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One size does not fit all: Links between shift-and-persist and asthma in youth are moderated by perceived social status and experience of unfair treatment

  • Phoebe H. Lam (a1), Gregory E. Miller (a1), Jessica J. Chiang (a1), Cynthia S. Levine (a1), Van Le (a1), Madeleine U. Shalowitz (a2), Rachel E. Story (a2) and Edith Chen (a1)...


The links between low socioeconomic status and poor health are well established, yet despite adversity, some individuals with low socioeconomic status appear to avoid these negative consequences through adaptive coping. Previous research found a set of strategies, called shift-and-persist (shifting the self to stressors while persisting by finding meaning), to be particularly adaptive for individuals with low socioeconomic status, who typically face more uncontrollable stressors. This study tested (a) whether perceived social status, similar to objective socioeconomic status, would moderate the link between shift-and-persist and health, and (b) whether a specific uncontrollable stressor, unfair treatment, would similarly moderate the health correlates of shift-and-persist. A sample of 308 youth (Meanage = 13.0, range 8–17), physician diagnosed with asthma, completed measures of shift-and-persist, unfair treatment, asthma control, and quality of life in the lab, and 2 weeks of daily diaries about their asthma symptoms. Parents reported on perceived family social status. Results indicated that shift-and-persist was associated with better asthma profiles, only among youth from families with lower (vs. higher) parent-reported perceived social status. Shift-and-persist was also associated with better asthma profiles, only among youth who experienced more (vs. less) unfair treatment. These findings suggest that the adaptive values of coping strategies for youth with asthma depend on the family's perceived social status and on the stressor experienced.

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      One size does not fit all: Links between shift-and-persist and asthma in youth are moderated by perceived social status and experience of unfair treatment
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Corresponding author

Address correspondence and reprint requests to: Phoebe H. Lam, Foundations of Health Research Center, 1801 Maple Avenue, Suite 2450, Evanston, IL 60201; E-mail:


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This research was supported by National Institutes of Health Grant R01 HL108723 (to E.C.).



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One size does not fit all: Links between shift-and-persist and asthma in youth are moderated by perceived social status and experience of unfair treatment

  • Phoebe H. Lam (a1), Gregory E. Miller (a1), Jessica J. Chiang (a1), Cynthia S. Levine (a1), Van Le (a1), Madeleine U. Shalowitz (a2), Rachel E. Story (a2) and Edith Chen (a1)...


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