Marja-Liisa Honkasalo

Migraine and Concomitant Symptoms Among 8167 Adult Twin Pairs

We studied the inheritance of migraine and concomitant symptoms among 2690 monozygotic (1524 female and 1166 male) pairs and 5497 dizygotic (2951 female and 2546 male) twin pairs. Our material consists of a population‐based questionnaire study among Finnish twins in 1981. The definition of migraine is based on a questionnaire method.

Interpersonal conflict as a predictor of work disability: A follow-up study of 15,348 finnish employees

This 6-year follow-up study investigates the impact of interpersonal conflict at work on work disability among 8,021 male and 7,327 female employees aged 24 to 65 years at baseline. Marital status, marital conflict, monotonous work, hectic work pace, hostility, neuroticism, life dissatisfaction, and experienced stress of daily activities were included in survival analyses, which were adjusted for age, social status, and general health status. Interpersonal conflict at work predicted work disability only among women (RR 1.56, CL 1.01-2.39). This risk was confined to women who reported simultaneous marital conflicts (RR 2.54, CL 1.03-6.22). When included in further analyses, life dissatisfaction was a significant risk factor among both genders, but monotonous work, neuroticism, and experienced stress of daily activities were risk factors only among men. These data suggest that interpersonal conflict could be a determinant of work disability, and this indicates the importance of gender and marital factors.

Interpersonal conflicts at work and psychosocial characteristics of employees.

Associations of psychosocial factors with interpersonal conflicts at work were studied in a sample drawn from the Finnish population using a mailed questionnaire. The sample consisted of 14,578 employees aged 24-64 years. The frequency of interpersonal conflicts at work was equal among both sexes. Our results suggest that occupational factors such as hectically paced work, monotonous work and white collar status are associated with interpersonal conflicts at work; and more conflicts are found in the younger age-groups. In the multivariate analyses, dissatisfaction with life, daily stress, neuroticism and hostility were found to be the significant risk factors for interpersonal conflicts at work for both sexes, whereas a higher educational level was a considerable risk factor only for men, and low self-assurance only for women. Among men the combination of hectically paced and monotonous work was also found to be a significant risk factor. The results indicate complexity of the concept of human relationships at work, and the importance of both occupational factors and psychological characteristics.

Recent interpersonal conflict at work and psychiatric morbidity: A prospective study of 15,530 employees aged 24–64

Relationships between psychiatric morbidity and interpersonal conflict at work among 15,530 Finnish employees aged 24 to 64 years were studied in a prospective follow-up: 4 years for all psychiatric hospitalizations, 5 years for suicide, and 6 years for long-term medication due to chronic psychosis. The association between interpersonal conflict at work and physician-diagnosed psychiatric morbidity was significant (RR 2.18, 95% CI 1.34-3.54) when results were adjusted for general health status, social class, and mental instability/stress. Results remained significant in additional models adjusted for neuroticism, marital status, conflict with spouse, and high alcohol consumption. The results were similar for both sexes.

A population-based survey of headache and migraine in 22,809 adults

SYNOPSIS

Vicissitudes of pain and suffering: Chronic pain and liminality

This article looks at how the Finnish experience of chronic pain is shaped by socio‐cultural practices. Along with the ambiguity that is necessarily present in all chronic illnesses, the invisibility of chronic pain blurs biomedical categorization and confuses diagnostics. This results in a double delegitimation—that of suffering a chronic illness and that of suffering chronic pain—which, obviously, has a serious effect on ones experience of pain as well as on ones self‐identity. I draw upon data collected from my interviews (conducted in a pain clinic in Finland) with patients who, for years, have suffered from chronic pain. People who are in pain feel that they have lost something precious, and, as a result, their subjectivity—their sense of who they are—becomes altered. This finding is in keeping with what we have learned from previous studies of chronicity. However, unlike Sue Estroffs (1993) and Jean Jacksons (1994) findings with regard to chronic illness (i.e., that it may be specifically located on a continuum of subjectness), my findings with regard to chronic pain indicate that it is ambiguous, that it involves a continuous back‐and‐forth movement along a continuum of subjectness. This movement involves reconciling ones self with, as well as distancing ones self from, pain; and it reflects the biomedical construction of chronic pain. In contrast to those narrative studies of chronic illness that represent illness as a “biographical disruption,” my interviews with Finnish patients indicate that those living with chronic pain experience continual disruptions—chronic pain being one among many.

THE USE OF TRANQUILIZERS, HYPNOTICS AND ANALGESICS AMONG 18,592 FINNISH ADULTS: ASSOCIATIONS WITH RECENT INTERPERSONAL CONFLICTS AT WORK OR WITH A SPOUSE

The use of tranquilizers, hypnotics, and analgesics was assessed by a postal questionnaire in a nationwide sample of 18,592 adults aged from 24 to 65 years: 14,800 employees, 2105 housewives and 687 unemployed persons. The use of tranquilizers was most frequent among unemployed persons whereas housewives did not use the studied medicines more than the employed women. In the multivariate analyses (adjusted for age, social class and neuroticism) unmarried status was associated with the use of tranquilizers and hypnotics among both genders. Reported recent interpersonal conflicts both at work and with a spouse were associated with the use of tranquilizers among men, whereas among women significant associations were found only for conflicts with a spouse. These results indicate that domestic factors are more likely to predict womens tranquilizer use.

Enduring as a mode of living with uncertainty

In addition to management and control, which in risk research have been studied extensively, there is a diversity and heterogeneity in peoples responses to uncertainty that has mostly remained hidden. The aim of my article is to discuss some of the variation in peoples ways of ‘living with uncertainty,’ an expression that is widely applied among many anthropologists and sociologists dealing with research into issues of risk and chronic illness. My intent is to open up and theorise the expression further with the argument that ‘living’ consists in a variety of actions and practices. I want to attend not only to the different empirical meanings of action and agency as they emerge within the activities of modern everyday life, but also to attend to the kinds of analytical questions that are opened up when action is analysed in its wide variety of modalities, as control, resistance, embracing, and enduring. What then does it mean to endure? According to the ethnographic results, enduring is constituted occasionally just in dwelling, or lingering, or embedded deeply within the everyday. What is created in these processes is ethical agency. The vocabulary of agency that the social sciences have in circulation, however, does not grasp this kind of agency to its fullest extent. This article thus is aimed at contributing to discussions on the relations between the uncertainty of the lived-everyday, which has been brought about by illness, and the varieties of human action by emphasising the potentialities and possibilities this agency has to offer.

Fragilities in life and death : Engaging in uncertainty in modern society

Abstract In health research, the concept of risk is used in several domains. It features in epidemiology and health promotion as well as in the sociology and anthropology of health and illness. Important problems are embedded in risk as an analytic category, and some of these are widely discussed within the discipline. First, risk cuts out the experience of illness and replaces it with problematic objectifications. Second, there are a multitude of different meanings assigned to risk which make it problematic as an analytic category. Third, the question of uncertainty has, along with the discourse of risk, attained a solely normative meaning of threat, or has become a residual category in anthropology and social science. Fourth, the individualizing character of the concept of risk eclipses the collective, historical, social and political processes that contribute to the uncertainties of life. Departing from the methodological approach to ‘social suffering,’ this paper will argue through two ethnographic studies that normative and individualizing assumptions lead social studies to overlook the way that local actors, rather than narrowly controlling contingency, may engage in it and live with it as a normal experience of human life. Along with risk, there are variations in local attitudes to uncertainty and there are socially shared ways of accounting for and acting with it. A major challenge for social studies is to embrace the need for the development and implementation of a neutral, non-normative language of contingency. The paradigm of social suffering enables a broader perspective to be brought to bear upon the lived experience of affliction and illness so as to expose a greater variation in human responses to the distress of everyday life.

Mental and somatic health and pre- and post-migration factors among older Somali refugees in Finland

Mental and somatic health was compared between older Somali refugees and their pair-matched Finnish natives, and the role of pre-migration trauma and post-migration stressors among the refugees. One hundred and twenty-eight Somalis between 50–80 years of age were selected from the Somali older adult population living in the Helsinki area (N = 307). Participants were matched with native Finns by gender, age, education, and civic status. The BDI-21 was used for depressive symptoms, the GHQ-12 for psychological distress, and the HRQoL was used for health-related quality of life. Standard instruments were used for sleeping difficulties, somatic symptoms and somatization, hypochondria, and self-rated health. Clinically significant differences in psychological distress, depressive symptoms, sleeping difficulties, self-rated health status, subjective quality of life, and functional capacity were found between the Somali and Finnish groups. In each case, the Somalis fared worse than the Finns. No significant differences in somatization were found between the two groups. Exposure to traumatic events prior to immigrating to Finland was associated with higher levels of mental distress, as well as poorer health status, health-related quality of life, and subjective quality of life among Somalis. Refugee-related traumatic experiences may constitute a long lasting mental health burden among older adults. Health care professionals in host countries must take into account these realities while planning for the care of refugee populations.