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Stress and Psychotropic Drug Use among the Elderly: An Exploratory Model*

Published online by Cambridge University Press:  29 November 2010

Guillème M. Pérodeau ,
Suzanne King  and
Micheline Ostoj
Guillème M. Pérodeau
Affiliation:
Université du Québec à Hull Douglas Hospital Research Centre
Suzanne King
Affiliation:
Douglas Hospital Research Centre and McGill University
Micheline Ostoj
Affiliation:
Douglas Hospital Research Centre
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Abstract

The aim of the present study was to examine the effect of stressors and other factors on psychotropic drug consumption among the elderly, with an emphasis on individual rather than social factors. Respondents were recipients of a home care program that focusses on personal care rather than health-related care. Data were derived from two in-home interviews (one week apart) of 99 users of psychotropic drugs residing in a socially deprived suburb of a major Canadian city. The initial path-analytic model explained a significant amount (19%) of variance in the amount of drug use. Age, sex, attitudes towards psychotropic drug use, and life events were the predictors which remained in our trimmed model of drug use which explained 17 per cent of the variance. The results suggest that younger individuals reported greater drug use than older respondents. Positive attitudes towards psychotropics and being female were associated with the highest level of drug use. Path analysis did not support our hypothesis of a stress-related mental health model of drug use and, instead, raised important questions regarding social factors. Several explanations for the results are discussed. Suggestions for future study and clinical implications are offered.

Résumé

L'objectif de la présente étude était de tester un modèle de cheminement causal de l'effet du stress et divers autres facteurs sur l'utilisation de psychotropes par des personnes âgées en nous appuyant sur des facteurs d'ordre individuel plutôt que social. Les participants étaient des bénéficiaires d'un service de maintien plutôt que de soins à domicile. Les données sont basées sur une série de deux entrevues (à une semaine d'intervalle) faites au domicile de 99 utilisateurs de médicaments psychotropes provenant d'une banlieue socialement défavorisée d'une grande ville canadienne. Le modèle de cheminement causal initial contribue à une partie appréciable (19%) de la variance dans la consommation de psychotropes. Les prédicteurs qui composent notre modèle final, expliquant 17 pour cent de la variance dans la consommation de médicaments sont l'âge, le sexe, les attitudes envers les psychotropes et les événements de vie. Les personnes plus jeunes consomment plus de psychotropes que les plus vieux. Une attitude positive envers les psychotropes et le fait d'appartenir au sexe féminin est associée à un niveau de consommation élevé. L'analyse de cheminement causal n'a pas confirmé notre modèle de consommation de psychotropes en fonction du stress et a plutôt mis à jour de nouvelles questions liées aux facteurs sociaux. Des explications sont offertes à cet effet. Des suggestions de recherche futures ainsi que les retombées cliniques des données sont présentées dans la conclusion.

Keywords

StressPsychotropic DrugsElderly.Stresspsychotropespersonnes âgées.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 11 , Issue 4 , Winter/hiver 1992 , pp. 347 - 369
Copyright
Copyright © Canadian Association on Gerontology 1992

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References

Blazer, D. (1980). Life events, mental health functioning and the use of health care services by the elderly. American Journal of Public Health, 70(11), 1174–1179.CrossRefGoogle ScholarPubMed
Burns, B., & Phillipson, C. (1986). Drugs, ageing, and society: Social and pharmacological perspectives. London: Croom Helm.Google Scholar
Cafferata, G.L., Kasper, J., & Bernstein, A. (1983). Family roles, structure, and stressors in relation to sex differences in obtaining psychotropic drugs. Journal of Health and Social Behaviour, 24, 132–143.CrossRefGoogle ScholarPubMed
Canada Health Survey. (1981). The health of Canadians: Report of the Canada Health Survey. Ottawa: Supply and Services Canada.Google Scholar
Canadian Pharmaceutical Association. (1988). Compendium of pharmaceuticals and specialities (23rd ed.). Ottawa: Canadian Pharmaceutical Association.Google Scholar
Caplan, R.D., Abbey, A., & Abramis, D.S. (1984). Tranquillizer use and well-being: A longitudinal study of social and psychological effects. Michigan: Institute for Social Research.Google Scholar
Chambers, C.D., & White, O.Z. (1980). Characteristics of high-frequency consumers of prescription psychoactive drugs. Chemical Dependencies: Behavioral and Biomedical Issues, 4(1), 33–46.Google ScholarPubMed
Clinthorne, J.K., Cisin, I.H., Balter, M.B., Mellinger, G.D., & Uhlenhuth, E.H. (1986). Changes in popular attitudes and beliefs about tranquillizers. Archives of General Psychiatry, 43, 527–532.CrossRefGoogle Scholar
Cooperstock, R. (1971). Sex differences in the use of mood-modifying drugs: An explanatory model. Journal of Health and Social Behaviour, 12, 238–244.CrossRefGoogle ScholarPubMed
Cooperstock, R., & Sims, M. (1971). Mood-modifying drugs prescribed in a Canadian city: Hidden problems. American Journal of Public Health, 61(5), 1007–1016.CrossRefGoogle Scholar
Derogatis, L.R., Lipman, R.S., Rickeis, K., Uhlenhuth, E.H., & Covi, L. (1974). The Hopkins Symptom Checklist: A self-report inventory. Behavioral Science, 19, 1–15.CrossRefGoogle Scholar
Duke University. (1978). Multidimensional functional assessment: The OARS methodology manual (2nd ed.). Durham, NC: The Duke University Center for the Study of Aging and Human Development.Google Scholar
Dunbar, G.C., Perera, M.H., & Jenner, F.A. (1989). Patterns of benzodiazepine use in Great Britain as measured by a general population survey. British Journal of Psychiatry, 155, 836–841.CrossRefGoogle ScholarPubMed
Eve, S.B., & Friedsam, H.J. (1981). Use of tranquillizers and sleeping pills among older Texans. Journal of Psychoactive Drugs, 13(2), 165–173.CrossRefGoogle ScholarPubMed
Folkman, S., Bernstein, L., & Lazarus, R. (1987). Stress process and the misuse of drugs in older adults. Psychology and Aging, 2(4), 366–374.CrossRefGoogle ScholarPubMed
Folkman, S., Lazarus, R.S., Pimley, S., & Novacek, J. (1987). Age differences in stress and coping processes. Psychology and Aging, 2, 171–184.CrossRefGoogle ScholarPubMed
Gabe, J., & Berry, M. (1988). Tranquillizers as a social problem. The Sociological Review, 36(2), 320–352.CrossRefGoogle Scholar
Gabe, J., & Lipshitz-Phillips, S. (1984). Tranquillizers as social control? Sociological Review, 32, 525–546.CrossRefGoogle Scholar
Glantz, M. (1981). Prediction of elderly drug abuse. Journal of Psychoactive Drugs, 13(2), 117–126.CrossRefGoogle ScholarPubMed
Glantz, M., & Backenheimer, M.S. (1988). Substance abuse among elderly women. Clinical Gerontologist, 81(1), 3–26.CrossRefGoogle Scholar
Guttman, P. (1978). Patterns of legal drug use by older Americans. Addictive Diseases: An International Journal, 3(3), 337–358.Google Scholar
Harel, Z., & Deimling, G. (1984). Social resources and mental health: An empirical refinement. Journal of Gerontology, 39(6), 747–752.CrossRefGoogle ScholarPubMed
Helman, C.G. (1981a). Tonic, fuel, and food: Social and symbolic aspects of the longterm use of psychotropic drugs. Social Science and Medicine, 15B, 521–533.Google ScholarPubMed
Helman, C.G. (1981b). Patients' perceptions of psychotropic drugs. Journal of the Royal College of General Practitioners, 31, 107–112.Google ScholarPubMed
Huffine, C.L., Folkman, S., & Lazarus, R.S. (1989). Psychoactive drugs, alcohol, and stress and coping processes in older adults. American Journal of Drug and Alcohol Abuse, 15(1), 101–113.CrossRefGoogle ScholarPubMed
Johnson, J.E., & Lauver, D.R. (1989). Alternative explanations of coping with stressful experiences associated with physical illness. Advances in Nursing Science, 11(2), 39–52.CrossRefGoogle ScholarPubMed
Jöreskog, K.G., & Sörbom, D. (1986). LISREL VI: Analysis of linear structural relationships. Chicago: National Educational Resources.Google Scholar
Kiyak, A., Liang, J., & Kahana, E. (1976). A methodological inquiry into the schedule of recent life events. Paper presented at the meeting of the American Psychological Association, Washington, DC.Google Scholar
Koumjian, K. (1981). The use of valium as a form of social control. Social Science and Medicine, 15E, 245–249.Google ScholarPubMed
Lader, M., & Higgitt, A. (1986). Management of benzodiazepine dependence. British Journal of Addiction, 81, 7–10.CrossRefGoogle ScholarPubMed
Lapierre, L., & Adams, O.B. (1989). Les personnes âgées. Québec: Les publications du Québec.Google Scholar
Lennard, H.L., & Cooperstock, R. (1980). The social context and functions of tranquillizer prescribing. In Mapes, R. (Ed.), Prescribing Practice and Drug Usage (pp. 73–82). London: Croom Helm.Google Scholar
Lexchin, J. (1990). Drug makers and drug regulators: too close for comfort. A study of the Canadian situation. Social Science and Medicine, 31, 1257–1264.CrossRefGoogle Scholar
Marks, J. (1983). The benzodiazepines: for good or evil. Neuropsychobiology, 10, 115–128.CrossRefGoogle ScholarPubMed
McCrae, R.M. (1982). Age differences in the use of coping mechanisms. Journal of Gerontology, 37(4), 454–460.CrossRefGoogle ScholarPubMed
Morgan, K. (1983). Sedative-hypnotic drug use and aging. Archives of Gerontology and Geriatrics, 2(3), 181–199.CrossRefGoogle Scholar
Murray, J., Dunn, G., Williams, P., & Tarnapolski, A. (1981). Factors affecting the consumption of psychotropic drugs. Psychological Medicine, 11, 551–560.CrossRefGoogle ScholarPubMed
Parry, H.J., Balter, M.B., Mellinger, G.D., Cisin, I.H., & Manheimer, D.J. (1973). National patterns of psychotherapeutic drug use. Archives of General Psychiatry, 28, 769–783.CrossRefGoogle ScholarPubMed
Peterson, L.G., & Perl, M. (1982). Psychiatric presentations of cancer. Psychosomatics, 23(6), 601–604.CrossRefGoogle ScholarPubMed
Pihl, R.O., Murdoch, D., Lapp, J.E., & Marinier, R. (1986). Psychotrope and alcohol use by women: One or two populations? Journal of Clinical Psychology, 42(6), 991–999.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
Plante, M.A. (1989). La consommation de psychotropes par la population âgée de la région des Laurentides. Hôtel-Dieu de Saint-Jérome: Département de santé communautaire.Google Scholar
Radloff, L. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
Régie de l'assurance maladie. (1986). Statistiques annuelles (28th ed.). Québec: Gouvernement du Québec.Google Scholar
Riska, E. (1989). How the sex differences in the use of psychotropic drugs are explained. Scandinavian Journal of Social Medicine, 170, 3–6.CrossRefGoogle Scholar
Shrout, P.E., Link, B.G., Dohrenwend, B.P., Skodol, A.E., Stueve, A., & Mirotznik, J. (1989). Characterizing life events as risk factors for depression: The role of fateful loss events. Journal of Abnormal Psychology, 98(4), 460–467.CrossRefGoogle ScholarPubMed
Smart, R.G., & Adlaf, E.M. (1988). Alcohol and drug use among the elderly: Trends in use and characteristics of users. Canadian Journal of Public Health, 79(4), 236–242.Google ScholarPubMed
Stephens, R.C., Haney, C.A., & Underwood, S. (1981). Psychoactive drug use and potential misuse among persons aged 55 years and older. Journal of Psychoactive Drugs, 13(2), 185–193.CrossRefGoogle ScholarPubMed
Turnbull, J.M. (1989). Anxiety and physical illness in the elderly. Journal of Clinical Psychiatry, 50(11), Suppl., 40–45.Google ScholarPubMed
U.S. Department of Health and Human Services (1982). Guide to drug abuse research terminology. Rockville, MD: National Institute on Drug Abuse.Google Scholar
Vallerand, R.J. (1989). Vers une méthodologie de validation transculturelle de questionnaires psychologiques: Implications pour la recherche en langue française. Psychologie Canadienne, 30, 662–680.CrossRefGoogle Scholar
Vestal, R.E. (1978). Drug use in the elderly: A review of problems and special considerations. Drugs, 16, 358–382.CrossRefGoogle ScholarPubMed
Vézina, J., & Bourque, P. (1985). Les stratégies comportementales adoptées par les personnes âgées devant les sentiments dépressifs. Canadian Journal on Aging, 4(3), 161–169.CrossRefGoogle Scholar
Wolfle, L.M., & Ethington, C.A. (1985). GEMINI: Program for analysis of structural equations. Behaviour Research Methods, Instruments and Computers, 17(5), 581–584.CrossRefGoogle Scholar