A prospective study of financial worry, mental health changes and the moderating effect of social support among Canadian adolescents during the COVID-19 pandemic.

We evaluated the association between social support received from significant others, family, and friends and HIV-related sexual risk behaviors among African American men involved in the criminal justice system. Project DISRUPT is a cohort study among African American men released from prison in North Carolina (N = 189). During the baseline (in-prison) survey, we assessed the amount of support men perceived they had received from significant others, family, and friends. We measured associations between low support from each source (<median value) and participants' sex risk in the 6months before incarceration. Low levels of social support from significant others, family, or friends were associated with poverty and homelessness, mental disorders, and substance use. Adjusting for age, poverty, and other sources of support, perceiving low support from significant others was strongly associated with multiple partnerships (fully adjusted odds ratio (OR) 2.64, 95% confidence interval (CI) 1.29-5.42). Low significant other support also was strongly associated with sex trade involvement when adjusting for age and poverty status (adjusted OR 3.51, 95% CI 1.25-9.85) but further adjustment for low family and friend support weakened the association (fully adjusted OR 2.81, 95% CI 0.92-8.55). Significant other support was not associated with other sex risk outcomes including concurrent partnerships, anal sex, or sex with an STI/HIV-infected partner. Low family support was associated with multiple partnerships in analyses adjusting for age and poverty (adjusted OR 1.98, 95% CI 1.05-3.76) but the association weakened and was no longer significant after adjusting for other sources of support (fully adjusted OR 1.40, 95% CI 0.65-3.00); family support was not correlated with other risk behaviors. Friend support was not significantly associated with sex risk outcomes. Indicators of overall support from any source were not associated with sex risk outcomes. Helping inmates maintain ties may improve economic security and well-being during community re-entry, while supporting and strengthening relationships with a significant other in particular may help reduce sex risk. Studies should evaluate the protective effects of distinct support sources to avoid masking effects of support and to best understand the influence of social support on health.

This study addresses the limited exploration of the interplay between racial discrimination, social relationships and cellular aging among African Americans. Utilizing latent class analysis, distinct risk and protective profiles were defined by perceptions of discrimination, social support, and negative interactions among middle-aged and older African Americans. Findings revealed four distinct profiles, demonstrating significant heterogeneity in experiences of discrimination, social relationships, and susceptibility to molecular stress among African Americans. The largest profile (32.09%) was characterized by high everyday and major discrimination, low family and friend support, and minimal strain. The second profile (25.37%) had wide variation, including moderate everyday discrimination, high major discrimination, very low family support, moderate friend support, moderate family and high friend strain. The smallest profile (19.4%) was characterized by high everyday and major discrimination, high family support, moderate friend support, and high strain from family and friends. Respondents in this profile had significantly elevated molecular stress compared to the reference profile (23.13%), which was characterized by low discrimination, high support, and high strain from family and friends. Regression analysis revealed that African Americans with more health conditions were more likely to belong to the high-risk profile than the reference profile. This study identified a subgroup of African Americans with an elevated risk of accelerated aging, marked by substantial racial discrimination and ambivalent social relationships. Findings provide insights into health disparities by identifying genes activated in response to discrimination and the potential influence of social factors in mitigating or exacerbating the effects of racial discrimination on cellular aging.

505 Background: Many colorectal cancer (CRC) patients suffer personal financial hardship from the disease and its treatment. We hypothesized that chemotherapy use is associated with even greater financial burden and worry. Methods: We analyzed data from a population-based survey of patients with stage III CRC in the Georgia and Detroit SEER catchment areas focusing on the effects of CRC and its treatment on personal finances. The primary outcomes were financial burden, assessed with a seven-component composite measure, and financial worry, assessed with a 5 point Likert scale. The primary independent variable was chemotherapy use. We evaluated relationships between chemotherapy use and individual components of financial burden, as well as composite financial burden and worry, using chi square analyses. Logistic regression was used to examine the effect of chemotherapy use on financial burden and worry, after controlling for patient characteristics. Results: Financial burden scores and financial worry were significantly higher among chemotherapy users (P&lt;0.001). Financial burden and worry were associated with younger age, lack of insurance, and lower education. After controlling for these factors, chemotherapy use remained significantly associated with both financial burden and financial worry. 717/844 respondents (85%) reported chemotherapy use. Chemotherapy users were more likely to use savings (34% vs 20%, P=0.001), borrow money/take out loans (14% vs 4%, P=0.001), fail to make credit card payments (14% vs 5%, P=0.003), reduce spending for food and/or clothing (31% vs 14%, P&lt;0.0001), decrease recreational activities (38% vs 15%, P&lt;0.0001), and reduce general expenses (51% vs 24%, P&lt;0.0001) than those who did not use chemotherapy. Conclusions: Adjuvant chemotherapy confers significant survival benefit in stage III colorectal cancer (CRC), but is associated with significantly increased personal financial burden and worry. Because financial stress has the potential to preclude adherence to recommended care, CRC patients who receive chemotherapy may require additional social services and economic support.

ABSTRACTWomen living with HIV are at increased risk for psychosocial distress, especially among social and economically disadvantaged women living in rural areas. Little is known about how social support and wealth impacts the mental health of women caring for young children in low- and middle-income countries. The purpose of this paper was to assess demographic, socio-economic, and social support correlates of depression and anxiety in HIV-infected+ female caregivers living in rural Uganda. Depression and anxiety were assessed using the Hopkins Symptom Checklist (HSCL-25), two-domains of social support (family and community) were measured with the adapted Multidimensional Scale for Perceived Social Support, and wealth was measured using a checklist of material possessions and housing quality among 288 women. Multivariable linear regression models assessed the association of depression and anxiety with demographic and social predictors. Sixty-one percent of women reported clinically significant symptoms of depression or anxiety using the standard HSCL-25 cut-off of >1.75. Lower wealth (p = .01) and family support (p = .01) were significantly associated with more depressive symptoms, with greater family support being more protective of depression in the highest wealth group (top 20%) compared to the lowest. More anxiety symptoms were associated with lower wealth (p = .001), lower family support (p = .02), and higher community support (p = .003). Economic and social support factors are important predictors of caregiver mental health in the face of HIV disease in rural Uganda. Findings suggest that interventions should consider ways to increase economic opportunities and strengthen family support for HIV+ caregivers.

The Role of Social Network and Support in Mental Health Service Use: Findings From the Baltimore ECA Study

BackgroundIn the United States, transgender, nonbinary, and gender diverse (TGD) young adults experience a higher risk of depression compared to their cisgender peers. Understanding factors associated with increased risk of depression within the TGD young adult population is important to guide clinical care as well as inform the development of interventions to reduce mental health disparities.ObjectiveThis exploratory study investigated the prevalence and correlates of positive screening for depressive symptoms among TGD young adults to inform the design, development, and implementation of national interventions aimed at improving mental health in this at-risk population.MethodsIn August 2022, a cross-sectional, nationwide online survey was conducted among TGD young adults aged 18‐25 (N=104) in the United States. Measures included sociodemographic variables, family characteristics, mental health care utilization, and the two-item Patient Health Questionnaire-2 (PHQ-2) screener for depression. Poisson regression models with robust variance estimation were fitted to estimate adjusted prevalence ratios (aPR) and 95% CI for correlates of PHQ-2 depression (score ≥3).ResultsThe study sample had a mean age of 22 (SD 2) years; 48/104 (46%) individuals identified as Black, Indigenous, or other People of Color, and 69/104 (66%) were nonbinary. Overall, 44 (42%) individuals screened positive for depression using PHQ-2. In a multivariable model adjusted for age, race and ethnicity, US census region, and health insurance status, factors associated with increased depression prevalence using PHQ-2 included low versus high family support (aPR 1.54, 95% CI 1.05‐2.27) and identifying with a nonChristian religion versus being unaffiliated (aPR 1.66, 95% CI 1.04‐2.63). Factors associated with reduced depression prevalence included living in a rural versus suburban area (aPR 0.48, 95% CI 0.26‐0.92) and receiving mental health therapy versus not (aPR 0.71, 95% CI 0.53‐0.97).ConclusionsThe high prevalence of depressive symptoms among TGD young adults in this study sample highlights the need for comprehensive mental health evaluation and support in this population. Depression risk is increased among certain subgroups, such as those with low family support. These findings are valuable in informing the development of interventions that aim to improve mental health outcomes among TGD young people.

We explored the role of particular sources of social support (friends, romantic partners, family) as moderators and mediators in the associations between perceived stress and individual well-being (loneliness, depressive symptoms, and self-rated physical health). We also tested the possible moderating effect of gender to ascertain whether women and men are differentially impacted by social support's diverse sources. Participants were 163 Latina/o emerging adults attending college (85% women; Mage = 20.2 years, range: 18-25). Holding perceived stress constant, friend support was negatively associated with loneliness, romantic partner support was negatively related to depressive symptoms, and family support was positively associated with self-rated physical health. Friend or romantic partner support moderated the relationships between perceived stress and loneliness, and self-rated physical health, but not depressive symptoms. Perceived stress and loneliness were indirectly and positively associated through lower friends and romantic partner supports, perceived stress and depressive symptoms were indirectly and positively related through lower romantic partner support, and perceived stress and self-rated physical health were related indirectly and negatively through lower family support. Gender moderated the relationships between family and friend support and self-rated physical health, and between friend support and depressive symptoms. Particular sources of support mediated the associations of perceived stress with well-being. Results highlight how social support helps Latina/o youth cope with stress and mitigate challenges associated with their college transition. Social support implications for physical and psychological health differ for male and female Latina/o college-attending emerging adults. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

In South Africa, high rates of adolescent pregnancy and HIV pose prominent public health challenges with potential implications for mental wellbeing. It is important to understand risk factors for mental health difficulties among adolescent mothers affected by HIV. This study aims to identify the prevalence of likely common mental disorder among adolescent mothers (both living with and not living with HIV) and explores hypothesised risk factors for likely common mental disorder. Cross-sectional data from adolescent mothers (10–19 years; n=1002) utilised within these analyses are drawn from a cohort of young mothers residing in the Eastern Cape Province, South Africa. All mothers completed a detailed questionnaire consisting of standardised measures of sociodemographic characteristics, mental health, and hypothesised risk factors. Logistic regression models were utilised to explore associations between hypothesised risk factors and likely common mental disorder. Risk factors were clustered within a hypothesised socioecological framework and entered into models using a stepwise sequential approach. Interaction effects with maternal HIV status were additionally explored. The prevalence of likely common mental disorder among adolescent mothers was 12.6%. Adolescent mothers living with HIV were more likely to report likely common mental disorder compared to adolescent mothers not living with HIV (16.2% vs 11.2%, X2=4.41, p=0.04). Factors associated with likely common mental disorder were any abuse exposure (OR=2.54 [95%CI:1.20–5.40], p=0.01), a lack of perceived social support (OR=4.09 [95%CI:2.48–6.74], p=<0.0001), and community violence exposure (OR=2.09 [95%CI:1.33–3.27], p=0.001). There was limited evidence of interaction effects between risk factors, and maternal HIV status. Violence exposure and a lack of perceived support are major risk factors for poor mental health among adolescent mothers in South Africa. Violence prevention interventions and social support may help to reduce risk. Identified risk factors spanning individual, interpersonal, and community levels have the potential to impact adolescent maternal mental health.

Health-related quality of life (HRQoL) is defined as a multidimensional subjective assessment of one’s physical and mental health. Homelessness is associated with numerous stressors that can reduce HRQoL. Social support is defined as the availability of individuals, or resources provided by individuals, to cope with stress. Interpersonal social support may be important in buffering HRQoL from the negative implications of stress. Here, we examine this association in a marginalized group known for high rates of physical and mental health comorbidities: adults experiencing homelessness. Participants (N = 581; 63.7% men; Mage = 43.6 ± 12.2) were recruited from homeless-serving agencies in Oklahoma City. Social support was measured with the 12-item Interpersonal Support Evaluation List (ISEL). HRQoL was measured by the Behavioral Risk Factor Surveillance System (BRFSS) survey using self-rated health, the number of poor mental and poor physical health days over the preceding 30 days, as well as the number of limited activity days as the result of poor mental and/or physical health. Perceived stress was assessed using the 4-item Perceived Stress Scale (PSS). The potential moderation effect of social support was examined by assessing the interaction term of social support and stress in a series of linear regression analyses, controlling for sex, age, months homeless, race, education, health insurance status, serious mental illness diagnosis, and recruitment agency/site. There was a significant interaction effect of social support and stress on the prediction of days of poor physical health, days of poor mental health, and days of limited activity (p in all cases ≤ 0.05). Results add to a growing literature on the potentially protective benefits of social support for HRQoL, extend them to a large sample of adults experiencing homelessness in the South, and demonstrate the significance of this moderating effect of social support over and above the influence of several prominent sociodemographic and diagnostic variables. Future work should determine if interventions designed to enhance social support can buffer HRQoL from the deleterious effects of stress among this vulnerable population.

Literature reports that depressive symptoms may precede suicidal ideation. Several studies have identified social support and substance use as moderators of this relationship. However, no study has evaluated these variables together by testing how substance use can affect the moderating effect of social support in this relationship. The purpose of this article is to individually evaluate dimensions of social support (friends, family, significant others, and school) and substance use (alcohol, marijuana, and other illicit drugs), as moderators of the relationship between depressive symptoms and suicidal ideation, as well as analyze the moderating role of substance use in the moderation exerted by social support in this relationship. This study, quantitative and cross-sectional, considered 775 adolescents [Average age = 15.48 (SD = 0.96), 45.9% women], from 20 randomly selected schools in Santiago de Chile. Simple moderation models were used to analyze possible moderators separately, and double moderation models were used to analyze the moderating role of substance use in the moderating effect of social support. The results show that the four dimensions of social support moderate the relationship between depressive symptomatology and suicidal ideation, showing the strongest interaction in the case of family support, followed by support of a significant person, support at school, and support of friends, in that order. On the other hand, alcohol was the only drug that moderated the relationship in question. In addition, the results show that the use of alcohol limits the moderating effect of social support in the fields of family, significant person, and school support, but not in the case of support of friends. The use of marijuana and other illicit drugs did not affect the moderating effects of social support for any of the areas evaluated. The results are discussed according to the different roles that alcohol use can play in adolescence, and how these, together with perceived social support, are related to the emergence of suicidal ideation from depressive symptoms.

Suicide rate is relatively high among Chinese rural elderly. While there has been some exciting work on reporting and preventing suicide among community-dwelling elderly, only a few published studies have addressed the issues of rural nursing homes in China. This study aimed to investigate the relationship among perceived social support, physical health, and suicidal thoughts of the elderly living in Chinese rural nursing homes. It also examined the moderating effects of social support on the path from physical health to suicidal thoughts of the rural institutional elderly in China. This study investigated 205 participants aged 60years and above in Chinese rural nursing homes. Participants' suicidal thoughts, perceived social support, and physical health were assessed. This study conducted descriptive analysis, Student's t-test, and Pearson's chi-square test to test how physical health and social support predicted suicidal thoughts, as well as the moderating effects of family's, friends', and others' social support on physical health and suicidal thoughts. Both physical health and perceived social support were significantly related to suicidal thoughts. Perceived social support from family, friends, and significant others moderated the relationship between physical health and suicidal thoughts. Findings of this study suggested that increasing social support and improving physical health would be effective in both suicide prevention and intervention for the residents in Chinese rural nursing homes.

Globally, mental disorders are the leading cause of disability in children and adolescents. Previous research has demonstrated that supportive relationships are a key protective factor against poor mental health in children, particularly amongst those who have experienced adversity. However, fewer studies have examined the relative impact of different types of supportive relationships. The current study examined the association between level of family adult support, school adult support, and school peer support and mental wellbeing in a sample of children (age 8–15 years, N = 2,074) from schools in the UK. All three sources of support were independently associated with mental wellbeing. Analyses demonstrated a graded relationship between the number of sources of support and the odds of low mental wellbeing (LMWB), reflecting a cumulative protective effect. While all three sources of support were best, it was not vital, and analyses demonstrated a protective effect of school sources of support on LMWB amongst children with low family support. Peer support was found to be particularly important, with prevalence of LMWB similar amongst children who had high peer support (but low family and school adult support), and those who had high family and school adult support, (but low peer support), indicating that high peer support has an equivalent impact of two other protective factors. Findings from the study highlight the crucial context schools provide in fostering positive peer relationships and supportive teacher–student relationships to promote mental health and resilience for all children, including both those with and without supportive home environments.

This study examines how levels of marital quality change the effect of social support on postpartum psychological distress among new Korean mothers using the Panel Study on Korean Children (N = 1585). In accord with findings from previous studies, this study shows that low marital quality negatively affects new mothers' mental health, but that social support alleviates psychological distress independent of marital quality. The main finding of this research is that the moderating effect of social support is contingent on levels of marital quality. Aggregated social support moderates the effects of marital quality on new mothers' mental health only when the level of marital quality is low. Furthermore, each dimension of social support (emotional, informational, and instrumental) only has a moderating effect when marital quality is low. The findings highlight the fact that the moderating effect of social support varies with the individual context and so customized social support that fits individual needs matters for the mental health of new mothers.

It is well known that the experience of victimization often leads to adverse health and behavioral outcomes in adolescents. However, less is known about why victimization results in such outcomes for some youth and not others. One possible explanation is the presence or absence of social support networks in an individual's life influence the effects of strain. Because youth are often less equipped to deal with stress and other negative emotions caused by strain, having positive sources to draw support from could prove beneficial (Agnew, 2002; Miller, Fagan, &amp; Wright, 2014). Drawing from general strain theory and its proposed conditioning hypothesis, the current study used two ordinary least square regressions to examine the moderating effect of social support on the relationship between victimization and two common forms of adolescent maladjustment: psychological distress and delinquency. Using data from NatSCEV III, analyses were conducted with a subsample of adolescents ages 10 to 17 (n = 1,957). Results showed that family social support significantly moderated the relationship between victimization and psychological distress, but not the victimization-delinquency relationship. To further test this moderating effect, a median-split was used. Results indicated that high family social support moderated the relationship between victimization and psychological distress. No moderating effect of friend social support was found.

The social conditions under which migrants to the UK live may be more significant than the experience of migration itself in leading to increased risk of mental illness. We aimed to compare the prevalence of mental, physical and social health problems in elderly Somalis, Bengalis and whites living in a deprived inner London area and examine associations between environmental circumstances, social support, physical health status, mood and life satisfaction in these groups. In addition, we wanted to test the hypothesis that differences in mental health between immigrants and whites are explained by social disadvantages rather than ethnicity. Cross-sectional survey with participants drawn from age-sex registers of general practices, augmented by other sources. East London--'first-generation' Somali and Bengali immigrants and white British. A total of 274 people aged 60+ years: 72 Somalis, 75 Bengalis and 127 whites. Symptoms of Anxiety and Depression Scale (SAD), Life Satisfaction Index (LSI). High SAD scores indicate more anxiety and depression symptoms; high LSI scores indicate greater life satisfaction. Highest SAD scores were found among Bengalis; lowest LSI scores were found among Bengalis and Somalis. The prevalences of depression (SAD score 6+) were 25% in Somalis, 77% in Bengalis and 25% in east London whites. Physical health status and SAD scores were associated in Somalis (r = +0.31, p < or = 0.01). Bengalis (r = +0.47, p < or = 0.001) and east London whites (r = +0.27, p < or = 0.01). Physical health problems also related to lower LSI scores in Somalis (r = -0.24, p < or = 0.05) and east London whites (r = -0.24, p < or = 0.01). Social factors (i.e. poor housing conditions, low family support and reported need of community services) were strongly associated with SAD scores among Somalis (r = +0.5, p < or = 0.001) and, to a lesser extent, among Bengalis (r = +0.33, p < or = 0.01). Ethnicity (i.e. being an immigrant as opposed to a non-immigrant) became a statistically non-significant risk factor for high SAD scores after adjusting for the effects of age, weekly income, physical health and social problems (OR = 0.71, 95% CI = 0.5-1.1, p = 0.09). A residual, but much attenuated effect for ethnicity on LSI scores persisted in the estimated model after controlling for the same set of independent risk factors (OR = 0.7, 95% CI = 0.4-1, p = 0.05). The marked variation in mental health between ethnic groups in east London might be a reflection of socioeconomic and health differentials acting concomitantly and adversely. Inequalities in housing, social support, income and physical health status accounted for variation in mood observed between immigrants and whites, and may partly explain differences in life satisfaction. These results seem to support a 'multiple jeopardy' theory of ageing in ethnic minorities in east London. Greater efforts are needed to recognize anxiety and depression in immigrant elders. Better social support and housing among 'minority ethnic' elders who live alone might be expected to alleviate social stress and improve mental health and psychological well-being.