Sociodemographic characteristics and drinking status as predictors of older women's health.

As part of a U.S. national survey of women's drinking and life experiences, the authors used responses from a subsample (n = 245) of women aged 55-90 years (M = 65.8 years) to examine the relationship of sociodemographic characteristics (income, marital status, and occupational status) and drinking status to several health outcomes (self-perceived general health, depression, sexual satisfaction, and sexual dysfunction). In all analyses, the authors controlled for respondent age. Results indicated that higher household income predicted greater lifetime and current sexual satisfaction with a partner as well as higher general health ratings. Women drinkers also reported better general health than did abstainers. An interaction between marital status (married or cohabitating vs. nonmarried) and employment status (employed vs. nonemployed) was a predictor of general health ratings. The authors found significant contrasts among the 4 groups when they controlled for age, income, and drinking status: (a) Among the employed respondents, the nonmarried women reported better general health than did the married women; and (b) among nonmarried respondents, the employed women reported better general health than did the nonemployed women.     

SOCIAL SUPPORT NETWORK DIFFERENTIALS AMONG MARRIED AND NONMARRIED BLACK FEMALES

Being married has generally been associated with better mental health for adult females, in part because of the social support derived from a primary network relationship. Without the benefit of a spouse, it would be expected that nonmarried adult females would have fewer sources of social support and concomitantly lower levels of psychological well-being. Focusing on selected network characteristics, this study analyzes the differences in social support available to a sample of 91 married and 183 nonmarried Black females residing in a metropolitan area. Results indicate that having a spouse has little influence on the number of socially supportive relationships or the most important sources of assistance with financial problems. A marital partner is a source of emotional support for married Black females, but only for less than one-third. Family members and extended kin are major sources of social support for Black females, irrespective of marital status.     

Extramarital Sex and Marital Dissolution: Does Identity of the Extramarital Partner Matter?

Panel data from married adults (N = 1,853) in the General Social Survey, a probability sample of the adult household population of the United States, were used to evaluate (a) the longitudinal association between extramarital sex and marital dissolution 2 years later, (b) whether probability of marital dissolution differed as a function of the type of relationship people reported having with their extramarital sex partner, and (c) the degree to which these associations were incremental to participants’ level of marital satisfaction at baseline. Compared to people who reported not engaging in extramarital sex, those who reported engaging in extramarital sex at baseline were significantly more likely to be separated or divorced 2 years later. Furthermore, the association between having extramarital sex with a close personal friend and marital dissolution was particularly strong. These associations remained statistically significant after adjusting for marital satisfaction. Results suggest that the identity of the extramarital sex partner and the type of relationship a person has with him or her has important implications for probability of marital dissolution above and beyond the contribution of marital satisfaction.     

Characteristics of Air Force personnel who choose pharmacological aids for smoking cessation following an involuntary tobacco ban and tobacco control program.

OBJECTIVE: The objective of this study was to compare characteristics of smokers who did and did not report use of cessation aids as part of a tobacco control program in a military setting (n = 8994). DESIGN: The study is a longitudinal epidemiological study where the relationship between smoking status at follow-up and use of pharmacologic aids to quit smoking were assessed. MAIN OUTCOME MEASURES: Smoking cessation, post baseline use of cessation aids to quit smoking. RESULTS AND CONCLUSIONS: Individuals remaining abstinent were 70% less likely to have used NRT/pharmacological aids compared to those that relapsed. NRT/pharmacological aid users were more likely to report plans to smoke after military training, to have friends who smoke, and to accept a cigarette from a friend. NRT/pharmacological aid users were more likely to believe that using NRT was safer than smoking and to have engaged in harm reduction strategies. Our findings suggest that selection bias related to such characteristics may explain some of the discrepancies between effect sizes reported in efficacy compared to effectiveness studies of NRT and smoking outcomes currently reported in the literature.     

Marital dissatisfaction and incidence of major depressive episode in a community sample

The association between marital dissatisfaction at baseline and 12-month incidence of major depressive episode (MDE) was examined in a community sample of married individuals from the New Haven Epidemiologic Catchment Area program (N = 904) who did not meet criteria for MDE at baseline. Results indicate that marital dissatisfaction was associated with increased incidence of MDE, with a significant risk ratio of 2.7 and an attributable risk of 29.5%. Thus, dissatisfied spouses were nearly 3 times more likely than nondissatisfied spouses to develop an MDE during the year, and nearly 30% of the new occurrences of MDE were associated with marital dissatisfaction. The association between marital dissatisfaction and risk of MDE (a) remained significant when controlling for demographics and depression history and (b) was not moderated by sex or by depression history. Findings suggest that marital dissatisfaction may be etiologically related to major depression.     

Marital status integration, suicide disapproval, and societal integration as explanations of marital status differences in female age-specific suicide rates

Sociological analyses of suicide have often neglected female suicide rates. Three competing explanations are tested to determine why the suicide rates of married women are, typically, lower than the suicide rates of women who are not married: (1) marital status integration, (2) societal integration, and (3) a nation's normative order about disapproval of suicide. Data refer to age and marital status-specific female suicide rates from 12 developed countries. The results provide the strongest support for the marital status integration theory and consistent support for the social integration perspective. There is also mixed support for the cultural disapproval of suicide hypothesis.     

Age variations in the suicide rates and self-reported subjective well-being of married and never married persons

Previous research has established that people who never marry have higher suicide rates and lower self-reported subjective well-being than the married. The present study examines how the differences between: (1) never married persons who live alone, (2) never married cohabitees; and (3) currently married people, vary between age groups. The relevance of such age variations for status integration theory and theories of marital selection is discussed. Summing up results from previous studies of suicide rates, the relative position of the never married is found to be most unfavourable for people in their 30s and 40s; the differences are smaller among the young and the old. Data on self-reported well-being are taken from a large-scale survey of the population of one of Norway's 19 counties (n = 51 000), and are analysed by means of ordinary multiple regression. With regard to single people who were married or who never married, the results are largely consistent with the suicide findings; the advantage of marriage increases until about 40 years of age, then declines. The survey data also provide information about unmarried cohabitation, which seems to be more or less equivalent to marriage in most age groups. Neither status integration theory nor any other single theory of marriage effects or marital selection seems to be able to account for these findings in a satisfactory way.     

Randomized controlled trial of an intervention to change cardiac misconceptions in myocardial infarction patients

There is converging evidence that changing beliefs about an illness leads to positive recovery outcomes. However, cardiac misconceptions interventions have been investigated mainly in Angina or Coronary Heart Disease patients, and less in patients following Myocardial Infarction (MI). In these patients, cardiac misconceptions may play a role in the adjustment or lifestyle changes. This article reports a randomized controlled trial of an intervention designed to reduce the strength of misconceptions in patients after a first MI. The primary outcome was the degree of change in misconceptions and the secondary outcomes were: exercise, smoking status, return to work and mood (anxiety and depression). Patients in the intervention condition (n = 60) were compared with a control group (n = 67) receiving usual care. Both groups were evaluated at baseline and 4, 8 and 12 months after hospital discharge. There was a significant time-by-group interaction for the total score of cardiac misconceptions. Patients in the intervention group significantly decreased their total score of cardiac misconceptions at 4 months compared with the control group and this difference was sustained over time. Patients in the intervention group were also more likely to exercise at the follow-up period after MI than the control group. This intervention was effective in reducing the strength of cardiac misconceptions in MI patients and had a positive impact on health behaviour outcomes. These results support the importance of misconceptions in health behaviours and the utility of belief change interventions in promoting health in patients with Myocardial Infarction.     

Prioritizing Patients for Surgery: Factors Affecting Allocation of Medical Resources for Kidney Transplantation,IVF, and Rhinoplasty1

The present study sought to investigate whether the factors that affect the allocation of scarce medical resources vary across different types of treatment and whether participants prioritize hypothetical patients based on patients' marital status, annual income, history of mental illness, and smoking habits. Study participants (N = 114) made prioritization decisions that were found to be very different across treatments. Repeated‐measure ANOVAs showed that single patients were favored for rhinoplasty, while married patients were favored for in vitro fertilization (IVF) and kidney transplant treatment. Nonsmoking patients were preferred over their smoking counterparts. Low‐income patients were favored for rhinoplasty and kidney transplant operations, but not for IVF. Mentally healthy patients were generally preferred over mentally ill patients.     

Will Improving My Marriage Improve My Sleep?

An essential component to overall health and well-being is sleep. Likewise, being happily married is associated with better physical, mental, and emotional health. In the present study, we examined links between marital satisfaction (MS) and aspects of sleep quality (SQ) among married individuals (N = 88) aged 39 to 64 years. Data were collected at baseline and 6-month follow-up. Regression analyses showed that MS at baseline was positively associated with overall SQ and sleep disturbance frequency at baseline and was negatively associated with minutes to fall asleep at follow-up. Results suggested that participants with greater MS at baseline reported better overall SQ at baseline and falling asleep faster at follow-up. However, results varied when controlling for other relevant covariates (e.g., age, depression, pain). Additionally, a negative change in MS between baseline and follow-up was a positive predictor of sleep disturbance frequency at follow-up, suggesting that participants whose MS decreased over time were more likely to report more frequent sleep disturbances 6 months later. Findings indicate that MS is linked with various aspects of SQ in married, middle-aged adults. Clinical implications, limitations of the current study, and areas for future research are discussed.     

Gender differences in smoking: A longitudinal study of beliefs predicting smoking in 11–15 year olds

This longitudinal study investigated differences in beliefs and perceived behavioural control between smokers and non-smokers in a large sample of adolescents. Positive and negative instrumental beliefs, normative beliefs, perceived behavioural control (PBC) and smoking status were assessed in the same participants at 11, 13 and 15 years of age. Prospective analyses among non-smokers revealed that for boys, negative instrumental beliefs in non-smokers at age 11 predicted smoking at age 15 years. For girls, normative beliefs and PBC in non-smokers at age 11 predicted smoking status at age 13; normative beliefs at age 11 predicted smoking at age 15; and positive instrumental beliefs and normative beliefs at age 13 predicted smoking status at age 15. Cross-sectional data revealed that smokers were significantly more likely than non-smokers to endorse positive instrumental beliefs, less likely to agree with negative instrumental belief items, more likely than non-smokers to perceive social pressure to smoke, and less likely to report control over smoking, and that female smokers reported less control over smoking and fewer negative instrumental beliefs than all other groups including male smokers at age 13. The need for belief-based preventative interventions that are age- and gender-relevant is discussed.     

Patterns of couple interaction during the transition to parenthood

Using latent transition analysis, this study identified Constructive and Destructive marital problem‐solving patterns in couples prenatally and at 3, 12, and 24 months postbirth. Most couples remained in the same group across the 2 years (27.5% and 52.2% who started as Destructive and Constructive, respectively). Always Destructive spouses reported more depressive symptomatology and more negative and less positive views of marriage than Always Constructive couples. Mixed wives mirrored Always Constructive wives in their depressive symptomatology and concurrent views of marriage; mixed husbands mirrored Always Constructive husbands in their depressive symptomatology and Always Destructive husbands in their concurrent views of marriage. Mixed couples divorced or separated at the highest rates (35.7%), while Always Constructive couples tended to remain married (93.1%).     

Life strains,coping, and emotional well-being: A longitudinal study of recently separated and married women

The stress and coping paradigm was used as the framework for a longitudinal study of recently separated and married women. Data were gathered at three different interviews over a period of 18 months. Comparing the two groups of women, it was found that life strains in the areas of financial concerns and spouse relations were related to both income level and marital status, with low-income and separated women experiencing the highest levels of these strains. Also, the separated women used coping strategies emphasizing personal change and reported more positive changes related to their family, work, and material conditions. Regression analyses on the entire sample showed that life strains were inversely related to emotional well-being and that coping served a stress-buffering function. It was concluded that the emotional well-being of separated and married women must be considered in the context of stress, coping, and change processes.     

Restricted Environmental Stimulation Therapy and Behavioral Self-Management in Smoking Cessation1

The relative impacts on smoking behavior of restricted environmental stimulation therapy (REST), behavioral self-management, and the combination were compared. Fifteen smokers from the community were treated in each of the three conditions and followed over a 12-month period. The combined treatment was very successful compared to standard smoking interventions (a mean of 66% reduction from baseline smoking rate and 53% of subjects completely abstinent on the 1-year follow-up), and subjects in this group smoked significantly less than those in either the REST or behavioral self-management only condition. Furthermore, subjects receiving REST, alone or in combination, were significantly less likely to relapse following treatment. The results were taken to support the importance of addressing multiple change objectives in smoking cessation programs.     

Televised Models of Female Achievement

Two studies examined the models of female achievement available to television viewers. The studies surveyed television's portrayal of both achievement behavior and its social consequences for the female achiever. Study I compared female models at four levels of achievement. Only those models at the lowest level of achievement were depicted as having successful social relations with males. Study II compared the marital status of male and female job holders. Compared with male job holders, females were depicted as less likely to be married, less likely to be successfully married, and more likely to be unsuccessfully married. Data on married females showed that those who held jobs were depicted as having 10 times as many unsuccessful marriages (proportionately) as housewives. It is suggested that female achievers portrayed on television are depicted in a way that does not encourage female viewers to imitate their behavior and in fact serves to inhibit achievement-oriented behavior in female viewers.     

A comparison of alcoholics whose drinking is totally uncontrolled and those whose drinking is mainly controlled

The analysis of drinking patterns of 77 married male alcoholics for the period of 12 months immediately following their intake into a treatment trial suggested the importance of a variable which has been neglected in the literature on alcohol dependence. Although only 3 had returned to a pattern of drinking which was, by their own and by their wives' accounts, totally controlled, there were wide individual differences amongst the remainder in the uniformity with which drinking was uncontrolled. Two extreme groups were identified: in 22 cases patients and their wives were agreed that drinking had been totally uncontrolled; in 14 cases patients and wives were agreed that drinking had been mainly controlled. There were no differences between these two groups in the amount of abstinence reported but there were major differences in other respects. Mainly controlled drinkers were more likely to think that they had no drinking problem or that their problem was of very recent origin, reported significantly fewer symptoms, were much less likely to be institutionalized during the 12 month period, were less likely to think of themselves as alcoholics and were less likely to express a preference for abstinence as a target. The hypothesis is suggested that this drinking pattern variable may serve as a differential predictor of successful outcome following abstinence-oriented or controlled drinking-oriented treatment.     

Positive emotion is associated with 6-year change in functional status in individuals aged 60 and older

Analyses examined both positive emotion (PE) at baseline and change in PE from baseline to follow up as predictors of change in functional status (FS). Initial models examined baseline PE, and change in PE, as predictors of change in FS adjusted for baseline PE, negative emotion (NE), FS, and age and gender. Final models included additional adjustments for frequency of social contact, marital status, body mass index, smoking status, drinking behavior, and comorbidity at baseline. Baseline PE was a predictor of change in FS, adjusted for NE, age, and gender (p?=?0.033). Additional covariates reduced the effect of baseline PE as a predictor of change in FS (p?=?0.115). Change in PE was a significant predictor of change in FS – increases in ratings of PE over time were associated with less decline in FS (p?=?0.001). The association for change in PE remained significant in the fully adjusted model (p?=?0.004). Results replicate our prior findings.     

Nicotine fading,self-monitoring and cigarette fading to produce cigarette abstinence or controlled smoking

This study developed and evaluated a smoking-treatment program. Twelve subjects were randomly assigned to one of two groups within a multiple baseline design. Subjects were first given a nicotine-fading and self-monitoring procedure for 3 weeks in which they changed their cigarette brands each week to ones containing progressively less nicotine and tar and plotted their daily intake of the two substances. Those subjects unable to quit smoking were then given a cigarette-fading procedure in which they systematically reduced the number of cigarettes smoked for 3 weeks. The study had two goals: (1) to achieve a reasonable percentage of abstinence; and (2) to reduce non-abstainers' smoking to a ‘safer’ level by having them smoke very low tar and nicotine cigarettes. The 12-month follow-up results revealed that 33% of the subjects were abstinent and all non-abstainers were smoking cigarettes lower in tar and nicotine than their baseline brands. Half the non-abstainers had decreased their smoking rate relative to baseline while the other half had increased. The subjects decreased their daily nicotine intake by 13.3 mg (81.6% reduction from baseline) and tar intake by 218.2 mg (85.5% reduction from baseline). These results suggest that the study's goals were achieved and that the non-aversive combined procedure could be used to treat not only habitual smokers but also those with cardiovascular and respiratory problems who cannot be treated by smoking-cessation procedures that use cigarette smoke as the aversive stimulus. Finally, a least-restrictive model for treating smoking is proposed and discussed.     

Marital status and the risk of suicide: experience from England and Wales, 1982-1996

This analysis examined suicide rates by age, sex, and marital status in England and Wales for the period 1982-1996. Never married, widowed, and divorced people had higher rates of suicide than those who were married, for both sexes. Among the widowed ages 20-39 years, both sexes had the highest rate, and the rate decreased with age. The suicide rate for divorced people was similar to those who had never married, except for the younger group ages 20-29 years. The male:female ratios for the relative suicide risk for never married, widowed, and divorced to married for both sexes were statistically significantly different for older adults. The decrease in suicide rates observed for the period 1982-1996 in England and Wales was mainly attributable to the reduction of suicide rates among the widowed and divorced.     

The relationship of marital satisfaction and social support to depressive symptomatology

The relationship between depressive symptomatology, as measured by the short-form Beck Depression Inventory (BDI), and two social support variables was assessed. Based on a sample of 131 married men and 136 married women, the results indicated that the quality of the marital relationship and the frequency of positive social contact with adults other than the spouse were significantly related to depressive symptomatology for both men and women. These two variables accounted for 16% of the variance in BDI scores. Further, analyses of risk for high BDI scores showed that individuals having the least support were 13 times more likely to be in the high-BDI group than individuals with the highest levels of social support. These results suggest that social isolation and marital discord are related to high BDI scores among married adults.