Cognitive ability as moderator of the association between social disadvantage and psychological distress: evidence from a population-based sample

Background: Social disadvantage consistently predicts both self-reported distress and clinically-diagnosed disorders such as depression. Yet, many individuals who are exposed to disadvantage do not report high levels of distress. This study extends our recent work showing that high cognitive ability may protect against the negative health consequences of exposure to disadvantaged backgrounds. We test whether this ‘buffer effect’ exists across clinically-relevant indices of mental health in a population-representative sample. Methods: 27,985 participants were drawn from the UK Household Longitudinal Study (Understanding Society). Clinical diagnoses of depression and clinically-relevant measures of psychological distress (i.e. Short Form-12 Mental Component, General Health Questionnaire) and trait neuroticism were assessed. Cognitive ability was derived from performance on word recall, verbal fluency and numerical ability tasks. Early-life disadvantage was gauged using family background measures assessing parental education and occupation at age 14. Results: Background disadvantage predicted increased levels of reported psychological distress and neuroticism. These associations were moderated by cognitive ability. Across all available mental health measures the negative association between early life disadvantage and poor adult mental health was strongest at low (-1SD) cognitive ability and was no longer evident at high (+1SD) levels of cognitive ability. Conclusions: The results provide support for a cognitive buffering hypothesis linking high cognitive ability to a decrease in the magnitude of the social gradient in mental health. Those disadvantaged by both low socioeconomic status and low cognitive ability may benefit from targeted prevention and treatment programs aiming to reduce socio-economic disparities in mental health

Does cognitive ability buffer the link between childhood disadvantage and adult health?

Objective: Individual differences in childhood cognitive ability have been neglected in the study of how early life psychosocial factors may buffer the long-term health consequences of social disadvantage. In this study, we drew on rich data from two large British cohorts to test whether high levels of cognitive ability may protect children from experiencing the physical and mental health consequences of early life socioeconomic disadvantage. Methods: Participants from the 1970 British Cohort Study (BCS; N = 11,522) were followed from birth to age 42 and those from the 1958 National Child Development Study (NCDS; N = 13,213) were followed from birth to age 50. Childhood social disadvantage was indexed using six indicators gauging parental education, occupational prestige, and housing characteristics (i.e. housing tenure and home crowding). Standardized assessments of cognitive ability were administered at age 10 (BCS) and 11 years (NCDS). Psychological distress, self-rated health, and all-cause mortality were examined from early adulthood to midlife in both cohorts. Results: Early social disadvantage predicted elevated levels of psychological distress and lower levels of self-rated health in both cohorts and higher mortality risk in the NCDS. Childhood cognitive ability moderated each of these relationships such that the link between early life social disadvantage and poor health in adulthood was markedly stronger at low (-1SD) compared to high (+1SD) levels of childhood cognitive ability. Conclusions: This study provides evidence that high childhood cognitive ability is associated with a decrease in the strength of socioeconomic status-driven health inequalities

Public perceptions of the effectiveness of income provision on reducing psychological distress

Purpose. The purpose of this paper is to understand public perceptions of the role of income for improving mental health, since public perceptions shape political decision-making. Socioeconomic determinants such as poverty cause a great deal of mental ill-health, yet it is not clear whether the general public believes this to be true. Lay understandings of health often overemphasize the roles of individual habits and medical treatments and underappreciate the importance of socioeconomic determinants. Design/methodology/approach. UK adults (n = 622) rated effectiveness of three interventions for reducing psychological distress: medication, psychotherapy, and providing sufficient income to cover necessities via a basic income. We manipulated whether participants rated effectiveness for an identified individual vs. the population in general. Participants also indicated their support for the introduction of the basic income scheme. Findings. Increasing income was rated highly effective for reducing psychological distress. Effectiveness ratings for income provision were as high as those for psychotherapy, and higher than those for medication. There was also an interaction with framing: in the population framing, income provision was rated more effective than either of the other two interventions. There were high levels of support for introducing a universal basic income scheme in this population. Originality. UK adults anticipate that income provision would be highly effective at reducing psychological distress; as or more effective than increasing access to psychotherapy or medication. Policymakers can assume that the public will be receptive to arguments for mental health interventions that tackle broader socioeconomic determinants, especially when these are framed in population terms

More ways than one: ERPs reveal multiple familiarity signals in the word frequency mirror effect

Recent dual-process models of the word frequency mirror effect place absolute familiarity, an item׳s baseline familiarity at a given time point, as responsible for false alarm differences and recollection for hit rate differences between high and low frequency items. One of the earliest dual-process propositions, however, posits an additional relative familiarity mechanism which is sensitive to recent presentation but relative to the absolute familiarity of a particular item (Mandler, 1980). In this study, it was possible to map these three mechanisms onto known event-related potential (ERP) effects in an old/new recognition task with high and low frequency words. Contrasts between ERPs elicited by high and low frequency new items were assumed to index absolute familiarity, and the distribution of this effect from 300 to 600 ms was topographically distinct from a temporally-overlapping midfrontally-distributed old/new effect which was larger for low than high frequency words, as would be expected from a relative familiarity mechanism. A later left parietal old/new effect, strongly linked to recollection, was only present for low frequency items. These frequency-sensitive amplitude differences for both old/new effects disappeared in a second recognition task in which old/new decisions were made under a time constraint, although the posterior absolute familiarity effect remained unaffected by the speeding of responses. The data support the assertion that three distinct recognition processes are affected by word frequency in recognition memory tasks, and the qualitatively distinct distributions associated with the two familiarity contrasts support the presence of two cognitively distinct familiarity mechanisms

Nap sleep preserves associative but not item memory performance

Many studies have shown that sleep improves memory performance, and that even short naps during the day are beneficial. Certain physiological components of sleep such as spindles and slow-wave-sleep are thought to be particularly important for memory consolidation. The aim of this experiment was to reveal the role of naps for hippocampus-dependent associative memory (AM) and hippocampus-independent item memory (IM) alongside their corresponding ERP old/new effects. Participants learnt single words and word-pairs before performing an IM- and an AM-test (baseline). One group was subsequently allowed to nap (∼90 min) while the other watched DVDs (control group). Afterwards, both groups performed a final IM- and AM-test for the learned stimuli (posttest). IM performance decreased for both groups, while AM performance decreased for the control group but remained constant for the nap group, consistent with predictions concerning the selective impact of napping on hippocampus-dependent recognition. Putative ERP correlates of familiarity and recollection were observed in the IM posttest, whereas only the later recollection-related effect was present in the AM test. Notably, none of these effects varied with group. Positive correlations were observed between spindle density during slow-wave-sleep and AM posttest performance as well as between spindle density during non-REM sleep and AM baseline performance, showing that successful learning and retrieval both before and after sleep relates to spindle density during nap sleep. Together, these results speak for a selective beneficial impact of naps on hippocampus-dependent memories

Is faster better? Effects of response deadline on ERP correlates of recognition memory in younger and older adults

Aging studies generally suggest that recollection is impaired whereas familiarity-based recognition remains relatively preserved in healthy older adults. The present event-related potential (ERP) study explores whether age-related impairments in recognition memory can be reduced under conditions in which recognition decisions are primarily driven by familiarity. Old and young adults performed an item recognition task with perceptually rich visual stimuli. A response deadline procedure was employed following previous studies which have shown that limiting response times attenuates recollection but leaves familiarity relatively unaffected. Age effects on memory performance were large in the non-speeded response condition in which recollection contributes to performance. When response time was limited, performance differences between groups were negligible. In the non-speeded condition the ERP correlate of recollection was not detectable in old adults. Conversely, in the speeded condition ERP correlates of familiarity were obtained in both age groups, though attenuated for old adults. For old adults in the speeded condition a temporally extended posterior negativity was obtained which was more pronounced for low performing participants. The results suggest that even though the neural generators of the familiarity signal degrade with age, familiarity is an important contributor to recognition memory in older adults and can lead to a disproportional benefit in memory in conditions designed to specifically enhance familiarity-based responding

Gratitude mediates consumer responses to marketing communications

Purpose: From Adam Smith onwards, gratitude has been held as invaluable to societal functioning in view of its role in helping individuals maintain their reciprocal obligations to one another. The purpose of the current research was to use current conceptions of gratitude derived from work in social psychology to test whether simple descriptions of hypothetical organisations could systematically differ in the extent to which they elicit gratitude, and subsequently whether gratitude would mediate behavioural intentions towards these organisations.  Methodology: In two studies, participants read vignettes describing hypothetical organisations that systematically differed in the extent to which the services they provided were costly to the organisation, of high value, and provided out of a genuine desire to help. Perceptions of these dimensions, feelings of gratitude, and behavioural intentions towards each organisation were subsequently measured.  Findings: The appraisal group manipulation significantly impacted consumers’ behavioural intentions towards these businesses, and the majority of this relationship was mediated by feelings of gratitude towards the organisations.  Research limitations/implications: These data indicate that gratitude not only mediates customer responses to relationship marketing investments, but may also be integral in marketing communications’ role in converting non-customers to customers. They also indicate that marketing communications should stress that an organisations services are of high value, of cost to the organisation and provided out of a genuine desire to help.  Originality/value: This paper shows for the first time that the same cognitive appraisals that underpin feelings of interpersonal gratitude mediate responses to global evaluations of organisations. This considerably broadens the situations under which gratitude had previously been considered to operate and argues for the inclusion of gratitude in understanding how marketing communications and relationship management are used to influence consumer responses

Public Preferences to Trade-off Gains in Total Health for Health Equality: Discrepancies Between an Abstract Scenario versus the Real-World Scenario Presented by COVID-19

Policymakers must ration healthcare. This necessity became salient during the COVID-19 pandemic. Some policymakers took that opportunity to reduce inequality of health outcomes at the expense of overall health gains. There is a literature that seeks to quantify the optimal trade-off between efficiency and equality in health outcomes: economists employ surveys to quantify the public’s preferred level of equity / efficiency trade-off. An odd result from these studies is that a non-trivial subsample of respondents choose to “level down” i.e. they choose as though an additional year of life delivers negative utility to society if it accrues to the most privileged. In an experiment of US and UK respondents (n = 495), we compare equity / efficiency trade-offs across an abstract scenario along the lines of that presented in previous surveys versus a COVID-19 scenario, where it is made explicit that healthcare rationing is a real and current necessity occasioned by the pandemic. We find that preference for “levelling down” is reduced in the COVID-19 scenario relative to the abstract scenario. This result implies that, at least in the context of the COVID-19 pandemic, previous results have overestimated the public’s willingness to sacrifice overall gains in population health in order to reduce inequality of health outcomes

Perceived health inequalities: Are the UK and US public aware of occupation-related health inequality, and do they wish to see it reduced?

Background: One underexamined factor in the study of lay views of socioeconomic health inequalities is occupation-related health. Examining health by occupational social class has a long history in the UK but has been comparatively overlooked in US public health literatures, where the relationship between health and work has attended more to hazard exposure. Methods: Representative samples of the UK and US indicated the perceived and ideal lifespan of people working in “higher managerial/professional” and “routine” occupations. We examine perceptions of inequality and desires for equality across occupation groups as a function of country and key socio-demographic variables. Results: 67.8% of UK and 53.7% of US participants identified that professionals live longer than routine workers. Multivariate models indicated that US participants were markedly less likely to be aware of occupation-related inequalities after controlling for age, gender, and education. Awareness was negatively related to age (in the US) and recent voting behaviours (both samples). Desiring equal life expectancy was less likely in the US sample, and less likely across both samples among older participants and those with lower levels of education. Conclusion: Employing a novel approach to measuring perceived and ideal life expectancy inequality, this is the first study to examine perceptions of lifespan inequality by occupational groups. It reports widespread understanding of the occupation-related gradient in lifespan and a desire that these inequalities be eliminated in the UK, but considerably less awareness and desire for equality in the US. Greater tolerance for social status inequalities in the US than other similar countries appear to also extend to differences in life expectancy