Social support during pregnancy: effects on maternal depressive symptoms, smoking and pregnancy outcome

BACKGROUND: The goal was to study the effects of social support during pregnancy on maternal depressive symptoms, quality of life and pregnancy outcomes. METHODS: Eight hundred ninety-six women were prospectively studied in the first trimester of pregnancy and following completion of the pregnancy. The sample was divided into quartiles yielding groups of low, medium and high social support based on perceived social support. RESULTS: Pregnant women with low support reported increased depressive symptoms and reduced quality of life. The effects of social support on pregnancy outcomes were particularly pronounced in women who had smoked during pregnancy, with significant main effects of social support in a two-way analysis of variance (smoking status and social support) for child body length (F = 4.26, P = 0.04; 50.43 +/- 2.81 cm with low support versus 51.76 +/- 2.31 cm with high support) and birthweight (F = 11.35, P = 0.001; 3175 +/- 453 g with low support versus 3571 +/- 409 g with high support). In smokers, pregnancy complications occurred more frequently when given low support {34 versus 10.3% with high support, chi(2) = 5.49, P = 0.019; relative risk (RR) = 3.3 [95% confidence interval (95% CI) = 1.1-10.2]}, and the proportion of preterm deliveries was greater given low support (10.0 versus 0% with high support, chi(2) = 3.84, P = 0.05, odds ratio = 8.1). CONCLUSIONS: Lack of social support constitutes an important risk factor for maternal well-being during pregnancy and has adverse effects on pregnancy outcomes.     

Substance use risk profiles and associations with early substance use in adolescence

We examined whether anxiety sensitivity, hopelessness, sensation seeking, and impulsivity (i.e., revised version of the Substance Use Risk Profile Scale) would be related to the lifetime prevalence and age of onset of alcohol, tobacco, and cannabis use, and to polydrug use in early adolescence. Baseline data of a broader effectiveness study were used from 3,783 early adolescents aged 11–15 years. Structural equation models showed that hopelessness and sensation seeking were indicative of ever-used alcohol, tobacco or cannabis and for the use of more than one substance. Furthermore, individuals with higher levels of hopelessness had a higher chance of starting to use alcohol or cannabis at an earlier age, but highly anxiety sensitive individuals were less likely to start using alcohol use at a younger age. Conclusively, early adolescents who report higher levels of hopelessness and sensation seeking seem to be at higher risk for an early onset of substance use and poly substance use.     

Peer and family support in children and adolescents with type 1 diabetes

OBJECTIVE: To examine social support and peer and family involvement in relation to diabetes management within a developmental context. METHODS: Sixty-eight youths ages 8 to 17 diagnosed with type 1 diabetes participated. This study represents the phase 1 data from a multisystemic, home-based intervention. Data included parent and youth report of disease management and conflict, youth-reported perceptions of support, peer participation in the intervention, and HbA1c. RESULTS: Adolescents perceived greater diabetes-related peer support than did school-age children. Perceived peer and family support were not correlated with metabolic control. Peer participation in the intervention was correlated with metabolic control. CONCLUSIONS: There is a developmental shift in perceptions of peer support. Increased perceptions of peer and family support overall may not result in improved metabolic control. Social support interventions should focus on the types of support that are most highly associated with positive health outcomes.     

Cigarette smoking,alcohol, and oral contraceptive use by Type A adolescent—The Bogalusa heart study

Type A behavior pattern (TABP) is an independent risk factor for cardiovascular (CV) disease and is characterized by hostile, aggressive, competitive behavior. TABP characteristics and CV risk factors have been found in children and adolescents. TABP has been correlated with adult alcohol consumption, but studies associating Type A and smoking are mixed. The purpose of this study is to investigate the smoking, alcohol use, and oral contraceptive use of Type A children and adolescents. The Hunter-Wolf Type A scale and a health habits questionnaire were evaluated for 2092 children, ages 8–17 years, within the context of a comprehensive biracial epidemiological CV screening in Bogalusa, Louisiana. Global Type A and factor components were evaluated: hostility, eagergy, desire for control, drive, and competitiveness. Correlation coefficients reflected the strongest associations between hostility and smoking and between hostility and drinking for white males. The age at menarche appeared to be correlated with the drive component.This research was supported by funds from the National Heart, Lung, and Blood Institute of the United States Public Health Service (USPHS), National Research and Demonstration Center-Arteriosclerosis (NRDC-A), HL15103.     

Testosterone and cigarette smoking in early adolescence

Social and psychological variables are used to explain why young people become cigarette smokers, whereas biological factors have been virtually ignored as possible determinants of that behavior. In this study, salivary testosterone was positively associated with cigarette smoking among 201 subjects 12–14 years of age. This finding suggests that testosterone should be included in future considerations of adolescent cigarette smoking.This research was supported by Grant CA38392 from the National Cancer Institute of the National Institutes of Health.     

The consistency of peer and parent influences on tobacco,alcohol, and marijuana use among young adolescents

The purpose of this study was to determine the degree to which the use of tobacco, alcohol, and marijuana by young adolescents can be described using a common theoretical model. Structural models were created in which psychosocial variables hierarchically predicted the use of each substance. The fit of a model in which paths from predictor variables were constrained to be equal was not inferior in any meaningful way to that of a model in which all path coefficients were freely estimated, thus suggesting that use of tobacco, alcohol, and marijuana by young adolescents may be considered to be a unitary phenomenon. A simplified model, in which these substances were combined into a single latent variable, showed a good fit. The results of these analyses suggest that it may be beneficial to consider adolescent substance use to be a unitary phenomenon.This research was supported by National Institute on Drug Abuse Grant 1-R18-DA-003406.     

Development and validation of the online social support for smokers scale

Background

Social networks play an important role in smoking. Provision of social support during cessation is a cornerstone of treatment. Online social networks for cessation are ubiquitous and represent a promising modality for smokers to receive and provide the support necessary for cessation. There are no existing measures specific to online social support for smoking cessation.

Objective

The objective was to develop a measure of social support to be used in online smoking cessation treatment research.

Methods

Initial items for the Online Social Support for Smokers Scale (OS4) were based on existing theory and scales delineated in various taxonomies. Preliminary field analysis (N = 73) was conducted on 23 initial items to optimize the scale. Further development was conducted on a refined 15-item scale in the context of a large randomized trial of Internet and telephone cessation treatment with follow-ups at 3, 6, 12, and 18 months. In all, 1326 participants were randomized to an enhanced Internet arm that included a large online social network; psychometric analyses employed 3-month follow-up data from those reporting use of the enhanced Internet intervention at least once (n = 873). Items were subjected to a factor analysis, and the internal consistency reliability of the scale was examined along with construct and criterion validity. Other measures used in the study included demographics, nicotine dependence, partner support for cessation, general social support, social integration, stress, depression, health status, online community use, Internet use behaviors, intervention satisfaction, and 30-day point prevalence abstinence.

Results

The final 12-item OS4 scale demonstrated high internal consistency reliability (Cronbach alphas .86-.89) across demographic and smoking strata of interest. The OS4 also demonstrated good construct and criterion validity, with the directionality of the observed associations providing support for most a priori hypotheses. Significant Pearson correlations were observed between the OS4 and the Partner Interaction Questionnaire (PIQ) Positive subscale (ρ = .24, P < .001). As hypothesized, participants with the highest OS4 scores were more likely to have actively participated in the enhanced Internet community and to have high levels of satisfaction with the enhanced Internet intervention. In logistic regression analyses, the OS4 was highly predictive of 30-day point-prevalence abstinence at 6, 12, and 18 months (all P values <.001). The odds of abstinence at 6 months rose by 48% for each standard unit increase in online social support (95% confidence interval [CI] 1.17 - 1.71), dropping only slightly to 37% at 12 and 18 months (95% CI 1.17 - 1.59).

Conclusions

The OS4 is a brief, reliable, and valid instrument for measuring online social support for smoking cessation. Results should be replicated and extended, but this study suggests the OS4 can be used to advance theory, understand mechanisms, and potentially help to improve the tailoring of Internet-based smoking cessation treatments. It can also inspire development of similar measures for other online health-related intervention research.

Trial registration

Clinicaltrials.gov #{"type":"clinical-trial","attrs":{"text":"NCT00282009","term_id":"NCT00282009"}}NCT00282009; http://clinicaltrials.gov/ct2/show/{"type":"clinical-trial","attrs":{"text":"NCT00282009","term_id":"NCT00282009"}}NCT00282009 (Archived by WebCite at http://www.webcitation.org/60XNj3xM6)     

Dimensions of assertiveness: differential relationships to substance use in early adolescence

We tested a multidimensional formulation of assertiveness and substance (tobacco, alcohol, and marijuana) use in 3 metropolitan-area school samples of adolescents aged 12-14 years. Three studies (N = 675, N = 1,430, and N = 5,545) included inner-city and surburban settings and included White, Black, and Hispanic students. Factor analysis of versions of the Gambrill-Richey Assertion Inventory indicated five independent dimensions of assertive behavior. Multiple regression analysis indicated that a dimension of Substance-specific Assertiveness was inversely associated with substance use, whereas dimensions of Social Assertiveness and Dating Assertiveness were positively associated with substance use. A dimension of General Assertiveness was unrelated to substance use. Interaction effects indicated that relations were stronger for girls for Substance and Social Assertiveness and for boys for Dating Assertiveness. Implications of the findings for models of assertive behavior and for design of primary prevention programs are discussed.     

Gender and alcohol use: the roles of social support, chronic illness, and psychological well-being

Men and women differ in their use of alcohol, in their rates of chronic illnesses and psychological symptoms, and in the social support they receive. In this paper, we assess how the latter three factors are associated with alcohol use, and how these associations differ by gender. Respondents were 3,074 male and 3,947 female randomly selected Health Maintenance Organization members who responded to a mail survey in 1990. Hierarchical multiple regression analyses indicate that social support is associated with alcohol consumption in similar ways for both genders, yet the associations between some demographic, physical health/functioning, and psychological well-being measures are different for men and women. Men with fewer role limits due to physical health drank more, while women with better psychological well-being drank less. Poor psychological well-being may be a modifiable risk factor for increased alcohol use among women; practitioners should be alert for greater consumption among men with few functional limitations and good health.     

Stressful life events among adolescents in Wuhan, China: Associations with smoking, alcohol use, and depressive symptoms

The associations among stress and adolescent smoking, alcohol use, and depression have been well documented in the United States, but few studies have evaluated the evidence for these associations in Asian cultures. This study developed a scale of stressful life events among 7th-grade adolescents in Wuhan, China. The events reported as most frequent involved bad grades or punishment at school, and the events reported as most severe involved disruptions in family life, such as death, divorce, or disability of parents. Associations were observed between life events (especially negative school-related events) and smoking, alcohol use, and depressive symptoms. Results indicate that school-related stress may lead to substance use and mental health problems among Chinese adolescents.     

Social support and functioning among community and clinical groups: A panel model

This study examined the relationship between social support and personal functioning in a longitudinal assessment of a representative sample of community men and women. Although there was considerable temporal stability in several indices of support and personal functioning, changes in levels of support during the follow-up period were associated with changes in functioning. These relationships varied according to the individual's gender and the source of support. Family support was more strongly related to functioning among women, while work support was more strongly related to functioning among men. In comparable analyses on patients recovering from alcoholism, levels of support and functioning were more variable over time, and changes in family support were somewhat more strongly related to changes in functioning. The findings are discussed in light of a perspective that considers the role of environmental stressors and resources in adaptation.     

Assessing friend support of adolescents' diabetes care: the diabetes social support questionnaire-friends version

OBJECTIVE: To develop and evaluate the Diabetes Social Support Questionnaire for Friends (DSSQ-Friends), a measure of friends' supportive behaviors for adolescents with diabetes. Gender and age differences in friends' support for diabetes were examined, as well as the relationship between friend support and adolescents' treatment adherence. METHODS: Seventy-four adolescents (11-18 years) completed the DSSQ-Friends in addition to other measures of social support and a measure of treatment adherence. The behaviors on the DSSQ-Friends were scored for supportiveness and frequency. A combined rating (frequency x support) was also calculated to adjust the frequency of friends' support for adolescents' perceptions of supportiveness. RESULTS: The DSSQ-Friends had acceptable internal consistency and good test-retest reliability; it correlated well with other measures of friend support. Age-related differences were minimal; however, compared to boys, girls reported more friend support for blood glucose testing and emotions. Friend support was not related to overall treatment adherence but was related to adherence for blood glucose testing. CONCLUSIONS: We discuss the utility of the DSSQ-Friends as a clinical and research tool for measuring diabetes-specific friend support and offer suggestions for future research on friends' support for adolescents' diabetes care.     

Social support and stress: Influences on lipid reactivity

Social support protects individuals from cardiovascular morbidity and mortality, possibly by attenuating physiological stress responses. The presence of supportive individuals during acute psychological stress has been shown to influence cardiovascular functioning, but in inconsistent directions. The purpose of this study was to test the notion that the presence of a supportive friend during an acute stressor would influence lipid reactivity. Forty healthy women participated in the study. One half engaged in a speech task while a friend was present; the other half participated in a speech task without a friend present. The speech stressor elicited elevations in total cholesterol and triglycerides under both conditions. Those with a friend present had greater total cholesterol reactivity to stress, relative to those without a friend present. These findings are similar to some studies in the cardiovascular literature, and may be due to increased threat appraisal among those with a friend present. This study was supported in part by National Institutes of Health grants HL-48363 and HL-48411, and by MO1-RR0034 to The Ohio State University General Research Clinical Research Center. We gratefully acknowledge the expert assistance of Karen Cook. The assays were performed in the laboratory of Dr. Linda Bausserman of the Division of Cardiology in the School of Medicine at Brown University.     

Giving and receiving social support in online substance use disorder forums: How self-efficacy moderates effects on relapse

ObjectiveIndividuals in recovery for substance use disorders (SUDs) increasingly use online social support forums, necessitating research on how communicating through these forums can affect recovery. This study examines how giving and receiving support within an SUDs recovery forum predict substance use, and considers whether effects vary according to participants’ self-efficacy.MethodsWe applied content analysis to 3440 messages that were posted by 231 participants in an online SUDs forum. Surveys assessed social support reception and substance use at three timepoints. We assessed relationships between giving and receiving support and substance use (risky drinking days, illicit drug use days), and the interactions between self-efficacy and social support in predicting substance use outcomes.ResultsReceiving more emotional support was associated with reduced illicit drug use at 6 and 12 months. For those with low self-efficacy, giving more emotional support predicted less risky drinking at month 12, whereas giving more informational support predicted more risky drinking at month 12.ConclusionThese results suggest conditional benefits of exchanging support in an online SUDs forum, depending upon type of support (informational versus emotional), the participants’ role (giver or receiver), and their self-efficacy.Practice implicationsWe discuss implications for designing and using peer-to-peer support platforms.     

The difficult temperament in adolescence: associations with substance use, family support, and problem behaviors

This study investigated interrelations between the number of difficult temperament factors (e.g., arrhythmicity, inflexibility, high distractibility) and substance use, perceived family support, and problem behaviors for a sample of 297 adolescents (M age = 15.7 years). The number of adolescent difficult temperament factors was associated significantly with more childhood behavior problems (e.g., hyperactivity, conduct disordered symptoms), which suggests some continuity of disordered behavior from childhood to adolescence. Number of adolescent difficult temperament factors also was associated with a higher percentage of substance users (for cigarettes, alcohol, marijuana, hard drugs), lower perceived family support, higher levels of depressive symptoms, and more delinquent activity. Number of difficult temperament factors was not associated significantly with gender or age of respondents.     

The diabetes social support questionnaire-family version: evaluating adolescents' diabetes-specific support from family members

OBJECTIVE: To develop and evaluate the Diabetes Social Support Questionnaire-Family Version (DSSQ-Family) for adolescents with type 1 diabetes. METHODS: Normative and individualized approaches to scoring were examined. Also examined were associations between diabetes-specific family support and adolescents' age, disease duration, gender, emotional support from family and friends, and treatment adherence. The most supportive family behaviors were identified as well. Adolescents (n = 74) rated 58 DSSQ-Family behaviors on their supportiveness and frequency and completed measures of emotional support from family and friends and treatment adherence. After eliminating nonsupportive items, the Total DSSQ-Family and five areas of diabetes care (insulin, blood testing, meals, exercise, emotions) were scored for frequency (normative approach) and frequency x support (individualized approach). The upper quartile of the DSSQ-Family items was identified as most supportive. RESULTS: Scores from the DSSQ-Family had high internal consistency. Higher frequency and individualized ratings were related to younger adolescent age and to more family emotional support and cohesion, but not to friend support or family conflict (in general). The individualized ratings were significant predictors of adolescents' adherence, even when controlling for age and general levels of family support. The most supportive family behaviors reflected emotional support for diabetes. CONCLUSIONS: The DSSQ-Family is a useful clinical and research tool for measuring adolescents' perceptions of diabetes-specific family support. Future interventions should stress family support for management tasks, taking into account the adolescent's perceptions of supportive behaviors. Additional research is needed with culturally diverse adolescents and with other chronic pediatric conditions.     

The relationship among social support,self‐esteem,affect balance and loneliness in individuals with substance use disorders in China

This study analyzed the potential mediating role of self‐esteem and affect balance on the relationship between social support and loneliness. Respondents were 426 substabce use disorders from the Shifosi and Dalianshan rehab facilities in China who had completed the Multidimensional Scale of Perceived Social Support, Rosenberg Self‐Esteem Scale, Positive and Negative Affect Scales, and UCLA Loneliness Scale. The results indicated that self‐esteem and affect balance fully mediated the relationship between perceived social support and loneliness and all the paths, ranging from social support through self‐esteem and affect balance to loneliness, were significant. Finally, we analyzed possible approaches to decreasing individuals with substance use disorders' loneliness.     

Social Network Behavior and Engagement Within a Smoking Cessation Facebook Page

BackgroundSocial media platforms are increasingly being used to support individuals in behavior change attempts, including smoking cessation. Examining the interactions of participants in health-related social media groups can help inform our understanding of how these groups can best be leveraged to facilitate behavior change.ObjectiveThe aim of this study was to analyze patterns of participation, self-reported smoking cessation length, and interactions within the National Cancer Institutes’ Facebook community for smoking cessation support.MethodsOur sample consisted of approximately 4243 individuals who interacted (eg, posted, commented) on the public Smokefree Women Facebook page during the time of data collection. In Phase 1, social network visualizations and centrality measures were used to evaluate network structure and engagement. In Phase 2, an inductive, thematic qualitative content analysis was conducted with a subsample of 500 individuals, and correlational analysis was used to determine how participant engagement was associated with self-reported session length.ResultsBetween February 2013 and March 2014, there were 875 posts and 4088 comments from approximately 4243 participants. Social network visualizations revealed the moderator’s role in keeping the community together and distributing the most active participants. Correlation analyses suggest that engagement in the network was significantly inversely associated with cessation status (Spearman correlation coefficient = −0.14, P=.03, N=243). The content analysis of 1698 posts from 500 randomly selected participants identified the most frequent interactions in the community as providing support (43%, n=721) and announcing number of days smoke free (41%, n=689).ConclusionsThese findings highlight the importance of the moderator for network engagement and provide helpful insights into the patterns and types of interactions participants are engaging in. This study adds knowledge of how the social network of a smoking cessation community behaves within the confines of a Facebook group.     

Interleukin-6 and use of social support in gynecologic cancer patients

Interleukin-6 (IL-6) is related to disease progression in ovarian and cervical cancers and is associated with abnormal endometrial cell growth. IL-6 is also involved in the stress response and depression. We examined relationships among distress, use of social support, IL-6, clinical status, and disability in gynecologic cancer patients. A sample of 21 gynecologic cancer patients with early stage or regionally advanced disease who had not yet received initial treatment and 33 healthy controls completed psychosocial assessments and had early morning blood draws. This was done presurgery for patients. Clinical and functional status of patients was assessed at 1 year. IL-6 was significantly higher among patients than among controls. Among patients, seeking instrumental support at diagnosis was associated with lower concurrent IL-6, better clinical status, and less disability at 1 year. Distress was not correlated with these outcome measures, and IL-6 did not mediate the effects of social support on these outcomes. These findings suggest that the ways patients cope with stress of cancer may be associated with a cytokine that is involved in tumor progression in gynecologic cancers and with clinical variables at 1 year. This work was partially supported by American Cancer Society Institutional Seed Grant IN-122Q to the University of Iowa and Grant RR00059 from the GCRCNCRR NIH to the CRC at the University of Iowa. We are grateful to Charles Davis and Jane Leserman for statistical consultation; Sharon Krogman, Karin Larsen, and Betsy Brandl for assistance with data collection; and Sue-Young Hong for laboratory assistance.     

服刑人员留守未成年子女的心理健康状况与社会支持

目的:探讨服刑人员留守未成年子女心理健康与社会支持的基本状况及两者关系。方法:采用方便取样,从某监狱选取服刑人员(已服刑3年以上)留守未成年子女20名为研究组;另外,从本地区一所农村小学、初中和一所城镇小学、初中抽取学生406人,采用最大限度配对法(考虑到城镇和农村、年龄、性别等),选取父亲或父母均在外地工作的学生(留守时间3年以上)20人为对照组。采用心理健康诊断测验(Mental Health Diagnosis,MHT)和社会支持评定量表(Social support scale,SSRS)对两组学生进行测查。结果:研究组在MHT对人焦虑和身体症状维度上的平均秩次均高于对照组[10.23vs.4.70,11.50vs.5.50,均P<0.05],在SSRS各维度得分上两组间差异均无统计学意义(均P>0.05);支持利用度对服刑人员留守未成年子女心理健康状况具有负向预测作用(β=-0.51,P=0.021)。结论:服刑人员留守未成年子女对人焦虑和躯体症状方面的心理问题突出,提高服刑人员留守未成年子女对社会支持利用度有利于改善其心理健康状况。