Trajectories of Psychological Adaptation to Marital Breakup after a Long-Term Marriage.

BACKGROUND: Marital dissolution is known to be among the most stressful life events with long-reaching negative consequences on individuals' lives. A limitation in research to date is that most studies have focused on the impact of marital disruption on well-being outcomes in younger adults. Furthermore, although population-based studies on divorce document a broad range of negative effects, more fine-grained analyses reveal a large heterogeneity in people's adjustment, which is still not well understood. OBJECTIVE: The aim was to explore trajectories of psychological adaptation to marital breakup after a long-term marriage, and to examine variables accounting for recovery or chronicity in terms of intrapersonal resources (personality, trait resilience, and personal growth), relationship variables (satisfaction with ex-relationship, length of marriage, and time since divorce), and sociodemographic variables (age, gender, and financial situation). METHODS: Latent transition analysis is used to examine the course of psychological adaptation (i.e., depressive symptoms, life satisfaction, hopelessness, mourning, and subjective health) to divorce over 2 years among 5 profiles of 308 divorcees (mean age: 55.6 years; average duration of former marriage: 23.62 years). We present two larger groups of individuals, one of which adapted very well ('resilients', 29%) and the other quite well ('average copers', 49%), as well as three groups with major difficulties ('vulnerables', 6%; 'malcontents', 12%, and 'resigned', 4%). In a second step, the differences between transition patterns were explored on the basis of the distal variables (i.e., intrapersonal resources, relationship variables, and sociodemographics). RESULTS: Although the probability of upward changes was higher for those individuals with lower adaptation at time point 1, only a small number of individuals made an upward change from the maladapted to the well-adapted groups throughout the 2 years. The groups of copers and resilients remained stable in their psychological adaptation. The most consistent results related to upward changes were intrapersonal resources, namely the NEO personality traits and trait resilience. CONCLUSION: The majority of individuals divorcing after a long-term marriage adapt successfully over time. Adaptation trajectories depend primarily on intrapersonal resources. However, a minority of divorcees exhibit enduring difficulties. Knowledge about the diversity of these trajectories of vulnerability could be of great help for designing psychological interventions to better tackle this critical life event.

Challenging future, challenging past: the relationship of social integration and psychological impairment in traumatized refugees.

BACKGROUND: Refugees have been shown to present high prevalence rates of trauma-related mental disorders. Despite their psychological impairment, they are expected to meet high functional requirements in terms of social integration into, and financial independence from, the host society. METHODS: This cross-sectional study examined the relationship of mental health problems, post-migration living difficulties (PMLD), and social integration in a sample of 104 refugees seeking treatment for severe posttraumatic stress and comorbid symptoms in two outpatient clinics in Switzerland. RESULTS: Despite an average time of residence in Switzerland of over 10 years, participants showed poor integration and a high number of PMLD. Integration difficulties were closely associated with psychological symptoms, but not with socio-demographic parameters such as education or visa status. CONCLUSIONS: Psychological impairment in treatment-seeking traumatized refugees is associated with poor integration. To foster social integration, it is crucial to better understand and address the specific needs of this highly vulnerable population.

Marital breakup in later adulthood and self-rated health: a cross-sectional survey in Switzerland.

OBJECTIVES: This research examines the impact of relationship status on self-rated health (SRH) by taking into account intrapersonal and social resources. METHODS: Data stem from a Swiss-based survey of 1355 participants aged 40-65 years. Three groups are compared: continuously married (n = 399), single divorcees (n = 532) and repartnered divorcees (n = 424). Linear regression models are used to examine the predictive role of relationship status on SRH and to investigate the moderating role of intrapersonal and social resources on SRH. RESULTS: Single divorcees show the lowest SRH scores, whereas their repartnered counterparts reported scores comparable to the continuously married-even after controlling for socio-demographic and economic variables. Although single divorcees reported higher levels of loneliness and agreeableness in addition to lower levels of resilience when compared with the other groups, none of these variables had a significant moderation effect on SRH. CONCLUSIONS: Our results underscore the positive effect of relationship status on SRH, and contribute new insights on the impact of later-life divorce. Given the growing number of divorcees, related public health challenges are likely to increase.

Treatment or "high": benzodiazepine use in patients on injectable heroin or oral opioids.

Benzodiazepine (BZD) use is widespread among opioid-maintained patients worldwide. We conducted a cross-sectional survey to investigate motives and patterns of BZD use and psychiatric comorbidity in a convenience sample of patients (n=193) maintained on oral opioid agonists or diacetylmorphine (DAM). Prolonged BZD use and high-risk behaviors like parenteral use were common. After principal component analysis, motives were divided into those related to negative affect regulation, positive affect regulation (i.e. reward-seeking) and somato-medical problems. Negative affect regulation and somato-medical motives were associated with prolonged use. Psychiatric comorbidity was associated with several self-therapeutic motives, most importantly to lose anxiety. Patients maintained on DAM were more likely to be ex-users of BZD and report high positive affect regulation. Therefore, patients maintained on different agonists may have deviating motives for BZD use, which could be of importance when addressing this issue. Treatment of psychiatric comorbidity, in particular anxiety, depressive and sleeping disorders, may be helpful in reducing BZD use, particularly in patients maintained on oral opioids.