Abstract
The enduring intuition behind Maslow’s hierarchy is that material security must be established before growth-oriented concerns become consequential for mental health. Contemporary evidence, however, does not support a strict sequence in which higher-order needs remain dormant until lower-order needs are satisfied. This integrative conceptual review develops an alternative: a conditional returns model in which security needs and growth-related psychological needs are partly independent, continuously operative, and dynamically linked. Evidence from cross-national surveys, social-policy interventions, poverty research, and self-determination theory supports five propositions: deprivation sensitivity, non-dormancy of growth needs, shifting relative importance, outcome specificity, and mediation with reciprocal feedback. The model replaces a sequential ladder with interacting domains characterized by nonlinear and context-dependent returns and generates falsifiable predictions concerning moderation, mediation, nonlinearity, and cross-level variation.
Keywords: need satisfaction, mental health, poverty, self-determination theory, meaning in life, well-being
Introduction
Depression and anxiety are together responsible for about 8% of the years lived with disability worldwide, and they are not diseases of affluence. Within a given location, people with the lowest incomes are typically 1.5 to 3 times more likely than the rich to experience them (Ridley et al., 2020). Mendelian randomization analyses using UK Biobank data have provided stronger causal evidence: poverty contributes to major depressive disorder and schizophrenia, while schizophrenia and ADHD causally contribute to poverty, establishing a bidirectional relationship that is not merely correlational (Ganesan et al., 2024). Yet material comfort clearly does not protect anyone completely. Plenty of people who have enough to eat, a secure home, and a doctor to call still report emptiness, drift, or a sense that their lives are going nowhere in particular.
One intuitive way to hold both observations at once is to imagine two kinds of need that matter at different times. The first kind is material and protective: food, shelter, health care, physical safety, and the family bonds that catch people when they fall. The second is developmental: acting with some autonomy, using one’s abilities, having a purpose, becoming more fully what one is capable of being. On this view, people whose first-kind needs are unmet gain the most from having them met, while people who are already secure gain the most from the second kind. This is a modern retelling of Maslow’s (1943) hierarchy, in which needs lower in the order must be reasonably satisfied before higher ones take over. It is also a view that is often applied informally, in clinics and in policy debates, with little scrutiny.
That scrutiny is now overdue. Recent metatheoretical evaluation of Maslow’s framework shows that the hierarchy, while intuitively appealing, suffers from conceptual vagueness, unfalsifiable mechanisms, and inconsistent empirical support across cultures (Schulz & Cornejo, 2026). The constructs are poorly operationalized, the proposed sequence is rarely tested directly, and the model reflects Western individualistic assumptions that overlook alternative motivational priorities in collectivist and spiritual traditions. Even Maslow’s own later writings cast doubt on the rigid sequential structure attributed to him. Yet the hierarchical intuition persists in clinical and policy discourse, often functioning as an implicit assumption rather than a tested hypothesis.
This article develops a conditional returns model to address that problem. Its contribution is threefold. First, it distinguishes security needs from growth-related psychological needs without assuming that either domain becomes inactive. Second, it integrates evidence on nonlinear material returns, basic psychological need satisfaction and frustration, meaning in life, and socioeconomic gradients into a common framework. Third, it translates the framework into five propositions that are falsifiable with longitudinal, cross-national, and intervention data. The core claim is narrower than a hierarchy but more specific than the generic observation that all needs matter: material security should yield its largest mental-health returns under deprivation, psychological growth needs should remain consequential across levels of security, and the relative contribution of particular needs should vary by context and outcome.
Two Domains of Need
I use security needs to refer to material and protective conditions that reduce exposure to immediate threat and instability: adequate food, stable housing, access to health care, physical safety, reliable utilities, and sufficient economic predictability. Growth-related psychological needs refer to experiential conditions that support agency, effective functioning, connection, and valued development, including autonomy, competence, relatedness, meaning, and purpose. These categories are analytic domains rather than mutually exclusive boxes. Close relationships, for example, can provide both psychological relatedness and material protection, while economic resources can expand autonomy by increasing feasible choices.
A critical refinement from recent SDT research is the distinction between need satisfaction and need frustration. These are not simply opposite ends of one continuum. A 2026 study applying SDT to the social determinants of health found that concrete access barriers—difficulties affording utilities, health care, and bills—relate most strongly to basic psychological need frustration and ill-being, whereas income and education relate more strongly to need satisfaction and well-being (Bradshaw et al., 2026). This dual-process pattern has direct implications for the conditional model: security deprivation may operate primarily by frustrating growth needs rather than merely failing to satisfy them. The distinction matters because frustration is not the absence of satisfaction; it is an active undermining of the need that carries distinct psychological costs.
Self-actualization is hard to measure, so I treat these proxies as operational stand-ins. The distinction between hedonic well-being (pleasure and the avoidance of pain) and eudaimonic well-being (meaning and self-realization) is the standard way of separating the two families of outcomes (Ryan & Deci, 2001). Ryff’s (1989) model of psychological well-being, which includes autonomy, environmental mastery, personal growth, purpose in life, self-acceptance, and positive relations with others, gives measurable dimensions for the eudaimonic side.
Family and close relationships do not fit neatly on either side. They are a psychological need (relatedness), but they also have a material function, because kin provide care, money, and housing in hard times. Across 148 studies covering 308,849 participants, stronger social relationships were associated with a 50% greater likelihood of survival, an effect comparable to well-established risk factors (Holt-Lunstad et al., 2010). I therefore treat close relationships as a bridging need that operates in both domains, and I return to their cultural variability below.
Where the Strict Hierarchy Fails
The strong form of the hierarchy predicts that higher needs should show little association with well-being until lower needs are met. Tay and Diener (2011) tested this with Gallup World Poll data from 123 countries. Need fulfillment was consistently associated with subjective well-being in every world region, and the association of any given need with well-being was largely independent of whether other needs were fulfilled. The results held when household income was taken into account. Basic needs were most strongly tied to life evaluation, social and respect needs to positive feelings, and basic, respect, and autonomy needs to negative feelings. People, it seems, do not queue their needs.
The evolutionary revision of the pyramid by Kenrick et al. (2010) argued that the foundational structure is worth preserving while adding extensions and reorganizing the top, where self-actualization no longer appears as a separate level. That decision drew an immediate response from Peterson and Park (2010), who asked what had happened to self-actualization. The disagreement is informative. Even the defenders of a hierarchy do not agree on what sits at the top, and the empirical record does not support a strict ordering.
The weaker claim survives: different needs may carry different weight in different conditions. That is a claim about conditional returns rather than sequence, and it is the claim I develop here. Recent work has begun to specify the mechanisms through which socioeconomic conditions shape these conditional returns. A 2025 study using Swedish survey data found that household income was the strongest socioeconomic predictor of need fulfillment and subjective well-being, but that only autonomy and security needs remained significant mediators of the socioeconomic gradient in structural equation models (Fors Connolly & Lindh, 2025). This is precisely the pattern the conditional model predicts: security needs dominate at low levels of socioeconomic resources, while autonomy emerges as a distinct mediator at higher levels.
Security Needs and Mental Health
The evidence that material deprivation harms mental health is stronger than for most questions in this area, because some of it is experimental. A review of the interdisciplinary literature concluded that the causal relation between poverty and common mental illness runs in both directions. Negative income shocks worsen mental health, antipoverty programs such as cash transfers improve it, and mental illness in turn reduces employment and income (Ridley et al., 2020). One proposed mechanism is that poverty produces stress and negative affect, which narrow attention and favor short-sighted decisions, forming a feedback loop that helps perpetuate poverty (Haushofer & Fehr, 2014). Recent experimental work has extended this account: perceived financial constraint impairs directed attention, particularly toward pleasurable, self-generated thought, and this impairment operates through both reduced ability and reduced motivation to engage in such thinking (Wu et al., 2025). The scarcity literature thus provides a cognitive mechanism linking material deprivation to the frustration of growth-related capacities.
Individual security needs show the same direction of association. In a meta-analysis of 19 studies with 372,143 participants, food insecurity was associated with higher odds of depression (OR = 1.40) and stress (OR = 1.34), though not of anxiety (Pourmotabbed et al., 2020). Most of the included studies were observational, so this establishes association rather than cause. Stronger causal evidence comes from the Oregon Health Insurance Experiment, in which low-income adults were randomly given the chance to apply for Medicaid. Coverage lowered the probability of screening positive for depression by 9.15 percentage points (95% CI [−16.70, −1.60]) and nearly eliminated catastrophic out-of-pocket medical spending (Baicker et al., 2013). The trial cannot separate the effect of care itself from the effect of reduced financial strain, and both are plausibly security effects.
I do not want to overstate the size of these effects. A meta-analysis of 17 randomized trials of cash transfers in low- and middle-income countries (26,794 participants) found a pooled reduction in depression and anxiety of d = −0.10, and no significant effect 2 to 9 years after programs ended (Wollburg et al., 2023). So the returns to security are steep in the sense that deprivation is where the gains concentrate, but they are modest in absolute terms and seem to depend on continued support.
Evidence on the shape of the relation is more contested. Kahneman and Deaton (2010) reported that emotional well-being stopped rising with income at roughly $75,000, and also that low income made the emotional pain of divorce, ill health, and loneliness worse. A later adversarial collaboration reanalyzed experience-sampling data and found that the flattening exists but is confined to the least happy 20% of people. For everyone else, happiness kept rising with log income, and in the happiest group it accelerated (Killingsworth et al., 2023). A 2026 panel analysis of 15 European countries found further evidence of an inverted U-shaped relationship between income and happiness at the aggregate level, with life satisfaction rising with GDP per capita up to a threshold and then declining at very high income levels, alongside strong evidence of two-way causality between happiness and productivity (Apergis & colleagues, 2026). Two lessons follow. Diminishing returns to money are not the same as satiation, and I should not claim that material returns disappear for the affluent. But for people prone to unhappiness, additional income past a certain point does not relieve it, which suggests that their distress has other sources. That is the observation that motivated the two-domain idea in the first place.
Growth Needs and Mental Health
The clearest evidence that growth-related needs matter broadly comes from Martela et al. (2023), who analyzed European Social Survey data from 27 countries (n = 48,550). Satisfaction of autonomy, competence, and relatedness was strongly related to happiness, life satisfaction, meaning in life, and depressive symptoms in every country, even after controlling for demographics and socioeconomic position. The needs also substantially, and sometimes fully, mediated the effects of socioeconomic position on well-being. That last result matters for the model below. If much of what income does psychologically passes through psychological need satisfaction, then security and growth are causally connected even if their statistical effects can be separated.
The pattern of which needs predict which outcomes is also informative. Across the world, material prosperity predicted life evaluation, whereas psychosocial prosperity (learning, autonomy, using one’s skills, respect, and being able to count on others) predicted positive feelings (Diener et al., 2010).
Do growth needs matter more once security is met? Some evidence says yes. Ng and Diener (2014) found that financial satisfaction was the strongest predictor of life evaluation and respect the strongest predictor of positive feelings, and that the associations of both financial satisfaction and postmaterialist needs (autonomy, social support, respect) with well-being were stronger in richer nations. Note that this is not a simple finding of “money matters less when you’re rich.” It has been interpreted as reflecting the fact that in poor, largely agricultural societies basic goods can often be obtained without money, so a money-based measure understates security there (as summarized in Ng & Diener, 2014, and by Page & Shapiro, cited in the source literature). Delhey (2009), using 48 countries from the fifth wave of the World Values Survey, found that as national wealth rose, life satisfaction was more strongly tied to post-material concerns (personal autonomy and job creativity) and less tied to income. The shift came more from the fading of material concerns than from the rising of post-material ones, and the fading was the stronger and more linear trend.
Do growth needs matter less under scarcity? Here the evidence pushes back. Across 132 nations, life satisfaction was higher in wealthy countries but meaning in life was higher in poor ones, partly because people in poor nations were more religious (Oishi & Diener, 2014). In three large datasets covering more than 500,000 individuals in 123 countries, meaning was a weaker predictor of happiness for people with greater financial resources than for those with fewer (Catapano et al., 2023). Within nations, income has been positively associated with meaning, mainly among people low in positive affect (Ward & King, 2016), so the between-nation and within-nation patterns are not the same. The Global Flourishing Study, covering 22 countries and over 200,000 people, likewise found a descriptive negative relation between meaning and national GDP per capita, though its authors stress that this is not a causal claim (VanderWeele et al., 2025).
Recent evidence complicates the picture further by showing that the relationship between socioeconomic position and meaning depends on relative, not just absolute, deprivation. A 2025 study of 17,634 Canadian adolescents found that relative deprivation was associated with lower meaning and purpose in life, and that this association was stronger in schools with high wealth inequality (Pickett et al., 2025). Relative advantage, by contrast, was associated with greater meaning. This suggests that the coupling between material circumstances and meaning is sensitive to social comparison processes, not merely to absolute resource levels. The between-nation finding that meaning is higher in poorer countries may coexist with the within-nation finding that relative deprivation undermines meaning, because the reference groups differ.
Reconciling the Patterns
These findings look contradictory only if “growth needs” is treated as one thing measured at one level. Three distinctions help.
The first is level of analysis. Nation-level patterns (meaning is higher in poorer nations) do not describe how individuals within a nation differ, and Ward and King’s (2016) within-nation result runs the other way. The relative deprivation findings from Elgar et al. (2025) further show that within-nation comparisons can themselves operate at different reference levels (school, neighborhood, nation).
The second is construct. Autonomy and respect, the needs that Ng and Diener (2014) and Delhey (2009) found to be more predictive in richer settings, are not the same as meaning and purpose, the constructs that Oishi and Diener (2014) and Catapano et al. (2023) found to be stronger under scarcity. One reasonable interpretation is that autonomy is a resource that can be exercised only when options exist, whereas meaning can function as a way of coping with hardship and so is more tightly coupled to well-being when circumstances are difficult. This is an interpretation, not something the cited studies tested directly.
The third is outcome. Life evaluation, positive feelings, and symptoms of depression respond to different needs (Diener et al., 2010; Tay & Diener, 2011), so a claim about “mental health” that does not specify the outcome will collide with data that use a different one.
A Conditional Model
The conditional returns model is summarized in five propositions. Each proposition concerns an observable pattern rather than a fixed developmental stage, and each can be contradicted by data.
Proposition 1 (deprivation sensitivity). The association between security-need satisfaction and distress (depressive, anxiety, and stress symptoms) is steepest when satisfaction is low and flattens as it rises, without reaching zero. This is supported by the concentration of gains among low-income and uninsured populations (Baicker et al., 2013; Ridley et al., 2020), by the flattening seen among the least happy (Killingsworth et al., 2023), and by the inverted-U pattern at the aggregate level (Nademi & Sedaghat Kalmarzi, 2026). The clause “without reaching zero” reflects the continued income gradient among happier people in the same reanalysis.
Proposition 2 (non-dormancy of growth needs). Growth-need satisfaction is positively associated with well-being, and negatively with depressive symptoms, at every level of security, including low levels. Under scarcity, meaning may be more tightly coupled to happiness than under abundance. This follows from Martela et al. (2023), Tay and Diener (2011), and Catapano et al. (2023). The dual-process finding that access barriers relate to need frustration while SES indicators relate to need satisfaction (Bradshaw et al., 2026) further implies that growth needs can be actively frustrated under deprivation, not merely left unfulfilled.
Proposition 3 (shifting relative importance). As security satisfaction rises, the share of between-person variance in positive affect and eudaimonic well-being associated with autonomy, competence, and respect increases relative to the share associated with material need satisfaction. This is consistent with Delhey (2009), Ng and Diener (2014), and the mediation findings of Hansson et al. (2025). Because Ng and Diener also found steeper money slopes in richer nations, the proposition concerns relative importance, and “security” must be defined by need satisfaction rather than by money.
Proposition 4 (outcome specificity). Security needs relate more strongly to life evaluation and to symptoms of material and financial distress, whereas growth and social-psychological needs relate more strongly to positive feelings and meaning. The specificity is relative, not exclusive, since Martela et al. (2023) found psychological needs also strongly related to depressive symptoms.
Proposition 5 (mediation and feedback). Deprivation harms mental health partly by frustrating growth needs (security → growth-need frustration → well-being), and poor mental health in turn erodes material security. Support comes from the mediation results in Martela et al. (2023), from the bidirectional evidence reviewed by Ridley et al. (2020) and Haushofer and Fehr (2014), from the Mendelian randomization findings of Ganesan et al. (2024), and from the SDOH–need frustration pathway documented by Ryan et al. (2026).
Taken together, the propositions replace a ladder with two partly independent domains whose returns are conditional on one another and are causally linked.
Testing the Model
The model is useful only if its propositions can fail. Security should therefore be measured directly rather than inferred from income alone. A multidimensional index could combine food insecurity, housing instability, unmet health-care needs, utility barriers, physical safety, and income volatility. Proposition 1 can be tested with restricted cubic splines, segmented regression, or generalized additive models and compared with linear alternatives. Proposition 2 requires estimating psychological-need slopes within the lowest security strata and testing whether they are distinguishable from zero. Proposition 3 requires formal interaction tests or variance-decomposition approaches that evaluate whether the relative contribution of autonomy, competence, respect, and meaning changes across the security distribution. Proposition 4 requires multivariate outcomes rather than a single undifferentiated mental-health score. Proposition 5 is best examined with longitudinal mediation, cross-lagged designs, natural experiments, or randomized interventions that measure both material access and need frustration over time.
Suitable data include the Global Flourishing Study, which was designed as a five-year panel of over 200,000 participants in 22 countries (VanderWeele et al., 2025), the European Social Survey used by Martela et al. (2023), and the Gallup World Poll. The model would be seriously damaged by any of the following: linear rather than concave security slopes, null growth-need associations in deprived strata, no rise in the relative importance of agentic needs as security increases, or no mediation of security effects through psychological needs.
Limitations and Boundary Conditions
The evidence base imposes important limits on the model. Much of the relevant literature is cross-sectional and relies on self-report, making reverse causation and common-method bias difficult to exclude. Income is frequently used as a proxy for material need satisfaction even though identical incomes can imply very different levels of security across households, places, and welfare regimes. Mendelian-randomization and experimental studies strengthen causal inference for selected links, but they do not establish the full model. Cross-national findings also risk ecological inference errors: associations between national wealth and meaning cannot be assumed to describe individual-level processes. Finally, several constructs grouped here as growth needs are theoretically distinct. Autonomy, competence, relatedness, respect, meaning, and self-actualization should not be collapsed into a single latent variable without evidence that such a structure is psychometrically defensible.
The cultural status of family, which I treated as a bridging need, is not uniform. In most Global Flourishing Study countries married respondents reported higher flourishing than single respondents, but the pattern was reversed in India and Tanzania (VanderWeele et al., 2025). A model that treats family as universally protective would need to allow for this. Self-actualization itself remains poorly operationalized, and the proxies I rely on capture part of it at best. The recent metatheoretical critique of Maslow (Schulz & Cornejo, 2026) reminds us that the construct’s vagueness is not merely a measurement problem but a conceptual one that the conditional model does not fully resolve. Finally, the effect sizes for security interventions are small (Wollburg et al., 2023), so “steep” describes where gains concentrate, not how large they are.
Implications
For population mental health in deprived settings, the model implies that security interventions such as income support and health insurance are well-justified first-line measures, but that their effects may fade if support ends (Wollburg et al., 2023). It also implies that programs which help people exercise autonomy and competence are not a luxury to be added later, because these needs matter under scarcity and may carry part of the effect of material support (Martela et al., 2023). The distinction between satisfaction and frustration (Bradshaw et al., 2026) suggests that interventions should aim not only to satisfy growth needs but to remove the access barriers that actively frustrate them. In secure populations, where distress persists after material conditions are adequate, interventions aimed at autonomy, meaning, and relationships are the more plausible levers. What the model argues against is substitution in either direction: encouraging people in poverty to find meaning in place of material help, or offering the secure only material solutions to problems that may not be material.
Conclusion
Maslow’s hierarchy endures because it captures a genuine asymmetry: relief from deprivation can matter enormously when basic security is absent. The evidence reviewed here, however, does not support converting that asymmetry into a universal sequence in which psychological growth waits for material sufficiency. A more defensible account treats security and growth-related psychological needs as partly independent but dynamically connected domains. Security has its largest expected returns under deprivation; psychological needs remain active across the security distribution; the relative importance of particular needs shifts with context; different outcomes respond to different need profiles; and material and psychological conditions can reinforce one another over time. The framework’s value lies not in offering another hierarchy, but in specifying nonlinear, moderated, and mediated predictions that can be tested and rejected.
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