Shift-and-Persist Strategies: Associations With Socioeconomic Status and the Regulation of Inflammation Among Adolescents and Their Parents

Psychosom Med. 2015 May;77(4):371-82. doi: 10.1097/psy.0000000000000157.


Objective: Shift-and-persist is a resilience construct hypothesized to be beneficial to physical health among individuals with low socioeconomic status (SES). This shift-and-persist construct entails a combination of reframing stressors more positively while also enduring adversity through finding purpose in life. In this study, we investigated how shift-and-persist relates to key inflammatory processes that are implicated in cardiovascular and other diseases. We also obtained validation information on a new shift-and-persist measure.

Method: A sample of 122 adolescents and 122 parents from a diverse range of SES backgrounds completed our shift-and-persist measure, a battery of other psychosocial questionnaires and interviews, and provided blood samples. Parents also provided SES information.

Results: Reliability and validity of the shift-and-persist measure were demonstrated across both adolescents and adults. Shift-and-persist moderated the association between SES and indicators of inflammatory regulation. Specifically, as SES declined, shift-and-persist was associated with greater sensitivity to glucocorticoids' anti-inflammatory properties (interaction in adolescents: [beta] = .21, p = .033; interaction in adults: [beta] = .25, p = .011), and also with less low-grade, chronic inflammation (interaction in adolescents: [beta] = .18, p = .044). Conversely, as SES increased, the opposite pattern was evident.

Conclusions: These findings suggest that adaptive psychosocial characteristics have the potential to regulate inflammatory processes in ways that may mitigate risk for a number of chronic diseases, particularly among disadvantaged groups.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Inflammation / blood*
  • Male
  • Middle Aged
  • Psychometrics / instrumentation*
  • Reproducibility of Results
  • Resilience, Psychological*
  • Social Class*
  • Surveys and Questionnaires / standards*