Key study: Subjective social status and stress in teenagers (Rahal et al. 2019)

Travis DixonHealth Psychology, Key Studies, Studies and Theories

Are you one of "the cool kids?" The answer might explain your stress levels.

Social status is an important predictor of numerous mental and physical health problems. Generally speaking, the lower your social status, the more at risk you are for developing health problems, like chronic stress and heart disease. While socioeconomic status has been extensively researched, more modern studies are focusing on subjective social status. This is particularly relevant for understanding stress in teenagers.

This study is included in our eBook for IB Health Psychology. Download a free preview.

Socioeconomic status (SES) is measured based on your (or your parents’) income, education and occupation. It’s a strong predictor of health for adults. However, in teenagers it’s less reliable. This is why subjective social status (SSS) is studied instead. This has also been linked to poorer mental and self-rated health in adolescents and adults (Cundiff & Matthews, 2017; Quon & McGrath, 2014). That is to say, those with lower SSS are more at risk for developing health problems. Danny Rahal and his colleagues conducted a quasi-experiment on Los Angeles teenagers to see if this correlation could be explained by the effect on SSS on the stress response.

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SSS and the Stress Teenage Stress Response

(Rahal et al. 2019)

Aim:  The aim of this study was to assess whether SSS influences health through psychological and physiological responses to stress.

MacArthur scale of subjective social status. It is used to assess... | Download Scientific Diagram

A simplified version of the MacArthur scale.


  • The study was conducted on 91 Los Angeles teenagers (seniors and recent graduates of high school).
  • SSS was measured using the MacArthur Scale of Subjective Social Status (Youth Version). Participants are shown a ladder with ten rungs and they signal where they think they rank amongst their peers.
  • Participants then went through the Trier Social Stress Test (TSST):
    • They were told they had to prepare and present a speech to a panel of people about why they were qualified for their ideal job. They prepared for 5 mins and presented for 5 mins to two confederates who gave non-verbal, negative feedback. They then had to subtract by 13s starting at 2935 and had to start again each time they got one wrong. They did this for five mins.
  • To measure their physiological responses to stress, their cortisol levels were measured before, during and after the stress test.
  • To measure their psychological responses to stress they completed a questionnaire to measure their levels of “fear” (This was sub-scale of the PANAS scale questionnaire).
  • In the analysis the researchers controlled for SES to isolate SSS as being an independent factor influence stress responses.


  • SSS was correlated with family and parental education (0.41 & 0.31) and did not differ by gender or ethnicity. This suggests there’s some connection between SES and SSS, although it’s quite weak.
  • Participants with low SSS had a slight but statistically significantly higher fear response to the TSST, as measured using the PANAS questionnaire.
  • Low SSS was associated with faster HPA axis reactivity. Surprisingly, it was also linked with faster recovery.

Income inequality (the differences between rich and poor, as shown in this image from Rio de Janeiro) is one social problem that could be contributing to differences in health outcomes.

Conclusions and Applications:

The researchers concluded that “…the perception of being of low status appears to be linked with differences in the stress response across all systems and may thereby uniquely shape health outcomes among low-status adolescents.” Similarly, they write that “increased fear reactivity suggests that adolescents of lower SSS may feel overwhelmed facing a challenging or novel task, and differences in stress physiology may reflect differences in emotion regulation which can have consequences for health.”

In other words, if you feel you have low social status you might feel more psychological stress in reaction to a stressful situation and this leads to your body releasing more stress hormones. This increase in stress hormones could have detrimental health effects if it persists for a long time.

This increased stress reaction could be an adaptation to the environment. For instance, people with lower social status might be exposed to more stressors (e.g. bullying) and so they need a more reactive stress response to be readily prepared to deal with threats. This is similar to research on young children who have grown up in violent homes have amygdalae that are more reactive to threatening faces in an fMRI (McCrory, 2013).

IB Exam Applications – IB Health Psychology

You can use this study for the following topics:

  • Sociocultural explanations of one health problem
  • Prevalence rates of one health problem
  • Determinants of health
  • Risk and protective factors
  • Dispositional factors
  • The biopsychosocial model
Critical Thinking Considerations

  • This study is a quasi-experiment comparing two groups of participants with a naturally occurring difference (their subjective social status). Does this affect our ability to draw causal conclusions about this study?
  • This study was conducted on teenagers. Do you think the same results would apply for adults? Why/why not?
  • Do you think the TSST is a valid way of testing stress responses?
  • Their psychological stress responses (fear responses in the PANAS questionnaire) and their subjective social status was collected using self-reported measures. Is this a limitation?


  • Danny Rahal, Jessica J. Chiang, Julienne E. Bower, Michael R. Irwin, Jaahnavee Venkatraman & Andrew J. Fuligni (2019): Subjective social status and stress responsivity in late adolescence, Stress, DOI: 10.1080/10253890.2019.1626369. Source.