Depression and unemployment: panel findings from the Epidemiologic Catchment Area study

Studies that have found an association between unemployment and psychological depression often fail to establish the direction of causal influence. Analyses of Epidemiologic Catchment Area panel data revealed that of employed respondents not diagnosed with major depression at first interview, those who became unemployed had over twice the risk of increased depressive symptoms and of becoming clinically depressed as those who continued employed. Although the increase in symptoms was statistically significant, the effect on clinical depression was not, possibly because of the low power of the test. The reverse causal path from clinical depression at Time 1 to becoming unemployed by Time 2 was not supported. The unemployment rate in the respondent's community at time of interview was not related directly to psychological depression but appeared associated indirectly with depression via its impact on the risk of becoming unemployed. Implications for policy and further research were discussed.     

Stability of diagnosis of obsessive-compulsive disorder in the Epidemiologic Catchment Area study

OBJECTIVE: This study examined the 1-year temporal stability of a National Institute of Mental Health Diagnostic Interview Schedule (DIS) lifetime diagnosis of obsessive-compulsive disorder in the Epidemiologic Catchment Area (ECA) study. METHOD: In that study, 20,862 individuals, aged 18 years and over, at five sites were evaluated by lay interviewers using the DIS (wave 1). All of those who were available 12 months later were reinterviewed (wave 2). In the present study, the temporal stability of wave 1 obsessive-compulsive disorder diagnoses at wave 2 was examined, as well as relationships with comorbid diagnoses. The consistency of reports of "new-onset" illness was also examined. Factors contributing to these measures were evaluated. RESULTS: The temporal stability of the diagnosis of obsessive-compulsive disorder was very low. Subjects with a stable diagnosis of obsessive-compulsive disorder had a higher rate of both obsessions and compulsions, an earlier age at onset, and more comorbid anxiety, affective, and alcohol abuse/dependence disorders at initial assessment. The originally reported 1-year incidence estimates for obsessive-compulsive disorder primarily reflect data from subjects at wave 2 who reported the onset of symptoms as preceding the wave 1 interview. Older and less-educated subjects had significantly higher error rates in reporting onset. CONCLUSIONS: The DIS diagnosis of obsessive-compulsive disorder has poor validity, leaving the true incidence and prevalence of the disorder unknown. Older and less-educated subjects require special attention in the design of instruments for use with community samples.     

Taking chances: problem gamblers and mental health disorders--results from the St. Louis Epidemiologic Catchment Area Study

OBJECTIVES: This study determined prevalence estimates of problem gambling and relationships to other psychiatric and substance use disorders. METHODS: In 1981, the Diagnostic Interview Schedule was used to collect epidemiological information on problem gambling and other disorders from 3004 adults in St. Louis, Mo. RESULTS: The lifetime prevalence of pathological gambling was 0.9%; 46% of those surveyed gambled recreationally. Problem gamblers (those reporting at least one gambling-related problem) were 9.2% of the sample and were predominately White (69%), male (78.2%), and young than nongamblers. They were at increased risk for several psychiatric diagnoses, especially for antisocial personality disorder, alcoholism, and tobacco dependence. CONCLUSIONS: Clinicians treating alcoholism and tobacco dependence may need to screen for problem gambling. Additional research in the context of increased gambling opportunities is needed.     

Differences in distress among adult children of alcoholics.

Investigated within-group differences in psychological distress, social support, and hardiness among adult children of alcoholics (ACAs). Members of ACA support groups (21 men, 58 women) were compared to ACA college students (27 men, 40 women) not involved in such support groups. Support group members reported higher levels of psychological distress, lower levels of hardiness, and less satisfaction with perceived social support than did the college student ACAs. Support group members also reported more negative feelings, attitudes, and behaviors with regard to parental alcoholism than did the college students. For both groups, hardiness and social support were negatively correlated with psychological distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short-term group treatment for adult children of alcoholics.

Highly significant test score changes of adult children of alcoholics supported the effectiveness of individual therapy in short-term groups. 24 Ss were tested on measures of loneliness (UCLA Loneliness Scale); anxiety, hostility, and depression (Multiple Affect Adjective Check List—Revised [MAACL—R]); and interpersonal dependency (Interpersonal Dependency Inventory [IDI]). MAACL—R Anxiety and Depression scores declined. MAACL—R Hostility scores rose at the end of the treatment and then declined sharply 8 wks later. Increases toward test norms occurred on the IDI Lack of Social Confidence scale. Scores on the IDI Emotional Reliance on Another Person scale, the IDI Assertion of Autonomy scale, and the UCLA Loneliness Scale fell within scale norms and showed little change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal study of children of alcoholics: Predicting young adult substance use disorders, anxiety, and depression.

This study tested the specificity of parent alcoholism effects on young adult alcohol and drug abuse/dependence, anxiety, and depression, and tested whether adolescent symptomatology and substance use mediated parent alcoholism effects. Participants were from a longitudinal study in which a target child was assessed in adolescence and young adulthood with structured interview measures (N?=?454 families at Time 1). Results showed unique effects of parent alcoholism on young adult substance abuse/dependence diagnoses over and above the effects of other parental psychopathology. There was some evidence of parent alcoholism effects on young adult depression and of maternal alcoholism effects on young adult anxiety, although these were not found consistently across subsamples. Mediational models suggested that parent alcoholism effects could be partially (but not totally) explained by adolescent externalizing symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief treatment for adult children of alcoholics: Accessing resources for self-care.

The case of a 57-yr-old female adult child of an alcoholic (ACA) illustrates that brief treatment may be all that is necessary to help many ACAs who possess the requisites for effective self-care but who have been blocked from using them. The case shows how therapy can find a way around the inhibition of the resource of self-care by mobilizing existing internal resources so that emotional needs can be responded to in the self. In this case, the techniques of accessing resources and anchoring were drawn from neurolinguistic programming. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality and object relational pathology in young adult children of alcoholics.

Compared 15 adult children of alcoholics (ACAs) with 15 non-ACAs, using the Millon Clinical Multiaxial Inventory (MCMI) and 2 Rorschach measures of developmental object relational pathology and egocentricity. Higher levels of personality pathology and lower levels of object relational development were found in ACAs compared with non-ACAs, confirming the presence of personality disorders and characterological defensive adaptation. Findings are consistent with the picture of moderate characterological pathology etiologically related to developmentally based object relational deficits in ACAs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intrapersonal and interpersonal functioning among middle-aged female adult children of alcoholics.

Examined group differences among a middle-aged, middle-class, community sample (N?=?616) of female adult children of alcoholics (ACOAs) and female non-ACOAs with regard to features of intra- and interpersonal functioning. Consistent with previous research, ACOAs reported higher levels of depression and lower levels of self-esteem. ACOAs also reported lower levels of perceived social support, family cohesion, and marital satisfaction and higher levels of marital conflict. ACOAs also indicated more parental role distress and perceived themselves as more powerless than non-ACOAs to control the actions of their offspring. ACOAs were more likely to drink for coping purposes (e.g., to relieve stress), although their level of alcohol consumption did not differ significantly from that of non-ACOAs. Although consistent differences were indicated between groups, ACOAs were still functioning in the nonpathological range on all measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The diagnosis and treatment of adult children of alcoholics as a specialized therapeutic population.

Discusses why treatment of adult children of alcoholics (ACAs) can be legitimately regarded as a subspecialty, even though its membership is diagnostically and developmentally heterogeneous. It is asserted that ACAs' pathology consists chiefly of different levels of developmental deficiencies and characterological adaptations. Case studies are presented to illustrate the pathogenic mechanisms triggered by or intertwined with parental alcoholism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric disorders and gynecological oncology: a review of the literature

The widespread use of complementary and alternative medicine techniques, often explored by patients without discussion with their primary care physician, is seen as a request from patients for care as well as cure. In this article, we discuss the reasons for the growth of and interest in complementary and alternative medicine in an era of rapidly advancing medical technology. There is, for instance, evidence of the efficacy of supportive techniques such as group psychotherapy in improving adjustment and increasing survival time of cancer patients. We describe current and developing complementary medicine programs as well as opportunities for integration of some complementary techniques into standard medical care.     

Hematologic disorders in children from southeast Asia

The overall laboratory features of the common RBC disorders occurring in Southeast Asians is summarized in Table 4. These erythrocyte disorders will continue to be important public health issues, and it has been predicted that most new cases of thalassemia in the United States will occur in this population group. The fertility rate in Southeast Asian families is very high, with an average of more than five children delivered by each married woman. This number of children is consistent with perceptions of ideal family size, and, to date, no evidence suggests any change in the size of Southeast Asian families who now reside in the United States. Moreover, attitudes about health care, reasons why one seeks medical attention, and a variety of other cultural issues may impair the effectiveness of genetic counseling and other preventive measures designed to reduce the incidence of serious blood diseases. Genetic screening and prenatal diagnosis clearly have led to a markedly decreased incidence of homozygous thalassemia disorders in high-risk Mediterranean populations throughout the world. With further assimilation into Western culture, a similar disease may occur in the Southeast Asian population also.     

Comorbidity of substance use disorders with mood and anxiety disorders: results of the International Consortium in Psychiatric Epidemiology

This article reports the results of a cross-national investigation of patterns of comorbidity between substance use and psychiatric disorders in six studies participating in the International Consortium in Psychiatric Epidemiology. In general, there was a strong association between mood and anxiety disorders as well as conduct and antisocial personality disorder with substance disorders at all sites. The results also suggest that there is a continuum in the magnitude of comorbidity as a function of the spectrum of substance use category (use, problems, dependence), as well as a direct relationship between the number of comorbid disorders and increasing levels of severity of substance use disorders (which was particularly pronounced for drugs). Finally, whereas there was no specific temporal pattern of onset for mood disorders in relation to substance disorders, the onset of anxiety disorders was more likely to precede that of substance disorders in all countries. These results illustrate the contribution of cross-national data to understanding the patterns and risk factors for psychopathology and substance use disorders.