Walsh, Stephanie and Sellwood, Bill and Duxbury, Anna (2024) Psychological Distress and Socioeconomic Status. A Consideration of Associated Factors. PhD thesis, Lancaster University.
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Abstract
Section one reports a quantitative systematic literature review which explores the acceptability of mental health services for people of low socioeconomic status. Four databases were searched (PsycInfo, CINAHL complete, MEDLINE and Academic Search Ultimate) and ten studies met the inclusion criteria. A narrative synthesis approach was implemented to systematically explore the findings of the papers. The psychological factors considered in relation to acceptability were: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, self-efficacy and cultural competence. Methodological quality was assessed using the Joanne Briggs Institute Critical Appraisal Checklist for Analytical Cross Sectional Studies. Concerns were noted regarding the measures of predictor and outcome variables. Strengths were found in the statistical analysis of confounders. Section two reports an empirical study investigating food insecurity in the United Kingdom. This research aimed to understand 1) the relationship between food insecurity and psychological distress and 2) whether shame moderates the relationship between these variables. Participants were aged 18+ and self-identified as food insecure within the previous six months. A cross-sectional survey was conducted online and via paper copies, consisting of measures of food insecurity, psychological distress and shame. The study findings show that food insecurity and shame account for 74% of the variance in psychological distress in people who report food insecurity. No moderation was found suggesting the relationship between food insecurity and psychological distress is not moderated by shame. However, a significant interaction may not have been found, as the study may have been underpowered. The findings of this research have implications for those working in both mental health services and food aid organisations and these are discussed. Section three contains a critical appraisal of issues relating to research into deprivation, including discussion of the sociopolitical context in which this research took place. Suggestions for future research are given.