Social support,distress, and well-being in older men living with HIV infection

Older men with HIV infection/AIDS, having often lived with the condition longer, are more likely to confront the stress of managing more advanced HIV disease than their younger counterparts. Meanwhile, they also are more likely to have less social support and experience more distress than younger persons with HIV infection. The moderating effect of social support on health functioning and distress is unknown for persons with HIV infection, particularly those who are older. Study objectives were to assess whether the association between perceived health functioning and psychological distress and well-being is moderated (or influenced) by social support and age and if the impact of social support on distress and well-being is more pronounced for older than for younger men living with HIV infection/AIDS. In this cross-sectional study of HIV-positive adult men (n = 199) who have sex with men, participants completed self-report assessments of perceived health functioning, social support, and psychological distress and well-being. Measures of health functioning and overall social support were significantly associated with outcome measures of distress and positive affect (all p < .05). However, the main effect for social support was qualified by a significant age-by-social support interaction for both outcomes (beta = -.190, p < .01 for distress; beta = .172, p < .05 for positive affect), indicating that the impact of social support on decreasing distress and increasing well-being was more pronounced in older men. The relationships between perceived health functioning and distress and well-being were not moderated by social support or age. The influence of social support on negative and positive moods in this population of HIV-infected men who have sex with men was significantly greater among older than among younger participants. With an increasing number of older people with HIV infection/AIDS, special efforts to create effective and sustainable social support interventions may be particularly beneficial to older persons living with HIV infection.     

Predictors of psychological distress in carers of people with amyotrophic lateral sclerosis: a longitudinal study

BACKGROUND: The majority of people providing informal care for people with amyotrophic lateral sclerosis (ALS) are spouses. This prospective study set out to examine changes in and predictors of psychological distress in spouse carers of people with ALS. METHOD: Fifty spouse carers of people with ALS underwent an initial interview and at least 21 underwent two further interviews, at median intervals of approximately 5-6 months. They rated the functional impact of their partner's ALS on everyday activities and everyday cognitive, emotional and behavioural changes that might have occurred in the person with ALS. They also rated their own social support and marital relationship, and completed measures of mood, burden and strain. The ALS Severity Scale was also completed for their partner with ALS. RESULTS: Over time, carers' psychological distress (a global measure combining mood, burden and strain) increased significantly. Initially carers' psychological distress was best predicted by the psychosocial impact of their spouse/partners' ALS, the extent to which their partner demonstrated emotional lability and how many other people were considered as dependents of the carer. Subsequently, carer distress was best predicted by an initial measure of negative social support and by their initial satisfaction with their social relationships. CONCLUSIONS: Despite the significant physical impairment associated with ALS, psychosocial factors appear important in determining short- and longer-term psychological well-being in carers of people with ALS and may help clinicians to predict which carers are likely to experience psychological difficulties as part of their caring role.     

Perceived neighborhood disorder and psychological distress among Latino adults in the United States: Considering spousal/partner relationship

It has been well-established that neighborhood disorder and disadvantage are detrimental to mental health and psychological well-being. There has been growing research interest in minority stress issues, however, less is known about how perceived neighborhood disorder matters for psychological well-being among Latino adults in the United States. Analyzing data from National Latino Asian American Study, 2002–2003, the present study investigates the relationships among perceived neighborhood disorder, spousal/partner relationships (i.e., spousal/partner strain and support), and psychological distress. The findings indicated that perceived neighborhood disorder and spousal/partner strain were positively associated with increased psychological distress, whereas spousal/partner support had no protective effect against psychological distress. Moreover, mediation analysis showed that the association between perceived neighborhood disorder and psychological distress was partially mediated by spousal/partner strain (i.e., 15.13%), not spousal support. Finally, moderation analysis revealed that the presence of spousal/partner strain exacerbated the relationship between perceived neighborhood disorder and psychological distress. Conversely, the absence of spousal/partner strain appeared to buffer the adverse impact of neighborhood disorder on psychological distress. These findings highlighted the ill effect of problematic neighborhood environments on the quality of the spousal/partner relationship and subsequently Latino's psychological well-being.     

Patient Outcomes in Association With Significant Other Responses to Chronic Fatigue Syndrome: A Systematic Review of the Literature

Social processes have been suggested as important in the maintenance of chronic fatigue syndrome (also known as myalgic encephalomyelitis; CFS/ME), but the specific role of close interpersonal relationships remains unclear. We reviewed 14 articles investigating significant other responses to close others with CFS/ME and the relationships between these responses and patient outcomes. Significant other beliefs attributing patient responsibility for the onset and ongoing symptoms of CFS/ME were associated with increased patient distress. Increased symptom severity, disability, and distress were also associated with both solicitous and negative significant other responses. Specific aspects of dyadic relationship quality, including high Expressed Emotion, were identified as important. We propose extending current theoretical models of CFS/ME to include two potential perpetuating interpersonal processes; the evidence reviewed suggests that the development of significant other–focused interventions may also be beneficial.     

Effects of spouses on distress experienced by BRCA1 mutation carriers over time

Concerns about psychological distress have arisen regarding genetic testing for susceptibility to late-onset diseases such as breast and/or ovarian cancer. Early results do not show large-scale psychological distress among those tested; therefore, research is now focusing on identifying subgroups that may be at risk for negative outcomes. Social support has been shown to buffer both negative physical and psychological outcomes in health research. The role of spouses as part of the tested person's social support system is shown to be significant in a sample of 57 BRCA1 mutation carriers. Separately, the tested person's perception of his/her spouse's anxiety and his/her perception of the spouse's support at the time of testing are predictive of the tested person's psychological distress up to 2 years after testing. The interaction of the two variables is even more predictive. For those tested who perceived their spouse to be both anxious and nonsupportive at the time of testing, distress levels reached clinically significant levels 1 week after results were received and remained above clinical threshold measured 4 months, 1 year, and 2 years after testing. While the effects were greatest for women, they were significant for both male and female carriers. These findings are an important addition to the literature and will augment clinicians' ability to identify individuals potentially at risk for negative responses to adverse genetic test results.     

Social Support, Social Conflict, and Adjustment Among Adolescents With Cancer

Objective: Evaluate support and conflict in close relationshipsof adolescents in active medical treatment for cancer. Familyand friend perceptions of supportive and conflictual behaviorswere examined in relation to psychological distress, takinginto account the impact of functional impairment induced bythe illness. Methods: Using self-report questionnaires, 50 adolescents betweenthe ages of 12 and 20 years rated the frequency of supportiveand conflictual interactions with parents, siblings and bestfriends. Results: Results indicated that perceived maternalconflict was associated with psychological distress. Conflictwith fathers, siblings, and best friends was not associatedwith distress. Supportive aspects of close relationships didnot predict psychological distress. The amount of physical impairmentaccounted for the most variance In distress, contributing between35% and 38%; of the variance. Conclusions: Results suggest that mother-adolescent conflictwould be an appropriate target for psychoso-cial interventions.     

Psychological distress of caregivers: the mediator effect of caregiving appraisal

This study concerns the role of caregiving appraisal, whether it explains why stressors in the caregiving situation affect caregivers' psychological distress. This putative mediator effect of caregiving appraisal is separately tested for spouse and non-spouse caregivers of demented elderly persons. Caregiving appraisal is operationalized by a measure of pressure from informal care as perceived by the caregiver. For spouse caregivers, perceived pressure explained the association between their caregiving tasks and psychological distress. However, the strong association found between behavioral problems and psychological distress was not explained by perceived pressure in spouse caregivers. Furthermore, results showed clear mediator effects of perceived pressure for associations between stressors (both behavioral problems of the demented elder and caregiving tasks) and non-spouse caregivers' psychological distress. Thus, it is inadequate to focus interventions merely on stressors in the caregiving situation, for non-spouse caregivers in particular. A reduction of perceived pressure from informal care is also needed.     

Subjective well-being and psychological distress: A three-generational study in the kibbutz

The purpose of the present study was to investigate the subjective well-being and psychological distress of kibbutz members representing three-generational strata. A total of 166 male and female Israeli kibbutz members completed the Mental Health Inventory (Veit & Ware, 1983) and reported on their self-evaluation of social position and of involvement in kibbutz life. Analysis of the data revealed the following: Second-generation kibbutz members reported higher subjective well-being as compared with first- and third-generation members. An interaction between gender and generation was found for psychological distress, and it appears that third-generation females have higher psychological distress than do third-generation males. Significant positive correlations were found between social position and subjective well-being as well as significant negative correlations with psychological distress only among second- and third-generation kibbutz members. In light of these correlations an ANCOVA revealed that, by covarying out social position and community involvement, the differences between the three generations on psychological distress disappeared. The findings are discussed in terms of social position within a multigenerational kibbutz community.     

Emotional support and gender in people living with HIV: effects on psychological well-being

Current research indicates that emotional support is strongly associated with physical and psychological adjustment in persons living with HIV/AIDS. While gender-differences in health and health behaviors of HIV positive patients are well studied, less is known about how men and women living with HIV/AIDS may differentially perceive and integrate support into their lives, and how it subsequently affects their psychological well-being. This cross-sectional study examines how emotional support received from partners and family/friends and gender explains psychological well-being (i.e., stress, depression, anxiety) in a sample of 409 partnered European HIV positive individuals. We hypothesized that gender would modify the associations between support and psychological well-being such that men would benefit more from partner support whereas women would benefit more from family/friend support. Results revealed that regardless of the source of support, men’s well-being was more positively influenced by support than was women’s well-being. Women’s difficulties in receiving emotional support may have deleterious effects on their psychological well-being.     

Spousal social support and strain: impacts on health in older couples

Using a nationally representative sample of couples aged 51+ in the United States (N = 1,923 couples), the current study investigated whether both partners’ perceptions of relationship support and strain are associated with an individual’s self-rated health and functional limitations. The sample had an average age of 67.17 years (SD = 9.0; range 50–97). Actor–Partner Interdependence Models adjusting for couple interdependencies were applied using multilevel models. After accounting for age, education, gender, race, and couple differences in length of marriage, results indicate that individual perceptions of support were significantly associated with higher self-rated health and fewer functional limitations. These individual-level benefits increased if the spouse also perceived positive support and low strain. Finally, the negative association of an individual’s perceived support on functional limitations was greater in those with a spouse reporting low levels of perceived strain. Findings are discussed relative to theory on behavioral and psychological pathways between partners’ perceptions of support and health.     

Exercise and social support are associated with psychological distress outcomes in a population of community-dwelling older adults

Exercise reduces the likelihood of psychological distress, but this may be due to incidental socializing. We gathered information on exercise, social support and three aspects of psychological distress from 583 community-dwelling older adults. Exercise and social support from friends were both associated with lower scores of depression, anxiety and perceived stress. For infrequent exercisers, having a low level of social support indicated higher levels of depression, whereas for frequent exercisers, having a low level of social support did not affect depression levels. Both exercise and social support have roles in regulating psychological well-being in older populations and exercisers are less susceptible to effects of low social support on depression.     

Self-Efficacy and Adjustment in Cancer Patients: A Preliminary Report

Abstract

The relation between cancer self-efficacy and patient cancer adjustment, depression, psychological distress, and behavioral dysfunction in 42 cancer patients was studied in a preliminary investigation. Participants were male cancer outpatients recruited from a Veterans Administration Medical Center who completed a Cancer Self-Efficacy Scale, the Center for Epidemiological Studies-Depression Scale, the Affect Balance Scale, and the Sickness Impact Profile. Correlational analyses indicated that self-efficacy was related to all adjustment measures. Regression analyses revealed that when age, education, time since initial diagnosis, and current disease status were controlled, the relationships between patient self-efficacy expectations and cancer adjustment, psychological distress, negative affect, positive affect, and behavioral dysfunction remained statistically significant. Taken together, the results of the analyses suggested that patient expectancies about control over cancer-related symptoms were related to several important aspects of patient functioning. The results underscored the need for further investigation of this construct in cancer patients.     

Breast cancer patients' topic avoidance and psychological distress: the mediating role of coping

Avoiding communication about cancer is common and is likely to have negative psychological health consequences for patients, yet the connection between topic avoidance and psychological well-being is not well understood. This study of women with breast cancer examined coping behaviors as mediating mechanisms through which their cancer-related topic avoidance might affect their psychological distress. Consistent with predictions, greater levels of patient topic avoidance were associated with higher levels of depression and anxiety. Results indicated that topic avoidance may decrease patients' use of emotional support and increase patients' self-blame, each of which may lead to higher levels of psychological distress.     

Buffering the effects of violence: communication and problem‐solving skills as protective factors for adolescents exposed to violence

Although many adolescents exposed to violence evidence negative outcomes, some report few deleterious effects, indicating the presence of moderating variables. This study examined the moderating role of family communication and problem solving on positive and negative outcomes in adolescents exposed to school and neighborhood violence. Participants were 90 adolescents and their parents, who completed measures of violence exposure, psychological and behavioral functioning, and communication and problem‐solving skills. Results indicated that after controlling for demographic variables and violence exposure in the home, communication and problem‐solving skills moderated the association between school and neighborhood violence exposure and psychological distress. There was no moderation of the violence exposure‐positive outcome association. The findings suggest that family communication and problem‐solving skills might serve a protective function for adolescents, thereby decreasing psychological distress in the face of school and neighborhood violence exposure. © 2011 Wiley Periodicals, Inc.     

I get no respect: the relationship between betrayal trauma and romantic relationship functioning

The current study explored the association among young adults' (N = 86) experiences of betrayal traumas (interpersonal trauma perpetrated by someone close) prior to age 18, psychological well-being, attachment styles, and romantic relationship function (i.e., dedication, relationship adjustment, and perceived partner respect). Based on betrayal trauma theory, we posited that participants' reports of betrayal traumas would be negatively related to their perceptions of respect from their partner but would not relate to their perceptions of relationship adjustment or dedication. Furthermore, we expected that the relationship between betrayal traumas and respect would be mediated by participants' attachment style and psychological well-being. Results identified a negative association between betrayal traumas and psychological well-being and a positive association between betrayal trauma and anxious and avoidant attachment. Betrayal traumas were also shown to be negatively related to partner respect and not significantly associated with dedication and relationship adjustment. Anxious attachment and psychological well-being were significant mediators for the relationship between betrayal traumas and perceived respect.     

Psychological Adjustment Following Diagnosis and Treatment of Cancer: An Examination of the Moderating Role of Positive and Negative Emotional Expressivity

In support of cognitive processing models, emotional expression appears to reduce associations between intrusions and psychological distress. Past research has focused primarily on the role of the expression of negative emotion, or emotion in general, in cognitive processing and adjustment. In the present study, we examined the role of both positive and negative emotional expressivity on relations between intrusions and both distress and avoidance among 93 individuals diagnosed with and treated for cancer. We hypothesized stronger negative associations between intrusive thoughts and both distress and avoidance for those individuals lower in positive or negative expressivity. Results generally supported hypotheses with regard to relations of intrusions and distress in association with positive expressivity. Negative expressivity, however, moderated relations between intrusions and distress, but not intrusions and avoidance. These findings underscore the importance of examining the impact of individual differences in negative, as well as positive, emotional expression on cognitive processing and psychological adjustment.     

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.     

Reverse culture shock,distress symptoms and psychological well-being of fresh foreign degree holders in Pakistan

This study explored to what extent does reverse culture shock predict the level of anxiety, depression, and psychological well-being among fresh foreign degree holders in Pakistan, in addition to finding out the relationship between the study variables. Participants consisted of 124 fresh foreign degree holders (109 men and 15 women) who were recruited through purposive and snowball sampling techniques. Reverse Culture Shock Scale, Major Depression Inventory, Beck Anxiety Inventory, and WHO-5 Well-being Index were used to measure study variables. Results show that reverse culture shock is a strong predictor of psychological well-being explaining 23% variance in well-being scores of fresh foreign degree holders. As hypothesized, it has positive associations with distress symptoms including anxiety and depression, whereas, a negative correlation was found with psychological well-being and the age of fresh foreign degree holders. However, contrary to the hypothesis, reverse culture shock has no association with time passed since arrival back home and duration of stay abroad.     

Gender and alcohol use: the roles of social support, chronic illness, and psychological well-being

Men and women differ in their use of alcohol, in their rates of chronic illnesses and psychological symptoms, and in the social support they receive. In this paper, we assess how the latter three factors are associated with alcohol use, and how these associations differ by gender. Respondents were 3,074 male and 3,947 female randomly selected Health Maintenance Organization members who responded to a mail survey in 1990. Hierarchical multiple regression analyses indicate that social support is associated with alcohol consumption in similar ways for both genders, yet the associations between some demographic, physical health/functioning, and psychological well-being measures are different for men and women. Men with fewer role limits due to physical health drank more, while women with better psychological well-being drank less. Poor psychological well-being may be a modifiable risk factor for increased alcohol use among women; practitioners should be alert for greater consumption among men with few functional limitations and good health.     

Psychological distress in couples dealing with colorectal cancer: Gender and role differences and intracouple correspondence

Objectives: This longitudinal study examined patterns of psychological distress in couples facing colorectal cancer within 6 months after surgery. In addition, correspondence in psychological distress was investigated between patients and their spouses, taking into account the gender of the patient. Method: The study had a longitudinal design, involving three assessment points; (T1) within 2 weeks after surgery, (T2) 3 months after baseline and (T3) 6 months after baseline. At T1, respondents were asked to indicate how they felt during the week prior to surgery. At T2 and T3, respondents reported their feelings during the preceding week. Psychological distress was measured using the 20‐item Center for Epidemiologic Studies Depression Scale (CES‐D) in 137 couples. Results: Concerning the week prior to surgery, females reported more distress being a patient, whereas males reported more distress being a spouse. In comparison with a reference group, females as well as males, regardless of their role, showed increased levels of psychological distress prior to surgery. At 3 and 6 months following surgery, increased levels of distress continued to exist in females, whereas males’ distress returned to normal levels. Neither within female‐patient couples, nor within male‐patient couples, were associations between patients’ and spouses’ distress found. Conclusion. We demonstrated a considerable impact of the cancer diagnosis on both female and male patients and their spouses before and 3 months after surgery. Six months after surgery, females, in particular, appear to be vulnerable to distress.