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In this article, the authors evaluate the possible roles of negative emotions and cognitions in the association between socioeconomic status (SES) and physical health, focusing on the outcomes of cardiovascular diseases and all-cause mortality. After reviewing the limited direct evidence, the authors examine indirect evidence showing that (a) SES r...

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Background Worldwide, socioeconomic differences in health and use of healthcare resources have been reported, even in countries providing universal healthcare coverage. However, it is unclear how large these socioeconomic differences are for different types of care and to what extent health status plays a role. Therefore, our aim was to examine to...
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Observational research suggests subordinate social status is associated with negative mental and physical health outcomes. However, observational studies have limitations, including confounding of social status with other factors, limited ability to infer causality, and difficulty of obtaining detailed affective and physiologic data. This study use...
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The importance of socioeconomic status (SES) for psychological functioning over the life span is increasingly acknowledged in psychological research. The Reserve Capacity Model by Gallo and Matthews (2003) suggests that SES is not only linked to physical health but also to the experience of positive and negative emotions. Moreover, due to different...
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Background Discrimination is a well-established stressor that is substantially associated with poor health and a known contributor to health inequalities. However, the role of discrimination in health service use is less explored. This study will take an intersectional approach to investigate differences in health service use and examine the role o...

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... We replicated some previous findings on the effects of sex and education over ER and ToM. Available evidence suggests an association between socioeconomic status (which is determined by education level, among other variables such as income) and emotion regulation ability, both among children (Brooks-Gunn, Duncan, Leventhal & Aber, 1997;Gersh, Aber & Raver, 2003;McLoyd, 1998) and adults (Singh & Shankar, 2013; for a review see Gallo & Mathews, 2003), although some studies have not observed this (Eisenberg & Spinrad, 2004). In our study, we found that participants who attained university education level experienced less emotional regulation difficulties than those with secondary education, although the magnitude of this effect was rather small. ...
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Theory of Mind is a construct closely related to the cognitive aspect of human empathy, which refers to the ability to represent and interpret mental states in others. The term Emotion Regulation includes all processes aimed to modulate the intensity and duration of different aspects of emotional experience. Clinical evidence suggests that theory of mind alterations and emotion regulation difficulties co-occur in several psychiatric disorders. In addition, it has been suggested that both abilities might be developmentally related, with theory of mind deficits leading to emotional dysregulation. The present study is the first to examine the associations between performance in a theory of mind experimental task (the “Reading the Mind in the Eyes” test) and Difficulties in Emotion Regulation Scale scores, in a non-clinical sample of argentinean adults. We found small, but significant associations between Theory of Mind and Emotion Regulation, indicating that those subjects with higher Theory of Mind scores were better at inhibiting impulsive reactions and identifying their own emotions. In addition, these associations were indepedent of sex, age and education level. These results are congruent (although they do not confirm) with the hypothesis of a developmental link between Theory of Mind and Emotion Regulation.
... To address the knowledge gaps outlined above, the Reserve Capacity Model proposed by Gallo and Matthews [24,26] served as our theoretical premise for focusing on a comprehensive array of intrapersonal factors, interpersonal factors, and stressors previously proposed to be relevant to Hispanic/Latino health. The Reserve Capacity Model was developed in light of debate on the existence of a "Hispanic Paradox," i.e., incongruent evidence showing that Hispanic/Latinos have better than expected health outcomes (mainly, lower burden of cardiovascular disease [CVD]) and higher life expectancy given their disproportionate exposure to adverse social circumstances (e.g., low socioeconomic status, immigration related stressors, and inadequate access to health care). ...
... To our knowledge, this is the most comprehensive examination of the associations of psychosocial factors with cognitive function among a large sample of diverse middle-aged and older Hispanics/Latinos. Guided by the Reserve Capacity Model [24,26], this study contributes to the literature in several ways. First, we extend results from previous studies conducted predominantly among older non-Hispanics Whites and Blacks to demonstrate that greater purpose in life [3,4], higher social support [9][10][11], and lower loneliness [14][15][16][17] are each associated with better global cognitive function among middle-aged and older Hispanics/Latinos regardless of adjustments. ...
... Guided by the Reserve Capacity Model [24,26] and using data from the landmark HCHS/SOL and its Sociocultural Ancillary Study, the present study addresses gaps in the literature on the associations of psychosocial factors with cognitive function among middleaged and older Hispanics/Latinos. Intrapersonal factors, interpersonal factors, and social stressors had differential relationships with individual cognitive tests; however, purpose in life and social support were associated with cognition across all cognitive test measures and regardless of adjustments. ...
Article
Background: Evidence suggests that psychosocial factors are associated with cognitive health in older adults; however, associations of psychosocial factors with cognition remain largely unexamined in middle-aged and older Hispanics/Latinos. Objective: To examine the cross-sectional associations of psychosocial factors with cognitive function among middle-aged and older Hispanics/Latinos living in the US. Methods: Baseline (2008-2011) data from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (n = 2,818; ages 45-74) were used to examine the associations of each psychosocial factor with global cognition (GC), verbal learning, verbal memory, verbal fluency, and processing speed independent of age, sex, education, Hispanic/Latino background, income, language, and depressive symptoms. Psychosocial variables included: intrapersonal factors (ethnic identity, optimism, and purpose in life), interpersonal factors (family cohesion, familism, social network embeddedness, and social support), and social stressors (perceived ethnic discrimination, loneliness, and subjective social status). Results: In fully-adjusted models, purpose in life and social support were each positively associated with all five cognitive variables. Loneliness was negatively associated with GC, verbal learning, memory, and processing speed. Ethnic identity was positively and familism negatively associated with GC, verbal fluency, and processing speed. Family cohesion was positively associated with verbal learning. Conclusion: These findings extend previous evidence from older, largely non-Hispanic White cohorts to show that higher purpose in life and social support are also strongly associated with cognitive health among middle-aged and older Hispanics/Latinos. We also highlight that intrapersonal factors, interpersonal factors, and social stressors have differential relationships with individual cognitive tests.
... Research reveals social disadvantages as well: compared to their working-class and more affluent peers, the poor report greater social isolation, fewer ties to potential sources of social support (e.g., family and friends), and more frequent experiences of interpersonal conflict (Mickelson & Kubzansky, 2003;Stephens, Cameron, & Townsend, 2014). Perhaps as a consequence, individuals with lower SES experience lower levels of subjective well-being (Luhmann, Murdoch, & Hawkley, 2014), more frequent experiences of sadness (Kushlev, Dunn, & Lucas, 2015), and heightened emotional reactivity to daily events (Gallo & Matthews, 2003), all of which can interfere with the effective stress management. ...
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The ways that couples form and manage their intimate relationships at higher and lower levels of socioeconomic status (SES) have been diverging steadily over the past several decades. At higher SES levels, couples postpone marriage and childbirth to invest in education and careers, but they eventually marry at high rates and have relatively low risk for divorce. At lower SES levels, couples are more likely to cohabit and give birth prior to marriage and less likely to marry at all. This review examines how SES comes to be associated with the formation, development, and dissolution of intimate relationships. Overall, research has highlighted how a couple's socioeconomic context facilitates some choices and constrains others, resulting in different capacities for relationship maintenance and different adaptive mating strategies for more and less advantaged couples. A generalizable relationship science requires research that acknowledges these differences and one that recruits, describes, and attends to socioeconomic diversity across couples. Expected final online publication date for the Annual Review of Psychology, Volume 72 is January 4, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
... A wealth of research has demonstrated that people with a lower SES have worse health outcomes than their higher SES counterparts, including elevated inflammation (e.g., Jousilahti, Salomaa, Rasi, Vahtera, & Palosuo, 2003;and Singh-Manoux, Marmot, & Adler, 2005). The reserve capacity model offers a theoretical framework for understanding these SES disparities (Gallo & Matthews, 2003). According to the model, people with a lower SES are disproportionately exposed to stressful or dangerous environments, like low-paying jobs and violent neighborhoods. ...
... According to the model, people with a lower SES are disproportionately exposed to stressful or dangerous environments, like low-paying jobs and violent neighborhoods. Being in these situations causes people with a lower SES to have a reduced "reserve capacity" (i.e., reduced interpersonal or intrapersonal resources) to cope with stress (Gallo & Matthews, 2003). Consistent with this argument, people with a lower SES have smaller social networks (an interpersonal resource) than their higher SES counterparts (Ajrouch, Blandon, & Antonucci, 2005). ...
... Similarly, a metaanalysis demonstrated that people with a lower SES have lower self-esteem (an intrapersonal resource) than those with a higher SES (Twenge & Campbell, 2002). Being a person with low SES and a reduced reserved capacity then leads to increased negative emotions and cognitions, including depression, hopelessness, anxiety, and hostility (Gallo & Matthews, 2003). ...
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Poor quality romantic relationships increase risk for health problems; elevated systemic inflammation is one promising underlying mechanism. This registered report utilized data from three publicly available data sets with large sample sizes (Add Health, MIDUS, NSHAP) to test this possibility. An internal meta‐analysis across all three studies determined that romantic relationship distress was unrelated to inflammation (assessed via C‐reactive protein levels). In addition, this link was not moderated by gender, socioeconomic status (SES), or the combination of gender and SES.
... Americans are sharply divided along class lines. There are wide class-based disparities in family structure, parenting strategies, religiosity, incarceration rates, and health outcomes (Lipset 1959;Gallo and Matthews 2003;Cherlin 2014;Putnam 2015;Fiske and Markus 2012). Class shapes all facets of social life. ...
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In this paper, I assess how social class influenced white vote choice in the 2016 U.S. presidential election. I use 2016 ANES data to create a measure of class that is based on an individual’s income, education, occupation, and wealth. I then use a structural equation model to show that an individual’s social class both directly and indirectly shaped vote choice. I demonstrate that low class standing was a significant predictor of support for Trump in the general election. I also show that social class exerted an indirect effect. Lower class standing is associated with higher levels of racial resentment and authoritarianism, which were in turn strong predictors vote choice. I conclude that social class was one of the primary determinants of white vote choice.
... The role of psychosocial factors in understanding socio-economic health inequalities can be further elucidated with the reserve capacity model [5]. Research suggests that lower socio-economic status is associated with greater exposure to negative life events and stressful situations. ...
... At the same time, individuals with lower socio-economic status have fewer resources to handle such situations, both because they are exposed to more situations where they must use their resources and because their environment prevents the development of new resources. This leaves people with lower socio-economic status more vulnerable to negative emotions and cognitions and thus also to mood disorders such as anxiety and depression [5]. ...
... The educational inequality in patient-rated physical and mental health, as well as quality of life, could reflect the higher co-morbidity burden found in the lower educational groups. It could also be explained by larger exposure to stressful events and lack of resources to handle these among the less educated groups [5]. ...
Article
Aims: This study aimed to explore whether educational level is associated with mental and physical health status, anxiety and depression symptoms and quality of life at hospital discharge and predicts cardiac events and all-cause mortality 1 year after hospital discharge in patients with ischaemic heart disease, arrhythmias, heart failure or heart valve disease. Methods: The DenHeart survey is cross-sectional and combined with data from national registers. Information on educational level and co-morbidity at hospital discharge and cardiac events and mortality 1-year post-discharge was obtained from registers. Patient-reported outcomes included SF-12, Hospital Anxiety and Depression Scale and HeartQoL. Multivariate linear and logistic regression and Cox proportional hazards regression models were used. Results: A total of 13,145 patients were included. A significant educational gradient was found in patient-reported mental and physical health status, anxiety and depression symptoms and quality of life, with lower educational groups reporting worse outcomes in adjusted analyses. No association was found between educational level and risk of cardiac events or all-cause mortality within 1 year after hospital discharge in adjusted analyses. Conclusions: In a large population of patients with cardiac disease a significant educational gradient was found in mental and physical health and quality of life at hospital discharge. There was, however, no association between educational level and risk of cardiac events or mortality 1 year after hospital discharge.
... В большинстве концептуальных моделей рассматриваются два возможных психологических механизма трансформации социально-экономической стратификации в неравенства в здоровье. Первый -механизм психологической депривации, фокусирующий внимание на неодинаковой подверженности людей стрессовым воздействиям, депрессии, негативным эмоциям -тревожности, враждебности, злобе, усиливающимся с понижением социально-экономического статуса; [28] и второй -механизм психологической адаптации, подчеркивающий позитивную роль психологических ресурсов личности, помогающих человеку справляться с трудностями жизни и способных служить защитой от стрессовых воздействий, однако неравномерно распределенных по ступеням социальной лестницы. Снижение статуса сопровождается ростом дефицита таких ресурсов -повышением вероятности того, что человек потеряет уверенность в возможности изменения жизни к лучшему, в своей способности контролировать происходящее, в своих силах, в своем «я» [29]. ...
... Кроме того, они могут отчасти служить объяснением социально-структурных неравенств в распространенности этих видов патологий [37; 39]. Как подтверждено исследованиями, низкому социально-экономическому статусу соответствует большее количество негативных событий жизни и более высокие стрессовые нагрузки [40; 41], установлено также, что с понижением социально-экономического статуса повышается вероятность развития дистресса, проявлений тревожности, симптомов депрессии, враждебности и злобы [28]. Все это косвенным образом указывает на возможность выполнения факторами стресса и дистресса медиативных функций во влиянии социально-экономического статуса на здоровье, заболеваемость и смертность. ...
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Psychological resources of the individual are an important factor of keeping health. Having such psychological features as awareness of their ability to control the life circumstances, a positive perception of themselves and belief in their own strength, self-esteem, optimistic view in the future, have a direct positive impact on the physical and psychological state of a person, promote healthy lifestyles, equip with the ability to cope struggles and reduce stress influence to health. The availability of such psychological resources and their reserve is especially important for people suffering from socially significant chronic diseases accompanied by physical and functional limitations, violations of psychological and social adaptation. However, according to numerous studies, in socially disadvantaged groups of the population – poorly educated, employed in the least prestigious and low-paid jobs with low incomes, together with high risks of morbidity and premature mortality from chronic diseases, there are low rates of psychological resistance due to a shortage of psychological resources. The study of the relationship between social status and individual psychological resources, which affect the health of different social strata’s representatives, allowed us to identify two main approaches. Within the framework of one approach, psychological features are considered to be a product of the structural conditions that determine the inequalities of their distribution in society. The deficit of psychological resources that experienced by representatives of socially vulnerable groups is consider to be contributing the negative impact of low socio-economic status on health and acts as one of the mediating mechanism for the transformation of socio-economic differences into inequalities in health. Another approach emphasizes the role of the person in changing the life circumstances, including those of them that are caused by the adverse effects of low socio-economic status. In this case, attention is focused not so much on the differences in the psychological reserves of individuals who occupy different positions in the socio-economic stratification, as on their variability within one social level. Empirical studies confirm that especially among the socially disadvantaged groups, individuals characterized by greater reserve of positive psychological properties, demonstrate significantly better health compared to those fellow citizens who are deprived of this reserve. In the literature, this phenomenon designates as a" buffer" effect, contributing to the reduction of negative health consequences of low status, and, consequently, to the reduction of socio-structural inequalities in health. In developed European countries, where government guarantees allow lower social strata to maintain self-esteem, confidence in the future and optimism, psychological resources lose their role as a mediator between socio-economic status and health and can lead to a buffer reduction of structural inequalities. In the less developed countries of Europe and in Russia, where public health and education programs do not allow people from the lower strata to maintain psychological stability, structural differences in the risks of chronic diseases and premature mortality persist.
... Higher SES not only promotes such skills, but also places a person in the setting with other optimistic persons of similar SES, which reinforces and validates their own optimistic perspective. By contrast, a lower SES person may suppress optimistic tendencies because these individuals (often minority groups) encounter more stressful environments that provide fewer resources to cope with and combat such challenges (Gallo and Matthews, 2003;Boehm et al., 2015). Positive coping may also affect sex differences in optimism in the current study. ...
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Little research has examined associations of positive psychosocial factors with the American Heart Association Life's Simple 7™ (LS7) among African Americans. This study examined the associations between positive optimistic orientation and LS7 among African Americans. Using exam 1 data (2000-2004) from the Jackson Heart Study, we examined cross-sectional associations of optimism (in tertiles) with LS7 components [smoking, physical activity, diet, body mass index, blood pressure, cholesterol, glucose] and a composite LS7 score (classified as poor, intermediate, ideal) among 4734 African Americans free of cardiovascular disease. Multivariable prevalence regression was used to estimate prevalence ratios (PR, 95% confidence interval-CI) of intermediate and ideal (vs. poor) individual LS7 components and composite LS7 score by optimism levels, adjusting for demographics, socioeconomic status, and depressive symptoms. For LS7 components with low prevalence, we estimated odds ratios. A greater percentage of participants with high vs. low optimism were younger, female, high SES, and not depressed. After full covariate adjustment, the prevalence ratio of ideal (vs. poor) composite LS7 score was 1.24 for participants who reported high (vs. low) optimism (95% CI 1.09-1.42) at exam 1. Higher levels of optimism were also associated with greater prevalence of ideal (vs. poor) physical activity and smoking. Promoting positive optimistic orientation may be an important step toward increasing the likelihood of achieving optimal cardiovascular health among African Americans.
... Socially and behaviorally, socioeconomically disadvantaged patients and those who lack sufficient sleep have poorer post-operative outcomes. 4,6,31 Moreover, depressed patients demonstrate adverse behavioral changes as poor hygiene, altered nutrition, and lack of adherence to medication, all of which exacerbate negative outcomes. 6,14 Therefore, appropriate management of pre-and post-operative depression is necessary. ...
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Purpose: Coronary artery bypass graft surgery (CABG) is a common and remarkably effective treatment for coronary heart disease, improving health status and enhancing quality of life. However, some outcomes after surgery remain unexplained, including psychological factors such as depression. The prevalence rates of pre- and post-operative depression among CABG patients are high, which is associated with negative short- and long-term outcomes. This study explores the impacts of pre-operative depressive symptoms on post-operative hospital length of stay (LOS) among patients undergoing CABG in Jordan. Patients and methods: This was a non-experimental, prospective observational study among 227 CABG patients recruited from 5 hospitals in Amman, Jordan. Depression was measured within an average of two weeks prior and one month after the operation using the Hospital Anxiety and Depression Scale. Length of stay was abstracted from medical records after discharge. Results: The average post-operative LOS was 11.40±10.41 days. The average pre-operative depression level was moderate; 12.76±6.80 and 42.47% complained of varying levels of depressive symptoms. The average post-operative depression level was moderate; 11.11±6.78 and 40.53% complained of varying levels of depressive symptoms. In stepwise regression models, depression scores and female gender were independent predictors that increased post-operative LOS. On the other hand, high income (≥1501$/month) and use of statins had protective effects and decreased post-operative LOS. The model explained 22.4% of the total variance regarding LOS. Conclusion: Pre-operative depressive symptoms increased post CABG LOS. Application of policies and depression assessment protocols prior to CABG by health care providers can identify high-risk groups (eg, females), so appropriate interventions can be designed and implemented to decrease morbidity and mortality.
... As such, family SES has potential effects on an individuals' physical and mental development and may exert a influence on GSE and CT in the long term. Previous studies have suggested that low family SES increased the risk of stress/adversity exposures, including traumatic life events, chronic stress, perceived stress, and daily hassles (Gallo et al., 2005;Hatch and Dohrenwend, 2007), which fosters negative emotions and psychological distress, such as anxiety, depressive symptoms, psychological disorders, hostile cognition, and anger (Gallo and Matthews, 2003). Additionally, individuals from lower SES families generally have fewer tangible/interpersonal resources and intrapersonal relationships to cope with stressful events when they are exposed to situations in which the utilization of resources is obligatorily required. ...
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Background: Critical thinking (CT) is an essential competence for medical students. Family socioeconomic status (family SES) and general self-efficacy (GSE) play crucial roles in the development of CT. However, the association among family SES, GSE, and CT in Chinese medical students has yet to be fully investigated. Objectives: To investigate the role of family SES and GSE in the development of CT in Chinese medical students. Methods: 1,338 medical students were recruited using multistage stratified cluster sampling from three institutions in China. The Chinese critical thinking disposition inventory (CTDI-CV), General Self-Efficacy Scale (GSES), and a self-made inventory assessing family SES were administered to collect data. The relationship between CT and family SES as well as GSE was evaluated by structural equation modeling. Results: Students of higher family SES obtained higher CTDI-CV and GSES scores. A positive correlation was found between family SES and CT (r = 0.101–0.141, p < 0.05 or p < 0.01), as well as between family SES and GSE (r = 0.111–0.129, p < 0.01). Moreover, GSE was moderately correlated with CT (r = 0.418, p < 0.01). The model of partial mediate effect of GSE showed the best fit index with X² = 29.698, df = 9 and X²/df = 3.300, NFI = 0.990, IFI = 0.993, TLI = 0.984, CFI = 0.993, RMSEA = 0.041. Conclusion: Family SES has a positive albeit limited influence on GSE and CT in Chinese medical students. GSE mediates the effect of family SES on CT and plays a larger role. Enhancing medical student’ GSE maybe an efficacious way to improve medical students’ CT.