Determinants, correlates and mediators of psychological distress: a longitudinal study.

This study examined determinants and correlates of psychological distress focusing on the roles of psychosocial resources, such as sense of mastery and social support in mediating and/or moderating the effects of life stressors, such as unfavourable socioeconomic conditions (SES), poor physical health and chronic daily stress on individuals' level of distress. Additionally, the above examination was conducted for men and women separately and the results were compared. The study was based on secondary analyses of data collected by Statistics Canada in two cycles of the National Population Health Survey: 2002/2003 and 2004/2005. The sample used included 2535 men and 3200 women between the ages of 25 and 64 years. Further, this research used structural equation techniques to examine pathways among life stressors, psychosocial resources and distress and block regression analysis to examine the moderating roles of mastery and social support. Chronic daily stress was measured in 2004/2005 and two years earlier, in 2002/2003. Main findings included: (1) higher levels of mastery and social support were found to be associated with less depressive symptoms for both men and women, (2) in addition to its significant main effect on distress, mastery moderated the detrimental effects of poor physical health and chronic daily stress on depressive symptoms for both genders, (3) the effects of daily stress, poor physical health and unfavourable SES on level of distress were partially mediated through mastery, (4) next to daily stress, poor physical health had the most impact on level of distress for both genders, albeit a stronger impact for women, (5) mastery played a more important role in the distress process of women compared with men, and (6) while perceived social support decreased the likelihood of distress for men directly, it decreased women's likelihood of distress by increasing their mastery. Symptoms of distress indicate present and/or future need for health care services. Thus, prevention of distress may lead to a reduction in health care costs in addition to the reduction of subjective suffering. Findings emphasize the importance of allocating resources to groups at high risk of developing distress, such as the poor and the physically unhealthy.