Life events, coping, stress, and depressive symptomatology.

The author presents data on the relationships between life events, coping resources, and depressive symptomatology. A probability sample (N = 517) was interviewed three years apart. Respondents with high life-event scores had significantly more depressive symptomatology than those with low scores. Those with personal, familial, and interpersonal resources had significantly less depressive symptomatology than those without such resources in both the low- and high-life-event groups. The best predictor of Time 2 depressive symptom scores was Time 1 symptom scores; losses and resources were also statistically significant factors. These findings demonstrate the complex interrelatedness of life events, coping resources, and depressive symptomatology.

Alcoholism, life events, and psychiatric impairmant.

A sample of 122 DPs was compared to a "normative" sample of CSRs. The presentation of psychiatric disorder scores and numbers and kind of stressful life events was detailed. Results of this comparative analysis suggest that research that focuses on high psychiatric disorder-controlling for life events is in order. Furthermore, therapeutic intervention must obviously take into account the iterative nature of alcohol and stressful life events. Also, these findings suggest and support the role of life stress in the possible formation of alcoholism.

Decision-making orientation and AIDS-related knowledge, attitudes, and behaviors of Hispanic, African-American, and white adolescents.

How adolescents' personal sense of directedness (i.e., peer, parent, or self-directed orientation) affects the decision-making processes of adolescent students regarding AIDS-related knowledge, attitudes, beliefs, behaviors, and skills (KABBS) is examined. The sample consisted of 10th-grade students in 8 public high schools (N = 2,515) in Dade County (greater Miami), Florida. The findings showed that decision-making orientation and directedness was a significant predictor of AIDS-related KABBS of adolescents. Overall, the level of AIDS-related KABBS that were associated with low risk was found significantly more often among self-directed students and least often among peer-directed students. The findings of this study suggest that future preadult health-risk research should incorporate the concept of differences of information processing across adolescents.

Race, socioeconomic status, and psychological distress: an examination of differential vulnerability.

Using data from a 1985 epidemiological survey of 2,115 adults in Florida, this research has two goals: it tests the proposition that race and SES jointly influence mental health, and it examines the contribution of undesirable life events and economic problems to psychological distress across SES groups. Using multiple indicators of SES and mental health, we found that the evidence for a model of joint influence of race and SES on mental health varied with the measures being used. The most general conclusion is that SES interacts with race to increase psychological symptoms of distress. Partitioning the sample into three SES categories (low, middle, high), we examined the contribution of stressors to the greater distress among lower-SES blacks compared to other blacks and lower-SES whites. Lower-SES blacks are more vulnerable than lower-SES whites to the impact of undesirable events, but they are less vulnerable than lower-SES whites to the impact of economic problems. Lower-SES blacks are more vulnerable than middle-SES blacks to the impact of both discrete events and economic problems. Limitations of the study indicate a need for future longitudinal studies with measures of coping resources and support networks to further our understanding of the race, social class and psychological distress relationship.

Epidemiological study of problem eating behaviors and related attitudes in the general population.

This article presents data on the eating behaviors and related attitudes among a probability sample of 2,075 adults living in the southeastern United States. These following results were found: 45.2% felt guilty after eating, 44.2% thought they had a weight problem, 21.9% had been dieting in the past 2 months; 12.9% reported some lifetime binging, 1.2% admitted self-induced vomiting, and 7.9% said their life was often dominated by food-related conflicts. Females, blacks, and those in the middle and lower socioeconomic status percentiles tended to have higher problem rates than their counterparts.

The relationship between alcohol use and attempts and success at smoking cessation.

This study assessed the relationships between alcohol use and smoking cessation in a general population sample (N = 2115) of adults living in a county in north Florida. Nearly half of the sample had ever smoked. Of these, 44% had successfully quit; 34% had tried unsuccessfully to quit; 21% reported never having tried to quit. In multivariate analyses which controlled for background factors, heavy drinkers were found to be less likely to attempt to quit smoking. And, if they had attempted to quit, they were less likely to succeed. Having quit drinking was very strongly related to success at smoking cessation, and slightly negatively related to attempts to quit smoking. Individuals who enjoyed smoking with alcohol were more likely to attempt to quit smoking and to be successful at quitting than those who did not enjoy smoking and drinking concurrently. Those who enjoyed smoking at stressful times were less likely to have tried to quit than those not using smoking to cope with stress. The authors suggest social-situational and stress perspectives as conceptual frameworks for future research.

Risk factors for suicidal behavior among Hispanic, African-American, and non-Hispanic white boys in early adolescence.

Using survey data from a longitudinal study of adolescents (n = 6760) in Miami, Florida, we assessed prevalence and risk factors for suicide ideation and attempts among a sample of Cuban-American, Nicaraguan, other Hispanic, African-American, and non-Hispanic white 6th- and 7th-grade boys. The results indicated that African-American boys had the highest level of suicide ideation (19.2%) during the past 6 months and that Nicaraguans and other Hispanics had the highest levels of lifetime suicide attempts (7.8%). The risk factor analyses indicated a differential distribution of risk factors by ethnic-racial subsamples, with blacks scoring higher than the other subsamples. Cumulative risk factors were related to increased suicidal ideation and attempts in all subsamples. However, the highest percentage of attempts among boys with eight or more risk factors was among other Hispanics (56.9%), and the lowest percentage was among non-Hispanic white boys (21.7%). An odds ratio analysis predicting attempts indicated that depressive symptoms, low self-esteem, and teacher and parent derogation were relatively higher for African-American and Hispanic subsamples, and deviancy-delinquency was relatively higher for non-Hispanic whites. High acculturation was associated with higher levels of suicide attempts in the three Hispanic subsamples (P < .05).

A replication and elaboration of the esteem-enhancement model.

Adolescents treated in clinical settings for drug use problems are often observed to have low self-esteem. This has led some researchers to the belief that mood or personality characteristics of adolescents predispose them to drug use. However, longitudinal field studies have failed to confirm a direct relationship between low self-esteem and substance abuse (Petraitis et al. 1995). Evidently, if an important causal relationship exists between self-esteem and drug use in the nonclinical adolescent population, it is complex and mediated by other factors. To address this issue, explanatory theories are needed that can organize the relationships between drug abuse and its antecendent causes including low self-esteem. One of the few theoretical approaches that has been put forward for empirical verification is the esteem-enhancement theory of Kaplan, Johnson, and Bailey (1986a, 1987, 1988).

The Pre-Adult Health Decision-Making Model: linking decision-making directedness/orientation to adolescent health-related attitudes and behaviors.

In light of the broad consequences of the acquired immunodeficiency syndrome (AIDS) epidemic, as well as the increased rates of sexually transmitted diseases (STDs), pregnancy, and alcohol and drug abuse among adolescents, there is a great need to understand how adolescents make health decisions. This paper presents a model for adolescent health behavior, the Pre-Adult Health Decision-Making Model (PAHDM), which takes into account the differential information processing from peer sources, parent sources, or through critical or reflexive self-analysis. Also presented is a review of the large corpora of psychological and sociological literature on adolescent development, adolescent health behaviors, and, more specifically, AIDS and other STDs as a public health problem. The need for additional research in the area of adolescent health decision-making, and for a health behavior model that is specific to the "lifeworld" of the adolescent, is stressed.

Mental health needs assessment approaches: a case for applied epidemiology.

This paper briefly describes the political and social factors which have prompted the rapid development of needs assessment as a research activity. It also suggests reasons for the likelihood of continuing assessment mandates through the 1980s. The five most commonly employed needs assessment methodologies are outlined and a critique is offered for each. The major focus of the paper is on the development and uses of an applied epidemiologic survey assessment model which has been designed and tested extensively by the authors in a variety of geographic areas and agency settings. Illustrations of how field survey data can be presented for enumerating mental health needs are also presented.

Crowding and mental health.

An epidemiologic investigation of the mental needs and services of 1645 respondents, aged 17 to 92 years and living in a representative southeastern county in Florida, revealed that 7.8% of the sample lived in crowded conditions. The crowded respondents scored significantly higher than did the uncrowded on both a depression scale and on the Health Opinion Survey. Associations between crowding and high scores on both scales were strongest among: respondents in the childrearing and middle years of life, blacks at all income levels, whites in the intermediate annual family income range of $6000 to $9999, and especially, females rather than males. Consistently, the crowded black population, and particularly, crowded white women, had much higher scores than did the uncrowded women. A multiple regression analysis showed that three variables--being a female, having a lower income, and crowding--accounted for 16.5% of the variance. The discussion emphasizes that the relationship between crowding and higher scores on indices of emotional distress is quite complicated. In crowded situations, depression may be a costly, semi-adaptive reaction to excessive interpersonal stimulation. Women living in crowded situations appear to be at high risk for depressive illness; their plight brings to mind the classic animal experiments which showed that the maternal behavior of females deteriorated in crowded situations.

Social indicators and mental health planning: an empirical case study.

This paper reports data from a series of studies designed to provide an empirical basis for making judgments regarding the utility and validity of social indicators as a method for assessing the need for mental health services. The following findings are included: (a) The methodological sophistication of the social indicators approach used did not greatly affect the utility of the technique as a means of identifying low- and high-need subareas in a large standard metropolitan statistical area. (b) Correlations between social indicator rankings of tracts/enumeration districts and mental health needs as determined by psychiatric scale scores varied in two different counties. (c) The degree of tract/district socioecological homogeneity appears to account for the diverse correlations. (d) Tract and enumeration district social indicator rankings uniquely account for less than 50% of the explained variance of individual mental health scores when analyzed in a regression equation which includes socioeconomic status as a variable.

An analytic comparison of persons arrested for driving while intoxicated and alcohol detoxification patients.

This article presents findings on an analytic comparison of two groups of persons for whom alcohol is an identical clinical or social problem--247 patients currently under treatment in a detoxification unit in a general hospital and 118 individuals who had been arrested for driving while intoxicated (DWI) and were attending a DWI school. A systematic comparison of these two groups yielded several important, statistically significant differences and it becomes increasingly apparent that distinctions can be made that permit the identification of high-risk segments of the DWI population, facilitating early diagnosis and differential treatment modes.