Depression is associated with poor physical health through lower distress tolerance among adults experiencing homelessness

Abstract

ABSTRACT Research is limited on the association between depression and perceived health status and the underlying mechanisms linking these variables among adults experiencing homelessness. The purpose of the current study was to evaluate the association between probable major depressive disorder (MDD) and perceived health status among a sample of adults experiencing homelessness and to determine whether this association is indirectly linked through distress tolerance. Adults experiencing homelessness were recruited from six homeless shelters in Oklahoma City, OK (n = 568). Participants self-reported their health status as poor/fair, probable MDD was assessed using Patient Health Questionnaire-8, and distress tolerance was assessed via the Distress Tolerance Scale (DTS with four subscales). Covariate-adjusted structural equation model indicated a significant indirect effect of MDD on health status through total distress tolerance (indirect effect = 0.070, 95% CI = 0.027, 0.118). The multiple mediation model with four DTS subscales indicated that only the appraisal subscale contributed independent variance to the indirect effect model (indirect effect = 0.067, 95% CI = 0.026, 0.111). Adults experiencing homelessness are at higher risk of probable MDD, negatively influencing their perception of health and quality of life. Results suggest the need for providing support to improve distress tolerance skills among those diagnosed with probable MDD to improve their health perception.