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Worthen M, Menchaca J, Laine M. An intersectional approach to understanding the correlates of depression in college students: Discrimination, social status, and identity. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1220-1231. [PMID: 34252348 DOI: 10.1080/07448481.2021.1926261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 03/07/2021] [Accepted: 05/02/2021] [Indexed: 05/31/2023]
Abstract
OBJECTIVE We assessed the impact of bearing multiple marginalized identities, experiencing discrimination and perceived social status on the prevalence of depression in college students using an intersectional approach. PARTICIPANTS Public health students at a diverse urban public university in Northern California (N = 338, response rate = 85%; 77% women, mean age 22). METHODS We used a cross-sectional survey to assess demographics, depression, discrimination and social standing using validated scales and estimate the relations between depression and co-factors. RESULTS 25.4% of students reported depression. Discrimination was associated with a higher level of depression and more severe symptoms. Higher perceived social status was associated with a lower level of depression and less severe symptoms. Hispanic/Latinx first generation women had three times the prevalence of depression as non-Hispanic/Latinx non-first generation men and there was a significant disparity in depression severity. CONCLUSIONS Intersectional approaches can shed light on the experiences of marginalized groups.
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Affiliation(s)
- Miranda Worthen
- Public Health & Recreation, San José State University, San Jose, California, USA
| | - Justin Menchaca
- Public Health & Recreation, San José State University, San Jose, California, USA
| | - Michelle Laine
- Public Health & Recreation, San José State University, San Jose, California, USA
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Zhang Y. The role of internet use in the relationship between occupational status and depression. PLoS One 2022; 17:e0272611. [PMID: 36215292 PMCID: PMC9550066 DOI: 10.1371/journal.pone.0272611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 07/22/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The emerging information and communications technology (ICT) and society 5.0 have integrated digital innovation and imaginative creativity to solve social problems and create social value in an aging society. Especially in China, the penetration rate of internet use has become more prominent. Nevertheless, the role of internet use in the relationship between occupational status and depression remains unknown. The purpose of this study was to estimate how internet use moderates the relationship between occupational status and depression in a sample of older adults in China. METHODS A cross-sectional design was used to assess the relationship between occupational status, internet use and depression. This study employed data from the Chinese General Social Survey (CGSS) conducted in 2017. The full sample size of this study is 2,403. OLS regression was adopted to explore the correlation between occupational status and depression and the moderating role of internet use. Meanwhile, a heterogeneity analysis based on residence registration was implemented to explore the difference between rural and urban sample groups. RESULTS The findings suggested that higher occupational status was related to lower depression level. By playing an inhibitory moderating role between the association of occupational status and depression, internet use and occupational status formed a substituting effect. Meanwhile, the above moderating effect was only significant in urban group and insignificant in rural group. Besides, being male and having higher social class were significantly and negatively correlated with depression. CONCLUSION This study began with the theory of social stratification and social mobility, added the theory of social capital, constructed an analytical framework of regulatory effect, put forward two basic assumptions, selected measurement indicators taking into account Chinese cultural factors, and conducted empirical tests using authoritative statistical software and national representative data, providing a new theoretical contribution to our understanding of the impact of occupational status and depression in developing countries.
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Affiliation(s)
- Yujie Zhang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China,* E-mail:
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Wallace K, Stewart EA, Wise LA, Nicholson WK, Parry JP, Zhang S, Laughlin-Tommaso S, Jacoby V, Anchan RM, Diamond MP, Venable S, Shiflett A, Wegienka GR, Maxwell GL, Wojdyla D, Myers ER, Marsh E. Anxiety, Depression, and Quality of Life After Procedural Intervention for Uterine Fibroids. J Womens Health (Larchmt) 2022; 31:415-424. [PMID: 34101502 PMCID: PMC8972021 DOI: 10.1089/jwh.2020.8915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background: Quality of life (QOL) and psychological health has been reported to be decreased among women with gynecological conditions such as uterine fibroids (UFs). Materials and Methods: Women enrolled in the Comparing Options for Management: PAtient-centered REsults for Uterine Fibroids (COMPARE-UF) registry, receiving procedural therapy for symptomatic UFs, were eligible for this analysis if they completed a series of health-related QOL surveys administered at three time points (baseline, 6-12 weeks postprocedure, and 1 year postprocedure; n = 1486). Ethical approval for this study was obtained at each recruiting site and the coordinating center (NCT02260752, clinicaltrials.gov). Results: More than 26% (n = 393) of women reported moderate anxiety/depression on the baseline anxiety/depression domain of the Euro-QOL 5-dimension instrument. At both the 6-12 weeks and 1-year postprocedural follow-up, there was significant improvement in the UF QOL symptom severity score (p < 0.001, p < 0.001), the total UF symptom QOL score (p < 0.001, p < 0.001), and the Euro-QOL 5-dimension visual analog scale (p < 0.001, p = 0.004) compared with the preprocedural baseline scores. The reporting of anxiety/depression decreased by 66.4% among women who were at baseline, whereas 5.6% of women previously reporting no anxiety/depression reported anxiety/depression at the 1-year follow-up. Conclusion: UF symptoms were more severe among women reporting anxiety/depression at baseline. At the 1-year follow-up, health-related QOL scores improved among all women and the prevalence of anxiety/depression decreased in most, but not all women, whereas severity of anxiety/depression worsened in a small percentage of women (5.6%). Overall, these results suggest that UF treatment improves symptoms of anxiety/depression associated with symptomatic UFs.
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Affiliation(s)
- Kedra Wallace
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Address correspondence to: Kedra Wallace, PhD, Department of Obstetrics and Gynecology, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, USA
| | | | - Lauren A. Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Wanda Kay Nicholson
- Center for Women's Health Research, Department of Obstetrics and Gynecology, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - John Preston Parry
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Shuaiqi Zhang
- Duke Clinical Research Institute, Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
| | | | - Vanessa Jacoby
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, California, USA
| | - Raymond M. Anchan
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Michael P. Diamond
- Department of Obstetrics and Gynecology, Augusta University, Augusta, Georgia, USA
| | | | - Amber Shiflett
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ganesa R. Wegienka
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
| | - George Larry Maxwell
- Department of Obstetrics and Gynecology, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Daniel Wojdyla
- Duke Clinical Research Institute, Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
| | - Evan R. Myers
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Erica Marsh
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Archibald JL, Neupert SD. “Keeping Up with the Joneses”: Subjective Social Status Predicts Proactive Coping. JOURNAL OF ADULT DEVELOPMENT 2022. [DOI: 10.1007/s10804-022-09392-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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5
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Race, Social Status, and Depressive Symptoms: A Moderated Mediation Analysis of Chronic Low Back Pain Interference and Severity. Clin J Pain 2021; 36:658-666. [PMID: 32487870 DOI: 10.1097/ajp.0000000000000849] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chronic low back pain (cLBP) is the leading cause of disability, with a significant societal cost. It disproportionately affects non-Hispanic blacks and individuals of lower socioeconomic status. The biopsychosocial framework has been used to study and manage cLBP, yet disparities persist. OBJECTIVE The objective of this study was to assess whether self-identified race moderated the relationship between perceived social status and cLBP outcomes (pain interference and pain severity) and investigate whether race moderated the indirect relationship between perceived social status and pain outcomes via depressive symptoms. METHODS Fifty-seven blacks and 48 whites with cLBP were recruited as part of a large ongoing study. Depressive symptoms, objective and subjective measures of socioeconomic status, and pain outcomes were measured. Hayes' moderated mediation model was used to estimate conditional direct and indirect relationship between these variables. RESULT On average black participants reported significantly more pain interference (4.12 [SD=2.65] vs. 2.95 [SD=2.13]) and severity (5.57 [SD=2.27] vs. 3.99 [SD=1.99]) than white participants, (P<0.05). Race moderated the association between perceived social status and pain interference: higher social status decreases pain interference for white participants, but that trend was not observed in black participants. Moreover, race moderated association of perceived social status with depressive symptoms (P<0.001); which mediates the effects of perceived social status on pain outcomes. CONCLUSION Higher perceived social status is associated with less severe depressive symptoms, which in turn is associated with less pain severity and less pain interference for whites but not for blacks with cLBP.
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Yu X, Zhang W, Kobayashi LC. Duration of subjective poverty in relation to subsequent cognitive performance and decline among adults aged ≥64 in China, 2005-2018. Soc Sci Med 2021; 283:114188. [PMID: 34225036 DOI: 10.1016/j.socscimed.2021.114188] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The effects of late-life subjective poverty on brain health are understudied. We aimed to investigate the association between duration of subjective poverty after age 64 and subsequent cognitive function and decline in China. METHODS Data were from 4118 adults aged ≥64 at baseline in the population-based China Longitudinal Healthy Longevity Survey (CLHLS), 2005-2018. The duration of subjective poverty was measured from self-rated economic status relative to neighbors in 2005, 2008, and 2011 (never; one time point; two or three time points). Cognitive function was assessed by the Chinese Mini-Mental State Exam (CMMSE; range: 0-30) in 2011, 2014, and 2018. We fitted attrition-weighted, multivariable mixed-effects Tobit regression models to examine the relationship between duration of subjective poverty from 2005 to 2011 and subsequent cognitive function and decline from 2011 to 2018. RESULTS A total of 2675 (64.96%) participants never reported subjective poverty over the period 2005-2011, 930 (22.58%) participants reported subjective poverty at one time point, and 513 (12.46%) reported subjective poverty at two or three time points. Compared to those who never reported subjective poverty, participants experiencing subjective poverty at one time point (β = -0.95, 95% CI: -1.48 to -0.41) and two or three time points (β = -2.01; 95% CI: -2.73 to -1.29) had lower CMMSE scores in 2011, indicating a dose-response relationship. Individuals with a longer duration of subjective poverty had a slower rate of decline in CMMSE scores than those never in subjective poverty (β = 1.44; 95% CI: 0.20 to 2.68 for 2018 X Two or three time points). CONCLUSION Subjective poverty in late life may have unique and cumulative contributions to cognitive aging among older adults in China. The lower level of initial cognitive function but slower rate of cognitive decline observed for those with greater subjective poverty is consistent with theories of cognitive reserve and empirical evidence from Western settings on other socioeconomic markers.
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Affiliation(s)
- Xuexin Yu
- Biomedical Big Data Center, West China Hospital, Sichuan University, Sichuan, China; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Wei Zhang
- Biomedical Big Data Center, West China Hospital, Sichuan University, Sichuan, China
| | - Lindsay C Kobayashi
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
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Association between hysterectomy and depression: a longitudinal follow-up study using a national sample cohort. ACTA ACUST UNITED AC 2020; 27:543-549. [DOI: 10.1097/gme.0000000000001505] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Effects of combined GnRH receptor antagonist linzagolix and hormonal add-back therapy on vaginal bleeding-delayed add-back onset does not improve bleeding pattern. Reprod Sci 2020; 27:988-995. [PMID: 32100275 DOI: 10.1007/s43032-020-00172-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/06/2019] [Indexed: 10/24/2022]
Abstract
Linzagolix is a novel, oral GnRH receptor antagonist developed for the treatment of endometriosis and uterine fibroids. We assessed high-dose linzagolix safety and bleeding pattern effects in healthy women using combined versus delayed hormonal add-back therapy (ABT). This was a single-center, open-label, parallel-group study in 32 premenopausal women, who were randomized to daily linzagolix (200 mg)/ABT for 10 weeks ("Combined-ABT") or linzagolix (200 mg) for 4 weeks followed by linzagolix (200 mg)/ABT for 6 weeks ("Delayed-ABT"). Main outcome measures included bleeding records, trough estradiol (E2) concentrations and adverse events. Linzagolix alone promptly reduced bleeding, leading to amenorrhea in all women by week 5. When combined ABT was started (week 5), spotting (≤ 0.80 days/week/subject) and bleeding (≤ 0.53 days/week/subject) occurred; bleeding was markedly more frequent than after ABT start in the "Combined-ABT" group. In the "Combined-ABT" group, spotting (≤ 0.69 days/week/subject) and occasional bleeding (≤ 0.25 days/week/subject) occurred during the first half of treatment with a tendency to further decrease during the second half. Linzagolix alone rapidly reduced E2 reaching median week 4 levels of 4.1 pg/mL. Median E2 after combined linzagolix/ABT ranged between 35 and 42 pg/mL for the "Delayed-ABT" group (weeks 5-10) and between 24 and 32 pg/mL for the "Combined-ABT" group (weeks 1-10). Linzagolix was well tolerated. Most frequently reported adverse events were headache (32/156) and hot flushes (19/156). Hot flushes exclusively occurred in the "Delayed-ABT" group. In this study, treatment start with a combined linzagolix/ABT regimen resulted in better bleeding control, no hot flushes, and lower median E2 levels than a "Delayed-ABT" regimen. These results may help defining the linzagolix/ABT regimen to be adopted when treating sex-hormone-dependent diseases. Clinical Trial Registration Number-EudraCT Number: 2017-003822-34.
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Castro IE, Hruska B, Gump BB. Race Differences in the Effect of Subjective Social Status on Hostility and Depressive Symptoms Among 9- to 11-Year-Old Children. J Racial Ethn Health Disparities 2020; 7:844-853. [PMID: 31989531 DOI: 10.1007/s40615-020-00707-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/10/2020] [Accepted: 01/21/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Research shows that subjective social status (SSS) is a salient determinant of health. However, there is little research on SSS-related group differences on psychosocial outcomes among children. The purpose of the current study was to determine if associations between psychosocial functioning and SSS in children varied as a function of racial groups. METHODS We used a series of regression models to examine associations between SSS and measures of hostility and depressive symptom severity in groups of Black and White children. All analyses controlled for objective markers of family- and neighborhood-level socioeconomic status. Participants included 291 school-age children in Syracuse, NY. RESULTS Among Black children, SSS was negatively associated with hostility scores, R2 = 0.10, F(6, 160) = 3.34, p = 0.006, but not depressive symptom severity. Conversely, among White children, SSS was negatively associated with depressive symptom severity, R2 = 0.18, F(6, 117) = 4.37, p = 0.001, but not hostility. CONCLUSION These racial differences in SSS-associated psychosocial functioning could be explained by race-based differences in attributions of social mobility and socioeconomic inequalities. Findings provide support for investigating possible tailoring of behavioral interventions to assist children in developing high SSS or coping with low SSS.
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Affiliation(s)
- Ivan E Castro
- Department of Public Health, Falk College, Syracuse University, Syracuse, NY, 13244, USA
| | - Bryce Hruska
- Department of Public Health, Falk College, Syracuse University, Syracuse, NY, 13244, USA
| | - Brooks B Gump
- Department of Public Health, Falk College, Syracuse University, Syracuse, NY, 13244, USA.
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Chen R, Kessler RC, Sadikova E, NeMoyer A, Sampson NA, Alvarez K, Vilsaint CL, Green JG, McLaughlin KA, Jackson JS, Alegría M, Williams DR. Racial and ethnic differences in individual-level and area-based socioeconomic status and 12-month DSM-IV mental disorders. J Psychiatr Res 2019; 119:48-59. [PMID: 31563857 PMCID: PMC7255491 DOI: 10.1016/j.jpsychires.2019.09.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/09/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to: (1) examine the associations of individual-level objective socioeconomic status (OSS), subjective socioeconomic status (SSS), and area-based indicators of socioeconomic status, with 12-month DSM-IV mood, anxiety, alcohol use, and drug use disorders; and, (2) determine the extent of racial/ethnic differences in these associations across non-Latino White, non-Latino Black, Latino, and Asian participants. Data are from the Collaborative Psychiatric Epidemiology Studies dataset, a collection of three population-based surveys of mental disorders among U.S. residents aged 18 and older (n = 13,775). Among all indicators of socioeconomic status, SSS was most consistently associated with 12-month mental disorders. Income was negatively associated with mood and anxiety disorders; education was negatively associated with alcohol use and drug use disorders. Significant interactions with race/ethnicity were found for the associations of socioeconomic indicators with anxiety, alcohol use, and drug use disorders but not with mood disorders. SSS was not associated with any of the 12-month mental disorders among Blacks. Education had stronger associations with 12-month anxiety and alcohol use disorders among Whites than among other racial/ethnic groups. Among Asians, low income compared to high income was associated with a lower risk of anxiety disorders and less than high school completion compared to college or more was associated with a lower risk of alcohol use disorders. Finally, tract-level income inequality was associated with a greater risk of drug use disorders only among Blacks. The patterns and magnitudes of the associations of individual-level and area-based socioeconomic indicators differed by type of disorder and race/ethnicity.
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Affiliation(s)
- Ruijia Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, United States.
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Ekaterina Sadikova
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Amanda NeMoyer
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States; Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, United States.
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States.
| | - Kiara Alvarez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, United States; Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, United States.
| | - Corrie L Vilsaint
- Recovery Research Institute, Massachusetts General Hospital Center for Addiction Medicine, 151 Merrimac Street, Boston, MA, 02114, United States.
| | - Jennifer Greif Green
- Wheelock College of Education & Human Development, Boston University, 2 Silber Way, Boston, MA, 02215, United States.
| | - Katie A McLaughlin
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02138, United States.
| | - James S Jackson
- Institute for Social Research, 5057 ISR, 426 Thompson St., Ann Arbor, MI, 48104, United States.
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, United States; Department of Medicine, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, United States.
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, United States.
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Neubert M, Süssenbach P, Rief W, Euteneuer F. Unemployment and mental health in the German population: the role of subjective social status. Psychol Res Behav Manag 2019; 12:557-564. [PMID: 31440107 PMCID: PMC6664150 DOI: 10.2147/prbm.s207971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 06/04/2019] [Indexed: 01/25/2023] Open
Abstract
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.
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Affiliation(s)
- Marie Neubert
- Division of Clinical Psychology and Psychotherapy, Philipps University, Marburg, Germany
| | - Philipp Süssenbach
- Division of Social and Personality Psychology, Fachhochschule des Mittelstands (FHM), University of Applied Sciences, Bielefeld, Germany
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Philipps University, Marburg, Germany
| | - Frank Euteneuer
- Division of Clinical Psychology and Psychotherapy, Philipps University, Marburg, Germany.,Division of Clinical Psychology and Psychotherapy, Medical School Berlin, Berlin, Germany
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Unexpected coexistent endometriosis in women with symptomatic uterine leiomyomas is independently associated with infertility, nulliparity and minor myoma size. Arch Gynecol Obstet 2019; 300:103-108. [PMID: 31006843 DOI: 10.1007/s00404-019-05153-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/05/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To determine risk factors for unexpected coexistent endometriosis in laparoscopic myomectomy for symptomatic uterine leiomyomas. METHODS This was a single-centre, retrospective cohort study conducted at a University Women's Hospital with a certified endometriosis centre. Data were collected from patients with symptomatic uterine leiomyomas who underwent laparoscopic myomectomy. The main outcome measured in the study was the presence of histologically confirmed endometriosis. Binary regression analysis was used to investigate risk factors for the coexistence of endometriosis. Postoperative complications were classified according to the Clavien-Dindo classification. RESULTS From 2014 to 2018, 223 patients underwent laparoscopic myomectomy for symptomatic leiomyomas, and 57 (25.6%) had unexpected endometriosis. Women with endometriosis significantly more frequently were nulliparous (66.7% vs. 51.2%; p = 0.04), had reported infertility (31.6% vs. 15.7%; p = 0.01) and smaller leiomyomas (mean diameter 4.92 cm) than women without endometriosis (mean diameter 6.02 cm; p = 0.006). Coexistent endometriosis significantly increased mean operative time (168.4 vs. 142.8 min; p = 0.05) while intra- and postoperative complications showed a similar distribution (p = 0.87) and length of hospital stay (p = 0.26). Binary regression analysis identified 2.3- and 2.2-fold increases in the risk of endometriosis for infertility (p = 0.042) and nulliparity (p = 0.041), respectively. Myoma size influenced the risk of endometriosis by a factor of 0.8 per cm (p = 0.037). CONCLUSIONS Coexistent endometriosis should be expected in leiomyoma patients particularly with nulliparity, infertility or minor myoma size as independent risk factors. Preoperative counselling should incorporate surgical therapy of coexisting endometriosis.
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Bove M, Mhillaj E, Tucci P, Giardino I, Schiavone S, Morgese MG, Trabace L. Effects of n-3 PUFA enriched and n-3 PUFA deficient diets in naïve and Aβ-treated female rats. Biochem Pharmacol 2018; 155:326-335. [PMID: 30028991 DOI: 10.1016/j.bcp.2018.07.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/14/2018] [Indexed: 01/08/2023]
Abstract
Depression is one of the most common psychiatric diseases and the prevalence of depressive symptoms in women is almost twice compared to men, although the reasons of this gender difference are not fully understood yet. Recently, soluble Aβ1-42 peptide has been receiving great importance in the development of depression, also since depression is highly comorbid with Alzheimer's disease and other neurodegenerative illnesses. Accordingly, we have previously shown that central Aβ injection is able to elicit depressive-like phenotype in male rats. In the present study, we reproduced for the first time the Aβ-induced depressive-like model in female rats, evaluating behavioural and neurochemical outcomes. Moreover, we studied the effect of lifelong exposure to either n-3 PUFA enriched or n-3 PUFA deficient diet, in female rats, both intact and after central Aβ administration. Our results confirmed the Aβ-induced depressive-like profile also in female rats. Moreover, chronic exposure to n-3 PUFA deficient diet led to highly negative alterations in behavioural and neurochemical parameters, while lifelong exposure to n-3 PUFA enriched diet was able to restore the Aβ-induced depressive-like profile in female rats. In conclusion, the Aβ-induced depressive-like profile was reversed by n-3 PUFA supplementation, indicating a possible therapeutic role of n-3 PUFA in the treatment of the burden of depressive disorders.
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Affiliation(s)
- Maria Bove
- Department of Physiology and Pharmacology "V. Erspamer", "Sapienza" University of Rome, Italy; Groningen Institute for Evolutionary Life Science, University of Groningen, The Netherlands
| | - Emanuela Mhillaj
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Paolo Tucci
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Ida Giardino
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Stefania Schiavone
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Maria Grazia Morgese
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luigia Trabace
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
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Zahodne L, Kraal A, Zaheed A, Sol K. Subjective Social Status Predicts Late-Life Memory Trajectories through Both Mental and Physical Health Pathways. Gerontology 2018; 64:466-474. [DOI: 10.1159/000487304] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 01/31/2018] [Indexed: 01/08/2023] Open
Abstract
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.
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Abstract
Introduction Perceptions of social standing have increasingly well-documented relationships with health. Higher subjective social status (SSS) is associated with better psychological well-being among women, and mothers of newborns. The relationship between SSS and psychological distress among mothers of young children, however, is largely unknown. SSS may provide insight into aspects of maternal functioning that are relevant to parenting capacity, as well as insight into future health; in addition, SSS is brief, and may be perceived as less intrusive than other measures of socioeconomic status or mental health. We evaluated the relationship between SSS and psychological distress among mothers of 5-year-old children from diverse socioeconomic backgrounds. Methods One hundred and sixty-two mothers of 5-year old children, who participated in a study of child self-regulation, completed surveys that assessed sociodemographics, mental health, and perceived social support. The MacArthur Scale of SSS used pictures of ten-rung ladders to assess respondents' social position in relation to the US (SES ladder) and their community (community ladder). Quantile regression models were used to assess the relationship between maternal psychological distress (perceived social support, depressive symptoms, anxiety) and the ladders (individually and together), adjusting for maternal age, race, education, and number of children. To examine whether the SSS-health relationships differed by race, the models were also stratified by race. Results Community ladder ranking was positively associated with social support (β = 1.34, SE = 0.33, p < .001), and negatively associated with depressive symptoms (β = -1.34, SE = 0.52, p < .05). SES ladder ranking was positively associated with social support (β = 1.17, SE = 0.52, p < .05). Findings in the full sample were driven by more robust relationships between psychological distress and community SSS among Black/African-American mothers. Discussion The findings suggest that perceived social standing in one's community is associated with maternal psychological well-being. Community SSS may be particularly influential for Black/African-American mothers' well-being.
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Diehl K, Hoebel J, Sonntag D, Hilger J. Subjective social status and its relationship to health and health behavior: comparing two different scales in university students. Int J Adolesc Med Health 2017; 31:/j/ijamh.ahead-of-print/ijamh-2017-0079/ijamh-2017-0079.xml. [PMID: 28841574 DOI: 10.1515/ijamh-2017-0079] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 07/10/2017] [Indexed: 06/07/2023]
Abstract
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.
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Affiliation(s)
- Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167 Mannheim, Germany, Phone: +49 621 383 9602, Fax: +49 621 383 9920
| | - Jens Hoebel
- Unit of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Diana Sonntag
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Health Sciences, University of York, York, UK
| | - Jennifer Hilger
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Hearing the Silenced Voices of Underserved Women: The Role of Qualitative Research in Gynecologic and Reproductive Care. Obstet Gynecol Clin North Am 2017; 44:109-120. [PMID: 28160888 DOI: 10.1016/j.ogc.2016.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In order to provide effective evidence-based health care to women, rigorous research that examines women's lived experiences in their own voices is needed. However, clinical health research has often excluded the experiences of women and minority patient populations. Further, clinical research has often relied on quantitative research strategies; this provides an interesting but limited understanding of women's health experiences and hinders the provision of effective patient-centered care. This article defines qualitative research and its unique contributions to research, and provides examples of how qualitative research has given insights into the reproductive health perspectives and behaviors of underserved women.
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Nezhat C, Li A, Abed S, Balassiano E, Soliemannjad R, Nezhat A, Nezhat CH, Nezhat F. Strong Association Between Endometriosis and Symptomatic Leiomyomas. JSLS 2017; 20:JSLS.2016.00053. [PMID: 27647977 PMCID: PMC5019190 DOI: 10.4293/jsls.2016.00053] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background and Objectives: The relationship between leiomyoma and endometriosis is poorly understood. Both contribute to considerable pain and may cause subfertility or infertility in women. We conducted this retrospective study to assess the rate of coexistence of endometriosis in women with symptomatic leiomyoma. The primary outcome measured was the coexistence of histology-proven endometriosis in women with symptomatic leiomyoma. Methods: This is a retrospective review of a data-based collection of medical records of 244 patients treated at a tertiary medical center, who were evaluated for symptomatic leiomyoma from March 2011 through December 2015. Of those, 208 patients underwent laparoscopic or laparoscopic-assisted myomectomy or hysterectomy. All patients provided consent for possible concomitant diagnosis and treatment of endometriosis. The remaining 36 patients underwent medical therapy and were excluded from the study. All patients who had myomectomy or supracervical hysterectomy underwent minilaparotomy for extracorporeal morcellation and specimen removal beginning in April 2012. Results: Of the 208 patients with the presenting chief concern of symptomatic leiomyoma and who underwent surgical therapy, 181 had concomitant diagnoses of leiomyoma and endometriosis, whereas 27 had leiomyoma. Of the 27 patients, 9 also had adenomyosis. Patients with only fibroid tumors were, on average, 4.0 years older than those with endometriosis and fibroids (mean age, 44 vs 40 ± SD). Patients with both pathologies were also more likely to present with pelvic pain and nulliparity than those with fibroid tumors alone. Conclusions: In our patient population, 87.1% of patients with a chief concern of symptomatic fibroids also had a diagnosis of histology-proven endometriosis, which affirms the need for concomitant diagnosis and intraoperative treatment of both conditions. Overlooking the coexistence of endometriosis in women with symptomatic leiomyoma may lead to suboptimal treatment of fertility and persistent pelvic pain. It is important for physicians to be aware of the possibility of this association and to thoroughly evaluate the abdomen and pelvis for endometriosis at the time of myomectomy or hysterectomy in an effort to avoid the need for reoperation.
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Affiliation(s)
- Camran Nezhat
- Center for Special Minimally Invasive and Robotic Surgery, Palo Alto, California, USA
| | - Anjie Li
- Center for Special Minimally Invasive and Robotic Surgery, Palo Alto, California, USA
| | | | - Erika Balassiano
- Center for Special Minimally Invasive and Robotic Surgery, Palo Alto, California, USA
| | - Rose Soliemannjad
- Center for Special Minimally Invasive and Robotic Surgery, Palo Alto, California, USA
| | - Azadeh Nezhat
- Center for Special Minimally Invasive and Robotic Surgery, Palo Alto, California, USA
| | - Ceana H Nezhat
- Nezhat Medical Center, Atlanta Center for Minimally Invasive Surgery and Reproductive Medicine, Atlanta, Georgia, USA
| | - Farr Nezhat
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, New York, USA
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Allchin A, Melchior M, Fombonne E, Surkan PJ. Parental social networks during childhood and offspring depression in early adulthood: a lifecourse approach. Depress Anxiety 2016; 33:1031-1038. [PMID: 27373544 DOI: 10.1002/da.22538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 04/11/2016] [Accepted: 06/12/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Little is known on how parental social relationships may affect their children's mental health. We sought to examine the relation between parental social relationship characteristics and subsequent offspring depression in young adulthood. METHODS We used 2009 Trajectoires Épidémiologiques en Population (TEMPO) study data from 1087 French young adults ages 22 to 35 and parental data from the corresponding Gaz et Eléctricité (GAZEL) study in 1991. Multivariable logistic regression was used to examine parental social networks, quality of parental relationships, and reciprocity of parental social support measured in 1991 in relation to offspring depression in young adulthood measured using the Adult Self Report in 2009. Analyses were stratified by participant sex. RESULTS In adjusted models, daughters of parents who reported giving more support to others than they received had 1.72 higher odds (95% CI, 1.09-2.70) of depression in young adulthood. Daughters of parents who were unsatisfied with their social relationships had 2.14 (95% CI, 1.22-3.76) higher odds of depression. Among male participants, there was no statistically significant association between parental relationship satisfaction, reciprocity of parental exchanges, and depression. CONCLUSIONS Parental relationships during mid-childhood have long-term associations with offspring depression. Results suggest that enhancing social support for parents may have positive implications for their children's mental health.
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Affiliation(s)
- Adelyn Allchin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maria Melchior
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Eric Fombonne
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Shaked D, Williams M, Evans MK, Zonderman AB. Indicators of subjective social status: Differential associations across race and sex. SSM Popul Health 2016; 2:700-707. [PMID: 29349181 PMCID: PMC5757747 DOI: 10.1016/j.ssmph.2016.09.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/12/2016] [Accepted: 09/27/2016] [Indexed: 11/26/2022] Open
Abstract
Background Subjective social status (SSS), or perception of rank on the social hierarchy, is an important indicator of various health outcomes. However, the psychosocial influences on this construct are unclear, and how these influences vary across different sociodemographic groups is poorly understood. Methods Participants were 2077 African-American and Whites (M age=47.85; 57% female; 58% African American, and 58% above poverty) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Multiple regression analyses examined (1) hypothesized psychosocial indicators of SSS and (2) the moderating effect of race and sex on the variables associated with SSS. Results In addition to the traditional measures of SES (i.e. income, employment, and education), psychosocial variables (i.e. depressive symptomatology, neighborhood satisfaction, and self-rated health) were significantly associated with SSS. However, some of these indicators varied with respect to race and sex. Three significant interactions were found: sex by employment, race by employment, and race by education, wherein objective measures of SES were more associated with SSS for Whites and men compared to African Americans and women. Conclusion Psychosocial measures may influence individuals’ perceptions of themselves on the social hierarchy. Additionally, SSS may vary by demographic group. When considering the impact of SSS on health, it is important to consider the unique interpretations that various demographic groups have when perceiving themselves on the social hierarchy. Subjective Social Status (SSS) is an important health indicator, but its psychosocial correlates are unknown. Additionally, it is unclear if indicators of SSS vary by demographic group (i.e. race and sex). Findings suggest that in addition to traditional measures of socioeconomic status (e.g. education), numerous psychosocial variables (e.g. depressive symptoms) were related to SSS. Indicators of SSS varied across race and sex, wherein objective measures of SES were more associated with SSS for Whites and men, than African Americans and women.
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Affiliation(s)
- Danielle Shaked
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD.,Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD
| | - Megan Williams
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD.,Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, Intramural Research Program, Baltimore, MD
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Schubert T, Süssenbach P, Schäfer SJ, Euteneuer F. The effect of subjective social status on depressive thinking: An experimental examination. Psychiatry Res 2016; 241:22-5. [PMID: 27152906 DOI: 10.1016/j.psychres.2016.04.081] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 02/09/2016] [Accepted: 04/23/2016] [Indexed: 11/16/2022]
Abstract
Subjective social status (SSS) predicts health outcomes above and beyond objective measures of social status. Both objective and subjective measures of social status are strongly related with depression. Cognitive mechanisms such as depressive cognitions, rumination, and a negative cognitive style are seen as both concomitant and antecedent to depression. This experiment examined the causal role of SSS in developing depressive thinking. Participants were randomly assigned to a low and a high status group and followed a manipulation procedure targeting their SSS. Depressive thinking was subsequently assessed by depressive cognitions, stress-reactive state rumination and negative cognitive style. Low status participants exhibited higher levels of depressive cognitions and rumination compared to their high status counterparts, but both groups did not differ regarding their cognitive style. Findings support the causal nature of the relationship between SSS and depressive thinking. Several mechanisms of how low SSS may lead to depression are discussed.
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Affiliation(s)
- Torben Schubert
- Division of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Philipp Süssenbach
- Division of Psychological Methods, Philipps-University of Marburg, Marburg, Germany
| | - Sarina J Schäfer
- Division of Social Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Frank Euteneuer
- Division of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany.
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