Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study

Integrating Social Determinants With the Interpersonal Theory of Suicide in a Study of Bipolar Outpatients

INTRODUCTION

Bipolar disorder, socioeconomic deprivation, and social isolation are major risk factors for suicide. The interpersonal theory of suicide (IPTS) posits perceived burdensomeness and thwarted belongingness as proximal causes of suicidal thoughts and behaviors, while the social determinants of health (SDOH) framework highlights distal socioeconomic factors. Studies of suicidality in bipolar disorder have used the IPTS and the SDOH framework, but few have integrated them to explore connections between distal and proximal factors.

METHODS

This study examined perceived burdensomeness and thwarted belongingness as mediators of the relationship between cumulative socioeconomic risk and suicide risk. Participants were 171 outpatients in a United States (U.S.) bipolar clinic (mean age = 39.0, 69.6% female, 73.7% Black/African American).

RESULTS

Cumulative socioeconomic risk, perceived burdensomeness, and thwarted belongingness were positively associated with suicide risk. Perceived burdensomeness mediated the relationship between cumulative socioeconomic risk and suicide risk, but thwarted belongingness did not.

CONCLUSION

Findings broadly suggest the IPTS and the SDOH framework can be fruitfully integrated to guide research and prevent suicide. The pathway from cumulative socioeconomic risk to suicide risk via perceived burdensomeness warrants further attention, particularly for individuals diagnosed with bipolar disorder. Implications for future studies of the IPTS, SDOH, and suicidality are discussed.

Unfavourable glucose metabolism is associated with functional somatic disorders. A cross-sectional general population-based study: The DanFunD study

OBJECTIVES

Several studies have observed associations between unfavorable levels of blood glucose metabolic markers (i.e., fasting glucose, fasting insulin, glycated hemoglobin (HbA1c), and insulin resistance (HOMA-IR)) and functional somatic disorder (FSD). However, such associations have not yet been systematically analyzed in a general population-based sample using various FSD delimitations simultaneously. The aim of this study was to assess whether an unfavorable glucose metabolism is associated with FSD.

DESIGN

Cross-sectional population-based study SETTING: Ten municipalities in the western part of greater Copenhagen area in Denmark PARTICIPANTS: A total of 8183 men and women aged 18-76 years were included. Various delimitations of FSD, i.e., chronic fatigue (CF), chronic widespread pain (CWP), irritable bowel (IB), and bodily distress syndrome (BDS), were measured using validated self-administrated questionnaires. In a stratified subsample, BDS was also assessed by diagnostic interviews.

OUTCOME MEASURES

Logistic regression models were estimated for each delimitation of FSD as outcome and fasting glucose, fasting insulin, HbA1c, and estimated insulin resistance. Results were adjusted for age, sex (model 1), lifestyle, and social factors (model 2) and presented as odds ratios (OR) with 95 % confidence intervals (CI).

RESULTS

When only adjusting for sex and age, positive associations were found between all FSD delimitations and glucose, insulin, and HbA1c, except for between IB and HbA1c. Positive associations were also found between all questionnaire-based BDS groups, and men with BDS confirmed by diagnostic interviews and elevated insulin resistance. After adjusting for lifestyle and social factors, associations remained significant between both CF and glucose and HbA1c and between multi-organ BDS and glucose and HbA1c. Further, CF, single-organ BDS, multi-organ BDS, and women with overall-BDS also remained associated with increased levels of insulin resistance.

CONCLUSION

FSD seems to be associated with especially an increase in plasma insulin levels and increased levels of insulin resistance. Elevated levels of blood glucose and HbA1c among all FSD groups could also completely be explained by unhealthy lifestyle. Prospective studies are needed for further clarification of the clinical relevance of this observation.

Impact of individual differences in cognitive reserve, stress, and busyness on episodic memory: an fMRI analysis of the Alabama Brain Study On Risk for Dementia

Cognitive reserve (CR) and busyness can boost memory, whereas stress can impair memory. Nevertheless, extant research has not yet examined busyness in conjunction with CR and stress, nor whether CR or stress moderate the relationship between busyness and episodic memory. Middle-aged and older adult participants (N = 71; ages 50-74; 31% African-American) answered lifestyle questionnaires and completed a visual paired-associate memory fMRI task. Dimension reduction techniques identified two latent CR factors-personal CR (own education; occupation complexity; socioeconomic status) and parental education (mother's/father's education), and identified two latent stress factors-external stress (neighborhood stress/violence; financial strain) and personal stress (perceived stress; work/personal stress). We cast these latent factors into a series of regression models, revealing that (1) in isolation, higher busyness predicted better episodic memory, (2) higher external stress predicted worse memory, (3) both greater personal CR and greater parental education predicted better memory, (4) busyness did not interact with stress nor with CR, and (5) in a combined model, higher parental education and lower external stress were significant independent predictors. Neuroimaging data revealed that higher CR was associated with more efficient brain activity in the hippocampus and posterior cingulate during successful episodic memory retrieval, whereas higher personal stress was associated with heightened activity in the precuneus. No interactions or main effects of busyness were observed for the fMRI data. Thus, although busyness was associated with superior episodic memory, busyness did not modulate brain activity during episodic memory retrieval, nor did CR or stress moderate the relationship between busyness and associative memory.

Identity as a resource or a demand

Individuals embody various social identities that can impact how they interface with the social environment. Stigma theories suggest that members of low-status or marginalized groups possess devalued social identities, and therefore, experience more stress. While social identities can lead to increased stress, individuals' appraisals of their identities are not necessarily perceived as harmful/demanding. Rather, social identities can also be appraised as resources or sources of strength bringing opportunities and facilitating goal attainment. Using the biopsychosocial (BPS) model of challenge and threat as a conceptual foundation, this research developed a novel measure to assess individuals' appraisals of their social identities. In Study 1 (N = 575), confirmatory factor analysis (CFA) evaluated the theorized factor structure (i.e., resource and demand appraisals) and assessed the overall fit of the model. Structural equation modeling (SEM) tested for associations between the resource and demand latent factors. Individuals appraising their ethnic-racial identity as a resource exhibited improved self and intergroup outcomes, while those perceiving it as a demand reported worse self-based and intergroup outcomes, as well as more distress. Study 2 (N = 743 Black and White Americans), which was preregistered, examined group differences in appraisals of ethnic-racial identity. SEM revealed that Black participants were more likely than White participants to appraise their ethnic-racial identity as demanding, leading to worse social and intergroup outcomes. Even when Black participants perceived their ethnic-racial identity as a resource, they still reported higher levels of discrimination, intergroup anxiety, and behavioral avoidance compared to their White counterparts. Implications for theory development and application to the stress literature are discussed.

Shift-and-Persist Strategies and Psychological Well-Being: Where Adolescents Stand on Social Ladder Matters

OBJECTIVES

Shift-and-persist coping strategies have been demonstrated to be beneficial for physical health of individuals in low socioeconomic status (SES); however, their impacts on psychological well-being remain less clear. This study aimed to examine: (1) whether the protective effects of shift-and-persist with respect to psychological well-being (i.e., depressive symptoms and subjective well-being) only exist among adolescents with lower (vs. higher) subjective SES, and (2) what drives the potential benefits, shifting strategy or persisting strategy, or both of them?

METHODS

This study recruited 686 middle school students (54.5% male; Mage = 12.57 years, SD = 0.65) from Guangdong Province, China, in January 2019, and they completed measures of subjective SES (i.e., perceived family social status), shift-and-persist strategies, depressive symptoms, subjective well-being, and demographic information.

RESULTS

Adolescents who engaged in more shift-and-persist strategies reported fewer depressive symptoms and higher levels of subjective well-being, with stronger effects among those lower (vs. higher) in subjective SES. When further exploring what drove these effects, results showed that persisting strategy was associated with fewer depressive symptoms and higher levels of subjective well-being, with more pronounced effects for adolescents with lower (vs. higher) subjective SES. The shifting strategy was associated with fewer depressive symptoms only among those with lower subjective SES, while associated with higher levels of subjective well-being regardless of subjective SES levels.

CONCLUSIONS

Findings support the applicability of the shift-and-persist model to both positive and negative indicators of psychological well-being and enrich the theory by providing preliminary evidence for the domain-specific roles of shifting strategy in buffering the negative psychological effects of low-SES contexts.

The mediating role of job fairness and job burnout between subjective social status and depressive symptoms in Chinese migrant workers: a generational difference analysis

BACKGROUND

In China, migrant workers (MWs) constitute a significant vulnerable group that may be highly susceptible to depression. However, there is a lack of empirical research exploring the correlation between subjective social status (SSS) and depressive symptoms among MWs. The objective of this study is to examine the mediating roles of job fairness and job burnout, as well as to investigate potential generational differences in this association.

METHODS

A cross-sectional study was conducted in China among two groups of 1,158 MWs (response rate, 89.08%): first generation migrant workers (FGMWs) and new generation migrant workers (NGMWs). The survey assessed SSS, depressive symptoms, job fairness, and job burnout using a questionnaire. Structural equation model was used to primarily analyze mediating roles of job fairness and job burnout in the relationship between SSS and depressive symptoms, as well as to explore potential generational differences in this association.

RESULTS

The study findings indicate that SSS significantly predicted higher depressive symptoms among MWs. However, the relationship between SSS and depressive symptoms was mediated by job fairness or job burnout. Notably, the indirect effect of SSS on depressive symptoms through job burnout was significant for FGMWs, but not for NGMWs.

CONCLUSION

This study fills a critical gap in understanding the connections between SSS, depressive symptoms, job fairness, and job burnout among MWs in China. It emphasizes the role of job fairness and job burnout as significant mediators that either worsen or alleviate the impact of SSS on depressive symptoms among MWs. Moreover, the findings suggest that the mediation differs significantly between FGMWs and NGMWs. These findings imply the need for different intervention methods to address the depressive symptoms of the two generations of MWs.

Subjective social status and health-related quality of life after critical illness: results from a three-year prospective cohort study

Subjective Social Status (SSS) reflects one's perceived rank within a given social structure and has been shown to be a unique correlate of physical and mental health. However, no research has been conducted to address populations of (recovering) critically ill patients. To shed light on the relationship between SSS and health in critically ill patients, we focus on survivors of acute respiratory distress syndrome (ARDS). A cohort study with N = 877 ARDS survivors was conducted in 61 intensive care units (ICUs) in Germany between 2014 and 2019. Health-related quality of life (HRQoL, Physical and Mental Component Scale: PCS, MCS of the SF-12) and SSS (MacArthur Scale) were assessed at 12, 24, and 36 months after discharge from ICU. Objective social status (Socioeconomic status [SES]) was assessed once at ICU baseline. Bivariate correlations between SSS and HRQoL (PCS and MCS) remain significant throughout the study period (r = .29 - .50, all p-values < .05). Subsequent hierarchical regression shows that SSS remains predictive for PCS and MCS even after controlling for SES (β = .335 - .486, all p values < .001). The results indicate the importance (and unique contribution) of the subjective localization within the status hierarchy for long-term HRQoL after critical illness.

Heart rate variability is not associated with multiple chemical sensitivity in a cross-sectional population-based study - The Danish study of functional disorders

OBJECTIVE

Multiple chemical sensitivity (MCS), a functional somatic disorder (FSD), is a multisystem, polysymptomatic disease, characterized by various individual symptoms attributed to low level of volatile chemical exposures. Symptoms relate to the autonomic nerve system (ANS) among others which is mandatory in the MCS delimitations. An accepted measure of ANS is heart rate variability (HRV). The aim was to explore associations between HRV and MCS in the general Danish population.

METHODS

In the Danish Study of Functional Disorders, 7493 adults filled in questionnaires and participated in a physical health examination (2012-2015). The "E motion" heart rate monitor device assessed time and frequency measures of HRV. For this study, 143 were categorized with MCS of which, 84 were subcategorized as MCS without comorbid FSD. The remaining population (n = 5525) was used as comparison group. Logistic regression models to assess odds ratio (OR) with 95 % confidence intervals (95 % CI) of MCS, and MCS without comorbid FSD for each HRV exposure adjusted for age, sex, and chronic stress.

RESULTS

Compared to the general population, median resting heart rate was higher (64.7 vs 63.1 bpm, p = 0.007) and median normal-to-normal intervals was lower (930 vs 952 ms, p = 0.007) in MCS individuals. Resting heart rate was associated with MCS (OR: 1.019, 95 %CI: 1.003; 1.037); but not after adjustment for chronic stress. No other associations with other HRV measures nor in MCS without comorbid FSD were found.

CONCLUSION

HRV was not associated with MCS. The magnitude of the differences between groups was small and of uncertain clinical significance.

Residential food environment and dietary antioxidant consumption among pregnant women: Modifying effects of socioeconomic factors and ethnic identity

BACKGROUND

Residential food environment influences dietary patterns, however the impact of individuals' perceived social identity on their antioxidant intake, an indicator of healthy dietary patterns, remains underexplored.

OBJECTIVE

We conducted a cross-sectional analysis using data collected in a longitudinal cohort. In the study, we aimed to investigate the interactions between the food environment and two indicators of social identity, specifically a subjective ladder measure of socioeconomic status (SES) and the Multigroup Ethnic Identity Measure (MEIM) score, in relation to dietary antioxidant intake (DAI) among n = 512 Boston and NYC-resident pregnant women.

METHODS

The modified Retail Food Environment Index (mRFEI) was calculated using the Centers for Disease Control and Prevention's equation, with higher scores indicating a healthier food environment. DAI was estimated by summing standardized data from six micronutrients (magnesium, selenium, zinc, and vitamins A, C, and E) obtained through the Block98 Food Frequency Questionnaires administered during pregnancy, with higher scores indicating increased intake. The mRFEI and DAI were dichotomized based on a median split. Multivariable-adjusted logistic regressions were used to analyze associations, both with and without considering women's subjective SES or MEIM levels as effect modifiers.

RESULTS

Women were racially/ethnically mixed (19.2 % White, 42.7 % Black, and 33.1 % Hispanic) with 32.2 % reporting more than high school education. In the main effect models, no significant association was observed between mRFEI and DAI. Women with higher MEIM scores exhibited higher DAI [Odds ratio (OR) =1.85, 95 % Confidence interval (CI) = 1.26-2.73]. Exploratory interaction models showed that subjective SES significantly modified the association (p-value for interaction = 0.03), specifically, women perceiving themselves to have a lower SES compared to their community (n = 45) exhibited a significantly positive association between mRFEI and DAI.

CONCLUSION

These findings suggest that women perceiving their SES to be lower than their neighborhoods may benefit from better access to healthy food.

Socioeconomic Position and Oral Health in Chinese Older Adults: A Life Course Approach

OBJECTIVES

We investigated associations between socioeconomic position (SEP) across childhood, adulthood, and older age and number of teeth among Chinese older adults.

METHODS

Data came from 15,136 participants aged 65 to 105 y in the Chinese Longitudinal Healthy Longevity Survey (2018 wave). The outcome was number of teeth. Pathways and sensitive period models were tested simultaneously via structural equation modeling. Ordinal logistic regression assessed the accumulation of risk and social mobility models. Differences were examined across 4 birth cohorts.

RESULTS

Adult and older age SEP had direct effects on number of teeth in older age (adulthood, direct β = 0.182, P < 0.001; older age, direct β = 0.093, P = 0.005), supporting the sensitive period model. Childhood SEP had an indirect effect on number of teeth (indirect β = 0.130, P < 0.001) through adult and older age SEP, supporting the pathway/accumulation of risk and social mobility models. Effects of SEP on number of teeth were more pronounced in younger cohorts. Graded associations in the expected directions were found between the number of periods in which participants experienced disadvantaged SEP and number of teeth, as well as social mobility trajectories and number of teeth.

CONCLUSION

Among Chinese older adults, the number of remaining teeth is subject to marked social inequalities. Our findings document the simultaneous applicability of life course models and a widening of oral health inequalities in China across generations. Interventions earlier in child and adult life are needed to address this problem and reduce oral health inequalities.

KNOWLEDGE TRANSFER STATEMENT

The findings of this study suggest marked socioeconomic inequalities in oral health among Chinese older adults. These inequalities are generated throughout the life course and appear to have widened across cohorts. This study emphasizes that interventions are needed to address the social determinants of oral health at all life stages.

Mediation effects of subjective social status and personality traits between childhood nurturing experiences and depressive symptoms in adult volunteers

Aim

Various risk factors, such as childhood nurturing experiences and subjective social status, have been identified to be involved in the onset of depression. However, the mechanism of depression is not yet fully understood. In this study, we hypothesized that nurturing experienced in childhood affects subjective social status and current personality traits, which in turn influence depressive symptoms in adulthood, and verified this hypothesis through structural equation modeling.

Methods

A questionnaire survey was conducted on 404 adults. Multiple regression analysis and structural equation modeling were conducted using demographic information and scores for the Patient Health Questionnaire-9, Parental Bonding Instrument, and NEO Five-Factor Inventory.

Results

Subjective social status was found to mediate the association between nurturing experiences and neuroticism (0.029 for Overprotection and -0.034 for Care). On the other hand, neuroticism was found to mediate the association between subjective social status and depressive symptoms (-0.097 in Care model and -0.103 in Overprotection model), as well as the association between nurturing experiences and depressive symptoms (0.144 for Overprotection and -0.134 for Care). Furthermore, it was also shown that complex paths, in which the association of nurturing experiences with depressive symptoms was mediated by two factors, namely, subjective social status and neuroticism, were statistically significant as indirect effects (0.016 for Overprotection and -0.018 for Care).

Conclusion

In this study, we clarified that nurturing experienced in childhood affects neuroticism in adulthood, which is mediated by subjective social status, and furthermore, the effects of nurturing on neuroticism lead to varying levels of depressive symptoms in adulthood. The mediation effects demonstrated in the present study may contribute towards unraveling the causes of depression and developing effective treatments for depressive symptoms.

Socioeconomic inequalities and their impact on the health of seniors 65

OBJECTIVES

The main aim of the article is to indicate how selected socioeconomic factors contribute to the selected characteristics of the subjectively perceived health of seniors 65+ living in the Czech Republic.

METHODS

Data collection took place in the Czech Republic from 27 January 2020 to 14 February 2020. The total number of interviews carried out in the research was 1,172, from a representative quota sample of seniors from the senior population living in the Czech Republic. Questionnaires were distributed in the form of PAPI interviews.

RESULTS

The assessment of subjective social status increases with education and employment (these three aspects are closely linked), and the assessment transferred to the senior years.

CONCLUSION

The accumulation of advantages and disadvantages should encourage the Government of the Czech Republic, as well as other European states, to focus on those who, based on their low levels of education and social status, have very low assessments of their subjective health. Prevention (in both health and social fields), which includes access to information and the subsequent better life decisions, must be implemented throughout a person's lifetime (so as to reduce the disadvantages that accumulate from the cradle to the grave).

"Us big boys gotta find a way that works": A qualitative study of casual sexual experiences among larger-bodied, White and Latino sexual minority men

Compared to their heterosexual counterparts, sexual minority men (SMM) are more likely to report that their own body image negatively impacts their sex lives, are more vulnerable to weight stigma, and more frequently experience size-based discrimination. Additionally, in comparison to heterosexual men, SMM report higher levels of anti-fat bias, both directed at themselves and intimate partners. Given this literature, we qualitatively examined how nine larger-bodied SMM (Mage = 37.89, SD = 12.42) experience and navigate weight stigma when seeking out casual sex. Our analytic process revealed four primary themes: Building a Gate, Letting Partners Past the Gate, Joy Inside the Gate, and When the Gate Fails. The gate refers to the protection that participants employed to avoid negative, unsafe, or fatphobic sexual encounters. Participants shared that they were aware of weight stigma within their own community, and many assumed (or were explicitly told) that their bodies were undesirable to potential partners. Further, participants readily delineated between fat attraction and fat fetishization, whereby the latter was universally framed as negative and degrading. These findings highlight the complex experience of engaging in casual sex for larger-bodied SMM and identify strategies these men use to protect themselves from body shame and weight stigma.

The negative association of low subjective socioeconomic status with future orientation: the protective role of low fatalism

BACKGROUND

Subjective socioeconomic status (SES), an individual's beliefs about his or her social class, is anticipated to be related to future orientation. This study proposed a moderation model to examine the relationship between subjective SES on future orientation and the protective role of low fatalism.

METHODS

Two studies were conducted to test the proposed model. Specifically, in Study 1, the structured questionnaires were administered to a sample comprising 217 Chinese participants (192 females, Mage = 18.24 ± 0.63). In Study 2, the structured questionnaires and an Imaginative Scenario Test were administered to collect data among 244 Chinese participants (167 females, Mage = 18.44 ± 0.73). Regression analyses were used to explore the moderating role of fatalism in the association between subjective SES on future orientation. The Bootstrap methods were used to test the significance of these moderating effects.

RESULTS

The results revealed two primary findings: (1) Fatalism moderated the pathway from subjective SES to future orientation. Specifically, low fatalism served as a protective factor, making low subjective SES less disruptive to their future orientation. (2) The moderating effect was primarily attributed to the "luck dimension", which was the belief that luck plays a pivotal role in determining one's fate.

CONCLUSIONS

The findings contribute to enriching the current understanding of the subjective SES on future orientation and the protective role of low fatalism.

Stereotypes bias social class perception from faces: The roles of race, gender, affect, and attractiveness

People quickly form consequential impressions of others' social class standing from nonverbal cues, including facial appearance. Extant research shows that perceivers judge faces that appear more positive, attractive, and healthy as higher-class, in line with stereotypes associating high class standing with happiness, attractiveness, and better wellbeing (which bear a kernel of truth). A wealth of research, moreover, demonstrates strong stereotypical associations between social class and both race and gender. The current work bridged these areas of inquiry to explore (1) intersectional biases in social class impressions from faces and (2) how associations between social class and attractiveness/health and affect can be used to shift social class impressions. Our studies found evidence of race and gender stereotypes impacting British perceivers' social class judgements, with Black (vs. White and Asian) and female (vs. male) faces judged as lower in class. Furthermore, manipulating faces' emotion expression shifted judgements of their social class, with variations in magnitude by faces' race, such that emotion expressions shifted judgements of Black faces more than White faces. Finally, manipulating faces' complexion to appear healthier/more attractive shifted social class judgements, with the magnitude of this varying by faces' and perceivers' race, suggesting a role of perceptual expertise. These findings demonstrate that stereotypes bias social class impressions and can be used to manipulate them.

Socioeconomic mobility, metabolic health, and diet: mediation via subjective socioeconomic status

OBJECTIVE

Socioeconomic mobility, i.e., changing socioeconomic status (SES) between adolescence and adulthood, may impact health through changing resources, social status, and health-related behaviors. This analysis examined whether subjective SES contributes to associations of mobility with metabolic health (BMI and metabolic syndrome) and unhealthy diets (fast-food consumption and sugar-sweetened beverage [SSB] consumption).

METHODS

National Longitudinal Study of Adolescent to Adult Health data were used (n = 4132). Mobility was defined as the difference between adolescent (collected 1994-1995, ages 11-19 years) and adult (collected 2016-2018, ages 33-43 years) SES. Linear and logistic regressions examined associations of mobility with metabolic and dietary outcomes and mediation by subjective SES.

RESULTS

Substantial upward mobility was associated with lower risk of high SSB consumption compared with stable disadvantaged SES (risk difference: -0.10 [95% CI: -0.16 to -0.041]). Subjective SES mediated associations of upward, but not downward, mobility with risks of developing metabolic syndrome, high fast-food consumption, and high SSB consumption; upward mobility was associated with higher subjective SES and lower risks of poor metabolic and dietary outcomes.

CONCLUSIONS

The finding that subjective SES contributed to associations between upward mobility and better health may inform development of interventions designed to promote healthier diets and reduce socioeconomic disparities in metabolic health.

Lifestyle factors as predictors of incident functional somatic disorder. Five-year follow-up of The DanFunD study

AIMS

To assess whether lifestyle factors, including sleep pattern, are predictors for the development of functional somatic disorder (FSD).

METHODS

A population-based prospective cohort of 9656 men and women aged 18-76 years was established in 2011-2015 and invited for re-examination in 2017-2020, when 5738 participated. Median follow-up period was 65 months. Participants filled in validated questionnaires on lifestyle, sleep pattern and various delimitations of FSD, which were operationalized using two different approaches: bodily distress syndrome (BDS) and functional somatic syndromes (FSS) (i.e. chronic fatigue, chronic widespread pain (CWP), irritable bowel, and multiple chemical sensitivity (MCS)). Baseline lifestyle and sleep pattern in relation to incidence of BDS and FSS (chronic fatigue, CWP, irritable bowel, MCS) was analysed by logistic regressions, adjusted for age, sex and subjective social status.

RESULTS

Inferior sleep quality at baseline predicted both incidence of BDS and all FSS delimitations except MCS. Smoking, alcohol intake, and low physical activity, but not diet, were predictors for the development of BDS. No uniform pattern was observed for the FSS. Smoking predicted development of chronic fatigue, CWP and irritable bowel, but not MCS. Alcohol and food quality only influenced the development of chronic fatigue whereas low physical activity only influenced the development of chronic fatigue and CWP.

CONCLUSIONS

Lifestyle factors and sleep pattern seem to be predictors for some delimitations of FSD, but the importance of the various lifestyle factors is different for the different delimitations. The study shows the importance of analysing the various FSSs separately.

Health behaviors at the start of the COVID-19 pandemic: Evidence for indirect effects of subjective social status via psychological distress

Subjective social status (SSS), the perception of one's social standing compared to others in society, and socioeconomic status (SES) are interconnected but distinct determinants of health. Intermediary factors such as distress and health behaviors can contribute to this relationship. This pre-registered study hypothesized that, in the early months of the COVID-19 pandemic, nonspecific psychological distress would indirectly link SSS and SES to perceived changes in three health behaviors: sleep quality, physical activity, and alcohol consumption. Data from 412 US adults were collected from April to June 2020 through an online cross-sectional survey. Findings indicated that lower SSS was indirectly associated with lower current sleep quality, worsened sleep quality, and decreased physical activity since the pandemic onset via greater psychological distress. Path analyses controlled for age, gender, race, COVID-19-related worry, and shelter-in-place status. Results are discussed in light of findings from COVID-19 research and the broader literature on SES health disparities.

Associations between subjective social status and predictors of interest in genetic testing among women diagnosed with breast cancer at a young age

PURPOSE

Genetic testing for gene mutations which elevate risk for breast cancer is particularly important for women diagnosed at a young age. Differences remain in access and utilization to testing across social groups, and research on the predictors of interest in genetic testing for women diagnosed at a young age is limited.

METHODS

We examined the relationships between subjective social status (SSS) and variables previously identified as possible predictors of genetic testing, including genome sequencing knowledge, genetic worry, cancer worry, health consciousness, decision-making preferences, genetic self-efficacy, genetic-related beliefs, and subjective numeracy, among a cohort of women who were diagnosed with breast cancer at a young age.

RESULTS

In this sample (n = 1,076), those who had higher SSS had significantly higher knowledge about the limitations of genome sequencing (Odds Ratio (OR) = 1.11; 95% CI = 1.01-1.21) and significantly higher informational norms (OR = 1.93; 95% CI = 1.19-3.14) than those with lower SSS. Similarly, education (OR = 2.75; 95% CI = 1.79-4.22), health status (OR = 2.18; 95% CI = 1.44-3.31) were significant predictors among higher SSS women compared to lower SSS women in our multivariate analysis. Lower SSS women with low self-reported income (OR = 0.13; 95% CI = 0.08-0.20) had lower odds of genetic testing interest. Our results are consistent with some prior research utilizing proxy indicators for socioeconomic status, but our research adds the importance of using a multidimensional indicator such as SSS to examine cancer and genetic testing predictor outcomes.

CONCLUSION

To develop interventions to improve genetic knowledge, researchers should consider the social status and contexts of women diagnosed with breast cancer at a young age (or before 40 years old) to ensure equity in the distribution of genetic testing benefits.

Manipulation of a social signal affects DNA methylation of a stress-related gene in a free-living bird

Social status directly affects the health of humans and other animals. Low status individuals receive more antagonistic encounters, have fewer supportive relationships and have worse health outcomes. However, the physiological and cellular processes that mediate the relationship between the social environment and health are incompletely known. Epigenetic regulation of the hypothalamic-pituitary-adrenal (HPA) axis, the neuroendocrine pathway that activates in response to stressors, may be one process that is sensitive to the social environment. Here, we experimentally manipulated plumage, a key social signal in female tree swallows (Tachycineta bicolor) and quantified methylation of four genes in the HPA axis before and after treatment. We found that dulling the white breast plumage affected methylation in one gene, CRHR1; however, the effect depended on the original brightness of the bird. Methylation in this gene was correlated with baseline corticosterone levels, suggesting that DNA methylation of CRHR1 helps regulate glucocorticoid production in this species. Methylation in two other genes, FKBP5 and GR, changed over the course of the experiment, independent of treatment. These results show that methylation of these genes is labile into adulthood and suggest that epigenetic regulation of the HPA axis could help birds respond to current environmental conditions.

Testosterone Treatment, Weight Loss, and Health-related Quality of Life and Psychosocial Function in Men: A 2-year Randomized Controlled Trial

OBJECTIVE

To determine the effect of testosterone vs placebo treatment on health-related quality of life (HR-QOL) and psychosocial function in men without pathologic hypogonadism in the context of a lifestyle intervention.

DESIGN, SETTING, PARTICIPANTS

Secondary analysis of a 2-year randomized controlled testosterone therapy trial for prevention or reversal of newly diagnosed type 2 diabetes, enrolling men ≥ 50 years at high risk for type 2 diabetes from 6 Australian centers.

INTERVENTIONS

Injectable testosterone undecanoate or matching placebo on the background of a community-based lifestyle program.

MAIN OUTCOMES

Self-reported measures of HR-QOL/psychosocial function.

RESULTS

Of 1007 participants randomized into the Testosterone for Type 2 Diabetes Mellitus (T4DM) trial, 648 (64%) had complete data available for all HR-QOL/psychosocial function assessments at baseline and 2 years. Over 24 months, while most measures were not different between treatment arms, testosterone treatment, compared with placebo, improved subjective social status and sense of coherence. Baseline HR-QOL/psychosocial function measures did not predict the effect of testosterone treatment on glycemic outcomes, primary endpoints of T4DM. Irrespective of treatment allocation, larger decreases in body weight were associated with improved mental quality of life, mastery, and subjective social status. Men with better baseline physical function, greater sense of coherence, and fewer depressive symptoms experienced greater associated decreases in body weight, with similar effects on waist circumference.

CONCLUSION

In this diabetes prevention trial, weight loss induced by a lifestyle intervention improved HR-QOL and psychosocial function in more domains than testosterone treatment. The magnitude of weight and waist circumference reduction were predicted by baseline physical function, depressive symptomology, and sense of coherence.

High economic inequality is linked to greater moralization

Throughout the 21st century, economic inequality is predicted to increase as we face new challenges, from changes in the technological landscape to the growing climate crisis. It is crucial we understand how these changes in inequality may affect how people think and behave. We propose that economic inequality threatens the social fabric of society, in turn increasing moralization-that is, the greater tendency to employ or emphasize morality in everyday life-as an attempt to restore order and control. Using longitudinal data from X, formerly known as Twitter, our first study demonstrates that high economic inequality is associated with greater use of moral language online (e.g. the use of words such as "disgust", "hurt", and "respect'). Study 2 then examined data from 41 regions around the world, generally showing that higher inequality has a small association with harsher moral judgments of people's everyday actions. Together these findings demonstrate that economic inequality is linked to the tendency to see the world through a moral lens.

When High Subjective Social Status Becomes a Burden: A Japan-U.S. Comparison of Biological Health Markers

High subjective social status (SSS) is believed to protect health in the current literature. However, high SSS entails social responsibilities that can be stressful in collectivistic cultural contexts. Here, we tested the hypothesis that those socialized in collectivistic societies (e.g., Japan) recognize their high social status as entailing social duties difficult to ignore even when they are excessive. Using cross-cultural survey data (N = 1,289) and a measure of biological health risk (BHR) by biomarkers of inflammation and cardiovascular malfunction, we found that higher SSS predicted lower BHR for American males. In contrast, higher SSS predicted higher BHR for Japanese males, mediated by the perceived difficulty of disengaging from their current goals. In both cultural groups, females showed no association between SSS and BHR. These findings suggest that social status has differing health implications, depending on the relative salience of privileges and burden-producing responsibilities in different cultural contexts.

Trends in adolescent mental health problems 2004-2020: Do sex and socioeconomic status play any role?

AIMS

This study aims to investigate trends in four types of adolescent mental health problems; that is, psychosomatic symptoms, depressive symptoms, suicidal ideations, and suicide attempts 2004-2020. A second aim is to investigate the moderating roles of socioeconomic status and sex in these trends.

METHODS

The analysis is based on repeated cross-sectional data 2004-2020 among grade 9 students in secondary schools in a Swedish county. In total, data from 19,873 students were included in the analysis. We fitted linear and logistic regression equations and used survey-years' coefficients to estimate the trends. We also estimated the moderating effects of socioeconomic status and sex using interactions between survey year and socioeconomic status and sex, respectively.

RESULTS

The trends in all mental health problems declined over time. Through its interaction with survey year, socioeconomic status moderated the trends; psychosomatic symptoms (B = -0.115, P<0.001), depressive symptoms (B = -0.084, P<0.001) and suicidal ideations (odds ratio 0.953, confidence interval 0.924-0.983) significantly declined over time among those with high socioeconomic status. However, socioeconomic status did not have an association with the trend in suicide attempts. Interaction between sex and year of survey was associated with significant decreasing trends in depressive symptoms and suicidal ideations only among girls.

CONCLUSIONS

Adolescent mental health problems have decreased over time, but only for adolescents with high socioeconomic status, or only in depressive symptoms and suicidal ideations for girls. The results shed light on the growing inequalities in health outcomes across levels of socioeconomic status.

Factors associated with having previously received a diagnosis of fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome: A cross sectional DanFunD study

OBJECTIVES

Fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome are highly prevalent conditions and part of the functional somatic syndromes (FSS) diagnosis, that are classified under the unifying umbrella term functional somatic disorder (FSD). Multiple factors are associated with FSD symptom development; However, few studies have explored these associations in relation to the diagnosis status. This study aims to examine associations with a previously received FSS diagnosis from a physician in participants fulfilling the FSD diagnostic criteria in a population-based sample.

METHODS

This research employs a comprehensive observational approach using a cross sectional design with data from the DanFunD part two cohort. Information about received FSS diagnoses was obtained from self-reported questionnaires. Participants fulfilling the FSD diagnostic criteria were identified with both self-reported questionnaires and diagnostic interviews. Validated questionnaires were used to assess the examined factors.

RESULTS

1704 cases fulfilled the diagnostic criteria for an FSD according to questionnaires or interviews in the DanFunD study. In participants fulfilling the diagnostic criteria, having previously received an FSS diagnosis by a physician was strongly associated with female sex, negative illness perceptions and poor health-related quality of life for questionnaire and interview-based diagnoses. Less consistent associations were observed for lower socioeconomic status, anxiety, and adverse life events.

CONCLUSION

Previously received FSS diagnoses showed associations with multiple factors with a particular strong association with female sex and poor health related quality of life.

Subjective social status across the past, present, and future: status trajectories of older adults

Beyond objective indicators of social status (e.g., income or education), the subjective social status (SSS; i.e., the self-assessed position in a social hierarchy) is associated with psychological well-being and physiological functioning. Existing research has focused on older adults' current status evaluations, neglecting perceived temporal stability or change in SSS which can further impact self-perception and emotional well-being. In the present study, we examined older adults' (N = 191; mean age = 73.5) SSS with regard to their past, present, and future. Examining SSS for multiple time-points allowed us to identify profiles representing trajectories of status from the past to the future by conducting latent profile analysis. Furthermore, we tested associations of the identified trajectory-profiles with aging anxiety and negative affect. Results showed that, on average, participants anticipated higher future status losses than they had experienced in the past, regardless of age. In the more nuanced profile analysis, we identified four trajectory-profiles: A high (17%), a moderate (57%), and a low perceived social status (14%) trajectory, as well as a profile representing a perceived decrease in status (12%). While a lower status was associated with more aging anxiety and negative affect, most aging anxiety and negative affect was found for profiles representing a low initial status-level and a perceived decrease in status. Findings implicate that social status comparisons with others but also status comparisons with past- and future-selves are relevant for older adults. The discussion highlights the benefits of improving or stabilizing subjective assessments of status in later adulthood.

"A 'Cool' Kid Wears a Brand, and Everyone's following Him" Hierarchal Social Status in Preadolescence: A New Developmental Perspective

Inequality in hierarchical social status, especially among socially excluded children, profoundly affects preadolescents. Historically viewed through a lens of psychopathology and moral deficiencies, it challenges the education system's approaches and interventions. This article introduces a developmental perspective, highlighting the hierarchical social status' role in shaping classroom cohesion, strength, and distinctiveness. This study's phenomenological, qualitative methodology aimed to gain preliminary insight into the children's perspectives. Drawing from 12 focus group discussions involving 140 latency-age (grade 5) children in Israel, it uniquely reveals the dynamic nature of hierarchical social status influenced by children's connections with the group. This dynamism promotes group unity, strengthens bonds, and prioritizes collective concerns, contributing to the development of a "social self" in the latency phase. Beyond theory, this study proposes innovative interventions to address social status disparities.

Associations Between Subjective Social Status and Health Behaviors Among College Students

OBJECTIVE

Examine the associations between subjective social status (SSS), diet, and health outcomes in college students.

METHODS

Cross-sectional study of 841 students enrolled at a large Midwestern university. Subjective social status within the US, as well as within the university, was measured using the MacArthur Scale of SSS. Outcomes included dietary intake (assessed using the Dietary Screening Questionnaire), body mass index, sleep, physical activity, alcohol use, and vaping behavior. Generalized linear models adjusting for students' sociodemographic characteristics were used to assess associations between SSS and outcomes of interest.

RESULTS

Higher SSS-US was associated with 4%, 3%, and 1% higher intake of fruits, whole grains, and fiber, respectively (P < 0.05). Higher SSS-US and SSS-university rankings were both significantly associated with lower body mass index and better sleep duration (P < 0.05). Higher SSS-university rankings were also associated with more days of physical activity and alcohol consumption (P < 0.05).

CONCLUSIONS AND IMPLICATIONS

In this exploratory study, higher SSS, apart from alcohol intake, was associated with more favorable health outcomes. More research is needed to consider additional psychological and biological mediators and dynamic aspects of SSS, examine potential interactions between SSS and racial and ethnic identities, and explore potential mechanisms underlying the observed associations.

Fear of a Black Neighborhood: Anti-Black Racism and the Health of White Americans

Does anti-Black racism harm White Americans? We advance hypotheses that address this question within the neighborhood context. Hypotheses are tested with neighborhood and survey data from a probability sample of White residents of Nashville, Tennessee. We find that regardless of neighborhood crime rates or socioeconomic compositions, Whites report heightened perceptions of crime and danger in their neighborhoods as the proportion of Black residents increases. Perceived neighborhood danger, in turn, predicts increased symptoms of psychophysiological distress. When stratified by socioeconomic status (SES), however, low-SES Whites also report perceptions of higher status when living near more Black neighbors, which entirely offsets their distress. We conclude that although anti-Black racism can ironically harm the health of White Americans, compensatory racist ideologies can also offset these harms, particularly for lower-status Whites. We situate our findings within broader discussions of anti-Black racism, residential segregation, and psychiatric disorders commonly observed among White Americans.

Measuring Subjective Inequality: Development and Validation of the Perceived Economic Inequality Scale (PEIS)

The main goal of the present research is to develop and validate the Perceived Economic Inequality Scale (PEIS), an instrument measuring individuals' perceptions of economic inequality at the national level. The study was conducted on a representative sample of the Italian population (N = 1,446, 51% women). The factorial structure of the scale was assessed through cross-validated exploratory-confirmatory factor analyses. To inspect the PEIS psychometric properties, item and correlation analyses were performed. The results showed that the PEIS is a valid and reliable unidimensional measure of perceived economic inequality at the national level. Further support of the PEIS construct validity was provided by the correlation of the scale score with the perceived wage gap and ideological beliefs like the economic system justification, social dominance orientation, meritocratic beliefs, and participants' political orientation. Crucially, multigroup confirmatory factor analysis supported configural, metric, and scalar invariances of the scale across socio-demographic groups. The PEIS allows researchers to assess the subjective component of economic inequality by also serving as a useful tool for unpacking the psychological correlates of perceived inequality.

Subjective economic inequality is associated with lower well-being through more upward comparison and lower trust

Individuals often misconstrue the actual degree of economic inequality, which might account for the ambiguity in the literature about the role that inequality plays in well-being. Instead of focusing on objective inequality, we propose a subjective inequality approach by investigating the long-term association between subjective economic inequality and well-being (N = 613). We found that subjective inequality predicted lower life satisfaction and higher depression one year later, which were accounted for by more upward socioeconomic comparison and lower trust. Furthermore, the negative association between subjective inequality and well-being remained constant, regardless of individuals' objective socioeconomic status (SES), subjective SES, and mindset of SES. The long-term association between subjective inequality and well-being remained robust after controlling for prior levels of well-being and multiple covariates. Our findings revealed that subjective inequality is detrimental to well-being and opens a new window into psychological research on economic inequality.

Lipid metabolism and functional somatic disorders in the general population. The DanFunD study

OBJECTIVES

Earlier studies on the association between plasma lipid profiles and functional somatic disorders (FSD) are mainly small case control studies hampered by selection bias and do not consider the great overlap between the various FSDs. The aim of the present study was to investigate the associations between various FSDs and plasma lipid profiles (total cholesterol, HDL cholesterol, non-HDL cholesterol and triglycerides) in a large, unselected population.

DESIGN

A cross-sectional general population-based study.

SETTING

The Danish Study of Functional Somatic Disorders (DanFunD) conducted in 2011-2015 in 10 municipalities in the western part of greater Copenhagen, Denmark.

PARTICIPANTS

A total of 8,608 men and women aged 18-76 years were included in the analyses. Various delimitations of FSD such as chronic fatigue, chronic widespread pain, irritable bowel, and bodily distress syndrome were measured using validated self-administrated questionnaires. Lipid parameters were measured from fasting plasma samples using colorimetric slide methods with Vitros 4600/5600 Ortho Clinical Diagnostics.

OUTCOME MEASURES

Logistic regression analyses were used to calculate possible associations between plasma lipids and the various delimitations of FSD. Associations are presented by OR (95% CI) and shown in boxplots.

RESULTS

We found a positive association between bodily distress syndrome and triglycerides and non-HDL cholesterol and a negative association with HDL-cholesterol, but no consistent association with total cholesterol. A similar pattern was observed for persons with chronic fatigue, and to some degree for persons with chronic widespread pain, whereas persons with irritable bowel did not show a clear association with the lipid profiles.

CONCLUSION

This is the first major study on plasma lipid profiles and FSD indicating an association between some delimitations of FSD and an unfavorable lipid profile. Due to the cross-sectional design, it cannot be determined whether the findings are consequences or determinants of FSD. Further studies-preferable prospective studies-are needed.

Neuroticism, perceived stress, adverse life events and self-efficacy as predictors of the development of functional somatic disorders: longitudinal population-based study (DanFunD)

BACKGROUND

Functional somatic disorder (FSD) is a unifying diagnosis that includes functional somatic syndromes such as irritable bowel, chronic widespread pain (CWP) and chronic fatigue. Several psychological factors are associated with FSD. However, longitudinal population-based studies elucidating the causal relationship are scarce.

AIMS

To explore if neuroticism, perceived stress, adverse life events (ALEs) and self-efficacy can predict the development of FSD over a 5-year period.

METHOD

A total of 4288 individuals who participated in the DanFunD baseline and 5-year follow-up investigations were included. FSD was established at both baseline and follow-up, with symptom questionnaires and diagnostic interviews. Neuroticism was measured with the short-form NEO Personality Inventory, perceived stress with the Cohen's Perceived Stress Scale, ALEs with the Danish version of the Cumulative Lifetime Adversity Measure and self-efficacy with the General Self-Efficacy Scale. Associations were investigated with multiple logistic regression models.

RESULTS

Perceived stress predicted incident FSD, irritable bowel, CWP and chronic fatigue (odds ratios: 1.04-1.17). Neuroticism predicted incident FSD and chronic fatigue (odds ratios: 1.03-1.16). ALEs predicted incident FSD, CWP and chronic fatigue (odds ratios: 1.06-1.18). An increase in perceived stress from baseline to follow-up was associated with incident FSD, irritable bowel, CWP and chronic fatigue (odds ratios: 1.05-1.22). Contrary, an increase in self-efficacy seemed to be a protective factor (odds ratios: 0.89-0.99).

CONCLUSIONS

High neuroticism, high perceived stress and a high number of ALEs are risk factors for the development of FSD. Particularly perceived stress seems to be an important contributor to the onset of FSD.

A longitudinal study of perceived social position and health-related quality of life

BACKGROUND

A large body of evidence suggests that there is a social gradient in the association between perceived social position and various health outcomes. Yet only a fraction of this research uses longitudinal data, and these studies usually rely on two data points in time, consider a single health outcome measure, overlook non-linear effects of perceived social position, and come almost exclusively from the Western welfare democracies.

METHODS

Using data for 1921 individuals from three waves (2008, 2013, 2018) of the Polish Panel Survey (POLPAN), we fit between- and within-individuals hybrid-effects models with cluster-robust standard errors to investigate the association between one's perceived social position (self-placement on a socioeconomic hierarchy scale varying 1 to 10) and subsequent health-related quality of life (HRQoL) measured using the Nottingham Health Profile (NHP) and its six components.

RESULTS

We find that the association between perceived social position and health-related quality of life is larger when estimated between individuals than within individuals, yet in fixed- and hybrid-effects models perceived social position remains significantly and negatively linked with both the aggregated NHP measure as well as with its components such as emotional reaction, physical abilities, sleep, and social isolation. We also identify that starting to perceive oneself at the lower end of the social hierarchy is associated with a deteriorating health-related quality of life but a change at the top of the perceived social hierarchy is not linked with an improvement in NHP scores.

CONCLUSIONS

We provide new evidence on the significant and non-linear links between perceived social position and health-related quality of life and highlight possible pathways linking these two aspects of individuals' lives.

Rising and falling on the social ladder: The bidimensional social mobility beliefs scale

Recent works in the field of Social Psychology have shown the importance of studying subjective social mobility from different perspectives. In the literature about subjective societal mobility, most of the research is focused on the mobility-immobility framing. However, several authors suggested studying social mobility beliefs effects differentiating according to mobility's trajectory, that is, upward (i.e., improving status over time) and downward (i.e., getting worse in status over time). The present research was motivated by the lack of measures that discriminate between beliefs in upward and downward societal mobility. Across two studies using different samples of the Spanish adult population, we examined both dimensions of social mobility beliefs and tested their predictive validity on other related constructs. In Study 1 (N = 164), with an EFA, we corroborated the independence between the two types of mobility. The internal structure was confirmed by a CFA in Study 2 (N = 400). Furthermore, it was shown that upward and downward mobility beliefs are differently related to other related constructs. The results from Studies 1-2 showed good convergent validity. In all correlations with the different constructs (attitudes towards inequality, meritocratic beliefs, justification of the economic system, and status anxiety) we found opposite direction effects for both types of societal mobility (upward and downward). The development of this new instrument can help to deepen our understanding of the psychosocial consequences of subjective social mobility, as well as to differentiate two processes that may have different consequences.

Moderation modelling of COVID-19 digital health literacy and sense of coherence across subjective social class and age among university students in Ghana

BACKGROUND

The study assessed the moderation modelling of digital health literacy and sense of coherence across subjective social class and age among university students in Ghana during the COVID-19 pandemic.

METHODS

A total of 1160 students were conveniently sampled from two universities namely, the University of Education, Winneba and University of Cape Coast, using the descriptive cross-sectional survey design. Preliminary analysis was performed using descriptive statistics, whilst multivariate multiple regression and moderation analyses (Haye's Model) were employed to analyze the main data.

RESULTS

The study revealed that COVID-19 digital health literacy is directly and positively associated with sense of coherence among university students. Further, higher subjective social class positively and strongly moderated the relationship between COVID-19 digital health literacy and sense of coherence among university students. Additionally, the relationship between COVID-19 digital health literacy and sense of coherence was indirectly prominent among relatively older university students than younger ones.

CONCLUSIONS

The findings have implications for university management/authorities and public health agencies to organize effective orientation and self-management training programmes for university students.

What Does the MacArthur Scale of Subjective Social Status Measure? Separating Economic Circumstances and Social Status to Predict Health

BACKGROUND

Subjective socioeconomic status is robustly associated with many measures of health and well-being. The MacArthur Scale of Subjective Social Status (i.e., the MacArthur ladder) is the most widely used measure of this construct, but it remains unclear what exactly the MacArthur ladder measures.

PURPOSE

The present research sought to explore the social and economic factors that underlie responses to the MacArthur ladder and its relationship to health.

METHODS

We investigated this issue by examining the relationship between scores on the MacArthur ladder and measures of economic circumstances and noneconomic social status, as well as health and well-being measures, in healthy adults in the USA.

RESULTS

In three studies (total N = 1,310) we found evidence that economic circumstances and social status are distinct constructs that have distinct associations with scores on the MacArthur ladder. We found that both factors exhibit distinct associations with measures of health and well-being and accounted for the association between the MacArthur ladder and each measure of health and well-being.

CONCLUSIONS

Our findings suggest that the MacArthur ladder's robust predictive validity may result from the fact that it measures two factors-economic circumstances and social status-that are each independently associated with health outcomes. These findings provide a novel perspective on the large body of literature that uses the MacArthur ladder and suggests health researchers should do more to disentangle the social and economic aspects of subjective socioeconomic status.

A pilot cross-sectional investigation of chronic shame as a mediator of the relationship between subjective social status and self-rated health among middle-aged adults

Subjective social status (SSS) is an important independent predictor of health outcomes, however, the pathways through which it affects health are poorly understood. Chronic shame has previously been suggested as a potential mechanism but this has never been investigated and the relationship between chronic shame and health is under-researched. The purpose of this pilot study was to explore whether chronic shame explains a significant portion of the association between SSS and self rated health (SRH). Two-hundred American adults aged 30-55 years were recruited via a crowd-sourcing platform and were asked to provide information on their SSS, level of chronic shame, and SRH. Chronic shame significantly mediated the relationship between SSS and SRH. This pilot study provides initial evidence that shame explains a significant portion of the relationship between subjective social status and self-rated health. These findings support the initiation of larger, longitudinal investigations into chronic shame as a mediator of the subjective social status and self-rated health relationship.

Advancing methods for the biodemography of aging within social contexts

Several social dimensions including social integration, status, early-life adversity, and their interactions across the life course can predict health, reproduction, and mortality in humans. Accordingly, the social environment plays a fundamental role in the emergence of phenotypes driving the evolution of aging. Recent work placing human social gradients on a biological continuum with other species provides a useful evolutionary context for aging questions, but there is still a need for a unified evolutionary framework linking health and aging within social contexts. Here, we summarize current challenges to understand the role of the social environment in human life courses. Next, we review recent advances in comparative biodemography and propose a biodemographic perspective to address socially driven health phenotype distributions and their evolutionary consequences using a nonhuman primate population. This new comparative approach uses evolutionary demography to address the joint dynamics of populations, social dimensions, phenotypes, and life history parameters. The long-term goal is to advance our understanding of the link between individual social environments, population-level outcomes, and the evolution of aging.

Higher subjective socioeconomic status is linked to increased charitable giving and mentalizing-related neural value coding

Socioeconomic status (SES), a concept related to an individual's economic and social position relative to others, can shape social interactions like altruistic behaviors. However, little is known about the exact neurocognitive mechanisms that link SES with altruism. Our study aimed to provide a comprehensive account of the sociocognitive and neural mechanisms through which SES affects charitable giving - an important variant of human altruism. To this end, participants completed a charitable donation task while their brain activity was measured using functional magnetic resonance imaging (fMRI). We also assessed participants' socio-cognitive ability to infer other people's mental states (i.e., mentalizing) - a driver of prosocial behavior - in an independent social task. Behaviorally, we found that both charitable giving and social cognition were status-dependent, as subjective SES positively predicted donations and mentalizing capacity. Moreover, the link between SES and charitable giving was mediated by individuals' mentalizing capacity. At the neural level, a multivariate pattern analysis of fMRI data revealed that higher subjective SES was associated with stronger value coding in the right temporoparietal junction (rTPJ). The strength of this value representation predicted charitable giving and was linked to mentalizing. Furthermore, we observed an increased negative functional coupling between rTPJ and left putamen with higher SES. Together, increased charitable giving in higher-status individuals could be explained by status-dependent recruitment of mentalizing-related value coding and altered functional connectivity in the brain. Our findings provide insights into the socio- and neurocognitive mechanisms explaining why and when higher SES leads to prosociality, which might ultimately inform targeted interventions to promote prosocial behavior in human societies.

Relationships between early-life family poverty and relative socioeconomic status with gestational diabetes, preeclampsia, and hypertensive disorders of pregnancy later in life

PURPOSE

Low early-life absolute and relative socioeconomic status (SES) may contribute to socioeconomic disparities in pregnancy complications (i.e., gestational diabetes mellitus [GDM], preeclampsia/eclampsia [PE], hypertensive disorders of pregnancy [HDP; preeclampsia/eclampsia, gestational hypertension, chronic hypertension]), but their independent associations with pregnancy complications have not been studied. This study investigated associations of early-life poverty and relative SES with risks of GDM, PE, and HDP.

METHODS

National Longitudinal Study of Adolescent to Adult Health data were used (GDM n = 802; PE n = 813; HDP n = 801). Objective poverty was defined as wave I low-income or receipt of federal nutrition assistance benefits. Relative SES was self-reported at wave V (ages 33-39) by asking whether the participant's family was financially worse off than average when growing up. Logistic regressions assessed relationships between poverty, relative SES, and self-reported lifetime diagnoses of GDM, PE, or HDP.

RESULTS

Lifetime prevalences of GDM, PE, and HDP were 9.23%, 12.00%, and 21.93%, respectively. Low relative SES (odds ratio: 2.04 [1.07, 3.89]) and poverty (odds ratio: 1.81 [0.97, 3.38]) were independently associated with GDM but not with PE or HDP.

CONCLUSIONS

Early-life poverty and relative SES are associated with GDM; understanding the mechanisms underlying these associations may help identify novel intervention targets to reduce socioeconomic disparities in GDM.

Evaluating Transition Readiness in Older Adolescents and Young Adults With Type 1 Diabetes

For older adolescents and young adults (AYAs) with type 1 diabetes, successful transition from pediatric to adult diabetes care requires ongoing planning and support. Yet, the transition to adult care is not always smooth. Some AYAs struggle to leave pediatric care or experience significant gaps between pediatric and adult diabetes care. The use of diabetes-specific transition readiness assessments can inform transition planning and support successful preparation for adult care. This study evaluated transition readiness in a diverse sample of AYAs nearing transition to adult diabetes care. Findings suggest that AYAs may benefit from additional preparation and education related to sexual health, tobacco use, and diabetes complications.

Delay Discounting and the Income-Food Insecurity-Obesity Paradox in Mothers

Food insecurity, defined as unpredictable access to food that may not meet a person's nutritional needs, is paradoxically associated with higher BMI (kg/m2) and obesity. Research has shown delay discounting, a behavioral economic measure of the preference for immediate rather than delayed rewards, is related to higher BMI, and moderates the relationship between income and food insecurity. Based on this research, we used regression models to test whether delay discounting, consideration of future consequences, and perceived stress were atemporal mediators of the food insecurity-BMI relation in 313 mothers, controlling for demographic variables. A secondary aim was to replicate the finding that delay discounting moderates the relationship between low income and high food insecurity. Results showed that low income was associated with higher food insecurity, and higher food insecurity was associated with higher BMI. Delay discounting was the only variable that was indirectly related to both paths of the food-insecurity-BMI relation. Delay discounting accounted for 22.2% of the variance in the low-income-food insecurity-obesity relation, and the total model accounted for 38.0% of the variance. The relation between low income and food insecurity was moderated by delay discounting. These data suggest that delay discounting is a potential mediator of the relationship between food insecurity and high BMI, which suggests reducing discounting in the future could be a novel target to reduce food insecurity and help people with food insecurity to reduce their excess body weight. Trial Registration. This trial is registered with NCT02873715.

Expanded-multidimensional turnover intentions: scale development and validation

BACKGROUND

This study aims to provide researchers and practitioners with a more elaborate instrument to measure turnover intentions based on the planned behaviour theory model. The questionnaire assesses 5 distinct aspects of turnover intentions (i.e., subjective social status, organisational culture, personal orientation, expectations, and career growth).

METHODS

In this cross-sectional study (comprise of 2 studies in one) a wave survey design was applied to a large diversity of workers drawn from the staff of universities, banks, hospitals, factories, and telecommunication companies. Exploratory factor analysis (EFA) was applied the identify the sub-dimensions and Cronbach's alpha to assess the reliability of the first study. In the second study, for the Confirmatory factor analysis to establishing structural model of the dimensions.

RESULTS

We demonstrate the reliability, factor structure, and validity evidence based on internal structure and relationship with other variables of the new measure among two samples (N1 = 622; N2 = 433). Twenty-five items with 5 factors were extracted to represent a broader perspective of turnover intention scale.

CONCLUSIONS

In total, the study indicates that the assessment can be used to reliably assess several major indicators of turnover intentions. Therefore, improved employees' evaluations and reduced loss of valuable staff as a result of avoidable measures in considering the interests of workers.

Heterogeneous gender gaps in mental wellbeing: Do women with low economic status face the biggest gender gaps?

Gender differences in depression are globally documented across a wide range of studies that analyse self-reports of depressive symptoms or clinical diagnoses. Extensive research fails to identify any single reason for this finding but given systematic variation in depressive symptomatology across social groups, gender differences must derive at least partly from environmental or social factors. Among the social factors that are considered most important are those relating to gender differences in socio-economic status and the underlying gender division of labor. In this study, we add to existing research by interrogating heterogeneity in gender differences in mental health. Studies that investigate environmental factors typically consider these only in relation to the average gender gap in depression. We use a novel sorting and classification method (Chernozhukov et al., 2018) that makes it possible to map the full distribution of gender differences in depressive symptomatology among comparable women and men. Although we cannot attribute causality, the method allows us to isolate those social factors that are distinctive to women who experience the largest gender gap in depressive symptoms compared to those who exhibit the smallest. The study analyses detailed nationally representative micro-data from South Africa, a country with high rates of poverty, which are higher still among women. As is common elsewhere, women report significantly more depressive symptoms than men, and low socio-economic status is correlated with poor mental health. However, women with low socio-economic status are not relatively more concentrated among women who face the largest gender gap in depressive symptomatology. These findings would not be consistent with the hypothesis that women have a greater tendency than men to ruminate over economic hardship and could rather point to resilience and a "steeling effect" among poor women.

"You did incredibly well!": teachers' inflated praise can make children from low-SES backgrounds seem less smart (but more hardworking)

Can teachers' inflated praise make children from low socioeconomic status (SES) backgrounds seem less smart? We conducted two preregistered experiments to address this question. We used hypothetical scenarios to ensure experimental control. An experiment with primary school teachers (N = 106, ages 21-63) showed that when a child from a low-SES (vs. high-SES) background succeeded in school, teachers attributed this success more to hard work and delivered more inflated praise (e.g., "You did incredibly well!") but less modest praise (e.g., "You did well!"). An experiment with primary school children (N = 63, ages 10-13) showed that when children learned that another child received inflated praise (while an equally performing classmate received modest praise or no praise), they perceived this child as less smart but more hardworking. These studies provide converging evidence that teachers' inflated praise, although well-intentioned, can make children from low-SES backgrounds seem less smart, thereby reinforcing negative stereotypes about these children's academic abilities.

Racial and ethnic differences in the relationship between financial worry and white matter hyperintensities in Latinx, non-Latinx Black, and non-Latinx White older adults

Socioeconomic status (SES) is associated with white matter hyperintensities (WMHs) and contributes to racial and ethnic health disparities. However, traditional measures of SES may not accurately represent individual financial circumstances among non-Latinx Black and Latinx older adults due to longstanding structural inequities. This study examined associations between multiple SES indicators (education, income, subjective financial worry) and WMHs across non-Latinx Black, Latinx, and non-Latinx White older adults in the Washington Heights-Inwood Columbia Aging Project (N = 662). Latinx participants reported the lowest SES and greatest financial worry, while Black participants evidenced the most WMHs. Greater financial worry was associated with higher WMHs volume above and beyond education and income, which were not associated with WMHs. However, this association was only evident among Latinx older adults. These results provide evidence for the minority poverty hypothesis and highlight the need for systemic socioeconomic interventions to alleviate brain health disparities in older adulthood.

Building Numeracy Skills: Associations between DUPLO® Block Construction and Numeracy in Early Childhood

Research shows that children's block construction skills are positively associated with their concurrent and later mathematics performance. Furthermore, there is evidence that block construction training is particularly beneficial for improving early mathematics skills in children from low-Socio Economic Status (SES) groups who are known to have lower maths performance than their peers. The current study investigates (a) the association between block construction and mathematics in children just before the start of formal schooling (4 years-of-age in the UK) and (b) whether the association between block construction and mathematics differs between children from more compared to less affluent families. Participants in this study included 116 children (M = 3 years 11 months, SD = 3 months) who all completed numeracy, block construction, and receptive vocabulary tasks. Socio-economic status and demographic information (child age, gender, ethnicity) were also obtained from parents. Findings show a strong positive association between block construction and early numeracy skills. Block construction skills explained approximately 5% of the variation in numeracy, even after controlling for age in months, household income, and child receptive vocabulary. When separated by SES group, for children from less affluent families, block construction explained a significant amount of variability (14.5%) in numeracy performance after covariates. For children from more affluent families, block construction did not explain a significant amount of variation in numeracy. These findings suggest that, interventions involving block construction skills may help to reduce SES-based attainment gaps in UK children's mathematics achievement.

Exploring the relationship between multiple dimensions of subjective socioeconomic status and self-reported physical and mental health: the mediating role of affect

Introduction

This study aimed to investigate the predictive effects of two types of subjective socioeconomic status on self-reported physical and mental health. Specifically, we examined the MacArthur Scale (MacArthur) which measures perceived socioeconomic rank in the society and a novel scale called ComSim, which assessed how participants compared themselves socioeconomically to others coming from a similar socioeconomic background. We also considered the influence of income, education, and personal relative deprivation (PRD) in these analyses. Additionally, we explored whether these effects were mediated through negative and positive affect.

Methods

The data were collected through a cross-sectional, two-wave survey of 294 women and 294 men, with a mean age 41.6 years. Participants were recruited via an online platform.

Results

The results from multivariate regression models revealed that socioeconomic status measured with both the MacArthur Scale and ComSim significantly predicted both self-reported health measures, whereas income and education did not predict any of these measures in the full multivariate models. PRD only predicted self-reported mental health. Mediation analyses showed that negative and positive affect mediated the relationships between socioeconomic status measured by ComSim and self-reported health measures.

Discussion

These findings are discussed in the context of the similarity hypothesis of social comparison theory. The results underscore the importance of considering multiple dimensions when examining socioeconomic health disparities.

Enhancing long-term smoking abstinence among individuals with a history of cervical intraepithelial neoplasia or cervical cancer (Project ACCESS): protocol for a randomized clinical trial

BACKGROUND

The prevalence of smoking among cervical cancer survivors is high and evidence-based smoking cessation interventions are critically needed. This paper describes the study design, methods, and data analysis plans for a randomized clinical trial (RCT) designed to evaluate the efficacy of a novel, personally tailored SMS-delivered text-based digital treatment adjuvant designed to enhance the long-term efficacy of a "Motivation And Problem-Solving" (MAPS) approach for smoking cessation among individuals with a history of cervical intraepithelial neoplasia (CIN) or cervical cancer. MAPS is a phone counseling approach designed to facilitate long-term abstinence that comprises 6 counseling calls over 12 months. The current trial is evaluating the efficacy of MAPS+, which comprises all MAPS components plus a 24-month digital treatment adjuvant. This trial represents a logical extension of our previous RCT, which compared the efficacy of MAPS to a quitline control condition and found that MAPS resulted in greater than a 2-fold increase in smoking abstinence at 12 months (i.e., 26.4% vs. 11.9%). This treatment effect was no longer significant at 18 months, suggesting that efficacy dissipated as time from the end of treatment increased. The primary aim of the current trial is to compare the efficacy of MAPS + and ST in facilitating long-term abstinence.

METHODS

Individuals who smoke and have a history of cervical cancer or CIN (N = 340) are recruited throughout Florida and randomly assigned to Standard Treatment [ST] or MAPS+. ST participants are electronically connected with the Florida Quitline. MAPS + consists of 6 proactive MAPS-based counseling calls over 12 months plus the novel, personally tailored, text message-based treatment adjuvant delivered over 24 months. All participants receive 12 weeks of combination nicotine replacement therapy (patch and lozenge) and are followed for 24 months. Participant recruitment commenced in December 2022 and is ongoing.

DISCUSSION

This study builds on promising results from our recent trial which found that MAPS was associated with substantially higher abstinence from smoking at the end of the 12-month treatment period. Finding that this low-burden, personally tailored digital treatment adjuvant improves the long-term efficacy of MAPS would have important clinical and public health implications.

TRIAL REGISTRATION

Clinical Trials Registry NCT05645146; https://clinicaltrials.gov/ct2/show/NCT05645146 ; Registered on December 9, 2022.