Dynamics of family economic hardship and the progression of health problems of husbands and wives during the middle years: a perspective from rural Mid-West

The intergenerational transmission of economic adversity, BMI, and emotional distress from adolescence to middle adulthood

The present study examined the intergenerational transmission of economic adversity, as well as physical and mental health across generations. Specifically, we examined the effects of parental economic adversity, body mass index (BMI), and emotional distress during the child's adolescence on their economic adversity, BMI, and emotional distress in middle adulthood. The study included 366 Generation 1 (G1) mothers and fathers and their adolescents (Generation 2; G2) in middle adulthood. G1 behavior was examined when G2 was 16 years old and G2 behavior was assessed at Age 42. In line with aspects of the family stress model, economic hardship was related to economic pressure, which in turn was related to emotional distress for both G1 and G2. For each generation, economic pressure was also associated with BMI. There was also evidence of the intergenerational transmission of economic hardship, BMI, and emotional distress from G1 to G2. Finally, the intergenerational transmission of economic adversity in the family of origin to adult health outcomes was explained by these same health behaviors of the first generation. Results suggest that economic adversity and parental health behaviors as experienced in adolescence have long-term economic and health consequences into middle adulthood. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Life course trajectories of chronic financial strain and acute stress reactivity: Steeling in response to recovery from strain

The steeling hypothesis suggests experiencing moderate strain may improve an individual's ability to cope with future strain, whereas crisis theory suggests that experiencing temporary strain will reduce the effect of future strain. The current study improves on past research by utilizing data from two independent prospective panel studies (one of 553 white rural Midwesterner women and 451 men and one of 624 African American women) spanning 26 and 22 years, respectively. We utilize growth mixture modeling to identify latent groups based on trajectories of financial strain and test interactions between class membership and later acute stressful events on chronic illness and physical health using three subscales from the RAND SF-12. We find being a group that experienced a period of temporary strain weakened the effect of later acute stressors on physical health for both samples and chronic illness for the African American sample. Results support crisis theory and highlight the importance of considering chronic strain as a life course process.

Midlife Marital and Financial Stress and the Progression of Later-Life Health Problems for Husbands and Wives

Objectives: Locating the family systems theory within the life course stress process perspective, this study investigates how husbands' and wives' marital and financial stress were implicated in their subsequent physical health, psychological distress, and loneliness. Methods: Using prospective data from 254 husbands and wives over 27 years, a path model examined the influence of marital stress and family financial stress during midlife (40-50 years) on later-life (65+ years) physical health, psychological distress, and loneliness. Results: For wives, loneliness was a mechanism linking marital stress to their health outcomes and their husbands' physical health. For husbands, physical health was a mechanism linking financial strain to husbands' health outcomes and wives' physical health. Discussion: The findings emphasize the consideration of midlife financial and marital stress for policies and programs for older adults, particularly the prevention of loneliness and improving interpersonal processes, as ways to protect from earlier stressful experiences.

Midlife family financial strain, sense of control and pain in later years: An investigation of rural husbands and wives

Research focussing on individual biopsychosocial processes leading to physical pain as a health condition is rare. The present study investigated sense of control as a mechanism linking early midlife stress to later-life physical pain for husbands and wives in long-term marriages. Using data from 508 rural husbands and wives over 27 years (1991-2017) with respondents in their early middle years (<42 years on average) in 1991 and in their later years (>67 years on average) in 2017, this study utilized a comprehensive analytical model in an structural equation modelling framework. Family financial stress (FFS) trajectories in early middle years were associated with depleted sense of control, which was related to increased physical pain in later years after controlling for concurrent physical illness, family income and age. In cross-lagged analyses FFS influenced physical pain over mid-later years. Physical pain also influenced FFS, suggesting a bi-directional association between FFS and physical pain. Findings elucidate how early midlife FFS influences the progression of physical pain over mid-later years through sense of control. Findings suggest effective intervention and prevention programs should focus on FFS in early years of adulthood as well as the maintenance and development of adults' sense of control.

Couple processes of family economic hardship, depressive symptoms, and later-life subjective memory impairment: moderating role of relationship quality

OBJECTIVES

To examine a) processes through which family economic hardship (FEH) contributes to spouses' mental health and subsequent subjective memory impairment (SMI) in later years and b) the moderating effect of overall relationship quality on these associations.

METHODS

With prospective data over 27 years from a sample of 224 husbands and wives in enduring marriages, the present study utilized latent growth curves to identify how FEH trajectories are associated with both spouses' depressive symptoms trajectories across their mid-later years (average age 40-65 years) and subsequent SMI in later life (> 67 years). The moderating role of relationship quality between depressive symptoms and SMI was also examined.

RESULTS

FEH experiences across the mid-later years (1991-2015) explained variation in husbands' and wives' depressive symptoms trajectories (1994-2015). Change in depressive symptoms was associated with husbands' and wives' SMI in later life (2017) after taking the level of depressive symptoms into account. Spousal dependencies, including partner effects, existed among husbands' and wives' depressive symptoms trajectories and SMI outcomes. Some of these dependencies were moderated by couples' overall relationship quality.

CONCLUSION

FEH has a persistent influence on husbands' and wives' SMI in later years. Depressive symptoms mediated the influence of FEH on later wellbeing. The findings are discussed as they relate to family systems and life course stress process theories. Implications are addressed at multiple levels including national- and state-policies and clinical interventions.

Pathways of the family stress model in midlife on physical health in later adulthood

The current study examined economic adversity and physical health outcomes in line with the family stress model (FSM) for husbands and wives in enduring marriages. Data came from 243 husbands and wives who participated from early middle to later adulthood. Assessments included observational and self-report measures. Economic hardship and economic pressure were assessed in early middle adulthood. Feelings of hostility and observed harsh couple interaction were examined in middle adulthood, and physical impairment was assessed in later adulthood. Results indicated that economic hardship related to economic pressure. In addition, economic pressure indirectly related to physical impairment via hostility and harsh couple interaction. For husbands, economic pressure was also directly associated with their own physical impairment in later adulthood. Finally, economic pressure was indirectly associated with husband to wife harsh couple interaction through wife hostility. Similarly, economic pressure was indirectly associated with wife to husband harsh couple interaction through husband hostility. Results suggest that economic adversity as experienced in early middle adulthood has long-term health consequences into later adulthood. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Trajectories of Depression between 30s and 50s: Latent Growth Modeling

Objectives: Previous studies have primarily focused on depression among older adults. Given that middle age links young adulthood to older adulthood and encompasses a variety of changes in roles and status, which influence depression, it is important to understand the changes of depression during this period. Methods: This study used data from the National Longitudinal Survey of Youth 1979. The final sample consisted of 834 individuals, and four points in time were used: 34, 36, 40, and 50 years of age. The Latent Growth Model (LGM) was used to estimate the trajectories of depression. Results: The trajectories of depression present a non-linear change, referring to V-shaped curve. The conditional model shows that there are significant individual differences on initial status. Males were negatively associated with the latent initial level of depression. Individuals who showed higher self-esteem and cognitive ability were negatively associated with the latent initial level of depression. In addition, health insurance was negatively associated with the latent initial levels of depression. Both employment and net worth predicted lower intercepts of depression. Discussion: As the 40s is a bridge between the lowest levels of depression and a gradual increase of depression, service providers should be aware of changes of depression among middle-aged adults and spend more time and resources to encourage those individuals to prepare for changes in depression. Prevention programs for depression and providing more opportunities for employment and education to save money should be more focused on young adults.

Prolonged Financial Distress After the Deepwater Horizon Oil Spill Predicts Behavioral Health

The economic impact of disasters is well known; however, the link between financial loss and behavioral health problems is unknown. Participants included 198 adults of ages 21 to 82, living within 10 miles of the Gulf Coast during the Deepwater Horizon Oil Spill and were involved in the fishing, harvesting, seafood processing, or service/tourism industries. The functional impact of financial resource loss at 2.5 years post spill was measured using the 26-item Financial Life Events Checklist (FLEC). Individuals responded to financial distress by reducing social events and utility bills and changing food-shopping habits. The FLEC significantly predicted higher drug use (Drug Abuse Screening Test), alcohol use (Alcohol Use Disorders Identification Test), mood problems (Profile of Mood States), and depressive symptoms (Beck Depression Inventory II) (p values ≤ 0.05) 4.5 years after the spill. This preliminary study supports the notion that the functional impact of financial loss has a long-term impact on behavioral health after an oil spill.

Stressful work conditions, positive affect, and physical health of middle-aged couples: A dyadic analysis

This study investigated actor and partner effects involving middle-aged husbands' and wives' stressful work conditions (SWCs), positive affect (PA), and health outcomes in a dyadic trajectory context in three steps. First, examination of husbands' and wives' individual trajectories showed significant interindividual variations in SWCs and PA over time. Second, a dyadic growth curve model incorporating both husbands' and wives' growth curves of SWCs and PA showed that husbands' and wives' trajectories of SWCs over their early middle years (1991-1994) were negatively associated with their own parallel trajectories of PA independent of depressive symptoms trajectories. Finally, most of the growth factors of PA trajectories of husbands and wives (1991-1994) predicted their own residual changes in physical illness and overall physical health in 2001. In dyadic models, although contemporaneous correlations between most of the study constructs between husbands and wives were significant, all partner effects involving growth parameters of SWCs, PA, and health outcomes were not significant. Most of the indirect effects from SWCs growth factors to health outcomes through PA were significant. The findings suggested that PA was an important health resource for middle-aged husbands and wives that mediates the influence of one's SWCs on own physical health outcomes.

Life Course Patterns of Concurrent Trajectories of BMI and Affective Symptoms of Rural Mothers: Socioeconomic Antecedents and Disease Outcomes in Later Life

OBJECTIVES

The current study, using prospective data over 25 years (1991-2015), concurrently investigates patterns of body mass index (BMI) and affective symptom trajectories in middle-aged mothers and the socioeconomic antecedents and disease outcomes of these patterns.

METHOD

Growth mixture modeling was used to identify latent classes of conjoint health risk trajectories (BMI, depressive symptoms, and anxiety symptoms) from 1991 to 2001. For each latent class, we identified mean trajectories of each health risk. Then, analyses were conducted identifying how these conjoint health risk classes were associated with respondents' socioeconomic background profiles in 1991 and subsequent chronic health problems in 2015.

RESULTS

Socioeconomic background profiles were significantly associated with initially high-risk trajectories. There was a statistically significant association between membership in certain classes of conjoint trajectories and physical health outcomes in later years. Consistent patterns of association with changes in different health outcomes including onset of diseases were observed when classes of conjoint risk trajectories are examined.

DISCUSSION

The identification of members of various conjoint risk trajectory groups provides a potentially useful prognostic tool for early preventive intervention efforts, treatment, and policy formation. Such interventions should promote and develop resiliency factors, thereby aiding in the redirection of middle-aged women's adverse risk trajectories.

The influence of mastery on mother's health in middle years: Moderating role of stressful life context

Using data from 416 middle-aged mothers gathered over the course of a decade, this study examined the influence of mastery trajectories (the initial level and change), on change in physical health. Mastery is defined as one's ability to control and influence his/her life and environment to reach a desired outcome or goal. Both the initial level and change in mastery from 1991 to 1994 were associated with decreased physical health problems over the middle years (1991-2001). Contextual moderation of this association by stressful life contexts including negative life events and work-family conflict was investigated. Moderation analysis showed that under conditions of low contextual life stressors, the level and increase in mastery significantly contributed to decreases in physical health problems in middle-aged mothers. Alternatively, conditions of high contextual life stressors inhibited the ability of mastery to influence physical health of mothers, suggesting that the positive health impact of mastery on physical health is mitigated by stressful life experiences. Implications for the need to maintain important personal resources, such as mastery, during times of stress are discussed.

Stressful Work Trajectories and Depressive Symptoms in Middle-Aged Couples: Moderating Effect of Marital Warmth

OBJECTIVES

The present study investigated the decade-long actor and partner infleunces between husbands' and wives' trajectories of stressful work conditions (SWCs) and their depressive symptoms while also considering the moderation of these influences by spousal warmth.

METHODS

Participants were 330 middle-aged dual-earner couples from the Iowa Midlife Transitions Project. Husbands and wives reported on own SWCs and reported on parenter's warmth in the years of 1991, 1992, and 1994. Depressive symptoms for husbands and wives were measured by the SCL-90-R in 1994 and 2001. Structural equation models, growth curves, and longitudinal data were used to perform our analyses.

RESULTS

For husbands and wives, trajectories of SWCs over early middle years (1991-1994) contributed to depressive symptoms in 1994. Notably, for husbands and wives, the severity (level) of SWCs in 1991 had a persistent influence on depressive symptoms a decade later (2001). For husbands, under conditions of wives' low warmth, SWCs exerted a relatively strong influence on their depressive symptoms. However, under conditions of high warmth from wives, most of these influences were greatly diminished.

DISCUSSION

Results from the current study indicate that contextual life experiences can have a persistent health influences over the life course.

Family hostility and depressive symptoms in middle-aged couples: Moderating effect of marital integration

This study examined (a) the associations between family hostility (husband-wife marital hostility and child hostility) and middle-aged husbands' and wives' depressive symptoms over an 11-year time period and (b) the moderating influence of couples' marital integration on these associations as measured by their joint activity. Higher order family-level latent constructs captured chronic husband-wife (marital) hostility using husbands' and wives' reports of chronic hostile interactions from 1990 to 1992, while a higher order latent construct of chronic child hostility toward parents was measured using parental reports of children's hostile behaviors from 1990 to 1992. Structural equation modeling with data from 370 families depicted the longitudinal impact of family hostility on depressive symptoms of both husbands and wives in 2001 after accounting for earlier levels of depressive symptoms in 1991. Separate models were fit for couples with high and low levels of marital integration. For couples who experienced low levels of marital integration, chronic marital hostility and child hostility were related to depressive symptoms in husbands and wives. However, for those with high marital integration, these influences were largely diminished. (PsycINFO Database Record

The decade-long effect of work insecurity on husbands' and wives' midlife health mediated by anxiety: A dyadic analysis

Although the detrimental physical health effects of work insecurity have been noted in previous research, less is known about the mediating processes, such as anxiety symptoms, that link work insecurity to physical health. Even less research has explored these effects at specific life stages and how these effects may impact significant others, even though the impact of this stress may vary across the life course and the mutual influences between married partners may cause dyadic effects stemming from partners' work insecurity. To fill these gaps, the current study incorporates theories that emphasize the stress-work connection, such as stress appraisal theory (Lazarus, 1999) and resource conservation theory (Hobfoll, 1989), into a neurobiological stress-health perspective. This study uses a sample of 330 consistently married, dual-earner husbands and wives who provided data at multiple time points over a 10-year period from 1991 to 2001. Results from a model including growth curves of work insecurity and anxiety symptoms when respondents were in their early middle years and reports of physical illness in their later middle years generally supported the hypothesized model. Both the level and rate of change in work insecurity were related to the change in anxiety symptoms over time. Similarly, the level and rate of change in anxiety symptoms from 1991 to 1994 were linked to subsequent illness years later in 2001. There was only partial support for the existence of partner effects. Findings are discussed as they relate to previous research as well as policy and clinical implications. (PsycINFO Database Record

Economic Hardship, Parents' Depression, and Relationship Distress among Couples With Young Children

Using data from the Fragile Families and Child Well-being Study (N = 1,492 couples), we assessed stress, health selection, and couple-crossover hypotheses by examining (1) the bidirectional association between economic hardship and depressive symptoms one, three, and five years after the birth of a child; (2) the association between economic hardship and depressive symptoms on relationship distress for both parents; and (3) whether the associations vary by marital status. The results suggest a pernicious cycle for mothers after the birth of the child. Economic hardship increases depression, but maternal depression also increases economic hardship. These reinforcing mechanisms increase both mothers' and fathers' relationship distress. Taken together, policies aimed at strengthening couples' relationships should work in tandem with economic and mental health policies to reach optimal outcomes for couples with a young child. Effect patterns were generally consistent between married and cohabiting couples, with some variation in levels of statistical significance.

EPA guidance on mental health and economic crises in Europe

This European Psychiatric Association (EPA) guidance paper is a result of the Working Group on Mental Health Consequences of Economic Crises of the EPA Council of National Psychiatric Associations. Its purpose is to identify the impact on mental health in Europe of the economic downturn and the measures that may be taken to respond to it. We performed a review of the existing literature that yields 350 articles on which our conclusions and recommendations are based. Evidence-based tables and recommendations were developed through an expert consensus process. Literature dealing with the consequences of economic turmoil on the health and health behaviours of the population is heterogeneous, and the results are not completely unequivocal. However, there is a broad consensus about the deleterious consequences of economic crises on mental health, particularly on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse, and suicidal behaviour. Unemployment, indebtedness, precarious working conditions, inequalities, lack of social connectedness, and housing instability emerge as main risk factors. Men at working age could be particularly at risk, together with previous low SES or stigmatized populations. Generalized austerity measures and poor developed welfare systems trend to increase the harmful effects of economic crises on mental health. Although many articles suggest limitations of existing research and provide suggestions for future research, there is relatively little discussion of policy approaches to address the negative impact of economic crises on mental health. The few studies that addressed policy questions suggested that the development of social protection programs such as active labour programs, social support systems, protection for housing instability, and better access to mental health care, particularly at primary care level, is strongly needed.

Socioeconomic Adversity and Women's Sleep: Stress and Chaos as Mediators

We examined income-to-needs ratio, perceived economic well-being, and education and their relations with European and African American women's sleep (n = 219). Sleep was examined through actigraphy and self-reports. Income-to-needs ratio was related to sleep minutes. Perceived economic well-being and education were associated with subjective sleep problems. Perceived stress mediated relations between both income-to-needs ratio and economic well-being and subjective sleep problems. Chaos emerged as a mediator linking income-to-needs ratio and subjective sleep problems. African American women had fewer sleep minutes and lower sleep efficiency than European Americans, and more robust relations between economic well-being and stress was observed for European Americans. Findings highlight the importance of economic adversity for women's sleep and explicate some pathways of risk.

Dyadic effects of gender minority stressors in substance use behaviors among transgender women and their non-transgender male partners

BACKGROUND

Despite evidence that interpersonal processes shape health behaviors, research concerning the dyadic effects of gender minority stressors on substance use behaviors of transgender people is scarce. The objective of this study was to use dyadic analysis to examine whether transgender discrimination was associated with substance use among transgender women and their male partners.

METHODS

Transgender women and their male partners (N=191 couples; N=382 individuals) completed questionnaires. Participants' mean age was 37.1; 79.1% were racial/ethnic minority; 61.3% earned <$500 per-month. The mean relationship duration was 37.9 months. Actor-Partner Interdependence Models were used to examine the associations between transgender-related discrimination and past 30-day non-marijuana illicit drug use adjusting for age, relationship length, financial hardship, and depressive distress among partners in these dyads.

RESULTS

Illicit drug use was reported by 31.4% of transgender women and 25.1% of their male partners. Perceived transgender discrimination was independently associated with increased odds of illicit drug use for transgender women (actor effect) but not for their male partners. Financial hardship statistically predicted drug use for both partners (actor effects). There were no partner effects for financial hardship on drug use. Overall, 34.5% of dyads had discrepant substance use. Discrimination scores of male partners differentiated dyads who reported discrepant substance use.

DISCUSSION

Gender minority stressors are critical to understanding substance use among transgender women and their male partners. Integrating socioeconomic status into gender minority stress frameworks is essential. Results have implications for substance use prevention and treatment, including the need to incorporate gender minority stressors into interventions.

Heterogeneity in multidimensional health trajectories of late old years and socioeconomic stratification: a latent trajectory class analysis

OBJECTIVES

This study examines (a) the heterogeneity in individual multidimensional health trajectories and (b) the socioeconomic stratification of individual multidimensional health trajectories during the late older years.

METHOD

This study used prospective data from 1,945 adults, 75 to 85 years old, collected over an 8-year period from the Health and Retirement Study. To examine inconsistent findings in the research literature, a latent trajectory class analysis was performed.

RESULTS

Multidimensional overall health trajectories showed three heterogeneous latent classes (maintaining, persistently high, and deteriorating), and profiles of ascribed and achieved socioeconomic characteristics of multidimensional health trajectory classes showed a significant social and racial/ethnic stratification in late older years.

DISCUSSION

Past adverse socioeconomic circumstances, including childhood and adulthood adversity, are potential sources of unobserved heterogeneity of multidimensional health trajectories even in late older years. The identification of members of latent trajectory health classes and the associated antecedents linked to health class membership are consistent with a life-course conceptual framework. Thus, multidimensional health capturing the full range of health problems needs to be investigated for proper examination of socioeconomic correlates of health. This facilitates the understanding of the associations between life-course experiences and health in late old age that ultimately have implications for prevention and intervention.

Family Economic Hardship and Progression of Poor Mental Health in Middle-aged Husbands and Wives

Using prospective data from 370 middle-aged husbands and wives during a 12-year period, we investigated the intra-individual and dyadic influence of family economic hardship on the levels of depressive symptoms of husbands and wives over their middle years. The results suggest that family economic hardship during the early middle years contributes to subsequent increase in depressive symptoms of husbands and wives after controlling for family economic hardship in late middle years. Consistent with stress-process theory, economic hardship influences depressive symptoms directly and indirectly through its influence on self-esteem. The results also provided evidence for the scar hypothesis which suggests that depression predicts subsequent level of self-esteem and form a reciprocal process between depressive symptoms and self-esteem over time. In sum, for both husbands and wives, our findings showed that depressive symptoms progress over the middle years through a self-perpetuating reciprocal process between self-esteem and depression initiated by early family economic hardship and through cross-spouse influences involving self-esteem and depressive symptoms.