Effects of change in fatigue and depression on physical activity over time in relapsing-remitting multiple sclerosis

This prospective, observational study examined the effects of change in the symptoms of fatigue and depression on physical activity over time in persons with relapsing-remitting multiple sclerosis (RRMS). Adults with a confirmed diagnosis of RRMS completed a battery of questionnaires at baseline (n = 269) and six-month follow-up (n = 263). The data were analyzed using linear panel analysis and covariance modeling in Mplus 3.0. The panel model fit the data (χ(2) = 24.00, df = 15, p = 0.07, SRMR = 0.04, CFI = 0.98) and demonstrated that changes in both fatigue (path coefficient = -0.09) and depressive symptoms (path coefficient = -0.12) were significantly associated with residual change in physical activity. Such findings support the importance of fatigue and depression for predicting longitudinal changes in physical activity in adults with RRMS.     

Positive Events and Social Supports as Buffers of Life Change Stress1

A perceived availability of social support measure (the ISEL) was designed with independent subscales measuring four separate support functions. In a sample of college students, both perceived availability of social support and number of positive events moderated the relationship between negative life stress and depressive and physical symptomatology. In the case of depressive symptoms, the data fit a “buffering” hypothesis pattern, i.e., they suggest that both social support and positive events protect one from the pathogenic effects of high levels of life stress but are relatively unimportant for those with low levels of stress. In the case of physical symptoms, the data only partially support the buffering hypothesis. Particularly, the data suggest that both social support and positive events protect one from the pathogenic effects of high levels of stress but harm those (i.e., are associated with increased symptomatology) with low levels of stress. Further analyses suggest that self-esteem and appraisal support were primarily responsible for the reported interactions between negative life stress and social support. In contrast, frequency of past social support was not an effective life stress buffer in either the case of depressive or physical symptomatology. Moreover, past support frequency was positively related to physical symptoms and unrelated to depressive symptoms, while perceived availability of support was negatively related to depressive symptoms and unrelated to physical symptoms.     

The Relational Context of Social Support in Young Adults: Links with Stress and Well-Being

This study examined the roles of relationship-specific social support and gender in the associations between perceived stress and well-being. Three sources of support (family, friends, and romantic partners) and three well-being indicators (loneliness, depressive symptoms, and physical health) were assessed in 628 young adults attending college (M _age = 19.72; range of 18–24). Stress directly predicted all well-being indicators, and indirectly predicted well-being through social support in relationship-specific ways. Family support mediated the relationship between stress and physical health, friend support mediated the association between stress and loneliness, and romantic partner support mediated the relationships of stress with both loneliness and depressive symptoms. With regard to loneliness and physical health, women were more strongly impacted when they had less support from friends.     

Financial strain,social capital,and perceived health during economic recession: a longitudinal survey in rural Canada

Although the health consequences of financial strain are well documented, less is understood about the health-protective role of social capital. Social capital refers to a sense of community embeddedness, which is in part reflected by group membership, civic participation, and perceptions of trust, cohesion, and engagement. We investigated whether perceptions of social capital moderate the relation between financial strain and health, both mental and physical. This longitudinal study surveyed adults in two communities in rural Ontario where significant job losses recently occurred. Data were collected on financial strain, social capital, perceived stress, symptoms of anxiety and depression, and physical health on three occasions over 18 months (N's = 355, 317, and 300). As expected, financial strain positively related to perceived stress, poor physical health and symptoms of anxiety and depression, whereas social capital related to less stress, better physical health, and fewer symptoms of anxiety and depression. Effects of financial strain on perceived stress and depressive symptoms were moderated by social capital such that financial strain related more closely to perceived stress and depressive symptoms when social capital was lower. The findings underscore the health-protective role of community associations among adults during difficult economic times.     

Depressive symptoms, social support, and personal health behaviors in young men and women.

This study investigated the relationship of depressive symptoms, social support, and a range of personal health behaviors in 2,091 male and 3,438 female university students from 16 countries. Depressive symptoms and social support were measured using the short Beck Depression Inventory and the Social Support Questionnaire; 9 personal health behaviors were also assessed. After the authors took age, social support, and clustering by country into account, depressive symptoms were significantly associated with lack of physical activity, not eating breakfast, irregular sleep hours, and not using a seat belt in both men and women, and additionally with smoking, not eating fruit, and not using sunscreen among women. Low social support was independently associated with low alcohol consumption, lack of physical activity, irregular sleep hours, and not using a seat belt in men and women. Bidirectional causal pathways are likely to link health behaviors with depressed mood.     

Type D personality, physical symptoms and subjective stress: the mediating effects of coping and social support

Coping style and social support may represent mechanisms to explain the relationship between Type D personality and ill-health. This study investigated whether Type D is associated with physical symptoms and perceived stress in a non-cardiac population, and if these relationships are mediated by coping and social support. In a cross-sectional study, 304 participants (110 males, mean age 22.1 years) completed measures of Type D, physical symptoms, coping, perceived stress and social support. Results showed that Type D, the interaction of negative affectivity and social inhibition (NA × SI), was positively correlated with physical symptoms, perceived stress, and avoidant coping, and negatively correlated with social support, problem-focused coping and emotion-focused coping. A series of bootstrapped multiple mediator tests showed that social support and avoidant coping fully mediated the relationship between Type D and physical symptoms. Furthermore, social support and emotion-focused coping partially mediated the relationship between Type D and perceived stress. These findings demonstrate for the first time that Type D personality is associated with physical symptoms in a non-cardiac population. Social support and coping style represent mechanisms that can, in part, explain the relationship between Type D and physical symptoms, and Type D and perceived stress.     

Type D personality,physical symptoms and subjective stress: The mediating effects of coping and social support

Coping style and social support may represent mechanisms to explain the relationship between Type D personality and ill-health. This study investigated whether Type D is associated with physical symptoms and perceived stress in a non-cardiac population, and if these relationships are mediated by coping and social support. In a cross-sectional study, 304 participants (110 males, mean age 22.1 years) completed measures of Type D, physical symptoms, coping, perceived stress and social support. Results showed that Type D, the interaction of negative affectivity and social inhibition (NA?×?SI), was positively correlated with physical symptoms, perceived stress, and avoidant coping, and negatively correlated with social support, problem-focused coping and emotion-focused coping. A series of bootstrapped multiple mediator tests showed that social support and avoidant coping fully mediated the relationship between Type D and physical symptoms. Furthermore, social support and emotion-focused coping partially mediated the relationship between Type D and perceived stress. These findings demonstrate for the first time that Type D personality is associated with physical symptoms in a non-cardiac population. Social support and coping style represent mechanisms that can, in part, explain the relationship between Type D and physical symptoms, and Type D and perceived stress.     

Cross-sectional and Longitudinal associations in coping strategies and physical health outcomes among HIV-Positive youth

This study assessed whether coping styles had an influence on physical health outcomes either concurrently or longitudinally in a sample of HIV-positive youth. Coping styles were characterized as positive, passive, depressive withdrawal, and escapist. A cross-sectional latent variable analysis (N = 279) assessed associations among environmental stress, self-esteem, social support, coping styles, AIDS symptoms, and CD4 count. A more restricted longitudinal analysis (N = 174) tested associations among earlier environmental stress, self-esteem, coping styles, and AIDS symptoms at follow-up. CD4 count was not associated with coping styles in the cross-sectional analysis. Concurrent AIDS symptoms were significantly predicted by depressive withdrawal and environmental stress. A passive coping style modestly predicted more AIDS symptoms longitudinally. Correlates of perceived health and well-being of persons with HIV/AIDS are important to investigate in addition to more objective measures such as CD4 count that may not be amenable to change through coping style interventions alone.     

Social support,social integration,and health-related quality of life over time: Results from the Fitness and Arthritis in Seniors Trial (FAST)

The present study tested whether baseline perceived social support and social integration predicted baseline and follow-up measures of health-related quality of life for 364 older adults with osteoarthritis. The findings are secondary analyses of a randomized controlled trial of an exercise intervention. Multiple regression analyses indicate that perceived social support was related to baseline measures of functioning in psychological (depressive symptoms, social functioning, and life satisfaction) and physical domains (self-rated disability, observed physical function, and perceived health), after accounting for demographic and clinical status factors. At 18-month follow-up (additionally controlling for exercise intervention and baseline outcomes), social support significantly predicted changes in psychosocial functioning, but was unrelated to changes in self-reported and observed physical health. The findings indicate that social support is an important predictor of long-term psychosocial outcomes, but is less important than baseline clinical status for physical health endpoints in this cohort of older adults. In contrast, social integration was not a consistent predictor of outcomes.     

Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses

The extent to which loneliness is a unique risk factor for depressive symptoms was determined in 2 population-based studies of middle-aged to older adults, and the possible causal influences between loneliness and depressive symptoms were examined longitudinally in the 2nd study. In Study 1, a nationally representative sample of persons aged 54 and older completed a telephone interview as part of a study of health and aging. Higher levels of loneliness were associated with more depressive symptoms, net of the effects of age, gender, ethnicity, education, income, marital status, social support, and perceived stress. In Study 2, detailed measures of loneliness, social support, perceived stress, hostility, and demographic characteristics were collected over a 3-year period from a population-based sample of adults ages 50-67 years from Cook County, Illinois. Loneliness was again associated with more depressive symptoms, net of demographic covariates, marital status, social support, hostility, and perceived stress. Latent variable growth models revealed reciprocal influences over time between loneliness and depressive symptomatology. These data suggest that loneliness and depressive symptomatology can act in a synergistic effect to diminish well-being in middle-aged and older adults.     

Perfectionism,Components of Stress Reactivity,and Depressive Symptoms

The current study examined the associations among dimensions of perfectionism, facets of stress reactivity, and self-reported depressive symptoms in 191 university students. Participants completed the Multidimensional Perfectionism Scale, the Perfectionism Cognitions Inventory, the Perceived Stress Reactivity Scale (PSRS), and a measure of depressive symptoms. The PSRS is a relatively new instrument that measures several distinguishable facets of stress reactivity including prolonged stress reactivity, reactivity to failure, and reactivity to social evaluation. Analyses confirmed that most of the perfectionism measures were associated with stress reactivity to failure experiences. Socially prescribed perfectionism and perfectionistic automatic thoughts were also associated with prolonged stress reactivity and reactivity to social evaluation. Moreover, all facets of stress reactivity were correlated with depressive symptoms. Finally, prolonged stress reactivity and reactivity to social evaluation mediated the links between perfectionism dimensions and depressive symptoms. The current findings provide general support for models of perfectionism and stress, and suggest that perfectionists have heightened sensitivities to stressors related to their self-definitions that are activated when threatening stressors involving these themes are experienced.     

Early and Late Life Exposure to Trauma and Biopsychosocial Well-Being in Centenarians

Few studies have investigated the proximal versus distal influence of traumatic life events (TLE) on biopsychosocial resources of very old adults. The Developmental Adaptation Model was used to test TLE experienced before and after the age of 60 on outcomes of centenarians’ physical disability, perceived health impairments, depressive symptoms, and social support. Cross-sectional data were collected from 154 community-dwelling centenarians. Results indicated that TLE in the latter half of life were positively associated with health impairments and depressive symptoms. The present results emphasize the importance of a process-oriented approach to resilience that allows flexibility in successful coping across the lifespan.     

The other way around: does health predict perceived support?

The aim in this study was to identify predictors of perceived social support before and after cataract surgery. We hypothesized that physical (comorbidity and visual acuity) and mental (depressive symptoms) health indicators would be directly and indirectly (through actually received support) associated with perceived support. One hundred and thirty-six cataract patients (69% women; mean age = 71.6 years) completed questionnaires before and after cataract surgery. Results showed that received support partially mediated the association between depressive symptoms and perceived support. However, mental and physical health variables were also directly associated with perceived support. We conclude that health status might feedback to perceptions of available support.     

The Roles of Social Support and Self-Efficacy in Physical Health’s Impact on Depressive and Anxiety Symptoms in Older Adults

Physical illness may precipitate psychological distress among older adults. This study examines whether social support and self-efficacy moderate the associations between physical health and depression and anxiety. Predictions were tested in 222 individuals age 60 or older presenting for help with worry. Physical health was assessed through self-report (subjective) and physical diagnoses (objective). Objective physical health did not have a significant association with depression or anxiety. Worse subjective physical health was associated with increased somatic anxiety, but not with depression or worry. The relationship between subjective physical health and depressive symptoms was moderated by self-efficacy and social support. As predicted, when self-efficacy was low, physical health had its strongest negative association with depressive symptoms such that as physical health improved, depressive symptoms also improved. However, the moderation effect was not as expected for social support; at high levels of social support, worse physical health was associated with increased depressive affect.     

Symptoms Among Partners,Family, and Friends of Individuals with Posttraumatic Stress Disorder: Associations with Social Support Behaviors,Gender, and Relationship Status

Social support represents an important recovery factor for individuals with posttraumatic stress disorder (PTSD). Nevertheless, partners, family, and friends who take on the role of caregiver for individuals with PTSD might face multiple difficulties. For example, they are at risk for developing anxiety and depressive symptoms, which could negatively affect their ability to offer support. This study examined the associations between the difficulties of individuals with PTSD (i.e., symptoms and level of functioning), their caregivers’ (partners, family, and friends) anxiety and depressive symptoms, and social support behaviors according to 2 variables: relationship status and gender. Sixty-five individuals with PTSD and either their partner, family member, or friend filled out questionnaires and participated in a trauma-oriented discussion. Social support behaviors were coded. Results revealed no associations between the difficulties of individuals with PTSD and their caregivers’ symptoms. However, caregivers’ depressive symptoms were negatively associated with the quality of some of their social support behaviors. Moreover, relationship status and gender were significant moderators, indicating stronger negative associations between anxiety and depressive symptoms and some social support behaviors of men and caregiving partners. Male caregivers could have difficulties offering appropriate support and responding to traditional masculine roles (e.g., being strong and self-reliant) when they report symptoms themselves. Partners are particularly involved in the everyday life of individuals with PTSD. Thus, they could have difficulties keeping an optimal emotional distance to offer support when they report symptoms themselves. Future directions as well as clinical implications are discussed.     

Depressive Symptomatology among HIV-Positive Women in the Era of HAART: A Stress and Coping Model

Objective: An enhanced stress and coping model was used to explain depression among HIV-positive women in healthcare and community settings where highly active anti-retroviral treatment (HAART) was commonplace. Method: HIV-infected women in four cities (N=978) were assessed, cross-sectionally, for mental and physical health, stress, social support, and other background factors. Results: Self-reported level of depressive symptomatology was high. Number of physical symptoms, illness intrusiveness, and perceived stress were positively associated with depressed mood, while coping self-efficacy and social support were negatively associated. Stress mediated the effect of health status on depression and coping self-efficacy mediated the effect of psychosocial resources on depression. Our enhanced stress and coping model accounted for 52% of variance in depressive symtpomatology. Conclusions: Interventions focused on improving coping self-efficacy, bolstering social supports, and decreasing stress in the lives of HIV-positive women may help to reduce the negative effects of HIV disease on mood.     

Stress,coping, HIV status,psychosocial resources,and depressive mood in African American gay,bisexual, and heterosexual men

The associations between stress, physical health, psychosocial resources, coping, and depressive mood were examined in a community sample of African American gay, bisexual, and heterosexual men (N=139). Data were collected from physical exams and in-person interviews. In our theoretical framework, depressive mood scores were regressed first on stressors, next on psychosocial resources, and finally on coping strategy variables. Results revealed that psychosocial resources mediate the effects of stressors, including health symptoms, hassles, and life events, on depressive mood. There were no significant differences in depressive mood associated with HIV status or sexual orientation. Results are discussed in terms of community interventions needed to provide social support as a buffer between stress and psychological distress in African American men. The research was completed at the Center for AIDS Prevention Studies, University of California at San Francisco and was supported in part by National Institute of Mental Health Grants MH44045 and MH42459. The authors express their appreciation to the participants in this study.     

Unemployment among women with multiple sclerosis: the role of coping and perceived stress and support in the workplace

Unemployment is high among individuals with multiple sclerosis (MS). Certain disease variables and demographics have been found to distinguish employed and unemployed individuals. However, these variables only account for 14–20% of the variance. Other factors, such as coping, perceived stress and social support, in the workforce have been proposed, but not yet fully examined. The purpose of the present investigation was to examine the role of known factors associated with unemployment in MS, as well as coping and perceived work stress and social support. Sixty-eight women with MS were asked about their employment status and reasons for leaving. They completed a comprehensive assessment including measures of cognition, disease symptoms, psychological functioning, coping and stress. Consistent with previous findings, certain disease and demographic variables were associated with being unemployed. In particular, women who left work due to their MS were found to be older, had a longer disease duration and progressive course, reported greater disability and fatigue, and performed worse on a cognitive measure. However, we also found that coping style distinguished those who were employed from those who left work due to their MS. In particular, those who left work reported utilizing maladaptive coping mechanisms such as behavioral disengagement and substance use. With regard to perceived work stress and support, individuals who were employed reported that job security and fellow co-workers were more of an uplift than a hassle in their lives, suggesting some benefit in employment. These findings suggest that further consideration be given to role of coping and perception of the benefit of employment among individuals with MS when making recommendations regarding work decisions.     

Cognitive predictors of posttraumatic stress symptoms six months following acute coronary syndrome

This study examined patients' illness representations assessed shortly after an acute coronary syndrome (ACS) as predictors of posttraumatic stress symptoms six months later. Illness representations were assessed in ACS patients using standard measures at a home visit three weeks after discharge from hospital. Posttraumatic stress symptoms were assessed at the same time, and again six months later. Patients were aged 61 years on average, the majority being men (89.8%) of white European decent (89%). Greater posttraumatic symptoms at six months were associated with beliefs that the illness would last a long time (timeline), that it had an unpredictable time course (timeline--cyclical), greater consequences, less personal and treatment control, poorer illness coherence and stronger negative emotional representations (emotional upset relating to the illness; p?相似文献   

Social support, locus of control, and depressive symptoms in hemodialysis patients

This study aimed to reveal how social support and psychological well-being association might differ with locus of control orientation for chronically ill patients receiving a restrictive and unpleasant medical treatment (i.e., hemodialysis). Data were collected from 104 hemodialysis patients. After controlling for the variance accounted for by gender and duration of dialysis, for patients with internal locus of control, lack of "perceived social support" was found to be associated with depressive symptoms. On the other hand, for patients with external locus of control, the same analysis revealed that lack of "satisfaction from the received social support" was associated with depressive symptoms. Thus, for hemodialysis patients the variables associated with depressive symptoms varied with their locus of control orientations. Furthermore, the present study underlined the importance of considering different aspects of social support while studying with chronically ill patients.