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.     

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.     

A Test of the Perfectionism Social Disconnection Model among Ethnic Minority Youth

Perfectionistic self-presentation (PSP) has been identified as a vulnerability factor in the development of depressive disorders during early adolescence. The Perfectionism Social Disconnection Model (PSDM) offers a theoretical framework suggesting PSP leads to depressive symptoms via interpersonal problems and social disconnection. Previous studies have supported the role of social disconnection as a mediator in the relation between PSP and suicidal ideation, but have not evaluated interpersonal problems in the model. Furthermore, the generalizability of the model has not been established for community and ethnic minority samples. Using cross-sectional data, the present study addresses these gaps by evaluating the PSDM and including social anxiety and loneliness as indicators of interpersonal problems and social disconnection, respectively, as predictors of youth depressive symptoms. The sample includes 289 (51.2% females) predominately low income and Latino and African American youth in fifth through seventh grade in three public schools. As predicted, social anxiety mediates the relationship between both PSP and loneliness and PSP and depressive symptoms. Moreover, mediational analyses indicate that social anxiety accounts for the relation between PSP and depression. Consistent with the PSDM model, the relationship between PSP and youth depressive symptoms is mediated sequentially through both social anxiety and loneliness, but primarily among the Latino sample.     

社会支持与大学生抑郁的关系:一个有调节的中介模型

为考察社会支持、社交焦虑、一般自我效能感和抑郁之间的关系,采用社会支持评定量表、社交焦虑量表、一般自我效能感量表以及抑郁自评量表对640名大学生进行调查。研究显示:(1)社交焦虑在社会支持与大学生抑郁之间起部分中介作用;(2)一般自我效能感在社会支持—社交焦虑—抑郁这一中介过程中的后半路径起调节作用。     

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.     

Interpersonal functioning and depressive symptoms in childhood: Addressing the issues of specificity and comorbidity

Research has supported linkages between depression and social impairment in youngsters, but has often focused on depressive symptoms in isolation. We collected data on depressive, anxiety, and externalizing symptoms in 161 school children. Information about interpersonal competence was gathered from several sources, including children, teachers, and behavioral observations. Depressive symptoms were found to be related to difficulties in multiple areas of competence, including maladaptive social problem-solving styles, conflict-negotiation and affect-regulation deficits, and peer rejection. Comparisons of the relative contributions made by depressive and anxiety symptoms to the prediction of functioning yielded some evidence for a specific relation between depressive symptoms and impairment. Children with cooccurring internalizing and externalizing symptoms generally suffered from the most social dysfunction. If replicated in clinical samples, findings such as these may help to guide intervention efforts with depressed children.We thank Daphne Isenberg, Margie Limon, Leslie Scher, and Jennifer Silverman for their assistance in various aspects of this study. We would also like to express our appreciation to the participating children and teachers and to the UCLA Bruin Kids Day Camp.     

Relations between plasma oxytocin,depressive symptoms and coping strategies in response to a stressor: the impact of social support

Background: Social support can serve as a protective factor against the negative impacts of stressors and may thereby promote well-being. As well, exogenous administration of oxytocin has been tied to diminished stress responses and might also enhance the effects of social support.

Methods/Results: In the current study, conducted among female undergraduate students (N?=?67), higher depressive symptoms were related to lower endorsements of problem-focused coping in response to a psychosocial stressor comprising the Trier Social Stress test (TSST). However, the relation between depressive symptoms and problem-focused coping was absent among participants who had a close female friend present serving as social support prior to the stressor experience. Additionally, endogenous plasma oxytocin levels were related to certain coping strategies being favored (e.g., problem-solving, humor, cognitive distraction, self-blame and support seeking) in response to the psychosocial stressor. However, the strength of these relations varied as a function of whether individuals had social support present or not.

Conclusion: These findings confirm the positive impact of social support in attenuating the relation between depressive symptoms and specific coping methods. The results of this study are consistent with view that oxytocin levels are accompanied by particular stress responses, possibly through the promotion of coping methods endorsed.     

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.     

Social Anxiety and Content Specificity of Interpretation and Judgemental Bias in Children

Previous research with adult samples has demonstrated that social anxiety disorder is associated with content‐specific interpretation and judgemental biases. The present study extends our understanding of the specificity of cognitive biases in childhood social anxiety. A sample of non‐clinical children aged 11–12 years completed social anxiety and depression scales and was presented with scenarios depicting hypothetical events varying along two dimensions: relevance to self (event occurs to self or to other) and domain of activity (event is social or non‐social). Partial support for the content‐specificity hypothesis was found. Children's social anxiety symptoms were positively associated with negative interpretation ratings for ambiguous self‐referent and other‐referent events, but only when these events were in the social domain. Further, children's social anxiety symptoms were positively associated with emotional cost judgements for ambiguous social and non‐social events, but only when these events referred to the self. Both patterns of results remained significant even after controlling for concurrent depressive symptoms. Implications of the results for our understanding of maintaining factors in childhood social anxiety are discussed. Copyright © 2011 John Wiley & Sons, Ltd.     

手机成瘾与抑郁：社交焦虑和负性情绪信息注意偏向的多重中介作用

为考察手机成瘾与抑郁的关系, 研究同时整合情绪和认知两方面因素, 探讨了社交焦虑和负性情绪信息注意偏向在手机成瘾和抑郁之间的多重中介作用。研究1共有545名大学生完成了大学生手机成瘾倾向量表、贝克抑郁量表和社会交往焦虑量表。研究2选取51名大学生采用问卷法和2(配对面孔表情的情绪类型: 负性、中性) × 2(探测点位置: 与负性情绪面孔表情同侧、与负性情绪面孔表情异侧)的被试内实验设计。结果表明: (1)手机成瘾、社交焦虑和抑郁两两间存在显著正相关, 且社交焦虑在手机成瘾和抑郁之间起完全中介作用; (2)社交焦虑和负性情绪信息注意偏向在手机成瘾与抑郁的关系中起链式中介作用, 而负性情绪信息注意偏向在手机成瘾与抑郁间的单独中介效应不显著。具体而言, 手机成瘾通过两条路径影响抑郁: 一是社交焦虑的单独中介作用; 二是社交焦虑→负性情绪信息注意偏向的链式中介作用。     

Social Anxiety Symptoms and Suicidal Ideation in a Clinical Sample of Early Adolescents: Examining Loneliness and Social Support as Longitudinal Mediators

Recent research has shown that social anxiety may be related to increased risk for suicidal ideation in teens, although this research largely has been cross-sectional and has not examined potential mediators of this relationship. A clinical sample of 144 early adolescents (72 % female; 12–15 years old) was assessed during psychiatric inpatient hospitalization and followed up at 9 and 18 months post-baseline. Symptoms of social anxiety, depression, suicidal ideation, loneliness, and perceived social support were assessed via structured interviews and self-report instruments. Structural equation modeling revealed a significant direct relationship between social anxiety symptoms at baseline and suicidal ideation at 18 months post-baseline, even after controlling for baseline depressive symptoms and ideation. A second multiple mediation model revealed that baseline social anxiety had a significant indirect effect on suicidal ideation at 18 months post-baseline through loneliness at 9 months post-baseline. Social anxiety did not have a significant indirect effect on suicidal ideation through perceived social support from either parents or close friends. Findings suggest that loneliness may be particularly implicated in the relationship between social anxiety and suicidality in teens. Clinicians should assess and address feelings of loneliness when treating socially anxious adolescents.     

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

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

Low-end specificity of childhood measures of emotional distress: consistent effects for anxiety and depressive symptoms in a nonclinical population

Previous research regarding the low-end specificity of self-report measures of affective distress in children suggests that defensiveness acts differentially to lower scores on self-report measures of depressive symptoms, but not on self-report measures of anxiety. This investigation examined this issue in a nonclinical sample of 442 children, ages 7 to 16. Participants completed measures of depressive symptoms (Children's Depression Inventory), anxiety symptoms (State-Trait Anxiety Inventory for Children) and defensiveness (Children's Social Desirability Scale). In contrast to previous research, the results in this study indicated similar effects of defensiveness on measures of depressive symptoms and anxiety. Low-end depression participants obtained significantly higher defensiveness scores, as did low-end anxious participants. In an attempt to circumvent the effects of defensiveness, we measured anhedonia (Pleasure Scale for Children, or PSC) as a proxy of depressive symptoms. We also found the PSC to be subject to the effects of defensiveness at approximately the same magnitude as the measures of anxiety and depressive symptoms.     

Tripartite model of depression and anxiety in youth psychiatric inpatients: relations with diagnostic status and future symptoms

Examined the relation of the depression aspect of the tripartite model of depression and anxiety to the diagnostic status and future symptoms of two samples that included 74 child and adolescent psychiatric inpatients, ages 7 to 17 years (M = 13.57, SD = 2.39), some with either internalizing or externalizing diagnoses. The tripartite model suggests that anhedonia (low positive affect, or PA) differentiates depression from other conditions, whereas generalized negative affect (NA) also characterizes depression but is not specific to it. In this study, differences among children in PA and NA were associated with depressive versus externalizing diagnostic status and with future symptoms of depression. Depressive disorder diagnoses were associated with the combination of low levels of PA and high levels of NA. Changes over time in depression, but not in anxiety, also were associated with the combination of low PA and high NA. Results provide support for the applicability, clinical utility, and extension of the tripartite model with children.     

Experiential Avoidance and Anxiety Sensitivity: Independent and Specific Associations with Children’s Depression,Anxiety, and Social Anxiety Symptoms

Experiential avoidance (EA) is a key component in acceptance and commitment therapy (ACT) theory and research. EA is associated with a wide range of psychopathology in adults including anxiety, in particular social anxiety, and depression, yet little research exists on EA in youth. Anxiety sensitivity (AS), like EA, has been viewed as a form of distress tolerance or emotion regulation. In a sample of 124 children (age 10 to 12), this study examined the independent and specific relations of EA and AS to children’s depression, anxiety, and social anxiety symptoms, both before and after controlling for comorbid symptoms. EA and AS had independent associations with each of children’s depression, anxiety, and social anxiety; and EA had significantly stronger relations than AS with each of children’s social anxiety and anxiety. After controlling for depression, only EA (and not AS) was uniquely related to both children’s anxiety and social anxiety. After controlling for anxiety and social anxiety, only AS (and not EA) was uniquely related to depression. After controlling for depression and social anxiety, neither EA nor AS was significantly related to anxiety. In contrast, after controlling for depression and anxiety, EA (and not AS) showed a significant and unique relation to children’s social anxiety. These findings indicate: 1) there are distinctions between EA and AS; 2) EA and AS are overlapping yet independent correlates for each of depression, anxiety and social and anxiety; and 3) EA and AS show some differential relations with children’s depression, anxiety, and social anxiety when comorbid symptoms are considered. Theoretical and treatment implications are highlighted.     

The development of the Social Bullying Involvement Scales

This study reports findings of a newly developed measure of social bullying based on Underwood's [2003] framework of social aggression. The Social Bullying Involvement Scales (SBIS) consist of four scales measuring the extent to which children experience social victimization, engage in social bullying, witness social bullying, and intervene in social bullying. The sample consisted of 636 participants (311 females and 325 males, age range 11-16 years; 71% White). Confirmatory factor analysis supported a revised version of Underwood's framework for each of the four participant role scales. Internal consistencies for each scale ranged from .93 to .97. Results revealed that social victimization was related to an increase in anxiety, depressive, and externalizing behaviors. Social bullying was associated with an increase in general externalizing behaviors only. Social witnessing was moderately correlated with depression scores. Intervening in social bullying was not linked with psychological maladjustment or externalizing behaviors. The SBIS provides a comprehensive measure of social victimization, social bullying, social witnessing, and social intervening.     

Self-Discrepancies as Predictors of Vulnerability to Distinct Syndromes of Chronic Emotional Distress

Two types of self-discrepancy differing in both domain and standpoint of self-guide were examined as predictors of vulnerability to chronic emotional syndromes. Study 1 assessed discrepancy between the actual/own self-state and the ideal/own self-guide and between the actual/own self-state and the ought/other self-guide in predicting syndromes of dejection and agitation as well as different types of anger. Actual/own: ideal/own discrepancy (AI) was uniquely related to dejection, frustration, and anger at self as measured 2 months later; actual/own:ought/other discrepancy (AOO) was uniquely related to agitation and to anger at others and resentment. Study 2 used structural equation modeling of the relations between AI and AOO discrepancy and social anxiety versus depression as measured weeks later. A model in which AOO was more strongly associated with social anxiety and AI was more strongly associated with depressive symptoms provided the best fit. The results support the convergent and discriminant validity of a self-discrepancy model of vulnerability to chronic emotional syndromes.     

Conceptions of Relationships in Children with Depressive and Aggressive Symptoms: Social-Cognitive Distortion or Reality?

This research tested skill-deficit and cognitive-distortion models of depression and aggression in 615 fifth- and sixth-grade children. Children completed a measure of their generalized conceptions of relationships in the peer domain and their level of depressive symptoms. Teachers completed measures of social competence, social status, and aggression. As anticipated, children with higher levels of depressive symptoms, either alone or in combination with aggression, demonstrated more negative conceptions of both self and peers than did nonsymptomatic children. Conceptions of relationships did not differentiate between aggressive and nonsymptomatic children. Children with depressive symptoms and children with aggressive symptoms displayed unique profiles of social competence deficits and problematic status in the peer group. Analysis of the accuracy of children's conceptions of relationships revealed support for both skill-deficit and cognitive-distortion models. Consistent with a skill-deficit model, children with depressive and depressive-aggressive symptoms were sensitive to actual differences in their social status. In contrast, aggressive children showed an insensitivity to social cues. Consistent with a cognitive-distortion model, children with depressive and depressive-aggressive symptoms had more negative conceptions than would be expected given their social status, whereas aggressive-unpopular children demonstrated a self-enhancement bias. These findings indicate the importance of integrated cognitive-interpersonal models of depression and aggression that incorporate multiple pathways among social-cognitive, interpersonal, and emotional functioning.     

Core Dimensions of Personality Broadly Account for the Link from Perceived Social Support to Symptoms of Depression and Anxiety

Specific personality traits and poor social support are risk factors for anxiety and depression. Little work, however, has considered the effects of social support and personality on these aspects of psychopathology simultaneously. We examined whether perceived social support mediates the effects of core personality domains on symptoms of anxiety and depression. Measures of personality (based on the Five‐Factor Model [FFM]), perceived social support, and symptoms of depression and anxiety were collected in a large Dutch adult population‐based sample (n = 555), and, except for depression symptoms, in an independent U.S. adult population‐based sample (n = 511). Path modeling was used to test the effects of FFM traits on symptoms of depression and anxiety, with and without the mediation of perceived social support. Social support showed no link to symptoms of anxiety and only modest links to symptoms of depression when controlling for the FFM traits. Neuroticism had the strongest effect on symptoms of both depression and anxiety, with Extraversion also showing links to symptoms of depression. Social support has limited influence on symptoms of depression, and no effects on anxiety, over and above the effects of personality. Links between social support and anxiety/depression may largely reflect influences of Neuroticism and Extraversion.     

Acculturative stress, social support, and coping: relations to psychological adjustment among Mexican American college students

This study examined the relations between acculturative stress and psychological functioning, as well as the protective role of social support and coping style, in a sample of 148 Mexican American college students (67% female, 33% male; mean age = 23.05 years, SD = 3.33). In bivariate analyses, acculturative stress was associated with higher levels of anxiety and depressive symptoms. Moreover, active coping was associated with better adjustment (lower depression), whereas avoidant coping predicted poorer adjustment (higher levels of depression and anxiety). Tests of interaction effects indicated that parental support and active coping buffered the effects of high acculturative stress on anxiety symptoms and depressive symptoms. In addition, peer support moderated the relation between acculturative stress and anxiety symptoms. Implications for reducing the effects of acculturative stress among Mexican American college students are discussed.