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Objectives: The COVID-19 pandemic brought multiple simultaneous consequences, with high potential to change fertility-related behaviors. We use nationally representative sex and contraceptive use event history calendar measures to demonstrate person-specific changes in contraceptive use after the pandemic, showing differences across demographic subgroups., Study Design: We use data from the first nationally representative web survey of U.S. fertility, fielded in 2020-2022: the American Family Health Study (AFHS). Using responses from 1357 female-identifying respondents ages 18-49, we analyze 26,274 person-months of sex and contraceptive use data spanning directly before and after the beginning of the pandemic to detect change., Results: Individual-level hazard models of starting and stopping contraception revealed no pandemic-related changes in starting contraception, but significant reductions in the rate of stopping contraception for specific subgroups. Hispanic females reduced their rates of stopping contraceptive use during the pandemic (lowering their odds of stopping use by 71%), ultimately behaving more similarly to individuals from other racial or ethnic subgroups. Additionally, those aged 41 and older significantly reduced their rates of stopping contraceptive use (lowering their odds of stopping use by 78%) relative to other age groups., Conclusions: Sudden large-scale health policy changes can produce significant changes in contraceptive use behaviors. The COVID-19 changes interacted with race, ethnicity, and age to produce different changes in contraceptive behaviors among different subgroups of the U.S., (Copyright © 2024. Published by Elsevier Inc.)

The evaluation of innovative web-based data collection methods that are convenient for the general public and that yield high-quality scientific information for demographic researchers has become critical. Web-based methods are crucial for researchers with nationally representative research objectives but without the resources of larger organizations. The web mode is appealing because it is inexpensive relative to in-person and telephone modes, and it affords a high level of privacy. We evaluate a sequential mixed-mode web/mail data collection, conducted with a national probability sample of U.S. adults from 2020 to 2022. The survey topics focus on reproductive health and family formation. We compare estimates from this survey to those obtained from a face-to-face national survey of population reproductive health: the 2017-2019 National Survey of Family Growth (NSFG). This comparison allows for maximum design complexity, including a complex household screening operation (to identify households with persons aged 18-49). We evaluate the ability of this national web/mail data collection approach to (1) recruit a representative sample of U.S. persons aged 18-49; (2) replicate key survey estimates based on the NSFG, considering expected effects of the COVID-19 pandemic lockdowns and the alternative modes on the estimates; (3) reduce complex sample design effects relative to the NSFG; and (4) reduce the costs per completed survey., (Copyright © 2024 The Authors.)

Background: This study adopts individual and societal-level approaches to examine the contribution of childhood risk factors to major depressive episodes (MDE) in 2526 American young adults., Methods: Nationally representative data from the 2017 U.S. Panel Study of Income Dynamics - Transition into Adulthood Supplement (PSID-TAS) were analyzed using multivariate methods to assess the impact of parental mental illness, childhood adversities, childhood mental disorders, and childhood physical conditions. Adjusted odds ratios and population attributable risk proportions (PARPs) are calculated to estimate the proportion of MDE cases related to risk factors., Results: The 12-month prevalence of positive screens for MDE was 25.4 %. Approximately 34 % of these were attributable to childhood mental disorders, 24 % to childhood physical conditions, 21 % to childhood adversities, and 16 % to parental mental illness. Childhood and parental depression were critical risk factors, both at the individual (odds ratio exceeding 2) and societal (PARP approximately 24 %) levels. Gender-specific risk factors were identified, with childhood physical abuse and childhood anxiety disorders constituting risk factors for females, and childhood externalizing disorders and childhood headaches as risk factors for males. Approximately 60 % of U.S. young adult MDE cases are attributable to risk factors before age 18., Limitations: Possible over reporting of MDE may have biased the associations between predictors and depression., Conclusions: Exposure to depression at a young age-one's own or parental depression-is a robust risk factor for both genders. Policies and interventions focused at alleviating the societal burden of depression should value its generational transmission., Competing Interests: Declaration of competing interest The authors have no relevant interests to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The American Family Health Study (AFHS) collected family health and fertility data from a national probability sample of persons aged 18-49 between September 2021 and May 2022, using web and mail exclusively. In July 2022, we surveyed AFHS respondents and gauged their willingness to become part of a national web panel that would create novel longitudinal data on these topics. We focus on predictors of willingness to participate, identifying the potential selection bias that this type of approach may introduce. We found that efforts of this type to create a national web panel may introduce potential selection bias in estimates based on the panel respondents, with individuals having higher socio-economic status being more cooperative. Thus, alternative recruitment strategies and re-weighting of the subsample may be needed to further reduce selection bias. We present methodological implications of our results, limitations of our approach, and suggestions for further research on this topic., Competing Interests: Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Major depressive disorder (MDD) is the leading cause of disability globally, with moderate heritability and well-established socio-environmental risk factors. Genetic studies have been mostly restricted to European settings, with polygenic scores (PGS) demonstrating low portability across diverse global populations., Methods: This study examines genetic architecture, polygenic prediction, and socio-environmental correlates of MDD in a family-based sample of 10 032 individuals from Nepal with array genotyping data. We used genome-based restricted maximum likelihood to estimate heritability, applied S-LDXR to estimate the cross-ancestry genetic correlation between Nepalese and European samples, and modeled PGS trained on a GWAS meta-analysis of European and East Asian ancestry samples., Results: We estimated the narrow-sense heritability of lifetime MDD in Nepal to be 0.26 (95% CI 0.18-0.34, p = 8.5 × 10 -6 ). Our analysis was underpowered to estimate the cross-ancestry genetic correlation (rg = 0.26, 95% CI -0.29 to 0.81). MDD risk was associated with higher age (beta = 0.071, 95% CI 0.06-0.08), female sex (beta = 0.160, 95% CI 0.15-0.17), and childhood exposure to potentially traumatic events (beta = 0.050, 95% CI 0.03-0.07), while neither the depression PGS (beta = 0.004, 95% CI -0.004 to 0.01) or its interaction with childhood trauma (beta = 0.007, 95% CI -0.01 to 0.03) were strongly associated with MDD., Conclusions: Estimates of lifetime MDD heritability in this Nepalese sample were similar to previous European ancestry samples, but PGS trained on European data did not predict MDD in this sample. This may be due to differences in ancestry-linked causal variants, differences in depression phenotyping between the training and target data, or setting-specific environmental factors that modulate genetic effects. Additional research among under-represented global populations will ensure equitable translation of genomic findings.

Although decades of research documents powerful associations between parents' characteristics and their children's marital behaviors, the role of parental mental health has largely been ignored, despite the high prevalence of mental disorders and their strong potential to shape multiple dimensions of family life. Many studies examine other consequences of mothers' mental disorders, particularly for young children, but rarely do studies investigate the consequences of fathers' mental disorders, especially the potential for long-term consequences. We construct a theoretical framework for the study of intergenerational influences on family formation behaviors, integrating parental mental health, and emphasizing the potential for father's disorders to shape their children's lives. To investigate these associations, we use new intergenerational panel data featuring clinically validated diagnostic measures of parental mental health for both mothers and fathers, assessed independently. Results demonstrate that fathers' major depressive disorder is associated with significantly earlier marriage timing among sons. These important new findings provide insights into key priorities for social research on family formation processes and intergenerational influences across many domains., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Forced intercourse is a high prevalence experience among US women, with high potential to produce subsequent major depressive episodes (MDE). However, the extent to which prior risk factors are associated with the timing of both sexual assault experiences and subsequent MDE onset is not known. The aim of this study was to document the associations between childhood depression, subsequent forced intercourse, and later MDE. We used retrospective information on childhood depression, forced intercourse, and MDE after forced intercourse from female respondents in the nationally representative 2017 US Panel Study of Income Dynamics-Transition to Adulthood Supplement (PSID-TAS, N = 1298, response rate: 87%). Multivariable logistic regression estimated these associations, controlling for age, race, poverty, religiosity, family history of depression, and adverse childhood experiences (such as parental physical abuse or parental violence). Women who experienced childhood depression (prevalence: 15%) had 2.57 times the odds of experiencing forced intercourse after depression onset, even after adjusting for these other risk factors. However, even though childhood depression is a powerful risk factor for later MDE, independent of that women who experienced forced intercourse had 2.28 times the odds of experiencing MDE after the occurrence of forced intercourse, adjusting for childhood depression and other risk factors. This study provided the first clear evidence for time-ordered associations between forced intercourse and subsequent MDE among women in the general population., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Aims: To measure the independent consequences of community-level armed conflict beatings on alcohol use disorders (AUD) among males in Nepal during and after the 2000-2006 conflict., Design: A population-representative panel study from Nepal, with precise measures of community-level violent events and subsequent individual-level AUD in males. Females were not included because of low AUD prevalence., Setting: Chitwan, Nepal., Participants: Four thousand eight hundred seventy-six males from 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15-59 were eligible (response rate 93%)., Measurements: Measures of beatings in the community during the conflict (2000-2006), including the date and distance away, were gathered through neighborhood reports, geo-location and official resources, then linked to respondents' life histories of AUD (collected in 2016-2018) using the Nepal-specific Composite International Diagnostic Interview with life history calendar. Beatings nearby predict the subsequent onset of AUD during and after the armed conflict. Data were analyzed in 2021-2022., Findings: Cohort-specific, discrete-time models revealed that within the youngest cohort (born 1992-2001), those living in neighborhoods where armed conflict beatings occurred were more likely to develop AUD compared with those in other neighborhoods (odds ratio = 1.66; 95% confidence interval = 1.02-2.71). In this cohort, a multilevel matching analysis designed to simulate a randomized trial showed the post-conflict incidence of AUD for those living in neighborhoods with any armed conflict beatings was 9.5% compared with 5.3% in the matched sample with no beatings., Conclusions: Among male children living in Chitwan, Nepal during the 2000-2006 armed conflict, living in a neighborhood where armed conflict beatings occurred is associated with increased odds of developing subsequent alcohol use disorder. This association was independent of personal exposure to beatings and other mental disorders., (© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Responsive survey design is a technique aimed at improving the efficiency or quality of surveys by using incoming data from the field to make design changes. The technique was pioneered on large national surveys, but the tools can also be applied on the smaller-scale surveys most commonly used by sociologists. We demonstrate responsive survey design in a small-scale, list-based sample survey of students on the topic of sexual misconduct. We investigate the impact of individual incentive levels and a two-phase responsive design with changes to mode of contact as approaches for limiting the potential of nonresponse bias in data from such surveys. Our analyses demonstrate that a two-phase design introducing telephone and face-to-face reminders to complete the survey can produce stronger change in response rates and characteristics of those who respond than higher incentive levels. These findings offer tools for sociologists designing smaller-scale surveys of special populations or sensitive topics.

Background: Alcohol use is a leading cause of disease. Although low- and middle-income countries (LMICs) have lower per capita alcohol consumption, the alcohol-attributable disease burden is high in these settings with consumption increasing. LMICs are also experiencing unprecedented levels of internal migration, potentially increasing mental stress, changing social restrictions on drinking, and increasing alcohol availability. We assessed the relationship between internal migration, opportunity to drink, and the transition from first use to regular alcohol use and alcohol use disorders (AUD) in Nepal, a low-income, South Asian country., Methods: A representative sample of 7435 individuals, aged 15-59 from Nepal were interviewed in 2016-2018 (93% response rate) with clinically validated measures of alcohol use and disorders and life history calendar measures of lifetime migration experiences. Discrete-time hazard models assessed associations between migration and alcohol use outcomes., Results: Net of individual sociodemographic characteristics, internal migration was associated with increased odds of opportunity to drink (OR 1.32, 95% CI 1.14 to 1.53), onset of regular alcohol use given lifetime use (OR 1.29, 95% CI 1.13 to 1.48) and AUD given lifetime use (OR 1.24, 95% CI 0.99 to 1.57). The statistically significant association between internal migration and opportunity to drink was specific to females, whereas the associations between migration and regular use and disorder were statistically significant for males., Conclusions: Despite high rates of internal migration worldwide, most research studying migration and alcohol use focuses on international migrants. Findings suggest that internal migrants are at increased risk to transition into alcohol use and disorders. Support services for internal migrants could prevent problematic alcohol use among this underserved population., Competing Interests: Competing interests: DG, FC, SH and WA report support from the National Institute of Mental Health (grant number R01MH110872); WA, DG and SH report support from a Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) centre grant to the Population Studies Center (PSC) at the University of Michigan (grant number P2CHD041028) during the conduct of the study. DG is also the Director of the Institute for Social and Environmental Research-Nepal (ISER-N), which collected the data for the research reported here. DG’s conflict of interest management plan is approved and monitored by the Regents of the University of Michigan. CB reports support from the National Institute of Mental Health and the Fogarty International Center (grant number R01MH120648)., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

In the United States, increasing access to the internet, the increasing costs of large-scale face-to-face data collections, and the general reluctance of the public to participate in intrusive in-person data collections all mean that new approaches to nationally representative surveys are urgently needed. The COVID-19 pandemic accelerated the need for faster, higher-quality alternatives to face-to-face data collection. These trends place a high priority on the evaluation of innovative web-based data collection methods that are convenient for the U.S. public and yield scientific information of high quality. The web mode is particularly appealing because it is relatively inexpensive, it is logistically flexible to implement, and it affords a high level of privacy and confidentiality when correctly implemented. With this study, we aimed to conduct a methodological evaluation of a sequential mixed-mode web/mail data collection protocol, including modular survey design concepts, which was implemented on a national probability sample in the U.S. in 2020-2021. We implemented randomized experiments to test theoretically-informed hypotheses that 1) the use of mail and increased incentives to follow up with households that did not respond to an invitation to complete a household screening questionnaire online would help to recruit different types of households; and 2) the use of modular survey design, which involves splitting a lengthy self-administered survey up into multiple parts that can be completed at a respondent's convenience, would improve survey completion rates. We find support for the use of mail and increased incentives to follow up with households that have not responded to a web-based screening questionnaire. We did not find support for the use of modular design in this context. Simple descriptive analyses also suggest that attempted telephone reminders may be helpful for the main survey., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 West et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Measures of forced intercourse from the U.S. National Center for Health Statistics (NCHS) indicate high prevalence among U.S. women, which is likely to produce unintended pregnancies. However, NCHS did not measure forced intercourse during the pandemic, limiting knowledge of recent prevalence rates., Methods: We use multiple nationally-representative, cross-sectional surveys representing the U.S. population from 2011 to 2022 to document these trends. This includes measures from the National Survey of Family Growth, the Panel Study of Income Dynamics Transition into Adulthood Supplement, and the American Family Health Study (AFHS) to provide population estimates of forced intercourse., Results: Reports of forced intercourse remained high during the pandemic, with more than 25% of U.S. females over 40 reporting lifetime forced intercourse in the AFHS (number of females in AFHS: 1,042). There was a significant increase among females aged 24-28 (p < 0.05) and rates are highest for those who did not complete college. Among females 24-28, 32.5% (S.E. = 5.7%) with less than 4 years of college reported forced intercourse, a significantly (p < 0.05) higher rate than among those with a higher level of education., Conclusions: Rates of forced intercourse among U.S. women remained high during the pandemic, increasing significantly in early adulthood. This exposure to forced intercourse is likely to produce an increase in unintended pregnancies and other sexual, reproductive, and mental health problems., (© 2023. The Author(s).)

Importance: Understanding the association of civil violence with mental disorders is important for developing effective postconflict recovery policies., Objective: To estimate the association between exposure to civil violence and the subsequent onset and persistence of common mental disorders (in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV]) in representative surveys of civilians from countries that have experienced civil violence since World War II., Design, Setting, and Participants: This study used data from cross-sectional World Health Organization World Mental Health (WMH) surveys administered to households between February 5, 2001, and January 5, 2022, in 7 countries that experienced periods of civil violence after World War II (Argentina, Colombia, Lebanon, Nigeria, Northern Ireland, Peru, and South Africa). Data from respondents in other WMH surveys who immigrated from countries with civil violence in Africa and Latin America were also included. Representative samples comprised adults (aged ≥18 years) from eligible countries. Data analysis was performed from February 10 to 13, 2023., Exposures: Exposure was defined as a self-report of having been a civilian in a war zone or region of terror. Related stressors (being displaced, witnessing atrocities, or being a combatant) were also assessed. Exposures occurred a median of 21 (IQR, 12-30) years before the interview., Main Outcomes and Measures: The main outcome was the retrospectively reported lifetime prevalence and 12-month persistence (estimated by calculating 12-month prevalence among lifetime cases) of DSM-IV anxiety, mood, and externalizing (alcohol use, illicit drug use, or intermittent explosive) disorders., Results: This study included 18 212 respondents from 7 countries. Of these individuals, 2096 reported that they were exposed to civil violence (56.5% were men; median age, 40 [IQR, 30-52] years) and 16 116 were not exposed (45.2% were men; median age, 35 [IQR, 26-48] years). Respondents who reported being exposed to civil violence had a significantly elevated onset risk of anxiety (risk ratio [RR], 1.8 [95% CI, 1.5-2.1]), mood (RR, 1.5 [95% CI, 1.3-1.7]), and externalizing (RR, 1.6 [95% CI, 1.3-1.9]) disorders. Combatants additionally had a significantly elevated onset risk of anxiety disorders (RR, 2.0 [95% CI, 1.3-3.1]) and refugees had an increased onset risk of mood (RR, 1.5 [95% CI, 1.1-2.0]) and externalizing (RR, 1.6 [95% CI, 1.0-2.4]) disorders. Elevated disorder onset risks persisted for more than 2 decades if conflicts persisted but not after either termination of hostilities or emigration. Persistence (ie, 12-month prevalence among respondents with lifetime prevalence of the disorder), in comparison, was generally not associated with exposure., Conclusions: In this survey study of exposure to civil violence, exposure was associated with an elevated risk of mental disorders among civilians for many years after initial exposure. These findings suggest that policy makers should recognize these associations when projecting future mental disorder treatment needs in countries experiencing civil violence and among affected migrants.

Policy Points The historic 2022 Supreme Court Dobbs v Jackson Women's Health Organization decision has created a new public policy landscape in the United States that will restrict access to legal and safe abortion for a significant proportion of the population. Policies restricting access to abortion bring with them significant threats and harms to health by delaying or denying essential evidence-based medical care and increasing the risks for adverse maternal and infant outcomes, including death. Restrictive abortion policies will increase the number of children born into and living in poverty, increase the number of families experiencing serious financial instability and hardship, increase racial inequities in socioeconomic security, and put significant additional pressure on under-resourced social welfare systems., (© 2023 The Authors. The Milbank Quarterly published by Wiley Periodicals LLC on behalf of The Milbank Memorial Fund.)

In push-to-web surveys that use postal mail to contact sampled cases, participation is contingent on the mail being opened and the survey invitations being delivered. The design of the mailings is crucial to the success of the survey. We address the question of how to design invitation mailings that can grab potential respondents' attention and sway them to be interested in the survey in a short window of time. In the household screening stage of a national survey, the American Family Health Study, we experimentally tested three mailing design techniques for recruiting respondents: (1) a visible cash incentive in the initial mailing, (2) a second incentive for initial nonrespondents, and (3) use of Priority Mail in the nonresponse follow-up mailing. We evaluated the three techniques' overall effects on response rates as well as how they differentially attracted respondents with different characteristics. We found that all three techniques were useful in increasing the screening response rates, but there was little evidence that they had differential effects on sample subgroups that could help to reduce nonresponse biases., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Association for Public Opinion Research. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objective: To identify factors independently associated with program participation and knowledge of campus processes to address sexual assault and harassment complaints., Participants: 1,182 undergraduates who completed the University of Michigan's 2015 campus climate survey on topics of sexual assault and harassment (67% response rate)., Methods: We analyze survey responses to estimate multivariable models that identify subgroups of the student population least likely to have participated in programs or to know campus processes., Results: Students living off campus, not involved in major organizations, and males are less likely to report attending programming. Students not involved in major organizations and females are less likely to report knowing campus processes., Conclusions: Specific student subpopulations are more difficult to engage in programs designed to reduce sexual assault and harassment. Targeting additional effort to these groups may improve campus sexual climate. Careful analyses of campus climate survey data can help construct campus-specific priorities for these interventions.

Background: This study used life histories from a setting of near universal marriage and childbearing (Nepal) to identify associations between both marital transitions and the transition into parenthood and alcohol use and disorder (AUD)., Methods: A retrospective, cross-sectional survey using life history calendars documented lifetime marital and childbearing histories of 4876 men and 5742 women aged 15-59 in 2016-18. The clinically validated, Nepal-specific Composite International Diagnostic Interview assessed first alcohol use opportunity, use, and disorder., Results: Being never married increased the odds of having the opportunity to drink for men (OR=1.30, 95% CI=1.14 - 1.48, p < 0.001) and women (OR=1.24, 95% CI=1.08 - 1.43, p = 0.003) compared to being married. While men were never married, widowed, or divorced they were at a greater risk of developing AUD. The transition to parenthood significantly increased the odds of AUD onset for men (OR=1.71, 95% CI=1.12 - 2.61, p = 0.013), independent of marital transitions. For women in this setting, becoming divorced increased the odds of having their first drink (OR=1.77, 95% CI=1.14 - 2.75, p = 0.011). Giving birth to a first child also increased the odds of first opportunity to drink for women (OR=1.30, 95% CI=1.07 - 1.57, p = 0.008)., Conclusions: We found associations between marital transitions and AUD that are consistent with findings worldwide. In this setting of near universal childbearing, the transition into fatherhood increased the odds of postpartum AUD among men., Competing Interests: Conflict of Interest Axinn, Ghimire, Cole, and Smoller report support from the National Institute of Mental Health (grant number R01MH110872); Axinn and Ghimire report support from a Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) center grant to the Population Studies Center (PSC) at the University of Michigan (grant number P2CHD041028); and Banchoff reports support from an NICHD training grant to the PSC at the University of Michigan (grant number T32HD007339) during the conduct of the study. Ghimire is also the Director of the Institute for Social and Environmental Research–Nepal (ISER-N) that collected the data for the research reported here. Ghimire’s conflict of interest management plan is approved and monitored by the Regents of the University of Michigan. Dr. Smoller is PI of a collaborative study of the genetics of depression and bipolar disorder sponsored by 23andMe for which 23andMe provides analysis time as in-kind support but no payments., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Importance: Individual-level social support protects against major depressive disorder (MDD) among adults exposed to trauma. Little is known about the consequences of community-level interventions in the general population., Objective: To determine the potential consequences of neighborhood social infrastructure on incident MDD in a high-risk general population., Design, Setting, and Participants: This longitudinal, multilevel study estimated associations between a neighborhood-level program in a case-control design and subsequent individual outcomes across 10 years (2006-2015) in a cohort of young adults. Exogenously placed social programs simulate natural experiment conditions in a high-poverty population experiencing armed conflict (1998-2006). The western Chitwan valley in Nepal has a general population at high risk of MDD, with neighborhoods exposed to interventions to improve social support. From a random sample (response rate 93%) selected to represent the general population in 2016, participants aged 25 to 34 years in 2006 were studied. These individuals resided within 149 neighborhoods that varied in their availability of active social support programs. The analyses were conducted between October 2020 and November 2021., Exposures: The Small Farmers Development Program (SFDP) uses shared, joint liability financial credit among neighbors to build social capital and cohesion within neighborhoods., Main Outcomes and Measures: Onset of DSM-IV MDD after the conflict, assessed by the Nepal-specific, clinically validated World Mental Health Composite International Diagnostic Interview with a life history calendar. The hypothesis tested was that exposure to SFDP reduced adult onset of MDD., Results: Of the 1917 survey participants, 886 (46.2%) were women, and 856 (44.7%) were of Brahmin or Chhetri ethnicity. Of the 149 neighborhoods, 21 had an active SFDP group, and 156 of 1917 (8.1%) participants experienced MDD between 2006 and 2015. Discrete-time hazard models showed participants living in neighborhoods with an SFDP experienced incident MDD at nearly half the rate as others (odds ratio = 0.55; 95% CI, 0.30-1.02; P = .06). A multivariate, multilevel matching analysis showed the incidence of MDD among adults living in neighborhoods with an SFDP was 19 of 256 (7.4%), compared with 33 of 256 (12.9%) in the matched sample with no SFDP (z = 2.05; P = .04)., Conclusions and Relevance: Living in a neighborhood with community-level social support infrastructure was associated with reduced subsequent rates of adult-onset MDD, even in this high-risk population. Investments in such infrastructure may reduce population-level MDD, supporting clinical focus on potentially unpreventable cases.

Cohabitation has become a normative experience for American young adults and a common setting for childbearing in recent decades. However, the high dissolution rate of cohabitation exposes young adults to the potential stress of intimate relationship dissolution and single parenthood during early adulthood. Drawing on data from the National Longitudinal Survey of Youth 1997, we apply growth curve models to analyze how cohabitation dissolution associates with trajectories of depressive symptoms and binge drinking behaviors for young adults (aged 17 to 35). We investigate how the presence of children moderates this association for men and women. We find that cohabitation dissolution is associated with increased depressive symptoms for both men and women. However, cohabitation dissolution is only positively associated with binge drinking behaviors for men, and a significant gender difference is observed. The presence of children when cohabitation dissolves strengthens the positive association between cohabitation dissolution and depressive symptoms among women, and this positive moderation fades away as young women age. These findings suggest that gender differences in the association of cohabitation dissolution with psychological distress are contingent on the types of psychological distress under consideration and also reveal that cohabitation dissolution intertwined with non-marital parenthood is harmful to mental health, especially for young women., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Event history calendars (EHCs) are frequently used in social measurement to capture important information about the time ordering of events in people's lives, and enable inference about the relationships of the events with other outcomes of interest. To date, EHCs have primarily been designed for face-to-face or telephone survey interviewing, and few calendar tools have been developed for more private, self-administered modes of data collection. Web surveys offer benefits in terms of both self-administration, which can reduce social desirability bias, and timeliness. We developed and tested a web application enabling the calendar-based measurement of contraceptive method use histories. These measures provide valuable information for researchers studying family planning and fertility behaviors. This study describes the development of the web application, and presents a comparison of data collected from online panels using the application with data from a benchmark face-to-face survey collecting similar measures (the National Survey of Family Growth).

Background: Cross-national studies have found, unexpectedly, that mental disorder prevalence is higher in high-income relative to low-income countries, but few rigorous studies have been conducted in very low-income countries. This study assessed mental disorders in Nepal, employing unique methodological features designed to maximize disorder detection and reporting., Methods: In 2016-2018, 10714 respondents aged 15-59 were interviewed as part of an ongoing panel study, with a response rate of 93%. The World Mental Health version of the Composite International Diagnostic Interview (WMH-CIDI 3.0) measured lifetime and 12-month prevalence of selected anxiety, mood, alcohol use, and impulse control disorders. Lifetime recall was enhanced using a life history calendar., Results: Lifetime prevalence ranged from 0.3% (95% CI 0.2-0.4) for bipolar disorder to 15.1% (95% CI 14.4-15.7) for major depressive disorder. The 12-month prevalences were low, ranging from 0.2% for panic disorder (95% CI 0.1-0.3) and bipolar disorder (95% CI 0.1-0.2) to 2.7% for depression (95% CI 2.4-3.0). Lifetime disorders were higher among those with less education and in the low-caste ethnic group. Gender differences were pronounced., Conclusions: Although cultural effects on reporting cannot be ruled out, these low 12-month prevalences are consistent with reduced prevalence of mental disorders in other low-income countries. Identification of sociocultural factors that mediate the lower prevalence of mental disorders in low-income, non-Westernized settings may have implications for understanding disorder etiology and for clinical or policy interventions aimed at facilitating resilience.

Understanding the consequences of marital experiences for individual mental health provides insight into how social relationships shape individual wellbeing. Using newly available, clinically validated diagnostic interviews with more than 10,000 respondents integrated with the longitudinal Chitwan Valley Family Study (CVFS), we assess the associations between marital experiences, intimate partner violence (IPV), and mental health and how they differ by gender in a setting of universal marriage-Nepal. Particularly novel, we integrate measures of arranged marriage, IPV, and marital quality into a single comprehensive analysis of the marital experiences shaping subsequent depression. This study reveals that becoming married can be positively associated with major depressive disorder (MDD) for women. IPV is a strong and independent risk factor for depression, but it only mediates a small portion of the consequences of marriage on depression. Among women, having no say at all in the selection of a spouse is also a strong and independent risk factor for depression, and IPV can only mediate a small portion of the consequences of arranged marriage on depression. We also investigate the associations between the positive (i.e., husband-wife emotional bond) and negative (i.e., spousal criticism and disagreement) dimensions of marital quality and depression. Frequent spousal disagreement significantly increases depression for women, but strong husband-wife emotional bond is not significantly associated with depression. Overall, the associations between marital experiences and mental health should be understood as contingent on both gender and the social contexts of marriage. Depending on these factors, specific marital experiences have the potential to increase transitions to depression, not just protect from depression.

Aims: To disaggregate associations with alcohol use disorder relative to those with early alcohol use stages in an adult population. We estimated prevalence rates and socio-demographic correlates for the opportunity to drink and transitions into life-time alcohol use, regular use and alcohol use disorder., Design: A retrospective, cross-sectional population survey within a family panel study., Setting: Chitwan in Nepal, an ethnically diverse setting with heterogeneous ethnic restrictions regarding alcohol., Participants: A total of 10 714 individuals aged 15-59 years (response rate = 93%)., Measurements: The Nepal-specific Composite International Diagnostic Interview assessed life-time alcohol use opportunity, any use, regular use, disorder and socio-demographic characteristics., Findings: Seventy per cent [95% confidence interval (CI) = 69.08-70.82%] of the population had the opportunity to drink, 38.06% (95% CI = 37.14-38.99%) had life-time alcohol use, 32.37% (95% CI = 31.48-33.27%) had regular alcohol use and 6.04% (95% CI = 5.60-6.50%) developed an alcohol use disorder. Compared with high-caste Hindus, all other ethnicities had greater odds of early stage transitions [odds ratios (OR) ranged from 1.31, 95% CI = 1.16-1.47 to 1.98, 95% CI = 1.81-2.18)], but not of development of disorder. Male sex was associated with greater odds of all transitions, from opportunity (OR = 5.71, 95% CI = 5.41-6.03) to development of disorder (OR = 1.95, 95% CI = 1.35-2.81). The youngest cohort had higher odds of all transitions, from opportunity (OR = 4.86, 95% CI = 4.47-5.29) to development of disorder (OR = 9.34, 95% CI = 6.88-12.70). Higher education was associated with lower odds of all transitions except opportunity [from use (OR = 0.77, 95% CI = 0.71-0.83) to the development of disorder (OR = 0.73, 95% CI = 0.59-0.89)]., Conclusions: The prevalence of life-time alcohol use among adults in Nepal appears to be low, but the overall prevalence of disorder is similar to other countries. Socio-demographic correlates of early alcohol use transitions differ from those associated with later transitions; while sex and age cohort were associated with all transitions, ethnicity was associated with early transitions (opportunity, life-time use, regular use), but not later transitions (use and regular use to disorder)., (© 2020 Society for the Study of Addiction.)

Objectives: Recall error biases reporting of earlier life experiences, even potentially traumatic experiences (PTEs). Better tools for accurate retrospective reporting of PTEs and other health risk factors have the potential for broad scientific and health intervention benefits., Methods: We designed a life history calendar (LHC) to support this task and randomized more than 1000 individuals to each arm of a retrospective diagnostic interview, including detailed measures of PTEs, with and without the LHC. This is one of the largest experiments ever done to assess the benefit of an LHC approach and the only large-scale experiment done in a poor, agrarian, non-Western setting (rural Nepal)., Results: Results demonstrate use of an LHC in retrospective measurement can significantly increase lifetime reports of PTEs, especially reports of two or more PTEs. The LHC increases PTE reporting more for men and those with less education., Conclusions: The LHC approach is practical for many uses ranging from large surveys of the general population to clinical intake of new patients. It significantly increases reporting of health risk factors., (© 2020 The Authors. International Journal of Methods in Psychiatric Research published by John Wiley & Sons Ltd.)

Though international out-migration is widespread, little evidence exists regarding the consequences for economic change in sending countries, particularly in the densely populated agricultural areas of Asia. We examine associations between labor out-migration, remittances, and agricultural change in Nepal. Existing studies of this important population-environment relationship generally ignore the role of local community context, which is known to shape demographic behavior and likely exit from farming as well. Research offers opposing views of the consequences of out-migration for agricultural change - (1) loss of farm labor reduces engagement in agriculture, versus (2) loosening credit constraints from remittances increases engagement in agriculture - and indicates that both mechanisms likely operate simultaneously. Both of these mechanisms are likely to be shaped by changes in local context. Using multilevel dynamic models, we estimate associations between out-migration and remittances by household members and subsequent exit from farming, controlling for variations in community context. Results suggest international out-migration is associated with higher odds of exit from farming and simultaneously remittances are associated with lower odds of exit from farming. Results are robust against several key variations in model specification, including controls for household characteristics and local community context. However, local community context exerts an important independent influence on the hazard of exit from farming., Competing Interests: Conflict of Interest: Dr. Ghimire is the Director of the Institute for Social and Environmental Research Nepal (ISER-N) in Nepal that collected the data for the research reported here. Dr. Ghimire’s conflict of interest management plan is approved and monitored by the Regents of the University of Michigan.

Importance: This study offers a rare opportunity to evaluate life-course differences in the likelihood of developing major depressive disorder (MDD) after exposure to georeferenced neighborhood-level violence during an armed conflict., Objective: To examine age cohort (age <11 vs ≥11 years) differences in associations of neighborhood-level violence with subsequent depression onset, independently of individual exposure and other key characteristics., Design, Setting, and Participants: The Chitwan Valley Family Study is a population-representative panel study (1995 to present) conducted in Western Chitwan in Nepal, a low-income country that experienced a medium-intensity armed conflict from 2000 to 2006. Data for violent events were collected during the armed conflict and were linked to lifetime histories of MDD (collected in 2016-2018). The present cohort study analyzes 10 623 participants within 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15 to 59 years at MDD assessment were eligible (response rate, 93%). Data analysis was performed from May 2019 to July 2020., Exposures: Georeferenced number of armed conflict-related physical beatings within 1 km of residential neighborhood., Main Outcomes and Measures: The main outcome was onset of MDD, as defined by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), during or after the conflict, stratified by children (aged <11 years) and older individuals (aged ≥11 years), assessed by the Nepal-specific World Mental Health-Composite International Diagnostic Instrument 3.0 with a life history calendar., Results: In total, 10 623 participants (5745 female [54.08%]; 4074 [38.35%] aged <11 years at the conflict start) contributed 171 899 person-years of exposure to the risk of MDD. Two or more beatings occurred within 1 km of 15 neighborhoods (9.9%). Discrete-time survival models showed that children (but not older individuals) living in neighborhoods with 2 or more beatings had a higher likelihood of developing MDD than those who lived in a community with no beatings (odds ratio, 1.82; 95% CI, 1.17-2.84; P = .008); there was also a significant interaction between age group and neighborhood beatings (odds ratio, 1.85; 95% CI, 1.27-2.70; P = .001). A confirmatory, multivariable, multilevel matching analysis showed a neighborhood association for children (z = -2.66; P = .008), but not older individuals (z = -0.454; P = .65). The mean (SE) incidence of MDD among children living in neighborhoods with 2 or more beatings nearby was 12.69% (2.37%) vs 5.08% (1.56%) in the matched unexposed sample., Conclusions and Relevance: The youngest individuals may be the most at risk during times of violence, with mental health consequences lasting long after conflicts have subsided and should be a priority for population-level interventions. Future research should consider other disorders, other types of violence, and elderly individuals.

Background: Marriage in general is associated with better mental health in high-income industrialized countries, but it is unknown to what extent this is also the case in South Asia., Methods: The Chitwan Valley Family Study (CVFS) in Nepal is a 24-year family panel study with a recent representative survey to investigate the association between sociodemographic changes and mental health (N = 10,516). We investigated timing of marital transitions and timing of onset of MDD in both male and female respondents, controlling for key confounders., Results: In this setting the transition to marriage is associated with increased odds of subsequent MDD first onset (median OR=2.28). For female respondents, divorce (OR=2.68), early widowed (OR=11.25), and even getting married significantly increased the odds of subsequent MDD onset (OR=3.03). For male respondents, only becoming widowed increased the odds of subsequent MDD (OR=16.32), but marriage did not reduce the odds of MDD., Limitations: Limitations of the study include large-scale protocol that may have resulted in underreporting of MDD and the exclusion of sub-threshold cases that may otherwise have qualified as a case in a clinical setting., Conclusions: In the Nepalese general population, marital transitions increase the odds of subsequent depression, especially among the female population. Results provide basic but essential vital health data that can guide clinicians to proactively plan sustainable healthcare both within South Asia and among many South Asians living in other places., Competing Interests: Declaration of Competing Interest Axinn, Chardoul, Ghimire and Zhang report support from an NIH/NIMH grant during the conduct of the study. Axinn and Ghimire report support from an NIH/NICHD grant during the conduct of the study. Ghimire is also the Director of the Institute for Social and Environmental Research in Nepal (ISER-N) that collected the data for the research reported here. Ghimire's conflict of interest management plan is approved and monitored by the Regents of the University of Michigan., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Unique longitudinal measures from Nepal allow us to link both mothers' and fathers' reports of their marital relationships with a subsequent long-term record of their children's behaviors. We focus on children's educational attainment and marriage timing because these two dimensions of the transition to adulthood have wide-ranging, long-lasting consequences. We find that children whose parents report strong marital affection and less spousal conflict attain higher levels of education and marry later than children whose parents do not. Furthermore, these findings are independent of each other and of multiple factors known to influence children's educational attainment and marriage timing. These intriguing results support theories pointing toward the long-term intergenerational consequences of variations in multiple dimensions of parents' marriages.

Background: Retrospective reports of lifetime experience with mental disorders greatly underestimate the actual experiences of disorder because recall error biases reporting of earlier life symptoms downward. This fundamental obstacle to accurate reporting has many adverse consequences for the study and treatment of mental disorders. Better tools for accurate retrospective reporting of mental disorder symptoms have the potential for broad scientific benefits., Methods: We designed a life history calendar (LHC) to support this task, and randomized more than 1000 individuals to each arm of a retrospective diagnostic interview with and without the LHC. We also conducted a careful validation with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition., Results: Results demonstrate that-just as with frequent measurement longitudinal studies-use of an LHC in retrospective measurement can more than double reports of lifetime experience of some mental disorders., Conclusions: The LHC significantly improves retrospective reporting of mental disorders. This tool is practical for application in both large cross-sectional surveys of the general population and clinical intake of new patients.

Opportunities to document associations between macro-level changes in social organization and the spread of new individual attitudes are relatively rare. Moreover, of the factors generally understood to be influential, little is known about the potential mechanisms that make them so powerful. Here we use longitudinal measures from the Chitwan Valley Family Study (CVFS) to describe the processes of ideational change across 12 years among a representative sample from a rural agrarian setting in South Asia. Findings from lagged dependent variable models show that (1) two key dimensions of social organization--education and international travel--are strongly associated with change in attitudes, net of prior attitudes; (2) reorganization of education and travel are associated with attitudes toward ideal age at marriage; and (3) this association varies by gender. Using the study's prospective design, we document not only these important associations but also potential mechanisms of education and travel--exposure to the English language and friends' international travel experience--as potentially powerful social influences on individuals' attitudes, independent of their own experiences.

Social processes that change quickly are difficult to study, because they require frequent survey measurement. Weekly, daily, or even hourly measurement may be needed depending on the topic. With more frequent measurement comes the prospect of more complex patterns of missing data. The mechanisms creating the missing data may be varied, ranging from technical issues such as lack of an Internet connection to refusal to complete a requested survey. We examine one approach to mitigating the damage of these missing data - a follow-up or closeout interview that is completed after the frequent measurement. The Relationship Dynamics and Social Life (RDSL) study used this approach. The study asked women weekly about their attitudes and behaviors related to sexual relationships and pregnancy. The surveys were carried out for 130 weeks and concluded with a closeout interview. We explore the patterns of missing data in the RDSL study and then examine associations between the data collected in the closeout survey and key variables collected in the weekly survey. We then assess the extent to which data from the closeout survey are useful in repairing the damage caused by missing data., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Purpose: The primary aims are to (1) obtain representative prevalence estimates of suicidal thoughts and behaviors (STB) among college students worldwide and (2) investigate whether STB is related to matriculation to and attrition from college., Methods: Data from the WHO World Mental Health Surveys were analyzed, which include face-to-face interviews with 5750 young adults aged 18-22 spanning 21 countries (weighted mean response rate = 71.4%). Standardized STB prevalence estimates were calculated for four well-defined groups of same-aged peers: college students, college attriters (i.e., dropouts), secondary school graduates who never entered college, and secondary school non-graduates. Logistic regression assessed the association between STB and college entrance as well as attrition from college., Results: Twelve-month STB in college students was 1.9%, a rate significantly lower than same-aged peers not in college (3.4%; OR 0.5; p < 0.01). Lifetime prevalence of STB with onset prior to age 18 among college entrants (i.e., college students or attriters) was 7.2%, a rate significantly lower than among non-college attenders (i.e., secondary school graduates or non-graduates; 8.2%; OR 0.7; p = 0.03). Pre-matriculation onset STB (but not post-matriculation onset STB) increased the odds of college attrition (OR 1.7; p < 0.01)., Conclusion: STB with onset prior to age 18 is associated with reduced likelihood of college entrance as well as greater attrition from college. Future prospective research should investigate the causality of these associations and determine whether targeting onset and persistence of childhood-adolescent onset STB leads to improved educational attainment.

Sexual assault on college campuses is a pervasive problem, recently receiving increased scientific and policy attention. However, the high focus on college student experience ignores general population prevalence, trends, and differences between those with college experience and those without. We analyze measures from the National Survey of Family Growth (NSFG) to provide a general population view of experiences with forced intercourse. Forced intercourse is a common experience in the U.S. population, has remained stable in recent years, and varies greatly by gender, age and race. The odds of forced intercourse are also significantly higher among those with less than four years of college. This ubiquitous public health problem is not limited to college campuses. Measures from the NSFG are an important resource for understanding population rates of (and trends in) forced intercourse, providing information to guide interventions and better target scientific investigation., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Theories relating the changing environment to human fertility predict declining natural resources may actually increase the demand for children. Unfortunately most previous empirical studies have been limited to cross-sectional designs that limit our ability to understand links between processes that change over time. We take advantage of longitudinal measurement spanning more than a decade of change in the natural environment, household agricultural behaviors, and individual fertility preferences to reexamine this question. Using fixed-effects models, we find that women experiencing increasing time required to collect firewood to heat and cook or fodder to feed animals (the dominant needs for natural resources in this setting) increased their desired family size, even as many other macro-level changes have reduced desired family size. In contrast to previous, cross-sectional studies we find no evidence of such a relationship for men. Our findings regarding time spent collecting firewood are also new. These results support the "vicious circle" perspective and economic theories of fertility pointing to the value of children for household labor. This feedback from natural resource constraint to increased fertility is an important mechanism for understanding long term environmental change.

Emotional influences on fertility behaviors are an understudied topic that may offer a clear explanation of why many couples choose to have children even when childbearing is not economically rational. With setting-specific measures of the husband-wife emotional bond appropriate for large-scale population research matched with data from a long-term panel study, we have the empirical tools to provide a test of the influence of emotional factors on contraceptive use to limit fertility. This article presents those tests. We use long-term, multilevel community and family panel data to demonstrate that the variance in levels of husband-wife emotional bond is significantly associated with their subsequent use of contraception to avert births. We discuss the wide-ranging implications of this intriguing new result.

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., Competing Interests: Declaration of Interest In the past three years, Dr. Kessler has served as a consultant for or received research support from Johnson & Johnson Wellness and Prevention, the Lake Nona Life Project, and Shire Pharmaceuticals. Dr. Kessler is a co-owner of DataStat, Inc., a market research company that carries out healthcare research. The other authors report no biomedical financial interests or potential conflicts of interest. Dr. Demyttenaere has served on advisory boards and speaker bureaus with Astra Zeneca, Eli Lilly, Lundbeck, Johnson & Johnson, Naurex and Servier. Dr. Demyttenaere has received grants from Eli Lilly, Fonds Ga Voor Geluk and Fonds voor Wetenschappelijk Onderzoek Vlaandereden.

Psychiatric disorders are one of the leading causes of disease-related disability in the world today. However, little is known about the ethnic variation of these disorders within populations. This is especially true in contexts outside of the United States and the European Diaspora. This study provides new evidence from South Asia on ethnic differences in Major Depressive Episode, Major Depressive Disorder, Panic Attack, Panic Disorder, Post-Traumatic Stress Disorder, and Intermittent Explosive Disorder. We use data from 400 adult interviews conducted in Nepal in a controlled comparison design as a case study. We use a series of multilevel logistic regression models to predict ethnic group differences in psychiatric disorders and episodes with measures from clinically validated World Mental Health survey instruments. Compared to the Brahmin/Chhetri group, we found historically excluded Dalits had statistically significantly higher odds of almost all psychiatric disorders and episodes. We also found that historically resilient Janajatis had statistically significantly lower odds of being diagnosed with PTSD than the majority Brahmin/Chhetri group. We also found no significant gender difference in MDD or MDE. Psychiatric disorders and episodes vary significantly by ethnicity within a rural Asian population, but gender differences are small.

This paper investigates the association between mass education and married women's experience with domestic violence in rural Nepal. Previous research on domestic violence in South Asian societies emphasizes patriarchal ideology and the widespread subordinate status of women within their communities and families. The recent spread of mass education is likely to shift these gendered dynamics, thereby lowering women's likelihood of experiencing domestic violence. Using data from 1775 currently married women from the Chitwan Valley Family Study in Nepal, we provide a thorough analysis of how the spread of mass education is associated with domestic violence among married women. The results show that women's childhood access to school, their parents' schooling, their own schooling, and their husbands' schooling are each associated with their lower likelihood of experiencing domestic violence. Indeed, husbands' education has a particularly strong, inverse association with women's likelihood of experiencing domestic violence. These associations suggest that the proliferation of mass education will lead to a marked decline in women's experience with domestic violence in Nepal., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: We provide rare evidence of factors producing psychiatric variation in a general population sample from rural South Asia. The setting is particularly useful for demonstrating that variations in the social organization of communities, often difficult to observe in rich countries, are associated with important variations in mental health., Methods: Clinically validated survey measures are used to document variation in psychiatric disorders among 401 adults. This sample is chosen from a systematic sample of the general population of rural Nepal, in a community-level-controlled comparison design. Multilevel logistic regression is used to estimate multivariate models of the association between community-level nonfamily social organization and individual-level psychiatric disorders., Results: Schools, markets, health services and social support groups each substantially reduce the odds of depression, post-traumatic stress disorder (PTSD), intermittent explosive disorder and anxiety disorders. Associations between schools, health services and social support groups and depression are statistically significant and independent of each other. The association between access to markets and PTSD is statistically significant and independent of other social organization and support groups., Conclusions: Community integration of some nonfamily social organizations promotes mental health in ways that may go unobserved in settings with many such organizations. More research on the mechanisms producing these associations is likely to reveal potential avenues for public policy and programs to improve mental health in the general population.

Conducting survey interviews on the internet has become an attractive method for lowering data collection costs and increasing the frequency of interviewing, especially in longitudinal studies. However, the advantages of the web mode for studies with frequent re-interviews can be offset by the serious disadvantage of low response rates and the potential for nonresponse bias to mislead investigators. Important life events, such as changes in employment status, relationship changes, or moving can cause attrition from longitudinal studies, producing the possibility of attrition bias. The potential extent of such bias in longitudinal web surveys is not well understood. We use data from the Relationship Dynamics and Social Life (RDSL) study to examine the potential for a mixed-device approach with active mode switching to reduce attrition bias. The RDSL design allows panel members to switch modes by integrating telephone interviewing into a longitudinal web survey with the objective of collecting weekly reports. We found that in this design allowing panel members to switch modes kept more participants in the study compared to a web only approach. The characteristics of persons who ever switched modes are different than those who did not - including not only demographic characteristics, but also baseline characteristics related to pregnancy and time-varying characteristics that were collected after the baseline interview. This was true in multivariate models that control for multiple of these dimensions simultaneously. We conclude that mode options and mode switching is important for the success of longitudinal web surveys to maximize participation and minimize attrition.

This article presents analyses of data from a pilot study in Nepal that was designed to provide an initial examination of the errors and costs associated with an innovative methodology for survey data collection. We embedded a randomized experiment within a long-standing panel survey, collecting data on a small number of items with varying sensitivity from a probability sample of 450 young Nepalese adults. Survey items ranged from simple demographics to indicators of substance abuse and mental health problems. Sampled adults were randomly assigned to one of three different modes of data collection: 1) a standard one-time telephone interview, 2) a "single sitting" back-and-forth interview with an interviewer using text messaging, and 3) an interview using text messages within a modular design framework (which generally involves breaking the survey response task into distinct parts over a short period of time). Respondents in the modular group were asked to respond (via text message exchanges with an interviewer) to only one question on a given day, rather than complete the entire survey. Both bivariate and multivariate analyses demonstrate that the two text messaging modes increased the probability of disclosing sensitive information relative to the telephone mode, and that respondents in the modular design group, while responding less frequently, found the survey to be significantly easier. Further, those who responded in the modular group were not unique in terms of available covariates, suggesting that the reduced item response rates only introduced limited nonresponse bias. Future research should consider enhancing this methodology, applying it with other modes of data collection (e. g., web surveys), and continuously evaluating its effectiveness from a total survey error perspective.

We study the influence of frequent survey measurement on behavior. Widespread access to the Internet has made important breakthroughs in frequent measurement possible-potentially revolutionizing social science measurement of processes that change quickly over time. One key concern about using such frequent measurement is that it may influence the behavior being studied. We investigate this possibility using both a population-based experiment with random assignment to participation in a weekly journal for twelve months (versus no journal) and a large-scale, population-based, journal-keeping study with weekly measurement for 30 months. Results reveal few of the measured behaviors are correlated with assignment to frequent measurement. Theoretical reasoning regarding the likely behavioral response to frequent measurement correctly predicts domains most vulnerable to this possibility. Overall, however, we found little evidence of behavioral response to frequent measurement., (Copyright © 2014 Elsevier Inc. All rights reserved.)

An international transition away from familially arranged marriages toward participation in spouse choice has endured for decades and continues to spread through rural Asia today. Although we know that this transformation has important consequences for childbearing early in marriage, we know much less about longer-term consequences of this marital revolution. Drawing on theories of family and fertility change and a rural Asian panel study designed to measure changes in both marital and childbearing behaviors, this study seeks to investigate these long-term consequences. Controlling for social changes that shape both marital practices and childbearing behaviors, and explicitly considering multiple dimensions of marital processes, we find evidence consistent with an independent, long-standing association of participation in spouse choice with higher rates of contraception to terminate childbearing. These results add a new dimension to the evidence linking revolutions in marital behavior to long-term declines in fertility and suggest that new research should consider a broader range of long-term consequences of changing marital processes.

This paper aims to increase understanding of the methodological issues involved in adding biomeasures to social research by investigating the potential of an event-triggered, self-collection technique for monitoring biological response to social events. We use data from the Relationship Dynamics and Social Life (RDSL) study, which collected saliva samples triggered by a life event important to the aims of the study - the end of a romantic relationship. Our investigation found little evidence that those who complied in the biosample collection were different from those who did not comply in terms of key study measures and sociodemographic characteristics. We also found no evidence that the biosample collection had adverse consequences for subsequent panel participation. We did find that prior cooperation in the study was an important predictor of biosample cooperation, which is important information in developing biosample collection strategies. As demand for biological samples directly linked to social data continues to grow, effective low-cost collection methods will become increasingly valuable. The evidence here indicates that self-collected biosamples may offer tremendous potential to meet this demand., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Efforts to develop and validate fully-structured diagnostic interviews of mental disorders in non-Western countries have been largely unsuccessful. However, the principled methods of translation, harmonization, and calibration that have been developed by cross-national survey methodologists have never before been used to guide such development efforts. The current report presents the results of a rigorous program of research using these methods designed to modify and validate the Composite International Diagnostic Interview (CIDI) for an epidemiological survey in Nepal., Methods: A five-step process of translation, harmonization, and calibration was used to modify the instrument. A blinded clinical reappraisal design was used to validate the instrument., Results: Preliminary interviews with local mental health expert led to a focus on major depressive episode, mania/hypomania, panic disorder, post-traumatic stress disorder, generalized anxiety disorder, and intermittent explosive disorder. After an iterative process of multiple translations-revisions guided by the principles developed by cross-national survey methodologists, lifetime DSM-IV diagnoses based on the final Nepali CIDI had excellent concordance with diagnoses based on blinded Structured Clinical Interview for DSM-IV (SCID) clinical reappraisal interviews., Conclusions: Valid assessment of mental disorders can be achieved with fully-structured diagnostic interviews even in low-income non-Western settings with rigorous implementation of replicable developmental strategies., (Copyright © 2013 John Wiley & Sons, Ltd.)

Research shows a strong association between traumatic life experience and mental health and important gender differences in that relationship in the western European Diaspora; but much less is known about these relationships in other settings. We investigate these relationships in a poor rural Asian setting that recently experienced a decade-long armed conflict. We use data from 400 adult interviews in rural Nepal. The measures come from World Mental Health survey instruments clinically validated for this study population to measure depression, posttraumatic stress disorder, and intermittent explosive disorder. Our results demonstrate that traumatic life experience significantly increases the likelihood of mental health disorders in this setting, and that these traumatic experiences have a larger effect on the mental health of women than men. These findings offer important clues regarding the potential mechanisms producing gender differences in mental health in many settings.

Theories of family stability and change, demographic processes, and social psychological influences on behavior all posit that parental attitudes and beliefs are a key influence on their children's behavior. Though we have evidence of these effects in Western populations, there is little information regarding this social mechanism in non-Western contexts. Furthermore, comparisons of mothers' and fathers' independent roles in these crucial intergenerational mechanisms are rare. This paper uses measures from a ten-year family panel study featuring independent interviews with both mothers and fathers in rural Nepal to investigate these issues. We test the association of specific attitudes, rather than broad ideational domains, about childbearing and old-age care with sons' subsequent marriage behavior. Our results indicate that both mothers' and fathers' attitudes have important and independent influences on sons' marriage behavior. Simultaneous study of both parents' attitudes reveals that gender-specific parenting contexts can shape the relationship between parental attitudes and children's behaviors. This crucial mechanism of intergenerational continuity and change is strong in this non-Western setting, with substantial implications for studies of intergenerational influences on behavior in all settings.

In this article, we construct and test a micro-level event-centered approach to the study of armed conflict and behavioral responses in the general population. Event-centered approaches have been successfully used in the macro-political study of armed conflict but have not yet been adopted in micro-behavioral studies. The micro-level event-centered approach that we advocate here includes decomposition of a conflict into discrete political and violent events, examination of the mechanisms through which they affect behavior, and consideration of differential risks within the population. We focus on two mechanisms: instability and threat of harm. We test this approach empirically in the context of the recent decade-long armed conflict in Nepal, using detailed measurements of conflict-related events and a longitudinal study of first migration, first marriage, and first contraceptive use. Results demonstrate that different conflict-related events independently shaped migration, marriage, and childbearing and that they can simultaneously influence behaviors in opposing directions. We find that violent events increased migration, but political events slowed migration. Both violent and political events increased marriage and contraceptive use net of migration. Overall, this micro-level event-centered approach yields a significant advance for the study of how armed conflict affects civilian behavioral responses.