequency of PMD was 24.6% (73/296). Overall, 38% of the students had extra severe anxiety, 26.5% had extra severe depression and 20.5% had extra severe stress on the Depression Anxiety and Stress Scale (DASS). The mean self-esteem score was 20.8 (5.5) and social support score was 57 (19.7). Both parents demonstrated low care and high protection trait on the Parental Bonding Instrument (PBI). Among those with PMD, mean (SD) age at discord was 11.4 (6.7) years. Mean (SD) duration of parental marriage was 20.9 (10.7) years and 35% of daughters received no financial help from the father. There was a significant association between PMD and depression, anxiety, stress and poor social support. PMD was associated with low paternal care and high protection trait.

CONCLUSIONS

The study showed an alarming burden of mental health problems including depression, anxiety and stress among young Saudi females. Marital discord is prevalent in Saudi Arabia and is significantly related to poor psychosocial health in the child. Parents undergoing marital discord should be educated about healthy parenting styles and their children should be provided with counselling and coping strategies to maintain their emotional and psychological well-being.

LIMITATIONS

Online survey could lead to volunteer bias. Only females are included in the study.

CONFLICT OF INTEREST

None.

Long-term effects of parental divorce on mental health - A meta-analysis

The aim of this study was to estimate the long-term effects of parental divorce on their offspring's mental health as well as substance-based addiction. We performed a systematic literature search on PubMed, Medline, PsyINFO, PsyARTICLES and PsycNET for the time period from 1990 until March 2018 in English language. In total 54 studies were included in the meta-analysis resulting in 117 effect sizes as well as a total sample of 506,299 participants. A significant association between parental divorce and every aspect of mental health was found with the following pooled ORs (95% CIs): Depression 1.29 (1.23-1.35), anxiety 1.12 (1.04-1.12), suicide attempt 1.35 (1.26-1.44), suicidal ideation 1.48 (1.43-1.54), distress 1.48 (1.37-1.6), alcohol 1.43 (1.34-1.53), smoking 1.64 (1.57-1.72) and drugs 1.45 (1.44-1.46) could be estimated. There was significant association between the effect sizes and the publication date specifically for distress (r = -0.995, p = .005). The results of the meta-analysis show a consistent direction of influence regarding the long-term effect of parental divorce on their children. Individuals affected by parental divorce have a higher risk of developing a variety of mental health conditions, although the effect sizes decreased from 1990 to 2017. Further research should focus on developing programmes to promote the resilience of children affected by divorce.

Children's age at parental divorce and depression in early and mid-adulthood

This study aimed to assess whether children's age at their parents' divorce is associated with depression in early and mid-adulthood, as indicated by medication purchase. A sibling comparison method was used to control for unobserved factors shared between siblings. The data were extracted from the Norwegian Population Register and Norwegian Prescription Database and included about 181,000 individuals aged 20-44 who had experienced parental divorce and 636,000 who had not. Controlling for age in 2004, sex, and birth order, children who were aged 15-19 when their parents divorced were 12 per cent less likely to purchase antidepressants as adults in 2004-08 than those experiencing the divorce aged 0-4. The corresponding reduction for those aged 20+ at the time of divorce was 19 per cent. However, the association between age at parental divorce and antidepressant purchases was only evident among women and those whose mothers had low education.

Multigroup Propensity Score Approach to Evaluating an Effectiveness Trial of the New Beginnings Program

We used a multigroup propensity score approach to evaluate a randomized effectiveness trial of the New Beginnings Program (NBP), an intervention targeting divorced or separated families. Two features of effectiveness trials, high nonattendance rates and inclusion of an active control, make program effects harder to detect. To estimate program effects based on actual intervention participation, we created a synthetic inactive control comprised of nonattenders and assessed the impact of attending the NBP or active control relative to no intervention (inactive control). We estimated propensity scores using generalized boosted models and applied inverse probability of treatment weighting for the comparisons. Relative to the inactive control, NBP strengthened parenting quality as well as reduced child exposure to interparental conflict, parent psychological distress, and child internalizing problems. Some effects were moderated by parent gender, parent ethnicity, or child age. On the other hand, the effects of active versus inactive control were minimal for parenting and in the unexpected direction for child internalizing problems. Findings from the propensity score approach complement and enhance the interpretation of findings from the intention-to-treat approach.

Parental separation in childhood as a risk factor for depression in adulthood: a community-based study of adolescents screened for depression and followed up after 15 years

BACKGROUND

Earlier research has investigated the association between parental separation and long-term health outcomes among offspring, but few studies have assessed the potentially moderating role of mental health status in adolescence. The aim of this study was to analyze whether parental separation in childhood predicts depression in adulthood and whether the pattern differs between individuals with and without earlier depression.

METHODS

A community-based sample of individuals with adolescent depression in 1991-93 and matched non-depressed peers were followed up using a structured diagnostic interview after 15 years. The participation rate was 65% (depressed n = 227; non-depressed controls n = 155). Information on parental separation and conditions in childhood and adolescence was collected at baseline. The outcome was depression between the ages 19-31 years; information on depression was collected at the follow-up diagnostic interview. The statistical method used was binary logistic regression.

RESULTS

Our analyses showed that depressed adolescents with separated parents had an excess risk of recurrence of depression in adulthood, compared with depressed adolescents with non-separated parents. In addition, among adolescents with depression, parental separation was associated with an increased risk of a switch to bipolar disorder in adulthood. Among the matched non-depressed peers, no associations between parental separation and adult depression or bipolar disorder were found.

CONCLUSIONS

Parental separation may have long-lasting health consequences for vulnerable individuals who suffer from mental illness already in adolescence.

Parental divorce and initiation of alcohol use in early adolescence

Parental divorce/separation is among the most commonly endorsed adverse childhood events. It has been shown to increase subsequent risk of alcohol dependence and problems across adolescence and early adulthood, but its influence on early stages of alcohol involvement has only recently been explored. In the present study, we examined whether time to first full drink was accelerated among youth who experienced parental divorce/separation. To determine specificity of risk, models controlled for perceived stress as well as family history of alcoholism, current parental drinking, and internalizing and externalizing problems. Developmental specificity in terms of timing of both parental divorce and first drink was also examined. Participants were 931 middle-school students (488 girls, 443 boys) who were enrolled in a prospective study on drinking initiation and progression (52% female; 23% non-White, 11% Hispanic). Students indicated whether and at what age they had consumed a full drink of alcohol. Parental divorce/separation was coded from a parent-reported life-events inventory and was grouped based on age experienced (ages 0-5, ages 6-9, age 10+). Cox proportional hazard models showed increased risk for onset of drinking as a function of divorce/separation, even controlling for stress, parental alcohol involvement, and psychopathology. There was no evidence for developmental specificity of the divorce/separation effect based on when it occurred nor in timing of first drink. However, the effect of parental divorce/separation on initiation was magnified at higher levels of parental drinking. Given the rates of parental divorce/separation and its association with increased risk of early drinking, investigation of the mechanisms underlying this link is clearly warranted. (PsycINFO Database Record

Self-harm risk between adolescence and midlife in people who experienced separation from one or both parents during childhood

BACKGROUND

Experience of child-parent separation predicts adverse outcomes in later life. We conducted a detailed epidemiological examination of this complex relationship by modelling an array of separation scenarios and trajectories and subsequent risk of self-harm.

METHODS

This cohort study examined persons born in Denmark during 1971-1997. We measured child-parent separations each year from birth to 15th birthday via complete residential address records in the Civil Registration System. Self-harm episodes between 15th birthday and early middle age were ascertained through linkage to psychiatric and general hospital registers. Incidence rate ratios (IRRs) from Poisson regression models were estimated against a reference category of individuals not separated from their parents.

RESULTS

All exposure models examined indicated an association with raised self-harm risk. For example, large elevations in risk were observed in relation to separation from both parents at 15th birthday (IRR 5.50, 95% CI 5.25-5.77), experiencing five or more changes in child-parent separation status (IRR 5.24, CI 4.88-5.63), and having a shorter duration of familial cohesion during upbringing. There was no significant evidence for varying strength of association according to child's gender.

LIMITATIONS

Measuring child-parent separation according to differential residential addresses took no account of the reason for or circumstances of these separations.

CONCLUSIONS

These novel findings suggest that self-harm prevention initiatives should be tailored toward exposed persons who remain psychologically distressed into adulthood. These high-risk subgroups include individuals with little experience of familial cohesion during their upbringing, those with the most complicated trajectories who lived through multiple child-parent separation transitions, and those separated from both parents during early adolescence.

Partner Meeting Contexts and Risky Behavior in College Students' Other-Sex and Same-Sex Hookups

We analyzed a sample of 12,065 hookup encounters among college students at 22 colleges and universities in the Online College Social Life Survey (OCSLS) to explore how partner meeting locales may influence college students' risky behavior when hookup partners are met in those contexts. For other-sex encounters, meeting in bars or at parties, through common interest groups or history, and (for women) at dormitories was associated with binge drinking during encounters, while meeting online and (for women) in public was associated with reduced binge drinking during encounters. Unprotected sex during other-sex encounters was more common when partners were met in public and less common with partners met in dormitories. Binge drinking and marijuana use during or just prior to encounters was associated with an increased risk of unprotected sex and other substance use. Marijuana use and unprotected sex during encounters was more common when students knew their hookup partner better or had hooked up with the partner before, while binge drinking was associated with hooking up with less familiar partners. Associations of meeting contexts with behavior were explained by the locale's association with institutional and personal trust, social scripts, and selection into certain contexts by students with a risk-taking personality.

Interpersonal Conflicts and Development of Self-Esteem from Adolescence to Mid-Adulthood. A 26-Year Follow-Up

This study investigated the association between interpersonal conflicts and the trajectory of self-esteem from adolescence to mid-adulthood. The directionality of effects between self-esteem and interpersonal conflicts was also studied. Participants of a Finnish cohort study in 1983 at age 16 (N = 2194) were followed up at ages 22 (N = 1656), 32 (N = 1471) and 42 (N = 1334) using postal questionnaires. Measures covered self-esteem and interpersonal conflicts including, conflicts with parents, friends, colleagues, superiors, partners, break-ups with girl/boyfriends, and divorces. Participants were grouped using latent profile analysis to those having “consistently low”, “decreasing”, or “increasing” number of interpersonal conflicts from adolescence to adulthood. Analyses were done using latent growth curve models and autoregressive cross-lagged models. Among both females and males the self-esteem growth trajectory was most favorable in the group with a consistently low number of interpersonal conflicts. Compared to the low group, the group with a decreasing number of interpersonal conflicts had a self-esteem trajectory that started and remained at a lower level throughout the study period. The group with an increasing number of interpersonal conflicts had a significantly slower self-esteem growth rate compared to the other groups, and also the lowest self-esteem level at the end of the study period. Cross-lagged autoregressive models indicated small, but significant lagged effects from low self-esteem to later interpersonal conflicts, although only among males. There were no effects to the opposite direction among either gender. Our results show that those reporting more and an increasing number of interpersonal conflicts have a lower and more slowly developing self-esteem trajectory from adolescence to mid-adulthood. While the result was expected, it does not seem to imply an effect from interpersonal conflicts to low self-esteem. Rather, if anything, our results seem to suggest that those with low self-esteem are more prone to later interpersonal conflicts.

Parental Divorce or Death During Childhood and Adolescence and Its Association With Mental Health

Despite the severity of the loss of a parent and the frequency of parental divorce, few studies compared their impact on mental health in the general adult population. The aim of this study was to estimate the prevalence, sociodemographic correlates, and psychiatric comorbidity of parental loss and parental divorce during childhood and adolescence. Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of US adults (n = 43,093). Of the 43,093 participants, parental divorce during childhood or adolescence was reported by 5776 participants, whereas 3377 experienced parental death during childhood or adolescence. Participants reporting a history of parental divorce present a significantly higher prevalence of psychiatric disorders, particularly alcohol and drug use disorders compared with control subjects. While participants experiencing the death of a parent reported a poorer overall health, the prevalence of psychiatric disorder after 17 years of age was not significantly higher than that of the control subjects.

Adult bone strength of children from single-parent families: the Midlife in the United States Study

Bone health may be negatively impacted by childhood socio-environmental circumstances. We examined the independent associations of single-parent childhood and parental death or divorce in childhood with adult bone strength indices. Longer exposure to a single-parent household in childhood was associated with lower bone strength in adulthood.

INTRODUCTION

Because peak bone mass is acquired during childhood, bone health may be negatively impacted by childhood socio-environmental disadvantage. The goal of this study was to determine whether being raised in a single-parent household is associated with lower bone strength in adulthood.

METHODS

Using dual-energy X-ray absorptiometry data from 708 participants (mean age 57 years) in the Midlife in the United States Biomarker Project, we examined the independent associations of composite indices of femoral neck bone strength relative to load (in three failure modes: compression, bending, and impact) in adulthood with the experience of single-parent childhood and parental death or divorce in childhood.

RESULTS

After adjustment for gender, race, menopause transition stage, age, and body mass index, each additional year of single-parent childhood was associated with 0.02 to 0.03 SD lower indices of adult femoral neck strength. In those with 9-16 years of single-parent childhood, the compression strength index was 0.41 SD lower, bending strength index was 0.31 SD lower, and impact strength index was 0.25 SD lower (all p values < 0.05). In contrast, parental death or divorce during childhood was not by itself independently associated with adult bone strength indices. The magnitudes of these associations were unaltered by additional adjustment for lifestyle factors and socioeconomic status in childhood and adulthood.

CONCLUSIONS

Independent of parental death or divorce, growing up in a single-parent household is associated with lower femoral neck bone strength in adulthood, and this association is not entirely explained by childhood or adult socioeconomic conditions or lifestyle choices.

Maternal and paternal psychosocial risk factors for clinical depression in a Norwegian community sample of adolescents

BACKGROUND

Parental characteristics can increase the risk of the development of adolescent depression. In this study, we focus on the parental factors of parents in a non-intact relationship, dissatisfaction with personal economy, physical illness or disability, and internalizing and externalizing problems. The aim is to examine which of these parental risk factors, separately for mothers and fathers, are associated with clinical depression in adolescents in a community sample.

METHODS

In the Youth and Mental Health study, 345 adolescents (mean age ± standard deviation 15.0 ± 0.6 years, range 13.8-16.6 years; 72.5% girls) and their parents (79% at least one parent) completed questionnaires and the diagnostic interview Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version (K-SADS-PL). Adolescents were classified into current major depressive disorder or dysthymia (n = 46), depression not otherwise specified (n = 48), or no depression (n = 251). The parental risk factors were based on interview and the Adult Self-Report. Risk factors associated with mothers (n = 267) and fathers (n = 167) were separately analyzed using ordinal logistic regression with current depression category as the dependent variable. All analyses were adjusted for youth sex and age.

RESULTS

Mothers' economical dissatisfaction, physical illness/disability, internalizing problems and externalizing problems were associated with adolescent current depression (P ≤ 0.02). Adjusting for all other factors, only mothers' internalizing problems (P < 0.001) remained significantly associated with adolescent depression. Fathers' risk factors were not associated with adolescent depression.

CONCLUSION

Characteristics of mothers are associated with adolescent current depression. Mothers' internalizing problems is independently strongly associated with increased risk of current adolescent depression. Clinicians should assess mothers' mental health when treating depressed adolescents.

Longitudinal course of diagnosed depression from ages 15 to 20 in a community sample: patterns and parental risk factors

The primary aim was to examine the associations of hypothesized maternal and paternal risk factors with course of depression diagnosis in a community sample from ages 15-20. In addition, we describe longitudinal stability and change in depression diagnosis over this period. In the Youth and Mental Health study 242 adolescents completed questionnaires and the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime interview at ages 15 and 20, and risk factors were measured by parent report including the Adult Self Report. Both groups who remained depressed and who recovered were more likely to have mothers with internalizing problems. Paternal internalizing problems was also significantly associated with course of depression. These findings suggest treatment of depression in adolescents and young adults may benefit from consideration of the parents' internalizing symptoms.

Predicting long-term outcomes for children affected by HIV and AIDS: perspectives from the scientific study of children's development

The immediate and short-term consequences of adult HIV for affected children are well documented. Little research has examined the long-term implications of childhood adversity stemming from caregiver HIV infection. Through overviews provided by experts in the field, together with an iterative process of consultation and refinement, we have extracted insights from the broader field of child development of relevance to predicting the long-term consequences to children affected by HIV and AIDS. We focus on what is known about the impact of adversities similar to those experienced by HIV-affected children, and for which there is longitudinal evidence. Cautioning that findings are not directly transferable across children or contexts, we examine findings from the study of parental death, divorce, poor parental mental health, institutionalization, undernutrition, and exposure to violence. Regardless of the type of adversity, the majority of children manifest resilience and do not experience any long-term negative consequences. However, a significant minority do and these children experience not one, but multiple problems, which frequently endure over time in the absence of support and opportunities for recovery. As a result, they are highly likely to suffer numerous and enduring impacts. These insights suggest a new strategic approach to interventions for children affected by HIV and AIDS, one that effectively combines a universal lattice of protection with intensive intervention targeted to selected children and families.

Does Parental Divorce Increase Risk Behaviors among 15/16 and 18/19 year-old Adolescents? A Study from Oslo, Norway

BACKGROUND

Several studies have reported an increase in risk behaviors among adolescents after experience of parental divorce. The aim of the study was to investigate whether parental divorce is associated with risk behavior among adolescents independent of mental health problems, first when early divorce was experienced, and second after experience of late parental divorce.

METHOD

One prospective (n=1861) and one cross-sectional study (n=2422) were conducted using data from two Young-HUBRO surveys in Oslo, Norway. All 15/16 year-old 10(th) grade students who participated in the first survey in the school year 2000/01 were followed-up in 2004 when they were 18/19 year-olds. The follow-up rate was 68%. The prospective study investigated the influence of late parental divorce that occurred between the age of 15/16 and 18/19. In the cross-sectional study we focused on early parental divorce that occurred before the participants were 15/16 year-old.

RESULTS

In the prospective study we could not discern a significant association between experiencing late parental divorce and an increase in risk behaviors among 18/19 year-old adolescents. In the cross-sectional study parental divorce was significantly associated with cigarette smoking and using doping agents.

CONCLUSION

Parental divorce that occurs when the children of divorced parents are 15/16 year-old or younger is associated with an increase in cigarette smoking and use of doping agents. However, no evidence of significant association is found between experience of late parental divorce and risk behaviors in late adolescence.

Ripple effects of developmental disabilities and mental illness on nondisabled adult siblings

Developmental disabilities and severe mental illness are costly to the affected individual and frequently to their family as well. Little studied are their nondisabled siblings. Here we examine major life course outcomes (education, employment, and marriage) of these siblings in adulthood using data from the Wisconsin Longitudinal Study. Our sample comprises 113 individuals with developmental disabilities and 337 of their nondisabled siblings; 97 individuals with mental illness and 235 of their nondisabled siblings; and 17,126 unaffected comparison group members. We find that siblings of individuals with mental illness have less education and less employment than the unaffected comparison group, whereas those who have a sibling with developmental disabilities had normative patterns of education and employment, but less marriage and more divorce. Robustness tests incorporating genetic data do not change the conclusions based on the nongenetic analyses.

Parental separation and adult psychological distress: an investigation of material and relational mechanisms

BACKGROUND

An association between parental separation or divorce occurring in childhood and increased psychological distress in adulthood is well established. However relatively little is known about why this association exists and how the mechanisms might differ for men and women. We investigate why this association exists, focussing on material and relational mechanisms and in particular on the way in which these link across the life course.

METHODS

This study used the 1970 British Cohort Study (n=10,714) to investigate material (through adolescent and adult material disadvantage, and educational attainment) and relational (through parent-child relationship quality and adult partnership status) pathways between parental separation (0-16 years) and psychological distress (30 years). Psychological distress was measured using Rutter's Malaise Inventory. The inter-linkages between these two broad mechanisms across the life course were also investigated. Missing data were multiply imputed by chained equations. Path analysis was used to explicitly model prospectively-collected measures across the life course, therefore methodologically extending previous work.

RESULTS

Material and relational pathways partially explained the association between parental separation in childhood and adult psychological distress (indirect effect=33.3% men; 60.0% women). The mechanisms were different for men and women, for instance adult partnership status was found to be more important for men. Material and relational factors were found to interlink across the life course. Mechanisms acting through educational attainment were found to be particularly important.

CONCLUSIONS

This study begins to disentangle the mechanisms between parental separation in childhood and adult psychological distress. Interventions which aim to support children through education, in particular, are likely to be particularly beneficial for later psychological health.

GP consultations for medically unexplained physical symptoms in parents and their children: a systematic review

BACKGROUND

There is evidence of an association of medically unexplained physical symptoms (MUPS) between parents and children, but it is unclear whether this association is also present for GP consultations.

AIM

To review the literature investigating the association of GP consultations for MUPS between parents and children.

DESIGN OF STUDY

Systematic review.

METHOD

Systematic search of MEDLINE(®), Embase, CINAHL, and PsycINFO databases from their inception to October 2012. Observational studies examining the association of GP consultations for MUPS between parents and children were included.

RESULTS

Eight studies were included in the review. Three studies found significant associations between GP consultations for multiple MUPS between parents and children. Two studies reported significant associations between irritable bowel syndrome diagnosis in parents and multiple MUPS in children. One study showed no significant associations between multiple MUPS in mothers and functional abdominal pain in children. Two studies investigated the association of non-specific low back pain in parents and children; one study showed a significant association, whereas the other study found no significant association. Formal pooling of the results was not performed owing to a high degree of study heterogeneity.

CONCLUSION

This review provides evidence of an association between GP consultations for MUPS in parents and children, although the evidence is limited by some potential biases and study heterogeneity. GPs need to be aware of this association, which has implications for management of children presenting with MUPS. More longitudinal research focusing on all common MUPS in children, which relies on more precise sources of data, is needed to further investigate this association.

Parental divorce in late adolescence does not seem to increase mental health problems: a population study from Norway

Background

Former studies have shown increased mental health problems in adolescents after parental divorce all over the Western world. We wanted to see if that still is the case in Norway today when divorce turns to be more and more common.

Methods

In a prospective study design, two samples were constituted, adolescents at a baseline survey in 2001/02 (n = 2422) and those at follow-up in 2003/04 (n = 1861), when the adolescents were 15/16 and 18/19 years-old, respectively. They answered self-administered questionnaires in both surveys of Young-HUBRO in Oslo. Early parental divorce was defined as that which occured before age 15/16 years, and late divorce occured between age 15/16 and 18/19. Internalized and externalized mental health problems were measured by the Hopkin’s Symptom Check List (HSCL-10) and the Strengths and Difficulties Questionnaire (SDQ).

Results

After linear regression models were adjusted for gender, ethnicity, family economy, social support, and mental health problem symptoms measured at baseline before parental divorce occured, late parental divorce did not lead to significant increase in mental health problems among adolescents in the city of Oslo. Early parental divorce was associated with internal mental health problems among young adolescents when adjusted only for the first four possible confounders.

Conclusions

It seems that parental divorce in late adolescence does not lead to mental health problems in Norway any more, as has been shown before, while such problems may prevail among young adolescents. This does not mean that parental divorce create less problems in late adolescence than before but these youths might have developed adjustment abilities against health effects as divorce have turned to be more common.

Impact of divorce and loss of parental contact on health complaints among adolescents

BACKGROUND

Mental health consequences related to divorce have been documented, but might be caused by concomitant factors such as conflicts and loss of parental contact (PC). We investigated these relationships and mental health among adolescents.

METHODS

The study was based on data from four cross-sectional surveys carried out between 1997 and 2009 among tertiary school students in Førde, Norway. We established two groups according to divorce experience (DE) with or without loss of PC. Frequencies of DEs were calculated with 95% confidence intervals. The group with no DE was used as reference group in all the analyses.

RESULTS

The divorce rate increased by 34% (6.8% absolute increase) between 1997 and 2009, but no sign of attenuated effects on emotional health was observed. Mental complaints were not attenuated as time since divorce increased. A majority of those losing contact with parents had no contact with their fathers. The study revealed only a modest increase of health complaints if PC was preserved, but a marked increase when the adolescents experienced loss of PC following the divorce. Interaction analyses showed no gender differences, and parental support and confidence in parent(s) did not mediate the associations between divorce and distress.

CONCLUSIONS

Emotional distress after divorce is not attenuated as divorce prevalence increases, but the deleterious effects of divorce on the well-being of adolescents seem to be confined to those experiencing a concomitant loss of PC. Efforts aiming at reducing parental hostility and improving mutual parental responsibility and care therefore seem important.

Gender differences in the association between parental divorce during childhood and stroke in adulthood: findings from a population-based survey

BACKGROUND

Although there is a substantial literature examining the mental health consequences of parental divorce, less attention has been paid to possible long-term physical health outcomes.

AIMS

The aim of this study was to examine the gender-specific association between childhood parental divorce and later incidence of stroke, while controlling for age, race ethnicity, socioeconomic status, health behaviors, diabetes, social support, marital status, mental health, and health care utilization.

METHODS

Secondary analysis of the population-based Behavioral Risk Factor Surveillance System survey; logistic regression analyses were conducted. The final sample included 4074 males and 5886 females. Respondents were excluded if they had experienced parental addictions to drugs or alcohol, any form of childhood abuse (physical, sexual, or emotional), or witnessed domestic violence.

RESULTS

A threefold risk of stroke was found for males who had experienced parental divorce before the age of 18 in comparison with males whose parents had not divorced [age- and race ethnicity-adjusted model odds ratio (OR) = 2·99, 95% confidence interval (CI) = 1·79, 4·98; fully adjusted model OR = 3·01, 95% CI = 1·68, 5·39]. Parental divorce was not significantly associated with stroke among women (fully adjusted OR = 1·64, 95% CI = 0·89, 3·02).

CONCLUSIONS

There is a robust association between parental divorce and stroke among males, even after adjustment for many known risk factors and the exclusion of respondents who had experienced parental addictions or family violence. Further research is needed to investigate plausible pathways linking parental divorce and stroke in males.

Best friend's and family members’ smoking habits and parental divorce during childhood are associated with smoking in adulthood

Aims

Smoking initiation during childhood or adolescence is strongly associated with friends’ smoking. Likewise, adverse living conditions increase the likelihood of future deviant behaviour. We examine whether smoking by a best friend and family members during school years as well as adverse childhood experiences are associated with smoking in adulthood.

Data and Design

We have analysed the responses of Finnish working-aged respondents in 1998 (N=25901) and 2003 (N=20773) to questions on the smoking status of friends and family members during school years as well as their answers on a six-item scale of childhood adversities. A case-control study design was used to compare current cigarette smokers (1998 and 2003) to non-smokers (1998 and 2003).

Results

If a best friend during school years was a smoker, the subject s odds ratio (OR) of being a smoker in adulthood was 4.43 among females and 3.91 among males compared to those with a non-smoking best friend in multivariate models adjusted for smoking by family members during school years and by six childhood adversities. These associations did not differ by age. Smoking in adulthood was associated with childhood adversities, most strongly with parental divorce or separation during the subjects’ school years.

Conclusion

Smoking by a best friend and parental divorce or separation during school years appears to be a strong factor of smoking in later life.

Longitudinal impact of frequent geographic relocation from adolescence to adulthood on psychosocial stress and vital exhaustion at ages 32 and 42 years: the Amsterdam growth and health longitudinal study

Background

We assessed mobility in different life stages over a 29-year period from adolescence through adulthood and its correlation with psychosocial stress and vital exhaustion at ages 32 and 42 years.

Methods

Data were derived from the Amsterdam Growth and Health Longitudinal Study, an observational longitudinal study of 420 boys and girls from age 13 to 42 years. Measurements included cumulative frequency of geographic relocation (CFGR), psychosocial stress (measured by a Dutch scale of experienced stress, VOEG-13), vital exhaustion (measured by the Maastricht Questionnaire, MQ), demographics, socioeconomic status, and other background characteristics.

Results

From 1976 to 2006, total CFGR was 3.56 ± 1.89 (range 0–13). Frequent geographic relocation during 2 life stages (age 22–32 years and 33–42 years) was significantly interrelated; however, this was not evident at age 13 to 21 years, which suggests a unique exposure to relocation during adolescence and youth. After adjusting for anticipated confounders, higher cumulative frequencies of residential changes during adolescence and youth were markedly associated with psychosocial stress and vital exhaustion at ages 32 and 42 years.

Conclusions

Frequent geographic relocation during adolescence and youth was an indicator of psychosocial stress and vital exhaustion in the transition to middle adulthood. Further consideration of the pathways in this web of causation may aid in stress prevention and minimize negative consequences.

Life course pathways to prenatal maternal stress

OBJECTIVE

To evaluate the impact of childhood stressors, recalled childhood stress, and stressors in adulthood on perceived stress in pregnancy.

DESIGN

Prospective cohort study.

SETTING

Pregnant women were recruited from pre-birth clinics in two communities.

PARTICIPANTS

Four-hundred and twenty-one pregnant women.

RESULTS

Perceived prenatal maternal stress was the main outcome measure. Recalled childhood stress was positively associated with prenatal stress (β = .54) after adjusting for other child and adult factors. Low family cohesion during childhood was indirectly associated with prenatal stress through its effects on recalled childhood stress, current family cohesion, and current subjective socioeconomic position (SEP). Low levels of adult subjective SEP (β = -.44) and family cohesion (β = -.25) were directly associated with prenatal stress. Perceived social support during childhood was indirectly associated with prenatal stress through its effect on recalled childhood stress and perceived social support in adulthood. Childhood subjective SEP indirectly influenced prenatal stress through its effect on adult subjective SEP and recalled childhood stress.

CONCLUSIONS

Prenatal stress is a result of the interplay between factors from childhood and adulthood. The study findings can be used to inform psychosocial risk assessment and interventions across the lifespan to decrease prenatal stress and its adverse outcomes.

Parental divorce and adult longevity

OBJECTIVE

Life course research has established associations between adverse childhood events and later life health. We examine the relationship of experiencing parental divorce before the age of 16 and survival across 34 years of adulthood.

METHODS

Analysis of panel data from a USA-based survey of 6,928 adults residing in Alameda County, California in 1965. Cox regression was used to examine associations between parental divorce and longevity.

RESULTS

Controlling for age, race/ethnicity, gender, and childhood socioeconomic position, respondents who recalled a parental divorce during childhood had increased risk of mortality compared to those with no separation. The association was stronger for premature mortality and deaths due to cardiovascular disease. Divorce in childhood was also associated with lowered adult education, fewer social network ties, more depression, and worse health practices. These factors appeared to explain the association with longevity.

CONCLUSION

Parental divorce in childhood is associated with lowered well-being in adulthood and long-term survival. Early prevention and health promotion efforts may be warranted for children who experience parental divorce or discord as a means of supporting enhanced trajectories of health and well-being.

Adolescent daughters' romantic competence: the role of divorce, quality of parenting, and maternal romantic history

This study examined the links between parental divorce, quality of maternal parenting, spousal relationships and middle adolescent romantic competence in 80 mother-adolescent daughter pairs (40 divorced). Mothers were asked to describe their attitudes and behaviors with regard to their daughters' romantic behavior. In addition, mothers were interviewed about their own romantic experiences when they were at the age of their daughters. Adolescent girls (mean age = 16.98 years; range 16-18) were administered a comprehensive interview about romantic competence. Findings indicated that adolescent girls from divorced families showed lower levels of romantic competence, which were expressed in their behavior, attitudes toward relationships and skill in handling those relationships. Divorce was found to have had an adverse effect on girls' romantic competence, whereas continued adaptive parenting and spousal relationships alleviated the effect of divorce. Mothers' coherent representation of their own adolescent romantic experiences also alleviated the effect of divorce on daughters' romantic behavior. Results show the important role of family relationships in fostering romantic competence among adolescent girls.

Stressful life events in childhood and risk of infectious disease hospitalization

Individuals exposed to high levels of stress might have an increased risk of infectious diseases. However, most of the previous studies have been conducted among adults. To examine the effect of childhood stress, we conducted a nationwide cohort study including all Danish children born from 1977 to 2004. Stressful life events (SFLE) included parental death, death of sibling or parental divorce. Outcome was defined as hospitalizations due to less severe (LSID) or severe infectious diseases (SID). Children were followed until the age of 15 years. The association between SFLE and risk of infections was evaluated through rate ratios (RR) comparing infectious disease incidence ratios in children with and without a history of SFLE. Overall, children exposed to SFLE were at 13% increased risk of LSID (RR = 1.13 (1.10-1.15)), but at no increased risk of SID hospitalization (RR = 1.05 (0.97-1.14)). Looking at the specific type of SFLE, parental divorce increased the risk of LSID (RR = 1.11 (1.09-1.14)) and SID hospitalization (1.11 (1.02-1.21)) by 11%, whereas no increased risk of LSID and SID hospitalization was observed following parental death. Finally, a 34% increased risk of LSID hospitalization (RR = 1.34 (1.23-1.45)) was observed following death of sibling, in contrast to no increased risk of SID hospitalization.

CONCLUSION

Childhood exposure to SFLE, especially parental divorce seems to increase the risk of infectious disease hospitalization. Although we cannot determine whether our observations are the result of a biological effect of stress, adoption of unhealthy behaviours or increased likelihood of hospitalization, our findings do have public health relevance as a considerable proportion of the children today will be exposed to SFLE, the majority to parental divorce.

Psychiatric and somatic health in relation to experience of parental divorce in childhood

BACKGROUND

The outcome of studies about the experience of parental divorce and its effects on mental and physical health differs, a result possibly caused by the use of different questionnaires and instruments, varying length of time since the divorce and divergent drop-out of participants.

AIMS

To study the presence of psychiatric records and number of diagnosed somatic and mental healthcare visits in a group of young adults with childhood experience of parental divorce in comparison to a group without this experience.

METHODS

The presence of records at public psychiatric clinics and 10 years of administrative healthcare data (somatic and mental) were checked for both groups.

RESULTS

Significantly more persons from the divorce group appeared in child and adolescent psychiatric care; this was most pronounced in females. However, there were no significant differences between the groups in the number of persons seeking adult psychiatry or in the number of psychiatric consultations. Experience of parental divorce was not found to be an indicator of larger somatic health problems.

CONCLUSION

Experience of parental divorce in childhood is not an indicator of adult psychiatric or somatic need of care.

Family social environment in childhood and self-rated health in young adulthood

BACKGROUND

Family social support, as a form of social capital, contributes to social health disparities at different age of life. In a life-course epidemiological perspective, the aims of our study were to examine the association between self-reported family social environment during childhood and self-reported health in young adulthood and to assess the role of family functioning during childhood as a potential mediating factor in explaining the association between family breakup in childhood and self-reported health in young adulthood.

METHODS

We analyzed data from the first wave of the Health, Inequalities and Social Ruptures Survey (SIRS), a longitudinal health and socio-epidemiological survey of a random sample of 3000 households initiated in the Paris metropolitan area in 2005. Sample-weighted logistic regression analyses were performed to determine the association between the quality of family social environment in childhood and self-rated health (overall health, physical health and psychological well-being) in young adults (n = 1006). We used structural equation model to explore the mediating role of the quality of family functioning in childhood in the association between family breakup in childhood and self-rated health in young adulthood.

RESULTS

The multivariate results support an association between a negative family social environment in childhood and poor self-perceived health in adulthood. The association found between parental separation or divorce in childhood and poor self-perceived health in adulthood was mediated by parent-child relationships and by having witnessed interparental violence during childhood.

CONCLUSION

These results argue for interventions that enhance family cohesion, particularly after family disruptions during childhood, to promote health in young adulthood.