Social Science & Medicine最新文献

{"title":"Understanding associations between sexual identity change and the mental health of lesbian, gay, and bisexual adults in the United Kingdom through longitudinal survey","authors":"Veena Muraleetharan ,&nbsp;Catherine L. Saunders","doi":"10.1016/j.socscimed.2025.118276","DOIUrl":"10.1016/j.socscimed.2025.118276","url":null,"abstract":"<div><div>While the existence of poorer mental health among lesbian, gay and bisexual (LGB) populations is well-established, most research does not acknowledge sexual identity shifts when quantifying disparities. This study begins to fill this gap by examining associations between sexual identity change from 2011 to 2023 and current psychological wellbeing and mental health diagnoses self-reported between 2021 and 2023 in the United Kingdom.</div><div>We utilized a nationally-representative sample of 25,141 respondents aged 16 and older who completed Understanding Society, a longitudinal household survey, in the 2021–2023 wave and responded to the sexual identity question in at least one wave. Using weighted linear and logistic regression, we examined associations between changes in reporting of sexual identity between heterosexual, LGB, and other identities and psychological distress and mental health diagnoses in Wave 13.</div><div>Sexual identity change was associated (p &lt; .05) with psychological distress and odds of reporting any mental health condition, depression, panic attacks, and anxiety, but not post-traumatic stress disorder. Changes towards LGB identities and consistently identifying as bisexual were significant predictors of poorer mental health across outcomes (increased distress range across groups:1.61–2.58, Adjusted Odds Ratio(AOR) range across items/groups:1.91–4.27). Those who changed from LGB to straight also had higher distress (1.65(95 % CI:0.40–2.91)) and odds of reporting any mental health diagnosis (AOR:1.99(1.34–2.96)) and depression (AOR:2.25(1.48–3.42)) than consistently-heterosexual respondents. Currently LGB-identifying groups, excluding those consistently reporting “other”, also had higher odds of reporting any mental health condition (AOR range:1.90–3.71) and depression (AOR range:2.15–3.76). These insights can improve services to reduce mental health disparities among LGB populations.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"382 ","pages":"Article 118276"},"PeriodicalIF":4.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Support or stress? How attachment and relationship dynamics associate with acute psychosocial stress in the presence of the romantic partner","authors":"Mathilde Gallistl ,&nbsp;Johanna Elea Hamann ,&nbsp;Ilona Croy ,&nbsp;Pascal Vrticka ,&nbsp;Veronika Engert","doi":"10.1016/j.socscimed.2025.118275","DOIUrl":"10.1016/j.socscimed.2025.118275","url":null,"abstract":"<div><div>Stress is a wide-spread phenomenon and associated with various detrimental health effects. A significant resource for stress buffering is social support. How social support is perceived, however, depends on a multitude of individual and interindividual factors. This study aimed to explore the stress-reducing properties of relationship-inherent variables. We investigated the association of attachment style, relationship quality and dyadic coping, with subjective and physiological stress responses to a psychosocial laboratory stressor in romantic partners. Seventy-nine couples participated (85 recruited, six dropouts), with one partner (\"target\") undergoing the Trier Social Stress Test and the other (\"observer\") observing the situation. Besides examining the role of targets' relationship variables, we also assessed the link between observers' relationship variables and targets' stress reactivity. We found that both targets' and observers' insecure-avoidant attachment scores were associated with targets' stress reactivity. In detail, while targets' insecure-avoidant attachment scores were negatively associated with targets' subjective stress experience, observers' insecure-avoidant attachment scores were positively associated with targets' heart rate reactivity. Further, higher insecure-avoidant attachment scores were linked to lower psychoendocrine covariance, i.e., a lower accordance between self-reported and cortisol stress responding. On the one hand, these data may suggest that under stress, insecure-avoidantly attached individuals suppress their experience of stress to preserve a sense of independence as part of their deactivating attachment strategy. The presence of an insecure-avoidantly attached partner during a stressful experience, on the other hand, seems to be a stressor rather than a source of support. Long-term, an insecure-avoidantly attached partner may negatively impact an individual's stress-related health and wellbeing.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"381 ","pages":"Article 118275"},"PeriodicalIF":4.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contested illness, contested identity: How women with fibromyalgia construct legitimacy online","authors":"Jenna M. Kerr ,&nbsp;Carey DeMichelis","doi":"10.1016/j.socscimed.2025.118251","DOIUrl":"10.1016/j.socscimed.2025.118251","url":null,"abstract":"<div><div>This research explores the lived experiences of women with fibromyalgia (FM) and the various ways they go about legitimizing a contested medical condition. Through ethnographic observation in a private online community, “<em>Fibro Women Canada,”</em> and in-depth interviews with its members, we explore how women work to be seen as legitimate pain patients in the eyes of their healthcare providers. We argue that FM produces a dilemma of legitimacy, a dilemma of identity, and a dilemma of morality for its sufferers. In the face of these dilemmas, <em>Fibro Women Canada</em> functions as a backstage environment that supports two distinct, yet interwoven, forms of legitimacy building: (1) <em>illness literacy</em>, and (2) <em>identity work</em>. In particular, we attend to the moral stakes of seeking biomedical recognition, illuminating the every-day strategies that women use to construct themselves as deserving of care.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"381 ","pages":"Article 118251"},"PeriodicalIF":4.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syndemic interactions of chronic pain, mental health problems, and opioid misuse and their association with academic performance and quality of life among college students","authors":"Fares Qeadan,&nbsp;Rose Thornquist,&nbsp;Benjamin Tingey","doi":"10.1016/j.socscimed.2025.118243","DOIUrl":"10.1016/j.socscimed.2025.118243","url":null,"abstract":"<div><h3>Background</h3><div>College students experience multiple stressors impacting academic performance and quality of life (QoL), including chronic pain, mental health issues, and opioid misuse, which can co-occur and exacerbate one another. Guided by syndemic theory, this study examined the associations between these three health conditions and academic performance and QoL.</div></div><div><h3>Methods</h3><div>We analyzed cross-sectional data from 334,957 students from the ACHA-NCHA III survey (2019–2022). Lifetime chronic pain and mental health problems were self-reported based on provider diagnosis or symptoms. Opioid misuse was defined as ever using heroin or using prescription opioids for nonmedical purposes. Syndemic burden was measured using individual indicators, a composite count (0–3), and interactions terms. Academic performance was measured via a binary indicator of impeded performance, and QoL was assessed using a weighted average score from four validated WHOQOL-BREF domains. Multiple logistic and linear regression were used, adjusting for demographic and contextual variables.</div></div><div><h3>Results</h3><div>Greater syndemic burden was associated with worse outcomes. Students with all three conditions had the highest odds of impeded academic performance (aOR = 7.38, 95 % CI: 6.52, 8.35) and the lowest QoL scores (<span><math><mrow><msub><mover><mi>β</mi><mo>ˆ</mo></mover><mrow><mi>A</mi><mi>D</mi><mi>J</mi></mrow></msub></mrow></math></span> = −12.05, 95 % CI: −12.37, −11.73). Each factor was independently associated with adverse outcomes, and significant interaction effects, especially when mental health problems were present, suggested syndemic amplification.</div></div><div><h3>Conclusion</h3><div>These findings support a syndemic framework linking chronic pain, mental health problems, and opioid misuse with academic and QoL outcomes in college students. Interventions should prioritize integrated mental health services and non-pharmacological pain management options in college health systems.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"381 ","pages":"Article 118243"},"PeriodicalIF":4.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making disordered bodies in the context of male eating disorders","authors":"Piotr Maron","doi":"10.1016/j.socscimed.2025.118250","DOIUrl":"10.1016/j.socscimed.2025.118250","url":null,"abstract":"<div><div>Male eating disorders (MEDs) are increasingly recognised as a significant public health issue in Australia and globally. In this paper, I examine clinicians' accounts to explore how male bodies, particularly those involved in practices such as ‘clean’ eating, exercise, and muscle building, are enacted as ‘disordered’ while investigating how lifestyle choices that are often admired or seen as ‘healthy’ can, in specific clinical contexts, be reframed as problematic. I show how clinicians problematise healthy eating practices, exercising and muscle building as situations that indicate a possible risk. I thus claim that clinicians' interpretations of ‘clean’ eating and muscle building signs of disorder are part of an evidence-making intervention – a more flexible and creative approach to care Consequently, by unpacking how the disordered male bodies become as such in clinical encounters, this paper concludes that health care delivery for male eating disorders could benefit from greater flexibility while asking whether there is room for a different diagnostic standard in terms of a more relational approach to care.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"381 ","pages":"Article 118250"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to 'Understanding deep disadvantage at the end of life: A nationwide analysis of unclaimed deaths' [Soc. Sci. Med. Volume 365, January 2025, 117551].","authors":"Jennifer Brite, Frank W Heiland, Deborah Balk","doi":"10.1016/j.socscimed.2025.118230","DOIUrl":"https://doi.org/10.1016/j.socscimed.2025.118230","url":null,"abstract":"","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":" ","pages":"118230"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond dental dams: a critical review of recent research on lesbian, bisexual and queer women's sexual health","authors":"Jennifer Power ,&nbsp;Ruby Grant ,&nbsp;Tinonee Pym ,&nbsp;Percy Gurtler ,&nbsp;Kerryn Drysdale ,&nbsp;Julie Mooney-Somers","doi":"10.1016/j.socscimed.2025.118249","DOIUrl":"10.1016/j.socscimed.2025.118249","url":null,"abstract":"<div><div>This paper presents findings from a critical review of literature on the sexual health of lesbian, bisexual, queer, and other sexuality-diverse (LBQ+) women. The review aimed to understand how LBQ + women's sexual health is framed in current research and the impact of this framing on recommendations for future research and practice. We also explored how holistic definitions of sexual health are applied in research. A narrative synthesis of literature published between 2012 and 2023 was conducted. We then undertook a critical review utilising Bacchi's ‘What's the problem represented to be’ (WPR) framework. There were 91 publications included in the review. Findings show that LBQ + women are diverse in their sexual identities, practices and experiences and that many LBQ + women have sex with cisgender men, irrespective of sexual identity. Despite this, research in this field often rests on the assumption that sex between cisgender women is the dominant sexual experience of LBQ + women and, therefore, that LBQ + women face low or no HIV/STI risks. This creates fragmented and unclear conclusions about what LBQ + women need regarding sexual health promotion and support. Further, the current literature provides limited insight into the significance of sexual identity and gender on LBQ + women's experiences navigating safe and pleasurable sex. We recommend future research focuses on LBQ + women's navigation of safety and pleasure in their sexual encounters and relationships, with consideration given to identity and community connection, as well as the social and relational contexts in which LBQ + women experience sex throughout their life course.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118249"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring at the end of life: Bereaved family members' experiences of preparedness, readiness, and anticipation fatigue","authors":"Nathan D. MacArthur,&nbsp;Emma Kirby,&nbsp;Jane Mowll","doi":"10.1016/j.socscimed.2025.118252","DOIUrl":"10.1016/j.socscimed.2025.118252","url":null,"abstract":"<div><div>Ensuring patient and family members' preparedness for dying is a key focus for palliative care. This article draws on the retrospective accounts of bereaved adult family members' experiences of anticipation and preparedness following a death in palliative or residential aged care. Participants completed in-depth interviews (n = 36). A constructivist grounded theory approach guided data collection and analysis, through which the complexities of engaging in preparedness whilst navigating questions of how to care well emerged. We propose the concept of <em>anticipation fatigue</em> as a means by which to understand the impacts of holding multiple, sometimes contradictory, positions in the pursuit of ‘good’ care at end of life. These results deepen our understandings of the impacts of caring-in-anticipation and offer insights for improving support to families receiving palliative care.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118252"},"PeriodicalIF":4.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The social experience of stress as premedical students in the United States","authors":"Caitlin Tickman,&nbsp;Lauren D. Olsen","doi":"10.1016/j.socscimed.2025.118253","DOIUrl":"10.1016/j.socscimed.2025.118253","url":null,"abstract":"<div><div>Premedical students (premeds) are stressed. While the literature describes some of the reasons why premeds are stressed and the impact of stress on students' desire or ability to continue along the premed pathway, there is less of an understanding about how premeds understand, interpret, and metabolize stress. We draw upon in-depth interviews with twenty-seven first-year premeds from a large, public, metropolitan university in the United States to gain insight into their experiences and expectations. Our sample is split between insiders—that is, students who have at least one parent with a college degree—and newcomers—or, students who are first-generation college students. First, we show that first-year premeds arrive to college with different experiences with stress, depending on their insider or newcomer status. Insiders have social and cultural capital that has primed them to be at ease with stress, whereas newcomers arrive to college with less comfort with the competitive environment and valorization of stress. Then, we describe students’ perceived lack of formal guidance from the premed advising office and how it opens up space for peer socialization around stress. We conclude by showing how insiders are less flustered by the stress while newcomers are more likely to begin to doubt themselves and their ability to become physicians. Bridging the peer socialization and social reproduction of inequalities literatures, we argue that it is possible that social understandings of stress are a key mechanism to the reproduction of inequalities within the medical profession.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118253"},"PeriodicalIF":4.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of bioequivalence regulation on pharmaceutical firm outcomes: Evidence from China","authors":"Menghan Shen,&nbsp;Xiaoxia Liang,&nbsp;Han Wu","doi":"10.1016/j.socscimed.2025.118242","DOIUrl":"10.1016/j.socscimed.2025.118242","url":null,"abstract":"<div><div>China's pharmaceutical market is dominated by generic drugs, accounting for 95 % of its market share. However, prior to 2016, these drugs were not required to undergo bioequivalence testing against their innovator drugs, raising concerns about the effectiveness of generic drugs. To address this issue, China implemented mandatory bioequivalence testing in 2016. This study investigates the impact of this policy change on generic drug firms' R&amp;D investments and their success in passing bioequivalence tests. Employing a difference-in-differences approach, we analyze R&amp;D investment data from 2012 to 2022 and bioequivalence approval data from 2012 to 2024 for 122 publicly listed pharmaceutical firms in China. Our findings reveal that firms responded to the new regulations by significantly increasing their R&amp;D investments by 20.7 %. In addition, the quality regulation has led to an average of 2.5 approval per firm annually. Hetergeneity analysis reveals that firms in wealthier provinces, larger firms, and those with prior higher R&amp;D capacities were more likely to increase their R&amp;D investments and pass bioequivalence tests compared to those that are not. In addition, pharmaceutical firms prioritize bioequivalence testing compliance for drugs facing stricter regulatory deadlines or those with potentially higher economic returns. These results suggest that the implementation of mandatory bioequivalence testing has spurred positive responses from the industry, and it is likely to have a positive impact on drug quality compared to the pre-regulation period. However, more comprehensive strategies are needed to ensure full compliance and further improve the quality of generic drugs in China.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118242"},"PeriodicalIF":4.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}