Functional versus structural social support, desirable events, and positive affect in older adults.

The independent contributions of structural social support versus functional support to positive affect in older adults were compared in this prospective design. Four social support models were translated from the stress-symptoms literature into promotional models for positive mental health and for relationships to desirable challenge events. A total of 1,031 older adults were interviewed 5 times at 6-month intervals, and events were measured across the middle 18-month period. The 2 support variables made quite different contributions. Functional support was directly related to positive affect 2 years later, independent of events; structural support had more transitory direct effects. Structural support, but not functional support, was related to the subsequent occurrence of challenge events and in turn was strengthened by challenge events, suggesting a dynamic interplay between the social network and desirable events.     

Correlates of suicide in the older adult population in Quebec

This study was undertaken to describe the characteristics of adults aged 60 years and over who committed suicide in Quebec in 1998-1999. In this study, 42.6% of the suicide cases presented mental disorders at the time of their death, mainly depression. Sixty-five (65.3%) percent of the suicide cases would have been considered as having a mental health disorder if sub-threshold depression cases were included. Only 27.7% of the cases did not express any idea of death during the 6-month period preceding their suicide. One interesting finding was that 53.5% of the suicide cases consulted a general practitioner or specialist during the 2-week period preceding their death. Our results showed that only 8.1% had a severe level of functional limitations at the time of their death. This result leads us to interpret with caution the conclusion of some studies suggesting that physical frailty is a major causal factor associated with suicide among the elderly.     

Evaluation of a mutual help network for the elderly residents of planned housing

We set up a mutual help network among the elderly residents of a government-subsidized apartment building and evaluated its impact on their social ties, social support satisfaction, and depression. A quasi-experimental design was used, with the residents of a similar building located in the same neighborhood serving as the control group. A total of 230 individual services were exchanged, and 28 group activities were organized during the study period. There was almost no difference between experimental and control groups with respect to the change over the study period in the number of social ties with other residents of the building. Support satisfaction decreased in both groups, but the decrease was larger in the experimental group. The control group had a slight decrease in the frequency of their depressive symptoms, whereas the experimental group had a moderate increase. More research is needed on the ability of social support interventions to produce beneficial effects on mental health among individuals who are not experiencing a particular life stress.     

Randomized Controlled Trial of a Multilevel Intervention to Address Social Determinants of Refugee Mental Health

Understanding processes that support the well-being of the unprecedented numbers of forcibly displaced people throughout the world is essential. Growing evidence documents post-migration stressors related to marginalization as key social determinants of refugee mental health. The goal of this RCT was to rigorously test a social justice approach to reducing high rates of distress among refugees in the United States. The 6-month multilevel, strengths-based Refugee Well-being Project (RWP) intervention brought together university students enrolled in a 2-semester course and recently resettled refugees to engage in mutual learning and collaborative efforts to mobilize community resources and improve community and systems responsiveness to refugees. Data collected from 290 Afghan, Great Lakes African, Iraqi, and Syrian refugees at four time points over 12 months were used to test the effectiveness of RWP to reduce distress (depression and anxiety symptoms) and increase protective factors (English proficiency, social support, connection to home and American cultures). Intention-to-treat analyses using multilevel modeling revealed significant intervention effects for all hypothesized outcomes. Results provide evidence to support social justice approaches to improving refugee mental health. Findings have implications for refugees worldwide, and for other immigrant and marginalized populations who experience inequities in resources and disproportionate exposure to trauma/stress.     

Physical activity-related well-being in older adults: social cognitive influences

In this study, the pattern and correlates of physical activity-related well-being in older adults (N = 174; men = 49, women = 125; mean age = 66 years) were examined across a 6-month exercise trial. Baseline levels of self-efficacy fitness, importance of physical activity, and social support and exercise participation across the trial were used as correlates of positive and negative feeling states. Psychological responses to physical activity were assessed on a bimonthly basis across the trial. Latent growth curve analyses indicated significant growth in positive well-being over the 6-month period, with increases reaching a threshold at 4 months. Self-efficacy was inversely related to change in positive well-being across the trial. Frequency of activity and increases in well-being over the trial were significant predictors of self-efficacy at program termination. Findings suggest the social cognitive context of the exercise experience may have influence on exercise-related well-being.     

Sexual Minority Stress and Social Support Explain the Association between Sexual Identity with Physical and Mental Health Problems among Young Lesbian and Bisexual Women

Bisexual women report more physical and psychological health problems than lesbian women do, which may be attributed to greater sexual minority stress and less social support. However, many studies combine lesbian and bisexual women into a single group. The current study examined if sexual minority stress and social support mediated the association between women’s sexual identity (lesbian or bisexual) and health-related outcomes. A total of 650 U.S. young adult lesbian (n?=?227) and bisexual (n?=?423) women completed an online survey about sexual minority stress, social support, and physical and mental health problems. Bisexual women reported more physical and mental health problems. A sequential mediation model showed that bisexual women reported greater sexual minority stress than lesbian women, which in turn was associated with less social support, which was associated with more physical and mental health problems. Greater sexual minority stress and lower social support may help explain why bisexual women report more health-related problems than lesbian women. The results of the present study support the importance of examining risk and protective factors for health problems separately for lesbian and bisexual women. Health-related intervention programs that target sexual minority women may need to be tailored differently for lesbian and bisexual women.

     

Intervention for infants with brain injury: results of a randomized controlled study

A randomized clinical trail (RCT) employed a 12-month individualized cognitive/sensorimotor stimulation program to look at the efficacy of the intervention on 62 infants with suspected brain injury. The control group infants received the State-funded follow-up program provided by the Los Angeles (LA) Regional Centers while the intervention group received intensive stimulation using the Curriculum and Monitoring System (CAMS) taught by public health nurses (PHNs). The developmental assessments and outcome measures were performed at 6, 12 and 18 months corrected age and included the Bayley motor and mental development, the Home, mother-infant interaction (Nursing Child Assessment Feeding Scale (NCAFS) and Nursing Child Assessment Teaching Scale (NCATS)), parental stress and social support. At 18 months, 43 infants remained in the study. The results indicate that the intervention had minimal positive effects on the Bayley mental and motor development scores of infants in the intervention group. Likewise, the intervention did not contribute to less stress or better mother-infant interaction at 12 or 18 months although there were significant differences in the NCAFS scores favoring the intervention group at 6 months. There was a significant trend, however, for the control group to have a significant decrease over time on the Bayley mental scores. Although the sample was not large and attrition was at 31%, this study provides further support to the minimal effects of stimulation and home intervention for infants with brain injury and who may have more significant factors contributing to their developmental outcome.     

Understanding the role of social support in trajectories of mental health symptoms for immigrant adolescents

This longitudinal study of 286, urban residing, first- and second-generation immigrant adolescents examined the degree to which acculturative stress is related to the developmental trajectories of mental health problems and the role of social support in this process. Participants were recruited when they entered 10th grade and two additional waves of data were gathered at 12-month intervals. Using individual growth curve modeling, the results show significant decline in internalizing mental health problems during the high school years. At the same time, greater exposure to acculturative stress predicted significantly more withdrawn/depressed, somatic, and anxious/depressed symptoms. Additionally, social support moderated the relation between acculturative stress and anxious/depressed symptoms. Gender and generation status differences were found only at baseline (10th grade).     

The role of risk and protective factors in predicting symptomatology in adolescent self-identified children of alcoholic parents

Tested a stress process model for predicting mental health symptoms in children of alcoholics (COAs). Stress and mental health measures were completed twice over a 3-month period by 145 high school students, 43 of whom self-identified as COAs. Using structural equation modeling, a stress process model for predicting mental health symptoms in children provided a good fit to the data. COA status was related to higher levels of negative and lower levels of positive events. In turn, positive and negative life events were found to have an immediate, but not a longitudinal, direct effect on adolescent symptomatology.     

Dynandcs in cancer caregiver's health over time: Gender-specific patterns and determinants

Abstract

This study exandned patterns and determinants of three dimensions of caregiver's health of newly diagnosed colorectal cancer patients, i.e. physical, mental and social functioning (N= 148). Physical functioning declined within a 6-month period in female caregivers, while no change was observed in male caregivers. For mental and social functioning, an improvement was observed in male and female caregivers. Change in physical functioning was associated with gender, age, income and initial level. Change in mental functioning was predicted by initial status and positive as well as negative caregiver experiences. Change in social functioning was mainly predicted by initial level and change in patient's dependency. Physical and mental functioning showed the least favorable patterns in female caregivers. The study shows that caregiving may lead to positive health consequences, and underlines the importance of making a distinction between male and female caregivers and of studying caregiver outcomes by using multidimensional assessments.     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition.     

Positive affect, negative affect, stress, and social support as mediators of the forgiveness-health relationship

Structural equation modeling was used to test a model in which positive affect, negative affect, perceived stress, and social support were hypothesized to mediate the relationship between forgiveness and mental and physical health. Six hundred and twenty-three undergraduates completed a battery of self-report measures. Results of the analyses indicated that the forgiveness-health relation was mediated by positive affect, negative affect, stress, and the interrelationship between negative affect and stress. There was limited support for social support and the interrelationship between positive affect and social support as mediators. The results suggested that the relationship between forgiveness and health is mediated rather than direct. Implications and directions for future research are discussed.     

Differential social support and life change as contributors to the social class-distress relationship in older adults

Four hypotheses previously put forth to explain the strong association between social class and mental health in the general population were examined in 1,326 older adults (55 years and older). Respondents were interviewed 3 times at 6-month intervals. Lower class was associated with more past life changes (occurring before Wave 1) and more subsequent life events (occurring between Waves 1 and 3); these changes were predictive of distress, supporting the differential exposure hypothesis. Lower class was associated with weaker social support (embeddedness), which was related to distress, supporting the resource deterrent hypothesis. There was little evidence that people of the lower classes were more vulnerable to stress or that their status was due to their weaker social support; thus, the differential vulnerability and applied buffering hypotheses were not consistently supported. Social support does appear to be a versatile resource for older adults. A significant portion of the class-distress relationship was not accounted for by life change, social support, or the interaction between these factors.     

Quality of workplace social relationships and perceived health

Associations between the quality of social relationships at work and mental and self-reported health were examined to assess whether these associations were independent of job strain. The study was based on cross-sectional survey data from 728 employees (response rate 58%) and included the Demand-Control-(Support) (DC-S) model, six items on the quality of social relationships at the workplace, the General Health Questionnaire (30), and an item on self-reported physical health. Logistic regression analyses were used. A first set of models were run with adjustment for age, sex, and socioeconomic group. A second set of models were run adjusted for the dimensions of the DC-S model. Positive associations were found between the quality of social relationships and mental health as well as self-rated physical health, and these associations remained significant even after adjustment for the dimensions. The findings add support to the Health and Safety Executive stress management standards on social relationships at the workplace.     

Mental and physical health of spouse caregivers: the role of personality.

Although personal resources of caregivers, such as coping skills and social support, have been shown to be important in understanding caregiver stress and health outcomes, personality traits have not previously been considered. The purpose of this study was to examine the association between the personality traits of neuroticism and dispositional optimism and mental and physical health outcomes. It was predicted that personality would have direct effects, and indirect effects through perceived stress, on health outcomes. Participants were spouse caregivers of patients diagnosed with Alzheimer's disease. Results showed that neuroticism and optimism were significantly related to mental and physical health. Furthermore, neuroticism had significant direct effects on all of the health outcomes, and substantial indirect effects, through perceived stress, on mental health outcomes. Optimism showed stronger indirect than direct effects on all health outcomes. These findings demonstrate the importance of including personality of the caregiver in theoretical and empirical models of the caregiving process.     

Social support, stress, and depressive symptoms among the elderly: test of a process model.

Effects of social support, negative life events, and daily hassles on depressive symptoms were assessed in 301 adults aged 65 or older, in person 3 times at 6-month intervals and by mail questionnaires every month over a 12-month period. Initial social support predicted severity of depressive symptoms 12 months later. Social support and initial levels of depressive symptomatology predicted number of daily hassles but not number of major life events. Effects of social support, depression, and major life events on the incidence of daily hassles remained significant without the inclusion of hassles reflecting depressive symptomatology or problems in relationships or whose content overlapped with major life events. Daily hassles mediated the effects of major life events on subsequent depression. Results did not differ for men and women. Implications for models of the relations among social support, stress, and depression are discussed.     

The impact of daily stress on health and mood: psychological and social resources as mediators

This study examined daily stress processes among 75 married couples across 20 assessments during a 6-month period. The somatic and psychological effects of common everyday hassles were investigated. Overall, there was a significant relationship between daily stress and the occurrence of both concurrent and subsequent health problems such as flu, sore throat, headaches, and backaches. The relationship of daily stress to mood disturbance was more complex. The negative effects of stress on mood were limited to a single day, with the following day characterized by mood scores that were better than usual. Furthermore, striking individual differences were found in the extent to which daily stress was associated with health and mood across time. Participants with unsupportive social relationships and low self-esteem were more likely to experience an increase in psychological and somatic problems both on and following stressful days than were participants high in self-esteem and social support. These data suggest that persons with low psychosocial resources are vulnerable to illness and mood disturbance when their stress levels increase, even if they generally have little stress in their lives.     

空巢老人心理健康的现状及研究述评

空巢老人的心理健康引起了国内外研究者们的高度关注,逐渐成为一个热点课题.在综合国内外有关空巢老人心理健康的研究文献后发现,目前,学界对空巢老人的界定并不统一;从其心理健康现状来看,空巢综合症是空巢老人各种身心症状的主要体现,主要受社会支持、性别、婚姻状况、经济收入以及其他一些社会人口学因素的影响.虽然对空巢老人心理健康的研究已取得一些成就,但仍存在一些尚待解决的问题,未来研究应从统一空巢老人的涵义,完善研究方法,深入对其自身内部心理因素的探讨及加强跨文化的比较与借鉴等方面来开展.     

Long-Term Effects of an Internet-Based Treatment for Posttraumatic Stress

Abstract

Advances in communication technology offer additional strategies for providing psychological treatment. Previous trials of Internet-based treatment approaches reported significant reductions in posttraumatic stress and related symptoms in response to Internet-based treatments relative to control groups. However, empirical data on the long-term effects of those approaches are sparse. In order to evaluate the long-term effect of an Internet-based intervention, the authors conducted an 18-month follow-up of an Internet-based cognitive behavioural therapy for posttraumatic stress. Severity of posttraumatic stress symptoms was the primary outcome. Additional measures were depression, anxiety, mental and physical health, and health care utilization during the follow-up period. Treatment group participants (n = 34) were assessed 1.5 years after completing treatment. Results indicated that reductions in symptoms of posttraumatic stress symptoms, depression, and anxiety found at posttreatment were sustained during the 18-month follow-up period. Preliminary evidence on long-term effects of Internet-based health care as shown in this study is promising. However, research with larger and clinically more diverse samples is needed to fully assess the clinical impact and potential of Internet-based health care provision.     

Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking

The purpose of the present study was to examine the role of emotional and instrumental social support seeking in the quality of life (QOL) and mental health of women with ovarian cancer. Participants were recruited through the Pennsylvania Cancer Registry, and one hundred women took part in a mail questionnaire that collected information on their demographics, medical status, social support seeking, QOL and mental health including anxiety, depression and stress. Hierarchical linear regression analyses were conducted to assess the influence of emotional and instrumental social support seeking on QOL and mental health. After controlling for remission status, greater emotional social support seeking was predictive of higher overall QOL, social/family QOL, functional QOL and lower depression scores. Instrumental social support seeking was not significant in the models. The results illustrate that social support seeking as a coping mechanism is an important consideration in the QOL and mental health of women with ovarian cancer. Future studies should examine the psychological and behavioral mediators of the relationship to further understand the QOL and mental health of women with ovarian cancer.