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Cecilia Åslund, BA; Jerzy Leppert, PhD; Bengt Starrin, PhD; Kent W. Nilsson, PhD

Arch Pediatr Adolesc Med. 2009;163(1):55-60.

Objective  To investigate the associations among social status, shaming experiences, and adolescent depression using a status-shaming model.

Design  Population-based, self-report cohort study.

Setting  Västmanland, Sweden.

Participants  A cohort of 5396 students in grade 9 (age 15-16 years) and the second year of high school (age 17-18 years).

Intervention  Participants completed the anonymous questionnaire Survey of Adolescent Life in Västmanland–2006 during class hours.

Main Outcome Measures  We investigated the prevalence of depression according to the Depression Self-Rating Scale of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision), A-criterion, regarding subjective social status, shaming experiences, and social background. Social status was measured as (1) attributed status of a family's socioeconomic and social standing and (2) acquired status of peer group and school. Binary logistic regressions were used for the analyses.

Results  Shaming experiences and low social status interacted with depression. If shaming experiences were present, participants with both high and low attributed status were at increased risk for depression (odds ratio [low and high groups, respectively], 5.4-6.9), whereas medium status seemed to have a protective function. For acquired status, the highest elevated risk was found in participants with low status (odds ratio [girls and boys, respectively], 6.7-8.6).

Conclusions  Social status may influence the risk for depression when an individual is subjected to shaming experiences. The present study contributes to the mapping of the influence of social status on health and may have essential implications for understanding, preventing, and treating adolescent depression.

Author Affiliations: Centre for Clinical Research, Uppsala University, Central Hospital of Västerås, Västerås (Ms Åslund and Drs Leppert and Nilsson), and Department of Social Studies, Karlstad University, Karlstad (Dr Starrin), Sweden; and Faculty of Health and Social Studies, Lillehammer College, Lillehammer, Norway (Dr Starrin).

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