title: Status incongruence revisited: associations with shame and  mental wellbeing.
abstract: Status incongruence has been related to poor health and all-cause mortality, and could be a growing public health problem due to changes in the labour market in later decades. Shaming experiences have been suggested as playing a part in the aetiology. The aim here was to study the risk for shaming experiences, pessimism, anxiety, depressive feelings, and poor mental wellbeing (as measured by the GHQ) with a special focus on shame, in four social status categories: negatively and positively incongruent individuals, and low-status and high-status congruent individuals. Data comprised 14,854 working men and women from a regional sample of randomly selected respondents, 18-79 years of age. Logistic regression was used to study differences in risk for negative emotional outcomes. Results showed that the negative incongruent category persisted as the group most at risk for all negative emotional outcomes (OR 1.5-1.9; p < 0.05-<0.001).When testing the risk for poor mental wellbeing among the status categories with and without shaming experiences, ORs for all groups with shaming experiences were elevated. Among groups without shame, only the negative incongruent category remained at risk (OR 2.7; p < 0.05) after adjustment. Negative incongruent status is associated with adverse emotional outcomes, among them shame, which is a previously unappreciated aspect of status incongruence.
authors.affiliation: Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. johlu@ihs.liu.se
authors.forename: Johanna
authors.initials: J
authors.lastname: Lundberg
authors.forename: Margareta
authors.initials: M
authors.lastname: Kristenson
authors.forename: Bengt
authors.initials: B
authors.lastname: Starrin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D002908:Chronic Disease; D003863:Depression / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D012307:Risk Factors; D012752:Shame; D012923:Social Class; D012959:Socioeconomic Factors; D012962:Sociology, Medical; D055815:Young Adult