The role of socioeconomic status in adjustment after ductal carcinoma in situ.
BACKGROUND
A large body of literature suggests that socioeconomic status (SES) is positively associated with mental and physical health. However, little research has examined the impact of SES on psychological adjustment after a major stressor. The current study examined whether SES (education and financial status) was associated with distress (anxiety and depression) in women diagnosed with ductal carcinoma in situ (DCIS). This study also explored whether social support explained the association between SES and distress and whether social support buffered the impact of low SES on distress.


METHODS
A total of 487 women with newly diagnosed DCIS were enrolled in the study. Participants completed questions about sociodemographic, psychosocial, and clinical characteristics at the time of enrollment and 9 months after their diagnosis.


RESULTS
Financial status was inversely associated with anxiety and depression at the 9-month follow-up. Financial status also predicted change in anxiety and depression. Women with high financial status reported a decline in anxiety and depression during the study period, whereas women with medium or low financial status reported an increase in anxiety and depression. In addition, the probability of exceeding the screening threshold suggestive of clinical depression increased with decreasing financial status. Education was not associated with anxiety or depression. The presence of social support did not explain the association between financial status and change in distress. Social support did not buffer the effect of low SES on anxiety and depression.


CONCLUSIONS
Women with medium or low SES were vulnerable to escalating anxiety and depression after a DCIS diagnosis.
de Moor
Janet S
JS
the Ohio State University College of Public Health, Columbus, Ohio, USA. jdemoor@cph.osu.edu
Partridge
Ann H
AH
Winer
Eric P
EP
Ligibel
Jennifer
J
Emmons
Karen M
KM
D000223:Adaptation, Psychological; D001007:Anxiety / Q000453:epidemiology; D001943:Breast Neoplasms / Q000523:psychology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000523:psychology*; D003863:Depression / Q000453:epidemiology; D004467:Economics; D004522:Educational Status; D005260:Female; D006801:Humans; D017533:Marital Status; D008875:Middle Aged; D012923:Social Class