Changes in the labor market and employment contracts over the past several decades and a recent global recession have increased the salience of perceived job insecurity as a risk factor for poor mental health. We use 25 years of prospective data from the Americans’ Changing Lives study to examine long-term histories of perceived job insecurity and their link to psychological distress. We build on the prior literature by using a much longer window of exposure and accounting for involuntary job losses over the lengthy observation period. We find that persistent perceived job insecurity is strongly and significantly associated with greater psychological distress among U.S. workers in the latter part of their careers. Moreover, considering histories of exposure reveals more nuance in the sociodemographic characteristics and employment interruptions that predict persistent or intermittent insecurity and that identify contemporary older workers at particular risk.
Although research shows that spouses influence each other’s health behaviors and psychological well-being, we know little about whether these patterns extend to young people in nonmarital as well as marital relationships. We use the National Longitudinal Study of Adolescent to Adult Health to consider how a romantic partner’s binge drinking and depression influence the respondent’s binge drinking and depression within 1,111 young adult couples and explore whether these processes are moderated by gender. We find that partners’ binge drinking is associated with increased odds of binge drinking for respondents and partners’ depression is associated with increased odds of depression for respondents. Further, depression among men is associated with reduced odds of binge drinking among their female partners. Findings suggest that processes of partner influence begin even in young adulthood with implications for cumulative effects on lifelong health behaviors and mental health.
This paper re-examines the study of immigrant mental health by arguing that the level of economic development of origin country alters both initial mental health status and subsequent trajectories of distress over time. Using five waves of longitudinal survey data from the National Population Health Survey of adults living in three metropolitan cities in Canada (N = 2,887), results show an increase in distress with time, but mainly among immigrants from lower gross national product (GNP) origin countries and only for the first 5 years postarrival, followed by a decline among all immigrants, irrespective of origin-country GNP. Increases in chronic stress exposure fully explain the initial increase in distress among immigrants from less developed countries of origin. Results call into question the generalizability of the "immigrant health paradox" to all immigrant groups and point to the importance of macro-level social and economic factors, and the matching of conditions at origin and destination, in the migration process.
A popular image of Americans is that they are among the most individualistic people on the planet. This long-standing myth has informed theorizing about the sense of control and its relevance for stress and mental health. Prior claims have suggested that differences based on individualistic and collectivistic values contribute to group differences in the sense of control. We analyze data from the World Values Survey to test this hypothesis, focusing on a comparison of Americans and individuals in East Asian societies. Findings demonstrate that Asians report lower perceived control than Americans—but adjustments for individualistic values do not explain these differences. The positive association between individualistic values and perceived control is stronger among Asians compared to Americans. Perceived control is associated most strongly with subjective well-being for Americans, but individualistic values do not explain the differences. Our observations question claims that Americans gain more from individualistic values while Asians are sanctioned for them. Given its significance for stress and mental health, it is essential to document social patterns in the levels and effects of perceived control. We contribute to that effort by uncovering unexpected patterns that challenge the claim that individualistic values—and their benefits for control—are a quintessentially American thing.
Adolescence is a period of tremendous socioemotional change, when youth develop important relationship skills that they carry with them into adulthood. The mental health of individuals during this period might act as resources or impediments that impact their ability to cultivate such skills as well as outcomes in their later romantic relationships. The current study examines how multiple dimensions of adolescent mental health (depressive symptomology, self-esteem, mastery, and impulsivity) are associated with outcomes in romantic relationships across the transition to adulthood, such as relationship conflict, relationship happiness, and number of dating partners. Youth with higher mastery, self-esteem, and impulsivity during adolescence had more romantic dating partners across the transition to adulthood. High levels of depressive symptomology and low mastery during adolescence were also associated with greater conflict within dating relationships in young adulthood.
Recent health policies encourage electronic messaging with providers to potentially improve health care. It is unclear whether the same potential exists for individuals with mental health symptoms. Whereas these individuals appear interested in such technologies, they may also be concerned about privacy and security risks. To clarify this ambiguity, we conceptualize electronic messaging as an impression management tool for individuals with depressive symptoms, who risk devaluation from others. Consequently, factors that increase the perceived risk of devaluation in face-to-face clinical encounters may increase the likelihood of electronically messaging providers. We empirically examined two factors: depressive symptom severity and trust in physician confidentiality, which is the expectation that one’s regular physician uses personal health information appropriately. We found that reporting severe depressive symptoms increased the likelihood of electronically messaging providers but only among respondents who lacked trust in physician confidentiality. Electronic messaging is potentially a means to reach this underserved population.
Prior research indicates an association between exposure to trauma (e.g., being victimized) and perpetration of crime, especially in the context of chronic victimization. This study examines the relationship between trauma exposure, posttraumatic stress disorder (PTSD), and history of arrest and incarceration among a representative sample of black Americans from the National Survey of American Life (N = 5,189). One-third had a history of arrest, and 18 percent had a history of incarceration. Frequency of trauma exposure was associated with involvement with the criminal justice system. Relative to never experiencing trauma, experiencing ≥4 traumas was associated with elevated odds of arrest (odds ratio [OR] = 4.03), being jailed (OR = 5.15), and being imprisoned (OR = 4.41), all p < .01. PTSD was also associated with likelihood of incarceration among those with a history of trauma (OR = 2.18, p < .01). Both trauma exposure and trauma-associated psychopathology are associated with increased likelihood of arrest and incarceration in adulthood among black Americans.
This article employs institutional ethnography (IE) inclusive of its distinctive epistemological stance to elucidate the institutional organization of the everyday work experience of the employee living with self-reported depression. The study was conducted within a large industrial manufacturing plant in Ontario, Canada. We discuss three institutionally organized processes that play a dominant role in coordinating the experiences of employees with self-reported depression: (1) employees’ work of managing and negotiating episodes of depression, (2) managers’ administrative work of maintaining privacy and confidentiality, and (3) the administrative work of authorizing illness. We shed light on how confidential medicalized disability management programs render managers ill prepared and inadequately trained to provide mental health support to their employees. Our findings inform advocacy efforts and facilitate both organizational and policy change to enhance services and supports for employees.
Mental health or well-being provides individuals with an enhanced agentic capacity for formal volunteering. However, this capacity may be realized more effectively through the structural resources for volunteering provided by education. Analyzing white respondents from the 1995-2005 National Survey of Midlife Development Panel Study (N = 1,431), we examine the contingent effects of mental well-being and education on the probability of formal volunteering. In longitudinal models, we find that mental well-being has a role in volunteering only at higher levels of education and that deficits in mental well-being reduce the effect of education. This holds across three representative indicators of mental well-being capturing the absence of negative symptoms as well as the presence of thriving or positive emotion. As a whole, our findings suggest that agency and structure are intertwined in determining who volunteers.
The purpose of this study is to examine microsocial and macrosocial contextual moderators of adolescent depressive contagion. Using data from the National Longitudinal Study of Adolescent Health (Add Health), the authors find evidence supporting the depressive contagion thesis. This effect is observed above and beyond key social relationship and sociodemographic controls. To examine the role of social context in moderating the effect of depressive contagion, the authors utilize a longitudinal mixed effects model using Wave 1 and Wave 2 of the Add Health survey. The results reveal that depressive contagion is more salient for adolescents who are embedded in dense peer networks and attend schools with high network density and mutuality. Furthermore, popular students, measured as the number of received friendship nominations, are more vulnerable to depressive contagion. Overall, the findings in this study demonstrate a differential vulnerability to depressive contagion dependent on microsocial and macrosocial context.
Examining the social context of disablement, we investigated how changes in social relations affect loneliness among married older men and women. With longitudinal data on 914 married persons from the National Social Life, Health, and Aging Project (NSHAP), we found that changes in the quality of marital and nonmarital relations moderate the effect of disability on loneliness in unexpected ways. Increases in negative marital quality buffer the effect of physical disability, while increases in nonmarital support exacerbate it. Although not predicted by existing theory, these findings are consistent with some prior work suggesting that health-related stressors, like physical disability, condition the meaning of changes in social relations. We find, however, that negative social relations ameliorate loneliness only among disabled married men; disabled married women experience increased loneliness under similar circumstances. These differences have not been previously identified. We conclude by discussing the gendered nature of the social context of disablement.
Using data from the FFCW (n = 1,492 couples), the authors assessed stress, health selection, and couple-crossover hypotheses by examining (1) the bidirectional association between economic hardship and depressive symptoms one, three, and five years after the birth of a child; (2) the association between economic hardship and depression on relationship distress for both parents; and (3) whether the associations vary by marital status. The results suggest a pernicious cycle for mothers after the birth of a child. Economic hardship increases depression, but maternal depression also increases economic hardship. These reinforcing mechanisms increase both mothers’ and fathers’ relationship distress. Taken together, policies aimed at strengthening couples’ relationships should work in tandem with economic and mental health policies to reach optimal outcomes for couples with young children. Effect patterns were generally consistent between married and cohabiting couples, with some variation in levels of statistical significance.
Structural resources, including access to health insurance, are understudied in relation to the stress process. Disability increases the likelihood of mental health problems, but health insurance may moderate this relationship. We explore health insurance coverage as a moderator of the relationship between disability and psychological distress. A pooled sample from 2008 to 2010 (N = 57,958) was obtained from the Integrated Health Interview Series. Chow tests were performed to assess insurance group differences in the association between disability and distress. Results indicated higher levels of distress associated with disability among uninsured adults compared with their peers with public or private insurance. The strength of the relationship between disability and distress was weaker for persons with public compared with private insurance. As the Affordable Care Act is implemented, decision makers should be aware of the potential for insurance coverage, especially public, to ameliorate secondary conditions such as psychological distress among persons who report a physical disability.
The authors examine a key proposition in the modified labeling theory—that a psychiatric label increases vulnerability to negative evaluation and social rejection—using an experimental design wherein female participants interact with a female teammate over a computer. The authors also evaluate a hypothesis derived from the disease-avoidance account of disgust by examining this same process for a nonpsychiatric illness: food poisoning. In addition, they introduce a composite measure of social distance behavior that is easy to implement in a laboratory experiment. The authors find, as predicted, that women seek greater social distance from teammates with a history of psychiatric or food poisoning hospitalization than they do from teammates with no hospitalization history. But, contrary to predictions, a teammate’s hospitalization history does not affect participants’ ratings of her likability. The results also do not vary significantly by psychiatric diagnosis (depression vs. schizophrenia), suggesting that the stigma of depression may be just as strong as the stigma of schizophrenia when information about symptoms is not available. The authors discuss the implications of these findings for the modified labeling theory of mental illness and for the literature on disgust and stigma. They also outline avenues for future research.
Many studies have associated adolescent violence exposure with later mental health outcomes, but because violence cannot be randomly assigned, few have established causality. Additionally, few have directly tested whether violence affects boys’ and girls’ psychological health differently. The author hypothesizes that (1) violence has a negative causal effect on depression and (2) the effects of violence on depression are worse for women than for men. Using National Longitudinal Study of Adolescent Health data, the author builds multilevel propensity score models with wave 1 predictors in a cross-lagged two-level hierarchical linear model estimating the effects of wave 2 violence on wave 3 outcomes. The results (1) confirm that women have higher depression scores than men net of other factors, (2) show that violence exposure raises average depression scores for both sexes, and (3) uncover no significant sex differences in effect size of violence on depression.
Is receipt of unsolicited support—aid that is passively obtained without asking—protective or destructive in collectivistic culture? This study focuses on receipt of unsolicited job leads and examines competing hypotheses on its direct and indirect effects (through financial dissatisfaction) on depression using unique nationally representative data of working-age urban adults in China. Its direct effect should be negative from the distress-reducing perspective but positive from the distress-inducing perspective. Its indirect effect should be negative based on the stress prevention model but positive predicted by comparative reference group theory. Also, the reinforced collectivistic norm explanation expects the distress-reducing perspective and the stress prevention model to have stronger explanatory power in China. Results from path analysis support the distress-inducing perspective and comparative reference group theory. Receipt of unsolicited job leads is positively associated with depression partially through financial dissatisfaction in urban China.
This study examines the role of social integration and social support, a significant yet under-investigated factor in mental health disparities by sexual orientation. By analyzing National Health and Nutrition Examination Survey data from a representative sample of the middle-aged U.S. population, the study shows that bisexual-identified individuals have the lowest levels of social resources and the poorest mental health status of all sexual orientation groups. Lesbian/gay-identified individuals and heterosexual-identified individuals with same-sex sexual experience are less socially integrated or perceive less emotional support than the sexual majority but do not report poorer mental health. Moreover, social integration and social support jointly mediate the link between sexual orientation and mental distress: sexual minorities are less socially integrated, which is related to a lower level of social support and, in turn, a higher level of mental distress. Additionally, minority-identified individuals reap more health benefits from confidants and emotional support. These findings suggest that sexual minorities are among those who most need and most benefit from supportive social relationships. The study therefore reveals the importance of social resource interventions in narrowing the mental health gap by sexual orientation.
Using a random sample of adult residents from the state of Texas, we examine how religious participation and secular civic engagement buffer the effects of perceived financial strain and neighborhood disadvantage on psychological distress. Our findings suggest that (a) both organizational religious and secular civic engagement buffer the deleterious effects of perceived financial hardship on respondents’ psychological distress, (b) organizational as well as nonorganizational religious participation buffers the detrimental effects of perceived neighborhood disadvantage on respondents’ psychological distress, (c) religious involvement has a more robust buffering effect than secular civic engagement, and (d) nonorganizational religious participation can serve as a coping mechanism for respondents who suffer from psychological distress. Research implications, study limitations, and directions for future research are discussed.
Since the establishment of the symptoms-based categories in the Diagnostic and Statistical Manual of Mental Disorders (DSM), Third Edition, sociologists have raised concerns about the DSM’s failure to appreciate social, contextual factors when defining mental disorders. The author describes recent developments in psychiatric nosology—the DSM-5 revision process and the emergence of the Research Domain Criteria (RDoC)—and then considers their implications for decontextualization. Drawing on in-depth interviews with psychiatrists involved in the DSM-5 controversy and a content analysis of key documents, the author first recounts the ambitious DSM-5 revisions, illuminating the DSM-5 Task Force’s embrace of dimensionalization as a solution to the problem of validity and the ultimate rejection of this "paradigm shift" by psychiatrists. The Task Force’s failures prompted the National Institute of Mental Health to promote RDoC as an alternative nosological framework that eschews DSM categories altogether. Next, the author explores the ramifications of these events for decontextualization, which neither DSM-5 nor RDoC explicitly addresses, demonstrating how RDoC is poised to escalate decontextualization through its brain-centric conceptualization of mental disorders. To counteract these developments, sociologists should continue to promote ways of defining mental distress that underscore its social embeddedness.
In this paper, I use data from 20 in-depth interviews with psychoanalytically trained psychiatrists (who prescribe medications and practice talk therapy) about their experiences navigating treatment in a profession dominated by the medical model. Psychiatrists’ descriptions of their field and their patients’ troubles support the central claims in sociology about the medicalization of psychiatry. Since the 1980s, the extent to which psychiatric troubles are medicalized has increased dramatically and in new ways. Pharmaceutical companies, insurance companies and consumers drive the current era in medicalization. Psychiatric training is also highly influential on practitioners’ propensities to think and act medically. Qualitative data are crucial for understanding the extent to which medicalization influences practitioners and the degree to which they foster the use of medical interventions. Very few researchers have examined the medicalization of psychiatry from the perspective of psychiatrists, especially psychoanalysts, who offer insight into why medicalization is largely unchallenged within psychiatry.
Drawing from 26 life story interviews of recent American veterans, this paper analyzes the identity struggle faced by soldiers returning from Operation Iraqi Freedom and Operation Enduring Freedom and reentering the civilian world. Instead of examining veterans’ problems as a consequence of post-combat mental illnesses such as PTSD and major depression, we analyze the contrast between the participants’ identities as soldiers and their identities as civilians. We find that the postwar transition causes adverse mental health effects that stem from contrasts between the military’s demands for deindividuation, obedience, chain-of-command, and dissociation and the civilian identity expectations of autonomy, self-advocacy, and being relational. Veterans’ reintegration to civilian society is further hindered by a culture that is perceived (by veterans) as having decreased understanding of the soldier/veteran experience itself. These identity conflicts—what we term warring identities—have an important yet understudied effect on veterans’ combat-related mental health problems.
Vacations enable people to help one another, spend time together in pleasant contexts, and renew relational resources. Reasoning that these shared activities spread social and psychological benefits through social networks, we hypothesized that increase in the number of vacationing workers engenders nonlinear decline in psychological distress at the population level. We applied time-series methods to aggregate data on monthly dispensation of antidepressants to the Swedish population for the 147 months starting January 1993. We obtained the data from the pharmacy corporation allied with the national health care system and from governmental sources. Dispensation of antidepressants declined logarithmically with increase in the number of vacationing workers, for men and women alike. The associations held among people beyond retirement age as well as people of working age, further evidence that vacation benefits spread beyond vacationing workers. The results bear on the social regulation of time for restoration as a general determinant of population health.
Although perceived discrimination is linked to poor mental health, little is known about the mental health significance of the number of perceived reasons for discrimination. Using survey data from a community-based sample of adults living in Miami, Florida (n = 1,944), this study tests whether those reporting multiple perceived reasons for major discriminating events are at increased risk for depression. Cross-sectional and longitudinal analyses reveal those reporting multiple reasons for major discrimination are at increased risk for lifetime major depression and subsequent depressive symptoms. While social support and mastery partially mediated the link between multiple perceived reasons for discrimination and subsequent depressive symptoms, this psychological risk was not fully explained by these coping resources. Together the findings underscore the psychological toxicity of perceived discrimination and the importance of considering multiple perceived reasons for discrimination as a risk factor for poor mental health.
Stress process researchers note that people actively seek to alter the impact of stressful life events through various coping mechanisms. Spousal bereavement sometimes requires individuals to revise their assumptions about the world and themselves. Meaning-making, comprising the dual processes of searching for and finding meaning, may be employed to alleviate symptoms of grief following spousal bereavement. The current study uses multilevel modeling to examine the influence of searching for and finding meaning on individual growth trajectories of psychological distress using data from 764 widows and widowers from a nationally representative longitudinal study. Results indicate that searching for meaning after spousal loss may be a double-edged sword: it is beneficial when meaning is found, but harmful when meaning remains elusive. Widows and widowers who searched for but did not find meaning exhibited the highest initial levels of psychological distress, but they also had slightly faster declines in psychological distress, becoming more similar to other meaning-making groups over time.
Race and socioeconomic status (SES) health disparities imply massive impact in terms of unequal suffering and dramatic social and economic costs. It is clear that status differences in the availability, use, and effectiveness of medical care and in a variety of health behaviors are implicated in these disparities. However, it is equally clear that adjustments for these differences leave the majority of race and SES health disparities unexplained. Despite wide acceptance of the idea that differences in stress exposure may contribute importantly to such disparities, it is contended that the stress hypothesis has never been effectively tested because of misclassification in the distinction between the disordered and the well and the inadequate estimation of differences in exposure to social stressors. This article reviews the empirical basis for this contention and describes an ongoing community study designed to more effectively evaluate the hypothesis that lifetime stress exposure represents a fundamental factor in observed race and SES health disparities. It is suggested that the application of aspects of the approach described may advance the capacity of future research to fully evaluate the mental health significance of the stress process.
Despite extensive evidence of the importance of marriage and marital processes for mental health, little is known about the interpersonal processes around depression within marriage and the extent to which these processes are gendered. We use a mixed-methods approach to explore the importance of gender in shaping processes around depression within marriage. We approach this in two ways: First, using quantitative longitudinal analysis of 2,601 couples from the Health and Retirement Study (HRS), we address whether depressive symptoms in one spouse shape the other spouse’s depressive symptoms and whether men or women are more influential in this process. We find that a wife’s depressive symptoms influence her husband’s future depressive symptoms, but a husband’s depressive symptoms do not influence his wife’s future symptoms. Second, we conduct a qualitative analysis of in-depth interviews with 29 couples wherein one or both spouses experienced depression to provide additional insight into how gender impacts depression and reactions to depression within marriage. Our study points to the importance of cultural scripts of masculinity and femininity in shaping depression and emotional processes within marriage and highlights the importance of applying a gendered couple-level approach to better understand the mental health effects of marital processes.