title: Are status inconsistency, work stress and work-family conflict associated with depressive symptoms? Testing prospective evidence in the lidA study.
abstract: BACKGROUND
  Depressive symptoms are common and economically relevant. Women suffer more often than men do. We analyze associations between social status inconsistency, psychosocial factors, and depressive symptoms stratified by gender.
  
  
  METHODS
  In the present study, 3340 employees of two age cohorts (1959, 1965) working in two waves (2011, 2014) of the prospective German lidA-study and who gave written consent to link register data regarding their employment histories were included. Gender-specific influences of social status inconsistency (deviation of observed income from expected average income based on acquired education) on depressive symptoms and mediation of these associations by work stress in terms of effort-reward-imbalance (ERI) and work-family-conflict (WFC) were analyzed with confirmatory cross-lagged path models.
  
  
  RESULTS
  Among men, consistent status (i.e., average income in a specific educational group) increased the frequency of depressive symptoms. No association between negative SSI (i.e., income below the average income given a specific educational attainment) or positive SSI (i.e., income above the average income given a specific educational attainment) and depressive symptoms was observed among men or women. ERI and WFC were longitudinally associated with the outcome and differed slightly regarding gender, i.e., showing stronger effects of ERI for women and of WFC for men. Mediation of the association between social status and depressive symptoms was observed for men and for consistent status (path: consistent status → ERI → depressive symptoms) but not for SSI.
  
  
  CONCLUSIONS
  ERI and WFC increase the risk of future episodes with depressive symptoms in men and in women irrespective of SSI, occupational position, full- or part-time work, regional factors or individual characteristics.
authors.affiliation: Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Parkstrasse 11, 89073 Ulm, Germany. Electronic address: richard.peter@uni-ulm.de.
authors.forename: Richard
authors.initials: R
authors.lastname: Peter
authors.affiliation: Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany. Electronic address: stefanie.march@med.ovgu.de.
authors.forename: Stefanie
authors.initials: S
authors.lastname: March
authors.affiliation: Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Parkstrasse 11, 89073 Ulm, Germany. Electronic address: jean-baptist.du-prel@uni-ulm.de.
authors.forename: Jean-Baptist
authors.initials: JB
authors.lastname: du Prel
mesh_terms: D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000209:etiology*; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D017132:Workplace / Q000523:psychology
keywords: Cross-lagged path analysis; Depressive symptoms; Effort-reward-imbalance; Gender; Social status inconsistency; Work-family-conflict