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.     

Creation and evaluation of a maternal mental health course

Perinatal Mood and Anxiety Disorders (PMADs) engender significant and increasing personal, social, developmental, and economic burdens to women, children, families, and global public health. In the US, a Master of Social Work (MSW) elective course, Introduction to Maternal Mental Health, was created to prepare future social workers to better understand, detect, intervene, and advocate with women struggling with perinatal mental health concerns. A pilot study used pre–post-surveys (N = 10) and a focus group to examine students’ knowledge acquisition, course satisfaction, and perceived self-efficacy. A Wilcoxon signed-rank test showed a statistically significant difference between pre- and post-survey course content knowledge scores. Positive focus group feedback and survey outcomes suggest that students benefitted from the course in terms of increased learning and professional efficacy in maternal mental health; however, the study should be replicated using a larger sample and comparison group. The course outline provided may be used to develop a similar course or to infuse maternal mental health content into existing courses. The paper concludes with implications and recommendations for social work educators.     

Disaster mental health services: a personal perspective

1. Services that may be provided by psychiatric-mental health nurses following a disaster include education, intervention, problem solving, advocacy, and referral. 2. Nurses providing disaster mental health services must be flexible and creative. Strong observational skills and teamwork are also essential characteristics in disaster settings. 3. Psychiatric-mental health nurses who wish to receive training for disaster mental health volunteer opportunities should contact their local chapter of the American Red Cross.     

The temporal landscape of shoes: a life course perspective

This empirically grounded article draws on an ESRC‐funded project on footwear, identity and transition to offer new understandings of how a linear model of the life course may, in practice, be disrupted, subverted or reconfigured. Combining the insights of material culture and life course studies, it develops the notion of a temporal landscape of shoes within which their scope for interrupting life course temporalities can be explored. In particular, it identifies four temporal strategies made possible through the symbolic efficacy of footwear: the retrieval of an earlier identity through the purchase of styles previously worn; the deferral of later life by rejecting comfortable shoes that might symbolically reposition someone as ‘old’; the release of former age‐based identities and the embracing of freedom from a felt need to wear impractical or painful shoes; the appropriation or reconfiguring of the past as a contemporary resource through the wearing of vintage/hand‐me‐down shoes.     

Green grey hairs: A life course perspective on environmental engagement

ABSTRACT

Older adults provide a long view of understanding environmental engagement from their early beginnings to their current community activities. This study draws on interviews with self-described environmentalists and follows a life course analysis that employs social work values and practice skills as they work towards environmental justice in their Midwestern communities. We conclude that the older adults of this second generation of environmentalists offer valuable lessons for social workers with regard to environmental justice, while at the same time contributing insights into older adult volunteering and addressing the challenge of a generational gap in participation in their community organizations.     

Referrals, language proficiency, and enrolment for children's mental health services

Alberta Health Services maintains a database of children, adolescents and adults referred to the child and adolescent mental health and psychiatry intake service. In this study, we sought to systematically assess the impact, if any, of English language proficiency on enrolment of children for mental health services. Specifically, we assessed the extent to which children referred for mental health services were enrolled. In doing so, we categorized our sample (12,143) as English Proficient (EP), or Less English Proficient (LEP). Overall, we found that LEP children were significantly less likely to be enrolled compared to EP children. This disparity in enrolment was only present when other variables were not taken into account. English Proficiency is an important factor for some subgroups.     

Improving physical and mental health in frontline mental health care providers: Yoga-based stress management versus cognitive behavioral stress management

The need for brief, low-cost, easily disseminable, and effective interventions to promote healthy lifestyles is high. This is especially true for mental health providers. The authors developed two studies to compare the impacts of Cognitive Behavioral Stress Management (CBSM) and Yoga-Based Stress Management (YBSM) interventions for health care professionals. Study 1 offered an 8-week YBSM intervention to 37 mental health care participants and collected health data pre- and post. Study 2 offered YBSM and CBSM classes to 40 randomly assigned mental health care providers and collected mental and physical health data at four time points. In Study 1, using t tests, the YBSM intervention affected a number of mental and physical well-being indices pre to post. In Study 2, using linear mixed modeling, YBSM and CBSM groups both improved significantly (p?p?F?=?4.34), physical activity (YBSM increased more, p?F?=?3.47), overall mental health (YBSM increased more, p?F?=?5.32), and secondary traumatic stress (YBSM decreased more, p?F?=?4.89). YBSM and CBSM appear to be useful for health care professionals’ mental and physical health. YBSM demonstrates some benefit above and beyond the extremely well studied and empirically supported CBSM, including increased physical activity, overall mental health, and decreased secondary traumatic stress benefits.     

The life course perspective on drug use: a conceptual framework for understanding drug use trajectories

This article discusses the life course perspective on drug use, including conceptual and analytic issues involved in developing the life course framework to explain how drug use trajectories develop during an individual's lifetime and how this knowledge can guide new research and approaches to management of drug dependence. Central concepts include trajectories marked by transitions and social capital and turning points influencing changes. The life course perspective offers an organizing framework for classifying varying drug use trajectories, identifying critical events and factors contributing to the persistence or change in drug use, analytically ordering events that occur during the life span, and determining contributory relationships.     

Childhood health and labor market inequality over the life course

The authors use data from the Health and Retirement Study's Earnings Benefit File, which links Health and Retirement Study to Social Security Administration records, to estimate the impact of childhood health on earnings curves between the ages of 25 and 50 years. They also investigate the extent to which diminished educational attainment, earlier onset of chronic health conditions, and labor force participation mediate this relationship. Those who experience poor childhood health have substantially diminished labor market earnings over the work career. For men, earnings differentials grow larger over the early to middle career and then slow down and begin to converge as they near 50 years of age. For women, earnings differentials emerge later in the career and show no evidence of convergence. Part of the child health earnings differential is accounted for by selection into diminished educational attainment, the earlier onset of chronic disease in adulthood, and, particularly for men, labor force participation.     

Effects of goal-striving stress on the mental health of black Americans

Although many scholars have theorized about how responding to the stress of blocked opportunities can affect the well-being of black Americans, few scholars have empirically examined the relationships between striving efforts, personal goals, and mental health among black Americans. This investigation examines the relationship between goal-striving stress and mental health in a national sample of black Americans. Results indicate that goal-striving stress is significantly related to lower levels of happiness, life satisfaction, self-esteem, and higher levels of psychological distress. We find that poverty status moderates the relationship between goal-striving stress and mental health. Compared to poorer persons, individuals above poverty with high goal-striving stress have significantly lower levels of happiness and life satisfaction. Overall, the findings provide a more complete context for understanding associations among socioeconomic status, goal-striving stress, and adverse mental health outcomes among black Americans.     

Financial strain over the life course and health among older adults

This paper focuses on financial strain across the life course as a condition underlying health inequalities observed in later life. The analysis is based on data from 1167 adults 65 years and older collected as part of the 'Aging, Stress and Health Study". Relying on retrospective data about hardship experienced over the life course, we find that long-term financial hardship is reflected in a range of health outcomes at late life, even after controlling for the effects of current financial circumstances. Moreover, the sheer persistence of hardship matters more than its episodic occurrence or timing, so that the health effects of early hardship may be obviated if followed by no further hardship. This pattern offindings is consistent with the notion of allostatic load, the cumulative damage done to health and well-being under the burden of an unrelenting stressor in a critically important life domain.     

Mexican American birthweight and child overweight: unraveling a possible early life course health transition

Mexican American children have a weight distribution that categorizes them as relatively healthy at birth but relatively unhealthy by age 3. This early life course transition in health based on weight raises the question of whether Mexican American children "outgrow" the epidemiologic paradox of favorable birth outcomes despite social disadvantage or whether their birthweight distribution places them on trajectory for overweight in childhood. We address this question using newly available 9-year follow-up data from the Fragile Families and Child Wellbeing birth cohort study linked to pre-natal medical records. We systematically investigate the roles of birthweight, pre-natal factors, and childhood factors in explaining racial/ethnic differences in childhood overweight. Our main finding is that Mexican American children do outgrow the paradox: Their rates of childhood overweight are higher than expected given their birthweight distribution. Observed pre-natal and childhood factors do not explain the elevated rates of overweight among Mexican American children.     

Negotiating narratives surrounding children's mental health diagnoses: Children and their contribution to the discourse

Despite increasing numbers of children diagnosed with mental health disorders, there is limited research on how children come to understand these diagnoses in childhood. This study examines the retrospective accounts of emerging adults who were diagnosed with mental health disorders in childhood to better understand how they made sense of their diagnoses over time. In-depth, semi-structured interviews were conducted with 42 emerging adults (ages 18 to 22) who were diagnosed with attention deficit hyperactivity disorder (ADHD), depression, generalized anxiety disorder (GAD), and/or bipolar disorder in childhood. Interviews elicited participants' experiences learning about their diagnoses and suggestions for how diagnoses should best be explained to children. Findings demonstrate that participants actively sought and obtained information about their diagnoses over time. They negotiated narratives from several sources, including parents, teachers, mental health professionals, peers, siblings, the media, reading materials, and the Internet. Many of those who embraced medical accounts of their diagnoses did so as they obtained in-depth medical information over time. Meanwhile, those whose parents were open and communicative without using medical narratives suggest it is possible to share information with children without utilizing the terminology of “disorder.” Participants emphasize the importance of being open with children and providing them assurances, explaining that their problems are legitimate, common, and “not their fault.” Implications for social work practice are discussed.     

Conceptual and methodologic issues in the evaluation of children's satisfaction with their mental health care

The assessment of client satisfaction has become an important aspect of evaluation research in the adult mental health field, but there has been relatively little extension of that approach to the child client population. This is due to the lack of adequate methodologies for assessing treatment satisfaction in children and to the overriding conceptual issues which make it difficult to develop such measures. Further information is needed to clarify developmental differences in the way both healthy as well as medically and psychiatrically ill children conceptualize illness and treatment. The authors suggest that specific methodologies for assessing child satisfaction with treatment can be systematically developed once a more explicit developmental framework has been delineated in the area of children's understanding of medical and psychiatric disorders and their treatments.     

Stress, health, and the life course: some conceptual perspectives

This article proposes several conceptual perspectives designed to advance our understanding of the material and experiential conditions contributing to persistent disparities in rates of morbidity and mortality among groups unequal in their social and economic statuses. An underlying assumption is that these disparities, which are in clear evidence at mid- and late life, may be anchored to earlier circumstances of the life course. Of particular interest are those circumstances resulting in people with the least privileged statuses having the greatest chances of exposure to health-related stressors. Among the stressors closely linked to status and status attainment are those that continue or are repeated across the life course, such as enduring economic strain and discriminatory experiences. Also taking a long-range toll on health are circumstances of stress proliferation, a process that places people exposed to a serious adversity at risk for later exposure to additional adversities. We suggest that this process can be observed in instances of trauma, in early out-of-sequence transitions, and in the case of undesired changes that disrupt behaviors and relationships in established roles. Effective effort to close the systemic health gaps must recognize their structural underpinnings.     

Incorporating flow into practice and performance

In the music profession, individuals often work under stress filled conditions. This is especially true for individuals making their living as performing musicians. Musical performance anxiety has been well documented in both students and professionals. For some, the experience may lead to a termination of what might otherwise remain a successful performing career. Humans are susceptible to anxiety and so the phenomenon of musical performance anxiety is not likely to disappear. Learning how to effectively deal with musical performance anxiety is paramount for those in the performing arts. Entering a state of flow, in which there is total absorption in an activity, allows for the possiblity of any ensuing anxiety to become facilitative, rather than debilitative. This article will discuss several characteristics of flow, as defined by Mihalyi Csikszentmihalyi, and provide practical applications for musical practice and performance in an attempt to counterbalance musical performance anxiety. Musicians will benefit from a closer examination of the elements of flow and means of incorporating these elements into practice and performance.     

Parents' divorce and children's life chances

This paper reports available British data from cross-sectional and longitudinal studies examining the long term impact of parental divorce on children's life chances. The authors suggest that an effect can be traced, lowering the educational attainment of both sexes and the socio-economic status of males in their mid-twenties following parental divorce or separation before the age of fourteen years. This effect is reduced but not removed by remarriage of the custodial parent.