Gender differences in stressful life events, social support, perceived stress, and alcohol use among older adults: results from a National Survey

Socioeconomic status, alcohol use and the role of social support and neighbourhood environment among individuals meeting criteria for a mental health problem: a cross-sectional study

PURPOSE

Indicators of socioeconomic status (SES), such as education and occupational grade, are known to be associated with alcohol use but this has not been examined among individuals with a mental health problem. This study developed latent classes of SES, their associations with alcohol use, and examined the indirect effect via social support and neighbourhood environment.

METHODS

A secondary analysis of the 2014 Adult Psychiatric Morbidity Survey was conducted among participants with a mental health problem (N = 1,436). SES classes were determined using a range of indicators. Alcohol use was measured using the Alcohol Use Disorder Identification Test. Social support and neighbourhood neighbourhood environment were measured using validated questionnaires. A latent class analysis was conducted to develop SES classes. Multinomial logistic regression examined associations of SES and alcohol use. Structural equation models tested indirect effects via social support and neighbourhood environment.

RESULTS

A four-class model of SES was best-fitting; "economically inactive,GCSE-level and lower educated,social renters", "intermediate/routine occupation,GCSE-level educated,mixed owner/renters", "retired, no formal education,homeowners", and "professional occupation,degree-level educated,homeowners". Compared to "professional occupation,degree-level educated, homeowners", SES classes were more likely to be non-drinkers; odds were highest for "economically inactive,GCSE-level and lower educated,social renters" (OR = 4.96,95%CI 3.10-7.93). "Retired, no formal education,homeowners" were less likely to be hazardous drinkers (OR = 0.35,95%CI 0.20-0.59). Associations between "economically inactive,GCSE-level and lower educated,social renters" and "retired, no formal education,homeowners" and non- and harmful drinking via social support and neighbourhood environment were significant.

CONCLUSIONS

In contrast to the alcohol harms paradox, among individuals with a mental health problem, lower SES groups were more likely to be non-drinkers while no associations with harmful drinking were found. There is also a need to examine the alcohol harms paradox in the context of the area in which they live.

Psychotropic medicine use without current or prior medical advice, storage at home and association with perceived stress in a primary health care setting in Greece

OBJECTIVE

Psychotropic medicines use alters according to socio-economic factors and perceived stress. The study aimed to assess the prevalence of use of psychotropic medicines and supplements (PMS) without medical advice, including storage at home, and its relationship with socio-demographic characteristics and perceived stress in primary care patients.

MATERIALS AND METHODS

A cross-sectional sample of adult attendees in an urban primary care unit in Crete, Greece, were surveyed during regularly scheduled appointments during a three-week period in October 2020. A questionnaire was distributed to investigate PMS use during the last 12 months. The validated Greek version of Perceived Stress Scale (PSS-14) was adopted to measure perceived stress.

RESULTS

Of 263 respondents (mean age 46.3±14.5 years; 66.5% females), 101 (38.4%; 95%CI 33.1-43.7%) recalled having psychotropic medicines stored at home cabinets and 72 (27.4%; 95%CI 22.4-32.3%) reported using PMS without medical advice in the last 12 months.

CONCLUSIONS

This study revealed a high prevalence of PMS use without medical advice, including storage at home. People>59 years of age, experiencing irregular sleep and scoring high in PSS, displayed increased prevalence of storing PMS at home or using them without medical advice. The findings could potentially inform primary care providers to focus on patients most likely to be users of PMS without medical advice.

Exploration of the Healthy Donor Effect Among 0.6 Million Blood Donors in China: Longitudinal Study

BACKGROUND

The World Health Organization emphasizes the importance of completely voluntary blood donation to maintain safe and sustainable blood supplies. However, the benefits of blood donation for donors, such as reducing the risk of disease, remain a topic of debate due to the existence of the healthy donor effect (HDE). This effect arises because of inherent health differences between blood donors and the general population, and it is also considered a methodological issue.

OBJECTIVE

This study aims to generate a more detailed health profile of blood donors from a donor cohort study to mitigate and quantify the HDE and properly interpret the association between blood donation and disease outcomes among blood donors.

METHODS

A retrospective cohort study was conducted between January 2012 and December 2018 among donors before their first donation. One-to-one propensity score matching was conducted through a random selection of individuals without any history of blood donation, as reported from their electronic health records. We conducted a Poisson regression between blood donors and non-blood donors before the first donation to estimate the adjusted incidence rate ratio (AIRR) of selected blood donation-related diseases, as defined by 13 categories of International Classification of Diseases, Tenth Revision (ICD-10) codes.

RESULTS

Of the 0.6 million blood donors, 15,115 had an inpatient record before their first donation, whereas 17,356 non-blood donors had an inpatient record. For the comparison between blood donors and the matched non-blood donors, the HDE (the disease incidence rate ratio between non-blood donors and blood donors) was an AIRR of 1.152 (95% CI 1.127-1.178; P<.001). Among disease categories not recommended for blood donation in China, the strongest HDE was observed in the ICD-10 D50-D89 codes, which pertain to diseases of the blood and blood-forming organs as well as certain disorders involving the immune mechanism (AIRR 3.225, 95% CI 2.402-4.330; P<.001). After age stratification, we found that people who had their first blood donation between 46-55 years old had the strongest HDE (AIRR 1.816, 95% CI 1.707-1.932; P<.001). Both male and female donors had significant HDE (AIRR 1.082, 95% CI 1.05-1.116; P=.003; and AIRR 1.236, 95% CI 1.196-1.277; P<.001, respectively) compared with matched non-blood donors.

CONCLUSIONS

: Our research findings suggest that the HDE is present among blood donors, particularly among female donors and those who first donated blood between the ages of 46 and 55 years.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2200055983; https://www.chictr.org.cn/showproj.html?proj=51760.

Changes in substance use and engagement in gaming/gambling in persons with severe mental illness during the COVID-19 pandemic and earthquakes: a community study in two points

Introduction

External stressors, such as COVID-19 pandemic and earthquake, can cause an increase in substance use and addictive behavior in persons with severe mental illnesses (SMI). We analyzed the changes and predictors of substance use and addictive behavior in SMI during these double disasters in Croatia.

Methods

Questionnaires exploring the presence of substance or behavior addiction disorder, mental ill health [Depression Anxiety Stress Scales-21 (DASS-21), Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), Obsessive-Compulsive Inventory-Revised], coping mechanisms, and perceived social support [Multidimensional Scale of Perceived Social Support (MSPSS)] were administered among 90 participants with SMI included in the RECOVER-E study in May/June 2020 (first COVID-19 wave, Zagreb earthquake) and in December 2020/January 2021 (second COVID-19 wave, Petrinja earthquake).

Results

In both time points, a major increase was observed in tobacco smoking (25.0%; 28.6%, respectively) predicted by discontinuation of antidepressants and higher DASS-21 score. Increased sedative use was observed (24.4%; 23.8%, respectively) predicted by higher PSS and ISI scores, lower MSPSS scores, antipsychotic discontinuation and not receiving community mental health team (CMHT) service.

Discussion

In persons with SMI during a double disaster special attention needs to be given to reducing mental-ill health and stress, providing social support and continuity of psychiatric care, through medications and CMHTs.

Mental health status and stressful life events among postgraduate nursing students in Cyprus: a cross-sectional descriptive correlational study

BACKGROUND

Despite prior evidence supporting the association between stressful life events and mental health status, there are limited data on the number and severity of stressful life events and their effects on university students' mental health status. Therefore, the present study aimed to: (a) examine mental health status and subsequent predictors of clinically significant mental distress symptoms, (b) estimate the number and severity of stressful life events, and (c) explore the associations between mental health status, stressful life events (number and severity) and sociodemographic characteristics.

METHODS

This study was descriptive, cross-sectional, and correlational with internal comparisons. A convenience sample of 90 Master of Science in nursing and midwifery students, participated in the study. Participants with a General Health Questionnaire-28 (GHQ-28) total score ≥ 24 were considered to have clinically significant mental distress symptoms. Descriptive and inferential statistics were evaluated, and Pearson's chi-square test for group differences was used to analyse the data. Analysis of variance and t-tests were used for comparisons between two or more groups, and regression analyses were employed to identify the predictors of GHQ-28 scores and clinical mental distress symptoms.

RESULTS

The final sample comprised 90 students (response rate: 97.8%), 33 (36.7%) of whom reported clinically significant symptoms of mental distress. Students with divorced parents [29.92 (± 10.62), p < .05] scored high on the GHQ-28. Participants who had low/no satisfaction with the education system posted higher scores than participants who had high/very high satisfaction [24.82 (± 11.68) vs. 17.93 (± 9.78), p < .05]. In the subscale measuring depressive symptoms, there was a statistically significant gender difference, with men reporting higher scores than females. [3.0± (3.69) vs. 1.60 (± 2.42), p = .034]. In multiple analyses of sociodemographic characteristics and those who scored higher on the Life Events Scale for Students (LESS) scale (≥ 340), the loss of parent/s was associated with the total GHQ-28 score (B=-17.046, p < .001). In multiple analyses, chronic physical disorders or disabilities and numerous stressful life events among students (≥ 8 events) were correlated with higher overall GHQ-28 scores (B = 15.232, p < .005).

CONCLUSION

The high frequency of clinical symptoms of mental distress among postgraduate university nursing students and their correlation with stressful life events highlights the need for university counselling services to provide psychological support strategies to students.

Stressful Life Events and Patterns of Polysubstance Use Among U.S. Late Middle-Aged and Older Adults: A Latent Class Analysis

The goals of this study were to identify patterns of polysubstance use and their associations with stressful life events among U.S. late middle-aged and older adults and examine whether gender moderates these associations. Adults aged 50 and older (N = 14,738) from the National Epidemiological Survey on Alcohol and Related Conditions-III were included. Latent class analysis was conducted to identify patterns of polysubstance use. Weighted multinomial logistic regression was estimated with a generalized structural equation model. Three different polysubstance use patterns (non-users/low substance users; cannabis and excessive alcohol users; painkiller and sedative/tranquilizer misusers) were identified. Higher levels of stressful life events were associated with patterns of polysubstance use. Gender moderated the association between stressful life events and co-misusing painkillers and sedatives/tranquilizers (p < 0.05). Substance use prevention efforts should consider aging adults' patterns of polysubstance use and associated stressful life events when designing and implementing gender-specific polysubstance use prevention interventions.

Childhood socioeconomic status interacts with cognitive function to impact scam susceptibility among community-dwelling older adults

OBJECTIVES

We examined whether childhood socioeconomic status (SES) is related to scam susceptibility in old age and tested the hypothesis that childhood SES interacts with cognitive function to impact scam susceptibility.

METHODS

This study employed a cross-sectional design. All data were collected in participants' community-based residences. Participants were 1071 older adults (mean age = 81.05 years, SD = 7.53) without dementia (median MMSE score = 28.29, IQR = 27.86-30.00). Participants completed assessments of childhood SES, cognitive function, and scam susceptibility. We used linear regression models to examine the associations of childhood SES and cognitive function with scam susceptibility.

RESULTS

In a regression model adjusted for age, gender, and education, poorer cognitive function was associated with higher scam susceptibility, but childhood SES was not. However, in an additional model that included the interaction of childhood SES and cognitive function, the interaction was significant, such that lower childhood SES was associated with higher scam susceptibility among participants with lower cognitive function.

CONCLUSION

Lower childhood SES is associated with higher scam susceptibility among older adults with lower levels of cognitive function. Thus, older adults who experienced limited resources in childhood and have lower cognitive function may represent a specific group for interventions to increase scam awareness and prevent financial exploitation.

Role of hormones in bone remodeling in the craniofacial complex: A review

Background

Diseases such as periodontitis and osteoporosis are expected to rise tremendously by 2050. Bone formation and remodeling are complex processes that are disturbed in a variety of diseases influenced by various hormones.

Objective

This study aimed to review and present the roles of various hormones that regulate bone remodeling of the craniofacial complex.

Methods

A literature search was conducted on PubMed and Google Scholar for studies related to hormones and jawbone. Search strategies included the combinations ("name of hormone" + "dental term") of the following terms: "hormones", "oxytocin", "estrogen", "adiponectin", "parathyroid hormone", "testosterone", "insulin", "angiotensin", "cortisol", and "erythropoietin", combined with a dental term "jaw bone", "alveolar bone", "dental implant", "jaw + bone regeneration, healing or repair", "dentistry", "periodontitis", "dry socket", "osteoporosis" or "alveolitis". The papers were screened according to the inclusion criteria from January 1, 2000 to March 31, 2021 in English. Publications included reviews, book chapters, and original research papers; in vitro studies, in vivo animal, or human studies, including clinical studies, and meta-analyses.

Results

Bone formation and remodeling is a complex continuous process involving many hormones. Bone volume reduction following tooth extractions and bone diseases, such as periodontitis and osteoporosis, cause serious problems and require a great understanding of the process.

Conclusion

Hormones are with us all the time, shape our development and regulate homeostasis. Newly discovered effects of hormones influencing bone healing open the possibilities of using hormones as therapeutics to combat bone-related diseases.

Support for health care workers and psychological distress: thinking about now and beyond the COVID-19 pandemic

INTRODUCTION

This study explores the relationship between emotional support, perceived risk and mental health outcomes among health care workers, who face high rates of burnout and mental distress since the beginning of the COVID-19 pandemic.

METHODS

A cross-sectional, multicentred online survey of health care workers in the Greater Toronto Area, Ontario, Canada, during the first wave of the COVID-19 pandemic evaluated coping strategies, confidence in infection control, impact of previous work during the 2003 SARS outbreak and emotional support. Mental health outcomes were assessed using the Generalized Anxiety Disorder scale, the Impact of Event Scale - Revised and the Patient Health Questionnaire (PHQ-9).

RESULTS

Of 3852 participants, 8.2% sought professional mental health services while 77.3% received emotional support from family, 74.0% from friends and 70.3% from colleagues. Those who felt unsupported in their work had higher odds ratios of experiencing moderate and severe symptoms of anxiety (odds ratio [OR] = 2.23; 95% confidence interval [CI]: 1.84-2.69), PTSD (OR = 1.88; 95% CI: 1.58-2.25) and depression (OR = 1.88; 95% CI: 1.57-2.25). Nearly 40% were afraid of telling family about the risks they were exposed to at work. Those who were able to share this information demonstrated lower risk of anxiety (OR = 0.58; 95% CI: 0.48-0.69), PTSD (OR = 0.48; 95% CI: 0.41-0.56) and depression (OR = 0.55; 95% CI: 0.47-0.65).

CONCLUSION

Informal sources of support, including family, friends and colleagues, play an important role in mitigating distress and should be encouraged and utilized more by health care workers.

Differential Pathways of Risky Drinking via Coping Motives in College and Noncollege Young Adults

The current study tested a mediation model of psychological functioning (i.e., perceived stressors, psychological distress, and self-regulation) and risky drinking through a drinking to cope pathway comparing college and noncollege young adults. Participants were 623 young adult drinkers (M age = 21.46) who completed an online survey. Multigroup analyses examined the proposed mediation model for college students and nonstudents. For nonstudents, the indirect effects of psychological distress to alcohol use outcomes (i.e., alcohol quantity, binge drinking frequency, and alcohol-related problems) via coping motives was significant. Further, coping motives significantly mediated the positive effects of self-regulation on alcohol quantity, binge drinking frequency, and alcohol-related problems. For students, greater psychological distress was associated with greater coping motives, which in turn, related to greater alcohol-related problems. Coping motives significantly mediated the positive effect of self-regulation on binge drinking frequency. Findings highlight the different pathways that may result in risky drinking and alcohol problems based on young adult's educational attainment. These results have important clinical implications, particularly for those who have not attended college.

Stressful Events During Last Year, Violence and Anxiety and Depression: A Moderated Mediation Model by Sex

The literature suggests that being subject to a stressful life and victimization may negatively affect mental health, and that women and men seem to differ in these variables. Nevertheless, neither the mediating role of victimization experiences in the relationship between stress and mental health, nor the moderated role of sex have been explored. A sample of 826 adults, aged from 18 to 77 years old, completed a set of self-reported questionnaires (69.4% women). Results revealed significant mediation effects of psychological violence on the relationship between stress, depression and anxiety. Participants who reported more stressful life events in the previous year, also reported higher psychological abuse, which in turn predicted higher depression and anxiety. Furthermore, the moderating effects of sex were found to be statistically significant. Results suggest that interventions should be tailored to individual needs in order to prevent secondary victimization derived from biased beliefs related to stress, violence and gender in professional practice.

Persistence of significant pain interference following substance use disorder remission: Negative association with psychosocial and physical recovery

BACKGROUND

Although substance use disorder (SUD) is frequently complicated by pain, the prevalence and correlates of persistent pain and dysfunction following SUD remission have not been studied.

METHODS

Using a cross-sectional sample of United States (US) adults with SUD identified in the National Epidemiologic Survey on Alcohol and Related Conditions Wave III, we evaluated the prevalence of moderate/severe pain interference (PI) in subgroups with current and remitted SUD and the independent association of SUD remission and PI with self-reported psychosocial and physical function (Mental Health Composite Score [MCS] and Physical Function Score [PFS] from the Short Form 12).

RESULTS

A fifth (20.6%; 7.6 million) of estimated 36.7 million US adults with past year SUD and a slightly higher proportion (25.6%; 9.6 million) of 37.4 million with SUD remission reported PI. MCS and PFS showed independent negative associations with PI among adults with both past year SUD and SUD remission. MCS had a positive independent association with SUD remission, but a stronger negative association with PI. While PFS had no statistically significant association with SUD remission, it had a strong negative association with PI. Analysis of interaction between SUD remission and PI revealed that SUD remission had no effect on the association of PI and MCS but had significant moderating influence on the association between PI and PFS.

CONCLUSIONS

Moderate to severe pain interference continues to be a significant problem among a sizable population achieving SUD remission potentially impeding recovery, and deserves focused clinical attention both active SUD and its remission.

Resilience, depression and anxiety and hazardous alcohol use behaviour among community dwelling older adults

INTRODUCTION

We examined the psychometric properties of the CD-RISC, including factor structure. Secondly, we examined if resilience factors moderate the association between negative affect and hazardous alcohol use.

METHOD

The sample population consisted of 1,368 community-dwelling older adults. We used standardized questionnaires to collect self-reported data on alcohol use behaviour, depression and anxiety and resilience by using respectively the Alcohol Use Identification Test (AUDIT), the Brief Symptom Inventory (BSI) and the Connor-Davidson Resilience Scale (CD-RISC).

RESULTS

Of the total sample (N 1.368), 80.1% reported using alcohol. The total sample and the drinking sample reported, respectively, a mean of 65.75 (SD 15.40) and 65.79 (SD 15.90) on the CD-RISC. Concerning the CD-RISC, exploratory factor analysis presents four factors of which three with a good reliability. Moderation analyses reflects that older adults with higher levels of resilient characteristics didn't report an association between negative affect and hazardous drinking. Alternatively, low resilient older adults did report an positive and significant association between negative affect and hazardous drinking.

CONCLUSION

The CD-RISC appeared to be a reliable instrument, containing three factors. In our sample, high resilience moderated the association between negative affect and hazardous drinking and may serve as a buffer against hazardous drinking.

Effects of genetic risk for alcohol dependence and onset of regular drinking on the progression to alcohol dependence: A polygenic risk score approach

BACKGROUND

Prior studies have established the importance of genetic contributions to the etiology of alcohol dependence (AD), and suggested an early onset of alcohol use represents an initial marker of this genetic risk, which is associated with a more rapid progression to AD and increased risk for AD itself. Building on prior work, the current study examined whether the additive effects of AD risk variants predicted the rate of progression to AD from the onset of regular drinking, a drinking milestone with high clinical relevance to AD prevention.

METHODS

Data from 1501 European-ancestry adults from the University of California - San Francisco Family Alcoholism Study were used to examine whether polygenic risk scores for AD (PRS_AD) and age-at-onset of regular drinking contributed uniquely to the likelihood of having a lifetime AD diagnosis and the rate of progression from regular drinking to AD. Mixed effects logistic regression and Cox proportional hazards regression analyses were employed.

RESULTS

Increases in PRS_AD were associated with a faster progression from regular drinking to AD independent of age-at-onset of regular drinking. An independent effect of age-at-onset of regular drinking was also observed indicating that a one-year delay in regular drinking was associated with a 7% decrease in the hazard of progression to AD among drinkers with an early onset (≤ 18), but a 3% increase among drinkers with a late onset (> 18) of regular drinking.

CONCLUSIONS

These results broaden our understanding of the contributions of measured genotypes underlying AD-risk on the etiology and clinical course of AD.

The Moderating Role of Social Support in the Relationship between Poor Mental Health and Excessive Alcohol Consumption: A Gender-Specific Analysis

Background: Social support can potentially attenuate the positive relationship between poor mental health and excessive drinking. The present study tried to understand: (1) whether there is a gender-specific relationship between poor mental health and excessive drinking; and (2) if and how social support moderates the relationship between poor mental health and excessive drinking. Methods: We analyzed the data from 2016 Behavioral Risk Factor Surveillance System (BRFSS; N = 33,705). Weighted data were stratified by gender and controlled for demographic variables. We assessed poor mental health and social support as correlates of heavy and binge drinking, followed by analyzing the moderation effect of social support X poor mental health interaction terms. Results: Poor mental health is linked with excessive drinking across genders. The interaction analysis shows that social support moderates the effect of ever having a poor mental health day in men's heavy drinking, but the interaction term is not significant in all other excessive drinking models, suggesting that social support may not buffer the negative impact of poor mental health on problem drinking, particularly among women. Conclusion: Individuals with greater mental health challenges are more likely to drink hazardously, regardless of gender. Those who have low level of social support and poor mental health, particularly men, are at risk for heavy drinking. Given the majority of the interaction results is not significant, the study provides limited support for the buffering role of social support between poor mental health and problem drinking.

Correlates of perceived stress among community-dwelling older African Americans

BACKGROUND

The purpose of this study was to identify correlates of perceived stress among older African Americans.

METHODS AND FINDINGS

Guided by the National Institute on Aging's (NIA) Health Disparities Research Framework, we grouped correlates into four levels-environmental, sociocultural, behavioral, and biological, and performed a cross-sectional analysis using ordinal logistic regression models. Participants included 722 African Americans [mean age = 73.61 years (SD = 6.33)] from the Minority Aging Research Study (MARS). Several protective correlates from environmental (e.g., larger life space), sociocultural (e.g., larger social network size), behavioral (e.g., more purpose in life), and biological (e.g., higher global cognition) levels were associated with a lower odds of having higher levels of perceived stress.

CONCLUSIONS

Perceived stress was associated with established and novel correlates from every level. Future research is needed to examine how changes in these correlates may impact perceived stress in older African Americans.

Who Uses Veterans Mental Health Services?: A National Observational Study of Male Veteran and Nonveteran Mental Health Service Users

ABSTRACT

Mental health (MH) research among veterans receiving services from the Veterans Health Administration (VHA) is extensive and growing and informs many clinical practice guidelines. We used nationally representative survey data to examine the generalizability of this extensive body of research by comparing sociodemographic and clinical characteristics of male veteran veterans health service (VHS) users (n = 491) with veteran non-VHS users (n = 840) and nonveteran (n = 6300) MH service users. VHS users were older, more often reported Black race, and less likely to have private or Medicaid insurance, but had similar prevalence of psychiatric or substance use disorder diagnoses but with a greater prevalence of posttraumatic stress disorder (PTSD). VHS users reported higher rates of medical diagnoses, pain interference, and poorer physical and MH status. These results suggest that VHA MH research may be reasonably generalizable to US mental health service users with caveats regarding age, PTSD diagnosis, pain, and racial distribution.

Assessing the validity, reliability and efficacy of the Cross-Cultural Stress Scale (CCSS) for psychosomatic studies

OBJECTIVE

The impact of stressful life events (SLEs) on health has been empirically studied with significant correlations documented. We developed a comprehensive stress rating toolkit, the Cross-Cultural Stress Scale (CCSS) from a triangulated qualitative research study. This article describes our pilot test of the scale to explore demographic-specific patterns of SLE scores and evaluate the scale's aptitude in assessing the stress-health correlation.

METHODS

The face and content-validated CCSS was shared via a web-based survey to diverse individuals grouped by: (a) gender, (b) age, (c) race and ethnicity, (d) native, foreign-born or first-generation, (e) educational attainment, and (f) income. Participants from the Amazon crowdsourcing marketplace MTurk (N = 216) first indicated perceived stress intensities assuming experiences of all the SLEs in the CCSS. They then selected SLEs they had personally experienced in the last 12 months (N = 176). Multivariable analyses were conducted on perceived intensities. Correlations of experienced SLEs with self-reported health based on the Centers for Disease Control and Prevention (CDC) Health Related Quality of Life (HRQOL) indicators measured by the Behavioral Risk Factors Surveillance System (BRFSS) were analyzed.

RESULTS

We validated the CCSS and obtained a high internal reliability (Cronbach's alpha >0.9). We found significant differences in stress rating by and within demographics. We also correlated stress to perceived health using the HRQOL and presence of a chronic disease ascertaining the stress-health hypothesis.

LIMITATION

Sampling limitations observed include data drawn from a convenience sample.

CONCLUSION

Despite sampling limitations, our research highlights demographic-specific stressors and offers an updated methodology in the stress-health correlation.

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.

Association of symptom severity, pain and other behavioral and medical comorbidities with diverse measures of functioning among adults with post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is an often disabling mental disorder whose management typically focuses on reducing PTSD symptoms. Chronic pain and other comorbidities that commonly accompany PTSD symptoms may also be independently associated with disability. Using data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions, we examined the independent association of PTSD symptom severity, pain interference, non-PTSD psychiatric and substance use disorders (SUD), and medical illnesses with each of four domains of function: mental health-related quality of life and physical functioning assessed with the Mental Health Composite Score (MCS) and Physical Function Score (PFS) of the Short Form-12; perceived social support from the Interpersonal Support and Evaluation List-12 (ISEL-12); and self-reported past year employment. Among 1779 individuals representing 11 million U.S. adults who met the Diagnostic and Statistical Manual-5 (DSM-5) criteria for Past Year PTSD, the MCS (41.2; SD 12.5), PFS (44.8; SD 13.2) and ISEL-12 (33.6; SD 7.2) indicated substantial disability when compared to population norms, and only 63.6% were employed. Multiple regression showed the MCS had a modest negative association with PTSD symptoms, pain interference, psychiatric multimorbidity and medical comorbidity although not with SUD. PFS and employment had significant negative associations with pain interference and medical comorbidity. ISEL-12 had a weak negative association with PTSD symptoms and non-PTSD psychiatric comorbidity. Common comorbidities thus significantly influence disability associated with PTSD, often more strongly than PTSD symptoms. PTSD treatment may require integrative multimorbidity management beyond a focus on PTSD symptoms.

The association of mental disorders with perceived social support, and the role of marital status: results from a national cross-sectional survey

Background

This study investigated whether (i) mental disorders were associated with perceived social support and its subcomponents, (ii) current marital status was related to perceived social support, and (iii) ‘Married’ status influenced the relationship between mental state and perceived social support.

Methods

Data from a cross-sectional national survey comprising 6126 respondents were used. Lifetime diagnosis for five mental disorders was assessed with a structured questionnaire. Perceived social support was measured with the Multidimensional Scale of Perceived Social Support (MSPSS) that provides Global and subscale scores for Significant Other, Family and Friends. Multiple linear regression analyses were conducted to address the research questions with MSPSS score as the dependent variable. Structural equation modeling (SEM) was performed to test mediation by marital status.

Results

All mental disorders included in the study, except alcohol use disorder (AUD), were significantly and negatively associated with Global MSPSS scores. After controlling for sociodemographic factors and chronic physical illness, major depressive disorder (β = - 0.299, 95% CI: -0.484 – -0.113, p = 002) and having any of the five mental disorders (β = - 0.133, 95% CI: -0.254 – -0.012, p = 032) were negatively associated with support from Significant Other, while support from Family and Friends was lower among all disorders, except AUD. Being married was positively associated with perceived social support in people with and without mental disorders. Results of the SEM partially support mediation by mental state - perceived social support relationship by ‘Married’ status.

Conclusion

Having mental disorders was associated with lower perceived social support. Being married has potential to influence this relationship.

A study to assess the effect of stressful life events on psychological distress levels of participants living in an urban area

Context:

Stressful life events affect the psychological wellbeing of individuals. Through this study, we aim to understand this effect and various other factors affecting the psychological wellbeing of the study participants.

Aims:

To determine the vulnerability of study participants to psychological distress following stressful life events

Settings and Design:

Cross-sectional observational study in an urban setting

Methods and Materials:

Systematic random sampling with a sample size of 178.

Statistical Analysis Used:

Analysis is done using SPSS version 22. Tests used are chi square test, Spearman's rank correlation test.

Results:

The number of life events and psychological distress scores had a positive correlation.The events that occurred in one month before history taking, a correlation was found to be strongest and no correlation was found between the events which occurred more than one year before study enrolment and the psychological distress. Factors like sleeping patterns, exercise, and marital status also had a significant correlation with the psychological distress score of participants.

Conclusions:

Mental health is dependent on many parameters with life events being a major factor at a given point of time. However, different factors apart from life events will affect psychological wellbeing, and mental health is an interplay of all those factors.

The role of social support on the effects of stress and depression on African American tobacco and alcohol use

OBJECTIVES

The current study explored whether social support (SS) from family and peers, influences the relationship between depressed mood (DM) and substance use (SU). We hypothesized that SS would have a protective effect on DM, and moderate the association between DM and SU.

PARTICIPANTS AND METHODS

Analyses focused on 703 individuals from the Carolina African American Twin Study on Aging (mean age = 49.78 years, STD = 14.52; 51% female). Participants reported on past year frequency of cigarettes and alcohol consumption, depressed mood, and stressful life events. Social support (SS) was assessed on two domains (i.e., emotional and instrumental), as well as for perceived quality and quantity of each type. Hypotheses were tested using ordinal logistic regression in Mplus while controlling for socioeconomic status, age, and gender.

RESULTS

Quality of emotional support was negatively associated with drinking. Smoking, but not drinking was associated with depressed mood. While individuals with high levels of depressed mood received more support, receiving better quality emotional support was associated with fewer mood and stress symptoms. Individuals who reported receiving better quality emotional support typically smoked fewer cigarettes.

CONCLUSION

Quantity of emotional support was associated with higher levels of negative emotionality, whereas the opposite was found for quality of emotional support. Emotional support may indirectly influence smoking via depressed mood. Effecting the perceived quality of support appears to be the mechanism by which emotional support helps to reduce smoking in adult African Americans.

Determinants of harmful use of alcohol among urban slum dwelling adults in Kenya

BACKGROUND

Harmful alcohol use is a public health problem associated with negative health and socio-economic impacts. However, patterns and dynamics of alcohol use among slum-dwellers in Kenya are poorly understood.

OBJECTIVE

To establish determinants of harmful alcohol use among adults in an urban slum setting in Kenya.

MATERIALS AND METHODS

Cross-sectional study involving a consecutively selected sample (N=215) from Githurai, in Nairobi. A pre-tested questionnaire that captured data on socio-demographics, drinking patterns, type, reasons, initiator, and support system.

RESULTS

Of the respondents, those above 31 years, married, separated/divorced/widowed, of high education, earning above 50 USD, and from dysfunctional families consumed more alcohol. Low earners consumed (p < 0.05) unrecorded while high earners drank (p< 0.001) recorded alcohol. Adults from families with a drinking father and sibling consumed more alcohol (p=0.001). Single, low educational attainment/earners, and those in dysfunctional families (p <0.05) drank due to stress and reported alcohol-related problems. Young, unmarried, and casual laborers were introduced (p < 0.05) to alcohol by friends.

CONCLUSION

Socio-demographic, economic, familial, social interactions, and stress are associated with harmful alcohol use among adults from slums calling for interventions targeting these factors.

Alcohol consumption among older women in the United States

Few studies have examined alcohol consumption among older women. Using the nationally representative National Survey on Drug Use and Health, we examined binge, moderate, and no alcohol consumption among women ages 50+ (n = 21,178). We calculated population prevalence by age and used multivariate logistic regression, controlling for seven sociodemographic factors. In adjusted results, women ages 65+ were more likely to have moderate or no alcohol consumption than those 50-64; Hispanic and African American women were more likely to engage in binge consumption than whites (all p < .01). More research is needed to understand binge alcohol consumption among older women in racial/ethnic minorities.

Psychosocial Stress and Overweight and Obesity: Findings From the Chicago Community Adult Health Study

BACKGROUND

Psychosocial stress has been implicated as a risk factor for overweight and obesity. However, research on psychosocial stressors and overweight and obesity has typically focused on single stressors in isolation, which may overestimate the impact of a specific stressor and fail to describe the role of cumulative stress on overweight and obesity risk.

PURPOSE

This study explores the association between overweight/obesity and cumulative exposure to a wide range of psychosocial stressors, among a multiracial/ethnic sample of adults.

METHODS

Using secondary data from the Chicago Community Adult Health Study (n = 2,983), we conducted multinomial logistic regression analyses to quantify associations between eight psychosocial stressors, individually and in combination, and measured overweight and obesity, adjusted for sociodemographic factors, alcohol use and smoking.

RESULTS

In separated covariate-adjusted models, childhood adversities (odds ratio [OR] = 1.16; confidence interval [CI] = [1.03, 1.30]), acute life events (OR = 1.18; CI = [1.04, 1.34]), financial strain (OR = 1.30; CI = [1.15, 1.47]), and relationship stressors (OR = 1.18; CI = [1.04, 1.35]) were associated with increased odds of obesity. In a model adjusted for all stressors simultaneously, financial strain was the only stressor independently associated with overweight (OR = 1.17; CI = [1.00, 1.36]) and obesity (OR = 1.21; CI = [1.05, 1.39]). Participants with stress exposure in the highest quintile across 2, 3, or ≥4 (compared to no) types of stressors had significantly higher odds of obesity.

CONCLUSIONS

Multiple types of stressors may be risk factors for obesity, and cumulative exposure to these stressors may increase the odds of obesity. Reducing exposure to stressors at the population level may have the potential to contribute to reducing the burden of obesity.

Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women

Background. Although chronic medical conditions (CMCs), depression, and self-rated health (SRH) are associated, their associations may depend on race, ethnicity, gender, and their intersections. In predominantly White samples, SRH is shown to better reflect the risk of mortality and multimorbidity for men than it is for women, which suggests that poor SRH among women may be caused not only by CMCs, but also by conditions like depression and social relations-a phenomenon known as "the sponge hypothesis." However, little is known about gender differences in the links between multimorbidity, depression, and SRH among African Americans (AAs). Objective. To study whether depression differently mediates the association between multimorbidity and SRH for economically disadvantaged AA men and women. Methods. This survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 AA older adults (age ≥ 55 years) were enrolled in this study, of which 266 were AA men and 474 were AA women. The independent variable was the number of CMCs. The dependent variable was SRH. Age and socioeconomic status (educational attainment and marital status) were covariates. Depression was the mediator. Gender was the moderator. Structural Equation Modeling (SEM) was used to analyze the data. Results. In the pooled sample that included both genders, depression partially mediated the effect of multimorbidity on SRH. In gender specific models, depression fully mediated the effects of multimorbidity on SRH for AA men but not AA women. For AA women but not AA men, social isolation was associated with depression. Conclusion. Gender differences exist in the role of depression as an underlying mechanism behind the effect of multimorbidity on the SRH of economically disadvantaged AA older adults. For AA men, depression may be the reason people with multimorbidity report worse SRH. For AA women, depression is only one of the many reasons individuals with multiple CMCs report poor SRH. Prevention of depression may differently influence the SRH of low-income AA men and women with multimorbidity.

Factors associated with alcohol consumption and prescribed drugs with addiction potential among older women and men - the Nord-Trøndelag health study (HUNT2 and HUNT3), Norway, a population-based longitudinal study

BACKGROUND

Little is known about factors associated with alcohol consumption and use of drugs with addiction potential in older adults. The aim of this study was to explore the association between socio-demographic variables, physical and mental health and the later (11 years) use of frequent drinking, prescribed drugs with addiction potential and the possible combination of frequent drinking and being prescribed drugs with addiction potential in older adults (≥ 65 years).

METHODS

In this longitudinal study, we used data from two surveys of the Nord-Trøndelag Health Study (HUNT2 1995-1997 and HUNT3 2006-2008), a population based study in Norway. We totally included 10,656 individuals (5683 women) aged 54 years and older when they participated in HUNT2. Frequent drinking was defined as drinking alcohol 4 days or more per week. Data on prescribed drugs with addiction potential were drawn from the Norwegian Prescription Database. Drugs with addiction potential were defined as at least one prescription of benzodiazepines, z-hypnotics or opioids during one year for a minimum of two consecutive years between 2005 and 2009.

RESULTS

The typical frequent drinker in HUNT3 was younger, more educated, lived in urban areas, and reported smoking and drinking frequently in HUNT2 compared to the non-frequent drinker in HUNT3. The typical user of prescribed drugs with addiction potential in HUNT3 was an older woman who smoked and was in poor health, suffered from anxiety, had been hospitalized in the last 5 years and used anxiety or sleep medication every week or more often in HUNT2. The typical individual in HUNT3 with the possible combination of frequent drinking and being prescribed drugs with addiction potential had more education, smoked, drank frequently and used anxiety or sleep medication in HUNT2.

CONCLUSION

Individuals who were identified as frequent drinkers in HUNT2 were more likely to be frequent drinkers in HUNT3, and to have the possible combination of frequent drinking and being prescribed drugs with addiction potential in HUNT3. Health care professionals need to be aware of use of alcohol among older adults using drugs with addiction potential.

Negative life events and incident alcohol use disorders among ethnic minorities

The association of negative life events (NLEs) with incident alcohol use disorders (AUDs) was examined among Blacks, Hispanics, and Whites in the second wave of the National Comorbidity Survey (NCS) among 3,679 participants without AUDs at the first wave. The number of past-year NLEs at NCS-2 was higher for Black than White participants, but the rates of incident AUDs did not differ by racial/ethnic group (14.2% among all participants). Past-year NLEs were associated with increased odds of incident AUDs for Whites and Hispanics but not Blacks. The implications of racial/ethnic differences in life events and AUDs are discussed.

Alcohol consumption and all-cause mortality in older adults in Spain: an analysis accounting for the main methodological issues

BACKGROUND AND AIMS

Observational evidence that light-to-moderate alcohol consumption lowers mortality is questioned because of potential selection biases and residual confounding. We assess the association between alcohol intake and all-cause death in older adults after accounting for those methodological issues.

METHODS

Data came from 3045 individuals representative of the non-institutionalized population aged ≥ 60 years in Spain. Participants were recruited in 2008-10, when they reported current and life-time alcohol intake; drinkers were classified as occasional (< 1.43 g/day), light (≥ 1.43 but < 20 g/day for men and ≥ 1.43 but < 10 g/day for women), moderate (≥ 20 but < 40 g/day for men and ≥ 10 but < 20 g/day for women) or heavy (≥ 40 g/day for men and ≥ 24 g/day for women)/binge. Participants were followed-up to 2017 to assess vital status. In analyses, ex-drinkers were removed from the abstainer group and were classified according to their life-time intake to address the 'abstainer bias'. Moreover, analyses were replicated in individuals without functional limitations, and excluded deaths in the first year of follow-up, to address reverse causation. Also, occasional drinkers were used as reference in some analyses to reduce the 'healthy drinker/survivor' bias. Results were adjusted for many covariates to minimize residual confounding.

RESULTS

Compared with never-drinkers, the hazard ratio (95% confidence interval) of mortality for light drinkers was 1.05 (0.71-1.56) and 1.20 (0.72-2.02) in those without functional limitations. Corresponding values for moderate drinkers were 1.28 (0.81-2.02) and 1.55 (0.87-2.75) and for heavy/binge drinkers 1.85 (1.07-3.23) and 2.15 (1.09-4.22). Results were consistent when occasional drinkers were used as reference. Among drinkers without functional limitations, the hazard ratio (95% confidence interval) of mortality per 10 g/day of alcohol was 1.12 (1.02-1.23).

CONCLUSION

After accounting for potential biases, light-to-moderate drinking among people 60+ years of age appears to have no statistically significant benefit on mortality compared with abstention from alcohol. By contrast, heavy/binge drinking shows a higher death risk compared with abstention from alcohol. Alcohol intake appears to have a positive dose-response with mortality among drinkers.

Changes in health status predict changes in alcohol consumption in older adults: the Seniors-ENRICA cohort

Background

Some of the previously reported health benefits of low-to-moderate alcohol consumption may derive from health status influencing alcohol consumption rather than the opposite. We examined whether health status changes influence changes in alcohol consumption, cessation included.

Methods

Data came from 571 current drinkers aged ≥60 years participating in the Seniors-ENRICA cohort in Spain. Participants were recruited in 2008–2010 and followed-up for 8.2 years, with four waves of data collection. We assessed health status using a 52-item deficit accumulation (DA) index with four domains: functional, self-rated health and vitality, mental health, and morbidity and health services use. To minimise reverse causation, we examined how changes in health status over a 3-year period (wave 0–wave 1) influenced changes in alcohol consumption over the subsequent 5 years (waves 1–3) using linear/logistic regression, as appropriate.

Results

Compared with participants in the lowest tertile of DA change (mean absolute 4.3% health improvement), those in the highest tertile (7.8% worsening) showed a reduction in alcohol intake (β: –4.32 g/day; 95% CI –7.00 to –1.62; p trend=0.002) and were more likely to quit alcohol (OR: 2.80; 95% CI 1.54 to 5.08; p trend=0.001). The main contributors to decreasing drinking were increased functional impairment and poorer self-rated health, whereas worsening self-rated health, onset of diabetes or stroke and increased prevalence of hospitalisation influenced cessation.

Conclusions

Health deterioration is related to a subsequent reduction and cessation of alcohol consumption contributing to the growing evidence challenging the protective health effect previously attributed to low-to-moderate alcohol consumption.

Smoking and drinking behaviors of military spouses: Findings from the Millennium Cohort Family Study

INTRODUCTION

The associations between stressful military experiences and tobacco use and alcohol misuse among Service members are well documented. However, little is known about whether stressful military experiences are associated with tobacco use and alcohol misuse among military spouses.

METHODS

Using 9872 Service member-spouse dyads enrolled in the Millennium Cohort Family Study, we employed logistic regression to estimate the odds of self-reported cigarette smoking, risky drinking, and problem drinking among spouses by Service member deployment status, communication regarding deployment, and stress associated with military-related experiences, while adjusting for demographic, mental health, military experiences, and Service member military characteristics.

RESULTS

Current cigarette smoking, risky drinking, and problem drinking were reported by 17.2%, 36.3%, and 7.3% of military spouses, respectively. Current deployment was not found to be associated with spousal smoking or drinking behaviors. Communication about deployment experiences with spouses was associated with lower odds of smoking, but not with risky or problem drinking. Spouses bothered by communicated deployment experiences and those who reported feeling very stressed by a combat-related deployment or duty assignment had consistently higher odds of both risky and problem drinking.

CONCLUSIONS

Our findings suggest that contextual characteristics about the deployment experience, as well as the perceived stress of those experiences, may be more impactful than the simple fact of Service member deployment itself. These results suggest that considering the impact of deployment experiences on military spouses reveals important dimensions of military community adaptation and risk.

Major life events and risk of alcohol use disorders: a prospective cohort study

AIMS

To estimate associations of individual major life events as well as accumulated major life events in childhood, adult private life and adult work life with risk of alcohol use disorders (AUD).

DESIGN

Prospective cohort study with baseline examination in 1991-93 and linkage to national registers to identify AUD at follow-up.

SETTING

Copenhagen, Denmark.

PARTICIPANTS

Individuals (aged 21-93 years) who participated in the Copenhagen City Heart Study in 1991-93 (n = 8758).

MEASUREMENTS

The primary outcome was first registration with AUD during follow-up (n = 249). AUD was identified in the Danish National Patient Register, in the Danish Psychiatric Central Register and in an outpatient treatment register. Major life events were assessed by a questionnaire in the Copenhagen City Heart study. Data were analysed by Cox proportional hazards models adjusted for age, sex, educational level, household income, cohabitation status and psychiatric comorbidity.

FINDINGS

Serious family conflicts in childhood [hazard ratio (HR) = 1.35; 95% confidence interval (CI) = 1.00, 1.83] and serious economic problems in adult life (HR = 2.22; 95% CI = 1.64, 3.01) were associated significantly with increased risk of AUD. Prospective analyses did not show consistent effects of accumulation of major life events in childhood or adult life, but an additional analysis based on all AUD registrations suggested an association between accumulated childhood events and risk of AUD.

CONCLUSIONS

Serious economic problems in adult life are associated strongly with risk of alcohol use disorders, and there may be an influence of accumulated childhood events on risk of alcohol use disorders.

Association between psychosocial work conditions and latent alcohol consumption trajectories among men and women over a 16-year period in a national Canadian sample

BACKGROUND

It is unclear how psychosocial working conditions influence future alcohol consumption. Using group-based trajectory modelling, this study aimed to determine: the number of latent alcohol consumption trajectories over 16 years in a representative sample of the Canadian workforce; the association between psychosocial working conditions and longitudinal alcohol consumption; and if the association between psychosocial work factors and longitudinal alcohol consumption differed among men and women.

METHODS

We included 5458 employed adults from the longitudinal Canadian National Population Health Survey. Average daily alcohol consumption was measured every 2 years from 1994 to 2010. Psychosocial work factors were measured in 1994 using the Job Content Questionnaire. Group-based trajectory modelling was used to derive the appropriate number of alcohol behaviour trajectories. The association between psychosocial work factors and alcohol trajectory membership was estimated using multinomial logistic regression. Models were stratified by sex to determine if these associations differed among men and women.

RESULTS

Three alcohol consumption trajectories were present: non-drinkers, light drinkers (0.5-1 drinks/day) and moderate drinkers (2-3 drinks/day). Higher workplace physical exertion and lower social support levels were associated with membership in the moderate drinking trajectory. Among men, lower psychological demands and higher physical exertion levels were associated with membership in the moderate drinking trajectory. Among women, lower levels of physical exertion were associated with membership in the light drinking trajectory, and higher psychological demand levels were associated with membership in the moderate drinking trajectory.

CONCLUSIONS

Our study suggests that workplace physical exertion and psychological demands may be associated with different alcohol consumption trajectories among men and women.

Alcohol use/abuse and help-seeking among U.S. adults: The role of racial-ethnic origin and foreign-born status

We used data from Wave 1 and Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions to examine racial-ethnic and nativity-based variations in alcohol use/abuse and treatment seeking while accounting for acculturation, stress, and social integration factors. The dependent variables included alcohol use, risky drinking, DSM-IV alcohol use disorder, and treatment seeking in the past 12 months. Racial-ethnic categories included African, European, Asian/Pacific Islander, Mexican, Puerto Rican, and other Hispanic/Latino. Acculturation, social stress, and social integration were assessed with previously validated, detailed measures. Bivariate probit models with sample selection were estimated for women and men. Immigrant status and origin associations with alcohol use/abuse and treatment seeking were strong and largely unaffected by other social factors. Europeans and men of Mexican origin had the highest while women of African, Asian/Pacific Islander, and Puerto Rican origins had the lowest rates of alcohol use/abuse. Years in the United States was associated with a higher risk of alcohol use/abuse for all immigrant groups. Foreign-born individuals were no less likely than U.S. natives to seek treatment if they were abusing or were dependent on alcohol. Further modeling of these relationships among specific immigrant groups is warranted. These findings inform alcohol rehabilitation and mental health services for racial-ethnic minorities and immigrants.

Effects of Workplace Generalized and Sexual Harassment on Abusive Drinking Among First Year Male and Female College Students: Does Prior Drinking Experience Matter?

BACKGROUND

Workplace harassment, a known risk factor for adult drinking, is understudied in college samples, but may help explain observed gender differences in drinking patterns.

OBJECTIVE

We examine effects of sexual and generalized workplace harassment on changes in drinking behavior over the first semesters of college, and the extent to which these effects differ based on prematriculation drinking for men and women students.

METHOD

Data derive from two waves of a longitudinal study of eight Midwestern colleges and universities. Data were collected from 2080 employed students via a Web-based survey assessing sexual and generalized workplace harassment, stressful life events, drinking to intoxication, and binge drinking prior to freshman year (fall 2011) and approximately one year later (summer to fall 2012). At baseline, lifetime drinking status, frequency of alcohol consumption, and demographics were also assessed.

RESULTS

Linear-mixed modeling indicated that employed women students who were frequent drinkers prematriculation were at risk for high levels of drinking associated with workplace harassment, while men who were nondrinkers were most at risk of increasing problem drinking over time when exposed to workplace harassment.

CONCLUSIONS

Alcohol use prevention efforts directed towards employed students are needed both prior to and during college, to instruct students how to identify workplace harassment and cope in healthier ways with stressful workplace experiences. These efforts might be particularly useful in stemming problematic drinking among women who drink frequently prior to college, and preventing men who are nondrinkers upon college entry from initiating problematic drinking during subsequent enrollment years.

Exercise capacity is not impaired after acute alcohol ingestion: a pilot study

The usage of alcohol is widespread, but the effects of acute alcohol ingestion on exercise performance and the stress hormone axis are not fully elucidated.We studied 10 healthy white men, nonhabitual drinkers, by Doppler echocardiography at rest, spirometry, and maximal cardiopulmonary exercise test (CPET) in two visits (2-4 days in between), one after administration of 1.5 g/kg ethanol (whisky) diluted at 15% in water, and the other after administration of an equivalent volume of water. Plasma levels of NT-pro-BNP, cortisol, and adrenocorticotropic hormone (ACTH) were also measured 10 min before the test, at maximal effort and at the third minute of recovery. Ethanol concentration was measured from resting blood samples by gas chromatography and it increased from 0.00 ± 0.00 to 1.25 ± 0.54‰ (P < 0.001). Basal echocardiographic and spirometric parameters were normal and remained so after acute alcohol intake, whereas ACTH, cortisol, and NT-pro-BNP nonsignificantly increased in all phases of the test. CPET data suggested a trend toward a slight reduction of exercise performance (peak VO2 = 3008 ± 638 vs. 2900 ± 543 ml/min, ns; peak workload = 269 ± 53 vs. 249 ± 40 W, ns; test duration 13.7 ± 2.2 vs. 13.3 ± 1.7 min, ns; VE/VCO2 22.1 ± 1.4 vs. 23.3 ± 2.9, ns). Ventilatory equivalent for carbon dioxide at rest was higher after alcohol intake (28 ± 2.5 vs. 30.4 ± 3.2, P = 0.039) and maximal respiratory exchange ratio was lower after alcohol intake (1.17 ± 0.02 vs. 1.14 ± 0.04, P = 0.04). In conclusion, we showed that acute alcohol intake in healthy white men is associated with a nonsignificant exercise performance reduction and stress hormone stimulation, with an unchanged exercise metabolism.

Binge Drinking and Depression: The Influence of Romantic Partners in Young Adulthood

Although research shows that spouses influence each other's health behaviors and psychological well-being, we know little about whether these patterns extend to young people in nonmarital as well as marital relationships. We use the National Longitudinal Study of Adolescent to Adult Health to consider how a romantic partner's binge drinking and depression influence the respondent's binge drinking and depression within 1,111 young adult couples and explore whether these processes are moderated by gender. We find that partners' binge drinking is associated with increased odds of binge drinking for respondents, and partners' depression is associated with increased odds of depression for respondents. Further, depression among men is associated with reduced odds of binge drinking among their female partners. Findings suggest that processes of partner influence begin even in young adulthood with implications for cumulative effects on lifelong health behaviors and mental health.

Lifecourse transitions, gender and drinking in later life

Older people consume less alcohol than any other adult age group. However, in recent years survey data on alcohol consumption in the United Kingdom have shown that while younger age groups have experienced a decline in alcohol consumption, drinking behaviours among the elderly have not reduced in the same way. This paper uses data from the English Longitudinal Study of Ageing to analyse both the frequency and quantity of older adult's alcohol consumption using a lifecourse approach over a ten-year period. Overall drinking declined over time and the analysis examined how socio-economic characteristics, partnership, employment and health statuses were associated with differences in drinking behaviours and how these changed over time. Higher wealth and level of education were associated with drinking more and drinking more frequently for men and women. Poorer self-rated health was associated with less frequent consumption and older people with poor and deteriorating health reported a steeper decline in the frequency of alcohol consumption over time. Men who were not in a partnership drank more than other men. For women, loss of a partner was associated with a steeper decline in drinking behaviours. These findings have implications for programmes to promote responsible drinking among older adults as they suggest that, for the most part, characteristics associated with sustaining wellbeing in later life are also linked to consuming more alcohol.

Factors Associated With High-Risk Alcohol Consumption Among LGB Older Adults: The Roles of Gender, Social Support, Perceived Stress, Discrimination, and Stigma

PURPOSE OF THE STUDY

Lesbian, gay, and bisexual (LGB) adults have elevated rates of high-risk alcohol consumption compared with heterosexual adults. Although drinking tends to decline with age in the general population, we know little about LGB older adults' drinking. Using 2014 data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS), we aimed to identify factors associated with high-risk drinking in LGB older adults.

DESIGN AND METHODS

A U.S. sample of 2,351 LGB adults aged 50-98 years completed a survey about personal and social experiences, substance use, and health. Multinomial logistic regression was conducted to identify predictors of past-month high-risk alcohol consumption.

RESULTS

Approximately one fifth (20.6%) of LGB older adults reported high-risk drinking, with nonsignificantly different rates between men (22.4%) and women (18.4%). For women, current smoking and greater social support were associated with greater likelihood of high-risk drinking; older age, higher income, recovery from addiction, and greater perceived stress were associated with lower likelihood. For men, higher income, current smoking, and greater day-to-day discrimination were associated with greater likelihood of high-risk drinking; transgender identity and recovery from addiction were associated with lower likelihood.

IMPLICATIONS

Social contexts and perceived drinking norms may encourage higher levels of alcohol consumption in LGB older women, whereas men's drinking may be linked with discrimination-related stress. Prevention and intervention with this population should take into account gender differences and sexual minority-specific risk factors. With future waves of data, we will be able to examine LGB older adults' drinking trajectories over time.

Relations among social support, PTSD symptoms, and substance use in veterans

Social support plays a significant role in the development, maintenance, and treatment of posttraumatic stress disorder (PTSD). However, there has been little investigation of social support with PTSD and its frequent comorbid conditions and related symptoms. Substance use disorders (SUDs) are 1 set of conditions that have yet to be investigated in combination with PTSD and social support. As compared with civilians, veterans are at increased risk for developing both PTSD and SUD. In this study, veterans (N = 171) with symptoms of PTSD (76% met diagnostic criteria) and SUD (83% met diagnostic criteria for any dependence) were recruited and completed clinician-rated and self-report measures of PTSD, SUD, and social support. Overall, low social support was reported in the sample. When controlled for the other disorder's symptoms, PTSD symptoms demonstrated a significant negative relation and SUD symptoms demonstrated a significant positive relation to social support. The PTSD findings are consistent with previous studies on PTSD and social support without SUD comorbidity. However, the SUD findings are inconsistent with previous studies, which focused primarily on older veterans. Together, these findings highlight the significance of social support in individuals with PTSD and SUD and promote future research within comorbid presentations. (PsycINFO Database Record

Life-stress and reactivity by gender in a longitudinal birth cohort at 30 and 35 years

PURPOSE

Previous literature has shown gender differences in reactivity to stressful life events. However, it is unclear whether gender differences in stress reactivity are consistent across a series of life event domains among longitudinal adult sample populations.

METHODS

Data were gathered from the Christchurch Health and Development Study (CHDS). The CHDS is a longitudinal birth cohort of 1265 children born in 1977 in Christchurch, New Zealand. Cohort members were questioned on their experience of, and distress from, a series of life event domains (interpersonal problems; victimization; illness/death; pregnancy/parenthood; employment/finance problems) spanning two age-periods 25-30 years (data collected in 2007) and 30-35 years (data collected in 2012). The data were pooled across observations and analyzed using population-averaged repeated-measures regression methods.

RESULTS

Overall, men and women reported experiencing similar numbers of life events for each domain. However, men reported more victimization and more employment/financial problems; women reported more illness/death events. Women reported experiencing more distress per life event for the domains of interpersonal problems, illness/death and pregnancy/parenthood. Men and women reported similar distress per life event for the victimization and employment/finance domains. The results were robust to control for: child and adolescent factors (childhood abuse exposure; adolescent personality; mental health) and adult factors (mental health; self-esteem).

CONCLUSION

These findings are consistent with a growing body of evidence indicating that some life events including interpersonal problems, illness/death and pregnancy/parenthood may be intrinsically more distressing for women. Detection of life event distress is important to aid in the prevention of mental/physical health problems.

Marital Histories and Heavy Alcohol Use among Older Adults

We develop a gendered marital biography approach-which emphasizes the accumulating gendered experiences of singlehood, marriage, marital dissolution, and remarriage-to examine the relationship between marital statuses and transitions and heavy alcohol use. We test this approach using individual-level (n = 10,457) and couple-level (n = 2,170) longitudinal data from the Health and Retirement Study, and individual-level (n = 46) and couple-level (n = 42) in-depth interview data. Quantitative results show that marriage, including remarriage, reduces men's but increases women's drinking relative to being never married and previously married, whereas divorce increases men's but decrease women's drinking, with some variation by age. Our qualitative findings reveal that social control and convergence processes underlie quantitative results. We call attention to how men's and women's heavy drinking trajectories stop, start, and change direction as individuals move through their distinctive marital biography.

Is regular drinking in later life an indicator of good health? Evidence from the English Longitudinal Study of Ageing

Background

Older people who drink have been shown to have better health than those who do not. This might suggest that moderate drinking is beneficial for health, or, as considered here, that older people modify their drinking as their health deteriorates. The relationship between how often older adults drink and their health is considered for two heath states: self-rated health (SRH) and depressive symptoms.

Methods

Data were analysed from the English Longitudinal Study of Ageing (ELSA), a prospective cohort study of older adults, using multilevel ordered logit analysis. The analysis involved 4741 participants present at wave 0, (1998/1999 and 2001), wave 4 (2008/2009) and wave 5 (2010/2011). The outcome measure was frequency of drinking in last year recorded at all three time points.

Results

Older adults with fair/poor SRH at the onset of the study drank less frequently compared with adults with good SRH (p<0.05). Drinking frequency declined over time for all health statuses, though respondents with both continual fair/poor SRH and declining SRH experienced a sharper reduction in the frequency of their drinking over time compared with older adults who remained in good SRH or whose health improved. The findings were similar for depression, though the association between depressive symptoms and drinking frequency at the baseline was not significant after adjusting for confounding variables.

Conclusions

The frequency of older adults’ drinking responds to changes in health status and drinking frequency in later life may be an indicator, rather than a cause, of health status.

The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings

PURPOSE

The NESARC, a "third-generation" psychiatric epidemiologic survey that integrated detailed measures of alcohol and drug use and problems has been the data source for over >850 publications. A comprehensive review of NESARC findings and their implications is lacking.

METHOD

NESARC was a survey of 43,093 participants that covered alcohol, drug and psychiatric disorders, risk factors, and consequences. Wave 1 of the NESARC was conducted in 2001-2002. Three years later, Wave 2 follow-up re-interviews were conducted with 34,653 of the original participants. Scopus and Pubmed were used to search for NESARC papers, which were sorted into topic areas and summarized.

RESULT

The most common disorders were alcohol and posttraumatic stress disorders, and major depression. Females had more internalizing disorders and males had more externalizing disorders, although the preponderance of males with alcohol disorders (the "gender gap") was less pronounced than it was in previous decades. A race/ethnic "paradox" (lower risk among disadvantaged minorities than whites) remains unexplained. Younger participants had higher risk for substance and personality disorders, but not unipolar depressive or anxiety disorders. Psychiatric comorbidity was extensive and often formed latent trans-diagnostic domains. Since 1991-1992, risk for marijuana and prescription drug disorders increased, while smoking decreased, although smoking decreases were less pronounced among those with comorbidity. A nexus of comorbidity, social support, and stress predicted transitions in diagnostic status between Waves 1 and 2. Childhood maltreatment predicted psychopathology. Alcohol and drug use disorders were seldom treated; attitudinal barriers (little perceived need, perceived alcoholism stigma, pessimism about efficacy) were more important in predicting non-treatment than financial barriers.

CONCLUSIONS

Understanding comorbidity and the effects of early stressors will require research incorporating biologic components, e.g., genetic variants and brain imaging. The lack of treatment for alcohol and drug disorders, predicted by attitudinal rather than financial variables, suggests an urgent need for public and professional education to reduce the stigma associated with these disorders and increase knowledge of treatment options.