Mental disorders among college students in the World Health Organization World Mental Health Surveys.

BACKGROUND: Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. METHOD: The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1572) and non-students in the same age range (18-22 years; n = 4178), including non-students who recently left college without graduating (n = 702) based on surveys in 21 countries (four low/lower-middle income, five upper-middle-income, one lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioral and substance disorders were assessed with the Composite International Diagnostic Interview (CIDI). RESULTS: One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders; 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. CONCLUSIONS: Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.

Unwanted childbearing, health, and mother-child relationships.

This paper investigates the relationships among unwanted childbearing, health, and mother-child relationships. We hypothesize that unwanted childbearing affects mother-child relationships in part because of the physical and mental health consequences of unwanted childbearing. Impaired mental health hampers women's interaction with their infants, and these poor neonatal relationships translate into poor mother-adult child relationships. Using the Intergenerational Panel Study of Mothers and Children--a 31-year longitudinal survey of a probability sample of 1,113 mother-child pairs begun in 1961--we demonstrate that mothers with unwanted births have lower quality relationships with their children from late adolescence (age 18) throughout early adulthood (ages 23 and 31). Furthermore, these lower quality relationships are not limited to the child born as a result of the unwanted pregnancy; all the children in the family suffer. Using the 1987-88 wave of the National Survey of Families and Households, a survey of a national probability sample of U.S. households, we show that mothers with unwanted births suffer from higher levels of depression and lower levels of happiness. We also demonstrate that they spank their young children more and spend less leisure time with them. We conclude that experiencing unwanted childbearing reduces the time and attention that mothers give their young children and that these early mother-child interactions set the stage for long-term, lower quality relationships.

The long-term impact of parents' childbearing decisions on children's self-esteem.

We examine the long-term impact of parents' childbearing decisions on children's self-esteem. We focus on subjective aspects of the home environment in the creation of children's internalized sense of self-worth. Unique 23-year family panel data combining measures of mothers' childbearing, mothers' childbearing intentions, and children's self-esteem allow us to examine the overall links between parents' childbearing and children's self-esteem. The results demonstrate that parents' childbearing intentions can have a significant long-term impact on their children's self-esteem. Children who were unintended by their mothers have significantly lower self-esteem 23 years later. Our findings indicate that giving birth to an unintended child can have a long-term negative impact on subjective aspects of the child's well-being, at least in terms of self-esteem. Unintended childbearing has received an increasing amount of research attention in recent years.

The neighborhood history calendar: a data collection method designed for dynamic multilevel modeling.

"This paper presents a new data collection method, called the Neighborhood History Calendar, designed to collect event histories of community-level changes over time. We discuss the need for and the uses of this method. We describe issues related to the design of instruments, collection of data, and data entry. We provide detailed examples from an application of this method to the study of marriage, contraception, and fertility in rural Nepal. The paper addresses applications of this same technique to other settings and research problems. We also extend the technique to collection of other forms of contextual-history data, including school histories and health service histories. Finally, we discuss how Geographic Information System (GIS) technology can be used to link together multiple sources of contextual-history data."

The influence of parents' martial dissolutions on children's attitudes toward family formation.

We investigate the influence of parents' martial dissolutions on their children's attitudes toward several dimensions of family formation. Hypotheses focus on the role of patients' attitudes as a mechanism linking parents' behavior to their children's attitudes. We test these hypotheses using intergenerational panel data that include measures of children's attitudes taken directly from children. Results demonstrate strong effects of parental divorce, remarriage, and widowhood on children's attitudes toward premarital sex, cohabitation, marriage, childbearing, and divorce. The results also show that parents' own attitudes link their behavior to their children's attitudes, although substantial effects of parental behavior remain after controlling for parents' attitudes.

Family influences on family size preferences.

Several studies have demonstrated important effects of parents' childbearing behavior on their children's childbearing preferences and behavior. The study described here advances our understanding of these family influences by expanding the theoretical model to include parental preferences, siblings' behavior, and changes in children's preferences through early adulthood. Using intergenerational panel data from mothers and their children, we test the effects of both mothers' preferences for their own fertility and mothers' preferences for their children's fertility. Although both types of maternal preferences influence children's childbearing preferences, mothers' preferences for their children's behavior have the stronger and more proximate effects. Mothers' preferences continue to influence their children's preferences through early adulthood; siblings' fertility is an additional determinant of children's family size preferences.

Competing hazards with shared unmeasured risk factors.

"The present paper develops a generalization of the standard discrete-time competing hazards model that allows for the types of stochastic dependencies resulting from shared unmeasured risk factors. An empirical example is provided using the process by which young women form their first conjugal residential union, with married and unmarried cohabitation representing the competing alternatives. The results suggest considerable and significant similarity of the alternatives in terms of the unmeasurables. It is also shown that, as a result, the independence assumption leads to substantially biased estimates of the net marriage and net cohabitation survival functions." The data concern a cohort of white children born in Detroit, Michigan, in 1961 and their mothers, followed up to 1985.

Family organization and fertility limitation in Nepal.

This paper uses the family mode of organization framework to link together hypotheses relating social change to fertility limitation. Experiences in nonfamily activities are predicted to affect fertility behavior, with the outcome depending on the social, economic, and cultural context. To provide individual-level tests of hypotheses, the paper uses data from a Nepalese community which recently began dramatic family and fertility transitions. The findings show that experiences in nonfamily activities before marriage increase the odds of subsequently adopting fertility limitation in this setting. The evidence also demonstrates the importance of including measures of husbands' experiences in models of fertility decisions.

The relationship between cohabitation and divorce: selectivity or causal influence?

Recent evidence linking premarital cohabitation to high rates of divorce poses a complex theoretical and empirical puzzle. We develop hypotheses predicting that premarital cohabitation is selective of those who are prone to divorce as well as hypotheses predicting that the experience of premarital cohabitation produces attitudes and values which increase the probability of divorce. Using multiwave panel data from a recent cohort of young men and women in the United States, we specify and test models of these predictions. The results are consistent with hypotheses suggesting that cohabitation is selective of men and women who are less committed to marriage and more approving of divorce. The results also are consistent with the conclusion that cohabiting experiences significantly increase young people's acceptance of divorce.