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.     

Traumatisation,psychological defence style,coping, symptomatology,and social support in HIV-positive: A pilot study

This paper examines degree of traumatisation, defence styles, coping strategies, symptomatology, and social support in a small sample of HIV-positive men and women in an effort to ascertain the psychological implications of living with Human Immunodeficiency Virus (HIV). Traumatisation and the potentially mediating effects of defence styles have only been the subject of a few studies of HIV positives. The study is based on a socio-demographic questionnaire, the Impact of Event Scale, the Defence Style Questionnaire, the Coping Styles Questionnaire, the Trauma Symptom Checklist, and the Crisis Support Scale. A degree of traumatisation that warrants treatment was found together with an association between particular coping strategies and symptomatology, and particular defence styles and symptomatology, respectively. Social support had increased over time, which is contrary to other research findings on social support.     

Structural gender differences in perceived social support

Gender is an important influence on support-relevant social interactions, however findings of studies on gender differences in social support are not definitive. Although differences between men and women in the various social support measures have been found in numerous studies, neither the cause nor the explanatory process is known. This study examines gender differences in the dimensionality of social support. A large sample (N=3210) from the general population of women (60%) and men aged between 18 and 65 years old (Mean AGE=34.1) responded to a brief scale with items assessing the distinct functions of the perceived availability of social support. Confirmatory factor analyses yielded one factor in the women's sample that measures global social support perceived, and two in the men's. The first factor in the men's sample measures emotional support (providing empathy, caring, validation of self-worth), and the second measures instrumental support (e.g. practical assistance or financial aid). We concluded that there are gender differences in the structure of perceived social support and that these differences can be explained by socialization experiences and social roles associated with gender.     

Does Posttraumatic Growth Buffer the Association Between Death Anxiety and Quality of Life Among People living with HIV/AIDS?

People living with HIV (PLWH) may experience death anxiety (DA), which can be detrimental to quality of life. Posttraumatic growth (PTG), however, is antithetical to DA, with its positive attributes at odds with negative psychosocial outcomes. Previous research has not examined the buffering effect of PTG on the association between DA and quality of life. Therefore, in addition to the direct effects of DA and PTG on health-related quality of life (HRQoL), we investigated the moderating role of PTG on the relationship between DA and HRQoL among people living with HIV/AIDS (PLWH) in Nigeria. Using cross-sectional design and availability sampling method, we selected 201 outpatients (men, n?=?63, 31.3%, women, n?=?138, 68.7%, mean age?=?40.1, SD?=?10.5) managed for HIV/AIDS in a Nigerian tertiary healthcare institution. Death Anxiety Inventory-Revised, Posttraumatic Growth Inventory-Short Form, and Patient-Reported Outcome Quality of Life-HIV were used to access DA, PTG and HRQoL, respectively. Results showed that while adjusting for socio-demographic factors (age, gender, time since diagnosis and educational status), DA was associated with physical health, mental health and social relationships domains of HRQoL as well as overall HRQoL. In contrast, PTG did not evidence significant association with HRQoL dimensions and overall HRQoL. The moderation effect of PTG on the association between DA and HRQoL was not supported. Independent of PTG, alleviating DA may be an important target in terms of therapeutic intervention towards improving quality life of PLWH.

     

Reviewers for Special Issue

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.     

Gender and social support: Taking the bad with the good?

In examining past research, a paradox can be found in the relationships between gender, social support, and depression. Although women report higher levels of depression than men, they also generally report more social support—a factor found to reduce depressive symptoms. In efforts to explain this seeming inconsistency, it was hypothesized that women report both more support and more depression because they are more likely than men to experience both positive and negative aspects of social relationships. Based on a community sample of predominantly Caucasian respondents, findings indicate that greater perceived support among women can be explained by more frequent contact with network members and a tendency to possess relationships characterized by greater intimacy, emotional disclosure, and empathy. However, women also report more frequent negative interactions with network members and are more adversely affected by marital conflict than are men. While negative interactions and conflict cannot account for gender differences in depression, they do help to explain how women can experience both more support and more depression. Among women, the health-enhancing effects of support on depression may be balanced by the detrimental effect of conflict.     

Personality, Social Networks, and Perceived Social Support among Alcoholics: A Structural Equation Analysis

ABSTRACT In this study we tested relations among personality characteristics, social network properties, and perceived social support both concurrently and prospectively. A sample of 294 men in treatment at a Department of Veterans Affairs Alcohol Treatment Unit was assessed during treatment and 3 months after discharge. Results of the cross-sectional structural equation analyses indicated that the personality characteristics of extraversion and neu-roticism were related to both social network properties and perceived social support. Characteristics of the alcoholic's social network were also related to perceived availability of support. Longitudinal analyses of perceived social support after treatment indicated that two social network properties (size of the network and the proportion of confidants) were predictive net of initial levels of social support. Extraversion and neuroticism were found to be indi-rectly related to perceived social support at Time 2 through their effects on social network properties and perceived social support during treatment. Implications of these findings for models of the nature and determinants of perceived social support 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.     

Personal Meaning,Social Support,and Perceived Stigma in Individuals Receiving HIV Mental Health Services

Human immunodeficiency virus (HIV) stigma represents a significant source of stress among individuals living with HIV disease, prompting interest in research to identify factors that may help to ameliorate the stress burden associated with HIV stigma. Consistent with this research line, the current study was conducted as a cross-sectional investigation examining associations between positive global personal meaning, social support, and perceived HIV stigma. Global personal meaning refers to beliefs and aspirations through which one ascribes value and purpose in living. The study sample was comprised of individuals living with HIV disease who presented for an initial visit in a specialty HIV mental health services program. In bivariate analyses, social support was negatively correlated with multidimensional aspects of HIV stigma that included distancing, blaming, and discrimination stigma, whereas personal meaning was negatively associated only with blaming stigma. In further analyses using structural equation modeling, social support significantly mediated the association between personal meaning and both distancing and blaming stigma. Interactions between positive personal meaning and social support may be useful to consider in future research on psychological resource factors and HIV stigma. Understanding these interactions may also inform clinical efforts to address HIV stigma concerns.     

Social Support,Conflict, and Integration Among Women Living With HIV/AIDS1

The relationship between depressive symptoms and perceptions of available social support, social conflict, and subjective social integration were examined as part of a psychosocial study of Puerto Rican, African American, and non‐Hispanic White women living with HIV/AIDS (N= 146) in New York City. Lower levels of subjective social integration and higher levels of social conflict were associated with more depressive symptoms. Perceived availability of social support was not significantly associated with depression in comparison with these other forms of support. No evidence was found for a stress‐buffering or a stress‐amplification effect. Significant ethnic differences in levels of social integration and social conflict also were noted. Results suggest that intervention efforts should go beyond addressing support to further address the conflict and lack, of integration experienced.     

The chronic illness quality of life (CIQOL) model: explaining life satisfaction in people living with HIV disease.

The chronic illness quality of life (CIQOL) model theorizes that life satisfaction in persons living with a chronic illness such as HIV disease is a function of illness-related discrimination, barriers to health care and social services, physical well-being, social support, and coping. The CIQOL model was evaluated using data from 275 persons living with HIV disease. Women reported less life satisfaction and confronted more barriers to health care and social services than men, and White participants reported higher perceptions of AIDS-related discrimination than non-White participants. The CIQOL model provided an excellent fit to study data (root-mean-square error of approximation = .03) and accounted for almost a third of the variance in life satisfaction scores. Barriers to health care and social services played a particularly prominent role in the model.     

Understanding smoking after acute illness: An application of the sentinel event method

The sentinel event theory provides a stepwise approach for building models to understand how negative events can spark health behaviour change. This study tested a preliminary model using the sentinel events method in a sample (N = 300) of smokers who sought care for acute cardiac symptoms. Patients completed measures on: smoking-related causal attribution, perceived severity of the acute illness event, illness-related fear and intentions to quit smoking. Patients were followed up one week after the health event and a seven-day timeline follow back was completed to determine abstinence from tobacco. Structural equation models were performed using average predictor scale scores at baseline, as well as three different time anchors for ratings of illness severity and illness-related fear. Quit intentions, actual illness severity and age were the consistent, positive and independent predictors of seven-day point prevalence abstinence. Additional research on the influences of perceptions and emotional reactions is warranted.     

“Whenever Jack sees a condom,he falls asleep”: experiences of condom use and erectile disorder among HIV positive men in a Zimbabwean rural setting

In this qualitative inquiry, we set out to explore the experience of condom use and erectile disorder (ED) among men living with HIV in a rural district of Zimbabwe. Data on condom use related erectile disorder with antiretroviral (ART) medication were collected from a purposive sample of 18 men living with HIV and AIDS (age range 23–54 years). These data were supplemented with those from a convenience sample of 23 women living with HIV who self-identified as partners of men living with HIV and AIDS (age range 26–37 years). The data were thematically analyzed. Results suggest that men attributed their experiencing of erectile problems to two main explanations: use of condoms and ART medication. These men reported inconsistent use of condoms and/or adherance to ART therapy due to a belief that these cause their ED. The women informants reported similar observations, including the shared gendered perspective that the men perceived a loss of sense of manhood from ED. Beliefs that influence health promotion with men living with HIV and AIDS are important to public health interventions with them.     

Assessment of positive and negative relationship adjustment in marriage

This study was conducted to evaluate, in a probability sample of married individuals (N = 2,071), the psychometric properties of a measure of positive and negative relationship adjustment, based on perceived frequency of positive and negative partner exchanges or interactions. Exploratory and confirmatory factor analyses support the presence of two correlated factors, and multigroup confirmatory factor analyses provided evidence for configural and metric invariance for gender, racial/ethnic, and age groups. The measure demonstrated good convergent validity in its association with another measure of relationship adjustment. Results support the use of this brief and easily administered measure to assess positive and negative aspects of relationship adjustment, particularly in situations in which the correlates of relationship adjustment are to be compared across demographic groups.     

The role of ordinary conversation and shared activity in the main effect between perceived support and affect

People with high perceived support have better mental health, but how this occurs is not well understood. We tested hypotheses from relational regulation theory that the main effect between perceived support and affect primarily reflects ordinary conversation and shared activity. In two studies (n = 193; n = 149), students rated three important network members and psychological reactions to each. In a third study (n = 72) strangers shared an activity in a round‐robin design. Affect was strongly determined by with who participants were interacting or thinking about. Perceived support, ordinary conversation, and shared activity were strongly linked, and each was related to high positive affect, low negative affect, perceived similarity, and few negative thoughts. Perceived support's link to affect emerged when strangers shared a brief activity. Thus, much of perceived support's main effect with affect could be explained as resulting from ordinary conversation and shared activity.     

The relationships between negative life events, perceived support in the school environment and depressive symptoms among Norwegian senior high school students: a prospective study

The present study prospectively explored the main and interactive effect of negative life events and social support from teachers and classroom peers on depressive symptoms in a sample of 198 (111 females, 87 males) students in a Norwegian senior high school. In the longitudinal multivariate analyses, self-reported depressive symptom levels at time-point two (T₂) were predicted by initial levels of depressive symptomatology, teacher support, and gender. Support from classroom peers at time-point one (T₁) was not associated with symptoms of depression at (T₂). Multivariate cross-sectional analysis also detected a significant positive association between negative life events and depressive symptoms. Finally, results suggest that perceived teacher support may buffer against negative life events leading to symptoms of depression.     

The relationship of marital satisfaction and social support to depressive symptomatology

The relationship between depressive symptomatology, as measured by the short-form Beck Depression Inventory (BDI), and two social support variables was assessed. Based on a sample of 131 married men and 136 married women, the results indicated that the quality of the marital relationship and the frequency of positive social contact with adults other than the spouse were significantly related to depressive symptomatology for both men and women. These two variables accounted for 16% of the variance in BDI scores. Further, analyses of risk for high BDI scores showed that individuals having the least support were 13 times more likely to be in the high-BDI group than individuals with the highest levels of social support. These results suggest that social isolation and marital discord are related to high BDI scores among married adults.     

Attitudes Toward People Living With HIV/AIDS: A Model of Attitudes to Illness1

This study examined attitudes toward people living with HIV/AIDS within a sample of 220 young men and women. As predicted, a multiple regression analysis revealed that the fear of contracting HIV/AIDS through casual contact was a significant predictor of both men's and women's willingness to interact with people living with HIV/AIDS. Attitudes toward homosexuality were also a significant predictor of attitudes toward people living with HIV/AIDS among women, who generally have a low risk of contracting the disease in Western societies. These results indicate that attitudes toward people with a serious illness may be strongly related to the perceived risk of contracting the disease.     

Social Support in Marriage

The current study examines the role of perceived adequacy of social support provided by spouses for both marital and individual functioning. Married individuals from a college sample (N = 177) recorded the adequacy of specific supportive behaviors provided by the spouse on a daily basis for 7 days. Perceived support adequacy was correlated in the expected direction with marital quality, depressive symptomatology, and perceived stress. Furthermore, hierarchical multiple regressions indicated that perceived support adequacy accounts for significant unique variance in marital quality, depressive symptomatology, and perceived stress, even after controlling for social desirability. Discussion focuses on limitations of the study and implications of the findings for clinical work with couples.     

Emotional Reactions to Health Status Changes and Emotional Well-Being Among HIV-Positive Persons with Limited Reading Literacy

People living with HIV-AIDS experience emotional distress in response to negative changes in their health status. The current study hypothesized that individuals with poorer health literacy skills would evidence greater emotional distress in response to negative changes in health status compared to persons with higher health literacy skills. HIV positive persons (N = 294) completed anonymous surveys that included measures of depression and social support and a subset of 98 participants completed two experimental vignettes depicting a person receiving test results showing an increase in HIV viral load (negative health changes) followed by a vignette suggesting decreased viral load (improved health changes). Responses to affective reactions and coping strategies indicated that persons with lower health literacy skills more strongly endorsed negative affective states and maladaptive coping strategies compared to persons with higher health literacy skills. In addition, lower health literacy was associated with greater symptoms of affective depression and poorer social support, whereas higher literacy was associated with greater negativistic thinking. Findings suggest the need for patient education and counseling regarding changes in health status among people living with HIV-AIDS, particularly persons with limited health literacy skills.