The effect of subjective social status on depressive thinking: An experimental examination

Social transition, socioeconomic status and self-rated health in China: evidence from a national cross-sectional survey (CGSS)

Background

Social transition is one of the multi-level mechanisms that influence health disparities. However, it has received less attention as one of the non-traditional social determinants of health. A few studies have examined China's social transition and its impact on health inequality in self-rated health (SRH). Therefore, this study explores the impact of China's market-oriented reforms-social transition and socioeconomic status (SES)-on residents' SRH.

Methods

Using the cross-sectional data from the Chinese General Social Survey (CGSS) in 2017, we analyzed the effects of social transition and SES on the SRH of Chinese residents using the RIF (Recentered influence function) method. The RIF decomposition method investigated health differences among different populations and their determinants.

Results

Social transition and SES have significant positive effects on the SRH of Chinese residents. The correlation between SES and the SRH of Chinese residents is moderated by social transition, implying that social transition can weaken the correlation between SES and the SRH of Chinese residents. The impacts of SES and social transition on SRH vary across populations.

Conclusion

Promoting social transition and favoring disadvantaged groups with more resources are urgently needed to promote equitable health outcomes.

Moderated moderation modelling of subjective social status, pocket money and depressive symptoms of university students in Ghana

Introduction

Although the relationship between subjective social status and depression in university students has been well-established, this association could be seen as a spurious one. Previous studies have shown that key variables like financial resources and age could play key roles in explaining the variances in social status and mental health outcomes. In this research, we assessed the complex interrelationships between subjective social status, financial resources at their disposal and depressive symptoms among university students within their young and middle adulthood stages.

Methods

A cross-sectional survey was conducted in a university in Ghana to sample 1134 university students through accidental sampling. The McArthur Scale and WHO-5 Well-being measure were used for the data collection.

Results

The results revealed that higher levels of subjective social status were associated with lower levels of depression. It was further found that the interaction between students' pocket money and age played unique roles in the relationship between subjective social status and depression.

Conclusion

The study findings call on stakeholders in education to explore funding opportunities and to examine ways of empowering parents (financially) to adequately support the students. Health educationists and promoters, including psychologists, school counsellors and parents could compliment these efforts by helping to train and empower students through self-regulation or management skills to help improve their well-being. Continuous efforts are required to improve the financial status and mental health of students.

Does subjective social status affect pain thresholds? - an experimental examination

Past research regarding the relationship between different constructs of social status and different aspects of pain has yielded divergent results. So far, there are few experimental studies to investigate the causal relationship between social status and pain. Therefore, the present study aimed to examine the effect of perceived social status on pain thresholds by experimentally manipulating participants' subjective social status (SSS). 51 female undergraduates were randomly assigned to a low- or high-status condition. Participants' perceived social standing was temporarily elevated (high SSS condition) or reduced (low SSS condition). Before and after experimental manipulation participants' pressure pain thresholds were assessed. The manipulation check confirmed that participants in the low-status condition reported significantly lower SSS than participants in the high-status condition. A linear mixed model revealed a significant group x time interaction for pain thresholds: Whereas participants' pain thresholds in the low SSS condition increased post manipulation, pain thresholds of participants in the high SSS condition decreased post manipulation (β = 0.22; 95% CI, 0.002 to 0.432; p < .05). Findings suggest that SSS may have a causal effect on pain thresholds. This effect could either be due to a change in pain perception or a change in pain expression. Future research is needed to determine the mediating factors.

Depression and its associated factors: A comparison between congenital and acquired physical disabilities

OBJECTIVE

While depression associated with disability has been extensively studied, how depression could differ depending on whether the disability is congenital or acquired remains to be investigated. The objective of this study was to compare depression and its related factors among people with congenital and acquired physical disabilities.

METHODS

We used the 2016 Panel Survey of Employment for the Disabled in Korea, a population-based survey for people with disability registered with the Korean government. Among 4577 participants, a total of 2128 participants with physical disability were analyzed using Chi-square test and binary logistic regression analysis.

RESULTS

The prevalence of depression was 12.9% in those with congenital physical disability and 16.0% in those with acquired physical disability. Stress due to disability and family relationship satisfaction were associated with higher and lower odds of depression, respectively, in both disability groups. Discrimination due to disability, divorce, social participation, and subjective social status were significant predictors of depression only in people with acquired disability.

CONCLUSIONS

Compared to those with congenital disability, individuals with acquired disability can be more susceptible to issues relating to social relationship, social standing and discrimination. Findings of this study suggest that acquired disability and adapting to changes associated with it can be a source of mental distress in addition to living with it. More efforts are needed to address discrimination, provide supportive social relationships, and provide supportive living conditions in order to reduce depression in persons living with disability, especially those with acquired disability.

Associations between subjective social status and psychological well-being among college students

Background: Higher subjective social status (SSS) is associated with better mental health among youth; however, few studies have examined youth's perceptions of past (childhood) or future (adulthood) SSS. Methods: Utilizing latent profile analysis, we examined unique profiles of past, present, and future SSS among 401 college students in the United States and tested associations between these profiles and psychological well-being (ie, depressive symptoms, negative affect, positive affect, and flourishing), controlling for family socioeconomic status (SES). Results: Results revealed four profiles: Low SSS (8%), Upward SSS (18%), Moderate SSS (43%), and High SSS (31%). Youth in the High SSS profile had the best psychological well-being, and those in the Low SSS profile had the worst. While the Upward SSS profile was associated with depressive symptoms and negative affect, it was protective in terms of positive affect. Discussion: Findings highlight unique effects of upward SSS mobility.Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2021.1954010.

Exploring the Mechanism of Subjective Social Status on Compulsive Shopping Behavior: A Moderated Mediation Model of Self-compassion and Depression

The present study aimed to explore the mediating role of depression in the relationship between subjective social status (SSS) and compulsive shopping behavior (CSB) and whether self-compassion (SC) played a moderating role in this model. The study was designed based on the cross-sectional method. The final sample includes 664 Vietnamese adults (Mage = 21.95, SD = 5.681 years). Participants completed an online survey, including questionnaires about SSS, CSB, depression, SC, and basic demographic information. First, the study results showed that SSS did not directly affect CSB (p > .05, 95% CI includes zero). Second, a mediating role of depression and a moderating role of SC in the research model was discovered (p < .001, 95% CI does not contain zero). Results indicated that individuals with a higher SSS experienced lower depression. Moreover, during a depressive episode, having a higher level of SC increases CSB. The study highlighted meaningful recommendations to promote consumers' mental health and healthy shopping behaviors.

Subjective social status and nocturnal blood pressure dipping

OBJECTIVE

Low social status has been linked to cardiovascular disease. Subjective social status (SSS), which represents one's perceived position in a social hierarchy, has been suggested to predict health outcomes beyond objective measures of socioeconomic status. The present study examined if lower SSS is related to reduced nocturnal blood pressure (BP) dipping, a risk factor for cardiovascular disease.

METHODS

In this cross-sectional study, a community sample of 53 healthy adults underwent 24-h ambulatory BP monitoring. All participants provided information on SSS and objective measures of socioeconomic status (i.e., education, occupation, and income). SSS was measured in comparison to others in the country (national SSS) as well as in comparison to one's social environment (local SSS) using the German versions of the MacArthur Scales.

RESULTS

Analyses found that participants with low local SSS exhibited attenuated nocturnal diastolic blood pressure dipping (β = 0.29, 95% CI [0.01, 0.57], p = .043) and mean arterial pressure dipping (β = 0.29, 95% CI [0.01, 0.57], p = .041). These associations remained significant after adjusting for objective socioeconomic status. No significant associations between national SSS and cardiovascular measures were observed.

CONCLUSION

In conclusion, one's perceived social position in the social environment (i.e., local SSS) is associated with nocturnal BP dipping. Therefore, local SSS may be an important psychosocial factor linking social inequality and cardiovascular health.

Subjective social status moderates back pain and mental health in older men

OBJECTIVES

Back pain and poor mental health are interrelated issues in older men. Evidence suggests that socioeconomic status moderates this relationship, but less is known about the role of subjective social status (SSS). This study examined if the association between back pain and mental health is moderated by SSS.

METHOD

We used a sample of community-dwelling older men (≥65 years) from the Osteoporotic Fractures in Men Study (N = 5994). Participants self-reported their back pain severity and frequency over the past 12 months. SSS was assessed with the MacArthur Scale of SSS. Mental health was assessed with the SF-12 Mental Component Summary (MCS).

RESULTS

Severe back pain was associated with lower SF-12 MCS scores (p = .03). Back pain frequency was not associated with SF-12 MCS scores. SSS moderated the back pain and mental health relationship. Among men with higher national or community SSS, the association between back pain severity and SF-12 MCS scores was not significant. However, among men with lower national or community SSS, more severe back pain was associated with lower SF-12 MCS scores (p's < .001). Among those with lower national or community SSS, greater back pain frequency was also associated with lower SF-12 MCS scores (p's < .05).

CONCLUSION

Where one ranks oneself within their nation or community matters for the back pain and mental health relationship. Higher SSS may be a psychosocial resource that buffers the negative associations of severe and frequent back pain on mental health in older men.

A protective rung on the ladder? How past and current social status shaped changes in health during COVID-19

An emerging body of work has started to document population health consequences of the social and economic transformations during the COVID-19 pandemic. We consider an individual’s relative social position in the stratification system—subjective social status (SSS)—and assess how past (childhood) and current SSS predict change in self-rated health during the pandemic. Using two waves of data from the Canadian Quality of Work and Economic Life Study, we follow respondents between the onset of lockdown measures in March and May of 2020 (N = 1886). Drawing from the life course perspective and stress process model, we find that lower current SSS predicts a greater likelihood of being in stable poor health and reporting declining health. Lower past SSS predicts a higher chance of being in stable poor health indirectly through current SSS. And lower cumulative SSS that sums both past and present SSS also predicts stable poor health, while perceived upward mobility over time is associated with stable good health. This robust relationship between SSS and health in such a short time period of two months at the start of the COVID-19 pandemic provides an important glimpse into the influence that SSS has on population health.

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Using two waves of data from the Canadian Quality of Work and Economic Life Study, we follow respondents between the onset of lockdown measures in March and May of 2020 (N = 1886). Drawing from the life course perspective and stress process model, we find that lower current SSS predicts a greater likelihood of being in stable poor health and reporting declining health.

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Lower past SSS predicts a higher chance of being in stable poor health indirectly through current SSS. And lower cumulative SSS that sums both past and present SSS also predicts stable poor health, while perceived upward mobility over time is associated with stable good health.

Are stress-related pathways of social status differentiation more important determinants of health inequities in countries with higher levels of income inequality?

We explored socioeconomic gradients in self-rated overall health (SROH) using indicators of materialist (educational attainment and perceived income adequacy) and psychosocial perspectives (subjective social status (SSS)) among adults living in countries with varying levels of income inequality, and the importance of psychosocial stress in mediating these associations. If psychosocial processes at the individual and societal levels correspond, associations between SSS and SROH should be higher among adults in countries with higher income inequality, and psychosocial stress should be a more important mediator of these associations. We used multigroup structural equation models to analyse cross-sectional data from the International Food Policy Study of adults (n = 22,824) in Australia, Canada, Mexico, the UK and the United States. Associations between SSS and SROH were not higher in more unequal countries, nor was psychosocial stress a more important mediator of these associations. Inequities in SROH in more unequal countries may not predominantly reflect stress-related pathways of social status differentiation.

Perceived poverty, perceived income adequacy and loneliness in Israeli young adults: Are social capital and neighbourhood capital resilience factors?

Loneliness is a severe risk factor that has been linked to diminished health outcomes and low quality of life across ages. Young adults have been identified as a high-risk group for experiencing loneliness, but only a few studies have explored the economic and social determinants of loneliness in this age group. Taking a social inequality approach to health, with loneliness as a focus, this study examined: (a) the associations between the following factors - subjective social status (SSS) indicators (perceived poverty and perceived income adequacy), offline and online social capital, and neighbourhood capital - and loneliness; and (2) whether social and neighbourhood capital were moderators in the association between SSS and loneliness. Cross-sectional data for individuals aged 20-29 were taken from the 2017 Israeli Social Survey (N = 1,508). Employing multinomial logit models, we found that perceived poverty was a strong predictor of loneliness. Greater social and neighbourhood capital decreased loneliness, whereas a higher use of online social networks increased loneliness. Neighbourhood capital and perceived trust were moderators, whereas trust was a resilience factor, neighbourhood capital strengthened the negative effect of perceived poverty on loneliness. To reduce the prevalence of loneliness in young adults, policymakers should examine various means of enhancing social and neighbourhood capital along with moderating the use of online social networks. However, they should be aware that interventions of this kind can do little to buffer the strong effect of perceived poverty on loneliness, as in most cases the effect of perceived poverty on the probability of loneliness is not ameliorated by improved social or neighbourhood resources.

Subjective social status is associated with happiness but not weight status or psychological distress: An analysis of three prospective birth cohorts from low- and middle-income countries

BACKGROUND

Subjective social status (SSS, perception of social position relative to a frame of reference) has been associated with physical, mental and socio-emotional wellbeing. However, these associations may be susceptible to unmeasured confounding by life course objective socio-economic position (SEP; such as wealth, education and employment) and life satisfaction.

PURPOSE

To estimate the association of position on ladders of perceived community respect and perceived economic status with weight, distress and wellbeing, independent of objective SEP in cohorts from three low and middle-income countries.

METHODS

We used data from birth cohorts in Guatemala (n = 1258), Philippines (n = 1323) and South Africa (n = 1393). We estimated the association of perceived community respect and perceived economic status with body mass index (kg/m²), the World Health Organization's Self-Reported Questionnaire-20 (SRQ-20) for psychological distress, and Lyubomirsky's Subjective Happiness Scale. We estimated these associations using robust linear regression models adjusting for indicators of life course objective SEP, early life characteristics, adult covariates, and life satisfaction.

RESULTS

Participants in South Africa (age 27-28y) rated themselves higher on average for both the respect (7 vs 5 in Guatemala and 6 in Philippines) and economic (5 vs 3 in Guatemala and 4 in Philippines) ladder measures. Position on neither community respect nor economic ladders were associated with BMI or psychological distress. Higher position on community respect (Guatemala: 0.03, 95%CI: 0.01, 0.04; Philippines: 0.03, 95% CI: 0.02, 0.05; South Africa: 0.07, 95%CI: 0.04, 0.09) and economic (Guatemala: 0.02, 95%CI: 0, 0.04; Philippines: 0.04, 95%CI: 0.02, 0.07; South Africa: 0.07, 95%CI: 0.04, 0.10) ladders were associated with greater happiness.

CONCLUSIONS

Subjective social status showed small but consistent associations with happiness in birth cohorts independent of life-course SEP.

Community Environment Perception on Depression: The Mediating Role of Subjective Social Class

Depression has become a major social issue of global concern, which has seriously threatened the quality of an individual’s life. Although the relationship between community environment and depression has aroused heated debate, the empirical research on the relationship between community environment perception and public depression is still relatively insufficient. Data for this study are from China Family Panel Studies in 2016, which were conducted by the institute of Social Science Survey, Peking University. This paper has tested group differences in the influence of community environment on public depression, as well as the mediating role of subjective social class between community environment perception and depression, so as to further explore the social psychological effect of community environment. The empirical study found that there are group differences in the impacts of community environment perception on depression. Specifically, men, rural residents, and people aged 60 and under are more likely to be depressed which were affected by the perception of community environment. Furthermore, we have found that the subjective social class can partly mediate community environment perception and depression. That is to say, the perception of community environment can induce depression by influencing the individual’s subjective social class. Among them, community living environment and community public facilities have the greatest impact, community emotional attachment and community security situation have the second impact, and neighborhood mutual aid and neighborhood relationship have the least impact. In other words, the community environment is deeply endowed with a social psychological effect. To ameliorate the public’s depression, it is necessary to consider the construction of community physical environment and the cultivation of harmonious community culture as powerful measures not to be ignored. In short, the important role of community environmental intervention in alleviating the public’s depression caused by social class cognition deserves attention.

Socioeconomic position over the life-course and subjective social status in relation to nutritional status and mental health among Guatemalan adults

Objective

We study how life course objective socioeconomic position (SEP) predicts subjective social status (SSS) and the extent to which SSS mediates the association of objective SEP with nutritional status and mental health outcomes.

Methods

We use data from participants of the INCAP Longitudinal Study 1969–2018 (n = 1258) from Guatemala. We use the MacArthur ladder for two measures of SSS - perceived community respect and perceived economic status. We estimate the association of SSS with health outcomes after adjusting for early life characteristics and life course objective SEP (wealth, schooling, employment) using linear regression. We use path analysis to study the extent of mediation by SSS on the health outcomes of body mass index (BMI; kg/m²), psychological distress (using the WHO Self-Reported Questionnaire; SRQ-20) and happiness, using the Subjective Happiness Scale (SHS).

Results

Median participant rating was 5 [IQR: 3–8] for the perceived community respect and 3 [IQR: 1–5] for the perceived economic status, with no differences by sex. Objective SEP in early life and adulthood were predictive of both measures of SSS in middle adulthood as well as health outcomes (BMI, SRQ-20 and SHS). Perceived community respect (z-scores; 1 z = 3.1 units) was positively associated with happiness (0.13, 95 % CI: 0.07, 0.19). Perceived economic status (z-scores; 1 z = 2.3 units) was inversely associated with psychological distress (−0.28, 95 % CI: −0.47, −0.09). Neither measure of SSS was associated with BMI. Neither perceived community respect nor perceived economic status attenuated associations of objective SEP with health outcomes on inclusion as a mediator.

Conclusions

Subjective social status was independently associated with happiness and psychological distress in middle adulthood after adjusting for objective SEP. Moreover, association of objective SEP with health was not mediated by SSS, suggesting potentially independent pathways.

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Subjective social status (SSS) is a self-appraisal of one's objective measures of socio-economic position (SEP; such as education and wealth) and social identity relative to their community.

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Perceived community respect and perceived economic status were positively associated with happiness and inversely associated with psychological distress respectively.

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Neither measure of SSS were associated with body mass index.

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The associations of objective SEP measures with health outcomes were not attenuated after adjusting for SSS, suggesting independent pathways.

The multiple mediating effects of social connectedness and self-care confidence on the relationship between subjective social status and emotional well-being in patients with heart failure: a cross-sectional study

BACKGROUND

Previous studies have shown that subjective social status (SSS) was positively associated with well-being in various populations. However, little is known about the relationship considering the underlying mechanism in patients with heart failure (HF).

AIMS

The aim was to study the effects of social connectedness and self-care confidence on the relationship between SSS and well-being in patients with HF according to the Reserve Capacity Model.

METHODS AND RESULTS

We recruited 296 patients from a general hospital using convenience sampling. SSS, social connectedness, self-care confidence, and well-being were assessed using self-reported questionnaires. A multiple mediation model was examined using the PROCESS macro in SPSS.Higher levels of SSS (r = 0.18, P < 0.01), social connectedness (r = 0.21, P < 0.01), and self-care confidence (r = 0.20, P < 0.01) were positively correlated with better emotional well-being, but not with physical well-being. The multiple mediation analysis revealed that the relationship between SSS and emotional well-being was mediated by social connectedness (effect: 0.061, 95% CI [0.014, 0.148]) and self-care confidence (effect: 0.110, 95% CI [0.006, 0.249]) separately, and together in serial (effect: 0.008, 95% CI [0.001, 0.028]).

CONCLUSIONS

Social connectedness and self-care confidence are multiple mediators of the relationship between SSS and emotional well-being. Interventions targeting to strengthening social connectedness and self-care confidence may improve emotional well-being directly. In addition, emotional well-being may be improved by enhancing SSS indirectly in patients with HF.

Effects of Environmental Quality Perception on Depression: Subjective Social Class as a Mediator

Although the relationship between environment and public depression has aroused heated debate, the empirical research on the relationship between environmental quality perception and public depression is still relatively insufficient. This paper aims to explore the influence of environmental quality perception on public depression and the mediating role of subjective social class between environmental quality perception and public depression. Using the China Family Panel Studies data of 2016 for empirical analysis, this study’s results show that environmental quality perception has a significant effect on public depression and subjective social class also has a significant effect on public depression. In addition, we found that subjective social class can play a partial mediating role between environmental quality perception and public depression, and the intermediary effect only comes from the contribution of the perception of living environmental quality, not the perception of overall environmental quality. That is to say, the perception of living environment quality deeply affects the subjective social class, and then induces public depression. In order to alleviate the relationship between environmental quality and public depression, it is recommended that the state environmental protection department and civil affairs department strengthen the improvement of public living environment so as to promote individual subjective social class and reduce the risk of public depression. Moreover, it is suggested that research with longitudinal design and comprehensive indicators be undertaken in the future.

Subjective socio-economic status predicts self-rated health irrespective of objective family socio-economic background

Aim: Subjective appraisals of socio-economic status (SES) are robustly associated with health outcomes, even when controlling for objective SES. Is this because objective SES is not accounted for in a sufficiently exhaustive way? Methods: I pool eight waves of nationally representative survey data from Germany (German General Social Survey, 2004-18, N=13,557) to assess the association between two separate subjective appraisals of SES (a 10-point scale and subjectively chosen social class membership) and poor self-rated health using logit and linear probability models. I account for an exhaustive range of objective SES variables, including respondents' household incomes and social status, as well as occupational status, social class and education of respondents and of their partners, fathers and mothers. Results: The association between subjective SES and poor self-rated health remains stable, even when accounting for a wide range of objective SES markers. This is true for both subjective SES measured on a 10-point scale and as a subjective class identification. Conclusions: Even when controlling for a large number of objective SES markers, subjective SES and self-rated health are linked, suggesting that subjective assessments of SES are meaningful measures of SES which form a distinct pathway to health.

Early life stress, subjective social status, and health during late adolescence

Objective: Both lower subjective social status (SSS)-or viewing oneself as having lower status relative to others-and greater early life stress consistently relate to poorer health in adolescence. Early life stress can also negatively influence one's social relationships and may thereby shape social status. The present studies investigated how early life stress relates to the development of SSS and how SSS relates to health across the transition to college.Design: In Study 1, 91 older adolescents (M_age = 18.37) reported early life stress, society SSS, and school SSS, and they reported their society SSS and school SSS again 2 years later. In Study 2, 94 first-year college students (M_age = 18.20) reported early life stress and society SSS at study entry and reported their dorm SSS, university SSS, and mental health monthly throughout the year.Results: Greater early life stress was related to lower society SSS, but not school SSS, in both studies. In Study 2, dorm and university SSS and early life stress were uniquely related to mental health, although associations weakened over time.Conclusion: Early life stress may predispose people to have low society SSS, and both low school SSS and high early life stress may increase risk for poorer health during transition periods.

Association between subjective social status and facets of depression self-stigma

Individuals with depressive symptoms frequently experience stigma, which may lower self-esteem and increase social withdrawal, further exacerbating symptoms. The association between depressive symptoms and subjective social status (SSS; perceived standing within one's community) have previously been identified. However, no work has connected the constructs of SSS and self-stigma among people with depression. Participants (N = 230) who screened positive for current major depressive episode via a self-report completed an online survey. A significant negative association between SSS and overall stigma (p = .024) was observed, which was largely explained by general self-stigma (p = .016) and stigmatizing experiences (p = .015) subscales. The results offer preliminary evidence that SSS may be associated with negative social consequences of stigmatizing health conditions.

Subjective social status and health during high school and young adulthood

Although many facets of social status (i.e., socioeconomic status, gender, race) are fairly stable, limited work has assessed how youths' identification with their status changes over time. Subjective social status (SSS) refers to one's perception of standing or rank relative to others, and for youth status is generally in the context of society or school. The current study assessed how adolescents' SSS in American society and in their school changes and predicts health and well-being during and after high school. A total of 336 adolescents (M_age = 16.40 at Wave 1) reported their SSS at up to three time points, each 2 years apart, such that youth provided data between the 10th grade and 3 years following the transition from high school. Piecewise multilevel modeling was used, including discontinuities to assess the importance of the transition from high school. Society SSS decreased across the period, especially among youth with lower family income, youth whose parents reported lower SSS, and youth who did not attend college. School SSS was stable during high school, declined after 12th grade, and remained stable thereafter. Moderation analyses revealed that school SSS declines more consistently among female adolescents than male adolescents and Latinos relative to other ethnic groups. Lower society and school SSS were associated with more depressive symptoms and greater likelihood of obesity, highlighting the relevance of SSS for health during this important developmental transition. Results suggest declines in SSS are especially common among disadvantaged groups as they age, and that lower SSS may indicate risk for poorer health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Subjective social status and stress responsivity in late adolescence

Subjective social status (SSS) reflects one's perception of one's standing within society. SSS has been linked with health outcomes, over and above socioeconomic status, and is thought to influence health in part by shaping stress responsivity. To test this, the present study examined the links between SSS and psychological, hypothalamic-pituitary-adrenal (HPA) axis, and cardiovascular responsivity in a sample of 87 ethnically diverse late adolescents (Mage = 18.39 years). Participants rated their family's SSS while either in high school (n = 50) or 1 year afterward (n = 37). Participants completed the Trier Social Stress Task (TSST) and reported their fear during baseline and after task completion, provided six saliva samples throughout the task, and had their heart rate monitored continuously throughout the task. Multilevel models, with time points nested within participants, were conducted to assess reactivity and recovery for each outcome. Results indicated that lower SSS was associated with greater fear reactivity and faster rates of HPA axis reactivity and recovery to baseline. Regarding cardiovascular responses, no differences were observed with respect to heart rate. Lower SSS predicted increased respiratory sinus arrhythmia during the stress task only among participants who rated their SSS while in high school; no association was observed for those who rated SSS after high school. Results suggest that perceptions of one's family's standing in society can shape responses to stress and potentially broader health.HighlightsSubjective social status (SSS) was linked with differences in stress responsivity. Specifically, lower SSS was associated with greater increases in fear following an acute stressor and faster rates of cortisol reactivity and recovery. Adolescents with lower SSS in high school showed less cardiovascular reactivity and recovery with respect to respiratory sinus arrhythmia, a marker of parasympathetic nervous system activity.

The relationship between mental disorders and actual and desired subjective social status

AIMS

Mental disorders are associated with lower subjective social status (SSS), but a more nuanced understanding of this relationship is needed. We examined the influence of disorder age of onset and recency on SSS and studied whether mental disorders are also associated with the discrepancy between actual and desired SSS.

METHOD

Data are from the baseline and second wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). Mental disorders were assessed with the Composite International Diagnostic Interview (CIDI 3.0), while both actual and desired SSS were assessed with a ten-rung ladder. Linear regression was used to examine the association between mental disorders and SSS.

RESULTS

Of 5303 participants, 2237 had a lifetime mental disorder at baseline. These participants reported significantly lower actual SSS (6.28) at follow-up than healthy participants (6.66, B = -0.38 [95% CI -0.48 to -0.27], p < 0.001) and a significantly greater actual-desired SSS discrepancy (1.14 v. 1.05 after controlling for actual SSS, B = 0.09 [0.01-0.17], p = 0.024). Lower age of onset of the first mental disorder was marginally significantly associated with lower actual SSS (B = 0.006 [0.000-0.012], p = 0.046). More recent disorders were also associated with lower actual SSS (B = 0.015 [0.005-0.026], p = 0.005), such that participants whose disorder remitted ⩾6 years before baseline were statistically indistinguishable from healthy participants.

CONCLUSIONS

Lifetime mental disorders are associated with lower actual SSS and a slightly greater discrepancy between actual and desired SSS. However, people with mental disorders in (long-term) remission have a similar social status as healthy participants.

What if I had not fallen from grace? Psychological distress and the gap between factual and counterfactual subjective social status

The aim of this work was to test the hypothesis that the discrepancy between factual and counterfactual subjective social status (DCS) relates to psychological distress beyond the effect of current (i.e., factual) subjective and objective social status. Participants were 124 single mothers (Study 1) and 310 persons who have become unemployed (Study 2). In both samples, higher DCS was related to more severe symptoms of stress and depression beyond the effect of current subjective and objective social status. Upward counterfactual thinking might be an additional psychological factor in the relationship between social inequality and health in socially deprived individuals.

Interplay of subjective and objective economic well-being on the mental health of Norwegian adolescents

Objective and subjective socioeconomic status (SES) are important determinants of adolescent mental health problems, but we know less about how they interact. Research has demonstrated independent associations of both variables to mental health problems, but less is known about their relationship and role in adolescent mental health problems. Data from the youth@hordaland study, a survey of 9079 Norwegian adolescents aged 16 to 19 were linked to official tax register information about household income, and was used to examine the relationship between perceived economic well-being and household income. We also investigated how perceptions of economic well-being interacted with household income in relation to adolescent mental health problems. The overall relationship between perceived and actual household income was relatively low (r = .33 [95% CI = 0.32–0.35], p < .001, although this relationship was somewhat higher in adolescents with either low or high household incomes. Low income and unfavorable perceptions of economic well-being were associated with most mental health problems. Importantly, the mental health benefits associated with higher income appeared to depend on the adolescents' perceptions of their family's relative economic position. The results show moderate associations between perceived economic well-being and household income and that the influence of perceived economic well-being on conduct- and peer problems depended on the level of household income. Symptoms of depression explained some of this association. Knowledge about how the adolescents feel about their relative economic standing may be potentially important information for adolescents with mental health problems, and additional work is needed to understand how adolescents establish perceptions of economic rank.

Factors associated with depression and anxiety symptoms among children seeking treatment for obesity: A social-ecological approach

BACKGROUND

Children with overweight/obesity are more likely to exhibit symptoms of depression and anxiety than are their peers without overweight/obesity; however, the rates and correlates of depression and anxiety symptoms among children seeking obesity treatment remain unclear.

OBJECTIVES

Examine the prevalence and associated factors of depression and anxiety symptoms among treatment-seeking children with overweight/obesity.

METHODS

Children 7 to 11 years old (N = 241) and their parents completed assessments before beginning family-based behavioral weight-loss treatment. Disorder-specific self-report questionnaires assessed child depression and anxiety. The social-ecological model served as a framework for examining factors associated with depression and anxiety symptoms.

RESULTS

Among our sample, 39.8% (96/241) met clinical cutoffs for depression and/or anxiety symptomatology. Specifically, of these 96, 48 met criteria for both depression and anxiety, 24 for depression only, and 24 for anxiety only. Child eating disorder pathology, parents' use of psychological control (ie, a parenting style characterized by emotional manipulation), and lower child subjective social status were significantly associated with greater child depression symptomatology. Child eating disorder pathology and parent psychological control were significantly associated with greater child anxiety symptomatology.

CONCLUSION

Nearly 40% of children exhibited psychopathology symptoms, and a variety of correlates were found. Thus, pediatric weight-loss providers may consider screening for and addressing mental health concerns (and associated factors) prior to and during treatment.

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.

Brief Report: Subjective Social Mobility and Depressive Symptoms in Syrian Refugees to Germany

Previous findings indicate that refugees are at increased risk for mental health problems. In addition to stressful pre-migration experiences, post-migration factors may contribute to poor mental health outcomes. Among immigrants to the United States, downward mobility in subjective social status (SSS) was associated with depression, corroborating the potentially detrimental mental health consequences of a decline in one's perceived social position. The present study examined whether downward mobility in SSS among male refugees from Syria to Germany is associated with depression. We found that refugees who experience stronger downward mobility in SSS exhibit more severe depressive symptoms and were more likely to fulfill provisional DSM-IV criteria for a diagnosis of Major Depression. Our findings highlight the importance to consider the 'social pain' of downward social mobility during the post-migration phase.

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.

Subjective social status and health: Multidisciplinary explanations and methodological challenges

Since the early 2000s, evidence has been accumulating that subjective social status – a person’s sense of their own position on the social ladder – affects health above and beyond objective socioeconomic status. To date, however, little is known about how these distinct health effects of subjective social status can be explained. This article narratively reviews different explanatory approaches and key methodological challenges, backed up by empirical findings and supplemented by the authors’ own reflections. Both social–psychological and psychoneurobiological explanations can make a theoretically plausible contribution to explaining the subjective social status–health relationship. Experimental and panel designs appear promising for addressing important methodological challenges in this strand of research.

Subjective social status is associated with compensation for large meals - A prospective pilot study

OBJECTIVES

Subjective social status (SSS) is known to be inversely associated with obesity. Our objective was to determine if SSS is associated with eating behaviors that would predispose to weight gain, specifically, with inadequate compensation for excess energy consumed during a single large meal. Therefore, we conducted a pilot study to determine the association of SSS with 24-h energy balance, 24-h and post-lunch energy intake, changes in body composition and changes in adjusted resting energy expenditure on days when a high-energy lunch was consumed in free-living human subjects.

METHOD

Female participants (7 normal weight and 10 overweight) consumed 60% of' estimated 24-h energy requirements as a lunchtime meal in the laboratory for 14 days. Subjective social status was measured at baseline using the MacArthur Scale. Remote Food Photography Method was used to record food intake outside of the lab on days 1-2, 7-8, and 12-13. Associations of 24-h energy balance, 24-h and post-lunch energy intake, changes in adjusted resting energy expenditure and changes in percent body fat (measured by dual x-ray absorptiometry) with SSS were studied.

RESULTS

Mean (standard deviation) age and BMI were 36.29 (8.25) years and 26.43 (2.32) kg/m², respectively. Lower SSS was significantly associated with positive energy balance (p for trend 0.002), and higher post-lunch energy intake (p = 0.02) when controlled for age and initial body mass index.

CONCLUSIONS

Our pilot data show that lower SSS is associated with higher post-lunch energy intake, which is indicative of poor energy compensation following a large meal. Over a longer time period, this could result in fat mass gain. Studies that are of longer duration and well-powered are warranted to confirm our findings.

Subjective Social Status Predicts Late-Life Memory Trajectories through Both Mental and Physical Health Pathways

Background: Subjective social status (SSS) is associated with mental and physical health, independent of objective socioeconomic status (SES), but its association with late-life cognitive decline is unknown. Objective: This study characterizes the association between SSS and late-life memory trajectories in a large, nationally representative sample of older adults in the United States. Methods: Using data from 8,530 participants aged 65 years and older in the Health and Retirement Study, structural equation models tested associations between SSS, objective SES (i.e., educational attainment, occupation, income, and wealth), physical and mental health, and 6-year memory trajectories, controlling for sociodemographic characteristics. Results: Independent of objective SES, lower SSS was associated with worse initial memory but not subsequent memory decline. The association between SSS and initial memory was separately mediated by chronic diseases, stroke, and depressive symptoms. Conclusion: Results provide preliminary behavioral evidence for the deleterious effects of social stress on cognitive aging. These results may help inform the development of policies and interventions to reduce cognitive morbidity among older adults who perceive a low position on the social hierarchy.

Subjective social status and its relationship to health and health behavior: comparing two different scales in university students

Background Little is known about the relationship between socioeconomic status (SES) and health in late adolescence. As it is difficult to measure SES in this age group directly, we used two subjective social status (SSS) scales with different reference groups for social comparison in the relatively homogeneous group of university students and analyzed the relationship with health and health behaviors. Methods We used two 10-rung ladders, a societal and a university one, to measure SSS in students (n = 689, 16-29 years). We compared the scales' ratings and analyzed relationships with sociodemographic factors, health outcomes and behaviors. Results On average, students rated their individual SSS higher on the university scale (6.87) than on the societal one (6.41). Regarding health outcomes and behaviors, we found similar results for both scales, while sociodemographic variables were more likely to be associated with the societal scale. Conclusion SSS seems to be a useful measure besides the objective SES. Our data suggest that both SSS scales are helpful in the framework of health inequality but differ slightly in what they measure. More detailed research may help to determine which scale is appropriate for individual study context.

Social Inequalities and Depressive Symptoms in Adults: The Role of Objective and Subjective Socioeconomic Status

BACKGROUND

There is substantial evidence that lower objective socioeconomic status (SES)-as measured by education, occupation, and income-is associated with a higher risk of depression. Less is known, however, about associations between perceptions of social status and the prevalence of depression. This study investigated associations of both objective SES and subjective social status (SSS) with depressive symptoms among adults in Germany.

METHODS

Data were obtained from the 2013 special wave of the German Health Update study, a national health survey of the adult population in Germany. Objective SES was determined using a composite index based on education, occupation, and income. The three single dimensions of the index were also used individually. SSS was measured using the MacArthur Scale, which asks respondents to place themselves on a 10-rung 'social ladder'. Regression models were employed to examine associations of objective SES and SSS with current depressive symptoms, as assessed with the eight-item Patient Health Questionnaire depression scale (PHQ-8 sum score ≥10).

RESULTS

After mutual adjustment, lower objective SES and lower SSS were independently associated with current depressive symptoms. The associations were found in both sexes and persisted after further adjustment for sociodemographic factors, long-term chronic conditions, and functional limitations. Mediation analyses revealed a significant indirect relationship between objective SES and depressive symptoms through SSS. When the three individual dimensions of objective SES were mutually adjusted, occupation and income were independently associated with depressive symptoms. After additional adjustment for SSS, these associations attenuated but remained significant.

CONCLUSIONS

The findings suggest that perceptions of low social status in adults may be involved in the pathogenesis of depression and play a mediating role in the relationship between objective SES and depressive symptoms. Prospective studies are needed to establish the direction of effects and to address questions of causality.