Relations between social support, appraisal and coping and both positive and negative outcomes in young carers

This study examined a stress/coping model of adjustment in early caregiving. It was hypothesized that better adjustment would be related to higher social support and approach coping, and lower stress appraisals and avoidant coping. One hundred young carers aged 10-25 years completed questionnaires. Predictors included choice in caregiving, social support, stress appraisal and coping. Dependent variables were global distress and positive outcomes (life satisfaction, positive affect, benefits). Correlations supported all hypothesized relations between the stress/coping predictors and adjustment outcomes. Regression analyses showed social support as the strongest predictor of adjustment, whereas coping and choice in caregiving emerged as weaker predictors and stress appraisal was unrelated to adjustment. The stress/coping framework and findings have the potential to inform interventions designed to promote well-being in young carers.     

Positive and negative life change and positive and negative affect among the rural elderly

Recent research has supported a separate domain model of life change and well-being. According to this model, negative life change primarily influences psychological distress or negative affect, whereas positive life change influences positive affect. Structured interview data from 140 rural older adults were used to test this model. Seven well-being indices were used: three tapping negative affect, two tapping positive affect, and two global measures of well-being. Results did not support the separate domain model. Composite well-being measures were related to both positive and negative life change. Positive affect was largely independent of life change, positive or negative. Contrary to predictions, negative affect was rarely associated with negative life change and was more consistently inversely related to positive life change. Age- and cohort-related reasons for these findings are discussed.     

玉树地震后幸存者的创伤后应激症状、生活满意度与积极情感/消极情感

目的:了解玉树震后幸存者的创伤后应激症状和生活满意度状况及其与积极情感/消极情感的关系。方法:在地震后3.5个月,对玉树地震灾区505名幸存者采用自编一般情况调查表和创伤后应激障碍检查量表平民版(PCL-C)、霍氏症状核查表(HSCL-25)、积极情感/消极情感量表(PANAS)、生活满意度量表(SWLS)进行评估。结果:PCL-C得分显示创伤后应激症状的阳性率为32.7%;HSCL-25得分显示焦虑症状的阳性率为53.3%,抑郁症状的阳性率为47.1%。女性、藏族、低文化水平幸存者有较高的创伤后应激症状阳性率(均P0.05)。回归分析显示,PANAS的NA得分与PCL-C得分、HSCL-25的焦虑和抑郁症状量表得分正相关(β=0.59、0.62、0.59,P0.05),与SWLS得分负相关(β=-0.15,P0.05);PANAS的PA得分与HSCL-25的焦虑量表得分负相关(β=-0.18,P0.05),与抑郁量表、SWLS得分正相关(β=0.10、0.38,P0.05)。年龄与PCL-C、SWLS得分正相关(β=0.10、0.12,P0.05)。女性的PCL-C和焦虑量表得分较高(β=0.11、0.11,P0.05),藏族人群SWLS得分较高(β=0.16,P0.05)。结论:玉树灾后幸存者的消极情感可能是发生创伤后应激症状的危险因素,且对幸存者的生活满意度有消极影响。积极情感有助于减轻焦虑症状并提高生活满意度。     

慢性乙型肝炎患者健康心理控制源研究

目的 通过调查慢性乙型肝炎患者的健康心理控制源,及与应付方式、社会支持、抑郁和焦虑情绪、生活质量的关系。方法 采用多维度健康状况心理控制源量表、应对方式调查表、社会支持评定量表、生活质量评定问卷ＳＦ－３６、抑郁和焦虑自评量表进行调查,并检测肝功能及乙型肝炎血清学标记物。结果 患者内控性、机遇性及有势力他人三种心理控制源之间呈正相关;内控性和机遇性心理控制源与自责、幼想应对方式及隐瞒应对方式正相关;     

农村老年人生活质量及与负性生活事件、社会支持的相关性

目的:了解农村老年人生活质量的相关因素,以及负性生活事件和社会支持对生活质量的交互作用.方法:在湖南浏阳农村社区采用多阶段抽样方法,共调查了839名≥60岁的常住居民(应答率为89.2％).用老年人生活事件量表(LESE)评估老年人的生活事件及其刺激量,用社会支持评定量表(SSRS)评估社会支持,用6条目生活质量量表(QOL)评估生活质量.结果:样本QOL得分为(20±4),SSRS得分为(40±8),负性生活事件总刺激量得分在0 ～ 240分之间,中位数M=12(P25=2,P75=32).多元线性回归分析显示,与配偶一起生活(b=-0.55)、收入较高(b=0.52)、负性生活事件刺激量较低(b=1.63)、社会支持较高(b=-0.69)的老人有较高的生活质量.交互作用分析显示负性生活事件刺激量评分与社会支持评分存在交互作用(超额相对危险度为2.72,95％CI =0.48 ～4.97;交互作用指数为2.42,95％ CI=1.25～4.62).结论:本研究提示对农村老年人,尤其是遭遇了负性生活事件的农村老年人,提供社会支持,有助于改善其生活质量.     

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.     

Stress, social support and coping in pregnancy: taking gender and ethnicity into account

The social support literature, despite its focus on women's strengths in relationships, has not fully addressed the social realities of women of diverse ethnic backgrounds and socio economic conditions. Specifically, the emphasis on marital relationships as primary sources of support during pregnancy marginalizes those women for whom these partnerships are unhelpful or unavailable. In addition, women's greater use of social support as a coping strategy is often portrayed in the coping literature as an ineffective approach to stress. Data from two studies of pregnant women are presented to illustrate these points and to present a new model of coping that reframes women's coping as prosocial, active and effective. Our article is designed to challenge researchers to examine the relevance of work on social support and coping to women of varying ethnicities and economic circumstances.     

Stress, social support, emotional regulation, and exacerbation of diffuse plaque psoriasis

The authors' aim was to investigate the role of stressful events, perceived social support, attachment security, and alexithymia in triggering exacerbations of diffuse plaque psoriasis. Inpatients experiencing a recent exacerbation of diffuse plaque psoriasis (N=33) were compared with inpatients with skin conditions believed to have a negligible psychosomatic component (N=73). Stressful events during the last year were assessed with Paykel's Interview for Recent Life Events. Attachment style, alexithymia, and perceived social support were assessed with the Experiences in Close Relationships questionnaire, the Toronto Alexithymia Scale, and the Multidimensional Scale of Perceived Social Support, respectively. Multiple logistic regression analysis was used to control for age, gender, education, marital status, and alcohol consumption. In relation to comparison subjects, the patients with psoriasis had lower perceived social support and higher attachment-related avoidance. Also, they were more likely to have high alexithymic characteristics. There were no differences between the patients with psoriasis and the comparison subjects in scores on the Experiences in Close Relationships anxiety scale, the total number of stressful events, and the number of undesirable, uncontrollable, or major events. Although caution should be applied in generalizing these findings to outpatients, this study suggests that alexithymia, attachment-related avoidance, and poor social support might increase susceptibility to exacerbations of diffuse plaque psoriasis, possibly through impaired emotional regulation. Several physiological mechanisms involving the neuroendocrine and the immune system might mediate the interplay between stress, personality, and diffuse plaque psoriasis.     

Predicting health-related quality of life in dialysis patients: Factors related to negative outcome expectancies and social support

ObjectivesDialysis patients report a low health-related quality of life (HRQOL) due to high disease burden and far-reaching consequences of dialysis treatment. This study examined several cognitive-behavioral and social factors, with a focus on negative outcome expectancies, that might be relevant for HRQOL in end-stage kidney disease (ESKD) patients treated with dialysis.MethodsPatients treated with hemodialysis or peritoneal dialysis were recruited from Dutch hospitals and dialysis centers. Patients completed self-report questionnaires at baseline (n = 175) and six months follow-up (n = 130). Multiple regression analyses were performed.ResultsHigher scores on factors related to negative outcome expectancies at baseline, especially helplessness and worrying, and less perceived social support were significantly related to worse HRQOL six months later. When controlling for baseline HRQOL, besides sex and comorbidity, helplessness remained significantly predictive of worse HRQOL six months later, indicating that helplessness is associated with changes in HRQOL over time.ConclusionsNegative outcome expectancies and social support are relevant markers for HRQOL and/or changes in HRQOL over time.Practice implicationsNegative outcome expectancies could be prevented or diminished by enhanced treatment information, an improved patient-clinician relationship, and interventions that promote adaptive and realistic expectations. Additionally, increasing supportive social relationships could be a relevant treatment focus.     

The psychological adaptation of psychologists in clinical training: the role of cognition,coping and social support

The current study sought to profile the psychological adaptation of psychologists in clinical training and examine the extent to which appraisal, coping and social support were related to psychological adaptation. A cross-sectional survey questionnaire design was used. A sample of 183 psychologists in clinical training (60.2% response rate) from 15 British clinical psychology training courses participated. They completed measures of cognition (appraisals of threat and control over course-related stressors), coping and social support. A multidimensional assessment of psychological adaptation included measures of perceived stress, self-esteem, anxiety and depression. Trainee clinical psychologists reported high levels of stress, but did not experience extensive problems of psychological adaptation in terms of anxiety, depression, self-esteem problems, marital problems, family problems, external stressors, interpersonal conflict, work adjustment or substance abuse. However, a significant subgroup reported self-esteem problems, work adjustment problems, depression and anxiety. Gender, age, current clinical placement and training course were related to psychological adaptation. Appraisal processes, coping and social support predicted a significant amount of variation in psychological adaptation. Appraisals of threat, avoidance coping, emotional support from clinical supervisors, emotional support from courses and emotional support from a confidante at home all predicted the variance in psychological adaptation. The findings were discussed in terms of a cognitive theory of stress and adaptation and implications for clinical psychology training were considered. Copyright © 1998 John Wiley & Sons, Ltd.     

Opposite effect of negative and positive affect on stress procoagulant reactivity

Exaggerated procoagulant responses to acute mental stress may contribute to coronary thrombosis, and continuing low-grade systemic coagulation activation may link negative affect with the development of coronary artery disease. We investigated whether negative and positive affect and perceived social support would moderate stress procoagulant reactivity. Psychological functioning, exhaustion, negative affectivity, depression, anxiety, worrying, vigor, and social support were assessed in 27 apparently healthy men (mean age 47 +/- 8 years) who underwent the 13-min Trier Social Stress Test combining preparation, speech, and mental arithmetic. Plasma levels of von Willebrand factor antigen (VWF:Ag), fibrinogen, factor VII clotting activity (FVII:C), FVIII:C, FXII:C, and D-dimer were measured immediately before and after stress. Acute stress elicited significant increases in hemodynamic, cortisol, and coagulant activity (p values < 0.05). VWF:Ag reactivity showed inverse relationships with exhaustion (r = -0.63, p < 0.001), negative affectivity (r = -0.53, p = 0.005), and worrying (r = -0.53, p = 0.005). Exhaustion and negative affectivity emerged as independent predictors of VWF:Ag reactivity explaining 54% of its variance. Fibrinogen reactivity showed inverse relationships with negative affectivity (r = -0.59, p = 0.002) and anxiety (r = -0.54, p = 0.005); negative affectivity emerged as an independent predictor of fibrinogen reactivity explaining 35% of its variance. Psychological functioning and FVII:C reactivity were also correlated (r = -0.52, p = 0.006). Whereas FVIII:C reactivity correlated positively with vigorous mood (r = 0.48, p = 0.012), positive associations between social support and procoagulant reactivity did not reach significance. Negative affect was associated with attenuated procoagulant reactivity to stress and the opposite was observed for positive affect. Negative affect is not likely to enhance the acute procoagulant stress response in healthy men.     

Self-esteem, social support, internalized homophobia, and coping strategies of HIV+ gay men

The relationship was examined between self-esteem, social support, internalized homophobia, and coping strategies used by HIV-positive (HIV+) gay men (N = 89) and between the use of coping strategies and mood state. Multiple regressions were conducted with avoidant (escape avoidance, accepting responsibility) and proactive (seeking social support, planful problem solving) coping serving as criterion variables. Greater homophobia and less self-esteem predicted avoidant coping, whereas less homophobia and less time since diagnosis predicted proactive coping. Greater time since diagnosis, less avoidant coping, less homophobia, and greater self-esteem predicted better mood state and accounted for 50% of the total variance.     

Type D personality,stress, and symptoms of burnout: The influence of avoidance coping and social support

Objective. This study investigated whether approach coping, avoidance coping, or perceptions of available social support mediated the relationship between Type D personality and perceived stress. Furthermore, this research also examined whether Type D moderated the relationship between perceived stress and symptoms of burnout. Methods. In this cross‐sectional study, 334 (male N =180; female N =154) first‐year undergraduate students completed the Type D Scale‐14 (DS14), the Brief Approach/Avoidance Coping Questionnaire, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, and the Oldenburg Burnout Inventory. Design. Cross‐sectional. Results. Multiple mediation analysis revealed that only resignation and withdrawal coping, but not social support partially mediated the relationship between Type D and perceived stress. A small moderation effect was found for the disengagement subscale of the burnout inventory, with Type D individuals experiencing higher levels of disengagement at low and average stress levels. The correlations between variables provided support for most of the prediction from the literature with regard to Type D. Conclusion. Of the participants in the present study, 24.9% were classified as Type D. These individuals tend to use more passive and maladaptive avoidance coping strategies such as resignation and withdrawal. This is associated with higher levels of perceived stress and linked to increased levels of burnout symptoms     

Effects of the economic crisis and social support on health-related quality of life: first wave of a longitudinal study in Spain

Background

Economic recession affects quality of life by increasing rates of mental disorders in particular. Social support can be an important protective factor.

Aim

To estimate the impact of being personally affected by an economic crisis on health-related quality of life (HRQoL), taking into account the possible buffering effect of perceived social support.

Design and setting

Data from the first wave (March 2012 to November 2012) of the ‘Social Support and Quality of Life Study’, a longitudinal study carried out in a primary health care centre in a deprived neighbourhood of Barcelona, Spain.

Method

A total of 143 participants were assessed using the 12-item Short-Form Health Survey, the List of Threatening Experiences and the Duke Social Support scales. The effect of economic crisis on mental and physical HRQoL was assessed using ordinary least squares regression models to test the interaction between social support and having experienced an economic crisis.

Results

There was no statistical association between having suffered an economic crisis and physical HRQoL. The interaction between social support and economic crisis was also tested without finding any statistical association. An interaction was detected between social support and economic crisis in relation to mental HRQoL; those who had low levels of social support and had also experienced an economic crisis had the lowest levels of mental HRQoL.

Conclusion

Social support constitutes a safety net that offers protection against the adverse effect of economic recessions on mental health. Primary care professionals are in a key position to promote social activities and to strengthen social networks in the community.     

医学毕业生就业焦虑与应对方式和社会支持的关系研究

探讨医学毕业生的就业焦虑与应对方式和社会支持三者之间的关系。采用就业焦虑问卷、应对方式问卷和社会支持评定量表对温州某医科高校医学毕业生进行调查。结果显示:医学毕业生应对方式的3个维度问题解决应对方式和合理化应对方式与社会支持呈正相关,消极情绪应对方式与社会支持呈负相关。问题解决应对方式与就业焦虑呈负相关,消极情绪应对方式与就业焦虑呈正相关,社会支持与就业焦虑呈负相关。采用积极的应对方式会缓解医学毕业生的就业焦虑,同时要提高医学毕业生的社会支持系统以降低其就业焦虑水平。     

Working through shame with an intercultural couple in Japan: Transforming negative emotional interactions and expanding positive emotional resources

Japan is often described as an intricate yet contradictory society in which the elements of the most advanced technologies and ancient cultural traditions coexist. Social cohesion rooted in uniformity and ethnic purity has long been the implicit, normative ideal in Japan, while diversity as intrinsic value is still a relatively new concept. In this monocultural milieu, intercultural couples often encounter issues associated with culturally-bound notions of gender roles and the societal pressure to conform to the implicit cultural ideal. The distress of unresolved past emotional injuries may also surface, which often results in the couple getting stuck in negative emotional cycles. This paper will discuss the case of Yoko and Frank, who were treated with an affect-focused approach in which their emotional conflicts, particularly their feelings of shame, were worked through while each partner developed their self- and other-emotion regulating capacity. The therapist also helped the couple develop new patterns of positive emotional interaction.     

Perceived social support among depressed elderly, middle-aged, and young-adult samples: cross-sectional and longitudinal analyses

BACKGROUND: A number of studies have concluded that the perceived quality of support is more strongly associated with mental health than with the actual structure of personal networks. This study examined clinical, historical, and phenomenological variables associated cross-sectionally and longitudinally with perceived social support. METHODS: Participants included elderly, middle-aged, and young-adult depressed samples derived from the Duke Clinical Research Center for the Study of Depression in Late Life. RESULTS: Cross-sectional multivariate analyses revealed that perceived social support was: (1) for the elderly associated with pessimistic thinking, being divorced, having strange ideas, the degree of social interaction, and instrumental support; (2) for middle-age associated with dysthymia, divorce, pessimistic thoughts, social interaction, and instrumental support; and (3) among young adults with instrumental support only. Longitudinal multivariate analyses indicated that only perceived social support at Time 1 predicted perceived social support 1 year later among elderly and middle-aged subjects, whereas only instrumental support predicted perceived social support 1 year later among the young-adult sample. LIMITATIONS: The small number of subjects among the young-adult sample limit conclusions regarding this group. In addition, only patients provided data. Future studies should consider using multiple informants to enhance the accuracy of reported social support. CONCLUSIONS: Our findings indicate that in addition to whatever else they do for depressed patients, clinicians must endeavor to address relationship or social support difficulties, especially in the elderly.     

Positive and negative religious coping,depressive symptoms,and quality of life in people with HIV

The present study examined the relationships of positive and negative types of religious coping with depression and quality of life, and the mediating role of benefit finding in the link between religious coping and psychological outcomes among 198 individuals with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). The results of multiple hierarchical analyses revealed that negative religious coping was significantly associated with a high level of depressive symptoms and a low level of quality of life, controlling for demographic and clinical variables. On the other hand, positive religious coping was significantly associated with positive domains of outcome measures such as positive affect and life satisfaction, but not with overall depressive symptoms or quality of life. Tests of mediation analyses showed that benefit finding fully mediated the relationship between positive religious coping and the positive sub-domains of psychological outcomes. The importance of investigating both positive and negative types of religious coping in their relationships with psychological adaptation in people with HIV was discussed, as well as the significance of benefit finding in understanding the link between religious coping and psychological outcomes.