Publications

Background: Theory and empirical evidence suggest that economic contraction predicts increased incidence of psychological disorder. The extent to which this relation can be causally attributed to the economic experiences of individuals remains uncertain. Methods: We critically examine literature concerning the impact of economic contraction, measured at the individual or ecological level, on four mental health outcomes (depression, suicide, substance abuse, and antisocial behavior) from the past two decades. Studies at the individual level use job loss, transition to inadequate employment, or welfare as the independent variable. Studies at the ecological level primarily use the unemployment rate. Results: In the studies that best establish causality, research indicates a moderate but significant adverse effect of job loss on individual depression symptoms, but the net population effect remains speculative. For suicide and antisocial behavior, individual- and ecological-level studies converge to suggest a moderate positive association with economic contraction. Although some research on substance abuse suggests procyclical effects, the majority indicate that job loss significantly increases the risk of heavy drinking and symptoms of alcohol abuse. For all outcomes, various characteristics of the population or the specific economic exposure studied can modify the overall association. Conclusions: The studies reviewed suggest that adverse economic transitions predict increased mental health problems, particularly depression, suicide, and substance abuse. The strength of the association, particularly when measuring the response of populations to contracting economies remains unclear. © 2010 M.E. Sharpe, Inc. All rights reserved.

BACKGROUND: Theory suggests that natural selection conserved reactivity in part because highly reactive women spontaneously abort less fit conceptuses, particularly small males. Other literature argues that high reactivity manifests clinically as anxiety disorders. If true, births to women diagnosed with anxiety disorders should exhibit a low secondary sex ratio (i.e. ratio of male to female births). We explored whether births to women diagnosed with anxiety disorders exhibit a lower sex ratio than births to women diagnosed with other psychiatric disorders, or to women without mental health diagnoses. METHODS: We performed a case-control comparison of the secondary sex ratios among groups of women categorized by mental health diagnosis using birth records linked to data from California County Mental Health system records. We compared sex ratios among 5994 deliveries to mothers diagnosed with anxiety disorders, 23 443 deliveries to mothers diagnosed with other psychiatric disorders and 1 099 198 comparison births. RESULTS: Although comparison births exhibited a higher sex ratio than births to women diagnosed with anxiety disorders or with other diagnoses, differences were not statistically significant. Births to African American women diagnosed with anxiety disorders, however, exhibited sex ratios significantly lower than comparison births among African Americans (OR = 0.89, P = 0.038) or births to African American women with other mental health diagnoses (OR = 0.88, P = 0.042). CONCLUSIONS: We found that infants born to African American women diagnosed with anxiety disorders exhibited a significantly lower secondary sex ratio than reference groups. We urge confirmatory tests of our findings and discuss implications of the reactivity/anxiety hypothesis for psychiatry, obstetrics and public health.

Although a substantial body of research points to a link between psychological distress and inflammatory responses in middle-aged and older adults, particularly those with cardiovascular disease, the relationship between inflammation and distress in young, healthy individuals has not been established. This study was designed to investigate the cross-sectional association between psychological distress and inflammatory proteins in a young, healthy representative population of English adults.