Depression and Modifiable Protective Factors among Underemployed Emerging Adults 公开

Abstract

Depression is a significant public health problem among emerging adults (i.e., 18 -25 year olds). Individuals who have difficulty finding suitable employment (i.e., underemployed) during their transition to adulthood may be at greater risk for depressive symptoms due to the stress they may experience. Understanding factors that may protect underemployed emerging adults from depressive symptoms may contribute to the development of effective intervention programs. However, little is known about the mental health outcomes of underemployed emerging adults, and the mechanisms that may mediate or moderate the relationship between stress and depressive symptoms. The aim of this mixed-methods dissertation study was to gain an in-depth understanding of stress, coping, and resilience among underemployed emerging adults. A diverse sample of underemployed emerging adults responded to an online questionnaire, and a subset participated in a one-on-one in-depth interview. Three analyses were completed as part of this dissertation study. Paper 1 examined whether race/ethnicity moderated the relationship between an additional stressor of discrimination and depressive symptoms, and whether perceived stress mediated the relationship. Qualitative data contextualized the quantitative findings. Paper 2 tested the transactional model of stress and coping to identify potential protective factors. Paper 3 developed a modified grounded theory of the resilience process among underemployed emerging adults. Results across the three studies suggest that this population has high levels of stress and depression, but that appraisal processes contribute to resilience. Additionally, coping and social support may contribute to resilience through more nuanced relationships than tested with the Transactional Model of Stress and Coping. Using the findings from these studies, future work could examine quantitatively how protective factors work together to contribute to resilience among underemployed emerging adults. Additionally, future prevention interventions could focus on the appraisal process.

Table of Contents

Table of Contents

Chapter 1: Introductory Literature Review...................................................................................................... 1

Depressive Disorders: A significant public health problem......................................................... 5

Emerging adults: An important risk group................................................................................................. 8

Depression and Emerging Adults..................................................................................................................... 12

Unemployment, Underemployment, and Depression................................................................... 18

Underemployment, Emerging Adulthood, and Depression...................................................... 26

Potential Moderators of the Underemployment-Depression Relationship................ 38

Theoretical Framework.............................................................................................................................................. 42

Rationale for Research................................................................................................................................................ 51

References............................................................................................................................................................................. 57

Chapter 2: Vulnerability among underemployed emerging adults: How does race moderate relationships of discrimination, perceived stress, and depressive symptoms?........................................................................................................................ 95

Abstract.................................................................................................................................................................................... 96

Introduction......................................................................................................................................................................... 97

Methods................................................................................................................................................................................ 104

Results.................................................................................................................................................................................... 110

Discussion........................................................................................................................................................................... 129

References.......................................................................................................................................................................... 138

Chapter 3: Resilience among underemployed emerging adults: How stress and coping relate to depressive symptoms 170

Abstract................................................................................................................................................................................. 171

Introduction...................................................................................................................................................................... 172

Methods................................................................................................................................................................................ 178

Results.................................................................................................................................................................................... 183

Discussion........................................................................................................................................................................... 186

References.......................................................................................................................................................................... 192

Chapter 4: Resilience among underemployed emerging adults: developing a model of vulnerability and protective processes 208

Abstract................................................................................................................................................................................. 209

Introduction...................................................................................................................................................................... 210

Methods................................................................................................................................................................................ 216

Results.................................................................................................................................................................................... 219

Discussion........................................................................................................................................................................... 256

References.......................................................................................................................................................................... 267

Chapter 5: Summary and Conclusions........................................................................................................... 291

Main Findings.................................................................................................................................................................. 292

Common Themes......................................................................................................................................................... 296

Evaluation of Dissertation Research........................................................................................................... 301

Future Studies................................................................................................................................................................ 303

Implications for Research and Practice................................................................................................... 304

References.......................................................................................................................................................................... 306

Table of Tables

Table 2.1. Description of quantitative and qualitative sample................................................ 153

Table 2.2. Description of stressors..................................................................................................................... 154

Table 2.3. Bivariate relationships for everyday discrimination and perceived stress 155

Table 2.4. Bivariate relationships for depressive symptoms..................................................... 158

Table 2.5. Reasons for discrimination by race/ethnicity............................................................... 160

Table 3.1. Descriptive details about the scales used in the path analysis..................... 203

Table 3.2. Correlations among independent and dependent variables.......................... 204

Table 4.1. Domains explored in qualitative interviews................................................................... 285

Table 4.2. Demographic and depressive symptom characteristics..................................... 286

Table 4.3. Additional demographic characteristics by depressive symptom status 287

Table 4.4. Groups by depressive symptoms status and risk level......................................... 288

Table of Figures

Figure 2.1. Hypothesized moderated mediation model.................................................................. 161

Figure 2.2. Mediation model, full sample, standardized coefficients (standard errors) 162

Figure 2.3. Mediation model, independent simultaneous group model between (a) Black participants and (b) White participants, standardized coefficients (standard errors)............................................................................................ 163

Figure 2.4. Qualitative sample details describing race, gender, discrimination, and stress 164

Figure 2.5. Mixed-methods results for discrimination and depressive symptoms by race/gender 165

Figure 2.6. Mixed-methods results for perceived stress and depressive symptoms by race/gender 166

Figure 2.7. Mixed-methods results for discrimination experiences and depressive symptoms by race/gender 168

Figure 3.1. Proposed path analysis.................................................................................................................... 205

Figure 3.2. Modified path analysis, standardized estimates....................................................... 206

Figure 3.3. Interaction between PSS and CSE predicting depressive symptoms.... 207

Figure 4.1. Model of vulnerability and protective processes contributing to resilience among underemployed emerging adults 289

Figure 4.2. Characteristics of participants by vulnerability factors, protective processes, and their interaction 290

About this Dissertation

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School	Laney Graduate School
Department	Behavioral Sciences and Health Education
Degree	PhD
Submission	Dissertation
Language	English
Research Field	Health Sciences, Public Health Psychology, Behavioral Health Sciences, Mental Health
关键词	depression resilience public mental health emerging adults underemployment
Committee Chair / Thesis Advisor	Thompson, Nancy J, Emory University
Committee Members	Windle, Michael, Emory University Cooper, Hannah, Emory University

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