Early Childhood Care in the Former East Germany and Mental Stress in Adulthood.

BACKGROUND: It is still debated in Germany whether early childhood care outside the family might cause mental stress in adulthood. In the German Democratic Republic (GDR-the former East Germany before unification), children were often cared for outside the family from a very early age. METHODS: To determine the relation between early childhood care outside the family and mental stress in adulthood, we carried out a survey among 1575 persons who were born and socialized in the GDR. They were classified into four care groups according to the age at which they were first cared for outside the family. Associations with depressiveness, somatization disorders, and anxiety disorders in adulthood were tested with logistic regression analysis. Care group-specific prevalences of experiences of abuse and neglect in childhood were estimated with analysis of variance. RESULTS: Comparisons of persons cared for outside the family before the age of three, or from the age of three onward, with persons cared for within the family in their preschool years did not reveal any difference with respect to depressiveness (odds ratio [OR] = 0.95; 95% confidence interval [0.58; 1.55]; OR = 1.05 [0.63; 1.74]), somatization disorders (OR = 1.11 [0.74; 1.67]; OR = 1.09 [0.71; 1.66]), or anxiety disorders (OR = 0.87 [0.46; 1.64]; OR = 1.12 [0.59; 2.10]). Nor were there any intergroup differences with respect to experiences of abuse and neglect. Certain features of the very small group of children who had long-term care outside the family are discussed in the article. CONCLUSION: No relation was found between early-childhood care in day-care centers in the GDR and mental stress in adulthood. The data were too sparse for any conclusions about specific aspects of care outside the home (e.g., quality or child-rearing norms).

Explorative analyses on spatial differences in the desire for social distance toward people with mental illness in a diverging city.

Introduction: Stigma is an individual and societal process based on attitudes and power and relates to both spatial disparities and social distinction. In this study, we examined differences in desire for social distance toward people with mental illness within a city using social and spatial information. Methods: ANOVAs and Scheffé post-hoc tests analyzed varying desires for social distance toward people with mental illness within Leipzig (East Germany). Joint Correspondence Analyses (JCA) explored correspondences between desire for social distance, socio-economic status, age, life orientation, social support, duration of living in Leipzig, and shame toward having a mental illness in five city districts of Leipzig in LIFE study participants (by Leipzig Research Center for Civilization Disease, data collected 2011-2014 and 2018-2021, n = 521). Results: Stigma varied among Leipzig's districts (F(df = 4) = 4.52, p = 0.001). JCAs showed that a higher desired social distance toward people with mental illness corresponded with spatial differences, high levels of pessimism, high shame of being mentally ill, low social support, low socio-economic status, and older age (75.74 and 81.22% explained variances). Conclusion: In terms of stigma, where people with mental illness live matters. The results identified target groups that should be addressed by appropriate intervention and prevention strategies for mental health care.

Historical and regional particularities in the prevalence of traumatic events and posttraumatic stress disorder in East and West Germany.

BACKGROUND: Epidemiological research on the prevalence of traumatic events and PTSD has shown that there are significant differences between countries, due to their different history and socialization processes. In the case of Germany, this is particularly relevant. Germany was divided into two states from 1949 to 1990. This study examines the prevalence of traumatic events and PTSD in the formerly divided East and West Germany. METHODS: For the prevalence of traumatic events, we used data from four representative surveys (years 2005, 2007, 2008, and 2016) with a total of N = 9,200 respondents. For the analyses of PTSD prevalence, we used data from three representative surveys (years 2005, 2007, 2008) with a total of N = 6676 respondents. We compared different birth cohorts, persons living in the former West vs. East Germany, and the application of different diagnostic criteria using a chi-square test. RESULTS: The overall one-month prevalence rate for PTSD was 3.4% (3.0% for men and 3.8% for women). We found significant differences in the occurrence of traumatic events between genders, different age cohorts as well as between people who live in East and West Germany. Significant differences in the prevalence of PTSD can only be observed for different age cohorts. Most of the age effects are due to traumatic events related to World War II (WWII). Prevalence rates for PTSD were higher when the diagnostic criterions of the DSM-V were applied compared to the criterions of the DSM-IV. CONCLUSIONS: Our data suggests that socio-political factors may need to be considered when accounting for differences in occurrence rates of traumatic events, but not for prevalence rates of PTSD, between East and West Germany. People who have experienced WW II have a higher risk of suffering from PTSD. Future epidemiological trauma research should take historical and regional peculiarities of countries into account.

[Differences in Area Specific Life Satisfaction Between East and West Germans in the Years 1991, 2006 and 2020]. / Unterschiede in der Zufriedenheit verschiedener Lebensbereiche zwischen Ost- und Westdeutschen in den Jahren 1991, 2006 und 2020.

RESEARCH: Question How did the general and area specific life satisfaction evolve between East and West Germany between 1991 and 2020? METHODS: Based on three representative surveys in the years 1991, 2006 and 2020 life satisfaction between East and West Germany was examined using mean comparison with tests of significance. The influence of relevant sociodemographic variables was calculated using Univariate Variance Analyses. RESULTS: 1991 large differences in the general life satisfaction as well as with satisfaction in the areas of living, spare time, health, finances and occupational did occur, with people in East Germany reporting to be less satisfied. These differences align during the observation time. DISCUSSION: The discrepancy in the general and area specific life satisfaction between East and West Germans did align during the last 30 years. A reason might be the improved economical living conditions in East Germany.

[Associations of Internal Migration and Somatoform Symptoms, Depression, and Anxiety in a German Representative Sample]. / Somatisierung, Depressivität und Angst bei Binnenmigrierten in einer deutschen repräsentativen Stichprobe.

AIM: The aim of the present study was to determine, if internal German migration was associated with mental distress, somatoform symptoms, depression, and anxiety. METHODS: Data from two representative studies from 2020 and 2021 were analysed (N=4922). Mental distress, including the dimensions somatoform symptoms, depression, and anxiety, was assessed with the short version of the Brief Symptom Inventory (BSI-18). Linear regression analyses were performed to examine associations between internal migration and mental distress while controlling for sociodemographic factors (gender, age, partner, household equivalised income, and education). RESULTS: Internal migrants from East to West Germany reported more mental distress, somatoform symptoms, depression, and anxiety than those who grew up and stayed in the East. This finding remained after controlling for sociodemographic factors. No differences were found between internal migrants from West to East Germany and those who grew up and stayed in West Germany. DISCUSSION: German internal migration should be taken into account when examining differences in mental health in East and West Germany. Our results suggest that particularly the group that had moved from the Eastern to the Western part of Germany reported significantly signs of mental distress.

Adverse childhood experiences growing up in East or West Germany or abroad.

Background: Adverse childhood experiences (ACEs) are potentially traumatic events that occur before the age of 18. The term encompasses various adverse childhood experiences, e.g., physical, psychological, and sexual abuse, physical and psychological neglect, and family dysfunction. Prevalence estimates for a broad spectrum of ACEs against the background of where childhood and adolescence were spent are scarcely available in Germany. This study examines the frequencies of adverse childhood experiences, considering growing up in East or West Germany or abroad and interacting with different age cohorts and gender. Methods: A total of 5,018 individuals (51.4% female) aged 14 years and older were retrospectively assessed on adverse childhood experiences using questionnaires "adverse childhood experiences" (ACE). Logistic regression models were used to analyze the association between birth cohort, gender, and where a person grew up. Descriptive statistics and univariate analyses were used to calculate frequencies, proportions, and unadjusted associations for each variable. Results: 37.4% (N = 1,878) of respondents reported experiencing at least one form of ACE. Individuals who grew up abroad report significantly more adverse childhood experiences than individuals in East or West Germany. Men and women who grew up in East Germany reported a lower rate of ACEs. We found significant effects for all predictors: Where childhood and adolescence were predominantly spent, year of birth, and gender. Significant differences in the prevalence of adverse childhood experiences within the gender groups were only found for sexual and physical abuse and substance dependence in the household. Conclusion: The results suggest that the socio-political context plays an essential role in the experience of adverse childhood experiences, both in frequency and risk. Thus, child abuse and neglect studies should increasingly focus on societal risk and protection mechanisms.

Individual and Work-Related Predictors of Exhaustion in East and West Germany.

Chronic exhaustion is a consequence of detrimental working conditions and demands, as well as inadequate coping techniques, potentially resulting in burnout. Previous research has studied occupational environment and individual factors as predictors of exhaustion. Although these differ between former East and West German states, the regional distinction regarding exhaustion has been neglected. To fill this gap, we used the Copenhagen Burnout Inventory in a representative German sample from 2014 to assess the burnout symptom exhaustion. Estimating ordinary least squares regressions, important burnout predictors were compared between the former East and West German states. Regional differences concerning occupational environments were related to the associations between individual factors, situational aspects of technostress and exhaustion. Associations between individual factors (e.g., female sex, lower working hours, age, partnership status, and household income) and exhaustion were stronger in East Germany, whereas technostress (strain of internet use, number of e-mails during leisure time, and social pressure to be constantly available) was more strongly associated with exhaustion in West Germany. Despite lower financial gratification and a higher social pressure to be constantly available in the East, West Germans were more afflicted by exhaustion. Individual factors and technostress should thus be considered when focusing on job-related mental health issues.

Eating disorder psychopathology: The role of attachment anxiety, attachment avoidance, and personality functioning.

OBJECTIVE: Although the relationship between insecure attachment patterns and eating disorder (ED) psychopathology has repeatedly been demonstrated, the underlying mechanisms of this association are not fully understood. Therefore, the current study aimed to examine personality functioning, defined as an impairment in self and interpersonal functioning, as a mediator between attachment insecurity and ED psychopathology. METHODS: In a representative population-based sample (N = 2508; age range 14-92 years) ED symptomatology, personality functioning, and attachment insecurity (anxiety and avoidance) were assessed. Besides descriptive uni-/bivariate analysis, path analysis was used to test a mediation model while controlling for the effects of age, gender, mental distress, and BMI. RESULTS: ED symptomatology was associated with lower levels of personality functioning (r = 0.22) and higher levels of attachment anxiety (r = 0.14) but did not correlate with attachment avoidance (r = 0.02). Path analysis revealed that personality functioning fully mediated the effect of attachment anxiety on ED symptomatology: The indirect effect via personality functioning (ß = 0.04, p < .001) accounted for 77% of the total effect. Fit indices were excellent. Sensitivity analyses revealed that the main results were mainly applicable to women and the middle age group. CONCLUSION: The present findings contribute to the growing body of research using dimensional conceptualizations of personality functioning, suggesting that it provides an informative, overarching framework for understanding and treating ED psychopathology. Findings indicate that underlying individual differences, e.g., with respect to insecure attachment configurations, have relevant implications for symptom manifestations. Potential clinical implications and avenues for future research are discussed.

[Internal Migration and Mental Health - Relevant Factors 20 and 30 years after Unification: Results of a Longitudinal Study in German]. / Binnenmigration und psychische Gesundheit in der Sächsischen Längsschnittstudie ­ Relevante Faktoren 20 und 30 Jahre nach der Wiedervereinigung.

Aim The aim of the present study was to determine the relevant factors in the mental health of people who experienced internal migration in comparison with people who did not. Methods Data from a longitudinal study in Saxony were used to compare the psychological distress of individuals who migrated internally with that of those who did not in 2010 and 2020. Bootstrapping-based mediation analysis was applied to examine possible mediators between internal migration and mental health.Results Individuals who experienced internal migration reported less mental distress compared to those who did not in 2010, but not in 2020, but these effects disappeared after including covariates and mediators. Important mediators in 2010 were life situation, political solidarity with FRG, winner of German Unification and job security; in 2020, these were threat of old-age poverty and experiences with system.Discussion Internal migration influences mental distress through different factors. Especially the current life circumstances play a crucial role.

Psychological and Socio-Economical Determinants of Health: The Case of Inner German Migration.

A substantial body of research has shown worse health conditions for East- vs. West-Germany in the wake of reunification. In the present study, we investigate how these differences between the two formerly divided regions developed and what maintains them. Specifically, we consider the associations between health status, income satisfaction, and health-related locus of control. In a quasi-experimental and longitudinal study design, we are particularly interested in the differences between individuals who stayed in East-Germany and those who were born in the East but migrated to West-Germany. To this end, we examined data from seven waves of the Saxony Longitudinal Study (2003-2009). Specifically, we tested a cross-lagged panel model with random effects, which evinced very good model fit. Most parameters and processes were equivalent between individuals who stayed in East-Germany vs. moved to West-Germany. Crucially, there was the expected pattern of positive correlations between health, income, and locus of control. In addition, we found substantially lower values for all three of these variables for the individuals who stayed in East-Germany (vs. moved to West-Germany). A possible explanation is the increase in socio-economic status that the internal migrants experienced. These findings present an important contribution of research in order to foster a better understanding on the social dynamics in Germany related to internal/domestic migrants and implications in the context of health outcomes (e.g., significantly more unemployment in East vs. West-Germany), especially since almost 20-25% of East-German citizens migrated to West-Germany. Until now, there are no similar studies to the Saxony longitudinal project, since the data collection started in 1987 and almost every year an identical panel has been surveyed; which can be particularly useful for health authorities. The study mainly focuses on social science research and deals with the phenomenon of reunification, approaching several subjects such as mental and physical health, quality of life and the evaluation of the political system. Yet even though many people have experienced such a migration process, there has been little research on the subjects we approach. With our research we deepen the understanding of the health consequences of internal migration.