The onset of suicidal ideation in childhood and adolescence

Event history analysis is used to address questions about the timing of first suicidal ideation during preadolescence and adolescence. Are suicidal thoughts atypical during development? Does the age trajectory of suicidal thoughts parallel that of suicidal actions? Do factors that moderate the risk of suicidal actions also moderate the risk of suicidal thoughts, and does their influence vary by developmental stage? Based on life history data from 364 college students, results indicate that suicidal thoughts in childhood are typical and that the risk of such thoughts begins to increase by age nine. Risk rates are affected by demographic factors (gender, race) and by the experience of parental absence. However, the influence of these factors depends on developmental stage, with whites being at increased risk only during adolescence, and parental absence having its strongest effect during preadolescence. In sum, this study suggests that many children and adolescents contemplate suicide, that the risk of doing so begins to increase at an early age, and that clear similarities exist between those groups at heightened risk for suicidal thought and those at heightened risk for suicidal action. Moreover, this study illustrates the power of employing an analytic technique suitable for modeling transitions. Finally, it highlights the need to model differential influences on suicidal ideation at different stages in development.

Evaluation of liquid-based cytology in cervical screening of high-risk populations: a split study of colposcopy and genito-urinary medicine populations

A split study evaluated the ThinPrep(R) PapTesttrade mark (TP; Cytyc Corp., Boxborough, MA) compared with current methodologies of cervical cytology in two high-risk cohorts. One thousand, three hundred cases from a colposcopy clinic and a genito-urinary medicine outpatient clinic were examined. The TP reported increased detection of all grades of dyskaryosis (mild, moderate and severe; + 4.5%) and a decrease in borderline and unsuitable cases (- 4.9%). Four cases of high-grade dyskaryosis (moderate or severe) were detected only using the TP, while an additional four cases classified as high-grade dyskaryosis with the TP were reported as borderline by our conventional methods. The split-study finding of increased sensitivity with the TP provides for improved clinical management of patients in our high-risk cohorts.

Trait understanding or evaluative reasoning? An analysis of children's behavioral predictions

This study tested the hypothesis that in predicting the future behavior of an actor, older children rely on trait inferences, whereas younger children rely on global, evaluative inferences. Vignettes depicting actors engaging in trait-relevant behaviors were presented to 5- and 6-year-olds (N = 67) and 9- and 10-year-olds (N = 71). For each actor, children made predictions of future behavior, evaluated the goodness and badness of the actor, and rated each actor on a relevant trait. A mediational analysis found that the behavioral predictions of older children were mediated solely by trait ratings, whereas those of younger children were mediated by evaluative ratings. Furthermore, unlike older children, younger children made trait-like predictions only when they made an evaluation of the actor. These results suggest that young children utilize evaluative reasoning when making behavioral predictions, and therefore rely on an inferential process that is distinct from that of older children.

Invisible support and adjustment to stress

Although there is abundant evidence that perceived availability of support buffers the effects of stressors on mental health, the relatively meager research on support transactions has failed to show an association between actual receipt of support and adjustment to stressors. The authors examined a possible explanation for this inconsistency, that awareness of receiving support entails an emotional cost and that the most effective support is unnoticed by the recipient. Using data from a daily diary study of support provision and receipt in couples, the authors show that many transactions reported by supporters are not reported by recipients. They also show that these invisible support transactions promote adjustment to a major stressor.

Invisible support and adjustment to stress

Although there is abundant evidence that perceived availability of support buffers the effects of stressors on mental health, the relatively meager research on support transactions has failed to show an association between actual receipt of support and adjustment to stressors. The authors examined a possible explanation for this inconsistency, that awareness of receiving support entails an emotional cost and that the most effective support is unnoticed by the recipient. Using data from a daily diary study of support provision and receipt in couples, the authors show that many transactions reported by supporters are not reported by recipients. They also show that these invisible support transactions promote adjustment to a major stressor.

Close relationships and adjustment to a life crisis: the case of breast cancer

When life crises occur, significant others are thought to help alleviate distress and resolve practical problems. Yet life crises may overwhelm significant others, eroding their ability to provide effective support. The accuracy of these contrasting accounts of relationship functioning was evaluated in a study of 102 breast cancer patients and their significant others, interviewed at 4 and 10 months after diagnosis. Results largely confirmed the negative account of relationship functioning. Although significant others provided support in response to patients' physical impairment, they withdrew support in response to patients' emotional distress. Moreover, support from significant others did not alleviate patients' distress or promote physical recovery. These results reveal limits to the effectiveness of close relationships in times of severe stress.

Close relationships and adjustment to a life crisis: the case of breast cancer

When life crises occur, significant others are thought to help alleviate distress and resolve practical problems. Yet life crises may overwhelm significant others, eroding their ability to provide effective support. The accuracy of these contrasting accounts of relationship functioning was evaluated in a study of 102 breast cancer patients and their significant others, interviewed at 4 and 10 months after diagnosis. Results largely confirmed the negative account of relationship functioning. Although significant others provided support in response to patients' physical impairment, they withdrew support in response to patients' emotional distress. Moreover, support from significant others did not alleviate patients' distress or promote physical recovery. These results reveal limits to the effectiveness of close relationships in times of severe stress.

A framework for studying personality in the stress process

This article presents a framework for studying personality in the stress process. The framework specifies that personality may affect both exposure and reactivity to stressful events and that both processes may explain how personality affects health and psychological outcomes. The framework also specifies that personality differences in reactivity may be due to differential choice of coping efforts and differential effectiveness of those efforts. In a 14-day daily study of 94 students, this framework was used to analyze the links among neuroticism, daily interpersonal conflicts, coping with conflicts, and distress. Results showed that high-neuroticism participants had greater exposure and reactivity to conflicts. Furthermore, high- and low-neuroticism participants differed both in their choice of coping efforts and in the effectiveness of those efforts, a possibility not considered in previous models of personality in the stress process.

A framework for studying personality in the stress process

This article presents a framework for studying personality in the stress process. The framework specifies that personality may affect both exposure and reactivity to stressful events and that both processes may explain how personality affects health and psychological outcomes. The framework also specifies that personality differences in reactivity may be due to differential choice of coping efforts and differential effectiveness of those efforts. In a 14-day daily study of 94 students, this framework was used to analyze the links among neuroticism, daily interpersonal conflicts, coping with conflicts, and distress. Results showed that high-neuroticism participants had greater exposure and reactivity to conflicts. Furthermore, high- and low-neuroticism participants differed both in their choice of coping efforts and in the effectiveness of those efforts, a possibility not considered in previous models of personality in the stress process.

Personality and the problems of everyday life: the role of neuroticism in exposure and reactivity to daily stressors

This article investigates mechanisms through which neuroticism leads to distress in daily life. Neuroticism may lead to distress through exposing people to a greater number of stressful events, through increasing their reactivity to those events, or through a mechanism unrelated to environmental events. This article evaluates the relative importance of these three explanations. Subjects were 339 persons who provided daily reports of minor stressful events and mood for 6 weeks. Exposure and reactivity to these minor stressors explained over 40% of the distress difference between high- and low-neuroticism subjects. Reactivity to stressors accounted for twice as much of the distress difference as exposure to stressors. These results suggest that reactions within stressful situations are more important than situation selection in explaining how neuroticism leads to distress in daily life.

Social relationships, personality, and anxiety during a major stressful event

Although it is commonly believed that social relationships buffer the effects of stress on mental health, these apparent buffering effects may be spurious reflections of personality or prior mental health. This possibility was investigated in a prospective study of a medical school entrance examination. Five weeks before the examination, Ss (N = 56) rated their personality (extraversion and neuroticism) and social relationships (number of social contacts and perceived support). They then rated their anxiety for 35 days surrounding the examination. Controlling for personality and prior anxiety, social contacts buffered against increases in anxiety, whereas perceived support did not. Further analyses revealed that discretionary social contacts were beneficial whereas obligatory contacts were not.

Social relationships, personality, and anxiety during a major stressful event

Although it is commonly believed that social relationships buffer the effects of stress on mental health, these apparent buffering effects may be spurious reflections of personality or prior mental health. This possibility was investigated in a prospective study of a medical school entrance examination. Five weeks before the examination, Ss (N = 56) rated their personality (extraversion and neuroticism) and social relationships (number of social contacts and perceived support). They then rated their anxiety for 35 days surrounding the examination. Controlling for personality and prior anxiety, social contacts buffered against increases in anxiety, whereas perceived support did not. Further analyses revealed that discretionary social contacts were beneficial whereas obligatory contacts were not.

Coping as a personality process: a prospective study

The study tested the proposition that coping is personality in action under stress. Using a stressful medical school entrance examination, the study examined (a) whether neuroticism emerged in coping patterns over time and (b) whether the influence of neuroticism on coping accounted for changes in anxiety and examination performance. Fifty premedical students reported their coping efforts at 35 days before, 10 days before, and 17 days after the examination. They provided daily reports of anxiety for 35 days surrounding the examination. Neuroticism influenced coping efforts and increases in daily anxiety under stress. Two types of coping, wishful thinking and self-blame, explained over half the relationship between neuroticism and increases in preexamination anxiety. Consistent with previous research, neither neuroticism nor specific coping efforts influenced examination performance.

Coping as a personality process: A prospective study

The study tested the proposition that coping is personality in action under stress. Using a stressful medical school entrance examination, the study examined (a) whether neuroticism emerged in coping patterns over time and (b) whether the influence of neuroticism on coping accounted for changes in anxiety and examination performance. Fifty premedical students reported their coping efforts at 35 days before, 10 days before, and 17 days after the examination. They provided daily reports of anxiety for 35 days surrounding the examination. Neuroticism influenced coping efforts and increases in daily anxiety under stress. Two types of coping, wishful thinking and self-blame, explained over half the relationship between neuroticism and increases in preexamination anxiety. Consistent with previous research, neither neuroticism nor specific coping efforts influenced examination performance.

Effects of daily stress on negative mood

This article examines the influence of daily stressors on mental health in a community sample. Ss were 166 married couples who completed diaries each day for 6 weeks. In pooled within-person analyses, daily stressors explained up to 20% of the variance in mood. Interpersonal conflicts were by far the most distressing events. Furthermore, when stressors occurred on a series of days, emotional habituation occurred by the second day for almost all events except interpersonal conflicts. Contrary to certain theoretical accounts, multiple stressors on the same day did not exacerbate one another's effects: rather an emotional plateau occurred. Finally on days following a stressful event, mood was better than it would have been if the stressor had not happened. These results reveal the complex emotional effects of daily stressors, and in particular they suggest that future investigations should focus primarily on interpersonal conflicts.

Effects of daily stress on negative mood

This article examines the influence of daily stressors on mental health in a community sample. Ss were 166 married couples who completed diaries each day for 6 weeks. In pooled within-person analyses, daily stressors explained up to 20% of the variance in mood. Interpersonal conflicts were by far the most distressing events. Furthermore, when stressors occurred on a series of days, emotional habituation occurred by the second day for almost all events except interpersonal conflicts. Contrary to certain theoretical accounts, multiple stressors on the same day did not exacerbate one another's effects: rather an emotional plateau occurred. Finally on days following a stressful event, mood was better than it would have been if the stressor had not happened. These results reveal the complex emotional effects of daily stressors, and in particular they suggest that future investigations should focus primarily on interpersonal conflicts.

Linking person and context in the daily stress process

In this study we combined daily diary data with interview data to investigate individual differences in the impact of stressful daily events on mood. Using a sample of 96 women in an urban community, we examined perceived neighborhood quality and major life events as possibly potentiating the effects of stressful daily events, and we viewed social supports as potentially buffering this daily process. Results confirmed that the presence of chronic ecologic stress (neighborhood perceptions) exacerbated the immediate effects of stressful daily events on mood and also increased the likelihood of enduring effects of daily stressors on next day's mood. Contrary to expectations, previous exposure to major life events decreased the impact of stressful daily events. The availability of social supports, although not buffering the impact of stressful daily events on mood, did mitigate the enduring effects of these events on next day's mood. This study also presents a method for analyzing daily time-series data, while correcting for potential problems of autocorrelated error terms. As such, this study represents a significant advance over previous analytic approaches to time-series data in the study of the stress process.