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Relationship Between Physical Health Status and Responses to a Psychological Distress Measure*

Published online by Cambridge University Press:  29 November 2010

Michel Préville
Affiliation:
Université de Sherbrooke
Louise Potvin
Affiliation:
Université de Montréal
Richard Boyer
Affiliation:
Université de Montréal
Bernard Boulerice
Affiliation:
Université de Montréal

Abstract

Data from the Quebec Health Survey (QHS) were used to examine the influence of physical health status on responses to the somatic and affective-cognitive components ofthe QHS psychological distress inventory (PDI) in three age groups (n = 600): 18–39 years, 40–64 years and 65 years and over. A structural equation modelling strategy using LISKEL VIII was employed to test an explanatory model of the association between physical health and both components of the PDI. The model included sex, perceived life stress, social support, and marital status as covariates. Results showed that the affective-cognitive component of distress was the main explanatory factor in the somatic symptom index. Results also indicated that physical health directly affects responses to the somatic component of the PDI. However, the same effect of physical health on responses to somatic symptoms was found in all three age groups. Findings lead to the conclusion that using a psychological distress measure that includes somatic items, like the PDI, will result in a small overestimation of psychological distress in older adults and younger age groups as well. However, somatic items do not introduce a differential bias in the estimation of respondents' psychological distress status according to age.

Résumé

Les données de l'enquête Santé Québec (ESQ) ont été utilisées pour examiner l'influence du statut de santé physique sur les réponses données aux items d'ordre somatique et affective-cognitive de l'inventaire de détresse psychologique (IDP) de l'ESQ. LISREL VIII a été employé pour tester un modèle explicatif de l'association entre ces variables dans trois groupes d'âge (n = 600): 18–39 ans, 40–64 ans et 65 ans et plus. Le sexe, le niveau de stress percu, le soutien social et le statut marital ont été introduits dans le modèle comme variables contrôles. Nos résultats ont montré que la composante affective-cognitive de l'IDP était le principal facteur explicatif des réponses obtenues à la composante somatique de l'échelle. Nos résultats indiquent aussi que le statut de santé physique influence directement les réponses aux items somatiques de l'IDP. Cependant, l'effet observé était similaire dans les trois groupes d'âge étudiés. Les résultats de cette étude suggèrent que l'utilisation d'une mesure de détresse psychologique comprenant des items d'ordre somatique, tel que l'IDP, entraîne une petite surestimation de la détresse psychologique dans tous les groupes d'âge. Cependant, les items somatiques n'introduisent pas un biais différentiel dans l'évaluation de la détresse psychologique des répondants en fonction dé l'âge.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2000

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References

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
Aneshensel, C.S., Frerichs, R.R., & Huba, G.J. (1984). Depression and physical illness: A multiwave, nonrecursive causal model. Journal of Health and Social Behavior, 25(12), 350371.CrossRefGoogle ScholarPubMed
Belloc, N.B., & Breslow, L. (1972). Relationship ofphysical health status and health practices. Preventive Medicine, 1, 409421.CrossRefGoogle Scholar
Belloc, N.B., Breslow, L., & Hochstim, J. (1971). Measurement of physical health in a general population survey. American Journal of Epidemiology, 93, 328336.CrossRefGoogle Scholar
Berkman, L.F., Berkman, C.S., Kasl, S., Freeman, D.H., Leo, L., Ostfeld, A.M., Cornoni-Huntley, J., & Brody, J.A. (1986). Depressive symptoms in relation to physical health and functioning in the elderly. American Journal of Epidemiology, 124(3), 372388.CrossRefGoogle ScholarPubMed
Berry, J.M., Storandt, M., & Coyne, A. (1984). Age and sex differences in somatic complaints associated with depression. Journal of Gerontology, 55(4), 465467.CrossRefGoogle Scholar
Blazer, D.G. (1982). Social support and mortality in an elderly community population. American Journal of Epidemiology, 115(5), 684694.CrossRefGoogle Scholar
Bolla-Wilson, K., & Bleecker, M.L. (1989). Absence of depression in elderly adults. Journal of Gerontology, 44(2), 5355.CrossRefGoogle ScholarPubMed
Bollen, K.A. (1989). Structural equations with latent variables. New York: John Wiley & Sons.CrossRefGoogle Scholar
Boyer, R., Preville, M., Legare, G., & Valois, P. (1993). La détresse psychologique dans la population du Québec non institutionnalisée: résultats normatifs de l'enquêté Santé Québec. [Psychological distress in the Quebec general population: normative values from the Quebec Health Survey.] Canadian Journal of Psychiatry, 28, 339343.CrossRefGoogle Scholar
Costa, P.T., & McCrae, R.R. (1985). Hypochondriasis, neuroticism, and aging: when are somatic complaints unfounded? American Psychologist, 40, 1928.CrossRefGoogle Scholar
Courtemanche, R., & Tarte, F. (1987). Plan de sondage de I'Enquête Santé Québec: Cahier technique 87-02 (Sampling plan of the Quebec Health Survey: Technical report 87-02). Enquête Santé Québec.Google Scholar
Dutton, D.B., & Levine, S. (1989). Socioeconomic status and health: Overview, methodological critique, and reformulation. In Bunker, J. P., Gomby, D. S., & Kehrer, B. H. (Eds.), Pathway to health: The role of social factors. The Henry J. Kaiser Family Foundation, California.Google Scholar
Foelker, G.A., & Shewchuk, R.M. (1992). Somatic complaints and the CES-D. Journal of American Geriatrics Society, 40, 259262.CrossRefGoogle ScholarPubMed
Frane, J. (1990). Description and estimation of missing data. BMDP statistical software manual: Volume 2. Berkeley: University of California Press.Google Scholar
Gurland, B.J., & Toner, J.A. (1982). Depression in the elderly: a review of recently published studies. In Eisdorfer, C. (Ed.), Annual Review of Gerontology and Geriatrics. New York: Springer.Google Scholar
Hays, R.D., Marshall, G.N., Wang, E.Y.I., & Sherbourne, C D. (1994). Four-year cross-lagged associations between physical and mental health in the medical outcomes study. Journal of Consulting and Clinical Psychology, 62(3), 441449.CrossRefGoogle ScholarPubMed
Holmes, T.H., & Rahe, R.H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11(2), 213218.CrossRefGoogle ScholarPubMed
IIfeld, F.W. (1976). Further validation of a psychiatric symptom index in a normal population. Psychological Reports, 39, 12151228.CrossRefGoogle Scholar
Jöreskog, K G., & Sörbom, D. (1993). LISREL VIII: User's reference guide. Mooresville, IN: Scientific Software Inc.Google Scholar
Kaplan, G.A., Roberts, R. E., Camacho, T.C., & Coyne, J.C. (1987). Psychological predictors of depression: prospective evidence from the Human Population Laboratory Studies. American Journal of Epidemiology, 125(2), 206220.CrossRefGoogle ScholarPubMed
Katon, W. (1984). Depression: relationship to somatization and chronic medical illness. Journal of Clinical Psychiatry, 45(3, sec. 2), 411.Google ScholarPubMed
Katon, W., Kleinman, A., & Rosen, G. (1982). Depression and somatization: A review (part 1). American Journal of Medicine, 72, 127135.CrossRefGoogle Scholar
Katon, W., Reis, R., & Kleinman, A. (1984). The prevalence of somatization in primary care. Comprehensive Psychiatry, 25(2), 208215.CrossRefGoogle ScholarPubMed
Kennedy, G.J., Kelman, H.R., Thomas, C, Wisniewski, W., Metz, H., & Bijur, P.E. (1989). Hierarchy of characteristics associated with depressive symptoms in an urban elderly sample. American Journal of Psychiatry, 146(2), 220225.Google Scholar
Krause, N. (1986). Social support, stress, and well-being among older adults. Journal of Gerontology, 41(4), 512519.CrossRefGoogle ScholarPubMed
Légaré, G., Boyer, R., Preville, M., & Valois, P. (1992). Caractéristiques des non-répondants à une enquete sanitaire de santé mentale [Characteristics of non-respondents in a mental health survey]. Journal canadien de santé publique, 83(4), 308310.Google Scholar
Iipowski, Z.J. (1988). Somatization: the concept and its clinical application. American Journal of Psychiatry, 145(11), 13581368.Google Scholar
Mirowsky, J., & Ross, C.E. (1992). Age and depression. Journal of Health and Social Behavior, 33, 187205.CrossRefGoogle ScholarPubMed
Murphy, J.M., Olivier, D.C., Monson, R.R., Sobol, A.M., Federman, E.B., & Leighton, A.H. (1991). Depression and anxiety in relation to social status: A prospective epidemiologic study. Archives of GeneralPsychiatry, 48, 223229.CrossRefGoogle Scholar
Murrell, S.A., Himmelfarb, S., & Wright, K. (1983). Prevalence of depression and its correlates in older adults. American Journal of Epidemiology, 117(2), 173185.CrossRefGoogle ScholarPubMed
Murrell, S.A., & Norris, F.H. (1991). Differential social support and life change as contributors to the social class-distress relationship in older adults. Psychology and Aging, 6(2), 223231.CrossRefGoogle Scholar
Préville, M., Potvin, L., & Boyer, R. (1995). The structure ofpsychological distress. Psychological Reports, 77, 275293.CrossRefGoogle Scholar
Préville, M., Potvin, L., & Boyer, R. (1998). Psychological distress and use of ambulatory medical services in the Quebec Medicare system. Health Services Research, 33(2), 275286.Google ScholarPubMed
Rodin, G., & Voshart, K. (1986). Depression in the medically ill: An overview. American Journal of Psychiatry, 143, 696705.Google ScholarPubMed
Ruegg, R.G., Zisook, S., & Swerdlow, N.R. (1988). Depression in the aged. Psychiatric Clinics of North America, 11(1), 8399.CrossRefGoogle ScholarPubMed
Salzman, C, & Shader, R.I. (1978). Depression in the elderly. I. Relationship between depression, psychological defense mechanisms and physical illness. Journal of the American Geriatrics Society, 26(6), 253260.CrossRefGoogle ScholarPubMed
Watson, D., & Pennebaker, J.W. (1989). Health complaints, stress, and distress: exploring the central role of negative affectivity. Psychological Review, 96(2), 234254.CrossRefGoogle ScholarPubMed
Waxman, H.M., McCreary, G., Weinrit, R.M., & Carner, E.A. (1985). A comparison of somatic complaints among depressed and non-depressed older persons. The Gerontologist, 25(5), 501507.CrossRefGoogle ScholarPubMed
Wells, J.A., & Strickland, D.E. (1982). Physiogenic bias as invalidity in psychiatric symptom scales. Journal of Health and Social Behavior, 23(3), 235252.CrossRefGoogle ScholarPubMed
Williamson, G.M., & Schulz, R. (1992). Physical illness and symptoms of depression among elderly outpatients. Psychology and Aging, 7(3), 343351.CrossRefGoogle ScholarPubMed
Zemore, R., & Eames, N. (1979). Psychic and somatic symptoms of depression among young adults, institutionalized aged and noninstitutionalized aged. Journal of Gerontology, 34(5), 716722.CrossRefGoogle ScholarPubMed