Thulitha Wickrama

Heterogeneity in Youth Depressive Symptom Trajectories: Social Stratification and Implications for Young Adult Physical Health

PURPOSE The first objective of this study was to investigate young adult physical health implications of adolescent depressive symptom trajectories. The second objective was to investigate the social stratification of adolescent depressive symptom trajectories. METHODS Data came from the National Longitudinal Study of Adolescent Health. The analysis included the identification of depressive symptom trajectory groups. These four groups were then compared in terms of socioeconomic characteristics and change in physical health problems, from adolescence to young adulthood. RESULTS Youth in the chronically high, increasing, and decreasing depressive symptoms groups showed significantly higher increases in physical health problems and poorer socioeconomic characteristics than did the consistently low group. CONCLUSIONS The associations of adolescent depressive symptom trajectory groups with changes in physical health provide evidence for the etiological processes through which depression influences physical health. Differing socioeconomic characteristics of depressive symptom trajectory groups suggest social stratification of trajectories.

Heterogeneity in Adolescent Depressive Symptom Trajectories: Implications for Young Adults' Risky Lifestyle

OBJECTIVES The first objective of this study was to empirically identify adolescent depressive symptoms trajectory among classes. The second objective was to investigate the implications of adolescent depressive symptom trajectories for their lifestyle factors in young adulthood. METHODS Data came from the National Longitudinal Study of Adolescent Health (Addhealth). The analysis included the identification of depressive symptom trajectory groups using Latent Class Analyses. The identified trajectory groups were then compared with regard to risky lifestyle factors in young adulthood. RESULTS Youth in the chronically high, increasing, and decreasing depressive symptoms groups showed significantly higher prevalence rates in most risky lifestyle factors compared with the consistently low trajectory group, after controlling for lagged measures, adolescent delinquency, family characteristics, and race/ethnicity. The risky lifestyle factors included: having multiple sex partners, having been arrested/committed crime, being an excessive drinker, being a smoker, and being unmarried. CONCLUSIONS The associations of adolescent depressive symptom trajectory groups with young adult risky lifestyle factors provide evidence for the psychosocial processes through which experiences with depressive symptoms influence young adult lifestyle.

Early socioeconomic disadvantage and young adult sexual health.

OBJECTIVE To test a longitudinal and multilevel model predicting young adult risky sexual behaviors and sexually transmitted infections. METHODS Data from 14,058 participants in 3 waves were used to link community and family disadvantage, adolescent adjustment problems, and risky sexual behaviors with STIs. RESULTS Community-level disadvantage, being African American, and being female remained predictors of sexual behaviors and STIs whereas adolescent adjustment mediated the effect of several family characteristics. CONCLUSIONS This study demonstrates how individual-, family-, and community-level characteristics and vulnerabilities contribute to young adult sexual risk and STI prevalence. Findings indicate specific individual characteristics and childhood experiences that should be specific targets of STI prevention efforts.

Change in the health of tsunami-exposed mothers three years after the natural disaster:

Background: Women’s experiences with secondary stressors resulting from natural disasters, such as increased economic insecurity, expanded caregiving responsibilities and disrupted family life, may contribute to women’s mental and physical health problems. Aims: The present study investigates change and stability in post-tsunami depressive symptoms and perceived physical health of tsunami-exposed mothers over three and a half years. Methods: Using data from 160 tsunami-affected mothers, the present study uses structural equation modelling to investigate (1) change, stability, cross-lagged reciprocal influences of mental and physical health and (2) the meditation effect of negative life events on the relationship between tsunami exposure and post-tsunami depressive symptoms and perceived physical health of tsunami-exposed mothers from 2005 to 2008. Results: Tsunami exposure contributed to depressive symptoms among mothers independently of pre-tsunami family adversities. Average depressive symptoms showed a decline whereas poor physical health showed an increase over this period. The results also revealed an interrelated health process between depression and physical health over time. Continuity of health problems were mediated by secondary stressors that also exerted an additive effect on later health problems. Conclusions: Post-disaster intervention and recovery programmes should focus not only on mothers’ exposure to natural disasters, but also their pre- and post-natural disaster adversities. They should reach disaster-exposed mothers directly and have an integrated health approach to disrupt continuities of health problems.

Association Between Body Mass Index and Depressive Symptoms of African American Married Couples Mediating and Moderating Roles of Couples’ Behavioral Closeness

This study examined (a) associations between body mass index (BMI) and depressive symptoms in African American husbands and wives, (b) transactional associations between husbands and wives in this relationship, and (c) mediating and moderating role of couples’ behavioral closeness in this association. Data came from a sample of 450 African American married couples residing in a southern state. The study found that (a) husbands’ and wives’ BMI is positively associated with their own depressive symptoms, (b) only the wives’ BMI is positively associated with their partners’ depressive symptoms, (c) only the wives’ BMI is positively associated with their own and their partners’ depressive symptoms indirectly through couples’ behavioral closeness, and (d) among wives, the association between BMI and depressive symptoms is mediated and moderated by couples’ behavioral closeness. Family interventions need to increase indoor, outdoor, and intimate partner activities, thereby reducing the association between depressive symptoms and body weight for African American couples.

The role of natural disaster in individual and relational adjustment in Sri Lankan mothers following the 2004 tsunami

The purpose of this study is to examine the associations between maternal mental health distress symptoms, including depression and post-traumatic stress disorder, the extent to which the presence of a childs disaster-related physical health problem(s) have interfered with daily functioning, and family cohesion over time among Sri Lankan mothers who survived the tsunami on 26 December 2004. Study variables were measured using a self-report questionnaire administered approximately four months after the event and three years later in summer 2008. Univariate, bivariate, and multivariate analyses were conducted. Path analysis was employed to assess the relationships between the key variables over time and the correlations in the study variables at each time point. Among other findings, the results of the path analysis indicated that post-traumatic stress symptom distress four months after the disaster significantly predicted variance in family cohesion three years later. Clinical and empirical research implications are presented and discussed.

Toward understanding posttraumatic stress and depression among trauma-affected widows in Sri Lanka.

OBJECTIVE In this study, we applied conservation of resources theory (Hobfoll, 1989) to explain high rates of depression and posttraumatic stress symptoms (PTSS) among war- and disaster-affected Tamil widows in the Eastern Province of Sri Lanka. We hypothesized exposure to potentially traumatic events and severity of current contextual problems would influence PTSS and depressive symptoms directly and indirectly through loss of psychological (view of self), environmental (sense of community), and energy (physical health) resources. METHOD Trained research assistants interviewed a convenience sample (N = 381) of women, using established measures of the constructs of interest. Data were analyzed using path analysis in MPlus. The significance of the indirect effects was tested using bootstrapping. RESULTS The model had an acceptable fit (χ2 = 4.06, df = 1, p < .05; Log Likelihood = -3344.26*; AIC = 6760.59; BIC = 6894.64; RMSEA = 0.09; CFI = .99; TLI = .91; SRMR = .02) and explained approximately 38% of the variance in both PTSS and depression. Contextual problems were significantly associated with PTSS and depression both directly and indirectly through deleterious effects on view of self, health status, and sense of community. Degree of trauma exposure was directly associated with indicators of distress. CONCLUSION Results support the utility of COR theory in this context and hold implications for research and program development. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Physical Health Problem Intrusion Linking Religious Attributions to Marital Satisfaction in Survivors of the 2004 Tsunami

The impact of the 2004 tsunami that struck East Asia on Buddhist, Sri Lankan mothers was investigated in this study. More specifically, the relationship between attributing the 2004 tsunami to Karma and marital satisfaction was examined in a sample of 163 women, 3 years after the Disaster. Mediation by persisting physical health problems, on the relationship between attributing the tsunami to Karma and martial satisfaction, after controlling for mental health status and income before the tsunami was also tested. Karma attributions were not directly associated with marital satisfaction. However, an indirect path positively linking Karma attributions with persistent physical health challenges, and negatively linking physical health challenges to marital satisfaction was observed. Using Hobfoll’s (1989) conservation of resources (COR) model, implications of physical health challenges for disaster survivors and attributions endorsing an external locus of control are discussed.

PTSD symptoms among tsunami exposed mothers in Sri Lanka: the role of disaster exposure, culturally specific coping strategies, and recovery efforts

ABSTRACT Background and objectives: Women in Sri Lanka have been uniquely exposed to a complex and protracted set of stressors stemming from a civil war conflict spanning over 25 years and the tsunami which struck Southeast Asia in 2004. This study investigates coping strategies and their association with trauma-related symptoms of tsunami-exposed mothers in Sri Lanka at two time points. Design: Data for this study come from surveys administered in two waves of data collection to investigate both mothers’ and adolescent children’s post-tsunami mental health in early 2005, three months after the tsunami struck, and again in 2008, three years later. Methods: Latent-variable structural equation modeling was used to test the study hypotheses among 160 tsunami-affected mothers in the Polhena village, Matara district, Sri Lanka. Results: Among the various coping strategies examined, the use of cultural rituals as well as inner psychological strength was associated with lower levels of posttraumatic stress symptoms. In contrast, passive religious beliefs were associated with greater posttraumatic stress levels. Conclusions: The results of this study reveal the differential associations of various coping strategies including rituals used by mothers exposed to the tsunami in Sri Lanka and their posttraumatic stress symptom levels.

Subjective Reactions to International Research Participation: An Illustration of Ethical Considerations With Women Heading Households in Sri Lanka.

here are unique ethical considerations in conducting international research with war and disaster-affected populations that are important for ensuring adequate protection of participants. Of particular importance is the distress that participants may experience as a result of being asked about traumatic stressors, psychological symptoms, and life problems. In this study, trauma-affected Tamil women in Eastern Sri Lanka were asked to report on their research-participation experience after taking part in a larger study on risk and resiliency. Results indicated that most participants experienced emotional upset as a result of taking part in the study. However, the degree of distress was generally not more than they anticipated, and most participants reported they would have participated had they known in advance how they would feel. Most participants perceived some benefit as a result of participating and agreed that items were personally relevant. Emotional distress from participation positively correlated with culturally specific symptoms of anxiety and depression. Contextual stressors and social support were not associated with participation-related distress. We discuss these findings as well as general issues that might arise in international research with trauma-affected populations. (PsycINFO Database Record