Fine-tuning theory to the needs of the world: Responding to Heller et al.

Comments on the Heller et al. telephone intervention with isolated elderly women are presented. The importance of addressing contextual factors involved in assessments of social support in community samples is discussed. Comparisons are drawn between the assessment of social support among an elderly sample and an assessment of social support among a sample of chronic illness patients. Three key issues are discussed: (a) Is a little support better than no support and is a little all we really need? (b) Is family support more important than friend support, at least to this population? (c) Can long-term relationships be replaced?     

Predicting outcome of chronic pain treatment via a modified self-efficacy scale

This study utilized a modified self-efficacy scale and examined the relationship of perceived self-efficacy to treatment outcome in a chronic, intractable, benign pain population (N = 62). In two separate studies a self-efficacy scale was given to inpatients in a combined cognitive-behavioral and medical treatment program. The scale categories consisted of (1) walking distance, (2) lifting ability, (3) pain coping, (4) working ability, and (5) social and recreational engagement. Self-efficacy beliefs were found to be associated with the level of functioning of these patients and their response to treatment. Patients with higher self-efficacy scores following treatment rated themselves as more improved and demonstrated better overall functioning with greater reductions in chronic illness behavior at followup. These observations support the merits of self-efficacy measures as predictors of treatment outcome in chronic pain patients.     

失眠症患者压力应对特征的调查分析及对临床干预的启示

本研究对失眠症患者的压力应对特征进行调查与分析。按照CCMD-3诊断标准,试验组失眠患者52例,在社区分层抽样52人作为对照组,用匹茨堡睡眠指数量表、防御方式问卷、应对方式问卷、社会支持评定量表进行测量。试验组不成熟型防御方式明显高于对照组,成熟型防御方式低于对照组;应对方式试验组以消极应对为主;试验组社会支持总体高于对照组,其中客观支持较高而主观支持和社会支持利用度较低。这些因素共同作用形成了失眠症迁延不愈的主要病理心理机制。心理治疗中要运用恰当的心理治疗方法,引导患者用成熟的、积极的应对方式应对各种压力源。     

中国癌症病人生活质量的测定──EORTC QLQ—C30在中国的试用

引进EORTCQLQ-C30,验证其在中国大陆的应用情况,为中国肿瘤学领域生活质量研究提供有效和实用的评定工具.运用随机对照实验设计,测查了289名癌症病人,结果显示各分量表中项目与所属量表的相关均高于与其他量表的相关,各分量表间呈中等偏下相关,量表因子结构分析与EORTC结果大体相似,三种方法检验的临床效度均较高.由此得出QLQ-C30各项心理测量学特性均达到要求,临床效度和实用性也比较好,在中国大陆的癌症病人中是可行的、可信的、有效的和敏感的.     

Do Internet‐Based Support Interventions Change Perceptions of Social Support?: An Experimental Trial of Approaches for Supporting Diabetes Self‐Management

Internet-based support groups are a rapidly growing segment of mutual aid programs for individuals with chronic illnesses and other challenges. Previous studies have informed us about the content of online exchanges between support group members, but we know little about the ability of these interventions to change participants' perceptions of support. A randomized trial of 160 adult Type 2 diabetes patients provided novice Internet users with computers and Internet access to 1 of 4 conditions: (a) diabetes information only, (b) a personal self-management coach, (c) a social support intervention, or (d) a personal self-management coach and the support intervention. After 3 months, individuals in the 2 support conditions reported significant increases in support on a diabetes-specific support measure and a general support scale. Participants' age was significantly related to change in social support, but intervention effects were still significant after accounting for this relationship. This report is a critical first step in evaluating the long-term effects of Internet-based support for diabetes self-management. The discussion identifies directions for future research.     

大学生的社会支持、孤独及自尊对主观幸福感的作用机制研究

对389名大学生施测社会支持量表、自尊量表、社会与感情孤独量表及主观幸福感量表,以探讨孤独和自尊在社会支持与主观幸福感的关系中的作用。结果表明：（1）主观幸福感与社会支持、自尊、孤独呈显著相关。（2）路径分析表明,自尊、孤独分别在社会支持与主观幸福感之间起显著的中介作用。社会支持→自尊→孤独→主观幸福感的显著路径表明,这些变量间存在更为复杂的关系。这些结果对于大学生心理健康教育具有重要的意义。     

社交网站支持对大学生社交网站成瘾的影响:有调节的中介模型

探讨社交网站支持对大学生社交网站成瘾的影响机制.采用社交网站支持量表、感觉寻求量表、错失恐惧量表和社交网站成瘾量表对501名大学生进行调查.结果发现:(1)社交网站支持正向预测大学生社交网站成瘾;(2)错失恐惧在社交网站支持与大学生社交网站成瘾间起部分中介作用;(3)感觉寻求调节了社交网站支持对大学生社交网站成瘾的影响...     

Quality of social support and associated social and psychological functioning in women with rheumatoid arthritis

Using a cross-sectional interview study of 194 women with rheumatoid arthritis, investigated the relationship between health status, social integration, qualitative aspects of social support, and social and psychological functioning in the presence of a chronic, disabling disease. Even after controlling for the influences of current physical limitations and social integration, qualitative dimensions of social support as measured by the Quality of Social Support Scale, a scale developed for this study, explained a significant proportion of the variance in home and family functioning and in depression.     

Measurement of psychosocial adjustment to breast cancer: a unidimensional or multidimensional construct?

Using data from a longitudinal study of Hoskins' 'Patterns of Adjustment to Breast Cancer among Women and their Partners', a conceptually derived multidimensional formulation of psychosocial adjustment was empirically tested. The Psychosocial Adjustment to Illness Scale was administered to both patients and partners at six times post-definitive surgery, i.e., 7-10 days, 30 days, 60 days, 90 days, 180 days, and one year. Extensive factor analytic studies were performed on data from the Psychosocial Adjustment to Illness Scale at four of the collection times when complete data sets were available for 128 patients and 121 partners. Results of the principal components analysis with varimax rotation were compared to factor analyses reported by the developers of the scale. The seven-factor matrix reported by Derogatis was not reproduced; instead, one factor was consistently identified at each of the four time periods as the best solution. Although items from all seven domains of the scale loaded on the single factor, items pertaining to psychological distress and role performance in the domestic and social environments were most prominent. These data support the need to validate empirically hypothesized separate dimensions of psychosocial adjustment to breast cancer in both patients and partners as proposed in a number of widely used tests.     

The impact of social support on the acceptance process among RA patients: A qualitative study

Acceptance is an important component of pain management, being associated with improved quality of life and lower levels of pain and depression. In enabling patients with chronic diseases to accept unpleasant consequences and to establish a new way of living, the support they receive from their social environment may play a decisive role. In this article, we identify the key sources and types of social support that are relevant for rheumatoid arthritis (RA) patients, and explore when and how those sources are important across the different stages of the acceptance process. We conducted a qualitative study involving 20 semi-structured interviews with RA patients in Switzerland. Analysis of the data followed the precepts of grounded theory. We found that, amid the complexity and variety of patients’ struggles for acceptance, there were some common experiences or ‘key moments’ in which social support played an important role. While three sources of support – family, physicians and the external social context – are fundamental for RA patients, all three may inhibit as well as encourage acceptance, due to the invisible and unpredictable character of the disease. There is a pervasive risk either of underestimating patients’ suffering or of over-supporting, both of which prevent patients accepting the disease and developing a new ‘normal’ life. We conclude that sources of social support need to find a middle way between scepticism and solicitousness.     

Dynamic role of social support in the link between chronic stress and psychological distress.

How a chronic environmental stressor can interfere with the buffering effects of social support by eroding social support was analyzed in this prospective, longitudinal study. A classic buffering effect of support was found after 2 months of exposure to the stressor, household crowding. Crowded residents with low perceived support had greater increases in psychological distress than did crowded residents with high perceived support. However, after 8 months exposure the buffering effect disappeared. Moreover, greater crowding had become directly associated with lower support, which in turn was associated with greater increases in psychological distress. All analyses controlled for prior distress. Under some types of chronic stress, the buffering effects of social support may be short-lived because the stressor eventually erodes social support.     

Exploring the mediation effect of social support and self-esteem on the relationship between humor style and life satisfaction in Chinese college students

In this study, we examined the mediator effects of social support and self-esteem on the relationship between humor style and life satisfaction in Chinese college students. We had 477 university students, with age range of 18–23 respond to self-report measures of humor style questionnaire, multi-dimensional scale of perceived social support, Rosenberg self-esteem scale and satisfaction with life scale. Results of structural equation modeling showed that social support and self-esteem fully mediated the relationship between affiliative humor, self-enhancing humor and life satisfaction. The final model also revealed a significant path from affiliative humor, self-enhancing humor through social support and self-esteem to life satisfaction. The results are discussed in terms of the conceptional context.     

Feeling Hopeful Inspires Support for Social Change

Hope is an emotion that has been implicated in social change efforts, yet little research has examined whether feeling hopeful actually motivates support for social change. Study 1 (N = 274) confirmed that hope is associated with greater support for social change in two countries with different political contexts. Study 2 (N = 165) revealed that hope predicts support for social change over and above other emotions often investigated in collective action research. Study 3 (N = 100) replicated this finding using a hope scale and showed the effect occurs independent of positive mood. Study 4 (N = 58) demonstrated experimentally that hope motivates support for social change. In all four studies, the effect of hope was mediated by perceived efficacy to achieve social equality. This research confirms the motivating potential of hope and illustrates the power of this emotion in generating social change.     

社会支持与大学生抑郁的关系:一个有调节的中介模型

为考察社会支持、社交焦虑、一般自我效能感和抑郁之间的关系,采用社会支持评定量表、社交焦虑量表、一般自我效能感量表以及抑郁自评量表对640名大学生进行调查。研究显示:(1)社交焦虑在社会支持与大学生抑郁之间起部分中介作用;(2)一般自我效能感在社会支持—社交焦虑—抑郁这一中介过程中的后半路径起调节作用。     

Mentoring and Peer-led Interventions to Improve Quality of Life Outcomes among Adolescents with Chronic Illnesses

Advancing adolescent medicine has resulted in increased survival rates for life-limiting health conditions that are now considered chronic conditions. Due to the increased rates of chronic illnesses, the broad outcomes of community-based programs for adolescents with these illnesses need to be examined. Therefore, the present study seeks to examine community-based, mentoring and peer-led programs that have a social support component to increase quality of life outcomes for adolescents with chronic illnesses. A comprehensive literature review was conducted to identify articles that included a social support component to increase quality of life outcomes for adolescents with chronic illnesses. Six articles were included in the narrative analysis. Programs were divided into two types of interventions: mentoring/coaching (n?=?3) and peer-led interventions (n?=?3). A summary of each study was developed and main themes from each intervention were identified by the research team. This review found six community-based peer-led and mentoring interventions that incorporated a social support component to improve the quality of life of adolescents with chronic illnesses. Critical components for a peer-led or mentoring intervention should include social support components such as health coaching and mentoring by peers or adults. Since the nature of chronic illnesses is lengthy in duration, social support research translated into practice may offer adolescents who have any of these illnesses a means to improve their psychosocial outcomes. The interventions outlined in this present review have yielded promising results. Recommendations for future studies are included.     

Medical help-seeking by different types of chronic pain patients

Abstract

This paper reports on a study of the use of health services by different types of patients with chronic benign pain. The purpose of the study was to identify differences in medical consumption between different types of pain patients. In the course of one year 586 patients were selected by 45 general practitioners: they included patients who had had almost daily chronic pain symptoms for at least six months, without a medical diagnosis (such as cancer or arthritis) to explain the pain. Patients were categorized according to the Multidimensional Pain Inventory which distinguishes four categories: the dysfunctional, who perceive severe pain and gain social support; the interpersonally distressed, who combine pain with affective and relational distress; adaptive copers, who cope with their pain in a number of ways; the average type, with characteristics of all three other types. It was hypothesised that adaptive copers would make less use of health services and would be more involved in self-help activities than dysfunctional or interpersonally distressed patients. Frequent use of psychological services by the interpersonally distressed group was expected. It was predicted that difference in health services use would continue during the subsequent year.

No differences were found between the four groups in location, temporal characteristics, or possible medical causes of the pain symptoms. Dysfunctional patients used more services than the others. Adaptive copers used the least. The four groups did not differ in self-care activities. Group-membership as well as pain severity are related to the use of health services. None of the groups showed a significant decline in the use of health services during the year. It is concluded that chronic pain is invalidating, but that not all patients are equally excessive in their use of medical services.     

To be or not to be at risk: Spontaneous reactions to risk information

Rheumatoid arthritis (RA) is a chronic disease, which can lead to considerable psychological distress. The present study evaluated anxiety and depression symptoms for this chronic and painful illness within the framework of the conservation of resources (COR) theory. Coping strategies, coping self-efficacy, religiousness and social support are very important personal resources, which have been found to protect individuals from psychological distress. The aim of the present study was to examine the predictive values of socio-demographic and illness-related variables, perceived social support, ways of coping, religiousness, arthritis self-efficacy and resource loss for psychological distress in a sample of 117 RA patients from Turkey, a secular, Islamic, non-western developing country. The results revealed that RA patients experience considerable anxiety and depressive symptoms. The results of the regression analysis showed that gender, helplessness coping and resource loss are significant predictors of anxiety, whereas arthritis self-efficacy and resource loss are significant predictors of depression. Resource loss appeared as an important predictor for both anxiety and depression. This finding was consistent with the COR theory. The clinical implications of these findings are discussed.     

From "in the air" to "under the skin": cortisol responses to social identity threat

The authors examined women's neuroendocrine stress responses associated with sexism. They predicted that, when being evaluated by a man, women who chronically perceive more sexism would experience more stress unless the situation contained overt cues that sexism would not occur. The authors measured stress as the end product of the primary stress system linked to social evaluative threat-the hypothalamic-pituitary-adrenal cortical axis. In Study 1, female participants were rejected by a male confederate in favor of another male for sexist reasons or in favor of another female for merit-based reasons. In Study 2, female participants interacted with a male confederate who they learned held sexist attitudes or whose attitudes were unknown. Participants with higher chronic perceptions of sexism had higher cortisol, unless the situation contained cues that sexism was not possible. These results illustrate the powerful interactive effects of chronic perceptions of sexism and situational cues on women's stress reactivity.     

Adjustment to hemodialysis treatment through behavioral controls

The present study was conducted to examine the hypothesis that compliant chronically ill patients, typically described as adjusted, reinforce more positive social environments using behavioral controls than noncompliant patients, typically described as maladjusted. Specifically, it is hypothesized that diet-compliant chronic hemodialysis patients emit significnatly more active involvement-in-treatment behaviors and more social behaviors than diet-noncompliant chronic hemodialysis patients. Subjects, who ranged in age from 30 to 77 years, were outpatients at a kidney center. Behavioral observations were conducted to assess the occurrence or frequency of (1) four involvement-in-treatment behaviors that are routinely taught to all patients and (2) two social behaviors, which were patient verbalizations and smiles. The results showed that compliant patients emitted significantly more involvement-in-treatment behaviors and smiles than noncompliant patients. Results support the proposed control framework that compliant, in contrast to non-compliant, chronically ill patients have recourse through positive behavioral controls when adjusting to the stresses of illness. It was proposed that through these controls, compliant patients reinforce positive environments rather than simply respond to life circumstances as given.     

Causal Models of Physical Exercise Participation: Testing the Predictive Power of the Construct "Pressure to Change"

This study examines 2 different causal models to predict physical exercise motivation and behavior under a longitudinal perspective. The first model includes 5 latent variables that were hypothesized to have an impact on exercise intention and behavior: behavior-specific social support, exercise self-efficacy, perceived health benefits, perceived barriers, and subjective vulnerability to cardiovascular disease. The second model was based on all variables of the first model, but additionally included the new variable "pressure to change." Pressure to change was defined as the extent to which a person feels the necessity that specific personal life circumstances (e.g., health status, social relations) may not remain as they are and ought to be changed. It was hypothesized that the inclusion of health-related pressure to change would result in a better prediction of exercise intention. The proposed causal models were tested separately at the stages of exercise adoption and maintenance. Covariance structure analyses (LISREL) confirmed that pressure to change may be an important factor in the motivational process that leads to the adoption of regular physical exercise. Adding this latent variable to the basic model improved the amount of explained variance in exercise intention by 6%. Furthermore, the results did not support the assumption that cognitive control is critical especially during the acquisition of exercise behaviors, but may be less influential once the behavioral routines have been established. Our data rather indicate that regular physical exercise, even if performed on a regular basis for years, always remains a behavior that requires a high level of cognitive guidance.