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Otten D, Heller A, Schmidt P, Beutel ME, Brähler E. Gender differences in the prevalence of mental distress in East and West Germany over time: a hierarchical age-period-cohort analysis, 2006-2021. Soc Psychiatry Psychiatr Epidemiol 2024; 59:315-328. [PMID: 37041297 PMCID: PMC10089379 DOI: 10.1007/s00127-023-02479-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/30/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE Mental distress has become a major public health concern. Temporal trends in psychological distress are complex and depend on numerous factors. In this study, we examined age-period-cohort effects for mental distress including gender and German region over a 15 years' time span. METHODS Data on mental distress from ten cross-sectional surveys of the general German population, covering the years from 2006 to 2021, was used. Hierarchical age-period-cohort analyses including gender and German region as predictors were performed to disentangle age, period, and cohort effects. The Patient Health Questionnaire-4 was used as a brief screener for mental distress. RESULTS We found significant period and cohort effects, with peek values for mental distress in the years 2017 and 2020 and for the oldest birth cohort (born before 1946). Age did not affect mental distress when cohort- and period effects as well as gender and German region were considered. An interaction effect for gender and the German region was found. Women in West Germany reported significantly higher mental distress compared to women in East Germany. Compared to men, women reported the highest prevalence in both regions. CONCLUSION Important political events as well as major crises can lead to an increase of mental distress in societies. Furthermore, an association between birth cohort and mental distress could be linked to socialization effects of that certain time, causing traumatic experiences or a specific coping style within this cohort group. Prevention and intervention strategies could benefit from acknowledging structural differences linked to period and cohort effects.
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Affiliation(s)
- Daniëlle Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
| | - Ayline Heller
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Peter Schmidt
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
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Maercker A, Ben-Ezra M, Esparza OA, Augsburger M. Fatalism as a traditional cultural belief potentially relevant to trauma sequelae: Measurement equivalence, extent and associations in six countries. Eur J Psychotraumatol 2019; 10:1657371. [PMID: 31528270 PMCID: PMC6735334 DOI: 10.1080/20008198.2019.1657371] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/30/2019] [Accepted: 08/11/2019] [Indexed: 11/01/2022] Open
Abstract
Background: Fatalism, known as the propensity to believe that one's destiny is externally determined, has so far been examined selectively, and not yet in a cross-cultural study. Moreover, a general, non-data-based speculation assumes that fatalism occurs to a lesser extent in countries of the Global North than in the Global South. Objective: Fatalism as a global psychological belief seems to have a prima facie validity, but this is to be investigated by measurement equivalence calculations across different countries from different world regions. Furthermore, socio-demographic and cultural geographic associations with fatalism scores will be investigated. Method: A six items fatalism scale was introduced in six large population-based samples from Europe, Africa, and Latin America (total n = 6'537). Testing of invariance followed standardized procedures for cross-cultural comparisons with a comprehensive parallel analysis. Regression analyses provided information on associations with socio-demography and cultural geography. Results: The fatalism construct divided into accentuated pessimistic and non-judgmental subscores in five of the six countries. The German sample showed the highest fatalism scores compared to almost all other countries. In particular higher age and lower educational attainment determine fatalism scores across countries. An explorative analysis of the associations between PTSD symptoms and fatalism scores for African countries revealed small correlations. Discussion: Fatalism as indicated by its subscores seems not to be an exclusive phenomenon of countries with higher economic and socio-cultural vulnerability. For all countries, sociodemographic groups can be identified in which these parts of a traditional belief system are more pronounced. Only for a subset of the countries examined has it been possible to analyse the associations with trauma. Further elaborated analyses in other samples should follow.
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Affiliation(s)
- Andreas Maercker
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland.,Wissenschaftskolleg Berlin-Institute of Advanced Study, Berlin, Germany
| | | | - Oscar A Esparza
- Institute of Social Sciences and Administration, Universidad Autónoma de Ciudad Juárez, Ciudad Juárez, Chihuahua, México
| | - Mareike Augsburger
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
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Estévez-Lamorte N, Pitzurra R, Foster S, Gmel G, Mohler-Kuo M, Schnyder U. Exposure to potentially traumatic events in young Swiss men: associations with socio-demographics and mental health outcomes (alcohol use disorder, major depression and suicide attempts). Eur J Psychotraumatol 2019; 10:1611093. [PMID: 31231475 PMCID: PMC6566504 DOI: 10.1080/20008198.2019.1611093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/11/2019] [Accepted: 04/13/2019] [Indexed: 11/24/2022] Open
Abstract
Background and objective: The aims of this study were to estimate the lifetime and 12-month prevalence of exposure to potentially traumatic events (PTEs) in young men in Switzerland and to assess factors and mental health outcomes associated with such events. Method: Data were drawn from the Cohort Study on Substance Use Risk Factors (C-SURF), encompassing 5,223 young men. Exposure to PTEs was assessed using the Post-traumatic Diagnostic Scale (PDS), Trauma History Questionnaire (THQ) and Life Event Checklist (LEC). Results: Lifetime prevalence of PTEs was 59.4%, with 37.3% reporting multiple types of events. Twelve-month prevalence was 31.2%, with 12.7% reporting multiple types of events. Low education level of participants, high maternal education, family affluence below average, and not living with biological parents were associated with a higher risk of having experienced one or more PTEs in one's lifetime. Low education level of participants and high maternal education were also related to exposure to one or more PTEs over the past 12 months. Logistic regression analyses demonstrated that PTE exposure was directly associated with all assessed mental health outcomes. The strongest relationship was found between exposure to multiple types of PTEs and suicide attempts (adjusted OR 4.9 [95% CI: 2.9-8.4]). Conclusions: These results indicate that having experienced one or multiple types of PTEs is common in Swiss young men. Efforts should be intensified to reduce exposure to PTEs and prevent and treat resulting problematic mental health outcomes in young adults.
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Affiliation(s)
- Natalia Estévez-Lamorte
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts, Lausanne, Western Switzerland.,Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland.,Epidemiology, Biostatistics and Public Health Institute, University of Zurich, Zurich, Switzerland.,Swiss Research Institute for Public Health and Addiction, Zurich, Switzerland
| | - Raffaela Pitzurra
- Epidemiology, Biostatistics and Public Health Institute, University of Zurich, Zurich, Switzerland
| | - Simon Foster
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland.,Epidemiology, Biostatistics and Public Health Institute, University of Zurich, Zurich, Switzerland.,Swiss Research Institute for Public Health and Addiction, Zurich, Switzerland
| | - Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Research Department, Addiction Switzerland, Lausanne, Switzerland.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Faculty of Health and Social Science, University of the West of England, Bristol, UK
| | - Meichun Mohler-Kuo
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts, Lausanne, Western Switzerland.,Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland.,Epidemiology, Biostatistics and Public Health Institute, University of Zurich, Zurich, Switzerland.,Swiss Research Institute for Public Health and Addiction, Zurich, Switzerland
| | - Ulrich Schnyder
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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