School of Population Health, The University of New South Wales, Sydney, Australia.
School of Liberal Arts and Social Sciences, Independent University, Dhaka, Bangladesh.
BMC Psychol. 2021 May 16;9(1):80. doi: 10.1186/s40359-021-00587-6.
While there is a growing body of empirical studies focusing on the social and behavioral predictors of psychological health, the mechanisms that may underlie the reported associations have not been adequately explored. This study aimed to examine the association of social and lifestyle factors with psychological distress, and the potential mediating role of the lifestyle factors in the estimated associations between social circumstances and psychological distress.
A total of 742 tertiary level students (53% females) from a range of socio-economic backgrounds and multiple educational institutions participated in this cross-sectional study. The 12-items General Health Questionnaire (GHQ-12) was utilized for measuring psychological distress. Data related to students' socio-demographic characteristics, family social circumstances, and lifestyle factors were also collected. Modified Poisson regression analysis was used to estimate the risk ratios (RR) and their 95% confidence intervals (CI).
The multivariable regression analysis suggests heightened risks of psychological distress associated with low parental Socio-Economic Position (SEP) (RR: 1.36; 95% CI: 1.07, 1.76), childhood poverty (RR: 1.31; 95% CI: 1.11, 1.55), and living away from the family (RR: 1.28; 95% CI: 1.07, 1.54). Among the lifestyle factors, past smoking, physical inactivity, inadequate fruit intake, and poor sleep quality were strongly associated with psychological distress and these associations persisted when the family social circumstances and lifestyle factors were mutually adjusted for. The lifestyle factors did not considerably mediate the estimated associations between family social circumstances and psychological distress.
The social and lifestyle factors operated independently to increase students' risk of psychological distress. Accordingly, while promoting students' healthy lifestyles may reduce the overall burden of psychological distress, any equity initiative aiming to minimize the social inequalities in psychological health should be targeted to improving the living conditions in early life.
虽然越来越多的实证研究关注心理健康的社会和行为预测因素，但尚未充分探讨可能导致这些关联的机制。本研究旨在检验社会和生活方式因素与心理困扰之间的关联，以及生活方式因素在社会环境与心理困扰之间的估计关联中可能发挥的中介作用。
本横断面研究共纳入了来自不同社会经济背景和多所教育机构的 742 名大学生（53%为女性）。使用 12 项一般健康问卷（GHQ-12）来衡量心理困扰。还收集了与学生社会人口特征、家庭社会环境和生活方式因素相关的数据。采用修正泊松回归分析来估计风险比（RR）及其 95%置信区间（CI）。
多变量回归分析表明，与低父母社会经济地位（SEP）（RR：1.36；95%CI：1.07，1.76）、童年贫困（RR：1.31；95%CI：1.11，1.55）和远离家庭（RR：1.28；95%CI：1.07，1.54）相关的心理困扰风险较高。在生活方式因素中，过去吸烟、身体活动不足、水果摄入不足和睡眠质量差与心理困扰密切相关，而当家庭社会环境和生活方式因素相互调整时，这些关联仍然存在。生活方式因素并没有显著中介家庭社会环境与心理困扰之间的估计关联。
社会和生活方式因素独立地增加了学生心理困扰的风险。因此，虽然促进学生健康的生活方式可能会减轻整体心理困扰负担，但任何旨在最小化心理健康社会不平等的公平倡议都应针对改善早期生活条件。
