King's College London Institute of Psychiatry, London, UK.
J Child Psychol Psychiatry. 2011 Oct;52(10):1081-8. doi: 10.1111/j.1469-7610.2011.02447.x. Epub 2011 Aug 4.
While there is considerable evidence of income gradients in child and adolescent behaviour problems, evidence relating to children and young people's emotional difficulties is more mixed. Older studies reported no income differentials, while recent reports suggest that adolescents from low-income families are more likely to experience emotional difficulties than their more affluent peers.
We compared the association between low- versus medium-/high-family income and parent-reported emotional difficulties in 15- and 16-year-olds in three large nationally representative cohorts studied in 1974, 1986 and 1999/2004. We then examined whether increases in the income differential could be accounted for by changes in the association of a range of sociodemographic factors (family type or size, maternal education or housing tenure) with either family income or emotional difficulties. Finally, in the most recent cohorts, we considered whether the effects of these sociodemographic variables were mediated by more proximal family factors (maternal distress, stressful life events or family dysfunction).
An increasing income differential in adolescent emotional problems emerged over the period, with standardized coefficients for associations with low income increasing from .07 in 1974 and 1986 to .30 in 1999/2004. This was due partially (10%) to sociodemographic risk factors for emotional difficulties becoming more strongly associated with low-income families over time, and partially (40%) to the increasing impact of these risk factors. In the most recent cohorts, about 40% of the effects of sociodemographic risks appear to have been mediated by more proximal family factors.
These findings have implications for our understanding of the health burden of emotional problems, recognition of the health burden associated with inequality and public concern about the consequences of social change.
虽然有大量证据表明儿童和青少年的行为问题与收入水平呈梯度相关，但有关儿童和年轻人情绪困难的证据则更为复杂。早期研究报告称收入并无差异，而最近的报告则表明，来自低收入家庭的青少年比他们较为富裕的同龄人更有可能经历情绪困难。
我们比较了在三个大型全国代表性队列中，1974 年、1986 年和 1999/2004 年研究的 15 至 16 岁青少年中，低家庭收入与中/高家庭收入与父母报告的情绪困难之间的关联。然后，我们检查了一系列社会人口因素（家庭类型或规模、母亲教育程度或住房所有权）与家庭收入或情绪困难之间的关联变化，是否可以解释收入差异的增加。最后，在最近的队列中，我们考虑了这些社会人口变量的影响是否通过更接近家庭的因素（母亲的痛苦、生活压力事件或家庭功能障碍）来中介。
青少年情绪问题的收入差异在这一时期逐渐扩大，与低收入相关的关联的标准化系数从 1974 年和 1986 年的 0.07 增加到 1999/2004 年的 0.30。这部分（约 10%）是由于情绪困难的社会人口风险因素随时间推移与低收入家庭的关联变得更强，部分（约 40%）是由于这些风险因素的影响越来越大。在最近的队列中，约 40%的社会人口风险的影响似乎通过更接近家庭的因素来中介。
这些发现对我们理解情绪问题的健康负担、认识不平等带来的健康负担以及对社会变革后果的公众关注具有重要意义。
