More mental health problems after divorce in couples with high pre-divorce alcohol consumption than in other divorced couples: results from the HUNT-study

BMC Public Health

Kristian Tambs¹  Mariann Idstad¹  Fartein A Torvik¹  Kamilla Rognmo¹ 

[1] Norwegian Institute of Public Health, Division of Mental Health, PO BOX 4404 NydalenN-0403, Oslo, Norway

关键词: Social causation;    Selection effects;    Mental health;    Alcohol use;    Divorce;   

Others  :  1161779
DOI  :  10.1186/1471-2458-13-852

 received in 2013-04-04, accepted in 2013-09-11,  发布年份 2013

【 摘 要 】

Background

Divorce is associated with mental health problems, and heavy drinking is related to higher risk of divorce. Less is known about the effects of divorce in couples where one or both drinks heavily. There are, however, reasons to expect different consequences of divorce in heavy risk using couples compared to other couples. Spouses of abusers may experience the divorce as a relief, whereas abusers may find it extra difficult to be left single. The aim of the study is to compare the effect of divorce on mental health in heavy drinking couples to the effect in couples who drink less.

Methods

Registry data were matched with data from the Nord-Trøndelag Health Study (HUNT 1 (T1) and 2 (T2)), enabling longitudinal analyses of approximately 11,000 couples. Interaction terms between 1) alcohol use on T1 and divorce between T1 and T2 (11 year time lag), and 2) alcohol use on T1 and time since divorce at T2 for all divorced couples were tested to examine changes in mental health between T1 and T2 for a) spouses of high-risk compared to low-risk users, and b) high-risk compared to low-risk users themselves. Data were analyzed using multivariate analysis of variance.

Results

There was a general effect of divorce on change in mental health between T1 and T2. We observed a significantly stronger worsening in mental health in female high-risk users and their spouses than in divorced low-risk users and their spouses. The results also suggest that the strain after divorce lasts longer in women with a high alcohol consumption and their spouses.

Conclusions

Divorce seems to affect couples where one or both drink heavily more than couples with a low consumption. Also there was some evidence of a slower healing of mental health problems after divorce in alcohol exposed couples than in other couples. The results only reached significance for female high consumers and their spouses, but due to limited statistical power, safe conclusions about gender specific effects cannot be drawn.

【 授权许可】

   
2013 Rognmo et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Ostermann J, Sloan FA, Taylor DH: Heavy alcohol use and marital dissolution in the USA. Social science & medicine (1982) 2005, 61(11):2304-2316.
• [2]Collins RL, Ellickson PL, Klein DJ: The role of substance use in young adult divorce. Addiction (Abingdon, England) 2007, 102(5):786-794.
• [3]Kessler RC, Walters EE, Forthofer MS: The social consequences of psychiatric disorders, III: probability of marital stability. The American journal of psychiatry 1998, 155(8):1092-1096.
• [4]Breslau J, Miller E, Jin R, Sampson NA, Alonso J, Andrade LH, Bromet EJ, de Girolamo G, Demyttenaere K, Fayyad J, et al.: A multinational study of mental disorders, marriage, and divorce. Acta psychiatrica Scandinavica 2011, 124(6):474-486.
• [5]Hope S, Rodgers B, Power C: Marital status transitions and psychological distress: longitudinal evidence from a national population sample. Psychological medicine 1999, 29(2):381-389.
• [6]Bjorkenstam E, Hallqvist J, Dalman C, Ljung R: Risk of new psychiatric episodes in the year following divorce in midlife: Cause or selection? A nationwide registerbased study of 703,960 individuals. The International journal of social psychiatry 2012.
• [7]Joung IM, van de Mheen HD, Stronks K, van Poppel FW, Mackenbach JP: A longitudinal study of health selection in marital transitions. Social science & medicine (1982) 1998, 46(3):425-435.
• [8]Kiecolt-Glaser JK, Newton TL: Marriage and health: his and hers. Psychological bulletin 2001, 127(4):472-503.
• [9]Richards M, Hardy R, Wadsworth M: The effects of divorce and separation on mental health in a national UK birth cohort. Psychological medicine 1997, 27(5):1121-1128.
• [10]Foran HM, O'Leary KD: Alcohol and intimate partner violence: a meta-analytic review. Clinical psychology review 2008, 28(7):1222-1234.
• [11]Boden JM, Fergusson DM, Horwood LJ: Alcohol misuse and violent behavior: findings from a 30-year longitudinal study. Drug and alcohol dependence 2012, 122(1–2):135-141.
• [12]Dawson DA, Grant BF, Chou SP, Stinson FS: The impact of partner alcohol problems on women's physical and mental health. Journal of studies on alcohol and drugs 2007, 68(1):66-75.
• [13]Homish GG, Leonard KE, Kearns-Bodkin JN: Alcohol use, alcohol problems, and depressive symptomatology among newly married couples. Drug and alcohol dependence 2006, 83(3):185-192.
• [14]Tempier R, Boyer R, Lambert J, Mosier K, Duncan CR: Psychological distress among female spouses of male at-risk drinkers. Alcohol (Fayetteville, NY) 2006, 40(1):41-49.
• [15]Schuckit MA, Smith TL, Eng MY, Kunovac J: Women who marry men with alcohol-use disorders. Alcoholism, clinical and experimental research 2002, 26(9):1336-1343.
• [16]Jacob T, Dunn NJ, Leonard K: Patterns of alcohol abuse and family stability. Alcoholism, clinical and experimental research 1983, 7(4):382-385.
• [17]Kahler CW, McCrady BS, Epstein EE: Sources of distress among women in treatment with their alcoholic partners. Journal of substance abuse treatment 2003, 24(3):257-265.
• [18]Cornelius JR, Kirisci L, Reynolds M, Homish GG, Clark DB: Husbands' SUD is associated with higher levels of co-occurring but not non-co-occurring psychiatric disorders among their wives. Addictive behaviors 2008, 33(9):1231-1234.
• [19]Rognmo K, Torvik FA, Ask H, Roysamb E, Tambs K: Paternal and maternal alcohol abuse and offspring mental distress in the general population: the Nord-Trondelag health study. BMC public health 2012, 12:448. BioMed Central Full Text
• [20]Smith PH, Homish GG, Leonard KE, Cornelius JR: Women ending marriage to a problem drinking partner decrease their own risk for problem drinking. Addiction (Abingdon, England) 2012, 107(8):1453-1461.
• [21]Power C, Rodgers B, Hope S: Heavy alcohol consumption and marital status: disentangling the relationship in a national study of young adults. Addiction (Abingdon, England) 1999, 94(10):1477-1487.
• [22]Miller-Tutzauer C, Leonard KE, Windle M: Marriage and Alcohol Use: A Longitudinal Study of Maturing Out. Journal of studies on alcohol and drugs 1991, 52(5):434.
• [23]Leonard KE, Rothbard JC: Alcohol and the marriage effect. Journal of studies on alcohol Supplement 1999, 13:139-146.
• [24]Umberson D: Family status and health behaviors: Social control as a dimension of social integration. Journal of health and social behavior 1987, 306-319.
• [25]Marshal MP: For better or for worse? The effects of alcohol use on marital functioning. Clinical psychology review 2003, 23(7):959-997.
• [26]Kearns-Bodkin JN, Leonard KE: Alcohol involvement and marital quality in the early years of marriage: a longitudinal growth curve analysis. Alcoholism, clinical and experimental research 2005, 29(12):2123-2134.
• [27]Amato PR, Rogers SJ: A longitudinal study of marital problems and subsequent divorce. Journal of marriage and the family 1997, 612-624.
• [28]Overbeek G, Vollebergh W, de Graaf R, Scholte R, de Kemp R, Engels R: Longitudinal associations of marital quality and marital dissolution with the incidence of DSM-III-R disorders. Journal of family psychology: JFP. journal of the Division of Family Psychology of the American Psychological Association (Division 43) 2006, 20(2):284-291.
• [29]Gustavson K, Røysamb E, von Soest T, Helland MJ, Mathiesen KS: Longitudinal associations between relationship problems, divorce, and life satisfaction: Findings from a 15-year population-based study. J Posit Psychol 2012, 7(3):188-197.
• [30]Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS: Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of general psychiatry 1994, 51(1):8-19.
• [31]Diedrick P: Gender differences in divorce adjustment. Journal of Divorce & Remarriage 1991, 14(3–4):33-46.
• [32]Asher RJ, Maree S, Bronner G, Bennett NC, Bloomer P, Czechowski P, Meyer M, Hofreiter M: A phylogenetic estimate for golden moles (Mammalia, Afrotheria, Chrysochloridae). BMC evolutionary biology 2010, 10:69. BioMed Central Full Text
• [33]Tambs K, Moum T: Low genetic effect and age-specific family effect for symptoms of anxiety and depression in nuclear families, halfsibs and twins. Journal of affective disorders 1993, 27(3):183-195.
• [34]Idstad M, Roysamb E, Tambs K: The effect of change in mental disorder status on change in spousal mental health: the HUNT study. Social science & medicine (1982) 2011, 73(9):1408-1415.
• [35]Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L: The Hopkins Symptom Checklist (HSCL). A measure of primary symptom dimensions. Modern problems of pharmacopsychiatry 1974, 7:79-110.
• [36]Graham JW: Missing data analysis: Making it work in the real world. Annu Rev Psychol 2009, 60:549-576.
• [37]Johnson DR, Wu J: An empirical test of crisis, social selection, and role explanations of the relationship between marital disruption and psychological distress: A pooled time-series analysis of four-wave panel data. J Marriage Fam 2002, 64(1):211-224.
• [38]Booth A, Amato P: Divorce and Psychological Stress. Journal of health and social behavior 1991, 32(4):396-407.
• [39]Goldberg WA, Greenberger E, Hamill S, Oneil R: Role Demands in the Lives of Employed Single Mothers with Preschoolers. Journal of family issues 1992, 13(3):312-333.
• [40]Lucas RE: Time does noe heal all wounds: A longitudinal study of reaction and adaptation to divorce. Psychol Sci 2005, 16:945-950.
• [41]Kitson GC: Portrait of divorce: Adjustment to marital breakdown.New. York: Guilford Press; 1992.
• [42]Hetherington EM: Intimate pathways: Changing patterns in close personal relationships across time. Fam Relat 2003, 52(4):318-331.
• [43]Torvik FA, Rognmo K, Tambs K: Alcohol use and mental distress as predictors of non-response in a general population health survey: the HUNT study. Social psychiatry and psychiatric epidemiology 2012, 47(5):805-816.
• [44]Knudsen AK, Hotopf M, Skogen JC, Overland S, Mykletun A: The Health Status of Nonparticipants in a Population-based Health Study The Hordaland Health Study. American journal of epidemiology 2010, 172(11):1306-1314.
• [45]Kringlen E, Torgersen S, Cramer V: A Norwegian psychiatric epidemiological study. Am J Psychiat 2001, 158(7):1091-1098.