Prospective Relations between Subjective Social Status and Depressive Symptoms in a Middle-Aged Community Sample: Exploring Biopsychosocial Mechanisms

Subjective social status (SSS) is a marker of perceived social rank that has been linked with depressive symptoms over and above objective socioeconomic status (SES), but longitudinal studies are limited. SSS has been theorized to capture perceived relative versus absolute deprivation and the corresponding psychosocial processes underlying status-based disparities in health. The literature suggests that upward social comparisons inherent in appraising SSS may confer psychosocial risk, which may in turn increase risk for depressive symptoms and stress-related inflammation involved in the pathogenesis of depression. However, no studies have examined whether interpersonal and biological factors simultaneously contribute to the inverse relation between SSS and depressive symptoms. This study examined whether (1) lower SSS was longitudinally associated with increased depressive mood symptoms, independent of income, and (2) whether higher social strain and lower social support simultaneously mediated the SSS— depressive mood symptoms relation directly and indirectly through higher interleukin-6 (IL-6). This study utilized secondary data from a representative community sample of 804 middle-aged adults taking part in a study of healthy aging between 2007 and 2012. Plasma levels of IL-6 and self-reported SSS, social support, and social strain were assessed at baseline, followed by an assessment of depressive mood symptoms by phone interview on average 20 months later. Results from multiple regression analysis revealed that lower SSS predicted higher depressive symptoms at follow-up after adjustment for sociodemographic characteristics and baseline depressive mood symptoms. Path analysis indicated that social strain significantly mediated the relation between SSS and depressive mood symptoms, but not after adjustment for baseline mood symptoms. Lower social support mediated the relation between lower SSS and higher depressive symptoms, but relations were non-significant in adjusted models. Contrary to predictions, paths including IL-6 were not significant. Lower SSS may represent a robust risk factor for subsequent depressive mood symptoms above and beyond income, in line with the conceptualization of SSS as a measure of relative deprivation. Further research examining biopsychosocial mechanisms would elucidate the implications of perceived low status and inform intervention efforts aimed at reducing the global burden of depressive symptoms.