Papers by Natalie Sachs-Ericsson
The influence of depression on cognitive decline in community-dwelling elderly persons
An association between depression and cognitive decline (CD) has been observed in cross-sectional... more An association between depression and cognitive decline (CD) has been observed in cross-sectional and case/control studies of elderly populations. Whereas a handful of longitudinal community studies have found depressive symptoms to predate the onset of CD, others have found no association between depression and subsequent cognitive dysfunction. The authors examined the association between depressive symptoms and cognitive errors measured 3 years apart in a longitudinal sample of community-dwelling elderly persons. Data were obtained from 4,162 subjects assessed as part of the Established Populations for Epidemiologic Studies of the Elderly, a population survey assessing physical, psychological, and social functioning of persons 65 years and older. Depressive symptoms were associated with subsequent CD even after controlling for baseline cognitive status, as well as demographic (e.g., race, gender, age, and socioeconomic status) and physical functioning variables. This was true for the sample as a whole, as well as for a subsample of participants who evidenced no baseline cognitive difficulties. Study results are consistent with others finding an association between depressive symptoms and subsequent CD. Theories regarding the causal mechanisms underlying the association between depression and cognitive decline are discussed.
Validating a Psychiatric Self-Report Screening Form for Homeless Medical Patients
Psi Chi Journal of Psychological Research
... 1984; Farr, Koegel, & Burnam, 1986; Fischer, Shapiro, Breakey, Anthony, & Kramer, 198... more ... 1984; Farr, Koegel, & Burnam, 1986; Fischer, Shapiro, Breakey, Anthony, & Kramer, 1986; Morse & Calsyn, 1986; Mulkern, Bra-dley, Spence, Allein, & ... A copy of the client-FARS can be obtained from the second author, Natalie Sachs-Ericsson, PhD, Department of Psy-chology ...
Perceptions of belongingness and social support attenuate PTSD symptom severity among firefighters: A multistudy investigation
Psychological services, Jan 29, 2018
Firefighters experience high rates of posttraumatic stress disorder (PTSD). It is imperative to i... more Firefighters experience high rates of posttraumatic stress disorder (PTSD). It is imperative to identify malleable factors that protect against the development of PTSD symptoms among this population. We examined whether perceptions of belongingness broadly (Study 1) and social support from supervisors, coworkers, and family/friends specifically (Study 2) are associated with lower PTSD symptom severity among firefighters. Study 1 included 840 U.S. firefighters (91.1% male); participants completed the Interpersonal Needs Questionnaire and PTSD Checklist-Civilian Version. Study 2 included 200 U.S. women firefighters exposed to a Criterion A traumatic event; participants completed the Generic Job Stress Questionnaire, Life Events Checklist for Diagnostic and Statistical Manual of Mental Disorders-5, and PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5. Linear regression analyses were conducted, adjusting for the number of years participants served as firefighte...
When Emotional Pain Becomes Physical: Adverse Childhood Experiences, Pain, and the Role of Mood and Anxiety Disorders
Journal of clinical psychology, Jan 22, 2017
We examined the association between retrospective reports of adverse childhood experiences (ACEs)... more We examined the association between retrospective reports of adverse childhood experiences (ACEs) and painful medical conditions. We also examined the mediating and moderating roles of mood and anxiety disorders in the ACEs-painful medical conditions relationship. Ten-year longitudinal data were obtained from the National Comorbidity Surveys (NCS-1, NCS-2; N = 5001). The NCS-1 obtained reports of ACEs, current health conditions, current pain severity, and mood and anxiety disorders. The NCS-2 assessed for painful medical conditions (e.g., arthritis/rheumatism, chronic back/neck problems, severe headaches, other chronic pain). Specific ACEs (e.g., verbal and sexual abuse, parental psychopathology, and early parental loss) were associated with the painful medical conditions. Baseline measures of depression, bipolar disorder, and posttraumatic stress disorder were also associated with the number of painful medical conditions. Anxiety and mood disorders were found to partially mediate t...
Racial Differences in the Effect of Stress on Health and the Moderating Role of Perceived Social Support
Journal of aging and health, Jan 16, 2015
The current study examined racial differences in the relationship between late-life stress and he... more The current study examined racial differences in the relationship between late-life stress and health functioning and the moderating role of perceived social support (PSS) in older adults. A biracial sample of community-dwelling older adults (65+) from the first two waves of the Duke University's Established Populations for Epidemiologic Studies of the Elderly (EPESE; N = 2,952) was analyzed. Baseline levels of PSS and stress were obtained. Health status was assessed at baseline and follow-up. Analyses revealed a positive effect of PSS on health functioning. There was a three-way interaction among race, stress, and PSS on health functioning. Probing the interaction, for Caucasians, PSS was beneficial at low stress, but not high stress. For African Americans, PSS had a positive effect regardless of stress level. PSS is an important protective factor for preserving positive health in late-life; however, benefits may differ by race and intensity of stressor.
Suicide and aging: special issue of Aging & Mental Health
Aging & mental health, 2016
Aging & Mental Health, 2015
The accuracy of the Content should not be relied upon and should be independently verified with p... more The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden.
The long-term impact of combat exposure on health, interpersonal, and economic domains of functioning
Aging & Mental Health, 2015
Wartime combat exposure is linked to a broad array of negative outcomes. The current study identi... more Wartime combat exposure is linked to a broad array of negative outcomes. The current study identified potential differences between middle-to-older aged men exposed to combat and those not exposed for physical health, interpersonal, and economic functioning over 10 years. Post-traumatic stress disorder (PTSD) and social support were examined as moderators between combat exposure and outcomes. Data from the National Comorbidity Survey, baseline and 10-year follow-up, were utilized. Only men aged 50-65 at follow-up (N = 727) were included. Group differences between combat and non-combat men were examined. Regression analyses were performed to examine relationships between earlier combat and health, interpersonal, and economic outcomes over time, while controlling for important covariates. Combat-exposed men were at increased risk for asthma, arthritis/rheumatism, lung diseases, headaches, and pain; they also had greater marital instability. However, combat-exposed men reported economic advantages, including higher personal earnings at follow-up. For combat-exposed men, PTSD did not increase risk for headaches; however, PTSD in non-combat men was associated with increased risk for headaches at follow-up. Whereas combat-exposed men with higher levels of social support were less likely to report chronic pain at follow-up, there were no group differences in pain at lower levels of social support. Individuals who experience combat may be susceptible to later health and marital problems; however, as combat-exposed men age, they demonstrate some resilience, including in economic domains of life. Given that consequences of combat may manifest years after initial exposure, knowledge of combat exposure is necessary to inform treatments and the delivery of disability benefits.
The Gerontologist, 2015
Purpose of the Study: Combat is a risk factor for posttraumatic stress disorder (PTSD); however, ... more Purpose of the Study: Combat is a risk factor for posttraumatic stress disorder (PTSD); however, less is known about how exposure to combat in early adulthood may contribute to the development of PTSD as the individual ages. Prior exposure to trauma may "sensitize" people to respond more intensely to subsequent stressors. Further, aging initiates new challenges that may undermine previous coping strategies. Over the life course combat veterans may be more reactive to new stressors and thus be more vulnerable to PTSD. Design and Methods: This study draws on the two waves of the National Comorbidity Survey (NCS-1) and NCS-2 (10year follow-up). Participants were male (noncombat N = 620 and combat N = 107) and 50-65 years of age at Wave-2. At baseline, participants were assessed for exposure to wartime combat, number of Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses in the past year, and lifetime PTSD. At follow-up, PTSD occurring between waves was determined. A measure of recent life stressors was also obtained. Results: Using logistic regression analyses, combat predicted PTSD at follow-up (controlling for baseline demographics, number of DSM diagnoses in the past year, lifetime PTSD). Recent life stressors were also associated with PTSD. Importantly, the effect of combat on PTSD was significant at high levels, but not low levels, of recent life stress. Implications: Veterans who have experienced combat may be more reactive to new stressors, and in turn be more vulnerable to PTSD. Combat veterans should be regularly assessed for current stressors and PTSD.
The moderating effect of the APOE [small element of] 4 allele on the relationship between hippocampal volume and cognitive decline in older depressed patients
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2011
the apolipoprotein E epsilon-4 (APOE [small element of] 4) allele and depression are independentl... more the apolipoprotein E epsilon-4 (APOE [small element of] 4) allele and depression are independently associated with increased risk for cognitive decline (CD). The authors have reported that depressed elders with an APOE [small element of]4 allele had greater CD compared with depressed elders without the allele. Depression affects the hippocampus, and reduced hippocampal volume has been associated with CD. This study sought to examine in depressed patients the relationships between hippocampal volume, the APOE [small element of] 4 allele, and their interaction on CD. Analyses were performed to examine the influence of baseline hippocampal volume, the APOE [small element of] 4 allele, and their interactions on change in cognitive functioning overtime. secondary data analysis using linear regression analyses. clinical Research Center for the Study of Depression in Later Life conducted at Duke University. depressed older patients (N = 61) followed up for 4 years. At baseline, cognitive f...
Harman (1-methyl-beta-carboline) in blood plasma and erythrocytes of nonalcoholics following ethanol loading
Alcohol (Fayetteville, N.Y.)
Eleven subjects having no history of substance abuse or dependence who agreed to abstain from alc... more Eleven subjects having no history of substance abuse or dependence who agreed to abstain from alcohol for one week prior to the investigation were selected to participate in the present study. On two occasions, separated by four to six weeks, blood was drawn over an 8-hour period (0, 0.5, 1, 2, 4 and 8 hours). On the first occasion, subjects were given an oral dose of ethanol (1 g/kg) after the first blood sample was drawn (ethanol-loading condition). On the second occasion no ethanol was administered (control condition). On both occasions no detectable harman was found in the plasma of subjects. In the control condition harman was detected in the erythrocytes of 7 subjects which remained relatively stable over time. In the ethanol-loading condition, however, a time-dependent increase of harman in the erythrocytes was observed. The concentration of ethanol, acetaldehyde, and erythrocyte-harman showed a parallel trend over time. These findings demonstrate an increased level of harman...
The influence of depression on cognitive decline in community-dwelling elderly persons
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2005
An association between depression and cognitive decline (CD) has been observed in cross-sectional... more An association between depression and cognitive decline (CD) has been observed in cross-sectional and case/control studies of elderly populations. Whereas a handful of longitudinal community studies have found depressive symptoms to predate the onset of CD, others have found no association between depression and subsequent cognitive dysfunction. The authors examined the association between depressive symptoms and cognitive errors measured 3 years apart in a longitudinal sample of community-dwelling elderly persons. Data were obtained from 4,162 subjects assessed as part of the Established Populations for Epidemiologic Studies of the Elderly, a population survey assessing physical, psychological, and social functioning of persons 65 years and older. Depressive symptoms were associated with subsequent CD even after controlling for baseline cognitive status, as well as demographic (e.g., race, gender, age, and socioeconomic status) and physical functioning variables. This was true for ...
Racial differences in cognitive decline in a sample of community-dwelling older adults: the mediating role of education and literacy
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2005
The authors examined racial differences in cognitive decline (CD) and the role of education and l... more The authors examined racial differences in cognitive decline (CD) and the role of education and literacy in mediating this relationship. The relationship between race and CD was examined over a 3-year period in a biracial community sample of older adults (N = 3,097) living in North Carolina. African Americans, as compared with White participants, had fewer years of education and were more likely to be assessed by the interviewer as not literate. Race predicted CD such that African Americans had higher rates than Whites. When education and literacy were entered into the analysis, the association between race and CD, although remaining statistically significant, was reduced and was of relatively weak magnitude. Also, physical functioning problems also predicted CD and were found to be greater in African Americans than in Whites. Education and literacy may be protective factors against CD. Socioeconomic disadvantages experienced by older African Americans in the South early in life, le...
Depressive symptoms moderate the influence of the apolipoproteine epsilon4 allele on cognitive decline in a sample of community dwelling older adults
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2009
The apolipoproteinE epsilon4 (APOE epsilon4) allele and a history of depression are each separate... more The apolipoproteinE epsilon4 (APOE epsilon4) allele and a history of depression are each separate risk factors for cognitive decline (CD). However, little research has investigated whether a history of depression influences the relationship between APOE epsilon4 and CD. The present study examined whether depressive symptoms had greater influence on subsequent CD among participants with APOE epsilon4 than those without the allele. Prospective 6-year longitudinal study. Community in-home interviews. A biracial sample of community dwelling older adults (N = 1,992) from the Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE). Data were drawn from Waves 1 to 3 of the EPESE, which were conducted 6 years apart. Cognitive functioning and depressive symptoms were assessed at both waves, and APOE genotyping was completed during the Wave 3 assessment. Regression analyses revealed that depressive symptoms and the APOE epsilon4 allele independently predicted CD. Importa...
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2009
Few studies have investigated smoking and cognitive decline (CD) among older Mexican Americans. I... more Few studies have investigated smoking and cognitive decline (CD) among older Mexican Americans. In this study, the authors explore the relationship between smoking status and cognitive changes over time in a large sample of community-dwelling older adults of Mexican descent. Latent growth curve analyses were used to examine the decreasing growth in the number of correct responses on a test of cognitive functioning with increasing age (7 years with four data collection points). In-home interviews were obtained from participants residing in the Southwest United States. Participants were community-dwelling older Mexican Americans. Cognitive functioning was assessed at each of the four data collection points with the Mini-Mental State Examination. Participants' self-reports of health functioning and smoking status were obtained at baseline. With the inclusion of health variables and other control variables, the effect of smoking status on cognitive functioning was significant such t...
Depressed older patients with the atypical features of interpersonal rejection sensitivity and reversed-vegetative symptoms are similar to younger atypical patients
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2012
The atypical depression (AD) subtype has rarely been examined in older patients. However, younger... more The atypical depression (AD) subtype has rarely been examined in older patients. However, younger AD patients have been characterized as having more severe and chronic symptoms of depression compared with non-AD patients. Secondary data analysis by using analyses of variance and Growth Curve Modeling. Clinical Research Center for the study of depression in later life. Depressed older patients (N = 248) followed over 2 years. In a longitudinal study, we examined depression severity and chronicity in patients with major depression with some features of AD, specifically rejection sensitivity and reversed-vegetative symptoms (e.g., hyperphagia and hypersomnia), or leaden paralysis, and compared them to non-AD patients. The Diagnostic Interview Schedule (DIS) was used to assess depressive symptoms and history. Depression severity and chronicity were assessed every 3 months by using the Montgomery Asberg Depression Rating Scale. The AD symptom group reported more DIS depressive symptoms, ...
Organizational Behavior and Human Performance, 1980
The usefulness of multiattribute utility (MAU) analysis was assessed by comparing tl~e sensitivit... more The usefulness of multiattribute utility (MAU) analysis was assessed by comparing tl~e sensitivity to both relevant and irrelevant information of analytically derived judgments and of holistic judgments. Subjects evaluated four hypothetical apartments, described to them in a series of letters, by indicating how much rent they would be willing to pay for each apartment. In addition, they completed a survey that requested judgments about the six attributes that characterized the apartments. From the survey, evaluations of the apartments were derived from an additive MAU model. The holistic rental judgments exhibited little sensitivity to differences among the apartments. However, they did show a '"linearity effect," an ordering of the apartments that apparently reflected an oversimplified interpretation of the information. Derived judgments showed no linearity effect, and did show a sensitivity to apartment differences. There was some evidence that derived judgments were less sensitive if the MAU judgments were made after making the holistic judgments. Holistic and derived judgments were generally uncorrelated, presumably because of the heavy information processing demands imposed by the holistic judgment task. The freedom to make choices has for centuries served as an inspirational goal for philosophers, statesmen, and revolutionaries, but for many of us there seems at times to be too much such freedom. Faced with decisions, decisions, decisions, one is tempted to ask, "Is there not an easier way?" Whether choosing lunch, automobile, home, or mate, the availability of a ready decision aid might be one way of resolving the conflict and uncertainty that seems to surround us. For an increasing number of psychologists, statisticians, and operations researchers, the better way is to be found through the arts of decision analysis, and especially through the arcane mysteries of multiattribute utility theory. Most problems of importance require us to evaluate complex, multifaceted objects or events, and to find a resolution of potentially conflicting objectives. Multiattribute utility (MAU) procedures can provide some comfort and assistance to the person who is faced with such conflict. They are based on axiomatic theories that prescribe the conditions under The research reported in this paper was supported by a grant from the Graduate School of Southern Illinois University at Carbondale. We would like to thank Eric Claeys for his help in conducting the experiment and analyzing the data. Requests for reprints should be sent to:
Organizational Behavior and Human Performance, 1980
Subjects were asked to list as many choices as they could in response to typical problems of pers... more Subjects were asked to list as many choices as they could in response to typical problems of personal choice. Seven conditions were compared with respect to the number of choices generated. In three conditions, subjects were told what the decision maker's objectives might be, and were asked to think of choices that might satisfy these objectives. In two conditions subjects were shown examples of possible choices, either organized in categories or listed randomly. Two control conditions were used. All subjects responded to the same pretest problem, then responded to two test problems. When the objectives were presented to subjects one at a time, the number of choices was greater than in other conditions; among the other conditions, however, there were no differences in overall number of choices. The two conditions in which examples were shown did produce more choices related to the examples. These results may be useful for helping a person to generate a complete list of alternatives when using formal methods of decision analysis, This study was supported by funds from the Office of Research Development and Administration, Southern Illinois University at Carbondale. The results were first presented at the International Conference on Cybernetics and Society in October 1979. We would like to thank Eric Claeys for his hard work in helping to run the study and score the data.
Untersuchung biologischer Marker des Alkoholismus
Suchtproblematik, 1991
Depression in Later Life: Aetiology, Epidemiology, Assessment, Diagnosis and Treatment
Sinclair/Pathy's Principles and Practice of Geriatric Medicine, 2012
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Papers by Natalie Sachs-Ericsson