Biomedical subjects

R C Kessler

Publications and source records attributed to R C Kessler.

At least 181 records · Page 10Linked to original sources

PubMed1992

Bulimia nervosa and major depression: a study of common genetic and environmental factors.

A genetic analysis of the co-occurrence of bulimia and major depression (MD) was performed on 1033 female twin pairs obtained from a population based register. Personal interviews were conducted and clinical diagnoses made according to DSM-III-R criteria. Additive genes, but not family environment, are found to play an important aetiological role in both bulimia and MD. The genetic liabilities of the two disorders are correlated 0.456. While unique environmental factors account for around half of the variation in liability to both bulimia and MD, these risk factors appear to be unrelated, i.e., each disorder has its own set of unique environmental risk factors. Thus, the genetic liability of bulimia and MD is neither highly specific nor entirely non-specific. There is some genetic correlation between the two disorders as well as some genetic and environmental risk factors unique to each disorder. Limitations and directions for future research are discussed.

Adolescent↗

PubMed1992

Speed of recovery from major depressive episodes in a community sample of married men and women.

A discrete-time survival analysis of recovery from major depressive episodes for a sample of married subjects (N = 119) identified several significant predictors of recovery including comorbidity for anxiety disorders or substance abuse, social support, age, and education. Furthermore, the analysis distinguished between different sources and types of social support, documenting that spouses' positive responses to the depression predict rapid recovery whereas the perception that friendships are conflictual predicts slow recovery. Finally, the analysis documented changes in the importance of predictor variables over the course of the episode. Specifically, spouse's negative reactions to the depression and subject's education level became more important predictors of recovery as the episode became longer, and the recovery advantage experienced by younger respondents lessened over time.

Adaptation, Psychological↗

PubMed1992

Social support, depressed mood, and adjustment to stress: a genetic epidemiologic investigation.

A survey of 821 same-sex female twin pairs from a population-based registry assessed 8 dimensions of social support and social integration. Twin analyses documented significant common environmental influences on 5 of these 8 measures and significant genetic influences on 5 of the 8. A decomposition of the multiplicative association between support and a measure of stressful life experiences in predicting depressed mood--an association typically interpreted as providing evidence for a stress-buffering effect of social support--shows clearly that it is the environmental and genetic factors that cause support, rather than support itself, that buffer the effects of stress on mood in most cases. We discuss the implications of this result for future research on the relationship between social support and psychopathology.

Adaptation, Psychological↗

PubMed1992

Evidence for genetic influences on personality from self-reports and informant ratings.

Self-report data on Extraversion (E) and Neuroticism (N), together with ratings by the co-twin, were obtained from a sample of 826 adult female twin pairs ascertained through a population-based twin register. Data were analyzed using a model that allowed for the contributions to personality ratings of the rater's personality (rater bias) as well as of the personality of the person being rated. For E, but not for N, significant rater bias was found, with extraverted respondents tending to underestimate, and introverted respondents tending to overestimate, the Extraversion of their co-twins. Good agreement between self-reports and ratings by the respondent's co-twin was found for both E and N. Substantial genetic influences were found for both personality traits, confirming findings from genetic studies of personality that have relief only on self-reports of respondents.

Adult↗

PubMed1992

The relationship between age and depressive symptoms in two national surveys.

There is inconsistency in the literature on the relationship between age and depressive symptoms. Although a careful review shows that some of this inconsistency can be reconciled by recognizing the nonlinear relationship (Newmann, 1989), 2 additional issues remain unclear. One is that most previous studies used depression screening scales that contain somatic items that could introduce an age bias. The other is that most previous studies combined samples of men and women even though there is evidence that the sex difference in depressive symptoms varies with age. These 2 issues are addressed in this article, using analyzed data from 2 large national surveys. There is a consistent, but quite modest, nonlinear association between age, somatic, and nonsomatic depressive symptoms in both surveys. There is no significant sex difference in the age curves.

Adult↗

PubMed1992

Familial influences on the clinical characteristics of major depression: a twin study.

We sought in this study to clarify the role that familial factors play in influencing the clinical presentation of major depression (MD). We examined the similarity of the historical and symptomatic features of MD in 176 pairs of female-female monozygotic (MZ) and dizygotic (DZ) twins from a population-based registry, where both members reported a history of MD defined by DSM-III-R criteria. The age at onset and treatment-seeking were significantly correlated in all twin pairs and the correlation in concordant DZ pairs was actually somewhat higher than in concordant MZ twins. The degree of impairment was modestly correlated in all twin pairs with substantially higher correlations in MZ vs DZ twins. No twin resemblance was observed for number of episodes or longest duration of an episode. Twin resemblance for the clinical features of MD was modest, but so was their consistency for the same individual over successive 1-year periods. However, in 5 of the 6 neurovegetative symptoms involving changes in appetite, weight and sleep, MZ twins were significantly correlated and correlations were significantly greater in concordant MZ vs DZ twins. Although the familial factors that cause twin resemblance for the age at onset and treatment seeking appear to be largely environmental, twin resemblance for the degree of impairment and neurovegetative symptoms are probably due largely to genetic factors. Our results suggest that familial factors influence the predisposition to some clinical features of MD.

Adult↗

PubMed1992

Widowhood and depression: explaining long-term gender differences in vulnerability.

Results from a 1986 national survey (N = 3,614) show that having ever been widowed is associated with current levels of depression and that this association is greater for men than women. Some of this apparent gender difference occurs because men have been widowed for a shorter average period of time than women and the effects of widowhood appear to lessen over time. Widowhood also is associated with different types and amounts of life strain for men and women. The results suggest that the primary mechanism linking widowhood to depression among women is financial strain. Among men, the more critical mechanisms seem to be strains associated with household management. When specific strains occur, they appear to have different effects on respondents who have ever been widowed and those who have not. Taken together, these results suggest that what appears on the surface to be a gender difference in vulnerability to the same life event turns out upon closer examination to occur because widowhood does not affect men and women in the same way.

Adult↗

PubMed1991

Factors facilitating adjustment to unemployment: implications for intervention.

Conducted a community survey in the Fall of 1984 in a sample of high unemployment blue-collar census tracts in southeastern Michigan. Results of earlier analyses using these data showed that involuntarily unemployed workers had significantly elevated levels of depression, anxiety, somatization, and self-reported physical illness relative to a stably employed comparison group (Kessler, House, & Turner, 1987). Results presented in this paper document that this relationship is modified by social support (as measured by social integration and the availability of a confidant), self-concept, and various coping processes. Further analyses allowed us to determine the way in which these modifiers operate. The modifying effects of social support and coping operate primarily by buffering the impact of unemployment-related financial strain on the health outcomes. Self-concept operates primarily by attenuating vulnerability to other stressful life events. The implications of these results for the design and implementation of preventive interventions are discussed.

Adaptation, Psychological↗

PubMed1991

Coping: a genetic epidemiological investigation.

This study examines data on self-report coping behaviour, life events and symptoms of anxiety and depression in a general population sample of 827 female twin pairs. Factor analysis identified three almost uncorrelated coping factors: turning to others; problem solving; and denial. Turning to others and problem solving were negatively and denial was positively related to levels of anxiety and depression. Turning to others and problem solving buffered the depressogenic and anxiogenic effects of stressful life events, while denial exacerbated the anxiogenic effects of life events. Structural equation model-fitting indicated that twin resemblance in turning to others and problem solving could be explained entirely by genetic factors with an estimated heritability of 30 and 31%, respectively. For denial, twin resemblance could be best explained by familial-environmental factors accounting for 19% of the total variation. Genes may affect the vulnerability to psychiatric disorders in part by influencing coping behaviour.

Adaptation, Psychological↗

PubMed1991

The reliability of life event reports in a community survey.

There is considerable evidence from inter-respondent and test-retest studies that the data obtained in structured life event inventories are not very reliable. Inter-respondent reliability estimates are presented in this paper for the life event reports obtained in a community survey that was designed to facilitate recall of life events. It is documented that respondents were able to recall many sorts of severe negative events with adequate reliability over a twelve-month recall period. Data are also presented to show that respondents could date event occurrence with good consistency. Sensitive events, such as involvement in criminal activities and difficulties in marriage, were not reliably reported. These results suggest that the problems of faulty memory and conceptual confusion about serious events can be overcome with careful question wording and administration procedures, but that the problem of respondent reticence about reporting sensitive events remains unresolved.

Adult↗

PubMed1991

Measuring daily events and experiences: decisions for the researcher.

There has been a burgeoning interest in studying daily events and experiences. This article discusses a variety of methodologic challenges that face daily event and experience researchers. The issues discussed include techniques for measuring events, the development of event checklists, sampling event content, specifying event appraisals, event validation procedures, and the creation of summary measures derived from event checklists. Procedural issues discussed include determining the number of observations and persons needed for daily event studies, the evaluation of response, attrition, and missing item bias, and problems linking event reports over time.

Adaptation, Psychological↗

PubMed1991

The family history method: whose psychiatric history is measured?

OBJECTIVE: The family history method, in which an informant is asked about the history of psychiatric illness in relatives, is widely used in psychiatric research. Previous research has examined the influence on family history information of characteristics of the relative. In this report, the authors seek to clarify the impact on family history reporting of the psychiatric history of the informant. METHOD: Both members of female twin pairs from a population-based twin registry were asked about the history of major depression, generalized anxiety disorder, and alcoholism in their mother and father. The authors examined twin pairs discordant for each of the three diagnoses and predicted that the affected twin would report higher rates of the same disorder in her parent than would the unaffected twin. RESULTS: Twins with a history of major depression or generalized anxiety disorder but not twins with alcoholism were significantly more likely to report the same disorder in their parents than were their unaffected co-twins. CONCLUSIONS: For major depression and generalized anxiety disorder, a family history diagnosis appears to reflect the psychiatric history of both the relative and the informant. Caution may be needed in the interpretation of results based on the family history method, although the magnitude of this problem may be attenuated by the use of multiple informants.

Alcoholism↗

PubMed1991

Stressful life events and symptom onset in HIV infection.

OBJECTIVE: The authors' goal is to provide basic epidemiologic data on the issue of reactivity to stress and HIV symptom onset by studying the relationship between a broad set of naturally occurring stressor events and HIV natural history in a large longitudinal community sample of HIV-seropositive homosexual men. METHOD: Subjects were recruited from a cohort of 1,011 homosexual men enrolled in the Chicago site of the Multicenter AIDS Cohort Study who also participated in the Coping and Change Study. The men were given self-administered questionnaires assessing behavioral, psychological, and psychosocial variables. Relationships between reports of stressful life events and longitudinal biomedical data measuring illness progression were examined. Life events were assessed by reports on the numbers of lovers, friends, and acquaintances who were diagnosed with AIDS or had died of AIDS and by scores on a checklist of 24 more general serious stressor events. The variables indicating progression of illness among initially asymptomatic men were a drop in T-helper lymphocyte percent (CD4%) between pairs of examinations of at least 25% and onset between examinations of thrush and/or fever lasting a minimum of 2 weeks. RESULTS: The authors found no evidence that serious stressor events have any meaningful effect on symptom onset indicated by either a drop in CD4% or onset of fever or thrush. CONCLUSIONS: There is no need for asymptomatic people with HIV infection to restrict their lives in order to avoid exposure to stressful life experiences or to develop special skills for coping with stress to forestall the progression of HIV illness.

Acquired Immunodeficiency Syndrome↗

PubMed1990

Chronic stress, acute stress, and depressive symptoms.

Although life events continue to be the major focus of stress research, recent studies suggest that chronic stress should be a more central focus. An evaluation of this issue is presented using data from a large community survey of married men (n = 819) and women (n = 936). Results show that chronic stresses are more strongly related to depressive symptoms than acute stresses in all but one life domain. The interaction patterns exhibited by chronic and acute stresses are predominantly associated with lower levels of depression than those predicted by a main effects model. This pattern suggests that chronic stresses may reduce the emotional effects of acute stresses. Although the processes through which this effect occurs are not clear, it is suggested that anticipation and reappraisal reduce the stressfulness of an event by making its meaning more benign. Implications for future research on chronic and acute stress effects are discussed.

Adaptation, Psychological↗

PubMed1990

Supportive interactions, negative interactions, and depressed mood.

Research on the association between social relationships and emotional functioning has emphasized the health-promoting effects of social support. Yet there is reason to believe that the absence of negative social interactions may be more important for mental health than the presence of supportive interactions. In this investigation we clarify important characteristics concerning the source, the recipient, and the combined influence of support and negativity. Data are presented regarding supportive and negative interactions with spouse, relatives, and friends; regression analyses suggest that negative interactions are more predictive of depressed mood than supportive interactions (specifically with spouse and friends). We also document several specifications suggesting directions for future research on the special importance of interactions in intimate relationships and the synergistic effects of situations in which supportive and negative interactions both occur.

Adaptation, Psychological↗

PubMed1990

Sources of discrepancy in the comparison of a lay-administered diagnostic instrument with clinical diagnosis.

This article presents a comparison of the diagnostic results from a lay-administered diagnostic interview for depression with a clinical diagnosis in a community sample. The purpose of the comparison is to assess reasons for the discrepancies between the two diagnostic approaches. The majority of the discrepancies result from inconsistent episode reports at the two interviews. We propose a number of possible explanations for the inconsistencies. An empirical analysis that identifies predictors of consistent vs. inconsistent reports supports a strong influence for respondent recall error. We discuss the implications of our analysis for previous comparisons of lay-administered and clinical diagnostic instruments.

Adult↗

PubMed1990

Psychological functioning in a cohort of gay men at risk for AIDS. A three-year descriptive study.

This study describes the mental health of a large cohort of gay men participating in the Chicago Multicenter AIDS Cohort Study/Coping and Change Study. Six biannual questionnaires were self-administered between 1984 and 1988. General mental health was determined by the Hopkins Symptom Checklist (HSCL). An abbreviated version of the Center for Epidemiologic Study Depression Scale (CESD-5) and an adapted Diagnostic Interview Schedule (DIS) question also measured depression. Suicidal ideation was assessed by one question in the HSCL. AIDS-specific distress was determined by three subscales specifically developed for this study. While mean HSCL and CESD-5 scores were stable during the observational period, AIDS-specific distress increased over time. The HSCL scores for the cohort were somewhat elevated above general population norms but considerably below psychiatric outpatient norms. Fewer than 12% of the men reported elevated HSCL or CESD-5 scores three or more times. A self-reported episode of depression of two weeks or more, measured by the DIS screening question, was experienced by 40.1% of the sample. Suicidal ideation was reported on three or more visits by 18.8% of the men. The younger members of this cohort exhibit greater general and AIDS-specific distress. Income was inversely associated with general distress. HIV-seropositive participants had generally higher AIDS-specific distress scores than those who were seronegative, but their scores were equivalent on the HSCL and CESD-5.

Acquired Immunodeficiency Syndrome↗

PubMed1990

Socioeconomic status differences in vulnerability to undesirable life events.

Previous research has documented consistently that persons holding low-socioeconomic status (SES) positions are more strongly affected emotionally by undesirable life events than are their higher-status counterparts. Two types of resources have been implicated in this differential vulnerability: financial resources and a broader class of coping resources, including social support and resilient personality characteristics. We present an analysis that disaggregates measure of life events and of SES to identify which events and which components of SES are most important for understanding differential vulnerability. We document that the lower-SES vulnerability persists across all types of personal events. In addition, we find that differential vulnerability is not confined to income but extends to education and occupational status as well. On the basis of these patterns, we conclude that differential vulnerability reflects more than a simple economic reality. Previous research offers speculative evidence that status differences in past and current social environments may explain differential vulnerability, especially through their effects on the socialization of resilient personality characteristics. We propose future research that could help to evaluate the validity of these speculations.

Adaptation, Psychological↗