Social support networks of white and black elderly people at risk for institutionalization.

The literature examining the role of social network size and support in moderating the relationship between stress and illness in the aged population has not taken racial differences into account. This study compares the potential moderating influence of social network size and support on the relationship between life stress and depressive symptoms for black and white community-dwelling elderly people at increased risk for institutionalization. Study data come from in-person interviews with a sample of 191 old-old (75 years and older) and poor residents of a three-census-tract area in Pittsburgh. Approximately 50 percent were white and 50 percent were black. Results indicate that the moderating effects of social network size and support were different for the black people than for the white people in this sample. For white aged people, having greater social support and a larger social network reduces the association between stress and depressive symptoms, as expected. For black elderly people, however, having more network members and receiving support from them is associated with a stronger relationship between stress and depressive symptomatology.     

The effects of social support and coping on the relationship between social anxiety and eating disorders

The current study examined the hypotheses that social support and coping moderate and or mediate the relationship between a broad and a narrow form of social anxiety and eating disorder symptoms. One hundred sixty-nine female undergraduates at a private Midwestern university, completed measures of social support, coping, social anxiety, fear of negative evaluation, and disordered eating attitudes and behaviors. Results of hierarchical multiple regression analyses indicated that higher levels of social support are associated with a weaker association between social anxiety and eating disorder symptomatology. Low use of task- and avoidant-oriented (distraction) coping and increased use of emotion-oriented coping are associated with a stronger association between social anxiety and eating disorder symptomatology. Implications for research and clinical intervention are discussed.     

Psychosocial correlates of depressive symptoms among Japanese high school students.

PURPOSE: To determine the psychosocial factors associated with the presence and persistence of depressive symptoms among high school students in Okinawa, Japan. METHODS: The study sample was 3202 students from 12 public senior high schools. Students completed self-administered questionnaires from October through December 1997. We measured depressive symptomatology using the Center for Epidemiologic Studies Depression Scale. We asked students to report whether they had depressive symptoms at any time in the immediate past week, and whether those symptoms persisted for 5-7 days. The psychosocial variables examined were life stressors, perceived social support, health practices, self-esteem, and Locus of Control. The relationship between the psychosocial factors and depressive symptoms was examined using hierarchical multiple regression analyses. RESULTS: After controlling for the effects of demographic and other psychosocial variables, presence of depressive symptoms was positively associated with life stressors in the domains of friends, family, and teachers. Similarly, persistence of depressive symptoms was also positively associated with life stressors in the domains of friends and teachers. Presence and persistence of depressive symptoms were negatively associated with positive health practices, more social support, high self-esteem, and internal Locus of Control. CONCLUSIONS: The psychosocial variables associated with presence and persistence of depressive symptoms were remarkably consistent. Life stressors might be risk factors; on the contrary, positive health practices, perceived social support, high self-esteem, and internal Locus of Control might be protective factors of depressive symptoms among Japanese adolescents.     

Depressive symptomatology among Namibian adolescent refugees

Symptoms of depression have been considered rare in sub-Saharan populations. Using a standard assessment measure of depressive symptomatology, the Beck Depression Inventory, the prevalence of symptoms of depression was obtained from a group (N = 56) of Namibian refugees residing in a sub-Saharan host country. Contrary to expectations, the rates of self-reported symptoms were quite frequent, with many symptoms reported as moderate or severe by a large proportion of these youths. Using a stress model to explore these data, it was demonstrated that social support ameliorated the effects of chronic stress, as represented by the length of time in exile. It is argued that adaptation, acculturation, and adolescent developmental demands result in self-reports of depressive symptoms. These demands, however, are lessened in intensity by a strong social support system that is especially helpful early in the exile period.     

Social Support and Employment Status Modify the Effect of Intimate Partner Violence on Depression Symptom Severity in Women: Results from the 2006 Behavioral Risk Factor Surveillance System Survey

BackgroundDepression and intimate partner violence (IPV) are significant health issues for U.S. women. Interaction effects between IPV and other psychosocial factors on the severity of depressive symptoms have not been fully explored. This study assessed effect modification, that is, how IPV interacts with sociodemographics, psychosocial factors and health risk behaviors, on the severity of depressive symptoms in women.MethodsWe utilized cross-sectional data from female respondents (n = 16,106) of the 2006 Behavioral Risk Factors Surveillance Survey. Sociodemographics, psychosocial variables, and health risk behaviors determined to be significantly associated with depression were tested for interaction effects with IPV. Weighted ordinal logistic regression and predicted probabilities illustrated the effect of IPV status on depressive symptom severity, stratified by interaction effects.ResultsRecent and lifetime IPV exposure were associated with more severe depressive symptoms compared with no IPV exposure. IPV history interacted with employment status and social support on the severity of depressive symptoms in women. Overall, any IPV exposure was associated with more severe depressive symptoms among women with low social support and unemployment, although the effect of recent (versus lifetime) IPV was most pronounced among women with high social support or employed women.ConclusionsSocial support and employment status interact with IPV on the severity of depressive symptoms in women. Therefore, social support or workplace interventions designed to improve depressive symptoms should examine IPV history.     

Associations of social support and stress with postpartum maternal mental health symptoms: Main effects,moderation, and mediation

Poor maternal mental health during the postpartum period can have significant effects on the health of mothers, infants, and families. The findings from cross-sectional studies suggest that stress and social support are related to maternal mental health. This study contributes to the literature through the use of longitudinal data, and examines moderation and mediation among these factors. In 2012–2013, mothers completed surveys assessing stress, social support, and depressive and anxiety symptoms following birth (n = 125), and 3 months (n = 110) and 6 months (n = 99) after birth. The authors examined temporal associations, moderation, and mediation of social support on the relationship between stress and postpartum depressive and anxiety symptoms using modified Poisson regression models and the counterfactual approach to mediation. Current levels of stress and social support were associated with depressive and anxiety symptoms, both independently and when considered together at multiple time points. Social support did not strongly moderate or mediate the relationships between stress and maternal mental health. Interventions to reduce current perceptions of stress and increase social support for mothers during the postpartum period may help improve maternal mental health symptoms. Efforts are needed to assess the current needs of mothers continuously.     

Living in the shadow of terrorism: psychological distress and alcohol use among religious and non-religious adolescents in Jerusalem

This study examines the effects of prolonged exposure to terrorism in 600 religious and non-religious Jewish adolescents living in Jerusalem, particularly post-traumatic stress (PTS) symptoms, depressive symptoms, alcohol use, coping strategies and social support. The youth in Jerusalem reported high exposure to terrorist acts. This exposure was associated with high PTS, depressive symptoms and alcohol use. Despite an apparently greater exposure to terrorism, religious adolescents reported lower levels of PTS and alcohol consumption, but similar levels of depressive symptoms to non-religious adolescents. Problem-solving coping predicted higher depressive symptoms for religious adolescents exposed to terrorism but not for similarly exposed non-religious adolescents. In contrast, emotion-focused coping predicted more alcohol consumption among highly exposed non-religious adolescents, while emotion-focused coping predicted more alcohol consumption among religious adolescents with low exposure. The overall findings suggest that religiosity may buffer the negative consequences of exposure in other ways than through coping or support.     

Gender differences in the association between psychosocial factors and depressive symptoms in Japanese junior high school students

To determine psychosocial factors associated both with depressive symptoms and with gender differences in depressive symptoms among junior high school students, we conducted self-administered questionnaires using a sample of 2,660 students of 13 public junior high schools in Okinawa, Japan. Depressive symptomatology was measured by the Center for Epidemiologic Studies Depression Scale (CES-D). The psychosocial variables examined were life stresses, social support, health practices, self-esteem, and locus of control. Depressive symptoms were positively associated with life stresses and negatively associated with health practices, social support, self-esteem, and internal locus of control. In addition, female students were likely to report more depressive symptoms, life stresses, and low self-esteem and poor health practices. After controlling for the psychosocial variables differed by gender, gender differences in depressive symptoms were eliminated. In conclusion, for depressive symptoms of junior high school students, life stresses might be risk factors, but positive health practices, social support, high self-esteem, and internal locus of control might be protective factors. Gender differences in depressive symptoms could be explained by the females' elevation on these psychosocial variables.     

Reconsidering the Effects of Poverty and Social Support on Health: A 5-Year Longitudinal Test of the Stress-Buffering Hypothesis

Prior research in the general population has found that social support can buffer the adverse effects of stressors on health. However, both stressors and social support may be qualitatively different for those living in urban poverty. We examined the effects of social support and poverty-specific stressors on self-rated health. We used data from the Welfare Client Longitudinal Survey (WCLS), a 5-year longitudinal study of 718 public aid recipients. We measured received social support and “net social support,” defined as the difference between support received and that given to others. We used restricted cubic splines to model the stress-buffering effects of social support on self-rated health as a function of stressful life events and neighborhood disorder. Increased exposure to stressors was associated with poorer self-rated health. Evidence of stress buffering was confined to those with the heaviest exposure to stressors, and its effects decreased across increasing levels of social support. Analyses using net social support had generally more modest effects than those using received social support. Social support does not buffer the effects of stressors on health uniformly for individuals living in conditions of urban poverty. Researchers and policymakers should be cautious in overestimating the beneficial effects that social support may have on health for marginalized populations.     

Urinary incontinence in middle aged women: childhood enuresis and other lifetime risk factors in a British prospective cohort

STUDY OBJECTIVE: To investigate the prevalence and lifetime risk factors for urinary incontinence in middle aged women. DESIGN: Nationally representative birth cohort study with prospective data on childhood enuresis, measured adult height and weight, childbearing histories and measures of socioeconomic status updated at regular contacts, and measures of menopausal status, symptomatology and health care in midlife. SETTING: England, Scotland and Wales. PARTICIPANTS: General population sample of 1333 women aged 48 years. MAIN RESULTS: Fifty per cent reported symptoms of stress incontinence and 22% reported symptoms of urge incontinence in the previous year. Eight per cent had severe symptoms. Women who at age 6 years had wet in the day or several nights a week were more likely to suffer severe incontinence and report urge symptoms but occasional bedwetting was not associated with an increased risk in adult life. Those who were older at the birth of their children and who had vaginal deliveries had an excess risk of stress symptoms. Heavier adult body weight was also a risk factor for these symptoms and for severe incontinence. Postmenopausal women were less likely to report stress symptoms. These risk factors remained significant after taking account of the increased reporting of incontinence among women with high levels of general symptomatology and general practitioner visits, and of stress symptoms among better educated women. CONCLUSIONS: Urinary incontinence is a common problem among middle aged women. This is the first prospective study of a general population sample to support the postulated link between childhood enuresis and adult incontinence. Child-bearing has long term adverse effects, particularly for older mothers. Overweight is a common risk factor.     

Psychosocial stress and social support as mediators of relationships between income, length of residence and depressive symptoms among African American women on Detroit's eastside

Patterns of mental health are clearly associated with life circumstances, including educational and economic opportunities, access to safe and supportive neighborhoods, socially structured exposures to stressors and to supportive relationships. In this article, we examine the social and economic correlates of depressive symptoms among African American women residing within a predominantly African American urban neighborhood in Detroit, USA, with relatively few economic resources. We identify distinct stressors associated with financial strain, neighborhood social disorder (concern about police responsiveness, safety stress), and experiences of discrimination. We test the extent to which each of these stressors mediates relationships between household income, length of residence in the neighborhood, social support and depressive symptoms. Our results suggest that for women in this racially segregated area with a high concentration of poverty, relationships between household income and symptoms of depression are partially mediated by financial stress and social support, but that stressors associated with neighborhood disorder and discrimination influence depressive symptoms independent of household income. Furthermore, we find that length of residence in the neighborhood is negatively associated with financial stress and positively associated with police stress and social support, with no significant net effect on symptoms of depression. We conclude that higher household income may help reduce symptoms of depression by reducing financial stress and strengthening social support even within neighborhoods with high concentrations of poverty. However, increased household income does not protect African American women residing in a high poverty community from distress associated with neighborhood disorder or experiences of discrimination.     

Effects of a worksite coping skills intervention on the stress,social support,and health outcomes of working mothers

This study examines the effectiveness of a 15-session worksite coping skills intervention aimed at modifying work- and family-related risk and protective factors and at reducing negative health outcomes among mothers employed in secretarial positions. A sample of 142 mothers employed at one of four corporate worksites was assessed at pretest, immediately following the intervention, and at 6-month follow-up using multiple self-report measures. Results showed that at immediate posttest, intervention participants reported significantly lower employee role stress, higher social support from work sources, and lower levels of alcohol and tobacco use. They also tended to report less use of avoidance coping and lower psychological symptomatology. At 6-month follow-up, intervention participants reported significantly lower work-family and work environment stress, higher social support from work sources, less avoidance coping, and lower psychological symptomatology. Attrition analyses provided support for the external and internal validity of the study findings. Results were discussed in relation to issues of longitudinal prevention research and worksite-based interventions.     

Romantic Partner and Biological Father Support: Associations with Maternal Distress in Low‐Income Mexican‐Origin Families

Paternal support is often linked to lower levels of maternal psychological distress; however, research has seldom considered the increasing numbers of Mexican‐origin families with a romantic partner social (RPS) father (i.e., mothers' partners who are not formally identified as stepfathers). This study applied a bioecological systems framework to test linkages between support from RPS fathers and maternal depressive symptoms and parenting stress and to consider whether nonresident biological father support and instrumental social support moderate these associations. Using data from the Fragile Families and Child Wellbeing Study, the authors analyzed a subsample of Mexican‐origin mothers (N = 76) with 3‐year‐old children. Findings indicated that maternal perceptions of support from RPS fathers were inversely related to depressive symptomatology only when mothers also perceived high levels of support from biological fathers, and the relationship with the RPS father began recently. Neither RPS nor biological father support was associated with maternal parenting stress.     

Predictors of post-traumatic stress symptoms in oklahoma city: Exposure, social support, peri-traumatic responses

Eighty-five adults seeking mental health assistance six months after the Oklahoma City bombing were assessed to determine which of three groups of variables (exposure, peri-traumatic responses, and social support) predicted development of post-traumatic stress disorder (PTSD) symptoms. Variables most highly associated with subsequent PTSD symptoms included having been injured (among exposure variables), feeling nervous or afraid (peri-traumatic responses), and responding that counseling helped (support variables). Combining primary predictors in the three areas, PTSD symptoms were more likely to occur in those reporting counseling to help and those feeling nervous or afraid at the time of the bombing. Implications of these findings are discussed for behavioral health administrators and clinicians planning service delivery to groups of victims seeking mental health intervention after terrorist attacks and other disasters.     

Social support as a double-edged sword: the relation of positive and problematic support to depression among rheumatoid arthritis patients

This study considers social network interactions as a potential source of both stress and support for individuals coping with a chronic illness. The sample consisted of 101 recently-diagnosed rheumatoid arthritis patients. Symptoms of depression were assessed using the Center for Epidemiologic Studies Depression scale. Hierarchical multiple regression analyses examined the conjoint effects of social support and problematic interactions on symptoms of depression. Receipt of positive or helpful support from close friends and family was related to lower depression; receipt of problematic support was related to increased depression. A positive x problematic support interaction suggested that the costs of problematic support do not cancel out the benefits of positive support. Patients who reported both little support and a greater degree of problematic interactions experienced the highest level of symptoms. The findings emphasize the need to consider positive and negative aspects of support transactions conjointly in assessing their stress-reducing and health-protective potential.     

Gender and somatosensory amplification in relation to perceived work stress and social support in Japanese workers

To examine gender-related differences in somatization among workers, 490 Japanese municipal office employees (248 women) completed the Medical Symptom Checklist, Somatosensory Amplification Scale (SSAS), and Profile of Mood States (POMS), along with questionnaires on their working environment. In women, SSAS scores were positively associated with perceived work stress, and negatively with social support levels (both p < 0.01). Female sex was significantly associated with SSAS scores (p < 0.01), controlling for the effects of total somatic symptom count, POMS tension-anxiety and depression scores, perceived working stress, and social support. The phenomenon of somatosensory amplification might be essential in estimating gender-specific symptoms in a working population.     

Coping strategies as predictors of psychosocial adaptation in a sample of elderly veterans with acquired lower limb amputations

This study examines the contribution of demographic/amputation-related variables and coping strategies to the prediction of psychosocial adaptation in veterans with acquired lower limb amputations. Multiple indicators of the psychosocial adjustment of 796 individuals in the UK aged between 26-92 years with lower limb amputations were assessed. Hierarchical linear regressions were performed to investigate relationships between demographic/amputation-related variables (i.e. age, time since amputation, amputation level and amputation aetiology), the dimensions of coping (namely problem solving, seeking social support and avoidance) and self-reported adaptation to amputation, as well as symptoms of intrusion, anxiety and depression. Results indicated that coping styles were important predictors of psychosocial adaptation. Avoidance was strongly associated with psychological distress and poor adjustment. In contrast, problem solving was negatively associated with depressive and anxious symptomatology whereas seeking social support was negatively associated with symptoms of depression and positively associated with social adaptation. These findings suggest the potential for interventions designed to promote particular coping strategies to improve psychosocial outcomes.     

Do maternal depressive symptoms,stress and a lack of social support influence whether mothers living in deprived circumstances adopt safety practices for the prevention of childhood injury?

BACKGROUND: Maternal depressive symptoms are common, as are childhood injuries, particularly among the socio-economically disadvantaged. Maternal depression may be associated with lesser engagement in injury prevention practices. Providing support to mothers can reduce the risk of child injury, but the mechanism by which this occurs is unclear. The aim of this study was to examine the relationship between maternal depressive symptoms, social support and stress, and engagement in home safety practices to prevent injuries to pre-school children living in socio-economically deprived families in the UK. METHODS: Three questionnaires were posted to mothers of young children living in deprived areas in the city of Nottingham, UK, who were enrolled in the control group of a randomized controlled trial (RCT). The questionnaires assessed socio-demographic characteristics at baseline; depressive symptoms, perceived social support and self-reported stress 21 months later and engagement in home safety practices 24 months post baseline. The mothers in the control group received no intervention. Main outcome measures were the use of fireguards, stair gates, smoke alarms, window locks and safe storage of medicines, sharp objects and cleaning products. RESULTS: One-third (36.4%) of mothers reported depressive symptoms. The most widely adopted safety practices were safe storage of medicines (93.5%) and use of smoke alarms (86.2%). The majority of mothers did not use fireguards (60.7%) or store sharp objects safely (63.8%). Depressive symptoms were not independently associated with any of the seven safety practices. Mothers reporting some lack of social support were more likely not to store medicines safely [odds ratio, OR, 4.08 (95% confidence interval, CI, 1.79-9.30) compared with those reporting no lack of social support] and mothers reporting moderate or large amounts of stress were more likely not to store sharp objects safely [OR 1.77 (95% CI 1.11-2.83) compared with mothers reporting no or little stress] after controlling for confounders. CONCLUSIONS: Our results suggest that depressive symptoms, stress and a lack of social support are not important influences on the adoption of safety practices by mothers living in deprived areas in the UK, at least in the short term. Further work is required to explore the effects of chronic maternal depressive symptoms on the adoption of safety practices.     

Job stress, social support, and prevalence of insomnia in a population of Japanese daytime workers

To clarify the relationship between perceived job stress, social support and prevalence of insomnia in Japanese daytime workers, 1161 male white-collar employees of an electric equipment manufacturing company (age, 23-60 years, mean age of 37.0) were surveyed by means of a mailed questionnaire. Perceived job stress was evaluated with the Japanese version of the generic NIOSH job stress questionnaire. Insomnia was diagnosed if workers had at least 1 of 3 types of symptoms on an almost nightly basis. The symptoms were (1) taking more than 30 min to fall asleep (Difficulty Initiating Sleep, DIS), (2) difficulty in maintaining sleep (DMS), or (3) early morning awakening (EMA). The overall prevalence of insomnia was 23.6% and the prevalences of the three subtypes were 11.3% for DIS, 14.2% for DMS, and 1.9% for EMA. Workers with high intragroup conflict (OR 1.6), high job dissatisfaction (OR 1.5), and high symptoms of depression (OR 2.0) (CES-D > 16) had a significantly increased risk for insomnia after adjusting for multiple confounding factors. Low employment opportunities, physical environment and low coworker support also were weakly associated with risk for insomnia among workers. Furthermore, high depressive symptoms significantly increased the risk of DIS (OR 2.4). Therefore in white-collar male daytime workers, psychological job stress factors such as interpersonal conflicts with fellow employees, job satisfaction, and social support were independently associated with a modestly increased risk of insomnia that included three different subtypes that were considered to be defining for the disorder.     

Life experiences, response styles and mental health among mothers and children in Beirut, Lebanon

A sample of 152 women living in Beirut, Lebanon was studied to determine the relationship between life experiences, mothers' depression, and children's health and behavior. Measures of the perceived negative impact of both war and nonwar related events, measures of available social support, sociodemographic variables, coping or response strategies and displacement were used to predict mothers' depressive symptomatology and their children's health. The level of perceived negative impact of war-related events was found to be strongly associated with higher levels of depressive symptomatology among mothers. More surprising was the relative importance of experiences unrelated to the war in predicting higher levels of depressive symptoms. Among the most noteworthy of the findings was the association between the use of an emotional response style and the measure of psychological dysfunction. Finally, the level of a mother's depressive symptomatology was found to be the best predictor of her child's reported morbidity, with higher levels of symptoms associated with higher levels of morbidity.