Susan Gore

The effect of social support in moderating the health consequences of unemployment.

In the context of a longitudinal investigation of the physical and mental health consequences of involuntary job loss, it is hypothesized that social supports modify the relationship between unemployment stress and health responses. As a result of two plant shutdowns, 100 stably employed, married men were interviewed at five stages over a two-year period. Social support was measured by a 13-item index covering the extent of supportive and affiliative relations with wife, friends and relatives. The rural unemployed evidenced a significantly higher level of social support than did the urban unemployed, a difference probably due to the strength of ethnic ties in the small community and a more concerned social milieu. No differences between the supported and unsupported were found with respect to weeks unemployed or to actual economic deprivation. However, while unemployed, the unsupported evidenced significantly higher elevations and more changes in measures of cholesterol, illness symptoms and affective response than did the supported. While health differences between supported and unsupported populations under stress are commonly interpreted as evidence that support buffers the effects of life stress, it is argued that these and other study findings demonstrate the exacerbation of life stress by a low sense of social support.

Adverse childhood experiences and mental health in young adults: a longitudinal survey

BackgroundAdverse childhood experiences (ACEs) have been consistently linked to psychiatric difficulties in children and adults. However, the long-term effects of ACEs on mental health during the early adult years have been understudied. In addition, many studies are methodologically limited by use of non-representative samples, and few studies have investigated gender and racial differences. The current study relates self-reported lifetime exposure to a range of ACEs in a community sample of high school seniors to three mental health outcomes–depressive symptoms, drug abuse, and antisocial behavior–two years later during the transition to adulthood.MethodsThe study has a two-wave, prospective design. A systematic probability sample of high school seniors (N = 1093) was taken from communities of diverse socioeconomic status. They were interviewed in person in 1998 and over the telephone two years later. Gender and racial differences in ACE prevalence were tested with chi-square tests. Each mental health outcome was regressed on one ACE, controlling for gender, race/ethnicity, and SES to obtain partially standardized regression coefficients.ResultsMost ACEs were strongly associated with all three outcomes. The cumulative effect of ACEs was significant and of similar magnitude for all three outcomes. Except for sex abuse/assault, significant gender differences in the effects of single ACEs on depression and drug use were not observed. However, boys who experienced ACEs were more likely to engage in antisocial behavior early in young adulthood than girls who experienced similar ACEs. Where racial/ethnic differences existed, the adverse mental health impact of ACEs on Whites was consistently greater than on Blacks and Hispanics.ConclusionOur sample of young adults from urban, socio-economically disadvantaged communities reported high rates of adverse childhood experiences. The public health impact of childhood adversity is evident in the very strong association between childhood adversity and depressive symptoms, antisocial behavior, and drug use during the early transition to adulthood. These findings, coupled with evidence that the impact of major childhood adversities persists well into adulthood, indicate the critical need for prevention and intervention strategies targeting early adverse experiences and their mental health consequences.

Social Roles, Sex Roles and Psychological Distress: Additive and Interactive Models of Sex Differences

Determinants of sex differences in psychological distress are explored through estimating additive and interactive regression models, The absence of employment or marriage is associated with depression for both men and women. Also, for this measure of distress, an additive model of social-role effects accounts for the observed sex difference, suggesting a structural interpretation of the genderldepression relationship. For the measure of psychophysiologic complaints, the pattern of influences differs. Here, gender and being a parent jointly influence level of symptomatology. Further analysis reveals this effect to be due primarily to sex differences among parents having young children. The pattern offindings for this variable is understood to support formulations pertaining to the stress of family roles for women.

Stress between Work and Family

The contributors of this book have presented data from a variety of research projects that show the many and dynamic ways in which the worlds or work and family are intricately connected. This interconnectedness becomes even more apparent when stressful experiences in the workplace or the family upset the homeostasis that may otherwise have been achieved between these domains. As such, the investigation of chronic stress in the workplace and disruptions such as job loss becomes a potential window investigators can use to explore normative family processes, just as chronic stress and change in the family informs our understanding of the meaning of work roles.

Social structure, life stress and depressive symptoms in a high school-aged population

Data from a randomly selected sample of 1,208 high school-aged adolescents were used to examine the means through which life stress is associated with depressive symptoms. Analyses focus on family structure, socioeconomic status, and gender as background risks which directly and indirectly influence symptoms, as well as vulnerability contexts that shape differential responsiveness to stressful experiences. Findings indicate (1) significant gender differences in aspects of stress exposure and in additive models of stress effects, but stresses and supports do not explain the significant gender difference in depressive symptoms; (2) girls in low education backgrounds have the highest levels of depressive symptoms; (3) there are no gender differences in vulnerability to stress; (4) children in single-parent families have higher symptom levels, effects explained by economic conditions and stress exposure--they are no more vulnerable than others to the depressing effects of these stresses; and (5) both boys and girls in low SES backgrounds are more vulnerable to a wide range of stresses and support deficits.

The impact of cumulative childhood adversity on young adult mental health: measures, models, and interpretations.

Research studies investigating the impact of childhood cumulative adversity on adult mental health have proliferated in recent years. In general, little attention has been paid to the operationalization of cumulative adversity, with most studies operationalizing this as the simple sum of the number of occurrences of distinct events experienced. In addition, the possibility that the mathematical relationship of cumulative childhood adversity to some mental health dimensions may be more complex than a basic linear association has not often been considered. This study explores these issues with 2 waves of data drawn from an economically and racially diverse sample transitioning to adulthood in Boston, Massachusetts, USA. A diverse set of childhood adversities were reported in high school and 3 mental health outcomes -- depressed mood, drug use, and antisocial behavior -- were reported 2 years later during the transition to adulthood. Our results suggest that both operationalization and statistical modeling are important and interrelated and, as such, they have the potential to influence substantive interpretation of the effect of cumulative childhood adversity on adult mental health. In our data, total cumulative childhood adversity was related to depressive symptoms, drug use, and antisocial behavior in a positive curvilinear manner with incremental impact increasing as adversities accumulate, but further analysis revealed that this curvilinear effect was an artifact of the confounding of high cumulative adversity scores with the experience of more severe events. Thus, respondents with higher cumulative adversity had disproportionately poorer mental health because of the severity of the adversities they were exposed to, not the cumulative number of different types of adversities experienced. These results indicate that public health efforts targeting prevention of childhood adversities would best be aimed at the most severe adversities in order to have greatest benefit to mental health in young adulthood.

Race and ethnic differences in depressed mood following the transition from high school.

Young adulthood is a period of increased mental health risk, with evidence linking psychological disorder to problematic role transitions. To our knowledge, there has been little or no research that examines the forces shaping minority mental health at this time. Using a diverse, urban sample of young adults who are followed over a two-year period, this paper examines the link between race/ethnicity and depressed mood and the transitional roles and interpersonal experiences that mediate this association. Findings indicate that blacks and Hispanics have elevated depressed mood relative to whites and Asian Americans, independent of socioeconomic background factors. The underrepresentation of blacks and Hispanics in four-year colleges largely explains the differences in depressed mood between members of these groups and Asian American youth. In contrast, comparisons of black and Hispanic youth to white youth highlight problems in peer and parental relations among individuals in the former groups. Overall, findings suggest that the heightened depressed mood among Hispanics and blacks relative to whites and Asian Americans reflects their increasingly disadvantaged pathways into adulthood, characterized by poorer prospects for educational advancement and more problematic relationships subsequent to the high school years.

Protective processes in adolescence: Matching stressors with social resources

Working within the “matching theory” of social supports, this research focuses on depressed mood and examines how resilience to stress during adolescence is shaped by developmental constraints on the use of support for coping with problems in the family, peer, and personal arenas. The sample is 1,036 adolescents systematically drawn from 3 community high schools in the Boston area. Predictions center on the efficacy of peer and family supports, and two intraindividual protective factors: sense of mastery and sense of social integration. Findings indicate little evidence of cross-domain stress buffering (where family support buffers the effects of peer stress on mood, and vice versa), suggesting that family and peer domains are more distinct during this stage of development. Protective effects for friendship stresses are evidenced, but boys are more able than girls to marshal their personal and support resources in managing friendship problems. Discussion centers on matching theory and the role of development in shaping coping responses to stress.

The Variable Effects of Stress on Alcohol Use from Adolescence to Early Adulthood

Despite evidence of a strong association between stress and level of drinking in adolescent populations, the role of stress in accounting for changes in drinking behavior throughout the adolescent years is unclear. This study uses a linear growth curve analysis to examine the determinants of within-individual changes in drinking frequency and binge drinking across five waves of data from a community sample of adolescents who were followed into young adulthood. Predictors of drinking include: stressful life events, parental and peer social support, and parental and peer relationship problems. Findings indicate significant effects of stressful life events and parental support and conflict on both the frequency and intensity of alcohol use. Although age-related changes in these variables coincide with changes in drinking behavior, they do not account for drinking variability over this period. Results from conditional models demonstrate that the impact of the stress is contingent on age, and that the strong associations between drinking and stress evidenced during the high school years weaken considerably as individuals move into their late teens and early twenties. Discussion centers on the complex motivations for and facilitators of drinking as young people mature and change environments over the adolescent years.

Depression and the social developmental context of adolescence.

This article examines the interrelations of personal and social factors in fostering longitudinal patterns of depressive symptoms, using 3 waves of data from high school students in the Boston area. Previously depressed and nondepressed youths differed markedly in their emotional responsiveness to family and friend relations. Chronically depressed youths were unresponsive to family problems, but were highly reactive to peer relations. Among previously asymptomatic youths, family relations exerted greater effects on depressed mood than relations with peers. Further analyses suggest a process through which chronic family turmoil shapes long-term mental health while also intensifying the distancing from family and investment in peer relationships that typically occurs in adolescence. Findings illustrate the importance of modeling transactions between personal and environmental factors in research on adolescent mental health and development.