Burden of psychosocial adversity and vulnerability in middle age: Associations with biobehavioral risk factors and quality of life
Burden of psychosocial adversity and vulnerability in middle age: Associations with biobehavioral risk factors and quality of life
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DOI：
10.1097/01.psy.0000097347.57237.2d
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发表时间：
2003-11-01
影响因子：
3.3
通讯作者：
Marmot, M
中科院分区：
文献类型：
--
作者：
Steptoe, A;Marmot, M
目的：许多心理社会因素与疾病风险有关。这项研究调查了暴露于多种来源的慢性压力和缺乏保护性心理社会资源的组合是否可能与情绪困扰、健康风险行为、生物风险因素和生活质量下降有关，与社会经济地位(SEP)无关。材料和方法：对来自白厅11个流行病学队列的227名年龄在47岁到59岁的男性和女性的数据进行了分析。心理社会逆境和脆弱指数(PAVIX)由工作需求、邻里压力、经济压力、低情感支持、有限的社会网络、低积极应对和低控制感的高分构成。结果：构成PAVIX的各项指标相对独立。低SEP参与者的PAVIX得分更高，单身、分居或离婚的参与者比已婚参与者更高。PAVIX与心理困扰、抑郁、绝望、睡眠问题、敌意、自卑和孤独感呈正相关，与年龄、性别、SEP和婚姻状况无关。与健康行为没有关联，但观察到与糖化血红蛋白、血浆纤维蛋白原、血浆粘度和体重(女性)的关系，这些也是独立于协变量的。PAVIX得分高的个人也报告了与健康相关的生活质量受损。讨论：累积的生活压力负担加上有限的保护性心理社会资源与不良的心理、生物和生活质量结果相关。这种调查心理社会因素的综合方法可能被证明对理解病因过程很有价值。
Objectives: Numerous psychosocial factors are associated with disease risk. This study investigated the possibility that a combination of chronic stress from exposure to multiple sources and absence of protective psychosocial resources would be related to heightened emotional distress, health risk behavior, biological risk factors, and impaired quality of life, independently of socioeconomic position (SEP). Materials and Methods: Data were analyzed from 227 men and women aged 47 to 59 years from the Whitehall 11 epidemiological cohort. A psychosocial adversity and vulnerability index (PAVIX) was constructed from high scores on measures of job demands, neighborhood stress, and financial strain, low emotional support, limited social networks, low active coping, and low sense of control. Results: The measures making up the PAVIX were relatively independent of one another. Scores on the PAVIX were greater in lower SEP participants, and in single, separated, or divorced than married participants. The PAVIX was positively associated with psychological distress, depression, hopelessness, sleep problems, hostility, low self-esteem and loneliness, independently of age, sex, SEP, and marital status. There were no associations with health behaviors, but relationships were observed with glycohemoglobin, plasma fibrinogen, plasma viscosity, and body mass (women), that were again independent of covariates. Individuals with high PAVIX scores also reported impaired health-related quality of life. Discussion: The accumulated burden of life stress coupled with limited protective psychosocial resources is associated with adverse psychological, biological, and quality of life outcomes. This integrated approach to the investigation of psychosocial factors may prove valuable in understanding etiological processes.