Predictors of social support and psychological distress in women with breast cancer

This investigation sought to understand previous well-cited and worrisome findings that women treated for breast cancer with breast-conserving surgery compared to mastectomy experience less social support and more mood disturbance, and that social support from significant others erodes over time. Ninety-three women with breast cancer and a subset of their partners completed assessments at the time of surgical treatment and at 3 and 13 months post-treatment. Contrary to the previous findings, type of surgical treatment was not related to perceptions of social support or psychological functioning. Perceptions of social support and psychological distress decreased over time, and the discrepancy between recipients' and providers' judgments of available support increased over time. Low levels of physical functioning led to relative increases in social support, whereas high levels of psychological distress led to relative decreases in social support. Social support as rated by patients (but not their partners) was a significant predictor of changes in psychological distress.     

Social support, social pressures and psychological distress during unemployment

A sample of 1150 unemployed 17 year-olds, containing blacks and whites, males and females, was obtained from 11 urban regions in England. Social support was measured in respect of five different forms of help from others. Measures were also obtained of psychological distress, perceived pressure from others to obtain a job, employment commitment, contact with other young people, and contact with other unemployed young people. Two forms of social support (having someone to turn to for help with money, and having someone to suggest interesting things to do) were significantly associated with measures of distress, as were perceived pressure to obtain a job and employment commitment, but not contact with other unemployed young people. The association between distress and having someone to turn to for help with money was greater for those perceiving pressure from others to obtain a job than those not perceiving pressure. Also, the association between distress and having someone to turn to when feeling low was greater for those with a high employment commitment than for those with a low one. Other associations between support and distress were found to be affected by sex and ethnic differences in the sample. The results are discussed in the light of a stress-buffering model of social support; and the need to disaggregate social support into its component parts is emphasized.     

Late middle-aged and older men living with HIV/AIDS: race differences in coping, social support, and psychological distress

Although AIDS mental health research has recently devoted more attention to the psychosocial needs of older adults living with human immunodeficiency virus (HIV) disease, studies of this population have typically combined older African-American and white participants into one large sample, thereby neglecting potential race differences. The current study examined race differences in stressor burden, ways of coping, social support, and psychological distress among late middle-aged and older men living with HIV/AIDS. Self-administered surveys were completed by 72 men living with HIV/AIDS in New York City and Milwaukee, WI (mean age = 53.4 years). Older African-American and white men experienced comparable levels of stress associated with AIDS-related discrimination, AIDS-related bereavement, financial dilemmas, lack of information and support, relationship difficulties, and domestic problems. However, in responses to these stressors, older African-American men more frequently engaged in adaptive coping strategies, such as greater positive reappraisal and a stronger resolve that their future would be better. Compared to their African-American counterparts, HIV-infected older white men reported elevated levels of depression, anxiety, interpersonal hostility, and somatization. African-American men also received more support from family members and were less likely to disclose their HIV serostatus to close friends. As AIDS becomes more common among older adults, mental health-interventions will increasingly be needed for this group. The development of intervention programs for this group should pay close attention to race-related differences in sociodemographic, psychosocial, and behavioral characteristics.     

Attachment, social support and well-being in young and older adults

The present study examined the link between attachment, social support and well-being in young and older adults. The results from multi-group path analyses showed significant between-group differences in the links between attachment, perceived support and well-being. Anxious attachment and well-being were inversely associated and this was stronger for the younger group than it was for the older group. Avoidant attachment was negatively related to perceived support satisfaction in the older age group only, and perceived support mediated the effects of avoidant attachment on mental health and loneliness in the older group. Generally, perceived satisfaction with support was more strongly related with well-being in older adults. The results point to differential links of insecure attachment styles with perceived support in different life-stages and to related cognitive, emotional and social processes.     

The prevalence and predictors of psychological distress in men with prostate cancer who are seeking support

Objective: The incidence of prostate cancer has risen sharply in the last decade, yet knowledge about the psychological health of men with this disease is still limited. A study was therefore undertaken to identify (1) the prevalence of psychological distress in these males, and (2) factors predicting psychological distress. Design: Retrospective cross‐sectional survey design by means of a self‐administered questionnaire. Method: A sample of 94 men with various stages of prostate cancer completed the Functional Assessment of Cancer Therapy—Prostate Instrument (FACT‐P), the Hospital Anxiety Depression Scale (HADS) and items measuring satisfaction with medical care. Results: We detected a prevalence rate of 38% of participants reporting psychological distress corresponding to a HADS cut‐off score at or above 15. A standard multivariate regression analysis revealed social/family well‐being, physical well‐being and functional well‐being as significant inverse predictors of psychological distress. Conclusions: Health professionals should be aware of the potential for psychological distress in patients exhibiting poor physical functioning and those with apparent deficits in social or family support in this under‐studied group of patients. Strategies for psychosocial intervention are implied.     

Gender differences in job strain, social support at work, and psychological distress

Using the demand-control-support model of job strain, the authors examined gender differences in the relationship between psychosocial work exposures and psychological distress in a cross-sectional sample of 7,484 employed Canadians. Compared with low-strain work, high-strain and active work were associated with a significantly higher level of distress in both men and women. Differences in psychological distress in relation to psychosocial work exposures were greater for men than for women. Low social support was associated with higher distress across all categories of job strain, and the combined effect of low social support and high job strain was associated with the greatest increase in distress. This pattern was similar in men and women. This study suggests that psychosocial work exposures may be a more significant determinant of psychological well-being in male workers compared with female workers.     

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.     

Risk factors and clinical outcomes associated with fixed airflow obstruction in older adults with asthma

Background

Asthma in older adults is associated with increased morbidity and mortality compared with asthma in younger patients. Fixed airflow obstruction (FAO) is associated with decreased survival in younger patients, but its significance remains unclear in older adults with asthma.

社区老年人社会支持对其认知功能的影响

目的:探讨社会支持对社区老年人认知功能的影响.方法:采用社会支持评定量表(SSRS)、简易精神状态评定量表(MMSE)对成都地区286名60岁及以上的社区老年人的社会支持及认知功能进行调查.结果:老年人认知功能总平均为(23.91±4.38)分.不同性别与受教育程度的老年人在认知功能上均差异具有统计学意义(P＜0.05...     

Instrumented measures of sedentary behaviour and physical activity are associated with mortality in community-dwelling older adults: A systematic review,meta-analysis and meta-regression analysis

BackgroundSedentary behaviour (SB) and physical activity (PA) can be objectively assessed with inertial sensors to describe bodily movement. Higher SB and lower PA is associated with higher chronological age and negative health outcomes. This study aimed to quantify the association between instrumented measures of SB (i-SB) and PA (i-PA) and mortality in community-dwelling older adults, to subsequently compare the quantitative effect sizes and to determine the dose-response relationships.MethodsAn electronic search in six databases from inception to 27th of June 2019 was conducted. All articles reporting on i-SB or i-PA and mortality in community-dwelling older adults aged 60 years or older were considered eligible. A meta-analysis was conducted for the association between i-SB and i-PA and mortality expressed in Hazard Ratios (HR) and 95% Confidence Intervals (95% CI). A meta-regression analysis was performed to determine the dose-response relationship between i-SB and steps per day and mortality.ResultsTwelve prospective articles representing eleven cohorts, reporting data of 38,141 participants were included. In total 2502 (6.4%) participants died during follow-up (2.0 to 9.8 years). Comparing the most sedentary with the least sedentary groups of participants resulted in a pooled HR of 2.44 (95% CI 1.82–3.25). Comparing the least active with the most active groups of participants resulted in a pooled HR of 1.93 (95% CI 1.39-2.69); 2.66 (95% CI 2.11–3.35); 3.43 (95% CI 2.61–4.52), and 3.09 (95% CI 2.33–4.11) for light, moderate-to-vigorous-, total PA and steps per day, respectively. Meta-regression analyses showed clear dose-response relationships between i-SB and steps per day and mortality risk.ConclusionBoth i-SB and i-PA are significantly associated with mortality in community-dwelling older adults, showing the largest effect size for total physical activity. Dose-response relationships could be observed for i-SB and steps per day.     

Exercise training and depression in older adults

This article provides a review of the evidence supporting exercise as an effective treatment of depression in older adults. Depression is prevalent among older adults and is associated with significant morbidity, increased risk of mortality, and economic burden. Although effective treatments for depression exist (e.g., antidepressant medication, cognitive-behavioral therapy), the disorder remains inadequately treated for many older individuals. Recently, the use of exercise as a treatment for depression has received increased attention. Results of these studies suggest that exercise leads to a reduction in depressive symptoms when compared to wait list, social contact controls, and antidepressant medication. However, many studies have significant methodological limitations. In the present article, we include discussion of these limitations and provide suggestions for future research.     

Serum uric acid and cognitive function in community-dwelling older adults

Among possible markers of age-related cognitive decline, uric acid (UA) is controversial because it has antioxidant properties but is increased in diseases that often lead to cognitive impairment. In this study of 96 elderly adults, participants with mildly elevated (but normal) serum UA were 2.7 to 5.9 times more likely to score in the lowest quartile of the sample on measures of processing speed, verbal memory, and working memory. Even after controlling for age, sex, race, education, diabetes, hypertension, smoking, and alcohol abuse, the multivariate-adjusted odds of poor verbal memory and working memory remained significant (ps < .05). Despite its antioxidant properties, these findings suggest that even mild elevations of UA might increase the risk of cognitive decline among older adults.     

Cardiovascular risk factors are associated with subclinical atherosclerosis in high functioning older adults

Background

The prevalence of subclinical atherosclerosis and its relationship with cardiovascular risk factors (CVRFs) is not well known in high functioning older adults. These data can help to decide if the implementation of preventive measures is necessary in this population.

Objective

To determine the prevalence and progression of subclinical atherosclerosis in high functioning older adults, the relationship between subclinical atherosclerosis and CVRFs, and the influence of the CVRFs on subclinical atherosclerosis progression.

Methods

Longitudinal cohort study. 246 high functioning older adults without clinical atherosclerotic disease. All subjects underwent carotid Doppler ultrasound at entry and 176 at 24 months.

Results

Plaque was observed in 146 (59.3%) subjects at baseline. CVRFs showed a linear relationship to the presence of plaque: plaque was observed in 32% of subjects with no CVRFs, 54.2% with 1 factor, 61.6% with 2 factors, and 69.3% with 3 or more (p = .001). Only hypertension was independently associated with the presence of plaque (OR 2.0; 95% CI 1.2–3.6; p = .013), adjusted for CVRFs. At 24 months, new plaque was observed in 20 (11.4%) subjects and carotid intima-media thickness had increased 0.02 mm per year. Subjects with plaque at baseline had a higher risk of greater total carotid plaque diameter at 2 years (OR 58.0; 95% CI, 19.7–170.5; p < .001), adjusted for all other CVRFs.

Conclusions

Subclinical atherosclerosis is common in high functioning older adults and is associated with the classic CVRFs. Controlling these factors could be helpful in reducing atherosclerosis in older patients.     

Stress,social support,and outcomes in two probability samples of homeless adults

This study investigated the main effects of social support measures and their stress‐buffering effects in two samples of homeless adults (Ns=249 and 219) obtained in the same large county (surrounding Detroit) at different points in time over an 8‐year period (1992–1994 and 2000–2002). The findings suggest that the construct of social support, commonly applied to broad community and student samples, can also be usefully applied to at‐risk groups such as the homeless. Although the study's main effects and stress‐buffering effects were generally consistent with existing research on social support, the findings point out that expected results do not consistently emerge even when similar sampling and measurement techniques are employed. For example, a measure of perceived support showed consistent main and stress‐buffering effects on psychological symptoms (but not other outcomes) and social network measures showed less consistent effects on outcomes (e.g., alcohol and drug abuse symptoms). © 2008 Wiley Periodicals, Inc.     

Levels and variables associated with psychological distress during confinement due to the coronavirus pandemic in a community sample of Spanish adults

Due to the COVID-19 pandemic's consequences and the state of alarm, literature has shown that people worldwide have experienced severe stressors that have been associated with increased prevalence of emotional distress. In this study, we explored psychological distress (depression, anxiety, and somatization symptoms) using an online survey platform in a sample of 1,781 Spanish adults during the confinement due to COVID-19, relationships between distress and sleep problems, affect, pain, sleep, emotional regulation, gender, type of housing, history of psychopathology, and living alone during the confinement, and differences depending on demographic and psychological variables. Results showed that between 25% and 39% of the sample referred to clinically significant levels of distress. In addition, women showed higher levels of distress, negative affect, perception of pain, and cognitive reappraisal and lower levels of emotional suppression and sleep quality than men. A history of psychopathology, being younger, living alone or in a flat was associated with higher distress. Finally, the variables most strongly related to distress were negative and positive affect, levels of pain, sleep quality, and emotional suppression. Our results highlight the important role of emotional suppression, cognitive reappraisal, and loneliness and the impact of being a woman and younger in Spain during the COVID-19 pandemic. Therefore, it would be necessary to provide assessments of distress levels in these population groups and focus psychological preventive and therapeutic online interventions on expressing emotions and preventing loneliness.     

Perceived barriers to social support from family and friends among older adults with HIV/AIDS

Research has found that HIV-infected adults age 50 and older are more socially isolated than younger HIV-infected individuals. This study examines the perceived barriers to obtaining emotional and practical social support from friends and family among 63 older adults (age 50+) living with HIV/AIDS. Many reported they did not receive enough emotional support (42%) or practical assistance (27%). Barriers to obtaining support included: (1) nondisclosure of HIV status; (2) others' fear of HIV/AIDS; (3) desire to be self-reliant and independent; (4) not wanting to be a burden; (5) unavailability of family; (6) death of friends to AIDS; and (7) ageism. These barriers may explain the greater social isolation of HIV-infected older adults and inform interventions targeted at reducing these barriers.