社会经济流动性与不同 HIV 感染者和非感染者的心理和认知功能。

Socioeconomic Mobility and Psychological and Cognitive Functioning in a Diverse Sample of Adults With and Without HIV.

机构信息

From the Department of Family Medicine (Weissberger), USC Keck School of Medicine, Alhambra, California; Interdisciplinary Department of Social Sciences (Weissberger), Bar Ilan University, Ramat Gan, Israel; Department of Psychology (Núñez, Tureson, Gold, Thames), USC Dornsife College of Letters, Arts, and Sciences; and Department of Psychiatry and Behavioral Sciences (Thames), USC Keck School of Medicine, Los Angeles, California.

出版信息

Psychosom Med. 2021 Apr 1;83(3):218-227. doi: 10.1097/PSY.0000000000000929.

DOI:10.1097/PSY.0000000000000929

PMID:33793453

Abstract

OBJECTIVE

This cross-sectional study examined the effects of socioeconomic status (SES) mobility from childhood to adulthood on psychological and cognitive well-being in African American and non-Hispanic White HIV-positive (HIV+) and HIV-seronegative (HIV-) adults who are part of an ongoing study investigating psychosocial and neurobehavioral effects of HIV.

METHODS

Participants (N = 174, 24.1% female, 59.2% African American, 67.8% HIV+) were categorized into four groups (upward mobility, downward mobility, stable-not-poor, chronic-poverty) based on self-reported childhood and current community SES (which were correlated with objective measures of SES and proxies of childhood SES). SES groups were compared on self-report measures of psychological well-being, subjective executive functioning ratings, and performance across six cognitive domains. Primary analyses were stratified by HIV status.

RESULTS

For the HIV+ group, SES mobility was associated with psychological well-being (chronic burden of stress: F(7,101) = 3.17, mean squared error [MSE] = 49.42, p = .030, η2 = 0.14; depressive symptoms: F(7,101) = 4.46, MSE = 70.49, p = .006,η2 = 0.14), subjective ratings of executive dysfunction (F(7,101) = 6.11, MSE = 114.29, p = .001,η2 = 0.18), and objective performance in executive functioning (F(9,99) = 3.22, MSE = 249.52, p = .030, η2 = 0.15) and learning (F(9,99) = 3.01, MSE = 220.52, p = .034, η2 = 0.13). In the control group, SES mobility was associated with chronic stress burden (F(5,49) = 4.677, p = .025, η2 = 0.15); however, no other relationships between SES mobility and outcomes of interest were observed (all p values > .20). In general, downward mobility and chronic poverty were associated with worse ratings across psychological well-being measures and cognitive performance.

CONCLUSIONS

Findings within the HIV+ group are consistent with previous studies that report downward mobility to be associated with poor psychological outcomes. People living with HIV may be particularly vulnerable to the adverse effects of socioeconomic instability.

摘要

目的

本横断面研究调查了从儿童期到成年期社会经济地位（SES）流动对非裔美国人和非西班牙裔白人 HIV 阳性（HIV+）和 HIV 阴性（HIV-）成年人心理和认知健康的影响，这些成年人是正在进行的研究的一部分，该研究调查了 HIV 对心理社会和神经行为的影响。

方法

参与者（N=174，24.1%为女性，59.2%为非裔美国人，67.8%为 HIV+）根据自我报告的儿童期和当前社区 SES（与 SES 的客观测量和童年 SES 的代表相关），分为四个组（向上流动、向下流动、稳定不穷、长期贫困）。SES 组在自我报告的心理幸福感、主观执行功能评定和六个认知领域的表现方面进行了比较。主要分析按 HIV 状况进行分层。

结果

对于 HIV+组，SES 流动与心理幸福感（慢性压力负担：F(7,101)=3.17，均方误差[MSE]=49.42，p=.030，η2=0.14；抑郁症状：F(7,101)=4.46，MSE=70.49，p=.006，η2=0.14）、主观执行功能障碍评定（F(7,101)=6.11，MSE=114.29，p=.001，η2=0.18）和客观执行功能（F(9,99)=3.22，MSE=249.52，p=.030，η2=0.15）和学习（F(9,99)=3.01，MSE=220.52，p=.034，η2=0.13）有关。在对照组中，SES 流动与慢性压力负担有关（F(5,49)=4.677，p=.025，η2=0.15）；然而，在 SES 流动与感兴趣的结果之间没有观察到其他关系（所有 p 值均大于.20）。一般来说，向下流动和长期贫困与较差的心理健康和认知表现相关。