社会逆境与抑郁症状之间因艾滋病毒感染状况和种族/族裔身份而异的关系。
Differential relationships between social adversity and depressive symptoms by HIV status and racial/ethnic identity.
作者信息
Williamson Timothy J, Mahmood Zanjbeel, Kuhn Taylor P, Thames April D
机构信息
Department of Psychology, University of California, Los Angeles.
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles.
出版信息
Health Psychol. 2017 Feb;36(2):133-142. doi: 10.1037/hea0000458. Epub 2016 Dec 8.
OBJECTIVE
Historically marginalized groups are likely to be exposed to social adversity, which predicts important mental health outcomes (e.g., depression). Despite the well-established relationship between adversity and poor health, few studies have examined how adversity differentially predicts mental health among people living with multiple, co-occurring marginalized identities or statuses. The current study fills this gap by examining whether relationships between social adversity and depressive symptoms differed between those living with or without a stigmatized disease (i.e., HIV) and/or marginalized racial/ethnic identity (i.e., African American).
METHOD
A community sample of men and women (N = 149) completed questionnaires assessing demographics and depressive symptoms. Additionally, a composite index of social adversity was derived from measures of perceived discrimination, socioeconomic status, financial restriction to receiving medical care, and perceived neighborhood characteristics. Multiple regression was used to test whether relationships between adversity and depressive symptoms differed as a function of HIV status and racial/ethnic identity.
RESULTS
A significant 3-way interaction between social adversity, HIV status, and racial/ethnic identity indicated that there was a direct relationship between adversity and depressive symptoms for HIV-positive (HIV+) African Americans but not for HIV-negative (HIV-) African Americans, HIV+ Caucasians, or HIV- Caucasians. Further, HIV+ African Americans evidenced a significantly greater relationship between adversity and depressive symptoms compared with HIV- African Americans, but not compared with other groups.
CONCLUSIONS
The findings suggest that HIV+ African Americans may be at risk for higher depressive symptoms amid adversity, highlighting the importance of evaluating intersectional identities/statuses in the context of mental health. (PsycINFO Database Record
目的
历史上被边缘化的群体可能会面临社会逆境，而这预示着重要的心理健康结果（如抑郁症）。尽管逆境与健康状况不佳之间的关系已得到充分证实，但很少有研究探讨逆境如何在具有多种同时存在的边缘化身份或地位的人群中对心理健康产生不同的预测作用。本研究通过考察社会逆境与抑郁症状之间的关系在患有或未患有污名化疾病（即艾滋病毒）和/或边缘化种族/族裔身份（即非裔美国人）的人群中是否存在差异，填补了这一空白。
方法
一个由男性和女性组成的社区样本（N = 149）完成了评估人口统计学和抑郁症状的问卷。此外，社会逆境综合指数源自对感知到的歧视、社会经济地位、接受医疗护理的经济限制以及感知到的邻里特征的测量。多元回归用于检验逆境与抑郁症状之间的关系是否因艾滋病毒感染状况和种族/族裔身份而有所不同。
结果
社会逆境、艾滋病毒感染状况和种族/族裔身份之间存在显著的三因素交互作用，表明对于艾滋病毒呈阳性（HIV+）的非裔美国人，逆境与抑郁症状之间存在直接关系，而对于艾滋病毒呈阴性（HIV-）的非裔美国人、HIV+的白种人或HIV-的白种人则不存在这种关系。此外，与HIV-的非裔美国人相比，HIV+的非裔美国人在逆境与抑郁症状之间的关系更为显著，但与其他群体相比则不然。
结论
研究结果表明，HIV+的非裔美国人在逆境中可能面临更高的抑郁症状风险，凸显了在心理健康背景下评估交叉身份/地位的重要性。（PsycINFO数据库记录
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