Work Stressors,Social Support,and Burnout in Junior Doctors: Exploring Direct and Indirect Pathways

The study tested a pathway model linking different occupational stressors, different sources of social support, and burnout. A sample of 184 junior medical doctors was used. Pathway analysis suggested that doctors who experienced increased time demands, organizational constraints, and a lack of personal confidence perceived their consultants as less supportive, whereas those who experienced greater clinical responsibility perceived their supervisors as more supportive. A lack of support from coworkers was linked with a lack of support from consultants, top management, and family. The perception of consultant support was linked with lower burnout, whereas the perception of coworker support was linked with higher burnout. The present findings may inform interventions aimed to support junior doctors experiencing burnout.     

Supportive interactions,negative interactions,and depressed mood

Research on the association between social relationships and emotional functioning has emphasized the health-promoting effects of social support. Yet there is reason to believe that the absence of negative social interactions may be more important for mental health than the presence of supportive interactions. In this investigation we clarify important characteristics concerning the source, the recipient, and the combined influence of support and negativity. Data are presented regarding supportive and negative interactions with spouse, relatives, and friends; regression analyses suggest that negative interactions are more predictive of depressed mood than supportive interactions (specifically with spouse and friends). We also document several specifications suggesting directions for future research on the special importance of interactions in intimate relationships and the synergistic effects of situations in which supportive and negative interactions both occur.     

Supportive and problematic social interactions: A social network analysis

Assessed the number of sources of supportive and problematic social interactions in the total social network as well as the number who were the sources of consistently supportive or problematic interactions in a sample of 2nd year medical students. Number of problematic interaction sources was hypothesized to be more predictive of psychological and physical well-being than number of supportive interaction sources. Results showed that total supportive and total problematic interaction sources were equally predictive of life satisfaction. The presence of at least one individual who is a consistent source of problematic interactions was most predictive of lower life satisfaction. Results indicate the importance of studying both supportive and problematic social interactions. They also suggest that interactions with individuals that are consistently problematic may negatively impact upon well-being.     

Social support for women with chronic pelvic pain: what is helpful from whom?

Eight women with Chronic Pelvic Pain (CPP) were asked, by means of semi-structured interview, what had been helpful and unhelpful in terms of social support from their partners, families, friends, acquaintances, doctors, nurses and other women with CPP. Firstly, thematic analysis employing a pre-defined social support category system revealed that particular forms of tangible support were preferred from specific support providers but emotional and informational support was appreciated from the whole support network. Secondly, interpretative phenomenological analysis revealed three major additional themes: ‘Pain and Suffering’ described the trauma suffered by these patients and the anger and anxiety surrounding their experience; ‘Ideal Social Support’ revealed a picture of desired support consisting of enduring emotional and practical support which did not undermine individual autonomy; ‘Shortfalls in Social Support’ had subsidiary themes entitled ‘Lack of empathy’ and ‘Lack of engagement’. These themes were described and discussed in relation to each other, extant research and their clinical implications.     

Coping, Conflictual Social Interactions, Social Support, and Mood Among HIV-Infected Persons

This study considers the interrelationships among coping, conflictual social interactions, and social support, as well as their combined associations with positive and negative mood. Research has shown that each of these variables affects adjustment to stressful circumstances. Few studies, however, examine this full set of variables simultaneously. One hundred forty HIV-infected persons completed a questionnaire containing measures of coping, social support, conflictual social interactions, and positive and negative mood. Factor analyses showed that perceived social support and conflictual social interactions formed separate factors and were not strongly related. Compared to perceived social support, social conflict was more strongly related to coping behaviors, especially to social isolation, anger, and wishful thinking. Conflictual social interactions were more strongly related to negative mood than was perceived social support. Coping by withdrawing socially was significantly related to less positive and greater negative mood. The findings point to the importance of simultaneously considering coping, supportive relationships, and conflictual relationships in studies of adjustment to chronic illness. In particular, a dynamic may occur in which conflictual social interactions and social isolation aggravate each other and result in escalating psychological distress.     

Victims' perceptions of social support: what is helpful from whom?

Although research has demonstrated that social interactions influence psychological well-being, little is known about what specific actions victims of stressful life events experience as helpful or unhelpful. Wortman and Dunkel-Schetter (1979) previously suggested that victims frequently experience rejection, withdrawal, and communication problems with those close to them. To address these issues, 55 cancer patients were interviewed concerning the specific actions they found to be helpful or unhelpful from several potential support providers: spouse, other family members, friends, acquaintances, others with cancer, physicians, and nurses. The data indicated that the Wortman and Dunkel-Schetter victimization model applied better to interactions with friends and acquaintances than to interactions with close family members. In addition, support was found to be partially dependent on the source: Particular actions were perceived to be helpful from some but not other network members. Implications for theory and research on social support are discussed.     

Adaptation to Spanish of the "Scale of perceived social support specific to the disease" of Revenson et al., 1991

This study aims to analyze the psychometric properties of the Spanish version of the Scale of Perceived Social Support Specific to the Illness of Revenson et al. 1991. A sample of 202 patients with chronic conditions was used. After making several factor analysis of the scale on all four versions (partner, family, friends and doctors), it was found a structure formed by two factors involving positive social support and not functional or problematic social support. The results obtained with Cronbach's alpha show that all scales have acceptable and adequate internal consistency. In this sense, this scale may be appropriate to identify properly perceived social support for chronic patients on the four sources of support studied.     

Perceptions of social support,receipt of supportive behaviors,and locus of control as moderators of the effects of chronic stress

Conclusion Although the cross-sectional methodology of the present study limits causal inference, the results concerning the buffering effects of received social support for those who have perceptions of internal locus of control corroborates previous research and thus suggests that causal interpretations offered may have some validity.Several general conclusions appear justified from the present study. First, it appears a measure of social support that asks respondents to report on the receipt of particular supportive actions yields different information than a measure that asks respondents to rate the amount of support available to them. Second, perceptions of internal locus of control in combination with receipt of supportive behaviors has a stress-buffering effect. Third, perceptions concerning locus of control appear important in determining the direct and moderating effects of perceived social support on psychological distress. Finally, the interpretation of social support by stress interactions in which support acts as a negative buffer, i.e., increases the stress-symptom relation, may increase our understanding of the role of social support in coping with stress.     

Social support and cancer: Adult patients' desire for support from family,friends, and health professionals

Examined cancer patients' desire for social support from family, friends, and health professionals upon whom they most depended for support. Before a single interaction with each of these sources, nonhospitalized adult cancer patients (N = 64) completed a questionnaire indicating their desire for support from the source on 11 functional components. Results indicated that emotional and instrumental functions of support were distinct and required separate examination. Distinctiveness of primary sources was manifest by patients' overall preference for tangible aid from family, modeling from friends who had cancer, and open communication and clarification from health professionals. Family and friends were equally preferred sources for dealing with affective reactions to the stressfulness of cancer. All three sources were similarly desired for self-esteem enhancement and for relief from decision-making and problem-solving responsibilities. Finally, patients' perceived prognosis but not the objective severity of their illness was associated with a heightened desire for support, especially for instrumental support functions.     

Psycho-social Counselling in Predictive Genetic Testing for Cancer: The Association Between Number of Supportive Sessions and Client Characteristics as Assessed by Psycho-social Workers

Given the increased demand on genetic services, it is important to identify clients who may require relatively more extensive psychosocial support. This paper describes which client characteristics, as assessed in the first psycho-social counselling session, were associated with requiring relatively more psycho-social support (≥3 sessions) in the process of predictive testing for cancer. The study population consisted of 244 counselees for hereditary cancer. Data were derived from an electronic data-base, used by psycho-social workers for the systematic registration of relevant details of each counselling session. Data were analysed for two respective groups: (A) patients who had a known mutation in the family and (B) patients with an as yet unknown mutation in the family. Results show that two or more psychosocial sessions were given if the information derived from the first session indicated the client to have childhood experiences with cancer (in group A), to experience the family role and/or the psychological impact as burdensome (in both groups) or to experience the social impact as burdensome (in group B). We conclude that the first assessment by a psychosocial worker already provides valuable information on the psychological support needs of patients. These findings provide insight into possible problem areas for clients dealing with predictive genetic testing.     

Gender differences in social support: a question of skill or responsiveness?

Spouses often report that wives provide better social support than husbands. Yet studies observing spouses' supportive interactions challenge this perception, finding no differences between husbands' and wives' supportive behaviors. This article offers reconciliation by suggesting that husbands and wives may differ, not in their skill at providing support, but in their responsiveness to their partners' changing needs over time. Observational and diary data from couples confirmed that, whereas husbands and wives did not differ on average in the support they provided each other, they did differ in the timing of that support. Wives tended to provide better support on days that their husbands experienced greater stress. However, when wives experienced greater stress, their husbands displayed both support and negativity.     

You Name It: Interpersonal Affect Labeling Diminishes Distress in Romantic Couples

Although it is increasingly acknowledged that social interactions may provide support at times of adversity, whether or how such interactions can buffer distress remains unclear. The objective of the present study was to examine whether naming the emotions of our partner in aversive situations can effectively reduce distress and whether the regulator’s empathy contributes to its effectiveness. We utilized a novel performance-based interpersonal affect labeling (IAL) paradigm. Seventy-four romantic couples were randomly divided into targets and regulators. The targets watched aversive pictures with low and high intensity and rated their level of distress after: (1) simply viewing the picture (control trials) (2) choosing a label that describes their emotional reaction (self-labeling trials), (3) viewing a label chosen for them by the regulator, their partner (IAL trials). It was found that IAL significantly reduced distress compared to self-labeling. Moreover, the effectiveness of IAL increased as a function of the regulator’s level of empathy. The results highlight the importance of empathy in social support and suggest that as simple an action as naming our partner’s emotions may be effective in reducing their distress. Moreover, it emphasizes the potential contribution of nonprofessional help in emotion regulation.     

When Words are not Enough: Psychotherapy with Clients Who are Living Below the Poverty Level

The present article describes six strategies found useful when working with depressed clients who are struggling with severe financial limitations. First, it is important to help clients maintain an attitude of hope for a better future, so they remain as positive yet realistic about their current options and future goals. Second, empathy is considered to be a central component in all psychotherapy sessions, helping therapists to understand their clients’ life experiences and ongoing struggles. Third, clients can learn to develop more adaptive perspectives about life, family, and friends, trying to focus on the positive events they have experienced and the supportive bonds they have developed. Fourth, clients can develop new specific coping skills that may help them to manage the problems they encounter. Fifth, many clients can better utilize the social support that is often available, starting to ask family members and friends for assistance and support when help is needed. Sixth, an interdisciplinary treatment team is often optimal when the treatment plan integrates the potential benefits derived from psychotherapy, medications, and social service agencies. An effective psychotherapist respects the limits of psychology while consulting with colleagues from other health care professions. These six strategies can help guide therapists when working with clients who are struggling with persistent depression in the face of adversity.     

共情对灾后青少年亲社会行为的影响：感恩、社会支持和创伤后成长的中介作用

以雅安地震极重灾区芦山县的542名中学生为被试, 在地震发生3.5年后, 采用人际反应指数量表测查被试的共情能力, 并在震后4.5年采用感恩问卷、社会关系网络问卷、创伤后成长问卷和亲社会行为问卷测查被试的感恩、社会支持、创伤后成长(posttraumatic growth, PTG)和亲社会行为, 从追踪的视角考察地震后青少年的共情能力对亲社会行为的影响, 并探讨感恩、社会支持和创伤后成长(PTG)在其中的中介作用。结果显示, 共情可直接正向预测亲社会行为; 共情对亲社会行为的预测可分别通过感恩、社会支持和PTG的中介进行; 共情还可以分别通过感恩经社会支持、感恩经PTG、社会支持经PTG、感恩经社会支持再经PTG的链式中介对亲社会行为起到正向预测作用。这一发现提示, 未来的创伤后心理辅导工作应更加关注青少年的积极心理和社会行为的发展。     

Doctors inhibit social threat empathy in the later stage of cognitive processing: Electrophysiological evidence

Previous studies have found that repeatedly exposed to a threatening situation may reduce doctors' level of empathy, reducing psychological stress and avoiding burnout and compassion fatigue. However, many essential studies found that it does not seem universal but rather modulated by group membership. In this study, we recorded event-related potentials (ERP) when doctors and controls watched visual stimuli describing patients attacking doctors (Threat events) or shaking hands with doctors (Neutral events). The present study showed an early N190 and a later centro-parietal P3 differential amplitude between threat stimuli and neutral stimuli were observed in the controls. For the doctors, there was such ERP differentiation in early N190. However, later stage P3 differential amplitude was not observed. The current research suggests that doctors could regulate empathy and avoid allocating more attention resources when processing social threats to ensure treatment efficiency and avoid burnout.     

Family and peer social support as specific correlates of adolescent depressive symptoms

Depression models that emphasize the social environment have not been tested with adolescents and their specificity to depressive symptoms has not been demonstrated In a study of 94 adolescent inpatients, distinctions were drawn between family and peer support to determine if these sources of support were differentially related to depression symptoms. Step-down multivariate multipleregression analyses showed that depression symptoms were uniquely predicted by social relationship variables after accounting for the effects of anxiety and conduct disorder symptoms. Depression was negatively related to family and paternal support, but it was positively related to peer support. Furthermore, family and paternal support interacted with peer support in the prediction of depression. The results are consistent with the assertion that disturbances in important supportive attachments have special significance for the experience of depressive symptoms by adolescents.This research was supported by postdoctoral research fellowship funds provided to the first author by the National Research Council and a grant to the second author by the Graduate Student Association of Arizona State University. The authors express appreciation to Dr. Ruedi Hahnloser, Senior Psychologist, and the patients and staff of Camelback Hospitals for their cooperation in conducting this research.     

An exploratory study of social support, distress, and life disruption among low-income Hispanic women under treatment for early stage breast cancer.

Relationships between distress and perceived availability of social support were examined in 51 Hispanic women being treated for early stage breast cancer. Distress and different types (emotional, instrumental) and sources (spouse, women family members, other family members, friends) of support were measured at presurgery, postsurgery, and at 3-, 6-, and 12-month follow-ups. Emotional support from friends and instrumental support from spouse at presurgery predicted lower distress postsurgery. No other prospective benefits of perceived support emerged. Distress at several time points predicted erosion of subsequent support, particularly instrumental support from women in the family. In contrast to the adverse effects of distress (and independent of them), illness-related disruption of recreational and social activities at 6 months elicited greater support at 12 months.     

Couples coping with cancer: Research issues and recent findings

The diagnosis of cancer in one partner can impose numerous changes for both the individual diagnosed with cancer and his or her healthy spouse. In this article, the literature on spouse social support in the context of cancer is reviewed. The importance of understanding support given and received within a close relationship using an interactional, contextual perspective is emphasized. Examining support-related interactions and understanding the personal characteristics that determine the type and amount of support that providers give and the kind of support individuals prefer, and investigating why significant others respond in supportive or critical ways is important. In addition, the study of support interactions must be placed in the both in the context of a marriage and in the context of a catastrophic life event such as cancer. A longitudinal study of patients with gastrointestinal cancer and their healthy partners was undertaken to examine these issues, and the design of this study is described. General problems conducting research with couples undergoing a severe life stressor as well as specific problems our research group has encountered while setting up a research program in the cancer setting are reviewed.     

The Relationship Between Parental Variables,Empathy and Prosocial-Flow with Prosocial Behavior Toward Strangers,Friends, and Family

The goal of this study was to explore the relationship between two different aspects of the parent–child relationship (parental challenge and authoritative parental style) and empathy as well as prosocial flow with prosocial behavior toward strangers, friends, and family. The participants were 422 young adults who were enrolled in undergraduate social responsibility courses at a University. The results show that the combination of parental support and parental challenge has an important influence on prosocial flow and on positive behavior such as prosocial behavior toward friends and family, but no influence on that toward strangers. Moreover, in the same way, empathy and prosocial flow promote prosocial behavior toward these three targets. The interpretations of these findings are delineated in the discussion.