A Multilevel Analysis of Gender Differences in Psychological Distress Over Time

Abstract Introduction/objectives To evaluate the journey to diagnosis, disease characteristics and burden of disease in male and female patients with axial spondyloarthritis (axSpA) across Europe. Method Data from 2846 unselected patients participating in the European Map of Axial Spondyloarthritis (EMAS) study through an online survey (2017–2018) across 13 countries were analysed. Sociodemographic characteristics, lifestyle, diagnosis, disease characteristics and patient-reported outcomes (PROs) [disease activity –BASDAI (0–10), spinal stiffness (3–12), functional limitations (0–54) and psychological distress (GHQ-12)] were compared between males and females using chi-square (for categorical variables) and student t (for continuous variables) tests. Results In total, 1100 (38.7%) males and 1746 (61.3%) females participated in the EMAS. Compared with males, females reported considerable longer diagnostic delay (6.1 ± 7.4 vs 8.2 ± 8.9 years; p < 0.001), higher number of visits to physiotherapists (34.5% vs 49.5%; p < 0.001) and to osteopaths (13.3% vs 24.4%; p < 0.001) before being diagnosed and lower frequency of HLA-B27 carriership (80.2% vs 66.7%; p < 0.001). In addition, females reported higher degree of disease activity in all BASDAI aspects and greater psychological distress through GHQ-12 (4.4 ± 4.2 vs 5.3 ± 4.1; p < 0.001), as well as a greater use of alternative therapies. Conclusion The patient journey to diagnosis of axSpA is much longer and arduous in females, which may be related to physician bias and lower frequency of HLA-B27 carriership. Regarding PROs, females experience higher disease activity and poorer psychological health compared with males. These results reflect specific unmet needs in females with axSpA needing particular attention. Key Points• Healthcare professionals’ perception of axSpA as a predominantly male disease may introduce some bias during the diagnosis and management of the disease. However, evidence about male-female differences in axSpA is scarce.• EMAS results highlight how female axSpA patients report longer diagnostic delay and higher burden of the disease in a large sample of 2846 participants of 13 European countries.• Results reflect unmet needs of European female patients. Healthcare professionals should pay close attention in order to accurately diagnose and efficiently manage axSpA cases while further research should be developed on the cause of reported gender differences.

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Increases in Risky Drinking During the COVID-19 Pandemic Assessed via Longitudinal Cohort Design: Associations With Racial Tensions, Financial Distress, Psychological Distress and Virus-Related Fears

Alcohol and Alcoholism ◽

10.1093/alcalc/agab019 ◽

2021 ◽

Author(s):

William V Lechner ◽

Natasha K Sidhu ◽

Jackson T Jin ◽

Ahmad A Kittaneh ◽

Kimberly R Laurene ◽

...

Keyword(s):

Psychological Distress ◽

High Risk ◽

Alcohol Use ◽

Financial Distress ◽

Daily Life ◽

Drinking Patterns ◽

Risky Drinking ◽

Factors Associated ◽

High Risk Drinking ◽

Over Time

Abstract Background The COVID-19 pandemic has created disruptions to daily life resulting in wide-spread unemployment and psychological distress. Recent studies have reported high rates of alcohol use during this time; however, longitudinal data remain scarce and factors associated with increases in high-risk drinking observed over time are unknown. Aims The current study examined changes in high-risk drinking patterns across four 7-day observation periods, prior to and following a university wide campus closure. Additionally, factors associated with changes in alcohol use patterns were examined including financial distress, psychological distress, impact of racial tensions and virus-related fears. Method Students (N = 1001) in the Midwestern USA completed repeated assessments between March and June 2020. Each survey included a timeline follow-back measure of alcohol use. Pandemic-related distress spanning several factors was assessed at the final follow-up. Results Risky drinking patterns increased significantly over time. Overall, psychological distress and impact of racial tensions were associated with higher rates of risky drinking, whereas COVID-19-related fears were associated with lower rates. However, only financial-related distress was associated with an increase in risky drinking patterns over time. Conclusions Increased risky drinking patterns observed in the current study may signal problems that are likely to persist even after the direct impact of the COVID-19 pandemic on daily life ends. Individuals experiencing financial distress may represent a particularly high-risk group. Interventions targeting the cross-section of job loss, financial stress and problematic alcohol use will be important to identify.

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Gender Differences in Grief Reactions following the Death of a Parent

OMEGA - Journal of Death and Dying ◽

10.2190/55wn-1vuf-tq3w-gd53 ◽

2006 ◽

Vol 52 (4) ◽

pp. 323-337 ◽

Cited By ~ 16

Author(s):

Elizabeth Lawrence ◽

Elizabeth L. Jeglic ◽

Laura T. Matthews ◽

Carolyn M. Pepper

Keyword(s):

Gender Differences ◽

Psychological Distress ◽

Psychological Functioning ◽

Clinical Importance ◽

Self Report ◽

Future Research ◽

Symptoms Of Depression ◽

Death Of A Parent ◽

And Coping ◽

Grief Reactions

This study examined gender differences in psychological functioning in a sample of college students who lost a parent to death. Male and female students ( n = 65) who had a parent that had died were asked to complete a series of self report questionnaires to assess psychological distress, feelings of grief and bereavement, and coping strategies. Overall, no gender differences were found between bereaved students on measures of psychological distress. However an avoidant coping style was related to symptoms of depression in females, but not in males. Students who lost a mother were more likely to report symptoms of depression, hopelessness, and suicidal ideation as compared to students who lost a father. Future research implications and the clinical importance of these findings are discussed.

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Predicting the gender of individuals with tinnitus based on daily life data of the TrackYourTinnitus mHealth platform

Scientific Reports ◽

10.1038/s41598-021-96731-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Johannes Allgaier ◽

Winfried Schlee ◽

Berthold Langguth ◽

Thomas Probst ◽

Rüdiger Pryss

Keyword(s):

Machine Learning ◽

Gender Differences ◽

Daily Life ◽

Sound Stimulation ◽

Life Data ◽

Symptom Profiles ◽

Symptom Profile ◽

The Family ◽

Gender Impacts ◽

Over Time

AbstractTinnitus is an auditory phantom perception in the absence of an external sound stimulation. People with tinnitus often report severe constraints in their daily life. Interestingly, indications exist on gender differences between women and men both in the symptom profile as well as in the response to specific tinnitus treatments. In this paper, data of the TrackYourTinnitus platform (TYT) were analyzed to investigate whether the gender of users can be predicted. In general, the TYT mobile Health crowdsensing platform was developed to demystify the daily and momentary variations of tinnitus symptoms over time. The goal of the presented investigation is a better understanding of gender-related differences in the symptom profiles of users from TYT. Based on two questionnaires of TYT, four machine learning based classifiers were trained and analyzed. With respect to the provided daily answers, the gender of TYT users can be predicted with an accuracy of 81.7%. In this context, worries, difficulties in concentration, and irritability towards the family are the three most important characteristics for predicting the gender. Note that in contrast to existing studies on TYT, daily answers to the worst symptom question were firstly investigated in more detail. It was found that results of this question significantly contribute to the prediction of the gender of TYT users. Overall, our findings indicate gender-related differences in tinnitus and tinnitus-related symptoms. Based on evidence that gender impacts the development of tinnitus, the gathered insights can be considered relevant and justify further investigations in this direction.

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The Road to Parenthood: Income and First Births in Sweden

Finnish Yearbook of Population Research ◽

10.23979/fypr.48412 ◽

2016 ◽

Vol 50 ◽

pp. 31-52 ◽

Cited By ~ 1

Author(s):

Ernesto Germán Silva

Keyword(s):

Gender Differences ◽

Positive Association ◽

Income Effect ◽

Entire Population ◽

Men And Women ◽

The Road ◽

The Moment ◽

Over Time

This paper considers the effect of income on the risk of having the first births in Sweden from 1968 to 2009. Variations by gender are given particular atention. The study follows men and women from the moment they turn 18 until they enter parenthood and it is based on register-based data covering the entire population of Sweden. Complementary log-log models show that there is a positive association between income and the risk of childbearing. The association gets stronger over time and the differences between men and women diminish. Gender differences appear when the income effect is related to the demand for work in the economy. An income above the median does not increase the risk of childbearing for women when the demand for work is relatively high.

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Profiles and predictors of the course of psychological distress across four years after heart transplantation

Psychological Medicine ◽

10.1017/s0033291705004563 ◽

2005 ◽

Vol 35 (8) ◽

pp. 1215-1227 ◽

Cited By ~ 45

Author(s):

MARY AMANDA DEW ◽

LARISSA MYASKOVSKY ◽

GALEN E. SWITZER ◽

ANDREA F. DiMARTINI ◽

HERBERT C. SCHULBERG ◽

...

Keyword(s):

Psychological Distress ◽

Heart Transplantation ◽

Social Supports ◽

Psychological Needs ◽

Physical Impairment ◽

Transplant Recipients ◽

Post Transplant ◽

High Distress ◽

Clinically Significant ◽

Over Time

Background. Like individuals exposed to other life stressors, patients undergoing organ transplantation typically show elevated psychological distress initially post-transplant, with improvement thereafter. However, this ‘average’ pattern may conceal subgroups with differing profiles of psychological response. We sought to identify unique temporal distress profiles, and their predictors, after heart transplantation.Method. A total of 156 transplant recipients (refusal rate, 6%) were enrolled and assessed at 2, 7, 12, 36, and 42 months post-transplant. Cluster analysis was used to identify distinct distress profiles over time. Multivariate analyses examined health and psychosocial predictors of the profiles.Results. Five groups were identified, with either: (a) low distress at all time-points (45% of the sample), (b) high, clinically significant distress at all times (21%), (c) high distress over several years with low distress only at final assessment (12%), (d) high distress during the first several months with decline thereafter (6%), or (e) fluctuating distress levels (16%). Patients showing any distress (versus none) were more likely to have a pre-transplant psychiatric history, poorer social supports and more physical impairment early post-transplant, and continued physical impairment over time. Among distressed patients, those with persistent (versus declining) distress were most likely to be female, waited more briefly for transplant, and were most physically impaired early post-transplant. While persistently distressed patients had better social supports early post-transplant, these supports subsequently worsened.Conclusions. Individuals differ in whether and when psychological distress abates after heart transplantation. Findings regarding distress profiles and their predictors may inform the design of interventions to address each transplant recipient's unique psychological needs.

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Does Being a Chief Resident Predict Leadership in Pediatric Careers?

PEDIATRICS ◽

10.1542/peds.105.s3.984 ◽

2000 ◽

Vol 105 (Supplement_3) ◽

pp. 984-988

Author(s):

Joel J. Alpert ◽

Suzette M. Levenson ◽

Cindy J. Osman ◽

Sabin James

Keyword(s):

Gender Differences ◽

Medical Education ◽

Training Programs ◽

Chief Resident ◽

Program Directors ◽

Pediatric Residents ◽

Pediatric Residency ◽

Survey Sample ◽

Professional Leadership ◽

Over Time

Objective. Many organizations make efforts to identify future pediatric leaders, often focusing on chief residents (CRs). Identifying future leaders is an issue of great importance not only to the ultimate success of the organization but also to the profession. Because little is known regarding whether completing a CR predicts future leadership in medicine, we sought to determine if former pediatric CRs when compared with pediatric residents who were not CRs reported more often that they were leaders in their profession. Design/Methods. Twenty-four pediatric training programs stratified by resident size (<18, 18–36, and >36) and geography (East, South, Midwest, and West) were selected randomly from the Graduate Medical Education Directory(American Medical Association, Chicago, IL). Program directors were contacted by mail and telephone and asked to provide their housestaff rosters from 1965–1985. The resulting resident sample was surveyed by questionnaire in 1995. Results. Fifteen of 17 program directors (88%) who possessed the requested data provided 1965–1985 rosters yielding a sample of 963 residents. Fifty-five percent of the resident sample (533) responded. Fifty-eight of the respondents had not completed a pediatric residency, leaving a survey sample of 475. Thirty-four percent (163) were CRs. The sample had a mean age of 47, 67% were male and 87% married. Fellowships were completed by 51%. More former CRs compared with non-CRs (75% vs 64%), more former fellows than non-fellows (75% vs 60%) and more males than females (74% vs 55%) reported they were professional leaders. These associations persisted in a logistic regression that controlled for CR status, gender, marital status, and fellowship status as leadership predictors. Former CRs, former fellows, and men were, respectively, 1.8, 2.3, and 2.3 times more likely to report professional leadership. Conclusions. Pediatric residents who were former CRs and/or fellows, and males were more likely to report professional leadership. Although men were more likely to report professional leadership, with more women entering pediatrics the reported gender differences will likely disappear over time.

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Caregiving in quarantine: Humor styles, reframing, and psychological well-being among parents of children with disabilities

Journal of Social and Personal Relationships ◽

10.1177/02654075211043515 ◽

2021 ◽

pp. 026540752110435

Author(s):

Heidi L. Fritz

Keyword(s):

Psychological Distress ◽

Social Interactions ◽

Children With Disabilities ◽

Well Being ◽

Family Satisfaction ◽

The United States ◽

Future Research ◽

Humor Styles ◽

Psychological Well Being ◽

Over Time

Prior research links adaptive humor styles (affiliative and self-enhancing) with enhanced psychological well-being and maladaptive humor styles (aggressive and self-defeating) with worse psychological well-being, primarily through humor styles’ influence on individuals’ social interactions and efforts to positively reframe stressors. The present study examined the unique relation of each humor style with psychological well-being with a focus on understanding mechanisms of adjustment under highly stressful conditions. Ninety-nine parents of children with disabilities were surveyed at the beginning of the COVID-19 pandemic in the United States in March 2020, and 79 parents completed follow-up surveys in July 2020. As predicted, at T1, self-enhancing humor was associated with less psychological distress and greater family satisfaction, self-defeating humor was associated with greater distress, and aggressive humor was associated with lower family satisfaction. Moreover, affiliative humor predicted decreased psychological distress over time, whereas self-defeating humor predicted increased psychological distress and decreased family satisfaction over time. Relations were largely mediated by caregiver positive reappraisal, family efforts to reframe daily disability-related challenges, and negative social interactions. Future research should further examine the influence of caregiver humor styles on family dynamics, family reframing norms, and caregiving efficacy.

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Changing gender differences in musculoskeletal pain and psychological distress

Health inequalities and welfare resourcesContinuity and change in Sweden ◽

10.1332/policypress/9781861347589.003.0003 ◽

2006 ◽

pp. 42-66

Author(s):

Örjan Hemström ◽

Gunilla Krantz ◽

Eva Roos

Keyword(s):

Gender Differences ◽

Psychological Distress ◽

Musculoskeletal Pain

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Individual quality of life in spousal ALS patient-caregiver dyads

Health and Quality of Life Outcomes ◽

10.1186/s12955-020-01551-5 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Miriam Galvin ◽

Tommy Gavin ◽

Iain Mays ◽

Mark Heverin ◽

Orla Hardiman

Keyword(s):

Quality Of Life ◽

Health Care ◽

Psychological Distress ◽

Caregiver Burden ◽

Life Quality ◽

Individual Quality ◽

Care Providers ◽

Individual Quality Of Life ◽

Over Time

Abstract Background Quality of life is a basic goal of health and social care. The majority of people with Amyotrophic Lateral Sclerosis (ALS) are cared for at home by family caregivers. It is important to recognize the factors that contribute to quality of life for individuals to better understand the lived experiences in a condition for which there is currently no curative treatment. Aim To explore individual quality of life of people with ALS and their informal caregivers over time. Methods Over three semi-structured home interviews, 28 patient-caregiver dyads provided information on a range of demographic and clinical features, psychological distress, caregiver burden, and individual quality of life. Quality of life data were analysed using quantitative and qualitative methods with integration at the analysis and interpretation phases. Results Individual Quality of Life was high for patients and caregivers across the interviews series, and higher among patients than their care partners at each time point. Family, hobbies and social activities were the main self-defined contributors to quality of life. The importance of health declined relative to other areas over time. Friends and finances became less important for patients, but were assigned greater importance by caregivers across the illness trajectory. Psychological distress was higher among caregivers. Caregiver burden consistently increased. Conclusion The findings from this study point to the importance of exploring and monitoring quality of life at an individual level. Self-defined contributory factors are relevant to the individual within his/her context. As an integrated outcome measure individual quality of life should be assessed and monitored as part of routine clinical care during the clinical encounter. This can facilitate conversations between health care providers, patients and families, and inform interventions and contribute to decision support mechanisms. The ascertainment of self-defined life quality, especially in progressive neurodegenerative conditions, mean health care professionals are in a better position to provide person-centred care.

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