Quality of Social Support in Mental and Physical Health

The current study investigates the relationship between social support and mental and physical health. Results indicate that poor functional support (or quality of support) is related to physical health problems while structural support (or social network size) is not. Moreover, although both poor functional and structural support are related to depression and anxiety, functional support is more strongly related to these outcome variables, the strongest relationship being associated with depression. Depression and hostility are also related to social isolation, although the relationship is again stronger for depression. The results suggest that the quality of social relationships is more important than quantity for optimal mental and physical health. The clinical relevance of these findings is that the quality of social support in the lives of individuals is central to recovery and should be addressed in medical and mental health treatment planning whenever it is an etiological or maintaining factor. The author dedicates this paper to her beloved father, Charles VanderVoort and her colleagues Dr. Uwe Stuecher and Dr. Gay Barfield whom she describes as “natural altruists, the rarest and most loving type of people in the world.”     

Some correlates of health locus of control among multicultural individuals

The relationship of locus of control to depression, anxiety, hostility, and physical health was assessed in a sample of multicultural college students (N = 162). Powerful Others Health Locus of Control was correlated with depression, anxiety, hostility, and recent physical symptoms while Chance Health Locus of Control (CHLC) was correlated with all of the above as well as chronic physical symptoms and major health problems. When controlling for a variety of health risk factors (viz., age, sex, body mass, exercise, smoking, salt, alcohol, and caffeine), only CHLC remained significant in the physical health models. Results support the cognitive model of mental health which emphasize the importance of adaptive beliefs. Specifically, they suggest that issues about control are related to negative affect and indicate that the often-cited relationship of an external locus of control to depression and anxiety also holds for hostility. The findings do not, however, support the view that anxiety and depression are associated with different types of external locus of control but rather suggest a unified set of locus of control beliefs underlying the three types of negative affect. In addition, evidence is provided for the external validity of the Multidimensional Health Locus of Control (MHLC) Scales with respect to mental health. Further, the results indicate that belief about one’s health may play a significant role in one’s physical health and that the health behavior model of the relationship between locus of control and physical health is insufficient to explain the relationship. As the Chance and Powerful Others MHLC scales were not related to health habits in this sample but were related to mental health (viz., depression, anxiety, and hostility), locus of control beliefs may be related to physical health via their relationship with mental health.     

Associations between social capital and health status in an Australian population

This study investigated the association between social capital and health related quality of life in a sample of Australian adults. Information was collected from a sample of adults in Queensland, Australia relating to health status, health related quality of life and related social determinants of health by computer-assisted-telephone-interview survey. Significant associations were observed between social capital and physical health when adjusting for selected demographic measures. No significant association was observed between social capital and mental health. The research produced equivocal results regarding the associations between social capital and the selected measures of health-related quality of life. Evidence is presented in support of the association between social capital and physical health status, whereas no associations were observed between mental health status and social capital. The role and relationship between health and social capital remains elusive. More work is required to clearly support social capital's role in physical and mental health and well-being.     

The Interplay Among Risk Factors for Suicidal Ideation and Suicide: The Role of Depression, Poor Health, and Loved Ones' Messages of Support and Criticism

When individuals who receive social support are in poor physical or mental health and are criticized or made to feel unwanted, they may perceive themselves as a burden. Poor physical health and depression were hypothesized to exacerbate the harmful effects on suicidal ideation of receiving critical negative messages and of receiving social support. These hypotheses were tested using secondary analyses of data from a sample of 533 unemployed married individuals who were assessed shortly after job loss, and 6 months later. The results of our analyses supported the hypotheses and demonstrated that for participants with poor health or high level of depressive symptoms an increase in critical messages and social support (from Time 1 to Time 2) predicted increased suicidal ideation. This relationship was not observed for non- depressed participants in good health. The results are discussed in terms of their implications for suicide prevention.     

The Social Networks of Women Experiencing Domestic Violence

The research literature has demonstrated that battered women living in shelters experience impaired social support. This study examines this phenomenon among battered women living in the community. This study compared a group of pregnant battered women (n = 145) and a group of pregnant nonbattered women (n = 58) in terms of their structural [e.g., total number of supporters, network members in violent relationships with their partners (an index of homophily or nonhomophily) and functional (e.g., emotional)] social support. Four reasons for impaired support in battered women were proposed and examined, including social isolation, failure to disclose abuse, homophily, and low SES. Only homophily was related to impaired support among battered women. In addition, the relationship between structural and functional support and mental health outcomes (e.g., depression, self-esteem) was examined. Criticism, practical support, homophily, and disclosure were all significant predictors of mental health for battered women. Implications for community-based interventions are discussed in the context of current intervention strategies with battered women.     

Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking

The purpose of the present study was to examine the role of emotional and instrumental social support seeking in the quality of life (QOL) and mental health of women with ovarian cancer. Participants were recruited through the Pennsylvania Cancer Registry, and one hundred women took part in a mail questionnaire that collected information on their demographics, medical status, social support seeking, QOL and mental health including anxiety, depression and stress. Hierarchical linear regression analyses were conducted to assess the influence of emotional and instrumental social support seeking on QOL and mental health. After controlling for remission status, greater emotional social support seeking was predictive of higher overall QOL, social/family QOL, functional QOL and lower depression scores. Instrumental social support seeking was not significant in the models. The results illustrate that social support seeking as a coping mechanism is an important consideration in the QOL and mental health of women with ovarian cancer. Future studies should examine the psychological and behavioral mediators of the relationship to further understand the QOL and mental health of women with ovarian cancer.     

Physical health and social network characteristics as determinants of mental health across cultures

This study examines cross-cultural differences in the etiology of depression and anxiety, two common indicators of mental health problems. Using an ethnically diverse sample of 162 college students, we found that chronic physical symptoms and social network characteristics, particularly network quality, were predictive of both depression and anxiety, yet their effects were mediated by ethnicity. Multiple regression analyses showed that social network quality, compared to physical health, was a much stronger predictor of mental health in Caucasian students, whereas among students of Asian/Pacific descent, physical health was a much stronger predictor of mental health than the social network characteristics. The observed differences were particularly strong for anxiety, which was not significantly associated with physical health in Caucasian students or social network size and quality in the Asian/Pacific group. Theoretical and clinical implications of the results are discussed.     

Physical health and social network characteristics as determinants of mental health across cultures

This study examines cross-cultural differences in the etiology of depression and anxiety, two common indicators of mental health problems. Using an ethnically diverse sample of 162 college students, we found that chronic physical symptoms and social network characteristics, particularly network quality, were predictive of both depression and anxiety, yet their effects were mediated by ethnicity. Multiple regression analyses showed that social network quality, compared to physical health, was a much stronger predictor of mental health in Caucasian students, whereas among students of Asian/Pacific descent, physical health was a much stronger predictor of mental health than the social network characteristics. The observed differences were particularly strong for anxiety, which was not significantly associated with physical health in Caucasian students or social network size and quality in the Asian/Pacific group. Theoretical and clinical implications of the results 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.     

Promoting Mental Health Equity: The Role of Integrated Care

People suffering from mental illness experience poor physical health outcomes, including an average life expectancy of 25 years less than the rest of the population. Stigma is a frequent barrier to accessing behavioral health services. Health equity refers to the opportunity for all people to experience optimal health; the social determinants of health can enable or impede health equity. Recommendations from the U.S. government and the World Health Organization support mental health promotion while recognizing barriers that preclude health equity. The United States Preventive Services Task Force recently recommended screening all adults for depression. The Satcher Health Leadership Institute at the Morehouse School of Medicine (SHLI/MSM) is committed to developing leaders who will help to reduce health disparities as the nation moves toward health equity. The SHLI/MSM Integrated Care Leadership Program (ICLP) provides clinical and administrative healthcare professionals with knowledge and training to develop culturally-sensitive integrated care practices. Integrating behavioral health and primary care improves quality of life and lowers health system costs.     

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.     

The effects of perceived social support on quality of life in patients awaiting coronary artery bypass grafting and their partners: testing dyadic dynamics using the Actor-Partner Interdependence Model

Patients awaiting coronary artery bypass grafting (CABG) need support from their partners or family caregivers to manage their self care successfully and to maximise quality of life. Partners need social support to help overcome the stressful tasks of an unexpected caregiving role. It is not known whether the individual's perceived social support contributes to their own, as well as their partner's quality of life. The aims of this study were to assess differences in social support and quality of life in patients and partners awaiting CABG, and to examine whether patients' and partners' perceived social support predicted their own, as well as their partner's quality of life before CABG. This cross-sectional study recruited 84 dyads (patients 84% males, aged 64.5 years and partners 94% females, aged 61.05 years). Perceived social support was assessed using the Medical Outcomes Study Social Support survey, with sub-scales for informational/emotional support, affectionate support, tangible support and positive social interaction. Quality of life was assessed using the Short-Form 12 Health Survey. Dyadic data were analysed using the Actor-Partner Interdependence Model, with distinguishable dyad regression. Results revealed the patients' informational/emotional support exhibited an actor effect on their own mental health (? = 0.19, p = 0.001); indicating those with low informational/emotional support had poorer mental health. There was a partner effect of the patients' informational/emotional support on their partner's mental health (? = 0.14, p = 0.024), indicating the patients' informational/emotional support was associated with the partner's mental health. None of the other types of social support exhibited an actor effect or a partner effect on the patient's or the partner's mental or physical health. More research into the relationship between social support and mental health is needed to help inform the design of interventions that target the dyad.     

Quality-of-life assessment in HIV-infected psychiatric outpatients: Perceived health,functional status,symptoms, and preferences for cardiopulmonary resuscitation

Abstract

The current study had two purposes: (1) to describe the reliability and validity of a measure of quality of life (QOL) in HIV-infected psychiatric outpatients, and (2) to predict cardiopulmonary resuscitation (CPR) preferences from disease stage, depression, and other QOL factors. We studied 63 patients, who were seen in one year at an HIV/AIDS psychiatry clinic. The results provide evidence for the validity of our instrument as a measure of health status in an HIV-infected psychiatric population. Overall symptoms were the strongest associates of functional limitations. disability, and perceived health, but depression was also significantly associated with all measures of QOL. Twenty-two patients (35.5%) would not have wanted to be revived if their heart stopped beating the day of the study. Disease stage and poor mental health were independent predictors of this preference, but severity of depression, social support, fatigue, perceived health, functional limitations, and life satisfaction were not.     

A Test and Refinement of the Demand–Control–Support Model in the Construction Industry

This study aims at a test and further refinement of the Demand–Control–Support (DCS) model among construction workers (N = 210). On the basis of theory and empirical evidence, we hypothesized that mental or physical job demands, low job control, and lack of social support at work have direct and synergistic effects on burnout. The model was expanded by hypothesizing that burnout mediates the relationships between these potentially demanding working conditions on the one hand, and health complaints on the other. Results of a series of structural equation analyses partly supported these hypotheses. The proposed model fitted adequately to the data, although some variables in the DCS model did not make a unique contribution to explaining variance in burnout and (indirectly) health complaints. Interestingly, lack of social support was the most important determinant of burnout and health complaints among construction workers. In addition, a significant three-way interaction effect partly confirmed the synergism hypothesis: Physical demands were only related to burnout if participants had poor job control and reported high social support. The implications of these findings for research and practice are discussed.     

亲子关系对贫困儿童问题行为的影响

以247名贫困儿童为被试进行问卷调查,构建家庭社会经济地位和亲子关系对贫困儿童问题行为的多重中介模型,得到抑郁、自我控制的中介作用。结果显示,亲子关系和社会经济地位分别通过中介路径影响贫困儿童问题行为,与亲子关系有关的中介路径为91.25%,与抑郁有关的中介效应为57.60%,与自我控制有关的中介效应为57.15%. 结论：良好的亲子关系或成为贫困儿童的保护因子;应关注贫困儿童心理健康,增加有效心理疏导机制;注重培养贫困儿童的自我控制能力。     

The buffering role of social support on the associations among discrimination,mental health,and suicidality in a transgender sample

Introduction: Per the minority stress framework, trans individuals often experience psychological distress given the unique stress engendered by gender identity–related discrimination. Prior research has identified social support as particularly important for psychological distress and has suggested that social support may moderate this relationship. The purpose of the current study was to explore the patterns of connections among discrimination, mental health, and suicidal ideation in trans individuals and whether social support moderates these relationships. Methods: Participants (N = 78) completed measures of these constructs as part of a national online survey. Results: A series of simultaneous multiple regressions found that harassment/rejection discrimination was a unique positive predictor of mental health symptoms and suicidal ideation, with depression positively predicting suicidal ideation. A mediational model indicated that the association between harassment/rejection discrimination and suicidal ideation was fully mediated by depression. Three moderated meditational models were run, and one yielded a significant interaction, such that discrimination predicted suicidal ideation most strongly when participants had low social support from a significant other in comparison to participants who had moderate or high support. Further, conditional direct effects identified that discrimination led to ideation only for individuals with low support from friends or a significant other but not for those with moderate or high support. Conclusions: Helping trans individuals cope with harassment and rejection, particularly by drawing on social support, may promote better mental health, which could help reduce suicidality in this population.     

Gender differences in social support and physical health

A large body of prospective data has accumulated linking social support to health, and most social scientists agree that low levels of support are associated with poor physical and mental health. Unfortunately, most of the research has been limited to White men. When women and people of color are included in the designs, the relationships between social support and physical health are more complicated. Prospective population-based studies provide evidence that low support is associated with increased risk of mortality in women. However, in several studies, results indicated that, for specific age groups, women with high social support have increased risk of mortality. Factors that may contribute to the observed gender differences in the social support-physical health relationship are discussed. Future research should include adequate numbers of women and more sophisticated measures of social support to move the field forward.     

The impact of direct and indirect bullying on the mental and physical health of Italian youngsters

The aim of the present study was to determine the extent to which direct and indirect bullying and victimization at school affects the mental and physical health of 661 Italian boys and girls, aged 11 to 15 years old. The impact of bullying and victimization is assessed by taking into account the relative buffering effect of a positive relationship with one or both parents. Internalizing symptoms such as withdrawn behaviors, somatic complaints, and anxiety and depression, measured with the self‐administered Youth Form of the Achenbach's Child Behavioral Checklist, are indicators of maladjustment. Multiple regression analyses revealed that being a girl is a strong significant risk factor for all internalizing symptoms. Being a victim of indirect bullying is the strongest predictor of withdrawn behaviors, somatic complaints, and anxiety/depression, independent of direct victimization, which significantly predicts somatic complaints, anxiety, and depression, but not withdrawn behaviors. Bullying others directly by hitting, threatening, or calling names is not a significant predictor the poor mental and somatic health of youngsters, whereas indirect bullying (spreading rumors or not talking to someone on purpose) does significantly predict anxiety and depression, as well as withdrawn behaviors. The negative impact of victimization and bullying is buffered by youngsters' positive relationship with one or both parents. Recommendations are provided with regard to possible intervention strategies underlying the importance of distinguishing between different forms of bullying and victimization and providing social support in each different case. Aggr. Behav. 30:343–355, 2004. © 2004 Wiley‐Liss, Inc.     

Opposing Trends of Religious Attendance and Religiosity in Predicting Elders’ Functional Recovery after an Acute Myocardial Infarction

This study examined the role of religion and spirituality in older adults’ functional recovery following an AMI. Participants were interviewed within 2 weeks of the AMI about their religious beliefs. Functional recovery was evaluated using the Short Physical Performance Battery (SPPB) at one month and seven months. We found that those who reported attending religious services more frequently had better functional recovery. In contrast, those who considered themselves more spiritual had worse functional recovery. These findings remained after controlling for age, gender, co-morbidity (Charlson Co-Morbidity Scale), depression (CES-D), social support (MOS Social Support Survey), and grip strength in Linear Mixed Models. The implications of the findings are discussed.Dr. Levy is an Associate professor in the Department of Epidemiology and Public health at Yale University. Her research focuses on the influence of psychosocial factors on aging health. She received the Margaret M. Baltes Early Career Award in Behavioral and Social Gerontology from the Gerontological Society of America, the Springer Award for Early Career Achievement on Adult Development and Aging from the American Psychological Association, and a Career Award from the National Institute on Aging. She was also awarded a Brookdale National Fellowship for Leadership in Aging. Kathryn Remmes Martin received her Bachelor’s Degree from the College of the Holy Cross and her Master’s Degree (MPH) in Chronic Disease Epidemiology from Yale University. She is currently a doctoral student in the Health Behavior and Health Education Department at the University of North Carolina Chapel Hill, School of Public Health.