Turner R J, Lloyd D A
School of Policy and Management, College of Urban and Public Affairs, Florida International University, Miami 33199, USA.
J Health Soc Behav. 1999 Dec;40(4):374-404.
Mental health generally and depression in particular have been repeatedly shown to vary in relation to gender, socioeconomic status, marital status, and age. These status differences may be linked to mental health because they tend to define important differences in stress exposure and in the availability of coping resources. This paper examines the capacity of the stress-process model to account for the social distribution of depression. We employ mediation analyses using data from a 1990-1991 survey of Toronto community residents. In general, we found hypothesized risk factors to vary across these statuses with depressive symptoms and disorder and the distribution of protective factors to vary inversely. Results indicate that the model as expressed in our analyses accounts for a substantial minority of observed depression differences across individuals and for a considerable portion of reliably observed variation across social statuses. Our findings with respect to major depressive disorder parallel those for depressive symptomatology. Most compelling is the nearly total explanation of the socioeconomic status association with depressive symptoms and the substantial contribution toward explaining the socioeconomic status-disorder relationship when stress process mediators are accounted for.
总体而言，心理健康状况，尤其是抑郁症，已被反复证明会因性别、社会经济地位、婚姻状况和年龄而有所不同。这些状况差异可能与心理健康有关，因为它们往往会在压力暴露和应对资源的可获得性方面造成重要差异。本文探讨了压力过程模型解释抑郁症社会分布的能力。我们使用1990 - 1991年多伦多社区居民调查的数据进行中介分析。总体而言，我们发现假设的风险因素在这些状况中各不相同，抑郁症状和障碍也有所不同，而保护因素的分布则呈相反变化。结果表明，我们分析中所表达的模型解释了个体间观察到的抑郁症差异中的相当一部分，以及社会状况间可靠观察到的变异中的很大一部分。我们关于重度抑郁症的研究结果与抑郁症状学的结果相似。最引人注目的是，当考虑压力过程中介因素时，几乎完全解释了社会经济地位与抑郁症状之间的关联，以及对解释社会经济地位与障碍关系的重大贡献。
