Correlates of neonatal morbidity: maternal characteristics and family resources

The association of mental characteristics, family resources, and receipt of prenatal care with infant birth weight, gestational age, and Apgar scores was assessed in a retrospective review of an extant computerized data base of admissions to a neonatal intensive care unit (NICU; n = 3,818). Prediction variables included mother's age, marital status, health insurance, parity, prenatal health problems, and prenatal drug use. Less favorable infant birth status was associated with prenatal health problems, being single, not having private insurance, obtaining a prior elective abortion, prenatal drug use, and not receiving prenatal care. Stepwise multiple regressions of predictor variables to birth weight and lack of prenatal care were performed. Low birth weight was associated with being single, receiving no prenatal care, and being Black. Lack of prenatal care was associated with mother's age, high parity, prenatal health problems, and prenatal illicit drug use. Pediatric interventions assessing maternal social and behavioral characteristics are proposed.     

A dyadic investigation of exercise support between cardiac patients and their spouses.

The authors examined married partners' similarity in reported exercise behavior as a moderator of the association between social support for exercise provided and received by extending an actor-partner dyadic effects model. Participants were married cardiac rehabilitation patients and their spouses (N=99 couples). For couples similar in their reported exercise behavior, a significant association was found between both partners' independent reports of providing exercise support to and receiving exercise support from one another (n=49 couples). However, for couples differing in their reported exercise behavior (n=50 couples), no association was found between either partner's provision and receipt of support for exercise. Findings have the potential to inform practitioners of patients who may not be receiving adequate social support for their recommended exercise. Future interventions may consider implementing dyadic educational or motivational strategies with patients and their spouses.     

Stress, psychosocial resources, and depressive symptomatology during pregnancy in low-income, inner-city women.

The authors examined the prospective influence of stress, self-esteem, and social support on the postpartum depressive symptoms of 191 inner-city women (139 European Americans and 52 African Americans) over 3 waves of data collection. Depressive symptomatology was measured by multiple indicators, including self-report and clinical scales. Women became less depressed as they move from prenatal to postpartum stages and adjusted to their pregnancy and its consequences. LISREL and regression analyses indicated that stress was related to increased depression, whereas greater income and social support were related to decreased depression. Self-esteem was related to lower depression at the prenatal and postpartum periods but not to change in depression from the prenatal to the postpartum period. The results also indicated that self-esteem and social support did not have additional stress-buffering effects over and above their direct effects on depression. Finally, African American women did not differ from European American women terms of depression or in terms of how they were impacted by stress or psychosocial resources.     

Accounting for changes in social support among married older adults: insights from the MacArthur Studies of Successful Aging

Using longitudinal, community-based data from the MacArthur Studies of Successful Aging, the authors examined determinants of changes in social support receipt among 439 married older adults. In general, social support increased over time, especially for those with many preexisting social ties, but those experiencing more psychological distress and cognitive dysfunction reported more negative encounters with others. Gender affected social support receipt: Men received emotional support primarily from their spouses, whereas women drew more heavily on their friends and relatives and children for emotional support. Discussion centers on the importance of social support provision to those with the greatest needs.     

Effects of group prenatal care on psychosocial risk in pregnancy: results from a randomised controlled trial

Few interventions have succeeded in reducing psychosocial risk among pregnant women. The objective of this study was to determine whether an integrated group prenatal care intervention already shown to improve perinatal and sexual risk outcomes can also improve psychosocial outcomes compared to standard individual care. This randomised controlled trial included pregnant women ages 14-25 from two public hospitals (N = 1047) who were randomly assigned to standard individual care, group prenatal care or integrated group prenatal care intervention (CenteringPregnancy Plus, CP+). Timing and content of visits followed obstetrical guidelines, from 18-week gestation through birth. Each 2-h group prenatal care session included physical assessment, education/skills building and support via facilitated discussion. Using intention-to-treat models, there were no significant differences in psychosocial function; yet, women in the top tertile of psychosocial stress at study entry did benefit from integrated group care. High-stress women randomly assigned to CP+ reported significantly increased self-esteem, decreased stress and social conflict in the third trimester of pregnancy; social conflict and depression were significantly lower 1-year postpartum (all p-values < 0.02). CP+ improved psychosocial outcomes for high-stress women. This 'bundled' intervention has promise for improving psychosocial outcomes, especially for young pregnant women who are traditionally more vulnerable and underserved.     

Personal Resources and the Social Distribution of Depression

This paper addresses the hypothesis that gender, age, marital status, and SES matter for depression partly because of associated differences in the availability and/or impact of the personal resources of mastery and self-esteem. It is argued that findings indicating that the social distributions of these resources complement those for depression would provide preliminary support for this hypothesis. Based on a large urban community sample (n = 1,390), our findings fail to support the availability hypothesis in relation to marital status, provide only modest support in reference to age and gender, but yield compelling support in relation to socioeconomic status (SES). Indeed, variations in the availability of these resources, especially mastery, provide a largely, if not entirely, adequate explanation for the SES–depressive symptoms relationship and accounts for nearly half of the SES–Major Depressive Disorder relationship. Although the significance of mastery was more pronounced among women and unmarried persons, such differences did not contribute to understanding observed gender or marital status variations in depression.     

Gender effects on social support provision and receipt

This study was conducted to examine the influence of gender on social support provision and receipt using both self-report and observational methodologies. In response to another person sharing a problem, we predicted that men would be more likely than women to provide advice, and women would be more likely than men to provide emotional support. We also predicted women would be more likely than men to receive emotional support, and men would be more likely than women to receive negative support. Sixty-one pairs of college students, same-sex and mixed-sex dyads, shared a problem with each other. Problem-sharing transactions were audiotaped and transcribed for content analysis. Opposite-sex providers offered more emotional support than did same-sex providers, whereas same-sex providers listened more than did opposite-sex providers. No gender differences were found for advice-giving. Men were more likely than women to receive negative support. These results suggest that gender composition of the dyad has a greater influence on support provision and receipt than provider or recipient gender alone.     

Behavioral and emotional responses to diet‐related support and control among same‐sex couples

Members of 63 lesbian and 72 gay couples reported how frequently their partners engaged in diet‐related social support and control (persuasion and pressure) and how they responded behaviorally and emotionally to such attempts. Although lesbian women received more frequent diet‐related social support than gay men, there were no gender differences in the receipt of diet‐related social control. Results of multilevel models that controlled for body mass index revealed that all participants responded to all types of involvement with guilt and to support and persuasion with appreciation. Responses to pressure differed for lesbian women and gay men and acted as a function of relationship quality. Findings from this study may increase awareness of the importance of same‐sex partners' involvement in eating behaviors.     

Receiving support as a mixed blessing: evidence for dual effects of support on psychological outcomes

Although social support is thought to boost feelings of closeness in dyadic relationships, recent findings have suggested that support receipt can increase distress in recipients. The authors investigated these apparently contrary findings in a large daily diary study of couples over 31 days leading up to a major stressor. Results confirm that daily support receipt was associated with greater feelings of closeness and greater negative mood. These average effects, however, masked substantial heterogeneity. In particular, those recipients showing greater benefits on closeness tended to show lesser cost on negative mood, and vice versa. Self-esteem was examined as a possible moderator of support effects, but its role was evident in only a subset of recipients. These results imply that models of dyadic support processes must accord a central role to between-individual heterogeneity.     

Daily supportive equity in close relationships

Receiving support in committed relationships has frequently been associated with negative psychological outcomes in the recipient, such as increased distress. The authors hypothesized that these negative effects could be offset by support recipients' reciprocation of support, that is, by creating a sense of supportive equity. To investigate this hypothesis, the authors obtained daily reports of mood and of received and given emotional support from both partners in 85 couples throughout a 4-week period. Reciprocity in support transactions was associated with higher levels of positive mood and lower levels of negative mood. In line with previous research, receiving support without reciprocation was associated with increases in negative mood. Giving support, regardless of receipt, was associated with a decrease in negative mood.     

Perinatal complications in births to low socioeconomic status schizophrenic and depressed women.

Pregnancy and birth complications in births to 57 schizophrenic, 28 depressed, and 31 well women were studied. The sample was of low socioeconomic status and predominantly African-American. The study extended earlier work on the perinatal status of infants born to schizophrenic women by including measures of severity of maternal disturbance, mother's age, IQ, and premorbid social competence, and family composition. The results show that maternal competence and the mother's diagnosis of schizophrenia were significant variables in determining the likelihood of less adequate prenatal care and more complicated births. The results indicate the importance of an assessment not only of a disturbed woman's diagnosis but also of her personal background and social competence in determining the likelihood of obstetrical complications.     

Predicting receipt of social support: a longitudinal study of parents' reactions to their child's illness

A sample of 101 women whose children required medical attention were interviewed at the time of initial hospital contact and again 1 year later. On the second occasion, their spouses were also interviewed for their assessment of their wives' personal and social characteristics. Greater personal resources, more intimate relations, and lower discomfort in seeking support were related to greater receipt of social support 1 year later. Chronic stress conditions were found, however, to diminish the effect of individuals' social characteristics on receipt of support. Spouses assessments showed moderate agreement with that of their wives, lending support to the validity of the findings. Implications for interventions in health-care settings were discussed.     

Receiving instrumental support at work: when help is not welcome

Although the role of social support in promoting employees' health and well-being has been studied extensively, the evidence is inconsistent, sometimes even suggesting that social support might have negative effects. The authors examined some psychological processes that might explain such effects. On the basis of the threat-to-self-esteem model, the authors tested the hypothesis that receiving imposed support elicits negative reactions, which are moderated by someone's need for support. The authors distinguished 3 different reactions: (a) self-related, (b) interaction-related, and (c) physiological. The results of an experiment with 48 temporary administrative workers generally confirmed the hypothesis. Imposed support elicited negative reactions, except when there was an unsolvable problem, but even then the effect of imposed support was not positive but neutral.     

Correlates of social support: Personal characteristics and social resources

This study attempted to identify potential determinants of receiving support using multivariate analysis. A community probability sample of 581 adults were surveyed. In addition to recording demographic variables and social support receipt, extraversion and locus of control were measured as personal characteristics; being married and numbers of confidants were recorded as social resources indicators. We found that (1) gender, education, extraversion, locus of control and social resources had direct effects on social support receipt; (2) education also had an indirect effect through locus of control, whereas extraversion had indirect effects through both locus of control and sod resources. Roles of personal characteristics and social resources in determining social support receipt were discussed.     

Why is the receipt of social support associated with increased psychological distress? an examination of three hypotheses

Abstract

Although there is a great deal of research linking social support with favourable psychological well-being outcomes a number of contradictory findings have been published showing support to be associated with increased psychological distress. These contrary findings arise when social support is measured as the receipt of supportive behavior rather than perceptions of support availability and quality. This paper examines three hypotheses that have been advanced to explain why the receipt of support is associated with distress. The first of these hypotheses (the support mobilisation hypothesis) argues that the relationship is a spurious one, and that it is a product of distressing circumstances which increase both support receipt and psychological distress. The other two hypotheses (the inequity hypothesis and the esteem threat hypothesis) both argue that receiving support actually causes distress. We tested these hypotheses in two samples. One sample was a group of individuals who reported having some form of disability (N = 106). the other sample was a 'healthy' comparison group (N = 134). Our analyses showed that in both groups the receipt of support was significantly and positively related to reports of anxiety, but not to reports of depression. Among the 'healthy' sample, controlling for subjects' sex largely explained the positive association between support receipt and anxiety. This was not the case among the 'disabled sample, where the inequity hypothesis received the strongest support. The implications of these findings for interventions based around the provision of social support are examined.     

Misery loves company: when sadness increases the desire for social connectedness

In three experiments, the authors investigated the effects of sadness on the desire for social connectedness. They hypothesized that sadness serves an adaptive function by motivating people to reach out to others and preferentially attend to information related to one's current level of social connectedness, but only when it is instigated by social loss. Consistent with this hypothesis, the authors observed that sadness induced by an emotional depiction of social loss enhanced (a) attention to nonverbal cues, an important source of information concerning an individual's current level of social connectedness (Experiment 1), and (b) the desire to engage in social behaviors (Experiment 2). In Experiment 3 the authors found that sadness that results from imagined social loss uniquely produced this pattern of effects. Sadness that resulted from imagined failure had different effects on motivation and no effect on sensitivity to nonverbal cues. These results support and refine functional explanations for the universality of sadness.     

Gender and sex role differences in the perception of social support

This study examined the relationships among support types (i.e., emotional, instrumental, and nonintimate social participation), gender, sex role orientation, and stress level among college undergraduates (N=253). Dependent variables included need, perceived availability, and satisfaction with support. Sex differences were found only in emotional support, with men reporting less need, perceived availability, and marginally less satisfaction than women. The only gender by sex role interaction was on need for emotional support. Traditional sex-typed men reported less need than traditional women, whereas there was no difference between androgynous men and women. While sex differences do exist for emotional support, the effects of sex role orientation on perceptions of social support appears to be somewhat circumscribed.     

Supportive relationships in later life

We adopted a multidimensional approach to the study of the social support convoys of older adults. We distinguished between age and gender differences in four specific dimensions of the social support convoy: (a) existence versus functioning of relationships in the convoy, (b) kinds of relationships (i.e., those with children, siblings, and friends), (c) types of social support (i.e., emotional support, respect, and health support), and (d) receipt versus provision of support. Using a national survey of 718 adults, multivariate and univariate analyses of variance were performed to determine age and gender differences in these four dimensions of social support. The multidimensional approach was useful in pinpointing those aspects of the social support convoy affected by aging. We anticipated that the social support convoy would be devastated by aging. Instead, we found that older people received less support (i.e., emotional and health support) in the absence of sibling relationships. Otherwise, the effects of aging had more to do with what the older person contributed to the convoy than with what he or she received. Women had better social support resources than men, particularly within their friendships. We found no evidence, however, that women's social support advantage counterbalanced the effects of aging on the convoy.     

Negative reactions to received spousal care: predictors and consequences of miscarried support.

This study focused on the negative reactions of older women with osteoarthritis to the receipt of instrumental support (i.e., physical assistance) from their husbands and the effects of such negative reactions on the women's psychological well-being and self-care. Applying a person-environment fit model, the authors predicted that women's negative reactions to spousal support would be determined by the fit between this support and the personal centrality (importance) of being functionally independent. Consistent with this prediction, women who received high levels of support from the husband and for whom being functionally independent was not highly central reacted less negatively to this support. More negative reactions to spousal support were related to greater concurrent depressive symptomatology and fewer self-care behaviors. In addition, negative reactions were predictive of the women's increased depressive symptomatology and decreased life satisfaction. Findings illustrate a useful theoretical approach to the examination of support from family caregivers.     

Correlates of parenting on a neonatal intensive care unit: maternal characteristics and family resources

The association of maternal characteristics, family resources, and receipt of prenatal care with parenting behaviors observed in a neonatal intensive care unit (NICU; n = 383) was assessed. The parenting behavior of mothers not receiving prenatal care (n = 128) was compared to that of mothers of the preceding and subsequent admissions (n = 256) by retrospective chart review. Parenting variables included frequency of visits to the NICU and evaluative ratings of parents' involvement with their infant. Parenting of the no-prenatal-care group was significantly less favorable than the control on all comparisons. Factor analysis supported a priori grouping of parenting variables. A stepwise multiple regression of maternal and family characteristics to the factor-derived variable, parenting, showed significant contributions for prenatal drug use and father involvement. Pediatric interventions assessing maternal social and behavioral characteristics are proposed.