Medical Outcomes Study Social Support Research Articles

Social support in parents of children with neurodevelopmental disorders

The aim of the present study was to compare the social support in parents of children with neurodevelopmental disorders. The sample consisted of 166 parents of children with neurodevelopmental disorders in Isfahan, Iran. Medical Outcomes Study Social Support Survey (MOS-SSS, Sherbourne and Stewart 1991) was used for measuring the availability of social support. The collected data were analyzed using two-way analysis of variance and multivariate analysis of variance. The results showed that there was no significant difference in social support scores between parents of children with neurodevelopmental disorders based on the type of child disorder and the gender of the parents (p > 0.05). The results also showed that there was no significant difference in the subscale of emotional/informational support, tangible support, and affectionate support between parents of children with neurodevelopmental disorders (p > 0.05) but in the one subscale (i.e. social interaction) parents of children with intellectual disability was significantly higher than parents of children with autism spectrum disorder and parents of children with attention deficit hyperactivity disorder. Moreover, The results showed that there was no significant difference in subscales of social support between parents of children with neurodevelopmental disorders based on the gender of the parents (p > 0.05). Therefore, according to the research findings, the design and implementation of support and educational programs for parents of children with neurodevelopmental disorders, especially in parents of children with ASD and ADHD, and to increase social interactions are essential and should be a priority in the programs of organizations providing psychological services.

Association of social support with mild cognitive impairment and dementia among older women: the Women’s Health Initiative Memory Study

AbstractBackgroundWomen comprise approximately two‐thirds of older adults with Alzheimer’s disease in the United States. Social support may be a modifiable risk factor for cognitive impairment. However, few long‐term, large prospective studies have examined associations of various forms of social support with cognitive impairment. Therefore, we examined the association of perceived social support with incident mild cognitive impairment (MCI) and dementia among older women.MethodThis prospective cohort study included 6,670 older women from the Women’s Health Initiative (WHI) Memory Study (WHIMS), a sub‐cohort of the WHI hormone therapy (HT) trials, who were free of dementia upon enrollment. Perceived social support was assessed at baseline using nine items from the Medical Outcomes Study Social Support Survey. All item ratings were summed to generate a summary score (range = 9‐45), with higher scores indicating greater perceived social support. Incident MCI and dementia were ascertained using a comprehensive neuropsychological battery and central adjudication by a panel of specialists with expertise in dementia diagnosis during up to 25 years of follow‐up. Cox proportional hazards models were used to assess associations of perceived social support with incident MCI, dementia, and overall cognitive impairment (MCI or dementia). We also examined associations of four types of social support (emotional/informational, affection, tangible, and positive social interaction) with MCI/dementia.ResultOverall, (mean age at baseline = 70.0 [SD 3.8] years; 97.0% non‐Hispanic/Latina; 89.8% White) 753 women had incident MCI, 697 had incident dementia, and 1,197 had incident overall cognitive impairment. There were no significant associations of social support with MCI (HR = 0.99; 95%CI = 0.98‐1.00), dementia (HR = 0.99; 95% CI = 0.98‐1.01), or overall cognitive impairment (HR = 0.99; 95% CI = 0.98‐1.00) after adjusting for age, education, income, race, ethnicity, marital status, smoking, alcohol intake, body mass index, history of diabetes, hormone therapy trial assignment, history of hormone therapy use, history of hypertension, and depressive symptom severity. There were no significant associations between the four types of social support and MCI/dementia.ConclusionPerceived social support was not significantly associated with incident cognitive impairment among older women. Future studies should explore other social factors, such as social isolation and loneliness, particularly in larger and racially/ethnically diverse populations.

Social Support and Mental Health in the Postpartum Period in Times of SARS-CoV-2 Pandemic: Spanish Multicentre Cohort Study

To explore the depression and anxiety symptoms in the postpartum period during the SARS-CoV-2 pandemic and to identify potential risk factors. A multicentre observational cohort study including 536 women was performed at three hospitals in Spain. The Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI) Scale, the Medical Outcomes Study Social Support Survey (MOS-SSS), and the Postpartum Bonding Questionnaire (PBQ) were assessed after birth. Depression (EPDS) and anxiety (STAI) symptoms were measured, and the cut-off scores were set at 10 and 13 for EPDS, and at 40 for STAI. Regarding EPDS, 32.3% (95% CI, 28% to 36.5%) of women had a score ≥ 10, and 17.3% (95% CI, 13.9% to 20.7%) had a score ≥ 13. Women with an STAI score ≥ 40 accounted for 46.8% (95% CI, 42.3% to 51.2%). A lower level of social support (MOS-SSS), a fetal malformation diagnosis and a history of depression (p = 0.000, p = 0.019 and p = 0.043) were independent risk factors for postpartum depression. A lower level of social support and a history of mental health disorders (p = 0.000, p = 0.003) were independent risk factors for postpartum anxiety. During the SARS-CoV-2 pandemic, an increase in symptoms of anxiety and depression were observed during the postpartum period.

Professional quality of life among Spanish veterinarians.

In Spain, the perceived professional quality of life among veterinarians has not been explored. Veterinarians were invited to complete an online questionnaire in which they answered the Professional Quality of Life scale, the Medical Outcomes Study Social Support Survey and the Warwick-Edinburgh Mental Well-Being Scale. Participants were asked whether they were receiving psychological therapy or were taking anxiolytics, hypnotics or antidepressant medication. Alcohol consumption was measured using the Alcohol Use Disorders Identification Test and nicotine dependence was assessed using the Fagerström test; participants were asked whether they took illegal drugs. The study sample comprised a total of 602 veterinarians, most of whom reported average levels of compassion satisfaction, secondary stress trauma and burnout. Emotional support and mental wellbeing influenced participants' professional quality of life. The percentage of veterinarians in psychological therapy and/or taking anxiolytics was higher than in the general population. A considerable number of clinical veterinarians in Spain may be suffering from work-related stress. Our study identifies salary, emotional support and mental wellbeing as important factors that affect the professional quality of life. Interventions to improve veterinary clinicians' professional quality of life should therefore focus on these factors.

Trajectories of social support are associated with health outcomes and depressive symptoms among older Taiwanese adults with diabetes following hip-fracture surgery.

This study examined trajectories of social support and their relationships with health outcomes over 2years post hip-fracture surgery for older adults with diabetes mellitus (DM). This was a secondary analysis of data derived from a clinical trial, which included 158 hip fractured older adults with DM who had completed the Medical Outcomes Study Social Support Survey at 1-, 12-, 18-, and 24-months following hospital discharge. Health outcomes for self-care, physical and nutritional status, mental health, and depression were assessed at 3-month intervals up to 24-months after hospital discharge. Trajectories of social support were derived with latent class analysis while hierarchical linear models were employed to assess the associations of social-support trajectory with health outcomes. Four social-support trajectories were derived for persons with DM following hip-fracture surgery: poor and declining (n=18, 11.4%), moderate and stable (n=29, 18.4%), high but declining (n=34, 21.5%), and high and stable (n=77, 48.7%). Relative to those in the poor and declining group, participants in the high and stable trajectory group performed better in Activities of Daily Living and quadriceps muscle power, had better mental Health-Related Quality of Life and nutritional status, and had fewer depressive symptoms. These differences persisted over the 2years following hospital discharge. These results suggest social support for persons with DM should be continually assessed following hip-fracture surgery.

Multimorbidity and depressive symptoms in older adults and the role of social support: Evidence using Canadian Longitudinal Study on Aging (CLSA) data.

The rising prevalence of multimorbidity poses challenges to health systems globally. The objectives of this study were to investigate: 1) the association between multimorbidity and depressive symptoms; and 2) whether social support plays a protective role in this association. A prospective population-based cohort study was conducted to analyze baseline and 3-year follow-up data of 16,729 community dwelling participants aged 65 and above in the Canadian Longitudinal Study of Aging (CLSA). Multimorbidity was defined as having three or more chronic conditions. The 10-item Center for Epidemiologic Studies Depression scale (CESD-10) was used to measure depressive symptoms. The 19-item Medical Outcomes Study (MOS) Social Support Survey was employed to assess perceived social support. Multivariate logistic regression models were used to examine the association between multimorbidity, social support and depressive symptoms. Multimorbidity was very common among participants with a prevalence of 70.6%. Fifteen percent of participants had depressive symptoms at baseline. Multimorbidity was associated with increased odds of having depressive symptoms at 3-year follow-up (adjusted odds ratio, aOR = 1.51, 95% CI 1.33, 1.71), and developing depressive symptoms by follow-up among those with no depressive symptoms at baseline (aOR = 1.65, 95% CI 1.42, 1.92). Social support was consistently associated with decreased odds of depressive symptoms, regardless of level of multimorbidity. Multimorbidity was positively associated with depressive symptoms over time, but social support served as a protective factor. As a modifiable, protective factor, emphasis should be placed in clinical practice to assess social support and refer patients to appropriate services, such as support groups. Similarly, health policy should focus on ensuring that older adults have access to social support opportunities as a way to promote mental health among older adults. Community organizations that offer social activities or support groups play a key role in this respect and should be adequately supported (e.g., with funding).

Association of Social Support Network with Telomere Length: A Cross-Sectional Study with Community-Dwelling Older Adults.

Considering that telomere length can be determined not only by issues related to cell biology but also by aspects related to social factors and environmental exposures, studies on the relationship between social aspects and telomere length can help to better understand the still scarcely known aspects of the human aging process. Thus, this research seeks to verify whether social support networks are associated with telomere length in older adults. This is a cross-sectional study conducted with 448 individuals aged at least 60 years living in the urban area of an inland Brazilian municipality. Relative quantification of telomere length was obtained through real-time qPCR. Social support was assessed through the Medical Outcomes Study Social Support Scale. Descriptive statistics and multiple logistic regression were used in data analysis. The evaluated social support networks for older adults consist in a mean of 16.4 people, and the percentage of older adults who reported up to five members in their network was 27.75%. Shorter telomere length was identified in 25% of the participants, and the older adults who reported having up to five members in their support network were more likely to have a shorter telomere length than those who reported more numerous networks (odds ratio: 1.89, p = 0.011) regardless of gender, age, household arrangement, cognitive decline, and dependence for basic and instrumental activities of daily living, which suggests that measures that stimulate the creation and maintenance of social support networks should be implemented to improve older adults' health.

Psychological distress, social support, and family satisfaction among family members of non-COVID-19 critical care patients: A cross-sectional study.

This study aims to explore the associations among psychological distress, perceived social support, and family satisfaction among family members of non-COVID-19 intensive care unit (ICU) patients during the COVID-19 pandemic. A cross-sectional study. Family members of patients with at least 48h in the ICU and without a COVID-19 diagnosis were screened between January and March 2021. For enrolled ICU family members, five questionnaires for perceived stress (Perceived Stress Scale), anxiety symptoms (General Anxiety Disorder-7), depressive symptoms (Patient Health Questionnaire-9), perceived social support (Medical Outcomes Study Social Support Survey), and family satisfaction (Family Satisfaction with Care in the Intensive Care Unit-24) were administered by phone either in English or Spanish language. Sociodemographic and patient clinical data were also collected. Data were analyzed using descriptive statistics, Pearson's correlations, Mann-Whitney U, and Fisher's exact tests. Of 87 eligible ICU family members, 63 were enrolled (72.4%); 27% of the sample presented with clinically significant symptoms of anxiety, 25.4% with depression, and 76.2% had a high perception of social support. ICU family members with low/fair perceived social support reported statistically significantly higher perceived stress and lower family satisfaction. Perceived stress was negatively correlated with family satisfaction. Clinically significant symptoms of anxiety and depression were not statistically associated with family satisfaction or perceived social support. While ICU admission-related stress may undermine family satisfaction, perceived social support may be positively associated with the way that ICU family members of non-COVID-19 patients evaluate the quality of care in the ICU. Knowing the factors that influence family satisfaction in the ICU may assist stakeholders and policy developers to improve family-centered care in the hospital setting. Early screening for psychological distress and social support levels during admission should be included in updates of visiting and communication policies in the ICU. Prompt identification of family members at risk of a poor ICU experience may enhance efforts to support them, particularly in acute care settings where differentiated approaches to COVID-19 and non-COVID-19 ICU family members are established.

Contributing Factors to Israeli Soldiers' Adaptation to Military Noncombat Positions.

Adjusting to a military environment is a complex process, with unique demands and various stressors placed on conscripts. In this study, we examined the unique and combined contribution of the independent variables that constitute an individual soldier's personal resources-the meaningfulness of the military role and the match between expectations and the job itself; cognitive flexibility; social support; and seeking help from a mental health officer (MHO)-to the adaptation (dependent variable) of noncombat soldiers to military service. The study group comprised 200 Israel Defense Forces noncombat soldiers aged 18-23 years (Meanage = 20.046 years, SD = 0.951). Of them, 107 (53.3%) had consulted a MHO. The remaining soldiers who had not consulted an MHO (n = 93, 46.5%) served as the comparison group. Research tools included the work and meaning questionnaire, the Cognitive Flexibility Scale, the Medical Outcomes Study (social support) questionnaire, and adaptation to the army questionnaire. Adaptation to service was found to relate positively to the meaningfulness of the military role, cognitive flexibility, and social support. Social support partially mediated the relation between cognitive flexibility and adaptation to service. Additionally, soldiers who had consulted an MHO had lower levels of cognitive flexibility and social support, and they adapted less well to service compared to the comparison group. The study indicates that soldiers who seek help have lower resources. Additional personal and environmental variables that contribute to the adjustment of soldiers in noncombat positions were also identified.

Self-reported emotional health and social support but not executive function are associated with participation after stroke

ABSTRACT Background Participation restrictions continue to be prevalent for community-dwelling stroke survivors. Research is needed to understand the associated post-stroke factors that limit or facilitate optimal participation and quality of life. Objectives To investigate emotional health, executive functioning (EF), and social support as predictors of participation restrictions post-stroke. Methods Cross-sectional data collected from participants ≥ 6 months after mild stroke with and without aphasia (N = 114) were analyzed using three participation outcome measures: Reintegration to Normal Living Index (RNL), Activity Card Sort (ACS), and the Stroke Impact Scale (SIS) Version 2.0 Participation/Role Function domain. Predictor variables investigated were emotional health (SIS Emotion domain scores), EF (Delis Kaplan Executive Function System Trail Making Condition 4: DKEFS), social support (Medical Outcomes Study Social Support Survey: MOS-SSS), stroke severity (National Institutes of Health Stroke Scale: NIHSS), and education level. Results Using multiple regression, these predictors accounted for 26.4% to 40% of the variance for the three participation outcomes. Emotional health was a significant independent predictor across all three measures. Social support was a significant predictor of participation as measured on the RNL. Executive function was not a significant predictor of participation when controlling for the other predictor variables. Conclusions Emotional health and social support should be considered as modifiable factors that could optimize meaningful participation and quality of life.

Protective factors against depressive symptoms among Brazilian healthcare workers during the initial stages of the COVID-19 pandemic: a cross-sectional study

ObjectivesThis study aims to assess the prevalence of depressive symptoms among healthcare workers and possible factors associated with this outcome (resilience, spirituality, social support, quality of life, among other individual...

Cognitive reserve and mental health in cognitive frailty phenotypes: Insights from a study with a Portuguese sample.

BackgroundResearch on prevalence of cognitive frailty phenotypes in community-dwelling older adults in different countries is important to estimate their prevalence and to determine the influence of cognitive reserve and mental health in order to prevent frailty. The aims of this study were to estimate the prevalence of reversible and potentially reversible cognitive frailty (R-CF, PR-CF) in a Portuguese sample of old adults and explore the associations between these phenotypes and demographic, comorbidity, social support, cognitive reserve and mental health factors.MethodsWe assessed frailty (Fried criteria) in 250 community-dwelling older adults (179 women) aged 60 years or over (mean 71.04 years) without dementia, neurological or psychiatric disorders. Subjective cognitive decline and Mild cognitive impairment were diagnosed according to standard criteria. The questionnaires Charlson Index, Medical Outcomes Study Social Support, Cognitive Reserve Index and General Health were used for assessing comorbidity, social support, cognitive reserve and mental health, respectively.ResultsPrevalence of R-CF was 14%, and that of PR-CF, 15.2%. Cognitive frailty profiles differed significantly in relation to education, comorbidity, mental health, and cognitive reserve, but not in age or sex. Multivariate logistic regression showed that age, sex, comorbidity, social support, mental health, and cognitive reserve together predicted R-CF and PR-CF (90% specificity 75% sensitivity) with significant OR for mental health and cognitive reserve.DiscussionCognitive reserve and mental health are important factors predicting R-CF and PR-CF. We recommend assessing these factors for early detection of cognitive frailty and promoting psychological well-being and lifestyles that increase cognitive reserve in adults.

Factors enabling comorbidities and secondary conditions in older adults with spinal cord injury

Objective: To examine the role of personal, social, and environmental factors predicting comorbidities and secondary conditions among older adults with spinal cord injury (SCI). Design: Cross-sectional study utilizing survey methods were used to collect the data analyzed with two distinct general linear models. Setting: Community-dwelling participants who resided in rural and urban areas. Participants: One hundred and eighty-three (183) participants with SCI ages 45 and over at least five years post injury. Interventions: Not applicable. Measures: Spinal Cord Injury Secondary Conditions Scale (SCI-SCS); Comorbidities Questionnaire; Spinal Cord Injury Functional Index Assistive Technology (SCI-FI/AT) Basic – Mobility; Spinal Cord Injury Quality of Life (SCI-QOL) Satisfaction with Social Roles and Activities Scale (SSRA); Cohen’s Social Network-Social Integration Index, the Medical Outcomes Study (MOS) Social Support Emotional/Informational Support Scale, and the Facilitators and Barriers Survey for Mobility (FABS-Mv2). Questions were also asked from the Behavioral Risk Factor Surveillance System (BRFSS). Results: Common predictors of comorbidities and secondary conditions included age, basic mobility, primary health care payer and parking limitations. An interaction between parking and neurological classification was observed for comorbidities. Neurological classification and employment were significantly associated with comorbidities while for secondary conditions, sex, years since injury, education, satisfaction with social roles and the home environment were critical factors. Conclusions: Our study shows the effects of demographic and injury factors, physical functioning, satisfaction with social roles, access to home environment adaptations and health resources in predicting comorbidities and secondary conditions among older adults with SCI.

Increased Social Support Reduces the Incidence of Motoric Cognitive Risk Syndrome.

Background and ObjectivesThe motoric cognitive risk syndrome (MCR) is a predementia syndrome characterized by slow gait and cognitive complaint. The relationship between MCR and social support—a potentially modifiable risk factor of dementia—is currently unknown. The current study aimed to determine whether MCR incidence varies as a function of social support in aging.Research Design and MethodsWe examined MCR incidence in 506 community-dwelling older adults (M Age 76.59; 57.3% female) without MCR or dementia at baseline. We quantified perceived levels of social support with the Medical Outcomes Study Social Support Survey, incorporating four different categories of support: (a) emotional/informational support, (b) tangible support, (c) affectionate support, and (d) positive social interactions. We used Cox regression analyses, adjusted for age, sex, race/ethnicity, education, marital status, comorbidities, and global cognition, to estimate hazard ratios (aHR) with 95% confidence intervals (CIs).ResultsOver a median follow-up time of 2.5 years (range = 1–7 years), 38 participants (9.8%) developed MCR. Increased tangible support decreased the risk of MCR by 30% (aHR: 0.70, 95% CI: 0.53–0.92, p = .011). Increased overall social support decreased the risk of MCR by 33% (aHR: 0.67, 95% CI: 0.46–0.98, p = .038). Other subcategories of social support were not associated with a decreased risk of MCR (p > .05).Discussion and ImplicationsHigher levels of tangible social support, as well as overall social support, were associated with reduced risk for MCR in older adults. Increasing social support may be a promising avenue of intervention for reducing the risk of MCR, dementia, and other forms of cognitive decline.

Psychological Distress and Behavioural Changes in Pregnant and Postpartum Individuals During the COVID-19 Pandemic

ObjectivesTo determine the psychological and behavioural effects of the COVID-19 pandemic on a Canadian cohort of individuals during pregnancy and the postpartum period. MethodsIn 2020, individuals between 20 weeks gestation and 3 months postpartum receiving maternity care from an urban Canadian clinic were invited to complete a questionnaire. The purpose-built questionnaire used validated scales including the Medical Outcomes Study Social Support Survey (MOS), Depression, Anxiety, and Stress Scale (DASS-21), Edinburgh Postnatal Depression Scale (EPDS), and questions from a SARS study. ResultsOne hundred nine people completed the questionnaire (response rate, 55%) of whom 57% (n = 62) were postpartum. Most respondents (107, 98%) were married and had completed post-secondary education (104, 95%). Despite these protective factors, moderate to severe levels of depression (22%), anxiety (19%) and stress (27%), were recorded using the DASS-21, and 25% of participants (26) had depression (score ≥11) using the EPDS. Despite high social support in all MOS domains (median scores 84–100), a majority of participants reported loneliness (69, 67%) and were nearly or totally housebound (65, 64%). About half of participants worried about themselves (50, 46.3%) or their baby (59, 54%) contracting COVID-19, while the majority postponed (80, 74.1%) and cancelled (79, 73.2%) prenatal appointments. Being homebound or feeling lonely / lacking support were significant risk factors for psychological distress (P = 0.02) whereas exercise and strong social support were protective (P < 0.05). ConclusionPregnant and postpartum individuals experienced moderate to severe depression, anxiety, and stress during the COVID-19 pandemic. Exercise and strong social support were protective. Health care provider enquiry of home circumstances and activity may identify individuals needing enhanced supports.

Maternal Peer Support Through a Caregroup Model Improves Complementary Feeding of Infants by Refugee Mothers in Post-Emergency Settlements in the West-Nile Region in Uganda

ObjectivesIntroduction: Infant complementary feeding in refugee settlements remains inadequate, amidst declining humanitarian aid. However, there is limited evidence for interventions to address these nutrition challenges in the refugee settlements. Objective: Examine the effects of peer-led integrated nutrition education on infant feeding by South Sudanese refugee mothers in the West-Nile region in Uganda. MethodsA community-based randomized control study enrolled 390 pregnant mothers in the 3rd trimester as baseline for a peer-led nutrition education intervention using the caregroup model. Two groups (moms-only and moms & dads combined) comprised treatments with a control group. Higher scores on the Medical Outcomes Study (MOS) Social Support Index were used as a proxy for better maternal social support. Infant complementary feeding was assessed using the 2021 WHO guidelines. Multivariable logistic regression models determined effects of the interaction of maternal social support by group over time on infant feeding practices. The models were adjusted for maternal and infant confounders. ResultsMaternal age (mean ± SD) was 27.7 ± 5.1 years while the infant birthweight was 3.1 ± 0.5 kg. Higher maternal social support positively affected timely introduction of solid and semi-solid foods in moms-only (β = 0.11, p = .011) and moms & dads (β = 0.11, p = .001) groups. Positive intervention effects were noted on infant minimum dietary diversity for both the moms-only group (β = 0.06, p = .01) and the moms & dads group (β = 0.03, p = .001), but no effect was observed between maternal social support and infant minimum meal frequency. However, higher maternal social support in both moms-only and moms & dads groups influenced meeting the minimum acceptable diet (β = 0.07, p = .016 and β = 0.04, p = .026 respectively) and consumption of eggs and/or flesh foods (β = 0.11, p < .0001 and β = 0.05, p = .004). ConclusionsA maternal peer support integrated nutrition education program improved complementary feeding of infants in post-emergency settlements. Enhanced maternal social support in nutrition-sensitive programs may benefit infants in post-emergency settlements in the West-Nile region in Uganda. Funding SourcesA grant from the Nestlé Foundation for the Study of Problems of Nutrition in the World, Switzerland.

Inadequate social support decreases survival in decompensated liver cirrhosis patients

IntroductionInadequate social support is associated with higher mortality both in the general population and in patients with chronic diseases. There are no studies that have described social support in liver cirrhosis and its impact on prognosis. ObjectivesTo analyze the impact social support has in the survival of patients with decompensated cirrhosis. MethodsProspective multicentric cohort study (2016–2019). Patients with decompensated liver cirrhosis were included. Epidemiological, clinical and social variables were collected, using the validated Medical Outcomes Study Social Support Survey, with a 12-month follow-up. ResultsA total of 127 patients were included, of which 79.5% were men. The most common etiology of cirrhosis was alcohol (74.8%), mean age was 60 years (SD 10.29), mean MELD was 15.6 (SD 6.3) and most of the patients had a Child–Pugh B (53.5%) or C (35.4%). In the assessment of social support, we observed that most of the patients (92.2%) had adequate global support. At the end of the follow-up (median 314 days), 70.1% of the patients survived. The 1-year survival rate in patients with inadequate global social support was 30%, compared to 73.5% in the presence of social support. In multivariate Cox regression analysis, inadequate social support predicted survival with an adjusted HR of 5.5 (95% CI 2,3-13,4) independently of MELD (HR 1.1, 95% CI 1–1.2), age (HR 1, 95% CI 1–1.1) and hepatocarcinoma (HR 10.6, 95% CI 4.1–27.4). ConclusionAdequate social support improves survival in liver cirrhosis, independently of clinical variables. Social intervention strategies should be considered for their management.

The role of trauma, social support, and demography on veteran resilience

ABSTRACT Background Historically, resilience has often been conceptualized as the sustained lack of symptoms following trauma exposure. In line with a novel conceptualization of resilience as being dynamic over lifespan, determined by interacting biological and environmental factors, we examined the VA Mid-Atlantic Post Deployment Mental Health Repository (PDMH) comprised of 3876 US Military Veterans with and without PTSD diagnoses. Methods We performed regression modelling to study the relationship between resilience (measured with Connor Davidson Resilience Scale; CD-RISC), posttraumatic stress disorder (PTSD) severity (Davidson Trauma Scale; DTS), social support (Medical Outcome Study Social Support Survey; MOSSS), combat exposure (Combat Exposure Scale; CES), childhood trauma (Trauma Life Events Questionnaire; TLEQ), and demographic factors. CD-RISC was positively correlated with years of education and negatively correlated with DTS, CES and TLEQ scores. Results We found an interaction between CD-RISC and CES in predicting PTSD severity (Davidson Trauma Scale). Specifically, high resilience predicted lower PTSD symptom severity than low resilience, this relationship was amplified with increasing levels of combat exposure. Structural equation modelling (SEM) identified an optimal latent variable that represents resilience and relationships between latent variables for resilience, trauma, and illness. We derived a resilience latent variable composed of age, education level, MOSSS and race. Conclusions Our results support a conceptualization of resilience as a multifactorial determinant that coexists with PTSD, a state rather than trait variable, and can be quantified by biological and behavioural metrics. HIGHLIGHTS • Historically, resilience has often been conceptualized as the sustained lack of symptoms following trauma exposure. • We examined the VA Mid-Atlantic Post Deployment Mental Health Repository (PDMH) comprised of 3876 US Military Veterans. • We found an interaction effect between CD-RISC and CES in predicting PTSD severity (Davidson Trauma Scale)

Social Support Fully Mediates the Association Between Communication Abilities and Social Participation Among Persons with Post-Stroke Aphasia

ABSTRACT Background Communication abilities have been considered to be a key influential factor for social participation in persons with post-stroke aphasia. Previous literature has shown that social support is positively associated with social participation post-stroke. However, few studies have investigated if social support mediates the negative impact of communication difficulties on social participation in persons with aphasia and without aphasia after stroke. Aims To investigate the mediation effect of social support on the association between communication abilities and social participation in persons with aphasia and without aphasia after stroke. Methods & Procedures A total of 116 participants who have had a stroke, including 60 persons with aphasia and 56 persons without aphasia, were enrolled. This study used a regression-based mediation analysis using Hayes’s PROCESS macro (SPSS model 4). Measures included the Medical Outcomes Study (MOS) - Social Support Survey as the mediator (perceived social support), the Stroke Impact Scale 2.0 (SIS) communication domain as the independent variable, and the Activity Card Sort (ACS) social activity domain as the dependent variable (social participation). Two separate models were built for persons with aphasia and without aphasia. As post hoc analyses, the four domains of MOS social support (emotional/informational support, affectional support, positive social interaction, and tangible support) were included as a mediator in four individual models. Outcomes & Results Our results showed that there was no difference in social participation between persons with aphasia and without aphasia after stroke. Perceived social support (b=0.180, 95% CI=0.054~0.352), including emotional/informational support (b=0.182, 95% CI=0.552~0.359), affectionate support (b=0.138, 95% CI=0.020~0.316), and positive social interaction (b=0.178, 95% CI=0.035~0.357), fully mediates the association between communication abilities and social participation in persons with aphasia, but did not for persons without aphasia (p>0.05). Conclusions The results indicate that perceived social support, specifically emotional/informational support, affectionate support, and positive social interaction, may be used as an intervention approach for improving social participation in persons with post-stroke aphasia.

The Relationship between Social Support and Postnatal Anxiety and Depression: Results from the Listening to Mothers in California Survey.

Perinatal mood and anxiety disorders (PMADs) impact multiple domains of maternal and child well-being. Estimates of postpartum depressive symptoms range from 6.5% to 12.9% and from 8.6% to 9.9% for postpartum anxiety. We sought to identify the role social support could play in mitigating PMADs. The data are drawn from the Listening to Mothers in California survey; results are representative of women who gave birth in 2016 in a California hospital. The Patient Health Questionnaire-4 was used to assess total symptoms of PMADs and anxiety and depressive symptoms individually. Two questions adapted from the Medical Outcomes Study Social Support Survey were used to assess emotional, practical, and functional (combined) social support. After exclusions for missing data related to PMADs or social support, we analyzed data from 2,372 women. At the time of survey administration (mean 5.7months after birth), 7.0% of respondents reported elevated PMAD symptoms and 45.9% reported that they always received functional social support. In multivariable analysis, controlling for demographic and pregnancy-related factors and prenatal anxiety and depressive symptoms, women who reported consistent support had a prevalence of elevated PMAD symptoms one-half that of those who did not (adjusted odds ratio, 0.50; 95% confidence interval, 0.34-0.74). This study suggests that consistent social support serves as a robust protective factor against postpartum symptoms of PMADs. Because many predictors of PMADs are not modifiable, social support stands out as an important target for programmatic intervention, particularly in light of increased isolation related to the COVID-19 pandemic.