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感知人际歧视与老年女性心理健康:跨领域、归因和时间的累积效应。

Perceived Interpersonal Discrimination and Older Women's Mental Health: Accumulation Across Domains, Attributions, and Time.

机构信息

Cathie Marsh Institute for Social Research, University of Manchester, Manchester, United Kingdom.

Department of Social Statistics, School of Social Sciences, University of Manchester, Manchester, United Kingdom.

出版信息

Am J Epidemiol. 2018 May 1;187(5):924-932. doi: 10.1093/aje/kwx326.

Abstract

Experiencing discrimination is associated with poor mental health, but how cumulative experiences of perceived interpersonal discrimination across attributes, domains, and time are associated with mental disorders is still unknown. Using data from the Study of Women's Health Across the Nation (1996-2008), we applied latent class analysis and generalized linear models to estimate the association between cumulative exposure to perceived interpersonal discrimination and older women's mental health. We found 4 classes of perceived interpersonal discrimination, ranging from cumulative exposure to discrimination over attributes, domains, and time to none or minimal reports of discrimination. Women who experienced cumulative perceived interpersonal discrimination over time and across attributes and domains had the highest risk of depression (Center for Epidemiologic Studies Depression Scale score ≥16) compared with women in all other classes. This was true for all women regardless of race/ethnicity, although the type and severity of perceived discrimination differed across racial/ethnic groups. Cumulative exposure to perceived interpersonal discrimination across attributes, domains, and time has an incremental negative long-term association with mental health. Studies that examine exposure to perceived discrimination due to a single attribute in 1 domain or at 1 point in time underestimate the magnitude and complexity of discrimination and its association with health.

摘要

经历歧视与心理健康状况不佳有关,但人们对跨属性、跨领域和跨时间的人际歧视的累积经历如何与精神障碍相关仍不得而知。本研究使用来自全国妇女健康研究(1996-2008 年)的数据,应用潜在类别分析和广义线性模型来估计感知人际歧视的累积暴露与老年妇女心理健康之间的关联。我们发现感知人际歧视有 4 种类型,从跨属性、跨领域和跨时间的歧视累积暴露到几乎没有或没有歧视报告不等。与其他所有类别相比,经历过跨属性、跨领域和跨时间的累积感知人际歧视的女性患抑郁症(流行病学研究中心抑郁量表评分≥16)的风险最高。无论种族/民族如何,这对所有女性都是如此,尽管感知歧视的类型和严重程度在不同种族/民族群体中有所不同。跨属性、跨领域和跨时间的感知人际歧视的累积暴露与心理健康呈负相关。那些仅在单一领域或单一时间点因单一属性而经历歧视的研究,低估了歧视的程度和复杂性及其与健康的关联。

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