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Bruffaerts R, Axinn WG, Ghimire DJ, Benjet C, Chardoul S, Scott KM, Kessler RC, Schulz P, Smoller JW. Community exposure to armed conflict and subsequent onset of alcohol use disorder. Addiction 2024; 119:248-258. [PMID: 37755324 PMCID: PMC10872606 DOI: 10.1111/add.16343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/17/2023] [Indexed: 09/28/2023]
Abstract
AIMS To measure the independent consequences of community-level armed conflict beatings on alcohol use disorders (AUD) among males in Nepal during and after the 2000-2006 conflict. DESIGN A population-representative panel study from Nepal, with precise measures of community-level violent events and subsequent individual-level AUD in males. Females were not included because of low AUD prevalence. SETTING Chitwan, Nepal. PARTICIPANTS Four thousand eight hundred seventy-six males from 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15-59 were eligible (response rate 93%). MEASUREMENTS Measures of beatings in the community during the conflict (2000-2006), including the date and distance away, were gathered through neighborhood reports, geo-location and official resources, then linked to respondents' life histories of AUD (collected in 2016-2018) using the Nepal-specific Composite International Diagnostic Interview with life history calendar. Beatings nearby predict the subsequent onset of AUD during and after the armed conflict. Data were analyzed in 2021-2022. FINDINGS Cohort-specific, discrete-time models revealed that within the youngest cohort (born 1992-2001), those living in neighborhoods where armed conflict beatings occurred were more likely to develop AUD compared with those in other neighborhoods (odds ratio = 1.66; 95% confidence interval = 1.02-2.71). In this cohort, a multilevel matching analysis designed to simulate a randomized trial showed the post-conflict incidence of AUD for those living in neighborhoods with any armed conflict beatings was 9.5% compared with 5.3% in the matched sample with no beatings. CONCLUSIONS Among male children living in Chitwan, Nepal during the 2000-2006 armed conflict, living in a neighborhood where armed conflict beatings occurred is associated with increased odds of developing subsequent alcohol use disorder. This association was independent of personal exposure to beatings and other mental disorders.
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Affiliation(s)
- Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum KU Leuven, Leuven, Belgium
| | - William G Axinn
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Dirgha J Ghimire
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Corina Benjet
- Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Instituto Nacional de Psiquiatría Ramón de La Fuente Muñiz, Mexico City, Mexico
| | - Stephanie Chardoul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Kate M Scott
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul Schulz
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Jordan W Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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Wang L, Yi Z. Marital status and all-cause mortality rate in older adults: a population-based prospective cohort study. BMC Geriatr 2023; 23:214. [PMID: 37016371 PMCID: PMC10074686 DOI: 10.1186/s12877-023-03880-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/09/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Living with a partner and separation is becoming more common among older people. Mortality disparities associated with marital status are significant in increasingly diverse aging populations. The link between marital status and all-cause mortality risk in older adults remains uncertain. METHODS This prospective cohort study included data from the US National Health and Nutrition Examination Survey (NHANES). We included NHANES participants ≥ 60 years of age (data from 1999 to 2014). Data for mortality follow-up beginning from the commencement date of survey participation to the last day of December 2015. Univariate- and multivariate-adjusted Cox proportional hazard models for marital status were estimated, and the findings were presented as regression coefficients and 95% confidence intervals (CI). Kaplan-Meier curves were reported. RESULTS Compared to never married individuals, the risk of all-cause mortality was 0.77 (0.50-1.18), 0.72 (0.56-0.93), 0.56 (0.36-0.88), and 0.84 (0.67-1.07) in those people living with a partner, married, separated, and divorced, respectively, after adjusting for demographics, socioeconomics, behavior, anthropometric variables, and medical history. The risk of all-cause mortality was 1.24 (0.97-1.59) in widowed participants. CONCLUSION This population-based cohort study included a large sample size followed by long-term follow-up. The association between marriage, health, and reduced mortality in older individuals has been illustrated in this study. Being married or separated was associated with a lower risk of mortality.
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Affiliation(s)
- Lei Wang
- Department of Cardiology, Aerospace Center Hospital, 15 Yuquan Road, Haidian District, 100049, Beijing, PR China
| | - Zhong Yi
- Department of Geriatric Medicine, Aerospace Center Hospital, 15 Yuquan Road, Haidian District, 100049, Beijing, PR China.
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Axinn WG, Banchoff E, Cole F, Ghimire DJ, Smoller JW. The transition to parenthood, opportunity to drink, drinking, and alcohol use disorder. Drug Alcohol Depend 2022; 241:109697. [PMID: 36423463 PMCID: PMC10314724 DOI: 10.1016/j.drugalcdep.2022.109697] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND This study used life histories from a setting of near universal marriage and childbearing (Nepal) to identify associations between both marital transitions and the transition into parenthood and alcohol use and disorder (AUD). METHODS A retrospective, cross-sectional survey using life history calendars documented lifetime marital and childbearing histories of 4876 men and 5742 women aged 15-59 in 2016-18. The clinically validated, Nepal-specific Composite International Diagnostic Interview assessed first alcohol use opportunity, use, and disorder. RESULTS Being never married increased the odds of having the opportunity to drink for men (OR=1.30, 95% CI=1.14 - 1.48, p < 0.001) and women (OR=1.24, 95% CI=1.08 - 1.43, p = 0.003) compared to being married. While men were never married, widowed, or divorced they were at a greater risk of developing AUD. The transition to parenthood significantly increased the odds of AUD onset for men (OR=1.71, 95% CI=1.12 - 2.61, p = 0.013), independent of marital transitions. For women in this setting, becoming divorced increased the odds of having their first drink (OR=1.77, 95% CI=1.14 - 2.75, p = 0.011). Giving birth to a first child also increased the odds of first opportunity to drink for women (OR=1.30, 95% CI=1.07 - 1.57, p = 0.008). CONCLUSIONS We found associations between marital transitions and AUD that are consistent with findings worldwide. In this setting of near universal childbearing, the transition into fatherhood increased the odds of postpartum AUD among men.
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Affiliation(s)
- William G Axinn
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA.
| | - Emma Banchoff
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA
| | - Faith Cole
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA
| | - Dirgha J Ghimire
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA
| | - Jordan W Smoller
- Department of Psychiatry and Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge St., Boston, MA 02114, USA
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Jennings EA, Chinogurei C, Adams L. Marital experiences and depressive symptoms among older adults in rural South Africa. SSM - MENTAL HEALTH 2022; 2:100083. [PMID: 36277994 PMCID: PMC9581082 DOI: 10.1016/j.ssmmh.2022.100083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 02/23/2022] [Accepted: 02/26/2022] [Indexed: 01/21/2023] Open
Abstract
This paper advances the understanding of how marital transitions may influence mental health by investigating these associations among a population of rural, Black South Africans aged 40+ that was directly impacted by apartheid. Using two waves of data from 4,176 men and women in Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we investigated associations between marital experiences and depressive symptoms, by gender, and explored whether economic resources is a moderator of these associations. We found that experiencing a marital dissolution was associated with more depressive symptoms than remaining married for both men and women. We also found that men, but not women, report greater depressive symptoms if they remained separated/divorced, remained widowed, or remained never married between waves. We found no evidence that a decline in wealth moderated the impact of marital dissolution on depressive symptoms for women or men. These findings suggest that the documented benefits of marriage for mental health, and differences by gender in those benefits, may extend to older, rural South Africans, despite the unique experiences of this population.
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Affiliation(s)
- Elyse A. Jennings
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, USA
| | - Chido Chinogurei
- School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Leslie Adams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Jennings EA, Farrell M, Liu Y, Montana L. Associations between cognitive function and marital status in the U.S., South Africa, Mexico, and China. SSM Popul Health 2022; 20:101288. [DOI: 10.1016/j.ssmph.2022.101288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/11/2022] [Accepted: 11/09/2022] [Indexed: 11/19/2022] Open
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Meng J, Liu E, Xiang N, Yue Z. Can community-based care moderate widowhood's health impact? -A longitudinal study among older Chinese adults. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5725-e5734. [PMID: 36200763 DOI: 10.1111/hsc.14002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/29/2022] [Accepted: 08/20/2022] [Indexed: 06/16/2023]
Abstract
The plethora of pathways leading to health problems of later life has made the causal assessment of widowhood on the health of older adults difficult. This research aimed to assess the short-term impact of widowhood on the objective health of older adults and to the moderating role of community-based care (CBC) in improving the health outcomes of older adults. In this study, the activities of daily living (ADLs) and number of hospitalisations of older adults were measured, and PSM-DID models were conducted. Widowhood had a significant negative impact on the objective health of older adults. Widowed adults had higher ADL scores (B = 0.569, 95 percent CI: 0.295 to 0.844) and more hospitalisations (B = 2.551, 95 percent CI: 1.189 to 3.914) than nonwidowed adults. Meanwhile, CBC in urban areas can significantly reduce ADL scores (B = -0.154, SE = 0.082) and the number of hospitalisations (B = -1.402, SE = 0.348) in older adults, whereas CBC in rural areas can only significantly reduce ADL scores (B = -0.197, SE = 0.087). Taken together, there is an urgent need to focus on the health of widowed and older adults and to provide CBC in both urban and rural areas equally.
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Affiliation(s)
- Jia Meng
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Erpeng Liu
- Institute of Income Distribution and Public Finance, Zhongnan University of Economics and Law, Wuhan, China
| | - Nan Xiang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Zhang Yue
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
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Hermosilla S, Choi KW, Askari MS, Marks T, Denckla C, Axinn W, Smoller JW, Ghimire D, Benjet C. What can we learn about polytrauma typologies by comparing population-representative to trauma-exposed samples: A Nepali example. J Affect Disord 2022; 314:201-210. [PMID: 35810829 PMCID: PMC9869468 DOI: 10.1016/j.jad.2022.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 06/14/2022] [Accepted: 07/03/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Potentially traumatic events (PTEs) are common and associated with detrimental outcomes over the life-course. Previous studies exploring the causes and consequences of PTE-exposure profiles are often from high-income settings and fail to explore the implications of sample selection (i.e., population-representative versus PTE-restricted). METHODS Among individuals in the Nepal Chitwan Valley Family Study, latent class analyses (LCA) were performed on 11 self-reported PTEs collected by the Nepali version of the World Mental Health Consortium's Composite International Diagnostic Interview 3.0 from 2016 to 2018, in a population-representative sample (N = 10,714), including a PTE-restricted subsample (N = 9183). Multinomial logistic regressions explored relationships between sociodemographic factors and class membership. Logistic regressions assessed relationships between class membership and psychiatric outcomes. RESULTS On average, individuals were exposed to 2 PTEs in their lifetime. A five-class solution showed optimal fit for both samples; however, specific classes were distinct. No single sociodemographic factor was universally associated with PTE class membership in the population-representative sample; while several factors (e.g., age, age at incident PTE, education, marital status, and migration) were consistently associated with class membership in the PTE-subsample. PTE class membership differentiated psychiatric outcomes in the population-representative sample more than the PTE-subsample. LIMITATIONS Primary limitations are related to the generalizability to high-income settings, debate on LCA model fit statistic usage for final class selection, and cross-sectional nature of data collection. CONCLUSIONS Although population-representative samples provide information applicable to large-scale, population-based programming and policy, PTE-subsample analyses may provide additional nuance in PTE profiles and their consequences, important for specialized prevention efforts.
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Affiliation(s)
- Sabrina Hermosilla
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, USA.
| | - Karmel W Choi
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA
| | - Melanie S Askari
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, USA
| | - Taylor Marks
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, USA
| | - Christy Denckla
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - William Axinn
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, USA
| | - Jordan W Smoller
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA
| | - Dirgha Ghimire
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, USA; Institute for Social and Environmental Research-Nepal, Chitwan, Nepal
| | - Corina Benjet
- Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
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New insight into chronic pruritus' characteristics and association with the demographic characteristics and sleep of community-dwelling older adults in Taiwan. Geriatr Nurs 2022; 46:21-26. [PMID: 35594646 DOI: 10.1016/j.gerinurse.2022.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 11/23/2022]
Abstract
This study aimed to understand the characteristics of chronic pruritus (CP), its correlations with sleep quality and demographic characteristics, and its impacts on sleep of older adults. This study used convenience sampling to recruit adults aged 65 or older and living at home. The prevalence rate of CP in older adults was 25.8%. Most subjects with CP reported mild pruritus on 1-2 anatomical parts, especially the lower extremities. Overall, the five domains of CP were correlated with the seven components of sleep quality (r > .14; p > .05) except for sleep disturbance. The global itchy scores were significantly different between different sexes, educational attainments, and marital statuses (p<.05-.001). CP, sex, and the number of comorbid diseases significantly contributed to global sleep quality (β = .26, -.19, .15, respectively; .000 ≤ p ≤ .011). This study provides new insight into the correlations of CP with marital status and educational attainment.
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Zhang Y, Axinn WG. Marital Experiences and Depression in an Arranged Marriage Setting. AJS; AMERICAN JOURNAL OF SOCIOLOGY 2021; 126:1439-1486. [PMID: 34720111 PMCID: PMC8550576 DOI: 10.1086/714272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Understanding the consequences of marital experiences for individual mental health provides insight into how social relationships shape individual wellbeing. Using newly available, clinically validated diagnostic interviews with more than 10,000 respondents integrated with the longitudinal Chitwan Valley Family Study (CVFS), we assess the associations between marital experiences, intimate partner violence (IPV), and mental health and how they differ by gender in a setting of universal marriage-Nepal. Particularly novel, we integrate measures of arranged marriage, IPV, and marital quality into a single comprehensive analysis of the marital experiences shaping subsequent depression. This study reveals that becoming married can be positively associated with major depressive disorder (MDD) for women. IPV is a strong and independent risk factor for depression, but it only mediates a small portion of the consequences of marriage on depression. Among women, having no say at all in the selection of a spouse is also a strong and independent risk factor for depression, and IPV can only mediate a small portion of the consequences of arranged marriage on depression. We also investigate the associations between the positive (i.e., husband-wife emotional bond) and negative (i.e., spousal criticism and disagreement) dimensions of marital quality and depression. Frequent spousal disagreement significantly increases depression for women, but strong husband-wife emotional bond is not significantly associated with depression. Overall, the associations between marital experiences and mental health should be understood as contingent on both gender and the social contexts of marriage. Depending on these factors, specific marital experiences have the potential to increase transitions to depression, not just protect from depression.
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Affiliation(s)
- Yang Zhang
- Department of Sociology, and Population Studies Center, University of Michigan
| | - William G. Axinn
- Department of Sociology and Public Policy, Population Studies Center, and Survey Research Center, University of Michigan
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