Psychometric properties of the S-Scale: Assessing a psychological mindset that mediates the relationship between socioeconomic status and depression

Individuals with low socioeconomic status (SES) are disproportionally affected by depressive disorders which are among the main causes for loss in healthy life years in adults worldwide. The main objective of the research presented here was to identify a psychological mindset of individuals with low SES and to investigate whether this mindset mediates the relationship between low SES and symptoms of depression. Towards these goals, a series of four studies was conducted: Study 1 identified a set of ten statements reflecting a psychological mindset associated with low SES using a population-based sample from Germany (N = 1,969). Study 2 cross-validated a psychometric scale (S-Scale) that was created based on these statements in a population-based sample from Germany (N = 3,907). Study 3 introduced a longitudinal perspective and showed that the S-Scale mediated the relationship between low SES and symptoms of depression assessed one year later in a German student sample (N = 1,275). Study 4 supported unidimensionality and construct validity of a unified version of the S-Scale and confirmed the mediation effect of the S-Scale for SES and depression while controlling for confounding variables (e.g., socially desirable responding) in a U.S. American convenience sample (N = 1,000). Evidence from four studies supported the reliability and validity of the S-Scale. Controlling for a psychological mindset as measured with this scale, low SES was no longer a predictor of depressive symptoms. The S-Scale can be used in clinical and research settings to assess a psychological mindset that puts individuals at risk for depression. Overall strengths of this series of studies include the use of population-based and longitudinal datasets and the application of findings to different operationalizations of SES. Future studies should investigate whether this mindset can be modified by psychological interventions and whether changes in this mindset predict improvements in depressive symptoms.

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What is the psychological mindset that mediates the relationship between socioeconomic status and symptoms of depression?

10.31219/osf.io/wrkan ◽

2020 ◽

Author(s):

Julia Velten ◽

Saskia Scholten ◽

Julia Brailovskaia ◽

Jürgen Margraf

Keyword(s):

Socioeconomic Status ◽

Low Socioeconomic Status ◽

Depressive Disorders ◽

The United States ◽

Population Based ◽

Mediation Effect ◽

Low Ses ◽

Symptoms Of Depression ◽

Life Years ◽

The Relationship

Individuals with low socioeconomic status (SES) are disproportionally affected by depressive disorders which are among the main causes for loss in healthy life years in adults worldwide. The main objective of the research presented here was to identify a psychological mindset of individuals with low SES and to investigate whether this mindset mediates the relationship between low SES and symptoms of depression. Towards these goals, a series of four studies was conducted using student, population-based, and convenience samples from Germany and the United States. Study 1 identified a set of ten statements reflecting a psychological mindset associated with low SES using a population-based sample from Germany. Study 2 cross-validated a psychometric scale (S-Scale) that was created based on these statements. Study 3 introduced a longitudinal perspective and showed that the S-Scale mediated the relationship between low SES and symptoms of depression assessed one year later. Study 4 supported unidimensionality and construct validity of a unified version of the S-Scale and confirmed the mediation effect of the S-Scale for SES and depression while controlling for confounding variables (e.g., socially desirable responding). Evidence from four studies supported the reliability and validity of the S-Scale. Controlling for a psychological mindset as measured with this scale, low SES was no longer a predictor of depressive symptoms. The S-Scale can be used in clinical and research settings to assess a psychological mindset that puts individuals at risk for depression.

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Association between socioeconomic status and longitudinal sleep quality patterns mediated by depressive symptoms

SLEEP ◽

10.1093/sleep/zsab044 ◽

2021 ◽

Author(s):

Ga Bin Lee ◽

Hyeon Chang Kim ◽

Ye Jin Jeon ◽

Sun Jae Jung

Keyword(s):

Socioeconomic Status ◽

Depressive Symptoms ◽

Sleep Quality ◽

Household Income ◽

Pittsburgh Sleep Quality Index ◽

Multinomial Logistic Regression ◽

Mental Healthcare ◽

Mediation Effect ◽

Multinomial Logistic Regression Model ◽

Mediating Role

Abstract Study Objectives We aimed to examine whether associations between socioeconomic status (SES) and longitudinal sleep quality patterns are mediated by depressive symptoms. Methods We utilized data on 3347 participants in the Korean Genome and Epidemiology Study aged 40–69 years at baseline from 2001 to 2002 who were followed up for 16 years. A group-based modeling approach was used to identify sleep quality trajectories using the Pittsburgh Sleep Quality Index (years 2, 6, 8, 10, and 12). Educational attainment (college graduated or less), monthly household income (≥$2500 or less), and occupation (unemployed, manual labor, and professional labor) at baseline (year 0) were used for analyses. Depressive symptoms were assessed using Beck’s Depression Inventory at year 4. Associations between SES and sleep quality patterns were examined using a multinomial logistic regression model. The mediation effect of depressive symptoms was further examined using PROC CAUSALMED. Results We identified five distinct sleep quality trajectories: “normal-stable” (n = 1697), “moderate-stable” (n = 1157), “poor-stable” (n = 320), “developing to poor” (n = 84), and “severely poor-stable” (n = 89). Overall, associations between SES levels and longitudinal sleep patterns were not apparent after full adjustment for sociodemographic and lifestyle factors measured at baseline. Depressive symptoms, however, tended to fully mediate associations between SES levels and sleep quality patterns (odds ratio range for indirect effects of depressive symptoms: for education, 1.05-1.17; for income, 1.05-1.15). Conclusion A significant mediating role for depressive symptoms between SES levels and longitudinal sleep quality warrants consideration among mental healthcare professionals.

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Association of depressive symptoms and socioeconomic status in determination of blood pressure levels and hypertension: The CONSTANCES population based study

Journal of Affective Disorders ◽

10.1016/j.jad.2020.10.018 ◽

2021 ◽

Vol 279 ◽

pp. 282-291

Author(s):

Alexandre Vallée ◽

Emmanuel Wiernik ◽

Sofiane Kab ◽

Cédric Lemogne ◽

Marcel Goldberg ◽

...

Keyword(s):

Blood Pressure ◽

Socioeconomic Status ◽

Depressive Symptoms ◽

Population Based ◽

Population Based Study

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The Relationship between Thyroid Function and Depressive Symptoms—the FIN-D2D Population-Based Study

Clinical Medicine Insights Endocrinology and Diabetes ◽

10.4137/cmed.s24111 ◽

2015 ◽

Vol 8 ◽

pp. CMED.S24111 ◽

Cited By ~ 4

Author(s):

Juha Saltevo ◽

Hannu Kautiainen ◽

Pekka Mäntyselkä ◽

Antti Jula ◽

Sirkka Keinänen-Kiukaanniemi ◽

...

Keyword(s):

Regression Analysis ◽

Depressive Symptoms ◽

Thyroid Function ◽

Participation Rate ◽

Population Based ◽

Thyroid Stimulating Hormone ◽

Free Triiodothyronine ◽

Population Based Study ◽

The Mean ◽

The Relationship

The association between thyroid function and depression is controversial. Both conditions express many similar symptoms, but the studies done give conflicting results. This study draws on a random, population-based sample of 4500 subjects aged 45–75 years old from Finland. The basic clinical study was done in 2007 for 1396 men and 1500 women (64% participation rate). Thyroid stimulating hormone (TSH), free thyroxine (F-T4), and free triiodothyronine (F-T3) were measured in 2013 from frozen samples. The 21-item Beck Depression Inventory (BDI-21) was applied to assess depressive symptoms (score ≥10 points). The prevalence of depressive symptoms was 17.5% in women and 12.5% in men. In women, the mean levels of TSH, F-T4, and F-T3 without depressive symptoms vs. with the presence of depressive symptoms were 1.92/1.97 mU/L, 13.1/13.1 pmol/L, and 3.91/3.87 pmol/L (NS), respectively. In men, the levels were 1.87/1.94 mU/L, 13.5/13.7 pmol/L, and 4.18/4.12 pmol/L (NS), respectively. In multiple regression analysis, TSH had no relationship to BDI-21 total score. We found no association between depressive symptoms and thyroid values.

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Impact of Socioeconomic Status and Race on Sepsis Epidemiology and Outcomes

The Journal of Applied Laboratory Medicine ◽

10.1093/jalm/jfaa151 ◽

2020 ◽

Author(s):

Emi Minejima ◽

Annie Wong-Beringer

Keyword(s):

Socioeconomic Status ◽

Low Income ◽

Formal Education ◽

Geographic Location ◽

The United States ◽

Risk Scores ◽

Low Ses ◽

The Relationship ◽

Poor Health Literacy ◽

Hispanic White

Abstract Background Socioeconomic status (SES) is a complex variable that is derived primarily from an individual’s education, income, and occupation and has been found to be inversely related to outcomes of health conditions. Sepsis is the sixth most common admitting diagnosis and one of the most costly conditions for in-hospital spending in the United States. The objective of this review is to report on the relationship between SES and sepsis incidence and associated outcomes. Content Sepsis epidemiology varies when explored by race, education, geographic location, income, and insurance status. Sepsis incidence was significantly increased in individuals of Black race compared with non-Hispanic white race; in persons who have less formal education, who lack insurance, and who have low income; and in certain US regions. People with low SES are likely to have onset of sepsis significantly earlier in life and to have poorly controlled comorbidities compared with those with higher SES. Sepsis mortality and hospital readmission is increased in individuals who lack insurance, who reside in low-income or medically underserved areas, who live far from healthcare, and who lack higher level education; however, a person’s race was not consistently found to increase mortality. Summary Interventions to minimize healthcare disparity for individuals with low SES should target sepsis prevention with increasing measures for preventive care for chronic conditions. Significant barriers described for access to care by people with low SES include cost, transportation, poor health literacy, and lack of a social network. Future studies should include polysocial risk scores that are consistently defined to allow for meaningful comparison across studies.

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Socioeconomic Status and Orofacial Clefts in Scotland, 1989 to 1998

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_2003_040_0481_ssaoci_2.0.co_2 ◽

2003 ◽

Vol 40 (5) ◽

pp. 481-485 ◽

Cited By ~ 29

Author(s):

J. D. Clark ◽

P. A. Mossey ◽

L. Sharp ◽

J. Little

Keyword(s):

Risk Factors ◽

Socioeconomic Status ◽

Cleft Lip ◽

Population Based ◽

Orofacial Clefts ◽

Smoking During Pregnancy ◽

Live Births ◽

Strong Positive Relationship ◽

The Relationship ◽

Deprived Areas

Objective The purpose of this study was to investigate the association between socioeconomic status and orofacial clefts (OFC) in Scotland. Design Study of prevalence at birth over a 10-year period using an area-based measure of material deprivation. Setting Population-based study throughout Scotland. Participants Eight hundred thirty-four live births with OFC born between January 1, 1989, and December 31, 1998, ascertained from the nationwide register of the Cleft Service in Scotland, compared with the total 603,825 live births in Scotland in this period. Results There was a strong positive relationship whereby the prevalence of OFC at birth increased with increasing deprivation. This trend was statistically significant for cleft lip and/or palate (CL[P]: p = .016) but not for cleft palate (CP; p = .078). For each type of cleft, the relative risk among those resident in the most deprived areas, compared with those resident in the least deprived areas, was 2.33. Conclusions The association between OFC and socioeconomic status is consistent with a report for an earlier period in a smaller part of Scotland. Unlike the earlier study, this pattern appears to be stronger for CL(P) than for CP. These observations do not appear to be an artifact of recording. It is possible that they reflect the association between deprivation and risk factors for OFC, most likely tobacco smoking during pregnancy. Because the relationship between OFC and socioeconomic status appears to have been virtually unstudied in other populations, it would be valuable to investigate this relationship elsewhere and determine whether known risk factors account for the relationship.

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The Relationship between Personal Resources and Depression in a Sample of Victims of Cyberbullying: Comparison of Groups with and without Symptoms of Depression

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249307 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9307

Author(s):

Lourdes Rey ◽

Cirenia Quintana-Orts ◽

Sergio Mérida-López ◽

Natalio Extremera

Keyword(s):

Mental Health ◽

Emotional Intelligence ◽

Depressive Symptoms ◽

Clinical Symptoms ◽

Personal Resources ◽

Symptoms Of Depression ◽

And Function ◽

The Relationship ◽

Adolescent Victims

Previous research has highlighted the relationship between being cybervictimised and the presence of clinical symptoms, such as depression. To date, however, there has been no comparative analysis of the personal resources profiles of adolescent victims of cyberbullying with and without depressive symptoms. The current study analysed the relationship between positive personal resources and clinical symptoms in 251 adolescent victims of cyberbullying at several Spanish high schools. It examined how several positive personal resources varied in adolescent victims of cyberbullying who displayed symptoms of depression (n = 89) or did not (n = 162). Victims of cyberbullying who displayed depressive symptoms reported lower levels of personal resources (emotional intelligence, gratitude, optimism, and forgiveness) than those who did not. Logistic regression provided evidence that gratitude was the strongest predictor of depressive symptoms in victims of cyberbullying, followed by emotional intelligence and optimism. These findings expand the existing literature on the role of personal resources in mental health and highlight the need for their development in youths to help them cope more effectively and function better after being cyberbullied.

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6074Cardiorespiratory fitness, socioeconomic status and mortality in middle-aged men: a population-based prospective cohort study

European Heart Journal ◽

10.1093/eurheartj/ehz746.0122 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

S Y Jae ◽

S Kurl ◽

B A Franklin ◽

J Choo ◽

H J Kim ◽

...

Keyword(s):

Socioeconomic Status ◽

Heart Disease ◽

Density Lipoprotein ◽

Population Based ◽

Lipoprotein Cholesterol ◽

Low Ses ◽

Risk Of Death ◽

Increased Risk ◽

Material Standard Of Living ◽

Cvd Mortality

Abstract Background Although both low socioeconomic status (SES) and poor cardiorespiratory fitness (CRF) are associated with increased chronic disease and a heightened risk of death, it remains unclear whether moderate-to-high levels of CRF confer survival benefits in low SES populations. Purpose The present study evaluated the hypothesis that SES and CRF predict all-cause mortality (ACM), cardiovascular disease (CVD) mortality and sudden cardiac death (SCD), and that moderate-to-high levels of CRF may attenuate the associations between low SES and adverse cardiovascular outcomes. Methods This prospective study was based on a population-based sample of 2,368 men aged 42 to 61 years, who were followed in the Kuopio Ischemic Heart Disease cohort. CRF was directly measured by peak oxygen uptake (VO2peak) during progressive exercise testing to volitional fatigue. SES was characterized using self-reported questionnaires via combined measures of income, education, occupation, occupational prestige, material standard of living, and housing conditions. CRF and SES were divided into tertiles, and 4 combined groups (Fit-high SES, Fit-low SES, Unfit-high SES, and Unfit-low SES) based on the median values of CRF and SES. Results During a 25 year median follow-up (interquartile ranges: 18–27 years), 1116 ACM, 512 CVD mortality and 221 SCD events occurred. After adjusting for potential confounders (age, smoking, alcohol, body mass index, systolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, glucose, diabetes, hypertensive medication, family history of coronary heart disease, and physical activity), the lowest levels of SES were at significantly increased risk for ACM (hazard ratio (HR) 1.49, 95% Confidence Interval (CI): 1.30–1.71), CVD mortality (HR 1.38, 1.13–1.69) and SCD (HR 1.34, 0.97–1.84). In contrast, higher levels of CRF were associated with lower risks of ACM (HR 0.56, 0.46–0.67), CVD mortality (HR 0.53, 0.40–0.71) and SCD (HR 0.53, 0.34–0.83). In combined associations of SES and CRF with mortality, unfit-low SES had significantly higher risks of ACM (HR 2.12, 1.75–2.57), CVD mortality (HR 2.20, 1.64–2.94) and SCD (HR 2.95, 1.79–4.86), but fit-low SES was not associated with a heightened risk of cardiovascular mortality or SCD (CVD mortality, 1.03, 0.73–1.46; SCD, 1.54, 0.87–2.72) as compared with their fit-high SES counterparts (reference). Conclusion Our findings indicate that both SES and CRF are independently associated with the risk of death; however, moderate-to-high levels of CRF appear to attenuate the risk of CVD mortality and SCD in low SES men. These unique data have important implications for public health interventions designed to enhance survival in underserved population cohorts.

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Childhood Depressive Symptoms, Physical Activity and Health Related Fitness

Journal of Sport and Exercise Psychology ◽

10.1123/jsep.25.4.419 ◽

2003 ◽

Vol 25 (4) ◽

pp. 419-439 ◽

Cited By ~ 28

Author(s):

Lois Michaud Tomson ◽

Robert P. Pangrazi ◽

Glenn Friedman ◽

Ned Hutchison

Keyword(s):

Physical Activity ◽

Depressive Symptoms ◽

Relative Risk ◽

Negative Relationship ◽

Physically Active ◽

Symptoms Of Depression ◽

Health Related ◽

Relationship Of ◽

The Relationship ◽

Health Related Fitness

While research has confirmed a negative relationship between adult depression and physical activity, there is little evidence for children. This study examined the relationship of being classified as physically active or inactive by a parent or a teacher to depressive symptoms in children 8 to 12 years of age (N = 933). It also assessed the relationship of playing sports outside of school, and of meeting health related fitness standards, to symptoms of depression. Relative risk of depressive symptoms for inactive classification was 2.8 to 3.4 times higher than it was for active, 1.3 to 2.4 times higher for children not playing sports outside of school, and 1.5 to 4.0 times higher for those not meeting health related fitness goals.

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Mediation effect of depressive symptoms in the relationship between perceived control and wellbeing in patients with heart failure and their partners

European Journal of Cardiovascular Nursing ◽

10.1177/1474515118755721 ◽

2018 ◽

Vol 17 (6) ◽

pp. 527-534 ◽

Cited By ~ 4

Author(s):

Maria Liljeroos ◽

Anna Strömberg ◽

Kristofer Årestedt ◽

Misook L Chung

Keyword(s):

Mental Health ◽

Heart Failure ◽

Depressive Symptoms ◽

Health Status ◽

Perceived Control ◽

Self Care ◽

Mental Health Status ◽

Mediation Effect ◽

Patients With Heart Failure ◽

The Relationship

Background: As treatment has improved, patients with heart failure live longer, and the care mostly takes place at home with partners providing the main assistance. Perceived control over heart failure is important in managing self-care activities to maintain health in patients and their family. Depressive symptoms are associated with impaired health status in patients with heart failure and their family. However, there is limited knowledge about how depressive symptoms affect the relationship between health status and perceived control over heart failure in patients with heart failure and their cohabiting partners. Aim: The aim of this study was to examine whether the relationship between perceived control and health status (i.e. mental and physical) was mediated by depressive symptoms in patients with heart failure and their partners. Methods: In this secondary data analysis, we included 132 heart failure patients and 132 partners who completed measures of depressive symptoms (the Beck depression inventory II), perceived control (the control attitude scale), and physical and mental health status (the short form-36) instruments. The mediation effect of depression was examined using a series of multiple regression in patients and their family caregivers separately. Results: We found a mediator effect of depressive symptoms in the relationship between perceived control and mental health status in both patients and partners. The relationship between perceived control and physical health status was mediated by depressive symptoms in the patients, not in the partners. Conclusion: Efforts to improve self-care management and maintenance by targeting perceived control may be more effective if depressive symptoms are also effectively managed.

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