Zilioli Samuele, Imami Ledina, Slatcher Richard B
Department of Psychology, Wayne State University, United States; Department of Family Medicine and Public Health Science, Wayne State University, United States.
Department of Psychology, Wayne State University, United States.
Psychoneuroendocrinology. 2017 Jan;75:36-43. doi: 10.1016/j.psyneuen.2016.09.025. Epub 2016 Oct 6.
Social class is a robust predictor of health, with risk for disease and mortality increasing towards the lower end of the socioeconomic (SES) spectrum. While certain psychological characteristics, such as high sense of control, can protect low-SES individuals from adverse health outcomes, very few studies have investigated the biological mechanisms underlying these relationships. In this study, we tested whether sense of control mitigated the associations between SES and cortisol activity, and SES and physical health in daily life (i.e., number and severity of physical symptoms). Next, we tested whether individual differences in cortisol secretion would act as a mechanism by which SES and perceived control influenced physical health. In a large national sample from the Midlife in the United States (MIDUS) survey, we found that SES interacted with perceived control in predicting morning cortisol levels, cortisol slopes, number of physical symptoms, and severity of physical symptoms. Specifically, SES disparities in these health outcomes were more pronounced among individuals reporting low levels of perceived control than among individuals endorsing high levels of perceived control. Further, we found that a flatter cortisol slope mediated the link between lower SES and greater number and severity of physical symptoms for those individuals who reported lower levels of perceived control, but not for individuals reporting higher levels of perceived control. These findings suggest that perception of greater control may act as a buffer against the effect of low SES on health-related physiological processes.
社会阶层是健康状况的有力预测指标，疾病风险和死亡率会随着社会经济地位（SES）范围的下限而增加。虽然某些心理特征，如高度的掌控感，可以保护低社会经济地位的个体免受不良健康后果的影响，但很少有研究调查这些关系背后的生物学机制。在本研究中，我们测试了掌控感是否会减轻社会经济地位与皮质醇活性之间以及社会经济地位与日常生活中的身体健康（即身体症状的数量和严重程度）之间的关联。接下来，我们测试了皮质醇分泌的个体差异是否会作为社会经济地位和感知到的掌控感影响身体健康的一种机制。在美国中年（MIDUS）调查的一个大型全国样本中，我们发现社会经济地位与感知到的掌控感在预测早晨皮质醇水平、皮质醇斜率、身体症状数量和身体症状严重程度方面存在相互作用。具体而言，在报告低水平感知掌控感的个体中，这些健康结果方面的社会经济地位差异比在认可高水平感知掌控感的个体中更为明显。此外，我们发现，对于那些报告低水平感知掌控感的个体，较平缓的皮质醇斜率介导了较低社会经济地位与更多数量和更严重身体症状之间的联系，但对于报告高水平感知掌控感的个体则不然。这些发现表明，更强的掌控感可能作为一种缓冲，抵御低社会经济地位对与健康相关的生理过程的影响。
