Division of General Pediatrics, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
Am J Public Health. 2012 Sep;102(9):1742-50. doi: 10.2105/AJPH.2011.300477. Epub 2012 Feb 16.
Although previous research has shown that low socioeconomic status (SES) is associated with mental illness, it is unclear which aspects of SES are most important. We investigated this issue by examining associations between 5 aspects of SES and adolescent mental disorders.
Data came from a national survey of US adolescents (n = 6483). Associations among absolute SES (parental income and education), relative SES (relative deprivation, subjective social status), and community level income variation (Gini coefficient) with past-year mental disorders were examined.
Subjective social status (mean 0, variance 1) was most consistently associated with mental disorder. Odds ratios with mood, anxiety, substance, and behavior disorders after controlling for other SES indicators were all statistically significant and in the range of 0.7 to 0.8. Associations were strongest for White adolescents. Parent education was associated with low risk for anxiety disorder, relative deprivation with high risk for mood disorder, and the other 2 indicators were associated with none of the disorders considered.
Associations between SES and adolescent mental disorders are most directly the result of perceived social status, an aspect of SES that might be more amenable to interventions than objective aspects of SES.
尽管先前的研究表明，社会经济地位（SES）较低与精神疾病有关，但尚不清楚 SES 的哪些方面最为重要。我们通过研究 SES 的 5 个方面与青少年精神障碍之间的关联来探讨这个问题。
数据来自对美国青少年的全国性调查（n=6483）。研究了绝对 SES（父母的收入和教育）、相对 SES（相对剥夺感、主观社会地位）和社区收入变化（基尼系数）与过去一年精神障碍之间的关联。
主观社会地位（均值为 0，方差为 1）与精神障碍最密切相关。在控制了其他 SES 指标后，与情绪、焦虑、物质和行为障碍相关的优势比均具有统计学意义，范围在 0.7 到 0.8 之间。这些关联在白人青少年中最强。父母教育与焦虑障碍的低风险相关，相对剥夺感与情绪障碍的高风险相关，而其他 2 个指标与所考虑的任何一种障碍均无关。
SES 与青少年精神障碍之间的关联最直接的是感知社会地位的结果，这是 SES 的一个方面，可能比 SES 的客观方面更易于干预。
