Marital satisfaction as a potential moderator of the association between stress and depression

BACKGROUND

Stress and marital dissatisfaction have been identified as risk factors for depression in separate lines of research. However, the interaction between stress and marital satisfaction in predicting depression over time has rarely been examined, despite the fact that marital satisfaction may weaken (i.e., buffer) the impact of stress on depression. This longitudinal study evaluated marital satisfaction as a moderator of the association between stress and depressive symptoms in a probability sample of American married adults.

METHODS

Married respondents from Wave I and Wave II of the Americans' Changing Lives (ACL) study (N = 1392) completed measures of marital satisfaction, stressful life events, and depressive symptoms at baseline and three-year follow-up.

RESULTS

Marital satisfaction and stressful life events were significantly associated with depressive symptoms in cross-sectional analyses and uniquely predicted depressive symptoms three years later, controlling for prior depressive symptoms. However, marital satisfaction did not moderate the association between stressful life events and depression. A sensitivity analysis of data from Wave IV and Wave V of the ACL yielded similar findings, supporting the replicability of the results.

LIMITATIONS

Broader assessment on stressful life events and assessment of perceived stress would provide a stronger test of the association between stress and depression as well as the degree to which this association is moderated by marital satisfaction.

CONCLUSIONS

Attending to both stress and marital satisfaction may provide a more comprehensive understanding of risk for depression than exclusive focusing on either stress or marital satisfaction, which may have beneficial implications for preventing and treating depression.

Associations between sexual precedent and sexual compliance: An event-level examination

Objective Most studies on agreeing to unwanted sex have assessed sexual encounters between people who have had sex before. Thus, we examined instances of sexual compliance with a novel sexual partner. Participants: A probability sample of college students at a university in the Midwest United States (N = 7,112). Methods: Participants completed an online survey based on measures from the National Survey of Sexual Health and Behavior. Results: Only 2.5% (n = 179) agreed to unwanted sexual activity at their most recent sexual encounter. People who were sexually compliant with a novel sexual partner frequently did so due to their own alcohol intoxication. Further, sexual compliance with novel sexual partners was less frequently associated with affectionate sexual behaviors or orgasm. Conclusions: Our initial findings regarding the effect of sexual precedent on sexual compliance warrant further research on instances when people agree to sex they don't want with novel partners.

Exercise-Induced Orgasm and Its Association with Sleep Orgasms and Orgasms During Partnered Sex: Findings From a U.S. Probability Survey

Prior research has described women's experiences with exercise-induced orgasm (EIO). However, little is known about men's experiences with EIO, the population prevalence of EIO, or the association of EIO with other kinds of orgasm. Using U.S. probability survey data, the objectives of the present research were to: (1) describe the lifetime prevalence of exercise-induced orgasm (EIO) and sleep orgasm; (2) assess respondents' age at first experience of EIO as well as the type of exercise connected with their first EIO; (3) examine associations between lifetime EIO experience and orgasm at respondents' most recent partnered sexual event; and (4) examine associations between lifetime EIO experience and sleep orgasms. Data were from the 2014 National Survey of Sexual Health and Behavior (1012 men and 1083 women, ages 14 years and older). About 9% of respondents reported having ever experienced exercise-induced orgasm. More men than women reported having experienced orgasm during sleep at least once in their lifetime (66.3% men, 41.8% women). The mean age for women's first EIO was significantly older than men (22.8 years women, 16.8 years men). Respondents described a wide range of exercises as associated with their first EIO (i.e., climbing ropes, abdominal exercise, yoga). Lifetime EIO experience was associated with lifetime sleep orgasms but not with event-level orgasm during partnered sex. Implications related to understanding orgasm and recommendations for clinicians and sex educators are discussed.

Comparing National Probability and Community-Based Samples of Sexual Minority Adults: Implications and Recommendations for Sampling and Measurement

Scientific evidence regarding sexual minority populations has generally come from studies based on two types of samples: community-derived samples and probability samples. Probability samples are lauded as the gold standard of population research for their ability to represent the population of interest. However, while studies using community samples lack generalizability, they are often better able to assess population-specific concerns (e.g., minority stress) and are collected more rapidly, allowing them to be more responsive to changing population dynamics. Given these advantages, many sexual minority population studies rely on community samples. To identify how probability and community samples of sexual minorities are similar and different, we compared participant characteristics from two companion samples from the Generations Study, each designed with the same demographic profile of U.S. sexual minority adults in mind. The first sample was recruited for a national probability survey, whereas the second was recruited for a multicommunity sample from four U.S. cities. We examined sociodemographic differences between the samples. Although there were several statistical differences between samples, the effect sizes were small for sociodemographic characteristics that defined the sample inclusion criteria: sex assigned at birth, race/ethnicity, and age cohort. The samples differed across other characteristics: bisexual respondents, respondents with less education, and those living in non-urban areas were underrepresented in the community sample. Our findings offer insights for recruiting community samples of sexual minority populations and for measuring sexual identity on probability surveys. They also bolster confidence in well-designed community samples as sources for data on sexual minority populations.

Analysis of Sexual Behaviors among Adults in Korea: Results from the "Korean National Survey on Sexual Consciousness"

Purpose

This study aimed to understand the characteristics of sexual behaviors among Korean adults to facilitate the development of strategies and policies focused on sexual health in groups categorized by sociodemographic characteristics.

Materials and Methods

A nationally representative probability sample of 2,500 individuals (1,273 men and 1,227 women) aged 18–69 years obtained using a stratified multiple-stage sampling method based on Statistics Korea (KOSTAT) participated in a cross-sectional online survey. The survey consisted of structured questionnaires comprising questions on demographic information, lifetime sexual behavior, and sexual behavior in the previous 12 months.

Results

The mean age at first sexual intercourse was lower in men than in women (21.9±4.4 vs. 24.1±4.4 years, p=0.001). The overall prevalence rate of sexual events with casual partners within previous 12 months was 13.1% (95% confidence interval [CI], 11.6%–14.5%). It was found to more commonly exist among lower age groups and men. The overall regular condom use rates with relationship partner and casual partner were 14.8% (95% CI, 13.2%–16.4%) and 39.6% (95% CI, 33.9%–45.3%), respectively. Condom use rate with casual partners among 20s and 30s men was 51.2%. Overall, only 10.4% of the respondents had received sexual education about sexually transmitted infections.

Conclusions

This study provided contemporary sexual behaviors in Korean adults, and identified socio-demographic factors that seem to influence sexual behaviors. Low condom use rates and low rate of receiving sexual education were concerns. The result of this study would be useful to health professionals to formulate policies and strategies related to sexual health.

Longitudinal associations between rumination and depressive symptoms in a probability sample of adults

BACKGROUND

According to the Response Styles Theory, rumination maintains and exacerbates depression. This study was conducted to examine the bidirectional longitudinal associations between rumination and depressive symptoms in a probability sample of Australian adults, evaluate the degree to which the strength of these longitudinal associations was moderated by gender, and test whether these longitudinal associations remained statistically significant when adjusting for the influence of demographic characteristics and neuroticism.

METHODS

A probability sample of Australian adults (N = 5891) completed self-report measures of rumination, neuroticism, and depressive symptoms at baseline and rumination and depressive symptoms at a four-year follow-up.

RESULTS

Results from regression analyses indicated that rumination predicted residual change in depressive symptoms and depressive symptoms predicted residual change in rumination, suggesting that rumination and depressive symptoms influence one another in a bidirectional, recursive fashion. Gender was not a significant moderator of the longitudinal associations between rumination and depressive symptoms. Analyses including the covariates of age, gender, and neuroticism, a personality trait characterized by heightened negative emotionality, indicated that the bidirectional longitudinal associations between rumination and depressive symptoms were not explained by their shared association with demographic characteristics or neuroticism.

LIMITATIONS

Within-person analyses involving repeated assessments, shorter time intervals, and assessment of brooding rumination would provide a stronger test of the potential causal association between rumination and depressive symptoms.

CONCLUSIONS

Study findings suggest that rumination may be both a potential risk factor for and a consequence of depressive symptoms in adults.

Probability Sample

We aimed to assess, among a U.S. probability sample of adult women: (1) the prevalence of, and reasons given for, faking and no longer faking orgasm, (2) women's histories of sexual non-communication and reasons for non-communication, (3) associations between sexual non-communication and sexual satisfaction and faking orgasm, (4) associations between specific sexual communication and recent sexual satisfaction, and (5) associations between specific sexual communication and faking orgasm. Respondents were 1008 adult women ages 18-94 from the GfK KnowledgePanel (a nationally representative probability sample of non-institutionalized and English-speaking adults), who completed a confidential Internet-based survey. Although 58.8% of female respondents reported having ever faked/pretended orgasm, 67.3% of those who had ever faked orgasm no longer did. Women who continued to fake orgasms were more likely to indicate embarrassment talking about sex with their partner in explicit ways and were less likely to agree that they and their partner are able to talk specifically about what makes sex more pleasurable for them. More than half (55.4%) of women reported they had wanted to communicate with a partner regarding sex but decided not to; the most common reasons were not wanting to hurt a partner's feelings (42.4%), not feeling comfortable going into detail (40.2%), and embarrassment (37.7%). Greater self-reported sexual satisfaction was associated with more comfortable sexual communication. Study findings and implications for professionals are discussed in the context of adult sexual development and learning. This includes growing more comfortable talking with a partner about sexual preferences and sexual pleasure.

Relationships Among Sexual Identity, Sexual Attraction, and Sexual Behavior: Results from a Nationally Representative Probability Sample of Adults in the United States

Sexual orientation is a multi-dimensional concept, at a minimum comprised of sexual identity, sexual attraction, and sexual behavior. Our study aimed to assess relationships among self-identified sexual identity, sexual attraction, and sexual behaviors in a probability sample of adults in the U.S. and to identify associated factors with diverse patterns. We collected data from adults in the 2015 National Survey of Sexual Health and Behavior, an Internet-based nationally representative probability survey of the general U.S. population. Concordance between sexual identity versus sexual attraction and sexual behaviors was assessed using percent agreement. We identified correlates of discordance using logistic regression. Concordance between sexual identity versus sexual attraction and past-year sexual behaviors was 94% and 96%, respectively, though our sample was predominately composed of heterosexual individuals. Women and sexual minority individuals reported greater discordance across sexuality-related measures than men and heterosexual individuals. Younger adults (aged 18-24 years) were more likely to report sexual behaviors discordant with sexual identity compared with older adults (including those ages 25-34 years). Higher levels of educational attainment were significantly associated with less discordance of reported recent sexual activity and sexual identity. Measures of sexual identity, attraction, and behaviors are not interchangeable. Future research should consider multiple sexuality-related measures in order to capture the complexity and variability of sexualities.

Epidemiology of substance use and dependence in the state of Punjab, India: Results of a household survey on a statewide representative sample

BACKGROUND

Despite its political sensitivity, little scientifically valid evidence on the prevalence, pattern and treatment need of substance use in the northern border state of Punjab, India is available till date.

METHODOLOGY

The 'universe' for the survey was the entire house-dwelling population of Punjab, of both genders, aged 11-60 years. Stratified multistage sampling technique was used. Following a pilot study, data were collected by trained research workers by face-to-face interview using pre-tested survey instruments.

RESULTS

From 6398 households, 13,925 respondents were interviewed. Prevalence of lifetime and current (12 month) dependence on any substance were 15.8% (95% confidence interval [CI] 15.1-16.4%) and 14.7% (95% CI 14.1-15.3%) respectively. Of the specific substances, current dependence was the highest on alcohol (10.9%; 95% CI 10.3-11.4%), followed by tobacco (8.1%; 95% CI 7.7-8.6%). Regarding opioids, lifetime use was 1.9% (95% CI 1.6-2.1%) and current dependence 0.8% (95%CI 0.7-1.0%). Use of and dependence on natural opioids was the highest. After projecting these figures to the entire source population of the state, number of currently dependent alcohol, tobacco and opioid users were 2.2, 1.6, and 0.17 million, respectively. Overall, substance use was predominant in men and significantly more common in rural areas. Majority (81%) of the tobacco users, and 51% each of alcohol and opioid users needed intervention. However, merely one in six subjects sought any professional help.

CONCLUSION

Punjab has a substantive problem related to substance use. Though alcohol and tobacco are by far the major substances of use and dependence, the large number of opioid users also raises concern. Treatment services need scaling-up.

Mixed effects models for recurrent events data with partially observed time-varying covariates: Ecological momentary assessment of smoking

Cigarette smoking is a prototypical example of a recurrent event. The pattern of recurrent smoking events may depend on time-varying covariates including mood and environmental variables. Fixed effects and frailty models for recurrent events data assume that smokers have a common association with time-varying covariates. We develop a mixed effects version of a recurrent events model that may be used to describe variation among smokers in how they respond to those covariates, potentially leading to the development of individual-based smoking cessation therapies. Our method extends the modified EM algorithm of Steele (1996) for generalized mixed models to recurrent events data with partially observed time-varying covariates. It is offered as an alternative to the method of Rizopoulos, Verbeke, and Lesaffre (2009) who extended Steele's (1996) algorithm to a joint-model for the recurrent events data and time-varying covariates. Our approach does not require a model for the time-varying covariates, but instead assumes that the time-varying covariates are sampled according to a Poisson point process with known intensity. Our methods are well suited to data collected using Ecological Momentary Assessment (EMA), a method of data collection widely used in the behavioral sciences to collect data on emotional state and recurrent events in the every-day environments of study subjects using electronic devices such as Personal Digital Assistants (PDA) or smart phones.

An inconvenient dataset: bias and inappropriate inference with the multilevel model

The multilevel model has become a staple of social research. I textually and formally explicate sample design features that, I contend, are required for unbiased estimation of macro-level multilevel model parameters and the use of tools for statistical inference, such as standard errors. After detailing the limited and conflicting guidance on sample design in the multilevel model didactic literature, illustrative nationally-representative datasets and published examples that violate the posited requirements are identified. Because the didactic literature is either silent on sample design requirements or in disagreement with the constraints posited here, two Monte Carlo simulations are conducted to clarify the issues. The results indicate that bias follows use of samples that fail to satisfy the requirements outlined; notably, the bias is poorly-behaved, such that estimates provide neither upper nor lower bounds for the population parameter. Further, hypothesis tests are unjustified. Thus, published multilevel model analyses using many workhorse datasets, including NELS, AdHealth, NLSY, GSS, PSID, and SIPP, often unwittingly convey substantive results and theoretical conclusions that lack foundation. Future research using the multilevel model should be limited to cases that satisfy the sample requirements described.

Semiparametric Inference for Data with a Continuous Outcome from a Two-Phase Probability Dependent Sampling Scheme

Multi-phased designs and biased sampling designs are two of the well recognized approaches to enhance study efficiency. In this paper, we propose a new and cost-effective sampling design, the two-phase probability dependent sampling design (PDS), for studies with a continuous outcome. This design will enable investigators to make efficient use of resources by targeting more informative subjects for sampling. We develop a new semiparametric empirical likelihood inference method to take advantage of data obtained through a PDS design. Simulation study results indicate that the proposed sampling scheme, coupled with the proposed estimator, is more efficient and more powerful than the existing outcome dependent sampling design and the simple random sampling design with the same sample size. We illustrate the proposed method with a real data set from an environmental epidemiologic study.