Association Between Stressful Life Events and Depression; Intersection of Race and Gender
Although stressful life events (SLEs) and depression are associated, we do not know if the intersection of race and gender modifies the magnitude of this link. Using a nationally representative sample of adults in the USA, we tested if the association between SLE and major depressive episode (MDE) depends on the intersection of race and gender.
Data came from the National Survey of American Life (NSAL), 2003, a cross-sectional survey that enrolled 5899 adults including 5008 Blacks (African-Americans or Caribbean Blacks), and 891 Non-Hispanic Whites. Logistic regression was used for data analysis. Stressful life events (past 30 days) was the independent variable, 12-month MDE was the dependent variable, and age, educational level, marital status, employment, and region of country were controls.
In the pooled sample, SLE was associated with MDE above and beyond all covariates, without the SLE × race interaction term being significant. Among men, the SLE × race interaction was significant, suggesting a stronger association between SLE and MDE among White men compared to Black men. Such interaction between SLE × race could not be found among women.
The association between SLE and depression may be stronger for White men than Black men; however, this link does not differ between White and Black women. More research is needed to better understand the mechanism behind race by gender variation in the stress–depression link.
KeywordsEthic groups Major depressive episode Stressful life events Race Gender
The National Survey of American Life (NSAL) is mostly supported by the National Institute of Mental Health, with grant U01-MH57716. Other support came from the Office of Behavioral and Social Science Research at the National Institutes of Health and the University of Michigan. For this analysis, public data set was downloaded from Interuniversity Consortium for Political and Social Research (ICPSR), Institute for Social Research at University of Michigan.
SA designed the work, analyzed the data, and drafted the manuscript. MML designed the work and revised the draft.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no competing interests.
Informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
- 4.Estrada-Martínez LM, Caldwell CH, Bauermeister JA, Zimmerman MA. Stressors in multiple life-domains and the risk for externalizing and internalizing behaviors among African Americans during emerging adulthood. J Youth Adolesc 2012, 41(12):1600–12.Google Scholar
- 8.Brown GW, Harris TO. Depression. In life events and illness, ed. GW Brown, TO Harris, pp. 49–93. New York: Guilford 1989.Google Scholar
- 9.Cervilla JA, Molina E, Rivera M, Torres-González F, Bellón JA, Moreno B, Luna JD, Lorente JA, Mayoral F, King M, Nazareth I, PREDICT Study Core Group, Gutiérrez B. The risk for depression conferred by stressful life events is modified by variation at the serotonin transporter 5HTTLPR genotype: evidence from the Spanish PREDICT-Gene cohort. Mol Psychiatry. 2007;12(8):748–55.PubMedCrossRefGoogle Scholar
- 10.Assari S, Smith JR, Caldwell CH, Zimmerman MA. Gender differences in longitudinal links between neighborhood fear, parental support, and depression among African American emerging adults. Society. 2015;5(1):151–70.Google Scholar
- 11.Assari S, Watkins DC, Caldwell CH. Race attribution modifies the association between daily discrimination and major depressive disorder among blacks: the role of gender and ethnicity. J Racial Ethnic Health Disparities 2014, 1-a.Google Scholar
- 12.Vogt D, Vaughn R, Glickman ME, Schultz M, Drainoni ML, Elwy R, Eisen S. Gender differences in combat-related stressors and their association with postdeployment mental health in a nationally representative sample of U.S. OEF/OIF veterans. J Abnorm Psychol. 2011;120(4):797–806.PubMedCrossRefGoogle Scholar
- 14.Kessler RC. The effects of stressful life events on depression. In: Spence JT, editor. Annual Review of Psychology. 48. Palo Alto: Annual Reviews Inc; 1997. p. 191–214.Google Scholar
- 15.Cohen S, Kessler RC, Gordon LU. Strategies for measuring stress in studies of psychiatric and physical disorders. In: Cohen S, Kessler RC, Gordon LU, editors. Measuring stress: a guide for health and social scientists. New York: Oxford University Press Inc; 1995. p. 3–26.Google Scholar
- 19.Assari S, Burgard S, Zivin K. Long-term reciprocal associations between depressive symptoms and number of chronic medical conditions: longitudinal support for black–white health paradox. J Rac Ethnic Health Dispar. 2015;1-9.Google Scholar
- 21.Williams DR, González HM, Neighbors H, Nesse R, Abelson JM, Sweetman J, Jackson JS. Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites: results from the national survey of American life. Arch Gen Psychiatry. 2007;64(3):305–15.PubMedCrossRefGoogle Scholar
- 37.Kessler RC, Calabrese JR, Farley PA, Gruber MJ, Jewell MA, Katon W, Keck PE, Nierenberg AA, Sampson NA, Shear MK, Shillington AC, Stein MB, Thase ME, Wittchen HU. Composite International Diagnostic Interview screening scales for DSM-IV anxiety and mood disorders. Psychol Med. 2013;43(8):1625–37.PubMedCrossRefGoogle Scholar
- 40.Assari S, Moghani Lankarani M, Moghani LR. Ethnicity modifies the effects of anxiety and drug use on suicidal ideation among Black adults in the United States. Int J Prev Med. 2013;4(11a):1151.Google Scholar
- 42.Assari S, Smith JR, Caldwell CH, Zimmerman MA. Gender differences in longitudinal links between neighborhood fear, parental support, and depression among African American emerging adults. Society. 2015;5(1):151–70.Google Scholar
- 53.Ryff, CD Keyes, CLM Hughes DL. Status inequalities, perceived discrimination, and eudaimonic well-being: do the challenges of minority life hone purpose and growth? J Health Soc Behav. 2003;44(3):275–291.Google Scholar
- 58.Jackson JS, Knight KM, Rafferty JA. Race and unhealthy behaviors: chronic stress, the HPA axis, and physical and mental health disparities over the life-course. Am J Public Health 2010;100:933–939.Google Scholar
- 59.Finch LE, Tomiyama AJ. Comfort eating, psychological stress, and depressive symptoms in young adult women. Appetite. 2015 (15a):00334–7.Google Scholar
- 62.Weinberg MS, Bhatt AP, Girotti M, Masini CV, Day HE, Campeau S, Spencer RL. Repeated ferret odor exposure induces different temporal patterns of same-stressor habituation and novel-stressor sensitization in both hypothalamic-pituitary-adrenal axis activity and forebrain c-fos expression in the rat. Endocrinology. 2009;150(2):749–61.PubMedCrossRefGoogle Scholar
- 68.Pugliesi K Gender and work stress: differential exposure and vulnerability. J Gend Cult Health. 1999;4:297–117.Google Scholar
- 69.McAdoo HP. Stress absorbing systems in Black families. Fam Relat. 1982;479–488.Google Scholar
- 77.Chatters LM, Taylor RJ, Jackson JS, Lincoln KD. Religious coping among African Americans, Caribbean Blacks and Non-Hispanic Whites. J Comp Psychol. 2008;36(3):371–86.Google Scholar
- 82.Cano A, Mayo A, Ventimiglia M. Coping, pain severity, interference, and disability: the potential mediating and moderating roles of race and education. J Pain. 2006;7(7):459–468.Google Scholar
- 91.Sandler IS. Guenther RT. Assessment of life stress events. Pp. 555–600 In:P Measurement Strategies in Health Psychology, edited by P. Karoly. New York: Wiley.1985.Google Scholar
- 92.McLean DE. Link BG. Unravelling complexity: strategies to refine concepts, measures, and research designs in the study of life events and mental health. Pp. 15–42 in Stress and Mental Health: Contemporary Issues and Prospects for the Future, edited by William R. Avison and Ian H. Gotlib. New York: Plenum.1994.Google Scholar
- 93.Wheaton B Sampling the Stress Universe. Pp. 77–114 In: Stress and mental health: contemporary i ssues and prospects for the future, edited by William R. Avison and Ian H. Gotlib. New York: Plenum; 1994.Google Scholar
- 103.Brown GW, Harris T. Social origins of depression. New York: Free Press; 1978.Google Scholar