Subjective Social Support Research Articles

Relationship between psychosocial factors and psychosomatic symptoms of sterilized women

Objective To study the relationship between the stress-related psychosocial factors and the psychosomatic symptoms of sterilized women. Methods 120 sterilized women were assessed with Symptom Check List 90(SCL-90),Social Supports Questionnaire(SSQ),Eysenck Personality Questionnaire(EPQ),Psychosocial Stress Scale for Group(PSSG)and a self-developed preoperative cognition scale.Data were analysed with SPSS. Results There was a significant correlation between scores of psychosomatic symptoms and stress-related psychosocial factors such as EPQ-N,subjective social support(SSS),negative emotion(NE),positive emotion(PE),negative coping style(NC) and some negative characteristics of pre-operative cognition.Multiple stepwise regression analysis showed that EPQ-N,PE and religion belief were in the equation. Conclusion The results indicated that neurotic syndrome of sterilized women may be mediated or influenced by negative characteristics of cognition,emotion,coping style and personality.

Depressive symptoms in middle-aged women are more strongly associated with physical health and social support than with socioeconomic factors

The association of socioeconomic factors, health-related factors, and social support with depressive symptoms has been extensively studied. However, most epidemiological studies have focused on a few factors such as marital status, social class, and employment. In this study of middle-aged women we analyzed both univariate and multivariate associations of socioeconomic factors, perceived physical health factors, and social support with self-rated depressive symptoms measured with the Beck Depression Inventory. A nationwide sample (n =1851) of Finnish women aged 48 -50 years was analyzed. Socioeconomic, health-related, and social support factors were all measured with single items. All variables, except level of urbanization, were significantly associated with depressive symptoms in univariate analyses. Multivariate associations were examined with standard multiple regression analyses in three stages: first with the socioeconomic factors, then with socioeconomic and health factors, and finally entering the social support factors into the regression model. In the first model, being either on a sick leave or at home as working status, being divorced, and having low income reached significance. In the second model, being divorced and having poor perceived physical health were the most powerful among the five significant variables. In the last model, explaining 32% of the variance, the most powerful predictors of depressive symptoms were perceived current physical health, satisfaction with received social support, and quality of intimate relationships. For the prevention or intervention of depressive symptoms among middle-aged women in the population subjects with concurrent subjective or objective health problems and poor social support seem to comprise a particularly important target group.

Phobic avoidance and regular dental care in fearful dental patients: a comparative study

The present investigation was a comparative study of 169 highly fearful dental patients, some of whom received regular dental care (n = 28) and some who never, or only when absolutely necessary, utilized dental care (n = 141). It was hypothesized that phobic avoidance is related to anticipatory stress and anxiety reactions, negative oral health effects, psychological distress, and negative social consequences. Background factors (sex, age, education, and dental attendance pattern), dental anxiety, general fears, general state and trait anxiety, mood states, depression, and quality of life effects were studied. Data were analyzed with descriptive statistics and with exploratory factor and multiple logistic regression analysis. It was shown that dental anxiety is significantly higher among the avoiders and this is in particular evident for anticipatory dental anxiety. Oral health differed between the groups, and it was shown that avoiders had significantly more missing teeth, whereas regular attenders had significantly more filled teeth. The avoiders reported a stronger negative impact on their daily life, whereas there were no significant differences between the groups with regard to general emotions. The logistic regression analysis showed that phobic avoidance was predicted only by anticipated dental anxiety and missing teeth. It was concluded that differences between high dental fear patients with regular dental care and phobic avoidance were mainly related to anticipated fear and anxiety, oral health effects, and concomitant negative life consequences. These results are discussed in terms of subjective stress, negative cognitions, social support, and coping-strategies.

Social and personal resources and the prevalence of phobic disorder in a community population.

Phobic disorder is one of the most prevalent psychiatric disorders in community populations and much attention has focused on the association of sociodemographic factors and social resources with the disorder. There has been little investigation of the more personal resources such as self-confidence, religiosity, social support and self-perceived health that may increase vulnerability. We used a sample of 2914 community residents aged 18 or older who participated in the Duke University Epidemiologic Catchment Area Study to explore the relationship between both social and personal resources and the prevalence of DIS/DSM-III phobic disorder. The 1-month prevalence of any phobic disorder was 7.6%. In bivariate analyses, we found both race/ethnicity and gender differences in prevalence, with a higher prevalence of phobic disorder in African-Americans and females. Lower socio-economic status, rural residence and unmarried status were also associated with current prevalence. No association was found for social network and social interaction. Impaired subjective social support, low self-confidence, perceived poorer physical health and co-morbid psychiatric disorder were significantly associated with current prevalence in uncontrolled analyses, while associations between lack of a confidant as well as religiosity and phobic disorder were not. Female gender (OR = 1.7), perceived low self-confidence (OR = 2.0), and two interaction terms, age x co-morbid psychiatric disorder and race/ethnicity x perceived physical health were associated with phobic disorder in controlled analyses using logistic regression. We conclude that both social and personal resources, particularly self-confidence, co-morbidity and perceived physical health are important correlates of phobic disorder.

Disability in Geriatric Depression

The authors examined impairment in self-maintenance skills and in instrumental activities of daily living (IADL) among 211 older patients with unipolar major depression. In regression models, self-maintenance impairment was associated with older age, less reported depressed mood, psychomotor retardation, and severe chronic medical illness. IADL deficit was associated with older age, greater severity of depression, less guilt, more apathy, weight loss, greater cognitive impairment, more severe chronic medical illness, less social interaction, lower subjective social support, and greater instrumental support. The authors conclude that efforts to remediate basic skills deficits in depressed older adults should focus on treating comorbid medical conditions; impaired IADL skills in geriatric depressed patients should improve with treatment of depression and medical illness. Clinicians should be aware that substantial IADL impairment may accompany mild cognitive impairment associated with depression in older patients.

Clinical, demographic and social characteristics of psychotic depression

The goal of this study was to compare the clinical, demographic and social characteristics of psychotic and non-psychotic depression in the elderly and younger age groups. Depressed patients ( n=674) meeting DSM-III-R criteria for major depressive episode were classified into two groups, psychotic and non-psychotic, based on the presence of delusions or hallucinations. The patients with psychotic and non-psychotic depression were compared on clinical, demographic, and social characteristics. Bivariate analyses revealed that younger age, psychomotor retardation, guilt, feelings of worthlessness, history of delusions in the past, and increased suicidal ideation and intent were found more commonly in psychotic as compared to non-psychotic depression. A fully adjusted logistic regression model also confirmed younger age, history of past delusions, and increased feelings of worthlessness to be associated more with psychotic than with non-psychotic depression. Trends were observed for psychotic depression to be associated with poor subjective social support and with bipolar illness. Cerebrovascular risk factors and gender composition did not differ significantly in the psychotic vs. non-psychotic groups. The study confirms previously described findings such as increased guilt, increased psychomotor retardation and increased suicidality in psychotic depression in a large sample of depressed patients. The study also introduces the concept of age as an important variable influencing psychotic depression. The limitation of this finding is that it is applicable to tertiary care samples. Further studies are needed to confirm this finding in other subgroups.

Suicidal behaviors in depressed men with a family history of suicide: Effects of psychosocial factors and age

Effects of impaired social support and stressful life events on non-lethal suicidal behaviors were examined in a clinical sample of high-risk patients: depressed adult men with a family history of suicide or attempted suicide. All subjects (N = 79) were participants in the Mental Health Clinical Research Center (MHCRC) for the Study of Depression in Later Life (Duke University, USA). Outcome measures were self-reported one-year histories of three suicide-related ideation symptoms and attempted suicide. One-year prevalences for these outcomes were: death ideation, 58%; death wish, 48%; suicidal ideation, 57%; and attempted suicide, 11%. In adjusted models, none of the four measures of social support (network size, frequency of social interaction, receipt of instrumental support, and subjective social support) increased the odds of any outcome. Thus, in this high-risk group, impaired social support did not appear to increase the odds of one-year history of any form of suicide-related ideation or of attempted suicide. The number of negative life events experienced during the year before the study interview was not associated with increased odds of any ideation symptom, but was marginally higher in men who had attempted suicide during that year. Older age was significantly protective against explicit suicidal ideation (OR 0.95, CI 0.91-0.99) in this sample, but did not affect the odds of attempted suicide.

Depression and social support in elderly patients with cardiac disease

Background Depression is common among patients with cardiac disease. A number of psychosocial factors may affect the relationship between physical health and depression. There is evidence from the psychiatric literature suggesting that negative life events and social support are important factors in the development and outcome of depression. It is unknown if these factors are important in the context of depression in medically ill patients. Thus it is important to examine the relationship among social support, negative life events, and the presence of depression in elderly patients with cardiac disease. Methods Patients with coronary artery disease were assessed with the Duke Depression Evaluation Schedule for the Elderly. This includes the mood and anxiety disorder section of the Diagnostic Interview Schedule modified for Diagnostic and Statistical Manual of Mental Disorders diagnoses, life events, and multidimensional assessment of social support. Two hypotheses were tested: (1) the number of concurrent negative life events will be higher in patients with coronary artery disease with major depression than those without depression, and (2) social support will be less in patients with major depression than in those without. Results Presence of major depression was associated with increased negative life events and lowered subjective social support after accounting for age, sex, and race. Conclusions The finding that subjective social support and negative life events are related to major depression suggests that even in the context of medical illness, social factors are still important in the development of major depression. (Am Heart J 1998;136:491-5.)

HEALTH, STRESS, COPING, AND SOCIAL SUPPORT IN GRANDMOTHER CAREGIVERS

The purposes of this study were to examine health, stress, coping, and supports of grandmothers who live with one or more grandchildren and participate in their care, and to examine whether differences exist between grandmothers with primary and partial responsibility for their grandchildren's care. A convenience sample of 90 women was recruited from various sites, and participants completed a selfadministered questionnaire. There were no differences between grandmothers who had primary responsibility for raising their grandchildren (n = 58) and those who did not (n = 32) in self-assessed health, anxiety, or depression; in coping; or in typical grandparenting stresses. Grandmothers with primary responsibility reported significantly greater parenting stresses and less instrumental and subjective social support. Grandmothers in both groups reported high depression and anxiety scores and favorable scores on grandparenting stresses. Implications for grandmother caregivers are discussed.

Crime, subjective social stress and support indicators, and ethnic origin: The Israeli experience*

This study investigated the relationship between the subjective perception of stress and support (as independent variables) and the prevalence of homicide, robbery, and property offenses, while controlling for the effect of ethnic origin. This was done by analyzing (on the aggregate level) how these crimes are related to the differential perception of stress and support among respondents of Eastern (Asian or North African) and Western (European or American) origin. The theoretical framework is provided by a model which postulates that crime will be related positively to stress factors and negatively to support systems. The theoretical model was substantially supported by the findings. Economic stress indicators had a greater effect on crime rates than did security-related indicators, especially among Eastern respondents, and the perception of social solidarity among Eastern respondents was related more closely to crime than among their Western counterparts, as expected. Contrary to expectation, however, the perception of stress was related less closely to robbery and property crime among Eastern respondents than among Western respondents. Suggestions are made for future studies in this new line of criminological research.

Age of first onset of bipolar disorder: Demographic, family history, and psychosocial correlates

The literature suggests that bipolar elders with early and late onset of the disorder present with different demographic, family history, and psychosocial profiles, which are less well characterized than those for elderly unipolar patients. In this cross-sectional clinical survey, we assessed subjects (n = 74) from the NIMH Clinical Research Center for the Study of Depression in Later Life at Duke University who had a consensus diagnosis of bipolar depression; the primary assessment instrument was the Duke Depression Evaluation Schedule. We found that bipolar subjects with later age of onset reported less family history of psychiatric problems, more comorbid vascular disease, and more instrumental and subjective social support. Stressful life events were more frequent among bipolar subjects with earlier age of depressive symptom onset. This study suggests that early-onset disorder may be characterized by a psychosocial component, whereas organic factors may be particularly important to late-onset bipolar disorder.

Age of first onset of bipolar disorder: Demographic, family history, and psychosocial correlates

The literature suggests that bipolar elders with early and late onset of the disorder present with different demographic, family history, and psychosocial profiles, which are less well characterized than those for elderly unipolar patients. In this cross-sectional clinical survey, we assessed subjects (n = 74) from the NIMH Clinical Research Center for the Study of Depression in Later Life at Duke University who had a consensus diagnosis of bipolar depression; the primary assessment instrument was the Duke Depression Evaluation Schedule. We found that bipolar subjects with later age of onset reported less family history of psychiatric problems, more comorbid vascular disease, and more instrumental and subjective social support. Stressful life events were more frequent among bipolar subjects with earlier age of depressive symptom onset. This study suggests that early-onset disorder may be characterized by a psychosocial component, whereas organic factors may be particularly important to late-onset bipolar disorder. Depression and Anxiety 7:76–82, 1998. © 1998 Wiley-Liss, Inc.

Social support and depression as risk factors for loss of physical function in late life

Poor physical function status in elders is a robust predictor of not only medical service use and institutionalization but also mortality. We assessed whether depressive symptoms and low social support would predict deficits in three domains of physical function among 3,240 community-dwelling older adults in the Piedmont of North Carolina over one year. Between 7-23% of the sample declined in functional ability, depending on the domain tested. Depressive symptoms and receipt of instrumental support predicted declines in all domains of physical function. Giving instrumental support and subjective social support protected elders against declines, and subjective social support buffered the detrimental effect of depression on risk of physical decline. This study suggests that significant risk of functional impairment could be reduced among elderly persons if coincidental depressive symptoms could be alleviated and/or deficits in their social environment remedied.

Crime patterns and their relation to subjective social stress and support indicators: The role of gender

This study investigated the relationship between the subjective perception of stress and support in the population (as independent variables) and the prevalence of homicide, robbery, and property offenses in society, while controlling for the effect of gender, i.e., how these crimes are related to the differential perception of stress and support among males and females. The theoretical framework is provided by a stress-support model which postulates that crime in society will be positively related to stress factors and negatively related to support systems. Eight stress indicators and four support (solidarity) indicators were included. The data regarding these indicators were derived from continuing surveys of representative samples of the urban population in Israel during the years 1967–1979. The theoretical model was supported by the findings, especially those relating to property offenses. The effects of the female indicators were strongest (and greater than those of males) with regard to property offenses. The regression coefficients of the female indicators were also consistently larger than those of males, indicating that women's perceptions of stress are better predictors of crime rates than those of males. The results are compared to those of previous studies and suggestions are made for future studies in this new line of criminological research.

Predictors of psychological health in caregivers of patients with closed head injury

The purpose of the current study was to investigate the contribution of coping strategies subjective burden and social support to psychological health in caregivers The sample included 69 primary caregivers of patients with severe closed head injuries There were three groups of caregivers acute 0-6 months post injury intermediate 6 months-1.5 years and long term > 1. 5 years All had participated in rehabilitation Caregivers completed an interview and series of questionnaires including the Ways of Coping Questionnaire Social Support Questionnaire Subjective Burden Measure and General Health Questionnaire The Disability Rating Scale was completed by staff to assess patients level of functioning at the time of caregivers assessment ANOVA revealed no between group differ ences in coping style or social support Multiple regression revealed that greater use of emotion focused coping was associated with greater emotional distress Coping style contributed to a greater proportion of the variance in caregivers psychological health than did patients level of functioning Increased satisfaction with social support was associated with less emotional distress The full model including group caregiver gender emotion focused coping social support patient level of recovery burden and the burden coping interaction accounted for over half of the variance in psychological health Results support a multidimensional model for explaining caregivers adjustment

Reliability and Discriminant Validity of Subjective Norm, Social Support, and Cohesion in an Exercise Setting

Reliability and Discriminant Validity of Subjective Norm, Social Support, and Cohesion in an Exercise Setting

Work characteristics and psychiatric disorder in civil servants in London.

To describe the association between self reported and externally assessed work characteristics and psychiatric disorder. Analysis of questionnaire data collected from the first phase of the Whitehall II study, a cohort study of an employed population. Twenty civil service departments in London. Altogether 6900 male and 3414 female civil servants aged 35-55 years. High levels of subjective social support at work, control at work, job variety, and skill use were associated with greater satisfaction and wellbeing and less psychiatric disorder measured by the 30 item general health questionnaire (GHQ). High levels of subjective work pace and conflicting demands were associated with less satisfaction and wellbeing and greater psychiatric disorder. The combined effects of work characteristics were similar to the effects of the work characteristics considered separately, except that for men there was a small interaction between psychological demands and control on the GHQ. There was little overall support for the two factor job strain model. In contrast, objective indices of work were generally not associated with the psychological indices. Findings in men and women were generally comparable and were not significantly influenced by employment grade. Negative affectivity and a tendency to report negatively about both work and the psychological indices may partly explain the difference in the findings between subjective and objective work characteristics. However, subjective work characteristics were still associated with psychiatric disorder after adjusting for negative affectivity. The potential confounding effects of employment grade did not explain the association between either subjective or objective work characteristics and the psychological indices. While modifications to the work environment may directly reduce certain adverse physical health effects, the influence of work place design and management on psychological wellbeing, satisfaction, and psychiatric disorder may be mediated through subjective perceptions of the work environment.

The effects of social support on Hopkins Symptom Checklist-assessed depression and distress in a cohort of human immunodeficiency virus-positive and -negative gay men. A longitudinal study at six time points.

Questionnaire data were collected from a panel of 342 gay men at risk for acquired immune deficiency syndrome enrolled in the Coping and Change Study between 1985 and 1987, and 1988 and 1990. Data were obtained across a period of 5 years in six serial wave pairs to determine the relationship of social support to Hopkins Symptom Checklist-assessed subsequent depression and general distress and to investigate whether the trends observed were stable or transient over time. Both objective and subjective components of social support demonstrated dramatic within-person stability over time (r = .47 to .86). A measure of subjective social support was modestly but significantly associated with lower depression at four of the six time periods and a lower level of general distress at one time period. Before appropriately controlling for current depression, subjective social support appeared to account for up to a third of the variance in future depression; after such controls were included in the regression equation, it became apparent that the independent contribution of support only ranged from 4% to 6% across the study period. This emphasizes the importance of including current mental health in longitudinal analyses. The respondents' social participation and involvement with others did not affect either depression or general distress at any time during the study period. These results indicate that while social participation may have no effect, subjective social support appears to influence often mental health in this cohort. Furthermore, human immunodeficiency virus seropositive men may at times benefit from such support.

Does age make a difference in the effects of physical health and social support on the outcome of a major depressive episode?

The authors examined the effects of physical health and social support on 6-month outcome of a major depressive episode in 67 patients who were less than 60 years old and 46 patients who were 60 years old or older. They hypothesized that despite their higher rate of troublesome health problems, older patients would have fewer depressive symptoms at follow-up than would younger patients. The Center for Epidemiologic Studies Depression Scale (CES-D Scale) and a modified version of the National Institute of Mental Health Diagnostic Interview Schedule were used to gather data from inpatients and outpatients treated at Duke University Medical Center during a face-to-face interview at baseline and over the telephone at 6-month follow-up. At baseline, all patients met DSM-III-R criteria for a major depressive episode. Data analyses included bivariate and multivariate procedures. At baseline, the mean CES-D Scale scores of the two age groups were similar. As expected, the mean illness index score of the older patients was significantly higher and their mean impaired subjective social support score was slightly lower than those of the younger patients. At 6-month follow-up, the mean CES-D Scale score of the younger patients was above the depressive threshold, but the mean CES-D Scale score of the older patients was below the depressive threshold. The illness index and impaired subjective support measures were significant predictors of depressive symptoms at 6 months for the younger patients but not for the older patients. The authors conclude that older depressed patients have a more favorable prognosis than younger depressed patients. Predictors of outcome vary by age.

Age and Impaired Subjective Support

We followed a cohort of subjects (predominantly inpatients) suffering a major depressive episode in midlife and late-life for 1 year (N = 118). In this follow-up study, we examined three hypotheses. a) Elder subjects suffering major depression, compared with middle-aged subjects, will more likely report endogenous symptoms and less likely report decreased life satisfaction symptoms at 1-year follow-up. b) Impaired social support during the index episode will predict poor life satisfaction, but not endogenous symptoms at 1-year follow-up, regardless of age. c) Impaired social support during the index episode will be more predictive of decreased life satisfaction symptoms in midlife, compared with late life, at 12-month follow-up. The first two hypotheses were not supported, but the third hypothesis was. Both decreased life satisfaction and endogenous symptoms at outcome were significantly predicted by impaired social support during the index episode. Impaired social support predicted a poor outcome from an episode of major depression in both middle life and late life in controlled analyses. However, the effect of impaired subjective social support was conditional on age. Subjective social support appears to have a decreasing influence on the report of both endogenous and decreased life satisfaction symptoms for older individuals.