Defining Despair: Assessing the Multidimensionality of Despair and Its Association with Suicidality and Substance Use in Early to Middle Adulthood

Citation

Gutin, Iliya; Copeland, William E.; Godwin, Jennifer; Harris, Kathleen Mullan; Shanahan, Lilly; & Gaydosh, Lauren (2023). Defining Despair: Assessing the Multidimensionality of Despair and Its Association with Suicidality and Substance Use in Early to Middle Adulthood. Social Science & Medicine, 320, 115764.

Abstract

Despite considerable scientific interest in documenting growing despair among U.S. adults, far less attention has been paid to defining despair and identifying appropriate measures. Emerging perspectives from social science and psychiatry outline a comprehensive, multidimensional view of despair, inclusive of individuals' cognitive, emotional, biological and somatic, and behavioral circumstances. The current study assesses the structure and plausibility of this framework based on longitudinal data spanning early to middle adulthood. We identified 40 measures of different dimensions of despair in Wave IV (2008-2009) of the National Longitudinal Study of Adult to Adolescent Health (n = 9149). We used structural equation modeling to evaluate hypothesized relationships among observed and latent variables; we then regressed Wave V (2016-2018) suicidality, heavy drinking, marijuana use, prescription drug misuse, and illicit drug use on latent despair. Our analyses find that models for separate dimensions of despair and overall despair demonstrated excellent fit. Overall despair was a significant predictor of Wave V outcomes, especially suicidality, accounting for 20% of its variation, as compared to 1%-7% of the variation in substance use. Suicidality was consistently associated with all domains of despair; behavioral despair explained the most variation in substance use. Given these results we contend that, lacking direct measures, latent despair can be modeled using available survey items; however, some items are likely better indicators of latent dimensions of despair than others. Moreover, the association between despair and key health behaviors varies considerably, challenging its status as a mechanism simultaneously underlying increased substance use and suicide mortality in the United States. Critically, further validation of measures in other surveys can improve the operationalization of despair and its associated conceptual and theoretical frameworks, thus advancing our understanding of this concept.

URL

http://dx.doi.org/10.1016/j.socscimed.2023.115764

Reference Type

Journal Article

Year Published

2023

Journal Title

Social Science & Medicine

Author(s)

Gutin, Iliya
Copeland, William E.
Godwin, Jennifer
Harris, Kathleen Mullan
Shanahan, Lilly
Gaydosh, Lauren

Article Type

Regular

Data Set/Study

National Longitudinal Study of Adolescent to Adult Health (Add Health)

Continent/Country

United States of America

State

Nonspecific

ORCiD

Gutin - 0000-0003-4216-8963
Harris, KM - 0000-0001-9757-1026