Youth with Chronic Pain and Postural Orthostatic Tachycardia Syndrome (POTS): Treatment Mediators of Improvement in Functional Disability

Intensive pain rehabilitation programs are effective in increasing functioning for youth with chronic pain (CP). However, the utility of such programs for youth with CP and co-morbid postural orthostatic tachycardia syndrome (POTS) is rarely examined. In addition, studies examining mediators of treatment for CP are sparse. This paper compares treatment outcomes for youth with CP (n?=?117) and youth with CP?+?POTS (n?=?118). Additionally, depression and pain catastrophizing were tested as potential mediators of treatment effects. Significant treatment improvements were found for functional disability, depression, pain catastrophizing, and perceived pain intensity but with no differences between groups. Improvements in depressed mood, pain catastrophizing (helplessness subscale), and pain severity partially mediated functioning improvement. Pain severity was not a significant mediator in the CP?+?POTS group. We concluded that depression and pain catastrophizing, especially the helplessness domain, can impact functioning improvement in adolescents with CP and POTS and are particularly important to target in treatment.     

Parenting Stress, Social Support, and Depression for Ethnic Minority Adolescent Mothers: Impact on Child Development

Rates of teenage pregnancies are higher for African American and Latina adolescents compared to their White peers. African American and Latina adolescent mothers also experience more adversities than their White peers, such as higher rates of depression, school dropout, and economic disadvantage. Furthermore, children of adolescent mothers are at higher risk for adverse development. Parenting stress and social support can impact outcomes experienced by adolescent parents and their children. The present study examined the influence of adolescent mothers’ parenting stress and perceived social support on maternal depression at baseline (6 months after birth), and its impact on infant development 1 year later (18 months after birth). Participants were 180 adolescent mothers of African American or Latino/Hispanic descent. Results suggest that higher levels of parenting stress and less perceived social support were associated with higher levels of depression in the adolescent mothers at baseline. Higher levels of maternal depression were also associated with more developmental delays in infants 1 year post-baseline. Additionally, depression mediated the relationship between parenting stress and later child outcomes. These findings highlight the importance of examining parenting factors such as parenting stress, social support, and maternal depression in ethnic minority adolescent parents, and provide valuable information regarding unique risk and protective factors associated with positive maternal outcomes for ethnic minority adolescent parents and healthy development for their children.     

Self-Esteem and Social Support as Moderators of Depression,Body Image,and Disordered Eating for Suicidal Ideation in Adolescents

The current study investigated risk factors for suicidal ideation in a community sample of 392 adolescents (males 51.9 %; females 48.1 %), while also evaluating self-esteem, perceived parent support, and perceived peer support as protective factors and potential moderators between suicidal ideation and the 3 risk factors. Disordered eating, depression, parent support, and peer support were found to be significant predictors of current suicidal ideation, but body satisfaction was not. The relationship between depression and suicidal ideation was significantly moderated by both self-esteem and parent support, while the relationship between disordered eating and suicidal ideation was significantly moderated by peer support. Results underscore the importance of examining protective factors for suicide risk, as they have the potential to reduce suicidal ideation in adolescents.     

Moderating Role of Perceived Social Support between Perceived Parenting Styles and Relational Aggression in Adolescents

This study examined the moderating role of perceived social support between perceived parenting styles and relational aggression (RA). A sample (N = 400) was selected through stratified sampling from public and private schools and colleges. Adolescents (n = 200 boys and n = 200 girls) completed (a) Demographic Performa, (b) Early Memories of Upbringing for Children to measure perceived parenting styles, (c) Social Support Questionnaire to measure perceived social support, and (d) Diverse Adolescent Relational Aggression Scale to measure RA. Statistical analyses showed that perceived social support moderated the relationship between perceived parenting styles and RA. Findings indicated that perceived social support strengthens the negative relationship between perceived father’s Overprotection parenting and RA. Results also showed that perceived social support strengthens positive relationship between perceived father’s Anxious Rearing parenting and RA. Moreover, perceived social support strengthens the positive relationship between perceived mother’s Rejection parenting and RA. Results help in implementing interventions to promote the consolidation or increment of sources that constitute adolescents with concrete and feasible actions in the cultural, educational, and counseling implications.     

Extrinsic Religious Orientation and Well-Being: Is Their Negative Association Real or Spurious?

Turning to religion to seek its social benefits has been associated with poor psychological well-being. Researchers have concluded that endorsing this extrinsic and social orientation toward religion is inauthentic and unhealthy. However, few studies have focused on extrinsic-social religious orientation’s negative relationship with well-being, leaving open the possibility that their relationship is spurious. The present study argues that people endorsing an extrinsic-social religious orientation also perceive lower levels of social support in their lives, thus their turning to religion to fill this social void. As social support is important for healthy psychological functioning, perceived social support may be the critical third variable explaining why extrinsic-social religious orientation appears to have psychological costs. This study supported our expectations among undergraduates in two countries: the United States (N = 156) and the Republic of Ireland (N = 255). There were negative bivariate associations between extrinsic-social religious orientation and both perceived social support and emotional well-being. Accounting for the effects of perceived social support, however, reduced the association between the extrinsic-social religious orientation and well-being to non-significance. Thus, people endorsing an extrinsic and social orientation toward religion tend to have poor well-being because they perceive less supportive relationships in their lives.     

A longitudinal study of psychosocial distress in breast cancer: prevalence and risk factors

This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.     

A longitudinal study of psychosocial distress in breast cancer: Prevalence and risk factors

This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.     

Does Spousal Support Moderate the Association Between Perceived Racial Discrimination and Depressive Symptoms among African American Couples?

Social stress theory proposes that stress resulting from one's social position in society leads to fewer coping resources, and subsequently causes an increase in mental health problems. Guided by this framework, we investigated whether the relationship between perceived discrimination and depressive symptoms was moderated by spousal social support in a sample of 487 African American heterosexual couples. Using the actor‐partner interdependence model, findings suggested that female partner's perceived racial discrimination was predictive of her depressive symptomology irrespective of spousal support and male partner's perceived racial discrimination was predictive of depressive symptomology only among men with low levels of spousal support. No partner effects were present. The results demonstrate the need to examine variability in social stress and mental health outcomes for those in close relationships.     

Enhancing Social Entrepreneurial Intentions through Entrepreneurial Creativity: A Comparative Study Between Taiwan and Hong Kong

Attention toward social entrepreneurship has increased worldwide, particularly within younger generations. Based on the identified model of social entrepreneurial intentions, this study proposed a multiple mediation framework to examine the mediating role of entrepreneurial creativity for university students. It also compared the differences between Taiwanese (N = 311) and Hong Kong students (N = 311). Through a survey using both online and offline channels, the results of Study 1 confirmed the factor structures of the 3 scales, involving 5 antecedents of social entrepreneurial intention (i.e., empathy, moral obligation, self-efficacy, perceived social support, and prior experience with social problems), 2 factors of entrepreneurial creativity (i.e., originality and usefulness), and 2 factors of social entrepreneurial intention (i.e. conviction and preparation). The results of Study 2 supported the proposed multiple mediation model across regions. Prior experience with social problems, perceived social support, and originality were identified as the 3 most influential factors affecting the social entrepreneurial intentions of university students. The major differences between Taiwan and Hong Kong involved prior experience, empathy, self-efficacy, perceived social support, and usefulness.     

Coping,social support,stigma, and gender difference among people living with HIV in Guangxi,China

The current study examined whether gender, HIV-related stigma, social support, and the interaction between gender and social support are associated with coping responses among people living with HIV and AIDS (PLWHA) in Guangxi, China. A total of 2987 PLWHA in Guangxi participated from October 2012 to August 2013. Multivariate analysis of covariance was conducted with gender and social support as main factors in the model, and stigma and other variables as covariates. After controlling for demographic variables and stigma, there were significant main effects of emotional social support (F = 1.61, p < .001), functional social support (F = 1.67, p < .001), and informational social support (F = 3.67, p < .001) on various coping strategies. The interaction between gender and informational social support (F = 1.33, p < .05), internalized stigma (F = 37.03, p < .001) and perceived stigma (F = 9.16, p < .001) were associated with various coping strategies. Findings signify the importance of HIV-related stigma and social support differences in the coping strategies among PLWHA in Guangxi, China.     

Racial Discrimination and African American Adolescents’ Adjustment: Gender Variation in Family and Community Social Support, Promotive and Protective Factors

The current investigation explores the promotive and protective role of family and community-specific social support on the association between perceived racial discrimination and African American adolescents’ adjustment (e.g., depressive symptoms, school suspensions, school engagement). One thousand nine-hundred forty-two African American adolescents (ages 12–18, M = 15.12; SD = 1.83; 59 % female) from a large Midwestern city participated in this investigation. Regression analyses revealed that perceived racial discrimination was associated with less positive adjustment outcomes for boys and girls. Additionally, there was partial support for gender variation in the promotive role of social support and adolescent adjustment. In particular, while only maternal support was associated with boys’ adjustment, both maternal and paternal support was associated with girls’ adjustment. Also, there was partial support for gender differentiation in the strength and directionality of protective factors. Though in an unpredicted direction, father support moderated the relationship between perceived racial discrimination and girls’ adjustment. Community supports (religious connection and mentor presence) emerged as protective factors for boys’. Findings highlight the role of gender in understanding potential promotive and protective factors for African American adolescents.     

Perceived Social Support Mediates the Relations Between Parental Attachment and Posttraumatic Growth and Resilience in Adolescents Following the Yancheng Tornado

Previous studies have shown that parental attachment is associated with higher levels of posttraumatic growth (PTG) and resilience in individuals who have experienced traumatic events. The present study investigated perceived social support as one pathway in which parental attachment is related to PTG and resilience among Chinese adolescents who have experienced trauma by considering the role of perceived social support. Participants were 443 Chinese adolescents who had experienced a severe tornado a year prior to this study. The results showed that our model fitted the data well [χ²/df = 2.847, comparative fit index (CFI) = 0.970, TLI = 0.963, root mean square error of approximation (RMSEA) (90% CI) = 0.065 (0.056–0.073)] and revealed that perceived social support partially mediated the relationship between parental attachment, and PTG and resilience. The clinical implications and limitations of our research, and recommendations for future research are discussed in this paper.     

Emotion,controllability and orientation towards stress as correlates of children’s coping with interpersonal stress

Guided by the motivational theory of coping (Skinner and Zimmer-Gembeck in Ann Rev Psychol 58:119–144. doi:10.1146/annurev.psych.58.110405.085705, 2007), we investigated children’s anticipated coping with three different stressful events (bullying, parental argument, parent–child verbal conflict), and examined whether their reliance on challenge coping responses versus threat coping responses could be accounted for by emotional reactions (including feelings of sadness, anger and fear), perceived controllability, and orientation or interest in the stressor. In addition, we examined parents’ reports of their children’s temperamental traits as correlates of coping. In random order followed by a positive stimulus, children (N = 206, age 8–12 years) watched each of the three stressful events, and reported their emotions, perceived control, orientation and coping after each one. As anticipated, results indicated that controllability was associated with more challenge coping (a composite of adaptive/approach coping responses such as problem solving and support seeking) and less threat coping (a composite of maladaptive/withdrawal coping responses such as helplessness and escape). In general, feelings of sadness were more strongly associated with challenge coping, whereas fear and anger especially related to more threat coping. Greater orientation towards the stressor was particularly predictive of more challenge coping, but also was associated with more threat coping in response to parent stressors. These associations were significant, even after controlling for temperament (negative reactivity, task persistence, withdrawal, and activity), which was generally unrelated to children’s coping. Other combinations of coping responses were also examined.     

Bereaved African American Adults: The Role of Social Support,Religious Coping,and Continuing Bonds

The present study identified relationships between social support, religious coping, continuing bonds, prolonged grief disorder (PGD) symptoms, and the quality of life among bereaved African American adults (N = 154). Perceived social support and less use of negative religious coping strategies predicted a higher quality of life and fewer PGD symptoms. Also, greater perceived social support, less use of negative religious coping strategies, and less use of continuing bonds significantly predicted fewer PGD symptoms. Implications suggest that the conceptualization of grief and loss for African Americans might include social support, religious coping, and continuing bonds.     

The Good, The Bad, and The Ugly: Domestic Violence Survivors’ Experiences with Their Informal Social Networks

Informal social networks play a critical role in buffering the negative effects of stressful life events. For women experiencing the stress of a violent relationship, family and friends are among the first sources of support sought; however, reactions to the abuse by family and friends are not uniformly perceived as helpful by survivors. The current study takes a qualitative approach to examining the range of possible reactions survivors may encounter from their social networks regarding the abuse. Special attention is given to negative and mixed reactions, as they have previously been under-examined in the literature. Findings suggest that survivors (N = 45) regularly experience negative and mixed reactions. Emergent themes suggest that both positive and negative reactions to abuse could be understood in four broad arenas: safety, emotional availability, input, and aid. However, positive and negative reactions emerged as distinct constructs within each arena; mixed reactions took multiple forms including being within person and within network.     

Interpretation bias and social anxiety: does interpretation bias mediate the relationship between trait social anxiety and state anxiety responses?

Two studies aimed to examine whether high socially anxious individuals are more likely to negatively interpret ambiguous social scenarios and facial expressions compared to low socially anxious individuals. We also examined whether interpretation bias serves as a mediator of the relationship between trait social anxiety and state anxiety responses, in particular current state anxiety, bodily sensations, and perceived probability and cost of negative evaluation pertaining to a speech task. Study 1 used ambiguous social scenarios and Study 2 used ambiguous facial expressions as stimuli to objectively assess interpretation bias. Undergraduate students with high and low social anxiety completed measures of state anxiety responses at three time points: baseline, after the interpretation bias task, and after the preparation for an impromptu speech. Results showed that high socially anxious individuals were more likely to endorse threat interpretations for ambiguous social scenarios and to interpret ambiguous faces as negative than low socially anxious individuals. Furthermore, negative interpretations mediated the relationship between trait social anxiety and perceived probability of negative evaluation pertaining to the speech task in Study 1 but not Study 2. The present studies provide new insight into the role of interpretation bias in social anxiety.     

Neighborhood Context and Perceptions of Stress Over Time: An Ecological Model of Neighborhood Stressors and Intrapersonal and Interpersonal Resources

We examine the association between neighborhood socio-economic disadvantage and perceived stress during middle and late adolescence among African American youth (N = 665; 51 % female; M = 15.9 years at baseline). In addition, we explored the ways through which neighborhood stressors interacted with an individual’s intra- and interpersonal resources (e.g., coping, social support and substance use), to affect their perceived stress trajectories during adolescence. First, we tested a neighborhood stressors model and found that youth who lived in neighborhoods with greater socioeconomic disadvantage had higher baseline stress and a steeper increase in stress over time. When we included individual-level risk and promotive factors in the model, however, the effect of neighborhood disadvantage on perceived stress was no longer significant, and the stress trajectory was explained by adolescent substance use, social support and perceptions of the neighborhood. Our results support theories of stress and coping, and the importance of proximal intra- and interpersonal factors in either amplifying or mitigating perceptions of stress. We discuss implications of the neighborhood context and how our findings may inform future prevention and intervention related to adolescent stress and development.     

Effects of received and mobilized support on recipients' and providers' self-efficacy beliefs: a 1-year follow-up study with patients receiving radical prostatectomy and their spouses

From a proactive agentic perspective, social support is not just seen as a protective cushion against environmental demands. Rather, support may facilitate an individual's self-regulation by enhancing perceived self-efficacy (i.e., enabling hypothesis). In the present study, patient-reported indicators of mobilized and received spousal support as predictors of their own and their spouses' self-efficacy beliefs were investigated within 1 year following radical prostatectomy. During this time frame, postoperative sequelae such as urinary incontinence and erectile dysfunctions are still likely to interfere with couples' everyday activities. Seventy-two patients receiving radical prostatectomy and their spouses participated. Patients' and spouses' self-efficacy beliefs and patients' received and mobilized spousal support were assessed prior to and 12 months following surgery. Additional patient-reported covariates at 1 year post-surgery were degree of bother by urinary incontinence, overall sexual satisfaction, and relationship satisfaction. Results indicated that patients' received spousal support was associated with higher levels of patients' self-efficacy only cross-sectionally, but not longitudinally. Support mobilized by the patient prior to and 1 year after surgery, however, positively predicted spouses' levels and changes in self-efficacy. Results, thus, did not fully confirm predictions by the enabling hypothesis of social support; rather, associated aspects, such as the degree of being mobilized as a provider of support or being needed, seem to enhance agency beliefs in spouses.     

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

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

Race,psychosocial vulnerability and social support differences in inner-city women's symptoms of posttraumatic stress disorder

Background/Objectives: Inner-city Black women may be more susceptible to posttraumatic stress disorder (PTSD) than White women, although mechanisms underlying this association are unclear. Living in urban neighborhoods distinguished by higher chronic stress may contribute to racial differences in women's cognitive, affective, and social vulnerabilities, leading to greater trauma-related distress including PTSD. Yet social support could buffer the negative effects of psychosocial vulnerabilities on women's health. Methods/Design: Mediation and moderated mediation models were tested with 371 inner-city women, including psychosocial vulnerability (i.e., catastrophizing, anger, social undermining) mediating the pathway between race and PTSD, and social support moderating psychosocial vulnerability and PTSD. Results: Despite comparable rates of trauma, Black women reported higher vulnerability and PTSD symptoms, and lower support compared to White Hispanic and non-Hispanic women. Psychosocial vulnerability mediated the pathway between race and PTSD, and social support moderated vulnerability, reducing negative effects on PTSD. When examining associations by race, the moderation effect remained significant for Black women only. Conclusions: Altogether these psychosocial vulnerabilities represent one potential mechanism explaining Black women's greater risk of PTSD, although cumulative psychosocial vulnerability may be buffered by social support. Despite higher support, inner-city White women's psychosocial vulnerability may actually outweigh support's benefits for reducing trauma-related distress.