Linking financial hardship throughout the life-course with psychological distress in old age: Sensitive period, accumulation of risks, and chain of risks hypotheses
Linking financial hardship throughout the life-course with psychological distress in old age: Sensitive period, accumulation of risks, and chain of risks hypotheses
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DOI：
10.1016/j.socscimed.2018.02.012
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发表时间：
2018-03-01
影响因子：
5.4
通讯作者：
Kareholt, Ingemar
中科院分区：
文献类型：
--
作者：
Darin-Mattsson, Alexander;Andel, Ross;Kareholt, Ingemar
主要目标是研究与老年经济困难和心理困扰相关的生命历程假设——敏感期、风险链和风险积累。我们使用了两项基于全国代表性样本的瑞典纵向调查。第一个调查包括18-75岁的人群，多次波动，第二个调查是纵向延续，包括76岁以上的人群。基线分析样本包括 2990 人。在童年时期（回顾性）评估经济困难，平均年龄为 54 岁、61 岁、70 岁和 81 岁。在同一年龄评估心理困扰（自我报告的焦虑和抑郁症状）。使用 WLSMV 估计的路径分析。从童年时期的经济困难到 70 岁时的心理困扰有直接的联系（0.26，p = 0.002）。童年时期的经济困难与基线（54 岁）和以后的心理困扰和经济困难风险增加有关。童年以后的经济困难与 81 岁时的心理困扰并不独立相关。较高的教育水平和就业水平降低了童年时期的经济困难对以后心理困扰和经济困难风险的负面影响。心理困扰和经济困难之间存在双向关系；对健康选择的支持略高于对社会因果关系的支持。我们发现，老年时的心理困扰受到童年时期经济困难的影响，通过一系列风险，包括早年的心理困扰。此外，童年时期的经济困难似乎直接影响老年时的心理困扰，与其他可衡量的情况（即风险链）无关。教育和就业可以减少童年时期不利的经济状况对晚年心理困扰的影响。当在同一模型中包含所有假设的检验时，我们没有发现风险累积的支持。
The primary objective was to investigate the life course hypotheses - sensitive period, chain of risks, and accumulation of risks - in relation to financial hardship and psychological distress in old age. We used two Swedish longitudinal surveys based on nationally representative samples. The first survey includes people 18-75 years old with multiple waves, the second survey is a longitudinal continuation, including people 76 + years old. The analytical sample included 2990 people at baseline. Financial hardship was assessed in childhood (retrospectively), at the mean ages of 54, 61, 70, and 81 years. Psychological distress (self-reported anxiety and depressive symptoms) was assessed at the same ages. Path analysis with WLSMV estimation was used. There was a direct path from financial hardship in childhood to psychological distress at age 70 (0.26, p = 0.002). Financial hardship in childhood was associated with increased risk of psychological distress and financial hardship both at baseline (age 54), and later. Financial hardship, beyond childhood, was not independently associated with psychological distress at age 81. Higher levels of education and employment decreased the negative effects of financial hardship in childhood on the risk of psychological distress and financial hardship later on. There was a bi-directional relationship between psychological distress and financial hardship; support for health selection was slightly higher than for social causation. We found that psychological distress in old age was affected by financial hardship in childhood through a chain of risks that included psychological distress earlier in life. In addition, financial hardship in childhood seemed to directly affect psychological distress in old age, independent of other measured circumstances (i.e., chains of risks). Education and employment could decrease the effect of an adverse financial situation in childhood on later-life psychological distress. We did not find support for accumulation of risks when including tests of all hypotheses in the same model.