The Impact of Relationship-Specific Support and Strain on Depressive Symptoms Across the Life Course

A healthy balance: the ratio of social support-to-demands is associated with metabolic syndrome

Metabolic syndrome is associated with increased risk for negative health events, decrements in quality of life, and greater health costs. The current study sought to identify whether the ratio of social support to social demands across multiple relationship types (spouse, friends, children, or other family members) were associated with concurrent metabolic syndrome in a nationally representative sample of US adults ages 32-40. Results indicate that the ratio of total social support to social demands was associated with a greater likelihood of meeting criteria for metabolic syndrome, even after statistically controlling for the effects of race, ethnicity, sex, age, income, and prior metabolic syndrome. When considering the relative contributions of each relationship type, greater support relative to demands from friends was the only relationship type that was significantly independently associated with lower likelihood of metabolic syndrome. Although not statistically significant, a trend-level negative association with spousal support/demands emerged, as did a trend-level positive association with support/demands from children. Taken together, the current study reaffirms the relevance of considering social support and demands with regards to metabolic syndrome and highlights the ways in which specific relationships may differentially relate to health risk.

20th Century Puerto Rico and Later-Life Health: The Association Between Multigenerational Education and Chronic Conditions in Island-Dwelling Older Adults

OBJECTIVES

Previous research on the association between education and older adult health in the U.S. has not included Puerto Rico. We investigated the effects of multigenerational educational attainment and chronic conditions among older Puerto Ricans residing on the archipelago's main island.

METHODS

Data were from the longitudinal Puerto Rican Elderly Health Conditions Project. Generalized Poisson regression models were used to examine if multigenerational educational attainment was associated with chronic disease.

RESULTS

Findings show that parental educational attainment was associated with fewer chronic conditions among females at baseline but not at follow-up, suggesting that the effects of parental education on health over time are less pronounced. For males, educational attainment across the three generations was not significantly associated with chronic disease at baseline or follow-up.

DISCUSSION

Multigenerational education is an important determinant of older adult health that continues to be relevant in Puerto Rico and the Latin American and Hispanic-Caribbean region.

Measurement of Social Strain in People with Dementia: A Preliminary Study of the Reliability and Validity of the Negative Relationship Quality Questionnaire in Indonesia

People with dementia (PWD) may exhibit symptoms that negatively affect their relationships with their families or friends which could cause social strain. The Negative Relationship Quality (NRQ) questionnaire can be used to measure social strain in PWD. There has never been an Indonesian adaptation of the NRQ. This preliminary study aimed to measure the validity and reliability of the NRQ among PWD in Indonesia (NRQ-INA). This study used a cross-sectional design. Forward−backward translation methods were conducted first. Pearson’s correlation and factor analysis were employed for the validity test. Cronbach’s alpha and test−retest were used to determine reliability. The NRQ-INA has four parallel items related to social strain that are divided into three subscales and asked to spouse/partner, family members, and friends, leading to a total of 12 questions. The results of validity testing from 60 respondents showed that all items in the NRQ-INA were strongly valid with correlation coefficients (r) of >0.8 (p < 0.01). Factor analysis showed a convergence with the variance explained of more than 50% for all items in each subscale, which also indicated that NRQ-INA had acceptable construct validity to measure social strain. Cronbach’s alpha values (α) were 0.926, 0.942, and 0.938 for the subscales of spouse, friends, and family members, respectively. The correlations of test−retest reliability for all items were >0.7 (p < 0.01), demonstrating a reliable NRQ-INA measurement. In conclusion, NRQ-INA had a good validity and reliability to measure social strain in PWD. Further study of the concurrent validity among PWD is still needed.

Illicit Drug Use among Commercial 'Boda Boda' Motorcyclists in Uganda

Background: Illicit drug use is a global public health problem with grave health and socio-economic consequences. Related intoxication has been associated with accidental injuries and fatalities. In Uganda, 67% of road traffic accidents are attributed to motorcyclists. Methods: This study assessed the prevalence and determinants of illicit drug use among commercial motorcyclists in Uganda, using a cross-sectional survey research design. We interviewed 785 commercial motorcyclists in the divisions of Nakawa, Rubaga, Makindye, and Kawempe of Kampala district. We used an on-spot saliva drug test kit to screen and detect the presence of illicit drugs. Data were analyzed using frequency distributions, cross tabulations and multi variable logistic regression. Results: Findings show that 11% of the cyclists used illicit drugs. The use of illicit drugs was associated with division of operation, religiosity, and whether a cyclist resided with a family. The odds of use of illicit drugs were higher among cyclists from Nakawa division compared to cyclists from Kawempe. Cyclists who went to places of worship on a weekly basis compared to those who were less frequent, and cyclists who lived with their families compared to those who did not, had reduced odds of use of illicit drugs. There are variations in the distribution of cyclists that use illicit drugs in Kampala. Religious commitment and residence with families had a mitigating influence on illicit drug use among commercial cyclists. Conclusion: Illicit drug use prevention, treatment, and harm reduction programs among cyclists should collaborate with faith-based organizations and other key stakeholders, and promote stable family relations.

Effects of Stress Exposure Versus Appraisal on Episodic Memory Trajectories: Evidence for Risk and Resilience Among Black Older Adults

OBJECTIVES

Chronic stressors, experienced disproportionately by Black older adults, are a risk factor for memory impairment. Racially patterned stress exposure may contribute to higher rates of Alzheimer's disease and related dementias (ADRD) among Black older adults compared with Whites, but less is known about the role of stress appraisal. This study examined whether chronic stress exposure mediates racial disparities in memory and whether stress appraisal moderates these associations.

METHODS

Participants included 16,924 older adults (Mage = 67.39, 21% Black) from the 2010 and 2012 waves of the Health and Retirement Study who completed measures of chronic stress exposure (health, financial, housing, relationships, and caregiving) and appraisal. Latent growth curves modeled longitudinal performance on a word list memory task over 6 years.

RESULTS

Black older adults reported greater stress exposure than Whites, and greater stress exposure partially mediated Black-White disparities in initial memory (standardized indirect effect = -0.002, p = .009). However, Black older adults appraised stressors as less upsetting than Whites. While stress appraisal did not moderate links between stress exposure and memory, appraising stressors as less upsetting was independently associated with better initial memory. Thus, Black-White disparities in initial memory was partially offset by Black participants' appraisal of stressors as less upsetting (standardized indirect effect = 0.002, p = .016).

DISCUSSION

Reducing chronic stress exposure may reduce racial disparities in ADRD risk. The counteractive effect of stress appraisal on Black-White disparities in episodic memory highlights resilience factors among Black older adults that should be characterized in future research to move beyond deficit models of ADRD inequality.

Age and sex trends in depressive symptoms across middle and older adulthood: Comparison of the Canadian Longitudinal Study on Aging to American and European cohorts

BACKGROUND

The literature suggests depressive symptoms differ in a non-linear fashion across adulthood and are more commonly reported in women as compared to men. Whether these trends are observed across countries in population-based cohorts is unclear.

METHODS

Cross-sectional observational study of approximately 138,000 women and men between the ages of 45 and 95 from three population-based cohorts representing Canadian, European, and American populations. Age, gender, educational attainment and annual income were assessed in each cohort. Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale in the US and Canadian cohorts, and by the EURO-D in the European cohort.

RESULTS

Across all three cohorts, non-linear age trends and gender differences were observed in the report of depressive symptoms, independent from educational attainment and annual income effects. The non-linear age trends reflected a negative association between depressive symptoms and age during midlife and then a positive association in late life. Females reported greater depressive symptoms than males; however, an interaction between gender and age was also observed in the Canadian and European cohorts. Among Canadians, the gender differences were largest after age 70, whereas among Europeans, gender differences where largest among those approximately aged 60.

LIMITATIONS

Limitations include: 1) the cross-sectional nature of the study, resulting in age differences potentially reflecting cohort effects rather than a developmental process; and 2) the use of different depressive symptoms measures across cohorts.

CONCLUSIONS

Characterization of depressive symptoms over mid and late adulthood in women and men provides insights into potential focal points for intervention and allocation of resources.

Social Network Typology and Serious Psychological Distress: Findings from the National Survey of American Life

This study examined the association between social network typology and serious psychological distress (SPD) across various adult developmental stages among African Americans. The sample for this study was drawn from the National Survey for American Life (N = 2,991). Network typology was identified using positive and negative family and church relationship indicators. Latent class distal outcome modeling was used to identify network typology and determine the association between network types and SPD. The findings indicate that network types and SPD were unassociated among respondents in the early adulthood group. In the middle and late adulthood group, respondents in the ambivalent and strained network types had higher SPD scores than respondents in the optimal type. Specific to the late adulthood group, respondents in the family-centered type had higher SPD scores than respondents in the optimal type. The findings are discussed in relation to prior research and practice implications.

Intimate Relationships and Depression: Searching for Causation in the Sea of Association

This article provides a critical review of existing research on intimate (marriage or marriage-like) relationship distress and risk for depression. Using the meta-framework of research triangulation, we seek to synthesize research evidence across several different methodologies and study designs and to draw the most reliable conclusion regarding a potential causal association between relationship distress and depression. Focusing on existing correlational (i.e., observational), genetically informed, and intervention (i.e., experimental) research on the association between relationship distress and depression, we conclude that the existing body of research evidence supports the claim that relationship distress is a causal risk factor for depression. A secondary aim of the article is to highlight a variety of effective methods that, when viewed from the perspective of triangulation, enhance the pursuit of causal inference, including propensity score matching, target trial emulation, directed acyclic graph approach, and Mendelian randomization.

Chronic Pain and Friendship among Middle-Aged and Older U.S. Adults

OBJECTIVES

This study examines how chronic pain affects friendship in later life. We test whether onset of pain leads to social network activation, as suggested by research on other health conditions (Latham- Mintus, Forth.), or whether pain-an unverifiable and often stigmatizing condition-functions as a "threat to the social self" (Karos et al., 2018).

METHODS

Using longitudinal data from the Health and Retirement Study (HRS; N=4,598; 2006/2008 as Time 1 and 2010/2012 as Time 2), we conducted OLS regressions with the lagged dependent variable approach to assess how new-onset chronic pain predicted (a) respondents' number of close friends and (b) their frequency of in-person meetings with friends, controlling for sociodemographic variables and health conditions.

RESULTS

New-onset severe pain predicted a decrease in number of friends. New-onset moderate pain, in contrast, predicted more friends and more frequent in-person meetings. (Findings were significant or marginally significant depending on model specifications.) Mild pain showed no significant association with either outcome. Pain had a greater effect on men's friendship outcomes than women's.

DISCUSSION

The effects of chronic pain on later-life friendships appear to depend on pain severity, and to differ between men and women. Onset of severe pain serves as a "threat to the social self," while onset of moderate pain contributes to social network activation; both associations are significantly more pronounced among men. These findings highlight the complex associations between health and social outcomes.

Emotional support as a mechanism linking childhood maltreatment and adult's depressive and social anxiety symptoms

BACKGROUND

Research has well-established that childhood maltreatment is associated with depressive and social anxiety symptoms in adults. Emotional support has been proposed as a mediator, yet research investigating the unique contributions of emotional support from friends, family members, and romantic partners in adulthood is sparse.

OBJECTIVE

The current study tested emotional support from family, friends, and romantic partners as mechanisms linking childhood maltreatment to depressive and social anxiety symptoms in adults.

PARTICIPANTS AND SETTING

Participants for the current study (N = 798) included adults in a committed romantic relationship and completed both the second wave of the National Survey of Midlife Development in the United States (MIDUS 2) as well as the MIDUS 2 biomarker follow-up project. Emotional support from family, friends, and romantic partners was measured at MIDUS 2 and mental health symptoms were reported at the MIDUS 2 biomarker follow up.

RESULTS

Emotional support from friends was identified as a mechanism from maltreatment to social anxiety symptoms (ß = .04, 95 % CI [.019, .066]), emotional support from family members was a mechanism to depressive symptoms (ß = .09, 95 % CI [.045, .146]), and emotional support from romantic partners was a mechanism for both depressive (ß = .02, 95 % CI [.005, .048]) and social anxiety symptoms (ß = .03, 95 % CI [.008, .048]).

CONCLUSIONS

The current study documents that emotional support may be a mechanism linking childhood maltreatment to mental health symptoms. Emotional support from different sources appear to be of significant importance in understanding adult mental health. Clinical implications are discussed.

Social Support, Strain, and Glycemic Control: A Path Analysis

Social support and strain have been linked with many health outcomes. However, less is known about whether these psychosocial factors are associated with Type 2 diabetes risk. This study uses the Midlife in the United States (MIDUS) dataset to examine the relationship between social support and strain from friends, family members, and spouse/partners and blood hemoglobin A1c levels in married/cohabiting adults who have not been diagnosed with diabetes. In addition, health locus of control is examined as a possible mediator. The study's findings suggest that support from friends is negatively associated with HbA1c levels, indicating a relationship between better glycemic control and social support from friends, and an indirect association for spouse/partner support. A direct effect for internal health locus of control was also found.

Disentangling the Stress Process: Race/Ethnic Differences in the Exposure and Appraisal of Chronic Stressors Among Older Adults

OBJECTIVES

Exposure to stressors is differentially distributed by race/ethnicity with minority groups reporting a higher stress burden than their white counterparts. However, to really understand the extent to which some groups bear a disproportionate stress burden, we need to consider race/ethnic differences in stress appraisal, specifically how upsetting stressors may be, in addition to stress exposure. We examine racial/ethnic differences in both the number of reported chronic stressors across five domains (health, financial, residential, relationship, and caregiving) and their appraised stressfulness among a diverse sample of older adults.

METHOD

Data come from 6,567 adults ages 52+ from the 2006 Health and Retirement Study.

RESULTS

Results show older blacks, U.S. and foreign-born Hispanics report more chronic stress exposure than whites and are two to three times as likely to experience financial strain and housing-related stress. Socioeconomic factors fully explain the Hispanic-white difference in stress exposure, but black-white differences remain. Despite experiencing a greater number of stressors, blacks and U.S.-born Hispanics are less likely to be upset by exposure to stressors than whites. U.S.-born Hispanics are less upset by relationship-based stressors specifically, while blacks are less upset across all stress domains in fully-adjusted models. Foreign-born Hispanics are only less upset by caregiving strain.

DISCUSSION

The distinction between exposure and appraisal-based measures of stress may shed light on important pathways that differentially contribute to race/ethnic physical and mental health disparities.

Perceived neighborhood social disorder as a predictor of depressive symptoms among unmarried older women and the stress-buffering effect of friends support

The current study examined whether perceived neighborhood social disorder predicted depressive symptoms among unmarried older women (N = 823) drawn from the 2016 Health and Retirement Study. This study also tested the stress-buffering effect of friends support. A negative binomial regression model showed that higher perceived neighborhood social disorder was associated with higher depressive symptoms. The number of close friends was a significant factor, but no stress-buffering effect of friends support was identified. This study highlights the adverse effect of negative perceptions of the neighborhood social environment on unmarried older women's depressive symptoms.

A Friend in Need? Exploring the Influence of Disease and Disability Onset on the Number of Close Friends Among Older Adults

OBJECTIVES

This research examines whether onset of life-threatening disease (i.e., cancer, lung disease, heart disease, or stroke) or activities of daily living disability influences the reported number of close friends.

METHOD

Using data from the Health and Retirement Study (HRS; 2006-2012), this research capitalizes on panel data to assess changes in number of close friends over a 4-year period. Lagged dependent variable (LDV) and change score (CS) approaches were used.

RESULTS

Both the LDV and CS models provide evidence that onset of life-threatening disease was associated with reporting more friends 4 years later. In particular, onset of cancer was associated with reporting more close friends.

DISCUSSION

This research provides evidence of the network activation hypothesis following onset of life-threatening disease among older adults.

Associations Between Social Connectedness, Emotional Well-Being, and Self-Rated Health Among Older Adults: Difference by Relationship Status

The present study investigates the association between social connectedness (i.e., social network characteristics, family and friend support, and social ties with neighbors), emotional well-being, and self-rated health and whether these associations differ based on respondents' relationship status among adults aged 62 and older. A series of multigroup generalized structural equation models (GSEMs) were conducted using data from the National Social, Health, and Aging Project. Social connectedness items were mostly positively associated with emotional well-being and self-rated health, and several of these associations are stronger for older adults who are unpartnered versus those who are cohabiting or married. Cohabiting and married individuals do not appear to have the same associations between social network size, friend support, and emotional well-being compared to unpartnered older adults. The present study lends support for how a variety of social supports are vital for older adults and their well-being.

Psychosocial Mechanisms Underlying Older Black Men's Health

Objectives

To evaluate the psychosocial mechanisms underlying older Black men's self-rated health, we examined: (a) the individual, cumulative, and collective effects of stressors on health; (b) the direct effects of psychosocial resources on health; and (c) the stress-moderating effects of psychosocial resources.

Method

This study is based on a nationally representative sample of Black men aged 51-81 (N = 593) in the Health and Retirement Study (HRS). Ordinary least squares (OLS) regression models of the psychosocial determinants of self-rated health draw on data from the HRS 2010 and 2012 Core datasets and Psychosocial Modules.

Results

Each of the six measures of stressors as well as a cumulative measure of stressors are predictive of worse self-rated health. However, when considered collectively, only two stressors (chronic strains and traumatic events) have statistically significant effects. Furthermore, two of the five psychosocial resources examined (mastery and optimism) have statistically significant protective effects, and prayer moderates the harmful effects of traumatic events on self-rated health.

Discussion

Conventional measures of stressors and coping resources-originally developed to account for variance in health outcomes among predominantly white samples-may not capture psychosocial factors most salient for older Black men's health. Future research should incorporate psychosocial measures that reflect their unique experiences.

Family Relationships and Well-Being

Family relationships are enduring and consequential for well-being across the life course. We discuss several types of family relationships—marital, intergenerational, and sibling ties—that have an important influence on well-being. We highlight the quality of family relationships as well as diversity of family relationships in explaining their impact on well-being across the adult life course. We discuss directions for future research, such as better understanding the complexities of these relationships with greater attention to diverse family structures, unexpected benefits of relationship strain, and unique intersections of social statuses.

Timing of housing crises: Impacts on maternal depression

Housing problems threaten maternal mental health, but the nature of the relationship between housing and depression across time is not fully understood. Drawing upon the literatures of household shocks and depressive illness, the present study leveraged longitudinal data from the Fragile Families and Child Well-Being Study to probe the relationship between a housingrelated crisis and depression among at-risk mothers (N = 2,503). Binary logistic regression tested whether a housing crisis predicted an episode of depression across up to one-, three-, and seven-year time lags. The sample was then balanced on key predictors of housing crises using greedy matching with propensity scores; regression models were replicated on the new matched samples. Results showed a housing crisis significantly elevated risk for depression within one year, but effects were attenuated across three and seven years; findings were consistent in the matched samples. Implications include the need to develop new conceptualizations of depression in the context of housing instability. Brief interventions may be most effective for addressing distress associated with housing crises and improving treatment access. Policies and programs addressing the lack of affordable housing in the United States may be effective means of reducing the burden of mental disorder on families with children.

Resource Loss and Gain, Life Satisfaction, and Health Among Retirees in Spain

OBJECTIVE

This article focuses on retirement transition from the Conservation of Resources (COR) perspective to better understand how aged participants' perceptions of retirement losses and gains significantly explain retirement well-being. In this article, the mediation of social support in the losses-well-being relationship is explored.

METHOD

The study was conducted with a two-wave longitudinal design. Participants at T1 were aged Spanish workers (>64 years) and at T2 were retirees, with a final sample of 275, who had retired during the previous 6 months.

RESULTS

Findings supported the assertion that losses better explain well-being than gains. In addition, specific losses revealed a higher explaining power of life satisfaction and health complaints depending on their content. Social support mediated between perceived losses and well-being.

DISCUSSION

This study suggests that both perceived losses and gains associated with retirement and social support during retirement should be taken into account when addressing postretirement well-being.