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What is psychological distress?
Two major forms
Depression is “feeling sad, demoralized, lonely, hopeless, or worthless, wishing y
ou were dead, having trouble sleeping, crying, feeling everything is an effort, and
being unable to get going. “
Anxiety “is being tense, restless, worried, irritable, and afraid.”
Distress embodies anxiety and depression symptoms reflecting affective impairment o
f functioning ranging from mild to severe, and indicative of the probability of disorder.
Defining neighbourhood in mental health literature.
Three focal dimensions
Physical boundaries of the neighbourhood
Related to social and demographic characteristics of individuals in the
Objective characteristics of neighhourhood
Perspectives of and interactions between residents
Cohesion, trust, collective efficacy
Two related sets of hypotheses in mental health literature:
Neighbourhoods that lack resources and present threats to individuals produce dis
Disadvantaged neighbourhoods only seem distressing because individuals distress
ed by their own personal disadvantages tend to live in them.
Main question researchers ask: Does any association between neighbourhood disa
dvantage and distress remain NET of individual-level disadvantage?
i.e., Spurious association?
Support for the Structural Model
Most studies find only modest support for the structural model after considering indivi
dual level variation
30-40% of the variation in mental health is due to between neighbourhood variati
neighbourhood structural factors account for these differences, the remaining vari
ation due to individual-level factors
Effects of neighbourhood disadvantage persist controlling for individual socioeco
Galea shows a two-fold increase in the rate of individual depression in NYC due t WK 6 2
o socioeconomic disadvantage of the neighbourhood, over and above individual d
Wheaton and Clarke show that the effect of neighbourhood disadvantage is worse
when individual disadvantage is worse.
Defining The Social Model of Neighbourhood
Individuals’ perspectives of the neighbourhood, and the interactions between residents
Collective efficacy, cohesion, trust, social ties, and capital
Real and perceived disorder – “objective social and physical conditions that indic
ate a breakdown of social control in the community”
From this perspective, neighbourhood disadvantage is a primary stressor that lead
s to disorganization and disorder–secondary stressors
Measures of organization and disorder measured at the individuallevel or agg
regate (“ecometric” assessment, Hill and Maimon 2013)
Individual-level (perceptions only; subjective)
Aggregate (more objective measure)
Neighbourhood disadvantage, disorder, and distress
Neighbourhood disadvantage---> perceived neighbourhood disorder ---> depression
Is perceived neighborhood disorder associated with levels of depression?
Yes. There is a positive association that is steepest at the lowest and highest levels
of neighborhood disorder—especially at the upper end.
Does perceived neighbourhood disorder mediate the association between neighbourho
od disadvantage and depression?
Yes. The remaining net effect of neighbourhood disadvantage (after we consider i