K. A. S. Wickrama

Marital Quality and Physical Illness: A Latent Growth Curve Analysis

K. A. S. WICKRAMA, FREDERICK 0. LORENZ, AND RAND D. CONGER Iowa State University GLEN H. ELDER, JR. University of North Carolina* Using latent growth curves, this study investigates the association between intraindividual changes in marital quality and physical illness for 364 wives and husbands in the rural Midwest. The results reveal that both the initial level of and the change in the marital quality of husbands and wives correlate with the initial level of and the change in physical health, after controlling for the influence of work stress, education, and income. Additional analyses imply that psychological wellbeing and behaviors that are health risks mediate or explain this association. The results provide stronger evidence for the association between marital quality and physical illness for both husbands and wives than has been obtained from cross-sectional studies or from longitudinal studies that have been limited to the investigation of interindividual differences. Key Words: marital quality, physical illness. Previous research demonstrates a significant association between marital roles and physical health (Gove, Hughes, & Style, 1983; Ross, Mirowsky, & Goldsteen, 1990). Few scholars, however, have examined how the degree of marital quality, rather than simply the status of being married, relates to physical well-being (Marcenes & Sheham, 1992). Yet subjective experience in the marital role may be a more powerful predictor of health status than is role occupancy (Barauch & Barnett, 1986). Gove and Umberson (1985), for example, found that intimate relationships are strongly related to overall well-being. Another limitation in previous research is that most of the studies focusing on the association between marital quality and health have examined only mental health (Lorenz, Conger, Montague, & Wickrama, 1993). In this study, we extend earlier research by investigating the correlation of marital quality, as indicated by marital stability, satisfaction, and happiness in the relationship, with physical illness, as reported by 364 wives and husbands who have been married long. In addition to examining the empirical relationship between marital quality and physical health, our study also addresses two important methodological issues largely neglected in previous research. First, earlier studies have focused on the correspondence between the levels of marital quality and physical health. We were able to locate only one study that has examined the relationship between interindividual changes in marital quality and changes in physical health (Booth & Johnson, 1994). No research in this area has investigated individual differences in intraindividual change in marriage and health, even though the investigation of change should explain individual growth or decline over time. Instead, prior studies of health and social relations have inferred intraindividual change from interindividual differences in levels of attributes (Lorenz & Wickrama, 1994). Actually monitoring the correspondence between changes in social relations and changes in health status provides stronger evidence for the dynamic association between those attributes, at least in comparison with the correspondence that can be obtained from interindividual differences in levels of marital quality and physical health at one point in time (McArdle, 1986; Patterson, 1983, Rogosa, Brandt, & Zimowski, 1982). Most important, none of the earlier studies that we have been able to identify has used individual trajectories of change to examine the systematic relationship between marital quality and physical wellbeing. In examining how the dynamics of marriage might affect changes in health status, it is important to note that changes in personal attributes across several points in time can take either linear or nonlinear forms. When true individual change follows interesting and even nonlinear trajectories, traditional analytical methods (correlational and covariant) are unlikely to reveal the intricacies of individual change (Willet & Sayer, 1994). …

Overt and Subtle Racial Discrimination and Mental Health: Preliminary Findings for Korean Immigrants

OBJECTIVES We examined differential effects of overt and subtle forms of racial discrimination on 2 dimensions of mental health-positive affect and depressive symptoms, and explored the mediating roles of emotional arousal and cognitive appraisal. METHODS Cross-sectional survey data were collected through face-to-face interviews with a sample (N=180) of adult Korean immigrants living in Toronto, Ontario. Maximum likelihood estimates of path coefficients were obtained using structural equation models. RESULTS Perceived racial discrimination was associated with both the erosion of positive affect and depressive symptoms. Overt discrimination was associated with the erosion of positive affect, and subtle discrimination was associated with depressive symptoms. Effects of subtle discrimination on depressive symptoms were mediated through cognitive appraisal. CONCLUSIONS The results emphasize the salience of subtle discrimination for the mental health of Asian immigrants. Experiences of overt racial bias seemed to be of little importance for the levels of depressive symptoms among those in our sample, although the experience of blatant discrimination tended to reduce positive mood.

Relationships among sexual satisfaction, marital quality, and marital instability at midlife.

Sexual satisfaction, marital quality, and marital instability have been studied over the life course of couples in many previous studies, but less in relation to each other. On the basis of the longitudinal data from 283 married couples, the authors used autoregressive models in this study to examine the causal sequences among these 3 constructs for husbands and wives separately. Results of cross-lagged models, for both husbands and wives, provided support for the causal sequences that proceed from sexual satisfaction to marital quality, from sexual satisfaction to marital instability, and from marital quality to marital instability. Initially higher levels of sexual satisfaction resulted in an increase in marital quality, which in turn led to a decrease in marital instability over time. Effects of sexual satisfaction on marital instability appear to have been mediated through marital quality.

The short-term and decade-long effects of divorce on women's midlife health.

We hypothesize that divorce immediately increases psychological distress and has long-term negative consequences for the physical health of divorced people. In addition, we hypothesize that divorce indirectly causes long-term increases in distress through stressful midlife events. The hypotheses are tested using data from 416 rural Iowa women who were interviewed repeatedly in the early 1990s when they were mothers of adolescent children; the women were interviewed again in 2001. The data support the hypotheses. In the years immediately after their divorce (1991–1994), divorced women reported significantly higher levels of psychological distress than married women but no differences in physical illness. A decade later (in 2001), the divorced women reported significantly higher levels of illness, even after controlling for age, remarriage, education, income, and prior health. Compared to their married counterparts, divorced women reported higher levels of stressful life events between 1994 and 2000, which led to higher levels of depressive symptoms in 2001.

Parental Support and Adolescent Physical Health Status: A Latent Growth- Curve Analysis

Applying latent growth curve analysis to a sample of 310 adolescents, this study demonstrates that level of and changes in observed parental behavior are liked to the level of and changes in adolescent physical health status, respectively, through adolescent perception of parental support. In addition, the level of observed parental behavior had a significant direct effect on subsequent changes in adolescent health status. The results provide evidence for the influence of parental support on adolescent physical health, both directly and indirectly through the adolescents perception of that support. Confidence in the findings is strengthened by (1) employing a prospective, longitudinal research design, (2) analyzing intraindividual changes in support and health, and (3) reducing potential method variance confounds by using multi-informant reports of parental behavior.

Family antecedents and consequences of trajectories of depressive symptoms from adolescence to young adulthood: a life course investigation.

Using prospective data from 485 adolescents over a 10-year period, the present study identifies distinct segments of depressive symptom trajectories—a nonsignificant slope during adolescence and a significant negative slope during the transition to adulthood. The study hypothesized that different age-graded life experiences would differentially influence these depressive symptom growth parameters. The findings show that early stressful experiences associated with family-of-origin SES affect the initial level of depressive symptoms. Experiences with early transitional events during adolescence explain variation in the slope of depressive symptoms during the transition to adulthood. The growth parameters of depressive symptoms and an early transition from adolescence to adulthood constrain young adult social status attainment. Consistent with the life-course perspective, family-of-origin adversity is amplified across the life-course by successively contingent adverse circumstances involving life-transition difficulties and poor mental health. The findings also provide evidence for intergenerational transmission of social adversity through health trajectories and social pathways.

Effects of a Preventive Intervention on Adolescent Substance Use Initiation, Expectancies, and Refusal Intentions

This study evaluated the effects of a school-based preventive intervention (Botvin, G. J. 1996, 2000) on growth trajectories of substance initiation (alcohol, tobacco, and marijuana), expectancies, and refusal intentions. A rural midwestern sample (N = 847) provided three waves of data from middle school students. Growth curve analyses demonstrated that the intervention significantly slowed the rate of increase in substance initiation and significantly slowed the rate of decrease in refusal intentions. The intervention also slowed the rate of decrease in negative outcome expectancies, although the significance level was only marginal. A multiple group comparison showed that the impact of initial levels of substance initiation on growth trajectories of refusal intentions differed between conditions, suggesting that the intervention decreased the effect of early substance initiation on the rate of change over time for refusal intentions. Gender differences also were found, although the intervention was effective in slowing the rate of increase in initiation for both genders.

Ambivalence in Mother-Adult Child Relations: A Dyadic Analysis.

The concept of ambivalence represents an interactional process in which individuals evaluate social relations as simultaneously positive and negative. This study investigates ambivalence in interpersonal relations through an empirical analysis of relationships between aging mothers and their adult children from their joint perspectives. Multilevel models examine the influence of dependence on levels of ambivalence in relationship dyads as well as differences in levels of ambivalence between mothers and their adult children. Results suggest that ambivalence increases under conditions of potential dependence, rather than through the help that is more routinely exchanged among family members. Within the relationship, mothers experienced less ambivalence than their sons and daughters; overall findings demonstrate the importance of analyzing multiple perspectives in social relationships.

Linking early social risks to impaired physical health during the transition to adulthood.

The present longitudinal study of 485 youth used structural equation models to investigate the ways in which a combination of social disadvantage in the family of origin and adolescent maladjustment increases risk for physical health difficulties during adulthood. The study examined a theoretical model that proposes that disruptions in the transition to adulthood mediate the effect of earlier social disadvantage and adolescent maladjustment on young adult physical health status. Results show that early risk factors initiate a sequence of negative influences on young adult physical health through early entry into family responsibility, truncated educational attainment, and poor occupational and economic status. These associations prevailed even after controlling for physical health status during adolescence.

Heterogeneity in Youth Depressive Symptom Trajectories: Social Stratification and Implications for Young Adult Physical Health

PURPOSE The first objective of this study was to investigate young adult physical health implications of adolescent depressive symptom trajectories. The second objective was to investigate the social stratification of adolescent depressive symptom trajectories. METHODS Data came from the National Longitudinal Study of Adolescent Health. The analysis included the identification of depressive symptom trajectory groups. These four groups were then compared in terms of socioeconomic characteristics and change in physical health problems, from adolescence to young adulthood. RESULTS Youth in the chronically high, increasing, and decreasing depressive symptoms groups showed significantly higher increases in physical health problems and poorer socioeconomic characteristics than did the consistently low group. CONCLUSIONS The associations of adolescent depressive symptom trajectory groups with changes in physical health provide evidence for the etiological processes through which depression influences physical health. Differing socioeconomic characteristics of depressive symptom trajectory groups suggest social stratification of trajectories.