Life Stress and Depression in University Students: Clinical Illustrations of Recent Research

Abstract

Through the use of case vignettes, this paper demonstrates the clinical relevance of findings from previously reported research conducted at the University of Toronto. These published studies link life stress to depression in university students. Three psychosocial factors—a family history of psychiatric illness, stressful life events, and lack of social support—are found to be significantly related to depressive symptoms. A fourth psychosocial factor, childhood or adolescent loss of a nurturing person, was not significantly related to the occurrence of depression. However, that factor remains an important therapeutic focus for a number of depressed students. In addition, the absence of at least a single confidant and certain life events (recent loss of a significant person, changes in living arrangements or academic situation, and financial problems) were identified as specific risk factors for depression. Although depression experienced by students is often serious enough to warrant professional intervention, only a minority seek professional help. The majority of those who do seek help are women; male students are less likely to associate somatic symptoms with emotional problems and are less willing to seek psychiatric help. The four case studies presented illustrate the clinical relevance of these research findings.     

Media Exposure or Pressure? The Mediating Role of Nonmediated Norms in Young Adults’ Body Esteem

This study explores how media use, sociocultural, and individual differences factors influence college students’ body esteem. Two hundred seventy-four college students participated in this online survey. Women reported lower body esteem than men. The influence of sociocultural pressure on body esteem was slightly more pronounced among men compared to women. Magazine reading and TV viewing had little bearing on body esteem. Sociocultural pressure was the most influential factor that contributed to both men and women’s low body esteem. Specifically, the most salient predictor of low body esteem for both men and women was influence from family and friends. Not only did peer and family pressure have a direct impact, they also mediated the impact of media pressure on body esteem. This study offers a prime location in which to integrate studies of media influence and interpersonal communication. Limitations and directions for future research are also outlined.     

TOO MANY MEN? SEX RATIOS AND WOMEN'S PARTNERING BEHAVIOR IN CHINA

The relative numbers of women and men are changing dramatically in China, but the consequences of these imbalanced sex ratios have received little attention. We merge data from the Chinese Health and Family Life Survey with community-level data from Chinese censuses to examine the relationship between cohort- and community-specific sex ratios and women's partnering behavior. Consistent with demographic-opportunity theory and sociocultural theory, we find that high sex ratios (indicating more men relative to women) are associated with an increased likelihood that women marry before age 25. However, high sex ratios are also associated with an increased likelihood that women engage in premarital and extramarital sexual relationships and have had more than one sexual partner, findings consistent with demographic-opportunity theory but inconsistent with sociocultural theory.     

Widows and widowers in today's society

With the increasing life span in our society, the number of widowed individuals has increased dramatically. The loss of a spouse is one of the most stressful life events for both women and men, yet there is little nursing research on the physical and psychosocial needs of older adults who are experiencing this loss. Some studies suggest that widowed women and men develop significant physical and mental health problems and complicated grief. Thus, it is important for nurses to recognize the diversity of grieving experiences and the increased vulnerability of widowed individuals to psychiatric illnesses that may result in suffering and impairment of daily functioning. With a better understanding of these needs, nurses can provide interventions that help these individuals maintain their health and independence.     

The Democratic Sex: Gender Differences and the Exercise of Power

ABSTRACT

Few have studied differences between how women and men lead, particularly at the local level. This article addresses this gap by reporting the results of a unique study of 192 female mayors and 192 male mayors in cities with populations of over 30,000 to consider whether the female mayors emphasized different policy issues and whether the women in local leadership created alternative decision-making processes in allocating resources. Overall, the results show similarities on policy issues, the use of power, and budget issues. However, some key gender differences emerge. Female mayors were far more willing to change the budget process, be more inclusive, and seek broader participation. Finally, more women mayors than men were willing to admit fiscal problems and discuss changes in their goals. Women mayors were also more likely than their male counterparts to believe that women face gender-based obstacles in the exercise of leadership.     

Young Adult Substance Use and Depression as a Consequence of Delinquency Trajectories During Middle Adolescence

This longitudinal study extended work from Wiesner and Windle (2004) by examining young adult outcomes (i.e., alcohol and illicit drug use, depression) of middle‐adolescent trajectories of delinquent behavior for a community sample of 724 young women and men (at average ages 23.8 years). Each domain of young adult adjustment problems was assessed with three indicators (i.e., lifetime rates of psychiatric disorders, annual rates of psychiatric disorders, elevated levels of problem behaviors). Findings indicated specificity in trajectory‐outcome associations, with all active offender pathway groups consistently showing poorer adjustment in the domains of young adult alcohol and illicit drug use (but not depression) relative to the rare offenders. However, there was almost no evidence of differential outcomes among the four most active offender trajectory groups. Overall, this study offered limited support for the contention that differing developmental courses and experiences during middle adolescence are linked to differential outcomes in early adulthood.     

Divorce,Stress and Social Supports

This paper considers variations in the use of social supports among persons who are in the process of divorcing. Three hundred and ten men and women aged 20 to 79 were interviewed. Most frequently turned to for help were friends, spouse, and counselors. Men and older respondents were found to seek out supports less frequently than women and younger respondents. Ethnicity and education influenced the pattern more than the frequency of support utilization. For all respondents, perceptions of the degree of stress evoked by the divorce appeared to be a major force behind the use of social supports.     

Improved outcomes following contact with a gambling helpline: the impact of gender on barriers and facilitators

Gambling helplines were developed at a time when evidence for help-seeking was almost entirely based on male gamblers and there is limited evidence that helplines have changed in response to the exponential increase in female gamblers over the past 20 years. The current study aimed to explore the impact of gender on calls to Australian helplines, including caller characteristics, barriers and facilitators to contact as well as call outcomes. We surveyed 170 callers (94% problem gamblers, 61% male) approximately 1 month following their helpline call and found gender differences in terms of age, preferred gambling type, employment and source of referral. Males reported barriers related to pride and problem denial more frequently than females did, and also reported more frequent problems associated with the welfare of others and/or their living arrangements that facilitated their calling. Males and females were equally likely to seek further help from formal, informal and self-help resources. With only 10% of callers not accessing further help, these findings highlight the importance of helplines as a key support for both men and women with gambling problems.     

“I've been independent for so damn long!”: Independence, masculinity and aging in a help seeking context

This paper draws on semi-structured interviews conducted with 36 older men to examine how older men's understandings of independence relate to their help seeking behaviours and health service use. We argue that discourses of masculinity and successful aging are both represented in men's talk about independence. Recognising that these discourses are intertwined is important for understanding how older men seek help and use health services. We outline the practice and policy implications of viewing older men's help seeking behaviours in this way, and how it might be useful for promoting older men's health.     

Gender,Marital Status and Social Support

Abstract

While many studies have examined the separate effects of gender and marital status on patterns of perceived social support, none have examined the simultaneous effects of these two variables while controlling for other relevant variables in a large, random sample. This paper responds to this lacuna by investigating the relationships among these variables for six specific types of problems that may elicit social support from others. Using data drawn from a representative sample of the United States population, results indicate that the perception of sources of social support is primarily shaped by differences in marital status as opposed to gender. However, gender is influential in some situations. While it is not significantly related to the perception of emotional support, gender is significantly related to the perception of instrumental support. (Women manifest a tendency to consider both spouse / partner and relatives as sources of instrumental support more than men, while men rely on friends as sources of instrumental support.) The suggestion that gender may find expression within categories of marital status is supported by findings indicating that, within each of the marital status categories, when men turn to relatives and / or friends for help they tend to be male and when women turn to relatives and / or friends for help they tend to be female. Suggestions for future research are offered.     

Closing the Need-Service Gap: Gender Differences in Matching Services to Client Needs in Comprehensive Substance Abuse Treatment

Despite the broad recognition in social work that services are more effective when they are tailored to individual client needs, we have only limited evidence of the impact that services matched to client needs have on treatment outcomes. This study examines gender differences in the impact of matched services, access services, and outcome-targeted services on substance abuse treatment outcomes by using data collected from 1992 through 1997 for the National Treatment Improvement Evaluation Study, a prospective, cohort study of substance abuse treatment programs and clients. The analytic sample consists of 3,027 clients (1,105 women and 1,922 men) who reported needed services from 59 treatment facilities. Findings from the study indicate that overall programs have only limited success in targeting services to client needs, but when they do, receipt of substance abuse counseling and matched services predicts both remaining in treatment and reduced posttreatment substance use for both women and men, but especially for women.     

The Use of Protective Behaviors in Relation to Gambling Among College Students

The purpose of the current study was to evaluate a measure of gambling protective behaviors and examine the relationship between indices of gambling behavior, including frequency, quantity and problem severity, and the use of gambling protective behaviors. Undergraduates from a large public university (N = 4,014) completed a web-based screening survey comprising measures of gambling and health behaviors, from which those who gambled within the past 6-months (n = 1,922, 48 % of the entire sample) were invited to complete the baseline assessment, including the Gambling Protective Behavior Scale (GPBS). The GPBS was determined to have two subscales, primarily consisting of harm reduction strategies that reduce the money or time spent on gambling, or avoidance strategies that help to minimize engagement in gambling activities. Hierarchical multiple regressions found participants’ sex moderated the relationship between use of protective behavioral strategies and gambling outcomes. However, effects were in the opposite direction to those hypothesized. Specifically, because women gambled less, had lower gambling problem severity, and reported more frequent use of gambling avoidance protective behaviors, the relationship between use of gambling protective behaviors and gambling outcomes was stronger for men than women. Men who used more avoidance strategies gambled less frequently compared to men who used fewer avoidance strategies. Similarly, men who used more harm reduction strategies spent fewer dollars on gambling and had lower scores on gambling problem severity compared to men using fewer harm reduction strategies for women these relationships were less pronounced. Implications of incorporating specific gambling protective behavioral strategies into prevention and treatment programs are discussed.     

CAUSES AND CONSEQUENCES OF LAYOFFS

Using probit analysis, this article finds that differential treatment accounts for a substantial portion of the higher layoff rates of blacks in comparison to whites. However, women are found to be considerably less prone to layoffs than men with similar characteristics. Among those who obtained subsequent employment (taking into account the possible selectivity bias in such a subsample), white males are hurt more by layoffs than black males in terms of both short-term and long-term earnings growth; women's earnings are not necessarily affected by layoff at all. However, whites and males are found to be more likely to be reemployed than blacks and females, respectively.     

Differential Labeling of Mental Illness Revisited: Patterns Before and After the Rise of Managed Care

With the National Comorbidity Survey of the early 1990s, Thoits (2005) recently showed that lower-status mentally ill individuals were not more often hospitalized or pressured into psychiatric treatment than comparably ill persons of higher status, disconfirming a central hypothesis of labeling theory. However, that finding may have been due to changes in the mental health treatment system introduced by the spread of managed care. The differential labeling hypothesis is reexamined here with data from the Epidemiological Catchment Area Studies (ECA) collected in the early 1980s before managed-care plans began to dominate the insurance marketplace and from the National Comorbidity Survey Replication conducted in the early 2000s when managed care had saturated the market. Little systematic support for the differential labeling hypothesis was found in the three studies, although, over time, the higher rates of mental hospitalization among less educated and low-income individuals found in the ECA survey disappeared. Trends across the studies suggest that educated and affluent persons with psychiatric problems more frequently sought hospital care. These findings further undermine the validity of the differential labeling hypothesis and suggest that service utilization or treatment-seeking factors may help explain mental hospitalization rates.     

Sex differences in psychosocial consequences of alcohol and drug abuse

This paper reports analyses of the 1985 National Household Survey on Drug Abuse to evaluate three perspectives on sex differences in the relationship of psychosocial problems to levels of substance use. The results are more consistent with a styles of deviance perspective than with either the generalized feminine vulnerability or the convergence theses. Compared to women, men report higher levels of alcohol and drug abuse during the past year and are more likely than women to have experienced each of 17 psychosocial problems resulting from alcohol or drug use. Significant sex by substance use interaction tests for problem indices and for individual problems suggest that substance abuse is related more strongly to intrapsychic problems among women and to problems in social functioning among men. Decompositions of the sex differences in mean levels of psychological and social/behavioral problems suggest that most of the differences can be explained by males' greater frequency of intoxication and drug use.     

Assessing Sexual Abuse/Attack Histories with Bariatric Surgery Patients

This study assessed sexual abuse/attack histories in 537 bariatric surgery patients using the PsyBari. The prevalence rates found were lower (15.5%, 19.3% of women, 5.2% of men) than other studies that used bariatric surgery patients but consistent with studies that used nonbariatric obese subjects. Furthermore, bariatric surgery patients who disclosed sexual abuse/attack were more likely to disclose physical abuse, psychological problems, psychological treatment, psychiatric medication, and psychiatric hospitalization. Among bariatric surgery patients who disclosed sexual abuse/attack, females were more likely to disclose suicidal ideation. A logistic regression found that for females, physical abuse and suicidal ideation reliably predicted abuse/attack status. For males, psychological problems, psychiatric medications, hospitalization, and suicidal ideation, reliably predicted abuse/attack status.     

An Interplay of Individual Motivations and Sociocultural Factors Predisposing Men to Acts of Rape in Kenya

ABSTRACT

There is a general public perception in Kenya that rapists are “sick” people who deserve to be put far away from the society. Consequently, rape perpetrators are left to be dealt with by the criminal justice system while most of the research has focused on the rape survivors without taking into consideration the need to explore and understand the motivations and sociocultural factors that could predispose men to rape. This paper examines this form of “deviant” sexuality characteristic of some men. The paper is based on findings of a study conducted in three main prisons in Kenya between January and March 2008. The study sample was drawn from the Kamiti, Naivasha, and Nyeri main prisons. Respondents were convicted rapists serving their jail terms. The findings suggest that a number of factors may predispose a man to rape. These factors could be either individual motivational factors, sociocultural factors, or a combination of both. The individual motivational factors identified included drug consumption, marital problems as an excuse for rape, inability to negotiate for consensual sex due to being shy or afraid of women, rape as a form of sexual access, psychological factors like pornographic influence and rape hallucinations, impersonal sex and power, and use of rape as a “tool” for punishment. On the other hand, the sociocultural factors identified included the view of rape as a sexual act rather than an act of violence, social attitude that the woman “invited” the rape, early childhood environment, cultural practices, peer influence, and a lack of parental advice on sexual activities.     

Substance Use Patterns and Consequences Among Lesbians,Gays, and Bisexuals

Substance abuse among gays and lesbians may be considered a “neglected area” of drug use research in criminology and criminal justice. In the current study, we seek to address the lack of scientific inquiry on substance use among lesbians, gays, and bisexuals by drawing from an availability sample of 179 lesbian, gay, and bisexual (LGB) adults to examine substance use patterns as well as the relationship of self-esteem with problems associated with using alcohol and drugs. Results showed consistency in the frequency of tobacco, alcohol, marijuana, and cocaine use in the past year; however, more gay and bisexual men than gay and bisexual women reported problems stemming from substance use.     

Traditional versus Western perceptions of mental illness: women of Moroccan origin treated in an Israeli mental health center

This paper focuses on the problems encountered in providing Westernized psychiatric treatment to a population with traditional healing beliefs. The sample comprised women of Moroccan origin living in Israel undergoing treatment for psychiatric disorders (N=38), and their treating psychiatrists (N=9). Ethnographic interviews were conducted among both groups. The results revealed that the symptoms, perceptions of the illness, and problems encountered in the therapeutic relationship differed across three age groups, young women (20–30 years), more mature women (31–42 years), and older women (43–60 years). While cultural conflict appeared to affect the development of mental illness in each group, this was most pronounced among women in the middle age range. Moreover, problems in the therapeutic alliance were greatest in this age group. The data from the therapists indicated that they maintained a Western perspective in both their understanding and diagnoses of these patients' illnesses. The different perspectives of the therapists and each of the three groups of women are discussed. It is concluded that professionals treating traditional populations must avoid imposing Western standards, and consider the treatment in the context of cultural beliefs. The developmental stages of the individual, and the stage of acculturation must also be taken into account if treatment is to be effective.     

Gender and the Mental–Physical Health Connection Among U.S. Adults

Using data from the 1995, 1998, and 2001 panels of Aging, Status, and Sense of Control (ASOC) Survey, we examine gender differences in the relationship between self‐rated physical health and mental health over time (n = 2,543). Gender‐stratified path models highlight how the nature of the mental–physical health relationship changes when we use indicators of mental health that have traditionally been labeled as female sensitive (depression) or male sensitive (heavy drinking). Results show that women and men are similar in that mental health has a stronger effect on physical health than the reverse. However, this is only the case when we use gender‐sensitive measures of mental distress: Men who drink heavily and women who are depressed report poorer self‐rated physical health over time, while heavy drinking for women and depression for men have no significant effects on their self‐rated physical well‐being. These results provide evidence of a health process that is gendered in its expression but more universal in its outcome—the exact measure might vary, but men and women alike are physically harmed by mental health problems.