Taina Huurre

Long-term psychosocial effects of parental divorce: a follow-up study from adolescence to adulthood.

ObjectiveThe purpose of this 16–year follow–up study was to investigate whether 32–year–old adults who had experienced parental divorce before 16 years of age (n = 317) differed in psychosocial well–being or life trajectories from those from non–divorced two–parent families (n = 1069).MethodThe data were obtained from a follow–up survey of a Finnish urban age cohort from the age of 16 till 32 years (n = 1471). The long–term impact of parental divorce on a variety of outcomes in adulthood, including psychological well–being, life situation, health behaviour, social networks and support, negative life events and interpersonal problems, was assessed.ResultsFemales from divorced compared to non–divorced families reported more psychological problems (higher scores in the Beck Depression Inventory, General Health Questionnaire and Psychosomatic Symptoms Score) and more problems in their interpersonal relationships. These differences were not found among males. Shorter education,unemployment, divorce, negative life events and more risky health behaviour were more common among subjects of both genders with a background of parental divorce.ConclusionsThe study revealed that parental divorce is an indicator of sufficient stress in childhood for its influences to persist well into adulthood, possibly with wider scope among females. It is important to recognise specific needs of children in the divorce process in order to prevent or minimize negative consequences and chain reactions during their subsequent life.

Incidence and Prevalence of Asthma and Allergic Rhinitis: A Cohort Study of Finnish Adolescents

Only limited data are available about the incidence of asthma and allergic rhinitis based on prospective longitudinal studies throughout childhood into adult life. The main purpose of the study was to estimate the incidence rate of asthma and allergic rhinitis from birth to early adulthood. We also estimated the prevalences of these diseases at 16, 22, and 32 years of age. The data were drawn from a follow‐up survey of a Finnish urban age cohort (1967 birth cohort, N = 2269) from age 16 to age 32 years. All data were based on self‐report. The prevalence of asthma from age 16 to age 32 years changed from 3.0% to 5.0% (males from 3.3% to 4.9%; females from 2.7% to 5.1%); and that of allergic rhinitis from 17.5% to 26.0% (males from 18.7% to 27.8%; females 16.2% to 24.5%), respectively. The overall incidence rate of asthma was approximately 2.1 new cases per 1000 person‐years (95% CI = 1.6–2.8). There was a tendency for boys to have a higher incidence rate of asthma than girls in childhood before 16 years of age: gender difference was reversed from period 17 to 22 years of age. In early adulthood (23–32 years), incidence rates were equal in both sexes. The incidence rate for allergic rhinitis in males was 13.4 per 1000 person‐years (95% CI = 11.8–14.8), slightly greater than in females, 11.4 (95% CI = 10.1–12.8). Among both genders, the highest incidence rate of allergic rhinitis was between 17 and 22 years. Our study adds to the limited knowledge on the incidence rates of asthma and allergic rhinitis.

Health, lifestyle, family and school factors in adolescence: predicting adult educational level

Background Education fundamentally shapes an individuals life chances and social status. Duration and level of education are associated with peoples incomes, socio-economic status, living standard, lifestyle and the respect and esteem they enjoy. Failure to fulfil educational potential may have long-term consequences for later occupational and social life, as well as creating problems for society at large. Purpose The aim of this prospective follow-up study was to investigate which health, lifestyle, family and school factors in adolescence had the strongest impact on educational level attained in adulthood. Sample The original study population included all 9th-grade school pupils aged 16 years attending secondary school in spring 1983 in Tampere, Finland (n = 2269). Subjects were followed up at 32 years of age in 1999 (n = 1471). Design and methods In 1983, 2194 pupils (96.7%) with a mean age of 15.9 years (SD 0.3 years) completed questionnaires during school hours. The questionnaire included questions about psychological and somatic health, lifestyle, family background, school factors and life events. In 1999, postal questionnaires were sent to the same study population when they were 32 years old. The follow-up questionnaire included basically the same questions about health and lifestyle as in adolescence and age-appropriate versions of questions about social relations and life events. Education was measured by the highest level of attained education. The follow-up cohort totalled 2091 persons (92%), and the response rate was 70.3% (n = 1471). The univariate associations between independent variables in adolescence and attained educational level in adulthood were analysed using the χ2 test, and Students t-test where appropriate. Multivariate logistic regression analyses using forward stepwise procedure were used to determine which factors in adolescence had the strongest impact on adult educational level. Results Several health, lifestyle, family and school factors in adolescence were univariately associated with educational attainment in adulthood. Multivariate analyses showed that, in both genders, low school achievement and manual class of origin were the strongest predictors of low educational level in adulthood. Additional significant predictors among females were poor perceived health status, spending less leisure-time on hobbies and more on dating, and among males, poor relationships with teachers and heavy drinking. Conclusions Mid-adolescence is an important period for future educational life trajectory. Based on our study results, more attention should be paid to adolescents with school difficulties, unhealthy lifestyle and poor perceived health. It is also important to promote educational equality in relation to family background.

Socioeconomic status as a cause and consequence of psychosomatic symptoms from adolescence to adulthood

BackgroundFew follow-up studies have investigated psychosomatic health and socioeconomic status (SES) and associations between them at different life stages. The aim of this study was to investigate differences in psychosomatic symptoms by SES in adolescence, early adulthood and adulthood and to examine whether lower SES leads to higher levels of symptoms (social causation) or higher levels of symptoms to lower SES (health selection) or both.MethodsAll 16-year-old ninth-grade school pupils of one Finnish city completed questionnaires at school. Subjects were followed up using postal questionnaires when aged 22 and 32 years.ResultsFemales reported significantly higher scores of psychosomatic symptoms than males at 16, 22 and 32 years of age. Higher rates of psychosomatic symptoms were found among females of manual class origin at 16 years. In addition, at 22 years, both females and males with only comprehensive school education and, at 32 years, those who worked in manual jobs had higher scores of symptoms. When low SES both as a cause and consequence of symptoms was investigated, the findings supported both these paths among females and more the health selection among males. In both genders, especially the path from psychosomatic symptoms in adolescence to lower education in early adulthood was strong.ConclusionsThe results highlight the need of greater consideration of psychosomatic symptoms, particularly in adolescence, in later socioeconomic outcomes.

Long-term impact of parental divorce on intimate relationship quality in adulthood and the mediating role of psychosocial resources.

The purpose of this 16-year prospective follow-up study was to investigate the association between parental divorce in childhood and intimate relationship quality in adulthood. The mediating role of psychosocial resources (parent-child relationships at 16 years, self-esteem and social support at 32 years) in this association was also studied. All 16 year olds of one Finnish city completed questionnaires at school and were followed up by postal questionnaires at 32 years of age (n = 1,471). Results showed that women and men from divorced families were more often divorced or separated at the age of 32 years than those from nondivorced families. However, parental divorce was associated with poorer intimate relationship quality only among women. Women from divorced families also had poorer relationships with their father and mother in adolescence, and they had lower self-esteem and satisfaction with social support in adulthood than women from intact families. No such associations were found among men. The impact of parental divorce on intimate relationship quality among women was partially mediated by mother-daughter relationship, self-esteem, and satisfaction with social support. The mediating role of mother-daughter relationship was not direct, however, but was mediated via self-esteem and satisfaction with social support. Our findings indicate that parental divorce affects daughters more than sons. In the context of parental divorce, the mother-daughter relationship in adolescence is important for the development of later psychosocial resources and, via them, for intimate relationship quality.

The problem of attrition in a Finnish longitudinal survey on depression

A cohort of all school children aged 16 years in 1983 (n=2194, 96.7%) in Tampere, Finland were studied at 16, 22 and 32 years of age by self-reported questionnaires. The non-response pattern was considered by modelling the individual response probability by panel year and gender. Gender and school performance at age 16 years were the most important predictors of non-response. They explained away the effect of all other variables at 16 and 22 years, except for earlier non-response at age 22. However, the ability of the models to predict non-respondents was very poor. The effect of attrition for the estimation of depression prevalence was evaluated first by longitudinal weighting methods used commonly in survey studies and then by Markov chain Monte Carlo (MCMC) simulation of the missing depression status. Under the missing-at-random assumption (MAR), both applied correction methods gave estimates of roughly the same size and did not significantly differ from the observed prevalence of depression. No indication of informative missingness was found. We therefore conclude that attrition does not seriously bias the estimation of depression prevalence in the data. In general, non-response models, which are needed to correct for informative missingness, are likely to have poor ability to predict non-response. Therefore, the plausibility of the MAR assumption is important in the presence of attrition.

A 26-year follow-up study of heavy drinking trajectories from adolescence to mid-adulthood and adult disadvantage

AIMS The aim of the study was to identify heavy drinking trajectories from age 16 to 42 years and to examine their associations with health, social, employment and economic disadvantage in mid-adulthood. METHODS Finnish cohort studys participants who were 16 years old in 1983 were followed up at age 22, 32 and 42 (n = 1334). Heavy drinking was assessed at every study phase and based on these measurements trajectories of heavy drinking were identified. The trajectory groups were then examined as predictors of disadvantage at age 42. RESULTS Five distinct heavy drinking trajectories were identified: moderate (35%), steady low (22%), decreasing (9%), increasing (11%) and steady high (23%). Frequencies of the trajectory groups differed by gender. Using the moderate trajectory as a reference category, women in the steady high trajectory had an increased risk of experiencing almost all disadvantages at age 42. In men, increasing and steady high groups had an increased risk for experiencing health and economic disadvantage. CONCLUSION Steady high female drinkers and steady high and increasing male drinkers had the highest risk for disadvantage in mid-adulthood. By identifying heavy drinking trajectories from adolescence to mid-adulthood we can better predict long-term consequences of heavy alcohol use and plan prevention and intervention programmes.

Longitudinal associations between depressive symptoms and body mass index in a 20-year follow-up

Objective:Longitudinal studies have rarely investigated changes in depressive symptoms and indicators of obesity simultaneously, although it is often proposed that the positive relationship between depression and obesity is bidirectional. The present study examined the reciprocal nature of the relationship between depressive symptoms and body mass index (BMI) in a 20-year follow-up survey.Methods:Participants of a Finnish cohort study in 1989 at 22 years (N=1656) were followed up at ages 32 (N=1262) and 42 (N=1155) with postal questionnaires. BMI was calculated on the basis of self-reported weight and height, and depressive symptoms were assessed using the short form of the Beck Depression Inventory. Latent growth models (LGM) and cross-lagged autoregressive models were used to determine prospective associations between depressive symptoms and BMI.Results:LGM analyses indicated that men with higher initial levels of depressive symptoms experienced a faster rate of increase in BMI (β=0.20, P<0.01). Among women, change in BMI or depressive symptoms was not predicted by the other construct, but initial levels of BMI and depressive symptoms as well as their rate of change correlated positively with each other (r=0.15 and 0.37, respectively). In cross-lagged models, depressive symptoms at age 32 predicted greater BMI at 42 (β=0.10, P<0.001) among men, whereas women with higher BMI at age 32 were more likely to have more depressive symptoms at 42 (β=0.08, P<0.05).Conclusions:Elevated depressive symptoms predicted weight gain in men, while changes in depressive symptoms and body weight occurred concurrently in women. Tentative evidence showed that women with excess body weight were more likely to have increased symptoms of depression 10 years later. More emphasis should be placed on depressive symptoms in weight control programs as well as on reducing weight-based stigmatization and discrimination in society.

Changes in psychological resources moderate the effect of socioeconomic status on distress symptoms: a 10-year follow-up among young adults.

OBJECTIVE This study examined the impact of socioeconomic status (SES) on changes in psychological resources and whether these changes in turn moderate the effect of SES on distress symptoms in a prospective 10-year follow-up among young adults. METHOD Subjects (N = 1239) were participants in two phases (1989, 22 years; 1999, 32 years) of a Finnish cohort study. The measurements were SES (basic education at 22 years, occupation at 32 years), distress symptoms (index of 17 somatic and mental complaints), and psychological resources (self-esteem, meaningfulness, locus of control). RESULTS The results showed that lower SES is associated with poorer psychological resources both concurrently and prospectively. Lower SES at age 22 also predicted slower resource development, but only among females. In prospective analyses among both genders, changes in psychological resources moderated the effect of SES on distress symptoms: for those with losses in psychological resources, lower SES was associated with greater increases in distress between 22 and 32 years of age, whereas for those with stable or increasing resources, no effects of SES on distress were found. CONCLUSION The results indicate that higher SES is associated with more favorable changes in psychological resources. In a longitudinal setting, SES differences in health seem to increase only when psychological resources decrease during the same period. The results emphasize the importance of dynamic conceptualizations of psychological resources in SES-health research.

Self-esteem growth trajectory from adolescence to mid-adulthood and its predictors in adolescence

The present study examined the trajectory of self-esteem from adolescence to mid-adulthood and its predictors in adolescence in a prospective cohort sample with a 26-year follow-up. Participants of a Finnish cohort study in 1983 at 16 years (N = 2194) were followed up at ages 22 (N = 1656), 32 (N = 1471) and 42 (N = 1334) years. Self-esteem development was analyzed using latent growth curve models with parental socioeconomic status (SES), parental divorce, school achievement, daily smoking, and heavy drinking as time invariant covariates. Self-esteem grew linearly from 16 to 32 years, but stabilized after that with no growth between 32 and 42 years. Males had significantly higher self-esteem throughout the follow-up, although females had a faster growth rate. Better school performance and higher parental SES were associated with a higher initial level of self-esteem among both genders, while parental divorce among females and daily smoking among males were associated with a lower initial level of self-esteem. Among females the growth rate of self-esteem was practically unaffected by the studied covariates. Among males, however, the initial differences in self-esteem favouring those from a higher SES background were indicated to diminish, while the differences between non-smokers and smokers were indicated to increase. The studied adolescent covariates combined had only limited predictive value for the later self-esteem development. However, the effects of any covariate on the level and slope of the self-esteem trajectory, even if small, should be assessed in combination in order to identify whether they lead to converging, diverging or constantly equidistant self-esteem trajectories. The findings highlight the variety of roles that adolescent behaviours and social environments may have in the developmental process of self-esteem from adolescence into mid-adulthood.