Financial circumstances, mastery, and mental health: Taking unobserved time-stable influences into account

Mattering and Self-Esteem as Bulwarks Against the Consequences of Financial Strain for Loneliness in Later Life: Differentiating Between- and Within-Person Processes

Financial strain likely constitutes a principal risk for loneliness in later-life, but a strong sense of mattering and self-esteem may mitigate these consequences by both offsetting and buffering the influence of financial strain. We test these arguments using data from a national longitudinal survey of older adults gathered between 2021 and 2022 (N = 2384), as nations emerged from the COVID-19 pandemic. Application of a within-between modelling strategy facilitates differentiation of inter-individual (i.e., between-person) and intra-individual (i.e., within-person) factors. Between-person financial strain is associated with greater loneliness, but within- and between-person mattering and self-esteem offset this association by forestalling loneliness. Between-person mattering buffers between-person financial strain, but between-person self-esteem buffers within-person financial strain. Consequently, within-person financial strain is associated with greater loneliness only at low levels of between-person self-esteem. In summary, accruing a strong sense of worth contributes to protecting older adults from the adverse consequences of financial strain for loneliness.

Sense of mastery in first-episode psychosis-a one-year follow-up study

Introduction

A sense of mastery refers to beliefs about having control over one's life and has been found to protect health and buffer the effect of stressful experiences.

Methods

We investigated sense of mastery in first-episode psychosis (FEP) patients and population controls at baseline and at one-year follow-up. Pearlin and Schooler's Sense of Mastery scale was completed by 322 participants at baseline and by 184 participants at follow-up.

Results

People having experienced FEP reported lower mastery than controls at both time points, but a modest increase was seen in patients at follow-up. The strongest correlates of high baseline mastery in FEP were lower depressive symptoms and higher perceived social support, whereas positive or negative psychotic symptoms did not associate with mastery. Current depressive symptoms also correlated with mastery at the follow-up point, and change in depressive symptoms correlated with change in mastery. Higher mastery at treatment entry predicted remission of psychotic symptoms one year later. Sense of mastery was also found to mediate the association of perceived social support with depressive symptoms.

Discussion

The usefulness of mastery measures should be further tested for estimations of patient prognosis in early psychosis.

Perceptions of Increases in Cost of Living and Psychological Distress Among Older Adults

Objectives: This article examines whether older adults' perceptions of an increase in their cost of living during a time of rapid inflation are associated with multiple aspects of psychological distress, as well as whether mastery buffers these associations. Methods: Data were derived from a two-wave longitudinal survey of older adults gathered in 2021 and 2022 (N = 4,010). Multiple regression models examined symptoms of depression, anxiety, and anger. Results: Perceptions of moderate or large increases in cost of living were associated with higher levels of distress at follow-up. Taking baseline financial strain, mastery, and psychological distress into account weakened these associations, but perceptions of a large increase in cost of living were still substantially linked with anger and anxiety. Mastery also buffered associations with anxiety and anger. Discussion: Macroeconomically derived adversities can shape anxiety and anger in later-life, but these mental health consequences fall more heavily on individuals possessing lower levels of mastery.

Two sides of the same coin? Absolute income and perceived income inadequacy as social determinants of health

BACKGROUND

Absolute income is commonly used in studies of health inequalities, however it does not reflect spending patterns, debts, or expectations. These aspects are reflected in measures concerning perceived income inadequacy. While health inequities by absolute income or perceived income inadequacy are well established, few studies have explored the interplay of absolute income and perceived income inadequacy in relation to health.

METHODS

Multiple data sources were linked into a nationally representative dataset (n = 445,748) of Dutch adults (18 +). The association between absolute income, perceived income inadequacy and health (self-reported health, chronic disease and psychological distress) was tested using logistic and Poisson regressions, controlling for various potential confounders (demographics, education) and mastery. Interactions were tested to check the association between perceived income inadequacy and health for different absolute income groups.

RESULTS

Perceived income inadequacy was reported at every absolute income group (with 42% of individuals in the lowest income group and 5% of individuals in the highest income group). Both absolute income and perceived income inadequacy were independently associated with health. The adjusted relative risk (RR) for lowest absolute income group is 1.11 (1.08-1.1.14) and 1.28 (1.24-1.32) for chronic disease and self-reported health respectively, and the Odds Ratio (OR) for psychological distress is 1.28 (1.16-1.42). For perceived income inadequacy the RR's were 1.41 (1.37-1.46) and 1.49 (1.44-1.54) and the OR for psychological distress is 3.14 (2.81-3.51). Mastery appeared to be an important mediator for the relationship between perceived income inadequacy, poor self-rated health and psychological distress.

CONCLUSIONS

Absolute income and perceived income inadequacy reflect conceptually different aspects of income and are independently associated with health outcomes. Perceived income inadequacy may be accounted for in health inequality studies, alongside measures of absolute income. In policy-making, targeting perceived income inadequacy might have potential to reduce health inequalities.

Changes in Religiosity and Reliance on God During the COVID-19 Pandemic: A Protective Role Under Conditions of Financial Strain?

BACKGROUND

The COVID-19 pandemic was one of the most devastating disasters of the twenty-first century and has exacted a steep health and economic toll. During times of suffering caused by the pandemic, religion/spirituality may prove to be a consistent and valuable coping resource.

PURPOSE

We situate changes in religious importance and reliance on God as key aspects of religious life that may be important coping mechanisms in response to pandemic-related financial hardship, addressing a gap in the literature on religious coping during the pandemic and considering self-reported changes in religiosity.

METHODS

We use data from a nationally representative sample of Americans that was collected in 2021 (N = 1704) and employ a series of OLS Regression Models.

RESULTS

Our results suggest that relying more heavily on God was associated with lower psychological distress, and a stronger reliance on God buffered the deleterious consequences of financial strain on psychological distress. No such patterns were documented for religious importance.

CONCLUSION AND IMPLICATIONS

We discuss our findings within the broader religion and health literature as to whether secondary control via a divine power reduces or enhances individual agency and discuss religion/spirituality may be a consistent and valuable coping resource through adversity and suffering. Though it may be challenging to maintain, or increase, religious/spiritual beliefs in the face of adversity, that there were observed benefits to well-being for doing so could serve as insightful guidance for both religious leaders and R/S individuals.

More income, less depression? Revisiting the nonlinear and heterogeneous relationship between income and mental health

This paper uses a large-scale nationally representative dataset to examine the nonlinear effect of income on mental health. To investigate their causal relationship, the exogenous impact of automation on income is utilized as the instrument variable (IV). In addition, to explore their nonlinear relationship, both income and its quadratic term are included in regressions. It is found that the impact of income on mental health is U-shaped rather than linear. The turning point (7.698) of this nonlinear relation is near the midpoint of the income interval ([0, 16.113]). This suggests that depression declines as income increases at the lower-income level. However, beyond middle income, further increases in income take pronounced mental health costs, leading to a positive relationship between the two factors. We further exclude the possibility of more complex nonlinear relationships by testing higher order terms of income. In addition, robustness checks, using other instrument variables and mental health indicators, different IV models and placebo analysis, all support above conclusions. Heterogeneity analysis demonstrates that males, older workers, ethnic minorities and those with lower health and socioeconomic status experience higher levels of depression. Highly educated and urban residents suffer from greater mental disorders after the turning point. Religious believers and Communist Party of China members are mentally healthier at lower income levels, meaning that religious and political beliefs moderate the relationship between income and mental health.

Agency and Subjective Health from Early Adulthood to Mid-Life: Evidence from the Prospective Youth Development Study

Understanding the determinants of subjective or self-rated health (SRH) is of central importance because SRH is a significant correlate of actual health as well as mortality. A large body of research has examined the correlates, antecedents, or presumed determinants of SRH, usually measured at a given time or endpoint. In the present study, we investigate whether individual mastery, a prominent indicator of agency, has a positive effect on SRH over a broad span of the life course. Drawing on longitudinal data from the Youth Development Study (n=741), we examine the impacts of mastery on SRH over a 24-year period (from ages 21-22 to 45-46). The findings of a fixed effects analysis, controlling time-varying educational attainment, unemployment, age, obesity, serious health diagnoses, and time-constant individual differences, lead us to conclude that mastery is a stable predictor of SRH from early adulthood to mid-life. This study provides evidence that psychological resources influence individuals' subjective assessment of their health, even when objective physical health variables and socioeconomic indicators are taken into account.

Housing cost burden and material hardship among older adults: How do they influence psychological health?

OBJECTIVES

Despite a growing body of evidence for the association between housing cost burden and psychological health, few studies have focused on the potential mediators of this association and the extent to which housing cost burden poses a threat to older adults' psychological health. This study aims to assess (a) the link between housing cost burden and psychological health among older adults and (b) how the association is mediated by material hardship.

METHODS

Using thirteen waves of a nationally representative longitudinal study in Korea, this study assessed the association between housing cost burden and depressive symptoms among older adults aged 65 or over. Mediation tests were conducted to identify whether material hardship explains the link between housing cost burden and depressive symptoms. We used fixed-effects models to take into account individual-level heterogeneity.

RESULTS

Housing cost burden was significantly associated with depressive symptoms among older adults, regardless of their housing tenure status. Different types of material hardship partially mediated the association between housing cost burden and depressive symptoms in older adults. Older adults with severe housing cost burden are more susceptible to all types of material hardship compared to those with a moderate burden.

CONCLUSIONS

To contribute further to the social causation discussions, future studies should seek to identify protective factors of depressive symptoms among older adults and other potential mechanisms of the association between older adults' socioeconomic conditions and their psychological health.

The Relationship Between Overqualification and Incident Diabetes: A 14-Year Follow-Up Study

OBJECTIVE

Recent research identified that workplace factors play a role in the development of diabetes mellitus (DM). This study examines the longitudinal association of work-related overqualification with the incidence of DM over a 14-year follow-up period.

METHODS

We used data from the 2003 Canadian Community Health Survey linked to the Ontario Health Insurance Plan and the Canadian Institute for Health Information Discharge Abstract databases. Cox proportional hazards regression models were performed to evaluate the relationship between overqualification and the incidence of DM.

RESULTS

Over the study period, there were 91,835 person-years of follow-up (median follow-up = 13.7 years). The final sample included 7026 respondents (mean [standard deviation] age at baseline = 47.1 [8.2]; 47% female). An elevated risk of DM was associated with substantial overqualification (hazard ratio = 1.58, 95% confidence interval = 1.01-2.49) after adjustment for sociodemographic, health, and work variables. Additional adjustment for body mass index and health behaviors attenuated this risk (hazard ratio = 1.30, 95% confidence interval = 0.81-2.08). Underqualification was not associated with the incidence of DM in adjusted regression models. We did not observe any statistical difference in the effects of overqualification on DM risk across sex or education groups.

CONCLUSIONS

This study adds to the growing body of research literature uncovering the relationships between work exposures and DM risk. The results from the study suggest that higher body mass index and, to a lesser extent, health behaviors may be mediating factors in the association between overqualification and incident DM. Further research on the association of overqualification with DM is warranted.

How do income changes impact on mental health and wellbeing for working-age adults? A systematic review and meta-analysis

BACKGROUND

Lower incomes are associated with poorer mental health and wellbeing, but the extent to which income has a causal effect is debated. We aimed to synthesise evidence from studies measuring the impact of changes in individual and household income on mental health and wellbeing outcomes in working-age adults (aged 16-64 years).

METHODS

For this systematic review and meta-analysis, we searched MEDLINE, Embase, Web of Science, PsycINFO, ASSIA, EconLit, and RePEc on Feb 5, 2020, for randomised controlled trials (RCTs) and quantitative non-randomised studies. We had no date limits for our search. We included English-language studies measuring effects of individual or household income change on any mental health or wellbeing outcome. We used Cochrane risk of bias (RoB) tools. We conducted three-level random-effects meta-analyses, and explored heterogeneity using meta-regression and stratified analyses. Synthesis without meta-analysis was based on effect direction. Critical RoB studies were excluded from primary analyses. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). This study is registered with PROSPERO, CRD42020168379.

FINDINGS

Of 16 521 citations screened, 136 were narratively synthesised (12·5% RCTs) and 86 meta-analysed. RoB was high: 30·1% were rated critical and 47·1% serious or high. A binary income increase lifting individuals out of poverty was associated with 0·13 SD improvement in mental health measures (95% CI 0·07 to 0·20; n=42 128; 18 studies), considerably larger than other income increases (0·01 SD improvement, 0·002 to 0·019; n=216 509, 14 studies). For wellbeing, increases out of poverty were associated with 0·38 SD improvement (0·09 to 0·66; n=101 350, 8 studies) versus 0·16 for other income increases (0·07 to 0·25; n=62 619, 11 studies). Income decreases from any source were associated with 0·21 SD worsening of mental health measures (-0·30 to -0·13; n=227 804, 11 studies). Effect sizes were larger in low-income and middle-income settings and in higher RoB studies. Heterogeneity was high (I²=79-87%). GRADE certainty was low or very low.

INTERPRETATION

Income changes probably impact mental health, particularly where they move individuals out of poverty, although effect sizes are modest and certainty low. Effects are larger for wellbeing outcomes, and potentially for income losses. To best support population mental health, welfare policies need to reach the most socioeconomically disadvantaged.

FUNDING

Wellcome Trust, Medical Research Council, Chief Scientist Office, and European Research Council.

Vicarious Discrimination, Psychosocial Resources, and Mental Health among Black Americans

Does hearing about or witnessing someone else experience discrimination harm individuals’ mental health? Using data from the Nashville Stress and Health Study, we answer this question by examining how vicarious discrimination impacts depressive symptoms, anxiety symptoms, and anger among black Americans. We also test whether mastery and self-esteem moderate the association between vicarious discrimination and each mental health outcome. Findings indicate experiencing vicarious discrimination via a family member has a similar impact on mental health to personally experiencing discrimination. While experiencing vicarious discrimination via a close friend also increased mental health problems, it appeared to be less harmful than personally experiencing discrimination. Moreover, self-esteem moderated the association between vicarious discrimination via a family member and via a close friend and mental health, while mastery did not. This study provides new insights into ways vicarious discrimination impacts health as well as the role that psychosocial resources play in shaping this relationship.

Education Level, Underemployment, and Health

Under the dual background of underemployment and health inequality, this study empirically analyzes the impact of education level on underemployed workers' health based on data from the 2016 China Labor-force Dynamics Survey. The results show that underemployment is significantly related to the decline of self-rated health, increased depressive tendencies, and the prevalence of illness over a certain period. The results indicate that underemployment can significantly reduce the health level of workers in both low and high education level groups. However, underemployment appears to have no significant impact on workers' health in the middle education level group. This result holds even if the measurement method of the indicators is adjusted and endogeneity is considered; this indicates that the research conclusions are robust. Moreover, this kind of health inequality mainly comes from the economic and leisure effects of underemployment for workers with different educational levels. Although underemployment significantly reduces the economic level of workers in each education level group, it brings a positive leisure effect to workers with a middle education level and a negative leisure effect to workers with a low education level. This study provides empirical support for increasing labor protection mechanisms for underemployed people and reducing the health inequality caused by differences in education level.

The Relationship Between Financial Worries and Psychological Distress Among U.S. Adults

This study examines the association between financial worries and psychological distress among US adults and tests its moderating effects by gender, marital status, employment status, education, and income levels. Data were derived from the cross-sectional 2018 National Health Interview Survey (NHIS) of the adult population. The hierarchical regression analysis revealed that higher financial worries were significantly associated with higher psychological distress. Additionally, the association between financial worries and psychological distress was more pronounced among the unmarried, the unemployed, lower-income households, and renters than their counterparts. The findings suggest that accessible financial counseling programs and public health intervention programs are needed to mitigate financial worries and its negative influences on overall psychological health, with greater attention devoted to vulnerable populations.

Socioeconomic position, social mobility, and health selection effects on allostatic load in the United States

The contemporaneous association between higher socioeconomic position and better health is well established. Life course research has also demonstrated a lasting effect of childhood socioeconomic conditions on adult health and well-being. Yet, little is known about the separate health effects of intergenerational mobility-moving into a different socioeconomic position than one's parents-among early adults in the United States. Most studies on the health implications of mobility rely on cross-sectional datasets, which makes it impossible to differentiate between health selection and social causation effects. In addition, understanding the effects of social mobility on health at a relatively young age has been hampered by the paucity of health measures that reliably predict disease onset. Analysing 4,713 respondents aged 25 to 32 from the National Longitudinal Study of Adolescent Health's Waves I and IV, we use diagonal reference models to separately identify the effects of socioeconomic origin and destination, as well as social mobility on allostatic load among individuals in the United States. Using a combined measure of educational and occupational attainment, and accounting for individuals' initial health, we demonstrate that in addition to health gradient among the socially immobile, individuals' socioeconomic origin and destination are equally important for multi-system physiological dysregulation. Short-range upward mobility also has a positive and significant association with health. After mitigating health selection concerns in our observational data, this effect is observed only among those reporting poor health before experiencing social mobility. Our findings move towards the reconciliation of two theoretical perspectives, confirming the positive effect of upward mobility as predicted by the "rags to riches" perspective, while not contradicting potential costs associated with more extensive upward mobility experiences as predicted by the dissociative thesis.

Socio-economic resources and adult mental health in Canada: controlling for time-invariant confounders and investigating causal directionality

OBJECTIVE

The aim of this study was to investigate whether family income and education have a causal effect on psychological distress among Canadian adults.

METHODS

We executed fixed-effects regression analyses using data from the Longitudinal and International Study of Adults (LISA). We investigated whether changes in family income and education from wave 2 (2014) to wave 3 (2016) corresponded with changes in psychological distress during this same time period. We also investigated whether changes in these socio-economic resources from wave 1 (2012) to wave 2 (2014) corresponded with lagged changes in psychological distress from wave 2 (2014) to wave 3 (2016). These models controlled for all time-invariant confounders with time-invariant effects, as well as the time-varying factors age, marital status, household size, and employment status.

RESULTS

Obtaining a postsecondary degree corresponded with lagged decreases in psychological distress among women ages 18 to 32 (b = -1.97; 95% CI = -3.53, -0.42) and men over the age of 32 (b = -1.86; 95% CI = -3.57, -0.15). The effect of postsecondary education was stronger when considering adults who stayed married throughout the three waves (b = -2.29; 95% CI = -4.37, -0.21).

CONCLUSION

Completing postsecondary education may have a lagged causal effect on psychological distress, and the life course timing for when postsecondary completion reduces distress is different for women and men.

Accumulation of economic hardship and health during the COVID-19 pandemic: Social causation or selection?

This study examines whether economic hardship during the COVID-19 pandemic is deleteriously associated with psychological distress and self-rated health. A social causation perspective suggests that exposure to economic hardship will harm well-being, but a social selection perspective suggests that the appearance of health effects of hardship during the pandemic are attributable to the increased risk of exposure to hardship associated with poor well-being at the start of the pandemic. We also propose a third perspective, economic selection, which suggests that economic hardship prior to the pandemic negatively affects health and increases risk of exposure to hardship during the pandemic; consequently, an association between health and economic hardship during the pandemic may be spurious, and entirely due to pre-existing levels of hardship. To test these competing perspectives, we use a longitudinal study based in Canada that began in late March of 2020 and followed respondents monthly in April, May, and June. Baseline psychological distress and self-rated health, as well as economic hardship prior to the pandemic, independently predict the accumulation of monthly periods of hardship from April to June. The accumulation of periods of hardship from April to June is deleteriously associated with psychological distress and self-rated health in June. Controls for prior economic hardship and baseline health weaken the association between accumulation of periods of hardship and psychological distress, while also eliminating the association between accumulation of hardship and self-rated health. These findings favor a social causation perspective for psychological distress and a social selection perspective for self-rated health, with less evidence found in support of economic selection. This study took place during the first months of the COVID-19 pandemic, though, and associations with self-rated health may have become more evident as hardship further wore on individual well-being over a longer period of time.

Recession hardships, personal control, and the amplification of psychological distress: Differential responses to cumulative stress exposure during the U.S. Great Recession

Recessions pose risks to mental health, yet the psychosocial mechanisms involved are less clear. One critical factor may be people's perceived control when faced with multiple recession hardships. Here we test a structural amplification hypothesis by assessing the role of perceived control as a mediator and moderator of the relation between recession shocks and psychological distress. We draw on waves 2 (2004-2006) and 3 (2013-2014) of the Midlife in the United States study (MIDUS), covering 1,739 US adults under age 75 from before and after the Great Recession. Our statistical models reveal that perceived control declines while distress rises in association with a greater accumulation of recession-related hardships. Perceived control partially mediated the recession hardships-distress association,attenuating it by about one-fifth. Further, perceived control modified the association between recession hardships and distress; individuals who reported larger declines in personal control had greater increases in distress, whereas those who experienced hardships but increased their perceived control did not exhibit significant changes in distress levels. Taken together, our findings support the structural amplification hypothesis, whereby an accumulation of recession hardships erode coping resources that would otherwise protect individuals from the mental health effects of stress exposure. Future research is needed to better understand sources of resilience at individual, community, and societal levels to help ameliorate sentiments of powerlessness and lack of perceived control during economic recessions.

Precarious sleep? Nonstandard work, gender, and sleep disturbance in 31 European countries

Despite the advent of precarious work, little is known about how this form of employment can generate disparities in sleep outcomes. We extend existing work by providing a theoretical framework linking different measures of work precarity to sleep problems. We argue that the association between objective precarious working conditions and sleep disturbance is channeled through and mediated by subjective work precarity. We further argue that gender moderates the relationship between objective and subjective work precarity. We test this theoretical framework using the 2010 European Working Conditions Survey. Our results indicate that objective precarious working conditions undermine sleep by promoting the subjective experience of insecurity. Furthermore, the indirect effect of objective precarious work on sleep disturbance through subjective employment insecurity varies by gender: compared to women in similar working conditions, men report higher levels of subjective precarity. This research makes important contributions to the literatures on the health consequences of nonstandard work and social determinants of well-being.

Predictors of Health Self-Management Program Preference Among Lower-to-Middle Wage Employed Adults With Chronic Health Conditions

PURPOSE

We examined the extent to which demographic, chronic disease burden, and financial strain characteristics were associated with a preference for engaging in the Chronic Disease Self-Management Program (presented as a "health self-management program" [HSMP]) over a financial self-management program (FSMP) and a no program preference (NPP) group among employed adults.

DESIGN

Cross-sectional, correlation design using baseline data from a randomized controlled trial (RCT).

SUBJECTS

The analytic sample included 324 workers aged 40 to 64 years with 1 or more chronic disease conditions recruited into the RCT from 2015 to 2017.

MEASURES

Chronic disease burden measures included the number of chronic conditions, body mass index (BMI), and the 8-item and 15-item Patient Health Questionnaire (PHQ-8 and PHQ-15). Financial strain was measured as the inability to purchase essentials and food assistance receipt. Both individual and household measures of income were assessed.

ANALYSES

Multinomial logistic regression and post-hoc marginal effects models.

RESULTS

Moderate-to-severe depressive symptoms increased the likelihood of having an HSMP preference when compared with those preferring the FSMP (RR = 4.2, P < .05) but not those having NPP; while higher BMI marginally increased HSMP preference over FSMP preference, but not NPP groups (RR = 1.04, P < .05). Financial strain differentially, but significantly, reduces the likelihood of HSMP preference at varying levels of household poverty, depressive symptom severity, and financial strain.

CONCLUSION

Middle-aged, lower-to-middle income workers with moderate-to-severe depressive symptoms opt for HSMPs over FSMPs, but preference for HSMPs significantly diminished when they are experiencing financial strain.

Trauma Exposure and Mental Health Problems Among Adults in Central Vietnam: A Randomized Cross-Sectional Survey

Background: There is relatively little evidence about the psychological and social impacts of trauma exposure in the general population in East Asian countries. Vietnam has a long history of war and poverty, is prone to natural disasters and has high mortality related to traffic accidents. The mental health systems may be inadequate to cope with the resultant trauma. Objectives: This research examines the lifetime prevalence of single and multiple traumas and the association between trauma exposure and depression, anxiety and post-traumatic stress disorder (PTSD) among a randomly selected sample of the adult population in Thua Thien-Hue province in central Vietnam. Methods: Six hundred and eight Vietnamese adults aged 18 years or older participated in the survey. The main tools in the face-to-face interview included the Life Event Checklist (LEC) to measure trauma exposure, the Hospital Anxiety and Depression Scale (HADS) and the PTSD Checklist for DSM-IV (PCL-IV). Hierarchical multiple logistic regression was used to examine associations between trauma exposure and mental health. Results: Forty seven percent of the participants experienced at least one traumatic event in their lifetime and about half of these people were exposed to multiple traumas. The prevalence of depression, anxiety, and PTSD symptoms among the total sample was 12.7, 15.5, and 6.9%, respectively. Prevalence of PTSD among those reporting trauma exposure was 14.8%. Exposure to a higher number of trauma types was associated with increased risk of having depression, anxiety, and PTSD symptoms. Interpersonal traumas were strongly associated with symptoms of all three mental disorders while non-interpersonal traumas were only associated with depressive symptoms. Conclusion: Our findings indicate high burden of lifetime trauma and mental ill health in the adult population of central Vietnam and show a cumulative effect of multiple traumas on symptoms of the three mental disorders. Interpersonal trauma appears to have a more harmful effect on mental health than non-interpersonal trauma. Efforts to improve mental health in Vietnam should focus on reducing risk of preventable interpersonal trauma in every stage of life, and more broadly, ensure greater availability of trauma-sensitive mental health programs and services.