Psychological Distress and Mortality: Are Women More Vulnerable?

Abstract

Does psychological distress increase mortality risk? If it does, are women more vulnerable than men to the effect of distress on mortality? Drawing from cumulative disadvantage theory, these questions are addressed with data from a 20-year follow-up of a national sample of adults ages 25−74. Event history analyses were performed to examine mortality from general and specific causes for men and women. Findings reveal that the effect of psychological distress on all-cause mortality was nonlinear for men. Moderate amounts of distress were associated with lower mortality risk, but high levels of distress raised men's mortality risk. Moreover, the curvilinear relationship between distress and mortality varied by cause of death for men and women. Men with high levels of psychological distress were more vulnerable to ischemic heart disease mortality. Women with high levels of distress were more vulnerable to cancer mortality.A wide array of research on mental health has identified adverse consequences of psychological distress. Strain, tenseness, and anxiety, especially when chronically experienced, can shape mind-body relations, thereby accelerating psychosomatic processes. Indeed, some research indicates that psychological distress can raise the risk of premature mortality.The finding that psychological distress is associated with higher mortality risk is well established in clinical samples, but this may be due to the substantially higher rate of suicide and accidental deaths in a clinical sample (Roberts, Kaplan, and Camacho 1990). For community-based samples, the relationship between psychological distress and mortality is more difficult to summarize. This is because some studies show that mortality risk is heightened for distress or depressive symptoms (Mendes de Leon et al. 1998; Somervell et al. 1989), while other studies are unable to find an independent effect on mortality (Fredman et al. 1989;Thomas et al. 1992).The purpose of this research is to identify possible reasons for the inconsistent findings and test hypotheses concerning this seemingly complex relationship. We believe that there are several plausible reasons for the inconsistency in results among previous studies, but we suggest that gender differences are critical to resolving the issue. The present research draws from cumulative disadvantage theory and specifies two questions to guide the analysis: Does

Age, Aging, and Mental Health

“…Moreover, the consequences of psychological distress on physical health and mortality are also often contingent on status strati fi cation (Ferraro & Nuriddin, 2006 ) .…”

Sticks and Stones May Break My Bones: The Effects of Emotional Abuse

“…Other physical conditions with a psychological element, ones that we are only just beginning to understand, such as idiopathic headache, fibromyalgia and irritable bowel syndrome, are also suffered predominantly by women, and are clearly linked to psychosocial risk factors (see Walker et al, 1997 andAli et al, 2000). Some researchers, such as Ferraro & Nuriddin (2006), go further and suggest that women are more likely to suffer health-related consequences due to experiencing childhood psychological stress than men, including higher risk of physical and mental illnesses. Due to such sex differences, biological and genetic models of all the above conditions are compellingly convincing.…”

“…Some give the impression of a difference in the outcomes of childhood experience between men and women, with women at higher risk of developing problems such as alcoholism (Long & Mullen 1994) or eating disorders (Hunt & Espelage, 2005) if they were subjected to psychological maltreatment as children. Ferraro & Nuriddin (2006) accept that this difference is inherent, and that this is the outcome of the accumulation of different experiences, or adaptation to them. This position is not as safe as it would seem however, as many studies demonstrating the effect of abuse on women do not include direct comparisons with male participants.…”

Stress, appraisal and work routine in wartime: do men and women differ?

“…Our research thus addresses the call to consider factors that may explain the conditions under which women may be disadvantaged in terms of stress resilience; as noted by Ferraro and Nuriddin (2006), "caution is needed when attributing residual differences in distress to a disadvantaged group." Researchers are further encouraged to investigate why women, more than men, benefit from such a resilience strategy.…”