Objectives Although evidence suggests that physical disability and depression may be reciprocally related, questions of causality versus spuriousness and the direction of causality remain to be confidently answered. This study considered the hypothesis of reciprocal influence; the possibility of spuriousness in relation to pain, stress, and lifetime major depression; and the possible mediating effects of pain and social stress. Methods We analyzed data from a two-wave panel study of Miami-Dade County residents (n = 1,455) that included a substantial oversampling of individuals reporting a physical disability. Results Results indicated that, although prior levels of physical limitations predicted changes in depressive symptoms, there was no evidence of the reverse association. Results also indicated that part of the association between prior physical limitations and changes in depressive symptoms was explained by intervening level of pain and, to a lesser extent, by the day-to-day experience of discrimination. Discussion Much of whatever causation may be involved in the linkage between physical limitations and depressive symptomatology flows from limitations to depression rather than in the reverse direction. Results also make clear that this linkage is not an artifact of shared associations with pain, social stress, or lifetime major depression.

No abstract

This study evaluates the bi-directional association between depressive symptoms and bodily pain, and examines the role of physical disability and perceived social stress in the depression-pain relationship. Data are employed from a two-wave panel study of Miami-Dade county residents (n = 1459) that includes a substantial over-sampling of individuals who identify as physically-disabled. Findings indicate that the bi-directional relationship between depression and pain is similar for those with and without a physical disability. Results also demonstrate that stress exposure, specifi cally recent life events and daily discrimination, partially mediated the relationship between prior levels of depression and changes in pain. Directions for future research and the need for a more comprehensive model of health incorporating physical, psychological, and social factors are discussed.

The negative effects of childhood abuse persist for many years, even into older adulthood. However, contrary to the findings in younger adults, self-esteem was not correlated with childhood abuse in older adults. Moreover, childhood abuse only had a negative effect on those who had low self-esteem. It may be through the process of lifespan development that some abused individuals come to separate out the effects of abuse from their self-concept.

Although perceived discrimination is linked to poor mental health, little is known about the mental health significance of the number of perceived reasons for discrimination. Using survey data from a communitybased sample of adults living in Miami, Florida (n = 1,944), this study tests whether those reporting multiple perceived reasons for major discriminating events are at increased risk for depression. Cross-sectional and longitudinal analyses reveal those reporting multiple reasons for major discrimination are at increased risk for lifetime major depression and subsequent depressive symptoms. While social support and mastery partially mediated the link between multiple perceived reasons for discrimination and subsequent depressive symptoms, this psychological risk was not fully explained by these coping resources. Together the findings underscore the psychological toxicity of perceived discrimination and the importance of considering multiple perceived reasons for discrimination as a risk factor for poor mental health.

No abstract

This study examines the sexual networks and HIV risk of clients with severe mental illness in treatment in institutional and community care settings. Data were gathered through structured interviews with 401 clients at three community mental health centers and two state psychiatric hospitals. Results indicate that community clients are more likely than hospital patients to be currently sexually active and to engage in high-risk sexual behavior whereas hospitalized patients tend to have more transient sexual relationships with partners who also have a mental illness. These findings suggest that mental health treatment settings may be shaping the HIV epidemic among psychiatric patients because of the impact they have on the structure of clients' sexual networks.

No abstract