Marital transitions and mental health

Most research identifies marital disruption as a precursor for poor mental health but is generally unable to discount the potential selection effect of poor mental health leading to marital disruption. We use data from nine annual waves of the British Household Panel Survey to examine social selection and social causation as competing explanations. Mental health is measured using the general health questionnaire. We examine mental health at multiple time points prior to and after a marital transition through separation or divorce and compare this process to those who experience widowhood. All groups transitioning out of marriage have a higher prevalence of poor mental health afterwards but for those separated or divorced, poor mental health also precedes marital disruption, lending support to both social-causation and social-selection processes. The processes both preceding and after the transition to widowhood differ, with increased prevalence of disorder centering around the time surrounding the death itself     

Marital status, marital transitions, and health: a gendered life course perspective

We work from a life course perspective to assess the impact of marital status and marital transitions on subsequent changes in the self-assessed physical health of men and women. Our results suggest three central conclusions regarding the association of marital status and marital transitions with self-assessed health. First, marital status differences in health appear to reflect the strains of marital dissolution more than they reflect any benefits of marriage. Second, the strains of marital dissolution undermine the self-assessed health of men but not women. Finally, life course stage is as important as gender in moderating the effects of marital status and marital transitions on health.     

Marital trajectories and mental health

This study expands the marital status and mental health literature by examining several dimensions of marital trajectories, including the number and type of prior marital losses and duration in current status. Data are drawn from the Piedmont Health Survey of the National Institute of Mental Health Epidemiologic Catchment Area Study, collected in 1982-83 (n = 2,158). Results indicate that number of prior losses moderates the health-enhancing effect of being currently married; higher order marriages are associated with worse mental health. Although results vary across the mental illnesses examined (depression, anxiety, and substance use), the negative effect of multiple loss also is observed for the currently divorced and widowed. There is less evidence that the type of prior loss (i.e., divorce or widowhood) moderates the effect of current marital status on mental health; however, some support is found among the presently widowed. The analyses of duration in current status suggest that the rate of decline in symptoms of anxiety following one's most recent loss varies by marital history among the currently widowed.     

Marital status, social support, and health transitions in chronic disease patients

Married persons tend to be healthier, both physically and mentally, than unmarried persons. We tested the hypothesis that being married results in better physical and mental health outcomes for chronic disease patients (N = 1,817) by increasing social support. We modeled health outcomes one year later, controlling for initial health status. Cross-validation studies of two random halves of the sample supported an indirect effect of marital status on mental health through social support, but did not support a relationship, direct or indirect, of either marital status or social support with physical health outcomes. In addition, specific types of functional support were not differentially predictive of mental health status.     

Revisiting the relationships among gender,marital status,and mental health

Three decades ago, Grove introduced his sex-role theory of mental illness, which attributes women's higher rates of psychological distress to their roles in society. Central to his hypothesis is that marriage is emotionally advantageous for men and disadvantageous for women. This article revisits this topic with data from the National Survey of Families and Households. The analyses indicate that the emotional benefits of marriage apply equally to men and women, but that men and women respond to marital transitions with different types of emotional problems. The implications of these findings for future research on gender and mental health are discussed.     

Marital distress,co-occurring depression,and marital therapy: a review

This article reviews several factors that contribute to marital distress and co-occurring depression and also reviews empirically supported therapies. Gender contributes to marital distress and depression but does not appear to be the cause of either. Marital distress and depression appear to have bidirectional influence on each other. The depressed spouse's depression has a marked impact on the marital adjustment of the nondepressed spouse. Both marital distress and depression appear to be chronic. It is recommended that treatment be designed to help couples be supportive of each another, to adapt, and to cope with the depressive symptoms within the framework of their ongoing marital relations.     

Hospital-to-community transitions. A bridge program for adolescent mental health patients

Making the transition from the hospital to a community setting can be extremely challenging for patients with acute mental health conditions. Transitional services have been created to help patients overcome difficulties associated with this transition. Nurses frequently play an integral role in the success of these services. By providing patients with individualized support during such transitions, nurses act as clinical liaisons and directly contribute to an increase in positive patient and system-level outcomes. This article describes a transitional service called the Bridge Program, designed to help adolescents make a successful transition from the hospital to the community. An overview of the Bridge Program is provided, and the results of an evaluation of this program are presented. Results suggest that the Bridge Program contributes to a decrease in the length of hospital stays and improves continuity of care for patients and their families.     

Characteristics of effective providers of marital and family therapy in rural mental health settings

Characteristics of effective providers of marital and family therapy (MFT) in rural mental health settings were investigated. The survey sample included 74 members of the National Association for Rural Mental Health who, through a modified Delphi process, created a composite picture of effective MFT providers. The findings yielded six major rank-ordered characteristics of effective MFT providers in rural mental health settings, with effective skills in MFT ranked first. Rural community understanding, appreciation and participation ranked second. Specific competencies contributing to each major characteristic were also identified and are discussed. Recommendations for use of this information are provided.     

Attitudes and beliefs about mental health among African American older adults suffering from depression

Depression among older adults is a major public health concern leading to increased disability and mortality. Less than 3% of older adults utilize professional mental health services for the treatment of depression, less than any other adult age group. And despite similar rates of depression, African Americans are significantly less likely to seek, engage and be retained in professional mental health services than their white counterparts. Cultural differences in the way depression symptoms are manifested, defined, interpreted and labeled may in part explain some of these racial differences in help-seeking behaviors. Focus group methodology was utilized to identify and explore attitudes and beliefs about depression and mental health treatment utilization among 42 older African Americans who had recently suffered a major depressive episode. Thematic analysis of identified six overarching themes: (a) perceptions of depression, (b) the African American experience, (c) seeking treatment as a last resort, (d) myths about treatment, (e) stigma associated with seeking treatment and (f) culturally appropriate coping strategies. We discuss implications for practice, education and research.     

Marital status,sex, and suicide: new longitudinal findings and Durkheim’s marital status propositions*

Abstract

The purpose of the paper was to use new longitudinal data to investigate the impact of marital status on suicide, and test Durkheim’s marital status propositions. Previous research found marital status was associated with suicide, but some studies neglected sex, most of the research was cross-sectional, and divorce and separated statuses were often combined. Data were obtained from the latest release of the U.S. National Longitudinal Mortality Study (NLMS), consisting of the largest U.S. sample of suicide victims, 2,013 out of 1.5 million persons. Proportional hazards and logistic regression models were fitted to the NLMS data based on follow-up from 1990 to 2011. Results showed that when combined, the divorced and separated were over 88% more likely to suicide than the married (ARR = 1.886, CI = 1.649, 2.156). When split, the divorced had suicide risk that was over 97% higher than that of the married (ARR = 1.973, CI = 1.711, 2.274). Separated individuals experienced suicide risk that was nearly 52% greater than that of the married (ARR = 1.515, CI = 1.130, 2.037). The Mountain and southern census divisions had higher suicide risks than New England. Discussion focused mainly on Durkheim’s theory of suicide.     

Motherhood,homeschooling, and mental health

Homeschooling fits neatly under the umbrella of intensive mothering, a prominent parenting style in the United States. Intensive mothering has been shown to increase the emotional distress of mothers, which may be exacerbated when mothers take on the additional burden of being responsible for the formal education of their children. Given that intensive mothering ideologies negatively impact maternal mental health, it makes sense to examine how homeschooling may exacerbate this outcome. In this paper, I examine the literature on intensive mothering, homeschooling, and mental health to demonstrate a need for further exploration to show how homeschooling mothers, encouraged by intensive mothering ideologies, may be putting their mental health, and more, at risk in their endeavors to be both “good mothers” as well as “good teachers.”     

Marijuana use, introspectiveness, and mental health

Conflicting evidence suggests that marijuana use may be associated with either positive or negative mental health. This study explores the possibility that the association of marijuana use with mental health differs among various subgroups of users. Specifically, we investigate the hypothesis that marijuana use and the personality disposition of introspectiveness interact in their effects on psychological well-being. Results support this hypothesis and show that marijuana use is associated significantly with psychological distress for highly introspective individuals. In contrast, marijuana use has no such association for those low on introspectiveness. Additional evidence shows that marijuana use involves primarily self-oriented cognitive and emotional experiences for highly introspective individuals, whereas for those low on introspectiveness it is characterized more often by perceptual distortions and sensorimotor sensations.     

The Coalition,austerity and mental health

In the United Kingdom, the Coalition government’s recent commitment to improving mental health provision masks the extent that their policies of austerity have already brought harm to those same services. Government-driven policies have led to significantly reduced funding within mental health, increasing pressure on a system that was already chronically under-resourced. Further, people who are experiencing mental distress, and mental health service users, have been especially vulnerable to the harms of the current austerity programme, including being at the sharp end of the assault on public services and welfare spending. This piece discusses the impact of austerity, exploring the effects of government policies and with a critical perspective of the dominant discourses around mental health. It argues that by exacerbating social inequality, government policies are also directly leading to worsening mental health in the United Kingdom.