Helene Raskin White

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.

Developmental associations between substance use and violence

This study examined the developmental associations between substance use and violence. We examined the trends in each behavior throughout adolescence, how the behaviors covaried over time, and the symmetry of associations taking into account frequency and severity of each behavior. We also examined whether changes in one behavior affected changes in the other behavior over time. Six years of annual data were analyzed for 506 boys who were in the seventh grade at the first assessment. Concurrent associations between frequency of substance use and violence were relatively strong throughout adolescence and were somewhat stronger for marijuana than alcohol, especially in early adolescence. Type or severity of violence was not related to concurrent alcohol or marijuana frequency, but severity of drug use was related to concurrent violence frequency. Depending, to some degree, on the age of the subjects, the longitudinal relationships between substance use and violence were reciprocal during adolescence and slightly stronger for alcohol and violence than for marijuana and violence. Further, increases in alcohol use were related to increases in violence: however, when early alcohol use was controlled, increases in marijuana use were not related to increases in violence. Only in early adolescence was the longitudinal relationship between marijuana use and later violence especially strong. The strength of the longitudinal associations between violence and substance use did not change when common risk factors for violence and substance use were controlled. Overall, the data lend more support for a reciprocal than for a unidirectional association between substance use and violence. Prevention efforts should be directed at aggressive males who are multiple-substance users in early adolescence.

Longitudinal Effects of Age at Onset and First Drinking Situations on Problem Drinking

The purpose of this study was to describe aspects of the first alcohol-use experience, and examine the predictive relations among age of first use, context of alcohol use initiation, and problem drinking with and without controls for psychosocial risk factors. Data were from the Rutgers Health and Human Development Project, a five-wave, prospective study of substance-use behaviors in a community sample. Respondents, who were first interviewed at age 12 (1979–81) and most recently at age 30 or 31 (1999–2000) (N = 371), reported on their first drinking experience, and on a range of known risk factors for alcohol abuse. Most alcohol initiation occurred during a family gathering. Regardless of initiation context, youth who drank at an early age were more likely than youth who initiated later to become problem drinkers, although the risk was relatively greater for the youth who first drank outside a family gathering. Based on multivariate logistic regressions, feeling drunk at initiation was the only onset-related variable significantly associated with problem drinking; other significant risks factors included male gender, delinquency, and family history of alcoholism. Because most initiation occurs at a family gathering, alcoholism prevention research may benefit from examining the role that drinking in family contexts could play with regard to socializing young drinkers to less risky drinking behaviors in adulthood. In particular, further research focusing on the subjective effects experienced by youth when they first drink may be merited.

Childhood victimization and illicit drug use in middle adulthood.

Using a prospective cohort design, the authors examined in this study whether childhood victimization increases the risk for illicit drug use and related problems in middle adulthood. Court-documented cases of childhood physical and sexual abuse and neglect and matched controls (N = 892) were first assessed as young adults (mean age = 29 years) during 1989-1995 and again in middle adulthood (mean age = 40 years) during 2000-2002. In middle adulthood, abused and neglected individuals were about 1.5 times more likely than controls to report using any illicit drug (in particular, marijuana) during the past year and reported use of a greater number of illicit drugs and more substance-use-related problems compared with controls. The current results reveal the long-term impact of childhood victimization on drug use in middle adulthood. These new results reinforce the need for targeted interventions with abused and neglected children, adolescents, and adults, and particularly for women.

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.

Developmental trajectories of cigarette use from early adolescence into young adulthood

This study identified developmental trajectories of cigarette smoking from early adolescence into young adulthood, and delineated whether risk factors derived from a social learning-problem behavior framework could differentiate among trajectories. Participants (N=374) were interviewed five times from age 12 until age 30/31. Using growth mixture modeling, three trajectory groups were identified--heavy/regular, occasional/maturing out, and non/experimental smokers. Being a female, having higher disinhibition, receiving lower grades, and more frequent use of alcohol or drugs significantly increased the probability of belonging to a smoking trajectory group compared with being a nonsmoker. Higher disinhibition and receiving lower grades also differentiated regular smokers from the rest of the sample. None of the risk factors distinguished occasional from regular smokers. When models were tested separately by sex, disinhibition, other drug use, and school grades were associated with smoking for both sexes. On the other hand, environmental factors, including socioeconomic status, parent smoking and friend smoking, were related to smoking for females but not for males. Sex differences in developmental trajectories and in smoking behavior among regular smokers were notable. Future research should examine transitions and turning points from adolescence to adulthood that may affect cessation and escalation differently for males and females.

Changes in substance use during the transition to adulthood: a comparison of college students and their noncollege age peers

This study examines transitions in alcohol, cigarette, and marijuana use and alcohol- and marijuana-related problems from late adolescence through young adulthood. Men and women who attend college are compared to their peers who do not to determine if the situational/socialization effects of college are unique during this developmental period. Prospective data from a community sample were collected at ages 18, 21, and 30 years. ANOVAs revealed that 18 year olds who transition out of high school, regardless of college status, reported higher levels of substance use than their peers who were still in high school. In addition, nonstudents compared to college students reported higher levels of cigarette and marijuana use in adolescence, emerging adulthood, and young adulthood and higher levels of alcohol- and marijuana-related problems in adolescence and young adulthood. Latent growth curve analyses revealed that college status was related to lower levels of alcohol and marijuana problems at age 18, greater increases from ages 18 to 21, and greater decreases from ages 21 to 30 even after controlling for level and growth in use. Overall, the findings suggest that nonstudents may be a more important target group than college students for drug use prevention efforts during emerging adulthood.

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.

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.

Potential Contributions of the Life Span Developmental Approach to the Study of Adolescent Alcohol and Drug Use: The Rutgers Health and Human Development Project, a Working Model

The Rutgers Health and Human Development Project is organized around a life span developmental perspective. This is oriented toward understanding the antecedents and variables relating to adolescent substance use and abuse. The project is interested in major developments of use patterns, particularly in regard to acquisition, early maintenance, and dependence (if it occurs). These patterns are best understood in a prospective-developmental model and not in a cross-sectional model. To do this the domain of the problem including the adolescents family, must be studied. The design factors are critical in such a study if causal analyses are to be developed and must be done under naturalistic, real world conditions. The Rutgers study, therefore, assesses the emergence and unfolding of adolescent substance use behaviors in interaction with the individuals physical, psychological and social development during the transition from adolescence to early adulthood. The project assessed three different aged samples (12, 15, 18) prospectively, over a three year span. Problem areas in the methodology of prospective, longitudinal studies are discussed.