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Biomedical subjects

R C Kessler

Publications and source records attributed to R C Kessler.

At least 199 records · Page 11Linked to original sources

Age, socioeconomic status, and health.

Analysts dispute what roles biomedical, psychosocial, and other factors play in determining the duration of morbidity and disability over the life course. Cross-sectional data from two national surveys of adults aged 25 years and over not only show, however, that age and socioeconomic status (SES) are significant predictors of self-reported physical health; they also demonstrate that the relation of age to health varies with SES features. Longitudinal research is needed to test the finding that enduring functional limitations in terms of time are actually compressed in higher SES groups. To improve well-being in our society, moreover, requires specifying why SES differences occur, and perhaps ultimately reducing socioeconomic inequality itself.

Activities of Daily Living↗

Situational determinants of coping and coping effectiveness.

This study contributes to the growing body of research on situational determinants of coping. Based on a general population sample of 1556 married men and women, it goes beyond previous efforts in two ways. First, it presents the first large-scale analysis of situational determinants of coping effectiveness in response to a wide variety of stressful life events and chronic difficulties. This analysis documents that previous aggregate analyses overlooked a number of specifications which, when observed, provide insights into the mechanisms of coping effectiveness. Second, it assesses the importance of two empirically generated multivariate coping profiles, passivity and versatility. The study's findings suggest that these profiles are associated significantly with adjustment to stress, that these associations differ across situations, and that they help to interpret the effects of separate coping strategies.

Adaptation, Psychological↗

Effects of daily stress on negative mood.

This article examines the influence of daily stressors on mental health in a community sample. Ss were 166 married couples who completed diaries each day for 6 weeks. In pooled within-person analyses, daily stressors explained up to 20% of the variance in mood. Interpersonal conflicts were by far the most distressing events. Furthermore, when stressors occurred on a series of days, emotional habituation occurred by the second day for almost all events except interpersonal conflicts. Contrary to certain theoretical accounts, multiple stressors on the same day did not exacerbate one another's effects: rather an emotional plateau occurred. Finally on days following a stressful event, mood was better than it would have been if the stressor had not happened. These results reveal the complex emotional effects of daily stressors, and in particular they suggest that future investigations should focus primarily on interpersonal conflicts.

Emotions↗

Network television news stories about suicide and short-term changes in total U.S. suicides.

A number of recent reports have documented a positive association between mass media news stories about suicide and subsequent short-term increases in total U.S. suicides. However, the estimated magnitude of this association varies considerably across these published reports and tends to be smaller in the more comprehensive studies. A detailed investigation of all network television suicide news stories broadcast between January 1, 1973, and December 31, 1984, was undertaken to resolve this inconsistency. The information about television coverage of suicides was more comprehensive than in previous studies. The analyses show that there was no reliable association between news stories and suicides among adults at any time over the 12 years investigated. A reliable association existed among teenagers between 1973 and 1980. This association reversed in 1981, however, and the relative risk of suicide associated with network news stories was consistently less than 1.0 through the end of the study period.

Adolescent↗

Employment, parental responsibility, and psychological distress: a longitudinal study of married women.

This paper uses 1985-1988 panel data from 745 married women in the Detroit, Michigan, US, Metropolitan Area to examine the mental health effects of employment and parenting status changes. Contrary to popular belief, the transition to parenting is not directly related to increases in psychological distress. Changes in employment status, however, are. Women who significantly increase their labor force participation report lower levels of psychological distress over the study period, while women who significantly decrease their labor force participation report higher psychological distress. The effects of labor force changes on mental health are not all modified by parenting status or changes in parenting status. The transition to parenting and increased parenting responsibilities, however, are indirectly related to increased psychological distress insofar as they result in decreased labor force participation. The implications of these results are used to evaluate 4 competing perspectives on the relationship between roles, stress, and psychological functioning.

Americas↗

The Health Belief Model in understanding compliance with preventive recommendations for AIDS: how useful?

The Health Belief Model (HBM) has been applied to a variety of health conditions: most are less threatening and require less complex responses than those arising in the case of AIDS. The utility of the HBM in understanding preventive behaviors in AIDS is examined in a cohort of homosexual men at two different time points. Longitudinal analyses estimated the relationship of indices assessing susceptibility, severity, benefits, and barriers, as well as sociodemographic factors, to sexual behavior across the next 18 months. Analyses further defined these associations in specific subgroups of participants, such as those initially at lower or higher risk. In general, measures of severity and socioeconomic advantage had the most consistently beneficial effect on various measures of behavior. Little or no beneficial effect was observed for other components of the HBM, notably a measure of perceived susceptibility. These analyses suggest that the special features of AIDS may require development of more adequate theoretical frameworks.

Acquired Immunodeficiency Syndrome↗

Effects of HIV infection, perceived health and clinical status on a cohort at risk for AIDS.

Data from a general population sample of 621 healthy homosexual men are used to evaluate the social and emotional effects of HIV antibody status, clinical signs detected by medical examination, and subjectively perceived symptoms. Participants are unaware of their serologic status at the time of data collection, thus allowing the effects of the virus to be separated from reactions to the knowledge of serologic status. The data show that seropositivity for HIV is not associated with elevated levels of social or emotional impairment. Clinical signs lead to impairment in baseline data, but these effects do not persist at a second wave. This weakening suggests that the effects are mediated by psychological pathways rather than biologic ones. This suspicion is confirmed in further analyses, which show that the effects of clinical signs are mediated by subjectively perceived symptoms. These results show that neither social nor emotional impairment is likely to be a prodromal sign of HIV infection in otherwise healthy homosexual men. The substantial levels of distress found among these men is more directly influenced by psychological determinants than biologic ones. This suggests that physicians should be aware of the psychological toll imposed on gay men who develop health problems in the current atmosphere of uncertainty regarding risk of AIDS.

AIDS Serodiagnosis↗

Clustering of teenage suicides after television news stories about suicides: a reconsideration.

A recent study reported a significant increase in teenage suicides after television newscasts about suicide in the period 1973-1979 and suggested that the increase might have resulted from an imitative effect of television. In the present study, the authors found no significant association between newscasts and subsequent teenage suicides over the period 1973-1984. Although teenage suicides increased after newscasts in 1973-1980, the authors identify reasons why this increase is not consistent with an imitative effect of television. Furthermore, during 1981-1984 teenage suicides decreased after newscasts about suicide; the reversal differs significantly from the association before 1981.

Adolescent↗

The prevalence of bulimia nervosa in the US college student population.

A phone survey to determine the prevalence of bulimia nervosa was conducted with a national probability sample of 1,007 male and female students from a stratified sample of 53 universities and colleges in the continental United States. Using the revised (DSM IIIR) diagnostic criteria, 1 per cent of the women and 0.2 per cent of the men were classified as bulimic. Bulimia was most prevalent (2.2 per cent prevalence rate) among undergraduate women living in group housing on campus.

Adult↗

Intervening processes in the relationship between unemployment and health.

A considerable amount of research documents the negative effects of job loss on both physical and mental health. Yet we know comparatively little about the mechanisms through which these effects occur. Unemployment, like other events, is not the same experience for everyone exposed to it. An understanding of this variation might be facilitated by breaking down the analysis of unemployment into a consideration of the various stresses that it creates or exacerbates. This is our purpose in the present paper. We demonstrate that, for one area of the United States, the effect of job loss on several health outcomes involves two mechanisms: (1) unemployment results in increased financial strain which, in turn, results in negative health effects, and (2) unemployment leaves the individual more vulnerable to the impact of unrelated life events. Controlling for financial strain, unemployed people in our sample who have not experienced an additional life event in the previous year are in no worse health than the stably employed. This provides useful insights into the nature of the unemployment experience in this particular setting. It also provides a basis for future detailed explorations of the various ways people cope with this event.

Adaptation, Psychological↗

Social factors in psychopathology: stress, social support, and coping processes.

Our review has focused centrally on the etiologic significance of social factors in the development of psychopathology. Our implicit assumption has been that social factors in general, and stressors in particular, may play a causal role in the development of psychopathology. Yet the evidence is clear that the vast majority of people who are exposed to stressful life events or to chronic stress situations do not develop significant psychiatric impairments. For this reason, research interest over the past decade has shifted to factors like social support and coping strategies that may ameliorate the impact of stress. We have examined some of the important empirical results from recent studies of stress, support, and coping, and we have discussed ways in which these new understandings have informed long-standing attempts to explain group differences in emotional functioning. In each section of the review we have attempted not only to summarize existing results but also to provide some evaluation of the literature and suggestions for future research. It is important to recognize that the contributors to the work reviewed here do not all share a common research agenda. Some of them are primarily committed to unraveling the psychosocial determinants of a particular clinical disorder. Others are mainly concerned with the effects of a particular stressor. Still others are interested in the processes that link stress to health across a broad array of stress situations and health outcomes. In the face of these diverse interests, it is little wonder that our understanding of social factors in psychopathology is uneven. There is good reason to believe, however that these diverse strands of research are beginning to converge on a common conception of the stress process and on a common research design. The conception at present is only in rough form, but its outlines are nonetheless capable of description. At its center is the notion that stress exposure sets off a process of adaptation. It recognizes that this process unfolds over time, and it acknowledges that this process is modified by structural factors as well as by personal dispositions and vulnerabilities. There is growing recognition that the analysis of this process requires longitudinal methods. Also, it is becoming increasingly clear that experimental interventions are required to unravel the parts of this process that link stress and health. It is too early to know if this nascent convergence will lead to an integrative theory of adaptation, yet it is almost certain to promote methodological and conceptual rigor and facilitate replication and cumulation of findings.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Psychological↗