Matching Items (2)
Description
Socioeconomic status (SES) is linked with poorer health outcomes across the range of SES. The Reserve Capacity Model (RCM) proposes that low SES fuels repeated and/or chronic exposure to elevated levels of stress, producing deleterious emotional, psychological, social, and physiological changes that result in development of disease over time. The RCM further asserts that a relative lack of social and psychological resources, including efficacy and social support, among low SES individuals accounts for their greater vulnerability to the effects of stress. Although the links between stress, reserve capacity, and health outcomes are framed in the RCM as an ongoing process that produces disease, the majority of investigations testing the model have not examined its utility in explaining 1) coping with daily stressors or 2) symptom flares among individuals managing a chronic illness. This study investigated the effects of SES, reflected in income level, on the: 1) levels of daily financial events and financial worry; 2) relations between daily financial worry and symptoms of pain and fatigue; and 3) extent to which daily coping efficacy and social support mediated the daily financial worry-symptom relation across 21 daily diary reports collected from 220 individuals with fibromyalgia (FM). Simple correlations showed that income was inversely related to frequency of financial events and level of financial worry across 21 days. Results from multilevel models indicated that daily increases in financial worry were unrelated to pain regardless of income level, but were related to increased fatigue among individuals with lower relative to higher income. Daily efficacy and support mediated the relations between financial worry and pain and fatigue, but the extent of mediation did not differ based on high versus low income level. Taken together, the findings suggest that individuals of low versus high income encounter more frequent financial stress and experience greater daily fatigue exacerbation related to that stress, in line with the RCM. Over time, the greater exposure and reactivity to financial strain may account for the inverse relation between income and disability among those with chronic pain.
ContributorsMoore, Shannon Victoria (Author) / Davis, Mary C. (Thesis advisor) / Luecken, Linda J. (Committee member) / Suk, Hye Won (Committee member) / Arizona State University (Publisher)
Created2017
Description
Subjective social status (SSS) is a marker of perceived social rank that has been linked with depressive symptoms over and above objective socioeconomic status (SES),
but longitudinal studies are limited. SSS has been theorized to capture perceived relative
versus absolute deprivation and the corresponding psychosocial processes underlying
status-based disparities in health. The literature suggests that upward social comparisons
inherent in appraising SSS may confer psychosocial risk, which may in turn increase risk
for depressive symptoms and stress-related inflammation involved in the pathogenesis of
depression. However, no studies have examined whether interpersonal and biological
factors simultaneously contribute to the inverse relation between SSS and depressive
symptoms. This study examined whether (1) lower SSS was longitudinally associated
with increased depressive mood symptoms, independent of income, and (2) whether
higher social strain and lower social support simultaneously mediated the SSS—
depressive mood symptoms relation directly and indirectly through higher interleukin-6
(IL-6). This study utilized secondary data from a representative community sample of
804 middle-aged adults taking part in a study of healthy aging between 2007 and 2012.
Plasma levels of IL-6 and self-reported SSS, social support, and social strain were
assessed at baseline, followed by an assessment of depressive mood symptoms by phone
interview on average 20 months later. Results from multiple regression analysis revealed
that lower SSS predicted higher depressive symptoms at follow-up after adjustment for
sociodemographic characteristics and baseline depressive mood symptoms. Path analysis
indicated that social strain significantly mediated the relation between SSS and
depressive mood symptoms, but not after adjustment for baseline mood symptoms.
Lower social support mediated the relation between lower SSS and higher depressive
symptoms, but relations were non-significant in adjusted models. Contrary to predictions,
paths including IL-6 were not significant. Lower SSS may represent a robust risk factor
for subsequent depressive mood symptoms above and beyond income, in line with the
conceptualization of SSS as a measure of relative deprivation. Further research
examining biopsychosocial mechanisms would elucidate the implications of perceived
low status and inform intervention efforts aimed at reducing the global burden of
depressive symptoms.
ContributorsMoore, Shannon Victoria (Author) / Davis, Mary (Thesis advisor) / Luecken, Linda (Committee member) / Anderson, Samantha (Committee member) / Infurna, Frank (Committee member) / Arizona State University (Publisher)
Created2021