An intersectional approach to understandings of mental health inequalities among men with disability
An intersectional approach to understandings of mental health inequalities among men with disability
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DOI：
10.1016/j.ssmph.2019.100464
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发表时间：
2019-12-01
影响因子：
4.7
通讯作者：
Kavanagh, Anne
中科院分区：
文献类型：
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作者：
King, Tania L.;Shields, Marissa;Kavanagh, Anne
残疾是一种重要的社会身份或社会类别，与严重的社会劣势有关。对男子来说，残疾可能与他们的男性身份不一致。自立是男性气质的一个组成部分，已知对残疾男子很重要，但也已知它与更广泛的成年男性人口的不良心理健康结果有关。交叉性方法提供了一种手段，可用来审查残疾人和非残疾人之间自力更生对心理健康的影响可能不同的方式。在12，052名年龄在18-55岁之间的男性样本中，我们使用了效果测量修正（EMM）来检查自力更生改变残疾和抑郁症状之间关系的方式。残疾评估使用华盛顿小组简短的问题集，捕捉功能限制。结果显示，报告更符合自立规范的残疾男性的心理健康状况比自立程度低的非残疾男性差得多，如抑郁症状所测量的（PRR：9.40，95%CI 7.88，11.22，p值< 0.001）。我们发现了抑郁症状的阳性EMM的证据，通过符合添加剂量表上的自立（RERI：2.84，95%CI 1.26，4.42，p值< 0.001）。这些结果提供的证据表明，高度符合自力更生的规范施加了特别有害的影响，男性残疾人的心理健康。鉴于残疾男子更有可能依赖他人的帮助和支持，这些结果为向残疾男子提供服务提供了重要的见解。
Disability is a key social identity or social category that is associated with significant social disadvantage. For men, having a disability can be discordant with their masculine identity. Self-reliance is one component of masculinity that is known to be important to men with disabilities, however it is also known to be associated with adverse mental health outcomes in the broader adult male population. Intersectionality approaches offer a means of examining the way that the effect of self-reliance on mental health might vary between those with and without a disability. Among a sample of 12,052 men aged 18-55 years from the Ten-to-Men study, we used effect measure modification (EMM) to examine the way that self-reliance modifies the relationship between disability and depressive symptoms. Disability was assessed using the Washington Group Short Set of questions, which capture functional limitations. Results showed that men with disabilities who reported higher conformity to self-reliance norms had much worse mental health than non-disabled men with low conformity to self-reliance, as measured in terms of depressive symptoms (PRR: 9.40, 95%CI 7.88, 11.22, p-value< 0.001). We found evidence of positive EMM of depressive symptoms by conformity to self-reliance on the additive scale (RERI: 2.84, 95%CI 1.26, 4.42, p-value< 0.001). These results provide evidence that high conformity to self-reliance norms exerts a particularly damaging effect on the mental health of men with disabilities. Given that men with disabilities are more likely to rely on help and support from others, these results provide important insights for the delivery of services to men with disability.