Ofra Anson

Life events, sense of coherence and health: Gender differences on the kibbutz

The effects of recently experienced life events (RLE) and of a personal coping resource--the sense of coherence (SOC)--on the health of men and women were investigated among members of two small and cohesive communities--two kibbutzim in Israel (n = 230). Results of analyses lend support to previous findings about the negative effects of life events on health, and to Antonovskys theory about the positive influence of SOC on health. Separate analyses for men and women, however, show that while RLEs negatively affect womens health, SOC has no significant counterbalancing effect on their health. Among men, an opposite pattern is found; their health is not affected by RLE, but is significantly affected by their SOC. Our findings lead to the conclusion that men and women are differentially affected by stressors and make different use of their coping resources. These findings should be taken into consideration in further research on stress, coping and health.

Exploring the bio-psycho–social approach to premenstrual experiences

A bio-psycho-social approach to the premenstrual syndrome suggests that cyclical hormonal changes are acknowledged and interpreted in light of the expectations and the attitudes acquired in the process of socialization. In this study, attitudes toward menstruation and premenstrual experiences of 229 Israeli students of different ethnic groups and gender role orientations were explored. The findings were consistent with previous reports: attitudes toward menstruation and premenstrual experiences were associated with exposure to premenstrual symptoms in women family members and negative messages during adolescence; respondents of a more traditional background perceived menstruation as relatively debilitating and bothersome but also a natural event and reported more severe experiences. However, models aimed at estimating the causal relationship indicated that attitudes toward menstruation depend on premenstrual experiences rather than predict them. The difficulties of investigating such reciprocal relationships of menstrual attitudes and premenstrual experiences cross-culturally and longitudinally are discussed.

Blood pressure and cognitive functioning among independent elderly

BACKGROUND The morbidity and mortality benefits of blood pressure (BP) control for the elderly is well documented. The cognitive consequences of hypertension control in this population, however, are still under debate. We aim to study the association between BP and cognitive performance in the elderly. Specifically, we explore 1) the possibility that BP is differentially associated with various cognitive domains; and 2) the utility of analyzing both BP and cognitive scores as continuous variables to unravel possible nonlinear associations. METHODS Four hundred ninety-five community living 70 to 85 year olds completed eight cognitive tests that measured memory, concentration, visual retention, verbal fluency, and the mini-mental state examination (MMSE). The performance of each test was analyzed first by comparing four groups (normotensives, normalized hypertensives, untreated hypertensives, and treated but uncontrolled hypertensives). Then, using BP values as continuous variables, linear, U-curve, and J-curve associations were estimated. RESULTS On all cognitive tests, except for verbal fluency, normotensives performed poorest, treated but uncontrolled hypertensives achieved the highest scores. The MMSE scores and the lighter concentration task were linearly related to BP; J-curve association was observed between memory and visual retention; prolonged concentration was related to pulse pressure alone. CONCLUSIONS Low BP, as observed among the normotensive subjects, was associated with poor cognitive performance. Mild hypertension appeared to enhance cognitive functioning among the subjects of this study. Moreover, we found support for the hypothesis that the association between BP and different dimensions of cognition take on different patterns.

Coping with Recent Life Events: The Interplay of Personal and Collective Resources

The importance of personal and collective resources in coping with recent life events was studied among 230 kibbutz members. The sense of coherence, a global life orientation that detects the ability to avoid stressors and to choose appropriate coping strategies and resources, represented personal resources. Collective resources, embedded in the social system to which one belongs, were measured by membership in a religious kibbutz, the kibbutz being viewed as a powerful, collective-coping resource by itself. Physical well-being, psychological distress, and functional limitations were used as outcome measures. Both types of resources have a salutogenic effect, but sense of coherence appears to be a better resource for avoiding the effect of recent life events and for moderating psychological distress and functional limitation after experiencing such events. The two types of resources have no additive effect, nor do they compensate for each other. Only one significant interaction was found, suggesting that the combination of the two resources is useful in avoiding functional limitation. It is also suggested that collective resources have a slight positive effect on personal resources, which, in turn, take over and become most valuable in coping with recent life events. When stress affects social functioning, these same personal resources facilitate the mobilization of whatever collective resources are available.

Health inequalities in rural China: evidence from HeBei Province

The purpose of this study was to examine the degree to which commonly used social class indicators-education, income, and occupation-are associated with health in the context of rural China. Data were collected from 10,226 individuals of working age (16-60) living in HeBei Province, the PRC. The association between education and income observed resembles the patterns documented in industrial societies, but the health status of farmers is quite similar to that of white collar employees. Persons in other than mainstream occupations report the poorest health status. Social selection and the costs of relative deprivation appear to be useful to the understanding of health inequality in rural China, though in a manner shaped by the particular social context.

Recent Life Events, Religiosity, and Health: An Individual or Collective Effect

While recent life events (RLE) cause ill health and psychological distress, religiosity is positively associated with health. The adverse effect of RLE on health is usually explained in terms of stress theory; the positive religiosity-health association is explained by the nature of the religious network, or by the effect of religiosity on the internal environment of the individual. Using data collected from a sample (n = 230) of two Israeli kibbutzim, one religious and one non-religious, with similar ecology, demography, and social structure, the stress-deterrent effect of religiosity is studied. Self-administered questionnaires, including a list of RLE, five health measures, and five religiosity measures, were randomly distributed. Our findings show that whereas RLE adversely relate to health, belonging to a religious community counterbalances the negative health consequences of RLE. Individual religiosity (private praying, theodicity, and religious commitment) do not have the same stress-deterrent effect.

Women's health and labour force status: An enquiry using a multi-point measure of labour force participation

Previous research indicates that working women are healthier than housewives, that the unemployed are less healthy than those currently employed, and that transitions into and out of paid work may be particularly associated with poor health. Women respondents in the 1979 U.S. National Health Interview Survey were divided into five categories: the long term employee, the newly employed, the unemployed, the recently non-employed and the housewife. The categories were compared on six measures of self-reported health and illness behaviour, controlling for age, SES, marital status, and age of youngest child. As expected the long term employees were the healthiest, followed by the recently employed; the unemployed and the housewives were not distinguishable in terms of their health; and the recently non-employed were the least healthy. This pattern was found for both the total sample, and for the sub sample of married mothers. The dynamic relationship between employment status and health, is discussed.

Family, gender, and attitudes toward retirement

The relationships between marital status, proximity of children, and attitudes toward retirement of 432 men and 373 women on the verge of retirement were studied. Three dimensions of attitudes were examined: attitudes toward losses associated with retirement, toward gains in entering retirement, and toward gains in leaving work. Women hold significantly more positive attitudes toward both types of gains; there are no gender differences concerning attitudes toward losses. The married of both sexes perceive more gains in entering retirement. Proximity of children is curvilinearly related to gain in entering retirement, especially among women. Attitudes toward losses and gains in leaving work are not associated with familial state. The meaning of work and the myth of the primacy of family for women are discussed.

Personality factors as predictors of medical student performance

Personality characteristics were studied among a group of candidates chosen to study medicine in a selection process determined in large part by personal interview ratings. These personality characteristics were examined further with regard to their relation to student performance in an interpersonally community‐oriented school of medicine. Seven scales taken from the California Psychological Inventory (CPI) were studied in regard to their relationship to interview ratings, cognitive and clinical performance and an overall rating by a team of teaching staff. ‘Dominance’, ‘Self‐acceptance’, ‘Well‐being’., ‘Tolerance’, ‘Responsibility’ and ‘Achievement via conformance’ were found to be significantly, albeit modestly, correlated to interview ratings, while ‘Achievement via independence’ was not. All seven CPI scales, except Responsibility significantly differentiated between contrasted groups on cognitive examination scores and overall teachers’ ratings, but not on clinical ratings. Discriminant analyses suggested that ‘Achievement via independence’, ‘Self‐acceptance’, ‘Dominance’ and ‘Achievement via conformance’ were the best overall predictors of cognitive performance and teaching staff ratings. Implications for selection of training of interpersonally, communityoriented professionals in medicine and allied helping fields are discussed.

The effects of replacing β-blockers with an angiotensin converting enzyme inhibitor on the quality of life of hypertensive patients

The aim was to evaluate the effects of a change of treatment from beta-blocker to captopril on the quality of life of hypertensive patients. One hundred forty-nine mild to moderate hypertensive patients who were being treated with beta-blockers were randomly assigned to receive captopril (12.5 to 50 mg twice daily), or to continue on beta-blocker treatment (atenolol: 25 to 100 mg once daily [n = 121], or propranolol, 10 to 80 mg twice daily [n = 12]). When required, 25 mg hydrochlorothiazide was added in each group. The patients were followed over periods ranging from 6 to 12 months. Blood pressure, treatment side effects, and quality of life were monitored. Blood pressure was equally well managed in both groups, though a lower level of treatment was required in the captopril group. The captopril treated patients exhibited favorable changes in several aspects of quality of life: sleep-related, gastrointestinal, and physical activity-related symptoms improved from baseline to end of follow-up. Drowsiness and the ability to concentrate significantly improved in the captopril group only (P <.01). Change in treatment from beta-blocker to captopril resulted in equally well controlled blood pressure on a lower drug dose. Moreover, the change to captopril had a positive impact on the quality of life.