Date of Award

2015

Document Type

Open Access Dissertation

Department

Epidemiology and Biostatistics

Sub-Department

Epidemiology

First Advisor

Kellee White

Second Advisor

Bo Cai

Abstract

Depression is the one of most common mental health conditions in Taiwan. Although evidence suggests that social capital is associated with depression, few studies have comprehensively explored the influence of social capital on depression. Also evidence in Taiwan is limited in comparison to other Western countries. Data from the 1997 Taiwan Social Change Survey (n=2,598), which is the only dataset that contains the best available information to measure and compare all three dimensions of social capital (network, cognitive, and structural social capital), were used to examine the association between three dimensions of neighborhood- and individual-level social capital and depression among Taiwanese adults 20 years and older. The 20-item Center for Epidemiological Studies Depression Scale was used to measure depressive symptoms; scores ≥ 15 indicated being at a risk for clinical depression. Three dimensions of social capital were assessed: cognitive social capital (measured using questions on perceived neighborhood trust and reciprocity), structural social capital (measured using questions about local social participation), and network social capital (measured using a position generator). In order to develop a greater understanding of the mechanisms linking social capital and depression, multivariable logistic regression models were used to assess the relationship between the three dimensions of social capital and the risk of clinical depression, the association between age-based patterns of social capital and the risk of clinical depression, and the independent association between neighborhood-level social capital and the risk of clinical depression.

The main findings from this study suggest the dimensions of social capital did not have the same relationship with being at the risk of clinical depression. Higher scores of cognitive social capital and structural social capital were both independently associated with lower odds of being at risk for clinical depression after controlling for potential confounders. Network social capital was not associated with being at risk for clinical depression except for network diversity. In the second paper, the study revealed that there are different age patterns for network, cognitive and structural social capita but we only observed age variations in network social capital and the risk for clinical depression among age 65 and older. The results from the third paper showed that neighborhood-level social capital was not associated with the risk of clinical depression. Disentangling the multidimensional and multilevel nature of social capital may inform our understanding of the mechanisms linking social capital and depression to promote mental health.

Rights

© 2015, Yun-Hsuan Wu

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