Subjective Social Status and Psychological Distress in Mothers of Young Children

Subjective Social Status and Longitudinal Changes in Systemic Inflammation

BACKGROUND

Subjective social status (SSS) refers to a person's perception of their social rank relative to others and is cross-sectionally linked to systemic inflammation independently of objective socioeconomic status.

PURPOSE

We test the extent to which SSS relates to multiyear changes in inflammation, or if associations differ by race or sex.

METHODS

Healthy adults (N = 331; 30-51 years) completed a baseline visit and 278 participants returned for a second visit 2.85 years later. At both visits, participants underwent a fasting blood draw and completed community (SSSC) and US (SSSUS) versions of the MacArthur Scale. Multiple linear regression analyses examined change in interleukin-6 (IL-6) and C-reactive protein (CRP) predicted by each type of SSS, adjusting for time between visits, sex, race, age, body mass index, smoking, baseline inflammation, and objective socioeconomic status. Additional analyses further adjusted for hopelessness and depressive symptoms. Interactions examined moderations by sex and race.

RESULTS

Lower SSSC was longitudinally associated with greater IL-6 independently of all covariates, including education and income (β = -0.06), hopelessness (β = -0.06), and depressive symptoms (β = -0.06). Lower SSSUS was longitudinally associated with greater IL-6 independently of demographic covariates including education and income (β = -0.06), but was slightly attenuated after adjusting for hopelessness (β = -0.06) and depressive symptoms (β = -0.06). There were no associations for CRP or moderation by race or sex.

CONCLUSIONS

Lower SSS may be associated with greater circulating markers of inflammation over time as suggested by increases in IL-6.

Allostatic load in children: The cost of empathic concern

Early-life adversity affects long-term health outcomes but there is considerable interindividual variability in susceptibility to environmental influences. We proposed that positive psychological characteristics that reflect engagement with context, such as being concerned about people or performance on tasks (i.e., empathic concern), could moderate the interindividual variation in sensitivity to the quality of the early environment. We studied 526 children of various Asian nationalities in Singapore (46.6% female, 13.4% below the poverty line) with longitudinal data on perinatal and childhood experiences, maternal report on empathic concern of the child, and a comprehensive set of physiological measures reflecting pediatric allostatic load assessed at 6 y of age. The perinatal and childhood experiences included adversities and positive experiences. We found that cumulative adverse childhood experience was positively associated with allostatic load of children at 6 y of age at higher levels of empathic concern but not significantly associated at lower levels of empathic concern. This finding reveals evidence for the importance of empathic concern as a psychological characteristic that moderates the developmental impact of environmental influences, serving as a source for vulnerability to adversities in children.

Importance of caregivers' subjective social status and neighbourhood disadvantage for adolescents with type 1 diabetes

AIMS

Adolescents with type 1 diabetes from low-income populations are more likely to have difficulty in managing their diabetes and ultimately have poorer glycaemic outcomes, but less is known about neighbourhood-level factors or subjective social status (SSS) as risk/protective factors. We examined associations between multiple indicators of socio-economic status with diabetes outcomes.

METHODS

One hundred and ninety-eight adolescents ages 13-17 (58% female, 58% White, non-Hispanic) experiencing moderate diabetes distress completed measures of diabetes management and diabetes distress, and their caregivers reported on SSS. Glycaemic indicators were extracted from medical records, and participants' addresses were used to determine area deprivation index (ADI).

RESULTS

Higher levels of neighbourhood disadvantage were significantly associated with higher haemoglobin A1c levels and average glucose levels, but caregivers' SSS was more strongly associated with all glycaemic indicators, diabetes management and diabetes distress.

CONCLUSIONS

Given strong associations between caregivers' SSS and glycaemic control, diabetes management, and diabetes distress, screening for caregivers' SSS may identify adolescents who would benefit from additional support.

The Socioeconomic Indicators Linked to Parent Health-Related Technology Use: Cross-sectional Survey

Background

Despite the prevalence of parent health information seeking on the internet and its impact on parenting behavior, there is a paucity of research on parents of young children (ages 3 to 8 years). Given the importance of this developmental period, exploring how family socioeconomic indicators linked to the digital divide and health inequities affect parent proxy- and self-seeking is critical to further understanding variability in health information seeking and associated outcomes.

Objective

This study aimed to explore parental health-related technology use (HTU), the process by which parents engage in support, advice, and information-seeking behavior related to their (self-seeking) and their children’s (proxy seeking) health across a range of hardware devices (eg, tablet, wearable, smartphone, laptop, and desktop computer) and sources (eg, search engines, mobile applications, social media, and other digital media).

Methods

A cross-sectional study including 313 parents and guardians of children ages 3 to 8 years recruited through Amazon Mechanical Turk (MTurk) was conducted. Parents were asked to complete a self-administered questionnaire on a broad range of parenting and parent-related constructs, including sociodemographic information, technology device ownership, and engagement in and use, features, and perceptions of HTU. Descriptive and bivariate analyses (chi-square tests) were performed to identify patterns and investigate associations between family socioeconomic indicators and parent HTU.

Results

The overwhelming majority (301/313, 96%) of parents of young children reported engaging in HTU, of which 99% (300/301) reported using search engines (eg, Google), followed by social media (62%, 188/301), other forms of digital media (eg, podcasts; 145/301, 48%), and mobile applications (114/301, 38%). Parents who engaged in HTU reported seeking information about their child’s behavior and discipline practices (260/313, 83%), mental or physical health (181/313, 58%), and academic performance (142/313, 45%). Additionally, nearly half (134/313, 43%) of parents reported searching for advice on managing their stress. Among parents who reported using each source, an overwhelming majority (280/300, 93%) indicated that search engines were a helpful online source for proxy- and self-seeking, followed by social media (89%, 167/188), other digital media (120/145, 83%), and mobile apps (87/114, 76%). Among parents who reported using any technology source, approximately one-fifth reported that technology sources were most comfortable (61/311, 20%), most understanding (69/311, 22%), and most influential toward behavior change (73/312, 23%) compared to traditional sources of health information–seeking, including mental health professionals, other health care professionals, school professionals, community leaders, friends, and family members. Indicators of family socioeconomic status were differentially associated with frequency and perceptions of and search content associated with parent HTU across technology sources.

Conclusions

The findings of this study underscore critical considerations in the design and dissemination of digital resources, programs, and interventions targeting parent and child health, especially for families in traditionally underserved communities.

The relationship between duration of subjective poverty and health among Chinese adults: Evidence from the China Family Panel Study

Introduction

The disadvantaged socioeconomic status could have accumulated negative effects on individual. In the Chinese context, studying subjective and relative poverty is more important under the implementation of the Targeted Poverty Alleviation campaign. This study aims to provide evidence of the relationship between the duration of subjective poverty and both physical and mental health among Chinese adults, using nationally longitudinal data from 2010 to 2018.

Materials and methods

Data were extracted from a nationally representative survey database-the China Family Panel Study (CFPS). The total sample size contains 12,003 adults, with 3,532 in the urban area and 8,471 in the rural area. Self-rated health and depressive symptoms were set as indicators of physical health and mental health, respectively. The duration of subjective poverty was measured by self-rated income level in the local area from 2010 to 2016. A series of ordinary least square regression was adopted to measure the relationship between duration of subjective poverty and health.

Results

For the urban residents, the average duration of subjective poverty is 1.99 time points, while 1.98 time points for the rural residents. Net of objective poverty, duration of subjective poverty has a significantly negative association with individual's self-rated health in the rural sample (Coef. = -0.10, p < 0.001). Compared with those who have not experienced subjective poverty, the self-rated health score of people who experienced four time points is likely to decrease by 0.54 in the rural area and 0.30 in the urban area. In terms of mental health, 1 unit increase in the duration of subjective poverty is related to 0.15 unit increase in Center for Epidemiologic Studies Depression Scale-8 (CES-D8) scores in the urban sample and 0.46 in the rural sample. Compared with those who have not experienced subjective poverty, the CES-D8 scores of people who experienced four time points are likely to increase by 1.47 in the rural area and 0.95 in the urban area.

Conclusion

A longer duration of subjective poverty has a cumulatively negative effect on Chinese residents' physical and mental health, especially in rural area. Our study advocates researchers and policymakers pay more attention to the cumulative effect of subjective poverty on health.

Subjective social status and allostatic load in mothers 1 year after birth

OBJECTIVE

Subjective social status (SSS) refers to an individual's perception of relative social rank. We tested associations between SSS and allostatic load, a multisystem index of physiological dysregulation, in a sample of women 1 year after the birth of a child.

METHOD

Participants (n = 1,168) in the Community Child Health Network study were recruited in five sites across the United States shortly after the birth of a child. SSS was assessed at 6 months after birth using the MacArthur Scale of Subjective Social Status. Participants also reported household income and years of education completed. Biomarkers were assessed and allostatic load was calculated by assigning one point for each of 10 biomarkers above clinical cutoffs at a subsequent visit approximately 6 months later. Multiple linear regression analyses tested associations of SSS with allostatic load, adjusting for socioeconomic (SES) indicators of household income, years of education, and other covariates (race/ethnicity, relationship status, maternal age, and study site). We also tested interactions between each of the objective SES measures and SSS.

RESULTS

Higher SSS predicted lower subsequent allostatic load independent of household income, education, and other covariates. Associations between SSS and allostatic load were strongest at higher levels of income and education.

CONCLUSIONS

Study findings demonstrate associations between perceptions of relative social standing and wear-and-tear on multiple physiological systems above and beyond indicators of objective SES, suggesting that psychosocial aspects of lower status may contribute to the gradient between social status and health. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Integrating Objective and Subjective Social Class to Advance Our Understanding of Externalizing Problem Behavior in Children and Adolescents: A Conceptual Review and Model

Extant research has identified both objective measures of socioeconomic status (SES) and subjective social class (SSC) as important predictors of psychosocial outcomes in childhood and adolescence, particularly with regard to externalizing symptoms. Given the importance of the associations with SES and SSC, a more nuanced and integrated conceptual understanding of early pathways of vulnerability implicated in the development and maintenance of youth externalizing problems is warranted. Thus, this review will: (1) operationalize both SES and SSC and their current standards of measurement; (2) examine current literature describing their respective associations with a range of externalizing symptoms in both children and adolescents; (3) review current theoretical models connecting SES and SSC and youth development and the strengths and limitations of those approaches; (4) propose a new conceptual socioecological model situating the impact of SES and SSC on youth externalizing problems in the context of parents and peers as a framework to further integrate existing research and guide future work; and (5) discuss potential clinical implications at the intersection of this work.

Relationships of Social Support, Stress, and Health among Immigrant Chinese Women in Japan: A Cross-Sectional Study Using Structural Equation Modeling

Social support could help immigrant Chinese women in Japan to improve health. However, these women suffer from numerous stresses associated with acculturation and child-rearing, which could impact the effect of social support on mental and physical health. This study aims to identify the relationships among social support, acculturative stress, parenting stress, mental health, and physical health to propose a structural path model of these relationships and to evaluate the mediating role of stress between social support and health. A questionnaire was used to collect data for the main variables and demographic factors. A total of 109 women participated (mean age 33.9 ± 5.6 years). The results show that immigrant Chinese women in Japan experienced a low level of mental health (44.7 ± 9.8). Additionally, social support directly influenced parenting stress (β = −0.21, p < 0.05), acculturative stress (β = −0.19, p < 0.05), and mental health (β = 0.31, p < 0.001) and indirectly influenced physical health (β = 0.09, p < 0.05). Parenting stress partially mediated the association between social support and mental health (β = 0.09, p < 0.05). To protect the effectiveness of social support on mental health, it is essential to reduce the parenting stress of immigrant Chinese women.

COVID-19 Quarantine-Related Mental Health Symptoms and their Correlates among Mothers: A Cross Sectional Study

Background

One of the strictest quarantines worldwide to limit the spread of coronavirus was enforced in Jordan during the COVID-19 pandemic.

Objectives

This study investigated reported mental health and changes in lifestyle practices among Jordanian mothers during COVID-19 quarantine. The specific objectives included studying the level of depression, anxiety, and stress symptoms and their potential statistical associations with demographic and lifestyle variables. Furthermore, the study aimed to investigate differences in mental health between different demographic and socio-economic groups and to examine the major lifestyle changes that occurred on mothers during the quarantine.

Methods

An online survey was developed and administered to 2103 mothers. Participants were asked to complete a sociodemographic data form, Depression, Anxiety, and Stress Scale (DASS-21), and a lifestyle section comparing the life of mothers before and during the quarantine. Reported scores of depression, anxiety, and stress were calculated and compared across different levels of demographics including income, education level, employment status, and city of residence.

Results

This study found that mothers with lower income, lower education, not employed, or living in cities outside the capital of Jordan reported having more depression, anxiety, and stress symptoms (p < .005). Changes in their lifestyle practices included weight gain, increased time allocated for teaching children at home, increased familial violence at home, and increased time allocated for caring for their family members (average increase of 5 hours daily).

Conclusions for Practice

The unprecedented times of quarantine have put mothers in unprecedented reported mental health problems. Providing psychological support to this group might be a priority.

Perceived family and individual social status and its association with depression and suicidality in an adolescent clinical sample

There is a well-documented association between subjective social status (SSS) and depression among adults. Yet, the research on SSS and suicidal thoughts and behaviors among adolescent minority populations is limited. The aim of this study was to examine the relationship between the adolescent's SSS and mental health in an adolescent sample. A total of 197 adolescents ages 12 to 18 years (M age = 14.58; SD = 1.54) and their parents were recruited in urban outpatient clinics. Sociodemographics and measures of depression, suicidal thoughts and behaviors, and SSS were collected in a cross-sectional survey and through chart review. Univariate and multivariate analyses were conducted to calculate statistical associations with depression and suicidal thoughts and behaviors. Significant negative associations were found between SSS and depression, suicidal ideation, and prior suicidal attempts, independent of socioeconomic status. Consideration should be given to assessing measures of social rank to appraise risk in adolescent outpatient clinical settings.

One Roof, Three Generations: Grandparental Co-residence and Child Outcomes in China

This study examined the association between grandparental co-residence and child academic and behavioral outcomes using a sample from Shanghai, China (n = 1,763), and was built on two theoretical perspectives: intergenerational solidarity theory and the contextual model of family stress. These models integrate the impact of residential and relational proximity to grandparents on child well-being and underscore the importance of family context. This study also explored the moderating effects of family resources using proxies that prior theoretical and empirical studies have found to be important to such associations: family income, parental education, hukou status, and subjective social status. Results indicated that among families without co-residing grandparents, rural and low-income parents reported their children to have more externalizing behavioral issues than their respective urban and non-low-income counterparts. In addition, children who resided in poorly resourced families (i.e., low family income, low parental education, low subjective social status, or rural hukou status) tended to benefit from living with grandparents compared to their well-resourced counterparts in terms of lower externalizing and internalizing behaviors reported by teachers. These results do not negate the potential beneficial effects of living with grandparents for children in well-resourced environments. Implications for practice and policy, as well as future research directions, are discussed.

Unemployment and mental health in the German population: the role of subjective social status

Purpose

Subjective social status (SSS) reflects individuals’ perceived position in a social hierarchy. Low SSS is associated with several mental health impairments. The aim of this cross-sectional study was to examine if unemployed individuals report lower SSS in Germany (national SSS) and lower SSS in their social community (local SSS) than employed individuals. Moreover, the relationship between unemployment, SSS, and mental health was examined.

Patients and methods

113 unemployed and 1117 employed individuals from a representative German panel provided information on their national and local SSS, their monthly income and their mental health. SSS was assessed with the German version of the MacArthur Scales. Mental health was measured using the mental component scale (MCS) of the SF-12.

Results

Unemployed individuals reported significantly lower national SSS, local SSS and mental health compared to employed participants. Mediational analyses suggest that the negative effect of employment status on mental health was explained via a reduction of national SSS. Local SSS did not mediate the association of employment status and mental health.

Conclusion

Unemployment is associated with lower SSS and reduced mental health. The perceived position relative to others in the country (ie, national SSS) mediates the association between employment status and mental health.

Social rank theory of depression: A systematic review of self-perceptions of social rank and their relationship with depressive symptoms and suicide risk

BACKGROUND

Depression can be debilitating, as well as a risk factor for self-harm and suicide. Social rank theory (SRT) suggests depression stems from feelings of defeat and entrapment that ensue from experiencing oneself to be of lower rank than others. This study aims to review the literature investigating the relationship between self-perceptions of social rank and depressive symptoms or suicidal ideation/behaviour.

METHODS

A keyword search of three psychological and medical databases was completed (Psychinfo, Medline, Web of Knowledge). Studies were quality assessed using established criteria.

RESULTS

An initial 1290 records were identified. After application of inclusion and exclusion criteria, 70 remained measuring depressive symptoms (n = 68), self-harm (n = 3) and suicidal ideation (n = 3). The main measures assessing social rank were the social comparison scale (SCS; n = 32) and subjective social status (SSS, n = 32), with six additional papers including another measure of social rank. In univariate analyses, as perceptions of social rank decreased, depressive symptoms (and suicidal ideation/self-harm) increased. Multivariate analyses indicated that social rank may act as a psychosocial mechanism to explain the relationship between social factors (in particular socio-economic status) and depressive symptoms. Additionally, psychological variables, such as rumination or self-esteem, may mediate or moderate the relationship between social rank and depressive or suicidal symptoms.

LIMITATIONS

Study quality was variable and 89% of studies were cross-sectional.

CONCLUSIONS

Although more prospective research is required, this review highlights the importance of understanding an individual's perception of their social position compared to others as it may lead to an enhanced understanding of the aetiology of depressive disorders.

Making meaning from money: Subjective social status and young children's behavior problems

While early exposure to poverty has been linked to decrements in children's behavior through underlying pathways of parenting stress and depression, extant research has typically relied on the use of objective measures of socioeconomic status (SES) to test these associations. However, children's development may be shaped by the ways that parents perceive social class, which may operate independently and differentially from objective SES. Using structural equation modeling, the present study explores relationships between parents' ratings of subjective social status (SSS), objective indicators of SES (income-to-needs ratio, education, employment status), and young children's (ages 0-3) behavior problems among 173 low-income families living in an urban area in the northeast United States. In addition, we consider whether parents' stress and depression underlie these associations. Results demonstrate negative relationships from both objective SES and SSS to parents' well-being. Moreover, in keeping with the Family Stress Model, we find that both SES and SSS are related to children's adjustment via parents' stress and depression; parents who have lower levels of education, are not employed, and who report lower SSS also report higher levels of stress, which in turn is related to higher levels of children's behavior problems. To our knowledge, this is the first study to test assumptions of the Family Stress Model using both subjective and objective indicators of social status, and one of few studies exploring linkages between parents' perceptions of SSS and children's behavior problems. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Relative social standing and suicide ideation among Kenyan males: the interpersonal theory of suicide in context

PURPOSE

The purpose of this study is to investigate the association between subjective social status and suicide ideation in a sample of young Kenyan men (age 18-34 years). Situating insights from the interpersonal theory of suicide within social determinants of health framework, we consider whether lower subjective social status predicts lower collective self-esteem (CSE), hopelessness, less meaning in life and more loneliness, and whether these characteristics mediate associations between subjective social status and suicide ideation.

METHOD

A community-based, semi-rural sample (n = 532) of young men, aged 18-34 years, was collected using a standardized questionnaire. The survey questionnaire included the following validated scale items: the short form of the Social and Emotional Loneliness Scale for Adults, CSE, Herth Hope Index, the Meaning in Life Questionnaire, and the Modified Scale for Suicide Ideation. Regression and mediation analyses were used to test hypotheses.

RESULTS

Nearly 12% of respondents reported suicide ideation. Suicide ideation was significantly more common among survey respondents who reported lower subjective social standing. In the first of two mediation models, we found that lower CSE and more loneliness mediate the association between lower subjective social status and suicide ideation. In the second model, we found that respondents with lower CSE and more loneliness expressed lower hope and meaning in life, which also mediated pathways to suicide ideation.

CONCLUSIONS

Findings show a novel synthesis of social determinants literature with the interpersonal theory of suicide. Suicide ideation, along with other mental and social outcomes, may figure more prominently than previously appreciated in the benefits of socio-economic equality. Those who do not participate equally in socio-economic development may be at greater risk of engaging in suicide ideation and behaviors. Suicide prevention research and programmatic responses should adopt a health equity perspective to ensure that prevention is targeted where people are more likely to engage in suicide ideation.

The role of formal support in the lives of children of mothers with intellectual disability

BACKGROUND

Mothers with intellectual disability face socioeconomic disadvantage and social isolation, which is associated with poorer child outcomes. Social services feature prominently in the lives of mothers with intellectual disability especially those without informal support; however, the role of formal support in the lives of their children has not been explored.

METHODS

Seven children aged 7-11 years took part in semi-structured interviews to explore their social experiences. Stories about interactions at home, school and with peers were analysed to illuminate influences, including social support, in their lives.

RESULTS

Formal support can provide an enduring relationship for children from socially restricted homes when it focuses on the child's abilities, interests and needs as distinct from those of their mother. Child-focused support can be from a paid worker or volunteer.

CONCLUSIONS

Family support services need to apply a child focus to improve the well-being of children in vulnerable families.