Reading summary of “Relationships between Poverty and Psychopathology”

Costello et al. (2003) in their study “Relationships between Poverty and Psychopathology” examined the association between poverty and mental illness using a quasi-experimental longitudinal design to address an elongated debate among the clinicians and researchers on whether the high prevalence of mental illness among the poor people is a social causation or a social selection. Before going deeper into the study, let’s talk about these two catchy terms: social causation and social selection. Let’s suppose that McGill students are the smarter one among the Canadian universities. One can explain that the quality faculty and state of art facilities of McGill contribute to the students to become smarter. In contrast, someone can claim that students with higher aptitude and intelligence, who are already smarter, come to study in McGill, and this how McGill gets smarter students among Canadian universities. The first explanation about the smartness of McGill students refers to social causation, and the later one refers to social selection.

Costello et al. (2003) examined whether the high prevalence of mental illness among the poor people is a social causation or social selection. In their study, they selected a representative sample of 1420 rural children aged from 9-13 years, and assessed them for 8 years (1993-2000). Among the sample participants, one quarter was from American Indian, and the rest were predominantly white. They used two main measures: psychometric symptoms consisting of emotional psychometric symptoms and behavioral psychometric symptoms, and level of poverty measured in terms of income threshold. In the fourth year, they used an intervention; a casino opening in the Indian reservation that provided income supplement to American Indian families. As effect of the intervention, 14% families came out of poverty, while 53% remained poor, and 32% were never poor. Now, they categorized these families into three groups: persistently poor who remained poor all the way before and after the intervention, ex-poor who were poor before the intervention and came out of poverty after the intervention, and the third one was never poor. They compared the psychometric symptoms scores within the group and across the groups.

Results showed that before the casino opening, the mean psychometric symptoms scores of children of persistently poor and ex-poor families were almost similar (M = 4.38 and M= 4.28 respectively) and were greater than that of never poor families (M = 2.75). The odds ratio of persistently poor families against ex-poor and never poor families were OR = 1.02 and OR = 1.59 respectively, and the odds ratio of ex-poor families against never poor families was OR =1.55. It is evident that before the casino opening, the prevalence of mental illness among the children of both persistently poor and ex-poor families was higher, and they were more likely to have mental disorders.

After the casino opening, the mean psychometric scores of the children of persistently poor families increase a little bit (M = 4.71), the mean scores of the children of ex-poor families decreased to a great extent (M = 2.90), and the mean score of the children of never poor families remained almost the same (M = 2.78) as before. The odds ratio of the children of persistently poor families, ex-poor families and never poor families before and after the casino opening were OR = 0.91, OR = 1.5, and OR = 1.00 respectively, which indicated that the likelihood of having mental disorders decreased significantly in case of the children of ex-poor families. The odd ratio of the children of persistently poor families against the children of ex-poor families after the intervention became OR = 1.69, which indicated that the likelihood of having mental disorders among the children of persistently poor families became 1.69 times higher than that of ex-poor families, where their odds ratio against never poor families became OR = 1.76, and the odds ratio of the children of ex-poor families against never poor families became OR = 1.04. Now, the likelihood of having mental disorders among the children of ex-poor and never poor families is almost similar.

The findings of this study established the social causation theory of poverty and mental illness against the paradigm of social selection. The mean psychometric symptoms scores decreased significantly among the children of ex-poor families when they came out of poverty. If the change wouldn’t happen, the theory of social selection could sustain. This study will help to change the attitude of many policy makers who feel comfortable to blame the poor people for their poverty and many other problems they face every day. It is also perceivable that as poverty affects mental illness, mental illness can lead poor people to further level of poverty, which might work similar to the theory of vicious cycle of poverty.

 

-Costello, E. J., Compton, S. N., Keeler. G. and Angold, A. 2003. Relationships between Poverty and Psychopathology: A natural experiment. Journal of American Medical Association. Vol. 290. No. 15. 

3 responses to “Reading summary of “Relationships between Poverty and Psychopathology””

  1. Lukas says:

    I think it’s also important to include the results of the mediator variable. As the authors note, when including Parental Supervision as a mediating variable into the model, which accounted for 77% of the effect of poverty level on number of psychiatric symptoms, the effect became non-significant. Pretty significant results, I’d say, yes/no?

    • Mohammad Khan says:

      Yes. Lax supervision is an example of mediation, and this is an appropriate mediator used in this study. But, it doesn’t weaken the claim for social causation of poverty and psychopathology. As I understand, social causation is different from simple cause-effect relationship to some extent. I believe the following statement of the authors can help to understand it “We ran a series of test for mediators of the link between poverty and psychopathology; that is, factors causally related to the symptoms that could be affected by relief from poverty.” As I understand, social causation is more of a flow of causation like a link than of a simple immediate cause-effect relationship.

  2. Gina Glidden says:

    Yes, I agree. This was a great example of mediation.

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