Comparing Growth Trajectories of Risk Behaviors From Late Adolescence Through Young Adulthood: An Accelerated Design.

Risk behaviors such as substance use or deviance are often limited to the early stages of the life course. Whereas the onset of risk behavior is well studied, less is currently known about the decline and timing of cessation of risk behaviors of different domains during young adulthood. Prevalence and longitudinal developmental patterning of alcohol use, drinking to the point of drunkenness, smoking, cannabis use, deviance, and HIV-related sexual risk behavior were compared in a Swiss community sample (N = 2,843). Using a longitudinal cohort-sequential approach to link multiple assessments with 3 waves of data for each individual, the studied period spanned the ages of 16 to 29 years. Although smoking had a higher prevalence, both smoking and drinking up to the point of drunkenness followed an inverted U-shaped curve. Alcohol consumption was also best described by a quadratic model, though largely stable at a high level through the late 20s. Sexual risk behavior increased slowly from age 16 to age 22 and then remained largely stable. In contrast, cannabis use and deviance linearly declined from age 16 to age 29. Young men were at higher risk for all behaviors than were young women, but apart from deviance, patterning over time was similar for both sexes. Results about the timing of increase and decline as well as differences between risk behaviors may inform tailored prevention programs during the transition from late adolescence to adulthood

Association Between Cannabis Use and Sexual Risk Behavior Among Young Heterosexual Adults

To study the association between cannabis use and frequent sexual risk behavior, we tested the hypothesis of a situational influence of cannabis use in sexual encounters using a combination of global association study and event-level analysis and examined possible mediator variables, including the personality trait of hedonism/risk preference, psychosocial stress, and HIV-related beliefs, using mediation models. The results of a computer-assisted telephone interview of a random sample of 2790 heterosexual men and women aged 16-24 years showed that risky sexual behavior was more frequent in cannabis-using men and women than in non-using persons. The results did not support a situational effect of cannabis intoxication on sexual risk behavior. The more frequent sexual risk behavior among cannabis users was mediated by decreased intentions to use HIV protection, by lower HIV-self-efficacy, and higher risk preference/hedonism. Only among women psychosocial stress was a partial mediator. The findings show that HIV prevention programs for cannabis-using young adults should emphasize the role of person variables instead of situation variable

Associations between social integration, participation and productivity loss among persons with chronic pain: a registry based cross sectional study.

PURPOSE To examine associations between factors of social inclusion and participation and productivity loss in employed persons with chronic pain, assessed for an interprofessional pain rehabilitation programme. We hypothesized that factors of social inclusion and participation and work related social factors are significantly associated with productivity when experiencing chronic pain and we expected a moderate effect. METHODS Cross-sectional study using data collected prospectively in an interprofessional patient registry for chronic pain. The primary end point was productivity loss, measured with the iMTA Productivity Costs Questionnaire. We included data from 161 individuals. To be included, persons had to be 18 years old or older, in paid work, and had to have a medical diagnosis of chronic pain syndrome with actual or potential tissue damage. In addition, participants had to have indicators of significant impairments in psychosocial functions. RESULTS Linear regression analysis showed that a highly stressful professional situation, frequent problems regarding the compatibility of the family and job and not being Swiss were associated with a significantly higher total productivity loss. Similar results were found for productivity loss in paid work. However, problems concerning the compatibility of the family and job did not reach the significance level for productivity loss in paid work. CONCLUSION The results of this study underscore the importance of factors of social inclusion and participation for interprofessional rehabilitation programmes to manage chronic pain especially when focussing on productivity loss

Professional support after partner loss: Likelihood and correlates of help-seeking behavior

Intimate partner loss in later life can be one of the most stressful events in adulthood. Individuals who struggle to adapt to the new life conditions may need support from a mental health professional. However, less is known about the likelihood to seek professional help after separation, divorce, or bereavement in later life and associated factors. This study investigated professional help-seeking (PHS) for partner loss after a long-term marriage in separated, divorced, and bereaved individuals and examined the extent to which specific person and event-related variables, as well as depressive symptoms, increase its likelihood. The data were derived from the LIVES “Intimate Partner Loss Study.” The self-administered questionnaires were completed by 388 adults. PHS was higher after separation (57%) and divorce (49%), compared to widowhood (18%). Higher likelihood of PHS was associated with separation and divorce, female gender, having someone to count on, loss unexpectedness, needing more time to overcome the loss, and more depressive symptoms. Informing individuals unlikely to seek help (e.g., males, bereaved, and individuals with no confidant) about PHS benefits may facilitate adaptation to partner loss

Factor structure of the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) in a clinical sample recruited from the community

Background: The Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) are widely used self-report questionnaires to assess symptoms of social anxiety. While SPS measures social performance anxiety, SIAS measures social interaction anxiety. They are mostly reported simultaneously, but there have not been consistent results of the joint factor structure and therefore no consistent recommendations on how to use and evaluate the questionnaires. The study aimed (1) to evaluate the underlying joint factor structure of the SPS and SIAS and (2) to test whether SPS and SIAS are reliable scales to assess two different aspects of social anxiety. Methods: The one-factor, two-factor, and bifactor model were tested in a clinical sample recruited from the community and diagnosed with a social anxiety disorder. Exploratory and con rmatory factor analyses were conducted, bifactor speci c indices were calculated, and the content of the less tting items was examined. Results: Con rmatory factor analyses showed that the best tting model was the bifactor model with a reduced set of items. The bifactor-speci c indices showed that the factor structure cannot be considered unidimensional and that SPS and SIAS are reliable subscales. A closer examination of the less tting item content and implications for future studies are discussed. Conclusions: In conclusion, SPS and SIAS can be reported together as an overall score of social anxiety and are separately reliable measures to assess different aspects of social anxiety

General and specific components of depression and anxiety in an adolescent population.

BACKGROUND: Depressive and anxiety symptoms often co-occur resulting in a debate about common and distinct features of depression and anxiety. METHODS: An exploratory factor analysis (EFA) and a bifactor modelling approach were used to separate a general distress continuum from more specific sub-domains of depression and anxiety in an adolescent community sample (n = 1159, age 14). The Mood and Feelings Questionnaire and the Revised Children's Manifest Anxiety Scale were used. RESULTS: A three-factor confirmatory factor analysis is reported which identified a) mood and social-cognitive symptoms of depression, b) worrying symptoms, and c) somatic and information-processing symptoms as distinct yet closely related constructs. Subsequent bifactor modelling supported a general distress factor which accounted for the communality of the depression and anxiety items. Specific factors for hopelessness-suicidal thoughts and restlessness-fatigue indicated distinct psychopathological constructs which account for unique information over and above the general distress factor. The general distress factor and the hopelessness-suicidal factor were more severe in females but the restlessness-fatigue factor worse in males. Measurement precision of the general distress factor was higher and spanned a wider range of the population than any of the three first-order factors. CONCLUSIONS: The general distress factor provides the most reliable target for epidemiological analysis but specific factors may help to refine valid phenotype dimensions for aetiological research and assist in prognostic modelling of future psychiatric episodes.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Evaluation of a guided internet-based self-help intervention for older adults after spousal bereavement or separation/divorce: A randomised controlled trial

Background: While several internet interventions target severe prolonged grief symptoms after bereavement, no randomised controlled trial investigated interventions for prolonged grief after separation/divorce. Methods: This randomised controlled trial aimed to evaluate the efficacy of a guided internet-based self-help intervention for prolonged grief symptoms after spousal bereavement or separation/divorce compared to a wait- list control group. Furthermore, we analysed whether the intervention was also efficacious for participants with milder grief symptoms. Results: A total of 110 participants were mainly recruited by newspaper articles. Average age was 51 years, 77% were separated/divorced, 79% were female. Dropout rate was 11%. Compared to the control group, the inter- vention resulted in significant reductions in grief (d = 0.81), depression (d = 0.59), psychopathological distress (d=0.39) (primary outcomes), embitterment (d=0.37), loneliness (d=0.37) and an increase in life sa- tisfaction (d = −0.41) (secondary outcomes). These gains were maintained over three months. Improvements were similar among widowed and separated/divorced participants as well as among participants with low, medium or high levels of grief at baseline. Limitations: Limitations include the self-selective sample and a rather small number of widowed participants. Conclusions: Findings indicate that an internet intervention based on models for coping with grief after be- reavement was not only beneficial for widowed but also separated or divorced participants. Furthermore, also participants with lower levels of grief at baseline benefitted from the intervention. This corroborates that in- dicated prevention efforts for grief are efficacious

Breakup after long-term marriage: How the past and ongoing relationship to the ex-partner is linked to psychological adaptation

While negative effects of divorce on well-being are well documented in research literature, the role of relationships with the ex-partner after marital breakup on adaptation remains unclear. This is especially the case for marital breakup after long-term marriage, which is still a neglected research topic. This research focuses on the relationships with the ex-partner (past and ongoing), and the extent to which the quality of these relations are linked to psychological adaptation to marital breakup (i.e., life satisfaction and depressive symptoms) over time. Therefore, we take into account socio-demographic variables (i.e., age, gender, financial resources), personality variables (i.e., personality traits, resilience) as well as the current relationship status. Data stem from two waves (2012, 2014) of a longitudinal survey-based study, which is part of the Swiss National Centre of Competence in Research ‘LIVES – Overcoming vulnerability: life course perspectives’. Our analyses are carried out on a subsample of 501 divorcees (349 females, 152 males) aged 40 – 65 years (M= 51 years, SD= 6.7). The average length of their former relationship was 21.6 years (SD= 8.1) and participants experienced the separation on average 3.8 years ago (SD= 2.8). Half of the participants (n= 255; 49%) were in a new relationship, the majority (71%, n= 360) were still in contact with their ex-partner. Of those persons, 29% reported ‘tense to very tense’ contact to the ex-partner, 29% responded with ‘partly tense, partly good’ and 41% reported of a ‘good to very good’ contact. Preliminary results by multiple linear regression analysis demonstrate that for those who are still in contact with the former partner, ongoing conflicts are related to worse adaptation (i.e., lower life satisfaction, higher depressive symptoms), even when the participants are in a new relationship. Variables related to the ex-relationship (i.e., length of and happiness with former relationship, initiator status of separation, time passed since separation) only play a limited role for adaptation. In a next step, we will examine longitudinal associations using structural equation modelling. These results offer important insights into the process of adaptation to martial breakup, which can be used for counselling

An internet-based self-help intervention for older adults after marital bereavement, separation or divorce: study protocol for a randomized controlled trial

Background: Marital bereavement and separation or divorce are among the most stressful critical life events in later life. These events require a dissolution of social and emotional ties, adjustments in daily routine and changes in identity and perspectives for the future. After a normative grief or distress reaction, most individuals cope well with the loss. However, some develop a prolonged grief reaction. Internet-based self-help interventions have proved beneficial for a broad range of disorders, including complicated grief. Based on the task model and the dual-process model of coping with bereavement, we developed a guided internet-based self-help intervention for individuals who experienced marital bereavement, separation or divorce at least 6 months prior to enrolment. The intervention consists of 10 text-based self-help sessions and one supportive email a week. The primary purpose of this study is the evaluation of the feasibility and efficacy of the intervention compared with a waiting control group. The secondary purpose is to compare the effects in bereaved and separated participants. Furthermore, we aim to analyze other predictors, moderators and mediators of the outcome, such as age, psychological distress and intensity of use of the intervention. Methods: The design is a randomized controlled trial with a waiting control condition of 12 weeks and a 24-weeks follow-up. At least 72 widowed or separated participants will be recruited via our study website and internet forums. Primary outcomes are reductions in grief symptoms, depression and psychological distress. Secondary outcome measures are related to loneliness, satisfaction with life, embitterment and the sessions. Discussion: The trial will provide insights into the acceptance and efficacy of internet-based interventions among adults experiencing grief symptoms, psychological distress and adaptation problems in daily life after spousal bereavement, separation or divorce. Findings will add to existing knowledge by (1) evaluating an internet-based intervention specifically designed for spousal bereavement and its consequences; (2) testing whether this intervention is equally effective for individuals after separation or divorce; and (3) suggesting adaptations to improve the efficacy of the intervention, selective indication and adaptations for different needs