The influence of social support on loneliness and depression among older elderly people in China: Coping styles as mediators

This study examines the direct effect of social support and the mediating effects of coping styles on loneliness and depression of older elderly people in China using data from the 2014 China Longitudinal Aging Social Survey. Our sample includes 905 males and 741 females aged 75 years and over. The mean age of the sample is 79.71 (standard deviation = 4.01). We use structural equation modeling to show that social support is significantly negatively associated with the incidence of loneliness and depression among older elderly people. Higher levels of social support are also significantly negatively associated with the use of negative coping styles and consequently predict fewer symptoms of loneliness and depression. A higher level of social support is significantly positively associated with positive coping styles and consequently predicts fewer depressive symptoms. However, positive coping styles are not significantly associated with loneliness. These findings emphasize the importance of social networks in resilience and have significant implications for gerontological social work practice in China.     

The influence of social support on cardiovascular responses during stressor anticipation and active coping

This study investigated effects of different types of social support on cardiovascular reactivity during anticipation of, performance of and recovery from an evaluative speaking task. Thirty male and 30 female students were assigned to one of three social conditions: alone, mental activation of supportive ties, actual support transactions. Cardiovascular effects of social support were found to differ over task conditions and they were not unidirectional. During passive stressor anticipation, support conditions attenuated SBP reactivity, in particular mental activation of supportive ties. During active speech performance gender-specific support effects were observed. The alone condition elicited higher SBP reactivity in men compared to women, support conditions enhanced SBP reactivity in women and attenuated SBP reactivity in men resulting in comparable cardiovascular activation across gender groups. Drawing from research on active coping and energization gender-specific cardiovascular activation was attributed to differences in effort expenditure.     

Definite involuntary childlessness: associations between coping, social support and psychological distress

BACKGROUND: Around 4% of all couples remain involuntarily childless. These people often experience insufficient social support, which further aggravates the distress symptoms such as physical health problems, anxiety, depression and complicated grief. This study investigates the association of coping style and the degree of satisfaction regarding social support from primary support groups with distress symptoms of involuntarily childless individuals. MATERIALS AND METHODS: Subjects in this cross-sectional study were people who wanted to have children with their partner but were unable to conceive and had acknowledged their involuntary childlessness. The sample consisted of 116 persons (response 88%) with an average age of 39 years (SD = 6.0), with 75% women. The sample group completed a questionnaire consisting of passive and active coping styles from the Utrecht Coping List (UCL), the discrepancy variant of the Social Support List (SSL-D), the short version of the Questionnaire on Experienced Health Complaints (VOEG-21), the Hospital Anxiety and Depression Scale (HADS) and the Inventory of Complicated Grief-Revised (ICG-R), adapted for this study. RESULTS: Women especially experienced more health complaints, more anxiety and depression symptoms and more complicated grief than the general population. Regression analysis shows that when controlled for sex and the duration of involuntary childlessness, the concepts passive coping style and dissatisfaction with social support were positively associated with health complaints, depression, anxiety and complicated grief. The concept active coping style was negatively associated with depression, anxiety and complicated grief. Explained variance of the different distress symptoms varied from 30 to 65%. A moderating association of perceived social support is only found between a passive coping style and health complaints. CONCLUSIONS: Psychosocial interventions should be continued after the childlessness has become definite. By teaching couples how to cope actively with their childlessness and how to ask for support, the negative consequences of their childlessness may be decreased.     

The impact of negative mood state on sleep‐related attentional bias in insomnia

Sleep‐related attentional bias is thought to play a role in the maintenance of insomnia. However, this concept has been questioned by several studies that did not show the presence of sleep‐related attentional bias in clinical insomnia or poor sleepers. Our goal in the present study was to test whether the mood state of individuals with insomnia affects the presence of sleep‐related attentional bias. To this end, 31 individuals with insomnia and 34 good sleepers were randomly assigned to a negative mood‐inducing condition or a control condition. They then completed a visual probe task with three types of pictorial stimuli (general threat, sleep‐related negative pictures and sleep‐related positive pictures). Vigilance, maintenance and the overall bias indexes were calculated based on the reaction time. We found individuals with insomnia only showed a greater overall bias compared with good sleepers following a negative mood induction, regardless of the pictures presented. In addition, we found that a negative mood state was significantly correlated with the overall attentional bias in good sleepers but not in individuals with insomnia. These findings suggest that sleep‐related attentional bias in insomnia can be modulated by mood state. This effect may reflect the dysregulation of top‐down attentional control in individuals with insomnia.     

The natural history of insomnia: predisposing,precipitating, coping,and perpetuating factors over the early developmental course of insomnia

While there is an extensive literature on predisposing, precipitating, coping, and perpetuating factors in those with chronic insomnia, very little work has been undertaken to evaluate these factors over the early developmental course of insomnia. The present aim was to determine whether several hypothesized factors in each domain (predisposing, precipitating, coping, and perpetuating), assessed during an episode of acute insomnia (AI), are related to its persistence or remission to normal sleep. Participants comprised n = 140 people with AI and n = 737 normal sleepers (NS) recruited from the general public. Participants completed measures assessing predisposing characteristics (personality traits, arousal predisposition, and insomnia vulnerability), precipitating events and outcomes (life events, perceived stress, anxiety, and depression), coping styles (thought control strategies and coping styles), and perpetuating factors (sleep preoccupation, pre-sleep arousal, dysfunctional beliefs, and fatigue). Additionally, insomnia status (from AI at baseline to its persistence or natural remission [NR]) was assessed 1 month later (n = 129). Baseline differences between NS and individuals with AI were observed in each domain with increasing age, lower openness to experience and conscientiousness, higher insomnia severity, levels of anxiety, and affective sleep preoccupation significantly predicting AI status. Further, a previous episode of insomnia, higher depression scores, and affective sleep preoccupation scores significantly predicted its persistence, as opposed to its NR. Results are discussed with reference to the conceptualization of insomnia and how the findings may influence the design of preventative interventions to circumvent the transition from acute to chronic insomnia.     

Divergent effects of active coping on psychological distress in the context of the job demands-control-support model: the roles of job control and social support

This study examined the effects of active coping on psychological distress in the context of the job demands-control-support model. Participants were 726 male nonmanagers in a large electrical company in Japan. Hierarchical multiple regression analyses were conducted to examine whether active coping and coping resources (job control, supervisor support, and coworker support) have interaction effects on psychological distress. Active coping had an interaction effect with coworker support, whereas it did not with job control and supervisor support. Results suggest that coworker support can facilitate the effectiveness of active coping, whereas job control or supervisor support cannot.     

The exploratory power of sleep effort,dysfunctional beliefs and arousal for insomnia severity and polysomnography‐determined sleep

Differences between subjective sleep perception and sleep determined by polysomnography (PSG) are prevalent, particularly in patients with primary insomnia, indicating that the two measures are partially independent. To identify individualized treatment strategies, it is important to understand the potentially different mechanisms influencing subjective and PSG‐determined sleep. The aim of this study was to investigate to what extent three major components of insomnia models, i.e. sleep effort, dysfunctional beliefs and attitudes about sleep, and presleep arousal, are associated with subjective insomnia severity and PSG‐ determined sleep. A sample of 47 patients with primary insomnia according to DSM‐IV criteria and 52 good sleeper controls underwent 2 nights of PSG and completed the Glasgow Sleep Effort Scale, the Dysfunctional Beliefs and Attitudes about Sleep Scale, the Pre‐Sleep Arousal Scale and the Insomnia Severity Index. Regression analyses were conducted to investigate the impact of the three predictors on subjective insomnia severity and PSG‐ determined total sleep time. All analyses were adjusted for age, gender, depressive symptoms and group status. The results showed that subjective insomnia severity was associated positively with sleep effort. PSG‐determined total sleep time was associated negatively with somatic presleep arousal and dysfunctional beliefs and attitudes about sleep. This pattern of results provides testable hypotheses for prospective studies on the impact of distinct cognitive and somatic variables on subjective insomnia severity and PSG‐determined total sleep time.     

HIV/AIDS‐related stigma,immediate families,and proactive coping processes among a clinical sample of people living with HIV/AIDS in Philadelphia,Pennsylvania

People living with HIV/AIDS (PLWHA) engage in proactive coping behaviors to minimize the risk of interpersonal stigma. This study explores proactive coping processes in navigating HIV/AIDS‐related stigma within immediate families. Data for this study come from 19 one‐on‐one, qualitative interviews with a diverse, clinical sample of PLWHA in Philadelphia, PA. Thematic analysis indicated that participants continue to experience enacted, anticipated, and internalized forms of HIV/AIDS‐related stigma. Participants discussed status concealment and selective disclosure as proactive coping resulting from anticipated stigma and physical distancing as proactive coping motivated by internalized HIV/AIDS‐related stigma. Study findings demonstrate how living with a stigmatized condition can affect PLWHA social interactions with close networks like immediate families, specifically in eliciting stigma‐avoidant behaviors. Anti‐stigma efforts that educate immediate families to overcome stigmatizing attitudes and provide HIV‐positive family members with high‐quality social support should be coupled with efforts that target health‐promotive self‐management strategies for PLWHA.     

中学生的亚健康状况与应激性生活事件、应对方式

目的:探讨中学生亚健康状况与应激性生活事件、应对方式的关系。方法:采用方便抽样的方法抽取4480名中学生,用自编一般情况问卷、青少年亚健康多维评定问卷(MSQA)、中学生生活事件多维评定问卷(MLER)和特质应对方式问卷(TCSQ)进行测评。结果:根据MSQA的症状检出率,将样本分为健康组(n=2241)、亚健康症状组(n=1762)和亚健康状态组(n=477)。亚健康状态组学生M LER各维度评分以及TCSQ消极应对方式因子得分均高于健康组和亚健康症状组(均P0.05)。M LER各维度评分和TCSQ消极应对因子得分与MSQA阳性症状数之间呈正相关(r=0.35～0.37,均P0.01),TCSQ积极应对因子得分与M SQA阳性症状数呈负相关(r=-0.15,P0.01)。回归分析显示M LER中家庭生活、学校生活、同伴关系和健康成长4个维度以及TCSQ积极应对、消极应对2个因子与MSQA阳性症状数之间回归关系成立,存在一定关联(β=0.07～0.21,P0.01);且应对方式在应激性生活事件和亚健康状况之间存在中介作用。结论:本研究提示,中学生的生活事件应激量越大,亚健康状况可能越严重,且应对方式可能起一定的中介作用。     

The role of coping responses and social resources in attenuating the stress of life events

The nature of individual coping responses to stressful life events was explored in a representative adult community sample. Two approaches to the classification of coping strategies were operationalized. Using these measures, small but significant gender and contextual differences in coping were identified. Mood and symptom levels were related to coping responses and to quantitative and qualitative measures of social resources. Measures of coping and social resources attenuated the relationship between undesirable life events and personal functioning.This research was supported in part by NIAAA Grant AA02863 and Veterans Administration Medical Research Funds.     

Coping,social support,and attachment style as psychosocial correlates of adjustment in men and women with HIV/AIDS

The purpose of this study was to examine psychosocial correlates of adjustment to HIV/AIDS in a sample of 137 HIV-positive persons (78 men and 59 women). Multiple regression analysis was used to examine relationships between perceived quality of general social support, three attachment styles, and three coping styles with total score on Positive States of Mind Scale (PSOMS), our measure of adjustment. The influence of demographic and medical status variables was also accounted for. PSOMS total score was significantly associated with greater satisfaction with social support related to HIV/AIDS, more secure attachment style, and less use of behavioral disengagement in coping with HIV/AIDS. These results indicate that for people with HIV or AIDS, those individuals who are more satisfied with their relationships, securely engaged with others, and more directly engaged with their illness are more likely to experience positive adjustment. Implications for physical health outcome and opportunities for intervention are discussed.     

Type D personality and cardiovascular reactivity to acute stress: The mediating effects of social support and negative social relationships

Type D personality has been consistently associated with adverse cardiovascular health with atypical cardiovascular reactions to psychological stress one potential underlying mechanism. As Type D individuals have been noted to report lower social support and greater perceptions of negativity in social interactions, this study examined if the association between Type D personality and cardiovascular reactivity was mediated by these social relationships. A sample of 195 undergraduate students (138 female) participated in this observational study, where they completed measures assessing Type D personality (DS14), social support, and perceptions of negative social relationships (National Institute of Health social relationship scales), before undergoing a traditional cardiovascular reactivity protocol. Systolic and diastolic blood pressure (SBP; DBP), heart rate (HR), cardiac output (CO), and total peripheral resistance (TPR) were monitored throughout. ANCOVAs and regressions indicated that Type D personality was associated with lower cardiovascular reactivity to a mental arithmetic stressor. Furthermore, mediation analyses (process macro) indicated that the relationship between Type D personality and cardiovascular reactivity was mediated via increased perceptions of negative social relationships, as well as lower levels of social support. Apart from a significant association between Type D personality and increased HR reactivity, all results failed to withstand adjustment for the individual effects of negative affect (NA) and social inhibition (SI) in controlled analyses. Overall, these findings suggest that the predictive utility of Type D personality on cardiovascular reactivity above and beyond the individual effects of NA and SI is limited, and may vary depending on the cardiovascular parameter of focus.     

Insomnia and accidents: cross‐sectional study (EQUINOX) on sleep‐related home,work and car accidents in 5293 subjects with insomnia from 10 countries

The link between sleepiness and the risk of motor vehicle accidents is well known, but little is understood regarding the risk of home, work and car accidents of subjects with insomnia. An international cross‐sectional survey was conducted across 10 countries in a population of subjects with sleep disturbances. Primary care physicians administered a questionnaire that included assessment of sociodemographic characteristics, sleep disturbance and accidents (motor vehicle, work and home) related to sleep problems to each subject. Insomnia was defined using the International Classification of Sleep Disorders (ICSD‐10) criteria. A total of 5293 subjects were included in the study, of whom 20.9% reported having had at least one home accident within the past 12 months, 10.1% at least one work accident, 9% reported having fallen asleep while driving at least once and 4.1% reported having had at least one car accident related to their sleepiness. All types of accident were reported more commonly by subjects living in urban compared to other residential areas. Car accidents were reported more commonly by employed subjects, whereas home injuries were reported more frequently by the unemployed. Car accidents were reported more frequently by males than by females, whereas home accidents were reported more commonly by females. Patients with insomnia have high rates of home accidents, car accidents and work accidents related to sleep disturbances independently of any adverse effects of hypnotic treatments. Reduced total sleep time may be one factor explaining the high risk of accidents in individuals who complain of insomnia.     

CBT for late‐life insomnia and the accuracy of sleep and wake perceptions: Results from a randomized‐controlled trial

Subjective and objective estimates of sleep are often discordant among individuals with insomnia who typically under‐report sleep time and over‐report wake time at night. This study examined the impact and durability of cognitive‐behavioural therapy for insomnia on improving the accuracy of sleep and wake perceptions in older adults, and tested whether changes in sleep quality were related to changes in the accuracy of sleep/wake perceptions. One‐hundred and fifty‐nine older veterans (97% male, mean age 72.2 years) who met diagnostic criteria for insomnia disorder were randomized to: (1) cognitive‐behavioural therapy for insomnia (n = 106); or (2) attention control (n = 53). Assessments were conducted at baseline, post‐treatment, 6‐months and 12‐months follow‐up. Sleep measures included objective (via wrist actigraphy) and subjective (via self‐report diary) total sleep time and total wake time, along with Pittsburgh Sleep Quality Index score. Discrepancy was computed as the difference between objective and subjective estimates of wake and sleep. Minutes of discrepancy were compared between groups across time, as were the relationships between Pittsburgh Sleep Quality Index scores and subsequent changes in discrepancy. Compared with controls, participants randomized to cognitive‐behavioural therapy for insomnia became more accurate (i.e. minutes discrepancy was reduced) in their perceptions of sleep/wake at post‐treatment, 6‐months and 12‐months follow‐up (p < .05). Improved Pittsburgh Sleep Quality Index scores at each study assessment preceded and predicted reduced discrepancy at the next study assessment (p < .05). Cognitive‐behavioural therapy for insomnia reduces sleep/wake discrepancy among older adults with insomnia. The reductions may be driven by improvements in sleep quality. Improving sleep quality appears to be a viable path to improving sleep perception and may contribute to the underlying effectiveness of cognitive‐behavioural therapy for insomnia.     

Sleep patterns and insomnia in a large population‐based study of middle‐aged and older adults: The Tromsø study 2015–2016

Epidemiological studies assessing adult sleep duration have yielded inconsistent findings and there are still large variations in estimation of insomnia prevalence according to the most recent diagnostic criteria. Our objective was to describe sleep patterns in a large population of middle‐aged and older adults, by employing accurate measures of both sleep duration and insomnia. Data stem from the Tromsø Study (2015–2016), an ongoing population‐based study in northern Norway comprising citizens aged 40 years and older (n = 21,083, attendance = 64.7%). Sleep parameters were reported separately for weekdays and weekends and included bedtime, rise time, sleep latency and total sleep time. Insomnia was defined according to recent diagnostic criteria (International Classification of Sleep Disorders; ICSD‐3). The results show that 20% (95% confidence interval,19.4–20.6) fulfilled the inclusion criteria for insomnia. The prevalence was especially high among women (25%), for whom the prevalence also increased with age. For men, the prevalence was around 15% across all age groups. In all, 42% of the women reported sleeping <7 hr (mean sleep duration of 7:07 hr), whereas the corresponding proportion among males was 52% (mean sleep duration of 6:55 hr). We conclude that the proportion of middle‐aged and older adults not getting the recommended amount of sleep is worryingly high, as is also the observed prevalence of insomnia. This warrants attention as a public health problem in this population.     

Efficacy and safety of doxepin 1 mg, 3 mg, and 6 mg in adults with primary insomnia

Study Objectives: