Nine-year psychiatric trajectories and substance use outcomes: an application of the group-based modeling approach

This study identifies longitudinal psychiatric trajectories of 934 adult individuals entering chemical dependency treatment in a private, managed care health plan and examines the relationship of these trajectories with substance use (SU) outcomes. The authors apply a group-based modeling approach to identify trajectory groups based on repeated measures of psychiatric severity for 9 years and identify four distinct groups. Results of multivariate logistic generalized estimating equation models find an association between psychiatric trajectories and long-term SU. Older cohorts and life course measures of marital status and employment status as individuals changed over time are related to drug and some alcohol outcomes.     

Parental health and children's economic well-being

The life course perspective emphasizes that past economic experiences and stage in the life course influence a family's ability to cope with negative life events such as poor health. However, traditional analytic approaches are not well-suited to examine how the impact of negative life events differs based on a family's past economic experiences, nor do they typically account for the potentially spurious association between negative life events and family economic well-being. We use finite mixture modeling to examine how changes in parental health affect children's exposure to poverty. We find that for some children the association between family head's health and children's exposure to poverty is spurious, while for other children family head's poor health is associated with increased risk of economic deprivation. The extent to which a family head's poor health alters children's economic well-being depends on a child's family's underlying economic trajectory and past history of exposure to disadvantage.     

Relationship education among incarcerated populations

Abstract

Incarceration represents a significant shift in the life course trajectories of the nearly seven million inmates in the American criminal justice system and their families and can have far-reaching effects on intimate and family relationships. Prior research has highlighted the relationship difficulties that inmates face while incarcerated and upon their release. Using a life course perspective, we review the disruptive impact of incarceration on relationships. We examine how relationship education targeted to incarcerated individuals may be an opportunity to provide knowledge and skills that help improve and maintain healthy relationships both during incarceration and upon release. Relationship education courses have consistently been shown to be effective within a variety of settings, and preliminary studies indicate that they may be effective within incarcerated populations as well.     

Conceptualizations of Family by Older Gay Men

SUMMARY

Gay lives challenge historically dominant understandings of family. Given that definitions of family have been heterosexually based, how do non-heterosexuals define and understand “family?” Drawing from the family life course perspective, we propose that contemporary cohorts of older gay men represent a strategic vantage point for understanding innovations in family life, and thus expand current understandings of a gay life course. We use data from an interview study of gay men over the age of 50 who talked about their family relationships. While providing diverse definitions of family, biological ties and closeness were two consistent dimensions for defining both positive and negative family relationships by these older gay men. Narratives of coming out were central to discussions of current relationships with parents and children. The findings from this study indicate that sexual orientation influences life trajectories and transitions and point to useful avenues for further research on contemporary family life.     

Life events and peer substance use and their relation to substance use problems in college students

Substance use disorders among college students are not well understood, and the present study examined the relationship of two environmental factors to alcohol and drug use problems in 616 (316 women) college students. Participants completed measures assessing substance use problems, life events, and substance use among peers. Alcohol use problems were significantly associated with higher drug use problems and regular use of illicit drugs among friends. Drug use problems were significantly associated with male gender, higher alcohol use problems, regular use of alcohol and drugs among friends, illicit drug use among romantic partners, and higher numbers of negative life events. Results extend previous research and suggest that college students who experience multiple negative life events and/or affiliate with substance using friends and romantic partners may be at risk for developing a substance use problem.     

Persistence and desistance in heavy cannabis use: the role of identity,agency, and life events

Many cannabis users ‘mature out’ of their drug use, and factors of cannabis use cessation have been identified. However, very little in-depth knowledge is available about the mechanisms underlying this phenomenon. Criminological studies have gained interesting insights in desistance from crime, yet these perspectives are rarely used in drug research. This qualitative, three-year longitudinal study explored the processes involved in desistance from frequent cannabis use for young adults. Using a narrative approach, desisters (frequent users who successfully quit their cannabis use) and persisters (frequent users with a persistent desire and unsuccessful attempts to quit) were compared. In the course of the study, desisters mainly exhibited increasing agency and goal setting, established strategies to achieve these goals, and could envision another self. Desistance was generally induced by life events that became turning points. Persisters experienced largely similar events, but lacked goals and strategies and held external factors responsible for their life course and failed quit attempts. Identity change is at the core of desistance from frequent cannabis use, and the meaning-giving to life events and experiences is essential. Agency is a necessary ingredient for desistance, develops over time and through action, and leads to a new drug-free identity with desistance in turn increasing agency.     

The place of sociology in a drug education curriculum

This article gives consideration to the part a sociological perspective can play in a drug education curriculum. Sociology's study of human behavior from the context of various social groupings is considered appropriate to any understanding of drugs and drug use, as are a number of substantive areas common to the discipline. The sociological perspective is examined from the broad foci of structure and process, and with each focus examples of a sociological approach to drug use is offered. The common concerns of these approaches, as well as their points of divergence, are discussed. A sample outline of a course in "Drugs and Society" is also presented, suggesting the ways in which the sociological issues discussed could provide an orientation to the study of drug use in a social context.     

Stress in Childhood and Adulthood: Effects on Marital Quality Over Time

We work from a stress and life course perspective to consider how stress affects trajectories of change in marital quality over time. Specifically, we ask whether stress is more likely to undermine the quality of marital experiences at different points in the life course. In addition, we ask whether the effects of adult stress on marital quality depend on childhood family stress experiences. Growth curve analysis of data from a national longitudinal survey (Americans' Changing Lives, N = 1,059 married individuals) reveals no evidence of age differences in the effects of adult stress on subsequent trajectories of change in marital experiences. Our results, however, suggest that the effects of adult stress on marital quality may depend on childhood stress exposure. Stress in adulthood appears to take a cumulative toll on marriage over time-but this toll is paid primarily by individuals who report a more stressful childhood. This toll does not depend on the timing of stress in the adult life course.     

How parental drug use and drug treatment compliance relate to family reunification

This study uses Cox regression to assess the relationships among parental drug use, drug treatment compliance, and reunification from substitute care. The study finds that drug treatment compliance is associated with faster reunification, even when accounting for ongoing drug use and three parenting measures. The findings are consistent with a conceptual framework suggesting that certain client actions, such as drug treatment compliance, may serve as markers that substantially affect client outcomes.     

The Developmental Life Course Perspective: A Conceptual and Organizing Framework for Human Behavior and the Social Environment

The developmental life course perspective (DLC) focuses attention on the socio-historical context in which we live our lives as it influences opportunities and life events that produce cumulative advantage or disadvantage. These large contextual forces shape preference and behavior, and it is within this context that the individual exerts personal agency. This perspective has particular utility as a conceptual framework for human behavior and the social environment courses as it integrates individual-level behavior within a social forces context. This article describes the DLC and its application as both a conceptual and an organizing framework for human behavior and the social environment courses at the masters level. It is illustrated with a case example.     

A life course approach: research orientations and future challenges

The need to study lifelong changes in health and functioning has resulted in increasing emphasis on a life course approach in different fields of inquiry. The aim of this approach is to explore how biological, psychological, and social risk factor trajectories, acting across the entire life course, influence age-related diseases, functional decline, and disability. The importance of the first years of life upon later development and adult characteristics was generally recognized already in the first half of the twentieth century, but it was not until the 1990s that different strands of medical and social research converge in the field of life course epidemiology, in which epidemiological processes are approached using different models such as biological programming, critical periods, pathways, and accumulation. The biological programming model holds that organ development in utero and early infancy determines the maximum functional capacity that an individual can attain and influences the development of certain chronic diseases later in life. The critical period model extends the idea to include child development and key social transitions over the entire life course. The pathway model focuses on the cumulative effect of life events along the developmental trajectories, with early advantage or disadvantage setting a person on a pathway to a later etiologically important exposure. The accumulation model describes the underlying social, behavioral, and biological processes that drive the impact of the life course on health. The growing focus on life course determinants of aging also has implications for studies of long-term changes in physical activity and their role in determining both gains and losses of health and functioning with aging. A life course approach presents great challenges for the continued development of testable theoretical models and effective study design and analysis.     

Incorporating children's lives into a life course perspective on stress and mental health

Emerging themes in demography, developmental medicine, and psychiatry suggest that a comprehensive understanding of mental health across the life course requires that we incorporate the lives of children into our research. If we can learn more about the ways in which the stress process unfolds for children, we will gain important insights into the factors that influence initial set points of trajectories of mental health over the life course. This will simultaneously extend the scope of the stress process paradigm and elaborate the life course perspective on mental health. Incorporating children's lives into the sociology of mental health will also extend the intellectual influence of the discipline on sociomedical and biomedical research on mental illness. I contend that sociology's greatest promise in understanding trajectories of mental health across the life course lies in a systematic analysis of the social and social-psychological conditions of children, the stressful experiences that arise out of these conditions, and the processes that mediate and moderate the stress process in childhood. In this regard, there are three major issues that sociologists could begin to address: (1) the identification of structural and institutional factors that pattern children's exposure to stress; (2) the construction of a stress universe for children; and (3) the identification of key elements of the life course perspective that may set or alter trajectories of mental health in childhood and adolescence.     

Stress,Coping, and Mental Health Differences among Homeless People

People who are chronically homeless are assumed to have higher rates of mental health problems than episodically or new‐entry homeless individuals. It is unclear to what extent early‐life and current stressors account for this disadvantage. Guided by cumulative disadvantage theory and stress research, we analyze data from a national study of the US homeless population to examine how stressors and coping resources throughout the life course are implicated in differences among homeless people in psychiatric disorders and alcohol or other drug abuse disorders. Logistic regression analysis reveals that new‐entry homeless persons are less likely than their chronically and episodically homeless counterparts to have current psychiatric disorders. This is explained by stressors and coping resources experienced in childhood and during adult homeless spells. Alcohol and other drug abuse is common but comparable across the three homeless types and shares an association with selected stress and coping measures. Findings lend credibility to an accumulation of risks perspective, highlighting how past as well as contemporaneous stressors are related to the mental health of homeless people.     

Interactive and higher-order effects of social influences on drug use.

The study of moderators and higher-order effects of social influences on drug use has many implications for theories of health behavior. In the present study, we investigated the longitudinal predictive effects of some of the prominent moderator variables that represent forms of susceptibility toward social influence in teenage drug use. We also studied the possibility that social influence may predict drug use in nonlinear (quadratic) forms, consistent with theories proposing that threshold or decelerating effects may occur in social influences on normatively sanctioned behaviors. Results showed that several of the interactive and quadratic predictive effects were significant. The findings supported the views that certain moderator variables act as buffers, which either protect the individual from social pressures to use drugs, or make the individual more susceptible to such pressures. In addition, two of the obtained quadratic effects of social influence lent support to the application of social impact theory to drug use. Overall, our findings suggest that interactive and nonlinear approaches to social influences on drug use provide a unique and viable theoretical perspective from which to construe this problem health behavior.     

Race-Ethnicity and Health Trajectories: Tests of Three Hypotheses across Multiple Groups and Health Outcomes

Racial-ethnic disparities in static levels of health are well documented. Less is known about racial-ethnic differences in age trajectories of health. The few studies on this topic have examined only single health outcomes and focused on black-white disparities. This study extends prior research by using a life course perspective, panel data from the Health and Retirement Study, and multilevel growth curve models to investigate racial-ethnic differences in the trajectories of serious conditions and functional limitations among blacks, Mexican Americans, and whites. We test three hypotheses on the nature of racial-ethnic disparities in health across the life course (aging-as-leveler, persistent inequality, and cumulative disadvantage). Results controlling for mortality selection reveal that support for the hypotheses varies by health outcome, racial-ethnic group, and life stage. Controlling for childhood socioeconomic status, adult social and economic resources, and health behaviors reduces but does not eliminate racial-ethnic disparities in health trajectories.     

Personality, drug preference, drug use, and drug availability

This study examined the relationship between drug preference, drug use, drug availability, and personality among individuals (n = 100) in treatment for substance abuse in an effort to replicate the results of an earlier study (Feldman, Kumar, Angelini, Pekala, & Porter, 2007) designed to test prediction derived from Eysenck's (1957, 1967) theories. Drug preference was measured by the method of paired-comparison and personality was measured with the Zuckerman-Kuhlman Personality Questionnaire-50 CC. Contrary to expectations, high compared with low scorers on Sociability and Impulsive-Sensation Seeking preferred depressants. Surprisingly, low compared with high scorers on neuroticism did not differ in preference for alcohol. As in the previous study, drug preference, use, and availability were highly correlated, although ease of availability was slightly more predictive of drug use than drug preference. Clinical and theoretical implications are discussed.     

Parenthood, Childlessness, and Well-Being: A Life Course Perspective

This article reviews recent research (1999 - 2009) on the effects of parenthood on wellbeing. We use a life course framework to consider how parenting and childlessness influence well-being throughout the adult life course. We place particular emphasis on social contexts and how the impact of parenthood on well-being depends on marital status, gender, race/ethnicity, and socioeconomic status. We also consider how recent demographic shifts lead to new family arrangements that have implications for parenthood and well-being. These include stepparenting, parenting of grandchildren, and childlessness across the life course.     

A Tale of Two Contexts: U.S. Migration and the Labor Force Trajectories of Mexican Women

Even though women have long participated in Mexico–U.S. migration studies assessing the labor market implications of international mobility for women are rare. Especially lacking are studies that follow a life‐course approach and compare employment trajectories across contexts and in connection with other transitions. Using life‐history data collected in Mexico and the U.S., we explore the impact of migration on women's employment, focusing on how the determinants of employment vary across contexts. We show that U.S. residence eliminates or even reverses the employment returns to education found in Mexico and that the constraints imposed on women's work by marriage are actually stronger in the U.S. context. We also explicitly connect migration to other life‐course events, documenting how the impact of context varies not only by marital status but also by where women's unions were formed.     

Patterns of Work and Schooling in Young Adulthood

If the years of late adolescence and early adulthood are depicted as rocky, disorderly, and experimental, then how should the life course stage that immediately follows be characterized? Using data from the National Longitudinal Study of the High School Class of 1972, we focus on work and school activities in the latter half of the young adult years (ages roughly 25–31) to empirically address whether the diversity of work and schooling patterns diminishes. Finding a lack of orderliness in work and schooling trajectories, and that holding two or more activities simultaneously is quite common, we question how this stage of the life course should be conceptualized. Moving away from the traditional sequential roles approach, we use multinomial logistic regression to differentiate among activity sequences commonly held by young men and women at these ages, and address how family of origin background factors and prior life experiences influence life course experiences in the later 20s and early 30s.