It was hypothesized that women are more vulnerable to depressive symptoms than men because they are more likely to experience chronic negative circumstances (or strain), to have a low sense of mastery, and to engage in ruminative coping. The hypotheses were tested in a 2-wave study of approximately 1,100 community-based adults who were 25 to 75 years old. Chronic strain, low mastery, and rumination were each more common in women than in men and mediated the gender difference in depressive symptoms. Rumination amplified the effects of mastery and, to some extent, chronic strain on depressive symptoms. In addition, chronic strain and rumination had reciprocal effects on each other over time, and low mastery also contributed to more rumination. Finally, depressive symptoms contributed to more rumination and less mastery over time.

Two models are proposed to relate maladaptive emotion regulation strategies and alcohol-related problems for women with a history of childhood sexual assault (CSA). The distress coping model suggests only one motive-drinking to cope with negative emotions-mediates the relationship between CSA and alcohol problems. The emotion regulation model suggests two motives mediate the relationship between CSA and alcohol problems: drinking to cope with negative emotions and drinking to enhance positive emotions. These models were tested in a random community sample of 697 women, ranging from 25 to 75 years old. Both motives partially mediated the relationship between CSA and alcohol problems. Effects were small, but reliable.

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Objective To assess the impact of providing an educational videotape,`Treatment Choices for Ischaemic Heart Disease: a Shared Decision-Making Program Videotape,' to patients referred for coronary angiography compared with standard patient-physician decision making (usual care). Study design Randomized controlled clinical trial.Setting University Hospital and Veterans A airs Hospital.Patients A consecutive sample of 217 patients referred for coronary angiography were randomized to receive`usual care' or to receive the videotape in addition to standard patient physician decision making (videotape): 109 completed the study (50% completion rate).Main outcome measures Knowledge of coronary artery disease, satisfaction, self-reported physical and mental health functioning, and the proportion of patients who were referred for coronary revascularization.Results Compared with patients who received`usual care,' those who received the videotape were more knowledgeable (mean score 83 vs. 58%; P < 0.0001) but less satis®ed with their treatment (79 vs. 88%; P 0.038). There were no signi®cant differences between the videotape and`usual care' groups with respect to satisfaction with the decision making process (mean score 73 vs. 77%; P 0.37), satisfaction with the decision made (mean score 73 vs. 78%; P 0.28), physical functioning (38 vs. 38%; P 0.76), mental health functioning (49 vs. 49%; P 0.94), or in referral for coronary revascularization (OR 0.60; 95% CI 0.22±1.65; P 0.33).Conclusion Although the educational videotape increased patients' knowledge level, it was associated with a decrease in their level of satisfaction with treatment. Before there is wide-spread dissemination of this technology, advocates should demonstrate its e ectiveness in everyday practice.