Mental health trajectories after juridical divorce: Does personality matter?

INTRODUCTION: This study investigated whether the Big Five personality dimensions were associated with mental health trajectories and/or intervention effects of a digital divorce intervention from juridical divorce to 12 months following juridical divorce. The study utilized a randomized controlled trial study design (N = 676) and measured mental health outcomes (anxiety, depression, somatization, and stress) at study inclusion (i.e., at juridical divorce) and 3-, 6-, and 12 months after juridical divorce. Big Five personality dimensions were measured 1 month post study inclusion. RESULTS: The study found that neuroticism is the personality dimension most predictive of post-divorce mental health outcomes. Specifically, divorcees with higher neuroticism scores indicated worse mental health immediately following divorce, but their symptom levels decreased more rapidly over a 12 months period after juridical divorce compared with lower neuroticism divorcees. It is also notable that their mean scores for the mental health outcomes remained higher at all time points (3, 6, and 12 months post baseline), relative to those lower in neuroticism. CONCLUSION: Findings are discussed in light of divorce-adjustment-theory and the stress-buffering model.

Symptoms of anxiety and depression in Denmark during the first year of the COVID-19 pandemic: A two-wave matched-control study.

Subsequent to the restriction measures taken to curb the COVID-19 infection rate, researchers theorized these would have detrimental mental health consequences. This two-wave matched-control study investigates depression and anxiety symptoms during the first 12 months of the pandemic (March 2020-March 2021) in Denmark with data from the I-SHARE and Project SEXUS studies. The I-SHARE study includes 1,302 (Time period 1 only n = 914, Time period 2 only n = 304, both time periods 1 and2 n = 84) Danish participants, and the sex and birth year-matched control participants from the Project SEXUS study comprise 9,980 Danes. During the first year of the pandemic, the study populations' anxiety and depression symptom mean levels did not significantly differ from pre-pandemic matched controls. Younger age, female gender, fewer children in the same household (depression only), lower education level, and not being in a relationship (depression only) were associated with increased anxiety and depression symptom scores. The key COVID-19-related variable linked with significantly higher anxiety and depression symptom scores was COVID-19-related loss of income. Contrary to initial concerns, we did not find a significant effect of the pandemic on anxiety and depression symptom scores. However, the results underscore the importance of structural resources to prevent income loss to safeguard mental health during crises such as a pandemic.

The International Sexual Health And REproductive Health during COVID-19 (I-SHARE) Study: A Multicountry Analysis of Adults from 30 Countries Prior to and During the Initial Coronavirus Disease 2019 Wave.

BACKGROUND: There is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of coronavirus disease 2019 (COVID-19). To address this gap, our team organized a multicountry, cross-sectional online survey as part of a global consortium. METHODS: Consortium research teams conducted online surveys in 30 countries. Sampling methods included convenience, online panels, and population-representative. Primary outcomes included sexual behaviors, partner violence, and SRH service use, and we compared 3 months prior to and during policy measures to mitigate COVID-19. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence. RESULTS: Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%), and 640 (14.1%) reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063 of 15 144, 7.0%) compared to before COVID-19 measures (1469 of 15 887, 9.3%). COVID-19 measures impeded access to condoms (933 of 10 790, 8.7%), contraceptives (610 of 8175, 7.5%), and human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing (750 of 1965, 30.7%). Pooled estimates from meta-analysis indicate that during COVID-19 measures, 32.3% (95% confidence interval [CI], 23.9%-42.1%) of people needing HIV/STI testing had hindered access, 4.4% (95% CI, 3.4%-5.4%) experienced partner violence, and 5.8% (95% CI, 5.4%-8.2%) decreased casual partner condom use (moderate certainty of evidence for each outcome). Meta-analysis findings were robust in sensitivity analyses that examined country income level, sample size, and sampling strategy. CONCLUSIONS: Open science methods are feasible to organize research studies as part of emergency responses. The initial COVID-19 wave impacted SRH behaviors and access to services across diverse global settings.

Anxiety, depression and associated factors among recently divorced individuals.

BACKGROUND: In divorce research, studies using large samples, very recently divorced individuals and validated measures of depression and anxiety with available background populations for comparison are missing. AIMS: This study aimed to investigate symptoms of depression and anxiety among recently divorced Danes and assess the explanatory power of relevant sociodemographic- and divorce-related variables on these symptoms. METHODS: The study utilized an online cross-sectional design and a total of 1856 Danish citizens recruited through the Danish State Administration. Average scores for depression and anxiety were compared to the Danish background population and regression analyses were conducted to assess the explanatory power of sociodemographic- and divorce characteristics on symptoms of depression and anxiety. RESULTS: Divorcees reported significantly higher levels of both depressive and anxiety symptoms than the background population with a large proportion of the sample scoring equal to or higher than generally recommended cut-off values for risk of suffering from a psychiatric diagnosable case of depression or anxiety. Both sociodemographic- and divorce characteristics were predictive of symptoms of depression and anxiety. CONCLUSION: The findings underline the relevance of public health intervention targeting symptoms of depression and anxiety among recently divorced individuals.

Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress.

INTRODUCTION: Appearance dissatisfaction is a sensitive issue and has been tied to depression, dissatisfaction in romantic relationships, and reduced sexual satisfaction. AIM: This study sought to examine associations between appearance satisfaction and specific sexual problems and related distress, testing also the moderating role of relationship satisfaction. METHODS: A large web-sample of Norwegians in romantic relationships (N = 2,903) completed a one-time survey. OUTCOMES: Participants reported on their experience of five different sexual problems and associated level of distress. RESULTS: We found that appearance satisfaction was associated with reporting fewer sexual problems, and specifically, with a smaller likelihood of experiencing problems with lack of enjoyment, lack of excitement, and lack of climax. Furthermore, appearance satisfaction was unrelated to overall sexual problem-related distress, but was associated with feeling less distress about lack of excitement and lack of climax. Relationship satisfaction did not serve as a moderator of the associations. CLINICAL TRANSLATION: These findings suggest the importance of attending to appearance satisfaction when working with clients with multiple sexual problems, particularly those related to excitement and enjoyment. STRENGTHS AND LIMITATIONS: Strengths of the study include a large sample of partnered adults and assessment of specific sexual problems and associated distress. A limitation is that outcomes were assessed using single items, rather than multi-item scales. CONCLUSION: The study highlights the importance of examining the presence of sexual problems and associated distress separately, and to consider appearance satisfaction as a predictor of sexual functioning. Øverup CS, Strizzi JM, Cipric A, et al. Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress. J Sex Med 2021;18:1532-1544.

"I Had Not Seen Star Wars" and Other Motives for Divorce in Denmark.

A total of 2,371 Danish residents participating in the Cooperation After Divorce randomized controlled trial study indicated the motives for their divorce. The most frequently given motives were lack of love/intimacy, communication problems, lack of sympathy/respect/trust, and growing apart. The least reported motives were violence, addiction, accident or illness, and personality. The results support global trends regarding an increased importance of emotional and psychological aspects of relationships. A factor analysis seeking to identify clusters in the motives did not yield statistically or theoretically strong results. This may indicate that experiences with and motives for divorce are heterogeneous and multifactorial.

Birth weight and quality of life in midlife: a 50-year follow-up study of 2079 individuals in Denmark.

PURPOSE: Low birth weight has been associated with a higher risk of reduced quality of life (QoL) in children, adolescents, and young adults, but the influence seems to diminish over time. However, previous studies have mainly focused on health-related QoL and compared individuals with low birth weight with individuals without low birth weight. The purpose of the present cohort study was to investigate the influence of the entire range of birth weights on three distinct measures of QoL in midlife. METHODS: The study population consisted of all live-born singletons from the Copenhagen Perinatal Cohort (CPC, 1959-1961) who participated in a 50-year follow-up examination in 2009-2011 (N = 2079). Birth weight was measured by three pediatricians at birth. QoL was measured at the follow-up by the participants' scores on three QoL self-report measures: The Satisfaction With Life Scale, the Vitality Scale of the Medical Outcomes Study 36-Item Short-Form Health Survey, and a single-item QoL measure based on the question: "How is your quality of life at the moment?". General linear regression and binary logistic regression were used to estimate the association between birth weight and QoL in midlife. RESULTS: Small, curvilinear associations of birth weight with life satisfaction, vitality, and the single-item QoL measure were found, suggesting that both low and high birth weights increase the risk of low satisfaction with life, low vitality and low QoL. CONCLUSION: The study findings suggest that low and high-range birth weight exert a lasting influence on distinct, but complementary aspects of QoL in midlife.

Friend or foe? Postdivorce hostility among recently divorced individuals.

High levels of hostility often occur during and postdivorce and may significantly affect the quality of life, parent-child relationships, and social functioning of divorcees. Moreover, hostility may predict aggressive and violent behavior. This study sought to (a) compare average general hostility levels of a large sample of Danish divorcees to the norms of the general adult Danish population, (b) compare general hostility levels between male and female divorcees, and (c) investigate the explanatory value of various sociodemographic and divorce-related factors on postdivorce general hostility and whether these factors differ across gender. Cross-sectional baseline data (N = 1,856) from a larger randomized controlled trial study was used in this study. Normative data from a general sample of Danish adults (N = 2,040) was used for comparisons of hostility levels between our study sample and the Danish background population. This study found that male and female divorcees did not report significantly different hostility levels. However, participants reported significantly higher hostility levels postdivorce than the comparative Danish norm sample. Significant predictors of postdivorce hostility were lower age, lower educational level, infidelity as a reason for divorce, higher degree of postdivorce conflict, worse communication with the former spouse, the former spouse as the initiator of the divorce, and new partner status with neither divorcees having a new partner, or only the former spouse having a new partner. The predictive strength of the factors did not differ across gender. The findings may be especially relevant for interventions targeting problematic outcomes postdivorce (e.g., preventing aggressive behavior).

Adaptation of the New Sexual Satisfaction Scale-Short Form Into Spanish.

Measuring and understanding sexual satisfaction is a key element in the evaluation of sexual health and the human sexual response. This study sought to adapt and validate the New Sexual Satisfaction Scale-Short Form from English into the Spanish language. A four-sample (two community samples, one LGB sample, and one university sample) study of 1,200 participants was completed in Spain between 2012-2014. Exploratory and confirmatory factor analyses demonstrated that the adapted version satisfactorily meets validation requirements. In posterior analyses, relationship stability and sexual orientation were factors that increased sexual satisfaction. Self-identified lesbian participants were more sexually satisfied than their heterosexual counterparts. Stable relationships appeared to be a factor for increased sexual satisfaction while age was not. Age and sexual identity/gender did not influence sexual satisfaction.

The effectiveness of control strategies for dementia-driven wandering, preventing escape attempts: a case report.

One of the most complicated aspects of caring for patients with dementia is dementia-driven wandering due to its adverse ramifications. We report a case of an 80-year-old man who had been previously diagnosed with dementia (with a score of 6 on the Reisberg Global Deterioration Scale - GDS). The patient went to an Adult Day Care Center on a daily basis where he demonstrated wandering behavior with a high rate of escape attempts (the number of times the Center's glass exit door was approached). The objective of this study is to present effective non-pharmacological intervention strategies for dementia-driven wandering; assessed strategies included: environmental (subjective barriers), cognitive/behavioral (cognitive training with differential reinforcement), and combined (subjective barriers + cognitive/behavioral). The results showed that all of these three strategies significantly decreased the number of escape attempts.

Using Pornography, Paying for Sex, and Violence: A Danish National Survey Study.

Only a few national cohort studies on using online pornography and buying sex have been published. The overall aim of this study, which analyzed data from a representative Danish national survey, was to provide an overview of incidence and associated population characteristics. The key aims were: first, to analyze frequencies of using online pornography and buying sex stratified by gender and other background characteristics; and, second, to investigate if and how using online pornography and buying sex were associated with sexual satisfaction, sexual activity, and violence. The findings revealed that having ever paid for sex and higher use of pornography were each associated with being male, younger, and not being in a relationship. Further, among men, having ever paid for sex and higher use of pornography were associated with not being sexually satisfied and, in part of the analysis, having committed violence to another person in the last year; however, these particular relationships were not statistically significant in the appropriately controlled regression analysis. We discuss gender, age, sexual aggression, and sexual satisfaction as factors associated with higher pornography use and buying sex.

Temporal Associations Between Depression and Hostility in the Context of a Divorce Intervention.

Divorce interventions have been found to be effective in reducing negative outcomes for newly divorced people, including depression and hostility. Typically, divorce interventions cover a variety of issues that may influence people's level of depression and hostility. However, it is unclear whether the interventions differentially affect the outcomes. That is, it may be that intervention participation leads to a reduction in depression, which is associated with a prospective reduction in hostility-or vice versa. The current study used a sample of 1,856 recently divorced Danes, who completed questionnaires at baseline, 3-, 6-, and 12-month post-divorce. Structural equation modeling revealed that while depression and hostility were concurrently associated, there were no prospective associations, except for baseline depression predicting 3-month hostility. Moreover, the associations did not differ by gender. The results suggest that the intervention content may have influenced both depression and hostility. These findings may be useful in guiding future divorce intervention developments.

Changes in Solo and Partnered Sexual Behaviors following the First COVID-19 Wave: Data from an International Study of 26 Countries.

Objective: To determine individual- and country-level factors associated with self-reported changes in solo and partnered sexual behaviors in an international sample of adults during COVID-19. Methods: Data were from the International Sexual Health And REproductive Health during COVID-19 study (I-SHARE)-a cross-sectional, multi-country study (N = 26 countries) assessing adult (N = 19,654) sexual/reproductive health before and during the first wave of COVID-19. We examined self-reported changes (three-point scale: decreased, no change, increased) in solo masturbation, hugging/holding hands/cuddling with a partner, sex with a primary partner, sex with a casual partner, sexting with a partner, viewing sexually explicit media and partnered cybersex. Ordinal regression assessed the impact of individual (age, gender- and sexual-identity, romantic partnership status, employment and income stability, household change and content, mental well-being, changes in alcohol use, and changes in marijuana use) and country-level (e.g., Oxford Stringency Index, Human Development Index, and the Palma Ratio) factors on behavior change. Results: The most common behavior to increase was hugging, kissing, or cuddling with a partner (21.5%), and the most common behavior to decrease was sex with a main partner (36.7%). Household factors like job/income instability and having children over the age of 12 years were significantly associated with decreased affectionate and sexual partnered sexual behaviors; more frequent substance use was linked to significantly increased solo, partnered, and virtual sexual behaviors. Conclusions: Understanding changes in sexual behaviors-as well as the factors that make changes more or less likely among adults around the world-are important to ensure adequate sexual health support development for future public health emergencies.

BDSM: Does it Hurt or Help Sexual Satisfaction, Relationship Satisfaction, and Relationship Closeness?

This national web-population study from Norway (N = 4,148) assessed 1) the prevalence of BDSM and role-play interests and behaviors, 2) the socio-demographic characteristics of the BDSM-oriented participants, and 3) the associations between a) BDSM and b) role-play interests and behaviors, and sexual satisfaction, relationship satisfaction, and relationship closeness. Over one in three study participants endorsed at least one BDSM interest or behavior variable. There were no gender nor educational level differences between the BDSM-oriented participants and their traditional "vanilla" (non-BDSM-oriented) counterparts, though BDSM and interests were more common among younger and self-identified LGBQ+ participants. Sexual satisfaction was positively associated with role-play and BDSM behaviors while interest in role-play (but not having previously engaged in it) was negatively associated with this outcome. Lower relationship closeness was associated with an interest in role-play (but not having tried it). No BDSM-related variables were significantly associated with relationship closeness. The findings suggest that BDSM interests and behaviors are relatively common and are linked with sexual and relationship satisfaction.

The future of divorce support: Is "digital" enough in presence of conflict?

Divorce conflict is the main driver of adverse postdivorce health adjustments among divorcing families. Despite the growing potential of online divorce support programs, there is concern that such solutions might not be sufficient to impact health-related disparities among high-conflict divorcees. The present study examined the effectiveness of the digital "Cooperation after Divorce" intervention as a function of conflict among 1856 recently divorced Danish residents. Linear mixed-effect regression modeling suggested that, although higher levels of divorce conflict at judicial divorce predicted worse health outcomes up to 1 year following divorce, the effectiveness of the digital divorce intervention did not vary as a function of the initial level of divorce conflict. Individuals in the intervention group with higher conflict in divorce still reported worse health at 12 months follow-up than those with lower levels of divorce conflict; however, much lower than the control group.

Examining gender effects in postdivorce adjustment trajectories over the first year after divorce in Denmark.

Research into gender and postdivorce mental and physical health has been highly inconsistent. The Gender Similarities Hypothesis suggests there are more similarities than differences and the Divorce Stress Adjustment Perspective suggests that structural inequalities may contribute to adverse postdivorce outcomes. We conducted secondary analyses from an RCT study to investigate if there were gender-specific trajectories and whether gender was associated with outcomes (self-perceived stress, symptoms of anxiety, depression, and somatization, general hostility, and overall mental and physical health) after controlling for effects of the intervention, income, and number of children using linear mixed-effect regression modeling, and whether number of children and income influenced these outcomes. Participants were 1,239 women and 617 men from the Cooperation after Divorce (CAD) study, conducted in Denmark, a country with less income disparity, high gender equality, shared childrearing by men and women, and societal acceptance of divorce. The analyses assessing the relationship between gender and 12-month postdivorce adjustment in terms of physical and mental health outcomes revealed that for self-perceived stress, symptoms of anxiety, depression, and somatization, hostility, and overall mental and physical health in this sample postdivorce adjustment trajectories were not gender-specific, and gender was only significantly associated with stress and somatization as a time-invariant additive effect. These findings suggest gender similarities in postdivorce adjustment and contribute to the Gender Similarities Hypothesis and the Divorce-Stress-Adjustment-Perspective by assessing individuals' postdivorce adjustment in a low-stigma and relatively egalitarian setting, providing a clearer assessment of the role of gender without potentially confounding issues of structural inequalities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Child Care Center Hand Hygiene Programs' Cost-Effectiveness in Preventing Respiratory Infections.

BACKGROUND: We previously demonstrated that a hand hygiene program, including hand sanitizer and educational measures, for day care center (DCC) staff, children, and parents was more effective than a soap-and-water program, with initial observation, in preventing respiratory infections (RIs) in children attending DCCs. We analyzed the cost-effectiveness of these programs in preventing RIs. METHODS: A cluster, randomized, controlled and open study of 911 children aged 0 to 3 years, attending 24 DCCs in Almeria. Two intervention groups of DCC-families performed educational measures and hand hygiene, one with soap-and-water (SWG) and another with hand sanitizer (HSG). The control group (CG) followed usual hand-washing procedures. RI episodes, including symptoms, treatments, medical contacts, complementary analyses, and DCC absenteeism days, were reported by parents. A Bayesian cost-effectiveness model was developed. RESULTS: There were 5201 RI episodes registered. The adjusted mean societal costs of RIs per child per study period were CG: €522.25 (95% confidence interval [CI]: 437.10 to 622.46); HSG: €374.53 (95% CI: 314.90 to 443.07); SWG: €494.51 (95% CI: 419.21 to 585.27). The indirect costs constituted between 35.7% to 43.6% of the total costs. Children belonging to the HSG had an average of 1.39 fewer RI episodes than the CG and 0.93 less than the SWG. It represents a saving of societal cost mean per child per study period of €147.72 and €119.15, respectively. The HSG intervention was dominant versus SWG and CG. CONCLUSIONS: Hand hygiene programs that include hand sanitizer and educational measures for DCC staff, children, and parents are more effective and cost less than a program with soap and water and initial observation in children attending DCCs.