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Sichalwe MM, Mwesiga CC, Kessy AT, Behera MR. Factors affecting utilization of outpatient healthcare services among the elderly population in Butiama and Musoma districts, Tanzania: A community-based cross-sectional study. PLoS One 2024; 19:e0304687. [PMID: 39028733 PMCID: PMC11259282 DOI: 10.1371/journal.pone.0304687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/16/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND In Tanzania and Sub-Saharan Africa, the elderly population has grown significantly due to improved quality of life, subsequently leading to prolonged life expectancy. Despite global development initiatives, elders still face insufficient care. Through a community-based investigation, this study assessed outpatient department (OPD) healthcare utilization and its determinants among the elderly in Butiama and Musoma districts, Tanzania. METHODOLOGY This study involved 415 elderly individuals aged 60 or older in Tanzania's Butiama and Musoma districts. Structured questionnaires were used to gather data, and the results were analyzed using SPSS 22. Univariate analysis utilized descriptive statistics, bivariate analysis involved cross-tabulation data, and multivariate logistic regression identified factors influencing OPD service utilization. RESULTS Approximately 43.4% of participants used OPD services in the past year. Divorced or separated individuals were over two times more likely to utilize OPD services compared to single participants. This association was statistically significant (OR 1.958; 95% CI 1.001-3.829; p = 0.05). About 74.5% of surveyed elders held a positive perception of OPD utilization. Although not statistically significant (p>0.05), individuals with a positive perception had 1.167 times higher odds of using OPD services (95% CI 0.746-1.826). CONCLUSION This study highlights a low overall utilization rate of OPD healthcare services among the elderly. Elderly individuals aged 80 years or older, along with widowed or divorced individuals, encounter specific barriers when accessing healthcare services. Positive perceptions play a crucial role in influencing healthcare utilization. It is essential to proactively offer tailored support and conduct further research, specifically addressing the distinct needs of divorced and widowed individuals when seeking healthcare services.
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Affiliation(s)
- Magnus Michael Sichalwe
- Family Welfare, Primary Health and Preventive Services Organisation, Morogoro, Tanzania
- Department of Community Health, Butiama District Hospital, Butiama, Tanzania
| | - Chrisostom Charles Mwesiga
- Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
- African Medical and Research Foundation, Dar es Salaam, Tanzania
| | - Anna Tengia Kessy
- Muhimbili University of Health and Allied Sciences, School of Public Health and Social Sciences, Dar es Salaam, Tanzania
| | - Manas Ranjan Behera
- Kalinga Institute of Industrial Technology, Kalinga Institute of Industrial Technology Deemed to Be University, School of Public Health, Odisha, India
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Abebe SA, Gashaw ZM, Ayichew Z, Angaw DA, Kindie EA. Prevalence and associated factors of depression among women with advanced pelvic organ prolapse in Northwest Ethiopia: cross-sectional study. BMC Womens Health 2024; 24:313. [PMID: 38816695 PMCID: PMC11137946 DOI: 10.1186/s12905-024-03162-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 05/27/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Depression is a symptom characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness and poor concentration. One of the most common mental illnesses in the world and a major contributor to morbidity and mortality is depression. The purpose of this study was to ascertain the prevalence of depression and the risk factors associated with it in women who had advanced pelvic organ prolapse. METHODS A facility-based cross-sectional study was conducted to determine depression among advanced pelvic organ prolapse women at Gondar University Comprehensive Specialized Hospital. All women who have advanced pelvic organ prolapse were consecutively included till it reached a total of 367 participants over four months. A structured questionnaire was used to obtain the sociodemographic characteristics, clinical characteristics and depression status of the participants. Depression measures were obtained by using the Patient Health Questionnaire tool, which is validated in the Ethiopian local language for chronic illnesses including pelvic organ prolapse using a cut point of five and above, which is considered to indicate depression. Women who screened positive were linked to a psychiatric clinic for further evaluation and treatment. Data was entered into a computer using Epi Info version 3.5.3 and then exported to STATA version 14 for analysis. Multivariable logistic regressions were fitted and odds ratios with 95% confidence intervals with a P value less than 0.05 were used to identify statistically significant factors. RESULTS The prevalence of depression was found to be 47.1% (95% CI: 43-52%). Being rural (AOR = 4.8; CI: 1.11-16.32), having a history of divorce because of pelvic organ prolapse (AOR = 5.5; CI: 1.85-16.32) and having a history of urinary symptoms (AOR = 3.1; CI: 1.12-8.59) were found to be independently associated with depression. CONCLUSIONS The prevalence of depression among women with advanced pelvic organ prolapse in this study is high as compared to other studies. Depression screening strategies should be designed for the early identification and treatment of depression among women with advanced pelvic organ prolapse.
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Affiliation(s)
- Sileshi Ayele Abebe
- Department of Gynecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Zelalem Mengistu Gashaw
- Department of Gynecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zelalem Ayichew
- Department of Gynecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Public Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Endeshaw Asaye Kindie
- Department of Pathology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Zhang D, Zheng W, Li K. The relationship between marital status and cognitive impairment in Chinese older adults: the multiple mediating effects of social support and depression. BMC Geriatr 2024; 24:367. [PMID: 38658842 PMCID: PMC11040757 DOI: 10.1186/s12877-024-04975-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Marital status is a potentially essential factor for cognitive impairment. Relevant research examining the potential pathways through which the marital status of spouseless older people is associated with cognitive impairment needs to be more adequate. Therefore, this study aims to investigate the serial mediating effects of various forms of social support and depression between marital status and cognitive impairment in older Chinese people. METHODS This study involved a secondary analysis of data from the 2014-2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), with a total of 2,647 Chinese older adults and 53.6% being males. Mediation analysis using the SPSS process macro was conducted. RESULTS The results indicated that marital status was significantly predictive of cognitive impairment among older people, and those with a spouse exhibited higher cognitive functioning. Informal social support and depression were found to play partial mediating roles in the association between marital status and cognitive impairment. The findings also revealed that marital status was unrelated to formal social support, and no association between formal social support and cognitive impairment was found. CONCLUSIONS The study findings highlight the need for social service providers to design programs for promoting connections associated with informal support to reduce their risk of depression and cognitive impairment and for policymakers to develop effective formal social support systems for older people without spouses. This study indicated that older people could regain the benefits of marriage to lower the risk of depression and improve their mental health.
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Affiliation(s)
- Donghang Zhang
- Department of Innovative Social Work, Faculty of Humanities and Social Sciences, City University of Macau, Macao, China
| | - Wenhao Zheng
- Faculty of Humanities and Social Sciences, City University of Macau, Avenida Padre Tomás Pereira Taipa, 999078, Macao, China
| | - Keyang Li
- Faculty of Humanities and Social Sciences, City University of Macau, Avenida Padre Tomás Pereira Taipa, 999078, Macao, China.
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Cecchini V, Agahi N. Does losing family members in midlife matter for late-life mental and cognitive health? A longitudinal study of older Swedes spanning 30 years. Aging Ment Health 2024:1-9. [PMID: 38644675 DOI: 10.1080/13607863.2024.2341877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/05/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES Mental and cognitive health is crucial to ensure well-being in older age. However, prolonged periods of stress, grief, and bereavement might compromise mental health balance, leading to profound changes. This study investigated the sex-stratified associations between midlife bereavement experiences (e.g. sibling loss, spousal loss, and multiple losses) and late-life depression (LLD) and cognitive impairment. METHOD Linked data from the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were used. Multiple logistic regressions were performed to examine the associations between midlife bereavement and LLD (n = 1078) and cognitive impairment (n = 995), separately. RESULTS Sibling loss and multiple losses in midlife were associated with lower odds of LLD, especially among women. Among men, sibling loss in midlife was associated with lower odds of cognitive impairment, while the experience of two losses among women suggested an increased (but non-significant) risk of cognitive impairment. Interaction analyses did not show significant effects between bereavement and gender on LLD and cognitive impairment. CONCLUSION Midlife bereavement might have gendered implications on LLD and cognitive impairment, but associations need to be confirmed by well-powered studies. Further research is warranted to elucidate the association between multiple midlife losses and reduced LLD risk.
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Affiliation(s)
- Valeria Cecchini
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Hu Y, Metsä-Simola N, Malmberg S, Martikainen P. Trajectories of antidepressant use before and after union dissolution and re-partnering in later life: a prospective total population register-based cohort study. J Epidemiol Community Health 2024; 78:277-283. [PMID: 38320855 DOI: 10.1136/jech-2023-221529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/16/2023] [Indexed: 04/12/2024]
Abstract
BACKGROUND Grey divorce and later remarriage have become increasingly common in high-income countries, but previous evidence on their impacts on mental health is scarce. Even less is known about the effects of non-marital separation and re-partnering in later life. METHODS Using Finnish registry data from 1996 to 2018 on 228 644 individuals aged 50-70 in 2000-2014, trajectories of antidepressant (AD) use 4 years before and 4 years after divorce, non-marital separation, bereavement and subsequent re-partnering were examined using individual fixed-effects (FE) linear probability models. RESULTS In adjusted FE models, for both genders AD use increased during the 4 years before divorce (men: 5.00 percentage points (95% CI 4.50 to 5.50); women: 6.96 (95% CI 6.34 to 7.59)), non-marital separation (men: 3.20 (95% CI 2.72 to 3.69); women: 5.98 (95% CI 5.30 to 6.66)) and bereavement (men: 4.53 (95% CI 3.97 to 5.09); women: 5.64 (95% CI 5.25 to 6.04)), with the increase accelerating immediately before the event. AD use gradually declined after union dissolution, after which it stabilised on a persistently higher level compared with pre-dissolution. Re-partnering was only associated with a small and transitory reduction in AD use (0.1-1.5 percentage points). The increases in AD use associated with union dissolution were larger in women than in men, whereas the small reductions in AD use associated with re-partnering were particularly short-lived among women. CONCLUSIONS Our results suggest that union dissolution in later life is associated with large and persistent increases in AD use, whereas the reductions associated with re-partnering are limited both in magnitude and duration.
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Affiliation(s)
- Yaoyue Hu
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Niina Metsä-Simola
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Satu Malmberg
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Max Planck Institute for Demographic Research, Rostock, Mecklenburg-Vorpommern, Germany
- Max Planck - University of Helsinki Center for Social Inequalities in Population Health, Helsinki, Finland
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Mohd Tamil A, Ismail NH, Jaafar MH, Md Isa Z, Ismail R, Mat Nasir N, Miskan M, Zainol Abidin N, Ab Razak NH, Joundi R, Yusof KH. Depressive symptoms among adults: Baseline findings of PURE Malaysia cohort study. Heliyon 2024; 10:e23042. [PMID: 38192831 PMCID: PMC10772557 DOI: 10.1016/j.heliyon.2023.e23042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction In Malaysia, the prevalence of depression has increased from 1.8 % to 2.3 % within a decade. Thus, this study was performed to identify depressive symptoms and its associated factors among Malaysian adults. Methods A cross-sectional study was conducted among the adult population aged 35-70 residing in rural and urban areas in Malaysia. Depressive symptoms were assessed using the short form Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Composite International Diagnostic Interview (CIDI) questionnaire. Logistic regression models were fitted to identify the associated factors related to depressive symptoms. Results About 3.7 % (95 % CI: 2.33-4.83) of the respondents reported having depressive symptoms. Younger adults aged 35-40 years old (AOR: 3.087; 95 % CI: 2.021-4.717), females (AOR: 2.318; 95 % CI: 1.669-3.219), widows and divorcees (AOR: 2.294; 95 % CI: 1.085-4.848), smokers (AOR: 1.843; 95 % CI: 1.334-2.545) and alcohol consumers (AOR: 1.843; 95 % CI: 1.264-2.688) showed a higher odds compared to their other counterparts. Underweight individuals (AOR: 1.899; 95 % CI: 1.177-3.065) and those diagnosed either with hypertension (AOR: 1.442; 95 % CI: 1.11-1.873), diabetes (AOR: 1.554; 95 % CI: 1.133-2.13), angina (AOR: 2.73; 95 % CI: 1.596-4.67), COPD (AOR: 4.187; 95 % CI: 1.528-11.472) or asthma (AOR: 1.906; 95 % CI: 1.309-2.774) were more likely to have depressive symptoms. Additionally, individuals with difficulty trusting people (AOR: 1.477; 95 % CI: 1.024-2.13) and those reported to experience either home or work-related stress (AOR: 2.584; 95 % CI: 2.003-3.331) were more prone to have depressive symptoms. Conclusion In this broad population-based study, about 3.7 % (95 % CI: 2.33-4.83) of respondents reported having depressive symptoms. Timely and well targeted collaborative intervention on the identified risk factors by the relevant authorities, would mitigate their effect on the quality of life and retard the progression into depression, especially among younger adults.
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Affiliation(s)
- Azmi Mohd Tamil
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Noor Hassim Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Mohd Hasni Jaafar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Zaleha Md Isa
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Rosnah Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Nafiza Mat Nasir
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor Branch, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia
| | - Maizatullifah Miskan
- Department of Primary Care Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Sungai Besi, 57000 Kuala Lumpur, Malaysia
| | - Najihah Zainol Abidin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
- Department of Diagnostic and Allied Health Science, Faculty of Health and Life Sciences, Management and Science University, 40100 Shah Alam, Selangor, Malaysia
| | - Nurul Hafiza Ab Razak
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Raed Joundi
- Division of Neurology, Hamilton Health Sciences, McMaster University and Population Health Research Institute, Hamilton General Hospital, Hamilton, ON, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Khairul Hazdi Yusof
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
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Sheftel MG, Margolis R, Verdery AM. Life Events and Loneliness Transitions Among Middle-Aged and Older Adults Around the World. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad149. [PMID: 37801643 PMCID: PMC10745269 DOI: 10.1093/geronb/gbad149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Indexed: 10/08/2023] Open
Abstract
OBJECTIVES Adult loneliness is a substantial social problem and a growing point of concern for policymakers around the world. We assess whether the predictors of loneliness onset among middle-aged and older adults vary from country to country in a large array of settings across world regions. Taking a life course perspective, we focus on common life events in our focal age range, including changes in partnership, coresidence, work, and health, and we test whether changes in them have comparable prospective associations with loneliness onset in different countries. METHODS We draw on respondent-level data from a diversity of world regions surveyed in 7 harmonized cross-national studies in 20 countries, representing 47% of the global population over the age of 50. Our innovative longitudinal approach estimates prospective transition probability models that examine how each life event predicts the transition into loneliness. RESULTS Despite substantial variation in the prevalence of loneliness and life events across the range of countries in our sample, our results highlight consistency in the predictors of loneliness transitions. Family and household changes like divorce, coresidence, and especially widowhood are paramount predictors of loneliness transition across settings, with changes in work and health playing more minor and less universal roles. DISCUSSION The results demonstrate the importance that family and household connections play in determining loneliness at these ages. These findings suggest that addressing late-life loneliness may require a focus on key life events, especially those concerning changes in families and households.
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Affiliation(s)
- Mara Getz Sheftel
- Population Research Institute, Pennsylvania State University, State College, Pennsylvania, USA
| | - Rachel Margolis
- Department of Sociology, University of Western Ontario, London, Ontario, Canada
| | - Ashton M Verdery
- Department of Sociology & Demography, Pennsylvania State University, State College, Pennsylvania, USA
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Cha H, Thomas PA. A Time of Healing: Can Social Engagement After Bereavement Reduce Trajectories of Depression After the Death of a Child? J Gerontol B Psychol Sci Soc Sci 2023; 78:1717-1726. [PMID: 37338825 PMCID: PMC10561884 DOI: 10.1093/geronb/gbad094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVES We work from a stress and life-course perspective to examine the mental health of parents who experienced the death of their child. We examine whether mental health eventually returns to pre-bereavement levels and how social engagement after bereavement may shape the recovery process of depressive symptoms. METHODS We analyze discontinuous growth curve models to assess the association between a child's death and trajectories of parents' depressive symptoms from the 1998-2016 Health and Retirement Study. The sample includes 16,182 parents aged 50 years and older. RESULTS Those who transitioned to bereavement experienced an elevation in depressive symptoms and a relatively long recovery time (e.g., 7 years) to their pre-bereavement mental health in our findings. However, when engaging in volunteer work after their loss, depressive symptoms reduce more quickly to their pre-bereavement levels. Volunteering offsets up to 3 years of the negative consequences of child loss. DISCUSSION The death of a child is a traumatic event with extensive health consequences, but research should more fully examine the dynamic nature and potential mitigation of these health consequences over time. Our findings expand the temporal lens to encompass healing processes after bereavement, incorporating the importance of social engagement.
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Affiliation(s)
- Hyungmin Cha
- Department of Sociology, Center on Aging and Population Sciences and Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Patricia A Thomas
- Department of Sociology, Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, USA
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Okyere J, Budu E, Ahinkorah BO, Aboagye RG, Seidu AA, Yaya S. Rural-urban differentials in the association between sex preference for children and marital dissolution in sub-Saharan Africa. PLoS One 2023; 18:e0291435. [PMID: 37796822 PMCID: PMC10553262 DOI: 10.1371/journal.pone.0291435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/30/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Marital dissolution, which refers to being divorced or separated, is considered one of the most dramatic demographic events that significantly disrupt families. Unearthing the factors predicting marital dissolution would support actions to reduce the incidence of this phenomenon. The present study sought to examine the association between sex preference for children and marital dissolution segregated by place of residence. METHODS Data for the study were extracted from the most recent Demographic and Health Surveys (DHS) of 25 countries in sub-Saharan Africa. Percentages were used to summarise the proportion of marital dissolution among women in sub-Saharan Africa. Binary logistic regression models were fitted to examine the association between sex preference for children and marital dissolution per place of residence. Results of the regression analysis were presented using adjusted odds ratios (aOR) with their respective 95% confidence interval (CI). RESULTS The overall prevalence of marital dissolution was 5.92% (95% CI: 5.83-6.00), and this ranged from 1.63% (95% CI: 1.41-1.85) in Burkina Faso to 15.62% (95% CI: 14.70-16.54) in Mozambique. In urban sub-Saharan Africa, the overall prevalence of marital dissolution was 8.88% (95% CI:8.78-8.99), with the lowest prevalence in Mali (3.30%; 95% CI: 2.91-3.69) and the highest in Uganda (18.60%; 95% CI: 17.95-19.25). For rural sub-Saharan Africa, the pooled prevalence was 4.11% (95% CI: 4.03-4.18), with the lowest (0.80%; 95% CI: 0.65-0.95) and highest (14.40%; 95% CI: 13.51-15.29) prevalences in Burkina Faso and Mozambique, respectively. Compared to women with no sex preference, the preference for boys was less likely to result in marital dissolution (aOR = 0.87; 95%CI = 0.83-0.90) in both urban and rural areas, whereas the preference for girls was more likely to result in marital dissolution (aOR = 1.06; 95%CI = 1.02-1.10). When the results were disaggregated by place of residence, in both urban (aOR = 0.87; 95%CI = 0.80-0.95) and rural areas (aOR = 0.87; 95%CI = 0.82-0.92), women who preferred boys were less likely to experience marital dissolution compared to those who had no preference. However, the preference for girls showed no statistically significant association with marital dissolution. CONCLUSION Our study has shown that sex preference for children has a significant association with marital dissolution in both rural and urban areas in sub-Saharan Africa. Whereas the preference for male children serves as a protective factor against marital dissolution, the preferences for females was found to increase the likelihood of marital dissolution. Thus, underscoring a need for anti-marital dissolution campaigns and initiatives to prioritise the sensitisation of society about the value of female children. Religious groups and leaders can leverage their platform to quell sex preferences and dissuade marital dissolution. Policies and programmes aimed at reducing the risk of marital dissolution in sub-Saharan Africa must also focus on enlightening the population on intimate partner violence prevention.
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Affiliation(s)
- Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
- REMS Consult Limited, Sekondi-Takoradi, Western Region, Ghana
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Abdul-Aziz Seidu
- REMS Consult Limited, Sekondi-Takoradi, Western Region, Ghana
- Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Australia
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College London, London, United Kingdom
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Rauf T. Differential sensitivity to adversity by income: Evidence from a study of Bereavement. SOCIAL SCIENCE RESEARCH 2023; 115:102920. [PMID: 37858363 DOI: 10.1016/j.ssresearch.2023.102920] [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: 04/19/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 10/21/2023]
Abstract
Adverse life events are often understood as having negative consequences for mental health via objective hardships, which are worse for persons with less income. But adversity can also affect mental health via more subjective mechanisms, and here, it is possible that persons with higher income will exhibit greater psychological sensitivity to negative events, for various reasons. Drawing on multiple sociological literatures, this article theorizes potential mechanisms of increasing sensitivity with income. The proposition of differential sensitivity is tested using the strategic case of spousal and parental bereavement among older US adults. The analyses find consistent evidence of increasing sensitivity of depressive symptoms with income. A series of robustness checks indicate that findings are not due to endogenous or antecedent selection. Further, exploratory analyses of mechanisms suggest that higher sensitivity among the affluent was driven by greater expectations and better relationship quality with the deceased. These findings problematize the conceptualization and assessment of human suffering in economically stratified societies.
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Affiliation(s)
- Tamkinat Rauf
- Department of Sociology, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI, 53706, USA.
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Meulman I, Loef B, Stadhouders N, Moger TA, Wong A, Polder JJ, Uiters E. Estimating healthcare expenditures after becoming divorced or widowed using propensity score matching. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:1047-1060. [PMID: 36251142 PMCID: PMC10406688 DOI: 10.1007/s10198-022-01532-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
Becoming divorced or widowed are stressful life events experienced by a substantial part of the population. While marital status is a significant predictor in many studies on healthcare expenditures, effects of a change in marital status, specifically becoming divorced or widowed, are less investigated. This study combines individual health claims data and registered sociodemographic characteristics from all Dutch inhabitants (about 17 million) to estimate the differences in healthcare expenditure for individuals whose marital status changed (n = 469,901) compared to individuals who remained married, using propensity score matching and generalized linear models. We found that individuals who were (long-term) divorced or widowed had 12-27% higher healthcare expenditures (RR = 1.12, 95% CI 1.11-1.14; RR = 1.27, 95% CI 1.26-1.29) than individuals who remained married. Foremost, this could be attributed to higher spending on mental healthcare and home care. Higher healthcare expenditures are observed for both divorced and widowed individuals, both recently and long-term divorced/widowed individuals, and across all age groups, income levels and educational levels.
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Affiliation(s)
- Iris Meulman
- Center for Health and Society, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
| | - Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Niek Stadhouders
- Scientific Center for Quality of Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tron Anders Moger
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Albert Wong
- Department of Statistics, Informatics and Modeling, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Johan J Polder
- Center for Health and Society, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Ellen Uiters
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Mellencamp KA. Gender Differences in Depressive Symptoms Following Child Death in Later Life. J Gerontol B Psychol Sci Soc Sci 2023; 78:1591-1603. [PMID: 36462213 PMCID: PMC10461527 DOI: 10.1093/geronb/gbac189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVES This study examined short- and long-term psychological adjustment to parental bereavement in later life for mothers and fathers. METHODS Using 9 waves of data from the United States (1998-2014 Health and Retirement Study), I estimated trajectories of mothers' and fathers' depressive symptoms surrounding child death in later life, highlighting gender differences in adjustment. Moderation analyses were performed to uncover heterogeneous trajectories across parental characteristics. RESULTS Mothers were more likely to experience child death and reported higher depressive symptoms prior to parental bereavement than fathers. Mothers and fathers who lost a child reported an increase in depressive symptoms that diminished over time. The short-term elevation in depressive symptoms was marginally greater for mothers than fathers, but depressive symptoms declined at a faster rate for mothers than fathers in the years following the death. These counterbalancing changes resulted in mothers and fathers returning to their respective prebereavement levels of depressive symptoms between 2 and 4 years postbereavement. Parental age moderated trajectories distinctly by gender, and the presence of surviving children buffered the impact of child death on depressive symptoms for mothers but not fathers. DISCUSSION Mothers more often experience child death in later life and their adjustment process differs from that of fathers, underscoring the salience of gender in shaping how older parents respond to the death of a child. Older parents and mothers without surviving children are vulnerable to prolonged elevations in depressive symptoms following the death of a child in later life.
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Affiliation(s)
- Kagan A Mellencamp
- Department of Sociology, Bowling Green State University, Bowling Green, Ohio, USA
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13
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Brown SL, Lin IF, Mellencamp, PhD KA. A Brief Report on Living Arrangements Following Gray Divorce. J Gerontol B Psychol Sci Soc Sci 2023; 78:1396-1401. [PMID: 36842065 PMCID: PMC10394990 DOI: 10.1093/geronb/gbad035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Indexed: 02/27/2023] Open
Abstract
OBJECTIVES We offer new insights on how older adults in the United States navigate the aftermath of gray divorce (i.e., divorce that occurs among adults aged 50+) by describing their living arrangements upon divorce and tracking the stability of these configurations over time. Living arrangements are important to decipher because they are linked to health, well-being, and longevity. METHODS Using data from the 1998-2014 Health and Retirement Study, we uncovered patterns of U.S. older adult living arrangements upon divorce (N = 1,057), distinguishing among those who lived alone, lived with others, and lived with a new partner. Multinomial logistic regression models were estimated to assess how individual characteristics (demographics, marital biography, economic resources, health, and social ties) were associated with these configurations. Cumulative survival probabilities gauged the relative stability of these 3 living arrangements. RESULTS About half of U.S. adults lived alone upon gray divorce, another one-third lived with others, and the remaining 14% lived with a new partner. Adults living with a new partner tended to exhibit the most advantaged sociodemographic profiles, whereas those living solo or with others were largely comparable. More than 70% of adults experienced a subsequent living arrangement transition if they lived with others upon divorce, versus just 50% of those living alone and only 30% of those with a new partner. DISCUSSION After divorce, older adults reside in a range of living arrangements, some of which are more stable than others. Future work should address whether and how these arrangements and their durability are related to postdivorce adjustment.
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Affiliation(s)
- Susan L Brown
- Department of Sociology, 239 Williams Hall, Bowling Green State University, Bowling Green, Ohio,USA
| | - I-Fen Lin
- Department of Sociology, 217 Williams Hall, Bowling Green State University, Bowling Green, Ohio,USA
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14
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Yin R, Yang Y, Tang L, Chang Y, Zhang F. Childhood abuse and association with adult depressive symptoms among people with cardiovascular disease. Front Public Health 2023; 11:1179384. [PMID: 37333526 PMCID: PMC10273208 DOI: 10.3389/fpubh.2023.1179384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Background To study the association between the total/different types of childhood abuse and adult depressive symptoms in people with cardiovascular disease (CVD). Methods The subjects were people with CVD who continuously participated in the China Health and Retirement Longitudinal Study (CHARLS) life history survey and the 2018 wave of the CHARLS national baseline Survey. Multi-level logistic regression models were used to analyze the relationship between emotional neglect, physical neglect, physical abuse and adult depressive symptoms. Results A total of 4,823 respondents were included in this study. The incidence of childhood abuse (existed emotional neglect, physical neglect or physical abuse) was 43.58% among people over 45 years old with CVD, which was higher than that of the general population (36.62%, p < 0.05). Adjusted model showed that overall childhood abuse was associated with adult depressive symptoms (OR = 1.230, 95%CI:1.094-1.383). Among different types of childhood abuse, only physical abuse was associated with depressive symptoms in adulthood (OR = 1.345, 95%CI:1.184-1.528). Conclusion Compared with that of the general population, the incidence of childhood abuse in CVD population is higher. Physical abuse in childhood increased the risk of depressive symptoms in adulthood. It suggested that the occurrence of depressive symptoms was the result of related factors in the whole life course. In order to prevent the depressive symptoms, childhood abuse also needs to be considered. It is very important to identify and prevent the continuation of childhood abuse in time.
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Affiliation(s)
- Ruoyun Yin
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Yuan Yang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lei Tang
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Yujiao Chang
- Department of Infectious Disease, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fan Zhang
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
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15
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Delaruelle K, Vergauwen J, Dykstra P, Mortelmans D, Bracke P. Marital-history differences in increased loneliness during the COVID-19 pandemic: A European study among older adults living alone. Arch Gerontol Geriatr 2023; 108:104923. [PMID: 36634441 PMCID: PMC9815881 DOI: 10.1016/j.archger.2023.104923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/22/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
The COVID-19 pandemic and related physical distancing measures have disproportionally affected older adults living alone due to their greater social isolation. Unlike previous studies on the subject, the current research recognizes the diversity amongst older adults living alone by considering the impact of marital history. Combining information from Wave 8 of the Survey of Health Ageing and Retirement (SHARE), with data of SHARELIFE and the SHARE Corona survey, we investigated the differential impact of the COVID-19 pandemic on loneliness in older men (N = 1504) and women (N = 4822) living alone. Logistic multilevel analyses were performed on data from 26 European countries and Israel. For men, we found that the short-term widowed were more likely to report increased loneliness than the medium- and long-term widowed and those living apart together (LAT). For women, the results indicated that the short- and medium-term widowed and the divorced were at greater risk for increased loneliness than those in a LAT relationship. Also, medium-term widowed women were more likely to report increased loneliness than their long-term widowed counterparts. The three hypothesized underlying mechanisms - i.e., (i) the opportunity mechanism, (ii) the expectation mechanism, and (iii) the vulnerability mechanism - only played a small role in explaining the observed differences. In sum, our study highlights the importance of recognizing the diversity within the group of older adults living alone when investigating the effects of the pandemic on loneliness, yet the mechanisms behind the stratifying role of marital history are not fully understood.
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Affiliation(s)
- Katrijn Delaruelle
- Ghent University, Department of Sociology, Technicum T1, Sint-Pietersnieuwstraat 41, 9000 Ghent, Belgium.
| | - Jorik Vergauwen
- University of Antwerp, Department of Sociology, Sint-Jacobstraat 2, 2000 Antwerpen, Belgium
| | - Pearl Dykstra
- Erasmus University Rotterdam, Department of Public Administration and Sociology, Burg. Oudlaan 50, 3062 PA Rotterdam, The Netherlands
| | - Dimitri Mortelmans
- University of Antwerp, Department of Sociology, Sint-Jacobstraat 2, 2000 Antwerpen, Belgium
| | - Piet Bracke
- Ghent University, Department of Sociology, Technicum T1, Sint-Pietersnieuwstraat 41, 9000 Ghent, Belgium
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16
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Donnelly R, Cha H, Umberson D. Multiple Family Member Deaths and Cardiometabolic Health among Black and White Older Adults. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:610-625. [PMID: 35932108 PMCID: PMC10204236 DOI: 10.1177/00221465221114485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Although the bereavement literature is voluminous, we know very little about how exposure to multiple family member deaths across the life course shapes health trajectories as people age and whether unequal exposure to bereavement contributes to racial inequities in cardiometabolic health. We use longitudinal data from the Health and Retirement Study (1992-2016) to consider how multiple family member deaths before midlife shape trajectories of cardiometabolic health after age 50 for Black and white adults (n = 22,974). Results show that multiple family member deaths prior to age 50 are associated with more cardiometabolic conditions at age 50 and a faster increase in conditions with advancing age. Moreover, Black adults are significantly disadvantaged by a greater risk of bereavement and more cardiometabolic conditions regardless of bereavement status. The life course trauma of exposure to multiple family member deaths uniquely contributes to the cardiometabolic risk of Black Americans.
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Weitzel EC, Löbner M, Glaesmer H, Hinz A, Zeynalova S, Henger S, Engel C, Reyes N, Wirkner K, Löffler M, Riedel-Heller SG. The Association of Resilience with Mental Health in a Large Population-Based Sample (LIFE-Adult-Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15944. [PMID: 36498017 PMCID: PMC9740913 DOI: 10.3390/ijerph192315944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/17/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
Resilience describes a good adaptation to adversity. Strengthening resilience is a promising approach in the prevention of mental health problems. Yet, research on the association of resilience with mental health symptoms in the general population is scarce. The aim of our study is to examine comprehensively the association of resilience with depressive symptoms, anxiety, and perceived stress in a large population-based sample. We analyzed data of n = 3762 participants from the follow-up assessment of the LIFE-Adult-Study, a population-based cohort study in Leipzig. Assessments included resilience (RS-11), depressive symptoms (CES-D), anxiety (GAD-7), and perceived stress (PSQ). The association of resilience with mental health symptoms was examined via multiple linear regression analyses. In our analyses, higher resilience predicted less mental health problems and contributed significantly to the explained variance in mental health outcomes. Women, individuals with previous mental disorders, and those without employment had higher mental health symptoms. Resilience is closely associated with mental health problems in the general population. Vulnerable groups should be targeted with public health measures. Strengthening resilience is a promising approach in the large-scale prevention of mental disorders.
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Affiliation(s)
- Elena Caroline Weitzel
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Samira Zeynalova
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtel-Str. 16–18, 04107 Leipzig, Germany
| | - Sylvia Henger
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtel-Str. 16–18, 04107 Leipzig, Germany
| | - Christoph Engel
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtel-Str. 16–18, 04107 Leipzig, Germany
| | - Nigar Reyes
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtel-Str. 16–18, 04107 Leipzig, Germany
| | - Kerstin Wirkner
- LIFE—Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - Markus Löffler
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtel-Str. 16–18, 04107 Leipzig, Germany
- LIFE—Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
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18
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Recksiedler C, Cheval B, Sieber S, Orsholits D, Stawski RS, Cullati S. Linking widowhood and later-life depressive symptoms: Do childhood socioeconomic circumstances matter? Aging Ment Health 2022; 26:2159-2169. [PMID: 34494920 PMCID: PMC8901780 DOI: 10.1080/13607863.2021.1972930] [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: 01/17/2021] [Accepted: 08/16/2021] [Indexed: 01/25/2023]
Abstract
Objectives: Widowhood and adverse childhood socioeconomic circumstances (CSC) have both been linked to increased levels of depressive symptoms in old age. Beyond their independent impact on depressive symptoms, experiencing adverse CSC may also trigger a cascade of cumulative adversity and secondary stressors across the life course that shapes how individuals weather stressful life events later on.Method: We examine whether exposure to adverse CSC moderates the relationship between later-life widowhood and depressive symptoms using data from the Survey of Health, Ageing and Retirement in Europe (2004-2017).Results: Mixed-effects models revealed that both widowhood and adverse CSC were associated with increased levels of depressive symptoms among men and women. Associations between widowhood and depressive symptoms, however, were not moderated by CSC for both genders.Conclusion: Persisting differences in the levels of mental health in response to later-life widowhood did not further widen in the presence of disparities experienced early in the life course. This may reflect the life-altering impact of this age-normative, yet stressful life event across the social strata.
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Affiliation(s)
- Claudia Recksiedler
- Department of Social Monitoring and Methodology, German Youth Institute, Munich, Germany
| | - Boris Cheval
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Stefan Sieber
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
| | - Dan Orsholits
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
| | - Robert S. Stawski
- School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR, USA
| | - Stéphane Cullati
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
- Population Health Laboratory, University of Fribourg, Fribourg, Switzerland
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Umberson D, Lin Z, Cha H. Gender and Social Isolation across the Life Course. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:319-335. [PMID: 35856404 PMCID: PMC10409601 DOI: 10.1177/00221465221109634] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Social isolation has robust adverse effects on health, well-being, dementia risk, and longevity. Although most studies suggest similar effects of isolation on the health of men and women, there has been much less attention to gendered patterns of social isolation over the life course-despite decades of research suggesting gender differences in social ties. We build on theoretical frames of constrained choice and gender-as-relational to argue that gender differences in isolation are apparent but depend on timing in the life course and marital/partnership history. Results indicate that boys/men are more isolated than girls/women through most of the life course, and this gender difference is much greater for the never married and those with disrupted relationship histories. Strikingly, levels of social isolation steadily increase from adolescence through later life for both men and women.
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20
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Ralston M, Jennings E, Schatz E. Who is at Risk? Social Support, Relationship Dissolution, and Illness in a Rural Context. SOCIOLOGICAL INQUIRY 2022; 92:1053-1082. [PMID: 36059856 PMCID: PMC9436001 DOI: 10.1111/soin.12456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study focuses on a cohort of adults (40-plus) in rural South Africa to unpack associations between physical health and receipt of social support, and the extent to which these associations were moderated by marital status. We use logistic regression to estimate the odds of having received emotional, physical, or financial support separately for men (N = 2247) and women (N = 2609). Our results suggest having an Activity of Daily Living (ADL) limitation or having at least one chronic condition was not significantly associated with social support receipt for women, but having an ADL limitation was associated with reduced odds of receiving financial support among men. Although marital status was strongly and significantly associated with receipt of social support for both men and women, marital status moderated the relationship between health indicators and social support receipt only for men. Our findings suggest that when men, but not women, experience a marital dissolution and are suffering from a disability or a chronic condition, their networks respond by providing needed social support.
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Affiliation(s)
| | | | - Enid Schatz
- University of Missouri; University of the Witwatersand
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21
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Work and Family Transitions Throughout Adulthood and the Impact on Health: A Systematic Review. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09382-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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22
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Lin IF, Brown SL, Mellencamp KA. The Roles of Gray Divorce and Subsequent Repartnering for Parent-Adult Child Relationships. J Gerontol B Psychol Sci Soc Sci 2022; 77:212-223. [PMID: 34309664 PMCID: PMC8755893 DOI: 10.1093/geronb/gbab139] [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] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Divorce is now widespread in later life, yet little is known about how older adults and their adult children respond in the aftermath of gray divorce. Guided by the life course perspective, this study examines the consequences of gray divorce and subsequent repartnering for parent-adult child relationships from the parent's perspective. METHODS Using longitudinal data from the 1998-2014 Health and Retirement Study in the United States, we estimated growth curve models to compare fathers' and mothers' frequent contact with and financial support to their adult children prior to, during, and following gray divorce. RESULTS Gray divorce and repartnering had disparate effects on father- versus mother-adult child relationships. Following a divorce, fathers' frequent contact with their adult children decreased but financial support to their adult children increased. Fathers' repartnering had an enduring negative effect on frequent contact with their children. Gray divorce did not alter mothers' financial support to adult children and it actually increased interaction between mothers and adult children as the odds of frequent contact doubled upon divorce. Repartnering had no appreciable effects on mothers' relationships with their adult children. DISCUSSION The results of our study are consistent with prior research showing that divorce creates a matrifocal tilt in our kinship system. The shifting dynamics of parent-adult child relationships in response to gray divorce and repartnering raise questions about whether gray-divorced parents will be able to rely on their adult children for care as they age.
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Affiliation(s)
- I-Fen Lin
- Department of Sociology, Bowling Green State University, Ohio, USA
| | - Susan L Brown
- Department of Sociology, Bowling Green State University, Ohio, USA
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23
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Jopp DS, Lampraki C, Meystre C, Znoj H, Brodbeck J. Professional Support After Partner Loss: Likelihood and Correlates of Help-Seeking Behavior. Front Psychol 2021; 12:767794. [PMID: 34887814 PMCID: PMC8649630 DOI: 10.3389/fpsyg.2021.767794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Intimate partner loss in later life can be one of the most stressful events in adulthood. Individuals who struggle to adapt to the new life conditions may need support from a mental health professional. However, less is known about the likelihood to seek professional help after separation, divorce, or bereavement in later life and associated factors. This study investigated professional help-seeking (PHS) for partner loss after a long-term marriage in separated, divorced, and bereaved individuals and examined the extent to which specific person and event-related variables, as well as depressive symptoms, increase its likelihood. The data were derived from the LIVES "Intimate Partner Loss Study." The self-administered questionnaires were completed by 388 adults. PHS was higher after separation (57%) and divorce (49%), compared to widowhood (18%). Higher likelihood of PHS was associated with separation and divorce, female gender, having someone to count on, loss unexpectedness, needing more time to overcome the loss, and more depressive symptoms. Informing individuals unlikely to seek help (e.g., males, bereaved, and individuals with no confidant) about PHS benefits may facilitate adaptation to partner loss.
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Affiliation(s)
- Daniela S. Jopp
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- LIVES Center, Swiss Centre of Expertise in Life Course Research, Lausanne, Switzerland
| | - Charikleia Lampraki
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- LIVES Center, Swiss Centre of Expertise in Life Course Research, Lausanne, Switzerland
| | - Claudia Meystre
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- LIVES Center, Swiss Centre of Expertise in Life Course Research, Lausanne, Switzerland
| | - Hansjörg Znoj
- LIVES Center, Swiss Centre of Expertise in Life Course Research, Lausanne, Switzerland
- Institute of Psychology University of Bern, Bern, Switzerland
| | - Jeannette Brodbeck
- LIVES Center, Swiss Centre of Expertise in Life Course Research, Lausanne, Switzerland
- Institute of Psychology University of Bern, Bern, Switzerland
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Abrams LR, Clarke PJ, Mehta NK. Unmet Expectations About Work at Age 62 and Depressive Symptoms. J Gerontol B Psychol Sci Soc Sci 2021; 77:615-625. [PMID: 34173825 DOI: 10.1093/geronb/gbab113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Exiting the labor force earlier or later than planned is common, with predictable economic consequences. However, the mental health ramifications of such off-time events are not known but are important to promoting well-being in retirement. METHODS Using the Health and Retirement Study (1992-2016), we created six groups based on the alignment of expectations about full-time work at age 62 (reported at ages 51-61) with realized labor force status after reaching age 62 (N=10,421). Negative binomial models estimated the adjusted association between unmet expectations about work and depressive symptoms. RESULTS Unexpectedly not working was associated with higher depressive symptoms than working as expected after adjusting for sociodemographic, economic, and health factors at the time of expectations (IRR=1.35, 95% CI:1.17, 1.56). Additionally adjusting for health declines and marriage dissolution between expectations and age 62 partially attenuated the association, but unexpectedly not working remained significantly associated with a 1.16 increase in the incidence rate of depressive symptoms. Unexpectedly working at 62 was not associated with depressive symptoms. Race/ethnicity interacted with expectation alignment (F(15,42)=2.44, p=0.0118) in that Hispanic respondents experienced an increase in depressive symptoms when working after unmet and unsure expectations compared to met expectations, whereas white respondents did not. DISCUSSION Unlike working longer than expected, unexpectedly not working at 62 was associated with depressive symptoms, even after accounting for health declines. Public and employer policies should assist workers in remaining in the labor force as long as planned and offer mental health supports for unexpected work exits.
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Affiliation(s)
- Leah R Abrams
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA
| | - Philippa J Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.,Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Neil K Mehta
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
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Zaheed AB, Sharifian N, Morris EP, Kraal AZ, Zahodne LB. Associations between life course marital biography and late-life memory decline. Psychol Aging 2021; 36:557-571. [PMID: 34166026 DOI: 10.1037/pag0000617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Late-life marital status is associated with cognitive aging; however, the influence of life course marital biography (i.e., changes in marital status) on late-life cognitive trajectories, as well as gender differences in the effects of marital biography, remain to be explored. Associations between (a) marital status at study baseline (currently married, previously married, never married) and (b) retrospectively reported life course marital biography (i.e., age at first marriage, time spent unmarried following initial marriage, history of divorce, history of widowhood) and up to 20 years of subsequent episodic memory trajectories were examined using latent growth curve models in 3,061 participants aged 51 + in the Health and Retirement Study 2017 Life History Mail Survey. Gender differences were examined with multiplicative interaction terms and stratified models. Participants who were married at study baseline demonstrated higher initial memory than previously and never married individuals. Older age at first marriage and shorter duration spent unmarried were each associated with better initial episodic memory among previously married individuals only; longer duration spent unmarried was associated with slower memory decline. Stratified models suggested that these associations may be driven by women. These results highlight the importance of considering multiple aspects of marital biography, not just current marital status, in cognitive aging research. Marital biography may have an enduring influence on cognitive aging, particularly among previously married older women. Future work is needed to identify mechanisms (e.g., socioeconomic resources, cognitive stimulation, self and spousal health, emotional support) through which marital histories influence cognitive aging. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Marital status and outcomes in chronic heart failure: Does it make a difference of being married, widow or widower? North Clin Istanb 2021; 8:63-70. [PMID: 33623875 PMCID: PMC7881434 DOI: 10.14744/nci.2020.88003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/27/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: We aimed to compare the outcomes of chronic heart failure (HF) patients with reduced ejection fraction (CHFrEF) in the Turkish Research Team in HF (TREAT-HF) registry according to marital status with a specific focus on being the widowed (widow/widower) versus the married. METHODS: TREAT-HF is a network, enrolling CHFrEF with a follow up for HF-related hospitalization (HFrH) and all-cause mortality (ACM). In this cohort, the widowed patients were compared with patients who were married before and after propensity score (PS) matching analysis. RESULTS: There were 723 cHFrEF patients with a complete dataset, including reported marital status at baseline for this analysis. Out of 723 patients with HF, 37 “never-married” and “divorced” patients were excluded from the analysis. Then, out of 686 remaining patients with HF, who had at least one reported marriage in the database, widowed patients with HF (n=124) were compared with married patients (n=562). The mean follow up period was 21±12 months up to 48 months. The widowed patients had a higher risk of HFrH (p=0.047), although ACM remained similar compared to married patients (p=0.054). After PS matching, HFrH remained more frequent among the widowed compared with the married (p=0.039) although ACM yielded similar rates. Of note, it was shown that being a widower (p=0.419) was not linked to increased risk of HFrH during follow up contrary to being a widow (p=0.037) despite similar age, ejection fraction, creatinine, NYHA functional class distribution and a similar rate of life-saving medications. CONCLUSION: PS matching analysis yielded that the widowed had increased the risk for HFrH. Of note, widowers did not seem to have an increased risk for HFrH, contrary to widows.
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Brown SL, Lin IF, Vielee A, Mellencamp KA. Midlife Marital Dissolution and the Onset of Cognitive Impairment. THE GERONTOLOGIST 2020; 61:1085-1094. [PMID: 33245327 PMCID: PMC8437503 DOI: 10.1093/geront/gnaa193] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Marital dissolution has become more common in midlife with the doubling of the divorce rate among middle-aged adults. Guided by the stress model that stipulates losing economic, social, and psychological resources lowers well-being, we posited that midlife adults who experienced divorce or widowhood were at greater risk of cognitive impairment than the continuously married. Subsequent repartnering was expected to negate the increased risk. RESEARCH DESIGN AND METHODS We used data from the 1998-2016 Health and Retirement Study to estimate discrete-time event history models using logistic regression to predict cognitive impairment onset for men and women. RESULTS Roughly 27% of men who experienced spousal death in midlife went on to experience mild cognitive impairment by age 65. For women, experiencing divorce or widowhood was associated with higher odds of cognitive impairment onset although these differentials were accounted for by economic, social, and psychological resources. Men and women who repartnered after marital dissolution did not appreciably differ from their continuously married counterparts in terms of their likelihoods of cognitive impairment onset. DISCUSSION AND IMPLICATIONS A stressful life event, midlife marital dissolution can be detrimental to cognitive well-being, placing individuals at increased risk of developing dementia in later life. The growing diversity of partnership experiences during the second half of life points to the continued importance of examining how union dissolution and formation shape health and well-being.
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Affiliation(s)
- Susan L Brown
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, Ohio, USA
| | - I-Fen Lin
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, Ohio, USA
| | - Alyssa Vielee
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, Ohio, USA
| | - Kagan A Mellencamp
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, Ohio, USA
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Jennings EA, Ralston M, Schatz E. Support in times of need: How depressive symptoms can impact receipt of social support among aging adults in rural South Africa. SSM Popul Health 2020; 12:100666. [PMID: 33072842 PMCID: PMC7549146 DOI: 10.1016/j.ssmph.2020.100666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 05/08/2020] [Accepted: 09/07/2020] [Indexed: 01/28/2023] Open
Abstract
The relationship between mental health and receipt of social support is not well understood in low- and middle-income countries. In this paper, we focus on a cohort of older adults (40-plus) in rural South Africa to unpack associations between mental health and receipt of social support, and the extent to which marital status modifies these associations. We use baseline data from a population-based study, Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), conducted between 2014 and 2015. Our results suggest that men and women who report depressive symptoms are less likely to receive social support: women are less likely to receive emotional and financial support, and men are less likely to receive physical and financial support. Both men and women who are married or partnered are more likely to receive social support than their non-married counterparts. The association between depressive symptomology and receipt of social support differs for women who are separated/divorced and for men who are widowed. Specifically, the association between having depressive symptoms and receiving physical or financial support is more positive for separated/divorced women than their married/cohabiting counterparts; for men, the association between having depressive symptoms and receiving physical support is more positive for widowed men than their married/cohabiting counterparts. Our findings speak to the complicated associations between social support, marriage and mental health in later life and the different experiences that men and women may have. We estimate links between mental health and receipt of social support among a cohort of aging adults in rural South Africa. Having depressive symptoms is negatively associated with odds of receiving some types of social support for men and women. Married men and women have greater odds of receiving all types of social support relative to non-married counterparts. Depressive symptoms are more positively associated with receipt of physical support for widowed vs. married men. Depressive symptoms more positively linked with receipt of physical or financial support for divorced vs. married women.
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Affiliation(s)
- Elyse A Jennings
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Enid Schatz
- Department of Public Health and Women's & Gender Studies, University of Missouri, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersand, Johannesburg, South Africa
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Gray divorce and mental health in the United Kingdom. Soc Sci Med 2020; 256:113030. [DOI: 10.1016/j.socscimed.2020.113030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 01/07/2023]
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Ferreira F, Castro D, Araújo AS, Fonseca AR, Ferreira TB. Exposure to Traumatic Events and Development of Psychotic Symptoms in a Prison Population: A Network Analysis Approach. Psychiatry Res 2020; 286:112894. [PMID: 32151849 DOI: 10.1016/j.psychres.2020.112894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 01/03/2023]
Abstract
Previous studies consistently observed an association between exposure to traumatic events and psychotic symptoms. However, little is known about the differential impact of distinct traumatic events and the role of general symptoms in mediating this relationship. Thus, our study aimed to explore the differential association of several traumatic events to the psychotic symptoms in a sample of prisoners and whether this association is mediated by general symptoms. The total sample from the Survey of Psychiatric Morbidity Among Prisoners in England and Wales (N = 3039; 75.4% male) was used. Participants completed a list of traumatic events experienced before reclusion, the Psychosis Screening Questionnaire, Clinical Review Schedule-Revised. Network analysis was used to estimate the network of interactions between traumatic events and general and psychotic symptoms. Shortest paths analysis was performed to identify the different development trajectories. Results suggested that memory problems, compulsions, and irritability might be key mediating symptoms for most traumatic events. However, sexual abuse showed alternative mediators that might be specific of this traumatic event. Finally, the traumatic events, suffered from violence at work, separation/divorce and been homeless showed direct associations with specific psychotic symptoms.
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Affiliation(s)
- Filipa Ferreira
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal; Center for Psychology at University of Porto.
| | - Daniel Castro
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal; Center for Psychology at University of Porto
| | - Ana Sofia Araújo
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal
| | - Ana Rita Fonseca
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal
| | - Tiago Bento Ferreira
- University Institute of Maia, Avenida Carlos Oliveira Campos Castêlo da Maia, 4475-690, Maia, Portugal; Center for Psychology at University of Porto
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