Robyn Lewis Brown

“Did I push myself over the edge?”: Complications of agency in psychosis onset and development

Objective: To investigate the subjective experience of agency in the onset and early development of psychosis. Method: We conducted 19 in-depth interviews with a sample of individuals with self-reported diagnoses of schizophrenia and/or affective psychosis. Interviews focused on participants’ experiences of agency and control in the onset and development of positive psychotic symptoms. Interviews were coded and transcripts analyzed by service-user researchers. Results: The majority of participants reported multiple ways in which they experienced their own agency or intentionality as involved in the initial onset of psychosis, in self-conscious engagement with symptom structure and content, and in their elaboration and development. For many, the moral implications of these felt experiences were considerable, at times leading to shame or guilt. Conclusion: Clinical accounts often stress the imposed, involuntary experience of symptoms and onset. Our project suggests that at least a subset of subjects with psychosis instead experience themselves as partly or fully “responsible” for onset, and actively involved in the shaping and elaboration of positive symptoms. In both clinical practice and future research, we argue that such complications should be explored and grappled with rather than downplayed.

Functional limitation and depressive symptomatology: Considering perceived stigma and discrimination within a stress and coping framework.

This study examines whether perceived stigma and discrimination moderate the associations between functional limitation, psychosocial coping resources, and depressive symptoms among people with physical disabilities. Using 2 waves of data from a large community study including a representative sample of persons with physical disabilities (N = 417), a moderated mediation analysis based on structural equation modeling was performed. Mediation tests demonstrated that mastery significantly mediates the association between functional limitation and depressive symptoms over the study period. Moderated mediation tests revealed that the linkage between functional limitation and mastery varies as a function of perceived stigma and experiences of major discrimination and day-to-day discrimination, however. The implications of these findings are discussed in the context of the stress and coping literature.

The effect of political generation on identity and social change: Age cohort consequences.

ABSTRACT In this article, we explore how political generation affects the ways in which diverse individuals come together and change their social and personal identities. Drawing on 52 in-depth interviews with members of the Red Hat Society, we show that women draw on their political generation, and the gains of the women’s movement specifically, to oppose cultural constructions of aging. The Red Hat Society provides a “free space” for women to foster a collective identity that both visibly challenges aging norms and provides its members new standards for self-approval. We conclude by highlighting the importance of focusing on political generation to understand collective action over the life course and call for more scholarship on the function of political generation in social change.

Economic stressors and alcohol-related outcomes: Exploring age cohort differences

OBJECTIVES This study examined processes linking age cohort, economic stressors, coping strategies and two drinking-related outcomes (i.e., past-month drinking and problematic drinking). METHODS Structural equation models were conducted utilizing data from a national survey. RESULTS Findings revealed the associations between economic stressors and both past-month drinking and problematic drinking were significantly greater for members of the millennial cohort compared to baby boomers. These effects are partly explained by the lesser tendency of members of the millennial cohort to use collective, politically-focused coping strategies. DISCUSSION These findings clarify the circumstances in which age matters most for the associations among economy-related stressors, coping strategies and drinking-related outcomes. They highlight how difficult economic circumstances influence the availability of coping strategies and, in turn, alcohol consumption - and differently for younger and older age cohorts.

Economic Stressors and Psychological Distress: Exploring Age Cohort Variation in the Wake of the Great Recession

This study examined processes linking age cohort, economic stressors, coping strategies and two indicators of psychological distress (i.e. depressive symptoms and anxiety symptoms). Structural equation models were conducted utilizing data from a national survey that was undertaken in order to understand life change consequences of the period of economic downturn from 2007 to 2009 known as the Great Recession. Findings revealed that the associations between economic stressors and symptoms of both depression and anxiety were significantly greater for members of the millennial cohort compared with baby boomers. These effects are partly explained by the greater tendency of members of the baby boomer cohort to use active coping strategies. These findings clarify the circumstances in which age matters most for the associations among economy-related stressors, coping strategies and psychological well-being. They highlight how difficult economic circumstances influence the availability of coping strategies and, in turn, psychological well-being-and differently for younger and older age cohorts. Copyright

Food Insecurity and Mental Health: A Gendered Issue?

Abstract Purpose Food insecurity and hunger are found to have important adverse mental health effects, and have been of particular interest to epidemiologists and public health scholars. The primary goal of the present study is to expand our understanding of the mental health effects of food insecurity by assessing gender-based disparities among a nationally-representative sample of U.S. adults. Methodology/approach Using data from the combined 2011-2012 and 2013-2014 cycles of The National Health and Nutrition Examination Survey (NHANES) (N=11,539), we estimated multiple ordinary least squares and binomial models using adult food insecurity measures and self-reported gender as main predictors of depressive symptoms and alcohol use. Findings Our results demonstrate that food insecurity is associated with depressive symptoms but not alcohol consumption. Additionally, we found an association between food insecurity and increased psychological distress among women relative to men. In contrast, no evidence of a difference in the association between food insecurity and alcohol use was observed across the two genders, indicating that experiences of food insecurity are particularly salient for psychological health among women. Implications and originality These findings add to the growing literature that household food insecurity has serious mental health consequences, and extend this work by clarifying ways in which gender accounts for differences in the association between food insecurity and psychological and behavioral outcomes.

People with Physical Disabilities, Work, and Well-being: The Importance of Autonomous and Creative Work

Abstract Objective Motivated by research linking job autonomy and job creativity with psychological well-being, this study examines how these work characteristics influence well-being among people with and without physical disabilities, utilizing both a categorical and continuous measure of disability. Method Data were drawn from two waves of a community study in Miami-Dade County, Florida, of 1,473 respondents. Structural equation modeling was used to assess whether job autonomy and job creativity mediate the associations between the indicators of physical disability considered and depressive symptoms and whether these associations varied by gender. Results Controlling for the effects of the sociodemographic control variables, both job autonomy and job creativity significantly influence the association between physical disability and depressive symptoms regardless of the measure of disability used. The effects of job autonomy were significantly greater for women than men in the context of greater functional limitation. Conclusions The findings highlight the need to further consider the work characteristics of employed people with disabilities. They also demonstrate that the conceptualization and measurement of physical disability has important research implications.

The Enduring Mental Health Effects of Post-9/11 Discrimination in the Context of the Great Recession: Race/Ethnic Variation

While prior study has linked discrimination experienced as a result of 9/11 with economic insecurity within the context of the Great Recession, the mental health effects of this linkage are unexamined. This study examined whether economic insecurity during the recession era helps account for long-term effects of 9/11-related discrimination on symptoms of depression and anxiety using structural equation modeling techniques to assess data from a national mail survey. Results reveal that the effects of 9/11-related discrimination on symptoms of depression and anxiety substantially derive from its association with recession era economic insecurity. The impact of 9/11-related discrimination on economic insecurity is also significantly greater for black Americans and Latinos compared to non-Hispanic whites and is further linked with more symptoms of depression and anxiety for both groups.

Food insecurity, psychological distress and alcohol use: understanding the salience of family roles for gender disparities

ABSTRACT The goal of this paper was to expand upon research documenting the adverse mental health effects of food insecurity by assessing the explanatory role of gender differences in family roles and arrangements among a nationally-representative sample of U.S. adults. Using data from the combined 2011–2012 and 2013–2014 cycles of The National Health and Nutrition Examination Survey (NHANES), we estimated a series of models using adult food insecurity measures and self-reported gender as main predictors of depressive symptoms and alcohol use. Our results demonstrate that marriage is protective against greater depressive symptomatology among women and men, and higher alcohol consumption among men. However, the protective effects of marriage against high alcohol use are reduced within the context of food insecurity among men. Further, the results indicate that parenthood is protective against greater depressive symptoms and alcohol consumption among women, but not men. The protective effects of having children are, however, diminished among women in food insecure households. These findings add to the growing literature on the mental health consequences of household food insecurity, and extend this work by clarifying ways in which family roles come to bear on gender differences in the association between food insecurity and psychological and behavioural outcomes.

Intersectionality, Work, and Well-Being: The Effects of Gender and Disability:

Intersectionality emphasizes numerous points of difference through which those who occupy multiple disadvantaged statuses are penalized. Applying this consideration to the workplace, we explore ways in which status-based and structural aspects of work undermine women and people with physical disabilities and diminish psychological well-being. We conceptually integrate research on the workplace disadvantages experienced by women and people with disabilities. Drawing on a longitudinal analysis of community survey data that includes a diverse sample of people with and without physical disabilities, we explore the claim that women with disabilities are burdened by greater disadvantage in work settings compared to men with disabilities and women and men without disabilities. We find evidence that in comparison with these groups, women with disabilities on average are more psychologically affected by inequitable workplace conditions, partly because they earn less, are exposed to more workplace stress, and are less likely to experience autonomous working conditions.