Depressive symptoms in mothers of pre-school children Effects of deprivation, social support, stress and neighbourhood social capital

Depressive symptoms in mothers of pre-school children Effects of deprivation, social support, stress and neighbourhood social capital . Mulvaney C & Kendrick D. . ( 2005 ) Social Psychiatry and Psychiatric Epidemiology , 40 , 202 – 208 .     

社会支持及心理复原力与大学生创伤后应激障碍的关联

  目的  了解大学生创伤后应激障碍(post-traumatic stress disorder, PTSD)的发生特点,探讨心理复原力在社会支持与创伤后应激障碍间的作用。  方法  采用直接抽选法选取安徽、上海两地高校572名大学生, 采用一般特征调查表、创伤后应激障碍量表平民版(the PTSD Checklist-Civilian Version,PCL-C)、心理韧性量表(Psychological Resilience Scale,PRS)、社会支持评定量表(Social Support Rating Scale,SSRS)进行问卷调查。  结果  25.0%的大学生有一定程度PTSD症状,11.7%有较明显PTSD症状,PTSD的阳性检出率为36.7%。大学生有较明显PTSD的检出率男生高于女生,大三学生高于其他3个年级,差异均有统计学意义(χ2值分别为4.31,16.81,P值均＜0.05)。大学生社会支持得分为(33.79±4.83) 分,心理复原力得分为(92.17±13.39)分,PTSD得分为(35.50±11.39)分,各变量两两之间相关性均有统计学意义(r=-0.49~0.76,P值均 < 0.05);中介效应检验结果发现,社会支持既可以直接负向预测PTSD(直接效应为-0.35),又可以通过心理复原力间接影响PTSD(间接效应为-0.32)。  结论  大学生存在一定程度或者严重程度PTSD症状的比例较高,心理复原力在社会支持和大学生的PTSD间起中介作用,即社会支持既能直接负向预测PTSD,又可以通过提升个体的心理复原力间接影响PTSD。     

社会支持在消防员创伤后应激障碍与心理健康中的中介效应分析

  目的  探讨消防员创伤后应激障碍（post-traumatic stress disorder,PTSD）、心理健康及社会支持之间的关系,为提高消防人员的心理健康水平提供理论依据。
  方法  选取兰州市某地159名消防员,采用创伤后应激障碍量表、心理健康量表（SCL-90）以及社会支持量表对其进行问卷调查,并采用SPSS 22.0进行数据分析。
  结果  159名消防员SCL-90量表均值（118.52 ± 35.07）分,PTSD量表均值（21.62 ± 7.56）分,社会支持量表均值（26.46 ± 6.03）分。PTSD与SCL-90量表得分呈正相关（r = 0.88,P < 0.01）,社会支持与SCL-90量表得分呈负相关（r = - 0.39,P < 0.01）,社会支持与PTSD量表得分呈负相关（r = - 0.32,P < 0.01）。社会支持在PTSD和SCL-90之间的中介效应有统计学意义（P < 0.05）,中介效应值为0.042,中介效应占总效应的4.8%。
  结论  对经历了突发负性事件的消防员,可以通过提高他们的社会支持,降低负性事件带给他们的焦虑、抑郁、恐惧等心理,从而提高他们的心理健康水平。
     

社会支持及应对方式对洪灾创伤后应激障碍慢性化的影响

目的 了解洪灾创伤后应激障碍(PTSD)慢性化,进一步研究社会支持及应对方式对洪灾后PTSD慢性化的影响。方法 2014年3-4月采用整群随机抽样方法对经历1998年洞庭湖洪灾,1999年初次调查确诊的PTSD患者分析其慢性化情况。调查中采用创伤后应激障碍量表平民版(PCL-C)将研究对象分为康复组和未康复组(慢性化组),采用社会支持评定量表(SSRS)、简易应对方式问卷(SCSQ)测评和比较两组研究对象。结果 120名研究对象中,14名(11.67%)诊断为PTSD患者。两组患者主观支持得分、客观支持得分、社会支持总分以及积极应对得分、应对方式总分的差异有统计学意义(P<0.05);多因素logistic回归显示:社会支持(OR=0.281,95% CI:0.117~0.678)、应对方式(OR=0.293,95% CI:0.128~0.672)是PTSD慢性化的保护因素;受灾经历(OR=1.626,95% CI:1.118~2.365)是PTSD慢性化的危险因素。结论 洪灾后PTSD患者慢性化值得重视,而良好的社会支持、积极的应对方式能显著改善其慢性化情况。     

The association between post-traumatic stress disorder symptoms and the quality of life among Wenchuan earthquake survivors: the role of social support as a moderator

Objective

To examine the role of the three types of social support as possible moderating factors between post-traumatic stress disorder (PTSD) and its relationship to two domains of the quality of life (QOL).

Methods

A cross-sectional survey was done in a local area near the epicenter of the severe earthquake in Wenchuan. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the standard Chinese 12-item Short Form (SF-12v2), and the Social Support Rating Scale (SSRS) were used to interview a total of 2,080 earthquake survivors in the one-year follow-up period. Multiple regressions were performed to evaluate the moderating role of social support on the relationship between PTSD and QOL.

Results

Among survivors one-year after the Wenchuan earthquake, being a woman (p < 0.01), having a lower level of education (p < 0.01), having a lower level of income (p < 0.01), having a worse housing status (p < 0.05) and having a higher level of exposure (p < 0.05) were risk factors for a poorer QOL (?R ² = 0.063). PTSD symptoms negatively influenced the QOL (?R ² = 0.145), while social support positively influenced the QOL (?R ² = 0.016). However, the interaction between social support and PTSD weakened the negative effect of PTSD on the QOL (?R ² = 0.012). Subjective support and support availability moderated the association between PTSD and the QOL (?R ² = 0.010).

Conclusion

Subjective support and support availability are more useful strategies to improve the QOL of the earthquake survivors with PTSD symptoms.     

Depressive symptoms, social networks and social support of elderly women

A total of 1,144 white married women aged 65-75 years living in Washington County, Maryland were interviewed during February-August 1979 as part of a larger study. This cross-sectional analysis was undertaken to investigate the question of whether or not selected demographic, social network, and social support characteristics of these women were related to their level of depressive symptoms. Women at the low end of the socioeconomic scale were found more likely to have a high level of depressive symptoms than were women at the high end. Two structural characteristics, size and homogeneity of the social network, were also found to be related to symptoms of depression, although only homogeneity of the social network reached statistical significance. There was a larger percentage of women with a high level of depressive symptoms among those with small networks and among those with heterogeneous networks. Those women with good quality networks, which offer the opportunity for social support, were much less likely to have a high level of depressive symptoms than others. Cross-sectionally, social network factors were related to level of depressive symptoms; this relationship now needs to be demonstrated prospectively.     

A cross-sectional community study of post-traumatic stress disorder and social support in Lao People's Democratic Republic

Objective

To estimate post-traumatic stress disorder (PTSD) symptoms in those injured and not injured by landmines or unexploded ordnance (UXO) in rural Lao People''s Democratic Republic and to determine whether the perception of social support was associated with PTSD symptom severity.

Methods

A community survey was conducted among 190 people injured by landmines or UXO and 380 age-, sex- and neighbourhood-matched non-injured individuals in the Sepone district of Savannakhet Province, the part of the Lao People''s Democratic Republic most heavily bombed during the Viet Nam War. Using the Harvard Trauma Questionnaire and the Medical Outcomes Study Social Support Survey, trained health-care workers conducted face-to-face interviews to assess PTSD symptoms and level of perceived social support. Multiple linear regression was performed to explore the association between social support and other factors and PTSD.

Findings

The prevalence of PTSD was higher among the injured (10%) than among the non-injured (4%), but the level of perceived social support was not significantly different between the two groups. A higher level of perceived social support was associated with milder symptoms of PTSD. Women, older people and those with a formal education were more often and more severely affected by PTSD.

Conclusion

The perception of strong social support might help to alleviate the symptoms of PTSD among people injured by landmines or UXO in rural parts of the Lao People''s Democratic Republic. Psychosocial interventions should be incorporated in assistance for the injured because they have more severe and longer-lasting symptoms of PTSD than the non-injured.     

汶川地震灾区中学生地震创伤后应激障碍与领悟社会支持的关系

目的 探讨汶川大地震灾区中学生地震创伤后应激障碍(PTSD)与领悟社会支持能力之间的关系.方法 使用创伤后应激障碍自评量表(PCL-C)和领悟社会支持量表(PSSS),对汶川地震灾区3所中学1966名中学生进行自填式问卷调查.结果 1966名中学生的PTSD筛查总阳性率为78.3%,重度PTSD占24.38%.不同领悟社会支持程度的学生PTSD阳性率差异有统计学意义(P<0.05),且PTSD严重程度与领悟社会支持高低程度呈负性相关(γ=-0.226,P<0.05);不同家庭内、外领悟社会支持程度的学生PTSD阳性率差异有统计学意义(P=0.009,P<0.05)且PTSD严重程度与家庭内、外领悟社会支持高低程度呈负性相关(γ=-0.176,P<0.05,γ=-0.214,P<0.05).结论 地震灾区中学生PTSD的发生率及严重程度与其领悟社会支持的高低程度存在一定关系,领悟社会支持越高者,PTSD发生率越低,程度越轻.对灾区中学生的心理干预应有针对性.     

汶川地震灾区中学生地震创伤后应激障碍与领悟社会支持的关系

Objective To explore the relationship between post-traumatic stress disorder (PTSD) and perceived social support (PSS)ability among middle school students in earthquake-stricken areas after the Wenchuan earthquake accident. Methods A total of 1966 students from three secondary schools of Wenchuan earthquake-stricken areas were evaluated by PTSD Checklist-Civilian Version (PCL-C) and Perceived Social Support Scale (PSSS). Results The overall incidence rate of PTSD was 78.3%, with severe PTSD as 24.38%. Significant differences on the incidence rates of PTSD were found among the students who were in different PSS levels (P<0.05) and significant negative correlation existed between the levels of severity on PTSD and PSS (γ=-0.226, P<0.05). Significant differences on PTSD incidence rates were found among those students who were from different families or out-family PSS levels (P=0.009, P<0.05). Significant negative correlation existed between the severity of PTSD and family or out-family PSS level (γ=-0.176, P<0.05, γ=-0.214, P<0.05). Conclusion Relationships between the incidence rate, severity of PTSD and PSS levels existed among the middle school students in Wenchuan earthquake-stricken areas, with higher PSS, lower incidence rate and lighter severity of PTSD. Psychological intervention for earthquake-stricken students should be carried out.     

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.     

Gender differences in posttraumatic stress symptoms and social support in a sample of HIV-positive individuals

The aim of the authors of the present study was to investigate gender differences in the levels of posttraumatic stress symptoms (PTSS) and social support in a Polish sample of HIV+ men (n = 613) and women (n = 230). This was an anonymous cross-sectional study, and participation was voluntary. The research questionnaires were distributed in paper form among patients of Warsaw’s Hospital for Infectious Diseases from January to October 2015. The level of PTSS was assessed using the PTSD Factorial Version Inventory. Social support was assessed using the Berlin Social Support Scales. HIV+ women scored higher on all PTSS dimensions compared to HIV+ men. HIV+ women were characterized by a higher need for support and more support actually received compared to HIV+ men. We observed a positive association between HIV infection duration and AIDS phase and the global trauma score only among HIV+ men. The moderation analysis also revealed a positive relationship between actual received support and the global trauma score among HIV+ women only. Increased clinician awareness is needed about the role of PTSS and social support among people living with HIV, especially taking gender differences into account.     

The influence of stress and social support on depressive symptoms in mothers with young children

Limited research has examined the associations of stress, social support, and depression among mothers with young children over time. Longitudinal studies are needed to identify risk and protective factors for maternal depression given that depression can be cyclical and may affect women through the early years of their children’s development. This study examined the relationships among stress, social support, and depressive symptoms in a national sample of low-income urban American women with young children. A secondary data analysis of the Fragile Families and Child Wellbeing Study, a national longitudinal panel study of nearly 5000 births across 20 cities with populations of 200,000 or more in the United States, was conducted. The analytic sample included all mothers (N = 3675) who completed assessments at baseline through year 5 of the study between 1998 and 2005. Multivariate models using generalized estimating equations were used to estimate the probability of being depressed as a function of stress-related risk factors, social support factors, and sociodemographic variables. The rate of depression each year ranged from 15% to 21%. The results suggest that stress related to economic hardship, parenting, and poor physical health increases the risk of depression among low-income urban mothers with young children. Instrumental and partner support were found to be potential protective factors in reducing the negative effects of stress, but only to a certain degree. Future efforts are needed to strengthen social support and mitigate chronic stressors that contribute to mental health problems in low-income communities.     

大学生社会支持依恋及应激与抑郁的相关性分析

目的 探讨社会支持、依恋和应激对大学生抑郁的影响,为大学生抑郁的干预和治疗提供理论依据.方法 采用整群抽样法,抽取湖南大学财经学院和中南大学二、三年级大学生647名进行调查.在完成了包含负性生活事件、社会支持、依恋和抑郁症状在内的首次测评1个月后完成负性生活事件和抑郁症状的追踪测评.结果 大学生社会支持网络大小、...     

中青年急性心肌梗死患者成人依恋、社会支持与创伤后应激障碍的关系

目的 了解中青年急性心肌梗死患者创伤后应激障碍现状,分析成人依恋、社会支持与创伤后应激障碍之间的关系。方法 采用便利抽样法选取190名中青年急性心肌梗死患者,使用一般资料调查表、创伤后应激障碍症状问卷、亲密关系经历量表、社会支持量表进行调查。结果 190名中青年急性心肌梗死患者创伤后应激障碍阳性率为41.6%,以再体验、麻木和高警觉症状为主。控制犯罪血管分布、病情知晓程度后,中青年急性心肌梗死患者的依恋回避、依恋焦虑、主观支持进入回归方程。主观支持在依恋回避与创伤后应激障碍之间起部分中介作用,中介效应占22.95%。依恋焦虑对创伤后应激障碍具有直接正向预测作用。结论 社会支持在依恋回避与创伤后应激障碍中起到中介作用,护理人员可以通过构建基于依恋回避的干预策略,提高中青年急性心肌梗死患者的社会支持水平,以预防创伤后应激障碍。     

工作压力、社会支持与教师职业枯竭关系

目的探讨中小学教师工作压力、社会支持与职业枯竭的关系。方法采用职业枯竭问卷、工作压力问卷和社会支持评定量表对湖南省衡阳市618名中小学教师进行问卷调查。采用SPSS 11.5软件进行分析。结果（1）中小学教师职业枯竭的整体状况并不严重,但教师情绪衰竭体验较为严重。（2）中小学教师职业枯竭与工作压力呈显著正相关,工作压力越大,职业枯竭的程度越严重。角色冲突、学生因素、职业发展带米的压力是引起教师职业枯竭程度加重的主要原因。（3）中小学教师职业枯竭与社会支持呈显著负相关,即社会支持对教师的职业枯竭具有调节作用。（4）中小学教师工作压力、社会支持与职业枯竭之间具有典型相关关系。结论工作压力、社会支持对中小学教师职业枯竭有重要影响。     

Relationship between perceived perinatal stress and depressive symptoms,anxiety, and parental self-efficacy in primiparous mothers and the role of social support

The aim of the authors in this study was to evaluate the relationships between perceived perinatal stress and social support to psychological health outcomes in mothers. A longitudinal, quantitative study was conducted in Geneva, Switzerland on 235 primiparous mothers from September 2010 to January 2012. Data were collected between gestational weeks 37 and 41 (T1), 2 days post-delivery (T2), and at 6 weeks postpartum (T3). Perinatal stress was associated with depressive symptoms (R² = 0.223), anxiety (R² = 0.242), and a low sense of parental self-efficacy (R² = 0.21). However, satisfaction with social support moderated the relationship of stress to the health of mothers. In particular, the authors noted that the more women were provided with support from their partners, the less depressive symptoms and elevated levels of anxiety they reported, even under stressful conditions, while the satisfaction of support from their mothers boosted their sense of competency. Furthermore, satisfaction with emotional support from professionals tempered the stress during the post-partum period (?R² = 0.032; p < .05). The results revealed that perinatal stress was related to the psychological health of mothers, but social support may modulate these effects. A number of approaches could be implemented to manage this stress.     

Relationship between sense of coherence and post-traumatic stress disorder symptoms among firefighters

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published by the American Psychiatric Association, the post-traumatic stress disorder (PTSD) is diagnosed when a person: (a) is exposed to a traumatic event that is well outside the range of usual human experience accompanied by intense fear or horror; (b) reexperiences the event in his/her thoughts, dreams and daily life; (c) avoids the stimuli associated with the trauma and numbs his/her emotions; (d) demonstrates symptoms of increased arousal; and (e) manifests these disturbances for a longer period than one month. Since the 1980s, it has been pointed out that PTSD may occur not only among survivors of severe traumatic events but also among those who have rescued the victims of those events. Members of fire brigades constitute a large occupational group exposed to traumatic experiences. The aim of our study was to find an answer to the question of what are the relationships between the level of PTSD symptoms and the sense of coherence (and its three dimensions). In all, 464 firemen were interviewed. PTSD-Interview developed by Watson et al. was used to assess the level of PTSD symptoms and the presence]absence of PTSD. The higher level of PTSD symptoms was associated with the lower level of the sense of coherence. A small group (3.9%) of subjects who experienced traumatic events met DSM-IV diagnostic criteria for PTSD. The sense of coherence of these people was significantly lower than that of others.     

地震灾区青少年创伤后应激障碍相关因素分析

目的了解社会支持和应付方式与四川省汶川地震灾区青少年创伤后应激障碍(PTSD)症状发生的关系,为采取干预措施提供参考依据。方法在四川省汶川地震5个月后采用整群抽样方法对四川省都江堰市都江堰中学抽取的472名高中生进行问卷调查。结果地震灾区高中生PTSD检出率为46.61%,其中男生和女生检出率分别为43.93%和48.84%,差异无统计学意义(P>0.05);PTSD阳性与阴性症状学生比较,客观支持、主观支持、支持利用度和社会支持总分差异均无统计学意义(P>0.05),自责、求助、幻想、退避和合理化因子分差异均有统计学意义(P<0.05),解决问题因子分差异无统计学意义(P>0.05);相关分析结果表明,客观支持与闯入、高警觉因子和事件影响量表(IES)总分均呈负相关(P<0.05);解决问题与高警觉因子呈负相关(P<0.05);求助与闯入因子和IES总分均呈负相关(P<0.05),自责、幻想、退避和合理化与回避、闯入、高警觉因子和IES总分均呈正相关(P<0.01)。结论应用成熟的应付方式和良好的社会支持可提高地震灾区青少年的心理健康水平,减少PTSD的发生。