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Biomedical subjects

G E Vaillant

Publications and source records attributed to G E Vaillant.

At least 19 recordsLinked to original sources
PubMed1997

Does depression generate negative life events?

This prospective study investigated whether major depressive disorder can cause negative life events. One hundred and thirteen normal college men have been followed biennially from age 26 until age 62. Fourteen major negative life events were assessed retrospectively by a self-report checklist. A blind rater read each man's complete records over the 35 years and used the same checklist prospectively. The negative life events were divided into dependent and independent groups according to whether the men's own behavior could have played a role in causing the events. In comparison with the normal control group, depressed individuals had a higher density of dependent negative life events after their first episode of depression. This difference did not exist for the occurrence of independent negative life events. Independent negative life events tended to be related to help seeking behaviors rather than to depression. This study confirmed our hypothesis that affective spectrum disorder can generate self-induced negative life events, which may contribute to the chronicity of the disorder.

Adult↗
PubMed1996

A long-term follow-up of male alcohol abuse.

BACKGROUND: This study attempted to determine the course of male alcohol abuse from the age of 40 years to 60 or 70 years, to estimate the duration of abstinence required for stable remission and to study the hypothesis of progression of symptoms in chronic alcohol abuse. METHODS: The subjects were 268 former Harvard University (Cambridge, Mass) undergraduates (college sample) and 456 nondelinquent inner-city adolescents (core city sample) who had been repeatedly studied in multidisciplinary fashion since 1940. Since 47 years of age, these men have been followed up biennially by questionnaire and every 5 years by physical examination. At some point during their lives, 55 (21%) of the college and 150 (33%) of the core city men met DSM-III criteria for alcohol abuse. The college cohort has been followed until the age of 70 years, the core city cohort until age 60 years. The dependent variables were mortality and alcohol abuse status every 5 years. RESULTS: By 60 years of age, 18% of the college alcohol abusers had died, 11% were abstinent, 11% were controlled drinkers, and 59% were known to be still abusing alcohol. By 60 years of age, 28% of the core city alcohol abusers had died, 30% were abstinent, 11% were controlled drinkers, and only 28% were known to be still abusing alcohol. CONCLUSIONS: In three respects the two socially divergent samples resembled each other. After abstinence had been maintained for 5 years, relapse was rare. In contrast, return to controlled drinking without eventual relapse was unlikely. Alcohol abuse could continue for decades without remission or progression of symptoms. The samples differed in that the core city men began to abuse alcohol when younger and, although they were more likely than the college men to become alcohol dependent, the core city men were twice as likely to achieve stable abstinence.

Adult↗
PubMed1996

1995 IPA/Bayer Research Awards in Psychogeriatrics. Late-life consequences of affective spectrum disorder.

Recent research suggests that affective disorder is associated with increased mortality and physical morbidity, but the reasons for this association remain uncertain. This report describes a 50-year prospective study of 240 men evaluated from the time they were university students in 1940-1942. A family history of mental illness was obtained and the men's habits, psychological adjustment, and marital and occupational satisfaction were followed every 2 years and their objective physical health was tracked every 5 years until age 70. Twenty-five men were identified as having affective spectrum disorder prior to age 53. Of the variables studied, the presence of affective spectrum disorder was the most powerful predictor of poor psychosocial outcome at age 65 and one of the most powerful predictors of poor physical health. Alcohol abuse and cigarette abuse accounted for the observed increased rates of heart disease and cancer. When alcohol abuse, smoking, and suicide were controlled for, affective disorder made a significant contribution to physical morbidity by age 70, but not to mortality from natural causes. Affective spectrum disorder, even in an educated population without antisocial trends, carries a profound negative risk to late-life physical and social adjustment.

Adaptation, Psychological↗
PubMed1996

Antecedents and consequences of negative life events in adulthood: a longitudinal study.

OBJECTIVE: This study investigated whether negative life events affected subjects' long-term physical and mental health. METHOD: One hundred thirteen normal college men completed biennial follow-up questionnaires from age 26 until age 62. At age 62 they retrospectively assessed 16 major negative life events with a self-report checklist. A blind rater read each man's complete records over the 35 years and completed the same checklist prospectively. The men had independent physical examinations at age 65. RESULTS: It was demonstrated that negative life events affect men's psychological health more than their physical health. The correlation of negative life events with physical health was so low that no significant relationship between the two variables could be established. Negative life events were significantly associated with affective spectrum disorder and its relevant indicators. Further, the Cox proportional hazards model revealed that negative life events, family history of depression, and psychosocial stability during the college years were independent and statistically significant predictors of depression. CONCLUSIONS: This study supports the widely held belief that biological factors (heredity), psychological factors (unstable personality), and social factors (negative life events) are all etiologically related to depression.

Adult↗
PubMed1996

Natural history of male psychological health, XIII: Who develops high blood pressure and who responds to treatment.

OBJECTIVE: This study was an effort to clarify both the psychological contributions to and the long-term consequences of uncomplicated essential hypertension. METHOD: The subjects were 193 healthy college students selected as sophomores and prospectively followed for over 50 years. Independent assessments of physical and mental health were made. RESULTS: Although objective indices of psychopathology predicted both physical morbidity and mortality, they did not predict hypertension. When pyknic somatotype, college diastolic blood pressure, and well-integrated personality in college were controlled, no other preadult variable predicted hypertension. As expected, heart disease, obesity, and alcohol abuse were each correlated with hypertension. After roughly 20 years, 14 of the 41 men with treated hypertension were in stable remission, and 13 men had developed cardiac complications. No differences between these groups could be discerned. CONCLUSIONS: Over time, hypertension appeared to be more a product of biological than of psychosomatic variables. Good psychological health did not diminish the risk of hypertension.

Adult↗
PubMed1995

A 50-year prospective study of the psychological sequelae of World War II combat.

OBJECTIVE: The authors took advantage of a 50-year prospective study of World War II veterans to examine the predictors and correlates of combat exposure, symptoms of posttraumatic stress disorder (PTSD), and trait neuroticism. METHOD: The subjects were 107 veterans who had been extensively studied before and immediately after serving overseas in World War II. All served as members of the study until the present time, and 91 completed questionnaires of both PTSD symptoms and neuroticism. RESULTS: In this study group, variables associated with positive psychosocial health in adolescence and at age 65 predicted combat exposure. Combat exposure and number of physiological symptoms during combat stress--but not during civilian stress--predicted symptoms of PTSD in 1946 and 1988. Combat exposure also predicted early death and study attrition. Psychosocial vulnerability in adolescence and at age 65 and physiological symptoms during civilian stress--but not during combat stress--predicted trait neuroticism at age 65. CONCLUSIONS: Combat exposure predicted symptoms of PTSD but not nonspecific measures of psychopathology. Premorbid vulnerability predicted subsequent psychopathology but not symptoms of PTSD.

Adult↗
PubMed1994

Ego mechanisms of defense and personality psychopathology.

It is often not just life stress but also a person's idiosyncratic response to life stress that leads to psychopathology. Thus, despite problems in reliability, the validity of defenses makes them a valuable diagnostic axis for understanding psychopathology. By including a patient's defensive style as part of the diagnostic formulation, the clinician is better able to comprehend what seems initially most unreasonable about the patient and to appreciate what is adaptive as well as maladaptive about the patient's defensive distortions of inner and outer reality. Clinical appreciation of the immature defenses (e.g., hypochondriasis, fantasy, dissociation, acting out, projection, and passive aggression) is particularly useful in classifying and caring for individuals with personality disorders.

Defense Mechanisms↗
PubMed1994

Evidence that the type 1/type 2 dichotomy in alcoholism must be re-examined.

Studies supporting Cloninger's original Type 1/Type 2 hypothesis for classifying the genetic transmission of alcoholism have sometimes failed to control for important sources of potential bias. First, the environmental effects of parental alcoholism must be distinguished from the genetic effects of parental alcoholism. Secondly, antisocial personality disorder must be distinguished from alcohol dependence. Thirdly, to control for developmental effects a cohort of alcoholics should be followed into late mid-life. The present report, a 50-year prospective study of the development of alcoholism in two community samples of 456 disadvantaged youth and 204 Harvard graduates, addresses these three potential sources of bias. In this report the age of onset of alcoholism and the degree of antisocial symptomatology was correlated with disturbed family environment but was quite independent of the presence or absence of a heredity positive for alcoholism. The reasons why such findings threaten the validity of the Type 1/Type 2 hypothesis are discussed.

Adolescent↗
PubMed1992

An intriguing association between ancestral mortality and male affective disorder.

We examine the relationship between ancestral age at death and affective disorder. A cohort of 204 socioeconomically favored men was selected for mental and physical health 50 years ago and followed up until age 69 +/- 1 (+/- SD) years in an interdisciplinary study. During follow-up, 49 of these men were identified at some point as being psychosocially impaired. Of these 49 men, 25 were identified as having probable affective disorder based on family history of affective illness, clinical signs, subjective symptoms, clinical diagnosis, and choice of pharmacological treatment. Objective signs and symptoms distinguished these 25 men from the remaining 24 men, whose adjustment over the 50 years was equally psychosocially impaired, but who were never noted to be significantly depressed. The mean age at death of the maternal grandfathers for the 25 depressed men was 60.4 years, significantly younger than the mean age at death of maternal grandfathers for either the total sample (70.1 years) or the 25 psychosocially impaired but not depressed men (68.8 years). The mean age at death of the depressed men's other five first-degree ancestors was not significantly different from the age at death of the ancestors of the rest of the sample. If depressed alcohol abusers were excluded, the mean age at death of maternal grandfathers of alcohol abusers did not differ from that of the controls' maternal grandfathers. The evidence for possible X-chromosome linkage in male psychobiological vulnerability to affective spectrum disorder is discussed.

Adult↗
PubMed1991

The association of ancestral longevity with successful aging.

A cohort of 184 men from socioeconomically advantaged ancestors has been followed from ages 18 to 65. In order to test the hypothesis that ancestral longevity would predict both mental and physical vigor, the men's physical and psychosocial health have been prospectively monitored, and the age at death of their parents and grandparents obtained. Ancestral longevity was strongly predictive of chronic illness at age 60 +/- 1 years and mortality at age 68 +/- 1 years. Long-lived ancestors, however, exerted little effect in predicting psychosocial vigor and mental health at age 65.

Affect↗
PubMed1990

Natural history of male psychological health, XII: a 45-year study of predictors of successful aging at age 65.

In order to determine important predictors of psychosocial and physical vitality in late midlife, the authors examined the lives of 173 men prospectively studied from ages 18 to 65. Biopsychosocial predictors--gathered before age 50--were examined for their correlation with three outcome variables measured at age 65: physical health, mental health, and life satisfaction. Extent of tranquilizer use before age 50 was the most powerful negative predictor of both mental and physical health outcomes at age 65. Another important predictor for mental health was maturity of defenses before age 50. Paradoxically, warm childhood environment made an important independent contribution to predicting physical--not mental--health.

Adaptation, Psychological↗
PubMed1990

Predicting exercise in late midlife from young adult personality characteristics.

This study explored the relationship between personality and exercise over the life span by using young adult personality characteristics to predict current exercise behavior in late middle-aged male graduates from the Harvard University classes of 1942 to 1944. After controlling for prior exercise behavior, body build, and fitness in young adulthood, we found that personality variables improved classification accuracy in discriminant analysis, and especially improved identification of frequent exercisers. Personality variables positively associated with frequent exercise include affective vitality, integration, lack of anxiety, and lack of shyness. Results are interpreted as supporting a psychobiological account of exercise behavior. Caution is suggested in generalizing the results to other populations, such as less privileged socio-economic classes or females.

Aging↗