Aitken Zoe, Krnjacki Lauren, Kavanagh Anne Marie, LaMontagne Anthony Daniel, Milner Allison
Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3010, Australia.
Centre for Population Health Research, School of Health and Social Development, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2017 Oct;52(10):1247-1255. doi: 10.1007/s00127-017-1418-5. Epub 2017 Jul 4.
Disability acquisition in adulthood is associated with deterioration in mental health. Social support may act as a "buffer" against poor mental health following disability acquisition. We tested the hypothesis that women and men with low social support experienced larger declines in mental health on acquisition of a disability compared to women and men with high social support.
We assessed whether social support, measured both prior and subsequent to disability acquisition, modified the association between disability acquisition and mental health using 14 annual waves of data from the Household, Income and Labour Dynamics in Australia Survey. Participants reported at least two consecutive waves of disability preceded by at least two consecutive waves without disability (2200 participants, 15,724 observations). Fixed-effects linear regression models were used to estimate average differences in mental health between waves with and without disability, for women and men separately. We tested for effect measure modification of the association by social support, including a three-way interaction between disability and social support prior and subsequent to disability acquisition.
Though the effects of disability acquisition on mental health were much larger for women, for both women and men there was a consistent pattern of association with social support. There was evidence that social support modified the association between disability acquisition and mental health, with the largest effects for those experiencing a change from high to low social support subsequent to disability and for people with consistently low social support.
These findings highlight the importance of developing new policy and practice strategies to improve the mental health of people with disabilities, including interventions to promote social support at the time of disability acquisition.
成年后获得残疾与心理健康恶化相关。社会支持可能作为获得残疾后心理健康不佳的一种“缓冲”。我们检验了这样一个假设，即与社会支持高的男性和女性相比，社会支持低的男性和女性在获得残疾后心理健康下降幅度更大。
我们利用澳大利亚家庭、收入和劳动力动态调查的14年年度数据，评估了在获得残疾之前和之后测量的社会支持是否改变了获得残疾与心理健康之间的关联。参与者报告在至少连续两波无残疾之前至少有连续两波残疾（2200名参与者，15724次观察）。固定效应线性回归模型分别用于估计有残疾和无残疾波次之间女性和男性心理健康的平均差异。我们检验了社会支持对关联效应量的修正，包括残疾与获得残疾之前和之后的社会支持之间的三向交互作用。
尽管获得残疾对女性心理健康的影响要大得多，但对男性和女性来说，与社会支持的关联模式是一致的。有证据表明社会支持改变了获得残疾与心理健康之间的关联，对那些在残疾后社会支持从高到低变化的人和社会支持一直较低的人影响最大。
这些发现凸显了制定新的政策和实践策略以改善残疾人心理健康的重要性，包括在获得残疾时促进社会支持的干预措施。
