Allan V. Horwitz

The impact of childhood abuse and neglect on adult mental health: a prospective study.

This paper examines the impact of three types of victimization in childhood--sexual abuse, physical abuse, and neglect--on lifetime measures of mental health among adults. In contrast to research that relies on retrospective recall of childhood victimization, this work uses a prospective sample gathered from records of documented court cases of childhood abuse and neglect in a midwestern city around 1970. These subjects were interviewed about twenty years later. In addition, this research compares outcomes of the 641 members of the abuse and neglect group with a matched control group of 510 persons who did not have documented cases of abuse or neglect. The results indicate that men who were abused and neglected as children have more dysthymia and antisocial personality disorder as adults than matched controls, but they did not have more alcohol problems. Abused and neglected women report more symptoms of dysthymia, antisocial personality disorder, and alcohol problems than controls. After controlling for stressful life events, however, childhood victimization had little direct impact on any lifetime mental health outcome. This research indicates the importance of adopting an approach that places childhood victimization in the context of other life stressors and of prospective changes over the life course.

A handbook for the study of mental health : social contexts, theories, and systems

We test whether significant differences in mental illness exist in a matched sample of Mental illness and the criminal justice system. In T. L. Scheid T. N. Brown (Eds.), A handbook for the study of mental health: Social contexts, theories. Find 9780521567633 A Handbook for the Study of Mental Health : Social Contexts, Theories, and Systems by Horwitz et al at over 30 bookstores. Buy, rent. A review of mental health problems in fathers following the birth of a child. for the study of mental health:Social contexts, theories, and systems (2nd ed., pp.

Gender role orientations and styles of pathology among adolescents

This paper assesses the effect of gender identity on rates of psychological distress, delinquency, and drug and alcohol problems among a representative sample of adolescents. It examines whether pathologies such as delinquency that are prevalent among males can be viewed as functionally equivalent to those involving the internalization of distress more common among females. As expected, females display higher rates of distress and males of delinquency and alcohol and drug problems. In addition to these sex differences, gender identity is related to the behaviors of interest. Both males and females with masculine identities show relatively low rates of distress and alcohol and drug problems. For males, high rates of delinquency are associated with identification with masculinity and rejection of femininity. The influence of gender identity on these styles of pathology increases over the course of adolescence and young adulthood. The implications of these findings for theories of the functional equivalence of sex-sterotyped pathologies are discussed.

The pathways into psychiatric treatment: some differences between men and women.

In this report we test several hypotheses on the different pathways through which ment and women enter psychiatric treatment: women in treatment should have been more likely than men to recognize perceived psychiatric problems, to discuss these problems with other people, and to enter treatment voluntarily. Data from interviews with 120 patients at a community mental health center are consistent with each hypothesis. Several implications of the findings for theories of help-seeking behavior and social control are discussed.

Becoming Married, Depression, and Alcohol Problems Among Young Adults

This paper examines three questions regarding the relationship between marriage and mental health, specifically depression and alcohol problems. First, does marriage lead to improved mental health compared to never marrying? Second, do any mental health benefits of marriage primarily accrue to men? Third, what qualitative aspects of marriage are related to psychological disorder? We explore these questions in a longitudinal sample of young adults sampled at age 21 and again at age 24. We find no indication that marriage reduces depression. Married people do report fewer alcohol problems than the never-married but this could be due to the selection of less problematic drinkers into marriage. We also fail to find that men receive disproportionate mental health benefits from marriage. Finally, we find that marital conflict is associated with problem drinking for men and depression for women. The results indicate the importance of considering stage in the life cycle and gender-sensitive indicators of psychological disorder in studies of marriage and mental health.

Burden assessment scale for families of the seriously mentally ill

Although there are many scales of family burden that are available and in use, there is no accepted standard. This paper describes a scale developed to assess the burden of families with a seriously mentally ill member. The Burden Assessment Scale (BAS), consisting of 19 items, is shown to have excellent reliability. Use of the BAS in two separate studies reveals the scale to have a stable factor structure, whether it is self- or interviewer-administered. The scale differentiates between family samples with different levels of burden and is sensitive to changes over time. The BAS, which is brief, reliable, and valid, is a practical tool for use in program evaluation. faThe authors express their appreciation to the staff of the Club/University of Medicine & Dentistry of New Jersey, Bonnie Schorske/Family Liaison of the New Jersey Division of Mental Health and Hospitals, and the program directors and staff of the eight Intensive Family Support Services programs funded by the State of New Jersey. We also thank Dr. Carol Weiss for adapting the BAS for use with Spanish-speaking population.

The use of multiple outcomes in stress research : A case study of gender differences in responses to marital dissolution

This study tests the hypothesis that the use of a single outcome variable distorts the mental health consequences of a stressor among different social groups. It uses the example of the impact of marital dissolution on the mental health of men and women to see whether rates of depression and alcohol problems rise disproportionately among women and men, respectively, who experience the same type of stressor. The sample compares 465 married subjects with 127 separated or divorced subjects drawn from a longitudinal study of 25-, 28-, and 31-year-olds. With controls for earlier rates of depression and alcohol problems, as well as for secondary stressors connected with separation and divorce, women undergoing marital dissolution show significantly greater increases in rates of depression compared to men who experience this stressor. Although men report far more alcohol problems than women, rates of these problems do not increase disproportionately among men, compared to women, during marital dissolution. The results indicate that the use of gender-typical mental health outcomes reduce, but do not eliminate,gender differences in the response to marital dissolution. They also indicate the need to use outcomes that typify how each group under study responds to stressful social conditions.

Ethnic differences in caregiving duties and burdens among parents and siblings of persons with severe mental illnesses.

The policy of community care for the seriously mentally ill increases the caregiving duties and resulting burden on families with members who have a mental illness. Ethnicity is one factor that might have an important impact on the caregiving duties family members perform and the burden that results from these duties. This study uses interviews with 78 parents and 70 siblings of patients scheduled for imminent release from a state mental hospital. The findings indicate that Black and White parents have equivalent caregiving duties, but White parents report substantially more caregiver burden. Black siblings report more caregiving duties than White siblings but report less caregiver burden. These ethnic differences remain after controls for income, gender, age, diagnosis, perceived stigma, and coresidence. The results indicate that ethnicity can be a critical factor affecting levels of informal caretaking for persons with serious mental illnesses.

Negative and Supportive Social Interactions and Quality of Life Among Persons Diagnosed with Severe Mental Illness

This study examined the relative importance of negative and supportive social interactions in predicting different aspects of quality of life (QOL) in a sample of persons diagnosed with severe mental illness (n = 104). Controlling for other variables that might explain such a relationship, we found that negative social interactions were significantly related to lower QOL in three subjective domains, while supportive social interactions were related to higher QOL in four objective domains and one subjective domain. We found negative social interactions that are stigmatizing to be particularly important in predicting QOL; additional analyses suggested that perceived stigma partially mediated the relationship between negative social interactions and QOL. We discuss the implications of the present findings for the study of the link between social relationships and QOL among persons with mental illness.

How the negative and positive aspects of partner relationships affect the mental health of young married people

The relationship between marriage and positive mental health is one of the most established findings in the stress literature. Few studies, however, examine the problematic as well as the supportive impacts of marriage on mental health. This paper uses a cohort of young adults who were sampled at 18, 21, or 24 years of age and resampled seven years later when they were married at 25, 28, or 31. It examines what factors are associated with the quality of marital relationships, the relative impact of and balance between negative and positive partner relationships on mental health, and sex differences in the determinants and outcomes of marital quality. The results indicate that the structural strains of parenthood and financial need and their interaction predict problematic and supportive spousal relationships and the difference in the levels of these two relationships. Problematic relationships with spouses have considerably stronger impacts than supportive relationships on depression. However, the difference between the amounts of supportive and problematic relationships with spouses has a greater impact on mental health than levels of either considered separately. Finally, relational quality has a greater impact on the mental health of wives than husbands. These findings indicate the importance of considering how marriage affects mental health in complex, rather than in straightforward, ways.