Husband and wife differences in response to undesirable life events

Partner's unemployment and subjective well-being: The mediating role of relationship functioning

Unemployment affects not only the subjective well-being of the individual, but also that of the partner. Based on the life course perspective and the spillover-crossover-model, we examine the mediating role of relationship functioning for such crossover effects of partner's unemployment on subjective well-being. We also test whether gender differences in the mechanism of relationship functioning can explain the larger overall crossover effects on women compared to men. We use data from the German Family Panel pairfam (2008/09-2018/19), which provide more direct and comprehensive measures of relationship functioning than previous research, and allow us to examine couples' communication and interactions, their conflict styles and behaviors, relationship satisfaction, and perceived relationship instability as mediators. To analyze the impact of the partner's transition to unemployment on subjective well-being, we use fixed effects panel regression models and the product method of mediation analysis to estimate the indirect effects of relationship functioning. The results show that a partner's transition to unemployment has a negative impact on one's own well-being. The effects are more pronounced for women than men which can be partly explained by gender-specific effects of the partner's unemployment on various aspects of relationship functioning, rather than by differential effects of the latter on one's own well-being.

Family Economic Strain and Adolescent Aggression during the COVID-19 Pandemic: Roles of Interparental Conflict and Parent-Child Conflict

Although the link from family economic strain to adolescent aggression has frequently been hypothesized, the results are mixed. Both interparental conflict and parent-child conflict are considered to be potential mediators of this link. However, the empirical evidence supporting this proposition is lacking. The present study investigated the direct effect of family economic strain on adolescent aggression as well as indirect effects through interparental conflict and parent-child conflict. Based on multi-informant data from 971 families with a child in middle and high schools in Y City, in Shanxi Province, structural equation modeling is conducted to examine the proposed theoretical model. Findings show that family economic strain has no significant direct impact on adolescent aggression. Interparental conflict and parent-child conflict mediate the link between family economic strain and adolescent aggression simultaneously and sequentially. This study expands current literature and deepens our understanding of the mechanisms underlying the relationship between family economic strain and adolescent aggression. Implications for policies and interventions to reduce the risk of adolescent aggression are discussed.

The Other Student Debt Crisis: How Borrowing to Pay for a Child's College Education Relates to Parents' Mental Health at Midlife

OBJECTIVES

More parents are borrowing to help their children pay for college. These loans may be a source of financial stress and worry, which could influence parents' mental health. We determine whether child-related educational debt is associated with worse mental health among parents and if fathers are more sensitive to this debt than mothers, given potential gender differences in financial decision-making and relationships with adult children.

METHOD

Data come from the National Longitudinal Survey of Youth 1979, a nationally representative sample of persons born between 1957 and 1964. We used the Center for Epidemiologic Studies Depression Scale and the Short Form-12 Mental Health Component Score to assess mental health. We restricted our sample to parents who had at least one biological child attend college and who were interviewed at age 50, when mental health was assessed (n = 3,545).

RESULTS

Among fathers, having any child-related educational debt versus none was associated with fewer depressive symptoms, but having greater amounts of child-related educational debt was associated with more depressive symptoms and worse mental health. No relationship was found for mothers.

DISCUSSION

Our findings indicate that the student debt crisis may also have mental health implications for aging parents, particularly for fathers.

Isolation but Diffusion? A Structural Account of Depression Clustering among Adolescents

Depression can cause people to withdraw from friendships or be avoided by others, protecting others from exposure to that depression. Yet, researchers observe depression contagion, particularly among adolescents. We address this empirical puzzle by examining the role of gender in structuring friendship networks and the implications for isolation and the spreading of depression. Using stochastic actor-based models of friendships among 421 adolescents from mixed-gender, all-girls, and all-boys classrooms in six Taiwanese high schools, we find that networks with only girls are characterized by high reciprocity and low transitivity. This, in turn, facilitates the withdrawal of depressed girls from interactions. In contrast, networks with all boys create more opportunities for depression to spread through interconnected pathways. Our computational experiment further demonstrates that local preferences governing friendship choice influence levels of network connectivity. This, coupled with depression withdrawal and peer influence, shapes depression prevalence at the network level. These findings refine our understanding of the mechanisms through which friendships expose boys and girls unequally to health risks of depression.

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.

Harsh times: do stressors lead to labor market losses?

This paper examines the links between stressful life events and labor market outcomes. We use twin data for Finnish men and women combined with register-based individual information on earnings, employment and social income transfers. The twin data allow us to account for shared environmental and genetic confounders. We measure the exposure to stressful life events in 1990. The labor market outcomes are measured during a 20-year follow-up over the period 1990-2009. Three findings stand out. First, stressors lead to worse labor market outcomes. Second, both men and women are distressed by labor market shocks, but they respond differently to marital problems and health shocks within the family. For example, women respond to marital problems by working more, whereas men respond similarly after facing a random health shock within the family. Third, the relationship between health shocks and labor market outcomes diminishes as time passes, whereas the consequences of labor market shocks are more permanent.

Financial Stress, Social Supports, Gender, and Anxiety During College: A Stress-Buffering Perspective

In this study, we examined financial stress and general anxiety in college students ( N = 304) with attention to the moderating roles of different types of social support (i.e., family support, social support) and gender, as assessed via moderated moderation. Results indicated that financial stress was moderately-to-strongly associated with symptoms of general anxiety. A three-way interaction revealed that perceived family support and gender were moderators of financial stress in relation to general anxiety. Consistent with a stress-buffering effect, for male college students financial strain was positively associated with general anxiety at low levels of perceived family support, but unrelated at high levels of family support. For female college students, a significant financial stress–anxiety link was present regardless of level of family support. This study highlights the potential mental health costs of financial stress faced by college students, with implications for tailoring mental health interventions that target financial stress.

The contribution of gender-based violence and network trauma to gender differences in Post-Traumatic Stress Disorder

Background

Posttraumatic stress disorder (PTSD) occurs twice as commonly amongst women as men. Two common domains of trauma, network trauma and gender based violence (GBV), may contribute to this gender difference in PTSD rates. We examined data from a nationally representative sample of the Australian population to clarify the characteristics of these two trauma domains in their contributions to PTSD rates in men and women.

Methods

We drew on data from the 2007 Australian National Survey of Mental Health and Well-being to assess gender differences across a comprehensive range of trauma domains, including (1) prevalence of lifetime exposure; (2) identification of an index trauma or DSM-IV Criterion A event; and (3) the likelihood of developing full DSM-IV PTSD symptoms once an index trauma was identified.

Results

Men reported more traumatic events (TEs) overall but women reported twice the prevalence of lifetime PTSD (women, 13.4%; men, 6.3%). Women reported a threefold higher level of exposure to GBV and were seven times more likely to nominate GBV as the index trauma as compared to men. Women were twice more likely than men to identify a network trauma as the index trauma and more likely to meet full PTSD symptoms in relation to that event (women, 20.6%; men, 14.6%).

Conclusion

Women are more likely to identify GBV and network trauma as an index trauma. Women’s far greater exposure to GBV contributes to their higher prevalence of PTSD. Women are markedly more likely to develop PTSD when network trauma is identified as the index trauma. Preventing exposure to GBV and providing timely interventions for acute psychological reactions following network trauma may assist in reducing PTSD rates amongst women.

Psychological and Physical Health of Nonoffending Parents After Disclosure of Sexual Abuse of Their Child

Disclosure of child sexual abuse can be traumatic for nonoffending parents. Research has shown its impact on mothers' mental health, which includes heightened psychological distress, depression, and post-traumatic stress disorder. Very little is known, however, about its impact on their physical health or on fathers' health. The self-perceived mental and physical health of nonoffending parents after child sexual abuse disclosure was compared to determine gender-related differences in this regard. Interviews were conducted with 109 mothers and 43 fathers of 6- to 13-year-old sexually abused children. Bivariate analyses revealed that a fair proportion of parents reported psychological and physical problems after disclosure. However, proportionally more mothers than fathers reported psychological distress, depression, and use of professional services. Fathers were more likely to resort to health services instead of social services and to use medication for depression. Study findings provide leads for health and social service providers for the development of intervention protocols and referral procedures sensitive to gender issues, and they shed new light on specific needs of nonoffending parents.

Racial, Ethnic, and Sociodemographic Differences in the Level of Psychosocial Distress among Older Americans

More than 2 million older Americans suffer from some form of depression. Yet late-life depression is often undiagnosed or underdiagnosed. The aim of this study was to explore the reasons for the observed differences in the level of depressive symptoms between older African Americans, Hispanics, and Whites. The data are from Wave 1 of the Asset and Health Dynamics Among the Oldest Old survey administered during 1993-1994. Ordinary least-squares regression results indicate that language acculturation, the number of years of education, and the number of years of U.S. residency are significant factors that help to explain differences in self-reported levels of depressive symptoms among this older population. In general, those who are men, are married, have more education, and are in better health have lower levels of depressive symptoms.

Gender Differences in the Life Concerns of Persons Seeking Alcohol Detoxification

BACKGROUND

This study explored the life concerns of persons seeking alcohol detoxification, a group with multiple life and psychosocial challenges. Gender may be an important contributor to the particular life concerns of persons with alcohol use disorders.

METHODS

Using a 32-item, previously-validated life concerns survey that captures ten conceptual domains, we interviewed persons entering inpatient alcohol detoxification asking them to rate their level of concern about health and welfare items.

RESULTS

Participants (n=189) were 27% female, with a mean age of 43.5 years. Overall, concern about alcohol problems was perceived as the most serious, followed by mental health, cigarette smoking, financial, and relationship problems. Men were significantly more concerned than women about six of the ten domains including money, drug use, transmissible diseases, and physical illness.

CONCLUSIONS

Recognition of the daily worries of persons seeking inpatient alcohol detoxification persons could allow providers to better tailor their services to the context of their patients' lives. Focusing on pressing life concerns such as mental health, financial, relationship problems, and other drug use may influence detoxification services and aftercare treatment choices.

Relation between stress and cytokine responses in inner-city mothers

BACKGROUND

Women in poor urban neighborhoods have high rates of stress and allergic diseases, but whether stress or stress correlates such as depression promote inflammatory and type 2 cytokine responses is unknown.

OBJECTIVE

To examine associations among external stressors, perceived stress, depression, and peripheral blood mononuclear cell cytokine responses of mothers enrolled in the Urban Environment and Childhood Asthma Study and test the hypothesis that stress would be positively associated with type 2 and selected proinflammatory (tumor necrosis factor-α and interleukin-8) responses.

METHODS

Questionnaire data from mothers living in 4 inner cities included information about external stress, stress perception, and depression. The external stress domains (interpersonal problems, housing, and neighborhood stress) were combined into a Composite Stressor score. Peripheral blood mononuclear cells were stimulated ex vivo and cytokine responses to innate, adaptive, and polyclonal immune stimuli were compared with stress and depression scores for 469 of the 606 study participants.

RESULTS

There were no significant positive associations between Composite Stressor scores, perceived stress, or depression scores and proinflammatory or type 2 cytokine responses, and these findings were not modified by allergy or asthma status. There were some modest associations with individual stressors and cytokine responses, but no consistent relations were noted. Depression was associated with decreased responses to some stimuli, particularly dust mite.

CONCLUSION

Composite measurements of stressors, perceived stress, or depression were not positively related to proinflammatory or type 2 cytokine responses in these young urban women. These data do not support the hypothesis that these factors promote cytokine responses associated with allergy.

TRIAL REGISTRATION

ClinicalTrials.gov, identifier NCT00114881.

Hard Times and Heart Break: Linking Economic Hardship and Relationship Distress

We used the Fragile Families and Child Well-Being Study to examine an integrated mediational model linking economic hardship to relationship distress. Depressive symptoms, partner's discord, parenting stress, and coparenting are combined into a joint model linking economic hardship to relationship distress among mothers and fathers in intimate relationships. Although economic hardship is significantly associated with each mediating factor, only discord is associated with both relationship distress and dissolution in the full model. Moreover, comparisons using multigroup structural equation modeling indicate that while economic hardship is associated with higher discord among both mothers and fathers, the influence is substantially larger among fathers. We suggest that the link between hardship and relationship distress is largely contingent on interactional processes (i.e., discord) and how mothers perceive their child's father in the midst of economic hard times.

Prescription drug misuse and gender

In recent years, prescription drug misuse has become a serious public health issue. A number of studies in this area have identified females to be at an increased risk for prescription drug misuse during adolescence. Guided by Agnew's general strain theory, the current research examined the relationship between prescription drug misuse and gender during adolescence. We used data from the 2010 National Survey on Drug Use and Health, a sample representative of the non-institutionalized population of the United States. Logistic regression models were estimated to examine the relationship between gender, prescription drug misuse, strain, and depression. The findings indicated that females were at an increased for prescription drug misuse. We also found support for general strain theory, as strain and depression were significantly related to prescription drug misuse. In addition, we found evidence that strain was gendered in that elements of general strain theory accounted for the relationship between prescription drug misuse and gender.

Using the Dynamic Model of Affect (DMA) to examine leisure time as a stress coping resource: Taking into account stress severity and gender difference

Affective complexity (AC) is a marker of psychological well-being. According to the Dynamic Model of Affect (DMA), stressful experiences reduce AC while positive events increase AC. One type of positive events is leisure, which was also identified as a coping resource. This study extended the DMA and leisure coping research by assessing gender difference in how daily stress severity and leisure time influence AC. Analyzing eight-day diary data, we found that females, compared to males, experienced greater decrease in AC with increase in stress severity but also bigger increase in AC with increase in leisure time. The finding highlights gender difference in affective reactivity to and coping with daily stress, the value of the DMA, and the importance of severity appraisal.

Physical limitation and emotional well-being: gender and marital status variations

Despite the proliferation of studies documenting the relationship between physical limitation and depressive symptoms in the United States, we currently do not know (1) whether physical impairment is associated with other dimensions of emotional well-being and (2) if these associations differ for men and women as well as married and nonmarried adults. We use panel data from two national samples to examine gender and marital status variations in the impact of physical limitation on four indicators of mental health. We find that physical limitation is associated with increases in depressive symptoms and negative feelings as well as decreases in positive emotions. Although the patterns are complex, we also find gender and marital status differences in these associations. Our results provide additional support for Aneshensel's (1992; Aneshensel, Rutter, and Lachenbruch 1991) argument about the highly contingent nature of stress reactivity and contribute to theory about both gender and marital status differences in the impact of stress on mental health.

Neural response to reward as a predictor of increases in depressive symptoms in adolescence

Adolescence is a developmental period characterized by significant increases in the onset of depression, but also by increases in depressive symptoms, even among psychiatrically healthy youth. Disrupted reward function has been postulated as a critical factor in the development of depression, but it is still unclear which adolescents are particularly at risk for rising depressive symptoms. We provide a conceptual stance on gender, pubertal development, and reward type as potential moderators of the association between neural response to reward and rises in depressive symptoms. In addition, we describe preliminary findings that support claims of this conceptual stance. We propose that (1) status-related rewards may be particularly salient for eliciting neural response relevant to depressive symptoms in boys, whereas social rewards may be more salient for eliciting neural response relevant to depressive symptoms in girls and (2) the pattern of reduced striatal response and enhanced medial prefrontal response to reward may be particularly predictive of depressive symptoms in pubertal adolescents. We found that greater vmPFC activation when winning rewards predicted greater increases in depressive symptoms over 2 years, for boys only, and less striatal activation when anticipating rewards predicted greater increases in depressive symptoms over 2 years, for adolescents in mid to late pubertal stages but not those in pre to early puberty. We also propose directions for future studies, including the investigation of social vs. monetary reward directly and the longitudinal assessment of parallel changes in pubertal development, neural response to reward, and depressive symptoms.

Economic Factors and Relationship Quality Among Young Couples: Comparing Cohabitation and Marriage

Are economic resources related to relationship quality among young couples, and to what extent does this vary by relationship type? To answer these questions, we estimated regression models predicting respondent reports of conflict and affection in cohabiting and married partner relationships using the National Longitudinal Study of Youth, 1997 (NLSY97, N = 2,841) and the National Longitudinal Study of Adolescent Health (Add Health, N = 1,702). We found that economic factors are an important predictor of conflict for both married and cohabiting couples. Affection was particularly responsive to human capital rather than short-term economic indicators. Economic hardship was associated with more conflict among married and cohabiting couples.

Parental support and adolescents' health in the context of parental employment status

Parental employment status is an important and often overlooked contextual factor that may influence parent-adolescent relationships. The aim of this study is to examine the effect of parental support on adolescents' health within the context of parental employment status. Data on perceived mother's and father's support, mother's and father's employment status and adolescents' perceived health were collected among 1992 adolescents (mean age 16.9) and analysed using chi-square and logistic regression. Father's support was significantly more often perceived as low when the father was unemployed, while the perception of mother's support did not differ in regards to the mother's employment. Among those with an unemployed father, mother's support appeared protective for adolescents' health, while when a mother was unemployed, father's support was more strongly associated with good health. Our results suggest that in the case of unemployment of one parent, support from the other parent may be more important for children.

Gender differences in the psychosocial experience of parents of children with cancer: a review of the literature

OBJECTIVE

To build a descriptive literature base of investigated and identified gender differences in the psychosocial experience of parents of children with cancer, in order to guide future research in this area.

METHODS

An extensive literature search was conducted using Medline, PsycINFO, CINAHL and EMBASE databases. Thirty papers were included in the review. Themes from these papers were identified, and on this basis, the review findings were grouped according to five main outcome categories: role perceptions, illness beliefs, psychological distress, coping strategies and perceptions of marital, family and child functioning.

RESULTS

Few gender differences were found in perceptions of marital, family and child functioning. There was a tendency toward traditional gender roles in the division of parental tasks. Findings in relation to parent psychological distress and preferred coping strategies were mixed, with trends toward increased distress, more emotion-focused coping and greater social support-seeking in mothers.

CONCLUSIONS

Further studies using longitudinal designs with solid theoretical groundings will provide valuable information on the unique psychosocial experiences of mothers and fathers throughout the child's illness, which may in turn guide the development of evidence-based interventions.

Gendered Responses to Serious Strain: The Argument for a General Strain Theory of Deviance

This paper expands and builds on newer avenues in research on gender and general strain theory (GST). I accomplish this by focusing on serious strains that are relevant for males and females, including externalizing and internalizing forms of negative emotions, and including multiple gendered deviant outcomes. Using the Add Health dataset, I find strong support for the impact of serious strains on both types of negative emotions and different forms of deviance for males and females. However, the experience of serious strain, emotionally and behaviorally, is gendered. Depressive symptoms are particularly important for all types of deviance by females. Including multiple types of deviant outcomes offers a fuller understanding of both similarities and differences by gender. These results support the utility of GST as a theory of deviance in general and support greater connections between GST, feminist theorizing, and the sociology of mental health.

Are high school students living in lodgings at an increased risk for internalizing problems?

This study aimed to investigate whether leaving home to live in lodgings during senior high school can be a risk factor for the development of internalizing problems. Utilizing two large-scale prospective community studies of 2399 and 3906 Norwegian students (age range 15-19 years), respectively, the difference in internalizing symptoms between adolescents living in lodgings and adolescents living with their parents during senior high school was examined. Female students living in lodgings had higher scores on internalizing problems than female students living at home, whereas no differences were found for males. Living in lodgings did not predict later internalizing problems, and prior internalizing problems did not predict moving into lodgings. It is therefore suggested that the negative effect of living in lodgings on high school students' well-being is temporary.

Cultural and Contextual Influences on Parenting in Mexican American Families

Family stress theory can explain associations between contextual stressors and parenting. However, the theory has not been tested among Mexican Americans or expanded to include cultural-contextual risks. This study examined associations between neighborhood, economic, and acculturative stressors and parenting behaviors in a sample of 570 two-parent Mexican American families. Results support the negative impact of economic stress on parenting through parental depressive symptoms. Neighborhood stress influenced fathers' depressive symptoms and parenting, but not mothers'. The effects of acculturative stress were inconsistent. Results suggest that contextual stressors common to Mexican American families impact parenting behaviors through parental depression.

Differential Impact of Involuntary Job Loss on Physical Disability Among Older Workers Does Predisposition Matter?

Older workers' share of involuntary job losses in the United States has grown fairly consistently in recent decades, prompting greater interest in the health consequences of involuntary unemployment among individuals nearing retirement. In this study, the authors applied the multifactorial model of geriatric health to investigate whether late-career involuntary job loss was associated with subsequent physical disability and whether the effect of involuntary job loss on physical disability varied by predisposition. Using data from the first four waves (1992 to 1998) of the Health and Retirement Survey, the authors measured predisposition with individual risk factors for functional disability and indices of aggregate risk. The results of gender-specific models fit with generalized estimating equations revealed that unmarried women and those with low predisplacement incomes had heightened risk for subsequent functional disability. No differential effects of job loss were found for men.

Parental health and children's economic well-being

The life course perspective emphasizes that past economic experiences and stage in the life course influence a family's ability to cope with negative life events such as poor health. However, traditional analytic approaches are not well-suited to examine how the impact of negative life events differs based on a family's past economic experiences, nor do they typically account for the potentially spurious association between negative life events and family economic well-being. We use finite mixture modeling to examine how changes in parental health affect children's exposure to poverty. We find that for some children the association between family head's health and children's exposure to poverty is spurious, while for other children family head's poor health is associated with increased risk of economic deprivation. The extent to which a family head's poor health alters children's economic well-being depends on a child's family's underlying economic trajectory and past history of exposure to disadvantage.

Trajectories of depressive symptoms and stressful life events among male and female adolescents in divorced and nondivorced families

This 11-year longitudinal study models the trajectories of depressive symptoms among approximately 550 females and males raised in divorced and nondivorced families in the rural Midwest. Using multilevel analyses, we demonstrate that, first, depressive symptoms changed according to a curvilinear pattern, especially for females; they increased during early to midadolescence and then declined in late adolescence to young adulthood. Second, compared with males, females experienced a greater number of depressive symptoms in adolescence and early adulthood. Third, children who experienced parental divorce by age 15 manifested a sharper increase in depressive symptoms compared to those from nondivorced families. Fourth, stressful life events children experienced shortly after parental divorce mediated the effect of parental divorce on depressive symptoms. Fifth and finally, time-varying stressful life events, particularly those related to relationship and personal loss, were significantly associated with the trajectories of depressive symptoms.

Depression and mental health among older Mexican American spouses

Although the association between marriage and well-being is well established, few studies have focused on learning more about the context of marriage and mental health. Recent research studying the mechanisms of marriage and health has focused on contagion of well-being among spouses. This study examined the association of depression with self-esteem, social support, life satisfaction, concern for independence, and cognitive function using baseline data for 553 older, Mexican American couples. Overall, we found evidence to suggest an interdependent relationship between husbands' and wives' emotional states, but the association was not equal for couples. Husbands' depression was significantly associated with the well-being of their wife, but the wife's depression was rarely associated with the husband's well-being. The findings from this study add to the increasing literature on spousal contagion by focusing on an under studied minority group, examining how depression affects well-being, and highlighting unequal effects of marriage on spousal well-being.

A literature overview of the relationship between life-events and alcohol use in the general population

AIMS

A critical review of the evidence of effects of stressful life-events on alcohol use in the general population, with a particular focus on study design.

METHODS

A literature search in Medline was conducted, covering the period from 1990 to 2005, to identify articles in which the relationship between life-events and alcohol use in the general population (i.e. non-problem drinking population) was investigated. Samples with a limited age range (e.g. college students) were excluded. Twelve studies with a cross-sectional design, and four articles with a longitudinal design were included in this review.

RESULTS

Four cross-sectional studies found evidence that experiencing life-events is related to higher alcohol use, three other studies, however, found no such association. The relationship between specific life-events and alcohol use in the five remaining cross-sectional studies is less clear-cut. Being a victim of crime was associated with higher alcohol use, but divorce and financial problems were related to both higher and lower alcohol use. Health-related life-events were found to be associated with lower alcohol use. In studies with a longitudinal design, it was found that health-related life-events and financial problems caused a decrease in alcohol use, and life-events related to spouse, friends and relatives, and retiring led to an increase in alcohol use.

CONCLUSIONS

Evidence points towards a relationship between the occurrence of life-events and alcohol use in the general population. The direction of the effect is, however, not unequivocal. When life-events are operationalized or categorized separately they are not only related to an increased alcohol use but also to a decreased alcohol use. Specification of the model to be tested, including buffering factors such as gender, social support, coping resources, as well as baseline consumption, is important for a correct estimation of the effect of negative life-events.

Quality of Life After Hyperthermic Isolated Limb Perfusion for Locally Advanced Extremity Soft Tissue Sarcoma

BACKGROUND

Quality of life (QoL) and posttraumatic stress symptoms (PTSS) were studied in patients with soft tissue sarcoma (STS) of the extremities treated with isolated limb perfusion and delayed resection, with or without adjuvant irradiation.

METHODS

Forty-one patients received a questionnaire that included the RAND-36 and Impact of Event Scale.

RESULTS

Thirty-nine STS survivors (16 [41%] male and 23 [59%] female; median age, 59 years; range, 15-78 years) participated in the questionnaire survey (response rate, 95%). The median age at perfusion was 49 years (range, 14-72 years). No significant differences were found in mean scores between STS survivors and the reference group with the exception of a worse physical functioning. Patients with amputations showed significantly worse physical and social functioning and more role limitations than patients whose limbs were saved. Eleven patients (28%) had a PTSS score of 0, and eight patients (20.5%) had a score>or=26, which suggested the need for psychological counseling. None of these eight patients had lost a limb. Patients who indicated that the choice of treatment was made by the surgeon rather than collaboratively showed significantly decreased social functioning, more role limitations, and intrusion. Greater treatment satisfaction was significantly related to better social functioning, more vitality, better general health perception, less intrusion, avoidance, and total Impact of Event Scale scores.

CONCLUSIONS

Even though STS survivors' QoL was different from that of a reference group only in physical functioning, one fifth of the patients had PTSS. An amputation, the physician's decision rather than the patient's decision for the perfusion treatment and a low satisfaction with the performed treatment negatively influenced QoL.

Body-mind-spirit intervention for IVF women

BACKGROUND

Literature supports the efficacy of psychosocial intervention for infertile women. An eastern body-mind-spirit group intervention has been developed to help infertile women in the Chinese population cope with the distress arising from IVF treatment.

METHODS

The eastern body-mind-spirit group intervention adopts a bio-psycho-social-spiritual health model, recognizing the strong association between mind, body, and spirit. Chinese philosophies and concepts of health will be integrated into the intervention, helping participants to regain balance and harmony both within themselves and between them and the environment. In this paper, a revisiting of assumptions, therapeutic goals, and the therapeutic process underlying this model are outlined. Program evaluation in terms of descriptive literary sketch done by the participants will be listed so as to illustrate the clinical process.

CONCLUSIONS

It was shown and reflected that the eastern Body-Mind-Spirit approach could enhance the holistic health of IVF women. Further investigation on the program efficacy is then suggested.

Preschool children with and without developmental delay: behaviour problems, parents' optimism and well-being

BACKGROUND

Children with intellectual disability are at heightened risk for behaviour problems, and these are known to increase parenting stress. This study explored the relation of behaviour problems to less child-related domains of parent well-being (depression and marital adjustment), as well as the moderating effect of a personality trait, dispositional optimism.

METHOD

Participating children (N = 214) were classified as developmentally delayed, borderline, or nondelayed. Mothers' and fathers' well-being and child behaviour problems were assessed at child ages 3 and 4 years.

RESULTS

Parents of delayed and nondelayed preschoolers generally did not differ on depression or marital adjustment, but child behaviour problems were strongly related to scores on both measures. Optimism moderated this relationship, primarily for mothers. When child behaviour problems were high, mothers who were less optimistic reported lower scores on measures of well-being than did mothers who were more optimistic.

CONCLUSIONS

Interventions for parents that aim to enhance both parenting skills and psychological well-being should be available in preschool. It may be beneficial for such programmes to focus not only on behaviour management strategies aimed at child behaviour change, but also on parents' belief systems, with the aim of increasing dispositional optimism.

Using problem-solving skills training to reduce negative affectivity in mothers of children with newly diagnosed cancer: report of a multisite randomized trial

Mothers of children with cancer experience significant distress associated with their children's diagnosis and treatment. The efficacy of problem-solving skills training (PSST), a cognitive-behavioral intervention based on problem-solving therapy, was assessed among 430 English- and Spanish-speaking mothers of recently diagnosed patients. Participants were randomized to usual psychosocial care (UPC; n=213) or UPC plus 8 sessions of PSST (PSST; n=217). Compared with UPC mothers, PSST mothers reported significantly enhanced problem-solving skills and significantly decreased negative affectivity. Although effects were largest immediately after PSST, several differences in problem-solving skills and distress levels persisted to the 3-month follow-up. In general, efficacy for Spanish-speaking mothers exceeded that for English-speaking mothers. Findings also suggest young, single mothers profit most from PSST.

Sources of social support as determinants of psychiatric morbidity after severe life events: prospective cohort study of female employees

OBJECTIVE

The aim of this study was to study prospectively the associations between sources of social support, life events, and psychiatric morbidity, as explicated in the chronic strain and the stress-buffering hypotheses.

METHODS

Psychiatric morbidity and sources of social support were assessed at Time 1 and 3 years later at Time 2 among 4250 female municipal employees. At Time 2, the participants were also asked about their preceding life events during the year.

RESULTS

After adjustment for baseline characteristics, low support from one's partner, coworkers, and supervisor at Times 1 and 2 was positively associated with psychiatric morbidity at Time 2 (OR = 1.1-1.6). The support of friends at Time 1 lowered the risk of psychiatric morbidity after death or severe illness in the family and after interpersonal conflict. High postevent network heterogeneity also lowered the risk of psychiatric morbidity after financial difficulty. For the remaining 33 combinations between different sources of social support and life events, no corresponding interactions were found.

CONCLUSION

The observed associations support the chronic strain hypothesis, but the support for the stress-buffering hypothesis was limited.

Quality of life and stress response symptoms in long-term and recent spouses of testicular cancer survivors

The aim of this study was to gain insight into the quality of life (QoL) and stress response of female spouses of men cured of testicular cancer in the long-term. Time since treatment completion varied from 0.5 to 23.8 years. Two hundred and fifty nine testicular cancer survivors and their spouses completed the Dutch version of the MOS Short Form (SF)-36 and the Impact of Event Scale. QoL data from a reference group of women were used for comparison. Spouses who had relationship with the testicular cancer survivor before the diagnosis (spouses during testicular cancer) had better functioning scores than the reference group, especially with respect to the physical QoL domains. Spouses who had started a relationship after treatment (spouses after testicular cancer) experienced more problems with psychological QoL domains than spouses during testicular cancer and than the reference group. The stress response of spouses during testicular cancer was related to that of the testicular cancer survivors and to the extent of treatment they had received. Although stress response levels were low, spouses during testicular cancer reported more stress response than the testicular cancer survivors. Time since completion of treatment did not affect QoL or stress response. This study showed that spouses during testicular cancer had a good QoL and little stress response. Functioning of spouses after testicular cancer was poorer with respect to various QoL domains, particularly the psychological measures.