The Association Between Income and Distress, Mental Disorders, and Suicidal Ideation and Attempts

McMillan, Katherine A.; Enns, Murray W.; Asmundson, Gordon J. G.; Sareen, Jitender

doi:10.4088/jcp.08m04986gry

Cited by 86 publications

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“…There has been a growing research focus on the relationship between socioeconomic factors (including low income) and psychopathology generally [6], as well as with suicide more specifically [11,10]. Such research has explored how different theories account for the relationship between low income and psychiatric illness.…”

Section: Discussionmentioning

confidence: 99%

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Explaining the income and suicidality relationship: income rank is more strongly associated with suicidal thoughts and attempts than income

Wetherall

Daly

Robb

et al. 2015

Soc Psychiatry Psychiatr Epidemiol

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Connor, R. C. (2015) Explaining the income and suicidality relationship: income rank is more strongly associated with suicidal thoughts and attempts than income. Social Psychiatry and Psychiatric Epidemiology, 50(6) and sex by education by region). Along with absolute income and demographic covariates, these variables were tested for associations with suicidal thoughts and attempts, both across the lifetime and in the past year.Results. Absolute income was associated with suicidal thoughts and attempts, both across the lifetime and in the past year. However, when income rank within the four comparison groups was regressed on lifetime suicidal thoughts and actions, only income rank remained significant and therefore accounted for this relationship. A similar result was found for suicidal thoughts within the past year although the pattern was less clear for suicide attempts in the past year.Conclusions. Social position, rather than absolute income, may be more important in understanding suicidal thoughts and attempts. This suggests that it may be psychosocial rather than material factors that explain the relationship between income and suicidal outcomes.

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Section: Discussionmentioning

confidence: 99%

“…Indeed, international evidence has highlighted that low income is an important factor in understanding suicide across countries as diverse as Sweden, the USA, and China [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Explaining the income and suicidality relationship: income rank is more strongly associated with suicidal thoughts and attempts than income

Wetherall

Daly

Robb

et al. 2015

Soc Psychiatry Psychiatr Epidemiol

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“…64 Tackling these factors will shift the population distributions of experienced probabilities of and vulnerabilities to threats, and thus ought to have population-level benefits regarding lower rates of anxiety. 47 Higher probability and vulnerability: low socioeconomic position characterized by more bad events, and fewer resources to cope with them when they occur Injuries or disabilities causing loss of physical mobility associated with increased anxiety (and this seems to be independent of the association between depression and physical conditions 48 ) Cano et al, 49 Suh et al, 50 Lenze et al, 51 and Bellin et al 52 Higher vulnerability: loss of mobility reduces people's ability to deal with threatening situations…”

Section: Implications For Therapymentioning

confidence: 99%

Anxiety: An Evolutionary Approach

2011

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Anxiety disorders are among the most common mental illnesses, with huge attendant suffering. Current treatments are not universally effective, suggesting that a deeper understanding of the causes of anxiety is needed. To understand anxiety disorders better, it is first necessary to understand the normal anxiety response. This entails considering its evolutionary function as well as the mechanisms underlying it. We argue that the function of the human anxiety response, and homologues in other species, is to prepare the individual to detect and deal with threats. We use a signal detection framework to show that the threshold for expressing the anxiety response ought to vary with the probability of threats occurring, and the individual's vulnerability to them if they do occur. These predictions are consistent with major patterns in the epidemiology of anxiety. Implications for research and treatment are discussed. Can J Psychiatry. 2011;56(12):707-715. Clinical Implications• Understanding the evolved function of the anxiety response can aid in understanding why people's propensity to become anxious varies with their life circumstances and developmental history.• Theory predicts that the threshold for mounting an anxiety response should depend on the probability of dangerous events occurring in the current environment, and the vulnerability of the person to those events should they occur. Numerous epidemiologic findings relating to anxiety disorders can be integrated within this framework. Limitations• The evolutionary criteria for when a mechanism is functioning adaptively are different from the criteria for identifying when a psychiatric disorder is present.• Evolutionary thinking has not yet been used to develop new treatment strategies for anxiety disorders, although it may aid in understanding why existing ones are effective. Key Words: anxiety, anxiety disorders, emotions, signal detection theory, behavioural ecology, evolutionary medicineIt is not informative to study variations of behaviour unless we know beforehand the norm from which the variants depart. 1, p 109A nxiety disorders are among the most common mental illnesses, with huge attendant quality of life and financial costs. For example, during 12 months in [2001][2002]4.6% of Canadians had symptoms meeting DSM-IV diagnostic criteria for an anxiety disorder, 2 and, during the course of their lifetimes, around 28.8% of Americans are estimated to be affected. 3 Although treatments for anxiety exist, these currently have limited efficacy. For example, for GAD, antidepressants, though more effective than placebo, have a number needed to treat of 5.54, meaning nearly 6 patients need to be treated with the drugs to produce 1 more clinically significant symptomatic improvement than placebo.4 Only around 46% of GAD patients show a clinically significant response to psychological therapy. 5 The pervasiveness of anxiety disorders and their resistance to treatment suggest a need for a deeper understanding of the sources of anxiety. We argue that to make some pro...

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“…The association between income and mental illness and the problem with reverse causality is well-known in the literature (Lorant et al, 2003;Johnson and Krueger, 2006;McMillan et al, 2010;National Center for Health Statistics, 2011;Sareen et al, 2011). This is the first study, to my knowledge, that addresses the problem of identification of the causal effect of income on the incidence of mood disorders in a large U.S. sample.…”

Section: Discussionmentioning

confidence: 99%

Negative emotions, income, and welfare: Causal estimates from the PSID

Clingingsmith

2016

Journal of Economic Behavior & Organization

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I use instrumental variables to estimate the causal effect of family income on the frequency with which individuals experience negative emotions. Doubling income reduces the experience of negative emotions by 0.26 SD on average. Percentage changes in income have a constant effect on negative emotion for family incomes below $80,000. Above $80,000, the effect of percentage changes declines, reaching zero at $200,000. A dollar change in family income has an eight times larger effect at the 20 th percentile of income than the 80 th percentile. Effects of income are similar on the high levels of negative emotion characteristic of mental illness, except there is no satiation.

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The Association Between Income and Distress, Mental Disorders, and Suicidal Ideation and Attempts

Abstract: Although conclusions cannot be drawn concerning causation, the strength of associations between income, suicidal ideation, suicide attempts, and substance abuse points to the need for secondary prevention strategies among low-income, high-risk populations.

Cited by 86 publications

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Explaining the income and suicidality relationship: income rank is more strongly associated with suicidal thoughts and attempts than income

Explaining the income and suicidality relationship: income rank is more strongly associated with suicidal thoughts and attempts than income

Anxiety: An Evolutionary Approach

Negative emotions, income, and welfare: Causal estimates from the PSID

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