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      Life Course Pathways of Adversities Linking Adolescent Socioeconomic Circumstances and Functional Somatic Symptoms in Mid-Adulthood: A Path Analysis Study

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          Abstract

          While research examining the health impact of early socioeconomic conditions suggests that effects may exist independently of or jointly with adult socioeconomic position, studies exploring other potential pathways are few. Following a chain of risk life course model, this prospective study seeks to examine whether pathways of occupational class as well as material and social adversities across the life course link socioeconomic disadvantage in adolescent to functional somatic symptoms in mid-adulthood. Applying path analysis, a multiple mediator model was assessed using prospective data collected during 26 years through the Northern Swedish Cohort. The sample contained 987 individuals residing in the municipality of Luleå, Sweden, who participated in questionnaire surveys at age 16, 21, 30 and 42. Socioeconomic conditions (high/low) in adolescence (age 16) were operationalized using the occupation of the parents, while occupational class in adulthood (manual/non-manual) was measured using the participant’s own occupation at age 21 and 30. The adversity measurements were constructed as separate age specific parcels at age 21 and 30. Social adversity included items pertaining to stressful life events that could potentially harm salient relationships, while material adversity was operationalized using items concerning unfavorable financial and material circumstances. Functional somatic symptoms at age 42 was a summary measure of self-reported physical symptoms, palpitation and sleeping difficulties that had occurred during the last 12 months. An association between socioeconomic conditions at age 16 and functional somatic symptoms at age 42 ( r = 0.068) which was partially explained by people’s own occupational class at age 21 and then material as well as social adversity at age 30 was revealed. Rather than proposing a direct and independent health effect of the socioeconomic conditions of the family, the present study suggests that growing up in an unfavorable socioeconomic environment might be a source for a chain of adverse material and social living situations, which in turn affects adult health.

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          Inventorying stressful life events as risk factors for psychopathology: Toward resolution of the problem of intracategory variability.

          An explosion of research on life events has occurred since the publication of the Holmes and Rahe checklist in 1967. Despite criticism, especially of their use in research on psychopathology, such economical inventories have remained dominant. Most of the problems of reliability and validity with traditional inventories can be traced to the intracategory variability of actual events reported in their broad checklist categories. The purposes of this review are, first, to examine how this problem has been addressed within the tradition of economical checklist approaches; second, to determine how it has been dealt with by far less widely used and far less economical labor-intensive interview and narrative-rating approaches; and, third, to assess the prospects for relatively economical, as well as reliable and valid, solutions. Copyright 2006 APA, all rights reserved.
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            Stress, life events, and socioeconomic disparities in health: results from the Americans' Changing Lives Study.

            It has been hypothesized that exposure to stress and negative life events is related to poor health outcomes, and that differential exposure to stress plays a role in socioeconomic disparities in health. Data from three waves of the Americans' Changing Lives study (n = 3,617) were analyzed to investigate prospectively the relationship among socioeconomic indicators, five measures of stress/negative life events, and the health outcomes of mortality, functional limitations, and self-rated health. The results revealed that (1) life events and other types of stressors are clearly related to socioeconomic position; (2) a count of negative lifetime events was positively associated with mortality; (3) a higher score on a financial stress scale was predictive of severe/moderate functional limitations and fair/poor self-rated health at wave 3; and (4) a higher score on a parental stress scale was predictive of fair/poor self-rated health at wave 3. The negative effects of low income on functional limitations attenuated to insignificance when waves 1 and 2 stress/life event measures were controlled for, but other socioeconomic disparities in health change remained sizable and significant when adjusted for exposure to stressors. The results support the hypothesis that differential exposure to stress and negative life events is one of many ways in which socioeconomic inequalities in health are produced in society.
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              Manifest variable path analysis: potentially serious and misleading consequences due to uncorrected measurement error.

              Despite clear evidence that manifest variable path analysis requires highly reliable measures, path analyses with fallible measures are commonplace even in premier journals. Using fallible measures in path analysis can cause several serious problems: (a) As measurement error pervades a given data set, many path coefficients may be either over- or underestimated. (b) Extensive measurement error diminishes power and can prevent invalid models from being rejected. (c) Even a little measurement error can cause valid models to appear invalid. (d) Differential measurement error in various parts of a model can change the substantive conclusions that derive from path analysis. (e) All of these problems become increasingly serious and intractable as models become more complex. Methods to prevent and correct these problems are reviewed. The conclusion is that researchers should use more reliable measures (or correct for measurement error in the measures they do use), obtain multiple measures for use in latent variable modeling, and test simpler models containing fewer variables.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                23 May 2016
                2016
                : 11
                : 5
                : e0155963
                Affiliations
                [001]Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Umeå, Sweden
                Leibniz Institute for Prevention Research and Epidemiology (BIPS), GERMANY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: FJ PEG MSS. Performed the experiments: FJ. Analyzed the data: FJ. Wrote the paper: FJ PEG. Worked together with developing the analysis for the study: FJ LMJS. Worked together with developing the original idea of the ms and the interpretations of findings: FJ PEG MSS. Revising the manus critically for important intellectual content: FJ PEG MSS LMJS AH.

                Article
                PONE-D-16-01799
                10.1371/journal.pone.0155963
                4877101
                27214206
                f0eef4b7-3c39-4ad6-b4e5-cad4421ea5ca
                © 2016 Jonsson et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 14 January 2016
                : 7 May 2016
                Page count
                Figures: 3, Tables: 3, Pages: 16
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100001862, Svenska Forskningsrådet Formas;
                Award ID: 259-2012-37
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100002960, Västerbotten Läns Landsting;
                Award ID: 355661
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100002960, Västerbotten Läns Landsting;
                Award ID: 402131
                Award Recipient :
                The study was supported by The Swedish Research Council Formas ( www.formas.se, grant# 259-2012-37) and by The County Council of Västerbotten ( www.vll.se, grant# 355661 and 402131). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Health Care
                Socioeconomic Aspects of Health
                Medicine and Health Sciences
                Public and Occupational Health
                Socioeconomic Aspects of Health
                Medicine and Health Sciences
                Public and Occupational Health
                Behavioral and Social Aspects of Health
                Social Sciences
                Sociology
                Social Research
                People and Places
                Population Groupings
                Age Groups
                Adults
                Social Sciences
                Economics
                Finance
                People and Places
                Population Groupings
                Professions
                Physical Sciences
                Mathematics
                Statistics (Mathematics)
                Confidence Intervals
                People and Places
                Population Groupings
                Age Groups
                Adolescents
                Custom metadata
                The dataset is part of the Northern Swedish Cohort (NSC) which is not freely accessible, this is because the Swedish Data Protection Act (1998:204) does not permit sensitive data on humans (like in the NSC questionnaires) to be openly shared. As such, the data are available upon request from the Principal Investigator Anne Hammarström ( anne.hammarstrom@ 123456umu.se ), pending ethical approval.

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                Uncategorized

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