Negative Aspects Of Close Relationships Research Articles

Close Relationships and Health: The Interactive Effect of Positive and Negative Aspects.

Most health research focuses on the independent associations of positive or negative aspects of close relationships with health outcomes. A small but growing literature has begun to examine interactive effects of positive and negative aspects. These interactive effects frequently predict health independently or above-and-beyond main effects of either the positive or the negative aspects, suggesting unique relationship processes or emergent features of these close relationship patterns. Our goal in this review is to lay out the existing approaches to studying the interactive effects of positive and negative aspects of close relationships, and to review available evidence linking these interactive effects to health outcomes. We conclude by discussing important unresolved issues and highlighting critical directions for future research.

Structural and functional aspects of social support as predictors of mental and physical health trajectories: Whitehall II cohort study

BackgroundSocial support is associated with better health. However, only a limited number of studies have examined the association of social support with health from the adult life course perspective and...

Structural and functional measures of social relationships and quality of life among older adults: does chronic disease status matter?

To evaluate the relative importance of structural and functional social relationships for quality of life (QoL) and the extent to which diagnosed chronic disease modifies these associations. Multivariate linear regression was used to investigate time-lagged associations between structural and functional measures of social relationships and QoL assessed 5 years apart by CASP-19, in 5925 Whitehall II participants (mean age 61, SD 6.0). Chronic disease was clinically verified coronary heart disease, stroke, diabetes or cancer. Social relationships-QoL associations were consistent across disease status (P-values for interaction: 0.15-0.99). Larger friend network (β = 1.9, 95% CI 1.5-2.3), having a partner (β = 1.2, 95% CI 0.5-1.7), higher confiding support (β = 2.2, 95% CI 1.8-2.7) and lower negative aspects of close relationships (β = 3.3, 95% CI 2.8-3.8) were independently related to improved QoL in old age. The estimated difference in QoL due to social relationships was equivalent to up to 0.5 SD of the CASP-19 score and was stronger than the effect of chronic disease (coronary heart disease β = 2.0, 95% CI 1.4-2.6). We found that beneficial aspects of social relationships in relation to QoL were, in order of importance: avoiding negative aspects of close relationships, having confiding support, having a wide network of friends and having a partner. These associations were not modified by chronic disease. Thus, despite inevitable physical deterioration, we may be able to enhance a satisfying late life by optimizing our social relationships.

Negative aspects of close relationships as risk factors for cognitive aging.

The extent to which social relationships influence cognitive aging is unclear. In this study, we investigated the association of midlife quality of close relationships with subsequent cognitive decline. Participants in the Whitehall II Study (n = 5,873; ages 45–69 years at first cognitive assessment) underwent executive function and memory tests 3 times over a period of 10 years (1997–1999 to 2007–2009). Midlife negative and positive aspects of close relationships were assessed twice using the Close Persons Questionnaire during the 8 years preceding cognitive assessment. Negative aspects of close relationships, but not positive aspects, were associated with accelerated cognitive aging. Participants in the top third of reported negative aspects of close relationships experienced a faster 10-year change in executive function (−0.04 standard deviation, 95% confidence interval: −0.08, −0.01) than those in the bottom third, which was comparable with 1 extra year of cognitive decline for participants aged 60 years after adjustment for sociodemographic and health status. Longitudinal analysis found no evidence of reverse causality. This study highlights the importance of differentiating aspects of social relationships to evaluate their unique associations with cognitive aging.

PP44 Impact of negative aspects of close relationships on cognitive ageing, the dark side of social relationships

<h3>Background</h3> The extent to which social relationships influence cognitive ageing is unclear. This study investigates the impact of mid-lif quality of close relationships on cognitive decline, using multilevel modelling. <h3>Methods</h3> Whitehall II study participants (n = 6495, aged 45–69 at baseline) provided cognitive assessments (executive function and memory) three times over 10 years. The quality of close relationships was assessed by the Close Persons Questionnaire. <h3>Results</h3> Higher levels of adverse close relationships in mid-life were related to lower concurrent memory (-0.07; 95% CI: -0.12,-0.02 SD) and accelerated 10-year decline in executive function (-0.04; 95% CI: -0.07,-0.01 SD). Participants reporting higher cumulative negative aspects of close relationships experienced greater decline in executive function (-0.04; 95% CI: -0.07,-0.01 SD). Longitudinal analysis found no evidence of reverse causality. <h3>Conclusion</h3> Adverse close relationships predict relatively rapid cognitive ageing. This study highlights the importance of differentiating aspects of social relationships to evaluate their unique health effects.

IMPACT OF NEGATIVE ASPECTS OF CLOSE RELATIONSHIPS ON COGNITIVE AGEING

Background: The extent to which social relationships influence cognitive ageing is unclear. This study investigates the impact of mid-life quality of close relationships on cognitive decline, using multilevel modelling. Methods:Whitehall II study participants (n1⁄46,495, aged 45-69 at baseline) provided cognitive assessments (executive function [reasoning, phonemic and semantic fluency] and memory) three times over 10 years. The quality of close relationships was assessed by the Close Persons Questionnaire. Results: Higher levels of adverse close relationships in mid-life were related to lower concurrent memory (-0.08; 95% CI: -0.12,-0.03 SD) and accelerated 10-year decline in executive function (-0.04; 95% CI: -0.07,-0.01 SD). Participants reporting higher cumulative negative aspects of close relationships experienced greater cognitive decline (-0.05; 95% CI: -0.08,-0.01 SD). Longitudinal analysis found no evidence of reverse causality. Conclusions: Adverse close relationships predict relatively rapid cognitive ageing. This study highlights the importance of differentiating aspects of social relationships to evaluate their unique health effects.

Negative aspects of close relationships are more strongly associated than supportive personal relationships with illness burden of irritable bowel syndrome

ObjectiveThis study assessed the relative magnitude of associations between IBS outcomes and different aspects of social relationships (social support, negative interactions). MethodSubjects included 235 Rome III diagnosed IBS patients (M age=41yrs, F=78%) without comorbid GI disease. Subjects completed a testing battery that included the Interpersonal Support Evaluation List (Social Support or SS), Negative Interaction (NI) Scale, IBS Symptom Severity Scale (IBS-SSS), IBS-QOL, BSI Depression, STAI Trait Anxiety, SOMS-7 (somatization), Perceived Stress Scale, and a medical comorbidity checklist. ResultsAfter controlling for demographic variables, both SS and NI were significantly correlated with all of the clinical variables (SS r's=.20 to .36; NI r's=.17 to .53, respectively; ps<.05) save for IBS symptom severity (IBS-SSS). NI, but not SS, was positively correlated with IBS-SSS. After performing r-to-z transformations on the correlation coefficients and then comparing z-scores, the correlation between perceived stress, and NI was significantly stronger than with SS. There was no significant difference between the strength of correlations between NI and SS for depression, somatization, trait anxiety, and IBSQOL. A hierarchical linear regression identified both SS and NI as significant predictors of IBS-QOL. ConclusionsDifferent aspects of social relationships – support and negative interactions – are associated with multiple aspects of IBS experience (e.g. stress, QOL impairment). Negative social relationships marked by conflict and adverse exchanges are more consistently and strongly related to IBS outcomes than social support.

Sa1329 Negative Aspects of Close Relationships Are More Strongly Associated With Symptom Burden of IBS Than Supportive Personal Relationships: Increasing the Precision of the Biopsychosocial Model

Sa1329 Negative Aspects of Close Relationships Are More Strongly Associated With Symptom Burden of IBS Than Supportive Personal Relationships: Increasing the Precision of the Biopsychosocial Model

Socioeconomic Status, Structural and Functional Measures of Social Support, and Mortality

The authors examined the associations of social support with socioeconomic status (SES) and with mortality, as well as how SES differences in social support might account for SES differences in mortality. Analyses were based on 9,333 participants from the British Whitehall II Study cohort, a longitudinal cohort established in 1985 among London-based civil servants who were 35–55 years of age at baseline. SES was assessed using participant's employment grades at baseline. Social support was assessed 3 times in the 24.4-year period during which participants were monitored for death. In men, marital status, and to a lesser extent network score (but not low perceived support or high negative aspects of close relationships), predicted both all-cause and cardiovascular mortality. Measures of social support were not associated with cancer mortality. Men in the lowest SES category had an increased risk of death compared with those in the highest category (for all-cause mortality, hazard ratio = 1.59, 95% confidence interval: 1.21, 2.08; for cardiovascular mortality, hazard ratio = 2.48, 95% confidence interval: 1.55, 3.92). Network score and marital status combined explained 27% (95% confidence interval: 14, 43) and 29% (95% confidence interval: 17, 52) of the associations between SES and all-cause and cardiovascular mortality, respectively. In women, there was no consistent association between social support indicators and mortality. The present study suggests that in men, social isolation is not only an important risk factor for mortality but is also likely to contribute to differences in mortality by SES.

Pathways to Care and Help-Seeking Experience Prior to Self-Harm

Help-seeking behavior may protect people from harming themselves. However, few studies have discussed how and why people access lay or professional help prior to self-harm. This study explored the subjective experiences of individuals with deliberate self-harm in terms of help-seeking behavior and medical care pathways. Researchers performed qualitative in-depth interviews and content analysis and used a sampling grid to recruit participants. Twenty emergency attendees between the ages of 18-55 years were interviewed on their help-seeking pathways and experiences using a standardized topic guide. Participants identified friends, family members, healthcare personnel, and their own initiative as the primary medical care pathways. Analysis showed help-seeking experiences significantly related to the physician-patient relationship, social support, and treatment adherence. These factors were also identified as prominent themes related to medical help-seeking behavior. Supportive attitudes and continuous care from formal and informal sources of help may facilitate help-seeking behavior, whereas negative influences from close friends or relatives may trigger a self-harm episode. Medication stockpiling and the negative aspects of close relationships should be addressed and minimized to raise the effectiveness of self-harm or suicide prevention efforts.

Negative Aspects of Close Relationships as a Predictor of Increased Body Mass Index and Waist Circumference: The Whitehall II Study

We investigated whether exposure to negative aspects of close relationships was associated with subsequent increase in body mass index (BMI) and waist circumference. Data came from a prospective cohort study (Whitehall II) of 9425 civil servants aged 35 to 55 years at baseline (phase 1: 1985-1988). We assessed negative aspects of close relationships with the Close Persons Questionnaire (range 0-12) at phases 1 and 2 (1989-1990). We measured BMI and waist circumference at phases 3 (1991-1994) and 5 (1997-1999). Covariates at phase 1 included gender, age, marital status, ethnicity, BMI, employment grade, smoking, physical activity, fruit and vegetable consumption, and common mental disorder. After adjustment for sociodemographic characteristics and health behaviors, participants with higher exposure to negative aspects of close relationships had a higher likelihood of a 10% or greater increase in BMI and waist circumference (odds ratios per 1-unit increase 1.08 [95% confidence interval (CI) =1.02, 1.14; P = .007] and 1.09 [CI = 1.04, 1.14; P ≤ .001], respectively) as well as a transition from the overweight (25 ≤ BMI < 30) to the obese (BMI ≥ 0) category. Adverse social relationships may contribute to weight gain.

The influence of childhood adversity on social relations and mental health at mid-life

Childhood adversity is predictive of affective and anxiety disorders in adulthood, although there are likely to be several mediating factors. Social relations and social networks are potential mediators, and have also been linked to onset and recovery of affective and anxiety disorders in adulthood. This study explored positive and negative aspects of close relationships, their association with mid-life anxiety and affective disorders, and their mediating role in the relationship between childhood adversity and mid-life disorders. Data from the 1958 British birth cohort were analysed using measures of adversity taken during childhood, measurements of social relations at 45 years, and diagnosis of affective and anxiety disorders at 45 years of age (N=9377). Childhood adversity was associated with smaller social network size and higher negative aspects of close relationships. Smaller social network size and negative aspects of close relationships, but not emotional or practical support, were associated with higher odds of having affective or anxiety disorder. However, social relations did not mediate or moderate the pathway between childhood adversity and mid-life affective and anxiety disorders. Social relations and affective and anxiety disorders were measured cross-sectionally so direction of causation cannot be determined. Negative aspects of close relationships and social network size, rather than emotional or practical support, are associated with affective and anxiety disorders. Childhood adversity is related to later social relationships as well as mid-life affective and anxiety disorders.

Close to the Heart: Cardiac Effects of Negative Relationships

Having social relationships is associated with better health. In some research, negative aspects of close relationships, more commonly reported by

Negative Aspects of Close Relationships and Heart Disease

The aims of the study were to (1) analyze the association between negative aspects of close relationships and increased risk for coronary heart disease and (2) examine whether the association is stronger among women and people of lower social position. Prospective cohort study of 9011 British civil servants (6114 men and 2897 women). Negative aspects of close relationships and other social support measures (confiding/emotional and practical) were assessed with the Close Persons Questionnaire during phase 2 (1989-1990) or phase 1 (1985-1988). Associations between negative aspects of close relationships and incident coronary events were determined during an average follow-up period of 12.2 years. Covariates included sociodemographic characteristics (age, sex, marital status, and employment grade), biological factors (obesity, hypertension, diabetes mellitus, and cholesterol level), psychosocial factors (negative affectivity, depression, and work stress), and health behaviors (smoking, alcohol intake, exercise, and fruit and vegetable consumption). After adjustment for sociodemographic characteristics, biological factors, and other dimensions of social support, individuals who experienced negative aspects of close relationships had a higher risk of incident coronary events (hazard ratio, 1.34; 95% confidence interval, 1.10-1.63). The association was attenuated but remained statistically significant after additional adjustment for negative affectivity and depression (hazard ratio, 1.25; 95% confidence interval, 1.02-1.55). Although women and men in a lower employment grade were more likely to be exposed to negative aspects of close relationships, sex and social position had no statistically significant interaction effects. Confiding/emotional and practical support were not associated with incident coronary events. Adverse close relationships may increase the risk of heart disease.

The psychosocial work environment and alcohol dependence: a prospective study

Aims: To examine whether a stressful psychosocial work environment predicts alcohol dependence. Methods: Alcohol dependence of participants in the Whitehall II occupational cohort of London based civil servants (1985–88) was...

Psychosocial Work Characteristics and Social Support as Predictors of SF-36 Health Functioning

To assess whether work characteristics and social support are predictors of physical, psychological, and social functioning. Work characteristics (Karasek and Siegrist models) and social support at baseline were used to predict health functioning measured by the SF-36 General Health Survey 5 years later in a prospective cohort study of 10,308 British male and female civil servants. Effort-reward imbalance and negative aspects of close relationships predicted poor physical, psychological, and social functioning after adjustment for the potential confounding effects of age, employment grade, baseline ill health, and negative affectivity. These psychosocial characteristics seem to act in a similar way in the healthy and those with existing illness. Psychological demands at work in women, and low confiding/emotional support in men, also predicted poor functioning. Etiologically. these effects are not mediated through health-related behaviors. Negative aspects of work (high demands and effort-reward imbalance) and negative aspects of close relationships are independent powerful predictors of poor health functioning. They may have an etiological role, which is independent of baseline illness.

Social support and psychiatric sickness absence: a prospective study of British civil servants.

Studies on the direct and buffering effects of social support have not examined psychiatric sickness absence and few studies have considered support both at home and at work. This study addresses prospectively the effects of chronic stressors and social supports, at home and at work, on psychiatric sickness absence rates. Sociodemographic factors, health and social support were measured at baseline, and short and long spells of sickness absence were measured prospectively over a 5-year period. The participants were a subsample of 4202 male and female civil servants, aged 35-55 years at baseline, from an occupational cohort, the Whitehall II Study, who completed detailed social support questions. Support from colleagues and supervisors at work is related to lower risk of short spells of psychiatric sickness absence, particularly for those also receiving high levels of negative aspects of close relationships from their closest person outside work. Negative aspects of close relationships from the closest person increase the risk of taking long spells of psychiatric sickness absence in men. High levels of material problems increase the risk of short spells of sickness absence. Negative aspects of close relationships may have an aetiological role in non-psychotic psychiatric disorder. Social support at work appears to protect against short spells of psychiatric sickness absence. This potentially implies that levels of short spells of absence might be reduced by increasing support at work. Conversely, emotional support at home may influenced absence-related behaviour and encourage a person to take absence at a time of illness.

Supportive and negative responses in the partner relationship: their association with psychological adjustment among individuals with cancer.

This study examined the association between positive and negative aspects of spouse responses and psychological adjustment among 158 individuals with cancer. Two contextual variables, gender and disease-related functional impairment, were taken into account when examining the association between spouse responses and patient psychological distress and well-being. Results indicated that negative aspects of close relationships played a comparatively stronger role than positive aspects in their associations with both psychological distress and well-being. For negative spouse responses, patient gender did not moderate the effects of these responses upon psychological outcomes. For positive aspects of spouse support, both gender and functional disability moderated the association between spouse support and psychological outcomes. These findings are integrated with the general literature on positive and negative aspects of close relationships. Implications for clinical interventions are also discussed.