Type D personality and social relations in adults with diabetes: results from diabetes MILES – The Netherlands

Abstract

Objective: To examine whether individual differences in Type D personality (combination of negative affectivity (NA) and social inhibition (SI)) could explain heterogeneity in perceived social support and relationship adjustment (intimate partner relationship) among people living with diabetes.

Design: In the Diabetes MILES—The Netherlands survey, 621 adults with type 1 or type 2 diabetes (54% female, age: 56?±?14 years) completed measures of Type D personality (DS14), perceived social support and relationship adjustment. We used established DS14 cut-off scores to indicate Type D personality, high NA only, high SI only and reference groups.

Results: Participants from the Type D and NA only groups perceived lower levels of social support (Welch[3,259]?=?37.27, p?<?0.001), and relationship adjustment (Welch[3,191]?=?14.74; p?<?0.01) than those from the SI only and reference groups. Type D was associated with lower social support (lowest quartile; adjusted OR?=?8.73; 95%CI?=?5.05?～?15.09; p?<?0.001) and lower relationship adjustment (lowest quartile; adjusted OR?=?3.70; 95%CI?=?2.10?～?6.53; p?<?0.001). Type D was also associated with increased levels of loneliness.

Conclusion: Participants with Type D and participants with high NA only tend to experience less social support and less relationship adjustment. Type D personality was also associated with more loneliness. Experiencing lower social support and relationship adjustment may complicate coping and self-management in people with diabetes.     

Type D personality,illness perception,social support and quality of life in continuous ambulatory peritoneal dialysis patients

The previous studies reported Type D was associated with poor quality of life (QoL), increased psychological distress, and impaired health status in cardiac patients. The aim of this study is to assess the relationships among Type D personality, illness perception, social support, and investigate the impact of Type D personality on QoL in continuous ambulatory peritoneal dialysis (CAPD) patients. Type D personality was assessed by the Chinese 14-item Type D Personality Scale (DS14). Illness perceptions were assessed using the Chinese version of the Brief Illness Perception Questionnaire (B-IPQ). Social support status was assessed by the well-validated social support rating scale (SSRS). Patients’ QoL was assessed by using Medical Outcomes Short Form 36 (SF-36), respectively. The Type Ds had significantly lower objective support score (8.18 ± 2.56 vs. 9.67 ± 3.28, p = 0.0001), subjective support score (6.71 ± 2.0 vs. 7.62 ± 1.93, p = 0.0001) and utilization of social support score (6.76 ± 2.0 vs. 7.61 ± 1.94, p = 0.0001) than that of the non-type Ds. Type Ds believed their illness had much more serious consequences (7.67 ± 2.64 vs. 6.27 ± 3.45, p < 0.001), and experience much more symptoms that they attributed to their illness (6.65 ± 2.54 vs. 7.31 ± 2.36, p = 0.023). Significant differences were found between Type Ds and non-Type Ds in PCS (40.53 ± 6.42 vs. 48.54 ± 6.21 p < 0.001) and MCS (41.7 1 ± 10.20 vs. 46.35 ± 9.31, p = 0.012). The correlation analysis demonstrated that Type D was negatively associated with physical component score (PCS) (r = –0.29, p < 0.01), mental component score (MCS) (r = –0.31, p < 0.01), and social support (r = –0.24, p < 0.001). Using multiple linear regression analysis, we found that Type D personality was independently associated with PCS (β = –0.32, p < 0.001) and MCS (β = –0.24, p < 0.001). Type D personality was a predictor of poor QoL in CAPD patients. The current study is the first to identify a strong association among Type D, illness perceptions, social support and QoL in CAPD patients. The worse illness perceptions and lower social support level therefore represent possible mechanisms to explain the link between Type D and poor QoL in CAPD patients.     

Dimensions of social support in the experience of work engagement in middle age: A Northern Finland Birth Cohort 1966 Study

So far, the relationship between the various dimensions of social support and work engagement has not been widely examined in the literature. In this study, we examined the relationship of social support at work (from a colleague or supervisor) and social support in one’s private life (from a spouse, relative or friend) with various dimensions of work engagement (vigor, dedication and absorption). The participants (N = 5,259–5,376, 46 years-old, 52.7% women) came from the Northern Finland Birth Cohort 1966 study. Social support was evaluated with the Social Support Questionnaire (SSQ), and work engagement was assessed with a short version of the Utrecht Work Engagement Scale (UWES-9). The data were analyzed using linear regression analyses. The results showed that high social support at work (p < 0.001) and in one’s private life (p < 0.001) were associated with higher total work engagement, higher vigor, higher dedication, and higher absorption. These findings were adjusted for gender, marital status, education and occupational status. The results were essentially unchanged when they were additionally adjusted for job strain and effort-reward imbalance. To conclude, our findings indicate that the experience of overall social support may play a role in the experience of work engagement.     

Is age kinder to the initially more able?: differential ageing of a verbal ability in the Healthy Old People in Edinburgh study

Studies that examine whether there is differential age-related decline in intelligence test scores according to initial cognitive status, social class and education are reviewed. We tested the differential ageing hypothesis which states that decline in ability scores over time will be lower in those with superior mental ability, more education and higher social class at the time of original testing. 387 healthy old people were tested at baseline and followed up 4 years later. The National Adult Reading Test (NART) was administered on both occasions. NART-estimated IQ fell by a mean of 2.1 points over 4 years (p<0.001). Subjects in higher social class categories had higher NART scores overall (p<0.001), and had smaller NART decrements over 4 years. Ex-professional and -secretarial groups fell by a mean of 1.4 points in this period, versus 3.2 points for skilled manual, semi-skilled and unskilled groups. In addition, those who fell more in NART were older (p=0.001), were less educated (p<0.001), and had lower NART (p<0.001) scores at baseline. In summary, those with higher baseline ability, in higher social class groups, with more education and who are younger are relatively protected from decline in this verbal ability with age. Possible mechanisms of differential decline in this verbal intelligence with age are discussed.     

The effects of gender upon doctor-patient interaction

Abstract

Despite extensive research examining doctor-patient communication, relatively link attention has been directed to the impact of gender differences (Weisman and Teitelbaum, 1985). The present study examines the effect of doctor and patient gender on interaction. The consultations of 102 patients (47 male and 55 female) and 15 doctors (8 male and 7 female) were taped and then analysed using a modification of a method developed by Butler and Cox (1992). Measures were also taken of doctor and patient word count, the proportion of doctor dialogue relative to the patient and frequency of interaction exchange. Female patients initiated significantly more agendas than male patients (p >0.001). Those men who raised emotional agendas were more likely to reintroduce these agendas than female patients (p>0.01). particularly in the presence of female doctors (p0.001). Consultations with female patients revealed higher overall (p>0.01) and patient (P>0.01) word count than those with male patients. A positive effect of “gender congruence” upon word count was observed with female doctors only (p0.001).     

The Effects of Social and Physical Functioning and Self-Management Abilities on Well-Being Among Patients with Cardiovascular Diseases,Chronic Obstructive Pulmonary Disease,and Diabetes

To increase our understanding of relationships between well-being and social/physical functioning and self-management abilities (SMAs) among chronically ill patients. The cross-sectional questionnaire-based study included 1,254 patients with cardiovascular diseases, 725 with chronic obstructive pulmonary disease, and 253 with diabetes (total, 2232/4200; 53 % response rate). Social and physical functioning correlated significantly with SMAs and well-being (all p?≤?0.001). After controlling for background characteristics, multiple regression showed that social and physical functioning were still related to SMAs (β?=?0.32–0.12; both p?≤?0.001) and well-being (β?=?0.39–0.14; both p?≤?0.001). The strengths of relationships between well-being and social (β?=?0.39 vs. 0.20) and physical (β?=?0.14 vs. 0.07) functioning declined significantly (both p?≤?0.001) when the SMA mediator was included in the equation. SMAs of chronically ill are related to their social and physical functioning. We found indications that chronically ill patients reporting lower levels of social and physical functioning are worse self-managers than are those with higher levels of functioning. Furthermore, SMAs may mediate the relationships between social and physical functioning and well-being. Self-management interventions aiming to enhance SMAs more broadly than traditional interventions aiming only to prevent functional decline are expected to improve SMAs and enhance well-being among chronically ill patients.     

Gender differences in depressive response: The role of social support

The present study investigated the possibility that women's ruminative response style to stressful events is due in part to differential advice that women and men receive from their social support networks. Undergraduates (60 men, 136 women) of various ethnic backgrounds (e.g., 21.4% English, 16.8% West Indian, 12.8% Chinese, 10.7% Italian) indicated the extent to which they would endorse various statements of advice for a stimulus person described as experiencing a negative life event. As predicted, subjects endorsed more ruminative advice for female stimulus persons than for male stimulus persons (p< .02). These findings imply that, since females in stressful situations seem more likely to receive ruminative advice than do their male counterparts, women's greater vulnerability to depressive symptoms may be partly the result of the concomitant dangers of stressful events and potentially harmful advice.     

儿童期心理虐待对青少年网络欺负的影响:领悟社会支持及性别的调节作用

近年来,网络欺负现象逐渐成为网络心理学研究的热点问题。青少年网络欺负的发生率约为60.8%,且每年都在呈增长的趋势,这对青少年正常的学习生活造成了严重的影响。故本研究主要探讨儿童期心理虐待对青少年网络欺负的影响,以及领悟社会支持和性别起到的调节作用。本研究以447名青少年作为被试(男生205人,女生242人,被试年龄范围为11~17岁,平均年龄为14.17±1.35岁),采用儿童期心理虐待量表、网络欺负问卷及领悟社会支持量表进行调查。运用SPSS 22.0及AMOS 21.0统计软件进行数据处理,Harman单因素法表明,本研究不存在严重的共同方法偏差问题。研究结果表明:(1)儿童期心理虐待与领悟社会支持呈显著负相关(r=-.14,p<.01),儿童期心理虐待与青少年网络欺负呈显著正相关(r=.44,p<.01),领悟社会支持与青少年网络欺负呈显著负相关(r=-.15,p<.01);(2)结构方程模型显示,模型各指标均达到了临界值(χ^2/df=2.67,GFI=.90,TLI=.91,CFI=.92,RMSEA=.07);(3)儿童期心理虐待对青少年网络欺负具有显著的正向预测作用(β=.21,p<.01),领悟社会支持对青少年网络欺负具有显著的负向预测作用(β=-.11,p<.05),同时,儿童期心理虐待与领悟社会支持的交互项对青少年网络欺负具有显著的负向预测作用显著(β=-.19,p<.01),简单斜率检验表明,对于低领悟社会支持水平的青少年,儿童期心理虐待对网络欺负有显著的正向预测作用(β=.54,p<.001);对于高低领悟社会支持水平的青少年,儿童期心理虐待对网络欺负的预测作用不显著(β=-.17,p>.05);(4)儿童期心理虐待与性别的交互项对青少年网络欺负具有显著的正向预测作用(β=.28,p<.001),简单斜率检验表明,对于男青少年,儿童期心理虐待对网络欺负有显著的正向预测作用(β=.54,p<.001);对于女青少年,儿童期心理虐待对网络欺负的预测作用不显著(β=.13,p>.05);由此可说明,儿童期心理虐待是青少年网络欺负出现的助推机制,而领悟社会支持和性别是青少年网络欺负出现的抑制机制,它可以弱化儿童期心理虐待对青少年网络欺负造成的创伤。     

Understanding early-onset drug and alcohol outcomes among youth: the role of family structure, social factors, and interpersonal perceptions of use

Research on adolescents focuses increasingly on features of the family in predicting and preventing illicit substance use. Multivariate analyses of data from the National Survey of Parents and Youth (N=4173) revealed numerous significant differences on risk variables associated with family structure on adolescent drug-related perceptions and substance use. Youth from dual-parent households were least likely to use drugs and were monitored more closely than single-parent youth (p<0.001). A path analytic model estimated to illuminate linkages among theoretically implicated variables revealed that family income and child's gender (p<0.001), along with family structure (p<0.05), affected parental monitoring, but not parental warmth. Monitoring and warmth, in turn, predicted adolescents' social and interpersonal perceptions of drug use (p<0.001), and both variables anticipated adolescents' actual drug use one year later (p<0.001). Results reconfirm the importance of parental monitoring and warmth and demonstrate the link between these variables, adolescents' social and intrapersonal beliefs, and their use of illicit substances.     

Comparing the Geographic Distributions and Growth of Mormons,Adventists, and Witnesses

Mormons, Adventists, and Witnesses have all felt called to take their teachings to the world and have experienced growth. However, they have varied considerably in both their geographic spread—where they have developed a presence over time—and also in where they have been more successful numerically. The result is sharply differing profiles: Adventists are concentrated more in the developing world; Witnesses and Mormons are proportionately stronger in the developed world, but in different parts of it. Within countries, Witnesses and Mormons are more urban, while Adventists are more concentrated in rural regions; Adventists also tend to be poorer than Witnesses and especially practicing Mormons. The article explores why these differing patterns developed, expanding on a recently developed theoretical model by Cragun and Lawson that religious growth depends on the synchronization of supply and demand and their corresponding components.     

The role of social support in women’s health and recovery processes

The aim of this study was to assess the psychological state of women who have undergone surgery for breast cancer or cardiac surgery, including examination of the role of social support in both groups. The study included 48 women (mean age: 66.04?±?8.3 years). They were divided into two groups according to diagnosis: 23 women (mean age: 69.2?±?8.6 years) who underwent heart surgery (cardiac group, CG) and 25 women (mean age: 63.2?±?7.0 years) treated for breast cancer and associated with the Women After Mastectomy Club (oncology group, OG). In addition to the assessment of socio-demographic variables, the following self-report questionnaires were administered: Satisfaction with Life Scale, Acceptance of Illness Scale, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory as well as Berlin Social Support Scale. In the CG, the severity of depressive symptoms was two times higher than in OG (p?=?.003). In both groups, there was a high percentage (80%) of women with severe symptoms of anxiety (p?=?.37). In both groups, the level of life satisfaction was similar (p?=?.58), but OG was characterized by a higher level of acceptance of the disease (p?=?.003). The correlation analysis showed that in both groups, social support was related differently to the parameters of emotional state. Women treated for breast cancer were in a better mental condition than women treated for heart disease. The support coming from other women in similar circumstances (Women After Mastectomy Club) seems to be more effective than the support coming from the patient’s immediate environment. The results for social support ought to be interpreted not only through the prism of mean values of received support, but also with regard to the information on the sources of support.     

Factors related to life satisfaction among urban African American adults receiving care at a publicly-funded sexual health clinic

Life satisfaction is linked to premature morbidity and mortality and it may be compromised for individuals living in economically-disadvantaged, urban neighborhoods. The present study explores how behavioral and social-environmental health factors are associated with life satisfaction among a sample of African American young adults. Participants (N = 307, M_age = 26.6 years, 53% male) were recruited from a publicly-funded clinic for a randomized controlled trial (RCT). Data from the baseline assessment of the RCT, which included measures of sleep, depression, anxiety, social support, alcohol and drug use problems, city stress, and life satisfaction, were used for the current study. Correlation analyses assessed bivariate associations between life satisfaction and the demographic and health-related factors. Linear regression using backward elimination determined the best fitting model of factors associated with life satisfaction. Backward elimination resulted in the following variables remaining as significantly associated with life satisfaction: age (b = ?2.40, p = .017), anxiety (b = ?5.32, p < .001), and social support (b = 2.89, p = .004). Feeling rested upon waking also remained in the best fitting model, although this association did not achieve statistical significance (p = .099). The results suggest that African American adults who are younger, less anxious, and report adequate social support are more likely to report satisfaction with life. These findings add to the literature aimed at examining health and social factors impacting the well-being of African Americans living in low-income, urban communities.     

快乐感与社会支持的关系

采用量表法以304个成年人为被试研究了快乐感和社会支持的关系。差异检验表明,男性的正向情感和社会支持源显著多于女性;而女性对社会支持的利用度显著高于男性;在快乐感、负向情感和人际支持上没有显著的性别差异。回归分析表明,社会支持中的人际支持(主要包括配偶、父母、朋友、邻里、同事的支持)和支持利用度(包括遇到烦恼时对支持的利用以及团体参与程度)对快乐感、正向情感和负向情感具有较好的预测作用。     

Distancing oneself from God: relationships with borderline personality symptomatology

Self-harm behaviour traditionally has been associated with borderline personality disorder. In this study, we examined the relationship between borderline personality symptomatology and intentionally distancing oneself from God as self-punishment, based on the assumption that such self-punishment may represent a form of self-harm behaviour. Data from four previous samples of primary care outpatients collected over a two-year period were combined (N?=?1511). Borderline personality was assessed with two measures: the borderline personality scale of the Personality Diagnostic Questionnaire-4 (PDQ-4) and the Self-Harm Inventory (SHI). Point-biserial correlation coefficients revealed that those who endorsed distancing oneself from God as punishment scored relatively higher on both the PDQ-4 (r?=?0.40, p?<?0.001) and the SHI (r?=?0.46, p?<?0.001). Similarly, when compared to respondents who denied ever having distanced themselves from God as punishment, those who did were more likely to exceed the clinical cut-off score on the PDQ-4 (47.3% vs. 10.9%, X^{2 ?}=?152.53, p?<?0.001) and the SHI (57.3% vs. 11.4%, X^{2 ?}=?224.12, p?<?0.001). Findings support our hypothesis that distancing oneself from God as punishment may be a form of self-harm behaviour associated with borderline personality symptomatology.     

Pain appraisal and quality of life in 108 outpatients with rheumatoid arthritis

Individual differences in emotional functioning, pain appraisal processing, and perceived social support may play a relevant role in the subjective experience of pain. Due to the paucity of data regarding individuals with Rheumatoid Arthritis (RA), the present study aimed to examine pain intensity, emotional functioning (psychological distress and alexithymia), pain appraisal (pain beliefs, pain catastrophizing, and pain-related coping strategies) and social support, and their relationships with the health-related quality of life (HRQoL) in patients with RA. Data were collected from 108 female patients diagnosed with RA. Clinically relevant levels of depressive and anxiety symptoms assessed by the HADS subscales were present in 34% and 41% of the patients, respectively, and about 24% of them exhibited the presence of alexithymia. The results of hierarchical multiple regression analyses showed that pain intensity, alexithymia, the maladaptive beliefs regarding the stability of pain and the coping strategy of guarding explained 54% of the variance in the physical component of HRQoL (p < 0.001). Depression subscale of the HADS, alexithymia, the coping strategy of resting, and the rumination factor of pain catastrophizing significantly explained 40% of the variance in the mental component of HRQoL (p < 0.001). The present findings provide evidence regarding the importance of emotional functioning and pain appraisal in the negative impact of RA on patients’ quality of life. These findings provide additional evidence for the biopsychosocial model of chronic pain, further supporting the complex interaction between emotional, cognitive, and behavioral processes in patients with chronic pain.     

Group Intervention for Adolescent Anxiety and Depression: Outcomes of a Randomized Trial with Adolescents in Kenya

Youth mental health interventions in low-resource communities may benefit from including empirically supported elements, using stigma-free content, and using trained lay-providers. We developed and evaluated such an intervention, targeting adolescent depression and anxiety in Kenya, where mental health care is limited by social stigma and a paucity of providers. Kenyan adolescents (N = 51, ages 14–17, 60.78% female) from a school in an urban slum in Nairobi with self-reported moderate-to-severe symptoms of depression or anxiety were randomized to the 4-week “Shamiri” (“thrive”) group intervention or a study skills control intervention of equal duration. The Shamiri intervention included growth mindset, gratitude, and value affirmation exercises. The content was delivered by recent high school graduates (ages 17–21, 60% male) trained as lay-providers. Participants met in school once-a-week in groups of 9–12 youths (average group size 10). Compared to the study-skills control, Shamiri produced greater reductions in adolescent depression symptoms (p = .038; d = .32) and anxiety symptoms (p = .039; d = .54) from baseline to 4-week follow-up, and greater improvements in academic performance (p = .034; d = .32) from the school-term before versus after the intervention. There were no effects on overall social support or perceived control, but the Shamiri group showed larger increases in perceived social support from friends (p = .028, d = .71). This appears to be the first report that a brief, lay-provider delivered, community-based intervention may reduce internalizing symptoms and improve academic outcomes in high-symptom adolescents in Sub-Saharan Africa. Larger replications with extended follow-ups will help gauge the strength and durability of these effects.     

Relationship of social support and social burden to repeated breast cancer screening in the women's health initiative.

Direct and interactive effects of social support, social burden (caregiving, negative life events, and social strain), education, and income on repeated use of breast cancer screening among a large (N=55,278), national sample of postmenopausal women participating in the Women's Health Initiative observational study were examined. Repeated screening decreased as emotional/informational support and positive social interactions decreased (ps<.01). Repeated mammography decreased with frequent caregiving (p<.01). Less social strain reduced the frequency of repeated breast self-examinations (BSEs; ps<.01), but frequent caregiving and more negative life events increased repeated use of BSE (ps<.01). Interactive effects suggested that emotional/informational but not tangible support is associated with repeated mammography and clinical breast examinations (ps<.01) and may be particularly important among low-income older women, especially those burdened by caregiving.     

Positive‐Themed Suicide Prevention Messages Delivered by Adolescent Peer Leaders: Proximal Impact on Classmates' Coping Attitudes and Perceptions of Adult Support

Developing science‐based communication guidance and positive‐themed messages for suicide prevention are important priorities. Drawing on social learning and elaboration likelihood models, we designed and tested two positive‐focused presentations by high school peer leaders delivered in the context of a suicide prevention program (Sources of Strength). Thirty‐six classrooms in four schools (N = 706 students) were randomized to (1) peer leader modeling of healthy coping, (2) peer leader modeling plus audience involvement to identify trusted adults, or (3) control condition. Students' attitudes and norms were assessed by immediate post‐only assessments. Exposure to either presentation enhanced positive coping attitudes and perceptions of adult support. Students who reported suicide ideation in the past 12 months benefited more than nonsuicidal students. Beyond modeling alone, audience involvement modestly enhanced expectations of adult support, congruent with the elaboration likelihood model. Positive peer modeling is a promising alternative to communications focused on negative consequences and directives and may enhance social–interpersonal factors linked to reduced suicidal behaviors.