A nursing professor once told me how a graduate student came to her all excited. There was a population cohort dying from an epidemic of cardiac disease that had been ignored in the literature: women above age 85.
Now, while we can chuckle together about the naivete of the observation, consider it for a moment from the graduate student’s perspective:
1. Clearly the phenomenon was real as a high percentage of women over age 85 may well be dying of cardiac disease.
2. The red flag of gender bias stood out–it was women who were being victimized by this scourge.
3. A literature search turned up no one acknowledging the problem.
What was missing was the larger context: the twin facts that no one lives forever, and everyone eventually dies of something.
Sometimes more experienced researchers fail to provide the needed context. The following study came to my attention this week. Truth be known, I have not read the entire study, just the abstract and the accounts of those who have, so I will admit up front that this discussion may be unfair to the researchers.
The Canadian study is The long arm of parental addictions: The association with adult children’s depression in a population-based study.
It came to my attention in Trouble Coping with Parental Addiction
I am going to quote the abstract in full:
Parental addictions have been associated with adult children’s depression in several clinical and population-based studies. However, these studies have not examined if gender differences exist nor have they controlled for a range of potential explanatory factors. Using a regionally representative sample of 6268 adults from the 2005 Canadian Community Health Survey (response rate=83%), we investigated the association between parental addictions and adulthood depression controlling for four clusters of variables: adverse childhood experiences, adult health behaviors, adult socioeconomic status and other stressors. After controlling for all factors, adults exposed to parental addiction had 69% higher odds of depression compared to their peers with non-addicted parents (OR=1.69; 95% CI, 1.25–2.28). The relationship between parental addictions and depression did not vary by gender. These findings underscore the intergenerational consequences of drug and alcohol addiction and reinforce the need to develop interventions that support healthy childhood development.
The authors suggest that previous studies have not directly looked at gender differences of children of addicted parents. If so, then that is a clear contribution to the literature. But, the abstract and the descriptive article that I cited above go further: there is the clear implication that beyond a correlation or “relationship,” depression is the consequence of parental addiction.
Let’s consider two scenarios:
First, parents engage in substance abuse. The substance abuse causes them to act out, to neglect their children’s physical and emotional needs. The children grow up insecure and prone to depression. That is the clear implication of the abstract.
Second, a small but measurable percentage of the population inherit a tendency to mental illnesses (bi-polar, uni-polar depression, anxiety disorder, etc.) They self-medicate with both legal and illegal substances. They have children, whom they raise while self-medicating. A high percentage of their children inherit the tendency to mental illness, including uni-polar depression, and depressive cycles of bi-polar, showing a higher tendency toward those illnesses in the general population.
I find the second scenario more compelling. Indeed, attributing the problems of children to their parents because children follow their parents temporally is to my mind a classic case of the post hoc, ergo propter hoc logical fallacy in which one concludes that events following another event were caused by the previous event due to their proximity.
Runny noses do not cause colds, nor does “catching a chill,” whatever that means. Scientific studies are confusing enough to the general public, particularly through the filter of news media that do not look past the headline. We need researchers to be more cautious and guarded in their conclusions.
When we read that President Harry Truman wanted some “one-handed economists,” we can be sure that the economists were doing their job in informing him. We need the same of healthcare researchers.
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