Judith M. Siegel

Stressful Life Events and Use of Physician Services Among the Elderly: The Moderating Role of Pet Ownership

The physician utilization behavior of 938 Medicare enrollees in a health maintenance organization was prospectively followed for 1 year. With demographic characteristics and health status at baseline controlled for, respondents who owned pets reported fewer doctor contacts over the 1-year period than respondents who did not own pets. Furthermore, pets seemed to help their owners in times of stress. The accumulation of prebaseline stressful life events was associated with increased doctor contacts during the study year for respondents without pets. This relationship did not emerge for pet owners. Owners of dogs, in particular, were buffered from the impact of stressful life events on physician utilization. Additional analyses showed that dog owners in comparison to owners of other pets spent more time with their pets and felt that their pets were more important to them. Thus, dogs more than other pets provided their owners with companionship and an object of attachment.

Body image, perceived pubertal timing, and adolescent mental health

PURPOSE To examine the impact of gender, racial-ethnic group, and perceived pubertal timing on body image and adolescent mental health. METHOD A three-stage, area probability sample was selected which included 877 teens (13-18 years) with diverse social and demographic characteristics. Interviews in English or Spanish were conducted in person. The content emphasized emotional distress and problematic behavior, exposure to social stressors, coping resources and behaviors, and socioeconomic and demographic characteristics of the adolescent and his or her family. RESULTS Girls were more depressed and had lower self-esteem than boys, but not after controlling for body image. Hispanics were more depressed and had lower self-esteem than other racial-ethnic groups, a difference that remained when controlling for body image. African-Americans had the most positive body image, a finding that could not be attributed to higher self-esteem or fewer depressive symptoms. The impact of perceived pubertal timing on body image varied considerably by gender and across racial-ethnic group. CONCLUSIONS Negative feelings about their bodies contribute to the higher prevalence of depressive symptomatology and lower self-esteem among girls. African-Americans appear to take pride in their bodies in a manner that sets them apart from other teenagers, suggesting they hold a different ideal. Relative to teenagers of other racial-ethnic backgrounds, Hispanics may be at elevated risk for mental health problems.

Exercise as a buffer of life stress: a prospective study of adolescent health.

The hypothesis that physical exercise provides benefits to individuals under periods of life stress has rarely been subject to empirical verification. This article presents the results of a longitudinal study of stress and well-being in adolescence in which the ability of exercise to buffer stress-induced deteriorations in physical health was examined. In accordance with predictions, prospective analyses revealed that the negative impact of stressful life events on health declined as exercise levels increased. These findings suggest that exercise may be a valuable resource for combating life stress. Discussion centers on possible mediating mechanisms and on the practical implications of the results.

Attributions for negative life events and depression: The role of perceived control.

Although perceptions of control occupied a central role in the development of learned helplessness theory, recent helplessness research has not considered controllability judgments when relating attributions to depression. Supporting the importance of this construct, the research discussed in this article found evidence that judgments of control interact with other attributions in predicting depression. Specifically, in a prospective study of stress and well-being in adolescence, internal, stable, and global attributions for negative events attributed to uncontrollable causes were found to be positively related to increases in depression (as predicted by the reformulated helplessness theory), but internal and global attributions for negative events attributed to controllable causes were found to be inversely related to increases in depression. The discussion considers the implications of the findings for understanding the nature of the relation between attributions for naturally occurring life events and depression.

Adolescent Depressed Mood in a Multiethnic Sample

This research assessed whether there is an impact of race-ethnicity on depressed mood among adolescents, independent of socioeconomic status, whether gender differences in depressed mood are apparent within all race-ethnicity subgroups, and whether pubertal development influences depressed mood in a similar manner within gender and race-ethnicity subgroups. A three-stage, area probability sampling frame was utilized to select adolescents, ages 12–17 years, for an in-person interview. Depressed mood was assessed by the Childrens Depression Inventory. Compared to Whites, African Americans, or Asian Americans, Latinos reported more symptoms of depressed mood, a finding that was independent of socioeconomic status. Advancing puberty was associated with depressed mood only among females, but the timing of pubertal changes, relative to ones peers, was related to depressed mood among both males and females, and among Latinos.

Sexual assault history and use of health and mental health services

A history of sexual assault may be associated with increased current use of mental health and medical services because of the psychologically and physically disruptive consequences of assault. To test this hypothesis, we estimated rates of mental health and medical services use among 2560 randomly selected community residents, 343 of whom had been sexually assaulted. Sexual assault was associated with seeking both forms of care. Controls for demographic variables, psychiatric diagnosis, health status, and insurance suggested that assault increases use indirectly, through poor mental and physical health. Uninsured, assaulted respondents were especially likely to consult medical providers. Respondents assaulted during childhood were particularly likely to seek mental health care. Assault was more common among mental health service users than nonusers, and among women using medical services compared to female nonpatients. The high prevalence of assault among service users underscores the need for providers to recognize and treat sexual assault-related problems.

Weathering the Storm: The Impact of Hurricanes on Physical and Mental Health

The authors briefly review the deaths, injuries, and diseases attributed to hurricanes that made landfall in the United States prior to Hurricane Katrina; recent hurricane evacuation studies and their potential for reducing death, injury, and disease; information available to date about mortality, injury, and disease attributed to Hurricane Katrina; and psychological distress attributable to hurricanes. Drowning in salt water caused by storm surges has been reduced over the past thirty years, while deaths caused by fresh water (inland) flooding and wind have remained steady. Well-planned evacuations of coastal areas can reduce death and injury associated with hurricanes. Hurricane Katrina provides an example of what happens when evacuation is not handled appropriately. Preliminary data indicate that vulnerable elderly people were substantially overrepresented among the dead and that evacuees represent a population potentially predisposed to a high level of psychological distress, exacerbated by severe disaster exposure, lack of economic and social resources, and an inadequate government response.

Victim-offender relationship and sexual assault

The effect of the victim-offender sexual assault relationship on women’s psychological symptomatology was examined in a randomized community survey. Fourteen and one-half percent of women (N = 240) experienced a sexual assault in adulthood. Assaults committed by strangers, acquaintances, and intimates were compared using both chi-square and two-way analyses of variance. Few differences were found in sexual assault experiences according to the victim-offender relationship. Offender use of violence showed a curvilinear relationship with degree of closeness of the victim-offender relationship, whereas victim resistance did not vary according to the victim-offender relationship. Analyses of psychological symptom measures showed that sexual distress was more common for women attacked by intimates, fear/anxiety was more common for women assaulted by strangers, and depression did not vary according to the victim-offender relationship.

Reactions to Sexual Assault A Community Study

Lifetime experience with sexual assault and psychological reactions to assault were assessed in a random community sample. Of the 15 emotional and behavioral reactions to sexual assault that were measured, anger, sadness, and anxiety were the most commonly reported (59%, 43%, and 40%, respectively) and fear reactions were the most persistent. Men were significantly less likely than women to report 11 of the 15 reactions. Factor analyses showed that the items could be reliably described by three factors: sexual distress, fear/anxiety, and depression. Demographic characteristics of the respondent and circumstances of the assault were utilized in regression models as predictors of the assault reactions factors. Age, physical threat, and assault outcome (intercourse) were related to sexual distress; gender, assault outcome, physical threat, and talking to someone about the assault were related to fear/anxiety; and physical threat and assault outcome were predictive of depressive symptoms.

Resistance to sexual assault: who resists and what happens?

To determine who resists sexual assault and what happens, data were examined from a probability sample of 3,132 adult community residents of Los Angeles, California. Seventy-five per cent of the respondents reporting an assault (n = 365) indicated that they had attempted to resist their most recent assault; talking was the most frequently used resistance strategy. The strongest predictor to emerge in the multivariate analyses of resistance was timing of assault: respondents assaulted only in childhood were less likely to resist than either respondents assaulted only in adulthood, or respondents assaulted in both phases. Univariate analyses indicated that resistance reduced the probability of sexual contact, however multivariate analyses suggested that assailant use of force was the most important determinant of assault outcome.