Psychosocial predictors of employment status among men living with spinal cord injury.

Objective: To explore the relationship between employment status and community access, perceived community discrimination, social support from significant others, depressive symptoms, and gender-related variables for 83 men living with spinal cord injury. Study Design: Correlational research. Setting: Internet-based investigation employing spinal cord injury listservs. Main Outcome Measure: Participant employment status. Results: A forced-entry hierarchical logistic regression indicated that means of injury, community access and perceived community discrimination, social support from significant others, depressive symptoms, and men’s adherence to masculine norms for primacy of work, self-reliance, and emotional control significantly predicted employment status. Conclusions: Psychosocial variables such as community access, perceived discrimination, social support from significant others, depressive symptoms, and gender identity represent important and understudied predictors of employment status among men living with spinal cord injury. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social connections and suicidal thoughts and behavior.

Disrupted social connectedness is associated with suicidal thoughts and behaviors among individuals with substance use disorders (SUDs). The current study sought to further characterize this relationship by examining several indices of social connectedness—(a) living alone, (b) perceived social support, (c) interpersonal conflict, and (d) belongingness. Participants (n = 814) were recruited from 4 residential substance-use treatment programs and completed self-report measures of social connectedness as well as whether they had ever thought about or attempted suicide. Multivariate results indicated that interpersonal conflict and belongingness were significant predictors of a history of suicidal ideation, and that belongingness, perceived social support, and living alone were significant predictors of suicide attempt. These results indicate the most consistent support for the relationship between suicidality and thwarted belongingness, and also support the clinical utility of assessing whether individuals live alone. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Relationships of job and family involvement, family social support, and work–family conflict with job and life satisfaction.

A model of the relationship between work and family that incorporates variables from both the work-family conflict and social support literatures was developed and empirically tested. This model related bidirectional work-family conflict, family instrumental and emotional social support, and job and family involvement to job and life satisfaction. Data came from 163 workers who were living with at least 1 family member. Results suggested that relationships between work and family can have an important effect on job and life satisfaction and that the level of involvement the worker assigns to work and family roles is associated with this relationship. The results also suggested that the relationship between work and family can be simultaneously characterized by conflict and support. Higher levels of work interfering with family predicted lower levels of family emotional and instrumental support. Higher levels of family emotional and instrumental support were associated with lower levels of family interfering with work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Phenotypic features of dentition in diastrophic dysplasia

BACKGROUND: Studies of hypertension, diabetes, and diet have indicated a relationship between social support and adherence to treatment regimens. Estimates of nonadherence following abnormal Pap test results range as high as 40%. In this study, the relationship between social support and adherence behavior was examined in a population of low-income, public-health-department patients with abnormal Pap smears. METHODS: Medical record reviews ascertained adherence behavior and interviews determined receipt of social support for 498 women. RESULTS: Related to adherence were: receipt of any social support; receipt of each of three types of support (informational, emotional, and tangible support); amount of support received; satisfaction with support; and source of support. Reported need for support was not related to adherence behavior. Receipt of social support was more strongly related to adherence when the woman's emotional response to the notification of the abnormal Pap smear was greater, and when acculturation was higher (among Latinas). Knowledge of the results of the Pap test was found to be an intervening variable between receipt of informational support and adherence. Knowledge of the purpose of the Pap smear was found to be independently related to adherence. Among black women, emotional support was most strongly related to adherence, while among Latinas, tangible support was most strongly related to adherence. In a multivariate model, Pap-test knowledge and the interaction between emotional response and receipt of any social support were significantly related to adherence. CONCLUSIONS: Findings suggest that supportive interventions, including provision of medical information, emotional support, child care, and transportation, could help to reduce nonadherence.     

Impact of social support on outcome in first stroke

BACKGROUND AND PURPOSE: The purpose of this study is to examine the impact of social support on outcome after first stroke in a prospective cohort study. Although modest evidence exists for the importance of several psychosocial factors, studies have failed to use widely recognized measures of outcome and social support, have failed to control for time since onset, and have not used longitudinal techniques. METHODS: Forty-six surviving patients were followed for 6 months after stroke. Recovery was measured using repeated measures of functional status as indicated by the Barthel Index of activities of daily living. Perceived social support was measured at 1, 3, and 6 months after onset. Repeated-measures multivariate analysis of variance was used to analyze changes in functional status. RESULTS: Significant differences were found across levels of social support in trajectories of functional status (p = 0.002). A significant three-way interaction between stroke severity, social support, and outcome was also found (p = 0.012). Patients with more severe stroke and the largest amount of social support attained an average Barthel Index that was 68 points (65%) higher than the group reporting the least support. CONCLUSIONS: High levels of social support were associated with faster and more extensive recovery of functional status after stroke. Social support may be an important prognostic factor in recovery from stroke. Socially isolated patients may be at particular risk for poor outcome.     

Marital conflict and boys' peer relationships: The mediating role of mother-son emotional reciprocity.

This study examined the role of mother-son emotional reciprocity in connections between marital conflict and the quality of boys' peer relationships. Parents from 84 intact families with preadolescent boys reported on the level of conflict in their marital relationship. Observations of mother-son interaction were coded for emotional reciprocity, and assessments of boys' peer relationships were obtained from both teachers and classmates. No direct connection between marital conflict and boys' peer relationships was observed. Rather, marital conflict affected boys' social competence indirectly, through its effect on the emotions expressed between mother and son. The findings support the proposal that emotional processes play an important role in connections between marital conflict and children's peer relationships and suggest that family emotional expressiveness deserves greater attention in both research and intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social Support, Positive States of Mind, and HIV Treatment Adherence in Men and Women Living With HIV/AIDS.

Numerous studies have linked social support to better medication adherence among illness groups, but few have examined potential mechanisms for this relationship. Relationships were examined between social support, depression, positive states of mind (PSOM), and medication adherence among HIV positive men who have sex with men (n = 61) and women (n = 29) on highly active antiretroviral therapy. Depression and PSOM were evaluated as potential mediators of the relationship between support and adherence. Cross-sectional data showed that greater social support and PSOM related to better adherence whereas higher depression scores related to nonadherence. PSOM partially mediated the relationship between social support and adherence. PSOM may be an important mechanism through which social support is related to better medication adherence in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation of parental marital status and perceived family conflict to adjustment in White adolescents.

Examined 2 contrasting views of how divorce relates to the long-term adjustment of children. The physical-wholeness position views divorce as the salient explanatory variable to adversely affect children's later adjustment through the physical dissolution of the 2-parent family; the psychological-wholeness position views perceived current family conflict as the critical variable that influences adjustment, regardless of parental marital status. Results from 823 White adolescents (age 13–18 yrs) fail to support the physical-wholeness position; parental marital status was not significantly related to psychological adjustment or satisfaction with social life. However, results provide strong support for the psychological-wholeness position: Ss' psychological adjustment and satisfaction with social life were significantly related to level of perceived conflict in the family. It is suggested that divorce be conceptualized as a crisis situation rather than as a universally negative event. Use of conflict identification and resolution interventions to reduce family conflict may prevent future problems in child development. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of social support and conflict on adolescent children of alcoholic and nonalcoholic fathers.

Studies of positive and negative social ties usually are done in isolation of each other, precluding an understanding of their relative contributions to psychological functioning. This research evaluated the effects of adolescents' conflict with and social support from key relationships (parents, siblings, and best friends) on adolescents' self-esteem, substance use, and externalizing symptoms. Ss were 296 adolescents and their parents; 145 families had alcoholic fathers, and 151 had nonalcoholic parents. Support and conflict provided by each network member showed only a mild negative correlation. Support from parents, but not siblings or best friends, was related to adolescents' reports of substance use and externalizing. Conflict with parents was consistently related to externalizing behaviors. There was no evidence that conflict within a relationship neutralizes the effectiveness of the support it provides. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Soluble recombinant neutral endopeptidase (CD10) as a potential antiinflammatory agent

The present study assessed fidelity to the behavioral family management (BFM) model for treating bipolar disorder patients and their families. The BFM Therapist Competency/Adherence Scale (BFM-TCAS) was developed to evaluate clinicians' competency and adherence to BFM, as outlined by Miklowitz' (1989) BFM Manual for use with bipolar patients. Therapist competency and treatment adherence was also evaluated with regard to two family characteristics: overall level of family difficulty and family expressed emotion (EE) status. The BFM-TCAS was used to code 78 videotaped sessions of 26 families with a bipolar member, selected from a larger treatment study of bipolar disorder patients. The findings suggest that, overall, clinicians adhered closely to the BFM manual. Specific areas in which there was high competency and treatment adherence were (a) skill in conveying factual information about bipolar illness, (b) establishment of a therapeutic environment, and (c) ability to take command of therapy sessions. The one area in which there was less competency and relatively weak adherence to the manual was the use of between-session homework assignments to assist families in mastering the BFM exercises. Results of this study also suggest that, for the most part, therapist competency and adherence ratings were not related to overall level of difficulty or to family EE status.     

Family structure and the mental health of children. Concurrent and longitudinal community-wide studies

This study provides a map of variations of families and some of the core relationships between types of family and the mental health of children. Family types in a poor, black urban community were defined in terms of the adults present at home. The resulting taxonomy is based on two populations: half of the community's 1964 first-grade children and families and the entire 1966 first-grade children and families. Eighty-six family types were found, falling into ten major classes. Family type was found to be strongly related over time to the child's social adaptational status (SAS) and his or her psychological well-being. The results suggest that (1) mother alone families entail the highest risk in terms of social maladaptation and psychological well-being of the child; (2) the presence of certain second adults has important ameliorative functions--mother/grandmother families being nearly as effective as mother/father families, with mother/stepfather families similar to mother alone in regard to risk; and (3) the absence of the father was less important than the aloneness of the mother in relation to risk.     

Living alone and neighborhood characteristics as predictors of social support in late life

OBJECTIVES: The purpose of this study was to devise and test a conceptual model that explains how neighborhood quality, fear of crime, and received emotional support affect an elderly person's expectations of future assistance should the need arise (i.e., anticipated support). METHODS: Using a nationwide survey of older adults, a series of nested latent variable models was tested to determine if the social support process differs between older adults living alone and those living with others. RESULTS: Consistent with a social ecological perspective, data suggest that anticipated support is lower among elders who live in deteriorated neighborhoods than among older adults who live in well-maintained neighborhoods. Moreover, the deleterious effects of run-down neighborhoods appear to be especially pronounced for older adults who live alone. DISCUSSION: Select constructs that link deteriorated neighborhoods with anticipated support are explored. Suggestions for future research are made.     

Social role and birth cohort influences on gender-linked personality traits in women: A 20-year longitudinal analysis.

Growth curve modeling was used to examine the impact of social role experiences (e.g., marital support, occupational prestige) and birth cohort on mean-level differences and age-related changes in positive personality traits indicative of either femininity or masculinity in 758 mothers heterogeneous in age, assessed 4 times over 2 decades. Both femininity and masculinity increased significantly from mean ages 39 through 59; each was predictive of an age change in the other. Low masculinity was associated with a more rapid increase in femininity, whereas high occupational prestige decreased the magnitude of association between masculinity and femininity. Femininity increased with more marital support but decreased with unmarried status, more children at home, and working full or part time; among full-time workers, that effect was modified by marital support. Masculinity increased with full-time work and high occupational prestige. A trend for differing levels of femininity, and contrasting associations of masculinity with femininity and marital conflict in women born after 1944 compared with those born earlier, suggests shifting social norms and gender relations in the marital role. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loneliness, social support and depression as interactive variables with cognitive status: testing Roy's model

This study examined the relationships between and among the variables of loneliness, social support, depression, and cognitive functioning in adults over 60, living in senior housing in a metropolitan area. Other variables, namely, life-satisfaction and ability to perform activities of daily living, were also measured. Although the research hypotheses were not supported, relationships between subjects' health status, life satisfaction, and self-assessment of health were significant. Assessment of these variables by community and advanced practice nurses who work with community elderly, to effect positive client outcomes, is presented within the context of Roy's adaptation model.     

Close emotional relationships in late life: Further support for proactive aging in the social domain.

The idea that age-related reductions in network size are proactively managed by older people is explored by examining the interrelationships among chronological age, network composition, social support, and feelings of social embeddedness (FSE) in a representative sample of 156 community dwelling and institutionalized adults aged 70–104 yrs. Comparisons between people with and without nuclear families are made to explore the influence of opportunity structures on network size. Social networks of very old people are nearly half as large as those of old people, but the number of very close relationships does not differentiate age groups. Among Ss without living nuclear family members, the number of emotionally close social partners predicted FSE better than among Ss with nuclear family members. Findings provide evidence for proactive selection, compensation, and optimization toward the goal of emotional enhancement and social functioning in old age. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parent-chld relationships and the management of insulin-dependent diabetes mellitus.

Several dimensions of parent–child relationships were examined as predictors of adherence to treatment and metabolic control in a multi-informant study of 88 children and adolescents with insulin-dependent diabetes mellitus who were recruited from 2 endocrinology clinics. Ratings of parent–child discipline, warmth, and behavioral support were not significantly associated with diabetes outcome, but parent–child conflict was a consistent correlate of both adherence and metabolic control. Within a public hospital subsample, conflict was related to parent, child, and nurse ratings of adherence and to a physiological index of metabolic control. These results were partially replicated in a private practice sample where conflict was significantly related to parents' ratings of adherence and to metabolic control. Conflict accounted for unique variance in diabetes outcome beyond that associated with other measures of the parent–child relationship, but the relation between conflict and metabolic control was no longer significant when adherence ratings were entered into regression equations first. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social conflict, social support, and psychological distress: Evidence of cross-domain buffering effects.

A longitudinal study examined the relative and joint effects of perceived social support and social conflict on psychological distress in 228 college students. Women had higher perceived social support from roommates and friends and less conflict with roommates than did men; there were no gender differences in level of conflict with friends or psychological distress. Roommate conflict predicted increases in psychological distress over time; this effect was attenuated by high levels of perceived social support from friends. Friend conflict also predicted increases in psychological distress over time; this effect was attenuated by high levels of perceived social support from roommates. These results show the importance of negative and positive aspects of social experiences to emotional functioning and the importance of compensatory social support for individuals facing social conflicts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A social problem-solving model of adherence to HIV medications.

HIV medication adherence remains a challenge and limits the degree to which treatment benefit can be maximized. This study tested an explanatory model of HIV medication adherence using a social problem-solving (SPS) framework. Associations of SPS with adherence are hypothesized to be direct and/or indirect via psychological health. HIV+ adults were interviewed using validated measures of SPS, psychological health, and antiretroviral therapy (ART) medication adherence. Structural equation modeling (SEM) techniques were used to test hypothesized relationships and to evaluate overall fit of the model to the data. SEM supported an indirect association (but not direct) of SPS on adherence via psychological health among the 545 HIV+ adults included in the analyses. Overall, the findings resulted in a model of adherence that offered very good fit to the data and correctly classified 97% of the cases as adherent versus nonadherent. Results support the use of SPS as a conceptual framework for understanding adherence to ART. Findings offer rationale and direction for SPS interventions to enhance adherence by improving psychological health. Such approaches, if effective, have the potential to positively impact psychological well being and adherence, thereby maximizing clinical benefit from treatment, which is linked to lower mortality from AIDS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loneliness as a specific risk factor for depressive symptoms: Cross-sectional and longitudinal analyses.

The extent to which loneliness is a unique risk factor for depressive symptoms was determined in 2 population-based studies of middle-aged to older adults, and the possible causal influences between loneliness and depressive symptoms were examined longitudinally in the 2nd study. In Study 1, a nationally representative sample of persons aged 54 and older completed a telephone interview as part of a study of health and aging. Higher levels of loneliness were associated with more depressive symptoms, net of the effects of age, gender, ethnicity, education, income, marital status, social support, and perceived stress. In Study 2, detailed measures of loneliness, social support, perceived stress, hostility, and demographic characteristics were collected over a 3-year period from a population-based sample of adults ages 50-67 years from Cook County, Illinois. Loneliness was again associated with more depressive symptoms, net of demographic covariates, marital status, social support, hostility, and perceived stress. Latent variable growth models revealed reciprocal influences over time between loneliness and depressive symptomatology. These data suggest that loneliness and depressive symptomatology can act in a synergistic effect to diminish well-being in middle-aged and older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Functional versus structural social support, desirable events, and positive affect in older adults.

The independent contributions of structural social support vs functional support to positive affect in older adults were compared in this prospective design. Four social support models were translated from the stress-symptoms literature into promotional models for positive mental health and for relationships to desirable challenge events. A total of 1,031 older adults were interviewed 5 times at 6-mo intervals, and events were measured across the middle 18-mo period. The 2 support variables made quite different contributions. Functional support was directly related to positive affect 2 yrs later, independent of events; structural support had more transitory direct effects. Structural support, but not functional support, was related to the subsequent occurrence of challenge events and in turn was strengthened by challenge events, suggesting a dynamic interplay between the social network and desirable events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)