Cumulative risk of compromised physical, mental and social health in adulthood due to family conflict and financial strain during childhood: A retrospective analysis based on survey data representative of 19 European countries

BACKGROUND: Childhood adversity (CA) has previously been linked to various health problems in adulthood. Investigations into the differential impact of distinct types of CA on a wide range of outcomes are scarce. This study aimed to assess the impact of self-reported childhood family conflict and/or financial strain on health and social functioning in adulthood among Europeans, while taking into account the mediating role of adulthood socioeconomic disadvantage (SED) in these associations. METHODS: Using the European Social Survey (ESS) collected in 2014, nationally representative cross-sectional data from 35 475 participants aged 15 years and older in 19 European countries were analysed. Logistic regressions were conducted to assess associations of retrospectively reported family conflict and/or financial strain in childhood with physical and mental health as well as health behaviours and social functioning in adulthood. RESULTS: A quarter of the European population reported having experienced family conflict, financial strain or both in childhood. Financial strain was reported more among older age groups and conflict more among younger age groups. A dose-response pattern with increased risk was demonstrated for almost all physical, behavioral, mental and social outcomes for these aspects of CA compared with no CA, with the highest risk observed in those who experienced both financial strain and family conflict. Adulthood SED mediated a significant proportion of the associations with financial strain (ranging from 5.4% to 72.4%), but did not mediate the associations with conflict. CONCLUSIONS: Individuals reporting family conflict or financial strain during childhood are at increased risk of developing a wide range of health and social problems. Those who report financial strain in childhood are more likely to experience SED in adulthood, which in turn increases their risk of experiencing health and social problems. Reported family conflict during childhood conferred increased risk of health and social problems, but adulthood SED did not appear to operate as an indirect pathway

An Interpretive Phenomenological Analysis (IPA) of coercion towards community dwelling older adults with dementia: Findings from MYsore studies of Natal effects on Ageing and Health (MYNAH)

The final publication is available at Springer via http://dx.doi.org/10.1007/s00127-016-1286-4Purpose Limited availability of specialist services places a considerable burden on caregivers of Persons with Dementia (PwD) in Low- and Middle-Income Countries (LMICs). There are limited qualitative data on coercive behavior towards PwD in an LMIC setting. Aim The aim of this study was to find relevant themes of the lived experience of relatives as caregivers for PwD in view of their use of coercive measures in community setting in South India. Method Primary caregivers (n = 13) of PwDs from the Mysore study of Natal effects on Ageing and Health (MYNAH) in South India were interviewed to explore the nature and impact of coercion towards community dwelling older adults with dementia. The narrative data were coded using an Interpretative Phenomenological Analysis (IPA) approach for thematic analysis and theory formation. Results Caregivers reported feeling physical and emotional burn-out, a lack of respite care, an absence of shared caregiving arrangements, limited knowledge of dementia, and a complete lack of community support services. They reported restrictions on their lives through not being able take employment, a poor social life, reduced income and job opportunities, and restricted movement that impacted on their physical and emotional well-being. Inappropriate use of sedatives, seclusion and environmental restraint, and restricted dietary intake, access to finances and participation in social events, was commonly reported methods of coercion used by caregivers towards PwD. Reasons given by caregivers for employing these coercive measures included safeguarding of the PwD and for the management of behavioral problems and physical health. Conclusion There is an urgent need for training health and social care professionals to better understand the use of coercive measures and their impact on persons with dementia in India. It is feasible to conduct qualitative research using IPA in South India

The moderating role of social network size in the temporal association between formal social participation and mental health: a longitudinal analysis using two consecutive waves of the Survey of Health, Ageing and Retirement in Europe (SHARE)

Introduction Previous studies have shown that engaging in formal social participation may protect against declining mental health, but social network size (the number of close social ties a person has) may moderate the relationship. We assessed the potential moderating role of social network size using longitudinal data. Methods Nationally representative data from two consecutive waves (2011, 2013) of the SHARE survey were analyzed. The data consisted of 38,300 adults from 13 European countries aged 50 years and older in 2011. Measures pertaining to formal social participation, social network size, quality of life, and depression symptoms were used. Multivariable linear regression models were conducted. Results The majority of participants (over 70% of the sample) had a social network size of four or less close social ties. We identified significant moderations in both models. Individuals with relatively few close social ties may have benefitted from formal social participation both in terms of reductions in depression symptoms and increases in quality of life, while formal social participation among those with many social ties did not appear to be beneficial, and may even to some extent have been detrimental. Conclusions Declines in mental health specifically among those with relatively few close social ties could potentially be prevented through the promotion of formal social participation. It is possible that such strategies could have a greater impact by specifically targeting individuals that are otherwise socially isolated. High levels of formal participation among those with relatively many close social ties may not be pragmatically beneficial