Trends in Adverse Childhood Experiences (ACEs) in the United States.

BACKGROUND: It is important for those called upon to discuss major social determinants of health such as adverse childhood experiences (ACEs) to have accurate knowledge about generational trends in their prevalence. OBJECTIVE: To review available trend data on major forms of ACEs. METHODS: A search of academic data bases was conducted by combining the term "trend" with a variety of terms referring to childhood adversities. RESULTS: Available trend data on ACEs from the 20th century show multi-decade declines in parental death, parental illness, sibling death, and poverty, but multi-decade increases in parental divorce, parental drug abuse and parental incarceration. More recent trend data on ACEs for the first fifteen to eighteen years of the 21st century show declines in parental illness, sibling death, exposure to domestic violence, childhood poverty, parental divorce, serious childhood illness, physical abuse, sexual abuse, physical and emotional bullying and exposure to community violence. Two 21st century ACE increases were for parental alcohol and drug abuse. Overall, there appear to have been more historical and recent improvements in ACEs than deteriorations. But the US still lags conspicuously behind other developed countries on many of these indicators. CONCLUSION: Awareness of improvements, as well as persistent challenges, are important to motivate policy makers and practitioners and to prompt them to recognize the feasibility of success in the prevention of ACEs.

Timing of vape use among adolescents: Differences by family structure.

BACKGROUND: The prevalence of adolescent e-cigarette (vape) use has increased significantly over the past several years. Given the risks associated with vape use, it is important to identify predictors of adolescent vape use onset. PURPOSE: The primary aim was to examine the time to vape use among adolescents, as a function of parental marital status and living arrangements. METHODS: A sample of 863 adolescents (Mage = 12.73, SD = 0.70; 52% girls; 61% non-Hispanic White) from public middle schools in the Northeast United States were asked about whether they vaped over the course of three years (fall 2016-spring 2019). Cox proportional hazards (PH) regression models were conducted to examine associations between parental divorce and the timing of vape use, gender differences in the association, and potential differences in the association as a function of living arrangements. RESULTS: Findings indicated that adolescents with divorced parents at Time 1 vaped earlier, and were 51% more likely to vape than adolescents with married parents. There were no gender differences, or differences in timing among those with divorced parents as a function of living with a step-parent. CONCLUSION: These findings highlight the importance of identifying familial risk factors associated with early vape use in adolescents.

Depressive Symptoms Following Later-life Marital Dissolution and Subsequent Repartnering.

The doubling of the divorce rate among individuals over age 50 during the past 20 years underscores the urgency of studying the consequences of gray divorce and subsequent repartnering for adult well-being. We filled this gap by using the 1998-to-2014 Health and Retirement Study to evaluate how the levels of depressive symptoms changed following gray divorce versus widowhood. Individuals who divorced or became widowed already had experienced higher levels of depressive symptoms before dissolution relative to those who remained married. Compared with those who became widowed, those who transitioned to divorce experienced a lower elevation and a shorter time to recovery in depressive symptoms. When repartnering, both groups experienced similar magnitudes of initial reduction and subsequent rates of increase. Both the negative consequences of marital dissolution and the beneficial effects of repartnership for mental health persisted for several years, although ultimately they reverted to their predissolution levels of depressive symptoms.

Proximate Sources of Change in Trajectories of First Marriage in the United States, 1960-2010.

This study examines proximate sources of change in first-marriage trajectories in the United States between 1960 and 2010. This was a period of tremendous social change: divorce became more common, people started marrying later or not marrying at all, innovations in medicine and changes in social and behavioral factors led to reduced mortality, inequality grew stronger and was reflected by more intense assortative mating, and the country underwent a massive educational expansion. Each of these factors influenced the formation and dissolution of first marriages over this period. This article extends the multiple-decrement life table to incorporate heterogeneity and assortative mating, which allows the quantification of how changes in the incidence of marriage, divorce, and mortality, along with changes in educational attainment and assortative mating, have shaped trends in first-marriage trajectories. The model is used to prove that stronger educational assortative mating leads to longer average durations of first marriage. Using data from multiple sources and this model, this study shows that although the incidence of divorce was the primary determinant of changes in first-marriage trajectories between 1960 and 1980, it has played a relatively smaller role in driving change in marital trajectories between 1980 and 2010. Instead, factors such as later age at first marriage, educational expansion, declining mortality, narrowing sex differences in mortality, and more intense educational assortative mating have been the major drivers of changes in first-marriage trajectories since 1980.

A Cohort Comparison of Predictors of Young Adult Union Formation and Dissolution in the US.

The theory of the second demographic transition argues that as educated Americans began valuing self-actualization and individual autonomy, delays in union formation spread through the US. The accelerated adulthood theory suggests that socioeconomic disadvantage distinguishes young adulthood such that those with fewer resources have shorter, more informal (i.e. cohabitation) unions, and those with more resources delay but achieve marriage and have greater union stability. We use two large, nationally representative samples of young adults collected about twenty years apart, the National Longitudinal Surveys of Youth 1979 and 1997 cohorts to examine cohort differences in union formation and dissolution and test interaction effects in demographic and socioeconomic correlates. We found that the NLSY97 cohort 1) entered into unions earlier than the NLSY79 cohort, 2) entered direct marriage (marriage without premarital cohabitation) later than the NLSY79 cohort, and 3) entered cohabiting unions earlier than the NLSY79 cohort. A greater proportion of young adults in the NLSY97 cohort dissolved their first union between ages 16 and 30. We found that socioeconomically disadvantaged young adults had earlier unions by some indicators (e.g. lower maternal education) and later unions by other indicators (e.g. unemployment) in both cohorts. We also found that in both cohorts, socioeconomic disadvantage undermined union stability. We also found evidence for interaction effects; some indicators of socioeconomic disadvantage (e.g. income, employment, and maternal education) had exacerbated effects on union formation and stability in the NLSY97 as compared to the NLSY79 cohorts perhaps because inequality grew over the twenty years between cohorts.

Interactive Effects of Maternal Alcohol Problems and Parental Separation on Timing of Daughter's First Drink.

BACKGROUND: Few studies examine risk to offspring who experience both parental alcohol problems and parental separation and still fewer consider gender of the affected parent. We examined interactive effects of maternal versus paternal alcohol problems and parental separation on timing of first alcoholic drink in daughters. METHODS: Data were drawn from a sample of 3,539 European (or other) ancestry (EA) and 611 African ancestry (AA) female twins born between 1975 and 1985, median age 15 at first assessment. Cox proportional hazards regression models were estimated predicting age at first full drink from parental history of alcohol problems (mother only, father only, or both parents), parental separation during childhood, and the interaction of parental alcohol problems and parental separation. Cox models were estimated without and with adjustment for correlated risk factors, separately for EA and AA twins. RESULTS: For both EA and AA twins, a significant interaction between parental separation and mother-only alcohol problems was observed, suggesting reduced risk of drinking associated with mother-only alcohol problems in separated versus intact families. CONCLUSIONS: Findings highlight parental separation as an important moderator of risk to children of mothers who have a history of problem drinking, with interactive effects observed consistently across racial group. To identify underlying processes, additional research is needed with more detailed characterization of separated families where mother only has a history of alcohol problems.

Recoupling in Mid-Life and Beyond: From Love at Last to Not So Fast.

Divorce rates have dropped in the United States, except for couples over 50 where they are rising steeply, along with rates of late-life recoupling. Both stepcouples and their young adult and adult children in new older stepfamilies are often surprised to find themselves facing many of the same challenges that younger stepfamilies do. Some challenges are even intensified by the decades-long relationships and additional layers of extended family that come with recoupling after mid-life. Stepfamilies formed in later life must also negotiate decisions about estate planning and elder care among stakeholders who often have sharply divergent agendas before there is time to establish trusting relationships. This article describes the "normal" challenges facing stepcouples who come together over age 50. It provides evidence-informed guidance for therapists in meeting these challenges on three levels of clinical work: Psychoeducational, Interpersonal, and Intrapsychic/Intergenerational. As in younger stepfamilies, "family therapy" must usually begin in subsystems-often the adult stepcouple and parent-adult child. The article then describes a particularly fraught subgroup of recouplers: over-50 fathers and their new partners, where the dad's young adult or adult daughter is very unhappy with his new relationship. In these latter stepfamilies, father-daughter repair must precede stepfamily bonding. Stepfamilies that are preceded by a partner's death and those that begin with affairs are also discussed. Finally, some "easy wrong turns" for therapists are described.

Family composition and marital dissolution in rural Nepal, 1945-2008.

The presence, number, sex, and age composition of children within families can have important influences on couples' marital outcomes. Children are valued across settings, but their value in settings where there is an absence of formalized social security is distinctive. This paper explores the influences of childlessness, and different number, age, and sex compositions of children, on the odds of marital dissolution among couples in rural Nepal. Results reveal that childless couples face significantly higher odds of dissolution than couples with at least one child, and each additional child-up to three children-reduces couples' odds of dissolution. Furthermore, having a child aged under two reduces couples' odds of marital dissolution, but interactions reveal that this age effect only holds at parity one. Surprisingly, despite a history of son preference in this setting, there is no evidence that children's within-parity sex composition is associated with the odds of marital dissolution.

Parental separation in childhood as a risk factor for depression in adulthood: a community-based study of adolescents screened for depression and followed up after 15 years.

BACKGROUND: Earlier research has investigated the association between parental separation and long-term health outcomes among offspring, but few studies have assessed the potentially moderating role of mental health status in adolescence. The aim of this study was to analyze whether parental separation in childhood predicts depression in adulthood and whether the pattern differs between individuals with and without earlier depression. METHODS: A community-based sample of individuals with adolescent depression in 1991-93 and matched non-depressed peers were followed up using a structured diagnostic interview after 15 years. The participation rate was 65% (depressed n = 227; non-depressed controls n = 155). Information on parental separation and conditions in childhood and adolescence was collected at baseline. The outcome was depression between the ages 19-31 years; information on depression was collected at the follow-up diagnostic interview. The statistical method used was binary logistic regression. RESULTS: Our analyses showed that depressed adolescents with separated parents had an excess risk of recurrence of depression in adulthood, compared with depressed adolescents with non-separated parents. In addition, among adolescents with depression, parental separation was associated with an increased risk of a switch to bipolar disorder in adulthood. Among the matched non-depressed peers, no associations between parental separation and adult depression or bipolar disorder were found. CONCLUSIONS: Parental separation may have long-lasting health consequences for vulnerable individuals who suffer from mental illness already in adolescence.

The marriage boom and marriage bust in the United States: An age-period-cohort analysis.

In the 1950s and 1960s there was an unprecedented marriage boom in the United States. This was followed in the 1970s by a marriage bust. Some argue that both phenomena are cohort effects, while others argue that they are period effects. The study reported here tested the major period and cohort theories of the marriage boom and bust, by estimating an age-period-cohort model of first marriage for the years 1925-79 using census microdata. The results of the analysis indicate that the marriage boom was mostly a period effect, although there were also cohort influences. More specifically, the hypothesis that the marriage boom was mostly a response to rising wages is shown to be consistent with the data. However, much of the marriage bust can be accounted for by unidentified cohort influences, at least until 1980.

The influences of parental divorce and maternal-versus-paternal alcohol abuse on offspring lifetime suicide attempt.

INTRODUCTION AND AIMS: Research indicates that parental divorce and parental alcohol abuse independently increase likelihood of offspring lifetime suicide attempt. However, when experienced together, only parental alcohol abuse significantly increased odds of suicide attempt. It is unclear to what extent differences in the effect of maternal versus paternal alcohol use exist on adult offspring lifetime suicide attempt risk. This study examined the influences of parental divorce and maternal-paternal histories of alcohol problems on adult offspring lifetime suicide attempt. DESIGN AND METHODS: The sample consisted of participants from the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions. The simultaneous effect of childhood or adolescent parental divorce and maternal and paternal history of alcohol problems on offspring lifetime suicide attempt was estimated using a logistic regression model with an interaction term for demographics and parental history of other emotional and behavioural problems. RESULTS: Parental divorce and maternal-paternal alcohol problems interacted to differentially influence the likelihood of offspring lifetime suicide attempt. Experiencing parental divorce and either maternal or paternal alcohol problems nearly doubled the likelihood of suicide attempt. Divorce and history of alcohol problems for both parents tripled the likelihood. DISCUSSION AND CONCLUSION: Individuals who experienced parental divorce as children or adolescents and who have a parent who abuses alcohol are at elevated risk for lifetime suicide attempt. These problem areas should become a routine part of assessment to better identify those at risk for lifetime suicide attempt and to implement early and targeted intervention to decrease such risk. [Thompson RG Jr,Alonzo D, Hu M-C, Hasin DS. The influences of parental divorce and maternal-versus-paternal alcohol abuse on offspringlifetime suicide attempt. Drug Alcohol Rev 2017;36:408-414].

Trends and correlates of single motherhood in Kenya: Results from the Demographic and Health Survey.

Single motherhood exposes women to poorer socioeconomic and health outcomes, which may also negatively impact child outcomes. The Demographic and Health Surveys of 1989, 1993, 1998, 2003, and 2009 were used to investigate trends over time and factors associated with single motherhood in Kenya. Urban residence, older age, and poorer economic status were associated with single motherhood over time. Women with more than one child, and those with children under 15 years living at home were less likely to be single mothers. As women become single mothers at different stages, targeted and supportive strategies are required to mitigate associated risks.

Midpregnancy Marriage and Divorce: Why the Death of Shotgun Marriage Has Been Greatly Exaggerated.

Conventional wisdom holds that births following the colloquially termed "shotgun marriage"-that is, births to parents who married between conception and the birth-are nearing obsolescence. To investigate trends in shotgun marriage, we matched North Carolina administrative data on nearly 800,000 first births among white and black mothers to marriage and divorce records. We found that among married births, midpregnancy-married births (our preferred term for shotgun-married births) have been relatively stable at about 10 % over the past quarter-century while increasing substantially for vulnerable population subgroups. In 2012, among black and white less-educated and younger women, midpregnancy-married births accounted for approximately 20 % to 25 % of married first births. The increasing representation of midpregnancy-married births among married births raises concerns about well-being among at-risk families because midpregnancy marriages may be quite fragile. Our analysis revealed, however, that midpregnancy marriages were more likely to dissolve only among more advantaged groups. Of those groups considered to be most at risk of divorce-namely, black women with lower levels of education and who were younger-midpregnancy marriages had the same or lower likelihood of divorce as preconception marriages. Our results suggest an overlooked resiliency in a type of marriage that has only increased in salience.

Intimate partner violence as a predictor of marital disruption in rural Rakai, Uganda: a longitudinal study.

OBJECTIVES: We assessed the association between intimate partner violence (IPV) and union disruption (divorce or separation) in the rural Ugandan setting of Rakai District. METHODS: We analyzed longitudinal data collected from April 1999 to June 2006, from 6834 women (15-49 years) living in 50 communities in Rakai. Participants were either officially married, traditionally married or in a consensual union during one or more surveys and completed at least one follow-up survey. The primary outcome was union disruption through divorce or separation from the primary sexual partner. RESULTS: Past year IPV ranged from 6.49 % (severe physical abuse) to 31.99 % (emotional abuse). Severe physical IPV was significantly associated with divorce/separation, after adjusting for other covariates (aOR = 1.80, 95 % CI 1.01-3.22). Another predictor of union disruption was a woman having two or more sexual partners in the past year (aOR = 8.42, 95 % CI 5.97-11.89). Factors protecting against divorce/separation included an increasing number of co-resident biological children and longer duration of union. CONCLUSIONS: IPV, particularly severe physical abuse, is an important risk factor for union disruption. Marital counseling, health education and interventions should address the role of IPV on the wellbeing of women and the stability of couples in Uganda.

Por que não se separam: a perda da confiança no relacionamento conjugal / Why don't you just break up: the loss of confidence in marriage / ¿Por qué no se separan: la pérdida de confianza en matrimonio

Quando se trabalha em terapia sistêmica, especialmente com casais, não é raro encontrar-se com alguns que brigam sem cessar, que não deixam passar nenhuma oportunidade para ferirem-se mutuamente, para fazerem-se mal com todos os recursos que possuem ao seu alcance, geralmente sem violência física, terminando as brigas sem que exista uma mínima reconciliação. São estes casais que, quando alguém os recebe acaba dizendo (em voz alta ou pra si mesmo, segundo como seja o seu dia): “por que não se separam?”. É uma pergunta pertinente. Se como parece, seu principal objetivo como casal é machucar-se mutuamente, e sofrem com sua relação, e não possuem motivos legais ou econômicos importantes que o impeçam, o divórcio poderia ser uma boa alternativa. Então, por que não se separam? Este artigo trata de dar respostas a essa pergunta, propondo que a origem do conflito interminável está em uma traição da confiança do casal com a família de origem, em uma situação de bloqueio da saída, quer dizer, da ruptura da relação. Utiliza-se, finalmente, um fragmento da ópera Aida, de Verdi, para exemplificar a proposta.(AU)

When you are working in systemic family therapy, especially with couples, it is not uncommon to find some of them fighting all the time, taking whatever opportunity to hurt each other, harming the other person and the relationship with the resources at hand, usually without physical violence. The fights stop with our repair or forgiveness. These are couples, when you see them you end up just saying (aloud or to yourself, depending on how you feel that day): "Why don´t you just break up?" It is an important question. If, as seems, the primary goal as a couple is to harm each other, and both suffer in their relationship, and there are no major legal or economic reasons that make them stay together , the divorce could be a good alternative. So why don´t they just separate? The article tries to answer exactly this question, suggesting that the source of endless conflict is a betrayal of the trust of each member of the couple with his or her family of origin. They can´t divorce because their loyalty to their family of origin blocks this exit: breakdown of the relationship. A fragment of Aida, Verdi's opera is used as an example to back up our working hypothesis.(AU)

Cuando se trabaja en terapia sistémica, especialmente con parejas, no es extraño encontrarse con algunas que se pelean sin cesar, que no dejan pasar ninguna oportunidad para herirse mutuamente, para hacerse daño con todos los recursos que tienen a su alcance, generalmente sin violencia física, terminando las peleas sin que haya una mínima reconciliación. Son esas parejas que, cuando uno las recibe acaba diciendo (en alta voz o para sus adentros, según como tenga el día): “¿Por qué no se separan?”. Es una pregunta pertinente. Si como parece, su principal objetivo como pareja es dañarse mutuamente, y sufren con su relación, y no hay motivos legales o económicos importantes que se lo impidan, el divorcio podría ser una buena alternativa. Entonces, ¿por qué no se separan?. El artículo trata de dar respuesta a esa pregunta, proponiendo que el origen del conflicto interminable está en una traición de la confianza de la pareja con la familia de origen, en una situación de bloqueo de la salida, es decir, de la ruptura de la relación. Se utiliza finalmente un fragmento de Aída, la ópera de Verdi, para ejemplificar la propuesta.(AU)

Trends in the economic consequences of marital and cohabitation dissolution in the United States.

Mothers in the United States use a combination of employment, public transfers, and private safety nets to cushion the economic losses of romantic union dissolution, but changes in maternal labor force participation, government transfer programs, and private social networks may have altered the economic impact of union dissolution over time. Using nationally representative panels from the Survey of Income and Program Participation (SIPP) from 1984 to 2007, we show that the economic consequences of divorce have declined since the 1980s owing to the growth in married women's earnings and their receipt of child support and income from personal networks. In contrast, the economic consequences of cohabitation dissolution were modest in the 1980s but have worsened over time. Cohabiting mothers' income losses associated with union dissolution now closely resemble those of divorced mothers. These trends imply that changes in marital stability have not contributed to rising income instability among families with children, but trends in the extent and economic costs of cohabitation have likely contributed to rising income instability for less-advantaged children.

The impact of childhood parental loss on risk for mood, anxiety and substance use disorders in a population-based sample of male twins.

Previous studies have identified the relationship between parental loss and psychopathology later in life. However, this relationship varied depending on the kind of loss, the parent involved, and the type of psychopathology. In the present study, we examined the association between parental loss (any loss, death, and separation) during childhood and lifetime risk for seven common psychiatric and substance use disorders in a sample of 2605 male twins from the Virginia population-based twin registry. Using structural equation modeling (SEM), we also examined the extent to which the influence of parental loss contributes to adult psychopathology. Parental separation was associated with a wide range of adult psychopathology, whereas parental death was specifically associated with phobia and alcohol dependence. Maternal and paternal separations were almost equally associated with most forms of psychopathology. SEM suggested that parental loss accounted for about 10% of the variance of adult psychopathology, of which parental separation had the strongest impacts on risk for depression and drug abuse/dependence (11% of the total variance). Our findings suggest that early parental separation has stronger and wider effects on adult psychopathology than parental death.

Who gets custody now? Dramatic changes in children's living arrangements after divorce.

This article reexamines the living arrangements of children following their parents' divorce, using Wisconsin Court Records, updating an analysis that showed relatively small but significant increases in shared custody in the late 1980s and early 1990s. These changes have accelerated markedly in the intervening years: between 1988 and 2008, the proportion of mothers granted sole physical custody fell substantially, the proportion of parents sharing custody increased dramatically, and father-sole custody remained relatively stable. We explore changes in the correlates of alternative custody outcomes, showing that some results from the earlier analysis still hold (for example, cases with higher total family income are more likely to have shared custody), but other differences have lessened (shared-custody cases have become less distinctive as they have become more common). Despite the considerable changes in marriage and divorce patterns over this period, we do not find strong evidence that the changes in custody are related to changes in the characteristics of families experiencing a divorce; rather, changes in custody may be the result of changes in social norms and the process by which custody is determined.

DSM-IV alcohol dependence and marital dissolution: evidence from the National Epidemiologic Survey on Alcohol and Related Conditions.

OBJECTIVE: The purpose of this study was to examine the cross-sectional and longitudinal associations among alcohol use disorder (AUD), stressful life events, and marital dissolution in a probability sample of adults. METHOD: The National Epidemiologic Survey on Alcohol and Related Conditions is a prospective, longitudinal study of a probability sample of 43,083 adults 18 years of age and older living in the United States. The interval between Wave 1 (W1) and Wave 2 (W2) was approximately 3 years. Cross-sectional analyses included 32,359 adults ages 18 and older who were ever married at W1, and longitudinal analyses included 17,192 adults who were currently married at W1 and who completed relevant W2 measures. Participants completed inhome surveys conducted with computer-assisted personal interviewing. RESULTS: Rates of lifetime marital dissolution were significantly higher among those with lifetime AUD (48.3%) than in those with no lifetime AUD (30.1%). The incidence of marital dissolution from W1 to W2 was 15.5% for those with a past-12-month AUD at W1, compared to 4.8% among those with no AUD. Proportional hazards regression analyses showed that past-12-month AUD, tobacco use disorder, other substance use disorder, stressful life events, older age at marriage, being married more than once, and being married to an alcoholic at W1 predicted greater hazards of marital dissolution at W2. These associations were not moderated by gender. CONCLUSIONS: AUD and stressful life events predict subsequent marital dissolution independently of other substance use disorders, mood and anxiety disorders, and personality disorders. Results were discussed within the framework of the Vulnerability-Stress-Adaptation model of marriage.