Hope S, Rodgers B, Power C
Department of Epidemiology and Public Health, Institute of Child Health, London.
Psychol Med. 1999 Mar;29(2):381-9. doi: 10.1017/s0033291798008149.
Evidence is conflicting as to whether the association between marital status and psychological distress is due to selection (i.e. distress influences marital status) or causation (marital status influences distress). We investigate: (i) whether differences in psychological distress pre-date marital transitions; (ii) whether levels of distress change following transitions; and (iii) potential mediating and moderating factors.
Data on psychological distress (indicated by the Malaise Inventory) and marital status at ages 23 and 33 were analysed for 4514 men and 4842 women from the 1958 birth cohort.
Higher levels of distress were found among the divorced and lower levels among the single and the married. Selection was seen in the lower initial mean symptoms of those who married (1.69 for men; 2.84 for women) compared to those remaining single (2.41 for men; 3.26 for women). Causation was indicated by the relative deterioration in distress of those who divorced compared to the continuously married (an increase of 0.31 and 0.03 respectively for men), especially in women (a decrease of 0.18 versus 0.71). This was most evident in women who were downwardly mobile and those with children. Recently separated men and women showed especially large increases in distress.
The relationship between marital status and psychological distress involves selection and causation. Findings failed to support ideas of marriage being protective (through social support), or detrimental (through family roles). Divorce increased distress, with both acute and longer-term components moderated by secondary factors such as childcare and declining socioeconomic status.
关于婚姻状况与心理困扰之间的关联是由于选择因素（即困扰影响婚姻状况）还是因果关系（婚姻状况影响困扰），证据存在冲突。我们进行了以下研究：（i）心理困扰的差异是否在婚姻转变之前就已存在；（ii）转变后困扰水平是否发生变化；以及（iii）潜在的中介和调节因素。
对来自1958年出生队列的4514名男性和4842名女性在23岁和33岁时的心理困扰（由不适量表表示）和婚姻状况数据进行了分析。
离婚者的困扰水平较高，单身者和已婚者的困扰水平较低。与仍保持单身的人（男性为2.41；女性为3.26）相比，已婚者最初的平均症状较低（男性为1.69；女性为2.84），这体现了选择因素。与持续婚姻者相比，离婚者的困扰相对恶化（男性分别增加0.31和0.03），尤其是女性（分别下降0.18和0.71），这表明了因果关系。这在社会经济地位下降且有孩子的女性中最为明显。最近分居的男性和女性的困扰增加尤为显著。
婚姻状况与心理困扰之间的关系涉及选择和因果关系。研究结果不支持婚姻具有保护作用（通过社会支持）或有害作用（通过家庭角色）的观点。离婚会增加困扰，育儿和社会经济地位下降等次要因素会缓和急性和长期的困扰。
