Mary Clare Lennon

Relationship between lifetime occupation and parietal flow Implications for a reserve against Alzheimer's disease pathology

Article abstract-We previously reported an inverse relation between parietal cerebral blood flow and years of education in Alzheimers disease (AD) patients matched for clinical severity. This suggested that the clinical manifestation of advancing AD pathology is delayed in patients with higher educational attainment. Other aspects of life experience may also provide a reserve against the clinical expression of AD. To test this hypothesis, we classified the primary lifetime occupations of 51 AD patients using the Dictionary of Occupational Titles, published by the US Department of Labor, and derived six factor scores describing intellectual, interpersonal, and physical job demands. Regional cerebral blood flow was measured using the xenon-133 inhalation method. After controlling for age, clinical dementia severity, and education, there was less relative perfusion in the parietal region in subjects whose occupations were associated with higher interpersonal skills and physical demands factor scores. We conclude that independent of education, aspects of occupational experience may provide a reserve that delays the clinical manifestation of AD. NEUROLOGY 1995;45: 55-60

Socioeconomic Status and Depression: The Role of Occupations Involving Direction, Control, and Planning

This article proposes a social causation explanation for the association between SES and depression/distress. The model links SES, occupational direction, control, and planning (DCP), personality factors, and depression/distress in a causal sequence. The data to test the social causation model against alternative, social selection models are derived from samples of psychiatric patients and community residents in Washington Heights, New York City. The key factor of DCP is operationalized using ratings from the Dictionary of Occupational Titles. The results support the social causation model and cannot be accounted for by several tests derived from social selection models. Thus the results increase the plausibility of the social causation model and suggest the need for further research on the links between occupational conditions and mental disorder.

Women, Work, and Well-Being: The Importance of Work Conditions*

This study investigates the role of work conditions in mediating the effect of employment status on married womens psychological well-being. Employed wives and full-time homemakers are compared on characteristics of their daily work activities and the consequences of these work conditions for psychological well-being. Using data from a national survey of employed wives and homemakers, I find that full-time housework involves more autonomy, more interruptions, greater physical effort, more routine, fewer time pressures, and less responsibility for matters outside ones control than paid work. Differences in work activities between employed wives and homemakers also have direct implications for well-being. Two of the dimensions examined--the extent to which the worker is responsible for things outside her control, and the amount of routine entailed--are associated with greater depressive symptoms among women, regardless of work status. It appears that, as compared to employed wives, full-time homemakers benefit from having less responsibility for things outside their control. Employed wives appear to benefit from having less routinized work than homemakers. As a result of the different configurations of their work characteristics, employed wives and homemakers experience on average similar levels of depressive symptoms.

Sex differences in distress: the impact of gender and work roles.

Investigators have suggested that social roles, particularly gender roles, may explain the tendency for women to have higher rates of demoralization than men. Results of studies comparing employed women, employed men, and housewives have been mixed, however, and investigators have begun to consider additional explanatory factors. This paper focuses on a potential source of gender differences in distress that has received relatively little attention: the workplace itself. I consider the extent to which work conditions and the sexual segregation of occupations are related to two measures of distress: demoralization, which is more prevalent among women, and drinking, which is more prevalent among men. Multiple regression analyses indicate that the only work-related factors associated with demoralization are substantive complexity and full-time work, and these have an effect among women only. Full-time work and low levels of complexity are associated wiMh higher levels of demoralization among women. Substantive complexity is also associated with drinking, but only among men; as complexity declines, levels of drinking increase. These findings indicate the importance of considering work-related factors and measures of distress associated differentially with gender when investigating gender differences in distress.

The dynamics of economic disadvantage and children's life chances

Recent research suggests that child well-being and subsequent status attainment are influenced not only by the duration of exposure to economic disadvantage during childhood, but also by the timing and sequencing of exposure. Unfortunately, traditional measures of childrens economic deprivation typically fail to differentiate between exposures to disadvantage at different stages in childhood and largely ignore how economic circumstances change over time. In this article, the authors propose a new method for assessing economic disadvantage during childhood that simultaneously captures childrens overall levels of exposure to economic disadvantage as well as the timing and sequencing of their exposure. This new method uses finite mixture modeling to classify children into a limited number of classes with similar histories of exposure to economic disadvantage. With this new methodology, it is possible both to assess how family characteristics affect patterns of exposure to disadvantage and to directly test alternative theories about the effect that different patterns of exposure have on achievement. The authors find that extended exposure to economic deprivation during childhood is least favorable to early adulthood achievement, but that—at least for human capital formation-the timing and sequencing of poverty also are important.

The Self and Mental Health: Self-Salience and the Emergence of Internalizing and Externalizing Problems*

How do schemas about self-salience—the importance of the self versus the collective in social relations—affect mental health? We propose that self-salience shapes the likelihood of experiencing internalizing or externalizing problems. Schemas that privilege others over the self increase the risk of internalizing symptoms, including depressive symptoms and anxiety, whereas those that privilege the self over others predispose individuals to externalizing behaviors of antisocial behavior and substance abuse. Furthermore, we propose that these schemas contribute to the gender differences that exist in these problems. We test these predictions with data from adolescents, the stage at which these problems and the gender differences in them arise. Results show that self-salience underlies both internalizing and externalizing problems. In addition, schemas about self-salience help explain the gender differences found in mental health problems.

Candidate risk factors for temporomandibular pain and dysfunction syndrome: Psychosocial, health behavior, physical illness and injury

&NA; The purpose of this paper is to identify potential risk factors for the temporomandibular pain and dysfunction syndrome (TMPDS). The investigation focuses on the relations of TMPDS to personal, social and recent experiential factors, especially health behaviors and physical illnesses and injuries, that contribute to life stress. The data come from a retrospective case‐control study of 151 TMPDS patients and 139 healthy controls. Results show that cases and controls are similar on most measures of personality characteristics although cases are somewhat more external in locus of control expectancy and appear far more distressed than do controls. There are no case/control differences in reports of desirable and undesirable life events that do not involve physical illness and injury. The social situations of cases and controls differ in that cases have fewer sources of emotional support than controls. No differences were found in the proportion of cases and controls who reported that they ever ground or clenched their teeth, although cases were told they do so more frequently by dentists than were controls. Excluding never married women, cases were less likely than controls to have children. This could not be explained on the basis of birth control and may provide a clue to a biologic base for the much higher rates of women than men who are treated for TMPDS. Cases reported more past pain‐related illnesses, more life‐threatening physical problems and more recent events involving injury and non‐pain‐related physical illnesses. There was no difference between cases and controls in reports of physical problems prior to age 13. TMPDS patients appear to be unusually distressed individuals who are beleaguered by physical illnesses and injuries as well as by pain, who tend to attribute their fate to external factors, and who have fewer sources of emotional support.

The influence of social support on AIDS-related grief reaction among gay men

This paper examines the relationships between instrumental and emotional social support and the experience of grief reaction in a sample of 180 gay men who had lost a lover or close friend to AIDS during the first 5 years of the epidemic. Structured, face-to-face interviews were conducted in mid-1985. Grief reaction was assessed through a newly developed 12-item scale (alpha = 0.85). Availability and adequacy of instrumental and emotional support were assessed with reference to the tasks of caretaking and emotional pain experienced during the lovers or close friends illness with AIDS. The findings indicate that gay men who lost a lover or close friend to AIDS experienced symptoms of grief similar to those reported in studies of bereaved spouses and parents. The intensity of these grief reactions appears to be influenced by a number of factors. First, more intense grief reactions were observed among those who had taken care of their lover or close friend during his illness compared with those who did not act as caretakers. Second, while the simple availability of instrumental and emotional support was unrelated to grief reactions, the perceived adequacy of both types of support was strongly related to the level of grief. Respondents who had received inadequate help with caretaking responsibilities experienced more intense symptoms of grief subsequent to the death compared with those who reported receiving adequate caretaking support. Similarly, respondents who did not obtain adequate emotional support for the pain they experienced during the course of the illness reported more intense symptoms of grief compared with those who felt they had received adequate support.(ABSTRACT TRUNCATED AT 250 WORDS)

Coping and Adaptation to Facial Pain in Contrast to Other Stressful Life Events

This article investigates whether coping with chronic pain influences adaptation to other negative life events using data on Temporomandibular Pain and Dysfunction Syndrome (TMPDS) patients (N = 99) and nonpatient controls (N = 98). It is found that cases cope very differently with pain than with other stressful events and that cases and controls do not differ on coping with nonpain events, with 2 exceptions. Cases view nonfateful events as more outside their control and they have more negative changes in usual activities following negative events. This excess of negative change is associated with greater demoralization and physical exhaustion. It is concluded that coping with repeated pain episodes leaves cases vulnerable to stressful events. Alternative interpretations, especially those involving the role of preexisting personality differences, are discussed.

The examination of myofascial face pain and its relationship to psychological distress among women.

In this study, 110 female myofascial face pain patients were assessed monthly for 10 months on measures of pain, distress, and stressful life events. D. A. Kenny and A. J. Zautras (1995) structural equation model for examining the separate trait, state, and error components of the variables was used to analyze the data. Both pain and distress had sizable trait variance, and the trait components were correlated. The 2 variables also showed sizable state variance, and the states of pain covaried with states of distress. A significant time-lagged relationship between the 2 variables was found: Increases in distress led to elevations in pain 1 month later. Stressful life events arising from major social roles were also associated with greater distress, but not pain. Illness events unrelated to the pain syndrome were associated with both pain and distress.